Assessment of craniofacial hyperhidrosis and flushing by sphenopalatine blockade - a randomized trial.

BACKGROUND: Craniofacial hyperhidrosis (CFH) and flushing express nervous system autonomic dysfunction. Available reference treatments lack good compliance. The study objective was to investigate variations of CFH/flushing after two methods of sphenopalatine ganglion (SPG) blockade. METHODOLOGY: CFH patients (n=25) were randomized in a ratio of 1:3 in two groups; 1) endoscopic application of topical lidocaine over SPG (TL; n=7); 2) endoscopic injection of lidocaine in the SPG (IL; n=18). CFH, flushing, rhinorrhoea, nasal obstruction, and smell detection were scored by Visual Analogue Scale (VAS). Nasal endoscopy, acoustic rhinometry, mucociliary transport test, smell/taste test, Schirmer test, Short Form-12, Chronic Skin Diseases Questionnaire, and Skin Satisfaction Questionnaire were also performed at visit 0, 1, 3 and 6 months. RESULTS: At baseline, groups reported similar CFH VAS (TL: 89.3 plus or minus 17.5mm; IL: 85.7 plus or minus 22.1mm) or flushing VAS (TL: 52.7 plus or minus 30mm; IL: 59 plus or minus 33.8mm). After 6 months, the least squares mean of CFH VAS in IL was -38.1 (-47.3 to -28.9) compared to TL 1.9 (-12.2 to 15.9). However, flushing VAS did not improve. Any rhinological measure nor quality of life test showed significant changes. One patient presented controlled epistaxis intraoperatively during IL. CONCLUSIONS: This preliminary study shows the sphenopalatine blockade injection as a safe procedure. Patients with CFH or flushing had significant improvement after lidocaine injection which lasted 6 months. Due to the small sample and the lack of objective measures more studies are needed.

Wild birds as sentinels for multiple zoonotic pathogens along an urban to rural gradient in greater Chicago, Illinois.

Wild birds are important in the maintenance and transmission of many zoonotic pathogens. With increasing urbanization and the resulting emergence of zoonotic diseases, it is critical to understand the relationships among birds, vectors, zoonotic pathogens, and the urban landscape. Here, we use wild birds as sentinels across a gradient of urbanization to understand the relative risk of diseases caused by three types of zoonotic pathogens: Salmonella pathogens, mosquito-borne West Nile virus (WNV) and tick-borne pathogens, including the agents of Lyme disease and human anaplasmosis. Wild birds were captured using mist nets at five sites throughout greater Chicago, Illinois, and blood, faecal and ectoparasite samples were collected for diagnostic testing. A total of 289 birds were captured across all sites. A total of 2.8% of birds harboured Ixodes scapularis--the blacklegged tick--of which 54.5% were infected with the agent of Lyme disease, and none were infected with the agent of human anaplasmosis. All infested birds were from a single site that was relatively less urban. A single bird, captured at the only field site in which supplemental bird feeding was practised within the mist netting zone, was infected with Salmonella enterica subspecies enterica. While no birds harboured WNV in their blood, 3.5% of birds were seropositive, and birds from more urban sites had higher exposure to the virus than those from less urban sites. Our results demonstrate the presence of multiple bird-borne zoonotic pathogens across a gradient of urbanization and provide an assessment of potential public health risks to the high-density human populations within the area.

Religion as a determinant of marital fertility.

PIP: Hypotheses are developed about the effects of husbands' and wives' religious affiliations upon fertility. The hypotheses are based upon the following ideas. First, different religions have different norms about fertility and the tradeoffs between the quality and quantity of children. Differences in religious beliefs between spouses may therefore lead to disagreement and conflict over fertility decisions and any possible resolution through bargaining. Second, a low level of religious compatibility between spouses may increase the probability of marital dissolution, decreasing the optimal amount of investments in spouse-specific human capital. Analyses of data from the 1987-88 National Survey of Families and Households conducted in the US suggest that both of these effects are important factors in explaining the observed linkages between the religious composition of marital unions and their fertility behavior.^ieng

The determinants of marital stability: a comparative analysis of first and higher-order marriages.

"This study examines similarities and differences in the determinants of stability for first marriages and remarriages. Focusing primarily on the role of investments in marriage-specific human capital, the paper develops several hypotheses about the effects of children from the current marriage, children from previous unions, and home-production skills. The empirical results, based on white and black respondents from the 1982 [U.S.] National Survey of Family Growth, are generally consistent with the hypotheses and underscore the importance of marriage-specific human capital as a determinant of union stability."

Religion as a determinant of marital stability.

Using data from the 1987-1988 National Survey of Families and Households, this paper studies the role of the religious composition of unions as a determinant of marital stability. With the exceptions of Mormons and individuals with no religious identification, stability is found to be remarkably similar across the various types of homogamous unions. Consistent with the notion that religion is a complementary marital trait, interfaith unions have generally higher rates of dissolution than intrafaith unions. The destabilizing effect of out-marriage varies inversely with the similarity in beliefs and practices of the two religions as well as with the mutual tolerance embodied in their respective doctrines. The results also suggest that religious compatibility between spouses at the time of marriage has a large influence on marital stability, rivaling in magnitude that of age at marriage and, at least for Protestants and Catholics, dominating any adverse effects of differences in religious background.

The effect of education on the practice of nursing.

This study examines the influence of investments in education on the nature of activities performed on the job. Specifically, attention is focused on whether registered nurses (RNs) with a baccalaureate degree differ from graduates of other programs entailing less schooling in the frequency with which they perform various nursing functions. Results of an ordered probit model using data from the 1986 Biennial Survey of Illinois RNs show that baccalaureate nurses perform high skill functions more often, indicating that education does influence the nature of work activities. Combined with the finding in previous studies that baccalaureate nurses earn significantly higher wages, these results suggest that the labor market differentiates among nurses by education, raising questions about the need to change current licensure laws on informational grounds.

On marriage-specific human capital: its role as a determinant of remarriage.

"This paper focuses on the determinants of the likelihood and timing of remarriage for women: which characteristics of women and their first unions are conducive to quick remarriage and which are associated with low remarriage probabilities?... By analyzing the role of transferable marriage-specific capital as an asset, the present paper suggests a reinterpretation of past results and shows that such human capital constitutes an important component of women's gains from remarriage....[It] studies the determinants of remarriage separately for white and black women. The effects of the duration of first union and the presence of children from that union on remarriage probabilities are found to differ by race, results which can be interpreted within the context of the model developed here." Data from the 1982 U.S. National Survey of Family Growth are used to test the model.

Female labor force behavior and fertility in the United States.

PIP: This article critically reviews the literature on fertility and female labor force behavior in the US, with particular emphasis on recent quantitative research by economists, demographers, and sociologists. It examines the empirical evidence regarding the influence on fertility and female employment of certain key variables, i.e., the value of female time, husband's income, and relative economic status; addresses the issue of whether there is direct causality between fertility and female labor supply; reviews simultaneous equations models and a new approach to the study of causality; discusses decisionmaking models; considers factors that may mediate the fertility-labor nexus, including child care arrangements, husband's income, wife's education, and the convenience of employment; and concludes with consideration of changes over time in the association between fertility and female employment. Economic theory suggests that an increase in the opportunity cost of children should be associated with a decrease in family size. For the US, the fact that the mother's education and other measures of the value of female time have a negative impact on fertility has been interpreted in this was and confirmed with many bodies of data. Most studies find also that indicators of the value of female time affect employment positively. Coefficients associated with measures of husband's income on female employment. In sum, the evidence suggests that at least part of the negative relationship between fertility and female employment may be traced to the fact that that these variables are influenced in opposite directions by changes in the value of female time and relative economic status. Whether changes in husband's income contribute to the negative association is less clear at this time. In 1950, the labor force participation rate for married women with children under 6 years of age was 11.9%; it was 28.3% for those with children 6-17 years of age. By 1960, the figures had risen respectively to 18.6% and 39.0% and by 1983 to 49.9% and 63.8%. The traditional pattern of post-school work, interruption of employment; and possibly a subsequent return to the labor force has been eroding, with women remaining more closely attached to the labor force during the childrearing years. If, as is likely, this trend continues, one may expect a move toward convergence in the male and female occupational distributions and a narrowing in the wage differential between the sexes. The implications that women's increased commitment to market activities may have in terms of income distribution among families and the quantity and quality of time spent on child care are less clear at the present time and require close attention. As Ryder (1980) documents, changes in the timing of births have come to be the primary driving force behind movements of period fertility in the US.^ieng

Child care arrangements and fertility: an analysis of two-earner households.

The determinants of child care arrangements and relations between child care and fertility are examined using data on two-earner households from the 1976 National Survey of Family Growth. We find that the probability of relying on market arrangements is higher among families in which the husband's income, the wife's wage, and the level of the wife's labor supply are high; these households are likely to benefit the most from subsidies to the market forms of care that are small relative to the total cost of care (e.g. the present system of tax credits). In addition, parental education, family size, child's age, race, religion, and place of residence have important influences on the choice of child care mode. When other factors are held constant, reliance on a relative for child care is positively associated with intentions to have further children among couples with infants and preschoolers.

Log-linear probability models: an application to the analysis of timing of first birth.

PIP: Using data (the initial sample was 5533 women aged 14 to 24) from the National Longitudinal Surveys conducted by Ohio State University's Center for Human Resource Research, and the log linear probability technic, the impact of family background variables and personal characteristics on the timing of 1st birth are examined. These factors are expected to affect age at entry into motherhood directly, and indirectly, through education. A variable which increases the education attainment of either father or mother will indirectly delay childbearing. The study attempts to disentangle direct and indirect influences, and determine whether some effects may be nonlinear. Regarding other variables: 1) maternal employment only slightly increases the likelihood of an early 1st birth; 2) a broken home is associated with more than a 100% increase in the probability of an early birth; and 3) planning to be employed at 35 is associated with a higher likelihood of bearing the 1st child at an early age, confirming the human capital theory that the optimal amount of investment in human capital is a positive function of how long one plans to use it. Total effects of race on both age at transition to motherhood and school are great, being almost double for nonwhites for probabilities of an early 1st birth; the probability of having dropped out of school by the date of the 1st birth is 0.3185 for nonwhites, but only 0.2260 for whites. In conclusion, parental education, race, and whether the young woman grew up in an intact family are significant variables. Number of siblings and plans for age 35 have opposite direct and indirect influences. Nonlinearities in the impact of some explanatory variables on age at 1st birth and education are shown. This study illustrates the potential usefulness of log linear probability models, and may provide a framework for the statistical analysis of a wide range of economic issues.^ieng

Myocarditis and acute infantile hemiparesis. Case report.

A 13-month-old infant developed acute hemiparesis in the course of myocarditis. Cranial CT suggested occlusion of the right middle cerebral artery, and it is believed that an embolus arising from a mural thrombus is the most likely cause of the cerebral vascular accident. Anticoagulant therapy should be considered in myocarditis when myocardial ischemic damage or an intracavitary thrombus are suspected.

The impact of child mortality on spacing by parity: a Cox-regression analysis.

Child mortality may affect spacing through biological and behavioral channels. The death of a child may elicit a desire to have another one soon; further, it may interrupt breastfeeding and shorten the sterile period following childbirth. The hypothesis that the child mortality-spacing linkage varies across parities, being strongest in the middle parities, is examined using microdata from Malaysia and the Cox-regression technique. The empirical results lend support to the hypothesis.

Segmental study of the terminal coronary vessels in coarctation of the aorta: a natural model for study of the effect of coronary hypertension on human coronary circulation.

An electron microscopic study of the coronary terminal circulation (starting with the small coronary arteries) was carried out on small pieces of myocardium operatively resected from the left ventricle on 11 patients with coarctation of the aorta. The patients were 4 to 20 years of age. Structural modifications were found in the small coronary arteries and arterioles. Two patterns of morphologic alterations were noted in these small resistance vessels. In the first pattern, seen in most of the children, the components of the arterial wall were still distinguishable, and well represented portions of smooth muscle layers were visualized together with muscle cells showing signs of degeneration and more or less widespread collagenous islets. The second pattern, seen in young adults, was characterized by a total collagenous transformation of the arterial wall. In contrast, the smaller microvessels (precapillary sphincter, metarterioles and capillaries) appeared free of pathologic change. It is postulated that the precapillary sphincters play a special protecting and regulating role in the coronary microcirculation in such cases with elevated coronary pressure. It is suggested that surgery should be performed at an early age to prevent further development of structural changes in the microvessels. The microcirculatory damage may contribute to the increased surgical mortality in patients with coarctation of the aorta operated on at a later age. These findings should trigger further research on the small coronary vessels in systemic hypertension.

An econometric analysis of the fertility and labor supply of unmarried women.

PIP: This article emphasizes the importance of dividing the life cycle into various stages for the analysis of female labor supply and fertility. It confirms the need for a multiperiod model for the case of unmarried women as well. The relationship between fertility and female employment varies across the life cycle stages; the pattern for postmarried women is similar to that of married women, but a completely different picture emerges for single women. It is also found that the impact of some exogenous variables on the labor supply of postmarried mothers changes over the life cycle, in the same direction as for married mothers. For the group of widowed, divorced, and separated women, the impact of female education on labor supply is much larger in the interval between marriage and 1st birth than in the subsequent stages. Also, although the former husband's income has no influence on the woman's market activity prior to the birth of the 1st child, it has a marked negative effect in the child rearing period. In the post child rearing stage, a variable that controls for other income sources, including alimony and child support, exerts a strong negative influence on female employment. Some differences in the fertility and labor supply behavior of married and unmarried women include: 1) the absence of husbands and their incomes in the case of unmarried women implies that such women face a relatively strong economic pressure to enter the labor market so that greater participation rates in the child rearing and post-child rearing stages occur; 2) whereas unmarried mothers are typically the sole earners in their households, they often qualify to receive other income such as welfare payments; 3) the labor supply of unmarried mothers is significantly affected by regional variations in the level of benefits; and 4) the family size of unmarried mothers is insensitive to being Catholic and having education.^ieng