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1.  ‘The History of Hindu Chemistry’ A Critical Review 
Ancient Science of Life  2010;30(2):58-61.
‘The History of Hindu Chemistry’ is one of the rare, important books published in twentieth century. Sir Prafulla Chandra Ray, the author of this book, who was a chemist by profession, has contributed greatly to the field of Rasashastra in his own style. The book in two volumes is in English and has achieved international recognition. The work became the cause of enlightening people specially, the Westerners about Indian Alchemy which, they were till then unaware of. In a way, ‘globalization’ of the concepts of Rasashastra has its starting point in the works of Sir P.C.Ray. The author has touched almost every area of Rasashastra of course, from the standpoint of modern Chemistry. A critical analysis of his contributions, the narration of the contents of the book are detailed in the paper.
PMCID: PMC3336279  PMID: 22557428
2.  Type-3 Gaucher disease with bilateral necrosis of the neck of femur: a case report 
Cases Journal  2009;2:9380.
Introduction
Though Gauchers disease (G.D.), a lipid storage disease is most commonly encountered by the hematologist but we present a case of G.D. type-3 which is rare in Indian subcontinent.
Case presentation
A 36-year-old Hindu, Indian male patient presented with bony pain, kyphosis, dragging sensation in the abdomen, dementia and ptosis of the left eyelid for one year. Clinical examination and history pointed to be a lipid storage disease. Radiological examination showed bilateral necrosis of the neck of femur. A final diagnosis of G.D. type-3 with bilateral necrosis of the femur neck was reported after examining the bone marrow smears. Unfortunately, we were unable to do the enzyme study as the patient was lost in the follow-up.
Conclusion
G.D. type-3 with bilateral necrosis of femur neck is rare in our sub-continent. We are adding a new case to stress the importance of early recognition by clinical manifestation and finding of G.C. which is hallmark in the diagnosis of G.D.
doi:10.1186/1757-1626-2-9380
PMCID: PMC2806396  PMID: 20072680
3.  Eight-year experience with 3392 endoscopically proven duodenal ulcers in Durban, 1972-79. Rise and fall of duodenal ulcers and a theory of changing dietary and social factors. 
Gut  1981;22(4):327-331.
From 1972 to 1979, a total of 3392 patients with endoscopically proven ulcers were seen, in six ethnic groups. The distribution was as follows: Africans 456 males, 182 females; Muslim Gujerati Indians 206 males, 60 females; Hindu Hindi 433 males; total North Indians 639 males, 195 females; Hindu Tamils 593 males, 184 females; Hindu Telegu 179 males, 46 females; total South Indians 872 males, 230 females, and Whites 465 males, 303 females. In the continent of India, it is predominantly the South Indians who suffer from duodenal ulcer. In Durban, the number of North Indians with duodenal ulcers approximates that of those from the South (North: South ratio 0.83). The first question raised by this study is that the protective factors in North Indians in India are not genetic, and are lost when they emigrate to Natal. This may be due to changes in diet. A seasonal analysis indicates that, for females, there is a striking Autumn and Winter predominance in all Indian groups, reaching 80% in Muslims and Telegus but not in African females (52.7%). The second question raised by this study is that protective factors must be sought which operate in Indian females in the Spring and Summer months. The third question emanating from this study is that duodenal ulcers (and ischaemic heart disease) appear to increase in times of dietary and social change. This occurred in the West from 1890 to 1960, and is still occurring in the Third World. The restoration of dietary fibre and unsaturated fat, and the possible adjustment to stress in the West since 1960, has been accompanied by a fall in the incidence of these diseases. A 'changing factors' theory of duodenal ulcers and ischaemic heart disease is proposed. These conditions fall when a 'plateau situation' is reached.
PMCID: PMC1419150  PMID: 7239324
4.  Organisational culture and post-merger integration in an academic health centre: a mixed-methods study 
Background
Around the world, the last two decades have been characterised by an increase in the numbers of mergers between healthcare providers, including some of the most prestigious university hospitals and academic health centres. However, many mergers fail to bring the anticipated benefits, and successful post-merger integration in university hospitals and academic health centres is even harder to achieve. An increasing body of literature suggests that organisational culture affects the success of post-merger integration and academic-clinical collaboration.
Methods
This paper reports findings from a mixed-methods single-site study to examine 1) the perceptions of organisational culture in academic and clinical enterprises at one National Health Service (NHS) trust, and 2) the major cultural issues for its post-merger integration with another NHS trust and strategic partnership with a university. From the entire population of 72 clinician-scientists at one of the legacy NHS trusts, 38 (53%) completed a quantitative Competing Values Framework survey and 24 (33%) also provided qualitative responses. The survey was followed up by semi-structured interviews with six clinician-scientists and a group discussion including five senior managers.
Results
The cultures of two legacy NHS trusts differed and were primarily distinct from the culture of the academic enterprise. Major cultural issues were related to the relative size, influence, and history of the legacy NHS trusts, and the implications of these for respective identities, clinical services, and finances. Strategic partnership with a university served as an important ameliorating consideration in reaching trust merger. However, some aspects of university entrepreneurial culture are difficult to reconcile with the NHS service delivery model and may create tension.
Conclusions
There are challenges in preserving a more desirable culture at one of the legacy NHS trusts, enhancing cultures in both legacy NHS trusts during their post-merger integration, and in aligning academic and clinical cultures following strategic partnership with a university. The seeds of success may be found in current best practice, good will, and a near identical ideal of the future preferred culture. Strong, fair leadership will be required both nationally and locally for the success of mergers and post-merger integration in university hospitals and academic health centres.
Electronic supplementary material
The online version of this article (doi:10.1186/s12913-014-0673-3) contains supplementary material, which is available to authorized users.
doi:10.1186/s12913-014-0673-3
PMCID: PMC4308851  PMID: 25608775
Organisational culture; Competing Values Framework (CVF); Post-merger integration; University Hospital; Academic Health Centre (AHC); Academic-Clinical Collaboration; Strategic partnership; Research and innovation; Teaching; Patient care
5.  The intractable cigarette ‘filter problem’ 
Tobacco Control  2011;20(Suppl_1):i10-i16.
Background
When lung cancer fears emerged in the 1950s, cigarette companies initiated a shift in cigarette design from unfiltered to filtered cigarettes. Both the ineffectiveness of cigarette filters and the tobacco industry's misleading marketing of the benefits of filtered cigarettes have been well documented. However, during the 1950s and 1960s, American cigarette companies spent millions of dollars to solve what the industry identified as the ‘filter problem’. These extensive filter research and development efforts suggest a phase of genuine optimism among cigarette designers that cigarette filters could be engineered to mitigate the health hazards of smoking.
Objective
This paper explores the early history of cigarette filter research and development in order to elucidate why and when seemingly sincere filter engineering efforts devolved into manipulations in cigarette design to sustain cigarette marketing and mitigate consumers' concerns about the health consequences of smoking.
Methods
Relevant word and phrase searches were conducted in the Legacy Tobacco Documents Library online database, Google Patents, and media and medical databases including ProQuest, JSTOR, Medline and PubMed.
Results
13 tobacco industry documents were identified that track prominent developments involved in what the industry referred to as the ‘filter problem’. These reveal a period of intense focus on the ‘filter problem’ that persisted from the mid-1950s to the mid-1960s, featuring collaborations between cigarette producers and large American chemical and textile companies to develop effective filters. In addition, the documents reveal how cigarette filter researchers' growing scientific knowledge of smoke chemistry led to increasing recognition that filters were unlikely to offer significant health protection. One of the primary concerns of cigarette producers was to design cigarette filters that could be economically incorporated into the massive scale of cigarette production. The synthetic plastic cellulose acetate became the fundamental cigarette filter material. By the mid-1960s, the meaning of the phrase ‘filter problem’ changed, such that the effort to develop effective filters became a campaign to market cigarette designs that would sustain the myth of cigarette filter efficacy.
Conclusions
This study indicates that cigarette designers at Philip Morris, British-American Tobacco, Lorillard and other companies believed for a time that they might be able to reduce some of the most dangerous substances in mainstream smoke through advanced engineering of filter tips. In their attempts to accomplish this, they developed the now ubiquitous cellulose acetate cigarette filter. By the mid-1960s cigarette designers realised that the intractability of the ‘filter problem’ derived from a simple fact: that which is harmful in mainstream smoke and that which provides the smoker with ‘satisfaction’ are essentially one and the same. Only in the wake of this realisation did the agenda of cigarette designers appear to transition away from mitigating the health hazards of smoking and towards the perpetuation of the notion that cigarette filters are effective in reducing these hazards. Filters became a marketing tool, designed to keep and recruit smokers as consumers of these hazardous products.
doi:10.1136/tc.2010.040113
PMCID: PMC3088411  PMID: 21504917
cigarette smoking; filtration; research; tobacco products
6.  Prevalence and family risk of ulcerative colitis and Crohn's disease: an epidemiological study among Europeans and south Asians in Leicestershire. 
Gut  1993;34(11):1547-1551.
The family history of patients identified during incidence studies in Leicestershire were investigated and the prevalence and comparative risks calculated; 1254 patients aged 15 to 80 years were sent a questionnaire about their family history. All cases with a positive family history were reviewed and confirmed cases included in the study. In Europeans the standardised prevalence of Crohn's disease was 75.8/10(5) and that of ulcerative colitis 90.8/10(5). The prevalence of Crohn's disease among South Asians was 33.2/10(5) and that of ulcerative colitis 135/10(5). The prevalence of Crohn's disease in Europeans was significantly greater than that in Hindus (chi 2 = 16, p < 0.001), while the prevalence of ulcerative colitis was significantly lower in Europeans than Hindus (chi 2 = 27, p < 0.001) and Sikhs (chi 2 = 4.4, p < 0.05). The comparative risk of developing ulcerative colitis in first degree relatives of Europeans patients with ulcerative colitis was increased by approximately 15, but the risk of Crohn's disease was not increased. The comparative risk of developing Crohn's disease among first degree relatives of patients with Crohn's disease was increased by up to 35, the comparative risk of ulcerative colitis was approximately 3. The risk among relatives of South Asian patients with Crohn's disease was not increased, but the risk of ulcerative colitis to relatives of patients with ulcerative colitis was. This study supports the view that Crohn's disease and ulcerative colitis arise in people with a genetic predisposition and exposed to some, as yet unknown, environmental factor.
PMCID: PMC1374420  PMID: 8244142
7.  Anthropogenic Natal Environmental Effects on Life Histories in a Wild Bird Population 
Current Biology  2014;24(5):536-540.
Summary
Recent work suggests that the environment experienced in early life can alter life histories in wild populations [1–5], but our understanding of the processes involved remains limited [6, 7]. Since anthropogenic environmental change is currently having a major impact on wild populations [8], this raises the possibility that life histories may be influenced by human activities that alter environmental conditions in early life. Whether this is the case and the processes involved remain unexplored in wild populations. Using 23 years of longitudinal data on the Mauritius kestrel (Falco punctatus), a tropical forest specialist, we found that females born in territories affected by anthropogenic habitat change shifted investment in reproduction to earlier in life at the expense of late life performance. They also had lower survival rates as young adults. This shift in life history strategy appears to be adaptive, because fitness was comparable to that of other females experiencing less anthropogenic modification in their natal environment. Our results suggest that human activities can leave a legacy on wild birds through natal environmental effects. Whether these legacies have a detrimental effect on populations will depend on life history responses and the extent to which these reduce individual fitness.
Highlights
•Anthropogenic habitat in early life affects life history•Reproductive scheduling and survival are modified•Modified life history strategy compensates for poor start in life
Cartwright et al. show that there is a legacy of human activity on the life histories of a tropical wild bird. Individuals born in human-modified habitat have altered schedules of reproduction and survival over their lifetimes, which appear to be an adaptive, plastic response to environmental change.
doi:10.1016/j.cub.2014.01.040
PMCID: PMC3969248  PMID: 24560573
8.  Tobacco Company Efforts to Influence the Food and Drug Administration-Commissioned Institute of Medicine Report Clearing the Smoke: An Analysis of Documents Released through Litigation 
PLoS Medicine  2013;10(5):e1001450.
Stanton Glantz and colleagues investigate efforts by tobacco companies to influence Clearing the Smoke, a 2001 Institute of Medicine report on harm reduction tobacco products.
Please see later in the article for the Editors' Summary
Background
Spurred by the creation of potential modified risk tobacco products, the US Food and Drug Administration (FDA) commissioned the Institute of Medicine (IOM) to assess the science base for tobacco “harm reduction,” leading to the 2001 IOM report Clearing the Smoke. The objective of this study was to determine how the tobacco industry organized to try to influence the IOM committee that prepared the report.
Methods and Findings
We analyzed previously secret tobacco industry documents in the University of California, San Francisco Legacy Tobacco Documents Library, and IOM public access files. (A limitation of this method includes the fact that the tobacco companies have withheld some possibly relevant documents.) Tobacco companies considered the IOM report to have high-stakes regulatory implications. They developed and implemented strategies with consulting and legal firms to access the IOM proceedings. When the IOM study staff invited the companies to provide information on exposure and disease markers, clinical trial design for safety and efficacy, and implications for initiation and cessation, tobacco company lawyers, consultants, and in-house regulatory staff shaped presentations from company scientists. Although the available evidence does not permit drawing cause-and-effect conclusions, and the IOM may have come to the same conclusions without the influence of the tobacco industry, the companies were pleased with the final report, particularly the recommendations for a tiered claims system (with separate tiers for exposure and risk, which they believed would ease the process of qualifying for a claim) and license to sell products comparable to existing conventional cigarettes (“substantial equivalence”) without prior regulatory approval. Some principles from the IOM report, including elements of the substantial equivalence recommendation, appear in the 2009 Family Smoking Prevention and Tobacco Control Act.
Conclusions
Tobacco companies strategically interacted with the IOM to win several favored scientific and regulatory recommendations.
Please see later in the article for the Editors' Summary
Editors' Summary
Background
Up to half of tobacco users will die of cancer, lung disease, heart disease, stroke, or another tobacco-related disease. Cigarettes and other tobacco products cause disease because they expose their users to nicotine and numerous other toxic chemicals. Tobacco companies have been working to develop a “safe” cigarette for more than half a century. Initially, their attention focused on cigarettes that produced lower tar and nicotine yields in machine-smoking tests. These products were perceived as “safer” products by the public and scientists for many years, but it is now known that the use of low-yield cigarettes can actually expose smokers to higher levels of toxins than standard cigarettes. More recently, the tobacco companies have developed other products (for example, products that heat aerosols of nicotine, rather than burning the tobacco) that claim to reduce harm and the risk of tobacco-related disease, but they can only market these modified risk tobacco products in the US after obtaining Food and Drug Administration (FDA) approval. In 1999, the FDA commissioned the US Institute of Medicine (IOM, an influential source of independent expert advice on medical issues) to assess the science base for tobacco “harm reduction.” In 2001, the IOM published its report Clearing the Smoke: Assessing the Science Base for Tobacco Harm and Reduction, which, although controversial, set the tone for the development and regulation of tobacco products in the US, particularly those claiming to be less dangerous, in subsequent years.
Why Was This Study Done?
Tobacco companies have a long history of working to shape scientific discussions and agendas. For example, they have produced research results designed to “create controversy” about the dangers of smoking and secondhand smoke. In this study, the researchers investigate how tobacco companies organized to try to influence the IOM committee that prepared the Clearing the Smoke report on modified risk tobacco products by analyzing tobacco industry and IOM documents.
What Did the Researchers Do and Find?
The researchers searched the Legacy Tobacco Documents Library (a collection of internal tobacco industry documents released as a result of US litigation cases) for documents outlining how tobacco companies tried to influence the IOM Committee to Assess the Science Base for Tobacco Harm Reduction and created a timeline of events from the 1,000 or so documents they retrieved. They confirmed and supplemented this timeline using information in 80 files that detailed written interactions between the tobacco companies and the IOM committee, which they obtained through a public records access request. Analysis of these documents indicates that the tobacco companies considered the IOM report to have important regulatory implications, that they developed and implemented strategies with consulting and legal firms to access the IOM proceedings, and that tobacco company lawyers, consultants, and regulatory staff shaped presentations to the IOM committee by company scientists on various aspects of tobacco harm reduction products. The analysis also shows that tobacco companies were pleased with the final report, particularly its recommendation that tobacco products can be marketed with exposure or risk reduction claims provided the products substantially reduce exposure and provided the behavioral and health consequences of these products are determined in post-marketing surveillance and epidemiological studies (“tiered testing”) and its recommendation that, provided no claim of reduced exposure or risk is made, new products comparable to existing conventional cigarettes (“substantial equivalence”) can be marketed without prior regulatory approval.
What Do These Findings Mean?
These findings suggest that tobacco companies used their legal and regulatory staff to access the IOM committee that advised the FDA on modified risk tobacco products and that they used this access to deliver specific, carefully formulated messages designed to serve their business interests. Although these findings provide no evidence that the efforts of tobacco companies influenced the IOM committee in any way, they show that the companies were satisfied with the final IOM report and its recommendations, some of which have policy implications that continue to reverberate today. The researchers therefore call for the FDA and other regulatory bodies to remember that they are dealing with companies with a long history of intentionally misleading the public when assessing the information presented by tobacco companies as part of the regulatory process and to actively protect their public-health policies from the commercial interests of the tobacco industry.
Additional Information
Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1001450.
This study is further discussed in a PLOS Medicine Perspective by Thomas Novotny
The World Health Organization provides information about the dangers of tobacco (in several languages); for information about the tobacco industry's influence on policy, see the 2009 World Health Organization report Tobacco interference with tobacco control
A PLOS Medicine Research Article by Heide Weishaar and colleagues describes tobacco company efforts to undermine the Framework Convention on Tobacco Control, an international instrument for tobacco control
Wikipedia has a page on tobacco harm reduction (note: Wikipedia is a free online encyclopedia that anyone can edit; available in several languages)
The IOM report Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction is available to read online
The Legacy Tobacco Documents Library is a public, searchable database of tobacco company internal documents detailing their advertising, manufacturing, marketing, sales, and scientific activities
The University of California, San Francisco Center for Tobacco Control Research and Education is the focal point for University of California, San Francisco (UCSF) scientists in disciplines ranging from the molecular biology of nicotine addiction through political science who combine their efforts to eradicate the use of tobacco and tobacco-induced cancer and other diseases worldwide
SmokeFree, a website provided by the UK National Health Service, offers advice on quitting smoking and includes personal stories from people who have stopped smoking
Smokefree.gov, from the US National Cancer Institute, offers online tools and resources to help people quit smoking
doi:10.1371/journal.pmed.1001450
PMCID: PMC3665841  PMID: 23723740
9.  Is Gene Flow Promoting the Reversal of Pleistocene Divergence in the Mountain Chickadee (Poecile gambeli)? 
PLoS ONE  2012;7(11):e49218.
The Pleistocene glacial cycles left a genetic legacy on taxa throughout the world; however, the persistence of genetic lineages that diverged during these cycles is dependent upon levels of gene flow and introgression. The consequences of secondary contact among taxa may reveal new insights into the history of the Pleistocene’s genetic legacy. Here, we use phylogeographic methods, using 20 nuclear loci from regional populations, to infer the consequences of secondary contact following divergence in the Mountain Chickadee (Poecile gambeli). Analysis of nuclear data identified two geographically-structured genetic groups, largely concordant with results from a previous mitochondrial DNA (mtDNA) study. Additionally, the estimated multilocus divergence times indicate a Pleistocene divergence, and are highly concordant with mtDNA. The previous mtDNA study showed a paucity of sympatry between clades, while nuclear patterns of gene flow show highly varied patterns between populations. The observed pattern of gene flow, from coalescent-based analyses, indicates southern populations in both clades exhibit little gene flow within or between clades, while northern populations are experiencing higher gene flow within and between clades. If this pattern were to persist, it is possible the historical legacy of Pleistocene divergence may be preserved in the southern populations only, and the northern populations would become a genetically diverse hybrid species.
doi:10.1371/journal.pone.0049218
PMCID: PMC3495768  PMID: 23152877
10.  Chemistry of Personalized Solar Energy 
Inorganic Chemistry  2009;48(21):10001-10017.
Personalized energy (PE) is a transformative idea that provides a new modality for the planet’s energy future. By providing solar energy to the individual, an energy supply becomes secure and available to people of both legacy and non-legacy worlds, and minimally contributes to increasing the anthropogenic level of carbon dioxide. Because PE will be possible only if solar energy is available 24 hours a day, 7 day a week, the key enabler for solar PE is an inexpensive storage mechanism. HX (X = halide or OH−) splitting is a fuel-forming reaction of sufficient energy density for large scale solar storage but the reaction relies on chemical transformations that are not understood at the most basic science level. Critical among these are multielectron transfers that are proton-coupled and involve the activation of bonds in energy poor substrates. The chemistry of these three italicized areas is developed, and from this platform, discovery paths leading to new HX and H2O splitting catalysts are delineated. For the case of the water splitting catalyst, it captures many of the functional elements of photosynthesis. In doing so, a highly manufacturable and inexpensive method has been discovered for solar PE storage.
doi:10.1021/ic901328v
PMCID: PMC3332084  PMID: 19775081
11.  From Osler to Olafson. The evolution of veterinary pathology in North America. 
Most branches of biological science in North America developed first in the United States, and later were taught and practiced in Canada. An exception was veterinary pathology, which as a discipline taught in veterinary colleges and as a field of research, developed first in Canada, and from there crossed the border to the United States. Pathology was first taught at the Montreal Veterinary College, founded in 1866 by Duncan McEachran, a graduate of the Edinburgh Veterinary College. From the outset, he formed a close association with the medical faculty of McGill University, permitting his students to attend the same classes in the basic subjects with the medical students. Eventually, the Montreal Veterinary College became formally affiliated with McGill University, as the Faculty of Comparative Medicine and Veterinary Science. The McGill veterinary faculty was forced to close for economic reasons in 1903, but it left an enduring legacy, particularly in the field of veterinary pathology. The legacy, a novel concept in the 1870's, was that pathology was the cornerstone of a veterinary education; the place where anatomy, physiology, chemistry and botany met with the clinical subjects, and gave the latter meaning. This tradition was formed at the Montreal Veterinary College by the world renowned physician William Osler, North America's leading medical teacher, whom McEachran had invited to teach at the College in 1876 in addition to his duties in the faculty of medicine. Osler had studied with Virchow in Berlin and applied his methods of autopsy technique and of scientific inquiry to his teaching of both human and veterinary pathology at McGill. Osler also undertook investigations into various diseases of domestic animals, at the request of McEachran, who doubled as Chief Veterinary Inspector for the Dominion Department of Agriculture. Osler left McGill University in 1884. Only after that year did other North American veterinary schools adopt pathology as a discipline of instruction. However, by 1884, Osler had already left his indelible imprint on the students (both medical and veterinary) he had taught in Montreal, one of whom took over the teaching of pathology in the veterinary college. Another, who followed Osler's example and also studied in Berlin with Virchow, wrote the first book in the English language on veterinary post mortem technique in 1889.(ABSTRACT TRUNCATED AT 400 WORDS)
Images
PMCID: PMC1255268  PMID: 3552167
12.  Genomics and chloroplast evolution: what did cyanobacteria do for plants? 
Genome Biology  2003;4(3):209.
Plant chloroplast originated, through endosymbiosis, from a cyanobacterium, but the genomic legacy of cyanobacterial ancestry extends far beyond the chloroplast itself, and persists in organisms that have lost chloroplasts completely.
The complete genome sequences of cyanobacteria and of the higher plant Arabidopsis thaliana leave no doubt that the plant chloroplast originated, through endosymbiosis, from a cyanobacterium. But the genomic legacy of cyanobacterial ancestry extends far beyond the chloroplast itself, and persists in organisms that have lost chloroplasts completely.
PMCID: PMC153454  PMID: 12620099
13.  The Legacy of Childhood Sexual Abuse and Family Adversity 
Purpose
To describe the process by which childhood adversity influences the life course of survivors of childhood sexual abuse.
Design
A community-based, qualitative, grounded theory design.
Methods
In this grounded theory study, data were drawn from open-ended interviews conducted as part of a larger study of women's and men's responses to sexual violence. The current study examines the experiences of 48 female and 40 male survivors of childhood sexual abuse and family adversity. Data were analyzed using the constant comparison method.
Findings
The participants described a sense of inheriting a life of abuse and adversity. The process by which childhood adversity influences the life course of adult survivors of childhood sexual abuse is labeled Living the Family Legacy. The theory representing the process of Living the Family Legacy includes three major life patterns: (a) Being Stuck in the Family Legacy, (b) Being Plagued by the Family Legacy, and (c) Rejecting the Family Legacy/Creating a New One. Associated with these life patterns are three processes by which the participants passed on a legacy to others, often their children: (a) Passing on the Family Legacy, (b) Taking a Stab at Passing on a New Legacy, and (c) Passing on a New Legacy.
Conclusions
The legacy of abuse and adversity has a profound effect on the lives of survivors of childhood sexual abuse. There are several trajectories by which the influence of childhood adversity unfolds in the lives of adult survivors and by which the legacy is passed on to others.
Clinical Relevance
The model representing the theoretical process of Living the Family Legacy can be used by clinicians who work with survivors of childhood sexual abuse and childhood adversity, especially those who have parenting concerns.
doi:10.1111/j.1547-5069.2008.00247.x
PMCID: PMC3152829  PMID: 19094148
Childhood sexual abuse; parenting; family adversity; grounded theory
14.  Risk of tuberculosis in immigrant Asians: culturally acquired immunodeficiency? 
Thorax  1991;46(1):1-5.
Study of the 620 Asian immigrants with tuberculosis notified in the Wandsworth area of south London between 1973 and 1988 showed a bimodal pattern of tuberculosis notifications: in 1977 there was a peak among Asians from East Africa, and in 1981 a peak among those from the Indian subcontinent. There was a mean lag time of five years between clinical presentation and immigration. Logit analysis showed that, although overall more men had tuberculosis than women, glandular tuberculosis was more common among women of all groups, and pulmonary tuberculosis was more common among Hindu women than Hindu men. Both subgroups of Asians had a substantially higher incidence of tuberculosis than white people, particularly at extrapulmonary sites. Hindus were also at a significantly greater risk of tuberculosis at all sites than Muslims (Hindu:Muslim risk ratio 5.5 for women and 3.7 for men). The increased susceptibility to tuberculosis of Hindus, particularly Hindu women, may be related to a culturally acquired immunodeficiency caused by vegetarianism and associated vitamin deficiency.
Images
PMCID: PMC1020904  PMID: 1871690
15.  Genetic variation in Northern Thailand Hill Tribes: origins and relationships with social structure and linguistic differences 
BMC Evolutionary Biology  2007;7(Suppl 2):S12.
Background
Ethnic minorities in Northern Thailand, often referred to as Hill Tribes, are considered an ideal model to study the different genetic impact of sex-specific migration rates expected in matrilocal (women remain in their natal villages after the marriage and men move to their wife's village) and patrilocal societies (the opposite is true). Previous studies identified such differences, but little is known about the possible interaction with another cultural factor that may potentially affect genetic diversity, i.e. linguistic differences. In addition, Hill Tribes started to migrate to Thailand in the last centuries from different Northern areas, but the history of these migrations, the level of genetic legacy with their places of origin, and the possible confounding effects related to this migration history in the patterns of genetic diversity, have not been analysed yet. Using both original and published data on the Hill Tribes and several other Asian populations, we focused on all these aspects.
Results
Genetic variation within population at mtDNA is lower in matrilocal, compared to patrilocal, tribes. The opposite is true for Y-chromosome microsatellites within the Sino-Tibetan linguistic family, but Hmong-Mien speaking patrilocal groups have a genetic diversity very similar to the matrilocal samples. Population divergence ranges between 5% and 14% at mtDNA sequences, and between 5% and 36% at Y- chromosomes STRs, and follows the sex-specific differences expected in patrilocal and matrilocal tribes. On the average, about 2 men and 14 women, and 4 men and 4 women, are exchanged in patrilocal and matrilocal tribes every generation, respectively. Most of the Hill Tribes in Thailand seem to preserve a genetic legacy with their likely geographic origin, with children adoption probably affecting this pattern in one tribe.
Conclusion
Overall, the sex specific genetic signature of different postmarital habits of residence in the Hill Tribes is robust. However, specific perturbations related to linguistic differences, population specific traits, and the complex migratory history of these groups, can be identified. Additional studies in different populations are needed, especially to obtain more precise estimates of the migration parameters.
doi:10.1186/1471-2148-7-S2-S12
PMCID: PMC1963483  PMID: 17767728
16.  Son Preference in the Context of Fertility Decline: Limits to New Constructions of Gender and Kinship in Nepal 
Studies in family planning  2010;41(2):89-98.
This article explores the persistence of son preference in a patrilineal, patrilocal society in the midst of fertility decline. Using survey and ethnographic data from Hindu-caste Nepali families in a semiurban village, I analyze which cultural norms regarding reproduction are questioned by contemporary married couples and which remain intact. Despite modest improvements in gender equality, levels of education, and economic conditions, the practical knowledge that daughters will be lost to other lineages and households pressures couples who might otherwise be willing to invest in daughters to continue procreating until they produce a son. Young mothers, therefore, reluctantly admit to needing a son, revealing a discrepancy between their initially stated reproductive ideals and their ultimate behavior.
PMCID: PMC4203699  PMID: 21466108
17.  ACUTE NON-ORGANIC PSYCHOSIS-OUTCOME AFTER 10 YEARS 
Indian Journal of Psychiatry  2000;42(4):356-362.
62 out of 68 acute psychosis patients who were initially recruited from the Bikaner Centre in 1982 for the Indian Council of Medical Research (ICMR) study on "phenomenology and natural history of acute psychosis" were assessed after completion of 10 years in 1992-93 on SCAAPS and PSE with the objective of studying the long term course and outcome of acute psychosis. The results show that 35 (56.45%) patients of acute brief episode of psychosis never had any psychotic illness during the course of follow-up. Remission was significantly better in the young, the unmarried, in those who belonged to the Hindu religion and in those who developed the full blown psychosis abruptly within 48 hours. Other sociodemographic, personal history variables, and symptomatology could not distinguish this remitted group from the rest of the patients.
PMCID: PMC2962735  PMID: 21407971
Acute non-organic psychosis; phenomenology; outcome
18.  Demographic and clinical profile of substance abusing women seeking treatment at a de-addiction center in north India 
Industrial Psychiatry Journal  2013;22(1):12-16.
Background:
In the recent decades increasing number of women have been seeking deaddiction services. Despite that the report data is very limited from India.
Objectives:
The present research aimed to study the demographic and clinical profile of women seeking deaddiction treatment at a tertiary care center in North India.
Materials and Methods:
Retrospective structured chart review of 100 women substance abusers seeking treatment at a deaddiction center between September 1978 and December 2011.
Results:
A typical case was of 36.3 years age, married (65%), urban (61%), nuclear family (59%) based housewife (56%), with good to fair social support (69%). The commonest substance of abuse was tobacco (60%), followed by opioids (27%), alcohol (15%), and benzodiazepines (13%). The common reasons for initiation of substance use were to alleviate frustration or stress (49%) and curiosity (37%). Family history of drug dependence (43%), comorbidity (25%), and impairments in health (74%), family (57%), and social domains (56%) were common. Only a third of the sample paid one or more follow visit, and of those 58% were abstinent at the last follow-up. Significant predictors identified were being non-Hindu and higher educational years for abstinent status at follow-up.
Conclusion:
The common substances of abuse were tobacco, opioids, and alcohol and benzodiazepines; and family history of drug abuse and comorbidity were common. The follow-up and outcome were generally poor. This profile gives us some clues to address a hidden health problem of the community.
doi:10.4103/0972-6748.123587
PMCID: PMC3895305  PMID: 24459367
Substance abuse; treatment seeking; treatment outcome predictors; women
19.  Cephalothoracoomphalopagus: A Rare Type of Conjoined Twin 
We present a case of female cephalothoracoomphalopagus conjoind twin, which is extremely rare type of conjoined twins. We also review the contemprory knowledge regarding incidence, etiopathogenesis, antenatal diagnosis and outcone or the prognosis of conjoint twins. The case belong to hindu female, no history of consanguineous marriage, ingestion of drugs or exposure to any radiation. History of one abortion and one twin delivery present. Conjoind twin was cephalothoracoomphalopagus type, delivered vaginaly at 30 wks of gestion to a 25 yrs old multigravida. Management of conjoind twin still remain challenges because of multiple congenital anomalies and poor outcome is seen.
doi:10.4103/2249-4847.128737
PMCID: PMC3982341  PMID: 24741542
Cephalothoracoomphalopagus; conjoind twin; outcome
20.  The Legacy of the U. S. Public Health Services Study of Untreated Syphilis in African American Men at Tuskegee on the Affordable Care Act and Health Care Reform Fifteen Years After President Clinton’s Apology 
Ethics & behavior  2012;22(6):411-418.
This special issue addresses the legacy of the United States Public Health Service Syphilis Study on health reform, particularly the Affordable Care Act (ACA). The 12 manuscripts cover the history and current practices of ethical abuses affecting American Indians, Latinos, Asian Americans and African Americans in the United States and in one case, internationally. Commentaries and essays include the voice of a daughter of one of the study participants in which we learn of the stigma and maltreatment some of the families experienced and how the study has impacted generations within the families. Consideration is given in one essay to utilizing narrative storytelling with the families to help promote healing.
This article provides the reader a roadmap to the themes that emerged from the collection of articles. These themes include population versus individual consent issues, need for better government oversight in research and health care, the need for overhauling our bioethics training to develop a population level, culturally driven approach to research bioethics. The articles challenge and inform us that some of our assumptions about how the consent process best works to protect racial/ethnic minorities may be merely assumptions and not proven facts. Articles challenge the belief that low participation rates seen in biomedical studies have resulted from the legacy of the USPHS Syphilis Study rather than a confluence of factors rooted in racism, bias and negative treatment. Articles in this special issue challenge the “cultural paranoia” of mistrust and provide insights into how the distrust may serve to lengthen rather than shorten the lives of racial/ethnic minorities who have been used as guinea pigs on more than one occasion. We hope that the guidance offered on the importance of developing a new framework to bioethics can be integrated into the foundation of health care reform.
doi:10.1080/10508422.2012.730808
PMCID: PMC3636721  PMID: 23630410
Tuskegee; research bioethics; survivors
21.  The ‘Stolen Generations' of Mothers and Daughters: Child Apprehension and Enhanced HIV Vulnerabilities for Sex Workers of Aboriginal Ancestry 
PLoS ONE  2014;9(6):e99664.
Objectives
The number of children in care of the state continues to grow in BC, Canada with a historical legacy of child apprehension among criminalized and marginalized populations, particularly women of Aboriginal ancestry and sex workers. However, there is a paucity of research investigating child apprehension experiences among marginalized mothers. The objective of the current analysis is to examine the prevalence and correlates of child apprehensions among female sex workers in Vancouver, Canada.
Methods
Analyses were drawn from the AESHA (An Evaluation of Sex Workers Health Access, 2010-present), a prospective cohort of street and off-street SWs, through outreach and semi-annual visits to the research office. Bivariate and multivariate logistic regression were used to examine correlates of child apprehension.
Results
Of a total of 510 SWs, 350 women who had given birth to at least one child were included in the analyses (median age = 37 yrs: IQR: 31–44 yrs). The prevalence of child apprehension among mothers was 38.3%, with 37.4% reporting having been apprehended themselves by child welfare services. In multivariable analysis, servicing clients in outdoor public spaces (versus formal sex work establishments or informal indoor settings) (adjusted odds ratio, (aOR) = 2.73; 95%CI 1.27–5.90), history of injecting drugs (aOR = 2.53; 95%CI 1.42–4.49), Aboriginal ancestry (aOR = 1.66; 95%CI 1.01–2.74) were associated with increased odds of child apprehension.
Discussion/Conclusions
Child apprehension rates are high, particularly among the most marginalized sex workers, including sex workers who use drugs and sex workers of Aboriginal ancestry. Structural reforms to child protection are urgently needed, that support family-based care address the historical legacy of colonization affecting Aboriginal peoples.
doi:10.1371/journal.pone.0099664
PMCID: PMC4057198  PMID: 24927324
22.  Piecing together the biogeographic history of Chenopodium vulvaria L. using botanical literature and collections 
PeerJ  2015;3:e723.
This study demonstrates the value of legacy literature and historic collections as a source of data on environmental history. Chenopodium vulvaria L. has declined in northern Europe and is of conservation concern in several countries, whereas in other countries outside Europe it has naturalised and is considered an alien weed. In its European range it is considered native in the south, but the northern boundary of its native range is unknown. It is hypothesised that much of its former distribution in northern Europe was the result of repeated introductions from southern Europe and that its decline in northern Europe is the result of habitat change and a reduction in the number of propagules imported to the north. A historical analysis of its ecology and distribution was conducted by mining legacy literature and historical botanical collections. Text analysis of habitat descriptions written on specimens and published in botanical literature covering a period of more than 200 years indicate that the habitat and introduction pathways of C. vulvaria have changed with time. Using the non-European naturalised range in a climate niche model, it is possible to project the range in Europe. By comparing this predicted model with a similar model created from all observations, it is clear that there is a large discrepancy between the realized and predicted distributions. This is discussed together with the social, technological and economic changes that have occurred in northern Europe, with respect to their influence on C. vulvaria.
doi:10.7717/peerj.723
PMCID: PMC4304866  PMID: 25653906
Text analysis; Habitat change; Introduction pathways; Bioclimatic modelling; Distribution; Naturalisation; Herbarium specimens
23.  CIS5/405: Web Technology in Healthcare - Delivering Electronic Records Using the Clinical Intranet 
Introduction
The development of electronic records - EPR & EHR (Electronic Patient Records & Electronic Health Records) - requires the use of innovative technology. With the emergence of web enabled applications, that technology is now available. In this paper, we consider the opportunities afforded by web technology and articulate their vision for making electronic records an affordable reality through the use of the ViewMax Integration Server. It is designed to be used as a discussion document for Health Authorities, Primary Care Groups and Trusts when considering their shared strategies for building electronic records.
Methods
Hospitals that have developed, or are developing EPR, have generally adopted one of the following approaches: Big Bang solutions or Interfaced solutions. Whilst both of these models have their merits, both also have significant limitations and disadvantages. With the advent of web technology, a "third way" has emerged. Through the development of e-commerce in the commercial sector, sophisticated Host-to-Web integration tools are now available, providing facilities which would have seemed impossible only a few years ago:
Systems can now be integrated and accessed through an industry standard web browser.
Legacy systems can be provided with a modern, intuitive interface, designed to support the needs of particular groups of users, and data from multiple, disparate systems, applications and screens can be combined into a single web page.
Data from one system can be easily transferred to other applications.
New applications developed using modern databases can be seamlessly integrated with existing host systems.
Most importantly, this new approach enables full interactive access to legacy technologies using a browser, without requiring any modification to host systems.
Utilising the latest Web integration tools it is now possible to incrementally develop cost-effective electronic records.
Results
The hospital is an average acute district general hospital, and runs a PAS and the normal range of departmental systems - pathology, radiology, pharmacy, theatres and maternity. The PAS shares demographic details with the departmental systems via point to point interfaces, so that all use the hospital number as the main patient identifier. The hospital wants to make better use of these systems to meet the following requirements:
Diagnostic result reporting for clinical staff.
Electronic ordering of pathology and radiology services.
Simplified ward based access to PAS ADT functions.
Patient event history.
Discharge letter production.
Discussion
Web integration tools enable applications to be integrated live within the user interface, and can be used to build "new" applications, by consolidating pieces of functionality from existing and new systems seamlessly within the browser.
doi:10.2196/jmir.1.suppl1.e10
PMCID: PMC1761750
Information Management; Electronic Records; Web Technology; Patient Administration System; Host-to-Web
24.  The Origins of 168, W23, and Other Bacillus subtilis Legacy Strains▿ †  
Journal of Bacteriology  2008;190(21):6983-6995.
Bacillus subtilis is both a model organism for basic research and an industrial workhorse, yet there are major gaps in our understanding of the genomic heritage and provenance of many widely used strains. We analyzed 17 legacy strains dating to the early years of B. subtilis genetics. For three—NCIB 3610T, PY79, and SMY—we performed comparative genome sequencing. For the remainder, we used conventional sequencing to sample genomic regions expected to show sequence heterogeneity. Sequence comparisons showed that 168, its siblings (122, 160, and 166), and the type strains NCIB 3610 and ATCC 6051 are highly similar and are likely descendants of the original Marburg strain, although the 168 lineage shows genetic evidence of early domestication. Strains 23, W23, and W23SR are identical in sequence to each other but only 94.6% identical to the Marburg group in the sequenced regions. Strain 23, the probable W23 parent, likely arose from a contaminant in the mutagenesis experiments that produced 168. The remaining strains are all genomic hybrids, showing one or more “W23 islands” in a 168 genomic backbone. Each traces its origin to transformations of 168 derivatives with DNA from 23 or W23. The common prototrophic lab strain PY79 possesses substantial W23 islands at its trp and sac loci, along with large deletions that have reduced its genome 4.3%. SMY, reputed to be the parent of 168, is actually a 168-W23 hybrid that likely shares a recent ancestor with PY79. These data provide greater insight into the genomic history of these B. subtilis legacy strains.
doi:10.1128/JB.00722-08
PMCID: PMC2580678  PMID: 18723616
25.  GOOD GIFTS FOR THE COMMON GOOD: Blood and Bioethics in the Market of Genetic Research 
This article is based on ethnographic fieldwork conducted with the Indian community in Houston, as part of a NIH–NHGRI-sponsored ethics study and sample collection initiative entitled “Indian and Hindu Perspectives on Genetic Variation Research.” At the heart of this research is one central exchange—blood samples donated for genetic research—that draws both the Indian community and a community of researchers into an encounter with bioethics. I consider the meanings that come to be associated with blood donation as it passes through various hands, agendas, and associated ethical filters on its way to the lab bench: how and why blood is solicited, how the giving and taking of blood is rationalized, how blood as material substance is alienated, processed, documented, and made available for the promised ends of basic science research. Examining corporeal substances and asking what sorts of gifts and problems these represent, I argue, sheds some light on two imbricated tensions expressed by a community of Indians, on the one hand, and of geneticists and basic science researchers, on the other hand: that gifts ought to be free (but are not), and that science ought to be pure (but is not). In this article, I explore how experiences of bioethics are variously shaped by the histories and habits of Indic giving, prior sample collection controversies, commitments to “good science” and the common “good of humanity,” and negotiations of the sites where research findings circulate.
doi:10.1525/can.2007.22.3.429
PMCID: PMC2367312  PMID: 18458755
blood donation; gift exchange; genetics research; bioethics; community consultation; India; Indian community in Houston; International HapMap Project

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