False Sense Of Security Research Articles

Incidence and predictors of acute coronary syndrome within a year following a negative stress test-a false sense of security: is routine screening any useful?

One of the major issues in management of the acute coronary syndrome (ACS) is classification of patients with atypical presentation who have low risk of having a coronary episode at presentation. There have been multiple studies on the stratification of high risk patients and medical management of such cases, however, there is a sub-class of patients who do not fit any category. In this paper, we have looked at the current literature on stratification of patients based on the study tools available and the risk of having a coronary episode during the following year. In our overview, we have found that the current methods in place namely, cardiac stress test and stress echocardiogram have a good prognostic factor in terms of mortality in the next one year and can safely stratify the patients at low risk when correlated with clinical presentation and laboratory studies. However, such data are limited for computerized tomography or magnetic resonant imaging and their application might be limited due to accessibility and cost of studies. Current guidelines for classification of high risk patient do an excellent job and we believe that proper application of stress tests together with other imaging modalities together with laboratory, clinical judgment, and proper use of medical management can help with safe discharge of patients from the emergency department (ED) and reduction of burden from healthcare.

Isolated Gastric Rupture due to Blunt Trauma: An Interesting Case

Isolated gastric rupture due to blunt trauma is anextremely rare entity in traumatology where the diagnosis can be extremely uncertain. Patients may be lulled into a false sense of security and present late which can be detrimental. Expedient treatment is lifesaving in this condition which can associated with high morbidity and mortality. We wish to present an interesting case of isolated gastric rupture in an adolescent.

Trading Yahweh's Word for a Price: Ethical Implications of the Collusion of Prophets and Priests in Micah 3:5-7, 11

Trading Yahweh’s word for a price is an attempt to articulate the implications of the mercenary attitude of prophets and priests in the book of Micah, in discharging their duties as religious functionaries. The article examines Micah’s indictment of charismatic and cultic Judean’s self-centered leadership for commercialising Yahweh’s word. This exploration is done against the background of the functions and responsibility of prophets and priests in the HB/OT. Prophets and priests both functioned in the religion of Ancient Israel and Judah as channels for the transmission of Yahweh’s word to their people and nation. However, Micah presents a charismatic and cultic Judean leadership that was bereft of ethical standard of responsibility, reliability, constancy and integrity. Rather than embodying ethical character that could inspire confidence and commitment, they traded Yahweh’s word for symbols of wealth and power and thus became stumbling blocks to genuine orthodoxy. Such attempt to lower the standard of God’s demand on people so as to gratify self in a religious function that is designed to embody integrity, honesty, reliability and accountability constitute not only affront on Yahweh but abuse of privilege and position, amount to religious deception and economic idolatry and create a false sense of security. https://doi.org/10.17159/2312-3621/2018/v31n3a13

Hepatitis in Developing Countries: Still a Scourge.

Screening is defined as the application of a diagnostic test to an asymptomatic population in order to detect a disease at a stage when intervention may improve its outcome and natural history.1 In simpler terms, screening is a strategy that is used in a population to identify the likely presence of an as-yet-undiagnosed sickness in individuals without its signs or symptoms. By itself, screening tests are somewhat unusual in that they are performed on people who are apparently in good health. However, screening interventions are intended for early identification of disease in a population, that may enable earlier intervention and treatment. The idea is to reduce mortality and suffering from a disease through early detection and management. Whereas screening may lead to an earlier diagnosis, the testing may not necessarily prove beneficial to person being screened. Apart from the issues of over- and mis-diagnosis, and inappropriate use or overuse, screening may create a false sense of security. Though screening strategies are never designed to be diagnostic, how to deal with false positive and false negative results remains an issue. JMS 2017;20(2):55-56

GATA2 in Bone Marrow Failure

The syndrome now known as GATA2 haploinsufficiency had been published at least since the 1970s under different clinical guises. With the identification of the gene in 2011, GATA2 deficiency became the overarching diagnosis for a complex syndrome with acoustic, cutaneous, lymphatic, pulmonary, leukemic, hematologic and infectious manifestations. Arising in both spontaneous and autosomal dominant patterns, the genetics made it recognizable and diagnosable even before symptoms arose. Over the last several years it has become clear that GATA2 is a major contributor to: pediatric and adolescent MDS, AML in younger adults, some cases of ALL, severe genital HPV infection, disseminated mycobacterial infections, pulmonary alveolar proteinosis, pulmonary hypertension and is associated with a variety of solid tumors. Mutations with more profound effects on GATA2 expression (nonsense and deletions) appear to have a more severe phenotype than do intronic mutations that alter transcript level but not transcript integrity. These latter intronic mutations may be associated with later onset of disease and more variable penetrance. Elucidating the gene targets on which GATA2 works and which partners it engages will lead to important observations in the molecular genetics of hematopoietic control.This variability of penetrance and expression is most apparent with the intronic mutations, in which whole generations may be relatively protected, presumably from genes in trans to GATA2 . An active search is on for these genes that appear to regulate GATA2 . One of the consequences of the variable penetrance of GATA2 deficiency is that it may be discordant within a family, allowing a false sense of security about use of a clinically well relative for bone marrow transplant donation. Hematopoietic stem cell transplantation is highly effective for cure of GATA2 deficiency. We have now done almost 40 transplants in GATA2 deficiency with high survival rates using related haploidentical donors, as well as with fully matched donors. The effects of transplantation are profound both in terms of hematopoietic and somatic results, including resolution of most HPV lesions, resolution of pulmonary alveolar proteinosis and resolution of pulmonary hypertension, when present. We have now encountered several cases of transplant from unexpectedly affected donors into a known GATA2, all of which have had poor outcomes. These cases reinforce the critical need for molecular confirmation of the GATA2 status of any related donor, regardless of lack of symptoms.GATA2 deficiency is recently recognized but successful treatments have emerged alongside the science. Efforts to understand and allow for manipulation of GATA2 expression are underway. DisclosuresNo relevant conflicts of interest to declare.

False sense of security

The US Department of Homeland Security (DHS) was planning procedural changes that would grab media data for millions of immigrants. From this week, its Alien Files database will collate social media handles, aliases, associated identifiable information, and search results. The DHS insists this is not a policy change, as it has already used publicly-available media to protect the homeland. As with all mass surveillance schemes, the idea that watching many people will allow computers to magically identify the bad guys and prevent a terrorist attack is flawed.

Cheating in a dental practical exam

There is increasing attention given to academic integrity across university education and dental schools are not immune to this problem (Andrews et al. J Dent Educ 71; 1027–1039, 2007; Ford & Hughes Eur J Dent Educ 16(1):e180–e186, 2012). While there has been an increasing concern about academic dishonesty in written exams and assignments, there appears to be a false sense of security in the integrity of practical assessments, involving dental procedures on simulated patients.This paper will present a situational analysis of two unusual cases of academic dishonesty in preclinical dental practical assessments. The first case involved a student bringing a previously prepared plastic tooth into the examination room and substituting it for the assessment tooth. The second case involved a student removing key teeth during the exam to enable them to have better access and advantage over others to complete the assessment task. These two cases resulted in a complete review of practical assessment procedures and the application of new processes to maintain academic integrity.

How many does it take? achievement of euploid blastocyst (BL) as the primary predictor of live birth (LB) in oocyte cryopreservation (OC)

Current data suggests that LB following transfer of a euploid embryo (EE) is independent of age or type of ART treatment. At our center, OC is routinely performed and trophectoderm biopsy-preimplantation genetic screening (TEBX-PGS) is now being used in conjunction with autologous OC thaw (AOCT) cycles. From our novel data, we estimated the no. of MII oocytes required to achieve LB at different ages. Retrospective study and theoretical model. Data from 152 patients (202 retrievals, 167 thaws) who underwent AOCT with intended TEBX-PGS aged 25-40y were reviewed. To calculate the no. of MII oocytes needed to achieve one EE the following data were assessed: total no. of MII oocytes that survived, 2-pronuclear (2PN) fertilization, development to BL, BL achieving quality for TEBX, and BL ploidy status after TEBX-PGS. The no. of MII oocytes needed to achieve one EE was calculated as no. MII thawed/EE. Because combining these technologies is relatively new, many pregnancies are currently ongoing (ONG). Thus “LB” included >1st trimester ONG pregnancies and babies born (BB), with the LB rate calculated as total no. ONG+BB/EE transferred. The theoretical no. of MII oocytes needed for one LB was then calculated as no. thawed MII needed to achieve one EE/LB rate per EE. See Table. Of the 1,839 MII oocytes that survived, 2PN fertilization rate was 75% and of those, 50% formed BL. 83% of BL were suitable for TEBX. The no. of MII oocytes needed to achieve one EE was 8, 12, and 13 for age groups of 25-34y, 35-37y, and 38-40y; LB rate per EE was 59.8% across all ages. Thus, the no. of MII calculated to achieve one LB was 13, 19, and 22 in the age groups, respectively. EE have a relatively uniform efficiency and therefore, achievement of an EE after OC, thaw, and fertilization can help to estimate the theoretical no. of cryopreserved MII oocytes required to achieve a LB. One criticism of OC is that it provides women with a false sense of security; because of varying cycle outcomes, OC cannot guarantee future birth. Our findings serve as a counseling tool by providing women with realistic expectations of OC outcomes at our center.Tabled 1Oocyte development and ploidy status following AOCT+TEBX-PGS by ageAge (y)25-34 (mean 30.7; n=23)35-37 (mean 36.5; n=61)38-40 (mean 38.9; n=118)Total (mean 37.2; n=202)Oocytes retrieved574104516013220MII thawed38569810882171MII survived32955895218392PN fertilized2554246931372BL124215353692BL biopsied110186279575Euploid486084192Aneuploid59122193374No. MII to achieve euploid8.02 (385/48)11.6 (698/60)13.0 (1088/84)No. MII to achieve LB13.4 (8.02/0.598)19.4 (11.6/0.598)21.7 (13.0/0.598)EE LB rate: 59.8% (52/87) Open table in a new tab

Attitudes towards Social Oocyte Freezing from a Socio-cultural Perspective.

The tendency to delay parenthood is increasing. It is partly driven by the availability of early reproductive technologies such as social oocyte freezing, the cryopreservation of oocytes for non-medical purposes. The goal of this study was to investigate relationships between attitudes towards social oocyte freezing and different socio-cultural backgrounds in a German sample cohort. A quantitative online questionnaire was compiled. A total of 643 participants completed the questionnaire which included items on attitudes toward social oocyte freezing, socio-demographics and items, obtained from the German DELTA Institute for Social and Ecological Research, devised to indicate specific milieus. Data were analyzed using parametric and non-parametric methods. There were clear correlations between attitudes towards social oocyte freezing and socio-cultural background, gender, cohort age, fertility problems, and attitudes to fertility. Positive attitudes towards social oocyte freezing were linked to struggles with fertility, a current or general wish to have a child, and flexible, progressive and self-oriented values. Participants who preferred to become parents at a younger age tended to reject cryopreservation. The huge number of university graduates, persons with fertility problems, and persons from specific socio-cultural backgrounds in our sample point to distinct groups interested in reproductive technologies such as social oocyte freezing. The investigated differences as a function of socio-cultural background suggest that more research into the desire to have children in German society is needed. In conclusion, it may be necessary to develop targeted family planning interventions to prevent affected women from buying into a false sense of security, thereby risking unwanted childlessness.

Outdoor spatial spraying against dengue: A false sense of security among inhabitants of Hermosillo, Mexico.

BackgroundGovernment-administered adulticiding is frequently conducted in response to dengue transmission worldwide. Anecdotal evidence suggests that spraying may create a “false sense of security” for residents. Our objective was to determine if there was an association between residents’ reporting outdoor spatial insecticide spraying as way to prevent dengue transmission and both their reported frequency of dengue prevention practices and household entomological indices in Hermosillo, Mexico.Methodology/Principal findingsA non-probabilistic survey of 400 households was conducted in August 2014. An oral questionnaire was administered to an adult resident and the outer premises of the home were inspected for water-holding containers and presence of Ae. aegypti larvae and pupae. Self-reported frequency of prevention practices were assessed among residents who reported outdoor spatial spraying as a strategy to prevent dengue (n = 93) and those who did not (n = 307). Mixed effects negative binomial regression was used to assess associations between resident’s reporting spraying as a means to prevent dengue and container indices. Mixed effects logistic regression was used to determine associations with presence/absence of larvae and pupae. Those reporting spatial spraying disposed of trash less frequently and spent less time indoors to avoid mosquitoes. They also used insecticides and larvicides more often and covered their water containers more frequently. Their backyards had more containers positive for Ae. aegypti (RR = 1.92) and there was a higher probability of finding one or more Ae. aegypti pupae (OR = 2.20). Survey respondents that reported spatial spraying prevented dengue were more likely to be older and were exposed to fewer media sources regarding prevention.Conclusions/SignificanceThe results suggest that the perception that outdoor spatial spraying prevents dengue is associated with lower adoption of prevention practices and higher entomological risk. This provides some support to the hypothesis that spraying may lead to a “false sense of security”. Further investigations to clarify this relationship should be conducted. Government campaigns should emphasize the difficulty in controlling Ae. aegypti mosquitoes and the need for both government and community action to minimize risk of dengue transmission.

Voluntary agreements between competitors: trick or truth?

Voluntary agreements in which competitors commit to common goals are important tools for corporate social responsibility. After entering into a commitment, however, competitors often have incentives to behave opportunistically. This is possible because voluntary agreements are not enforced by external sanctions. We present the results of an exploratory laboratory experiment that investigates the behavior of competitors engaging in commitments and consequently the effectiveness of such measures. We find that introducing a publicly visible commitment device that is implemented with a low probability mitigated conflict between competitors substantially. Our results show that subjects’ inclination to defect one another after competition was mainly driven by the opponents’ refusal to enter into a commitment. In our experiment, a commitment was not used to trick the competitor into a false sense of security but rather to convey the truth about subjects’ moral behavior. We conclude that the efforts of (non-)governmental institutions to reinforce trust between competitors may be of substantial value.

“Lady, Shall I Lie in Your Lap?”: Gender, Status, and Touch on the English Stage

“Lady, Shall I Lie in Your Lap?”: Gender, Status, and Touch on the English Stage

Security of the Civilian Population from the Consequences of Aerial Warfare in the Light of the Hague Rules of Aerial Warfare of 1923

The WWI had introduced a variety of unknown means and method of warfare. Among them, one type of warfare played especially significant part during Great War hostilities – the rise of the air power. From the technical newbie, which was introduced by the Wright Brothers in 1909 the capabilities of aircraft rapidly increase during the first years of war and after the conflict. However, despite the obvious technical development, the new type of warfare is responsible for spreading the fear and terror among civilian population. The first aerial bombings of London and other towns in the United Kingdom had devastating impact on morale of the non-combatants and caused extensive damage to their properties and infrastructure. The applicable international humanitarian law was outrun by this situation. The Fourth Hague Convention from 1907 was accepted before aircraft`s first combat deployment and lacked any specific provisions in this aspect. No other specific rules concerning the conduct of aerial warfare was adopted before the year 1914. When the gun finally silenced it was natural that international community was demanding an increase own security from the negative consequences of new developed types of warfare. Nevertheless, the main agenda concentrate over the problem of chemical weaponry and unrestricted submarine warfare, while the supreme powers of the mid- war world decide to regulate the conduct of modern combat during the Washington Disarmament Conference in 1922-1923. Quickly the conference became a playground for the state members, which focus on the post-war order rather than the solving the main issues of the international humanitarian law. However, the members of the conference had established an mixed commission of jurist and military officers who had been authorized to prepare a draft of aerial warfare code. The document was finally finished in 1923, and its know as Hague Rules of Aerial Warfare (HRAW), containing 60 articles concerning the use of the air power during the armed conflict. The proposed provisions outruns its times, introducing the 'prototypes' principles of military objective and proportionality, which later became an basic rules of contemporary law of armed conflict. As a way of protecting civilian population in urban areas, the draft proposed an restricted rules of engaging combatants in populated zones. Unfortunately, the HRAW has never been adopted as a treaty law. The futuristic approach to the issues of noncombatants security from the implications of unrestricted aerial bombings, as proposed by the mixed commission in 1923, have been ignored by the public opinion, which seemed to forget the fear and terror when the aerial actions against inhabited areas have been conducted by the fighting sides during the WWI. It is important to observe that the mid-war societies generally had been lulled into the false sense of security, considering that the eventual advantages of aircraft capabilities would overturn any possible threats of unregulated aerial warfare. Above explains why the states were unlike to accept any provisions which could constrain the future development of aviation. Nevertheless, the HRAW has significant role in shaping the future conventions and treaties, being considered a part of customary international law. The point of the paper is to examine the core of draft from 1923 and examine how the HRAW protected the civilian population from the consequences of the unlimited aerial warfare and how the 'security of noncombatants' principle and 'military way of thinking' have been balanced by this document.

Aware, motivated and striving for a ‘safe tan’: an exploratory mixed-method study of sun-protection during holidays

ABSTRACTBackground: This article presents an exploratory study, aiming to explore the correspondence between knowledge, motivation and sun-protection practices during holidays.Methods: Seventeen participants aged 21–62 years old, recruited from community settings took part in individual face-to-face semi-structured interviews, completed sun sensitivity questions and an objective assessment of sunscreen use. Holidaymakers’ knowledge about sun-safe messages, intentions and perceptions of barriers and facilitators for sun-protection were assessed. Qualitative data were analysed using thematic analysis and integrated with quantitative data, using a pragmatic theory-informed approach to synthesise the findings.Results: Participants were well informed about sun-safe messages, highly motivated to protect themselves from solar UV radiation (UVR) and they perceived themselves as well protected. However, they did not seem to use effective protective practices. Sunscreen was the preferred method of sun-protection, but most participants used considerably less than the recommended amount and significantly overestimated the amount of time they could be safely exposed. Seeking shade was the least used method of sun-protection and covering-up strategies were mostly implemented as a partial protection (i.e. hats or sunglasses). The desire to reach an optimal balance between getting a tan and using sun-protection to avoid sunburns was preeminent. Several additional barriers and facilitators for sun-protection were identified.Conclusions: Holidaymakers might have a false sense of security when it comes to sun-exposure. They are aware of the need to protect from solar UVR, but the motive for a safe tan, the overreliance on sunscreen, the overestimation of the safe sun-exposure time for their skin type and the insufficient application of sunscreen leaves holidaymakers motivated to protect their skin at significant risk of overexposure, sunburn and skin cancer. Public health messages need to address how to implement effective sun-safe strategies.

Severe Tardive Dystonia on Low Dose Short Duration Exposure to Atypical Antipsychotics: Factors Explored

Tardive dystonia (TD) is a serious side effect of antipsychotic medications, more with typical antipsychotics, that is potentially irreversible in affected patients. Studies show that newer atypical antipsychotics have a lower risk of TD. As a result, many clinicians may have developed a false sense of security when prescribing these medications. We report a case of 20-year-old male with hyperthymic temperament and borderline intellectual functioning, who developed severe TD after low dose short duration exposure to atypical antipsychotic risperidone and then olanzapine. The goal of this paper is to alert the reader to be judicious and cautious before using casual low dose second generation antipsychotics in patient with no core psychotic features, hyperthymic temperament, or borderline intellectual functioning suggestive of organic brain damage, who are more prone to develop adverse effects such as TD and monitor the onset of TD in patients taking atypical antipsychotics.

Hoarseness of voice after supraclavicular ultrasound-guided subclavian perivascular brachial plexus block

Supraclavicular brachial plexus nerve block is ideal for surgical procedures at or distal to the elbow. Ultrasound (USG) continues to grow in popularity as a method of nerve localization, and for the supraclavicular block, it has the advantage of allowing real-time visualization of the plexus, pleura, and vessels along with the needle and local anesthetic spread, but it may conversely create a false sense of security. The incidence of the recurrent laryngeal nerve (RLN) block occurring with supraclavicular approach is 1.3% of patients. [10] Incidence of RLN block with USG-guided supraclavicular block is not known. In this case report, we discuss a rare complication of RLN block which occurred while performing a supraclavicular perivascular block performed under USG guidance.

Pill testing at music festivals: can we do more harm?

Pill testing at music festivals: can we do more harm?

Betere zorg voor kinderen met koorts op de huisartsenpost

Kool M, Elshout G, Bohnen AM, Koes BW, Berger MY. Better care for febrile children seen at out-of-hours services. Huisarts Wet 2016;59(11):474-7. Parents contact out-of-hours services relatively often because their child has a temperature and mention one or more alarm symptoms. The vast majority of these children have a non-serious infection and do not require further treatment. Children that appear to be seriously ill should be referred to secondary care. The Dutch Association of General Practitioners’ guideline ‘Children with fever’ recommends that children with only one alarm symptom be referred, but the majority of these referrals turn out to be a false alarm. General practitioners are relatively conservative in their referrals and score better in this respect than diagnostic algorithms, so it seems that they are guided by more than the alarm symptoms alone. It is more complex if GPs are uncertain about the seriousness of the illness. They often prescribe an antibiotic to reassure themselves and the parents, but this should be avoided because it gives a false sense of security. It would be better to clearly tell the parents when and where they should contact the service again. If the medical record is complete and unambiguous, the course of the disorder can be reviewed in the follow-up consultation, even if this occurs with a different GP.

Spontaneous heterotopic triplet pregnancy

Abstract Introduction Heterotopic pregnancy is a rare condition characterized by the occurrence of two or more simultaneous pregnancies in two or more implantation sites. Aim To report a case of spontaneous ectopic pregnancy co-existing with twin living intra-uterine pregnancies of 10 weeks gestation. Case study A 29-years-old woman 10-weeks pregnant presented to the emergency department with acute abdomen. Transvaginal ultrasound revealed di-amniotic intrauterine living twins and right adnexal mass inseparable from the ovary. Laparoscopy revealed intact right tubal pregnancy managed by salpingostomy. Results and discussion Diagnosis of heterotopic ectopic is difficult as we cannot depend on β-subunit of human chorionic gonadotropin level because of the presence of a co-existent intrauterine pregnancy which affects the hormonal level and the false sense of security that may be present on visualizing an intrauterine pregnancy by ultrasonography (USG), therefore, it is important to visualize the adnexa even in the presence of an intrauterine pregnancy to avoid missing a possible co-existent ectopic pregnancy. Surgery is the gold standard treatment. Other treatment modalities as laparoscopic or transvaginal USG guided injection of hyperosmolar glucose or potassium chloride have less success rates. Conclusions It is important to scan the adnexa even in the presence of an intrauterine pregnancy to avoid missing a possible co-existent ectopic pregnancy. Surgery is the gold standard treatment, however, other modalities were described with less success.

Legends in Science: from Boom to Bust

In biology and medicine, a scientist’s legend is most commonly determined by their sphere of influence, either on surrounding peers, on clients in the case of medical practitioners, or on the wider scientific public in the case of research scientists. A scientific paper still constitutes the most effective portal through which ideas, knowledge and opinions can be shared among academics and scholars. Thus, legends in science are built upon a scientist’s published literature. Legend was always assumed to be safe in its final form, i.e., a published paper. Yet, a powerful movement of post-publication peer review has begun to identify that not all has been well with the vetting process that led to the publication of a tranche of the scientific literature, and that editorial oversight and weakness has prevailed in a number of cases, leading to retractions and a more critical re-assessment of the literature. One could say that the half-life of a scientific paper has only just begun once it is published. Within this context of science publishing that has given a sense of false security, legends may evolve from boom to bust within the space of weeks or even months. The legendary status of a scientist is therefore no longer safe if there are hidden or undiscovered errors, fraud or misconduct.