Just Seconds of Laughter Reveals Relationship Status: Laughter with Friends Sounds More Authentic and Less Vulnerable than Laughter with Romantic Partners.

The dual pathway model posits that spontaneous and volitional laughter are voiced using distinct production systems, and perceivers rely upon these system-related cues to make accurate judgments about relationship status. Yet, to our knowledge, no empirical work has examined whether raters can differentiate laughter directed at friends and romantic partners and the cues driving this accuracy. In Study 1, raters (N = 50), who listened to 52 segments of laughter, identified conversational partner (friend versus romantic partner) with greater than chance accuracy (M = 0.57) and rated laughs directed at friends to be more pleasant-sounding than laughs directed at romantic partners. Study 2, which involved 58 raters, revealed that prototypical friendship laughter sounded more spontaneous (e.g., natural) and less "vulnerable" (e.g., submissive) than prototypical romantic laughter. Study 3 replicated the findings of the first two studies using a large cross-cultural sample (N = 252). Implications for the importance of laughter as a subtle relational signal of affiliation are discussed.

Autoimmune conditions in the World Trade Center general responder cohort: A nested case-control and standardized incidence ratio analysis.

BACKGROUND: The World Trade Center (WTC) general responder cohort (GRC) was exposed to environmental toxins possibly associated with increased risk of developing autoimmune conditions. OBJECTIVES: Two study designs were used to assess incidence and risks of autoimmune conditions in the GRC. METHODS: Three clinically trained professionals established the status of possible GRC cases of autoimmune disorders adhering to diagnostic criteria, supplemented, as needed, by specialists' review of consenting responders' medical records. Nested case-control analyses using conditional logistic regression estimated the risk associated with high WTC exposure (being in the 9/11/2001 dust cloud or ≥median days' response worked) compared with low WTC exposure (all other GRC members'). Four controls were matched to each case on age at case diagnosis (±2 years), sex, race/ethnicity, and year of program enrollment. Sex-specific and sensitivity analyses were performed. GRC age- and sex-adjusted standardized incidence ratios (SIRs) were compared with the Rochester Epidemiology Project (REP). Complete REP inpatient and outpatient medical records were reviewed by specialists. Conditions meeting standardized criteria on ≥2 visits were classified as REP confirmed cases. RESULTS: Six hundred and twenty-eight responders were diagnosed with autoimmune conditions between 2002 and 2017. In the nested case-control analyses, high WTC exposure was not associated with autoimmune domains and conditions (rheumatologic domain odds ratio [OR] = 1.03, 95% confidence interval [CI] = 0.77, 1.37; rheumatoid arthritis OR = 1.12, 95% CI = 0.70, 1.77). GRC members had lower SIR than REP. Women's risks were generally greater than men's. CONCLUSIONS: The study found no statistically significant increased risk of autoimmune conditions with WTC exposures.

Chest CT scan findings in World Trade Center workers.

We examined the chest CT scans of 1,453 WTC responders using the International Classification of High-resolution CT for Occupational and Environmental Respiratory Diseases. Univariate and bivariate analyses of potential work-related pleural abnormalities were performed with pre-WTC and WTC-related occupational exposure data, spirometry, demographics and quantitative CT measurements. Logistic regression was used to evaluate occupational predictors of those abnormalities. Chest CT scans were performed first at a median of 6.8 years after 9/11/2001. Pleural abnormalities were the most frequent (21.1%) across all occupational groups In multivariable analyses, significant pre-WTC occupational asbestos exposure, and work as laborer/cleaner were predictive of pleural abnormalities, with prevalence being highest for the Polish subgroup (n = 237) of our population. Continued occupational lung disease surveillance is warranted in this cohort.

Intravenous therapy: a review of complications and economic considerations of peripheral access.

Despite the growing frequency of intravenous (IV) injections, establishing peripheral IV access is challenging, particularly in patients with small or collapsed veins. Therefore, patients often endure failed attempts and eventually become venous depleted. Furthermore, maintaining patients' vascular access throughout treatment is difficult because a number of complications including phlebitis, infiltration, extravasation, and infections can occur. The aim of this article is to review the use of the IV route for administering therapy, identify and analyze key risks and complications associated with achieving and maintaining peripheral IV access, examine measures to reduce these risks, and discuss implications for nurses in clinical practice.

Disaster 101: a novel approach to disaster medicine training for health professionals.

BACKGROUND: Despite efforts to improve preparedness training for health professionals, disaster medicine remains a peripheral component of traditional medical education in the United States (US) and is a rarely studied topic in the medical literature. OBJECTIVES: Using a pre-/post-test design, we measured the extent to which 4(th)-year medical students perceive, rapidly learn, and apply basic concepts of disaster medicine via a novel curriculum. METHODS: Via a modified Delphi technique, an expert curriculum panel developed a 90-min didactic training scenario and two 40-min training exercises for medical students: a hazardous material scene and a surprise mass casualty incident (MCI) scenario with 100 life-sized mannequins. Medical students were quizzed before and after the didactic training scenario about their perceptions and their disaster medicine knowledge. RESULTS: Students rated their overall knowledge as 3.76/10 pretest compared to 7.64/10 after the didactic program. Students' post-test scores improved by 54% and students participating in the MCI drill correctly tagged 94% of the victims in approximately 10 min. The average overall rating for the experience was 4.85/5. CONCLUSIONS: The results of this educational demonstration project reveal that students will value and can rapidly learn some core elements of disaster medicine via a novel addition to a medical school's curriculum. We believe the principle of a highly effective and well-received medical student course that can be easily added to a university curriculum has been demonstrated. Further research is needed to validate core competencies and performance-based education goals for US health professional trainees.

South Carolina Area Health Education Consortium Disaster Preparedness and Response Training Network: an emerging partner in preparedness training.

The South Carolina Area Health Education Consortium (SC AHEC) was funded in 2003 to train healthcare professionals in disaster preparedness and response. During the 5 years of funding, its Disaster Preparedness and Response Training Network evolved from disaster awareness training to competency-based instruction and performance assessment. With funding from the assistant secretary for preparedness and response (ASPR), a project with implications for national dissemination was developed to evaluate 2 aspects of preparedness training for community-based healthcare professionals. The SC AHEC designed disaster preparedness curricula and lesson plans, using a consensus-building technique, and then (1) distributed sample curricula and resources through the national Area Health Education Center system to assess an approach for providing preparedness training and (2) delivered a standardized preparedness curriculum to key influential thought leaders from 4 states to evaluate the effectiveness and acceptability of the curriculum. As a result of this project, the SC AHEC recommends that preparedness training for community-based practitioners needs to be concise and professionally relevant. It should be integrated into existing healthcare professions education programs and continuing education offerings. The project also demonstrated that although AHECs may be interested and well suited to incorporate preparedness training as part of their mission, more work needs to be done if they are to assume a prominent role in disaster preparedness training.

Ethnic composition, age and sex, together with location and standard of housing as determinants of HTLV-I infection in an urban Trinidadian community

The presence of antibody to human T-cell leukaemia virus (HTLV-I) has been assessed in 2,143 men and women who represent 83 percent of all adults aged 35 to 69 years resident in a defined urban community in Trinidad. Individuals of African descent had a higher sero-positivity rate (7.0 percent) than those originating from India (1.4 percent), Europe (0 percent) or of mixed descent (2.7 percent). Women were infected more frequently than men, and the prevalence of infection increased with age in both sexes. Sero-positivity rates were significantly increased in adults who lived in housing of poor quality (p less than 0.001) or close to water courses (p less than 0.025). These data and others raise the possibility that one route of HTLV-I transmission may be via insect vectors under particular domestic circumstances.(AU)

Alcohol consumption: protection against coronary heart disease and risks to health

In a prospective cardiovascular study of 1341 Trinidadian men aged 35-69 years undertaken between 1977 and 1986, the baseline prevalance rates of cardiac and arterial disease and diabetes mellitus were increased in the 118 (8.8 percent) who had been but were no longer regular drinkers. This finding suggested that awareness of these disorders was a discouragement to drinking alcohol. When this group and all with coronary heart disease (CHD) or diabetes at entry were excluded, a significant inverse trend was found between alcohol consumption in the week before recruitment and risk of CHD across the subsequent average follow-up of 7.5 years. Men who had taken 5-14 drinks had about half the CHD risk of those who had had no alcohol, even after allowance for age, ethnicity, smoking, blood pressure and serum cholesterol concentration. The overall morbidity and mortality experience in this community indicated a protective effect of alcohol against CHD, but adverse health consequences from multiple causes in drinkers who were alcohol dependent. (AU)

High density lipoprotein cholesterol concentration as a predictor of coronary heart disease in West Indian men

Study objective- The aim of the study was to determine whether the inverse association between high density lipoprotein cholesterol concentration and risk of coronary heart disease described in people of European stock was also present in other racial groups. Design- The study was a prospective population survey. Cardiovascular risk factors were examined, including fasting serum lipid estimation (obtained at recruitment). Setting- This was a community based study within a defined survey area in Trinidad. Participants- All men aged between 35 and 69 years within the survey area were identified and followed between 1977 and 1986. Analysis was confined to those of African, Asian Indian, and mixed decent who were free of coronary heart disease at entry (n=960, 69 percent of age eligible men in the survey population). Measurements and main results- 64 men developed coronary heart disease during the study period. A strong inverse curvilinear relation was found between high density lipoprotein cholesterol and coronary heart disease incidence (p<0.005), independent of age or other relevant characteristics including low density lipoprotein cholesterol. Conclusions- A low serum concentration of high density lipoprotein cholesterol is a risk factor for coronary heart disease in non-whites as well as in whites. (AU)

Ethnicity and other characteristics predictive of coronary heart disease in a developing community; principal results of the St. James survey, Trinidad

A ten year community survey was undertaken to investigate the high coronary heart (CHI) incidence among people of Indian (South Asian) descent in Trinidad, West Indies. Of 2491 individuals aged 35-69, 2215 (89 percent) were examined and 2069 (83 percent) found to be clinically free of CHD at baseline. After exclusion of 71 of minority ethnic groups, 786 African, 598 Indian, 147 European and 467 adults of mixed descent were followed for CHD morbidity and mortality. In both sexes, adults of Indian origin had higher prevalence rates of diabetes mellitus, a low concentration of high density lipoprotein(HDL) cholesterol, and recent abstinence from alcohol than other ethnic groups. Indian men also had larger skinfold thicknesses than other men. In participants free of CHD at entry, the age-adjusted relative risk of a cardiac event believed due to CHD, was at least twice as high in Indian men and women as in other ethnic groups. In men, blood pressure, diabetes mellitus and low-density lipoprotein(LDL) cholesterol concentration were positively and independently related to risk of CHD, wheras alcohol consumption and HDL cholesterol concentration were inversely associated with risk after allowing for age and ethnic group. The ethnic contrast in CHD persisted when these characteristics were taken into account. In the smaller sample of women, only ethnic groups were predictive of CHD as defined. The failure of point estimates of risk to explain the high CHD incidence in Indians calls for focus on age of onset of risk and examination of other potential risk factors such as insulin concentration. (AU)

Adult male all-cause, cardiovascular and cerebrovascular mortality in relation to ethnic group, systolic blood pressure and blood glucose concentration in Trinidad, West Indies

In a prospective survey of 1342 Trinidadian men aged 35 to 69 years at recruitment, age-adjusted mean blood pressures were highest in those of African descent, intermediate in Indians and men of Mixed origin, and lowest in Europeans. Age-adjusted fasting blood glucose concentrations were highest in Indians and lowest in men of European descent. Relative risks of all-cause, cardiovascular and cerebrovascular mortality increased progressively with increasing systolic pressure, whereas for fasting blood glucose concentration the associations were U-shaped. No ethnic differences were apparent in relative risk. For systolic pressure, mortality from all-causes and cardiovascular diseases respectively were about two and three times higher at 180mmHg or more than at pressures below 130 mmHg. For blood glucose, all-cause and cardiovascular mortality were about four times higher at fasting concentrations greater than 7.7 mmol/l than in the lowest risk group (4.2-4.6 mmol/l), All-cause population attributable mortality rates for systolic pressures of 130 mmHg or more were 1.3 to 2.8 times higher in Indian men than in other groups. For blood glucose in excess of 4.6 mmol/l, population attributable mortality was between 2.9 and 6.9 times higher in Indians than in other groups. The findings emphasized the high mortality in men of Indian descent, partly due to an apparent underlying predisposition to cardiovascular disease, and partly to their high prevalence of diabetes mellitus. (AU)

High total and cardiovascular disease mortality in adults of Indian descent in Trinidad, unexplained by major coronary risk factors

A prospective survey has been undertaken of a total community of 1343 men and 1149 women, aged 35-69 years at recruitment, living in Port-of Spain, Trinidad. By comparison with adults of African descent, age-adjusted relative risks of death from all causes and from cardiovascular diseases were significantly increased in those of Indian origin (0.5 and 0.3, respectively). Adults of European descent had an all-cause and cardiovascular mortality relative risk of 0.8 and 2.1, respectively. These ethnic differences in risk were not explained by systolic blood pressure, fasting blood glucose concentration, serum high-density lipoprotein or low-density lipoprotein concentration, or smoking habits. Differences in risk of cardiovascular death between Indian and European men seemed to be accounted for by the high prevalence of diabetes in Indians (19 percent) but other ethnic contrasts in mortality were unrelated to diabetes mellitus. (AU)

Ethnic differences in all-cause and cause-specific mortality among adults in Trinidad: The St. James Cardiovascular Survey - abstract

The St. James Cardiovascular Survey was established in 1977 to examine the relations of conventional risk factors to subsequent all-cause and cause-specific morbidiy and mortality among adults aged 35-69 years at recruitment. Up to April 30, 1985, 178 deaths were recorded among 1,343 male subjects and 80 deaths among 1,079 female subjects. After adjusting for age differences, risk of death from all causes was significantly associated with ethnic group in men (xý of 3 = 16.8, p<0.001) and women (xý of 3 = 13.2, p < .005). Risk was 55 percent and 45 percent higher for Indian men women relative to African men and women. Risk for Mixed subjects was lowest compared to African (40 percent lower in males, 60 percent lower in females). Cardiovasular diseases and malignant neoplasms were the major causes of death in men (70 percent) of total deaths) and women (62 percent of total deaths). Among men, cardiovascular disease was the principal cause of death in all ethnic groups but made a greater contribution to total mortality amon Indian (60 percent) and European (70 percent) men than in the African and Mixed (37 percent) men than in Indians (9 percent) and Europeans (7 percent). A similar pattern was observed in women. After adjusting for age, risk of death from heart disease was more than twice as high for Indian men as for African. Ethnic group was not associated with mortality from either cerebrovascular disease or malignant (AU)

Obesity in women in an urban Trinidad community: prevalence and associated characteristics

Triceps skinfold, body mass index (BMI), blood pressure, blood/glucose concentration and serum lipoprotein concentrations were measured in 590 (80 percent) of 738 women aged 35-69 years resident within a defined area of Port of Spain, Trinidad. A triceps skinfold of 32 mm or more (the 70th percentile of overall distribution) was found in 36 percent of women of African descent and 28 percent of women of other ethnic origin. Respective figures for a BMI of 30.0 kg/mý or more were 32 percent and 27 percent at ages 46 to 64 years. Obesity was associated with an increase in blood pressure, increased fasting blood glucose, LDL cholesterol and VLDL triglyceride concentrations, and a reduction in HDL cholesterol concentration. Obese women had an increased tendency to a history of early menarche, multiparity and children of high birth weight. These findings suggested that, irrespective of ethnic origins, the effects of obesity on health in this female population resembled those in white North American women. (AU)