Copyright of Canadian Journal of Ophthalmology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Other Chemicals and Drugs, Other Psychology, Religion Law, Religious Thought, Theology and Philosophy of Religion, Social and Cultural Anthropology, and Tourism

Ashland, Oregon is a smart little community nestled in the foothills of the Siskiyou Mountains about 20 minutes north of the California border. Home to Southern Oregon University and host to the yearly Shakespeare Festival, Ashland is one of those places both progressive and picturesque that often occupies a top spot on waiting-room magazines' “Best Small Towns” or “Best Places to Retire” lists. It's got a walkable business district with cozy fine-dining bistros, new-age book shops and old-school hotels. It's got the requisite breathtaking views—Oregon's famed firs snake up and down steep, mist-laden hills to the east and west. It's got equal parts West-Coast hippie charm and urbane artiness, but it still retains the ruddy feel of the Northwest wilderness.Less well-known is the fact that Ashland is home to the Church of the Holy Light of the Queen, the unofficial base in the United States for a growing alternative religion called Santo Daime. With origins in the Brazilian Amazon, Santo Daime would attract little attention if not for one fact: worshipers drink ayahuasca, an imported jungle brew that contains dimethyltryptamine, or DMT, a highly potent hallucinogen.DMT can cause intense dissociation—the feeling that you've left your body—and everything from excruciating horror to intense euphoria. It's often associated with the near-death experience; some scientists postulate that the human brain contains otherwise dormant amounts of the psychedelic compound, and it releases that cache when your mind thinks it's done for. Ayahuasca contains DMT and is used widely by various shamans and tribes in the Amazon, where it's known as yage, hoasca, or La Purga (“the purge”). Santo Daime's followers, the Daimestas, refer to ayahuasca as Daime Tea, and they drink it as their one and only sacrament. The DMT-packed tea is the cornerstone of their religion and all church functions. DMT is also listed by the U.S. DEA as a Schedule-I substance, the department's strictest classification.Ashland’s Church of the Holy Light of the Queen was founded by Padrinho (“Godfather” in Portuguese) Jonathan Goldman, an ebullient yet laid-back former Boston acupuncturist with a working-class, midwestern Jewish upbringing and a lifelong intuition for battling the status quo. Goldman, his family and his church have been under fire from the DEA since the church formed and started hosting underground Santo Daime rituals in Ashland in 1993. Police stormed Goldman's house in a 1999 raid, and they arrested him and effectively shut down the church. He responded by filing a lawsuit against the federal government, seeking a religious freedom exemption from the Controlled Substances Act.Nine years later, Ashland's Daimestas prevailed in an Oregon district court, and they've been drinking Daime Tea with impunity since March 2009.Daime Tea is an entheogen—a substance meant purely for spiritual and psychotherapeutic purposes. The Daimestas say it's something everyone should be allowed to have. They believe it grants direct access to the divine and can lead to life-changing insights and sustained happiness.I wondered, is there any real spiritual healing going on here, or are the Daimestas just futzing around with an acute psychedelic for kicks? Just who are these people anyway, and do they believe there's a real connection between God and drugs?After learning of these strange folks, I had to take a trip to Ashland to find out the answers.***The way Santo Daime's doctrine works is simple: the religion is open to anyone who shows interest. So one day last fall I wrote to Goldman and asked if I could come to Ashland and observe the church’s members doing whatever it is they do. It was weeks before I heard back. Goldman informed me that he would be open to a story, but under one condition: I had to attend a church service, which he called a “work.” And not as an observer. As a participant.He instructed me to set up an interview with someone named John Seligman, a fellow Daime expert and the chief screener of new church applicants.Seligman sent me a Goldman-penned introduction to the Daime, a blank medical waiver and a note scheduling my interview for early January. I read the airy introduction, scratched my head and called Goldman for some basic background. He said the work would involve a kind of dancing that puts participants in a trance state of “active meditation.” Add in the Daime Tea, which he called a “super-powerful, altering, natural substance,” and you've got a shortcut—a very intense, demanding shortcut—to profound spiritual vision.“What the Daime offers is a direct experience that is only reserved for mystics,” Goldman said.That sounded alright, but I wanted some objective information on the strange psychedelic brew I was about to swallow. Not surprisingly, dredging up coherent accounts about ayahuasca isn’t easy. And, as with most substances of its ilk, user experience varies wildly from person to person.Take The Yage Letters, for instance, a tortuous, fragmented tale about Burroughs' and Ginsberg's frustrating quests for the drink in South and Central America. Ginsberg wrote of a pleasant (if bizarre) first ayahuasca experience, where he peered “at a mystery” through a “big black hole of God-Nose.” His next trip, however, was all vomiting and horrifying snake hallucinations. “I was frightened,” he complained, “and simply lay there with wave after wave of death-fear rolling over me till I could hardly stand it.” And his final summation of ayahuasca doesn’t quite read like a ringing endorsement: “I am afraid of some real madness, a Changed Universe permanently changed.”By the time January came around, I had decided the short version was twofold: the Daime would be very intense and demanding yet simple and beautiful. And I might puke my guts out. So I headed north through the flatlands and into the mountains on Interstate 5. The sun shone through the thickly misty sky like an incandescent silver dollar, and I wondered if I might soon be tripping with the angels, talking to God and driving back home as a mystic.***My orientation was set for the morning of the work. It was a damp, snowy Saturday when I arrived at the church's headquarters, a nondescript, street-level office space at the end of a short commercial strip.I knocked on a door marked with a Star of David festooned with birds and circles and a glowing, double-beamed cross in the center. Seligman appeared and beckoned me in, instructing me to take off my shoes. He looked a little disheveled, sporting ragged, paint-splattered pants and a day or two of stubble on his face, with eyebrows like miniature scouring pads and a chunk of gray tufts protruding from either side of his head. Other than the strangeness of his eerie calm and a clear, steady look in his eye—qualities I later noticed were present in all the Daimestas I would meet—he struck me as a pretty benign guy.“Welcome, Alex,” he said.We shook hands and sat down on folding chairs at an altar shaped like a six-pointed star. A certain degree of anonymity is important to the Daimestas, so rather than engaging me in a lot of small talk, Seligman merely closed his eyes. We sat for a few minutes in silent meditation. Then, Seligman opened his heavy-lidded eyes and in a half-whispered tone declared the room we were sitting in a “sacred space.”In a slow, considered way, Seligman began by explaining the basics. This particular work would be an important one, a celebration of Three Kings Day, which sounded familiar to me from having grown up Catholic (although all I remembered was that it had something to do with Christmas). For this work, we’d be singing the entirety of a 128-song hymnbook in Portuguese and dancing for up to 12 hours. And every two hours, we’d be drinking another swig of Daime Tea. Once the work started, Seligman said, what I could expect and what would be expected of me would include the following: maintaining vibrational cohesiveness and harmony through music and dancing... holding the current... creating a bridge... allowing celestial energies to come down through the altar metaphorically and actually... and holding a sacred communion both private and communal with divine guides.What the hell was this man talking about?Seligman's soothing voice and nebulous syntax only amplified my anxiety. I was starting to feel pretty awkward. As his exposition on something about divine entities ground to a halt, I was thinking about weaseling out. Maybe I could fail the interview.“Having strangers come in—it doesn't distract from the energy, the current, at all?” I asked in a loud, abrupt voice.Seligman smiled calmly and watched me squirm. I wasn't getting away that easily.“There are no visitors,” he said. “Everybody's a participant.” He explained to me that all are guaranteed a protective and nurturing environment, a container to process the unpredictable and often demanding revelations brought forth by drinking Daime Tea. The container provides the proper setting, as I imagined Timothy Leary might put it, for the revelations, which may send me on a brutal ride through latent emotional traumas and truths.“Throwing up may be part of that,” Seligman said. “What we allow—this container that we create—is to process it. There's an invitation. It's not expected of you, but if it comes up, we are holding space for you to move through that. We invite you to cry. We are there to help.”Really? I was about to spend twelve hours in the divine container with a bunch of caterwauling strangers, feet sore, sobbing, puking, and high on DMT the whole time?“About the tea,” I said, trying to maintain a tone of composure. “What if it's not working out for me and I'm having a bad time of it after the first drink? Could I skip the next go-round?”“The answer is yes,” Seligman replied. “But the answer is also no.” It would all be up to the divine guides. “If you feel like you're gonna die,” he assured me, “sit back down, close your eyes and breathe.”To stall the onset of total panic, I focused on picking out and memorizing the practical rules Seligman was laying out. If I wanted to get out of the dancing line and go sit down or vomit, I should do so only between hymns. If I wanted to go outside and “take a leak or commune with a tree,” I had to let a guardian at the door know about it. I was not to cross my arms or legs at any time during the work. And I had to dress in all white. That sounded eerily cultish to me.I looked down at my unwashed, cream-colored jeans.“These alright?” I asked.Seligman scoffed and shook his head. “They're dirty. It's important that you be clean.” He grabbed a pencil and drew me a map to the local paint store, where I could get a nice, crisp, brilliantly colorless pair of painter's pants—ones pleasing to the divine guides, who might otherwise be bummed if I didn't show up looking as pure as a virgin bride on her wedding day.He handed me the map and a packet with more rules, guidelines and a massive list of drugs, medications and foods to avoid. I sat down at a desk and for the second time filled out the medical waiver, a three-page affair that I had of course forgotten to bring with me. I was not taking any antidepressants. Check. Never been hospitalized for psychological problems. Check. “Is there anything else about your physical or emotional status of which we should be made aware?” I guess not.I signed my name at the bottom of the last page, indemnifying the church from any nausea, diarrhea or “mental changes” I might suffer as a result of the work, and I promised to take full personal responsibility for “whatever may occur, anticipated or unanticipated.”And with that, my orientation was complete.“I'm very glad you came,” Seligman said. He stuck my papers into a file and sent me out the door.***Later that day, I met my sponsor, Maleko Dawnchild, at his ex-girlfriend's parents' house, where he was living temporarily. It was a comfortable, normal suburban two-story on an Ashland cul-de-sac. Dawnchild answered the door shirtless and in loose-fitting pajama pants. I had caught him in the middle of a stretching session.“This is gonna be a good work,” he said, wide-eyed and smiling.As Dawnchild limbered up on a yoga mat in the middle of the living room, he told me about how he first discovered the Daime in Hawaii—he went there after tiring of his hard-partying life as a model in Los Angeles. Then he got up and ran to the kitchen, where he slammed a kale smoothie. He sprinted upstairs to change and descended in a snappy white suit with a gold star pinned on the lapel. We were ready for the work.Dawnchild and I drove about 10 miles outside of town and navigated a winding, unpaved path through the wilderness until we finally made it to our destination. It was Goldman's hillside property, on which he had built a salão, a round, domed building where the church's works are held. It was nestled in the woods right behind Goldman's house. Men in white suits and black ties emerged from cars with women wearing tiara-like crowns and long, white dresses with green strips of fabric that formed a “y” across their chests. They looked like girl scouts. People of all ages kept arriving, hugging each other and saying hello, until the salão was almost full, with almost 60 white-clad worshipers crammed into the building. Then all of us lined up three rows deep around an altar just like the one in Seligman's office, men on one side and women on the other.Goldman arrived to begin the service with armloads of Daime Tea in big jugs. We said a couple Hail Marys and Our Fathers. Then, just as I had every week for years when I was a Catholic schoolboy, I got in line for the sacrament. Except this time, it wasn't the communion wafer and sip of wine I was waiting for. It was Daime Tea. As I watched Daimestas who were in line in front of me walk past with empty double-shot-sized glasses and scrunched-up faces, I desperately forced thoughts of Jonestown out of my mind.It was my turn.I approached the guardian, who was holding a glass at eye level and gazing at the mahogany broth inside. He offered it to me. I took the glass, closed my eyes and gulped down the tea. It was thick and boasted major overtones of chewing tobacco, licorice, Listerine and dirt.I felt a mild wave of calm—but that was it. Everyone returned to formation around the altar, and thus began the work. We opened our hymnbooks and started to sing the hinarios, hymns written by Afro-Portuguese rubber plantation worker Raimundo Irineu Serra, who founded Santo Daime in the 1930s. The songs were about God, heartbreak and happiness. Men with shakers kept the rhythm. Everyone sang, and I mumbled and stepped on my feet in the back row until I finally picked up on it, shuffling three steps to the left, pivoting, and shuffling three steps to the right. This went on for a good hour and a half, with pauses between songs during which Goldman would incant various thanksgivings (“Viva Santo Daime!”). The whole crowd would respond with a hearty “Viva!” Then it was time to drink tea again.Seligman was distributing the stuff this time, and he looked like a new man—cleaned up, freshly shaven and impressive in his crispy whites. He handed me the glass.“You startin' to feel it yet?” he asked me, winking.I nodded and downed the bitter brew. This seemed to be the effective dose, the one that really put us “in the power,” as the Daimestas say—I would just say it got us fucked up. A few people got out of the dancing line to sit down and puke into plastic bowls, while guardians stood watch and cleaned up after them. Dawnchild, my sponsor, made shooing sounds, swayed like a gymnast warming up for floor exercises and snatched invisible flies out of the air. One woman sat on the floor with a sheet over her head and began to cry, and another went outside to wail and run around in the darkness. Goldman, reminiscent of Bill Murray in one of his younger, more charismatic roles, listed from side to side and bellowed out the hymns just a bit louder than anyone else.I looked up at the streamers and tinsel that stretched from the skylight at the top of the salão to the edges of the walls, and half the ceiling began to overlap with the other. I could feel the loud resonance of the acapella hymns, and I marveled at this whole room full of people moving in unison. It was at this point that I understood the appeal of this religion: it is primal rather than modern. It follows no dogma, nor does it promote proselytizing. It's based on simplicity, rhythm and synchronicity—just add drugs and music. The tea is basically fuel to keep people focused on singing and dancing as the primary activity, but they're also allowed to remove themselves for moments of personal therapy and expression while guardians keep an eye on them to ensure their safety.I glanced at the hymnbook in my hand and noticed that we were only about a quarter of the way through it, and I had one more realization: Santo Daime requires the sort of discipline that your average recreational drug enthusiast or thrill-seeker simply wouldn't have the patience to stick with. They don't call it a “work” for nothing.***Jonathan Goldman is proud of what he's created.“I knew we would be involved in creating a legal sanction for the Daime to operate in the U.S.,” he says. “We planned it from the beginning.”It's the afternoon after the work, and Goldman is at home in a state of relaxed glory. Surrounded by countless indoor plants and an exhaustive array of icons from most major world religions, he reclines on a leather couch facing a massive picture window that frames a killer view of the Siskiyou Mountains. Padrinho Goldman considers himself a representative of the Daime (“the masters of the astral,” he calls it), not to mention a shaman, a healer and a master of ceremonies. He says that when he established the Church of the Holy Light of the Queen in Ashland in 1993, he had a feeling he was going to “liberate the Daime.”What Goldman didn't plan was what happened in 1999, when he received a shipment of Daime Tea that had been traced by federal authorities. When the tea arrived, so did Ashland police. They held guns on his family, ransacked his house and took him to jail.Goldman fought back, hiring a team of lawyers to sue the U.S. Department of Justice under President George W. Bush. The ten-year legal battle culminated in a March 2009 ruling by U.S. District Judge Owen Panner, who found that the government had indeed overreacted, substantially burdening the church's sincere exercise of its religion, and that the Department of Justice had failed to prove that the Controlled Substances Act should apply to these harmless, if somewhat out-there, Diamestas. And almost as if to fulfill the Padrinho's prophesy, Panner gave the church a pass under the Religious Freedom Restoration Act. It was an exceptionally rare exemption granted also to Native Americans for their use of peyote and more recently upheld (with some restrictions) by the U.S. Supreme Court for New Mexico's União do Vegetal (UDV), another Brazil-based, ayahuasca-sipping sect.The DEA’s people aren’t happy about Judge Panner's ruling, and the department is scrutinizing the church yet again. Goldman says the officials he’s been dealing with don't think any district court judge has the power to grant exemptions to anyone for schedule-I substances. DEA Associate Chief Council Karen Richardson refused to comment on “ongoing litigation,” but she confirmed in a letter that the department has indeed appealed Panner's decision in the Ninth Circuit Court.And a call to DEA spokesman Chris Jakim yielded little more than proof that Jakim knows how to do his job—the only information he'd offer in regards to the church specifically or ayahuasca in general was a reiteration of the DEA's party-line on schedule-I drugs. He said that DMT is not accepted for use by anyone in the medical field and that there's a high risk in the use of ayahuasca as medicine, as it's not done under professional supervision.In a way, Jakim has a point: The Diamestas aren't a bunch of doctors or psychiatrists. And for a lot of people, drinking ayahuasca is a psychotherapeutic procedure done in an attempt to heal some very serious psychic wounds.In fact, that was the context through which Goldman himself first discovered Daime Tea at the end of 1987; never a particularly spiritual man, he had been struggling for years with issues of guilt, self-hatred and repression, he says. Nothing was really working. He was miserable. His heart, he says, was a “stone peach pit.” Then Goldman's psychotherapist took him and a group of former clients to Brazil.“He told me that if I went,” Goldman says, “I'd have the equivalent of ten years of psychotherapy and ten years of meditation in one month by drinking this weird tea. I was like, 'Good deal. Let's go.'”Did it work? “Without Daime I'd be dead,” Goldman says, “and if not dead, I'd be miserable, sick, neurotic, crazy, divorced, alone...” He trails off before telling of his first psychoactive-aided healing.“We were dancing and singing all night,” he says, “and I felt so sick and nauseous the whole time. Because of all this repression I had, I had so much to clean. And I was really arrogant and I was really controlling and I was slippery and I was smart so I could avoid the really deep stuff in me—and the Daime didn't allow any of that. It was the first force I met that was smarter, quicker, way more knowledgeable and way more wise than I was. So I was impressed.”It is that very impressive promise of spiritual deep-cleaning that brings many to the fold. A number of Daimestas claim to have cured—or at least greatly alleviated—their addictions and neuroses by drinking Daime Tea, sometimes after only one session. And while the little medical research that's been done on ayahuasca drinkers seems to support their claims, the Daimestas at the church have no real way of knowing whether or not their inductees will benefit from the stuff or be driven mad by it; they rely largely on the honor system to drum out anyone for whom ayahuasca would be “inappropriate.”“Their screenings are relatively superficial,” UCLA Professor of Psychiatry Dr. Charles M. Grob says of Santo Daime. “These churches are not that thorough.”In 1996, Grob studied Brazilian followers of UDV, whose adherents call ayahuasca “hoasca.” In his report, “Human Psychopharmacology of Hoasca,” he concludes that for members who had entered the UDV with issues ranging from alcoholism to depression, all disorders had indeed remitted without recurrence. Churchgoers were emphatic that they had undergone radical transformations of behavior and attitudes and that they were able to use ayahuasca to “eliminate their chronic anger, resentment, aggression and alienation,” according to the report. But only in the proper context, and only for the right people.“With ayahuasca,” Grob says, “you have a powerful means by which to achieve a transpersonal experience. But only if you do adequate screening and control conditions.”Driving out to the woods to do something akin to an acid test in an attempt to overcome serious psychological troubles may be a dicey proposition. For instance, Grob says, if an ayahuasca neophyte has a latent, unknown family history of schizophrenia, he or she may have an “untoward reaction” to the DMT. That could mean anything from intense hallucinations to outright psychotic breaks. And if any aspiring Daimestas are less than forthcoming during the interview and don't disclose to Seligman that they're taking antidepressants, after quaffing the tea they may find themselves suffering from serotonin syndrome. That happens when the monoamine oxidase inhibitor (MAOI), the other active ingredient in the ayahuasca, interacts with the selective serotonin reuptake inhibitor (SSRI) component of the depression medication. Serotonin syndrome can lead to tremors, high fever and even death. “It's a medical crisis when it occurs,” Grob says.These possibilities are ostensibly what's keeping the DEA sniffing around the church. But Goldman remains confident that the church's screening process and its guardian system provide the essential safeguards to ensure that a good time is had by all. He has a feeling the Diamestas will emerge victorious against any appeals. After all, there seems to be a demand for what he's offering.“Things have changed a lot,” Goldman says of the time since the ruling. “Operating freely is a big deal, and our mission is starting to grow.” Last year's 12-hour Three Kings Day work had drawn only about 30 worshipers. This year, Goldman says, the number had more than doubled.As for my own spiritual experience with DMT—it was alright. I may not have gotten lasting satisfaction or fulfillment from my first time drinking Daime Tea. I didn't throw up, see snakes or have a conversation with Christ. But I certainly enjoyed myself in the moment. I also gained an understanding of how spirituality can coexist in a very simple way with what is for all intents and purposes an intoxicant, and how that sensation can be so meaningful for so many people.Unless the DEA gets its way, more curious seekers like me will continue to make the pilgrimage to Goldman's church for a completely unique spiritual experience—and the Daimestas will be shouting “Viva!” with open arms for years to come.

Fluorides -- Health aspects, Drinking water -- Health aspects, and Learning disabilities -- Diagnosis

OBJECTIVES: Recent studies have connected increased fluoride exposure with increased risk of neurodevelopmental-related outcomes, such as ADHD (attention deficit hyperactivity disorder) and lower IQ in children. Our primary objective was to examine the association between fluoride exposure and reported diagnosis of a learning disability among a population-based sample of Canadian children aged 3-12 years. METHODS: We analyzed data from Cycles 2 and 3 of the Canadian Health Measures Survey. Four measures of fluoride exposure were available: 1) urinary fluoride ([micro]mol/L), 2) creatinine-adjusted urinary fluoride ([micro]mol/mmol), 3) specific gravity-adjusted urinary fluoride ([micro]mol/L), and 4) fluoride concentration of tap water (mg/L) (Cycle 3 only). Diagnosis of a learning disability (yes/no) was based on parental- or self-report. Associations were examined using logistic regression (where possible), unadjusted and adjusted for covariates. RESULTS: When Cycles 2 and 3 were examined separately, reported learning disability diagnosis was not significantly associated with any measure of fluoride exposure in unadjusted or adjusted models. When Cycles 2 and 3 were combined, a small but statistically significant effect was observed such that children with higher urinary fluoride had higher odds of having a reported learning disability in the adjusted model (p = 0.03). However, the association was not observed in models that used creatinine-adjusted urinary fluoride and specific gravity-adjusted urinary fluoride, which are believed to be more accurate measures due to their correction for urinary dilution. CONCLUSION: Overall, there did not appear to be a robust association between fluoride exposure and parental- or self- reported diagnosis of a learning disability among Canadian children. KEY WORDS: Population; fluoridation; cognition; learning disorders; surveys and questionnaires OBJECTIFS : Des etudes recentes ont revele que la croissance de l'exposition au fluorure augmente le risque de maladies reliees au developpement des neurones telles que, TDAH (trouble deficitaire de l'attention, avec ou sans hyperactivite) et de QI moins eleves chez les enfants. Notre objectif principal est d'examiner le lien entre l'exposition au fluorure et les diagnostics publies sur les troubles d'apprentissage selon un echantillon de la population d'enfants ages de 3 a 12 ans. METHODES : Nous avons analyse les donnees des cycles 2 et 3 de l'Enquete canadienne sur les mesures de la sante. Quatre mesures de fluorure etaient disponibles : 1) fluorure urinaire ([micro]mol/L), 2) fluorure urinaire normalisee par la creatinine ([micro]mol/mmol), 3) fluorure urinaire specifique normalisee pour la gravite ([micro]mol/L), et 4) concentration de fluorure de l'eau du robinet (mg/L) (Cycle 3 seulement). Le diagnostic des troubles d'apprentissage (oui ou non) etait fonde sur les rapports parentaux ou sur l'auto-evaluation. Les liens ont ete examines en utilisant la regression logistique (la oU c'etait possible), donnees non corrigees et corrigees pour les covariables. RESULTATS : Lorsque les cycles 2 et 3 ont ete examines separement, le diagnostic sur les troubles d'apprentissage ne presentait aucun lien significatif avec les mesures d'exposition au fluorure, dans les modeles corriges ou non corriges. Lorsque les cycles 2 et 3 ont ete regroupes, un leger effet, mais dont la signification statistique a ete observee comme quoi les enfants ayant demontre un taux de fluorure urinaire plus eleve avaient plus de chances d'avoir des troubles d'apprentissage selon le modele corrige (p = 0.03). Cependant, ce lien n'a pas ete observe dans les modeles qui utilisaient des taux de fluorure urinaire corriges pour la creatinine et corriges pour la gravite specifique, lesquels sont censes etre plus precis en raison de la correction pour la dilution urinaire. CONCLUSION : En general, nous n'avons trouve aucun lien solide entre l'exposition au fluorure et les diagnostics des parents ou des autoevaluations parmi les enfants canadiens quant aux troubles d'apprentissages. MOTS CLES : population; fluorisation; cognition; troubles d'apprentissage; sondages et questionnaires

NEUROPATHY, PROGNOSIS, ALTERNATIVE medicine, DIAGNOSIS, and CLINICAL medicine

Copyright of Diabetes & Metabolism is the property of Masson Editeur and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of EMC-Endocrinologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé Des adultes atteints de trouble du spectre de l'autisme et vivant dans des institutions spécialisées ont été le sujet de notre étude. L'évaluation comportementale des résidents a été réalisée avec l'échelle pour l'observation des comportements-problèmes d'adultes avec autisme (EPOCAA) de Recordon-Gaboriaud et Granier-Deferre. Il apparaît que notre échantillon obtient des résultats très différents de celui de l'échantillon de Recordon-Gaboriaud et Granier-Deferre. Notre principal objectif a été d'étudier l'effet de la sévérité de la déficience intellectuelle et de la médication sur l'échelle d'évaluation des comportements-problèmes. La première hypothèse porte sur le degré de la déficience intellectuelle : plus elle sera sévère et plus la probabilité d'avoir des comportements-problèmes sera grande. Nous faisons également l'hypothèse que les différentes médications interagissent avec les comportements-problèmes évalués à l'EPOCAA. Il ressort que la déficience intellectuelle profonde associée à l'autisme majore les comportements-problèmes. La seconde hypothèse concernant la médication est invalidée. Abstract Objectives We studied adults with autism spectrum disorder living in a specialized residential care home (n = 148). The participants' behavioral problems were assessed using the French-language Scale for the Observation of Behavioral Problems in Adults with Autism (Échelle Pour l'Observation des Comportements-problèmes d'Adultes avec Autisme , EPOCAA; Recordon-Gaboriaud & Granier-Deferre). The study's main objectives were to (i) replicate the data from the EPOCAA reference group in a new sample of institutionalized adults, and (ii) study the impact of intellectual disability and medication on the EPOCAA scale. Our first hypothesis was that the severity of intellectual impairment would be associated with a greater likelihood of major behavioural problems. Our second hypothesis was that treatment (or the absence of treatment) with psychotropic and/or anti-epileptic medications would interact with the behavioural problems evaluated on the EPOCAA. Method We first used Cohen's d to compare the results from our sample with those given in the EPOCAA. Next, we performed a multivariate analysis of covariance with intellectual impairment, sex, the use of anti-epileptic medications (as a yes/no binary variable), and the use of psychotropic medications (as a yes/no binary variable) as fixed factors, and age as a covariate. Results All patients suffered from profound to severe intellectual impairment and low autonomy, which justified their permanent residence in a care home. A behavioral assessment of the study participants showed that the overall EPOCAA scores were much lower in the study sample than in the scale's reference sample. The combination of profound intellectual disability and autism was associated with more behavioral problems than severe intellectual impairment. The residents' intellectual impairments were predominantly related to two domains (object use and sensorimotor activities/stereotypy) and to the severity of difficulties in the social interactions domain. The second hypothesis was not confirmed: the presence or absence of the various medications did not appear to influence behavioral problems. These results are discussed with a view to improving the residents' quality of life. [ABSTRACT FROM AUTHOR]

WATER quality, ENDOCRINE disruptors, MARINE pollution, and SEWAGE disposal plants

Endocrine disrupting compounds (EDCs) can be found in domestic sewage, wastewater treatment plant effluents, natural water, rivers, lakes and in the marine environment. Jurujuba Sound, located in the state of Rio de Janeiro, Southeastern Brazil, receives untreated sewage into its waters, one the main sources of aquatic contamination in this area. In this context, the aim of the present study was to evaluate the estrogenic potential of water sampled from different depths and from areas with differential contamination levels throughout Jurujuba Sound. Water quality was evaluated and acute toxicity assays using Allviibrio fischeri were conducted, while estrogenic activity of the water samples was determined by a Yeast Estrogen Screening assay (YES). Water quality was mostly within the limits established for marine waters by the Brazilian legislation, with only DOC and ammoniacal nitrogen levels above the maximum permissible limits. No acute toxicity effects were observed in the Allivibrio fisheri assay. The YES assay detected moderate estrogenic activity in bottom water samples from 3 sampling stations, ranging from 0.5 to 3.2 ng L −1 , as well as in one surface water sample. Estrogenic activity was most frequently observed in samples from the bottom of the water column, indicating adsorption of estrogenic compounds to the sediment. [ABSTRACT FROM AUTHOR]

BANANAS, FREE trade, COMMODITY exchanges, and INTERNATIONAL trade

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COGNITIVE therapy, COGNITIVE psychology, MOOD (Psychology), AFFECTIVE disorders, and PERSONALITY & emotions

Copyright of European Review of Applied Psychology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

PEDIATRIC dentistry, CPR (First aid) for children, and EDUCATION

Aim: The study evaluated the theoretical knowledge and practical ability of students in paediatric dentistry concerning basic life support (BLS) and cardiopulmonary resuscitation (CPR) in children and babies.Methods: Seventy paediatric dentistry students answered a questionnaire and also performed a simulation of the manoeuvres of BLS and CPR on baby and child manikins.Results: The results showed that 41 (58%) students had never received BLS training. When questioned about the correct ratio of compression and ventilation during CPR, most students answered incorrectly. For the CPR of babies in the presence of a first responder only 19 (27.1%) answered correctly (30 × 2), and for babies with two rescuers, 23 (32.8%) answered correctly (15 × 2); in relation to the correct rhythm of chest compressions, 38 (54.4%) answered incorrectly; when asked if they felt prepared to deal with a medical emergency in their dental surgeries, only 12 (17.1%) stated “yes”. In the practice evaluation, 51 (73%) students who had been assessed in CPR manoeuvres for children and 55 (78%) in the manoeuvres for babies scored inadequately.Conclusions: The evaluated students did not have adequate knowledge about CPR in children and babies. [ABSTRACT FROM AUTHOR]

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ESTROGEN, HYDROLOGICAL research, YEAST, WATER treatment plants, and OZONIZATION

The estrogenicity of waters collected from an important hydrological system in Brazil (Paraiba do Sul and Guandu Rivers) was assessed using the yeast estrogen screen (YES) assay. Sampling was performed in rivers and at the outlets of conventional water treatment plants (WTP). The removal of estrogenic activity by ozonation and chlorination after conventional water treatment (clarification and sand filtration) was investigated employing samples of the Guandu River spiked with estrogens and bisphenol A (BPA). The results revealed a preoccupying incidence of estrogenic activity at levels higher than 1 ng L −1 along some points of the rivers. Another matter of concern was the number of samples from WTPs presenting estrogenicity surpassing 1 ng L −1 . The oxidation techniques (ozonation and chlorination) were effective for the removal of estrogenic activity and the combination of both techniques led to good results using less amounts of oxidants. [ABSTRACT FROM AUTHOR]

BONE-anchored hearing aids, PATIENT satisfaction, AUDIOMETRY, TELEPHONE surveys, DEAFNESS, QUESTIONNAIRES, and QUALITY of life

Summary: Objectives: To assess patient satisfaction with bone-anchored hearing aids (BAHA) and the role of preoperative audiometric testing. Patients and methods: A telephone satisfaction survey was conducted on all patients implanted between June 1, 2005 and February 1, 2008. Patients with unilateral total deafness underwent preoperative audiometric tests in quiet and in noise and stereoaudiometry with and without BAHA. Patients with a conductive hearing loss underwent preoperative audiometric tests in quiet and in noise and real-life testing at home using a headband. A standardized satisfaction questionnaire derived from the Entific BAHA questionnaire was used. Results: Twenty-two out of 26 patients responded to the questionnaire. Ten patients were implanted for conductive hearing loss (CHL) and 12 for unilateral total deafness (UTD). Mean follow-up was 19 months in the UTD group and 21 months in the CHL group. Sixty-seven percent of UTD and 80% of CHL patients reported improved quality of life. The BAHA was worn for more than 4hours per day by 83% of UTD and 100% of CHL patients, and at least 5 days per week by 67% of UTD and 80% of CHL patients. Conclusion: BAHAs provided real benefit in all situations for CHL patients. In UTD, its benefit basically related to noisy environments. In UTD, satisfaction on preoperative stereoaudiometric testing in noise with and without BAHA was predictive of postimplantation satisfaction. In response to the question “Would you do it again?”, 81% of patients answered “Yes”. [ABSTRACT FROM AUTHOR]

Yes, but only for a parameter value that makes it almost coincide with the standard model. We reconsider the cosmological dynamics of a generalized Chaplygin gas (gCg) which is split into a cold dark matter (CDM) part and a dark energy (DE) component with constant equation of state. This model, which implies a specific interaction between CDM and DE, has a Λ CDM limit and provides the basis for studying deviations from the latter. Including matter and radiation, we use the (modified) CLASS code (Blas et al., 2011) to construct the CMB and matter power spectra in order to search for a gCg-based concordance model that is in agreement with the SNIa data from the JLA sample and with recent Planck data. The results reveal that the gCg parameter α is restricted to | α | ≲ 0 . 05 , i.e., to values very close to the Λ CDM limit α = 0 . This excludes, in particular, models in which DE decays linearly with the Hubble rate. [ABSTRACT FROM AUTHOR]

Summary: Background: New drug regimens of greater efficacy and shorter duration are needed for tuberculosis (TB) treatment. The identification of accurate, quantitative, non-culture based markers of treatment response would improve the efficiency of Phase 2 TB drug testing. Methods: In an unbiased biomarker discovery approach, we applied a highly multiplexed, aptamer-based, proteomic technology to analyze serum samples collected at baseline and after 8 weeks of treatment from 39 patients with pulmonary TB from Kampala, Uganda enrolled in a Centers for Disease Control and Prevention (CDC) TB Trials Consortium Phase 2B treatment trial. Results: We identified protein expression differences associated with 8-week culture status, including Coagulation Factor V, SAA, XPNPEP1, PSME1, IL-11 Rα, HSP70, Galectin-8, α2-Antiplasmin, ECM1, YES, IGFBP-1, CATZ, BGN, LYNB, and IL-7. Markers noted to have differential changes between responders and slow-responders included nectin-like protein 2, EphA1 (Ephrin type-A receptor 1), gp130, CNDP1, TGF-b RIII, MRC2, ADAM9, and CDON. A logistic regression model combining markers associated with 8-week culture status revealed an ROC curve with AUC = 0.96, sensitivity = 0.95 and specificity = 0.90. Additional markers showed differential changes between responders and slow-responders (nectin-like protein), or correlated with time-to-culture-conversion (KLRK1). Conclusions: Serum proteins involved in the coagulation cascade, neutrophil activity, immunity, inflammation, and tissue remodeling were found to be associated with TB treatment response. A quantitative, non-culture based, five-marker signature predictive of 8-week culture status was identified in this pilot study. [Copyright &y& Elsevier]

MENTAL disabilities, DEVELOPMENTAL disabilities, PATHOLOGICAL psychology, INTELLECT, JUDGMENT (Psychology), and LEARNING

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HIV infections, THERAPEUTICS, BLIND experiment, PLACEBOS (Medicine), ANTIRETROVIRAL agents, RNA, and CLINICAL trials

Summary: Background: Vicriviroc, a novel HIV CCR5 antagonist, demonstrated significant efficacy and favorable tolerability in phase II trials in treatment-experienced subjects, supporting further evaluation in phase III studies. Methods: Two identical double-blind, placebo (PBO)-controlled trials in CCR5-tropic HIV-infected subjects with documented resistance to two antiretroviral classes were conducted. Subjects were randomized to vicriviroc 30 mg QD (N = 571) or PBO (N = 286) with open-label optimized background therapy (OBT) containing ≥2 fully active antiretroviral drugs. The primary endpoint was percentage of subjects with <50 copies/mL HIV RNA at 48 weeks. It was analyzed in a logistic regression with treatment (vicriviroc + OBT/PBO + OBT), use of enfuvirtide in baseline OBT (yes/no), and baseline HIV RNA (≤100,000/>100,000 copies/mL) as covariates. In addition, a pre-planned analysis to examine other efficacy and safety endpoints was conducted. Results: Baseline characteristics of the pooled mITT population (vicriviroc, n = 486; PBO, n = 235) included mean HIV RNA of 4.6 log10 copies/mL and mean CD4 count of 257 cells/μL. Approximately 60% of subjects received ≥3 active drugs in the OBT. The percentage of subjects with <50 copies/mL HIV RNA was not significantly different between vicriviroc and PBO at week 48 (64% vs 62%, p = 0.6). However, in subjects receiving ≤2 active drugs in their OBT, the proportion achieving <50 copies/mL HIV RNA was higher in those receiving vicriviroc compared with PBO (70% vs 55%, p = 0.02). Conclusions: The studies failed to show significant efficacy gains when vicriviroc was added to OBT. However, given the efficacy results of earlier vicriviroc trials and other CCR5 antagonist, studies are needed to define the role of this class of drugs in the treatment of HIV. Clinical trial identifier: http://www.clinicaltrial.gov/: VICTOR-E3 (NCT00523211) and VICTOR-E4 (NCT00474370). [Copyright &y& Elsevier]

Abstract: Background and aims: The European ‘IMMIDIET’ study was designed to evaluate the effect of genetic and dietary habit interactions on cardiovascular disease risk factors in non-diabetic subjects. Copper, zinc and selenium are involved in redox balance and modifications of their homeostasis could be associated with metabolic syndrome. Because few studies have dealt with trace element status in metabolic syndrome with conflicting results, we aimed at investigating the relationships between plasma copper, zinc and selenium concentrations and metabolic syndrome in the IMMIDIET population. Methods and results: Male–female couples born and living in Abruzzo, Italy (n = 271); Limburg, Belgium (n = 267), southwest part of London, England (n = 263) and 205 Italian–Belgian mixed couples living in Belgium were enrolled. Data on medical history, hypertension and blood lipid profile, medication use, smoking and alcohol habits, physical activity and socioeconomic status were collected using a standardised questionnaire. Anthropometric, blood pressure, glucose, insulin, lipid profile and copper, zinc and selenium measurements were performed. Participants were classified in two groups according to the presence of metabolic syndrome (Yes/No). Comparison between these two groups, performed separately in men and women, indicated no association in men whereas, in women, metabolic syndrome was associated with higher plasma selenium concentrations (odds ratio (OR) = 1.55(1.28–1.89)); this association remained significant after adjustment for age, group, social status, physical activity, energy intake, alcohol consumption, smoking and hormonal status (OR = 1.33 (1.06–1.67)). Conclusion: Our results indicate gender differences in the association between plasma selenium concentration and metabolic syndrome without diabetes and may suggest a sub-clinical deleterious effect of high selenium status in women. [Copyright &y& Elsevier]

Abstract We report the generation of the human iPSC line LEIi008-A from a patient with retinitis pigmentosa-11 caused by a dominant nonsense mutation in the PRPF31 gene (NM_015629.3:c.1205C > A p.(Ser402Ter)). A second line, LEIi009-A, was generated from a related non-penetrant carrier of the same mutation with no retinal disease. Reprogramming of patient dermal fibroblasts using episomal plasmids containing OCT4 , SOX2 , KLF4 , L-MYC , LIN28 , shRNA for p53 and mir302/367 microRNA generated cell lines displaying pluripotent stem cell marker expression, a normal karyotype and the capability to differentiate into the three germ layer lineages. Resource table Unlabelled Table Unique stem cell lines identifier LEIi008-A LEIi009-A Alternative names of stem cell lines 1093ips4 (LEIi008-A) 1374ips1 (LEIi009-A) Institution Lions Eye Institute, Nedlands, Western Australia, Australia Contact information of distributor Samuel McLenachan: smclenachan@lei.org.au Fred Chen: fredchen@lei.org.au Type of cell lines iPSC Origin Human Cell Source Dermal fibroblasts Clonality Clonal Method of reprogramming Episomal Multiline rationale Unaffected mother and affected son carrying same dominant PRPF31 mutation Gene modification Yes Type of modification Hereditary Associated disease Retinitis Pigmentosa 11 Gene/locus PRPF31/ 19q13.42 Method of modification N/A Name of transgene or resistance N/A Inducible/constitutive system N/A Date archived/stock date LEIi008-A: 18/12/17; LEIi009-A: 17/11/17 Cell line repository/bank https://hpscreg.eu/cell-line/LEIi008-A https://hpscreg.eu/cell-line/LEIi009-A Ethical approval Human Research Ethics Office, University of Western Australia (RA/4/1/7916) [ABSTRACT FROM AUTHOR]

CARDIOVASCULAR diseases risk factors, C-reactive protein, MYOCARDIAL infarction, MEDICAL care, and RACE discrimination

Background: The objective of the study was to evaluate the association between race/ethnic (r/e) discrimination and subclinical cardiovascular disease (CVD). Although r/e discrimination is a chronic stressor that might have negative health effects, cardiovascular data related to experiences with discrimination among different r/e groups in the United States remain sparse. Methods: Using data from the Dallas Heart Study, we assessed the association between perceived r/e discrimination and traditional CVD risk factors, C-reactive protein (CRP), aortic plaque area and wall thickness, and coronary calcium (CAC) score among black, white, and Hispanic participants. Prevalent CAC was defined as a CAC score ≥10 Agatston units; CRP elevation was defined as ≥3 mg/L. Participants were asked, “Have you ever been discriminated against due to your race/ethnicity? (responses: yes, no, or don''t know)”. Results: Blacks reported r/e discrimination more frequently than whites or Hispanics (P < .0001). Blacks who reported r/e discrimination were more likely to be college graduates, to have a family history of myocardial infarction, and to be more physically active than blacks who did not report r/e discrimination (each P < .05). Hispanics who reported r/e discrimination had a higher prevalence of smoking (P < .01) and were more likely to be born in the United States. In models that adjusted for traditional CVD risk factors and medication use, we generally found no association between reports of r/e discrimination and aortic wall thickness, aortic plaque area, prevalent CAC, or elevated CRP in any of the r/e groups. Among blacks, stratification by gender and education did not change the observed relationship between perceived r/e discrimination and CAC or CRP. Conclusions: Although perceived r/e discrimination is associated with certain health characteristics that may result in negative health outcomes, in general, we found no association of r/e discrimination with either subclinical atherosclerosis as determined by CAC score, aortic wall thickness and aortic plaque area, or inflammation as assessed by elevated CRP levels. [Copyright &y& Elsevier]