[Social media monitoring of asthmatic children treated in a specialized program: Parents and caregivers expectations].

PubMed

Urrutia-Pereira, Marilyn; Ávila, Jennifer Bg; Cherrez-Ojeda, Ivan; Ivancevich, Juan Carlos; Solé, Dirceu

2015-01-01

Social media has been used in support of patients with asthma. However, it remains unclear what are the expectations of parents or caregivers of asthmatic patients. To evaluate the expectations of parents or caregivers of asthmatic children treated at Children's Asthma Prevention Program (PIPA), Uruguaiana, RS, in relation to the use of social media. An observational, descriptive, cross-sectional survey of parents or caregivers of children seen at Children's Asthma Prevention Program through responses to a written questionnaire on the use of new technologies and different applications to enhance information about asthma. 210 parents or caregivers (median age: 25 years; age range: 18-42 years of patients were enrolled. The mean age of their children was 7.3 years (age range: 2 to 18 years), the mean duration of asthma was 4.7 years and 65% of parents/caregivers of these children had less than eight years of schooling. Most of them (72%) had no access to the Internet via cell/mobile phones and only 18% actively used to gathered information about asthma by internet. There was high interest (87%) in receiving information via social media. Parents or caregivers of children attending the PIPA program expressed high interest in using social media. However, few use it to control their children's disease. While providing a great benefit to use social media as a mean of communication in health, the content needs to be monitored for reliability and quality. The privacy of users (doctors and patients) must be preserved and it is very important to facilitate the access to Internet.

Spatial Attention and Temporal Expectation Under Timed Uncertainty Predictably Modulate Neuronal Responses in Monkey V1

PubMed Central

Sharma, Jitendra; Sugihara, Hiroki; Katz, Yarden; Schummers, James; Tenenbaum, Joshua; Sur, Mriganka

2015-01-01

The brain uses attention and expectation as flexible devices for optimizing behavioral responses associated with expected but unpredictably timed events. The neural bases of attention and expectation are thought to engage higher cognitive loci; however, their influence at the level of primary visual cortex (V1) remains unknown. Here, we asked whether single-neuron responses in monkey V1 were influenced by an attention task of unpredictable duration. Monkeys covertly attended to a spot that remained unchanged for a fixed period and then abruptly disappeared at variable times, prompting a lever release for reward. We show that monkeys responded progressively faster and performed better as the trial duration increased. Neural responses also followed monkey's task engagement—there was an early, but short duration, response facilitation, followed by a late but sustained increase during the time monkeys expected the attention spot to disappear. This late attentional modulation was significantly and negatively correlated with the reaction time and was well explained by a modified hazard function. Such bimodal, time-dependent changes were, however, absent in a task that did not require explicit attentional engagement. Thus, V1 neurons carry reliable signals of attention and temporal expectation that correlate with predictable influences on monkeys' behavioral responses. PMID:24836689

Impact of sea level rise on tide gate function.

PubMed

Walsh, Sean; Miskewitz, Robert

2013-01-01

Sea level rise resulting from climate change and land subsidence is expected to severely impact the duration and associated damage resulting from flooding events in tidal communities. These communities must continuously invest resources for the maintenance of existing structures and installation of new flood prevention infrastructure. Tide gates are a common flood prevention structure for low-lying communities in the tidal zone. Tide gates close during incoming tides to prevent inundation from downstream water propagating inland and open during outgoing tides to drain upland areas. Higher downstream mean sea level elevations reduce the effectiveness of tide gates by impacting the hydraulics of the system. This project developed a HEC-RAS and HEC-HMS model of an existing tide gate structure and its upland drainage area in the New Jersey Meadowlands to simulate the impact of rising mean sea level elevations on the tide gate's ability to prevent upstream flooding. Model predictions indicate that sea level rise will reduce the tide gate effectiveness resulting in longer lasting and deeper flood events. The results indicate that there is a critical point in the sea level elevation for this local area, beyond which flooding scenarios become dramatically worse and would have a significantly negative impact on the standard of living and ability to do business in one of the most densely populated areas of America.

Minihepcidins prevent iron overload in a hepcidin-deficient mouse model of severe hemochromatosis

PubMed Central

Ramos, Emilio; Ruchala, Piotr; Goodnough, Julia B.; Kautz, Léon; Preza, Gloria C.; Nemeth, Elizabeta

2012-01-01

The deficiency of hepcidin, the hormone that controls iron absorption and its tissue distribution, is the cause of iron overload in nearly all forms of hereditary hemochromatosis and in untransfused iron-loading anemias. In a recent study, we reported the development of minihepcidins, small drug-like hepcidin agonists. Here we explore the feasibility of using minihepcidins for the prevention and treatment of iron overload in hepcidin-deficient mice. An optimized minihepcidin (PR65) was developed that had superior potency and duration of action compared with natural hepcidin or other minihepcidins, and favorable cost of synthesis. PR65 was administered by subcutaneous injection daily for 2 weeks to iron-depleted or iron-loaded hepcidin knockout mice. PR65 administration to iron-depleted mice prevented liver iron loading, decreased heart iron levels, and caused the expected iron retention in the spleen and duodenum. At high doses, PR65 treatment also caused anemia because of profound iron restriction. PR65 administration to hepcidin knockout mice with pre-existing iron overload had a more moderate effect and caused partial redistribution of iron from the liver to the spleen. Our study demonstrates that minihepcidins could be beneficial in iron overload disorders either used alone for prevention or possibly as adjunctive therapy with phlebotomy or chelation. PMID:22990014

Efficacy of Hi-Lo Evac Endotracheal Tube in Prevention of Ventilator-Associated Pneumonia in Mechanically Ventilated Poisoned Patients.

PubMed

Ghoochani Khorasani, Ahmad; Shadnia, Shahin; Mashayekhian, Mohammad; Rahimi, Mitra; Aghabiklooei, Abbas

2016-01-01

Background. Ventilator-associated pneumonia (VAP) is the most common health care-associated infection. To prevent this complication, aspiration of subglottic secretions using Hi-Lo Evac endotracheal tube (Evac ETT) is a recommended intervention. However, there are some reports on Evac ETT dysfunction. We aimed to compare the incidence of VAP (per ventilated patients) in severely ill poisoned patients who were intubated using Evac ETT versus conventional endotracheal tubes (C-ETT) in our toxicology ICU. Materials and Methods. In this clinical randomized trial, 91 eligible patients with an expected duration of mechanical ventilation of more than 48 hours were recruited and randomly assigned into two groups: (1) subglottic secretion drainage (SSD) group who were intubated by Evac ETT (n = 43) and (2) control group who were intubated by C-ETT (n = 48). Results. Of the 91 eligible patients, 56 (61.5%) were male. VAP was detected in 24 of 43 (55.8%) patients in the case group and 23 of 48 (47.9%) patients in the control group (P = 0.45). The most frequently isolated microorganisms were S. aureus (54.10%) and Acinetobacter spp. (19.68%). The incidence of VAP and ICU length of stay were not significantly different between the two groups, but duration of intubation was statistically different and was longer in the SSD group. Mortality rate was less in SSD group but without a significant difference (P = 0.68). Conclusion. The SSD procedure was performed intermittently with one-hour intervals using 10 mL syringe. Subglottic secretion drainage does not significantly reduce the incidence of VAP in patients receiving MV. This strategy appears to be ineffective in preventing VAP among ICU patients.

Retention of movement pattern changes after a lower extremity injury prevention program is affected by program duration.

PubMed

Padua, Darin A; DiStefano, Lindsay J; Marshall, Stephen W; Beutler, Anthony I; de la Motte, Sarah J; DiStefano, Michael J

2012-02-01

Changes in movement patterns have been repeatedly observed immediately after completing a lower extremity injury prevention program. However, it is not known if movement pattern changes are maintained after discontinuing the training program. The ability to maintain movement pattern changes after training has ceased may be influenced by the program's duration. The authors hypothesized that among individuals who completed either a 3-month or 9-month training program and who demonstrated immediate movement pattern changes, only those who completed the 9-month training program would maintain movement pattern changes after a 3-month period of no longer performing the exercises. Cohort study; Level of evidence, 2. A total of 140 youth soccer athletes from 15 separate teams volunteered to participate. Athletes' movement patterns were assessed using the Landing Error Scoring System (LESS) at pretest, posttest, and 3 months after ceasing the program (retention test). Eighty-four of the original 140 participants demonstrated improvements in their LESS scores between pretest and posttest (change in LESS score >0) and were included in the final analyses for this study (n = 84; 20 boys and 64 girls; mean age, 14 ± 2 years; age range, 11-17 years). Teams performed 3-month (short-duration group) and 9-month (extended-duration group) injury prevention programs. The exercises performed were identical for both groups. Teams performed the programs as part of their normal warm-up routine. Although both groups improved their total LESS scores from pretest to posttest, only the extended-duration training group retained their improvements 3 months after ceasing the injury prevention program (F(2,137) = 3.38; P = .04). Results suggest that training duration may be an important factor to consider when designing injury prevention programs that facilitate long-term changes in movement control.

Pharmacotherapeutic Aspects of Space Medicine

NASA Technical Reports Server (NTRS)

Putcha, Lakshmi

2004-01-01

Medications are used for a wide variety of indications during space flight. For example, astronauts have taken drugs in flight to ameliorate or prevent symptoms of space motion sickness, headache, sleeplessness, backache, nasal congestion, and constipation. Russian cosmonauts reportedly take medications to prevent metabolic disturbances of the myocardium and intestinal flora, and to optimize their work capacity. Although the discomfort associated with some acute responses to microgravity (e.g., space motion sickness) is expected to diminish with length of time in flight, other responses that have delayed onset (e.g., maintaining nutritional status, bone and muscle strength, and perhaps immune response) may affect health and quality of life during longer missions. Therefore, as the duration of space flights increases, the need for treatment with medications is expected to increase accordingly. Medications carried on Space Shuttle missions have varied somewhat from flight to flight, depending on the individual needs of the crewmembers. Medications use during Shuttle flights seems to be more prevalent than during earlier programs, perhaps because drugs are provided in easy-to-use forms. In fact, nearly all medications taken to date have been ingested orally in tablet form. However, given that the oral route may not be ideal for those suffering motion-sickness symptoms, intramuscular and intranasal preparations are being tested. For example, intramuscular administration of promethazine hydrochloride (Phenergan(Registered TradeMark)) has been reported to be more effective in alleviating motion-sickness symptoms. The difficulties involved in conducting definitive studies of drug efficacy during U.S. space flights have been compounded by the absence of a systematic approach to determining which drugs were taken by whom and under what circumstances. The use of some drugs in space has been less efficacious than expected. The onset, intensity, and duration of the response produced by any drug depend upon rates of absorption, distribution, metabolism, and elimination of the drug; space flight-induced changes in blood flow and the function of the gastrointestinal (GI) tract, liver, or kidneys may alter these processes. Another important aspect of clinical efficacy of medications in space is the stability of pharmaceuticals. As the U.S. space program is moving toward extended Space Shuttle flights and beyond, to space station missions and planetary explorations, understanding how space flight affects organ systems and clinical pharmacology is necessary to optimize pharmacotherapeutics in space and ensure adequate safety and health of crewmembers.

Microbial Impact on Success of Human Exploration Missions

NASA Technical Reports Server (NTRS)

Pierson, Duane L.; Ott, C. Mark; Groves, T. O.; Paloski, W. H. (Technical Monitor)

2000-01-01

The purpose of this study is to identify microbiological risks associated with space exploration and identify potential countermeasures available. Identification of microbial risks associated with space habitation requires knowledge of the sources and expected types of microbial agents. Crew data along with environmental data from water, surfaces, air, and free condensate are utilized in risk examination. Data from terrestrial models are also used. Microbial risks to crew health include bacteria, fungi, protozoa, and viruses. Adverse effects of microbes include: infections, allergic reactions, toxin production, release of volatiles, food spoilage, plant disease, material degradation, and environmental contamination. Risk is difficult to assess because of unknown potential changes in microbes (e.g., mutation) and the human host (e.g., immune changes). Prevention of adverse microbial impacts is preferred over remediation. Preventative measures include engineering measures (e.g., air filtration), crew microbial screening, acceptability standards, and active verification by onboard monitoring. Microbiological agents are important risks to human health and performance during space flight and risks increase with mission duration. Acceptable risk level must be defined. Prevention must be given high priority. Careful screening of crewmembers and payloads is an important element of any risk mitigation plan. Improved quantitation of microbiological risks is a high priority.

Spatial Attention and Temporal Expectation Under Timed Uncertainty Predictably Modulate Neuronal Responses in Monkey V1.

PubMed

Sharma, Jitendra; Sugihara, Hiroki; Katz, Yarden; Schummers, James; Tenenbaum, Joshua; Sur, Mriganka

2015-09-01

The brain uses attention and expectation as flexible devices for optimizing behavioral responses associated with expected but unpredictably timed events. The neural bases of attention and expectation are thought to engage higher cognitive loci; however, their influence at the level of primary visual cortex (V1) remains unknown. Here, we asked whether single-neuron responses in monkey V1 were influenced by an attention task of unpredictable duration. Monkeys covertly attended to a spot that remained unchanged for a fixed period and then abruptly disappeared at variable times, prompting a lever release for reward. We show that monkeys responded progressively faster and performed better as the trial duration increased. Neural responses also followed monkey's task engagement-there was an early, but short duration, response facilitation, followed by a late but sustained increase during the time monkeys expected the attention spot to disappear. This late attentional modulation was significantly and negatively correlated with the reaction time and was well explained by a modified hazard function. Such bimodal, time-dependent changes were, however, absent in a task that did not require explicit attentional engagement. Thus, V1 neurons carry reliable signals of attention and temporal expectation that correlate with predictable influences on monkeys' behavioral responses. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

The differential effects of full-time and part-time work status on breastfeeding.

PubMed

Mandal, Bidisha; Roe, Brian Eric; Fein, Sara Beck

2010-09-01

Return to work is associated with diminished breastfeeding. Although more mothers breastfeed after returning to work compared to a decade ago, research has not documented the variations in breastfeeding initiation and duration based on full-time and part-time (less than 35h/week) work status. In this study, we clarify these differences. Longitudinal data from the Infant Feeding Practices Study II, collected between 2005 and 2007, for over 1400 mothers are used. In analyzing initiation, mother's work status was categorized by the expected number of hours she planned to work postpartum. In the duration model, work status was categorized based on the actual number of hours worked upon mother's return to employment after controlling for baby's age when she returned to work. Covariates in logistic and censored regressions included demographics, maternity leave, parity, past breastfeeding experience, hospital experience, and social support. Compared with expecting not to work, expecting to work <35h/week was not associated with breastfeeding initiation while expecting to work full-time decreased breastfeeding initiation. Compared with breastfeeding mothers who did not work, returning to work within 12 weeks regardless of work status and returning to work after 12 weeks while working more than 34h/week were associated with significantly shorter breastfeeding duration. Part-time work and increased amount of leave taken promote breastfeeding initiation and duration.

Bone Density Following Three Years of Recovery from Long-Duration Space-Flight

NASA Technical Reports Server (NTRS)

Amin, S.; Achenbach, S. J.; Atkinson, E. J.; Sibonga, J.

2010-01-01

Bone loss during long-duration space flight is well recognized, but the long-term implications on bone health following return from flight remain unclear. Among US crew who were involved in long-duration missions in space (Mir and ISS), we have previously shown that at approximately 12 months following return, men, but not women, had BMD values at most sites that were still lower than would be expected had they not been exposed to a prolonged period of microgravity. We now extend our observations to 3 years of follow-up post-flight. Using their age, pre-flight BMD and follow-up time, post-flight BMD values for each US crew were predicted based on the model developed from the community sample. We found BMD measures to be either stable or improve by 3 years relative to their immediate post-flight BMD, however only total hip BMD still remains significantly lower than would be expected had they not been exposed to microgravity. Among male US crew, who have had their BMD measured following at least 3 years of recovery post long-duration flight, they continue to have lower BMD at the hip than would be expected, raising potential concerns regarding future hip fracture risk.

Extended-duration venous thromboembolism prophylaxis in acutely ill medical patients with recently reduced mobility: a randomized trial.

PubMed

Hull, Russell D; Schellong, Sebastian M; Tapson, Victor F; Monreal, Manuel; Samama, Meyer-Michel; Nicol, Philippe; Vicaut, Eric; Turpie, Alexander G G; Yusen, Roger D

2010-07-06

Extended-duration low-molecular-weight heparin has been shown to prevent venous thromboembolism (VTE) in high-risk surgical patients. To evaluate the efficacy and safety of extended-duration enoxaparin thromboprophylaxis in acutely ill medical patients. Randomized, parallel, placebo-controlled trial. Randomization was computer-generated. Allocation was centralized. Patients, caregivers, and outcome assessors were blinded to group assignment. (ClinicalTrials.gov registration number: NCT00077753) SETTING: 370 sites in 20 countries across North and South America, Europe, and Asia. Acutely ill medical patients 40 years or older with recently reduced mobility (bed rest or sedentary without [level 1] or with [level 2] bathroom privileges). Eligibility criteria for patients with level 2 immobility were amended to include only those who had additional VTE risk factors (age >75 years, history of VTE, or active or previous cancer) after interim analyses suggested lower-than-expected VTE rates. Enoxaparin, 40 mg/d subcutaneously (2975 patients), or placebo (2988 patients), for 28 +/- 4 days after receiving open-label enoxaparin for an initial 10 +/- 4 days. Incidence of VTE up to day 28 and of major bleeding events up to 48 hours after the last study treatment dose. Extended-duration enoxaparin reduced VTE incidence compared with placebo (2.5% vs. 4%; absolute risk difference favoring enoxaparin, -1.53% [95.8% CI, -2.54% to -0.52%]). Enoxaparin increased major bleeding events (0.8% vs. 0.3%; absolute risk difference favoring placebo, 0.51% [95% CI, 0.12% to 0.89%]). The benefits of extended-duration enoxaparin seemed to be restricted to women, patients older than 75 years, and those with level 1 immobility. Estimates of efficacy and safety for the overall trial population are difficult to interpret because of the change in eligibility criteria during the trial. Use of extended-duration enoxaparin reduces VTE more than it increases major bleeding events in acutely ill medical patients with level 1 immobility, those older than 75 years, and women. Sanofi-aventis.

Modeling the effect of sedentary behaviour on the prevention of population obesity using the system dynamics approach

NASA Astrophysics Data System (ADS)

Abidin, Norhaslinda Zainal; Zaibidi, Nerda Zura; Zulkepli, Jafri Hj

2015-10-01

Obesity is a medical condition where an individual has an excessive amount of body fat. There are many factors contributing to obesity and one of them is the sedentary behaviour. Rapid development in industrialization and urbanization has brought changes to Malaysia's socioeconomic, especially the lifestyles of Malaysians. With this lifestyle transition, one of the impact is on weight and obesity. How does sedentary behaviour have an impact on the growth of Malaysian population's weight and obesity? What is the most effective sedentary behaviour preventing strategy to obesity? Is it through reduction in duration or frequency of sedentary behaviour? Thus, the aim of this paper is to design an intervention to analyse the effect of decreasing duration and frequency of sedentary behaviour on the population reversion trends of average weight (AW), average body mass index (ABMI), and prevalence of overweight and obesity (POVB). This study combines the different strands of sub-models comprised of nutrition, physical activity and body metabolism, and then synthesis these knowledge into a system dynamics of weight behaviour model, namely SIMULObese. Findings from this study revealed that Malaysian's adults spend a lot of time engaged in sedentary behaviour and this resulted in weight gain and obesity. Comparing between frequency and duration of sedentary behaviour, this study reported that reduced in duration or time spend in sedentary behaviour is a better preventing strategy to obesity compared to duration. As a summary, this study highlighted the importance of decreasing the frequency and duration of sedentary behaviour in developing guidelines to prevent obesity.

49 CFR 543.8 - Duration of exemption.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 6 2010-10-01 2010-10-01 false Duration of exemption. 543.8 Section 543.8 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EXEMPTION FROM VEHICLE THEFT PREVENTION STANDARD § 543.8 Duration of...

The Influence of Socioeconomic Status on Changes in Young People's Expectations of Applying to University

ERIC Educational Resources Information Center

Anders, Jake

2017-01-01

A much larger proportion of English 14-year-olds expect to apply to university than ultimately make an application by age 21, but the proportion expecting to apply falls from age 14 onwards. In order to assess the role of socioeconomic status in explaining changes in expectations, this paper applies duration modelling techniques to the…

A Systematic Review of Strategies to Prevent Cisplatin‐Induced Nephrotoxicity

PubMed Central

Crona, Daniel J.; Faso, Aimee; Nishijima, Tomohiro F.; McGraw, Kathleen A.; Galsky, Matthew D.

2017-01-01

Abstract Introduction. Cisplatin, a platinum‐based antineoplastic agent, is the cornerstone for the treatment of many malignancies. Nephrotoxicity is the primary dose‐limiting toxicity, and various hydration regimens and supplementation strategies are used to prevent cisplatin‐induced kidney injury. However, evidence‐based recommendations on specific hydration regimens are limited. A systematic review was performed to evaluate clinical studies that have examined hydration and supplementation strategies to prevent cisplatin‐induced nephrotoxicity. Materials and Methods. PubMed and Excerpta Medica databases were searched from 1966 through October 2015 for clinical trials and other studies focused on hydration regimens to prevent nephrotoxicity in cancer patients treated with cisplatin. The University of Oxford Centre for Evidence‐Based Medicine criteria were used to grade level of evidence. Results. Among the 1,407 identified studies, 24 were included in this systematic review. All studies differed on type, volume, and duration of hydration. Among the 24 studies, 5 evaluated short‐duration hydration, 4 evaluated low‐volume hydration, 4 investigated magnesium supplementation, and 7 reviewed forced diuresis with hydration. Short‐duration and lower‐volume hydration regimens are effective in preventing cisplatin‐induced nephrotoxicity. Magnesium supplementation may have a role as a nephroprotectant, and forced diuresis may be appropriate in some patients receiving cisplatin. Conclusion. Hydration is essential for all patients to prevent cisplatin‐induced nephrotoxicity. Specifically, short‐duration, low‐volume, outpatient hydration with magnesium supplementation and mannitol forced diuresis (in select patients) represent best practice principles for the safe use of cisplatin. The Oncologist 2017;22:609–619 Implications for Practice. The findings contained within this systematic review show that (a) hydration is essential for all patients to prevent cisplatin‐induced nephrotoxicity, (b) short‐duration, low‐volume, outpatient hydration regimens appear to be safe and feasible, even in patients receiving intermediate‐ to high‐dose cisplatin, (c) magnesium supplementation (8–16 milliequivalents) may limit cisplatin‐induced nephrotoxicity, and (d) mannitol may be considered for high‐dose cisplatin and/or patients with preexisting hypertension. These findings have broad implications for clinical practice and represent best practice principles for the prevention of cisplatin‐induced nephrotoxicity. PMID:28438887

Optimized methods for epilepsy therapy development using an etiologically realistic model of focal epilepsy in the rat

PubMed Central

Eastman, Clifford L.; Fender, Jason S.; Temkin, Nancy R.; D’Ambrosio, Raimondo

2015-01-01

Conventionally developed antiseizure drugs fail to control epileptic seizures in about 30% of patients, and no treatment prevents epilepsy. New etiologically realistic, syndrome-specific epilepsy models are expected to identify better treatments by capturing currently unknown ictogenic and epileptogenic mechanisms that operate in the corresponding patient populations. Additionally, the use of electrocorticography permits better monitoring of epileptogenesis and the full spectrum of acquired seizures, including focal nonconvulsive seizures that are typically difficult to treat in humans. Thus, the combined use of etiologically realistic models and electrocorticography may improve our understanding of the genesis and progression of epilepsy, and facilitate discovery and translation of novel treatments. However, this approach is labor intensive and must be optimized. To this end, we used an etiologically realistic rat model of posttraumatic epilepsy, in which the initiating fluid percussion injury closely replicates contusive closed-head injury in humans, and has been adapted to maximize epileptogenesis and focal non-convulsive seizures. We obtained week-long 5-electrode electrocorticography 1 month post-injury, and used a Monte-Carlo-based non-parametric bootstrap strategy to test the impact of electrode montage design, duration-based seizure definitions, group size and duration of recordings on the assessment of posttraumatic epilepsy, and on statistical power to detect antiseizure and antiepileptogenic treatment effects. We found that use of seizure definition based on clinical criteria rather than event duration, and of recording montages closely sampling the activity of epileptic foci, maximize the power to detect treatment effects. Detection of treatment effects was marginally improved by prolonged recording, and 24 h recording epochs were sufficient to provide 80% power to detect clinically interesting seizure control or prevention of seizures with small groups of animals. We conclude that appropriate electrode montage and clinically relevant seizure definition permit convenient deployment of fluid percussion injury and electrocorticography for epilepsy therapy development. PMID:25523813

Ankles back in randomized controlled trial (ABrCt): braces versus neuromuscular exercises for the secondary prevention of ankle sprains. Design of a randomised controlled trial.

PubMed

Janssen, Kasper W; van Mechelen, Willem; Verhagen, Evert Alm

2011-09-27

Ankle sprains are the most common sports and physical activity related injury. There is extensive evidence that there is a twofold increased risk for injury recurrence for at least one year post injury. In up to 50% of all cases recurrences result in disability and lead to chronic pain or instability, requiring prolonged medical care. Therefore ankle sprain recurrence prevention in athletes is essential. This RCT evaluates the effect of the combined use of braces and neuromuscular training (e.g. proprioceptive training/sensorimotor training/balance training) against the individual use of either braces or neuromuscular training alone on ankle sprain recurrences, when applied to individual athletes after usual care. This study was designed as three way randomized controlled trial with one year follow-up. Healthy individuals between 12 and 70 years of age, who were actively participating in sports and who had sustained a lateral ankle sprain in the two months prior to inclusion, were eligible for inclusion. After subjects had finished ankle sprain treatment by means of usual care, they were randomised to any of the three study groups. Subjects in group 1 received an eight week neuromuscular training program, subjects in group 2 received a sports brace to be worn during all sports activities for the duration of one year, and group 3 received a combination of the neuromuscular training program and a sports brace to be worn during all sports activities for the duration of eight weeks. Outcomes were assessed at baseline and every month for 12 months therafter. The primary outcome measure was incidence of ankle sprain recurrences. Secondary outcome measures included the direct and indirect costs of recurrent injury, the severity of recurrent injury, and the residual complaints during and after the intervention. The ABrCt is the first randomized controlled trial to directly compare the secondary preventive effect of the combined use of braces and neuromuscular training, against the use of either braces or neuromuscular training as separate secondary preventive measures. This study expects to identify the most effective and cost-efficient secondary preventive measure for ankle sprains. The study results could lead to changes in the clinical guidelines on the prevention of ankle sprains, and they will become available in 2012. Netherlands Trial Register (NTR): NTR2157.

Laser eye injuries.

PubMed

Barkana, Y; Belkin, M

2000-01-01

Laser instruments are used in many spheres of human activity, including medicine, industry, laboratory research, entertainment, and, notably, the military. This widespread use of lasers has resulted in many accidental injuries. Injuries are almost always retinal, because of the concentration of visible and near-infrared radiation on the retina. The retina is therefore the body tissue most vulnerable to laser radiation. The nature and severity of this type of retinal injury is determined by multiple laser-related and eye-related factors, the most important being the duration and amount of energy delivered and the retinal location of the lesion. The clinical course of significant retinal laser injuries is characterized by sudden loss of vision, often followed by marked improvement over a few weeks, and occasionally severe late complications. Medical and surgical treatment is limited. Laser devices hazardous to the human eye are currently in widespread use by armed forces. Furthermore, lasers may be employed specifically for visual incapacitation on future battlefields. Adherence to safety practices effectively prevents accidental laser-induced ocular injuries. However, there is no practical way to prevent injuries that are maliciously inflicted, as expected from laser weapons.

Human Factors of Remotely Piloted Aircraft

NASA Technical Reports Server (NTRS)

Hobbs, Alan Neville

2014-01-01

The civilian use of remotely piloted, or unmanned aircraft is expected to increase rapidly in the years ahead. Despite being referred to as unmanned some of the major challenges confronting this emerging sector relate to human factors. As unmanned aircraft systems (UAS) are introduced into civil airspace, a failure to adequately consider human factors could result in preventable accidents that may not only result in loss of life, but may also undermine public confidence in remotely piloted operations. Key issues include pilot situational awareness, collision avoidance in the absence of an out-the-window view, the effects of time delays in communication and control systems, control handovers, the challenges of very long duration flights, and the design of the control station. Problems have included poor physical layout of controls, non-intuitive automation interfaces, an over-reliance on text displays, and complicated sequences of menu selection to perform routine tasks. Some of the interface problems may have been prevented had an existing regulation or cockpit design principle been applied. In other cases, the design problems may indicate a lack of suitable guidance material.

The duration of light treatment and therapy outcome in seasonal affective disorder.

PubMed

Knapen, S E; van de Werken, M; Gordijn, M C M; Meesters, Y

2014-09-01

Seasonal affective disorder (SAD) is characterized by recurrent episodes of major depression with a seasonal pattern, treated with light therapy (LT). Duration of light therapy differs. This study investigates retrospectively whether a single week of LT is as effective as two weeks, whether males and females respond differently, and whether there is an effect of expectations as assessed before treatment. 83 women, and 25 men received either one-week (n=42) or two weeks (n=66) of LT were included in three studies. Before LT, patients׳ expectations on therapy response were assessed. Depression severity was similar in both groups before treatment (F(1,106)=0.19ns) and decreased significantly during treatment (main effect "time" F(2,105)=176.7, p<0.001). The speed of therapy response differs significantly in treatment duration, in favor of 1 week (F(2,105)=3.2, p=0.046). A significant positive correlation between expectations and therapy response was found in women (ρ=0.243, p=0.027) and not in men (ρ=-0.154,ns). When expectation was added as a covariate in the repeated-measures analysis it shows a positive effect of the level of expectation on the speed of therapy response (F(2,104)=4.1, p=0.018). A limitation is the retrospective design. There is no difference between 1 and 2 weeks of LT in overall therapy outcome, but the speed of therapy response differed between 1 week LT and 2 weeks LT. Together with the significant correlation between expectations and therapy response in women, we hypothesize that expectations play a role in the speed of therapy response. Copyright © 2014 Elsevier B.V. All rights reserved.

Health care delivery system for long duration manned space operations

NASA Technical Reports Server (NTRS)

Logan, J. S.; Shulman, E. L.; Johnson, P. C.

1983-01-01

Specific requirements for medical support of a long-duration manned facility in a low earth orbit derive from inflight medical experience, projected medical scenarios, mission related spacecraft and environmental hazards, health maintenance, and preventive medicine. A sequential buildup of medical capabilities tailored to increasing mission complexity is proposed. The space station health maintenance facility must provide preventive, diagnostic, and therapeutic medical support as immediate rescue capability may not exist.

Preventive Interventions for the Second Half of Life: A Systematic Review.

PubMed

Hajat, Cother; Selwyn, Adriana; Harris, Mark; Yach, Derek

2018-05-01

Recent improvements in life expectancy globally require intensified focus on noncommunicable diseases and age-related conditions. The purpose of this article is to inform the development of age-specific prevention guidelines for adults aged 50 and above, which are currently lacking. PubMed, Cochrane database, and Google Scholar and explicit outreach to experts in the field. Meta-analyses, intervention-based, and prospective cohort studies that reported all-cause mortality, disease-specific mortality, or morbidity in adults were included. A systematic review was undertaken in 2015 using search terms of a combination of and "intervention," "mortality," "reduction," "improvement," "death," and "morbidity." Interventions were categorized according to the Center for Evidence-Based Medicine Level of Evidence framework. A summary table reports for each intervention the impact, strength of evidence, initiation, duration, and details of the intervention. Age-decade-specific preventive recommendations have been proposed relating to physical activity, diet, tobacco and alcohol use, medication adherence, screening and vaccination, and mental and cognitive health. Clear recommendations have been made according to the existing evidence base, but further research investment is needed to fill the many gaps. Further, personalized approaches to healthy aging complemented by population-wide approaches and broader cross-sector partnerships will help to ensure greater longevity is an opportunity, rather than a burden, for society.

[Consequences of new patient discharge guidelines on the cost structure of radioiodine therapy].

PubMed

Dietlein, M; Troche, C J; Moka, D; Bausch, V; Lauterbach, K W; Schicha, H

1998-01-01

Consequences of the new recommendations by the Federal German Radiation Protection Committee (SSK) for patient discharge guidelines (residual activity of 250 MBq for I-131) were calculated for duration of stay and radioiodine therapy cost management. For 601 consecutively admitted patients with hyperthyreosis, actual duration of stay and duration of stay according to previous guidelines (from 1993) were calculated, as well as duration of stay according to recommended values. Following BPflV statutes, cost-analysis considered the cause and volume of goitre, and by using sensitivity analyses included a range of diagnostics, service assessment, and duration of stay. Duration of stay following I-131 therapy (in Germany) is expected to fall by 35-50% (average future stay 4.0 +/- 2.8 days), average costs from DM 4,452 to DM 3,680 (-17.4%). Not including pretreatment diagnostics, cost reduction (service assessment 17-24%) was estimated at 21-25%. Compared to strumectomy, I-131 therapy costs are expected to be lower for goitres (Graves' disease) up to at least 60 ml, toxic nodules of at least 25 ml, and toxic multinodular goitres of at least 90 ml. In the future, I-131 therapy will be more cost-effective even with larger goitres. Since reimbursement is determined by the duration of stay, new reimbursement procedures are discussed in this paper.

Willingness to pay to prevent chemotherapy induced nausea and vomiting among patients with breast, lung, or colorectal cancer.

PubMed

Miller, Paul J E; Balu, Sanjeev; Buchner, Deborah; Walker, Mark S; Stepanski, Edward J; Schwartzberg, Lee S

2013-10-01

Understanding the value patients place on avoiding various aspects of chemotherapy induced nausea and vomiting (CINV) can help medical professionals assess whether current and emerging treatments are acceptable based on their costs and expected effects. Little is known, however, about the value patients place on avoiding various aspects of CINV. The current study helps fill this gap in the literature. 301 patients completed a discrete-choice conjoint survey. Patients viewed 25 conjoint tasks, each containing two descriptions of CINV, and indicated which they preferred. The descriptions combined levels from eight CINV attributes (likelihood of nausea, duration of nausea, severity of nausea, likelihood of vomiting, duration of vomiting, severity of vomiting, need to seek treatment for dehydration, and out-of-pocket treatment costs). Cost contributed more to patient choices than any other single attribute. The combined effect of the likelihood, duration, and severity attributes for nausea, however, was a stronger driver of patient choices than cost, as was the combined effect of the likelihood, duration, and severity attributes for vomiting. The nausea attributes also were a stronger driver of patient choices than the vomiting attributes. Patients were willing to pay to avoid increases in all attributes, except likelihood of vomiting, where the result was not statistically different from zero. Willingness-to-pay varied by income, disease stage, Eastern Cooperative Oncology Group performance status, chemotherapy status, and whether patients worked while on chemotherapy. Although the study used a convenience sample, data were collected from several geographically dispersed U.S. oncology clinics. Several antiemetics are now available at different price points. This study assesses the value patients place on their benefits and may be used to inform decisions about the management of CINV.

Improving the quality of pressure ulcer care with prevention: a cost-effectiveness analysis.

PubMed

Padula, William V; Mishra, Manish K; Makic, Mary Beth F; Sullivan, Patrick W

2011-04-01

In October 2008, Centers for Medicare and Medicaid Services discontinued reimbursement for hospital-acquired pressure ulcers (HAPUs), thus placing stress on hospitals to prevent incidence of this costly condition. To evaluate whether prevention methods are cost-effective compared with standard care in the management of HAPUs. A semi-Markov model simulated the admission of patients to an acute care hospital from the time of admission through 1 year using the societal perspective. The model simulated health states that could potentially lead to an HAPU through either the practice of "prevention" or "standard care." Univariate sensitivity analyses, threshold analyses, and Bayesian multivariate probabilistic sensitivity analysis using 10,000 Monte Carlo simulations were conducted. Cost per quality-adjusted life-years (QALYs) gained for the prevention of HAPUs. Prevention was cost saving and resulted in greater expected effectiveness compared with the standard care approach per hospitalization. The expected cost of prevention was $7276.35, and the expected effectiveness was 11.241 QALYs. The expected cost for standard care was $10,053.95, and the expected effectiveness was 9.342 QALYs. The multivariate probabilistic sensitivity analysis showed that prevention resulted in cost savings in 99.99% of the simulations. The threshold cost of prevention was $821.53 per day per person, whereas the cost of prevention was estimated to be $54.66 per day per person. This study suggests that it is more cost effective to pay for prevention of HAPUs compared with standard care. Continuous preventive care of HAPUs in acutely ill patients could potentially reduce incidence and prevalence, as well as lead to lower expenditures.

Early Prevention of Childhood Disability in Developing Countries.

ERIC Educational Resources Information Center

Simeonsson, Rune J.

1991-01-01

This paper presents a disability prevention framework for community-based rehabilitation services, by conceptualizing early intervention in terms of primary, secondary, and tertiary levels of prevention. The framework views prevention as the effort to reduce a disability's expression, duration, or extended impact. (Author/JDD)

Exploration Health Risks: Probabilistic Risk Assessment

NASA Technical Reports Server (NTRS)

Rhatigan, Jennifer; Charles, John; Hayes, Judith; Wren, Kiley

2006-01-01

Maintenance of human health on long-duration exploration missions is a primary challenge to mission designers. Indeed, human health risks are currently the largest risk contributors to the risks of evacuation or loss of the crew on long-duration International Space Station missions. We describe a quantitative assessment of the relative probabilities of occurrence of the individual risks to human safety and efficiency during space flight to augment qualitative assessments used in this field to date. Quantitative probabilistic risk assessments will allow program managers to focus resources on those human health risks most likely to occur with undesirable consequences. Truly quantitative assessments are common, even expected, in the engineering and actuarial spheres, but that capability is just emerging in some arenas of life sciences research, such as identifying and minimize the hazards to astronauts during future space exploration missions. Our expectation is that these results can be used to inform NASA mission design trade studies in the near future with the objective of preventing the higher among the human health risks. We identify and discuss statistical techniques to provide this risk quantification based on relevant sets of astronaut biomedical data from short and long duration space flights as well as relevant analog populations. We outline critical assumptions made in the calculations and discuss the rationale for these. Our efforts to date have focussed on quantifying the probabilities of medical risks that are qualitatively perceived as relatively high risks of radiation sickness, cardiac dysrhythmias, medically significant renal stone formation due to increased calcium mobilization, decompression sickness as a result of EVA (extravehicular activity), and bone fracture due to loss of bone mineral density. We present these quantitative probabilities in order-of-magnitude comparison format so that relative risk can be gauged. We address the effects of conservative and nonconservative assumptions on the probability results. We discuss the methods necessary to assess mission risks once exploration mission scenarios are characterized. Preliminary efforts have produced results that are commensurate with earlier qualitative estimates of risk probabilities in this and other operational contexts, indicating that our approach may be usefully applied in support of the development of human health and performance standards for long-duration space exploration missions. This approach will also enable mission-specific probabilistic risk assessments for space exploration missions.

Prospective study of physical activity and sleep in middle-aged and older adults.

PubMed

Tsunoda, Kenji; Kitano, Naruki; Kai, Yuko; Uchida, Ken; Kuchiki, Tsutomu; Okura, Tomohiro; Nagamatsu, Toshiya

2015-06-01

Few prospective cohort studies have examined the association between physical activity (PA) and insomnia prevention, and the effective PA intensity remains unclear. This prospective study explores how PA intensity prevents incident short sleep duration and subjective insufficient sleep in middle-aged and older adults. A self-reported questionnaire gathered data on sleep and PA variables, including moderate low-intensity PA (MLPA); moderate high-intensity PA (MHPA); and vigorous-intensity PA (VPA), during health checkups conducted in Meiji Yasuda Shinjuku Medical Center in Tokyo. This study followed two cohorts from a 2008 baseline survey: (1) participants free of short sleep duration (n=7,061) and (2) participants free of insufficient sleep (n=7,385). They were divided into middle-aged (<60 years; 45.7 [8.8] years for sleep duration and 45.5 [8.8] years for sleep sufficiency) and older adults (both groups aged 65.3 [4.7] years) and followed for a mean 3.4 years until 2013. Data were analyzed in 2014. Engaging in MHPA (hazard ratio [HR]=0.81, 95% CI=0.67, 0.98) and VPA (HR=0.83, 95% CI=0.71, 0.97) had a significant preventive effect on incident subjective insufficient sleep among middle-aged adults. For older adults, only MLPA (HR=0.58, 95% CI=0.42, 0.81) had a significant preventive effect on incident insufficient sleep, and PA did not significantly affect incident short sleep duration. Middle-aged adults engaging in MHPA and VPA and older adults engaging in MLPA can effectively maintain sleep sufficiency. When providing an effective PA program to prevent insomnia, the intensity of PA should correspond to the participant's age. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Preventive vaccination contributes to control classical swine fever in wild boar (Sus scrofa sp.).

PubMed

Rossi, S; Pol, F; Forot, B; Masse-Provin, N; Rigaux, S; Bronner, A; Le Potier, M-F

2010-04-21

Over the last 20 years, oral vaccination implementing a live attenuated vaccine has been experimented in Europe in order to control classical swine fever (CSF) in Wild Boar (Sus scrofa sp.). This has generally led to an enhanced seroprevalence and a decreased viroprevalence at the scale of the whole vaccinated populations, but no quantitative analysis has demonstrated the protective effect of preventive vaccination or intensive baiting. In the present paper we conducted a retrospective analysis at the scale of the municipality, taking into account the local dynamics and possible covariates of infection to test the effect of preventive vaccination and of the baiting effort. To be efficient, vaccination was expected to increase seroprevalence above the level considered as suitable for preventing disease invasion (40-60%) independently of infection, to protect free areas from disease invasion or contribute to control subsequent disease intensity and duration. We also hypothesized that a better baiting effort would be correlated with an improvement of immunisation and disease control. In uninfected municipalities, seroprevalence increased up to 40% after 1 year, i.e., three vaccination campaigns. We observed a significant protective effect of preventive vaccination, especially within municipalities that had been vaccinated at least 1 year before disease emergence and where virus detection did not last more than one quarter. On the other hand, we did not detect a significant effect of the baiting effort on local seroprevalence or disease dynamics, suggesting that the baiting system could be improved. We discuss these results regarding the improvement of management measures and further research perspective. Copyright 2009 Elsevier B.V. All rights reserved.

Linking melodic expectation to expressive performance timing and perceived musical tension.

PubMed

Gingras, Bruno; Pearce, Marcus T; Goodchild, Meghan; Dean, Roger T; Wiggins, Geraint; McAdams, Stephen

2016-04-01

This research explored the relations between the predictability of musical structure, expressive timing in performance, and listeners' perceived musical tension. Studies analyzing the influence of expressive timing on listeners' affective responses have been constrained by the fact that, in most pieces, the notated durations limit performers' interpretive freedom. To circumvent this issue, we focused on the unmeasured prelude, a semi-improvisatory genre without notated durations. In Experiment 1, 12 professional harpsichordists recorded an unmeasured prelude on a harpsichord equipped with a MIDI console. Melodic expectation was assessed using a probabilistic model (IDyOM [Information Dynamics of Music]) whose expectations have been previously shown to match closely those of human listeners. Performance timing information was extracted from the MIDI data using a score-performance matching algorithm. Time-series analyses showed that, in a piece with unspecified note durations, the predictability of melodic structure measurably influenced tempo fluctuations in performance. In Experiment 2, another 10 harpsichordists, 20 nonharpsichordist musicians, and 20 nonmusicians listened to the recordings from Experiment 1 and rated the perceived tension continuously. Granger causality analyses were conducted to investigate predictive relations among melodic expectation, expressive timing, and perceived tension. Although melodic expectation, as modeled by IDyOM, modestly predicted perceived tension for all participant groups, neither of its components, information content or entropy, was Granger causal. In contrast, expressive timing was a strong predictor and was Granger causal. However, because melodic expectation was also predictive of expressive timing, our results outline a complete chain of influence from predictability of melodic structure via expressive performance timing to perceived musical tension. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

PREvention STudy On preventing or reducing disability from musculoskeletal complaints in music school students (PRESTO): protocol of a randomised controlled trial.

PubMed

Baadjou, Vera A E; Verbunt, Jeanine A M C F; Eijsden-Besseling, Marjon D F van; Samama-Polak, Ans L W; Bie, Rob A D E; Smeets, Rob J E M

2014-12-01

Up to 87% of professional musicians develop work-related complaints of the musculoskeletal system during their careers. Music school students are at specific risk for developing musculoskeletal complaints and disabilities. This study aims to evaluate the effectiveness of a biopsychosocial prevention program to prevent or reduce disabilities from playing-related musculoskeletal disorders. Secondary objectives are evaluation of cost-effectiveness and feasibility. Healthy, first or second year students (n=150) will be asked to participate in a multicentre, single-blinded, parallel-group randomised controlled trial. Students randomised to the intervention group (n=75) will participate in a biopsychosocial prevention program that addresses playing-related health problems and provides postural training according to the Mensendieck or Cesar methods of postural exercise therapy, while incorporating aspects from behavioural change theories. A control group (n=75) will participate in a program that stimulates a healthy physical activity level using a pedometer, which conforms to international recommendations. No long-term effects are expected from this control intervention. Total follow-up duration is two years. The primary outcome measure is disability (Disabilities of Arm, Shoulder and Hand questionnaire). The secondary outcome measures are pain, quality of life and changes in health behaviour. Multilevel mixed-effect logistic or linear regression analyses will be performed to analyse the effects of the program on the aforementioned outcome measurements. Furthermore, cost-effectiveness, cost-utility and feasibility will be analysed. It is believed that this is the first comprehensive randomised controlled trial on the effect and rationale of a biopsychosocial prevention program for music students. Copyright © 2014 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Prevention and treatment of postmenopausal osteoporosis.

PubMed

Hallworth, R B

1998-10-01

The purpose of the review is to outline the interventions, both pharmacological and non-pharmacological, available to prevent postmenopausal osteoporosis (PMO) and treat the established disease. Current suggested guidelines for the most cost-effective treatment and prophylactic strategies are included following a consideration of the available options. As life expectancy has increased so has the incidence of PMO which has major quality of life implications for the sufferers and economic implications for the authorities responsible for their treatment. PMO represents a significant public health problem and although more effective treatments are becoming available prevention of the disease by taking account of existing risk factors is preferable. Indeed, a population approach to prevention may be more cost effective than screening for the disease. Attention to dietary calcium intake and exercise regimes have been shown to be effective prophylactic measures premenopausally, while the treatment of choice is hormone replacement therapy (HRT). HRT treats other postmenopausal symptoms in addition to PMO and is available in many presentations, containing different hormones, at different doses intended for different routes of administration. The optimum treatment duration is controversial and may contribute to some of the risks associated with HRT such as endometrial and breast carcinoma and venous thromboembolism (VTE). Newer effective treatments include the bisphosphonates and novel formulations of calcitonin, but older approaches such as vitamin D, anabolic steroids and fluoride are still utilised in some circumstances. However, most promise has been shown by synthetic hormonal modulators currently being trialled.

Applying an Employee-Motivation Model to Prevent Student Plagiarism.

ERIC Educational Resources Information Center

Malouff, John M.; Sims, Randi L.

1996-01-01

A model based on Vroom's expectancy theory of employee motivation posits that instructors can prevent plagiarism by ensuring that students understand the rules of ethical writing, expect assignments to be manageable and have personal benefits, and expect plagiarism to be difficult and have important personal costs. (SK)

Cue-induced cigarette cravings and smoking cessation: the role of expectancies.

PubMed

Erblich, Joel; Montgomery, Guy H

2012-07-01

Cue-induced cigarette cravings have been oft studied as potentially important predictors of smoking cessation outcomes. The literature on the relationship between cue-induced cravings and cessation, however, remains mixed. One possible explanation for the discrepant results in the literature may be the as-yet untested variability in expectancies of craving. Indeed, as with many interoceptive responses, cravings and their downstream consequences may be influenced by expectancies. To date, no study has examined the influence of expected cravings following smoking cue exposures on actual craving experiences and cessation outcomes. The objective of this study, therefore, was to test the possibility that smokers' expected craving levels in response to smoking cues would be related to actual cravings following cue exposure and that expected cravings would be related to cessation outcomes. Nicotine-dependent adult smokers (n = 153) were exposed to sets of neutral and smoking cues and completed questionnaires assessing (a) prior to the exposures, the cigarette craving levels they expected to experience following the cue exposures and (b) following the exposures, their actual craving levels. Participants also reported the duration of their most recent quit attempt and their perceived future quit difficulty. Findings indicated that expected cravings assessed prior to the cue exposures were significantly related to actual cravings following the exposures. In addition, both expected cravings and actual cravings were related to shorter previous quit duration and higher perceived quit difficulty. Study results highlight the importance of considering both expected and actual cravings in cue-induced craving paradigms.

A Network Selection Algorithm Considering Power Consumption in Hybrid Wireless Networks

NASA Astrophysics Data System (ADS)

Joe, Inwhee; Kim, Won-Tae; Hong, Seokjoon

In this paper, we propose a novel network selection algorithm considering power consumption in hybrid wireless networks for vertical handover. CDMA, WiBro, WLAN networks are candidate networks for this selection algorithm. This algorithm is composed of the power consumption prediction algorithm and the final network selection algorithm. The power consumption prediction algorithm estimates the expected lifetime of the mobile station based on the current battery level, traffic class and power consumption for each network interface card of the mobile station. If the expected lifetime of the mobile station in a certain network is not long enough compared the handover delay, this particular network will be removed from the candidate network list, thereby preventing unnecessary handovers in the preprocessing procedure. On the other hand, the final network selection algorithm consists of AHP (Analytic Hierarchical Process) and GRA (Grey Relational Analysis). The global factors of the network selection structure are QoS, cost and lifetime. If user preference is lifetime, our selection algorithm selects the network that offers longest service duration due to low power consumption. Also, we conduct some simulations using the OPNET simulation tool. The simulation results show that the proposed algorithm provides longer lifetime in the hybrid wireless network environment.

Study on the expectation differences between the both sides of farmland transfer at the level of farmer

NASA Astrophysics Data System (ADS)

Yang, Liyong; Liu, Dejiang; Qiu, Cheng; Wu, Xianhua

2017-12-01

The expected consistency between the both sides of farmland transfer is the key to the success or failure of transfer. We use the participatory rural appraisal method, carry out a questionnaire survey of farmers in Yunnan Province, and analysis empirically the expectation differences on the will, price, duration, objects and contract between the both sides of farmland transfer. The research shows that: farmers in the suburban village tend to be willing to transfer out rather than transfer in, while farmers in the outer suburbs village tend to prefer to transfer in rather than transfer out. They are relatively small in the expectation of will, duration, objects and contract between the both sides of farmland transfer, and the transfer price "gap" is the most important factor that impedes the farmland transfer. Measures should be taken to promote the farmland transfer from three aspects, such as the promotion of farmland protection regulations, the establishment and improvement of transfer institutions and the opening of transfer price.

Migration from new-accession countries and duration expectancy in the EU-15: 2002–2008

PubMed Central

DeWaard, Jack; Ha, Jasmine Trang; Raymer, James; Wiśniowski, Arkadiusz

2016-01-01

European Union (EU) enlargements in 2004 and 2007 were accompanied by increased migration from new-accession to established-member (EU-15) countries. The impacts of these flows depend, in part, on the amount of time that persons from the former countries live in the latter over the life course. In this paper, we develop period estimates of duration expectancy in EU-15 countries among persons from new-accession countries. Using a newly developed set of harmonised Bayesian estimates of migration flows each year from 2002 to 2008 from the Integrated Modelling of European Migration (IMEM) Project, we exploit period age patterns of country-to-country migration and mortality to summarize the average number of years that persons from new-accession countries could be expected to live in EU-15 countries over the life course. In general, the results show that the amount of time that persons from new-accession countries could be expected to live in the EU-15 nearly doubled after 2004. PMID:28286353

Impact of Extended-Duration Shifts on Medical Errors, Adverse Events, and Attentional Failures

PubMed Central

Barger, Laura K; Ayas, Najib T; Cade, Brian E; Cronin, John W; Rosner, Bernard; Speizer, Frank E; Czeisler, Charles A

2006-01-01

Background A recent randomized controlled trial in critical-care units revealed that the elimination of extended-duration work shifts (≥24 h) reduces the rates of significant medical errors and polysomnographically recorded attentional failures. This raised the concern that the extended-duration shifts commonly worked by interns may contribute to the risk of medical errors being made, and perhaps to the risk of adverse events more generally. Our current study assessed whether extended-duration shifts worked by interns are associated with significant medical errors, adverse events, and attentional failures in a diverse population of interns across the United States. Methods and Findings We conducted a Web-based survey, across the United States, in which 2,737 residents in their first postgraduate year (interns) completed 17,003 monthly reports. The association between the number of extended-duration shifts worked in the month and the reporting of significant medical errors, preventable adverse events, and attentional failures was assessed using a case-crossover analysis in which each intern acted as his/her own control. Compared to months in which no extended-duration shifts were worked, during months in which between one and four extended-duration shifts and five or more extended-duration shifts were worked, the odds ratios of reporting at least one fatigue-related significant medical error were 3.5 (95% confidence interval [CI], 3.3–3.7) and 7.5 (95% CI, 7.2–7.8), respectively. The respective odds ratios for fatigue-related preventable adverse events, 8.7 (95% CI, 3.4–22) and 7.0 (95% CI, 4.3–11), were also increased. Interns working five or more extended-duration shifts per month reported more attentional failures during lectures, rounds, and clinical activities, including surgery and reported 300% more fatigue-related preventable adverse events resulting in a fatality. Conclusions In our survey, extended-duration work shifts were associated with an increased risk of significant medical errors, adverse events, and attentional failures in interns across the United States. These results have important public policy implications for postgraduate medical education. PMID:17194188

33 CFR 25.117 - Proof of amount claimed for personal injury or death.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Duration of time injuries prevented or limited employment, (4) Past, present, and future limitations on employment, (5) Duration and extent of pain and suffering and of any disability or physical disfigurement, (6...

The preventive effect and duration of action of two doses of inhaled furosemide on exercise-induced asthma in children.

PubMed

Novembre, E; Frongia, G; Lombardi, E; Resti, M; Zammarchi, E; Vierucci, A

1995-12-01

Exercise-induced asthma can be prevented by treatment with inhaled furosemide. In this study we evaluated the effect and duration of action of two doses (15 and 30 mg) of inhaled furosemide in prevention of exercise-induced asthma in children. Ten children with exercise-induced asthma (8 boys and 2 girls, aged 6 to 13 years) were included in the study. Each patient was tested with three treatment regimens (placebo, 15 mg of furosemide, and 30 mg of furosemide) in random order on 3 separate days. Patients performed exercise challenges on a treadmill at 20 minutes and 1, 2, 3, and 6 hours after each treatment. Pulmonary function, urinary output, and fluid intake were monitored. Both doses of furosemide had a significantly greater protective effect than placebo, but there was no significant difference between the two doses of furosemide. The higher dose of furosemide was associated with increased urinary output and had a longer duration of action. A 30 mg dose of furosemide is more effective for treatment of exercise-induced asthma in terms of duration but has a significant diuretic effect.

Worklife expectancies of fixed-term Finnish employees in 1997-2006.

PubMed

Nurminen, Markku

2008-04-01

Fixed-term employment is prevalent in the Finnish labor force. This form of employment contract is marked by fragmentary work periods, demands for flexibility in workhours, and concern for multiple insecurities. A nonpermanent employee may also incur adverse health consequences. Yet there exist no exact statistics on the duration of fixed-term employment. This paper estimated the future duration of the time that a Finn is expected to be engaged in irregular work. Multistate regression modeling and stochastic analysis were applied to aggregated data from surveys conducted among the labor force by Statistics Finland in 1997-2006. In 2006, a Finnish male was expected to work a total of 3.8 years in fixed-term employment, combined over consecutive or separate time spans; this time amounts to 8% of his remaining work career from entry into the work force until final retirement. For a woman the expectancy was greater, 6.5 years or 13%. For the age interval 20-29 years, the total was 16% for men and 23% for women. The type and duration of employment is influenced by security factors and economic cycles, both of which affect men and women differently. Over the past decade, fixed-term employment increased consistently in the female labor contingent, and it was more pronounced during economic slowdowns. This labor market development calls for standards for flexibility and guarantees for security in the fragmented future worklives of fixed-term employees.

The Design of Time-Series Comparisons under Resource Constraints.

ERIC Educational Resources Information Center

Willemain, Thomas R.; Hartunian, Nelson S.

1982-01-01

Two methods for dividing an interrupted time-series study between baseline and experimental phases when study resources are limited are compared. In fixed designs, the baseline duration is predetermined. In flexible designs the baseline duration is contingent on remaining resources and the match of results to prior expectations of the evaluator.…

Higher Education as an Extended Duration Service: An Investigation of the Determinants of Vietnamese Overseas Student Loyalty

ERIC Educational Resources Information Center

Pham, Hiep-Hung; Lai, Sue Ling

2016-01-01

Regarding higher education as a type of extended duration service, this article proposes a framework considering adjusted expectation, disconfirmation, satisfaction, and commitment in a conceptual model to explain international student loyalty. Employing a structure equation model to the sample data collected from 252 Vietnam overseas students…

20 CFR 617.44 - Findings required.

Code of Federal Regulations, 2010 CFR

2010-04-01

... individual began and completed the relocation within the limitations specified in § 617.42(a)(7) and § 617.43... employment of long-term duration, or a bona fide offer of such suitable employment, in the area of intended... employment affording a reasonable expectation of employment of long-term duration, or a bona fide offer of...

Estimation of duration and mental workload at differing times of day by males and females

NASA Technical Reports Server (NTRS)

Hancock, P. A.; Rodenburg, G. J.; Mathews, W. D.; Vercruyssen, M.

1988-01-01

Two experiments are reported which investigated whether male and female operator duration estimation and subjective workload followed conventional circadian fluctuation. In the first experiment, twenty-four subjects performed a filled time-estimation task in a constant blacked-out, noise-reduced environment at 0800, 1200, 1600, and 2000 h. In the second experiment, twelve subjects performed an unfilled time estimation task in similar conditions at 0900, 1400, and 1900 h. At the termination of all experimental sessions, participants completed the NASA TLX workload assessment questionnaire as a measure of perceived mental workload. Results indicated that while physiological response followed an expected pattern, estimations of duration and subjective perception of workload showed no significant effects for time-of-day. In each of the experiments, however, there were significant differences in durational estimates and mental workload response depending upon the gender of the participant. Results are taken to support the assertion that subjective workload is responsive largely to task-related factors and indicates the important differences that may be expected due to operator gender.

Economic evaluation of meningococcal serogroup B childhood vaccination in Ontario, Canada.

PubMed

Tu, Hong Anh T; Deeks, Shelley L; Morris, Shaun K; Strifler, Lisa; Crowcroft, Natasha; Jamieson, Frances B; Kwong, Jeffrey C; Coyte, Peter C; Krahn, Murray; Sander, Beate

2014-09-22

Invasive Neisseria meningitidis serogroup B (MenB) disease is a low incidence but severe infection (mean annual incidence 0.19/100,000/year, case fatality 11%, major long-term sequelae 10%) in Ontario, Canada. This study assesses the cost-effectiveness of a novel MenB vaccine from the Ontario healthcare payer perspective. A Markov cohort model of invasive MenB disease based on high quality local data and data from the literature was developed. A 4-dose vaccination schedule, 97% coverage, 90% effectiveness, 66% strain coverage, 10-year duration of protection, and vaccine cost of C$75/dose were assumed. A hypothetical Ontario birth cohort (n=150,000) was simulated to estimate expected lifetime health outcomes, quality-adjusted life years (QALYs), and costs, discounted at 5%. A MenB infant vaccination program is expected to prevent 4.6 invasive MenB disease cases over the lifetime of an Ontario birth cohort, equivalent to 10 QALYs gained. The estimated program cost of C$46.6 million per cohort (including C$318,383 for treatment of vaccine-associated adverse events) were not offset by healthcare cost savings of C$150,522 from preventing MenB cases, resulting in an incremental cost of C$4.76 million per QALY gained. Sensitivity analyses showed the findings to be robust. An infant MenB vaccination program significantly exceeds commonly used cost-effectiveness thresholds and thus is unlikely to be considered economically attractive in Ontario and comparable jurisdictions. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Injury Prevention in Aircraft Crashes: Investigative Techniques and Applications (la Prevention des lesions lors des accidents d’ avions: les techniques d’investigation et leurs applications)

DTIC Science & Technology

1998-02-01

provide the aircrew and passengers with a level of protection commensurate with the risk of operating aircraft in the military and civilian...the time taken to reach peak acceleration and upon the peak acceleration level attained. Long duration acceleration, which can be experienced in...acceleration depends principally on the plateau level of the acceleration imposed on the body, as the response to long duration acceleration is due

Protection from glutamate-induced excitotoxicity by memantine

PubMed Central

Kutzing, Melinda K.; Luo, Vincent; Firestein, Bonnie L.

2014-01-01

This study investigates whether the uncompetitive NMDA receptor antagonist, memantine, is able to protect dissociated cortical neurons from glutamate-induced excitotoxicity (GIE). Treatment with glutamate resulted in a significant loss of synchronization of neuronal activity as well as a significant increase in the duration of synchronized bursting events (SBEs). By administering memantine at the same time as glutamate, we were able to completely prevent these changes to the neuronal activity. Pretreatment with memantine was somewhat effective in preventing changes to the culture synchronization but was unable to fully protect the synchronization of electrical activity between neurons that showed high levels of synchronization prior to injury. Additionally, memantine pretreatment was unable to prevent the increase in the duration of SBEs caused by GIE. Thus, the timing of memantine treatment is important for conferring neuroprotection against glutamate-induced neurotoxicity. Finally, we found that GIE leads to a significant increase in the burst duration. Our data suggest that this may be due to an alteration in the inhibitory function of the neurons. PMID:22203191

Enhanced detection of terrestrial gamma-ray flashes by AGILE.

PubMed

Marisaldi, M; Argan, A; Ursi, A; Gjesteland, T; Fuschino, F; Labanti, C; Galli, M; Tavani, M; Pittori, C; Verrecchia, F; D'Amico, F; Østgaard, N; Mereghetti, S; Campana, R; Cattaneo, P W; Bulgarelli, A; Colafrancesco, S; Dietrich, S; Longo, F; Gianotti, F; Giommi, P; Rappoldi, A; Trifoglio, M; Trois, A

2015-11-16

At the end of March 2015 the onboard software configuration of the Astrorivelatore Gamma a Immagini Leggero (AGILE) satellite was modified in order to disable the veto signal of the anticoincidence shield for the minicalorimeter instrument. The motivation for such a change was the understanding that the dead time induced by the anticoincidence prevented the detection of a large fraction of Terrestrial Gamma-Ray Flashes (TGFs). The configuration change was highly successful resulting in an increase of one order of magnitude in TGF detection rate. As expected, the largest fraction of the new events has short duration (<100 μs), and part of them has simultaneous association with lightning sferics detected by the World Wide Lightning Location Network. The new configuration provides the largest TGF detection rate surface density (TGFs/km 2 /yr) to date, opening prospects for improved correlation studies with lightning and atmospheric parameters on short spatial and temporal scales along the equatorial region.

Emerging Therapeutic Opportunities for Skeletal Restoration

PubMed Central

Kawai, Masanobu; Mödder, Ulrike I.; Khosla, Sundeep; Rosen, Clifford J

2011-01-01

Preface Osteoporosis, a syndrome characterized by thin bones and fractures, has become more prevalent in both women and men. Established therapies for this disorder consist primarily of drugs that prevent bone loss, such as the bisphosphonates and selective estrogen receptor modulators. Although these drugs have been shown to reduce fractures in randomized trials, there is an urgent need for treatments that could lower fracture risk further without additional adverse effects. The introduction of parathyroid hormone (teriparatide), which significantly increases bone mineral density, albeit for a relatively short duration, raised expectations that drugs which stimulate bone formation might cure osteoporosis. After outlining current approaches to treating osteoporosis, this review focuses on emerging therapeutic opportunities for osteoporosis that are based on recent insights into skeletal physiology. Such novel strategies offer promise for not only reducing age-related bone loss and the associated risk of fractures, but restoring bone mineral density to healthy levels. PMID:21283108

Men, Women, and Life Annuities

ERIC Educational Resources Information Center

King, Francis P.

1976-01-01

A senior research officer of Teacher Insurance and Annuity Association (TIAA) and College Retirement Equities Fund (CREF) discusses the issue of different life annuity benefits to men and women concluding that age and sex are two objective and statistically reliable factors used in determining life expectancy and thus the expected duration of…

Systematic Review of Prognostic Factors for Return to Work in Workers with Sub Acute and Chronic Low Back Pain.

PubMed

Steenstra, Ivan A; Munhall, Claire; Irvin, Emma; Oranye, Nelson; Passmore, Steven; Van Eerd, Dwayne; Mahood, Quenby; Hogg-Johnson, Sheilah

2017-09-01

Purpose We systematically reviewed the evidence on factors that predict duration of sick leave in workers after 6 weeks low back pain (LBP) related sick leave. We hypothesized that different factors affect the duration of the leave depending on the time away from work. Methods The review occurred in seven phases: (1) developing the central question, (2) conducting the literature search, (3) identifying relevant publications, (4) quality appraisal, (5) data extraction, (6) evidence synthesis, and (7) knowledge translation. We searched for studies that reported episodes of LBP and sick leave that lasted more than 6 weeks. All included studies reported at least one prognostic factor where return to work was the outcome. Results We identified twenty-two relevant publications. The impact of pain, functional status and radiating pain seems to change with duration of work disability. Workers' recovery expectations remain important after 6 weeks. Modified duties are rarely studied in later phases of work disability. Depression/mental health did not appear to be an important factor in later phases. Workplace physical factors remain important. There is insufficient evidence that pain catastrophising and fear avoidance are predictive factors in later phases. There was moderate evidence for age in the later phases. Functional capacity and claim related factors were supported by some evidence. Discusion Physical demands in the workplace are preventing workers from getting back to work in a timely fashion across phases. The psychosocial work environment is understudied in later phases. Overall, we cannot conclude that prognostic factors change over time.

[Longevity, disease, and duration of disability].

PubMed

Matsushita, S

1996-12-01

Disability and the resulting lowered quality of life are serious issues accompanying increased longevity. Active life expectancy #(8) can be to used to distinguish the number of years without disability from the number with disability; increases were found in both in longevity #(9, 19). With the same rate of age-related new disability in the cohorts between 1970 and 1990, the total disability increased three fold #(11). In elderly patients I showed that 1) the duration of disability of those at a specific age at death (predeath) #(1) increased with age, and it decreased in those who remained without disability, 2) the cumulative number of days of disability for patients who died at a specific age (a convolution function of predeath and mortality) #(2), approached a normal distribution, which is consistent with the central limit theorem, 3) competing risk with chronic disease in a patient greatly affects the incidence and duration of disability, 4) using the central limit theorem we can predict that preventing dementia will retard premature rectangularization of the disability-free survival curve, and will thus reduce the total disability, 5) disability is an example of how variation and selection of chronic diseases (disease Darwinism) can alter population structure. Insights into the evolution of senescence #(14-21), pleiotropy, and slower rates of molecular evolution in the core than at the border #(26, 27), reveal that the central nervous system is relatively robust and conservative for pleiotropy and may senesce relatively slowly, which support a new way of thinking #(3, 4) about old age. To minimize disability, public knowledge and education about an ideal lifestyle and the evolution of senescence is essential.

The impact of heat waves on mortality in 9 European cities: results from the EuroHEAT project.

PubMed

D'Ippoliti, Daniela; Michelozzi, Paola; Marino, Claudia; de'Donato, Francesca; Menne, Bettina; Katsouyanni, Klea; Kirchmayer, Ursula; Analitis, Antonis; Medina-Ramón, Mercedes; Paldy, Anna; Atkinson, Richard; Kovats, Sari; Bisanti, Luigi; Schneider, Alexandra; Lefranc, Agnès; Iñiguez, Carmen; Perucci, Carlo A

2010-07-16

The present study aimed at developing a standardized heat wave definition to estimate and compare the impact on mortality by gender, age and death causes in Europe during summers 1990-2004 and 2003, separately, accounting for heat wave duration and intensity. Heat waves were defined considering both maximum apparent temperature and minimum temperature and classified by intensity, duration and timing during summer. The effect was estimated as percent increase in daily mortality during heat wave days compared to non heat wave days in people over 65 years. City specific and pooled estimates by gender, age and cause of death were calculated. The effect of heat waves showed great geographical heterogeneity among cities. Considering all years, except 2003, the increase in mortality during heat wave days ranged from + 7.6% in Munich to + 33.6% in Milan. The increase was up to 3-times greater during episodes of long duration and high intensity. Pooled results showed a greater impact in Mediterranean (+ 21.8% for total mortality) than in North Continental (+ 12.4%) cities. The highest effect was observed for respiratory diseases and among women aged 75-84 years. In 2003 the highest impact was observed in cities where heat wave episode was characterized by unusual meteorological conditions. Climate change scenarios indicate that extreme events are expected to increase in the future even in regions where heat waves are not frequent. Considering our results prevention programs should specifically target the elderly, women and those suffering from chronic respiratory disorders, thus reducing the impact on mortality.

Cue-Induced Cigarette Cravings and Smoking Cessation: The Role of Expectancies

PubMed Central

Montgomery, Guy H.

2012-01-01

Introduction: Cue-induced cigarette cravings have been oft studied as potentially important predictors of smoking cessation outcomes. The literature on the relationship between cue-induced cravings and cessation, however, remains mixed. One possible explanation for the discrepant results in the literature may be the as-yet untested variability in expectancies of craving. Indeed, as with many interoceptive responses, cravings and their downstream consequences may be influenced by expectancies. To date, no study has examined the influence of expected cravings following smoking cue exposures on actual craving experiences and cessation outcomes. The objective of this study, therefore, was to test the possibility that smokers’ expected craving levels in response to smoking cues would be related to actual cravings following cue exposure and that expected cravings would be related to cessation outcomes. Methods: Nicotine-dependent adult smokers (n = 153) were exposed to sets of neutral and smoking cues and completed questionnaires assessing (a) prior to the exposures, the cigarette craving levels they expected to experience following the cue exposures and (b) following the exposures, their actual craving levels. Participants also reported the duration of their most recent quit attempt and their perceived future quit difficulty. Results: Findings indicated that expected cravings assessed prior to the cue exposures were significantly related to actual cravings following the exposures. In addition, both expected cravings and actual cravings were related to shorter previous quit duration and higher perceived quit difficulty. Conclusions: Study results highlight the importance of considering both expected and actual cravings in cue-induced craving paradigms. PMID:22218404

Valuing Trial Designs from a Pharmaceutical Perspective Using Value-Based Pricing.

PubMed

Breeze, Penny; Brennan, Alan

2015-11-01

Our aim was to adapt the traditional framework for expected net benefit of sampling (ENBS) to be more compatible with drug development trials from the pharmaceutical perspective. We modify the traditional framework for conducting ENBS and assume that the price of the drug is conditional on the trial outcomes. We use a value-based pricing (VBP) criterion to determine price conditional on trial data using Bayesian updating of cost-effectiveness (CE) model parameters. We assume that there is a threshold price below which the company would not market the new intervention. We present a case study in which a phase III trial sample size and trial duration are varied. For each trial design, we sampled 10,000 trial outcomes and estimated VBP using a CE model. The expected commercial net benefit is calculated as the expected profits minus the trial costs. A clinical trial with shorter follow-up, and larger sample size, generated the greatest expected commercial net benefit. Increasing the duration of follow-up had a modest impact on profit forecasts. Expected net benefit of sampling can be adapted to value clinical trials in the pharmaceutical industry to optimise the expected commercial net benefit. However, the analyses can be very time consuming for complex CE models. © 2014 The Authors. Health Economics published by John Wiley & Sons Ltd.

Duration of menopausal vasomotor symptoms over the menopause transition.

PubMed

Avis, Nancy E; Crawford, Sybil L; Greendale, Gail; Bromberger, Joyce T; Everson-Rose, Susan A; Gold, Ellen B; Hess, Rachel; Joffe, Hadine; Kravitz, Howard M; Tepper, Ping G; Thurston, Rebecca C

2015-04-01

The expected duration of menopausal vasomotor symptoms (VMS) is important to women making decisions about possible treatments. To determine total duration of frequent VMS (≥ 6 days in the previous 2 weeks) (hereafter total VMS duration) during the menopausal transition, to quantify how long frequent VMS persist after the final menstrual period (FMP) (hereafter post-FMP persistence), and to identify risk factors for longer total VMS duration and longer post-FMP persistence. The Study of Women's Health Across the Nation (SWAN) is a multiracial/multiethnic observational study of the menopausal transition among 3302 women enrolled at 7 US sites. From February 1996 through April 2013, women completed a median of 13 visits. Analyses included 1449 women with frequent VMS. Total VMS duration (in years) (hot flashes or night sweats) and post-FMP persistence (in years) into postmenopause. The median total VMS duration was 7.4 years. Among 881 women who experienced an observable FMP, the median post-FMP persistence was 4.5 years. Women who were premenopausal or early perimenopausal when they first reported frequent VMS had the longest total VMS duration (median, >11.8 years) and post-FMP persistence (median, 9.4 years). Women who were postmenopausal at the onset of VMS had the shortest total VMS duration (median, 3.4 years). Compared with women of other racial/ethnic groups, African American women reported the longest total VMS duration (median, 10.1 years). Additional factors related to longer duration of VMS (total VMS duration or post-FMP persistence) were younger age, lower educational level, greater perceived stress and symptom sensitivity, and higher depressive symptoms and anxiety at first report of VMS. Frequent VMS lasted more than 7 years during the menopausal transition for more than half of the women and persisted for 4.5 years after the FMP. Individual characteristics (eg, being premenopausal and having greater negative affective factors when first experiencing VMS) were related to longer-lasting VMS. Health care professionals should counsel women to expect that frequent VMS could last more than 7 years, and they may last longer for African American women.

Beneficial effects of losartan for prevention of paroxysmal atrial fibrillation in patients with sick sinus syndrome: analysis with memory function of pacemaker.

PubMed

Takii, Eiichi; Inage, Tomohito; Yoshida, Teruhisa; Ohe, Masatsugu; Gondo, Takeki; Haraguchi, Go; Ito, Shogo; Kumanomido, Jun; Imaizumi, Tsutomu; Fukuomoto, Yoshihiro

2016-03-01

Renin-angiotensin system (RAS) inhibitors may be useful in preventing the occurrence of paroxysmal atrial fibrillation (PAF). However, evaluation of such effect is difficult because many PAF episodes are asymptomatic and not all episodes are detected by intermittent electrocardiographic monitoring. A pacemaker has been developed with dedicated functions for AF detection and electrocardiogram storage. Accordingly, we examined the effect of losartan, an angiotensin receptor blocker on PAF occurrence using this new modality. We enrolled 70 consecutive patients who had undergone dual-chamber pacemaker implantation for sick sinus syndrome. Finally, 62 patients participated in the study. Thirty patients were randomized to the losartan group (mean 43 ± 12 mg/day) and 32 patients to the control group. They were followed up for 3 months. The frequency, the maximum duration and the total duration of PAF recorded by the stored electrocardiograms for the last 1 month during the observation period and study period were compared between the two groups. The change in the frequency of PAF from the observation period in the losartan and control groups was similar (-35 ± 25 vs. -67 ± 62 times; NS). However, the change in the maximum duration and the total duration of PAF was significantly shorter in the losartan group than in the control group (-493 ± 158 vs. -10 ± 69 min; p < 0.05, and -4007 ± 2334 vs. 1119 ± 714 min; p < 0.05, respectively). Losartan suppressed the maximum duration and the total duration of PAF in patients with sick sinus syndrome without hemodynamic changes. This is the first study to show the effect of a renin-angiotensin system inhibitor on the secondary prevention of PAF using the dedicated functions of a pacemaker for PAF detection and electrocardiogram storage.

Power plant maintenance scheduling using ant colony optimization: an improved formulation

NASA Astrophysics Data System (ADS)

Foong, Wai Kuan; Maier, Holger; Simpson, Angus

2008-04-01

It is common practice in the hydropower industry to either shorten the maintenance duration or to postpone maintenance tasks in a hydropower system when there is expected unserved energy based on current water storage levels and forecast storage inflows. It is therefore essential that a maintenance scheduling optimizer can incorporate the options of shortening the maintenance duration and/or deferring maintenance tasks in the search for practical maintenance schedules. In this article, an improved ant colony optimization-power plant maintenance scheduling optimization (ACO-PPMSO) formulation that considers such options in the optimization process is introduced. As a result, both the optimum commencement time and the optimum outage duration are determined for each of the maintenance tasks that need to be scheduled. In addition, a local search strategy is presented in this article to boost the robustness of the algorithm. When tested on a five-station hydropower system problem, the improved formulation is shown to be capable of allowing shortening of maintenance duration in the event of expected demand shortfalls. In addition, the new local search strategy is also shown to have significantly improved the optimization ability of the ACO-PPMSO algorithm.

The locations of cosmic explosions

NASA Technical Reports Server (NTRS)

Fruchter, A. S.; Levan, A. J.; Strolger, L.; Vreeswijk, P. M.; Bersier, D.; Burud, I.; Castro-Ceron, J. M.; Consclice, C.; Dahlen, T.; Strolger, L.

2005-01-01

When massive stars exhaust their fuel they collapse and often produce the extraordinarily bright explosions known as core-collapse supernovae. Recently, it has become apparent that stellar collapse can power the even more brilliant relativistic explosions known as long-duration gamma-ray bursts. In some cases, a gamma-ray burst and a supernova have been observed from the same event. One would thus expect that gamma-ray bursts and supernovae should be found in similar environments. Here we show that this expectation is wrong. Using Hubble Space Telescope imaging of the host galaxies of long-duration gamma-ray bursts and core-collapse supernovae, we demonstrate that while the distribution of the supernovae in their hosts traces the blue light of young stars, the gamma-ray bursts are much more concentrated on the very brightest regions of their hosts. Furthermore, the host galaxies of the gamma-ray bursts are significantly fainter and more irregular than the hosts of the supernovae. Together these results suggest that long-duration gamma-ray bursts are associated with the very most massive stars and may be restricted to galaxies of limited chemical evolution. Our results directly imply that long-duration gamma-ray bursts are relatively rare in galaxies such as our own Milky Way.

Preventing traumatic childbirth experiences: 2192 women's perceptions and views.

PubMed

Hollander, M H; van Hastenberg, E; van Dillen, J; van Pampus, M G; de Miranda, E; Stramrood, C A I

2017-08-01

The purpose of this study is to explore and quantify perceptions and experiences of women with a traumatic childbirth experience in order to identify areas for prevention and to help midwives and obstetricians improve woman-centered care. A retrospective survey was conducted online among 2192 women with a self-reported traumatic childbirth experience. Women were recruited in March 2016 through social media, including specific parent support groups. They filled out a 35-item questionnaire of which the most important items were (1) self-reported attributions of the trauma and how they believe the traumatic experience could have been prevented (2) by the caregivers or (3) by themselves. The responses most frequently given were (1) Lack and/or loss of control (54.6%), Fear for baby's health/life (49.9%), and High intensity of pain/physical discomfort (47.4%); (2) Communicate/explain (39.1%), Listen to me (more) (36.9%), and Support me (more/better) emotionally/practically (29.8%); and (3) Nothing (37.0%), Ask for (26.9%), or Refuse (16.5%) certain interventions. Primiparous participants chose High intensity of pain/physical discomfort, Long duration of delivery, and Discrepancy between expectations and reality more often and Fear for own health/life, A bad outcome, and Delivery went too fast less often than multiparous participants. Women attribute their traumatic childbirth experience primarily to lack and/or loss of control, issues of communication, and practical/emotional support. They believe that in many cases, their trauma could have been reduced or prevented by better communication and support by their caregiver or if they themselves had asked for or refused interventions.

Testing a social cognitive theory-based model of indoor tanning: implications for skin cancer prevention messages.

PubMed

Noar, Seth M; Myrick, Jessica Gall; Zeitany, Alexandra; Kelley, Dannielle; Morales-Pico, Brenda; Thomas, Nancy E

2015-01-01

The lack of a theory-based understanding of indoor tanning is a major impediment to the development of effective messages to prevent or reduce this behavior. This study applied the Comprehensive Indoor Tanning Expectations (CITE) scale in an analysis of indoor tanning behavior among sorority women (total N = 775). Confirmatory factor analyses indicated that CITE positive and negative expectations were robust, multidimensional factors and that a hierarchical structure fit the data well. Social cognitive theory-based structural equation models demonstrated that appearance-oriented variables were significantly associated with outcome expectations. Outcome expectations were, in turn, significantly associated with temptations to tan, intention to tan indoors, and indoor tanning behavior. The implications of these findings for the development of messages to prevent and reduce indoor tanning behavior are discussed in two domains: (a) messages that attempt to change broader societal perceptions about tan skin, and (b) messages that focus more narrowly on indoor tanning-challenging positive expectations, enhancing negative expectations, and encouraging substitution of sunless tanning products.

Duration and quality of the peer review process: the author's perspective.

PubMed

Huisman, Janine; Smits, Jeroen

2017-01-01

To gain insight into the duration and quality of the scientific peer review process, we analyzed data from 3500 review experiences submitted by authors to the SciRev.sc website. Aspects studied are duration of the first review round, total review duration, immediate rejection time, the number, quality, and difficulty of referee reports, the time it takes authors to revise and resubmit their manuscript, and overall quality of the experience. We find clear differences in these aspects between scientific fields, with Medicine, Public health, and Natural sciences showing the shortest durations and Mathematics and Computer sciences, Social sciences, Economics and Business, and Humanities the longest. One-third of journals take more than 2 weeks for an immediate (desk) rejection and one sixth even more than 4 weeks. This suggests that besides the time reviewers take, inefficient editorial processes also play an important role. As might be expected, shorter peer review processes and those of accepted papers are rated more positively by authors. More surprising is that peer review processes in the fields linked to long processes are rated highest and those in the fields linked to short processes lowest. Hence authors' satisfaction is apparently influenced by their expectations regarding what is common in their field. Qualitative information provided by the authors indicates that editors can enhance author satisfaction by taking an independent position vis-à-vis reviewers and by communicating well with authors.

On-the-job moms: work and breastfeeding initiation and duration for a sample of low-income women.

PubMed

Kimbro, Rachel Tolbert

2006-01-01

As both employed and breastfeeding mothers increase, more women are facing the decision of whether and how to combine the behaviors. This paper examines three hypotheses for a sample of low-income women: 1) Mothers who expect to return to work after the birth of their baby will be less likely to initiate breastfeeding; 2) The timing of the return to work and quitting breastfeeding will coincide; 3) Mothers in professional jobs and Stay-at-Home (SAH) Moms will breastfeed for longer durations than mothers with other types of jobs. The Fragile Families and Child Wellbeing Study, a sample of mostly low-income, unmarried U.S. mothers, offers a unique opportunity to study this issue, as there is reason to believe that employment may impact breastfeeding differently for low-income women. Logistic regression determines the relationship between the expectation of work and breastfeeding initiation, and discrete-time logit models examine breastfeeding duration, the timing of the return to work, and occupation type. Expecting to work in the year after the baby's birth does not impact breastfeeding initiation. The timing of quitting breastfeeding and the return to work are closely and powerfully linked, and mothers in administrative and manual positions quit earlier than other women. Interestingly, women in service occupations do not differ in breastfeeding duration from SAH mothers or professionals. This research demonstrates that low-income women are having difficulty combining work and breastfeeding, which has important health implications for their infants, and that women working in administrative and manual occupations may face special constraints.

Fantasies About Stem Cell Therapy in Chronic Ischemic Stroke Patients

PubMed Central

Kim, Young Seo; Chung, Dan-il; Choi, Hojin; Baek, Wonki; Kim, Hyun Young; Heo, Sung Hyuk; Chang, Dae-Il; Na, Hae Ri; Kim, Seung Hyun

2013-01-01

Stem cell therapy (SCT) has been proposed for the treatment of neurological disorders. Although there is insufficient clinical evidence to support its efficacy, unproven SCTs are being performed worldwide. In this study, we investigated the perspectives and expectations of chronic ischemic stroke patients and physicians about SCTs. A total of 250 chronic ischemic stroke patients were interviewed at 4 hospitals. Structured open and closed questions about SCT for chronic stroke were asked by trained interviewers using the conventional in-person method. In addition, 250 stroke-related physicians were randomly interviewed via an e-mail questionnaire. Of the 250 patients (mean 63 years, 70% male), 121 (46%) responded that they wanted to receive SCT in spite of its unknown side effects. Around 60% of the patients anticipated physical, emotional, and psychological improvement after SCT, and 158 (63%) believed that SCT might prevent strokes. However, physicians had much lower expectations about the effectiveness of SCTs, which was not in line with patient expectations. Multivariate analysis revealed that the male gender [odds ratio (OR): 2.00, 95% confidence interval (CI): 1.10–3.64], longer disease duration (OR: 1.01, 95% CI: 1.00–1.02), higher modified Rankin Scale score (OR: 1.30, 95% CI: 1.06–1.60), and familiarity with stem cells (OR: 1.86, 95% CI: 1.10–3.15) were independently associated with wanting SCT. The major source of information about SCT was television (68%), and the most reliable source was physicians (49%). Patients have unfounded expectations that SCT will improve their functioning. Considering our finding that the major source of information on stem cells is media channels, but not the physician, to decrease patients' inappropriate exposure, doctors should make more effort to educate patients using mass media with accurate information. PMID:22784218

Atrial Fibrillation During an Exploration Class Mission

NASA Technical Reports Server (NTRS)

Lipset, Mark A.; Lemery, Jay; Polk, J. D.; Hamilton, Douglas R.

2010-01-01

Background: A long-duration exploration class mission is fraught with numerous medical contingency plans. Herein, we explore the challenges of symptomatic atrial fibrillation (AF) occurring during an exploration class mission. The actions and resources required to ameliorate the situation, including the availability of appropriate pharmaceuticals, monitoring devices, treatment modalities, and communication protocols will be investigated. Challenges of Atrial Fibrillation during an Exploration Mission: Numerous etiologies are responsible for the initiation of AF. On Earth, we have the time and medical resources to evaluate and determine the causative situation for most cases of AF and initiate therapy accordingly. During a long-duration exploration class mission resources will be severely restricted. How is one to determine if new onset AF is due to recent myocardial infarction, pulmonary embolism, fluid overload, thyrotoxicosis, cardiac structural abnormalities, or CO poisoning? Which pharmaceutical therapy should be initiated and what potential side effects can be expected? Should anti-coagulation therapy be initiated? How would one monitor the therapeutic treatment of AF in microgravity? What training would medical officers require, and which communication strategies should be developed to enable the best, safest therapeutic options for treatment of AF during a long-duration exploration class mission? Summary: These questions will be investigated with expert opinion on disease elucidation, efficient pharmacology, therapeutic monitoring, telecommunication strategies, and mission cost parameters with emphasis on atrial fibrillation being just one illustration of the tremendous challenges that face a long-duration exploration mission. The limited crew training time, medical hardware, and drugs manifested to deal with such an event predicate that aggressive primary and secondary prevention strategies be developed to protect a multibillion-dollar asset like the International Space Station or a mission to the Moon or Mars. Learning Objectives: The audience will become familiar with the risks and challenges inherent to developing a therapeutic strategy for the treatment of atrial fibrillation during a long-term exploration class mission.

Supraventricular tachycardia and the struggle to be believed.

PubMed

Wood, Kathryn A; Wiener, Carolyn L; Kayser-Jones, Jeanie

2007-12-01

Little research exists examining patient experiences of life with supraventricular tachycardia (SVT). Realistic expectations of symptoms, patient management strategies, and treatment options are important components of patient education and treatment decisions. This descriptive qualitative study explored patients' experiences living with SVT. Grounded theory methodology was used with semi-structured interviews of 25 SVT patients undergoing radiofrequency ablation treatment. The main core category that emerged from the data was the "struggle to be believed". The struggle or work of living with SVT entails: (1) living with the uncertainty of the occurrence and duration of an episode, (2) "covering up" to manage symptoms and appear normal, (3) searching for causative factors to prevent further episodes, and (4) experimenting with management techniques to shorten or end episodes. Clinical diagnosis and referral for ablation treatment were more difficult for women suggesting existence of a gender bias. As with many other chronic conditions, the illness trajectory work is formidable. Patients in this study with SVT, however, reported facing the additional difficulty of being believed. Disruptions in self-esteem and personal relationships are the effects of not being believed. Providers could avoid minimizing women's symptoms by listening seriously and offering realistic expectations; including insight into patient experiences and the trajectory of the dysrhythmia; and efficacy of drug and ablation treatments.

76 FR 14028 - Generic Drug User Fee; Notice of Public Meeting; Reopening of the Comment Period

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-15

... is reopening the comment period for the expected duration of the active negotiation phase to ensure... throughout the negotiation phase, FDA is reopening the comment period until June 30, 2011. FDA expects that the public component of the GDUF negotiations will be complete by the end of June 2011. Therefore, the...

Return to work following surgery for lumbar radiculopathy: a systematic review.

PubMed

Huysmans, Eva; Goudman, Lisa; Van Belleghem, Griet; De Jaeger, Mats; Moens, Maarten; Nijs, Jo; Ickmans, Kelly; Buyl, Ronald; Vanroelen, Christophe; Putman, Koen

2018-05-22

Informing patients about postoperative return to work (RTW) expectations is of utmost importance because of the influence of realistic expectations on RTW outcomes. We aimed to give an overview of the duration of sick leave and RTW rates after surgery for lumbar radiculopathy and to list predictors of and factors related to RTW. A systematic review was carried out. A systematic literature search was conducted in PubMed, Web of Science, EMBASE, and SCOPUS. Full-text articles on RTW following surgery for lumbar radiculopathy were included through double-blind screening. Risk of bias was assessed using a modified version of the Downs and Black checklist. Sixty-three full-text articles (total sample size: 7,100 patients) were included. Risk of bias was scored low to high. Mean duration of sick leave ranged from 0.8 to 20 weeks. Within 0.1-240 months post surgery, 3%-100% of patients resumed work. Most important predictors for work resumption were preoperative work status, presence of comorbidities, age, sex and duration of preoperative symptoms. Duration of sick leave can be predicted by the preoperative level of pain or disability and presence of symptoms of depression, occupational mental stress, and lateral disc prolapse. Furthermore, less invasive surgical techniques were found to result in better RTW outcomes compared with more invasive techniques. Diverse results were found for RTW rates and duration of sick leave. Preoperative work status, presence of comorbidities, and several demographic factors were retrieved as predictors of RTW and duration of sick leave. Copyright © 2018 Elsevier Inc. All rights reserved.

Socio/psychological issues for a Mars mission

NASA Technical Reports Server (NTRS)

Bluth, B. J.

1986-01-01

Some of the socio/psychological problems expected to accompany such a long duration mission as the trip to Mars are addressed. The emphasis is on those issues which are expected to have a bearing on crew performance. Results from research into aircraft accidents, particularly those related to pilot performance, are discussed briefly, as a limited analog to space flight. Significant comparisons are also made to some aspects of long duration Antarctic stays, submarine missions, and oceanographic vessel voyages. Appropriate lessons learned from U.S. and Russian space flight experiences are provided. Design of space missions and systems to enhance crew performance is discussed at length, considering factors external and internal to the crew. The importance of incorporating such design factors early in the design process is stressed.

30 CFR 250.515 - Blowout prevention equipment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... foreseeable conditions and circumstances, including subfreezing conditions. The working pressure rating of the BOP system and BOP system components shall exceed the expected surface pressure to which they may be subjected. If the expected surface pressure exceeds the rated working pressure of the annular preventer, the...

Human fear conditioning and extinction: Timing is everything . . . or is it?

PubMed Central

Prenoveau, Jason M.; Craske, Michelle G.; Liao, Betty; Ornitz, Edward M.

2012-01-01

A differential fear conditioning paradigm was used with 107 healthy undergraduate participants to evaluate the effect of conditioned stimulus (CS) temporal properties on fear acquisition and extinction. Two minute duration CSs were used for Day 1 fear acquisition. Participants were randomized to receive either 1, 2, or 4 minute CS durations during Day 2 extinction. Extinction re-test was examined on Day 3 using the original acquisition CS duration (2 minutes). Findings indicated that participants who were aware of the CS+/unconditioned stimulus (US) contingency (n=52) develop a temporal expectation about when the unconditioned stimulus will be delivered. Although the shorter duration CS resulted in greater fear reduction during extinction, cessation of fear responding at re-test was the same for CS extinction durations ranging from half the CS acquisition duration to twice the CS acquisition duration. Thus, extinction performance did not predict extinction at re-test, which could have important implications for optimizing exposure therapy for anxiety disorders. PMID:22349998

Trends in fall-related hospital admissions in older persons in the Netherlands.

PubMed

Hartholt, Klaas A; van der Velde, Nathalie; Looman, Caspar W N; van Lieshout, Esther M M; Panneman, Martien J M; van Beeck, Ed F; Patka, Peter; van der Cammen, Tischa J M

2010-05-24

Fall-related injuries, hospitalizations, and mortality among older persons represent a major public health problem. Owing to aging societies worldwide, a major impact on fall-related health care demand can be expected. We determined time trends in numbers and incidence of fall-related hospital admissions and in admission duration in older adults. Secular trend analysis of fall-related hospital admissions in the older Dutch population from 1981 through 2008, using the National Hospital Discharge Registry. All fall-related hospital admissions in persons 65 years or older were extracted from this database. Outcome measures were the numbers, and the age-specific and age-adjusted incidence rates (per 10,000 persons) of fall-related hospital admissions in each year of the study. From 1981 through 2008, fall-related hospital admissions increased by 137%. The annual age-adjusted incidence growth was 1.3% for men vs 0.7% for women (P < .001). The overall incidence rate increased from 87.7 to 141.2 per 10,000 persons (an increase of 61%). Age-specific incidence increased in all age groups, in both men and women, especially in the oldest old (>75 years). Although the incidence of fall-related hospital admissions increased, the total number of fall-related hospital days was reduced by 20% owing to a reduction in admission duration. In the Netherlands, numbers of fall-related hospital admissions among older persons increased drastically from 1981 through 2008. The increasing fall-related health care demand has been compensated for by a reduced admission duration. These figures demonstrate the need for implementation of falls prevention programs to control for increases of fall-related health care consumption.

Salmonella infections in food workers identified through routine Public Health Surveillance in Minnesota: impact on outbreak recognition.

PubMed

Medus, Carlota; Smith, Kirk E; Bender, Jeffrey B; Leano, Fe; Hedberg, Craig W

2010-11-01

The frequency of Salmonella-infected food workers identified through routine surveillance from 1997 to 2004 in Minnesota was determined in order to evaluate the impact of surveillance on the detection of outbreaks in restaurants and to quantify the duration of Salmonella shedding in stool. Of 4,976 culture-confirmed Salmonella cases reported to the Minnesota Department of Health, 110 (2.2%) were identified as food workers; this was less than one-half the number expected based on the incidence of Salmonella in the general population. Twenty food workers (18%) were associated with outbreaks. Twelve were involved in nine independent outbreaks at the restaurants where they worked. The identification of the index food worker in six of these outbreaks was critical to the initiation of outbreak investigations that revealed much larger problems. Among food workers who submitted specimens until at least one negative result was obtained (n = 69), the median duration of shedding was 22 days (range, 1 to 359 days). Among the four most common serotypes (Enteritidis, Typhimurium, Heidelberg, and Newport) the median duration of shedding was significantly longer for Salmonella Newport (80 days; P = 0.02) and for Salmonella Enteritidis (32 days; P = 0.04) than for Salmonella Heidelberg (8 days). Food workers should be considered an important source of Salmonella transmission, and those identified through surveillance should raise a high index of suspicion of a possible outbreak at their place of work. Food service managers need to be alert to Salmonella-like illnesses among food workers to facilitate prevention and control efforts, including exclusion of infected food workers or restriction of their duties.

Pulmonary embolism after long duration rail travel: economy class syndrome or rail coach syndrome.

PubMed

Mittal, S K; Chopra, S; Calton, R

2011-07-01

Pulmonary embolism after long duration air travel is well described. However it can also occur following a long duration rail or road transport. We present a case of 43 year old male who developed deep venous thrombosis and acute pulmonary embolism after a long rail journey. We propose to call it as rail coach syndrome and stress the need for taking the same preventive measures as recommended for airline passengers.

The Case for Adolescent HIV Vaccination in South Africa

PubMed Central

Moodley, Nishila; Gray, Glenda; Bertram, Melanie

2016-01-01

Abstract Despite comprising 0.7% of the world population, South Africa is home to 18% of the global human immunodeficiency virus (HIV) prevalence. Unyielding HIV subepidemics among adolescents threaten national attempts to curtail the disease burden. Should an HIV vaccine become available, establishing its point of entry into the health system becomes a priority. This study assesses the impact of school-based HIV vaccination and explores how variations in vaccine characteristics affect cost-effectiveness. The cost per quality adjusted life year (QALY) gained associated with school-based adolescent HIV vaccination services was assessed using Markov modeling that simulated annual cycles based on national costing data. The estimation was based on a life expectancy of 70 years and employs the health care provider perspective. The simultaneous implementation of HIV vaccination services with current HIV management programs would be cost-effective, even at relatively higher vaccine cost. At base vaccine cost of US$ 12, the incremental cost effectiveness ratio (ICER) was US$ 43 per QALY gained, with improved ICER values yielded at lower vaccine costs. The ICER was sensitive to duration of vaccine mediated protection and variations in vaccine efficacy. Data from this work demonstrate that vaccines offering longer duration of protection and at lower cost would result in improved ICER values. School-based HIV vaccine services of adolescents, in addition to current HIV prevention and treatment health services delivered, would be cost-effective. PMID:26825890

Potential Universal Application of High-intensity Interval Training from Athletes and Sports Lovers to Patients.

PubMed

Azuma, Koichiro; Matsumoto, Hideo

2017-06-25

Recently, high-intensity interval training (HIIT) has received much attention as a promising exercise option not only to improve aerobic fitness, but also to prevent and improve lifestyle-related diseases. Epidemiological studies have shown that the exercise volume, as determined by the product of exercise intensity, duration, and frequency, has been shown to be important for improvements in muscle mitochondrial activity and subsequent improvements in aerobic fitness, insulin sensitivity, and metabolic variables. Therefore, continuous moderate-intensity training has been widely recommended. On the other hand, the main contributor of HIIT to improvements in aerobic fitness and metabolic variables is its high-intensity nature, and many recent studies have shown results favoring HIIT when compared with conventional continuous training, despite its shorter exercise duration and smaller exercise volume. In this review, we aim to show the possible universal application of HIIT in a hospital setting, where athletes, sports lovers, and patients have sought medical advice and have the opportunity to undergo detailed evaluations, including an exercise stress test. For athletes, HIIT is mandatory to achieve further improvements in aerobic fitness. For patients, though higher levels of motivation and careful evaluation are required, the time constraints of HIIT are smaller and both aerobic and resistance training can be expected to yield favorable results because of the high-intensity nature of HIIT.

The Case for Adolescent HIV Vaccination in South Africa: A Cost-Effectiveness Analysis.

PubMed

Moodley, Nishila; Gray, Glenda; Bertram, Melanie

2016-01-01

Despite comprising 0.7% of the world population, South Africa is home to 18% of the global human immunodeficiency virus (HIV) prevalence. Unyielding HIV subepidemics among adolescents threaten national attempts to curtail the disease burden. Should an HIV vaccine become available, establishing its point of entry into the health system becomes a priority. This study assesses the impact of school-based HIV vaccination and explores how variations in vaccine characteristics affect cost-effectiveness. The cost per quality adjusted life year (QALY) gained associated with school-based adolescent HIV vaccination services was assessed using Markov modeling that simulated annual cycles based on national costing data. The estimation was based on a life expectancy of 70 years and employs the health care provider perspective. The simultaneous implementation of HIV vaccination services with current HIV management programs would be cost-effective, even at relatively higher vaccine cost. At base vaccine cost of US$ 12, the incremental cost effectiveness ratio (ICER) was US$ 43 per QALY gained, with improved ICER values yielded at lower vaccine costs. The ICER was sensitive to duration of vaccine mediated protection and variations in vaccine efficacy. Data from this work demonstrate that vaccines offering longer duration of protection and at lower cost would result in improved ICER values. School-based HIV vaccine services of adolescents, in addition to current HIV prevention and treatment health services delivered, would be cost-effective.

The Impact of Mission Duration on a Mars Orbital Mission

NASA Technical Reports Server (NTRS)

Arney, Dale; Earle, Kevin; Cirillo, Bill; Jones, Christopher; Klovstad, Jordan; Grande, Melanie; Stromgren, Chel

2017-01-01

Performance alone is insufficient to assess the total impact of changing mission parameters on a space mission concept, architecture, or campaign; the benefit, cost, and risk must also be understood. This paper examines the impact to benefit, cost, and risk of changing the total mission duration of a human Mars orbital mission. The changes in the sizing of the crew habitat, including consumables and spares, was assessed as a function of duration, including trades of different life support strategies; this was used to assess the impact on transportation system requirements. The impact to benefit is minimal, while the impact on cost is dominated by the increases in transportation costs to achieve shorter total durations. The risk is expected to be reduced by decreasing total mission duration; however, large uncertainty exists around the magnitude of that reduction.

[A prediction model for internet game addiction in adolescents: using a decision tree analysis].

PubMed

Kim, Ki Sook; Kim, Kyung Hee

2010-06-01

This study was designed to build a theoretical frame to provide practical help to prevent and manage adolescent internet game addiction by developing a prediction model through a comprehensive analysis of related factors. The participants were 1,318 students studying in elementary, middle, and high schools in Seoul and Gyeonggi Province, Korea. Collected data were analyzed using the SPSS program. Decision Tree Analysis using the Clementine program was applied to build an optimum and significant prediction model to predict internet game addiction related to various factors, especially parent related factors. From the data analyses, the prediction model for factors related to internet game addiction presented with 5 pathways. Causative factors included gender, type of school, siblings, economic status, religion, time spent alone, gaming place, payment to Internet café, frequency, duration, parent's ability to use internet, occupation (mother), trust (father), expectations regarding adolescent's study (mother), supervising (both parents), rearing attitude (both parents). The results suggest preventive and managerial nursing programs for specific groups by path. Use of this predictive model can expand the role of school nurses, not only in counseling addicted adolescents but also, in developing and carrying out programs with parents and approaching adolescents individually through databases and computer programming.

The potential imposition of wage controls on nurses: a threat to nurses, patients, and hospitals.

PubMed

Buerhaus, Peter I

2008-01-01

When there are shortages of RNs, hospitals and health care organizations in competitive nurse labor markets respond by increasing wages: some hospitals will respond faster and some will offer higher wages than others. The wage increase brings about two important short and long-run outcomes that, together, will increase the supply of RNs in the labor market. Because wage controls prevent the flexibility of wages to adjust, they can cause a shortage to develop when the demand for RNs is increasing (as in the 1970s), and wage controls will lengthen the duration of a shortage once it has begun. The impacts of prolonged RN shortages are multifaceted and destructive to nurses, patients, and hospitals. Looking ahead over the next 15 years when the demand for RNs is expected to grow by roughly 3% per year and the supply of RNs by much less than that, a new nursing shortage is projected to develop and reach a deficit of 285,000 RNs by 2020. The worst thing that could happen to the nursing profession would be to impose wage controls on nurses as this would prevent the needed short and long-run labor supply responses from developing and thereby eliminate the shortage.

Tobacco Interventions and Anaesthesia- A Review

PubMed Central

Saha, Usha

2009-01-01

Summary Tobacco use is the leading preventable agent of death in the world. It is manufactured on a large scale in India and has a huge international market also. Death toll from tobacco use is on the rise. Use of tobacco is also increasing esp. in developing countries, in teenagers & in women, despite government, WHO and intervention by other statutory bodies. Prolonged use of tobacco or its products, as smoke or chew, endows significant risk of developing various diseases. With advances in surgical and anaethesia techniques & prolonged life expectancy, anaesthetist will be faced with management of these patients. Tobacco consumption affects every major organ system of the body; esp. lung, heart and blood vessels. Perioperative smoking cessation can significantly reduce the risk of postoperative complications & duration of hospital stay. Anaesthetist can play an important role in motivating these patients to quit smoking preoperatively by providing brief counselling and nicotine replacement therapy in reluctant quitters. More of concern is the effect of passive smoking (second & third hand smoke) on non smokers. This is a review of tobacco & its products, their health consequences, diseases caused, anaesthetic considerations & their role in helping these patients quit smoking Preventing nicotine addiction and improving smoking cessation strategies should be the priority and despite these being only partially successful, strong measures at all levels should be continued & enforced. PMID:20640112

Widespread Bordetella parapertussis Infections-Wisconsin, 2011-2012: Clinical and Epidemiologic Features and Antibiotic Use for Treatment and Prevention.

PubMed

Koepke, Ruth; Bartholomew, Michael L; Eickhoff, Jens C; Ayele, Roman A; Rodd, Diane; Kuennen, Joan; Rosekrans, Jean; Warshauer, David M; Conway, James H; Davis, Jeffrey P

2015-11-01

During October 2011-December 2012, concurrent with a statewide pertussis outbreak, 443 Bordetella parapertussis infections were reported among Wisconsin residents. We examined clinical features of patients with parapertussis and the effect of antibiotic use for treatment and prevention. Patients with polymerase chain reaction results positive for B. parapertussis reported during October 2011-May 2012 were interviewed regarding presence and durations of pertussis-like symptoms and receipt of azithromycin treatment. Data regarding acute cough illnesses and receipt of azithromycin prophylaxis among parapertussis patient household members (HHMs) were also collected. Using multivariate repeated measures log-binomial regression analysis, we examined associations of treatment receipt by the HHM with the earliest illness onset and prophylaxis receipt among other HHMs with the presence of any secondary cough illnesses in the household. Among 218 patients with parapertussis, pertussis-like symptoms were frequently reported. Illness durations were significantly shorter among patients with treatment initiated 0-6 days after cough onset, compared with nonrecipients (median durations: 10 vs 19 days, P = .002). Among 361 HHMs from 120 households, compared with nonrecipients, prompt prophylaxis of HHMs was associated with no secondary cough illnesses (relative risk: 0.16; 95% confidence interval, .04-.69). Bordetella parapertussis infection causes pertussis-like illness that might be misclassified as pertussis if B. parapertussis testing is not performed. Prompt treatment might shorten illness duration, and prompt HHM prophylaxis might prevent secondary illnesses. Further study is needed to evaluate antibiotic effectiveness for preventing parapertussis and to determine risks and benefits of antibiotic use. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

30 CFR 250.516 - Blowout prevention equipment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... pressure rating of the BOP system and BOP system components shall exceed the expected surface pressure to which they may be subjected. If the expected surface pressure exceeds the rated working pressure of the...-control procedure that indicates how the annular preventer will be utilized, and the pressure limitations...

30 CFR 250.516 - Blowout prevention equipment.

Code of Federal Regulations, 2013 CFR

2013-07-01

... pressure rating of the BOP system and BOP system components shall exceed the expected surface pressure to which they may be subjected. If the expected surface pressure exceeds the rated working pressure of the...-control procedure that indicates how the annular preventer will be utilized, and the pressure limitations...

30 CFR 250.515 - Blowout prevention equipment.

Code of Federal Regulations, 2012 CFR

2012-07-01

... pressure rating of the BOP system and BOP system components shall exceed the expected surface pressure to which they may be subjected. If the expected surface pressure exceeds the rated working pressure of the...-control procedure that indicates how the annular preventer will be utilized, and the pressure limitations...

How the Brain Decides When to Work and When to Rest: Dissociation of Implicit-Reactive from Explicit-Predictive Computational Processes

PubMed Central

Meyniel, Florent; Safra, Lou; Pessiglione, Mathias

2014-01-01

A pervasive case of cost-benefit problem is how to allocate effort over time, i.e. deciding when to work and when to rest. An economic decision perspective would suggest that duration of effort is determined beforehand, depending on expected costs and benefits. However, the literature on exercise performance emphasizes that decisions are made on the fly, depending on physiological variables. Here, we propose and validate a general model of effort allocation that integrates these two views. In this model, a single variable, termed cost evidence, accumulates during effort and dissipates during rest, triggering effort cessation and resumption when reaching bounds. We assumed that such a basic mechanism could explain implicit adaptation, whereas the latent parameters (slopes and bounds) could be amenable to explicit anticipation. A series of behavioral experiments manipulating effort duration and difficulty was conducted in a total of 121 healthy humans to dissociate implicit-reactive from explicit-predictive computations. Results show 1) that effort and rest durations are adapted on the fly to variations in cost-evidence level, 2) that the cost-evidence fluctuations driving the behavior do not match explicit ratings of exhaustion, and 3) that actual difficulty impacts effort duration whereas expected difficulty impacts rest duration. Taken together, our findings suggest that cost evidence is implicitly monitored online, with an accumulation rate proportional to actual task difficulty. In contrast, cost-evidence bounds and dissipation rate might be adjusted in anticipation, depending on explicit task difficulty. PMID:24743711

Comparison of Scalar Expectancy Theory (SET) and the Learning-to-Time (LeT) model in a successive temporal bisection task.

PubMed

Arantes, Joana

2008-06-01

The present research tested the generality of the "context effect" previously reported in experiments using temporal double bisection tasks [e.g., Arantes, J., Machado, A. Context effects in a temporal discrimination task: Further tests of the Scalar Expectancy Theory and Learning-to-Time models. J. Exp. Anal. Behav., in press]. Pigeons learned two temporal discriminations in which all the stimuli appear successively: 1s (red) vs. 4s (green) and 4s (blue) vs. 16s (yellow). Then, two tests were conducted to compare predictions of two timing models, Scalar Expectancy Theory (SET) and the Learning-to-Time (LeT) model. In one test, two psychometric functions were obtained by presenting pigeons with intermediate signal durations (1-4s and 4-16s). Results were mixed. In the critical test, pigeons were exposed to signals ranging from 1 to 16s and followed by the green or the blue key. Whereas SET predicted that the relative response rate to each of these keys should be independent of the signal duration, LeT predicted that the relative response rate to the green key (compared with the blue key) should increase with the signal duration. Results were consistent with LeT's predictions, showing that the context effect is obtained even when subjects do not need to make a choice between two keys presented simultaneously.

A new table for prevention of hypoglycaemia during physical activity in type 1 diabetic patients.

PubMed

Grimm, J J; Ybarra, J; Berné, C; Muchnick, S; Golay, A

2004-11-01

The ability to adjust both insulin and nutrition to allow safe participation in physical activity and high performance has recently been recognized as an important management strategy in these patients. In particular, the important role played by the patient in self-monitoring blood glucose during physical activity and then using these data to improve performance and decrease hypoglycaemias is now fully accepted. The primary objective of this study is to compare different therapeutic options in exercising Type 1 diabetic patients (n=67) with or without CHO compensation and/or with or without insulin dosage reduction in order to prevent hypoglycaemias during and after exercise. Sixty-seven type 1 diabetic patients were aggregated into four treatment categories according to four strategies to prevent hypoglycaemia episodes, with or without carbohydrate compensation and/or with or without insulin dosage reduction. The protocol included 7 different disciplines and 9 subgroups according to 3 different durations (<20 min., 20-60 min., > 60 min.) and 3 intensity degrees (<60% of Maximal Heart Rate, 60-75% and > 75%). Our study shows that by replacing adequately the carbohydrates during the practice of physical exercise it is possible to prevent almost all hypoglycaemia episodes, independently of the insulin dosage adjustments. Furthermore, the amount of extra-carbohydrates correlates well with the number of hypoglycaemia while the decrease in insulin dosage does not. Adequate carbohydrate replacement during and after exercise seems to be the most important measure to prevent hypoglycaemia. However, the insulin dosage adjustment does not play such an important role. A decrease from 20 to 30% seems reasonable only for a long duration exercise (> 60 min.). Finally, a new user-friendly table for prevention of hypoglycaemia is proposed for physical activity of different intensity and duration.

Patients' expectations of orthodontic treatment: part 2--findings from a questionnaire survey.

PubMed

Sayers, M S; Newton, J T

2007-03-01

To describe patients' and their parents' expectations of orthodontic treatment. A questionnaire survey of 100 patients and their primary care-givers attending a new patient orthodontic consultant clinic, at a teaching hospital. GKT Orthodontic Department, King's College Dental Hospital, London, UK. The sample consisted of 100 participants who completed the questionnaire, including 50 patients aged 12-14 years who had been referred to the orthodontic department for treatment. One parent of each patient was also invited to participate. Participants completed a valid questionnaire measure of orthodontic expectations that was tested for reliability and validity. Descriptive analysis of the responses was undertaken, and comparisons of children's and parents' expectations, in addition to ethnicity, were made. Patients and parents have similar expectations of treatment, with the exception of expectations of duration of orthodontic treatment (P<0.01), having a brace fitted at the initial visit (P<0.05), and restrictions with regard to what one can eat and drink as a result of orthodontic treatment (P<0.05). Among the patient participants, different ethnic groups displayed different expectations of the initial orthodontic assessment visit, the likelihood of wearing headgear, the impact of orthodontic treatment on diet, and the reaction of peers to treatment (P<0.05). For patients, ethnic group differences were reported for expectations regarding the initial visit, headgear and dietary restrictions (P<0.05). Patients and their parents share similar expectations of orthodontic treatment for most aspects of care, although parents are more realistic in their estimation of the duration of treatment and the initial visit. The expectations of patients differ from those of their parents with regard to dietary and drink restrictions in relation to orthodontic treatment. Ethnicity significantly influences expectations of orthodontic treatment, and this may relate to differences in the patients' and their parents' assessed outcome of care.

Amount of torque and duration of stretching affects correction of knee contracture in a rat model of spinal cord injury.

PubMed

Moriyama, Hideki; Tobimatsu, Yoshiko; Ozawa, Junya; Kito, Nobuhiro; Tanaka, Ryo

2013-11-01

Joint contractures are a common complication of many neurologic conditions, and stretching often is advocated to prevent and treat these contractures. However, the magnitude and duration of the stretching done in practice usually are guided by subjective clinical impressions. Using an established T8 spinal cord injury rat model of knee contracture, we sought to determine what combination of static or intermittent stretching, varied by magnitude (high or low) and duration (long or short), leads to the best (1) improvement in the limitation in ROM; (2) restoration of the muscular and articular factors leading to contractures; and (3) prevention and treatment of contracture-associated histologic alterations of joint capsule and articular cartilage. Using a rat animal model, the spinal cord was transected completely at the level of T8. The rats were randomly assigned to seven treatment groups (n = 4 per group), which were composed of static or intermittent stretching in combination with different amounts of applied torque magnitude and duration. We assessed the effect of stretching by measuring the ROM and evaluating the histologic alteration of the capsule and cartilage. Contractures improved in all treated groups except for the low-torque and short-duration static stretching conditions. High-torque stretching was effective against shortening of the synovial membrane and adhesions in the posterosuperior regions. Collagen Type II and VEGF in the cartilage were increased by stretching. High-torque and long-duration static stretching led to greater restoration of ROM than the other torque and duration treatment groups. Stretching was more effective in improving articular components of contractures compared with the muscular components. Stretching in this rat model prevented shortening and adhesion of the joint capsule, and affected biochemical composition, but did not change morphologic features of the cartilage. This animal study tends to support the ideas that static stretching can influence joint ROM and histologic qualities of joint tissues, and that the way stretching is performed influences its efficacy. However, further studies are warranted to determine if our findings are clinically applicable.

Napping in English preschool children and the association with parents' attitudes.

PubMed

Jones, Caroline Helen Dorothy; Ball, Helen Louise

2013-04-01

Age-independent variability in childrens' napping duration may be influenced by parental preference and attitudes and childrens' availability or lack of opportunity to nap. Our study examined English preschool childrens' napping duration, frequency and location, and the association of daily nap duration with parents' attitudes towards napping. Parents of three-year-old children in deprived and nondeprived areas of a town in North-East England were interviewed regarding their attitudes towards child napping and completed four-day and five night sleep diaries documenting their childrens' daytime and nighttime sleep. Of 84 children, half had at least one nap during the four-day study period (median [interquartile range] daily nap duration across all children was 1 [21] min; for nappers only was 21 [34] min). Naps tended to be infrequent and short and few (6%) occurred in a bedroom. Children whose parents allowed or encouraged napping had significantly longer daily nap duration (n=25, median [interquartile range] daily nap duration 21 [34] min) compared to those whose parents tried to prevent them from napping (n=29, 1 [21] min), and those whose parents reported that children did not want to nap (n=30, 0 [0] min) (U=23.21; p<.001). Positive parental attitude towards napping was associated with longer child nap duration. Napping appeared to be mainly sporadic and opportunistic and was negatively perceived and prevented by one-third of parents. The consequences of premature nap cessation are not known; given the importance of sufficient sleep in childhood, we should possibly consider enabling young children to nap more freely. Copyright © 2013 Elsevier B.V. All rights reserved.

Long pacing pulses reduce phrenic nerve stimulation in left ventricular pacing.

PubMed

Hjortshøj, Søren; Heath, Finn; Haugland, Morten; Eschen, Ole; Thøgersen, Anna Margrethe; Riahi, Sam; Toft, Egon; Struijk, Johannes Jan

2014-05-01

Phrenic nerve stimulation is a major obstacle in cardiac resynchronization therapy (CRT). Activation characteristics of the heart and phrenic nerve are different with higher chronaxie for the heart. Therefore, longer pulse durations could be beneficial in preventing phrenic nerve stimulation during CRT due to a decreased threshold for the heart compared with the phrenic nerve. We investigated if long pulse durations decreased left ventricular (LV) thresholds relatively to phrenic nerve thresholds in humans. Eleven patients, with indication for CRT and phrenic nerve stimulation at the intended pacing site, underwent determination of thresholds for the heart and phrenic nerve at different pulse durations (0.3-2.9 milliseconds). The resulting strength duration curves were analyzed by determining chronaxie and rheobase. Comparisons for those parameters were made between the heart and phrenic nerve, and between the models of Weiss and Lapicque as well. In 9 of 11 cases, the thresholds decreased faster for the LV than for the phrenic nerve with increasing pulse duration. In 3 cases, the thresholds changed from unfavorable for LV stimulation to more than a factor 2 in favor of the LV. The greatest change occurred for pulse durations up to 1.5 milliseconds. The chronaxie of the heart was significantly higher than the chronaxie of the phrenic nerve (0.47 milliseconds vs. 0.22 milliseconds [P = 0.029, Lapicque] and 0.79 milliseconds vs. 0.27 milliseconds [P = 0.033, Weiss]). Long pulse durations lead to a decreased threshold of the heart relatively to the phrenic nerve and may prevent stimulation of the phrenic nerve in a clinical setting. © 2013 Wiley Periodicals, Inc.

Effect of probiotics on the incidence of ventilator-associated pneumonia in critically ill patients: a randomized controlled multicenter trial.

PubMed

Zeng, Juan; Wang, Chun-Ting; Zhang, Fu-Shen; Qi, Feng; Wang, Shi-Fu; Ma, Shuang; Wu, Tie-Jun; Tian, Hui; Tian, Zhao-Tao; Zhang, Shu-Liu; Qu, Yan; Liu, Lu-Yi; Li, Yuan-Zhong; Cui, Song; Zhao, He-Ling; Du, Quan-Sheng; Ma, Zhuang; Li, Chun-Hua; Li, Yun; Si, Min; Chu, Yu-Feng; Meng, Mei; Ren, Hong-Sheng; Zhang, Ji-Cheng; Jiang, Jin-Jiao; Ding, Min; Wang, Yu-Ping

2016-06-01

To evaluate the potential preventive effect of probiotics on ventilator-associated pneumonia (VAP). This was an open-label, randomized, controlled multicenter trial involving 235 critically ill adult patients who were expected to receive mechanical ventilation for ≥48 h. The patients were randomized to receive (1) a probiotics capsule containing live Bacillus subtilis and Enterococcus faecalis (Medilac-S) 0.5 g three times daily through a nasogastric feeding tube plus standard preventive strategies or (2) standard preventive strategies alone, for a maximum of 14 days. The development of VAP was evaluated daily, and throat swabs and gastric aspirate were cultured at baseline and once or twice weekly thereafter. The incidence of microbiologically confirmed VAP in the probiotics group was significantly lower than that in the control patients (36.4 vs. 50.4 %, respectively; P = 0.031). The mean time to develop VAP was significantly longer in the probiotics group than in the control group (10.4 vs. 7.5 days, respectively; P = 0.022). The proportion of patients with acquisition of gastric colonization of potentially pathogenic microorganisms (PPMOs) was lower in the probiotics group (24 %) than the control group (44 %) (P = 0.004). However, the proportion of patients with eradication PPMO colonization on both sites of the oropharynx and stomach were not significantly different between the two groups. The administration of probiotics did not result in any improvement in the incidence of clinically suspected VAP, antimicrobial consumption, duration of mechanical ventilation, mortality and length of hospital stay. Therapy with the probiotic bacteria B. Subtilis and E. faecalis are an effective and safe means for preventing VAP and the acquisition of PPMO colonization in the stomach.

High-frequency, low-magnitude vibration does not prevent bone loss resulting from muscle disuse in mice following botulinum toxin injection.

PubMed

Manske, Sarah L; Good, Craig A; Zernicke, Ronald F; Boyd, Steven K

2012-01-01

High-frequency, low-magnitude vibration enhances bone formation ostensibly by mimicking normal postural muscle activity. We tested this hypothesis by examining whether daily exposure to low-magnitude vibration (VIB) would maintain bone in a muscle disuse model with botulinum toxin type A (BTX). Female 16-18 wk old BALB/c mice (N = 36) were assigned to BTX-VIB, BTX-SHAM, VIB, or SHAM. BTX mice were injected with BTX (20 µL; 1 U/100 g body mass) into the left hindlimb posterior musculature. All mice were anaesthetized for 20 min/d, 5 d/wk, for 3 wk, and the left leg mounted to a holder. Through the holder, VIB mice received 45 Hz, ± 0.6 g sinusoidal acceleration without weight bearing. SHAM mice received no vibration. At baseline and 3 wk, muscle cross-sectional area (MCSA) and tibial bone properties (epiphysis, metaphysis and diaphysis) were assessed by in vivo micro-CT. Bone volume fraction in the metaphysis decreased 12 ± 9% and 7 ± 6% in BTX-VIB and BTX-SHAM, but increased in the VIB and SHAM. There were no differences in dynamic histomorphometry outcomes between BTX-VIB and BTX nor between VIB and SHAM. Thus, vibration did not prevent bone loss induced by a rapid decline in muscle activity nor produce an anabolic effect in normal mice. The daily loading duration was shorter than would be expected from postural muscle activity, and may have been insufficient to prevent bone loss. Based on the approach used in this study, vibration does not prevent bone loss in the absence of muscle activity induced by BTX.

Developmental windows of breast cancer risk provide opportunities for targeted chemoprevention

PubMed Central

Martinson, Holly A.; Lyons, Traci R.; Giles, Erin D.; Borges, Virginia F.; Schedin, Pepper

2014-01-01

The magnitude of the breast cancer problem implores researchers to aggressively investigate prevention strategies. However, several barriers currently reduce the feasibility of breast cancer prevention. These barriers include the inability to accurately predict future breast cancer diagnosis at the individual level, the need for improved understanding of when to implement interventions, uncertainty with respect to optimal duration of treatment, and negative side effects associated with currently approved chemoprevention therapies. None-the-less, the unique biology of the mammary gland, with its postnatal development and conditional terminal differentiation, may permit the resolution of many of these barriers. Specifically, lifecycle-specific windows of breast cancer risk have been identified that may be amenable to risk-reducing strategies. Here, we argue for prevention research focused on two of these lifecycle windows of risk: postpartum mammary gland involution and peri-menopause. We provide evidence that these windows are highly amenable to targeted, limited duration treatments. Such approaches could result in the prevention of postpartum and postmenopausal breast cancers, correspondingly. PMID:23664839

Involving the consumers: An exploration of users' and caregivers' needs and expectations on a fall prevention brochure: A qualitative study.

PubMed

Schoberer, Daniela; Breimaier, Helga E; Mandl, Manuela; Halfens, Ruud J G; Lohrmann, Christa

2016-01-01

This study aims to explore and compare nursing home residents', family members', and nursing staff's needs and expectations regarding a fall prevention brochure. Focus groups were carried out with 25 residents, 12 family members and 14 nursing staff separately, from three randomly selected nursing homes. Qualitative content analysis was used to analyze the data using a concept-driven coding frame. Results showed that residents want to be informed about dealing with extrinsic fall risks and coping strategies after a fall event. In addition, family members wanted to have detailed information on intrinsic fall risks as well as specific fall prevention strategies, such as body exercises. Of special importance for nursing staff was that not all falls are preventable even when preventive measures were taken. As the need and expectations of users differ substantially, one brochure could not comprise all postulated criteria and different brochures are necessary for residents and for family members. Copyright © 2016 Elsevier Inc. All rights reserved.

The costs of prevention.

PubMed

Weinstein, M C

1990-01-01

A prevention program is cost-effective if it yields more health benefits than do alternative uses of health care resources. Some prevention programs meet this standard: either they actually save more health care resources than they utilize, or their net costs per healthy year of life gained are lower than those of alternatives such as curative or palliative medicine. Other prevention programs, however, are less cost-effective than are medical treatments for the same disease. One lesson for public policy is that generalizations about the cost-effectiveness of "prevention" are unwise. Another lesson is that prevention programs should not be subjected to a higher standard than other health programs: they should not be expected to save money, but they should be expected to yield improved health at a reasonable price.

Irrelevant speech does not interfere with serial recall in early blind listeners.

PubMed

Kattner, Florian; Ellermeier, Wolfgang

2014-01-01

Phonological working memory is known be (a) inversely related to the duration of the items to be learned (word-length effect), and (b) impaired by the presence of irrelevant speech-like sounds (irrelevant-speech effect). As it is discussed controversially whether these memory disruptions are subject to attentional control, both effects were studied in sighted participants and in a sample of early blind individuals who are expected to be superior in selectively attending to auditory stimuli. Results show that, while performance depended on word length in both groups, irrelevant speech interfered with recall only in the sighted group, but not in blind participants. This suggests that blind listeners may be able to effectively prevent irrelevant sound from being encoded in the phonological store, presumably due to superior auditory processing. The occurrence of a word-length effect, however, implies that blind and sighted listeners are utilizing the same phonological rehearsal mechanism in order to maintain information in the phonological store.

Attitude changes during and after long submarine missions.

PubMed

Weybrew, B B; Molish, H B

1979-01-01

To assess the kind and degree of attitude changes occurring during a 2-month submerged mission, two enlisted crews of one fleet ballistic missile submarine (FBM) (n = 101 each) were administered the Submarine Attitude Questionnaire before and after two 55-day submerged missions interspersed with a rehabilitation period of the same duration. Results showed that time-in-service and pay grade bore a U-shaped relationship to positive attitudes toward the service. During submergence, most attitudes became negative and then reversed polarity during rehabilitation. However, there were no cumulative effects upon attitudes during successive missions. Attitudes pertaining to the realities of the mission (for example, boredom, hazardous aspects) became more negative but recovered faster. On the other hand, attitude changes related to long-range expectancies in terms of goal achievement of the crew members were less likely to recover. Several possible explanations for these attitude changes are discussed in the context of the mission of the FBM submarine. Suggestions for preventing or alleviating untoward attitude changes during long submarine missions are also presented.

The Tail Suspension Test

PubMed Central

Terrillion, Chantelle E.; Piantadosi, Sean C.; Bhat, Shambhu; Gould, Todd D.

2012-01-01

The tail-suspension test is a mouse behavioral test useful in the screening of potential antidepressant drugs, and assessing of other manipulations that are expected to affect depression related behaviors. Mice are suspended by their tails with tape, in such a position that it cannot escape or hold on to nearby surfaces. During this test, typically six minutes in duration, the resulting escape oriented behaviors are quantified. The tail-suspension test is a valuable tool in drug discovery for high-throughput screening of prospective antidepressant compounds. Here, we describe the details required for implementation of this test with additional emphasis on potential problems that may occur and how to avoid them. We also offer a solution to the tail climbing behavior, a common problem that renders this test useless in some mouse strains, such as the widely used C57BL/6. Specifically, we prevent tail climbing behaviors by passing mouse tails through a small plastic cylinder prior to suspension. Finally, we detail how to manually score the behaviors that are manifested in this test. PMID:22315011

30 CFR 250.1706 - What are the requirements for blowout prevention equipment?

Code of Federal Regulations, 2014 CFR

2014-07-01

... circumstances, including subfreezing conditions. The working pressure rating of the BOP system and system components must exceed the expected surface pressure to which they may be subjected. If the expected surface pressure exceeds the rated working pressure of the annular preventer, you must submit with Form BSEE-0124...

30 CFR 250.1706 - What are the requirements for blowout prevention equipment?

Code of Federal Regulations, 2013 CFR

2013-07-01

... circumstances, including subfreezing conditions. The working pressure rating of the BOP system and system components must exceed the expected surface pressure to which they may be subjected. If the expected surface pressure exceeds the rated working pressure of the annular preventer, you must submit with Form BSEE-0124...

Sleep duration and overweight/obesity in children: implication for pediatric nursing

PubMed Central

Liu, Jianghong; Zhang, Angelina; Li, Linda

2012-01-01

Purpose The purpose of this study was to review evidence from the last 5 years (2006-2011) regarding a relationship between sleep duration and childhood overweight/obesity. Conclusions Among the 25 studies selected from PubMed and Web of Knowledge databases, all indicated significant associations between short sleep duration and childhood overweight/obesity. Studies explored a range of pediatric populations, methodologies, and potential contributing factors. Practice Implications Childhood sleep duration may be a modifiable risk factor in preventing obesity. In addition to identifying and assessing patients’ sleep habits, nurses play important roles as educators regarding the importance of adequate sleep and promoting it in children. PMID:22734873

Ohio River Denial as a Transportation Corridor and Its Economic Impacts on the Energy Industry

DTIC Science & Technology

2009-03-01

of freight transport market demand elasiticities, and mode choice probability elasticities of rail and full truck load carriers in the intercity ...obvious that under real conditions, travel demand would alter if time and duration of delay could be anticipated. First, cost of delay was defined...replication was expressed in terms of duration of the simulation interval, simulated travel time for this interval time, and expected travel time. Then

The clinical consequences of an ageing world and preventive strategies.

PubMed

Lunenfeld, Bruno; Stratton, Pamela

2013-10-01

Over the past century, the world has seen unprecedented declines in mortality rates, leading to an accelerated increase in the world population. This century will realise falling fertility rates alongside ageing populations. The 20th century was the century of population growth; the 21st century will be remembered as the century of ageing. Increase in life expectancy is one of the highest achievements of humankind; however, ageing and age-related disease is a mounting challenge for individuals, families, and for social, economic, and healthcare systems. Since healthy life expectancy has lagged behind the increase in life expectancy, the rise in morbidity will increase the burden on healthcare systems. Implementation of preventive health strategies to decrease, delay or prevent frailty, lung, breast and colon cancer, cardiovascular disease, metabolic syndrome, osteoporosis and osteopaenia, may increase health expectancy, and permit women to age gracefully and maintain independent living, without disability, for as long as possible. Published by Elsevier Ltd.

ICT-based system to predict and prevent falls (iStoppFalls): study protocol for an international multicenter randomized controlled trial.

PubMed

Gschwind, Yves J; Eichberg, Sabine; Marston, Hannah R; Ejupi, Andreas; Rosario, Helios de; Kroll, Michael; Drobics, Mario; Annegarn, Janneke; Wieching, Rainer; Lord, Stephen R; Aal, Konstantin; Delbaere, Kim

2014-08-20

Falls are very common, especially in adults aged 65 years and older. Within the current international European Commission's Seventh Framework Program (FP7) project 'iStoppFalls' an Information and Communication Technology (ICT) based system has been developed to regularly assess a person's risk of falling in their own home and to deliver an individual and tailored home-based exercise and education program for fall prevention. The primary aims of iStoppFalls are to assess the feasibility and acceptability of the intervention program, and its effectiveness to improve balance, muscle strength and quality of life in older people. This international, multicenter study is designed as a single-blinded, two-group randomized controlled trial. A total of 160 community-dwelling older people aged 65 years and older will be recruited in Germany (n = 60), Spain (n = 40), and Australia (n = 60) between November 2013 and May 2014. Participants in the intervention group will conduct a 16-week exercise program using the iStoppFalls system through their television set at home. Participants are encouraged to exercise for a total duration of 180 minutes per week. The training program consists of a variety of balance and strength exercises in the form of video games using exergame technology. Educational material about a healthy lifestyle will be provided to each participant. Final reassessments will be conducted after 16 weeks. The assessments include physical and cognitive tests as well as questionnaires assessing health, fear of falling, quality of life and psychosocial determinants. Falls will be followed up for six months by monthly falls calendars. We hypothesize that the regular use of this newly developed ICT-based system for fall prevention at home is feasible for older people. By using the iStoppFalls sensor-based exercise program, older people are expected to improve in balance and strength outcomes. In addition, the exercise training may have a positive impact on quality of life by reducing the risk of falls. Taken together with expected cognitive improvements, the individual approach of the iStoppFalls program may provide an effective model for fall prevention in older people who prefer to exercise at home. Australian New Zealand Clinical Trials Registry Trial ID: ACTRN12614000096651.International Standard Randomised Controlled Trial Number: ISRCTN15932647.

ICT-based system to predict and prevent falls (iStoppFalls): study protocol for an international multicenter randomized controlled trial

PubMed Central

2014-01-01

Background Falls are very common, especially in adults aged 65 years and older. Within the current international European Commission’s Seventh Framework Program (FP7) project ‘iStoppFalls’ an Information and Communication Technology (ICT) based system has been developed to regularly assess a person’s risk of falling in their own home and to deliver an individual and tailored home-based exercise and education program for fall prevention. The primary aims of iStoppFalls are to assess the feasibility and acceptability of the intervention program, and its effectiveness to improve balance, muscle strength and quality of life in older people. Methods/Design This international, multicenter study is designed as a single-blinded, two-group randomized controlled trial. A total of 160 community-dwelling older people aged 65 years and older will be recruited in Germany (n = 60), Spain (n = 40), and Australia (n = 60) between November 2013 and May 2014. Participants in the intervention group will conduct a 16-week exercise program using the iStoppFalls system through their television set at home. Participants are encouraged to exercise for a total duration of 180 minutes per week. The training program consists of a variety of balance and strength exercises in the form of video games using exergame technology. Educational material about a healthy lifestyle will be provided to each participant. Final reassessments will be conducted after 16 weeks. The assessments include physical and cognitive tests as well as questionnaires assessing health, fear of falling, quality of life and psychosocial determinants. Falls will be followed up for six months by monthly falls calendars. Discussion We hypothesize that the regular use of this newly developed ICT-based system for fall prevention at home is feasible for older people. By using the iStoppFalls sensor-based exercise program, older people are expected to improve in balance and strength outcomes. In addition, the exercise training may have a positive impact on quality of life by reducing the risk of falls. Taken together with expected cognitive improvements, the individual approach of the iStoppFalls program may provide an effective model for fall prevention in older people who prefer to exercise at home. Trial registration Australian New Zealand Clinical Trials Registry Trial ID: ACTRN12614000096651. International Standard Randomised Controlled Trial Number: ISRCTN15932647. PMID:25141850

Functional disability and depression in the general population. Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS).

PubMed

Spijker, J; Graaf, R; Bijl, R V; Beekman, A T F; Ormel, J; Nolen, W A

2004-09-01

Data on the temporal relationships between duration of depression and recovery and functional disability are sparse. These relationships were examined in subjects from the general population (n = 250) with newly originated episodes of DSM-III-R major depression. The Netherlands Mental Health Survey and Incidence Study is a prospective epidemiological survey in the adult population (n = 7076), using the Composite International Diagnostic Interview (CIDI). Duration of depression and duration of recovery over 2 years were assessed with a life chart interview. Functional disabilities were assessed with the MOS-SF-36 and with absence days from work. Functional disabilities and absence days in depressed individuals were not found to be associated with duration of depression. Functioning in daily activities improved with longer duration of recovery but social functioning not. Functioning deteriorates by actual depressive symptomatology and comorbid anxiety but not by longer duration of depression. After symptomatic recovery, functioning improves to premorbid level, irrespective of the length of the depression. Improvements in daily activities and work can be expected with longer duration of recovery.

Fertility in The Netherlands as an expected value process and developmental readiness.

PubMed

Taris, T W

1998-01-01

In this 2-wave panel study, the decision to have children was examined in the context of Feather's (1982) expectancy-value model among a representative sample of 288 childless Dutch adults aged 18-30 years. The effects of 2 indicators of developmental readiness (age and duration of relationship) were also explored. It was expected that (a) the likelihood of having a baby would increase as a function of intentions, evaluations of being childless, and expected rewards of having children and (b) developmental readiness would be positively related to whether respondents had children at the 2nd wave of the study. Structural equation modeling was used. The results largely supported expectations. Developmental readiness affected fertility both directly and indirectly via the expected rewards of having children.

Performance Probability Distributions for Sediment Control Best Management Practices

NASA Astrophysics Data System (ADS)

Ferrell, L.; Beighley, R.; Walsh, K.

2007-12-01

Controlling soil erosion and sediment transport can be a significant challenge during the construction process due to the extent and conditions of bare, disturbed soils. Best Management Practices (BMPs) are used as the framework for the design of sediment discharge prevention systems in stormwater pollution prevention plans which are typically required for construction sites. This research focuses on commonly-used BMP systems for perimeter control of sediment export: silt fences and fiber rolls. Although these systems are widely used, the physical and engineering parameters describing their performance are not well understood. Performance expectations are based on manufacturer results, but due to the dynamic conditions that exist on a construction site performance expectations are not always achievable in the field. Based on experimental results product performance is shown to be highly variable. Experiments using the same installation procedures show inconsistent sediment removal performances ranging from (>)85 percent to zero. The goal of this research is to improve the determination of off-site sediment yield based on probabilistic performance results of perimeter control BMPs. BMPs are evaluated in the Soil Erosion Research Laboratory (SERL) in the Civil and Environmental Engineering department at San Diego State University. SERL experiments are performed on a 3-m by 10-m tilting soil bed with a soil depth of 0.5 meters and a slope of 33 percent. The simulated storm event consists of 17 mm/hr for 20 minutes followed by 51 mm/hr for 30 minutes. The storm event is based on an ASTM design storm intended to simulate BMP failures. BMP performance is assessed based on experiments where BMPs are installed per manufacture specifications, less than optimal installations, and no treatment conditions. Preliminary results from 30 experiments are presented and used to develop probability distributions for BMP sediment removal efficiencies. The results are then combined with spatial and temporal distributions of perimeter sediment loadings for a construction site to estimate the time dependent risk of off-site sediment discharge over the duration of a project (ex., 0, 25, 50, 75 and 100 percent complete). The results are used to highlight the importance of considering all phases of construction when developing stormwater pollution prevention plans.

Incorporating coping into an expectancy framework for explaining drinking behaviour.

PubMed

Hasking, Penelope A; Oei, Tian P S

2008-01-01

Expectancy Theory has offered much in the way of understanding alcohol use and abuse, and has contributed greatly to prevention and treatment initiatives. However although many cognitive-behavioural treatment approaches are based on expectancy constructs, such as outcome expectancies and self-efficacy, high relapse rates imply that expectancy theory may be too narrow in scope, and that additional variables need to be examined if a comprehensive understanding of drinking behaviour, and better treatment outcomes, are to be achieved. We suggest that the coping strategies an individual employs present one such set of variables that have largely been neglected from an expectancy framework. Although coping skills training is routinely used in prevention and treatment of alcohol problems, coping research has suffered from a poor theoretical framework. In this paper we review the existing research relating expectancies, self-efficacy and coping to drinking behaviour and propose a model which explains both social and dependent drinking, by incorporating coping into an expectancy theory framework. We also outline research and clinical implications of the proposed model.

[The use of mood stabilizers in preventive treatment of patients with schizoaffective disorders].

PubMed

Chritinin, D F; Sumarokova, M A

2014-01-01

To study an effect of combination therapy consisting of mood stabilizers on the quality of remission in patients with schizoaffective disorders. Authors examined 56 outpatients with ICD-10 diagnosis of schizoaffective disorder (F25). Patients in remission received anti-relapse therapy with antipsychotics and were not treated with mood stabilizers for at least two years, and then they received a combined anti-relapse therapy, including both antipsychotics and mood stabilizers. The combined use of pharmacotherapy creates a better remission. No statistically significant differences in the effect of different groups of mood stabilizers on the average duration of remission are identified. The inclusion of mood stabilizers in the scheme of preventive treatment has no effect on the average duration of subsequent hospitalization. Mood stabilizers are effective in the prevention of suicidal behavior in patients with schizoaffective disorder, they reduce the risk of disability in patients with schizoaffective disorder and increase compliance.

Task uncertainty and communication during nursing shift handovers.

PubMed

Mayor, Eric; Bangerter, Adrian; Aribot, Myriam

2012-09-01

We explore variations in handover duration and communication in nursing units. We hypothesize that duration per patient is higher in units facing high task uncertainty. We expect both topics and functions of communication to vary depending on task uncertainty. Handovers are changing in modern healthcare organizations, where standardized procedures are increasingly advocated for efficiency and reliability reasons. However, redesign of handover should take environmental contingencies of different clinical unit types into account. An important contingency in institutions is task uncertainty, which may affect how communicative routines like handover are accomplished. Nurse unit managers of 80 care units in 18 hospitals were interviewed in 2008 about topics and functions of handover communication and duration in their unit. Interviews were content-analysed. Clinical units were classified into a theory-based typology (unit type) that gradually increases on task uncertainty. Quantitative analyses were performed. Unit type affected resource allocation. Unit types facing higher uncertainty had higher handover duration per patient. As expected, unit type also affected communication content. Clinical units facing higher uncertainty discussed fewer topics, discussing treatment and care and organization of work less frequently. Finally, unit type affected functions of handover: sharing emotions was less often mentioned in unit types facing higher uncertainty. Task uncertainty and its relationship with functions and topics of handover should be taken into account during the design of handover procedures. © 2011 Blackwell Publishing Ltd.

Can the adult skeleton recover lost bone?

NASA Technical Reports Server (NTRS)

Leblanc, Adrian; Schneider, Victor

1991-01-01

The loss of bone mineral with aging and subsequent development of osteoporosis is a common problem in elderly women, and as life expectancy increases, in elderly men as well. Space flight also causes bone loss and could be a limiting factor for long duration missions, such as, a Mars expedition or extended occupation of a Space Station. Before effective countermeasures can be devised, a thorough knowledge of the extent, location, and rate of bone loss during weightlessness is needed from actual space flight data or ground-based disuse models. In addition, the rate and extent that these losses are reversed after return from space flight are of primary importance. Although the mechanisms are not likely to be the same in aging and space flight, there are common elements. For example, strategies developed to prevent disuse bone loss or to enhance the rate of recovery following space flight might have direct applicability to clinical medicine. For various reasons, little attention has been given to recovery of bone mass following space flight. As a prelude to the design of strategies to enhance recovery of bone, this paper reviews published literature related to bone recovery in the adult. We conclude that recovery can be expected, but the rate and extent will be individual and bone site dependent. The development of strategies to encourage or enhance bone formation following space flight may be as important as implementing countermeasures during flight.

No Evidence for Heritability of Male Mating Latency or Copulation Duration across Social Environments in Drosophila melanogaster

PubMed Central

Taylor, Michelle L.; Evans, Jonathan P.; Garcia-Gonzalez, Francisco

2013-01-01

A key assumption underpinning major models of sexual selection is the expectation that male sexual attractiveness is heritable. Surprisingly, however, empirical tests of this assumption are relatively scarce. Here we use a paternal full-sib/half-sib breeding design to examine genetic and environmental variation in male mating latency (a proxy for sexual attractiveness) and copulation duration in a natural population of Drosophila melanogaster. As our experimental design also involved the manipulation of the social environment within each full-sibling family, we were able to further test for the presence of genotype-by-environment interactions (GEIs) in these traits, which have the potential to compromise mate choice for genetic benefits. Our experimental manipulation of the social environment revealed plastic expression of both traits; males exposed to a rival male during the sensitive period of adult sexual maturation exhibited shorter mating latencies and longer copulation durations than those who matured in isolation. However, we found no evidence for GEIs, and no significant additive genetic variation underlying these traits in either environment. These results undermine the notion that the evolution of female choice rests on covariance between female preference and male displays, an expectation that underpins indirect benefit models such as the good genes and sexy sons hypotheses. However, our results may also indicate depletion of genetic variance in these traits in the natural population studied, thus supporting the expectation that traits closely aligned with reproductive fitness can exhibit low levels of additive genetic variance. PMID:24155948

No effect of recumbency duration on the occurrence of post-lumbar puncture headache with a 22G cutting needle.

PubMed

Kim, Sung R; Chae, Hyun S; Yoon, Mi J; Han, Jung H; Cho, Kwang J; Chung, Sun J

2012-01-30

Supine recumbence has been widely performed to prevent post-lumbar puncture headache (PLPH). However, the optimal duration of supine recumbence is controversial. The aim of the study is to compare the occurrence of PLPH according to the duration of supine recumbence in patients with neurological disorders. A non-equivalent control/experimental pre-/post-test study design was used. Seventy consecutive patients were prospectively enrolled between July 2007 and July 2008. Thirty-five patients underwent supine recumbence for four hours after lumbar puncture (Group 1) and 35 patients underwent supine recumbence for one hour (Group 2). The overall frequency of PLPH was 31.4%. The frequency of PLPH was not significantly different between the Group 1 (28.6%) and Group 2 (34.3%) (P = 0.607). In patients with PLPH, the median severity (P = 0.203) and median onset time of PLPH (P = 0.582) were not significantly different between the two groups. In a logistic regression analysis, the previous history of post-lumbar puncture headache was a significant risk factor for the occurrence of PLPH (OR = 11.250, 95% CI: 1.10-114.369, P = 0.041). Our study suggests that short duration (one hour) of supine recumbence may be as efficient as long duration (four hours) of supine recumbence to prevent PLPH.

No effect of recumbency duration on the occurrence of post-lumbar puncture headache with a 22G cutting needle

PubMed Central

2012-01-01

Background Supine recumbence has been widely performed to prevent post-lumbar puncture headache (PLPH). However, the optimal duration of supine recumbence is controversial. The aim of the study is to compare the occurrence of PLPH according to the duration of supine recumbence in patients with neurological disorders. Methods A non-equivalent control/experimental pre-/post-test study design was used. Seventy consecutive patients were prospectively enrolled between July 2007 and July 2008. Thirty-five patients underwent supine recumbence for four hours after lumbar puncture (Group 1) and 35 patients underwent supine recumbence for one hour (Group 2). Results The overall frequency of PLPH was 31.4%. The frequency of PLPH was not significantly different between the Group 1 (28.6%) and Group 2 (34.3%) (P = 0.607). In patients with PLPH, the median severity (P = 0.203) and median onset time of PLPH (P = 0.582) were not significantly different between the two groups. In a logistic regression analysis, the previous history of post-lumbar puncture headache was a significant risk factor for the occurrence of PLPH (OR = 11.250, 95% CI: 1.10-114.369, P = 0.041). Conclusions Our study suggests that short duration (one hour) of supine recumbence may be as efficient as long duration (four hours) of supine recumbence to prevent PLPH. PMID:22289169

Prevention of poststroke depression: does prophylactic pharmacotherapy work?

PubMed

Salter, Katherine L; Foley, Norine C; Zhu, Lynn; Jutai, Jeffrey W; Teasell, Robert W

2013-11-01

Given the negative influence of poststroke depression (PSD) on functional recovery, cognition, social participation, quality of life, and risk for mortality, the early initiation of antidepressant therapy to prevent its development has been investigated; however, individual studies have offered conflicting evidence. The present systematic review and meta-analysis examined available evidence from published randomized controlled trials (RCTs) evaluating the effectiveness of pharmacotherapy for the prevention of PSD to provide updated pooled analyses. Literature searches of 6 databases were performed for the years 1990 to 2011. RCTs meeting study inclusion criteria were evaluated for methodologic quality. Data extracted included the antidepressant therapy used, treatment timing and duration, method(s) of assessment, and study results pertaining to the onset of PSD. Pooled analyses were conducted. Eight RCTs were identified for inclusion. Pooled analyses demonstrated reduced odds for the development of PSD associated with pharmacologic treatment (odds ratio [OR] 0.34; 95% confidence interval [CI] 0.22-0.53; P<.001), a treatment duration of 1 year (OR 0.31; 95% CI 0.18-0.56; P<.001), and the use of a selective serotonin reuptake inhibitor (OR 0.37; 95% CI 0.22-0.61; P<.001). The early initiation of antidepressant therapy, in nondepressed stroke patients, may reduce the odds for development of PSD. Optimum timing and duration for treatment and the identification of the most appropriate recipients for a program of indicated prevention require additional examination. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.

The effectiveness of alternative planned durations of residential drug abuse treatment.

PubMed Central

McCusker, J; Vickers-Lahti, M; Stoddard, A; Hindin, R; Bigelow, C; Zorn, M; Garfield, F; Frost, R; Love, C; Lewis, B

1995-01-01

Randomized controlled trials were conducted at two residential drug abuse treatment facilities to compare programs that differed in planned duration. One trial compared a 6-month and a 12-month therapeutic community program (n = 184), and the second compared a 3-month and a 6-month relapse prevention program (n = 444). Retention rates over comparable time periods differed minimally by planned treatment duration, and the longer programs had lower completion rates. There was no effect in either trial of planned treatment duration on changes in psychosocial variables between admission and exit or on rates or patterns of drug use at follow-up between 2 and 6 months after exit. PMID:7573630

Management of chronic daily headache: challenges in clinical practice.

PubMed

Saper, Joel R; Dodick, David; Gladstone, Jonathan P

2005-04-01

Chronic daily headache (CHD) refers to a category of headache disorders that are characterized by headaches occurring on more than 15 days per month. This category is subdivided into long- and short-duration (>4 or <4 hours) CDH disorders based on the duration of individual headache attacks. Examples of long-duration CDH include transformed migraine (TM), chronic migraine (CM), new daily persistent headache (NDPH), acute medication overuse headache, and hemicrania continua (HC). The goal of this review is to enable clinicians to accurately diagnose and effectively manage patients with long-duration CDH. Patients with CDH often require an aggressive and comprehensive treatment approach that includes a combination of acute and preventive medications, as well as nondrug therapies.

Preventive maintenance. 'Problem recognition style' can be used to segment the market and promote healthier lifestyles.

PubMed

Jayanti, R K

1997-01-01

Problem recognition styles--desired state types (DSTs) and actual state types (ASTs)--have an effect on preventive health care decision making. Segmenting the market along these lines can help marketers position products and services to educate and attract people who will not see a doctor unless there is something wrong with them. Both groups expect the same benefits from preventive health care actions, but ASTs fail to act on those expectations. Therefore, marketing strategy touting the benefits of preventive health care might be futile. Educational promotional campaigns aimed at both DSTs and ASTs also are wasteful because DSTs already possess much health knowledge, lead wellness-oriented lifestyles, and practice preventive health behaviors.

Assessing the impact of heart failure specialist services on patient populations.

PubMed

Lyratzopoulos, Georgios; Cook, Gary A; McElduff, Patrick; Havely, Daniel; Edwards, Richard; Heller, Richard F

2004-05-24

The assessment of the impact of healthcare interventions may help commissioners of healthcare services to make optimal decisions. This can be particularly the case if the impact assessment relates to specific patient populations and uses timely local data. We examined the potential impact on readmissions and mortality of specialist heart failure services capable of delivering treatments such as b-blockers and Nurse-Led Educational Intervention (N-LEI). Statistical modelling of prevented or postponed events among previously hospitalised patients, using estimates of: treatment uptake and contraindications (based on local audit data); treatment effectiveness and intolerance (based on literature); and annual number of hospitalization per patient and annual risk of death (based on routine data). Optimal treatment uptake among eligible but untreated patients would over one year prevent or postpone 11% of all expected readmissions and 18% of all expected deaths for spironolactone, 13% of all expected readmisisons and 22% of all expected deaths for b-blockers (carvedilol) and 20% of all expected readmissions and an uncertain number of deaths for N-LEI. Optimal combined treatment uptake for all three interventions during one year among all eligible but untreated patients would prevent or postpone 37% of all expected readmissions and a minimum of 36% of all expected deaths. In a population of previously hospitalised patients with low previous uptake of b-blockers and no uptake of N-LEI, optimal combined uptake of interventions through specialist heart failure services can potentially help prevent or postpone approximately four times as many readmissions and a minimum of twice as many deaths compared with simply optimising uptake of spironolactone (not necessarily requiring specialist services). Examination of the impact of different heart failure interventions can inform rational planning of relevant healthcare services.

The Impact of Attention on Judgments of Frequency and Duration

PubMed Central

Winkler, Isabell; Glauer, Madlen; Betsch, Tilmann; Sedlmeier, Peter

2015-01-01

Previous studies that examined human judgments of frequency and duration found an asymmetrical relationship: While frequency judgments were quite accurate and independent of stimulus duration, duration judgments were highly dependent upon stimulus frequency. A potential explanation for these findings is that the asymmetry is moderated by the amount of attention directed to the stimuli. In the current experiment, participants' attention was manipulated in two ways: (a) intrinsically, by varying the type and arousal potential of the stimuli (names, low-arousal and high-arousal pictures), and (b) extrinsically, by varying the physical effort participants expended during the stimulus presentation (by lifting a dumbbell vs. relaxing the arm). Participants processed stimuli with varying presentation frequencies and durations and were subsequently asked to estimate the frequency and duration of each stimulus. Sensitivity to duration increased for pictures in general, especially when processed under physical effort. A large effect of stimulus frequency on duration judgments was obtained for all experimental conditions, but a similar large effect of presentation duration on frequency judgments emerged only in the conditions that could be expected to draw high amounts of attention to the stimuli: when pictures were judged under high physical effort. Almost no difference in the mutual impact of frequency and duration was obtained for low-arousal or high-arousal pictures. The mechanisms underlying the simultaneous processing of frequency and duration are discussed with respect to existing models derived from animal research. Options for the extension of such models to human processing of frequency and duration are suggested. PMID:26000712

The impact of attention on judgments of frequency and duration.

PubMed

Winkler, Isabell; Glauer, Madlen; Betsch, Tilmann; Sedlmeier, Peter

2015-01-01

Previous studies that examined human judgments of frequency and duration found an asymmetrical relationship: While frequency judgments were quite accurate and independent of stimulus duration, duration judgments were highly dependent upon stimulus frequency. A potential explanation for these findings is that the asymmetry is moderated by the amount of attention directed to the stimuli. In the current experiment, participants' attention was manipulated in two ways: (a) intrinsically, by varying the type and arousal potential of the stimuli (names, low-arousal and high-arousal pictures), and (b) extrinsically, by varying the physical effort participants expended during the stimulus presentation (by lifting a dumbbell vs. relaxing the arm). Participants processed stimuli with varying presentation frequencies and durations and were subsequently asked to estimate the frequency and duration of each stimulus. Sensitivity to duration increased for pictures in general, especially when processed under physical effort. A large effect of stimulus frequency on duration judgments was obtained for all experimental conditions, but a similar large effect of presentation duration on frequency judgments emerged only in the conditions that could be expected to draw high amounts of attention to the stimuli: when pictures were judged under high physical effort. Almost no difference in the mutual impact of frequency and duration was obtained for low-arousal or high-arousal pictures. The mechanisms underlying the simultaneous processing of frequency and duration are discussed with respect to existing models derived from animal research. Options for the extension of such models to human processing of frequency and duration are suggested.

Chemosensory assessment of sperm competition levels and the evolution of internal spermatophore guarding

PubMed Central

Carazo, P; Font, E; Alfthan, B

2006-01-01

Males of many species adjust their reproductive behaviour according to the perceived risk of sperm competition. Although this phenomenon is widespread in insects and other animals, the mechanisms that allow mates to assess sperm competition levels remain largely unexplored. In this study, we analysed the mating behaviour of pairs of Tenebrio molitor beetles under three odour treatments representing increasing levels of sperm competition risk (SCR) and sperm competition intensity (SCI). Copula duration and male and female post-copulatory behaviour varied significantly with odour treatment. Both copula duration and post-copulatory associations (PCAs) increased significantly in odour treatments reflecting high male density. To our knowledge, this is the first study to report that insects may assess the actual density of potential competitors at the time of mating, a cue to SCR and SCI, on the basis of chemical cues. In T. molitor, males inhibit sperm release from the spermatophore of a rival male when remating takes place at short intervals. We show that, when sperm competition levels are high, PCAs increase female remating interval just above that necessary to prevent spermatophore inhibition by rival males. This finding strongly suggests that strategic male behaviour plays a ‘spermatophore guarding’ role in this species. Although common in insects with external spermatophore transfer, spermatophore guarding is not expected in species with rapid ejaculate transfer and internal spermatophore delivery. Our results reveal that spermatophore guarding may evolve, even under these circumstances, as an evolutionary response to short-term spermatophore inhibition or displacement mechanisms. PMID:17148255

Occupational Skin Disease Prevention: An Educational Intervention for Hairdresser Cosmetology Students.

PubMed

Haughtigan, Kara; Main, Eve; Bragg-Underwood, Tonya; Watkins, Cecilia

2017-11-01

Cosmetologists frequently develop occupational skin disease related to workplace exposures. The purpose of this study was to evaluate an educational intervention to increase cosmetology students' occupational skin disease knowledge and use of preventive practices. A quasi-experimental design was used to evaluate students' knowledge, behaviors, intentions, expectancies, and expectations. A 20-minute verbal presentation and printed two-page educational handout were provided for participants. Statistically significant increases in knowledge, frequency of glove use, and frequency of moisturizer use were found, but the frequency of handwashing did not increase. In addition, the Behavioral Strategies subscale, the Intention subscale, and the Expectancies subscale showed statistically significant improvements. The results of this study suggest an educational intervention can increase cosmetology students' knowledge of occupational skin diseases and their use of preventive strategies.

Frequently Asked Questions (FAQs) | Cancer Prevention Fellowship Program

Cancer.gov

Am I eligible? To be considered for the Cancer Prevention Fellowship Program (CPFP), you must meet eligibility criteria related to educational attainment, US citizenship/permanent residency status, and the duration of prior postdoctoral research experience. Refer to the Eligibility Requirements for details. How do I apply? You must apply through our online application process.

Prevention of Child Sexual Abuse Victimization: A Meta Analysis of School Programs.

ERIC Educational Resources Information Center

Rispens, Jan; Aleman, Andre; Goudena, Paul P.

1997-01-01

Meta-analysis of 16 evaluation studies of school programs aimed at the prevention of child sexual abuse victimization found significant and considerable mean postintervention and follow-up effect sizes, indicating that the programs were effective in teaching children sexual abuse concepts and self-protection skills. Program duration and content…

PREVENTION REFERENCE MANUAL: CONTROL TECHNOLOGIES, VOL. 2. POST-RELEASE MITIGATION MEASURES FOR CONTROLLING ACCIDENTAL RELEASES OF AIR TOXICS

EPA Science Inventory

The volume discusses prevention and protection measures for controlling accidental releases of air toxics. The probability of accidental releases depends on the extent to which deviations (in magnitude and duration) in the process can be tolerated before a loss of chemical contai...

Estimating the Size and Cost of the STD Prevention Services Safety Net.

PubMed

Gift, Thomas L; Haderxhanaj, Laura T; Torrone, Elizabeth A; Behl, Ajay S; Romaguera, Raul A; Leichliter, Jami S

2015-01-01

The Patient Protection and Affordable Care Act is expected to reduce the number of uninsured people in the United States during the next eight years, but more than 10% are expected to remain uninsured. Uninsured people are one of the main populations using publicly funded safety net sexually transmitted disease (STD) prevention services. Estimating the proportion of the uninsured population expected to need STD services could help identify the potential demand for safety net STD services and improve program planning. In 2013, an estimated 8.27 million people met the criteria for being in need of STD services. In 2023, 4.70 million uninsured people are expected to meet the criteria for being in need of STD services. As an example, the cost in 2014 U.S. dollars of providing chlamydia screening to these people was an estimated $271.1 million in 2013 and is estimated to be $153.8 million in 2023. A substantial need will continue to exist for safety net STD prevention services in coming years.

Estimating the Size and Cost of the STD Prevention Services Safety Net

PubMed Central

Haderxhanaj, Laura T.; Torrone, Elizabeth A.; Behl, Ajay S.; Romaguera, Raul A.; Leichliter, Jami S.

2015-01-01

The Patient Protection and Affordable Care Act is expected to reduce the number of uninsured people in the United States during the next eight years, but more than 10% are expected to remain uninsured. Uninsured people are one of the main populations using publicly funded safety net sexually transmitted disease (STD) prevention services. Estimating the proportion of the uninsured population expected to need STD services could help identify the potential demand for safety net STD services and improve program planning. In 2013, an estimated 8.27 million people met the criteria for being in need of STD services. In 2023, 4.70 million uninsured people are expected to meet the criteria for being in need of STD services. As an example, the cost in 2014 U.S. dollars of providing chlamydia screening to these people was an estimated $271.1 million in 2013 and is estimated to be $153.8 million in 2023. A substantial need will continue to exist for safety net STD prevention services in coming years. PMID:26556931

Context effects in a temporal discrimination task" further tests of the Scalar Expectancy Theory and Learning-to-Time models.

PubMed

Arantes, Joana; Machado, Armando

2008-07-01

Pigeons were trained on two temporal bisection tasks, which alternated every two sessions. In the first task, they learned to choose a red key after a 1-s signal and a green key after a 4-s signal; in the second task, they learned to choose a blue key after a 4-s signal and a yellow key after a 16-s signal. Then the pigeons were exposed to a series of test trials in order to contrast two timing models, Learning-to-Time (LeT) and Scalar Expectancy Theory (SET). The models made substantially different predictions particularly for the test trials in which the sample duration ranged from 1 s to 16 s and the choice keys were Green and Blue, the keys associated with the same 4-s samples: LeT predicted that preference for Green should increase with sample duration, a context effect, but SET predicted that preference for Green should not vary with sample duration. The results were consistent with LeT. The present study adds to the literature the finding that the context effect occurs even when the two basic discriminations are never combined in the same session.

Why Nations Become Wealthy: The Effects of Adult Longevity on Saving

PubMed Central

Kinugasa, Tomoko; Mason, Andrew

2007-01-01

We analyze steady state and out-of-steady-state effects of the transition in adult longevity on the national saving rate using historical data and international panel data. The rise in adult life expectancy has a large and statistically significant effect on aggregate saving. The effects have been especially pronounced in East Asia because its mortality transition was very rapid. Gains in life expectancy are much more important than declines in child dependency. Population aging may not lead to lower saving rates in the future if life expectancy and the duration of retirement continue to increase. PMID:18167514

[Studying the fertility peak in Beijing].

PubMed

Zhong, L

1989-07-01

Beijing, China, is experiencing a baby boom in response to 2 periods of large population increase in the mid-1950s and early 1960s. The average number of annual births was 220,000 in the first period and 269,000 in the second period. The causes of the large increase in the population in the first period were an improvement of health conditions which led to a reduction in mortality, immigration flow, and an erroneous population policy. The causes in the second period were recuperative fertility after three years of natural calamity and increased fertility among immigrants. Net migration had an important role in population growth these two periods; it also will have an important impact in future population changes. According to population projections, another baby boom is expected to occur before the end of the end of the century. During the up-coming baby boom period, 1.54 million births are expected, 190,000 per annum. The average increase in population size is expected to 127,000 per year. In the peak year, it may be around 200,000. Thanks to the family planning (FP) program the occurrence of the third baby boom in Beijing has been postponed and the duration will be shortened. From 1972 to 1982, 2.57 million births was averted due to FP, which drastically reduced pressure on the demand for resources and on the momentum of the next baby boom. Another baby booms is not expected during the early half of the 21st century, although an elevated birth rate within the range of normal fluctuation is predicted. The projection was based on the assumption of restricted migration and the enforcement of the FP program. The realization of the projected population will depend on deferred marriage, deferred child-bearing, prolonged birth spacing, the prevention of high parity fertility, the maintenance of the current population policy, and control over the reproductive behavior of the new migrant population.

Regulatory focus affects predictions of the future.

PubMed

Guo, Tieyuan; Spina, Roy

2015-02-01

This research investigated how regulatory focus might influence trend-reversal predictions. We hypothesized that compared with promotion focus, prevention focus hinders sense of control, which in turn predicts more trend-reversal developments. Studies 1 and 3 revealed that participants expected trend-reversal developments to be more likely to occur when they focused on prevention than when they focused on promotion. Study 2 extended the findings by including a control condition, and revealed that participants expected trend-reversal developments to be more likely to occur in the prevention condition than in the promotion and control conditions. Studies 4 and 5 revealed that participants' chronic prevention focus predicted a low sense of control (Study 4), and that promotion focus predicted a high sense of control (Studies 4 and 5). Furthermore, participants with a high sense of control expected trend-reversal developments to be less likely to occur. Thus, the results provided converging evidence for the hypothesis. © 2014 by the Society for Personality and Social Psychology, Inc.

Primary Care Physicians and Coronary Heart Disease Prevention: A Practice Model.

ERIC Educational Resources Information Center

Makrides, Lydia; Veinot, Paula L.; Richard, Josie; Allen, Michael J.

1997-01-01

The role of primary care physicians in coronary heart disease prevention is explored, and a model for patient education by physicians is offered. A qualitative study in Nova Scotia examines physicians' expectations about their role in prevention, obstacles to providing preventive care, and mechanisms by which preventive care occurs. (Author/EMK)

Time flies faster under time pressure.

PubMed

Rattat, Anne-Claire; Matha, Pauline; Cegarra, Julien

2018-04-01

We examined the effects of time pressure on duration estimation in a verbal estimation task and a production task. In both temporal tasks, participants had to solve mazes in two conditions of time pressure (with or without), and with three different target durations (30 s, 60 s, and 90 s). In each trial of the verbal estimation task, participants had to estimate in conventional time units (minutes and seconds) the amount of time that had elapsed since they started to solve the maze. In the production task, they had to press a key while solving the maze when they thought that the trial's duration had reached a target value. Results showed that in both tasks, durations were judged longer with time pressure than without it. However, this temporal overestimation under time pressure did not increase with the length of the target duration. These results are discussed within the framework of scalar expectancy theory. Copyright © 2018 Elsevier B.V. All rights reserved.

Patient-accessible tool for shared decision making in cardiovascular primary prevention: balancing longevity benefits against medication disutility.

PubMed

Fontana, Marianna; Asaria, Perviz; Moraldo, Michela; Finegold, Judith; Hassanally, Khalil; Manisty, Charlotte H; Francis, Darrel P

2014-06-17

Primary prevention guidelines focus on risk, often assuming negligible aversion to medication, yet most patients discontinue primary prevention statins within 3 years. We quantify real-world distribution of medication disutility and separately calculate the average utilities for a range of risk strata. We randomly sampled 360 members of the general public in London. Medication aversion was quantified as the gain in lifespan required by each individual to offset the inconvenience (disutility) of taking an idealized daily preventative tablet. In parallel, we constructed tables of expected gain in lifespan (utility) from initiating statin therapy for each age group, sex, and cardiovascular risk profile in the population. This allowed comparison of the widths of the distributions of medication disutility and of group-average expectation of longevity gain. Observed medication disutility ranged from 1 day to >10 years of life being required by subjects (median, 6 months; interquartile range, 1-36 months) to make daily preventative therapy worthwhile. Average expected longevity benefit from statins at ages ≥50 years ranges from 3.6 months (low-risk women) to 24.3 months (high-risk men). We can no longer assume that medication disutility is almost zero. Over one-quarter of subjects had disutility exceeding the group-average longevity gain from statins expected even for the highest-risk (ie, highest-gain) group. Future primary prevention studies might explore medication disutility in larger populations. Patients may differ more in disutility than in prospectively definable utility (which provides only group-average estimates). Consultations could be enriched by assessing disutility and exploring its reasons. © 2014 American Heart Association, Inc.

The Relationship Context of Premarital Serial Cohabitation

PubMed Central

Cohen, Jessica; Manning, Wendy

2011-01-01

Even though serial cohabitation is on the rise, it has not been integrated into recent family research. We analyze the National Survey of Family Growth (NSFG) cycle 6 to explore the relationship context of serial cohabitation for women throughout emerging adulthood (N=3,397). We provide a relationship context for serial cohabitation by examining the age at first cohabitation, duration of cohabiting unions, marital expectations and transitions, as well as premarital sexual histories. Furthermore, we examine the change in these relationship indicators across women’s birth cohorts. We find that serial cohabitors’ co-residential unions are about the same duration as single-instance cohabiting unions. Serial cohabitors start cohabiting younger, report lower marital expectations than single-instance cohabitors and a smaller proportion marry before age 30. Women who have more premarital sex partners have significantly greater odds of serial cohabiting. These findings indicate that women face increasingly complex relationship trajectories during emerging adulthood. PMID:24381370

Rainfall intensity-duration thresholds for postfire debris-flow emergency-response planning

USGS Publications Warehouse

Cannon, S.H.; Boldt, E.M.; Laber, J.L.; Kean, J.W.; Staley, D.M.

2011-01-01

Following wildfires, emergency-response and public-safety agencies can be faced with evacuation and resource-deployment decisions well in advance of coming winter storms and during storms themselves. Information critical to these decisions is provided for recently burned areas in the San Gabriel Mountains of southern California. A compilation of information on the hydrologic response to winter storms from recently burned areas in southern California steeplands is used to develop a system for classifying magnitudes of hydrologic response. The four-class system describes combinations of reported volumes of individual debris flows, consequences of debris flows and floods in an urban setting, and spatial extents of the hydrologic response. The range of rainfall conditions associated with different magnitude classes is defined by integrating local rainfall data with the response magnitude information. Magnitude I events can be expected when within-storm rainfall accumulations (A) of given durations (D) fall above the threshold A = 0.4D0.5 and below A = 0.5D0.6 for durations greater than 1 h. Magnitude II events will be generated in response to rainfall accumulations and durations between A = 0.4D0.5 and A = 0.9D0.5 for durations less than 1 h, and between A = 0.5D0.6 and A = 0.9D0.5 or durations greater than 1 h. Magnitude III events can be expected in response to rainfall conditions above the threshold A = 0.9D0.5. Rainfall threshold-magnitude relations are linked with potential emergency-response actions as an emergency-response decision chart, which leads a user through steps to determine potential event magnitudes and identify possible evacuation and resource-deployment levels. Use of this information in planning and response decision-making process could result in increased safety for both the public and emergency responders. ?? 2011 US Government.

A novel design of combining the angiotensin converting enzyme (ACE) inhibitor captopril with the angiotensin receptor blocker (ARB) losartan using homo coupling via PEG diacid linker.

PubMed

Hashemzadeh, Mehrnoosh; Park, Shery; Ju, Hee; Movahed, Mohammad R

2013-12-01

Cardiovascular disease is the leading cause of death in American adults. Furthermore, the incidence of congestive heart failure is on the rise as a major cause of hospitalization and mortality in this population. Angiotensin Converting Enzyme (ACE) inhibitors prevent the production of angiotensin II, which has been shown to reduce mortality in patients with congestive heart failure. Angiotensin II receptor blockers (ARB) were developed as a direct inhibitor of angiotensin II. ARBs have been shown to be effective in the treatment of patients with systolic heart failure but do not cause chronic coughing which is a common side effect of ACE inhibitors. In theory, a compound that has the combined effect of an ACE inhibitor and an ARB should be more effective in treating heart failure patients than either agents alone. Therefore, the purpose of this manuscript is to design and discuss the benefits of a new molecule, which combines captopril, an ACE inhibitor, with losartan, an ARB. In this experiment Captopril and Losartan were modified and synthesized separately and combined by homo or mono coupling. This was achieved by taking advantage of PEG (Polyethylene glycol) as a linker. It is expected that this molecule will have the combined modes of action of both ACEs and ARBs. Benefits from combination therapy include; increased efficacy, reduced adverse effects, convenience, compliance, and prolonged duration. Consequently, this combined molecule is expected to block the production of angiotensin II more efficiently and effectively. Although captopril and losartan work in the same system by blocking the effect of angiotensin II they have different action sites and mechanisms some patents are also discussed. Losartan blocks the AT1 receptor which is expressed on the cell surface, while captopril inhibits ACE, preventing production of angiotensin II, which is present in both the plasma and on the cell surface, especially on endothelial and smooth muscle cells.

Conditioned [corrected] stimulus informativeness governs conditioned stimulus-unconditioned stimulus associability.

PubMed

Ward, Ryan D; Gallistel, C R; Jensen, Greg; Richards, Vanessa L; Fairhurst, Stephen; Balsam, Peter D

2012-07-01

In a conditioning protocol, the onset of the conditioned stimulus ([CS]) provides information about when to expect reinforcement (unconditioned stimulus [US]). There are two sources of information from the CS in a delay conditioning paradigm in which the CS-US interval is fixed. The first depends on the informativeness, the degree to which CS onset reduces the average expected time to onset of the next US. The second depends only on how precisely a subject can represent a fixed-duration interval (the temporal Weber fraction). In three experiments with mice, we tested the differential impact of these two sources of information on rate of acquisition of conditioned responding (CS-US associability). In Experiment 1, we showed that associability (the inverse of trials to acquisition) increased in proportion to informativeness. In Experiment 2, we showed that fixing the duration of the US-US interval or the CS-US interval or both had no effect on associability. In Experiment 3, we equated the increase in information produced by varying the C/T ratio with the increase produced by fixing the duration of the CS-US interval. Associability increased with increased informativeness, but, as in Experiment 2, fixing the CS-US duration had no effect on associability. These results are consistent with the view that CS-US associability depends on the increased rate of reward signaled by CS onset. The results also provide further evidence that conditioned responding is temporally controlled when it emerges.

CS Informativeness Governs CS-US Associability

PubMed Central

Ward, Ryan D.; Gallistel, C. R.; Jensen, Greg; Richards, Vanessa L.; Fairhurst, Stephen; Balsam, Peter D

2012-01-01

In a conditioning protocol, the onset of the conditioned stimulus (CS) provides information about when to expect reinforcement (the US). There are two sources of information from the CS in a delay conditioning paradigm in which the CS-US interval is fixed. The first depends on the informativeness, the degree to which CS onset reduces the average expected time to onset of the next US. The second depends only on how precisely a subject can represent a fixed-duration interval (the temporal Weber fraction). In three experiments with mice, we tested the differential impact of these two sources of information on rate of acquisition of conditioned responding (CS-US associability). In Experiment 1, we show that associability (the inverse of trials to acquisition) increases in proportion to informativeness. In Experiment 2, we show that fixing the duration of the US-US interval or the CS-US interval or both has no effect on associability. In Experiment 3, we equated the increase in information produced by varying the C̅/T̅ ratio with the increase produced by fixing the duration of the CS-US interval. Associability increased with increased informativeness, but, as in Experiment 2, fixing the CS-US duration had no effect on associability. These results are consistent with the view that CS-US associability depends on the increased rate of reward signaled by CS onset. The results also provide further evidence that conditioned responding is temporally controlled when it emerges. PMID:22468633

Review article: Medical decision models of Helicobacter pylori therapy to prevent gastric cancer.

PubMed

Sonnenberg, A; Inadomi, J M

1998-02-01

The aim of the present article is to study the utility of Helicobacter pylori eradication programmes in decreasing the incidence of gastric cancer. Three types of decision models are employed to pursue this aim, i.e. decision tree, present value, and declining exponential approximation of life expectancy (DEALE). 1) A decision tree allows one to model the interaction of multiple variables in great detail and to calculate the marginal cost, as well as the marginal cost-benefit ratio, of a preventive strategy. The cost of gastric cancer, the efficacy of H. pylori therapy in preventing cancer, and the cumulative probability of developing gastric cancer exert the largest influence on the marginal cost of cancer prevention. The high cost of future gastric cancer and a high efficacy of therapy make screening for H. pylori and its eradication the preferred strategy. 2) The present value is an economic method to adjust future costs or benefits to their current value using a discount rate and the length of time between now and a given time point in the future. It accounts for the depreciation of money and all material values over time. During childhood, the present value of future gastric cancer is very low. Vaccination of children to prevent gastric cancer would need to be very inexpensive to be practicable. Cancer prevention becomes a feasible option, only if the time period between the preventive measures and the occurrence of gastric cancer can be made relatively short. 3) The DEALE provides a means to calculate the increase in life expectancy that would occur, if death from a particular disease became preventable. Life expectancy of the general population is hardly affected by gastric cancer. For life expectancy to increase appreciably by vaccination or antibiotic therapy directed against H. pylori infection, these interventions would need to be focused towards a sub-population with an a priori high risk for gastric cancer.

Understanding adolescent response to a technology-based depression prevention program.

PubMed

Gladstone, Tracy; Marko-Holguin, Monika; Henry, Jordan; Fogel, Joshua; Diehl, Anne; Van Voorhees, Benjamin W

2014-01-01

Guided by the Behavioral Vaccine Theory of prevention, this study uses a no-control group design to examine intervention variables that predict favorable changes in depressive symptoms at 6- to 8-week follow-up in at-risk adolescents who participated in a primary care, Internet-based prevention program. Participants included 83 adolescents from primary care settings ages 14 to 21 (M = 17.5, SD = 2.04), 56.2% female, with 41% non-White. Participants completed self-report measures, met with a physician, and then completed a 14-module Internet intervention targeting the prevention of depression. Linear regression models indicated that several intervention factors (duration on website in days, the strength of the relationship with the physician, perceptions of ease of use, and the perceived relevance of the material presented) were significantly associated with greater reductions in depressive symptoms from baseline to follow-up. Automatic negative thoughts significantly mediated the relation between change in depressive symptoms scores and both duration of use and physician relationship. Several intervention variables predicted favorable changes in depressive symptom scores among adolescents who participated in an Internet-based prevention program, and the strength of two of these variables was mediated by automatic negative thoughts. These findings support the importance of cognitive factors in preventing adolescent depression and suggest that modifiable aspects of technology-based intervention experience and relationships should be considered in optimizing intervention design.

Better concrete mixes for rapid repair in Wisconsin.

DOT National Transportation Integrated Search

2017-04-01

With the increasing demands on the highway system and increasing costs of user delay, the use and development of rapid-repairtechniques are expected to grow rapidly. High early strength (HES) portland cement concrete can help reduce the duration oftr...

Impact of a Randomized Controlled Trial to Reduce Bedsharing on Breastfeeding Rates and Duration for African-American Infants.

PubMed

Moon, Rachel Y; Mathews, Anita; Joyner, Brandi L; Oden, Rosalind P; He, Jianping; McCarter, Robert

2017-08-01

Bedsharing is associated with both increased breastfeeding and increased risk of sudden and unexpected infant deaths. The objective was to determine impact of sleep location and counseling about sleep location on breastfeeding exclusivity and duration in African-Americans. 1194 mothers of newborns were randomized to receive messaging emphasizing either safe sleep practices to reduce SIDS risk or safe sleep practices to prevent SIDS/suffocation. Mothers completed four interviews in the 6 months after delivery. The most common sleep arrangement was roomsharing without bedsharing ("roomsharing"). Duration of any breastfeeding was 6.1 and 5.3 weeks for infants who usually bedshared or roomshared, respectively (p = 0.01). Duration of exclusive breastfeeding was 3.0 and 1.6 weeks for infants who usually bedshared or roomshared, respectively (p < 0.001). Group assignment did not affect breastfeeding duration. The most common sleep arrangement for African-American infants <6 months was roomsharing. An intervention designed to discourage bedsharing did not impact breastfeeding duration.

The paradox of disease prevention: celebrated in principle, resisted in practice.

PubMed

Fineberg, Harvey V

2013-07-03

Prevention of disease is often difficult to put into practice. Among the obstacles: the success of prevention is invisible, lacks drama, often requires persistent behavior change, and may be long delayed; statistical lives have little emotional effect, and benefits often do not accrue to the payer; avoidable harm is accepted as normal, preventive advice may be inconsistent, and bias against errors of commission may deter action; prevention is expected to produce a net financial return, whereas treatment is expected only to be worth its cost; and commercial interests as well as personal, religious, or cultural beliefs may conflict with disease prevention. Six strategies can help overcome these obstacles: (1) Pay for preventive services. (2) Make prevention financially rewarding for individuals and families. (3) Involve employers to promote health in the workplace and provide incentives to employees to maintain healthy practices. (4) Reengineer products and systems to make prevention simpler, lower in cost, and less dependent on individual action. (5) Use policy to reinforce choices that favor prevention. (6) Use multiple media channels to educate, elicit health-promoting behavior, and strengthen healthy habits. Prevention of disease will succeed over time insofar as it can be embedded in a culture of health.

Individual Differences in Preventive Jealousy Determine Men's Jealousy after Subliminal Exposure to Rivals Wearing High- or Low-Status Clothes.

PubMed

Massar, Karlijn; Buunk, Abraham Bram P

2016-02-01

This study investigated sex differences in jealousy after subliminal exposure to rivals wearing high-status or low-status clothes. It was expected that individual differences in preventive jealousy would moderate the relationship between a rival's characteristics and jealousy. Participants (Men: n = 54, M age = 21.6 yr., SD = 3.5; women: n = 71, M age = 20.7 yr., SD = 1.9) completed a parafoveal subliminal priming paradigm as well as questionnaires about jealousy and preventive jealousy. As predicted, women were not affected by their rival's status, but women high in preventive jealousy reported more jealousy than women low in preventive jealousy. However, whereas men low in preventive jealousy reported equal amounts of jealousy after exposure to a high-status and a low-status rival, surprisingly, and contrary to the expectations, men high in preventive jealousy reported most jealousy after exposure to a low-status rival. To explain these unexpected results, threats to self-esteem were discussed.

Beating time: How ensemble musicians' cueing gestures communicate beat position and tempo.

PubMed

Bishop, Laura; Goebl, Werner

2018-01-01

Ensemble musicians typically exchange visual cues to coordinate piece entrances. "Cueing-in" gestures indicate when to begin playing and at what tempo. This study investigated how timing information is encoded in musicians' cueing-in gestures. Gesture acceleration patterns were expected to indicate beat position, while gesture periodicity, duration, and peak gesture velocity were expected to indicate tempo. Same-instrument ensembles (e.g., piano-piano) were expected to synchronize more successfully than mixed-instrument ensembles (e.g., piano-violin). Duos performed short passages as their head and (for violinists) bowing hand movements were tracked with accelerometers and Kinect sensors. Performers alternated between leader/follower roles; leaders heard a tempo via headphones and cued their partner in nonverbally. Violin duos synchronized more successfully than either piano duos or piano-violin duos, possibly because violinists were more experienced in ensemble playing than pianists. Peak acceleration indicated beat position in leaders' head-nodding gestures. Gesture duration and periodicity in leaders' head and bowing hand gestures indicated tempo. The results show that the spatio-temporal characteristics of cueing-in gestures guide beat perception, enabling synchronization with visual gestures that follow a range of spatial trajectories.

Spatial analysis of highway incident durations in the context of Hurricane Sandy.

PubMed

Xie, Kun; Ozbay, Kaan; Yang, Hong

2015-01-01

The objectives of this study are (1) to develop an incident duration model which can account for the spatial dependence of duration observations, and (2) to investigate the impacts of a hurricane on incident duration. Highway incident data from New York City and its surrounding regions before and after Hurricane Sandy was used for the study. Moran's I statistics confirmed that durations of the neighboring incidents were spatially correlated. Moreover, Lagrange Multiplier tests suggested that the spatial dependence should be captured in a spatial lag specification. A spatial error model, a spatial lag model and a standard model without consideration of spatial effects were developed. The spatial lag model is found to outperform the others by capturing the spatial dependence of incident durations via a spatially lagged dependent variable. It was further used to assess the effects of hurricane-related variables on incident duration. The results show that the incidents during and post the hurricane are expected to have 116.3% and 79.8% longer durations than those that occurred in the regular time. However, no significant increase in incident duration is observed in the evacuation period before Sandy's landfall. Results of temporal stability tests further confirm the existence of the significant changes in incident duration patterns during and post the hurricane. Those findings can provide insights to aid in the development of hurricane evacuation plans and emergency management strategies. Copyright © 2014 Elsevier Ltd. All rights reserved.

Probiotics for respiratory tract infections in children attending day care centers-a systematic review.

PubMed

Laursen, Rikke Pilmann; Hojsak, Iva

2018-05-12

Probiotics have been suggested to have a preventive effect on respiratory tract infections (RTIs), but limited evidence exist on strain-specific effects. The main aim of this systematic review and meta-analysis was to evaluate strain-specific probiotic effects on RTIs in children attending day care. We included 15 RCTs with 5121 children in day care settings (aged 3 months to 7 years), but due to high diversity in reported outcomes, different number of RCTs were available for evaluated outcomes. Twelve RCTs (n = 4527) reported results which could be compared in at least one outcome of the meta-analysis. Compared to placebo, Lactobacillus rhamnosus GG (LGG) significantly reduced duration of RTIs (three RCTs, n = 1295, mean difference - 0.78 days, 95% confidence interval (CI) - 1.46; - 0.09), whereas no effect was found on other evaluated outcomes. Based on the results from two studies (n = 343), Bifidobacterium animalis subsp. lactis BB-12 showed no effect on duration of RTIs or on absence from day care. Meta-analyses on other strains or their combination were not possible due to limited data and different outcome measures. LGG is modestly effective in decreasing the duration of RTIs. More RCTs investigating specific probiotic strains or their combinations in prevention of RTIs are needed. What is known: • Previously published systematic reviews have suggested that probiotics may have a preventive effect on respiratory infections, but limited data exist on strain specific effects. What is new: • This systematic review showed that use of Lactobacillus rhamnosus GG modestly reduces the duration of respiratory tract infections.

A PCT algorithm for discontinuation of antibiotic therapy is a cost-effective way to reduce antibiotic exposure in adult intensive care patients with sepsis.

PubMed

Kip, Michelle M A; Kusters, Ron; IJzerman, Maarten J; Steuten, Lotte M G

2015-01-01

Procalcitonin (PCT) is a specific marker for differentiating bacterial from non-infective causes of inflammation. It can be used to guide initiation and duration of antibiotic therapy in intensive care unit (ICU) patients with suspected sepsis, and might reduce the duration of hospital stay. Limiting antibiotic treatment duration is highly important because antibiotic over-use may cause patient harm, prolonged hospital stay, and resistance development. Several systematic reviews show that a PCT algorithm for antibiotic discontinuation is safe, but upfront investment required for PCT remains an important barrier against implementation. The current study investigates to what extent this PCT algorithm is a cost-effective use of scarce healthcare resources in ICU patients with sepsis compared to current practice. A decision tree was developed to estimate the health economic consequences of the PCT algorithm for antibiotic discontinuation from a Dutch hospital perspective. Input data were obtained from a systematic literature review. When necessary, additional information was gathered from open interviews with clinical chemists and intensivists. The primary effectiveness measure is defined as the number of antibiotic days, and cost-effectiveness is expressed as incremental costs per antibiotic day avoided. The PCT algorithm for antibiotic discontinuation is expected to reduce hospital spending by circa € 3503 per patient, indicating savings of 9.2%. Savings are mainly due to reductions in length of hospital stay, number of blood cultures performed, and, importantly, days on antibiotic therapy. Probabilistic and one-way sensitivity analyses showed the model outcome to be robust against changes in model inputs. Proven safe, a PCT algorithm for antibiotic discontinuation is a cost-effective means of reducing antibiotic exposure in adult ICU patients with sepsis, compared to current practice. Additional resources required for PCT are more than offset by downstream cost savings. This finding is highly important given the aim of preventing widespread antibiotic resistance.

Predictors of Hospitalization among Children on ART in Ethiopia: a Cohort study.

PubMed

Haileamlak, Abraham; Hagos, Tesfalem; Abebe, Workeabeba; Abraham, Loko; Asefa, Henok; Teklu, Alula M

2017-02-01

Substantial progress has been made in the management of pediatric HIV infection in Ethiopia with the implementation of mother-to-child-prevention programs. Since the introduction of HAART in 2005, mortality among HIV-infected children has reduced while the rate of hospitalization was expected to rise. The purpose of this study, therefore, was to assess predictors of hospitalization in children on ART in seven university referral hospitals in Ethiopia. A prospective cohort study design was employed on children age 0-18 years as part of a multisite observational study. ART-experienced eligible and ART-naïve children with HIV/AIDS were enrolled into the Advanced Clinical Monitoring (ACM) till December 31, 2012 were included. From the database, information on hospitalization and other independent variables were extracted. Analysis was done using both SPSS for Windows version 16.0 and STATA. Descriptive analyses and modeling was done using logistic regression. Of the 405 children on ART (174 experienced, 231 naive), 86 (20.7%) were hospitalized for various reasons; two children were excluded since they were hospitalized for unrelated conditions (appendicitis and burn). Fifty one (60.7%) of the eighty four admitted children were hospitalized in the first six months of ART initiation. Of the independent variables, only the presence of opportunistic infections and duration on ART were significantly associated with hospitalization both on bi-variable and multivariable analyses (P-value <0.05). As the duration on ART increased by one month, the risk of hospitalization decreased by 5.4%, which is statistically significant (P < 0.001). Whereas the incidence (number) of OI's increased by one, the risk of being hospitalized increased by 35.2% (P = 0.002). Of the individual opportunistic infections, pneumonia was found to be the only predictor of hospitalization (P-value = 0.002). This study showed that nearly two-third of the hospitalization was within 6 months of initiation of ART; and presence of OI and duration on ART were the only predictors of hospitalization.

Dermabrasion

MedlinePlus

... your expectations. Talk with your doctor about your motivations and expectations, as well as the potential risks. ... 12 months to prevent permanent changes in skin color. If dark skin coloring is a concern after ...

Screening of young competitive athletes for the prevention of sudden cardiac death with a wireless electrocardiographic transmission device: a pilot study.

PubMed

Cho, Jae Hyung; Selen, Mats A; Kocheril, Abraham G

2015-08-11

The 12-lead electrocardiographic screening for the prevention of sudden cardiac death in young competitive athletes is not cost-effective and thus not routinely recommended. We investigate whether a less expensive wireless electrocardiographic transmission device can be used to screen for the prevention of sudden cardiac death in this population. During pre-participation screening, twenty college football players underwent two electrocardiograms: a conventional 12-lead electrocardiogram and a wireless 9-lead electrocardiogram. We compared several electrocardiographic parameters (QRS duration, left ventricular hypertrophy using the Cornell voltage criteria and the Sokolow-Lyon criteria, ST deviation and corrected QT interval) to determine the correlation. The QRS duration, left ventricular hypertrophy using the Cornell voltage criteria and the Sokolow-Lyon criteria and corrected QT interval exhibited significant correlation between the two types of electrocardiograms (correlation coefficient 0.878, 0.630, 0.770 and 0.847, respectively with P values of 0.01, 0.003, 0.01 and 0.01, respectively). ST deviation in V1 was weakly correlated between the two types of electrocardiograms without statistical significance (correlation coefficient 0.360 with a P value of 0.119). Our newly developed wireless 9-lead electrocardiogram demonstrated significant correlations with a conventional 12-lead electrocardiogram in terms of QRS duration, left ventricular hypertrophy and corrected QT interval.

Factors affecting patient valuations of caries prevention: Using and validating the willingness to pay method.

PubMed

Vernazza, Christopher R; Wildman, John R; Steele, Jimmy G; Whitworth, John M; Walls, Angus W G; Perry, Ross; Matthews, Roger; Hahn, Petra; Donaldson, Cam

2015-08-01

Determining the value of, or strength of preference for health care interventions is useful for policy makers in planning health care services. Willingness to pay (WTP) is an established economic technique to determine the strength of preferences for interventions by eliciting monetary valuations from individuals in hypothetical situations. The objective of this study was to elicit WTP values for a dental preventive intervention and to analyze the factors affecting these as well as investigating the validity of the WTP method. Patients aged 40 years plus attending dental practices in the UK and Germany were recruited on a consecutive basis over one month. Participants received information about a novel root caries prevention intervention. They then completed a questionnaire including a WTP task. Where the coating was indicated, patients were offered this for a payment and acceptance was recorded. Analysis included econometric modelling and comparison of expected (based on stated WTP) versus actual behaviour. The mean WTP for the coating was £96.41 (standard deviation 60.61). Econometric models showed that no demographic or dental history factors were significant predictors of WTP. 63% of the sample behaved as expected when using stated WTP to predict whether they would buy the coating. The remainder were split almost equally between those expected to pay but who did not and those who were expected to refuse but paid. Values for a caries preventive intervention had a large and unpredictable variance. In comparing hypothetical versus real preferences both under- and over-valuation occurs. Wide and unpredictable variation in valuations for prevention may mean that there are difficult policy questions around what resource should be allocated to dental prevention and how to target this resource. Copyright © 2015 Elsevier Ltd. All rights reserved.

Epidemiologic Analyses of Risk Factors for Bone Loss and Recovery Related to Long-Duration Space Flight

NASA Technical Reports Server (NTRS)

Sibonga, Jean; Amin, Shreyasee

2010-01-01

AIM 1: To investigate the risk of microgravity exposure on long-term changes in bone health and fracture risk. compare data from crew members ("observed") with what would be "expected" from Rochester Bone Health Study. AIM 2: To provide a summary of current evidence available on potential risk factors for bone loss, recovery & fracture following long-duration space flight. integrative review of all data pre, in-, and post-flight across disciplines (cardiovascular, nutrition, muscle, etc.) and their relation to bone loss and recovery

Behavioral, psychiatric, and sociological problems of long-duration space missions

NASA Technical Reports Server (NTRS)

Kanas, N. A.; Fedderson, W. E.

1971-01-01

A literature search was conducted in an effort to isolate the problems that might be expected on long-duration space missions. Primary sources of the search include short-term space flights, submarine tours, Antarctic expeditions, isolation-chamber tests, space-flight simulators, and hypodynamia studies. Various stressors are discussed including weightlessness and low sensory input; circadian rhythms (including sleep); confinement, isolation, and monotony; and purely psychiatric and sociological considerations. Important aspects of crew selection are also mentioned. An attempt is made to discuss these factors with regard to a prototype mission to Mars.

PegIFN-α2a for the treatment of chronic hepatitis B and C: a 10-year history.

PubMed

Degasperi, Elisabetta; Viganò, Mauro; Aghemo, Alessio; Lampertico, Pietro; Colombo, Massimo

2013-05-01

Chronic HBV and HCV are progressive diseases leading to cirrhosis and liver transplantation. Persistent viral eradication or suppression can positively affect the natural course of the infection, by preventing disease progression. Since its introduction more than 30 years ago, IFN-α has represented the foundation of HBV and, lately, anti-HCV treatment. Pegylation of the IFN-α molecule (PegIFN-α2a) has provided improvements in both efficacy and administration schedule, thus becoming part of the standard-of-care regimen for HCV and HBV therapy in the last 10 years. Currently, treatment of finite duration with PegIFN-α2a may achieve a sustained virological response off-treatment and HBsAg seroconversion. PegIFN-α2a will most likely remain the backbone of HCV treatment for the next few years, despite the availability of direct-acting antivirals that are expected to improve cure rates. However, many efforts are concentrated on developing new compounds, with the goal of administrating all oral regimens and eliminating PegIFN from anti-HCV treatment.

Review: the environmental status and implications of the nitrate time lag in Europe and North America

NASA Astrophysics Data System (ADS)

Vero, Sara E.; Basu, Nandita B.; Van Meter, Kimberly; Richards, Karl G.; Mellander, Per-Erik; Healy, Mark G.; Fenton, Owen

2018-02-01

The efficacy of water quality policies aiming to reduce or prevent nitrate contamination of waterbodies may be constrained by the inherent delay or "time lag" of water and solute transport through unsaturated (soil) and saturated (groundwater) pathways. These delays must be quantified in order to establish realistic deadlines, thresholds and policy expectations, and to design effective best management practices. The objective of this review is to synthesise the current state of research on nitrate-related time lags in both the European and North American environmental and legislative contexts. The durations of time lags have been found to differ according to climatic, pedological, landscape and management scenarios. Elucidation of these driving factors at a watershed scale is essential where water quality is impaired or at risk. Finally, the existence of time lags is increasingly being acknowledged at a policy level and incorporated into the development of environmental legislation. However, the full impact of these time lags is not yet fully understood or appreciated, and continued outreach and education in scientific, public and policy venues is still required.

Greco-Arab and Islamic Herbal-Derived Anticancer Modalities: From Tradition to Molecular Mechanisms

PubMed Central

Zaid, Hilal; Silbermann, Michael; Ben-Arye, Eran; Saad, Bashar

2012-01-01

The incidence of cancer is increasing in the developed countries and even more so in developing countries parallel to the increase in life expectancy. In recent years, clinicians and researchers advocate the need to include supportive and palliative care since the establishment of the diagnosis and throughout the duration of treatment, with the goal of improving patients' quality of life. This patient-centered approach in supportive care is also shared by various traditional and complementary medicine approaches. Traditional Arab-Islamic medicine offers a variety of therapeutic modalities that include herbal, nutritional, and spiritual approaches. Physicians and scholars, such as Avicenna (980–1037), Rhazes (965–915), Al Zahrawi (936–1013), and Ibn al Nafis (1218–1288) referred to cancer etiology in various medicinal texts and suggested both preventive and therapeutic remedies to alleviate suffering. This review presents research data related to the anticancer activities of herbs used in Arab-Islamic medicine and allude to their potential role in improving the quality of life of cancer patients. PMID:22203868

Light Pollution a tool for Astronomy Education

NASA Astrophysics Data System (ADS)

Metaxa, M.; Niarchos, P.

2006-08-01

The problem of Light Pollution exists most everywhere, and is still growing rapidly. The maintenance of dark skies at a prime astronomical location but as well elsewhere depends very much on the awareness of the public, and particularly with key decision makers responsible for developments, including lighting engineers. It is necessary to continually promote awareness of light pollution and its effects. Thus the preservation of the astronomical environment is strongly connected and requires effective education. We will present the educational project that the newly formed Commission for the prevention of Light Pollution, of the Hellenic Astronomical Society will support based on innovating teaching of Astronomy. The framework of the project will be to collaborate through our National Pedagogical Institute with all possible school networks so to efficiently introduce the topic to schools and to relate it with our national curriculum. The help of Astronomers and Lighting Engineers through the respective Commission will facilitate and will provide the natural environment for this educational project. The duration will be two years, and through the project we expect the students-teachers to act as "reporters" for this serious problem.

Immunogenicity, effectiveness and safety of combined hepatitis A and B vaccine: a systematic literature review.

PubMed

Bakker, Marina; Bunge, Eveline M; Marano, Cinzia; de Ridder, Marc; De Moerlooze, Laurence

2016-07-01

Hepatitis A and B are two of the most common vaccine-preventable diseases and vaccination for Hepatitis A virus (HAV) and hepatitis B virus (HBV) is recommended for those at risk of contracting HAV and/or HBV through their occupation, travel or lifestyle. To describe the vaccine efficacy, immunogenicity, effectiveness and safety of the combined vaccine against hepatitis A and hepatitis B. A systematic review of the literature published between 1990 and 2015. Anti-HAV seropositivity rates ranged from 96.2% to 100% and anti-HBs seroprotection rates from 82% to 100%. Antibodies persisted up to 15 years and geometric mean concentration (GMC) remained above the seropositivity cut-off value for both. Anti-HAV and anti-HBs immune responses were lower in less immunocompetent individuals one month after completion of the immunization schedule. The safety profiles of Twinrix(TM) and monovalent hepatitis A and B vaccines were similar. The vaccine offers satisfactory long-term immunogenicity rates, expected duration of protection and safety profile similar to the monovalent hepatitis A or B vaccines.

Lung cancer mortality in nickel/chromium platers, 1946-95.

PubMed

Sorahan, T; Burges, D C; Hamilton, L; Harrington, J M

1998-04-01

To investigate mortality from lung cancer in nickel/chromium platers. The mortality experience of a cohort of 1762 chrome workers (812 men, 950 women) from a large electroplating and light engineering plant in the Midlands, United Kingdom, was investigated for the period 1946-95. All subjects were first employed in chrome work at the plant during the period 1946-75, and had at least six months employment in jobs associated with exposure to chromic acid mist (hexavalent chromium). Detailed job histories were abstracted from original company personnel records and individual cumulative durations of employment in three types of chrome work were derived as time dependent variables (chrome bath work, other chrome work, any chrome work). Two analytical approaches were used--indirect standardisation and Poisson regression. Based on mortalities for the general population of England and Wales, male workers with some period of chrome bath work had higher lung cancer mortalities (observed deaths 40, expected deaths 25.41, standardised mortality ratio (SMR) 157, 95% confidence interval (95% CI) 113 to 214, p < 0.01) than did other male chrome workers (observed 9, expected 13.70, SMR 66, 95% CI 30 to 125). Similar findings were shown for female workers (chrome bath workers: observed 15, expected 8.57, SMR 175, 95% CI 98 to 289, p = 0.06; other chrome workers: observed 1, expected 4.37, SMR 23, 95% CI 1 to 127). Poisson regression was used to investigate risks of lung cancer relative to four categories of cumulative duration of chrome bath work and four categories of cumulative duration of other chrome work (none, < 1 y, 1-4 y, > or = 5 y). After adjusting for sex, age, calendar period, year of starting chrome work, period from first chrome work, and employment status (still employed v left employment), there was a significant positive trend (p < 0.05) between duration of chrome bath work and risks of mortality for lung cancer. Relative to a risk of unity for those chrome workers without any period of chrome bath work, risks were 2.83 (95% CI 1.47 to 5.45), 1.61 (95% CI 0.75 to 3.44), and 4.25 (95% CI 1.83 to 9.87) for the second, third, and fourth exposure categories, respectively. Duration of other chrome work was not a useful predictor of risks of lung cancer. Similar findings for both variables were obtained when adjustment was made for sex and age only. Similar findings for both variables were obtained relative to risk of chrome nasal ulceration. The findings are consistent with the hypothesis that soluble hexavalent chromium compounds are potent human lung carcinogens.

Self-management levels of diet and metabolic risk factors according to disease duration in patients with type 2 diabetes.

PubMed

Cho, Sukyung; Kim, Minkyeong; Park, Kyong

2018-02-01

Metabolic risk factors should be managed effectively in patients with type 2 diabetes mellitus (T2DM) to prevent or delay diabetic complications. This study aimed to compare the self-management levels of diet and metabolic risk factors in patients with T2DM, according to the duration of illness, and to examine the trends in self-management levels during the recent decades. Data were collected from the Korea National Health and Nutrition Examination Surveys (KNHANES, 1998-2014). In our analysis, 4,148 patients with T2DM, aged ≥ 30 years, were categorized according to the duration of their illness (< 5 years, 5-9 years, and ≥ 10 years). Demographic and lifestyle information was assessed through self-administered questionnaires, and biomarker levels (e.g., fasting glucose level, blood pressure, or lipid level) were obtained from a health examination. Dietary intake was assessed by a 24-recall, and adherence level to dietary guidelines (meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol) were assessed. Multivariable generalized linear regression and unconditional logistic regression models were used to compare the prevalence rates of hyperglycemia, dyslipidemia, and hypertension according to the duration of patients' illness, accounting for the complex survey design of the KNHANES. In the multivariable adjusted models, patients with a longer duration (≥ 10 years) of T2DM had a higher prevalence of hyperglycemia than those with a shorter duration of T2DM (< 5 years) (odds ratio 2.20, 95% confidence interval 1.61-3.01, P for trend < 0.001). We did not observe any associations of disease duration with the prevalence of hypertension and dyslipidemia. In addition, the adherence levels to dietary recommendations did not significantly differ according to disease duration, except adherence to moderate alcohol consumption. There were significant decreasing trends in the prevalence of hyperglycemia in patients with a duration of illness ≥ 10 years ( P for trend = 0.004). Although the proportion of patients with adequate control of glucose levels has improved in recent decades, poorer self-management has been found in those with a longer disease duration. These findings suggest the need for well-planned and individualized patient education programs to improve self-management levels and quality of life by preventing or delaying diabetic complications.

Novel Influenza A (H1N1) Outbreak at the U.S. Air Force Academy: Epidemiology and Viral Shedding Duration (American Journal of Preventive Medicine, Volume 20, Number 10, 2009)

DTIC Science & Technology

2009-01-01

and Viral Shedding Duration atherine Takacs Witkop, MD, MPH, Mark R. Duffy, DVM, MPH, Elizabeth A. Macias, PhD, homas F. Gibbons, PhD, James D. Escobar...oseltami- ir two times daily for 5 days if the patients indicated onset of ymptoms no more than 72 hours prior to presentation. pper-class cadets

Physiological Health Challenges for Human Missions to Mars

NASA Technical Reports Server (NTRS)

Norsk, Peter

2015-01-01

During the next decades, manned space missions are expected to be aiming at the Lagrange points, near Earth asteroids, and Mars flyby and/or landing. The question is therefore: Are we ready to go? To answer this with a yes, we are currently using the International Space Station to develop an integrated human physiological countermeasure suite. The integrated countermeasure suite will most likely encounter: 1) Exercise devices for aerobic, dynamic and resistive exercise training; 2) sensory-motor computer training programs and anti-motion sickness medication for preparing EVAs and G-transitions; 3) lower limb bracelets for preventing and/or treating the VIIP (vision impairment and intracranial pressure) syndrome; 4) nutritional components for maintenance of bone, muscle, the cardiovascular system and preventing oxidative stress and damage and immune deficiencies (e. g. omega-3 fatty acids, PRO/K, anti-oxidants and less salt and iron); 5) bisphosphonates for preventing bone degradation.; 6) lower body compression garment and oral salt and fluid loading for landing on a planetary surface to combat orthostatic intolerance; 7) laboratory analysis equipment for individualized monitoring of biomarkers in blood, urine and saliva for estimation of health status in; 8) advanced ultrasound techniques for monitoring bone and cardiovascular health; and 9) computer modeling programs for individual health status assessments of efficiency and subsequent adjustments of countermeasures. In particular for future missions into deep space, we are concerned with the synergistic effects of weightlessness, radiation, operational constraints and other spaceflight environmental factors. Therefore, increased collaboration between physiological, behavioral, radiation and space vehicle design disciplines are strongly warranted. Another venue we are exploring in NASA's Human Research Program is the usefulness of artificial gravity for mitigating the health risks of long duration weightlessness.

Classroom characteristics and implementation of a substance use prevention curriculum in European countries.

PubMed

Caria, Maria Paola; Faggiano, Fabrizio; Bellocco, Rino; Galanti, Maria Rosaria

2013-12-01

Partial implementation may explain modest effectiveness of many school-based preventive programmes against substance use. We studied whether specific characteristics of the class could predict the level of implementation of a curriculum delivered by class teachers in schools from some European countries. Secondary analysis of data from an evaluation trial. In seven European countries, 78 schools (173 classes) were randomly assigned to a 12-unit, interactive, standardized programme based on the comprehensive social influence model. Curriculum completeness, application fidelity, average unit duration and use of role-play were monitored using structured report forms. Predictors of implementation were measured by aggregating at class level information from the baseline student survey. Class size, gender composition, mean age, factors related to substance use and to affection to school were analysed, with associations estimated by multilevel regression models. Implementation was not significantly predicted by mean age, proportion of students with positive academic expectation or liking school. Proportion of boys was associated with a shorter time devoted to each unit [β = -0.19, 95% confidence intervals (CI) -0.32 to -0.06]. Class size was inversely related to application fidelity [Odds ratio (OR) 0.92, 95% CI 0.85 to 0.99]. Prevalence of substance use was associated with a decreased odds of implementing all the curriculum units (OR 0.81, 95% CI 0.65 to 0.99). Students' connectedness to their class was associated with increased odds of teachers using role-play (OR 1.52, 95% CI 1.03 to 2.29). Teachers' implementation of preventive programmes may be affected by structural and social characteristics of classes and therefore benefit from organizational strategies and teachers' training in class management techniques.

Effect of intermittent standing and walking on physiological changes induced by head-down bed rest

NASA Technical Reports Server (NTRS)

Vernikos, J.; Ludwig, D. A.; Ertl, A. C.; Wade, C. E.; Keil, L.; OHara, D.

1994-01-01

Continuous exposure to gravity may not be necessary to prevent compromised physiological function resulting from exposure to microgravity. However, minimum gravity (G) exposure requirements, effectiveness of passive Gz versus activity in a G field, and optimal G stimulus amplitude, duration, and frequency are unknown. To partially address these questions, a 4-day, 6 degree head-down bed rest (HDBR) study (one ambulatory control day, 4 full HDBR days, one recovery day) was conducted. Nine males, 30-50 yr, were subjected to four different +1 Gz (head-foot) exposure protocols (periodic standing or controlled walking for 2 or 4 h/day in 15 min doses), plus a continuous HDBR (0 Gz) control. Standing 4 h completely prevented and standing 2 h partially prevented post-HDBR orthostatic intolerance. Both walking conditions (2 h and 4 h) attenuated the decrease in peak VO2 and prevented the increased urinary Ca2+ excretion associated with HDBR. Both 4 h conditions (standing and walking) attenuated plasma volume loss during HDBR. It was concluded that various physiological systems benefit differentially from passive +1 Gz or activity in +1 Gz and the duration (2 h vs. 4 h) of the stimulus may be an important moderating factor.

40 CFR 68.165 - Offsite consequence analysis.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.165 Offsite consequence... released in pounds; (7) Release rate; (8) Release duration; (9) Wind speed and atmospheric stability class...

40 CFR 68.165 - Offsite consequence analysis.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.165 Offsite consequence... released in pounds; (7) Release rate; (8) Release duration; (9) Wind speed and atmospheric stability class...

40 CFR 68.165 - Offsite consequence analysis.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.165 Offsite consequence... released in pounds; (7) Release rate; (8) Release duration; (9) Wind speed and atmospheric stability class...

An Introduction to the Outcomes of Children with Hearing Loss Study

PubMed Central

Moeller, Mary Pat; Tomblin, J. Bruce

2015-01-01

The landscape of service provision for young children with hearing loss has shifted in recent years as a result of newborn hearing screening and the early provision of interventions, including hearing technologies. It is expected that early service provision will minimize or prevent linguistic delays that typically accompany untreated permanent childhood hearing loss. The post-newborn hearing screening era has seen a resurgence of interest in empirically examining the outcomes of children with hearing loss to determine if service innovations have resulted in expected improvements in children’s functioning. The Outcomes of Children with Hearing Loss (OCHL) project was among these recent research efforts, and this introductory article provides background in the form of literature review and theoretical discussion to support the goals of the study. The OCHL project was designed to examine the language and auditory outcomes of infants and preschool-aged children with permanent, bilateral, mild-to-severe hearing loss and to identify factors that moderate the relationship between hearing loss and longitudinal outcomes. We propose that children who are hard of hearing experience limitations in access to linguistic input, which lead to a decrease in uptake of language exposure and an overall reduction in linguistic experience. We explore this hypothesis in relation to three primary factors that are proposed to influence children’s access to linguistic input: aided audibility, duration and consistency of hearing aid (HA) use, and characteristics of caregiver input. PMID:26731159

Evaluation of Sunshine Duration around a Building in an Urban Area

NASA Astrophysics Data System (ADS)

Kang, J. E.; Kim, J.

2017-12-01

In this study, sunshine duration around a building in a building-congested district in Busan, Korea was analyzed using a numerical model. This model considers sunshine duration blocking caused by topography and buildings and it is properly applicable to evaluation of sunshine duration environment in urban areas. The 2 km Í 2 km area where the building with 45-m height was located at the center was selected as a target area. We selected the target period from December 21 to December 23, 2015, considering the winter solstice (December 22, 2015) when it is expected to have the largest effect of sunshine blocking due to buildings. We validated the calculated solar altitude and azimuth angles against those provided by Korea astronomy and space science institute (KASI) and the calculated results gave very good agreement with those provided by KASI. Topography and buildings used as the input data of the model were constructed using a geographic information system (GIS) data. In order to analyze, in detail, the change in sunshine duration caused by the construction of the building, the sunshine duration on the roof and walls (eastern, western, southern, northern side) were investigated before and after the construction.

Context-Dependent Duration Signals in the Primate Prefrontal Cortex

PubMed Central

Genovesio, Aldo; Seitz, Lucia K.; Tsujimoto, Satoshi; Wise, Steven P.

2016-01-01

The activity of some prefrontal (PF) cortex neurons distinguishes short from long time intervals. Here, we examined whether this property reflected a general timing mechanism or one dependent on behavioral context. In one task, monkeys discriminated the relative duration of 2 stimuli; in the other, they discriminated the relative distance of 2 stimuli from a fixed reference point. Both tasks had a pre-cue period (interval 1) and a delay period (interval 2) with no discriminant stimulus. Interval 1 elapsed before the presentation of the first discriminant stimulus, and interval 2 began after that stimulus. Both intervals had durations of either 400 or 800 ms. Most PF neurons distinguished short from long durations in one task or interval, but not in the others. When neurons did signal something about duration for both intervals, they did so in an uncorrelated or weakly correlated manner. These results demonstrate a high degree of context dependency in PF time processing. The PF, therefore, does not appear to signal durations abstractedly, as would be expected of a general temporal encoder, but instead does so in a highly context-dependent manner, both within and between tasks. PMID:26209845

Coach Expectations About Off-Field Conduct and Bystander Intervention by U.S. College Football Players to Prevent Inappropriate Sexual Behavior.

PubMed

Kroshus, Emily; Paskus, Tom; Bell, Lydia

2015-09-21

The objective of the present study was to assess whether there is a positive association between expectations about off-field conduct set by the team coach and the likelihood that college football players intend to engage as prosocial bystanders in the prevention of what they consider to be inappropriate sexual behavior. In a sample of U.S. collegiate football players (N = 3,281), a path analysis model tested the association between coach expectations, perceived likelihood of discipline for off-field transgressions, and likelihood of intending to intervene to prevent inappropriate sexual behavior. Mediation of these relationships by the athlete's sense of exploitative entitlement and their attitudes about intervening were also assessed. Findings supported the hypothesized relationships, with expectations and discipline associated with bystander intentions both directly and indirectly through the mediating pathways of entitlement and attitudes about intervening. These findings provide evidence about the important role that sports team coaches can play in encouraging bystander intervention by clarifying expectations and consequences for conduct off the field of play. Athletic departments can provide a framework within which coaches are informed about the importance of setting and enforcing standards for off-field behavior, and are appropriately incentivized to do so. © The Author(s) 2015.

Stochastic extreme downscaling model for an assessment of changes in rainfall intensity-duration-frequency curves over South Korea using multiple regional climate models

NASA Astrophysics Data System (ADS)

So, Byung-Jin; Kim, Jin-Young; Kwon, Hyun-Han; Lima, Carlos H. R.

2017-10-01

A conditional copula function based downscaling model in a fully Bayesian framework is developed in this study to evaluate future changes in intensity-duration frequency (IDF) curves in South Korea. The model incorporates a quantile mapping approach for bias correction while integrated Bayesian inference allows accounting for parameter uncertainties. The proposed approach is used to temporally downscale expected changes in daily rainfall, inferred from multiple CORDEX-RCMs based on Representative Concentration Pathways (RCPs) 4.5 and 8.5 scenarios, into sub-daily temporal scales. Among the CORDEX-RCMs, a noticeable increase in rainfall intensity is observed in the HadGem3-RA (9%), RegCM (28%), and SNU_WRF (13%) on average, whereas no noticeable changes are observed in the GRIMs (-2%) for the period 2020-2050. More specifically, a 5-30% increase in rainfall intensity is expected in all of the CORDEX-RCMs for 50-year return values under the RCP 8.5 scenario. Uncertainty in simulated rainfall intensity gradually decreases toward the longer durations, which is largely associated with the enhanced strength of the relationship with the 24-h annual maximum rainfalls (AMRs). A primary advantage of the proposed model is that projected changes in future rainfall intensities are well preserved.

On a Clear Day, You Can See ICS: The Dying Art of Incident Command and the Normal Accident of NIMS - A Policy Analysis

DTIC Science & Technology

2013-03-01

response in an effort to determine “What can be done better next time?” and “How do we prevent this from happening again?” One basic expectation that...effort to determine “What can be done better next time?” and “How do we prevent this from happening again?” One basic expectation that citizens have of...to determine “What can be done better next time?” and “How do we prevent this from happening again?” After the tragic events of September, 11, 2001

Determinants of willingness to pay taxes for a community-based prevention programme.

PubMed

Lindholm, L A; Rosén, M E; Stenbeck, M E

1997-06-01

Prevention can reduce the risk of disease, but has other consequences as well. Willingness-to-pay (WTP) is one method to analyse these multi-dimensional consequences, if the stated WTP is assumed to be a function of all the expected positive and negative effects perceived. An interview study of a community-based cardiovascular disease prevention programme in northern Sweden shows that expectations regarding reduced mortality in the community and future savings in public health care spending increase the perceived value of the programme. Among personal benefits, decreased disease risk was not positively associated with WTP, while a low level of anxiety was.

Development of regional skews for selected flood durations for the Central Valley Region, California, based on data through water year 2008

USGS Publications Warehouse

Lamontagne, Jonathan R.; Stedinger, Jery R.; Berenbrock, Charles; Veilleux, Andrea G.; Ferris, Justin C.; Knifong, Donna L.

2012-01-01

Flood-frequency information is important in the Central Valley region of California because of the high risk of catastrophic flooding. Most traditional flood-frequency studies focus on peak flows, but for the assessment of the adequacy of reservoirs, levees, other flood control structures, sustained flood flow (flood duration) frequency data are needed. This study focuses on rainfall or rain-on-snow floods, rather than the annual maximum, because rain events produce the largest floods in the region. A key to estimating flood-duration frequency is determining the regional skew for such data. Of the 50 sites used in this study to determine regional skew, 28 sites were considered to have little to no significant regulated flows, and for the 22 sites considered significantly regulated, unregulated daily flow data were synthesized by using reservoir storage changes and diversion records. The unregulated, annual maximum rainfall flood flows for selected durations (1-day, 3-day, 7-day, 15-day, and 30-day) for all 50 sites were furnished by the U.S. Army Corps of Engineers. Station skew was determined by using the expected moments algorithm program for fitting the Pearson Type 3 flood-frequency distribution to the logarithms of annual flood-duration data. Bayesian generalized least squares regression procedures used in earlier studies were modified to address problems caused by large cross correlations among concurrent rainfall floods in California and to address the extensive censoring of low outliers at some sites, by using the new expected moments algorithm for fitting the LP3 distribution to rainfall flood-duration data. To properly account for these problems and to develop suitable regional-skew regression models and regression diagnostics, a combination of ordinary least squares, weighted least squares, and Bayesian generalized least squares regressions were adopted. This new methodology determined that a nonlinear model relating regional skew to mean basin elevation was the best model for each flood duration. The regional-skew values ranged from -0.74 for a flood duration of 1-day and a mean basin elevation less than 2,500 feet to values near 0 for a flood duration of 7-days and a mean basin elevation greater than 4,500 feet. This relation between skew and elevation reflects the interaction of snow and rain, which increases with increased elevation. The regional skews are more accurate, and the mean squared errors are less than in the Interagency Advisory Committee on Water Data's National skew map of Bulletin 17B.

The ICV Study: Integrated Cardiovascular

NASA Technical Reports Server (NTRS)

Levine, Benjamin D.; Bungo, Michael W.

2009-01-01

This viewgraph presentation describes the effects of long duration manned spaceflight on heart structure and function. Clinical consequences for orthostatic tolerance, cardiac arrhythmias, and countermeasures to prevent clinical problems are also discussed.

Men and women with psychosis and the impact of illness-duration on sex-differences: The second Australian national survey of psychosis.

PubMed

Hanlon, Mary-Claire; Campbell, Linda E; Single, Natalie; Coleman, Clare; Morgan, Vera A; Cotton, Susan M; Stain, Helen J; Castle, David J

2017-10-01

We aimed to examine and compare sex-differences in people receiving treatment for psychotic illnesses in community settings, based on long or short duration of illness; expecting association between longer illness-duration and worse outcomes in women and men. Clinical, demographic and service-use data from the Survey of High Impact Psychosis were analysed by sex and duration of illness (≤5 years; ≥6 years), using independent t-tests, chi-square tests, one-way ANOVA, and Cramer's V. Of the 1825 participants, 47% had schizophrenia, 17.5% bipolar and 16.1% schizo-affective disorders. More women than men had undertaken post-school education, maintained relationships, and been living in their own homes. Women with a shorter-illness-duration showed social functioning equivalent to non-ill women in the general population. Men tended to have an early illness onset, show premorbid dysfunction, be single, show severe disability, and to use illicit substances. Men with a longer-illness-duration were very socially disadvantaged and isolated, often experiencing homelessness and substance use. Men with a short-illness-duration were most likely to be in paid employment, but two-thirds earned less than $AUD500 per fortnight. Men with longer-illness-duration showed most disability, socially and globally. Interventions should be guided by diagnosis, but also by a person's sex and duration of illness. Copyright © 2017 Elsevier B.V. All rights reserved.

Long-Term Costs and Health Consequences of Issuing Shorter Duration Prescriptions for Patients with Chronic Health Conditions in the English NHS.

PubMed

Martin, Adam; Payne, Rupert; Wilson, Edward Cf

2018-06-01

The National Health Service (NHS) in England spends over £9 billion on prescription medicines dispensed in primary care, of which over two-thirds is accounted for by repeat prescriptions. Recently, GPs in England have been urged to limit the duration of repeat prescriptions, where clinically appropriate, to 28 days to reduce wastage and hence contain costs. However, shorter prescriptions will increase transaction costs and thus may not be cost saving. Furthermore, there is evidence to suggest that shorter prescriptions are associated with lower adherence, which would be expected to lead to lower clinical benefit. The objective of this study is to estimate the cost-effectiveness of 3-month versus 28-day repeat prescriptions from the perspective of the NHS. We adapted three previously developed UK policy-relevant models, incorporating transaction (dispensing fees, prescriber time) and drug wastage costs associated with 3-month and 28-day prescriptions in three case studies: antihypertensive medications for prevention of cardiovascular events; drugs to improve glycaemic control in patients with type 2 diabetes; and treatments for depression. In all cases, 3-month prescriptions were associated with lower costs and higher QALYs than 28-day prescriptions. This is driven by assumptions that higher adherence leads to improved disease control, lower costs and improved QALYs. Longer repeat prescriptions may be cost-effective compared with shorter ones. However, the quality of the evidence base on which this modelling is based is poor. Any policy rollout should be within the context of a trial such as a stepped-wedge cluster design.

Recent advances in ultrasonic treatment: Challenges and field applications for controlling harmful algal blooms (HABs).

PubMed

Park, Jungsu; Church, Jared; Son, Younggyu; Kim, Keug-Tae; Lee, Woo Hyoung

2017-09-01

Algal blooms are a naturally occurring phenomenon which can occur in both freshwater and saltwater. However, due to excess nutrient loading in water bodies (e.g. agricultural runoff and industrial activities), harmful algal blooms (HABs) have become an increasing issue globally, and can even cause health effects in humans due to the release of cyanotoxins. Among currently available treatment methods, sonication has received increasing attention for algal control because of its low impact on ecosystems and the environment. The effects of ultrasound on algal cells are well understood and operating parameter such as frequency, intensity, and duration of exposure has been well studied. However, most studies have been limited to laboratory data interpretation due to complicated environmental conditions in the field. Only a few field and pilot tests in small reservoirs were reported and the applicability of ultrasound for HABs prevention and control is still under question. There is a lack of information on the upscaling of ultrasonication devices for HAB control on larger water bodies, considering field influencing factors such as rainfall, light intensity/duration, temperature, water flow, nutrients loading, and turbidity. In this review article, we address the challenges and field considerations of ultrasonic applications for controlling algal blooms. An extensive literature survey, from the fundamentals of ultrasound techniques to recent ultrasound laboratory and field studies, has been thoroughly conducted and summarized to identify future technical expectations for field applications. Case studies investigating spatial distribution of frequency and pressure during sonication are highlighted with future implications. Copyright © 2017 Elsevier B.V. All rights reserved.

Optimal duration of dual anti-platelet therapy after percutaneous coronary intervention: 2016 consensus position of the Italian Society of Cardiology.

PubMed

Barillà, Francesco; Pelliccia, Francesco; Borzi, Mauro; Camici, Paolo; Cas, Livio Dei; Di Biase, Matteo; Indolfi, Ciro; Mercuro, Giuseppe; Montemurro, Vincenzo; Padeletti, Luigi; Filardi, Pasquale Perrone; Vizza, Carmine D; Romeo, Francesco

2017-01-01

Definition of the optimal duration of dual anti-platelet therapy (DAPT) is an important clinical issue, given the large number of patients having percutaneous coronary intervention (PCI), the costs and risks of pharmacologic therapy, the consequences of stent thrombosis, and the potential benefits of DAPT in preventing ischaemic outcomes beyond stent thrombosis. Nowadays, the rationale for a prolonged duration of DAPT should be not only the prevention of stent thrombosis, but also the prevention of ischaemic events unrelated to the coronary stenosis treated with index PCI. A higher predisposition to athero-thrombosis may persist for years after an acute myocardial infarction, and even stable patients with a history of prior myocardial infarction are at high risk for major adverse cardiovascular events. Recently, results of pre-specified post-hoc analyses of randomized clinical trials, including the PEGASUS-TIMI 54 trial, have shed light on strategies of DAPT in various clinical situations, and should impact the next rounds of international guidelines, and also routine practice. Accordingly, the 2015 to 2016 the Board of the Italian Society of Cardiology addressed newer recommendations on duration of DAPT based on most recent scientific information. The document states that physicians should decide duration of DAPT on an individual basis, taking into account ischaemic and bleeding risks of any given patient. Indeed, current controversy surrounding optimal duration of DAPT clearly reflects the fact that, nowadays, a one size fits all strategy cannot be reliably applied to patients treated with PCI. Indeed, patients usually have factors for both increased ischaemic and bleeding risks that must be carefully evaluated to assess the benefit/risk ratio of prolonged DAPT. Personalized management of DAPT must be seen as a dynamic prescription with regular re-evaluations of the risk/benefit to the patient according to changes in his/her clinical profile. Also, in order to derive more benefit than harm from new treatments, a multi-parametric approach using several risk scores of the ischaemic and bleeding risks might improve the process of risk factor characterization. In patients with high ischaemic risk, particularly those with a history of myocardial infarction, the benefits of extended DAPT (particularly with ticagrelor up to 3 years) are likely to outweigh the risks.

Overutilization and underutilization of operating rooms - insights from behavioral health care operations management.

PubMed

Fügener, Andreas; Schiffels, Sebastian; Kolisch, Rainer

2017-03-01

The planning of surgery durations is crucial for efficient usage of operating theaters. Both planning too long and too short durations for surgeries lead to undesirable consequences, e.g. idle time, overtime, or rescheduling of surgeries. We define these consequences as operating room inefficiency. The overall objective of planning surgery durations is to minimize expected operating room inefficiency, since surgery durations are stochastic. While most health care studies assume economically rational behavior of decision makers, experimental studies have shown that decision makers often do not act according to economic incentives. Based on insights from health care operations management, medical decision making, behavioral operations management, as well as empirical observations, we derive hypotheses that surgeons' behavior deviates from economically rational behavior. To investigate this, we undertake an experimental study where experienced surgeons are asked to plan surgeries with uncertain durations. We discover systematic deviations from optimal decision making and offer behavioral explanations for the observed biases. Our research provides new insights to tackle a major problem in hospitals, i.e. low operating room utilization going along with staff overtime.

All-sky search for long-duration gravitational wave transients with initial LIGO

NASA Astrophysics Data System (ADS)

Abbott, B. P.; Abbott, R.; Abbott, T. D.; Abernathy, M. R.; Acernese, F.; Ackley, K.; Adams, C.; Adams, T.; Addesso, P.; Adhikari, R. X.; Adya, V. B.; Affeldt, C.; Agathos, M.; Agatsuma, K.; Aggarwal, N.; Aguiar, O. D.; Ain, A.; Ajith, P.; Allen, B.; Allocca, A.; Amariutei, D. V.; Anderson, S. B.; Anderson, W. G.; Arai, K.; Araya, M. C.; Arceneaux, C. C.; Areeda, J. S.; Arnaud, N.; Arun, K. G.; Ashton, G.; Ast, M.; Aston, S. M.; Astone, P.; Aufmuth, P.; Aulbert, C.; Babak, S.; Baker, P. T.; Baldaccini, F.; Ballardin, G.; Ballmer, S. W.; Barayoga, J. C.; Barclay, S. E.; Barish, B. C.; Barker, D.; Barone, F.; Barr, B.; Barsotti, L.; Barsuglia, M.; Barta, D.; Bartlett, J.; Bartos, I.; Bassiri, R.; Basti, A.; Batch, J. C.; Baune, C.; Bavigadda, V.; Bazzan, M.; Behnke, B.; Bejger, M.; Belczynski, C.; Bell, A. S.; Bell, C. J.; Berger, B. K.; Bergman, J.; Bergmann, G.; Berry, C. P. L.; Bersanetti, D.; Bertolini, A.; Betzwieser, J.; Bhagwat, S.; Bhandare, R.; Bilenko, I. A.; Billingsley, G.; Birch, J.; Birney, R.; Biscans, S.; Bisht, A.; Bitossi, M.; Biwer, C.; Bizouard, M. A.; Blackburn, J. K.; Blair, C. D.; Blair, D.; Blair, R. M.; Bloemen, S.; Bock, O.; Bodiya, T. P.; Boer, M.; Bogaert, G.; Bogan, C.; Bohe, A.; Bojtos, P.; Bond, C.; Bondu, F.; Bonnand, R.; Bork, R.; Boschi, V.; Bose, S.; Bozzi, A.; Bradaschia, C.; Brady, P. R.; Braginsky, V. B.; Branchesi, M.; Brau, J. E.; Briant, T.; Brillet, A.; Brinkmann, M.; Brisson, V.; Brockill, P.; Brooks, A. F.; Brown, D. A.; Brown, D.; Brown, D. D.; Brown, N. M.; Buchanan, C. C.; Buikema, A.; Bulik, T.; Bulten, H. J.; Buonanno, A.; Buskulic, D.; Buy, C.; Byer, R. L.; Cadonati, L.; Cagnoli, G.; Cahillane, C.; Bustillo, J. Calderón; Callister, T.; Calloni, E.; Camp, J. B.; Cannon, K. C.; Cao, J.; Capano, C. D.; Capocasa, E.; Carbognani, F.; Caride, S.; Diaz, J. Casanueva; Casentini, C.; Caudill, S.; Cavaglià, M.; Cavalier, F.; Cavalieri, R.; Cella, G.; Cepeda, C.; Baiardi, L. Cerboni; Cerretani, G.; Cesarini, E.; Chakraborty, R.; Chalermsongsak, T.; Chamberlin, S. J.; Chan, M.; Chao, S.; Charlton, P.; Chassande-Mottin, E.; Chen, H. Y.; Chen, Y.; Cheng, C.; Chincarini, A.; Chiummo, A.; Cho, H. S.; Cho, M.; Chow, J. H.; Christensen, N.; Chu, Q.; Chua, S.; Chung, S.; Ciani, G.; Clara, F.; Clark, J. A.; Cleva, F.; Coccia, E.; Cohadon, P.-F.; Colla, A.; Collette, C. G.; Constancio, M.; Conte, A.; Conti, L.; Cook, D.; Corbitt, T. R.; Cornish, N.; Corsi, A.; Cortese, S.; Costa, C. A.; Coughlin, M. W.; Coughlin, S. B.; Coulon, J.-P.; Countryman, S. T.; Couvares, P.; Coward, D. M.; Cowart, M. J.; Coyne, D. C.; Coyne, R.; Craig, K.; Creighton, J. D. E.; Cripe, J.; Crowder, S. G.; Cumming, A.; Cunningham, L.; Cuoco, E.; Canton, T. Dal; Danilishin, S. L.; D'Antonio, S.; Danzmann, K.; Darman, N. S.; Dattilo, V.; Dave, I.; Daveloza, H. P.; Davier, M.; Davies, G. S.; Daw, E. J.; Day, R.; DeBra, D.; Debreczeni, G.; Degallaix, J.; De Laurentis, M.; Deléglise, S.; Del Pozzo, W.; Denker, T.; Dent, T.; Dereli, H.; Dergachev, V.; DeRosa, R.; De Rosa, R.; DeSalvo, R.; Dhurandhar, S.; Díaz, M. C.; Di Fiore, L.; Di Giovanni, M.; Di Lieto, A.; Di Palma, I.; Di Virgilio, A.; Dojcinoski, G.; Dolique, V.; Donovan, F.; Dooley, K. L.; Doravari, S.; Douglas, R.; Downes, T. P.; Drago, M.; Drever, R. W. P.; Driggers, J. C.; Du, Z.; Ducrot, M.; Dwyer, S. E.; Edo, T. B.; Edwards, M. C.; Effler, A.; Eggenstein, H.-B.; Ehrens, P.; Eichholz, J. M.; Eikenberry, S. S.; Engels, W.; Essick, R. C.; Etzel, T.; Evans, M.; Evans, T. M.; Everett, R.; Factourovich, M.; Fafone, V.; Fair, H.; Fairhurst, S.; Fan, X.; Fang, Q.; Farinon, S.; Farr, B.; Farr, W. M.; Favata, M.; Fays, M.; Fehrmann, H.; Fejer, M. M.; Ferrante, I.; Ferreira, E. C.; Ferrini, F.; Fidecaro, F.; Fiori, I.; Fisher, R. P.; Flaminio, R.; Fletcher, M.; Fournier, J.-D.; Franco, S.; Frasca, S.; Frasconi, F.; Frei, Z.; Freise, A.; Frey, R.; Frey, V.; Fricke, T. T.; Fritschel, P.; Frolov, V. V.; Fulda, P.; Fyffe, M.; Gabbard, H. A. G.; Gair, J. R.; Gammaitoni, L.; Gaonkar, S. G.; Garufi, F.; Gatto, A.; Gaur, G.; Gehrels, N.; Gemme, G.; Gendre, B.; Genin, E.; Gennai, A.; George, J.; Gergely, L.; Germain, V.; Ghosh, A.; Ghosh, S.; Giaime, J. A.; Giardina, K. D.; Giazotto, A.; Gill, K.; Glaefke, A.; Goetz, E.; Goetz, R.; Gondan, L.; González, G.; Castro, J. M. Gonzalez; Gopakumar, A.; Gordon, N. A.; Gorodetsky, M. L.; Gossan, S. E.; Gosselin, M.; Gouaty, R.; Graef, C.; Graff, P. B.; Granata, M.; Grant, A.; Gras, S.; Gray, C.; Greco, G.; Green, A. C.; Groot, P.; Grote, H.; Grunewald, S.; Guidi, G. M.; Guo, X.; Gupta, A.; Gupta, M. K.; Gushwa, K. E.; Gustafson, E. K.; Gustafson, R.; Hacker, J. J.; Hall, B. R.; Hall, E. D.; Hammond, G.; Haney, M.; Hanke, M. M.; Hanks, J.; Hanna, C.; Hannam, M. D.; Hanson, J.; Hardwick, T.; Harms, J.; Harry, G. M.; Harry, I. W.; Hart, M. J.; Hartman, M. T.; Haster, C.-J.; Haughian, K.; Heidmann, A.; Heintze, M. C.; Heitmann, H.; Hello, P.; Hemming, G.; Hendry, M.; Heng, I. S.; Hennig, J.; Heptonstall, A. W.; Heurs, M.; Hild, S.; Hoak, D.; Hodge, K. A.; Hofman, D.; Hollitt, S. E.; Holt, K.; Holz, D. E.; Hopkins, P.; Hosken, D. J.; Hough, J.; Houston, E. A.; Howell, E. J.; Hu, Y. M.; Huang, S.; Huerta, E. A.; Huet, D.; Hughey, B.; Husa, S.; Huttner, S. H.; Huynh-Dinh, T.; Idrisy, A.; Indik, N.; Ingram, D. R.; Inta, R.; Isa, H. N.; Isac, J.-M.; Isi, M.; Islas, G.; Isogai, T.; Iyer, B. R.; Izumi, K.; Jacqmin, T.; Jang, H.; Jani, K.; Jaranowski, P.; Jawahar, S.; Jiménez-Forteza, F.; Johnson, W. W.; Jones, D. I.; Jones, R.; Jonker, R. J. G.; Ju, L.; Haris, K.; Kalaghatgi, C. V.; Kalogera, V.; Kandhasamy, S.; Kang, G.; Kanner, J. B.; Karki, S.; Kasprzack, M.; Katsavounidis, E.; Katzman, W.; Kaufer, S.; Kaur, T.; Kawabe, K.; Kawazoe, F.; Kéfélian, F.; Kehl, M. S.; Keitel, D.; Kelley, D. B.; Kells, W.; Kennedy, R.; Key, J. S.; Khalaidovski, A.; Khalili, F. Y.; Khan, S.; Khan, Z.; Khazanov, E. A.; Kijbunchoo, N.; Kim, C.; Kim, J.; Kim, K.; Kim, N.; Kim, N.; Kim, Y.-M.; King, E. J.; King, P. J.; Kinzel, D. L.; Kissel, J. S.; Kleybolte, L.; Klimenko, S.; Koehlenbeck, S. M.; Kokeyama, K.; Koley, S.; Kondrashov, V.; Kontos, A.; Korobko, M.; Korth, W. Z.; Kowalska, I.; Kozak, D. B.; Kringel, V.; Krishnan, B.; Królak, A.; Krueger, C.; Kuehn, G.; Kumar, P.; Kuo, L.; Kutynia, A.; Lackey, B. D.; Landry, M.; Lange, J.; Lantz, B.; Lasky, P. D.; Lazzarini, A.; Lazzaro, C.; Leaci, P.; Leavey, S.; Lebigot, E.; Lee, C. H.; Lee, H. K.; Lee, H. M.; Lee, K.; Leonardi, M.; Leong, J. R.; Leroy, N.; Letendre, N.; Levin, Y.; Levine, B. M.; Li, T. G. F.; Libson, A.; Littenberg, T. B.; Lockerbie, N. A.; Logue, J.; Lombardi, A. L.; Lord, J. E.; Lorenzini, M.; Loriette, V.; Lormand, M.; Losurdo, G.; Lough, J. D.; Lück, H.; Lundgren, A. P.; Luo, J.; Lynch, R.; Ma, Y.; MacDonald, T.; Machenschalk, B.; MacInnis, M.; Macleod, D. M.; Magaña-Sandoval, F.; Magee, R. M.; Mageswaran, M.; Majorana, E.; Maksimovic, I.; Malvezzi, V.; Man, N.; Mandel, I.; Mandic, V.; Mangano, V.; Mansell, G. L.; Manske, M.; Mantovani, M.; Marchesoni, F.; Marion, F.; Márka, S.; Márka, Z.; Markosyan, A. S.; Maros, E.; Martelli, F.; Martellini, L.; Martin, I. W.; Martin, R. M.; Martynov, D. V.; Marx, J. N.; Mason, K.; Masserot, A.; Massinger, T. J.; Masso-Reid, M.; Matichard, F.; Matone, L.; Mavalvala, N.; Mazumder, N.; Mazzolo, G.; McCarthy, R.; McClelland, D. E.; McCormick, S.; McGuire, S. C.; McIntyre, G.; McIver, J.; McWilliams, S. T.; Meacher, D.; Meadors, G. D.; Meidam, J.; Melatos, A.; Mendell, G.; Mendoza-Gandara, D.; Mercer, R. A.; Merzougui, M.; Meshkov, S.; Messenger, C.; Messick, C.; Meyers, P. M.; Mezzani, F.; Miao, H.; Michel, C.; Middleton, H.; Mikhailov, E. E.; Milano, L.; Miller, J.; Millhouse, M.; Minenkov, Y.; Ming, J.; Mirshekari, S.; Mishra, C.; Mitra, S.; Mitrofanov, V. P.; Mitselmakher, G.; Mittleman, R.; Moggi, A.; Mohapatra, S. R. P.; Montani, M.; Moore, B. C.; Moore, C. J.; Moraru, D.; Moreno, G.; Morriss, S. R.; Mossavi, K.; Mours, B.; Mow-Lowry, C. M.; Mueller, C. L.; Mueller, G.; Muir, A. W.; Mukherjee, Arunava; Mukherjee, D.; Mukherjee, S.; Mullavey, A.; Munch, J.; Murphy, D. J.; Murray, P. G.; Mytidis, A.; Nardecchia, I.; Naticchioni, L.; Nayak, R. K.; Necula, V.; Nedkova, K.; Nelemans, G.; Neri, M.; Neunzert, A.; Newton, G.; Nguyen, T. T.; Nielsen, A. B.; Nissanke, S.; Nitz, A.; Nocera, F.; Nolting, D.; Normandin, M. E. N.; Nuttall, L. K.; Oberling, J.; Ochsner, E.; O'Dell, J.; Oelker, E.; Ogin, G. H.; Oh, J. J.; Oh, S. H.; Ohme, F.; Oliver, M.; Oppermann, P.; Oram, Richard J.; O'Reilly, B.; O'Shaughnessy, R.; Ott, C. D.; Ottaway, D. J.; Ottens, R. S.; Overmier, H.; Owen, B. J.; Pai, A.; Pai, S. A.; Palamos, J. R.; Palashov, O.; Palomba, C.; Pal-Singh, A.; Pan, H.; Pankow, C.; Pannarale, F.; Pant, B. C.; Paoletti, F.; Paoli, A.; Papa, M. A.; Paris, H. R.; Parker, W.; Pascucci, D.; Pasqualetti, A.; Passaquieti, R.; Passuello, D.; Patrick, Z.; Pearlstone, B. L.; Pedraza, M.; Pedurand, R.; Pekowsky, L.; Pele, A.; Penn, S.; Pereira, R.; Perreca, A.; Phelps, M.; Piccinni, O.; Pichot, M.; Piergiovanni, F.; Pierro, V.; Pillant, G.; Pinard, L.; Pinto, I. M.; Pitkin, M.; Poggiani, R.; Post, A.; Powell, J.; Prasad, J.; Predoi, V.; Premachandra, S. S.; Prestegard, T.; Price, L. R.; Prijatelj, M.; Principe, M.; Privitera, S.; Prodi, G. A.; Prokhorov, L.; Punturo, M.; Puppo, P.; Pürrer, M.; Qi, H.; Qin, J.; Quetschke, V.; Quintero, E. A.; Quitzow-James, R.; Raab, F. J.; Rabeling, D. S.; Radkins, H.; Raffai, P.; Raja, S.; Rakhmanov, M.; Rapagnani, P.; Raymond, V.; Razzano, M.; Re, V.; Read, J.; Reed, C. M.; Regimbau, T.; Rei, L.; Reid, S.; Reitze, D. H.; Rew, H.; Ricci, F.; Riles, K.; Robertson, N. A.; Robie, R.; Robinet, F.; Rocchi, A.; Rolland, L.; Rollins, J. G.; Roma, V. J.; Romano, J. D.; Romano, R.; Romanov, G.; Romie, J. H.; Rosińska, D.; Rowan, S.; Rüdiger, A.; Ruggi, P.; Ryan, K.; Sachdev, S.; Sadecki, T.; Sadeghian, L.; Saleem, M.; Salemi, F.; Samajdar, A.; Sammut, L.; Sanchez, E. J.; Sandberg, V.; Sandeen, B.; Sanders, J. R.; Sassolas, B.; Saulson, P. R.; Sauter, O.; Savage, R.; Sawadsky, A.; Schale, P.; Schilling, R.; Schmidt, J.; Schmidt, P.; Schnabel, R.; Schofield, R. M. S.; Schönbeck, A.; Schreiber, E.; Schuette, D.; Schutz, B. F.; Scott, J.; Scott, S. M.; Sellers, D.; Sentenac, D.; Sequino, V.; Sergeev, A.; Serna, G.; Setyawati, Y.; Sevigny, A.; Shaddock, D. A.; Shah, S.; Shahriar, M. S.; Shaltev, M.; Shao, Z.; Shapiro, B.; Shawhan, P.; Sheperd, A.; Shoemaker, D. H.; Shoemaker, D. M.; Siellez, K.; Siemens, X.; Sigg, D.; Silva, A. D.; Simakov, D.; Singer, A.; Singer, L. P.; Singh, A.; Singh, R.; Sintes, A. M.; Slagmolen, B. J. J.; Smith, J. R.; Smith, N. D.; Smith, R. J. E.; Son, E. J.; Sorazu, B.; Sorrentino, F.; Souradeep, T.; Srivastava, A. K.; Staley, A.; Steinke, M.; Steinlechner, J.; Steinlechner, S.; Steinmeyer, D.; Stephens, B. C.; Stone, R.; Strain, K. A.; Straniero, N.; Stratta, G.; Strauss, N. A.; Strigin, S.; Sturani, R.; Stuver, A. L.; Summerscales, T. Z.; Sun, L.; Sutton, P. J.; Swinkels, B. L.; Szczepanczyk, M. J.; Tacca, M.; Talukder, D.; Tanner, D. B.; Tápai, M.; Tarabrin, S. P.; Taracchini, A.; Taylor, R.; Theeg, T.; Thirugnanasambandam, M. P.; Thomas, E. G.; Thomas, M.; Thomas, P.; Thorne, K. A.; Thorne, K. S.; Thrane, E.; Tiwari, S.; Tiwari, V.; Tomlinson, C.; Tonelli, M.; Torres, C. V.; Torrie, C. I.; Töyrä, D.; Travasso, F.; Traylor, G.; Trifirò, D.; Tringali, M. C.; Trozzo, L.; Tse, M.; Turconi, M.; Tuyenbayev, D.; Ugolini, D.; Unnikrishnan, C. S.; Urban, A. L.; Usman, S. A.; Vahlbruch, H.; Vajente, G.; Valdes, G.; van Bakel, N.; van Beuzekom, M.; van den Brand, J. F. J.; van den Broeck, C.; van der Schaaf, L.; van der Sluys, M. V.; van Heijningen, J. V.; van Veggel, A. A.; Vardaro, M.; Vass, S.; Vasúth, M.; Vaulin, R.; Vecchio, A.; Vedovato, G.; Veitch, J.; Veitch, P. J.; Venkateswara, K.; Verkindt, D.; Vetrano, F.; Viceré, A.; Vinciguerra, S.; Vinet, J.-Y.; Vitale, S.; Vo, T.; Vocca, H.; Vorvick, C.; Vousden, W. D.; Vyatchanin, S. P.; Wade, A. R.; Wade, L. E.; Wade, M.; Walker, M.; Wallace, L.; Walsh, S.; Wang, G.; Wang, H.; Wang, M.; Wang, X.; Wang, Y.; Ward, R. L.; Warner, J.; Was, M.; Weaver, B.; Wei, L.-W.; Weinert, M.; Weinstein, A. J.; Weiss, R.; Welborn, T.; Wen, L.; Weßels, P.; Westphal, T.; Wette, K.; Whelan, J. T.; White, D. J.; Whiting, B. F.; Williams, R. D.; Williamson, A. R.; Willis, J. L.; Willke, B.; Wimmer, M. H.; Winkler, W.; Wipf, C. C.; Wittel, H.; Woan, G.; Worden, J.; Wright, J. L.; Wu, G.; Yablon, J.; Yam, W.; Yamamoto, H.; Yancey, C. C.; Yu, H.; Yvert, M.; ZadroŻny, A.; Zangrando, L.; Zanolin, M.; Zendri, J.-P.; Zevin, M.; Zhang, F.; Zhang, L.; Zhang, M.; Zhang, Y.; Zhao, C.; Zhou, M.; Zhou, Z.; Zhu, X. J.; Zucker, M. E.; Zuraw, S. E.; Zweizig, J.; LIGO Scientific Collaboration; Virgo Collaboration

2016-02-01

We present the results of a search for long-duration gravitational wave transients in two sets of data collected by the LIGO Hanford and LIGO Livingston detectors between November 5, 2005 and September 30, 2007, and July 7, 2009 and October 20, 2010, with a total observational time of 283.0 days and 132.9 days, respectively. The search targets gravitational wave transients of duration 10-500 s in a frequency band of 40-1000 Hz, with minimal assumptions about the signal waveform, polarization, source direction, or time of occurrence. All candidate triggers were consistent with the expected background; as a result we set 90% confidence upper limits on the rate of long-duration gravitational wave transients for different types of gravitational wave signals. For signals from black hole accretion disk instabilities, we set upper limits on the source rate density between 3.4 ×1 0-5 and 9.4 ×1 0-4 Mpc-3 yr-1 at 90% confidence. These are the first results from an all-sky search for unmodeled long-duration transient gravitational waves.

PTH(1-34) for the Primary Prevention of Postthyroidectomy Hypocalcemia: The THYPOS Trial.

PubMed

Palermo, Andrea; Mangiameli, Giuseppe; Tabacco, Gaia; Longo, Filippo; Pedone, Claudio; Briganti, Silvia Irina; Maggi, Daria; Vescini, Fabio; Naciu, Anda; Lauria Pantano, Angelo; Napoli, Nicola; Angeletti, Silvia; Pozzilli, Paolo; Crucitti, Pierfilippo; Manfrini, Silvia

2016-11-01

There are no studies evaluating teriparatide for prevention of post-thyroidectomy hypocalcemia. Our objective was to evaluate whether teriparatide can prevent postsurgical hypocalcemia and shorten the hospitalization in subjects at high risk of hypocalcemia following thyroid surgery. This was a prospective phase II randomized open-label trial. This trial was set on a surgical ward. Twenty-six subjects (six males, 20 females) with intact PTH lower than10 pg/ml 4 hours after thyroidectomy were included. Subjects were randomized (1:1) to receive SC administration of 20 mcg of teriparatide every 12 hours until the discharge (treatment group) or to follow standard clinical care (control group). Adjusted serum calcium, duration of hospitalization, and calcium/calcitriol supplementation were measured. Overall, the incidence of hypocalcemia was 3/13 in treatment group and 11/13 in the control group (P = .006). Treated patients had a lower risk of hypocalcemia than controls (relative risk, 0.26 [95% confidence interval, 0.09-0.723)]). The median duration of hospitalization was 3 days (interquartile range, 1) in control subjects and 2 days (interquartile range, 0) in treated subjects (P = .012). One month after discharge, 10/13 subjects in the treatment group had stopped calcium carbonate supplements, while only 5/13 in the control group had discontinued calcium. The ANOVA for repeated measures showed a significant difference in calcium supplements between groups at 1-month visit (P = .04) as well as a significant difference between discharge and 1-month visit in the treatment group (P for interaction time group = .04) Conclusions: Teriparatide may prevent postsurgical hypocalcemia, shorten the duration of hospitalization, and reduce the need for calcium and vitamin D supplementation after discharge in high risk subjects after thyroid surgery.

Patient/parent expectations of orthodontic treatment.

PubMed

Obilade, Omolara Abiodun; da Costa, Oluranti Olatokunbo; Sanu, Oluwatosin Oluyemi

2017-03-01

Expectations of orthodontic treatment may differ between the patient and their parents, as the parents' expectations may not reflect those of the child. The aim of this study, therefore, was to determine the expectations of patients and their parents. This was a clinic-based, comparative, cross-sectional study involving 110 patients aged between 10 and 19 years, as well as their accompanying parents or guardians. The expectations of both patients and parents were determined using a questionnaire developed by Sayers and Newton. Results showed that the expectations of the patients and parents differed significantly in a number of areas with the parents' expectations often exceeding those of the patients. Both patients and parents were found to be ignorant about some aspects of orthodontic treatment, with 47.3% of patients and 39.1% of parents unaware of the duration of orthodontic treatment and, as such, requiring information from their clinicians. The results highlight the importance of patient education and counseling as well as the need to focus on the individual patient and not assume that their expectations mirror those of the accompanying parent. Copyright © 2016. Published by Elsevier Masson SAS.

Latitudinal variation in diapause duration and post-winter development in two pierid butterflies in relation to phenological specialization.

PubMed

Posledovich, Diana; Toftegaard, Tenna; Wiklund, Christer; Ehrlén, Johan; Gotthard, Karl

2015-01-01

Diapause plays a central role in insect life cycles by allowing survival during adverse seasonal conditions as well as synchronizing life cycles with the period of mate and food availability. Seasonal timing is expected to be particularly important for species that are dependent on resources available during a short time window-so-called phenological specialists-and latitudinal clines in seasonality are expected to favor local adaptation in phenological timing. However, to what degree latitudinal variation in diapause dynamics and post-winter development due to such local adaptation is influenced by the degree of phenological specialization is not well known. We experimentally studied two pierid butterfly species and found that the phenological specialist Anthocharis cardamines had shorter diapause duration than the phenological generalist Pieris napi along a latitudinal gradient in Sweden. Moreover, diapause duration increased with latitude in P. napi but not in A. cardamines. Sensitivity of the two species to winter thermal conditions also differed; additional cold temperature during the winter period shortened diapause duration for P. napi pupae but not for A. cardamines pupae. In both species, post-winter pupal development was faster after longer periods of cold conditions, and more southern populations developed faster than northern populations. Post-winter development was also invariably faster at higher temperatures in both species. We argue that the observed differences in diapause dynamics between the two species might be explained by the difference in phenological specialization that influences the costs of breaking diapause too early in the season.

Poor medication adherence to bisphosphonates and high self-perception of aging in elderly female patients with osteoporosis.

PubMed

Wu, X; Wei, D; Sun, B; Wu, X N

2016-10-01

Non-adherence to bisphosphonates exposes the elderly female osteoporosis patients to an increased risk of fracture. This was one of the first studies to explore the relationship between medication adherence and self-perception of aging. Feelings of lacking control and expectations for negative events, beliefs of illness's chronic duration nature, and its linkage with aging were associated with of poor medication adherence. To examine the relationship between medication adherence to bisphosphonates and self-perception of aging in elderly female patients with osteoporosis. This was a cross-sectional survey. A convenience sample of 245 elderly female patients with osteoporosis prescribed regular oral bisphosphonate therapy was recruited from three tertiary hospitals in China. Sociodemographic and osteoporosis-related data, Morisky Medication Adherence Scale-8 (MMAS-8) and Aging Perceptions Questionnaire (APQ) data were collected. Mean adherence score measured by MMAS-8 was 4.46(SD = 1.91; range, 0.25-7.00). Percentages of good and poor adherence were 28.6 and 71.4 %, which showed a poor medication adherence. Six domains of APQ statistically significantly associated with medication adherence. Interestingly, with control of age, educational status, marital status, and symptoms accompanying osteoporosis as covariates in the multivariate linear regression model, the effects of three domains disappeared. Significantly, worse adherence was observed in those patients who had higher feelings of lack of control, more expectations for negative events, more beliefs of osteoporosis's chronic duration nature and its linkage with aging. We conclude that feelings of lacking control, expectations for negative events, beliefs of illness's chronic duration nature, and its linkage with aging were associated with poor medication adherence in elderly female patients with osteoporosis. Concerns about self-perception of aging need to be addressed in order to improve medication adherence.

Expected Utility Distributions for Flexible, Contingent Execution

NASA Technical Reports Server (NTRS)

Bresina, John L.; Washington, Richard

2000-01-01

This paper presents a method for using expected utility distributions in the execution of flexible, contingent plans. A utility distribution maps the possible start times of an action to the expected utility of the plan suffix starting with that action. The contingent plan encodes a tree of possible courses of action and includes flexible temporal constraints and resource constraints. When execution reaches a branch point, the eligible option with the highest expected utility at that point in time is selected. The utility distributions make this selection sensitive to the runtime context, yet still efficient. Our approach uses predictions of action duration uncertainty as well as expectations of resource usage and availability to determine when an action can execute and with what probability. Execution windows and probabilities inevitably change as execution proceeds, but such changes do not invalidate the cached utility distributions, thus, dynamic updating of utility information is minimized.

A review of evidence for the link between sleep duration and hypertension.

PubMed

Gangwisch, James E

2014-10-01

There are lines of evidence from experimental sleep deprivation studies, population-based epidemiological studies, and an interventional study that point to the potential efficacy of adequate quality sleep to prevent and treat hypertension. Experimental sleep restriction has been shown to raise blood pressure and heart rate. Insufficient sleep on a chronic basis can raise average 24-hour blood pressure and lead to structural adaptations that entrain the cardiovascular system to operate at an elevated blood pressure equilibrium and increase the risk for hypertension. Disruptions in the timing and duration of sleep could also disrupt circadian rhythmicity and autonomic balance, which can increase the prevalence of the nondipping pattern, disturb diurnal rhythm of cardiac output, and increase blood pressure variability. Short sleep duration has been found to be associated with higher blood pressure and hypertension in both cross-sectional and longitudinal epidemiological studies. The association appears stronger in middle-aged adults and in women. Experimental sleep extension has been shown to significantly reduce blood pressure in individuals with prehypertension or stage 1 hypertension. The observed association between sleep duration and hypertension raises the hypothesis that interventions to extend sleep and improve sleep quality could serve as effective primary, secondary, and tertiary preventive measures for hypertension. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Effect of daily short-duration weight-bearing on disuse-induced deterioration of musculoskeletal system

PubMed Central

Leung, K-S.; Li, Y-H.; Liu, Y.; Wang, H.; Tam, K-F.; Chow, D.H.K.; Wan, Y.; Ling, S.; Dai, Z.; Qin, L.; Cheung, W-H.

2015-01-01

Objectives: To investigate deterioration of musculoskeletal system due to prolonged disuse and the potential of daily short-duration weight-bearing as countermeasures. Methods: Twenty-four adult male Sprague-Dawley rats were divided into Control Group (CG, no intervention), Tail-suspension Group (TG, tail-suspension without treatment), and Weight-Bearing Group (WBG, tail-suspension with 20 min/day, 5 days/week body weight loading). After four weeks of treatment, femur and tibia, soleus and extensor digitorum longus were evaluated for bone and muscle quality respectively. Tensile properties of bone-tendon insertion (BTI) were evaluated using patella-patellar tendon complex. Results: Disuse induced deterioration on bone, muscle, and BTI after four weeks. Compared with CG, TG and WBG showed significant decrease in bone mineral density (BMD) of trabecular bone in distal femur (4.3-15.2%), muscle mass (31.3-52.3%), muscle cross-sectional area (29.1-35%), and failure strength of BTI (23.9-29.4%). Tensile test showed that the failure mode was avulsion of bone at the BTI. No significant difference was detected between TG and WBG for all assessments on bone, muscle, and BTI. Conclusions: Disuse caused deterioration of bone, muscle, and BTI while daily short-duration of weight-bearing did not prevent this deterioration. Mechanical stimulation with higher intensity and longer duration may be necessary to prevent musculoskeletal deterioration resulted from prolonged disuse. PMID:26032214

Early diagnosis and multidisciplinary care reduce the hospitalization time and duration of tube feeding and prevent early obesity in PWS infants.

PubMed

Bacheré, N; Diene, G; Delagnes, V; Molinas, C; Moulin, P; Tauber, M

2008-01-01

To describe and evaluate the impact of very early diagnosis and multidisciplinary care on the evolution and care of infants presenting with Prader-Willi syndrome (PWS). 19 infants diagnosed with PWS before the second month of life were followed by a multidisciplinary team. Median age at the time of analysis was 3.1 years [range 0.4-6.5]. The data were compared with data collected in 1997 from 113 questionnaires filled out by members of the French PWS Association. The patients from this latter data set were 12.0 years [range 4 months to 41 years] at the time of analysis, with a median age of 36 months at diagnosis. The duration of their hospitalization time was significantly reduced from 30.0 [range 0-670] to 21 [range 0-90] days (p = 0.043). The duration of gastric tube feeding was significantly reduced from 30.5 [range 0-427] to 15 [range 0-60] days (p = 0.017). Growth hormone treatment was started at a mean age of 1.9 +/- 0.5 years in 10 infants and L-thyroxine in 6 infants. Only 1 infant became obese at 2.5 years. Early diagnosis combined with multidisciplinary care decreases the hospitalization time, duration of gastric tube feeding and prevents early obesity in PWS infants. (c) 2007 S. Karger AG, Basel.

Mentored Research | Cancer Prevention Fellowship Program

Cancer.gov

The major activity for Cancer Prevention Fellows is mentored research. All fellows are expected to develop original scientific projects and to report their findings at scientific meetings and in leading journals.

Pressurization and expulsion of a flightweight liquid hydrogen tank

NASA Technical Reports Server (NTRS)

Vandresar, N. T.; Stochl, R. J.

1993-01-01

Experimental results are presented for pressurization and expulsion of a flight-weight 4.89 cu m liquid hydrogen storage tank under normal gravity conditions. Pressurization and expulsion times are parametrically varied to study the effects of longer transfer times expected in future space flight applications. It is found that the increase in pressurant consumption with increased operational time is significant at shorter pressurization or expulsion durations and diminishes as the duration lengthens. Gas-to-wall heat transfer in the ullage is the dominant mode of energy exchange, with more than 50 percent of the pressurant energy being lost to tank wall heating in expulsions and the long duration pressurizations. Advanced data analysis will require a multidimensional approach combined with improved measurement capabilities of liquid-vapor interfacial transport phenomena.

Modifying Status Relations in Israel Youth: An Application of Expectation States Theory.

ERIC Educational Resources Information Center

Cohen, Elizabeth G.; Sharan, Shlomo

Group participation by Israeli youth is examined in light of the Theory of Status Characteristics and Expectation States. This theory maintains that social and/or group status influences expectations of competence and triggers self-fulfilling prophecies of performance. An experiment designed to prevent unwanted dominance of high status…

Preventive treatment of migraine.

PubMed

Silberstein, Steven D

2005-01-01

Migraine preventive therapy, even in the absence of a headache, is given in an attempt to reduce the frequency, duration, or severity of attacks. Circumstances that might warrant preventive treatment include disabling migraine attacks, the overuse of acute medications or failure of or contraindication to acute medications, troublesome side effects from medication, hemiplegic migraine, or very frequent headaches (more than 2 a week). The major medication groups for preventive treatment include anticonvulsants, antidepressants, b-adrenergic blockers, calcium channel antagonists, serotonin antagonists, neurotoxins, nonsteroidal anti-inflammatory drugs, and others. If preventive medication is indicated, the agent preferentially should be chosen from one of the first-line categories, based on the drug's side-effect profile and the patient's coexistent and comorbid conditions.

Activity in the chronically critically ill.

PubMed

Winkelman, Chris; Higgins, Patricia A; Chen, Yea-Jyh Kathy

2005-01-01

Although therapeutic activity prevents functional decline and reduces mortality, little is known about typical levels of activity among intensive care unit (ICU) patients. This report of a preliminary study describes typical therapeutic activity and compares the use of two measures of activity in a small sample of chronically critically ill adults. Type, frequency, and duration of therapeutic activity were measured simultaneously with direct observation and actigraphy. The only consistent activity documented was turning (frequency: 3 turns/8 hours; duration: mean average of 11 minutes). Analysis demonstrated acceptable agreement between the two measures of activity for both frequency and duration of therapeutic but not for type of activity. Congruence between measures for duration of activity was also supported. This study provides information for investigators and practitioners who are interested in measuring or implementing therapeutic activity in selected critically ill adults.

Activity in the Chronically Critically III

PubMed Central

Winkelman, Chris; Higgins, Patricia A.; Kathy Chen, Yea-Jyh

2006-01-01

Although therapeutic activity prevents functional decline and reduces mortality, little is known about typical levels of activity among intensive care unit (ICU) patients. This report of a preliminary study describes typical therapeutic activity and compares the use of two measures of activity in a small sample of chronically critically ill adults. Type, frequency, and duration of therapeutic activity were measured simultaneously with direct observation and actigraphy. The only consistent activity documented was turning (frequency: 3 turns/8 hours; duration: mean average of 11 minutes). Analysis demonstrated acceptable agreement between the two measures of activity for both frequency and duration of therapeutic but not for type of activity. Congruence between measures for duration of activity was also supported. This study provides information for investigators and practitioners who are interested in measuring or implementing therapeutic activity in selected critically ill adults. PMID:16327517

The insomnia with short sleep duration phenotype: an update on it's importance for health and prevention.

PubMed

Fernandez-Mendoza, Julio

2017-01-01

It was first proposed in the late 1990s that objective markers of sleep disturbance could serve as an index of the biological severity of insomnia. In 2013, a heuristic model of two insomnia phenotypes based on objective sleep duration was proposed. Herein, we review the studies conducted in the past 3 years on the insomnia with short sleep duration phenotype and its implications for a clinical research agenda. Studies have shown that insomnia with objective short sleep duration is associated with physiologic hyperarousal and cardiometabolic and neurocognitive morbidity, whereas insomnia with normal sleep duration is not. Both insomnia phenotypes are associated with psychiatric morbidity albeit through different psychobiological mechanisms. Novel recent studies have included occupational outcomes, developmental approaches, at-home objective sleep testing, diagnostic accuracy measures, and response to cognitive-behavioral treatment. Accumulating evidence in the past years has continued to support that insomnia with short sleep duration is a more severe phenotype of the disorder associated with physiologic changes, significant morbidity and mortality and, potentially, a differential response to treatment.

Total Breast-Feeding Duration and Dental Caries in Healthy Urban Children.

PubMed

Wong, Peter D; Birken, Catherine S; Parkin, Patricia C; Venu, Isvarya; Chen, Yang; Schroth, Robert J; Maguire, Jonathon L

2017-04-01

To determine if there is an association between longer breast-feeding duration and dental caries in healthy urban children. We conducted a cross-sectional study of urban children aged 1 to 6 years recruited through The Applied Research Group for Kids (TARGet Kids!) practice-based research network between September 2011 and August 2013. The main outcome measure was parental report of dental caries. The adjusted predicted probability of dental caries was 7%, 8%, 11%, and 16% with total duration of breast-feeding duration of 12, 18, 24, and 36 months, respectively. In the adjusted logistic regression analyses, relative to breast-feeding 0 to 5 months, the odds of dental caries with total breast-feeding duration >24 months was 2.75 (95% confidence interval 1.61-4.72). Among healthy urban children, longer breast-feeding duration was associated with higher odds of dental caries. These findings support heightened awareness and enhanced anticipatory guidance for preventive dental care, particularly among children who breast-feed beyond 2 years of age. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

7 CFR 636.9 - Cost-share agreements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF... a minimum duration of one year after the completion of conservation activities identified in the... O&M agreement that describes the O&M for each conservation activity and the agency expectation that...

7 CFR 636.9 - Cost-share agreements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF... a minimum duration of one year after the completion of conservation activities identified in the... O&M agreement that describes the O&M for each conservation activity and the agency expectation that...

7 CFR 636.9 - Cost-share agreements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF... a minimum duration of one year after the completion of conservation activities identified in the... O&M agreement that describes the O&M for each conservation activity and the agency expectation that...

7 CFR 636.9 - Cost-share agreements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF... a minimum duration of one year after the completion of conservation activities identified in the... O&M agreement that describes the O&M for each conservation activity and the agency expectation that...

Comparative benefit of malaria chemoprophylaxis modelled in United Kingdom travellers.

PubMed

Toovey, Stephen; Nieforth, Keith; Smith, Patrick; Schlagenhauf, Patricia; Adamcova, Miriam; Tatt, Iain; Tomianovic, Danitza; Schnetzler, Gabriel

2014-01-01

Chemoprophylaxis against falciparum malaria is recommended for travellers from non-endemic countries to malarious destinations, but debate continues on benefit, especially with regard to mefloquine. Quantification of benefit for travellers from the United Kingdom (UK) was modelled to assist clinical and public health decision making. The model was constructed utilising: World Tourism Organization data showing total number of arrivals from the UK in countries with moderate or high malaria risk; data from a retrospective UK Clinical Practice Research Datalink (CPRD) drug utilisation study; additional information on chemoprophylaxis, case fatality and tolerability were derived from the travel medicine literature. Chemoprophylaxis with the following agents was considered: atovaquone-proguanil (AP), chloroquine with and without proguanil (C ± P), doxycycline (Dx), mefloquine (Mq). The model was validated for the most recent year with temporally matched datasets for UK travel destinations and imported malaria (2007) against UK Health Protection Agency data on imported malaria. The median (mean) duration of chemoprophylaxis for each agent in weeks (CPRD) was: AP 3.3 (3.5), C ± P 9 (12.1), Dx 8 (10.3), Mq 9 (12.3): the maximum duration of use of all regimens was 52 weeks. The model correctly predicted falciparum malaria deaths and gave a robust estimate of total cases--model: 5 deaths from 1118 cases; UK Health Protection Agency: 5 deaths from 1153 cases. The number needed to take chemoprophylaxis (NNP) to prevent a case of malaria considered against the 'background' reported incidence in non-users of chemoprophylaxis deemed in need of chemoprophylaxis was: C ± P 272, Dx 269, Mq 260, AP 252; the NNP to prevent a UK traveller malaria death was: C ± P 62613, Dx 61923, Mq 59973, AP 58059; increasing the 'background' rate by 50% yielded NNPs of: C ± P 176, Dx 175, Mq 171, AP 168. The impact of substituting atovaquone-proguanil for all mefloquine usage resulted in a 2.3% decrease in estimated infections. The number of travellers experiencing moderate adverse events (AE) or those requiring medical attention or drug withdrawal per case prevented is as follows: C ± P 170, Mq 146, Dx 114, AP 103. The model correctly predicted the number of malaria deaths, providing a robust and reliable estimate of the number of imported malaria cases in the UK, and giving a measure of benefit derived from chemoprophylaxis use against the likely adverse events generated. Overall numbers needed to prevent a malaria infection are comparable among the four options and are sensitive to changes in the background infection rates. Only a limited impact on the number of infections can be expected if Mq is substituted by AP.

[The design of a nationwide cohort study in Germany : the pretest studies of the German National Cohort (GNC)].

PubMed

Ahrens, W; Greiser, H; Linseisen, J; Kluttig, A; Schipf, S; Schmidt, B; Günther, K

2014-11-01

The German National Cohort (GNC) is the largest population-based cohort study in Germany. Beginning in 2014, a total of 200,000 women and men aged 20-69 years will be examined in 18 study centers. The aim of the study is to investigate the etiology of chronic diseases in relation to lifestyle, genetic, socioeconomic, and environmental factors and to develop appropriate methods for early diagnosis and prevention of diseases such as cardiovascular and respiratory diseases, cancer, diabetes, neurodegenerative/psychiatric diseases, as well as musculoskeletal and infectious diseases. Pretest studies (phase 1 and 2) were conducted to select methods, instruments, and procedures for the main study, to develop standard operating procedures, and to design and test the examination program according to acceptance, expected duration, and feasibility. The pretest studies included testing of interviews, questionnaires, anthropometric measurements, several medical examinations, and the collection of biosamples. In addition, the logistic, technical, and personnel infrastructure for the main study could be established including the study centers, the central infrastructure for data management, processes to coordinate the study, and data protection and quality management concepts. The examination program for the main phase of the GNC was designed and optimized based on the results of the pretest studies. The GNC is a population-based, highly standardized and excellently phenotyped cohort that will be the basis for new strategies for risk assessment and identification, early diagnosis, and prevention of multifactorial diseases.

[Mobbing--special reference to the nursing profession].

PubMed

Milutinović, Dragana; Prokes, Bela; Gavrilov-Jerkovié, Vesna; Filipović, Danka

2009-01-01

Heinz Leymann defined this phenomenon as a hostile and unethical communication. In his definition Leymann points out that the distinction between "conflict" and "mobbing" does not focus on what is done or how it is done, but rather on the frequency and duration of whatever is done. The exposure to the strain of mobbing begins to result in psychiatrically or psychosomatically pathological conditions due to the accumulation of negative emotions. Leyman emphasizes four main factors which cause harrasment in the workplace: lack of clarity of goals in work, inadequate management, victim's social status and low moral standards in the work environment. The epidemiological data in the European Union, indicate great national differences relative to the percentage of those subjected to mobbing, with increasing exposure rates in all professions, the highest being found in education (14%) and health services. Nurses are considered a professional group at a rather high risk for trauma caused by harrasment in the workplace. "Horizontal violence" is a widely used term regarding mobbing aclions in nursing profession even though vertical violence is present both in this profession and all other health services. Horizontal violence is implied due to the traditional assumption that nurses have a subordinate role compared to doctors, which often brings them into conflict with their peers. Mobbing may be prevented by systematic primary prevention, information, education, and training in communication skills. As a result, we could expect to get a higher quality of nursing care and healthier nurses.

Culture-related service expectations: a comparative study using the Kano model.

PubMed

Hejaili, Fayez F; Assad, Lina; Shaheen, Faissal A; Moussa, Dujana H; Karkar, Ayman; AlRukhaimi, Mona; Barhamein, Majdah; Al Suwida, Abdulkareem; Al Alhejaili, Faris F; Al Harbi, Ali S; Al Homrany, Mohamed; Attar, Bisher; Al-Sayyari, Abdulla A

2009-01-01

To compare service expectations between Arab and Austrian patients. We used a Kano model-based questionnaire with 20 service attributes of relevance to the dialysis patient. We analyzed 530, 172, 60, and 68 responses from Saudi, Austrian, Syrian, and UAE patients, respectively. We compared the customer satisfaction coefficient and the frequencies of response categories ("must be," "attractive," "one-dimensional," and "indifferent") for each of the 20 service attributes and in each of the 3 national groups of patients. We also investigated whether any differences seen were related to sex, age, literacy rate, or duration on dialysis. We observed higher satisfaction coefficients and "one-directional" responses among Arab patients and higher dissatisfaction coefficients and "must be" and "attractive" responses among Austrian patients. These were not related to age or duration on dialysis but were related to literacy rate. We speculate that these discrepancies between Austrian and Arab patients might be related to underdeveloped sophistication in market competitive forces and to cultural influences.

Long gamma-ray bursts and core-collapse supernovae have different environments.

PubMed

Fruchter, A S; Levan, A J; Strolger, L; Vreeswijk, P M; Thorsett, S E; Bersier, D; Burud, I; Castro Cerón, J M; Castro-Tirado, A J; Conselice, C; Dahlen, T; Ferguson, H C; Fynbo, J P U; Garnavich, P M; Gibbons, R A; Gorosabel, J; Gull, T R; Hjorth, J; Holland, S T; Kouveliotou, C; Levay, Z; Livio, M; Metzger, M R; Nugent, P E; Petro, L; Pian, E; Rhoads, J E; Riess, A G; Sahu, K C; Smette, A; Tanvir, N R; Wijers, R A M J; Woosley, S E

2006-05-25

When massive stars exhaust their fuel, they collapse and often produce the extraordinarily bright explosions known as core-collapse supernovae. On occasion, this stellar collapse also powers an even more brilliant relativistic explosion known as a long-duration gamma-ray burst. One would then expect that these long gamma-ray bursts and core-collapse supernovae should be found in similar galactic environments. Here we show that this expectation is wrong. We find that the gamma-ray bursts are far more concentrated in the very brightest regions of their host galaxies than are the core-collapse supernovae. Furthermore, the host galaxies of the long gamma-ray bursts are significantly fainter and more irregular than the hosts of the core-collapse supernovae. Together these results suggest that long-duration gamma-ray bursts are associated with the most extremely massive stars and may be restricted to galaxies of limited chemical evolution. Our results directly imply that long gamma-ray bursts are relatively rare in galaxies such as our own Milky Way.

Is Matching Innate?

PubMed Central

Gallistel, C.R; King, Adam Philip; Gottlieb, Daniel; Balci, Fuat; Papachristos, Efstathios B; Szalecki, Matthew; Carbone, Kimberly S

2007-01-01

Experimentally naive mice matched the proportions of their temporal investments (visit durations) in two feeding hoppers to the proportions of the food income (pellets per unit session time) derived from them in three experiments that varied the coupling between the behavioral investment and food income, from no coupling to strict coupling. Matching was observed from the outset; it did not improve with training. When the numbers of pellets received were proportional to time invested, investment was unstable, swinging abruptly from sustained, almost complete investment in one hopper, to sustained, almost complete investment in the other—in the absence of appropriate local fluctuations in returns (pellets obtained per time invested). The abruptness of the swings strongly constrains possible models. We suggest that matching reflects an innate (unconditioned) program that matches the ratio of expected visit durations to the ratio between the current estimates of expected incomes. A model that processes the income stream looking for changes in the income and generates discontinuous income estimates when a change is detected is shown to account for salient features of the data. PMID:17465311

Is matching innate?

PubMed

Gallistel, C R; King, Adam Philip; Gottlieb, Daniel; Balci, Fuat; Papachristos, Efstathios B; Szalecki, Matthew; Carbone, Kimberly S

2007-03-01

Experimentally naive mice matched the proportions of their temporal investments (visit durations) in two feeding hoppers to the proportions of the food income (pellets per unit session time) derived from them in three experiments that varied the coupling between the behavioral investment and food income, from no coupling to strict coupling. Matching was observed from the outset; it did not improve with training. When the numbers of pellets received were proportional to time invested, investment was unstable, swinging abruptly from sustained, almost complete investment in one hopper, to sustained, almost complete investment in the other-in the absence of appropriate local fluctuations in returns (pellets obtained per time invested). The abruptness of the swings strongly constrains possible models. We suggest that matching reflects an innate (unconditioned) program that matches the ratio of expected visit durations to the ratio between the current estimates of expected incomes. A model that processes the income stream looking for changes in the income and generates discontinuous income estimates when a change is detected is shown to account for salient features of the data.

The perils of the imperfect expectation of the perfect baby.

PubMed

Chervenak, Frank A; McCullough, Laurence B; Brent, Robert L

2010-08-01

Advances in modern medicine invite the assumption that medicine can control human biology. There is a perilous logic that leads from expectations of medicine's control over reproductive biology to the expectation of having a perfect baby. This article proposes that obstetricians should take a preventive ethics approach to the care of pregnant women with expectations for a perfect baby. We use Nathaniel Hawthorne's classic short story, "The Birthmark," to illustrate the perils of the logic of control and perfection through science and then identify possible contemporary sources of the expectation of the perfect baby. We propose that the informed consent process should be used as a preventive ethics tool throughout the course of pregnancy to educate pregnant women about the inherent errors of human reproduction, the highly variable clinical outcomes of these errors, the limited capacity of medicine to detect these errors, and the even more limited capacity to correct them. Copyright (c) 2010 Mosby, Inc. All rights reserved.

Overtreatment in couples with unexplained infertility.

PubMed

Kersten, F A M; Hermens, R P G M; Braat, D D M; Hoek, A; Mol, B W J; Goddijn, M; Nelen, W L D M

2015-01-01

What is the percentage of overtreatment, i.e. fertility treatment started too early, in couples with unexplained infertility who were eligible for tailored expectant management? Overtreatment occurred in 36% of couples with unexplained infertility who were eligible for an expectant management of at least 6 months. Prognostic models in reproductive medicine can help to identify infertile couples that would benefit from fertility treatment. In couples with unexplained infertility with a good chance of natural conception within 1 year, based on the Hunault prediction model, an expectant management of 6-12 months, as recommended in international fertility guidelines, prevents unnecessary treatment. A retrospective cohort study in 25 participating clinics, with follow-up of all couples who were seen for infertility in 2011-2012. In all, 9818 couples were seen for infertility in the participating clinics. Couples were eligible to participate if they were diagnosed with unexplained infertility and had a good prognosis of natural conception (>30%) within 1 year based on the Hunault prediction model. Data to assess overtreatment were collected from medical records. Multilevel regression analyses were performed to investigate associations of overtreatment with patient and clinic characteristics. Five hundred and forty-four couples eligible for expectant management were included in this study. Among these, overtreatment, i.e. starting medically assisted reproduction within 6 months, occurred in 36%. The underlying quality indicators showed that in 34% no prognosis was calculated and that in 42% expectant management was not recommended. Finally, 16% of the couples for whom a correct recommendation of expectant management for at least 6 months was made, started treatment within 6 months anyway. Overtreatment was associated with childlessness, higher female age and a longer duration of infertility. No associations between overtreatment and clinic characteristics were found. The response rate was low compared with other fertility studies. Evaluation of possible selection bias showed that responders had a higher socio-economic status than non-responders. Our findings show that developing and publishing guideline recommendations on tailored expectant management (TEM) is not enough and that overtreatment still occurs frequently. Future research should focus on tailored efforts to implement guideline recommendations on TEM. Supported by Netherlands Organisation for Health Research and Development (ZonMW). ZonMW had no role in designing the study, data collection, analysis and interpretation of data or writing of the report. Competing interests: none. www.trialregister.nl NTR3405. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Probiotics: Prevention of Severe Pneumonia and Endotracheal Colonization Trial (PROSPECT): A Feasibility Clinical Trial

ClinicalTrials.gov

2018-03-23

Ventilator Associated Pneumonia (VAP); Other Infections; Antibiotic-Associated Diarrhea; C-Difficile; Duration of Mechanical Ventilation; Length of ICU Stay; Length of Hospital Stay; ICU and Hospital Mortality

Does acute tobacco smoking prevent cue-induced craving?

PubMed

Schlagintweit, Hera E; Barrett, Sean P

2016-05-01

Smoking cessation aids appear to be limited in their ability to prevent craving triggered by exposure to smoking-associated stimuli; however, the extent to which cue-induced cravings persist following denicotinized or nicotine-containing tobacco smoking is not known. Thirty (17 male) ⩾12-hour abstinent dependent smokers completed two sessions during which they smoked a nicotine-containing or denicotinized cigarette. Instructions regarding the nicotine content of the cigarette varied across sessions, and all participants were exposed to a neutral cue followed by a smoking cue after cigarette consumption. Craving was assessed before and after cigarette consumption and cue exposure. Reduced intentions to smoke were associated with both nicotine expectancy (p<0.05) and nicotine administration (p<0.01), while reduced withdrawal-related craving was uniquely associated with nicotine administration (p<0.05). Smoking-associated stimuli increased craving regardless of nicotine expectancy or administration (p-values<0.001). While both nicotine pharmacology and expectancy appear to contribute to craving reduction associated with acute tobacco smoking, neither smoking-related nicotine administration nor expectation prevents increases in craving following exposure to smoking-associated stimuli. These findings suggest that cue-induced craving may be resistant to various pharmacological and psychological interventions. © The Author(s) 2016.

Workshop on Exercise Prescription for Long-Duration Space Flight

NASA Technical Reports Server (NTRS)

Harris, Bernard A., Jr. (Editor); Stewart, Donald F. (Editor)

1989-01-01

The National Aeronautics and Space Administration has a dedicated history of ensuring human safety and productivity in flight. Working and living in space long term represents the challenge of the future. Our concern is in determining the effects on the human body of living in space. Space flight provides a powerful stimulus for adaptation, such as cardiovascular and musculoskeletal deconditioning. Extended-duration space flight will influence a great many systems in the human body. We must understand the process by which this adaptation occurs. The NASA is agressively involved in developing programs which will act as a foundation for this new field of space medicine. The hallmark of these programs deals with prevention of deconditioning, currently referred to as countermeasures to zero g. Exercise appears to be most effective in preventing the cardiovascular and musculoskeletal degradation of microgravity.

Effect of HMB/Arg/Gln on the prevention of radiation dermatitis in head and neck cancer patients treated with concurrent chemoradiotherapy.

PubMed

Imai, Takayuki; Matsuura, Kazuto; Asada, Yukinori; Sagai, Shun; Katagiri, Katsunori; Ishida, Eiichi; Saito, Daisuke; Sadayasu, Rei; Wada, Hitoshi; Saijo, Shigeru

2014-05-01

This prospective randomized Phase II study was designed to evaluate the preventive effect of an oral nutrition supplement composed of beta-hydroxy-beta-methylbutyrate, arginine and glutamine (beta-hydroxy-beta-methylbutyrate/arginine/glutamine) on radiation dermatitis in head and neck cancer patients. Forty patients with histologically proven head and neck cancer, treated with concurrent chemoradiotherapy involving cisplatin were recruited. They were randomly assigned to the beta-hydroxy-beta-methylbutyrate/arginine/glutamine supplement treatment group (Group A) or the control group that received no supplement (Group B). The primary endpoint of this study was the percentage of patients developing ≥Grade 3 dermatitis. The secondary endpoints were the percentage of patients developing ≥Grade 2 dermatitis, and the duration of each grade of dermatitis relative to the observation period. The incidence of ≥Grade 3 dermatitis did not differ between the two groups. However, as secondary endpoints of this study, the incidence of ≥Grade 2 dermatitis was lower in Group A than B (62.6 vs. 94.4%; P < 0.05), and the duration of ≥Grade 1 dermatitis was shorter in Group A than B (44.8 vs. 56.7%; P < 0.01), as was the duration of ≥Grade 2 dermatitis (16.5 vs. 26.5%; P < 0.05). Our study indicated that beta-hydroxy-beta-methylbutyrate/arginine/glutamine supplementation was potentially effective in the prevention of radiation dermatitis in head and neck cancer patients.

Inhibition of potassium currents is involved in antiarrhythmic effect of moderate ethanol on atrial fibrillation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang, Baode; Li, Chenxing

Excessive consumption of alcohol is a well-established risk factor of atrial fibrillation (AF). However, the effects of moderate alcohol drinking remain to be elucidated. This study was designed to determine the effects of moderate ethanol ingestion on atrial fibrillation and the electrophysiological mechanisms. In acetylcholine-induced canine and mouse AF models, the moderate ethanol prevented the generation and persistence of AF through prolonging the latent period of AF and shortening the duration of AF. The action potential duration (APD) was remarkably prolonged under the concentration range of 12.5–50.0 mM ethanol in guinea pig atrial myocytes. Ultra-rapid delayed rectified potassium currents (I{submore » Kv1.5}) were markedly inhibited by 12.5–50.0 mM ethanol in a concentration-dependent manner. Ethanol with 50.0 mM could inhibit rapid delayed rectifier potassium currents (I{sub hERG}). Ethanol under 6.25–50.0 mM did not affect on inward rectifier potassium currents (I{sub Kir2.1}). Collectively, the present study provided an evidence that moderate ethanol intake can prolong the APD of atrial myocytes by inhibition of I{sub Kv1.5} and I{sub hERG}, which contributed to preventing the development and duration of AF. - Highlights: • Moderate ethanol prevented the development of AF in animal models. • Moderate ethanol prolonged APD in guinea pig atrial myocytes. • Moderate ethanol inhibited Kv1.5 currents.« less

76 FR 31613 - NIOSH Fire Fighter Fatality Investigation and Prevention Program (FFFIPP)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-01

... NIOSH-063B] NIOSH Fire Fighter Fatality Investigation and Prevention Program (FFFIPP) AGENCY: The... Fire Fighter Fatality Investigation and Prevention Program (FFFIPP). NIOSH is seeking stakeholder input on the FFFIPP to ensure that the program is meeting the needs and expectations of the U.S. fire...

Securitisation, Counterterrorism and the Silencing of Dissent: The Educational Implications of "Prevent"

ERIC Educational Resources Information Center

O'Donnell, Aislinn

2016-01-01

This paper outlines some of the implications of counterterrorist legislation, including Prevent, for the pedagogical relationship and for educational institutions. The concept of "radicalisation", central to the Prevent Strategy, is one that is contested in the field of counterterrorism, yet educators are now expected to identify and…

Duration of breast-feeding and cardiovascular risk factors among Iranian children and adolescents: the CASPIAN III study.

PubMed

Izadi, Vajihe; Kelishadi, Roya; Qorbani, Mostafa; Esmaeilmotlagh, Mohammad; Taslimi, Mahnaz; Heshmat, Ramin; Ardalan, Gelayol; Azadbakht, Leila

2013-05-01

Studies examining the relationship between breast-feeding (BF) duration and cardiovascular disease (CVD) risk factors have reached contradictory results. This study aims to investigate the relationship between BF duration and CVD risk factors in adolescents. This national population-based study was conducted among 5258 Iranian students, ages 10 to 18 y living in central cities of 27 provinces of Iran. Association was examined between duration of BF and adolescent blood pressure, overweight, obesity, and fasting blood glucose and lipid profiles. Analyses were adjusted for potential confounders. Low birth weight was less frequent in the longer than in the shorter BF duration categories (P < 0.0001). Number of children was lower in individuals with longer BF duration (P = 0.01). Individuals with longer BF duration used more homemade food than those with shorter BF duration (P < 0.0001). Means of total cholesterol and systolic blood pressure were lower in participants with the longest BF period compared with those with the shortest BF duration; this difference was marginally significant (P = 0.06). No significant association was found between BF duration and CVD risk factors in logistic regression after adjustment for potential confounders. Although the long-term benefits of BF on preventing CVDs are well documented, controversies exist as to the association of BF duration with such beneficial effects. In this study, there was no substantial evidence that longer BF duration was protective against CVD risk factors among adolescents. More prospective studies are recommended to clarify this association. Copyright © 2013 Elsevier Inc. All rights reserved.

Assessment of the age for a preventive ultrasonographic examination of the prostate in the dog.

PubMed

Mantziaras, G; Alonge, S; Faustini, M; Luvoni, G C

2017-09-15

The prostate commonly develops benign prostatic hyperplasia (BPH) in dogs over 5 years, while in aged dogs other pathological findings might be revealed by ultrasonographic exam. The aim of the present study was to estimate the most suitable age for a preventive ultrasonographic examination of the prostate in the dog. The prostate of 1003 intact male dogs of 64 different breeds, of different ages (1-18 years) and bodyweights (2-55 kg) was evaluated with ultrasound, irrespective of the reason for clinical examination. The age of each dog was expressed as the ratio between the actual age and the maximum longevity expected for the breed. Dogs were divided in two groups based on breeds' life expectancy as short life (SL) and long life (LL). The size of the prostate (normal, enlarged or small) and the presence of abnormal sonographic findings were recorded for each dog. The results of the present study indicate that the most suitable age for a preventive ultrasonographic exam of the prostate in the dog is approximately at 40% of its expected longevity, both in short and long life breeds, because at this age there is a strong possibility to be able to detect abnormal prostatic findings. In 47.5% of the dogs at least one abnormal finding of the prostate was revealed by ultrasonographic exam, while dogs with long life expectancy showed a significantly higher prevalence of abnormalities, than dogs with short life expectancy. The most frequent findings were the increase of prostatic size (33.5%) and the presence of at least one cyst (33.6%), with no difference between SL and LL dogs. In conclusion, a preventive examination of the prostate starting at 40% of expected longevity in dogs of short and long life breeds is strongly recommended for early detection of abnormalities, for scheduling specific follow up and for suggesting effective therapeutic protocols. Copyright © 2017 Elsevier Inc. All rights reserved.

Models for patients' recruitment in clinical trials and sensitivity analysis.

PubMed

Mijoule, Guillaume; Savy, Stéphanie; Savy, Nicolas

2012-07-20

Taking a decision on the feasibility and estimating the duration of patients' recruitment in a clinical trial are very important but very hard questions to answer, mainly because of the huge variability of the system. The more elaborated works on this topic are those of Anisimov and co-authors, where they investigate modelling of the enrolment period by using Gamma-Poisson processes, which allows to develop statistical tools that can help the manager of the clinical trial to answer these questions and thus help him to plan the trial. The main idea is to consider an ongoing study at an intermediate time, denoted t(1). Data collected on [0,t(1)] allow to calibrate the parameters of the model, which are then used to make predictions on what will happen after t(1). This method allows us to estimate the probability of ending the trial on time and give possible corrective actions to the trial manager especially regarding how many centres have to be open to finish on time. In this paper, we investigate a Pareto-Poisson model, which we compare with the Gamma-Poisson one. We will discuss the accuracy of the estimation of the parameters and compare the models on a set of real case data. We make the comparison on various criteria : the expected recruitment duration, the quality of fitting to the data and its sensitivity to parameter errors. We discuss the influence of the centres opening dates on the estimation of the duration. This is a very important question to deal with in the setting of our data set. In fact, these dates are not known. For this discussion, we consider a uniformly distributed approach. Finally, we study the sensitivity of the expected duration of the trial with respect to the parameters of the model : we calculate to what extent an error on the estimation of the parameters generates an error in the prediction of the duration.

Examining Hurricane Track Length and Stage Duration Since 1980

NASA Astrophysics Data System (ADS)

Fandrich, K. M.; Pennington, D.

2017-12-01

Each year, tropical systems impact thousands of people worldwide. Current research shows a correlation between the intensity and frequency of hurricanes and the changing climate. However, little is known about other prominent hurricane features. This includes information about hurricane track length (the total distance traveled from tropical depression through a hurricane's final category assignment) and how this distance may have changed with time. Also unknown is the typical duration of a hurricane stage, such as tropical storm to category one, and if the time spent in each stage has changed in recent decades. This research aims to examine changes in hurricane stage duration and track lengths for the 319 storms in NOAA's National Ocean Service Hurricane Reanalysis dataset that reached Category 2 - 5 from 1980 - 2015. Based on evident ocean warming, it is hypothesized that a general increase in track length with time will be detected, thus modern hurricanes are traveling a longer distance than past hurricanes. It is also expected that stage durations are decreasing with time so that hurricanes mature faster than in past decades. For each storm, coordinates are acquired at 4-times daily intervals throughout its duration and track lengths are computed for each 6-hour period. Total track lengths are then computed and storms are analyzed graphically and statistically by category for temporal track length changes. The stage durations of each storm are calculated as the time difference between two consecutive stages. Results indicate that average track lengths for Cat 2 and 3 hurricanes are increasing through time. These findings show that these hurricanes are traveling a longer distance than earlier Cat 2 and 3 hurricanes. In contrast, average track lengths for Cat 4 and 5 hurricanes are decreasing through time, showing less distance traveled than earlier decades. Stage durations for all Cat 2, 4 and 5 storms decrease through the decades but Cat 3 storms show a positive increase though time. This compliments the results of the track length analysis indicating that as storms intensify faster, they are doing so over a shorter distance. It is expected that this research could be used to improve hurricane track forecasting and provide information about the effects of climate change on tropical systems and the tropical environment.

10 CFR 745.116 - General requirements for informed consent.

Code of Federal Regulations, 2014 CFR

2014-01-01

... a subject in research covered by this policy unless the investigator has obtained the legally... release the investigator, the sponsor, the institution or its agents from liability for negligence. (a... the study involves research, an explanation of the purposes of the research and the expected duration...

Drought Resilience and Water Conservation - Agency-Wide Actions and Research

EPA Science Inventory

In many areas of the United States, the frequency and duration of drought events are increasing. This pattern is expected to continue and to shift outside of historical trends, making forecasting our water quality and supply more difficult. EPA is conducting research and working ...

Development of a Traffic Management Decision Support Tool for Freeway Incident Traffic Management (FITM) Plan Deployment : Research Summary

DOT National Transportation Integrated Search

2017-12-01

In designing an effective traffic management plan for non-recurrent congestion, it is critical for responsible highway agencies to have some vital information, such as estimated incident duration, resulting traffic queues, and the expected delays. Ov...

20 CFR 617.32 - Eligibility.

Code of Federal Regulations, 2010 CFR

2010-04-01

... employment in the commuting area, and has a reasonable expectation of obtaining suitable employment of long-term duration outside the commuting area and in the area where the job search will be conducted. For...) Verification of employer contacts. The State agency shall verify contacts with employers certified by the...

78 FR 28276 - Operating Limitations at John F. Kennedy International Airport

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-14

... Limitations at John F. Kennedy International Airport AGENCY: Federal Aviation Administration (FAA), DOT... duration of the Order. The reasons for issuing the Order have not changed appreciably since it was implemented. Without the operational limitations imposed by this Order, the FAA expects severe congestion...

78 FR 28280 - Operating Limitations at Newark Liberty International Airport

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-14

... Limitations at Newark Liberty International Airport AGENCY: Federal Aviation Administration (FAA), DOT. ACTION... duration of the Order. The reasons for issuing the Order have not changed appreciably since it was implemented. Without the operational limitations imposed by this Order, the FAA expects severe congestion...

International Space Station as Analog of Interplanetary Transit Vehicle For Biomedical Research

NASA Technical Reports Server (NTRS)

Charles, John B.

2012-01-01

Astronaut missions lasting up to six months aboard the International Space Station (ISS) have much in common with interplanetary flights, especially the outbound, Earth-to-Mars transit portion of a Mars mission. Utilization of ISS and other appropriate platforms to prepare for crewed expeditions to planetary destinations including Mars has been the work of NASA's Human Research Program (HRP) since 2005. HRP is charged specifically to understand and reduced the risks to astronaut health and performance in space exploration missions: everything HRP does and has done is directly related to that responsibility. Two major categories of human research have capitalized on ISS capabilities. The first category centers on the biomedical aspects of long-duration exposure to spaceflight factors, including prolonged weightlessness, radiation exposure, isolation and confinement, and actual risk to life and limb. These studies contribute to astronaut safety, health and efficiency on any long-duration missions, whether in low Earth orbit (LEO) or beyond. Qualitatively, weightlessness is weightlessness, whether in LEO or en route to Mars. The HRP sponsors investigations into losses in muscle and bone integrity, cardiovascular function, sensory-motor capability, immune capacity and psychosocial health, and development and demonstration of appropriate treatments and preventative measures. The second category includes studies that are focused on planetary expeditions beyond LEO. For these, ISS offers a high fidelity analog to investigate the combined effects of spaceflight factors (described above) plus the isolation and autonomy associated with simulated increasing distance from Earth. Investigations address crew cohesion, performance and workload, and mission control performance. The behavioral health and performance and space human factors aspects of planetary missions dominate this category. Work has already begun on a new investigation in this category which will examine the effects of a simulated lag in communications (mimicking that expected in transit to Mars) on astronaut performance aboard ISS. Extension of the current ISS increment duration from six months to nine or even twelve months would provide opportunities for expanded research relevant to long duration missions, albeit at the cost of fewer astronauts as subjects for those investigations. Given the possible limited access to ISS after 2020, if ISS is intended to facilitate future exploration missions, then the in-flight human investigations should focus on those that clearly enable future exploration missions.

When theory and biology differ: The relationship between reward prediction errors and expectancy.

PubMed

Williams, Chad C; Hassall, Cameron D; Trska, Robert; Holroyd, Clay B; Krigolson, Olave E

2017-10-01

Comparisons between expectations and outcomes are critical for learning. Termed prediction errors, the violations of expectancy that occur when outcomes differ from expectations are used to modify value and shape behaviour. In the present study, we examined how a wide range of expectancy violations impacted neural signals associated with feedback processing. Participants performed a time estimation task in which they had to guess the duration of one second while their electroencephalogram was recorded. In a key manipulation, we varied task difficulty across the experiment to create a range of different feedback expectancies - reward feedback was either very expected, expected, 50/50, unexpected, or very unexpected. As predicted, the amplitude of the reward positivity, a component of the human event-related brain potential associated with feedback processing, scaled inversely with expectancy (e.g., unexpected feedback yielded a larger reward positivity than expected feedback). Interestingly, the scaling of the reward positivity to outcome expectancy was not linear as would be predicted by some theoretical models. Specifically, we found that the amplitude of the reward positivity was about equivalent for very expected and expected feedback, and for very unexpected and unexpected feedback. As such, our results demonstrate a sigmoidal relationship between reward expectancy and the amplitude of the reward positivity, with interesting implications for theories of reinforcement learning. Copyright © 2017 Elsevier B.V. All rights reserved.

Modelling the impact of causal and non-causal factors on disruption duration for Toronto's subway system: An exploratory investigation using hazard modelling.

PubMed

Louie, Jacob; Shalaby, Amer; Habib, Khandker Nurul

2017-01-01

Most investigations of incident-related delay duration in the transportation context are restricted to highway traffic, with little attention given to delays due to transit service disruptions. Studies of transit-based delay duration are also considerably less comprehensive than their highway counterparts with respect to examining the effects of non-causal variables on the delay duration. However, delays due to incidents in public transit service can have serious consequences on the overall urban transportation system due to the pivotal and vital role of public transit. The ability to predict the durations of various types of transit system incidents is indispensable for better management and mitigation of service disruptions. This paper presents a detailed investigation on incident delay durations in Toronto's subway system over the year 2013, focusing on the effects of the incidents' location and time, the train-type involved, and the non-adherence to proper recovery procedures. Accelerated Failure Time (AFT) hazard models are estimated to investigate the relationship between these factors and the resulting delay duration. The empirical investigation reveals that incident types that impact both safety and operations simultaneously generally have longer expected delays than incident types that impact either safety or operations alone. Incidents at interchange stations are cleared faster than incidents at non-interchange stations. Incidents during peak periods have nearly the same delay durations as off-peak incidents. The estimated models are believed to be useful tools in predicting the relative magnitude of incident delay duration for better management of subway operations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Preventing dementia by promoting physical activity and the long-term impact on health and social care expenditures.

PubMed

Baal, Pieter H M van; Hoogendoorn, Martine; Fischer, Alastair

2016-04-01

Preventing dementia has been proposed to increase population health as well as reduce the demand for health and social care. Our aim was to evaluate whether preventing dementia by promoting physical activity (PA) a) improves population health or b) reduces expenditure for both health and social care if one takes into account the additional demand in health and social care caused by increased life expectancy. A simulation model was developed that models the relation between PA, dementia, mortality, and the use of health care and social care in England. With this model, scenarios were evaluated in which different assumptions were made about the increase in PA level in (part of) the population. Lifetime spending on health and social care related to dementia was highest for the physically inactive (£28,100/£28,900 for 40-year-old males/females), but spending on other diseases was highest for those that meet PA recommendations (£55,200/£43,300 for 40-year-old males/females) due to their longer life expectancies. If the English population aged 40-65 were to increase their PA by one level, life expectancy would increase by 0.23years and health and social care expenditures would decrease by £400 per person. Preventing dementia by increasing PA increases life expectancy and can result in decreased spending overall on health and social care, even after additional spending during life years gained has been taken into account. If prevention is targeted at the physically inactive, savings in dementia-related costs outweigh the additional spending in life years gained. Copyright © 2016 Elsevier Inc. All rights reserved.

Comparison and validation of statistical methods for predicting power outage durations in the event of hurricanes.

PubMed

Nateghi, Roshanak; Guikema, Seth D; Quiring, Steven M

2011-12-01

This article compares statistical methods for modeling power outage durations during hurricanes and examines the predictive accuracy of these methods. Being able to make accurate predictions of power outage durations is valuable because the information can be used by utility companies to plan their restoration efforts more efficiently. This information can also help inform customers and public agencies of the expected outage times, enabling better collective response planning, and coordination of restoration efforts for other critical infrastructures that depend on electricity. In the long run, outage duration estimates for future storm scenarios may help utilities and public agencies better allocate risk management resources to balance the disruption from hurricanes with the cost of hardening power systems. We compare the out-of-sample predictive accuracy of five distinct statistical models for estimating power outage duration times caused by Hurricane Ivan in 2004. The methods compared include both regression models (accelerated failure time (AFT) and Cox proportional hazard models (Cox PH)) and data mining techniques (regression trees, Bayesian additive regression trees (BART), and multivariate additive regression splines). We then validate our models against two other hurricanes. Our results indicate that BART yields the best prediction accuracy and that it is possible to predict outage durations with reasonable accuracy. © 2011 Society for Risk Analysis.

Sleep Duration and Insomnia Symptoms as Risk Factors for Suicidal Ideation in a Nationally Representative Sample

PubMed Central

Chakravorty, Subhajit; Siu, H.Y. Katy; Lalley-Chareczko, Linden; Brown, Gregory K.; Findley, James C.; Perlis, Michael L.; Grandner, Michael A.

2015-01-01

Objective: Suicidal behavior (suicidal ideation, suicide attempts, and suicide completion) has been increasingly linked with difficulty initiating sleep, maintaining sleep, and early morning awakenings. However, the relationship between suicidal behavior and sleep duration abnormalities is unclear, especially at the population level. The present study used a nationally representative sample to examine the association of suicidal ideation with extreme sleep durations and insomnia symptoms. Method: Cross-sectional data from adult respondents (≥ 18 years of age, N = 6,228) were extracted from the 2007–2008 wave of the National Health and Nutritional Examination Survey. Ordinal logistic regression analyses were used to evaluate the relationship of suicidal ideation with sleep duration, global insomnia, and individual insomnia symptoms in models adjusted for sociodemographic, socioeconomic, and health-related covariates. Results: Suicidal ideation was associated with abnormalities of sleep duration. This relationship ceased to exist once the model was adjusted for depressive symptoms. As expected, an increased level of suicidal ideation was consistently associated with insomnia. Of the insomnia symptoms, difficulty maintaining sleep was found to be the most predictive of suicidal ideation, followed by difficulty initiating sleep (P< .05). Conclusions: Abnormalities of sleep duration and continuity should prompt a clinical assessment for suicide risk. PMID:27057399

Rescaling of temporal expectations during extinction

PubMed Central

Drew, Michael R.; Walsh, Carolyn; Balsam, Peter D

2016-01-01

Previous research suggests that extinction learning is temporally specific. Changing the CS duration between training and extinction can facilitate the loss of the CR within the extinction session but impairs long-term retention of extinction. In two experiments using conditioned magazine approach with rats, we examined the relation between temporal specificity of extinction and CR timing. In Experiment 1 rats were trained on a 12-s, fixed CS-US interval and then extinguished with CS presentations that were 6, 12, or 24 s in duration. The design of Experiment 2 was the same except rats were trained using partial rather than continuous reinforcement. In both experiments, extending the CS duration in extinction facilitated the diminution of CRs during the extinction session, but shortening the CS duration failed to slow extinction. In addition, extending (but not shortening) the CS duration caused temporal rescaling of the CR, in that the peak CR rate migrated later into the trial over the course of extinction training. This migration partially accounted for the faster loss of the CR when the CS duration was extended. Results are incompatible with the hypothesis that extinction is driven by cumulative CS exposure and suggest that temporally extended nonreinforced CS exposure reduces conditioned responding via temporal displacement rather than through extinction per se. PMID:28045291

Probiotics and prebiotics in prevention and treatment of diseases in infants and children.

PubMed

Vandenplas, Yvan; Veereman-Wauters, Genevieve; De Greef, Elisabeth; Peeters, Stefaan; Casteels, Ann; Mahler, Tania; Devreker, Thierry; Hauser, Bruno

2011-01-01

To evaluate the impact of probiotics and prebiotics on the health of children. MEDLINE and LILACS were searched for relevant English and French-language articles. Human milk is rich in prebiotic oligosaccharides and may contain some probiotics. No data suggest that addition of probiotics to infant formula may be harmful, but evidence of its efficacy is insufficient for its recommendation. Since data suggest that addition of specific prebiotic oligosaccharides may reduce infections and atopy in healthy infants, their addition to infant formula seems reasonable. Long-term health benefits of pro- and prebiotics on the developing immune system remain to be proven. Selected probiotics reduce the duration of infectious diarrhea by 1 day, but evidence in prevention is lacking, except in antibiotic-associated diarrhea. Some specific probiotics prevent necrotizing enterocolitis, and other microorganisms may be beneficial in Helicobacter pylori gastritis and in infantile colic. Evidence is insufficient to recommend probiotics in prevention and treatment of atopic dermatitis. The use of probiotics in constipation, irritable bowel syndrome, inflammatory bowel disease, and extra-intestinal infections requires more studies. Duration of administration, microbial dosage, and species used need further validation for both pro- and prebiotics. Unjustified health claims are a major threat for the pro- and prebiotic concept.

Medical effects of iodine disinfection products in spacecraft water

NASA Technical Reports Server (NTRS)

Sauer, Richard L.; Janik, Daniel S.; Thorstenson, Yvonne R.

1987-01-01

Various iodination products (IDPs), including iodinated and iodine-induced new compounds, will be present in the iodine-disinfected water that is expected to be used by crews on the NASA Space Station and on long duration missions. The metabolic intermediaries created by such a process may be more important to crew health than the parent IDPs, and reclamation and recycling may be expected to produce additional products. These medical effects may be expressed in crews as hypersensitivity, allergic, acute toxic, and chronic toxic reactions, as well as modifications of immune system response.

Prevention and treatment of hand oedema after stroke.

PubMed

Kuppens, Stefanie P M; Pijlman, Hanneke C P; Hitters, Minou W M G C; van Heugten, Caroline M

2014-01-01

As there is no evidence for a specific treatment for post-stroke-induced hand oedema, rehabilitation centre Blixembosch formalized a best practice protocol. We investigated whether the Blixembosch hand oedema protocol is usable in daily practice and leads to lower incidence (prevention) and shorter duration (treatment) compared with care as usual. In a non-randomised comparative trial, we investigated 206 post-stroke patients admitted to two Dutch rehabilitation centres. Hand volumes were measured at least bi-weekly using a volumeter. Treatment was started according the protocol (Blixembosch) or following care as usual (Leijpark). Usability was assessed with a survey among professionals. In the Blixembosch group, 16% developed oedema after admission, compared with 21% in the control group (p = 0.019). Average duration of oedema (both developed before and after admission) was 6.5 weeks in the Blixembosch group compared with 3.1 weeks in the control group (p = 0.000). Professionals were positive about the protocol. The study showed that the protocol is usable in daily practice and has a small beneficial effect on hand oedema incidence rates compared with care as usual. The negative effect on duration of hand oedema could also be caused by the difference in prognosis between the two groups.

[Effectiveness of palifermin in the prevention of oral mucositis in patients with haematological cancers].

PubMed

Ayago Flores, D; Ferriols Lisart, R

2010-01-01

To assess the effectiveness of palifermin for the prevention of oral mucositis in patients with haematological cancers. Retrospective observational study of cohorts of patients with haematological cancer undergoing cytotoxic therapy causing hematopoietic ablation. The main variable assessed was the duration of the oral mucositis. Secondary variables assessed were incidence of mucositis, febrile or septic neutropenia and the administration of opioids and parenteral nutrition. We included 36 patients in this study, 11 in the group that received palifermin and 25 in the control group. The duration of oral mucositis was 4.6+/-3.1 days (median: 5 days) in the patients treated with palifermin in comparison with 7.4+/-4.0 days (median: 6 days) in patients treated with conventional prophylactic therapy (p<0.05). However, no significant differences were seen in the incidence of mucositis, febrile or septic neutropenia, opioid administration of the use of parenteral nutrition. Prophylactic treatment with palifermin reduces the duration of oral mucosities in patients with haematological cancer. Further studies are necessary with larger samples to be able to assess palifermin and its influence on other variables, such as incidence of mucositis, sepsis, febrile neutropenia, etc. Copyright © 2009 SEFH. Published by Elsevier Espana. All rights reserved.

Quasi-stiffness of the knee joint in flexion and extension during the golf swing.

PubMed

Choi, Ahnryul; Sim, Taeyong; Mun, Joung Hwan

2015-01-01

Biomechanical understanding of the knee joint during a golf swing is essential to improve performance and prevent injury. In this study, we quantified the flexion/extension angle and moment as the primary knee movement, and evaluated quasi-stiffness represented by moment-angle coupling in the knee joint. Eighteen skilled and 23 unskilled golfers participated in this study. Six infrared cameras and two force platforms were used to record a swing motion. The anatomical angle and moment were calculated from kinematic and kinetic models, and quasi-stiffness of the knee joint was determined as an instantaneous slope of moment-angle curves. The lead knee of the skilled group had decreased resistance duration compared with the unskilled group (P < 0.05), and the resistance duration of the lead knee was lower than that of the trail knee in the skilled group (P < 0.01). The lead knee of the skilled golfers had greater flexible excursion duration than the trail knee of the skilled golfers, and of both the lead and trail knees of the unskilled golfers. These results provide critical information for preventing knee injuries during a golf swing and developing rehabilitation strategies following surgery.

77 FR 56645 - Federal Acquisition Regulation; Information Collection; Accident Prevention Plans and Recordkeeping

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-13

... selecting ``Search''. Select the link ``Submit a Comment'' that corresponds with ``Information Collection... involves work of a long duration, or hazardous nature, the contracting officer shall insert the clause with...

The pharmacoeconomic benefits of cholesterol reduction.

PubMed

Gonzalez, E R

1998-02-01

Recent studies show that cholesterol-lowering therapy can reduce morbidity and mortality in hypercholesterolemic patients without preexisting coronary heart disease (primary prevention) and with coronary heart disease (secondary prevention). The high cost of treatment per event prevented, especially for primary prevention, raises concerns about widespread use of cholesterol-lowering therapy. Does cholesterol reduction reduce utilization of healthcare resources, and can society afford to pay for reducing cholesterol in all patients with hypercholesterolemia, irrespective of risk factors? Is cost-effectiveness of therapy affected by differing cholesterol levels, age of the patients, the duration of therapy, or the presence of risk factors? Current pharmacoeconomic studies support the use of the statins for secondary prevention, and primary prevention in high-risk patients, and provide key information for policy decision making in the treatment of patients with hypercholesterolemia.

Probiotics for the management of neonatal hyperbilirubinemia: a systematic review of randomized controlled trials.

PubMed

Deshmukh, Janki; Deshmukh, Mangesh; Patole, Sanjay

2017-08-31

Neonatal jaundice requiring phototherapy is associated with significant socioeconomic burden including hospital readmission, prolonged hospital stay, and separation of the baby from mother. To assess the efficacy and safety of probiotics in reducing the need for phototherapy and its duration in neonatal hyperbilirubinemia. A systematic review of randomized controlled trials (RCTs) of probiotic supplementation for prevention or treatment of jaundice in neonates (any gestation or weight) using the Cochrane methodology. Primary outcome was the duration of phototherapy. Secondary outcomes included incidence of jaundice, total serum bilirubin (TSB) level at 24, 48, 72, 96 h, and day 7, duration of hospital stay, and adverse effects (e.g. probiotic sepsis). Results were summarized as per GRADE guidelines. Nine RCTs (prophylactic: six trials, N = 1761; therapeutic: three trials, N = 279) with low to high risk of bias were included. Meta-analysis (random-effects model) showed probiotic supplementation reduced duration of phototherapy [N = 415, mean difference (MD): -11.80 (-17.47, -6.13); p < .0001; level of evidence (LOE): low]. TSB was significantly reduced at 96 h [MD: -1.74 (-2.92, -0.57); p = .004] and 7 d [MD: -1.71 (-2.25, -1.17); p < .00001; LOE: low] after probiotic treatment. Prophylactic probiotics did not reduce the incidence of jaundice significantly [N = 1582, relative risk (RR): 0.56 (0.25, 1.27); p = .16; LOE: low]. There were no probiotic-related adverse effects. Limited low-quality evidence indicates that probiotic supplementation may reduce the duration of phototherapy in neonates with jaundice. Routine use of probiotics to prevent or treat neonatal jaundice cannot be recommended. Large well-designed trials are essential to confirm these findings.

Mild Depressive Symptoms Among Americans in Relation to Physical Activity, Current Overweight/Obesity, and Self-Reported History of Overweight/Obesity.

PubMed

Dankel, Scott J; Loenneke, Jeremy P; Loprinzi, Paul D

2016-10-01

Overweight/obese individuals are at an increased risk for depression with some evidence of a bidirectional association. The preventative effects of physical activity among overweight/obese individuals have been well documented; however, less is known on how the duration of overweight/obesity alters the association with negative health outcomes. Therefore, the purpose of this investigation was to determine how the classification, and more specifically duration, of overweight/obesity alters the association between physical activity and depressive symptoms. The 2005-2006 National Health and Nutrition Examination Survey (NHANES) data were used (n = 764), and individuals were divided into six mutually exclusive groups based on physical activity status, weight classification (measured BMI), and duration of weight classification (assessed via recall). Multivariable linear and logistic regression analyses were computed to examine odds of depressive symptoms (patient health questionnaire (PHQ)-9) among groups. After adjusting for covariates, only individuals who were inactive and overweight/obese at the examination and 10 years prior were at an increased odds of depressive symptoms in comparison to those who were active and normal weight (odds ratio (OR) = 2.40; 95 % confidence interval (CI) 1.03, 5.61; p = 0.04). Physical activity appeared to ameliorate the association with depressive symptoms independent of overweight/obesity classification or duration. The cyclic nature of overweight/obesity and depression (i.e., bidirectional association) appears to increase the odds of depression as the length of overweight/obesity is increased. These results provide support for clinicians to assess not only their clients' current BMI but also the duration in which they have been at a certain weight classification and to further promote physical activity as a preventative measure against depressive symptoms.

Primary care clinician expectations regarding aging.

PubMed

Davis, Melinda M; Bond, Lynne A; Howard, Alan; Sarkisian, Catherine A

2011-12-01

Expectations regarding aging (ERA) in community-dwelling older adults are associated with personal health behaviors and health resource usage. Clinicians' age expectations likely influence patients' expectations and care delivery patterns; yet, limited research has explored clinicians' age expectations. The Expectations Regarding Aging Survey (ERA-12) was used to assess (a) age expectations in a sample of primary care clinicians practicing in the United States and (b) clinician characteristics associated with ERA-12 scores.  This study was a cross-sectional survey of primary care clinicians affiliated with 5 practice-based research networks, October 2008 to June 2009. A total of 374 of the 1,510 distributed surveys were returned (24.8% response rate); 357 analyzed. Mean respondent age was 48.6 years (SD = 11.6; range 23-87 years); 88.0% physicians, 96.0% family medicine, 94.9% White, and 61.9% male. Female clinicians reported higher ERA-12 scores; clinicians' age expectations decreased with greater years in practice. Among the clinicians, higher ERA-12 scores were associated with higher clinician ratings of the importance of and personal skill in administering preventive counseling and the importance of delivering preventive services. Agreement with individual ERA-12 items varied widely. Unrealistically high or low ERA could negatively influence the quality of care provided to patients and patients' own age expectations. Research should examine the etiology of clinicians' age expectations and their association with older adult diagnoses and treatment. Medical education must incorporate strategies to promote clinician attitudes that facilitate successful patient aging.

How short are ultra short light pulses? (looking back to the mid sixties)

NASA Astrophysics Data System (ADS)

Weber, H. P.; Dändliker, R.

2010-09-01

With the arrival of mode locking for Q-switched lasers to generate ultra short light pulses, a method to measure their expected time duration in the psec range was needed. A novel method, based on an intensity correlation measurement using optical second harmonic generation, was developed. Other reported approaches for the same purpose were critically analysed. Theoretical and subsequent experimental studies lead to surprising new insight into the ultra fast temporal behaviour of broadband laser radiation: Any non mode locked multimode emission of a laser consists of random intensity fluctuations with duration of the total inverse band width of emitted radiation. However, it was shown, that with mode locking isolated ultra short pulses of psec duration can be generated. This article summarizes activities performed in the mid sixties at the University of Berne, Switzerland.

A voluntary deductible in health insurance: the more years you opt for it, the lower your premium?

PubMed

van Winssen, K P M; van Kleef, R C; van de Ven, W P M M

2017-03-01

Adverse selection regarding a voluntary deductible (VD) in health insurance implies that insured only opt for a VD if they expect no (or few) healthcare expenses. This paper investigates two potential strategies to reduce adverse selection: (1) differentiating the premium to the duration of the contract for which the VD holds (ex-ante approach) and (2) differentiating the premium to the number of years for which insured have opted for a VD (ex-post approach). It can be hypothesized that premiums will decrease with the duration of the contract or the number of years for which insured have opted for a VD, providing an incentive to insured to opt for a deductible also in (incidental) years they expect relatively high expenses. To test this hypothesis, we examine which premium patterns would occur under these strategies using data on healthcare expenses and risk characteristics of over 750,000 insured from 6 years. Our results show that, under the assumptions made, only without risk equalization the premiums could decrease with the duration of the contract or the number of years for which insured have opted for a VD. With (sophisticated) risk equalization, decreasing premiums seem unfeasible, both under the ex-ante and ex-post approach. Given these findings, we are sceptical about the feasibility of these strategies to counteract adverse selection.

Incidence and duration of group B Streptococcus by serotype among male and female college students living in a single dormitory.

PubMed

Foxman, Betsy; Gillespie, Brenda; Manning, Shannon D; Howard, Laura J; Tallman, Patricia; Zhang, Lixin; Marrs, Carl F

2006-03-15

Group B Streptococcus causes a variety of morbid and sometimes fatal conditions affecting individuals of all age groups. There are nine known serotypes of this Gram-positive coccus but few estimates of the incidence and duration of its colonization and none by serotype in the literature. In 2001, the authors conducted a prospective cohort study among 257 men and women living in a single dormitory in Ann Arbor, Michigan. The 3-week incidence with any serotype was 11.3% (+/-3.9%) among women and 8.8% (+/-3.0%) among men; 3-week incidence rates were highest for serotype V (4.7% for women and 3.5% for men) and type Ia (2.3% for women and 2.4% for men), with no significant differences by gender. The estimated average duration of any group B Streptococcus colonization was longer for women (13.7 weeks) than men (8.5 weeks); serotype Ia was carried an average of 6.5 weeks longer in women, and serotype III was carried 4.9 weeks longer. Colonization with more than one serotype occurred significantly less than would be expected by chance (p < 0.001). Based on the overall incidence, transmission occurred between roommate pairs at the rate expected. Group B Streptococcus colonization is frequent and dynamic, but it is not transmitted by casual contact.

Statistical Studies of Solar White-light Flares and Comparisons with Superflares on Solar-type Stars

NASA Astrophysics Data System (ADS)

Namekata, Kosuke; Sakaue, Takahito; Watanabe, Kyoko; Asai, Ayumi; Maehara, Hiroyuki; Notsu, Yuta; Notsu, Shota; Honda, Satoshi; Ishii, Takako T.; Ikuta, Kai; Nogami, Daisaku; Shibata, Kazunari

2017-12-01

Recently, many superflares on solar-type stars have been discovered as white-light flares (WLFs). The statistical study found a correlation between their energies (E) and durations (τ): τ \\propto {E}0.39, similar to those of solar hard/soft X-ray flares, τ \\propto {E}0.2{--0.33}. This indicates a universal mechanism of energy release on solar and stellar flares, i.e., magnetic reconnection. We here carried out statistical research on 50 solar WLFs observed with Solar Dynamics Observatory/HMI and examined the correlation between the energies and durations. As a result, the E–τ relation on solar WLFs (τ \\propto {E}0.38) is quite similar to that on stellar superflares (τ \\propto {E}0.39). However, the durations of stellar superflares are one order of magnitude shorter than those expected from solar WLFs. We present the following two interpretations for the discrepancy: (1) in solar flares, the cooling timescale of WLFs may be longer than the reconnection one, and the decay time of solar WLFs can be elongated by the cooling effect; (2) the distribution can be understood by applying a scaling law (τ \\propto {E}1/3{B}-5/3) derived from the magnetic reconnection theory. In the latter case, the observed superflares are expected to have 2–4 times stronger magnetic field strength than solar flares.

Sleep Duration in Relation to Attention Deficit Hyperactivity Disorder in American Adults.

PubMed

Bogdan, Alexander R; Reeves, Katherine W

2018-01-01

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition being diagnosed in increasing numbers. While the link between sleep and ADHD is of increasing interest, the relationship between sleep duration and ADHD remains largely uninvestigated in adult populations. We evaluated the association between self-reported sleep duration and ADHD in a cohort of American adults using data from the 2012 National Health Interview Survey (Centers for Disease Control and Prevention, 2012). Of the 30,858 participants eligible for our analyses, there were 1,122 cases of ADHD. Elevated and diminished sleep durations were both associated with increased odds of reporting ADHD (≤ 6 hr: OR = 1.50, 95% CI 1.19, 1.90; ≥ 9 hr: OR = 1.49, 95% CI 1.26, 1.75) in fully adjusted models. Future prospective studies are necessary to further examine this association in adult patients.

Antagonism of methoxyflurane-induced anesthesia in rats by benzodiazepine inverse agonists.

PubMed

Miller, D W; Yourick, D L; Tessel, R E

1989-11-28

Injection of the partial benzodiazepine inverse agonist Ro15-4513 (1-32 mg/kg i.p.) or nonconvulsant i.v. doses of the full benzodiazepine inverse agonist beta-CCE immediately following cessation of exposure of rats to an anesthetic concentration of methoxyflurane significantly antagonized the duration of methoxyflurane anesthesia as measured by recovery of the righting reflex and/or pain sensitivity. This antagonism was inhibited by the benzodiazepine antagonist Ro15-1788 at doses which alone did not alter the duration of methoxyflurane anesthesia. In addition, high-dose Ro15-4513 pretreatment (32 mg/kg) antagonized the induction and duration of methoxyflurane anesthesia but was unable to prevent methoxyflurane anesthesia or affect the induction or duration of anesthesia induced by the dissociative anesthetic ketamine (100 mg/kg). These findings indicate that methoxyflurane anesthesia can be selectively antagonized by the inverse agonistic action of Ro15-4513 and beta-CCE.

Who Supports Breastfeeding Mothers? : An Investigation of Kin Investment in the United States.

PubMed

Cisco, Jayme

2017-06-01

Breastfeeding is one important form of maternal investment that is influenced by support from kin and non-kin. This paper investigates who provides support for breastfeeding mothers and their children, what type of support they provide, and how support impacts breastfeeding duration. The data were derived from a survey of 594 American mothers and were analyzed using quantitative methods, including Cox regression. Analyses indicate that mothers receive significant support, particularly from spouses and maternal grandmothers. More frequent breastfeeding discussions with La Leche League and maternal grandfathers were associated with longer duration, whereas discussions with physicians were associated with shorter breastfeeding duration. Results indicate that consulting others specifically about breastfeeding may influence breastfeeding decisions. The results are consistent with the idea that social support may influence breastfeeding duration and that some types of support are more influential than others. Furthermore, support persons should be educated about breastfeeding to prevent early weaning.

Mistrusting Companies, Mistrusting the Tobacco Industry: Clarifying the Context of Tobacco Prevention Efforts that Focus on the Tobacco Industry

ERIC Educational Resources Information Center

Thrasher, James F.; Jackson, Christine

2006-01-01

Campaigns to prevent adolescent smoking increasingly depict the tobacco industry as deceitful and exploitative. This study was undertaken to determine how adolescents' expectations about the trustworthiness of companies, in general, influence the pathway through which anti-tobacco industry campaigns prevent smoking. Structural equation modeling…

40 CFR 68.170 - Prevention program/Program 2.

Code of Federal Regulations, 2013 CFR

2013-07-01

... the process. (c) The name(s) of the chemical(s) covered. (d) The date of the most recent review or... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.170 Prevention program/Program... of completion of the most recent hazard review or update. (1) The expected date of completion of any...

40 CFR 68.170 - Prevention program/Program 2.

Code of Federal Regulations, 2012 CFR

2012-07-01

... the process. (c) The name(s) of the chemical(s) covered. (d) The date of the most recent review or... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.170 Prevention program/Program... of completion of the most recent hazard review or update. (1) The expected date of completion of any...

40 CFR 68.170 - Prevention program/Program 2.

Code of Federal Regulations, 2014 CFR

2014-07-01

... the process. (c) The name(s) of the chemical(s) covered. (d) The date of the most recent review or... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.170 Prevention program/Program... of completion of the most recent hazard review or update. (1) The expected date of completion of any...

Early Detection and Prevention of Mental Health Problems: Developmental Epidemiology and Systems of Support.

PubMed

Costello, E Jane

2016-01-01

This article reviews the role of developmental epidemiology in the prevention of child and adolescent mental disorders and the implications for systems of support. The article distinguishes between universal or primary prevention, which operates at the level of the whole community to limit risk exposure before the onset of symptoms, and secondary or targeted prevention, which operates by identifying those at high risk of developing a disorder. It discusses different aspects of time as it relates to risk for onset of disease, such as age at first exposure, duration of exposure, age at onset of first symptoms, and time until treatment. The study compares universal and targeted prevention, describing the systems needed to support each, and their unintended consequences.

Prevention Programs to Augment Family and Child Resilience Can Have Lasting Effects on Suicidal Risk.

PubMed

Brent, David

2016-04-01

In this commentary, the effects of four family-based preventive interventions designed to augment parent and child resilience, originally designed to prevent mental health and substance abuse, on suicide ideation and attempts are reviewed. Three of the preventive interventions showed a beneficial effect either on child suicide ideation or attempts, and one found a beneficial effect on parental suicidal ideation. The duration of effects in two of these studies was well longer than a decade. These studies suggest that interventions to augment family and child resiliency originally designed to prevent mental health and substance abuse disorders can also have beneficial, often long-term, effects on suicidal ideation and behavior. © 2016 The American Association of Suicidology.

FOREST ECOSYSTEM CARBON AND NITROGEN ACCUMULATION DURING THE FIRST CENTURY AFTER AGRICULTURAL ABANDONMENT

EPA Science Inventory

Forests of the northeastern U.S. are expected to serve as a substantial sink for carbon (C) and nitrogen (N) as they recover from extensive clearing and agriculture. However, questions remain concerning the rate, distribution and duration of this potential sink. We used a chron...

40 CFR 60.7 - Notification and record keeping.

Code of Federal Regulations, 2010 CFR

2010-07-01

... control systems, productive capacity of the facility before and after the change, and the expected... submitted for each pollutant monitored at each affected facility. (1) If the total duration of excess emissions for the reporting period is less than 1 percent of the total operating time for the reporting...

40 CFR 60.7 - Notification and record keeping.

Code of Federal Regulations, 2013 CFR

2013-07-01

... control systems, productive capacity of the facility before and after the change, and the expected... submitted for each pollutant monitored at each affected facility. (1) If the total duration of excess emissions for the reporting period is less than 1 percent of the total operating time for the reporting...

40 CFR 60.7 - Notification and record keeping.

Code of Federal Regulations, 2011 CFR

2011-07-01

... control systems, productive capacity of the facility before and after the change, and the expected... submitted for each pollutant monitored at each affected facility. (1) If the total duration of excess emissions for the reporting period is less than 1 percent of the total operating time for the reporting...

40 CFR 60.7 - Notification and record keeping.

Code of Federal Regulations, 2014 CFR

2014-07-01

... control systems, productive capacity of the facility before and after the change, and the expected... submitted for each pollutant monitored at each affected facility. (1) If the total duration of excess emissions for the reporting period is less than 1 percent of the total operating time for the reporting...

40 CFR 60.7 - Notification and record keeping.

Code of Federal Regulations, 2012 CFR

2012-07-01

... control systems, productive capacity of the facility before and after the change, and the expected... submitted for each pollutant monitored at each affected facility. (1) If the total duration of excess emissions for the reporting period is less than 1 percent of the total operating time for the reporting...

40 CFR 721.3435 - Butoxy-substituted ether alkane.

Code of Federal Regulations, 2010 CFR

2010-07-01

... contaminated with the PMN substance shall be disposed of after every work shift. (ii) Hazard communication... during normal and expected duration and conditions of exposure within the work area by testing the... gloves may be exposed in the work area. There must be no permeation of the gloves by the chemical...

Shallow Habitat Air Dive (SHAD-I): Psychological Screening of Divers as Subjects for Long Duration Saturation Experimentation

DTIC Science & Technology

1974-05-31

are listed below: The diagnostic subtests are: Hypochondriasis (Hs), exaggerated anxiety or concern about one’s health; Depression (D), feelings of...attitudes are expected outcomes. 4. Somatic symptomatology possibly corre- lated with changes in general emotionality as the experiment progressed was

An open science approach to modeling and visualizing cyanobacteria blooms in lakes and ponds

EPA Science Inventory

It is expected that cyanobacteria blooms will increase in frequency, duration, and severity as inputs of nutrients increase and the impacts of climate change are realized. Partly in response to this, federal, state, and local entities have ramped up efforts to better understand b...

HIV prevention for South African youth: which interventions work? A systematic review of current evidence

PubMed Central

2010-01-01

Background In South Africa, HIV prevalence among youth aged 15-24 is among the world's highest. Given the urgent need to identify effective HIV prevention approaches, this review assesses the evidence base for youth HIV prevention in South Africa. Methods Systematic, analytical review of HIV prevention interventions targeting youth in South Africa since 2000. Critical assessment of interventions in 4 domains: 1) study design and outcomes, 2) intervention design (content, curriculum, theory, adaptation process), 3) thematic focus and HIV causal pathways, 4) intervention delivery (duration, intensity, who, how, where). Results Eight youth HIV prevention interventions were included; all were similar in HIV prevention content and objectives, but varied in thematic focus, hypothesised causal pathways, theoretical basis, delivery method, intensity and duration. Interventions were school- (5) or group-based (3), involving in- and out-of-school youth. Primary outcomes included HIV incidence (2), reported sexual risk behavior alone (4), or with alcohol use (2). Interventions led to reductions in STI incidence (1), and reported sexual or alcohol risk behaviours (5), although effect size varied. All but one targeted at least one structural factor associated with HIV infection: gender and sexual coercion (3), alcohol/substance use (2), or economic factors (2). Delivery methods and formats varied, and included teachers (5), peer educators (5), and older mentors (1). School-based interventions experienced frequent implementation challenges. Conclusions Key recommendations include: address HIV social risk factors, such as gender, poverty and alcohol; target the structural and institutional context; work to change social norms; and engage schools in new ways, including participatory learning. PMID:20187957

Higher education delays and shortens cognitive impairment: a multistate life table analysis of the US Health and Retirement Study.

PubMed

Reuser, Mieke; Willekens, Frans J; Bonneux, Luc

2011-05-01

Improved health may extend or shorten the duration of cognitive impairment by postponing incidence or death. We assess the duration of cognitive impairment in the US Health and Retirement Study (1992-2004) by self reported BMI, smoking and levels of education in men and women and three ethnic groups. We define multistate life tables by the transition rates to cognitive impairment, recovery and death and estimate Cox proportional hazard ratios for the studied determinants. 95% confidence intervals are obtained by bootstrapping. 55 year old white men and women expect to live 25.4 and 30.0 years, of which 1.7 [95% confidence intervals 1.5; 1.9] years and 2.7 [2.4; 2.9] years with cognitive impairment. Both black men and women live 3.7 [2.9; 4.5] years longer with cognitive impairment than whites, Hispanic men and women 3.2 [1.9; 4.6] and 5.8 [4.2; 7.5] years. BMI makes no difference. Smoking decreases the duration of cognitive impairment with 0.8 [0.4; 1.3] years by high mortality. Highly educated men and women live longer, but 1.6 years [1.1; 2.2] and 1.9 years [1.6; 2.6] shorter with cognitive impairment than lowly educated men and women. The effect of education is more pronounced among ethnic minorities. Higher life expectancy goes together with a longer period of cognitive impairment, but not for higher levels of education: that extends life in good cognitive health but shortens the period of cognitive impairment. The increased duration of cognitive impairment in minority ethnic groups needs further study, also in Europe.

Analysis of erythema after Er:YAG laser skin resurfacing.

PubMed

Ko, Na Young; Ahn, Hyo-Hyun; Kim, Soo-Nam; Kye, Young-Chul

2007-11-01

Postoperative erythema can be expected to occur in every patient after laser resurfacing, and pigmentary disturbances may be related to the intensity and the duration of erythema. This study was undertaken to assess the clinical features of erythema, the factors that influence its duration, and the relation between the duration of erythema and the incidence of hyperpigmentation and hypopigmentation in skin of Asian persons after Er:YAG laser resurfacing. A total of 218 patients (skin phototypes III to V) were recruited and treated with a short-pulsed Er:YAG laser, a variable-pulsed Er:YAG laser, or a dual-mode Er:YAG laser for skin resurfacing. Clinical assessments were performed retrospectively using medical charts and serial photographs. Postoperative erythema was observed in all patients after Er:YAG laser resurfacing with a mean duration of 4.72 months. In 98.2% of patients, erythema faded completely within 12 months. Postinflammatory hyperpigmentation was observed in 38.1% of patients after Er:YAG laser resurfacing. Skin phototype, level of ablation, and depth of thermal damage caused by a long-pulsed laser appear to be important factors that affect the duration of erythema. Moreover, prolonged erythema was related to the risk of postinflammatory hyperpigmentation.

[Clinical re-evaluation of effects of two different "cocktail therapy" to prevent from phlebitis induced by Chansu injection].

PubMed

Zhao, Yu-Bin; Hao, Zhe; Zhang, Hong-Dan; Xie, Yan-Ming

2012-09-01

To re-evaluate the effects of different "cocktail therapy" to prevent from phlebitis induced by Chansu injection. Patients treated with Chansu injection were divided randomLy into 4 groups with 90 per group, control group, phentolaminum group, the magnesium sulfate group-phentolaminum group, and anisodamine-phentolaminum group. Patients in the control group only received the routine nursing treatment, and patients in the various experiment group received different interventions. The comparison was made in the morbidity and the starting time of occurrence of phlebitis, the severity of pain, duration of pain. The morbidity of phlebitis was 8%, 8%, 6%, respectively. The starting time of phlebitis occurrence was (22 +/- 4), (27 +/- 5), (28 +/- 7) h, respectively. The NRS of pain was (4.75 +/- 1.51), (3.27 +/- 1.02), (2.71 +/- 1.63), respectively. The duration time of pain was (4.25 +/- 1.36), (2.51 +/- 1.05), (2.19 +/- 1.13) d respectively. In control group, the morbidity of phlebitis, the starting time of occurrence of phlebitis, the severity of pain, duration of pain was 30%, (16 +/- 4) h, (6.34 +/- 1.21), (5.47 +/- 1.07) d, respectively. As compared with the control group, a significance difference was found between every group in three test groups and control group respectively (P<0.05). The morbidity and the starting time of occurrence of phlebitis, the severity of pain, duration of pain was significantly reduced respectively by two different "cocktail therapy".

Knowledge, practices and expectations of preventive care: a qualitative study of patients attending government general outpatient clinics in Hong Kong.

PubMed

Tam, Denise Y S; Lo, Yvonne Y C; Tsui, Wendy

2018-05-09

Evidence-based preventive care recommendations have been well established, but studies have persistently reported gaps between these recommendations and general practitioners' practices in providing preventive care. Many studies have explored factors that affect the delivery of preventive care from the perspectives of the practitioners, but relatively few have evaluated the patients' point of view. The purpose of this study was to explore patients' understanding of preventive care, the actions they were taking in terms of preventive health and their expectations from family doctors in providing preventive care. A qualitative study was conducted based on one-on-one in-depth interviews. Twenty-eight patients without chronic illnesses were purposively recruited from government general outpatient clinics in Hong Kong. The interviews took place between November 2013 and February 2014. The participants' knowledge of preventive care was limited, and their preventive practices were mostly restricted to healthy lifestyle practices. They rarely obtained individualised preventive care advice from doctors. Screening investigations were initiated after symptoms had already occurred, and the decision of what to check was arbitrary. Few of the participants knew what they wanted from their doctors in terms of preventive care. These findings show significant gaps between evidence-based preventive recommendations and patients' current knowledge and practice, and show the need for a wider spectrum of preventive care education and reliable sources to provide individualised and affordable preventive assessment and screening services. Most importantly, primary care providers must take a more proactive role to provide preventive services.

The expected benefit of preventive mastectomy on breast cancer incidence and mortality in BRCA mutation carriers, by age at mastectomy.

PubMed

Giannakeas, Vasily; Narod, Steven A

2018-01-01

Preventive breast surgery is offered to unaffected BRCA mutation carriers to prevent breast cancer incidence and mortality. The clinical benefit of preventive mastectomy can be measured in several ways, including extension of life expectancy (mean years of life gained) and by estimating the probability of surviving until age 80. We sought to estimate the expected benefit of a preventive mastectomy at various ages, using these indices of mortality, by simulating hypothetical cohorts of women. The age-specific annual risks of developing breast cancer were used to estimate the actuarial risk of developing breast cancer by age 80 for women with a BRCA1 or BRCA2 mutation. The probability of developing breast cancer before age 80 was then modified to include competing causes of death, including from ovarian cancer. The mortality rate from breast cancer after a diagnosis of breast cancer was set at 2% annually for the first 10 years and then 1% annually for years ten to twenty. The incidence rate and mortality rate from ovarian cancer were based on published literature. We assumed that preventive mastectomy was associated with complete protection against subsequent breast cancer. A series of simulations was conducted to evaluate the reduction in the probability of death (from all causes) until age 80, according to the age at mastectomy. The actuarial risk of developing breast cancer until age 80 was estimated to be 70.8%. The actual risk (incorporating competing risks) was 64.0%. The probability of being alive at age 80 by having a mastectomy at age 25 increased by 8.7% (from 42.7 to 51.3%). The estimated benefit declined with age at mastectomy; for surgery done at age 50 the improvement in survival to age 80 was much more modest (2.8% at age 80, from 42.7 to 45.5%). Among BRCA mutation carriers, the mortality benefit of preventive mastectomy at age 25 is substantial, but the expected benefit declines rapidly with increasing age at surgery.

A Study of Innovation: ERD Takes Pollution Prevention to a New Level

DOE Office of Scientific and Technical Information (OSTI.GOV)

Southmayd, A.

1999-01-20

ERD approaches its mission with a vision of continuously exceeding customer needs and expectations and continuously improving. It's this vision of continuous improvement that drives the ERD pollution prevention program towards innovation.

78 FR 54469 - Solicitation of Written Comments on Draft National Action Plan for Adverse Drug Event Prevention

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-04

... developed with the expectation and understanding that outlining ADE prevention goals and, more importantly... coordinated federal partnerships, as well as public and private sector collaborations and aligned approaches...

An expectancy-value analysis of viewer interest in television prevention news stories.

PubMed

Cooper, C P; Burgoon, M; Roter, D L

2001-01-01

Understanding what drives viewer interest in television news stories about prevention topics is vital to maximizing the effectiveness of interventions that utilize this medium. Guided by expectancy-value theory, this experiment used regression analysis to identify the salient beliefs associated with viewer attitudes towards these types of news stories. The 458 study participants were recruited over 30 days from a municipal jury pool in an eastern U.S. city. Out of the 22 beliefs included in the experiment, 6 demonstrated salience. Personal relevance, novelty, shock value, and the absence of exaggeration were the core values reflected in the identified salient beliefs. This study highlights the importance of explaining the relevance of prevention stories to viewers and framing these stories with a new spin or a surprising twist. However, such manipulations should be applied with savvy and restraint, as hyping prevention news was found to be counterproductive to educating the public.

Sleep at night and association to aggressive behaviour; Patients in a Psychiatric Intensive Care Unit.

PubMed

Langsrud, Knut; Kallestad, Håvard; Vaaler, Arne; Almvik, Roger; Palmstierna, Tom; Morken, Gunnar

2018-05-01

Evaluations of associations between sleep at night and aggressive behaviour in Psychiatric Intensive Care Units (PICU) are lacking. The aims were to explore if sleep duration or night-to-night variations in sleep duration correlated with aggressive behaviour and aggressive incidents the next day and through the whole admission. Fifty consecutive patients admitted to a PICU were included (521 nights) and the nurses registered the time patients were sleeping, aggressive behaviour with The Brøset Violence Checklist (BVC) and aggressive incidents with The Staff Observation Aggression Scale-Revised (SOAS-R). At admission, short sleep duration the first night correlated with aggressive behaviour the next day and admissions with violent incidents had a median of 4.0 h difference in sleep from night one to night two compared to 2.1 h for the rest of the admissions. During the stay, large absolute difference in sleep duration between two nights correlated with aggressive behaviour the next day and short sleep duration was associated with violent incidents. Short sleep duration and night-to-night variations in sleep duration are both associated with increased risk for aggression in PICUs. This observation might help to predict and prevent aggressive incidents. Copyright © 2018 Elsevier B.V. All rights reserved.

Direct oral anticoagulants for extended thromboprophylaxis in medically ill patients: meta-analysis and risk/benefit assessment.

PubMed

Al Yami, Majed S; Kurdi, Sawsan; Abraham, Ivo

2018-01-01

Standard-duration (7-10 days) thromboprophylaxis with low molecular weight heparin, low dose unfractionated heparin, or fondaparinux in hospitalized medically ill patients is associated with ~50% reduction in venous thromboembolism (VTE) risk. However, these patients remain at high risk for VTE post-discharge. The direct oral anticoagulants (DOACs) apixaban, rivaroxaban and betrixaban have been evaluated for extended-duration (30-42 days) thromboprophylaxis in this population. We review the efficacy and safety results from the 3 pivotal trials of extended-duration DOAC thromboprophylaxis in medically ill patients. We performed a meta-analysis of these pivotal trials focusing on 6 VTE (efficacy) and three bleeding outcomes (safety). These results were integrated into a quantitative risk/benefit assessment. The trials evaluating extended-duration DOAC thromboprophylaxis in medically ill patients failed to establish clear efficacy and/or safety signals for each agent. Our meta-analysis shows that, as a class, DOACs have selective and partial extended-duration prophylactic activity in preventing VTE events. However, this is associated with a marked increase in the risk of various bleeding events. The risk/benefit analyses fail to show a consistent net clinical benefit of extended-duration DOAC prophylaxis in medically ill patients. At this time, the evidence of safe and effective extended-duration thromboprophylaxis with DOACs in this population is inconclusive.

A cross-sectional study of the association between working hours and sleep duration among the Japanese working population.

PubMed

Ohtsu, Tadahiro; Kaneita, Yoshitaka; Aritake, Sayaka; Mishima, Kazuo; Uchiyama, Makoto; Akashiba, Tsuneto; Uchimura, Naohisa; Nakaji, Shigeyuki; Munezawa, Takeshi; Kokaze, Akatsuki; Ohida, Takashi

2013-01-01

This study aimed to clarify the association between long working hours and short sleep duration among Japanese workers. We selected 4,000 households from across Japan by stratified random sampling and conducted an interview survey of a total of 662 participants (372 men; 290 women) in November 2009. Logistic regression analyses were performed using "sleep duration <6 hours per day" as a dependent variable to examine the association between working hours/overtime hours and short sleep duration. When male participants who worked for ≥7 but <9 hours per day were used as a reference, the odds ratio (OR) for short sleep duration in those who worked for ≥ 11 hours was 8.62 (95% confidence interval [CI]: 3.94-18.86). With regard to overtime hours among men, when participants without overtime were used as a reference, the OR for those whose period of overtime was ≥ 3 hours but <4 hours was 3.59 (95% CI: 1.42-9.08). For both men and women, those with long weekday working hours tended to have a short sleep duration during weekdays and holidays. It is essential to avoid working long hours in order to prevent short sleep duration.

Sleep duration and chronic diseases among U.S. adults age 45 years and older: evidence from the 2010 Behavioral Risk Factor Surveillance System.

PubMed

Liu, Yong; Wheaton, Anne G; Chapman, Daniel P; Croft, Janet B

2013-10-01

To examine the effects of obesity and frequent mental distress (FMD) on the relationship of sleep duration with coronary heart disease (CHD), stroke, and diabetes. Cross-sectional study. Population-based surveillance. There were 54,269 adults age 45 y or older who completed the 2010 Behavioral Risk Factor Surveillance System survey in 14 states. Nearly one third (31.1% or an estimated 11.1 million) of respondents age 45 y and older reported being short sleepers (≤ 6 h), 64.8% being optimal sleepers (7-9 h), and 4.1% being long sleepers (≥ 10 h) in a 24-h period. Compared with the optimal sleep duration, both short and long sleep durations were significantly associated with obesity, FMD (mental health was not good ≥ 14 days during the past 30 days), CHD, stroke, and diabetes after controlling for sex, age, race/ethnicity, and education. The U-shaped relationships of sleep duration with CHD, stroke, and diabetes were moderately attenuated by FMD. The relationship between sleep duration and diabetes was slightly attenuated by obesity. Sleep duration had U-shaped relationships with leading chronic diseases. Further prospective studies are needed to determine how mental health and maintenance of a normal weight may interact with sleep duration to prevent chronic diseases.

Activity of ergoferon against lethal influenza A (H3N2) virus infection in mice.

PubMed

Skarnovich, Maria A; Emelyanova, Alexandra G; Petrova, Nataliia V; Borshcheva, Alena A; Gorbunov, Evgeniy A; Mazurkov, Oleg Yu; Skarnovich, Maksim O; Tarasov, Sergey A; Shishkina, Larisa N; Epstein, Oleg I

2017-01-01

The influenza A virus accounts for serious annual viral upper respiratory tract infections. It is constantly able to modify its antigenic structure, thus evading host defence mechanisms. Moreover, currently available anti-influenza agents have a rather limited application, emphasizing the further need for new effective treatments. One of them is ergoferon, a drug containing combined polyclonal antibodies - anti-interferon gamma, anti-CD4 receptor and anti-histamine - in released-active form. The purpose of the study was to assess ergoferon antiviral efficacy in mice challenged with the A/Aichi/2/68 (H3N2) influenza virus. The virus was inoculated intranasally at a 90% lethal dose. Ergoferon was administered at 0.4 ml/day per os in a preventive and therapeutic regimen - daily for 5 days prior to and for 16 days after the challenge. The reference product, Tamiflu (oseltamivir), was used as a positive control treatment - at 20 mg/kg/day for 5 days after the challenge. Mice in the negative control group received distilled water which had been utilized for test sample preparation; untreated control animals received no treatment. Antiviral efficacy was assessed by an increase in survival rate, average life expectancy and virus titre reduction in the challenged mouse lungs. Survival rate and average life expectancy values were increased significantly in groups treated with ergoferon and Tamiflu, as compared with controls. Lung virus titres were reduced in these groups as observed on days 2 and 4 post-inoculation. Ergoferon demonstrated antiviral activity by reducing the severity and duration of the major signs of induced influenza infection.

Awareness, attitude, and expectations toward dental implants among removable prostheses wearers.

PubMed

Al-Dwairi, Ziad N; El Masoud, Bilal Mohammed; Al-Afifi, Sanaa A; Borzabadi-Farahani, Ali; Lynch, Edward

2014-04-01

To assess removable denture patient awareness, expectations, and source of information about dental implants (DIs). Three hundred patients [150 removable partial denture (RPD) wearers and 150 complete denture wearers (CDWs)] attended the removable prosthodontic clinic at Faculty of Dentistry, Jordan University of Science and Technology. Patients were evaluated using a pilot-tested, 21-question questionnaire. Ninety-six percent of participants were aware of DIs, with no difference between CDWs and RPD wearers (p > 0.05). The participants' friends and relatives were the main source of information (63.4%), followed by dentists (32.4%). Improvement in function was the predominant reason (55.7%) for patients to consider DIs. Fear of unknown side effects was the major factor in preventing patients from choosing DIs (11.7%), followed by high cost (9.7%) and surgical risk (8.7%). Approximately 89% had no information or were poorly informed about DIs. Over two-thirds of patients did not know about the care (78.3%) of DIs, causes of DI failure (69.7%), or DI duration of service (80.7%). Only 24.7% knew that DIs would be anchored to the jawbone; however, 27.3% and 56.7% of CDWs and RPD wearers, respectively, preferred (p < 0.05) to have their teeth replaced with DIs. High costs were considered the major disadvantage of DIs in 45% of participants, followed by fear of surgery (27.3%), and long treatment times (24.7%). There was a high awareness about DIs among removable denture patients; however, this awareness was associated with a low level of accurate information. © 2013 by the American College of Prosthodontists.

Threatening social context facilitates pain-related fear learning.

PubMed

Karos, Kai; Meulders, Ann; Vlaeyen, Johan W S

2015-03-01

This study investigated the effects of a threatening and a safe social context on learning pain-related fear, a key factor in the development and maintenance of chronic pain. We measured self-reported pain intensity, pain expectancy, pain-related fear (verbal ratings and eyeblink startle responses), and behavioral measures of avoidance (movement-onset latency and duration) using an established differential voluntary movement fear conditioning paradigm. Participants (N = 42) performed different movements with a joystick: during fear acquisition, movement in one direction (CS+) was followed by a painful stimulus (pain-US) whereas movement in another direction (CS-) was not. For participants in the threat group, an angry face was continuously presented in the background during the task, whereas in the safe group, a happy face was presented. During the extinction phase the pain-US was omitted. As compared to the safe social context, a threatening social context led to increased contextual fear and facilitated differentiation between CS+ and CS- movements regarding self-reported pain expectancy, fear of pain, eyeblink startle responses, and movement-onset latency. In contrast, self-reported pain intensity was not affected by social context. These data support the modulation of pain-related fear by social context. A threatening social context leads to stronger acquisition of (pain-related) fear and simultaneous contextual fear but does not affect pain intensity ratings. This knowledge may aid in the prevention of chronic pain and anxiety disorders and shows that social context might modulate pain-related fear without immediately affecting pain intensity itself. Copyright © 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.

New Strategy for Prostate Cancer Prevention Based on Selenium Suppression of Androgen Receptor Signaling

DTIC Science & Technology

2009-10-01

efficacy of methylselenocysteine (MSC) and finasteride in preventing the clonal expansion of early stage, small volume prostate cancer using a tumor...xenograft model. When used alone, MSC had little effect on tumor growth, whereas finasteride was only effective for a short duration. However, the...repeat of the experiment with larger sample size is needed to corroborate the findings. We also demonstrated a synergy between emodin and finasteride in

Duration of surgical-orthodontic treatment.

PubMed

Häll, Birgitta; Jämsä, Tapio; Soukka, Tero; Peltomäki, Timo

2008-10-01

To study the duration of surgical-orthodontic treatment with special reference to patients' age and the type of tooth movements, i.e. extraction vs. non-extraction and intrusion before or extrusion after surgery to level the curve of Spee. The material consisted files of 37 consecutive surgical-orthodontic patients. The files were reviewed and gender, diagnosis, type of malocclusion, age at the initiation of treatment, duration of treatment, type of tooth movements (extraction vs. non-extraction and levelling of the curve of Spee before or after operation) and type of operation were retrieved. For statistical analyses two sample t-test, Kruskal-Wallis and Spearman rank correlation tests were used. Mean treatment duration of the sample was 26.8 months, of which pre-surgical orthodontics took on average 17.5 months. Patients with extractions as part of the treatment had statistically and clinically significantly longer treatment duration, on average 8 months, than those without extractions. No other studied variable seemed to have an impact on the treatment time. The present small sample size prevents reliable conclusions to be made. However, the findings suggest, and patients should be informed, that extractions included in the treatment plan increase chances of longer duration of surgical-orthodontic treatment.

Acupuncture for alcohol withdrawal: a randomized controlled trial.

PubMed

Trümpler, François; Oez, Suzan; Stähli, Peter; Brenner, Hans Dieter; Jüni, Peter

2003-01-01

Previous trials on acupuncture in alcohol addiction were in outpatients and focused on relapse prevention. Rates of dropout were high and interpretation of results difficult. We compared auricular laser and needle acupuncture with sham laser stimulation in reducing the duration of alcohol withdrawal. Inpatients undergoing alcohol withdrawal were randomly allocated to laser acupuncture (n = 17), needle acupuncture (n = 15) or sham laser stimulation (n = 16). Attempts were made to blind patients, therapists and outcome assessors, but this was not feasible for needle acupuncture. The duration of withdrawal symptoms (as assessed using a nurse-rated scale) was the primary outcome; the duration of sedative prescription was the secondary outcome. Patients randomized to laser and sham laser had identical withdrawal symptom durations (median 4 days). Patients randomized to needle stimulation had a shorter duration of withdrawal symptoms (median 3 days; P = 0.019 versus sham intervention), and tended to have a shorter duration of sedative use, but these differences diminished after adjustment for baseline differences. The data from this pilot trial do not suggest a relevant benefit of auricular laser acupuncture for alcohol withdrawal. A larger trial including adequate sham interventions is needed, however, to reliably determine the effectiveness of any type of auricular acupuncture in this condition.

The projected public health and economic impact of vitamin D fortified dairy products for fracture prevention in France.

PubMed

Hiligsmann, Mickael; Reginster, Jean-Yves

2018-04-01

There is a paucity of research that projects the public health and economic impact of healthcare interventions in the future. In this study, we aimed to estimate the public health and economic impact of vitamin D fortified dairy products for the years 2020, 2030, 2040, 2050 and 2060. We used a previously validated Markov microsimulation model that was designed to assess the public health and economic impact of dairy products for fracture prevention in the French general population aged over 60 years in the year 2015. The expected benefit (in terms of fractures prevented) of the recommended intake of dairy products compared to the absence of appropriate intake is expected to increase by 63% in 2040 and by 85% in 2060. The cost per quality-adjusted life years gained of the appropriate intake of dairy products is expected to decrease from €58,244 in 2015 to €42,616 in 2060. The potential public health and economic benefits of vitamin D fortified dairy products is expected to substantially increase in the future, especially in the population aged over 80 years. Decision makers should be aware of the current and future potential benefits of dairy products to protect bone fractures.

Sleep in healthy black and white adolescents.

PubMed

Matthews, Karen A; Hall, Martica; Dahl, Ronald E

2014-05-01

Inadequate sleep among adolescents has negative consequences for self-regulation, emotional well-being, and risk behaviors. Using multiple assessment methods, we evaluated the adequacy of sleep among healthy adolescents from a lower socioeconomic community and expected differences by race. A total of 250 healthy high school students enrolled in public school (mean age: 15.7 years; 57% black, 54% female) from families of low to middle class according to the Hollingshead scale participated in weeklong assessments of sleep duration and fragmentation, assessed by using actigraphy; sleep duration and perceived quality, assessed by using daily diaries; and daytime sleepiness and sleep delay, assessed by using a questionnaire. Students slept during the school week a mean ± SD of 6.0 ± 0.9 hours per night according to actigraphy and 6.8 ± 1.1 hours according to daily diary, and during the weekend, a mean of 7.4 ± 1.2 and 8.7 ± 1.4 hours, respectively. Black participants and male participants slept less and had more fragmented sleep; female participants reported poorer quality of sleep in their daily diaries and more daytime sleepiness. The results remained significant after adjustments for age, physical activity, smoking status, and percentile BMI. Most students slept less than the 8 to 9 hours suggested by the guidelines of the Centers for Disease Control and Prevention. Black male participants had the least amount of sleep, which may play a role in the substantial risks experienced by this demographic group. Our findings are consistent with recommendations that pediatricians should routinely screen their adolescent patients about their sleep, especially those from at-risk subgroups. Copyright © 2014 by the American Academy of Pediatrics.

HIV-1 concentrations in human breast milk before and after weaning

PubMed Central

Kuhn, Louise; Kim, Hae-Young; Walter, Jan; Thea, Donald M.; Sinkala, Moses; Mwiya, Mwiya; Kankasa, Chipepo; Decker, Don; Aldrovandi, Grace M.

2015-01-01

Concentrations of HIV-1 RNA and DNA in mucosal compartments influence the risk of sexual transmission and mother-to-child transmission of HIV-1. Breast milk production is physiologically regulated such that supply is a function of infant demand but whether demand also influences HIV-1 dynamics in breast milk is unknown. We tested whether minor and major changes in feeding frequency influence breast milk viral concentrations in 958 HIV-1-infected women, who were followed with their infants for 24 months as part of a trial in Lusaka, Zambia. Women were randomized to wean abruptly at 4 months or to continue breastfeeding for a duration of their own choosing. Two weeks after breastfeeding cessation i.e. weaning (4.5 months) HIV-1 concentrations in breast milk were substantially higher (median RNA 2,708 copies/ml and DNA 14 copies/ml) than if breastfeeding continued (median RNA <50 copies/ml and DNA <1 copy/ml, p<0.0001). Among those continuing breastfeeding, HIV-1 concentrations in milk were higher if breastfeeding was non-exclusive (median RNA 293 copies/ml and DNA 2 copies/ml, p=0.0006). Elevated milk viral concentrations after stopping breastfeeding explained higher than expected rates of late postnatal HIV transmission in those who weaned early. Changes in the frequency of breastfeeding peri-weaning and with non-exclusive breastfeeding influenced milk viral concentrations. This may explain the reduced risk of HIV-1 transmission associated with exclusive breastfeeding and may explain why early weaning does not achieve the magnitude of HIV prevention predicted by models. Our results support continuation of maternal antiretroviral drug interventions over the full duration of time when any breast milk exposures are likely to occur after planned weaning. PMID:23596203

A Start Toward Micronucleus-Based Decompression Models; Altitude Decompression

NASA Technical Reports Server (NTRS)

Van Liew, H. D.; Conkin, Johnny

2007-01-01

Do gaseous micronuclei trigger the formation of bubbles in decompression sickness (DCS)? Most previous instructions for DCS prevention have been oriented toward supersaturated gas in tissue. We are developing a mathematical model that is oriented toward the expected behavior of micronuclei. The issue is simplified in altitude decompressions because the aviator or astronaut is exposed only to decompression, whereas in diving there is a compression before the decompression. The model deals with four variables: duration of breathing of 100% oxygen before going to altitude (O2 prebreathing), altitude of the exposure, exposure duration, and rate of ascent. Assumptions: a) there is a population of micronuclei of various sizes having a range of characteristics, b) micronuclei are stable until they grow to a certain critical nucleation radius, c) it takes time for gas to diffuse in or out of micronuclei, and d) all other variables being equal, growth of micronuclei upon decompression is more rapid at high altitude because of the rarified gas in the micronuclei. To estimate parameters, we use a dataset of 4,756 men in altitude chambers exposed to various combinations of the model s variables. The model predicts occurrence of DCS symptoms quite well. It is notable that both the altitude chamber data and the model show little effect of O2 prebreathing until it lasts more than 60 minutes; this is in contrast to a conventional idea that the benefit of prebreathing is directly due to exponential washout of tissue nitrogen. The delay in response to O2 prebreathing can be interpreted as time required for outward diffusion of nitrogen; when the micronuclei become small enough, they are disabled, either by crushing or because they cannot expand to a critical nucleation size when the subject ascends to altitude.

A KCNQ1 Mutation Causes a High Penetrance for Familial Atrial Fibrillation

PubMed Central

Bartos, Daniel C.; Anderson, Jeffrey B.; Bastiaenen, Rachel; Johnson, Jonathan N.; Gollob, Michael H; Tester, David J.; Burgess, Don E.; Homfray, Tessa; Behr, Elijah R.; Ackerman, Michael J.; Guicheney, Pascale; Delisle, Brian P.

2012-01-01

Background Atrial fibrillation (AF) is the most common cardiac arrhythmia, and its incidence is expected to grow. A genetic predisposition for AF has long been recognized, but its manifestation in these patients likely involves a combination of rare and common genetic variants. Identifying genetic variants that associate with a high penetrance for AF would represent a significant breakthrough for understanding the mechanisms that associate with disease. Method and Results Candidate gene sequencing in five unrelated families with familial AF identified the KCNQ1 missense mutation p.Arg231His (R231H). In addition to AF, several of the family members have abnormal QTc intervals, syncope, or experienced sudden cardiac arrest or death. KCNQ1 encodes the voltage-gated K+ channel that conducts the slowly activating delayed rectifier K+ current in the heart. Functional and computational analyses suggested that R231H increases KCNQ1 current (IKCNQ1) to shorten the atrial action potential (AP) duration. R231H is predicted to minimally affect ventricular excitability, but it prevented the increase in IKCNQ1 following PKA activation. The unique properties of R231H appeared to be caused by a loss in voltage-dependent gating. Conclusions The R231H variant causes a high penetrance for interfamilial early-onset AF. Our study indicates R231H likely shortens atrial refractoriness to promote a substrate for reentry. Additionally, R231H might cause abnormal ventricular repolarization by disrupting PKA activation of IKCNQ1. We conclude genetic variants, which increase IKs during the atrial AP, decrease the atrial AP duration, and/or shorten atrial refractoriness, present a high risk for interfamilial AF. PMID:23350853

Meta-analysis: the effects of Lactobacillus rhamnosus GG supplementation for the prevention of healthcare-associated diarrhoea in children.

PubMed

Szajewska, H; Wanke, M; Patro, B

2011-11-01

In children, healthcare-associated diarrhoea, in particular, due to rotavirus, may prolong the hospital stay and increase medical costs, prompting interest in effective, low-cost, preventive strategies. To review systematically data on the efficacy of administering Lactobacillus rhamnosus GG (LGG) for the prevention of healthcare-associated diarrhoea. MEDLINE, EMBASE, Health Source: Nursing/Academic Edition, the Cochrane Library, trial registries and proceedings of major meetings were systematically searched for randomised controlled trials (RCTs) performed in children aged 1 month to 18 years that compared administration of LGG with placebo or no intervention. Two reviewers assessed studies for inclusion and risk of bias and extracted the data. Outcome measures included the incidences of healthcare-associated diarrhoea and rotavirus gastroenteritis. If appropriate, meta-analyses were carried out using the fixed effects model. Three RCTs involving 1092 children were included. Compared with placebo, LGG administration for the duration of hospital stay was associated with significantly lower rates of diarrhoea (two RCTs, n = 823, relative risk, RR 0.37, 95% confidence interval, CI 0.23-0.59) and symptomatic rotavirus gastroenteritis (three RCTs, n = 1043, RR 0.49, 95% CI 0.28-0.86). There was no significant difference between the LGG and the control groups in the incidence of asymptomatic rotavirus infection, duration of hospitalisation or duration of diarrhoea. LGG was well tolerated, and no harms were reported in any of the trials. In hospitalised children, the administration of Lactobacillus rhamnosus GG compared with placebo has the potential to reduce the overall incidence of healthcare-associated diarrhoea, including rotavirus gastroenteritis. © 2011 Blackwell Publishing Ltd.

Efficacy of Oral Cryotherapy on Oral Mucositis Prevention in Patients with Hematological Malignancies Undergoing Hematopoietic Stem Cell Transplantation: A Meta-Analysis of Randomized Controlled Trials

PubMed Central

Zhai, Ruiren; Zhao, Shasha; Luo, Lan; Li, Dandan; Zhao, Xiaoli; Wei, Huaping; Pang, Zhaoxia; Wang, Lili; Liu, Daihong; Wang, Quanshun; Gao, Chunji

2015-01-01

Objectives Controversy exists regarding whether oral cryotherapy can prevent oral mucositis (OM) in patients with hematological malignancies undergoing hematopoietic stem cell transplantation (HSCT). The aim of the present meta-analysis was to evaluate the efficacy of oral cryotherapy for OM prevention in patients with hematological malignancies undergoing HSCT. Methods PubMed and the Cochrane Library were searched through October 2014. Randomized controlled trials (RCTs) comparing the effect of oral cryotherapy with no treatment or with other interventions for OM in patients undergoing HSCT were included. The primary outcomes were the incidence, severity, and duration of OM. The secondary outcomes included length of analgesic use, total parenteral nutrition (TPN) use, and length of hospital stay. Results Seven RCTs involving eight articles analyzing 458 patients were included. Oral cryotherapy significantly decreased the incidence of severe OM (RR = 0.52, 95% CI = 0.27 to 0.99) and OM severity (SMD = -2.07, 95% CI = -3.90 to -0.25). In addition, the duration of TPN use and the length of hospitalization were markedly reduced (SMD = -0.56, 95% CI = -0.92 to -0.19; SMD = -0.44, 95% CI = -0.76 to -0.13; respectively). However, the pooled results were uncertain for the duration of OM and analgesic use (SMD = -0.13, 95% CI = -0.41 to 0.15; SMD = -1.15, 95% CI = -2.57 to 0.27; respectively). Conclusions Oral cryotherapy is a readily applicable and cost-effective prophylaxis for OM in patients undergoing HSCT. PMID:26024220

Efficacy of oral cryotherapy on oral mucositis prevention in patients with hematological malignancies undergoing hematopoietic stem cell transplantation: a meta-analysis of randomized controlled trials.

PubMed

Wang, Li; Gu, Zhenyang; Zhai, Ruiren; Zhao, Shasha; Luo, Lan; Li, Dandan; Zhao, Xiaoli; Wei, Huaping; Pang, Zhaoxia; Wang, Lili; Liu, Daihong; Wang, Quanshun; Gao, Chunji

2015-01-01

Controversy exists regarding whether oral cryotherapy can prevent oral mucositis (OM) in patients with hematological malignancies undergoing hematopoietic stem cell transplantation (HSCT). The aim of the present meta-analysis was to evaluate the efficacy of oral cryotherapy for OM prevention in patients with hematological malignancies undergoing HSCT. PubMed and the Cochrane Library were searched through October 2014. Randomized controlled trials (RCTs) comparing the effect of oral cryotherapy with no treatment or with other interventions for OM in patients undergoing HSCT were included. The primary outcomes were the incidence, severity, and duration of OM. The secondary outcomes included length of analgesic use, total parenteral nutrition (TPN) use, and length of hospital stay. Seven RCTs involving eight articles analyzing 458 patients were included. Oral cryotherapy significantly decreased the incidence of severe OM (RR = 0.52, 95% CI = 0.27 to 0.99) and OM severity (SMD = -2.07, 95% CI = -3.90 to -0.25). In addition, the duration of TPN use and the length of hospitalization were markedly reduced (SMD = -0.56, 95% CI = -0.92 to -0.19; SMD = -0.44, 95% CI = -0.76 to -0.13; respectively). However, the pooled results were uncertain for the duration of OM and analgesic use (SMD = -0.13, 95% CI = -0.41 to 0.15; SMD = -1.15, 95% CI = -2.57 to 0.27; respectively). Oral cryotherapy is a readily applicable and cost-effective prophylaxis for OM in patients undergoing HSCT.

Physical activity for prevention of osteoporosis in patients with severe haemophilia on long-term prophylaxis.

PubMed

Khawaji, M; Astermark, J; Akesson, K; Berntorp, E

2010-05-01

Physical activity has been considered as an important factor for bone density and as a factor facilitating prevention of osteoporosis. Bone density has been reported to be reduced in haemophilia. To examine the relation between different aspects of physical activity and bone mineral density (BMD) in patients with severe haemophilia on long-term prophylaxis. The study group consisted of 38 patients with severe haemophilia (mean age 30.5 years). All patients received long-term prophylaxis to prevent bleeding. The bone density (BMD g cm(-2)) of the total body, lumbar spine, total hip, femoral neck and trochanter was measured by dual energy X-ray absorptiometry. Physical activity was assessed using the self-report Modifiable Activity Questionnaire, an instrument which collects information about leisure and occupational activities for the prior 12 months. There was only significant correlation between duration and intensity of vigorous physical activity and bone density at lumber spine L1-L4; for duration (r = 0.429 and P = 0.020) and for intensity (r = 0.430 and P = 0.019); whereas no significant correlation between all aspects of physical activity and bone density at any other measured sites. With adequate long-term prophylaxis, adult patients with haemophilia are maintaining bone mass, whereas the level of physical activity in terms of intensity and duration play a minor role. These results may support the proposition that the responsiveness to mechanical strain is probably more important for bone mass development in children and during adolescence than in adults and underscores the importance of early onset prophylaxis.

A review of expectancy theory and alcohol consumption.

PubMed

Jones, B T; Corbin, W; Fromme, K

2001-01-01

Research is reviewed on the association between alcohol outcome expectancies and consumption which has led many to argue that manipulating expectancies might be a route to manipulating consumption for problem prevention and treatment. Studies indirectly and directly evaluating this latter position are reviewed. Expectancies predicting treatment outcome: two studies have shown that the more positive expectancies held at treatment, the poorer is treatment outcome, but five other studies have failed to find this. Three related studies have shown that the more negative expectancies held at treatment, the better the treatment outcome. This evaluation provides evidence inconsistent with the main position for positive expectancy and limited support for negative. Expectancy manipulations and ad libitum consumption: three studies in the laboratory have shown that increasing positive expectancies through word priming increases subsequent consumption and two studies have shown that increasing negative expectancies decreases it. A single study in the field showed a similar relationship. This evaluation provides evidence consistent with the main position but is limited by measuring consumption changes over only 1-2 hours. Prevention programmes with expectancy components: seven projects are reviewed in which positive expectancies were targeted, but only two report an expectancy change analysis and in both cases the expectancy change did not relate to subsequent consumption. This evaluation provides evidence inconsistent with the main position. Expectancy challenge: two related studies are reviewed in which positive expectancy challenges reduce subsequent consumption but changes in expectancy were not evaluated as predictors of consumption change. Two studies are reviewed which found a reduction in positive expectancy following expectancy challenge but no reduction in consumption. One study is reviewed in which when negative expectancy was increased in treatment there was a better treatment outcome at 3 months follow-up than when it was not. This evaluation provides evidence inconsistent with the main position for positive expectancy and limited consistent evidence for negative. It is concluded that the research has still to be done that securely links expectancy manipulations with subsequent changes in consumption, and fulfils the early promise from association studies.

Postpartum Depression Prevention for Reservation-Based American Indians: Results from a Pilot Randomized Controlled Trial

ERIC Educational Resources Information Center

Ginsburg, Golda S.; Barlow, Allison; Goklish, Novalene; Hastings, Ranelda; Baker, Elena Varipatis; Mullany, Britta; Tein, Jenn-Yun; Walkup, John

2012-01-01

Background: Postpartum depression is a devastating condition that affects a significant number of women and their offspring. Few preventive interventions have targeted high risk youth, such as American Indians (AIs). Objective: To evaluate the feasibility of a depression prevention program for AI adolescents and young adults. Methods: Expectant AI…

Migraine preventive therapy: selection of appropriate patients and general principles of management.

PubMed

D'Amico, Domenico; Lanteri-Minet, Michel

2006-08-01

The goal of this review is to communicate the rationale and the possible benefits of migraine preventive treatments to clinicians and patients, and to address the many problematic issues created by missed diagnosis or misdiagnoses and inadequate migraine management. Successful implementation of migraine preventive treatment requires appropriate patient selection based on several factors, including the frequency of migraine attacks (> or =2-3 attacks/month), the level of disability incurred and the frequency of acute medication usage. Unfortunately, several epidemiologic surveys indicate that preventive therapies are significantly underutilized, which supports the need for greater dialog concerning migraine prevention between consumers and physicians. Effective migraine preventive therapy should reduce the frequency, duration, and severity of migraine, and also improve function, reduce disability, and possibly reduce the risk of worsening the headache syndrome, through acute medication overuse.

Count distribution for mixture of two exponentials as renewal process duration with applications

NASA Astrophysics Data System (ADS)

Low, Yeh Ching; Ong, Seng Huat

2016-06-01

A count distribution is presented by considering a renewal process where the distribution of the duration is a finite mixture of exponential distributions. This distribution is able to model over dispersion, a feature often found in observed count data. The computation of the probabilities and renewal function (expected number of renewals) are examined. Parameter estimation by the method of maximum likelihood is considered with applications of the count distribution to real frequency count data exhibiting over dispersion. It is shown that the mixture of exponentials count distribution fits over dispersed data better than the Poisson process and serves as an alternative to the gamma count distribution.

Prophylactic treatment of Rocky Mountain spotted fever.

PubMed Central

Kenyon, R H; Williams, R G; Oster, C N; Pedersen, C E

1978-01-01

Prophylactic treatment of Rocky Mountain spotted fever with a single dose of oxytetracycline was investigated in guinea pigs. Disease was prevented when treatment was administered shortly before expected onset. Relapses occurred when treatment preceded expected onset by 48 h or more. PMID:97307

77 FR 74662 - Federal Acquisition Regulation; Submission for OMB Review; Accident Prevention Plans and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-17

... Keyword or ID'' and selecting ``Search''. Select the link ``Submit a Comment'' that corresponds with... involves work of a long duration, or hazardous nature, the contracting officer shall insert the clause with...

Sleep duration and its correlates in middle-aged and elderly Chinese women: the Shanghai Women’s Health Study

PubMed Central

Tu, Xiangdong; Cai, Hui; Gao, Yu-Tang; Wu, Xiaoyan; Ji, Bu-Tian; Yang, Gong; Li, Honglan; Zheng, Wei; Shu, Xiao Ou

2012-01-01

Background Abnormal sleep duration, either long or short, is associated with disease risk and mortality. Little information is available on sleep duration and its correlates among Chinese women. Methods Using information collected from 68,832 women who participated in the Shanghai Women’s Health Study (SWHS), we evaluated sleep duration and its correlations with sociodemographic and lifestyle factors, health status, and anthropometric measurements and their indexes using polynomial logistic regression. Results The mean age of the study population was 59.6 years (SD=9.0; range: 44.6–79.9 years) at time of sleep duration assessment. Approximately 80% of women reported sleeping 6–8 hours per day, 11.5% slept five hours or less, and 8.7% slept nine hours or more. As expected, age was the strongest predictor for sleep duration and was negatively correlated with sleep duration. In general, sleep duration was positively associated with energy intake, intakes of total meat and fruits, body mass index (BMI), waist-hip ratio (WHR), and waist circumference (WC) after adjustment for age and other factors. Both short and long sleep duration were negatively associated with education level, family income, and leisure-time physical activity and positively associated with number of live births, history of night shift work, and certain chronic diseases, compared to sleep duration around seven hours/day (6.5–7.4 hours/day). Short sleep duration was related to tea consumption and passive smoking. Long sleep duration was related to menopausal status and marital status. Conclusions In this large, population-based study, we found that sleep duration among middle-aged and elderly Chinese women was associated with several sociodemographic and lifestyle factors and with disease status. The main limitation of the study is the cross-sectional design that does not allow us to draw any causal inference. However, this study provides information for future investigation into the nature of these associations so that recommendations can be developed to reduce sleep problems in middle-aged and elderly Chinese women. It also provides important information on potential confounders for investigation of sleep duration on health outcomes in this population. PMID:22938861

Sleep duration and its correlates in middle-aged and elderly Chinese women: the Shanghai Women's Health Study.

PubMed

Tu, Xiangdong; Cai, Hui; Gao, Yu-Tang; Wu, Xiaoyan; Ji, Bu-Tian; Yang, Gong; Li, Honglan; Zheng, Wei; Shu, Xiao Ou

2012-10-01

Abnormal sleep duration, either long or short, is associated with disease risk and mortality. Little information is available on sleep duration and its correlates among Chinese women. Using information collected from 68,832 women who participated in the Shanghai Women's Health Study (SWHS), we evaluated sleep duration and its correlations with sociodemographic and lifestyle factors, health status, and anthropometric measurements and their indexes using polynomial logistic regression. The mean age of the study population was 59.6 years (SD=9.0; range: 44.6-79.9 years) at time of sleep duration assessment. Approximately 80% of women reported sleeping 6-8 h/day, 11.5% slept 5h or less, and 8.7% slept 9h or more. As expected, age was the strongest predictor for sleep duration and was negatively correlated with sleep duration. In general, sleep duration was positively associated with energy intake, intakes of total meat and fruits, body mass index (BMI), waist-hip ratio (WHR), and waist circumference (WC) after adjustment for age and other factors. Both short and long sleep duration were negatively associated with education level, family income, and leisure-time physical activity and positively associated with number of live births, history of night shift work, and certain chronic diseases, compared to sleep duration around 7 h/day (6.5-7.4h/day). Short sleep duration was related to tea consumption and passive smoking. Long sleep duration was related to menopausal status and marital status. In this large, population-based study, we found that sleep duration among middle-aged and elderly Chinese women was associated with several sociodemographic and lifestyle factors and with disease status. The main limitation of the study is the cross-sectional design that does not allow us to draw any causal inference. However, this study provides information for future investigation into the nature of these associations so that recommendations can be developed to reduce sleep problems in middle-aged and elderly Chinese women. It also provides important information on potential confounders for investigation of sleep duration on health outcomes in this population. Copyright © 2012 Elsevier B.V. All rights reserved.

Life expectancy--a commentary on this life table variable.

PubMed

Singer, Richard B

2005-01-01

In 1992, I wrote an article on a method of modifying the Decennial US Life Table to accommodate any pattern of excess mortality expressed in terms of excess death rate (EDR), for the specific purpose of calculating the reduced life expectancy, e. I believe this was the first article published in the Journal of Insurance Medicine (JIM) that dealt specifically with life expectancy as an index of survival and risk appraisal, never used in the classification of extra mortality risk in applicants for life insurance. In this commentary, I discuss the 1989-91 US Decennial Life Table in detail. I link the subject matter of the 1992 article with several more recent articles that also focus on the utility of life expectancy in underwriting structured settlement annuities and preparing reports on life expectancy for an attorney in a tort case. A few references are given for further reading on life table methodology and its use in the most accurate estimate of life expectancy, given the inherent limitations of the life table and the limited duration of follow-up studies.

Dose-Response Relationship of Neuromuscular Training for Injury Prevention in Youth Athletes: A Meta-Analysis

PubMed Central

Steib, Simon; Rahlf, Anna L.; Pfeifer, Klaus; Zech, Astrid

2017-01-01

Background: Youth athletes with intensive sports participation are at an increased risk of sustaining injuries. Neuromuscular training programs reduce sports-related injury risk in this population, however, the dose-response relationship is largely unknown. Thus, the aim of this meta-analysis was to identify the optimal frequency, volume, duration, and period of neuromuscular training to prevent injuries in youth athletes. Methods: Computerized database searches (PubMed, Scopus, SPORTDiscus, The Cochrane Library, PEDro) were conducted in January 2017, with search terms related to youth sports, neuromuscular training, and injury prevention. Eligible trials (i) evaluated a neuromuscular training program; (ii) included youth athletes of 21 years or younger; (iii) had an analytical design (RCTs, quasi-experimental, cohort studies); (iv) contained original data; (v) and provided injury data. Two reviewers independently extracted data and assessed quality of eligible studies. Injury rate ratios (IRRs) for lower extremity injuries were pooled meta-analytically, and moderator analyses examined the effect of training frequency, duration, volume, and period. Results: Data from 16 trials yielded an overall risk reduction of 42% with neuromuscular training (IRR = 0.58, 95%CI 0.47–0.72). Training frequencies of two (IRR = 0.50; 95%CI 0.29–0.86) or three times (IRR = 0.40; 95%CI 0.31–0.53) per week revealed the largest risk reduction, and a weekly training volume of more than 30 min tended to be more effective compared to lower volumes. Programs with 10–15 min (IRR = 0.55; 95%CI 0.42–0.72) session duration produced effects comparable to those with longer session duration (IRR = 0.60; 95%CI 0.46–0.76). Interventions lasting more than 6 months were not superior to shorter programs. Conclusion: This meta-analysis revealed that NMT performed in short bouts of 10–15 min, two to three times per week, with a weekly training volume of 30–60 min had the largest preventive effect for lower extremity injuries in youth athletes. These effects can be achieved within 20–60 sessions and training periods of <6 months. The present results are derived from a relatively small number of studies with heterogeneous methodological quality and should be treated with caution. The study was a priori registered at PROSPERO (CRD42016053473). PMID:29184511

Differential arthropod responses to warming are altering the structure of Arctic communities

PubMed Central

2018-01-01

The Arctic is experiencing some of the fastest rates of warming on the planet. Although many studies have documented responses to such warming by individual species, the idiosyncratic nature of these findings has prevented us from extrapolating them to community-level predictions. Here, we leverage the availability of a long-term dataset from Zackenberg, Greenland (593 700 specimens collected between 1996 and 2014), to investigate how climate parameters influence the abundance of different arthropod groups and overall community composition. We find that variation in mean seasonal temperatures, winter duration and winter freeze–thaw events is correlated with taxon-specific and habitat-dependent changes in arthropod abundances. In addition, we find that arthropod communities have exhibited compositional changes consistent with the expected effects of recent shifts towards warmer active seasons and fewer freeze–thaw events in NE Greenland. Changes in community composition are up to five times more extreme in drier than wet habitats, with herbivores and parasitoids generally increasing in abundance, while the opposite is true for surface detritivores. These results suggest that species interactions and food web dynamics are changing in the Arctic, with potential implications for key ecosystem processes such as decomposition, nutrient cycling and primary productivity. PMID:29765633

Real-time radiative divertor feedback control development for the NSTX-U tokamak using a vacuum ultraviolet spectrometer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Soukhanovskii, V. A., E-mail: vlad@llnl.gov; Kaita, R.; Stratton, B.

2016-11-15

A radiative divertor technique is planned for the NSTX-U tokamak to prevent excessive erosion and thermal damage of divertor plasma-facing components in H-mode plasma discharges with auxiliary heating up to 12 MW. In the radiative (partially detached) divertor, extrinsically seeded deuterium or impurity gases are used to increase plasma volumetric power and momentum losses. A real-time feedback control of the gas seeding rate is planned for discharges of up to 5 s duration. The outer divertor leg plasma electron temperature T{sub e} estimated spectroscopically in real time will be used as a control parameter. A vacuum ultraviolet spectrometer McPherson Modelmore » 251 with a fast charged-coupled device detector is developed for temperature monitoring between 5 and 30 eV, based on the Δn = 0, 1 line intensity ratios of carbon, nitrogen, or neon ion lines in the spectral range 300–1600 Å. A collisional-radiative model-based line intensity ratio will be used for relative calibration. A real-time T{sub e}-dependent signal within a characteristic divertor detachment equilibration time of ∼10–15 ms is expected.« less

Forecasting patient outcomes in the management of hyperlipidemia.

PubMed

Brier, K L; Tornow, J J; Ries, A J; Weber, M P; Downs, J R

1999-03-22

To forecast adult patient outcomes in the management of hyperlipidemia using adult National Health and Examination Survey III (NHANES III) population statistics and National Cholesterol Education Program (NCEP) guidelines for goals of therapy. Review of the hyperlipidemia drug therapy English-language medical literature with emphasis on randomized controlled trials of more than 6 weeks' duration published in the last 7 years, product package inserts, US Food and Drug Administration submission information, and NHANES III population statistics. Data were extracted from studies of lipid-lowering therapy to modify low-density lipoprotein (LDL) levels for primary and secondary prevention of coronary heart disease. The data that were evaluated included sample size, study design, therapeutic intervention, length of study, percentage change in LDL levels, and patient demographics. Cumulative frequency curves of the LDL distribution among the US adult population were constructed. The mean efficacy of drug therapy from qualified studies was used to extrapolate the percentage of the population expected to respond to the intervention and to forecast the patient outcome. A useful tool for clinicians was constructed to approximate the percentage of patients, based on risk stratification, who would reach NCEP target goal after a given pharmacotherapeutic intervention to decrease LDL levels.

Real-time radiative divertor feedback control development for the NSTX-U tokamak using a vacuum ultraviolet spectrometer

DOE PAGES

Soukhanovskii, V. A.; Kaita, R.; Stratton, B.

2016-08-04

Here, a radiative divertor technique is planned for the NSTX-U tokamak to prevent excessive erosion and thermal damage of divertor plasma-facing components in H-mode plasma discharges with auxiliary heating up to 12 MW. In the radiative (partially detached) divertor, extrinsically seeded deuterium or impurity gases are used to increase plasma volumetric power and momentum losses. A real-time feedback control of the gas seeding rate is planned for discharges of up to 5 s duration. The outer divertor leg plasma electron temperature T e estimated spectroscopically in real time will be used as a control parameter. A vacuum ultraviolet spectrometer McPhersonmore » Model 251 with a fast charged-coupled device detector is developed for temperature monitoring between 5 and 30 eV, based on the Δn = 0, 1 line intensity ratios of carbon, nitrogen, or neon ion lines in the spectral range 300–1600 Å. A collisional-radiative model-based line intensity ratio will be used for relative calibration. A real-time T e-dependent signal within a characteristic divertor detachment equilibration time of ~10–15 ms is expected.« less

Proposed changes to the reimbursement of pharmaceuticals and medical devices in Poland and their impact on market access and the pharmaceutical industry

PubMed Central

Badora, Karolina; Caban, Aleksandra; Rémuzat, Cécile; Dussart, Claude; Toumi, Mondher

2017-01-01

ABSTRACT In Poland, two proposed amendments to the reimbursement act are currently in preparation; these are likely to substantially change the pricing and reimbursement landscape for both drugs and medical devices. Proposed changes include: alignment of medical device reimbursement with that of pharmaceuticals; relaxing the strict reimbursement criteria for ultra-orphan drugs; establishment of an additional funding category for vaccines; introduction of compassionate use, and a simplified reimbursement pathway for well-established off-label indications; appreciation of manufacturers’ innovation and research and development efforts by creating a dedicated innovation budget; introduction of a mechanism preventing excessive parallel import; prolonged duration of reimbursement decisions and reimbursement lists; and increased flexibility in defining drug programmes. Both amendments are still at a draft stage and many aspects of the new regulations remain unclear. Nonetheless, the overall direction of some of the changes is already evident and warrants discussion due to their high expected impact on pharmaceutical and device manufacturers. Here we evaluate the main changes proposed to the reimbursement of drugs, vaccines, and medical devices, and examine the impact they are likely to have on market access and pharmaceutical industry in Poland. PMID:29081924

Protection of rhesus macaques from vaginal infection by vaginally delivered maraviroc, an inhibitor of HIV-1 entry via the CCR5 co-receptor.

PubMed

Veazey, Ronald S; Ketas, Thomas J; Dufour, Jason; Moroney-Rasmussen, Terri; Green, Linda C; Klasse, P J; Moore, John P

2010-09-01

An effective vaginal microbicide could reduce human immunodeficiency virus type 1 (HIV-1) transmission to women. Among microbicide candidates in clinical development is Maraviroc (MVC), a small-molecule drug that binds the CCR5 co-receptor and impedes HIV-1 entry into cells. Delivered systemically, MVC reduces viral load in HIV-1-infected individuals, but its ability to prevent transmission is untested. We have now evaluated MVC as a vaginal microbicide with use of a stringent model that involves challenge of rhesus macaques with a high-dose of a CCR5-using virus, SHIV-162P3. Gel-formulated, prescription-grade MVC provided dose-dependent protection, half-maximally at 0.5 mM (0.25 mg/mL). The duration of protection was transient; the longer the delay between MVC application and virus challenge, the less protection (half life of approximately 4 h). As expected, MVC neither protected against challenge with a CXCR4-using virus, SHIV-KU1, nor exacerbated postinfection viremia. These findings validate MVC development as a vaginal microbicide for women and should guide clinical programs.

Protection of rhesus macaques from vaginal infection by vaginally delivered Maraviroc, an inhibitor of HIV-1 entry via the CCR5 co-receptor

PubMed Central

Veazey, Ronald S.; Ketas, Thomas J.; Dufour, Jason; Moroney-Rasmussen, Terri; Green, Linda C.; Klasse, P.J.; Moore, John P.

2010-01-01

An effective vaginal microbicide could reduce human immunodeficiency virus type 1 (HIV-1) transmission to women. Among microbicide candidates in clinical development is Maraviroc (MVC), a small molecule drug that binds the CCR5 co-receptor and impedes HIV-1 entry into cells. Delivered systemically, MVC reduces viral load in HIV-1-infected people, but its ability to prevent transmission is untested. We have now evaluated MVC as a vaginal microbicide, using a stringent model involving challenge of rhesus macaques with a high-dose of a CCR5-using virus, SHIV-162P3. Gel-formulated, prescription-grade MVC provided dose-dependent protection, half-maximally at 0.5 mM (0.25 mg/ml). The duration of protection was transient; the longer the delay between MVC application and virus challenge, the less protection (T1/2 ~ 4 h). As expected, MVC neither protected against challenge with a CXCR4-using virus, SHIV-KU1, nor exacerbated post-infection viremia. These findings validate MVC development as a vaginal microbicide for women, and should guide clinical programs. PMID:20629537

Differential arthropod responses to warming are altering the structure of Arctic communities.

PubMed

Koltz, Amanda M; Schmidt, Niels M; Høye, Toke T

2018-04-01

The Arctic is experiencing some of the fastest rates of warming on the planet. Although many studies have documented responses to such warming by individual species, the idiosyncratic nature of these findings has prevented us from extrapolating them to community-level predictions. Here, we leverage the availability of a long-term dataset from Zackenberg, Greenland (593 700 specimens collected between 1996 and 2014), to investigate how climate parameters influence the abundance of different arthropod groups and overall community composition. We find that variation in mean seasonal temperatures, winter duration and winter freeze-thaw events is correlated with taxon-specific and habitat-dependent changes in arthropod abundances. In addition, we find that arthropod communities have exhibited compositional changes consistent with the expected effects of recent shifts towards warmer active seasons and fewer freeze-thaw events in NE Greenland. Changes in community composition are up to five times more extreme in drier than wet habitats, with herbivores and parasitoids generally increasing in abundance, while the opposite is true for surface detritivores. These results suggest that species interactions and food web dynamics are changing in the Arctic, with potential implications for key ecosystem processes such as decomposition, nutrient cycling and primary productivity.

Primary Care Clinician Expectations Regarding Aging

PubMed Central

Davis, Melinda M.; Bond, Lynne A.; Howard, Alan; Sarkisian, Catherine A.

2011-01-01

Purpose: Expectations regarding aging (ERA) in community-dwelling older adults are associated with personal health behaviors and health resource usage. Clinicians’ age expectations likely influence patients’ expectations and care delivery patterns; yet, limited research has explored clinicians’ age expectations. The Expectations Regarding Aging Survey (ERA-12) was used to assess (a) age expectations in a sample of primary care clinicians practicing in the United States and (b) clinician characteristics associated with ERA-12 scores. Design and Methods: This study was a cross-sectional survey of primary care clinicians affiliated with 5 practice-based research networks, October 2008 to June 2009. A total of 374 of the 1,510 distributed surveys were returned (24.8% response rate); 357 analyzed. Mean respondent age was 48.6 years (SD = 11.6; range 23–87 years); 88.0% physicians, 96.0% family medicine, 94.9% White, and 61.9% male. Results: Female clinicians reported higher ERA-12 scores; clinicians’ age expectations decreased with greater years in practice. Among the clinicians, higher ERA-12 scores were associated with higher clinician ratings of the importance of and personal skill in administering preventive counseling and the importance of delivering preventive services. Agreement with individual ERA-12 items varied widely. Implications: Unrealistically high or low ERA could negatively influence the quality of care provided to patients and patients’ own age expectations. Research should examine the etiology of clinicians’ age expectations and their association with older adult diagnoses and treatment. Medical education must incorporate strategies to promote clinician attitudes that facilitate successful patient aging. PMID:21430129

Characterizing Adult Sleep Behavior Over 20 Years-The Population-Based Doetinchem Cohort Study.

PubMed

Zomers, Margot L; Hulsegge, Gerben; van Oostrom, Sandra H; Proper, Karin I; Verschuren, W M Monique; Picavet, H Susan J

2017-07-01

To describe sleep duration patterns of adults over a 20-year period; to compare sociodemographic, lifestyle, and health characteristics across these patterns; and to relate the patterns to sleep quality. The study population consisted of 3695 adults aged 20 to 59 years at baseline. Five measurements of self-reported sleep duration were used to compose seven patterns from 1987 to 2012: persistent short (≤6 hours), moderate (7-8 hours), or long (≥9 hours) sleep duration and several changing patterns (varying and became short, moderate, or long sleepers). Multinomial logistic regression analyses were used to compare characteristics across sleep duration patterns. About 56% of the adults had persistent moderate sleep duration over 20 years. This group had a better sleep quality than the other groups. Of the adults who changed in their sleep duration (40%), 43% became a short sleeper. Sleep duration patterns that deviate from persistent moderate sleep duration were associated with physical inactivity during leisure time (odds ratios [ORs] and 95% confidence intervals [95% CIs] varied between 1.26 [1.04-1.53] and 1.58 [1.06-2.37]) and with poor self-rated health (ORs [95% CIs] varied between 1.50 [1.20-1.87] and 2.15 [1.48-3.12]). Nearly half of the adults did not have persistent moderate sleep duration over a 20-year period and more than one-sixth became short sleeper. This is reason for concern considering the adverse health status associated with short and long sleep duration. Leisure-time physical activity is a potential important target to prevent unfavorable changes in sleep duration over the life course. © Sleep Research Society 2017. Published by Oxford University Press [on behalf of the Sleep Research Society].

Optimal breastfeeding durations for HIV-exposed infants: the impact of maternal ART use, infant mortality and replacement feeding risk.

PubMed

Mallampati, Divya; MacLean, Rachel L; Shapiro, Roger; Dabis, Francois; Engelsmann, Barbara; Freedberg, Kenneth A; Leroy, Valeriane; Lockman, Shahin; Walensky, Rochelle; Rollins, Nigel; Ciaranello, Andrea

2018-04-01

In 2010, the WHO recommended women living with HIV breastfeed for 12 months while taking antiretroviral therapy (ART) to balance breastfeeding benefits against HIV transmission risks. To inform the 2016 WHO guidelines, we updated prior research on the impact of breastfeeding duration on HIV-free infant survival (HFS) by incorporating maternal ART duration, infant/child mortality and mother-to-child transmission data. Using the Cost-Effectiveness of Preventing AIDS Complications (CEPAC)-Infant model, we simulated the impact of breastfeeding duration on 24-month HFS among HIV-exposed, uninfected infants. We defined "optimal" breastfeeding durations as those maximizing 24-month HFS. We varied maternal ART duration, mortality rates among breastfed infants/children, and relative risk of mortality associated with replacement feeding ("RRRF"), modelled as a multiplier on all-cause mortality for replacement-fed infants/children (range: 1 [no additional risk] to 6). The base-case simulated RRRF = 3, median infant mortality, and 24-month maternal ART duration. In the base-case, HFS ranged from 83.1% (no breastfeeding) to 90.2% (12-months breastfeeding). Optimal breastfeeding durations increased with higher RRRF values and longer maternal ART durations, but did not change substantially with variation in infant mortality rates. Optimal breastfeeding durations often exceeded the previous WHO recommendation of 12 months. In settings with high RRRF and long maternal ART durations, HFS is maximized when mothers breastfeed longer than the previously-recommended 12 months. In settings with low RRRF or short maternal ART durations, shorter breastfeeding durations optimize HFS. If mothers are supported to use ART for longer periods of time, it is possible to reduce transmission risks and gain the benefits of longer breastfeeding durations. © 2018 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

Introduction

NASA Astrophysics Data System (ADS)

Gaskin, J. A.; Smith, I. S.; Jones, W. V.

In 1783, the Montgolfier brothers ushered in a new era of transportation and exploration when they used hot air to drive an un-tethered balloon to an altitude of 2 km. Made of sackcloth and held together with cords, this balloon challenged the way we thought about human travel, and it has since evolved into a robust platform for performing novel science and testing new technologies. Today, high-altitude balloons regularly reach altitudes of 40 km, and they can support payloads that weigh more than 3000 kg. Long-duration balloons can currently support mission durations lasting 55 days, and developing balloon technologies (i.e. Super-Pressure Balloons) are expected to extend that duration to 100 days or longer; competing with satellite payloads. This relatively inexpensive platform supports a broad range of science payloads, spanning multiple disciplines (astrophysics, heliophysics, planetary and earth science). Applications extending beyond traditional science include testing new technologies for eventual space-based application and stratospheric airships for planetary applications.

Sample Size Requirements and Study Duration for Testing Main Effects and Interactions in Completely Randomized Factorial Designs When Time to Event is the Outcome

PubMed Central

Moser, Barry Kurt; Halabi, Susan

2013-01-01

In this paper we develop the methodology for designing clinical trials with any factorial arrangement when the primary outcome is time to event. We provide a matrix formulation for calculating the sample size and study duration necessary to test any effect with a pre-specified type I error rate and power. Assuming that a time to event follows an exponential distribution, we describe the relationships between the effect size, the power, and the sample size. We present examples for illustration purposes. We provide a simulation study to verify the numerical calculations of the expected number of events and the duration of the trial. The change in the power produced by a reduced number of observations or by accruing no patients to certain factorial combinations is also described. PMID:25530661

Expected time-invariant effects of biological traits on mammal species duration.

PubMed

Smits, Peter D

2015-10-20

Determining which biological traits influence differences in extinction risk is vital for understanding the differential diversification of life and for making predictions about species' vulnerability to anthropogenic impacts. Here I present a hierarchical Bayesian survival model of North American Cenozoic mammal species durations in relation to species-level ecological factors, time of origination, and phylogenetic relationships. I find support for the survival of the unspecialized as a time-invariant generalization of trait-based extinction risk. Furthermore, I find that phylogenetic and temporal effects are both substantial factors associated with differences in species durations. Finally, I find that the estimated effects of these factors are partially incongruous with how these factors are correlated with extinction risk of the extant species. These findings parallel previous observations that background extinction is a poor predictor of mass extinction events and suggest that attention should be focused on mass extinctions to gain insight into modern species loss.

Mortality Among Workers Exposed to Toluene Diisocyanate in the US Polyurethane Foam Industry: Update and Exposure-Response Analyses

PubMed Central

Pinkerton, Lynne E.; Yiin, James H.; Daniels, Robert D.; Fent, Kenneth W.

2017-01-01

Background Mortality among 4,545 toluene diisocyante (TDI)-exposed workers was updated through 2011. The primary outcome of interest was lung cancer. Methods Life table analyses, including internal analyses by exposure duration and cumulative TDI exposure, were conducted. Results Compared with the US population, all cause and all cancer mortality was increased. Lung cancer mortality was increased but was not associated with exposure duration or cumulative TDI exposure. In post hoc analyses, lung cancer mortality was associated with employment duration in finishing jobs, but not in finishing jobs involving cutting polyurethane foam. Conclusions Dermal exposure, in contrast to inhalational exposure, to TDI is expected to be greater in finishing jobs and may play a role in the observed increase in lung cancer mortality. Limitations include the lack of smoking data, uncertainty in the exposure estimates, and exposure estimates that reflected inhalational exposure only. PMID:27346061

The Confidence-Accuracy Relationship for Eyewitness Identification Decisions: Effects of Exposure Duration, Retention Interval, and Divided Attention

ERIC Educational Resources Information Center

Palmer, Matthew A.; Brewer, Neil; Weber, Nathan; Nagesh, Ambika

2013-01-01

Prior research points to a meaningful confidence-accuracy (CA) relationship for positive identification decisions. However, there are theoretical grounds for expecting that different aspects of the CA relationship (calibration, resolution, and over/underconfidence) might be undermined in some circumstances. This research investigated whether the…

Analysis of Alternatives (AoA) Process Improvement Study

DTIC Science & Technology

2016-12-01

stakeholders, and mapped the process activities and durations. We tasked the SAG members with providing the information required on case studies and...are the expected time saves/cost/risk of any changes? (3) Utilization of case studies for both “good” and “challenged” AoAs to identify lessons...16 4 CASE STUDIES

49 CFR 238.435 - Interior fittings and surfaces.

Code of Federal Regulations, 2012 CFR

2012-10-01

... expected to strike the fitting, when the floor of the passenger car decelerates with a triangular crash... attachment in a passenger car shall be designed to withstand, with deflection but without total failure, the... triangular crash pulse having a peak of 8g and a duration of 250 milliseconds. (b) Each seat back in a...

49 CFR 238.435 - Interior fittings and surfaces.

Code of Federal Regulations, 2013 CFR

2013-10-01

... expected to strike the fitting, when the floor of the passenger car decelerates with a triangular crash... attachment in a passenger car shall be designed to withstand, with deflection but without total failure, the... triangular crash pulse having a peak of 8g and a duration of 250 milliseconds. (b) Each seat back in a...

49 CFR 238.435 - Interior fittings and surfaces.

Code of Federal Regulations, 2014 CFR

2014-10-01

... expected to strike the fitting, when the floor of the passenger car decelerates with a triangular crash... attachment in a passenger car shall be designed to withstand, with deflection but without total failure, the... triangular crash pulse having a peak of 8g and a duration of 250 milliseconds. (b) Each seat back in a...

49 CFR 238.435 - Interior fittings and surfaces.

Code of Federal Regulations, 2011 CFR

2011-10-01

... expected to strike the fitting, when the floor of the passenger car decelerates with a triangular crash... attachment in a passenger car shall be designed to withstand, with deflection but without total failure, the... triangular crash pulse having a peak of 8g and a duration of 250 milliseconds. (b) Each seat back in a...

Continued Driving and Time to Transition to Nondriver Status through Error-Specific Driving Restrictions

ERIC Educational Resources Information Center

Freund, Barbara; Petrakos, Davithoula

2008-01-01

We developed driving restrictions that are linked to specific driving errors, allowing cognitively impaired individuals to continue to independently meet mobility needs while minimizing risk to themselves and others. The purpose of this project was to evaluate the efficacy and duration expectancy of these restrictions in promoting safe continued…

Intensity - Duration - Frequency Curves for U.S. Cities in a Warming Climate

NASA Astrophysics Data System (ADS)

Ragno, Elisa; AghaKouchak, Amir; Love, Charlotte; Vahedifard, Farshid; Cheng, Linyin; Lima, Carlos

2017-04-01

Current infrastructure design procedures rely on the use of Intensity - Duration - Frequency (IDF) curves retrieved under the assumption of temporal stationarity, meaning that occurrences of extreme events are expected to be time invariant. However, numerous studies have observed more severe extreme events over time. Hence, the stationarity assumption for extreme analysis may not be appropriate in a warming climate. This issue raises concerns regarding the safety and resilience of infrastructures and natural slopes. Here we employ daily precipitation data from historical and projected (RCP 8.5) CMIP5 runs to investigate IDF curves of 14 urban areas across the United States. We first statistically assess changes in precipitation extremes using an energy-based test for equal distributions. Then, through a Bayesian inference approach for stationary and non-stationary extreme value analysis, we provide updated IDF curves based on future climatic model projections. We show that, based on CMIP5 simulations, U.S cities may experience extreme precipitation events up to 20% more intense and twice as frequently, relative to historical records, despite the expectation of unchanged annual mean precipitation.

Updated Intensity - Duration - Frequency Curves Under Different Future Climate Scenarios

NASA Astrophysics Data System (ADS)

Ragno, E.; AghaKouchak, A.

2016-12-01

Current infrastructure design procedures rely on the use of Intensity - Duration - Frequency (IDF) curves retrieved under the assumption of temporal stationarity, meaning that occurrences of extreme events are expected to be time invariant. However, numerous studies have observed more severe extreme events over time. Hence, the stationarity assumption for extreme analysis may not be appropriate in a warming climate. This issue raises concerns regarding the safety and resilience of the existing and future infrastructures. Here we employ historical and projected (RCP 8.5) CMIP5 runs to investigate IDF curves of 14 urban areas across the United States. We first statistically assess changes in precipitation extremes using an energy-based test for equal distributions. Then, through a Bayesian inference approach for stationary and non-stationary extreme value analysis, we provide updated IDF curves based on climatic model projections. This presentation summarizes the projected changes in statistics of extremes. We show that, based on CMIP5 simulations, extreme precipitation events in some urban areas can be 20% more severe in the future, even when projected annual mean precipitation is expected to remain similar to the ground-based climatology.

Dynamics and detection of laser induced microbubbles in the retinal pigment epithelium (RPE)

NASA Astrophysics Data System (ADS)

Fritz, Andreas; Ptaszynski, Lars; Stoehr, Hardo; Brinkmann, Ralf

2007-07-01

Selective Retina Treatment (SRT) is a new method to treat eye diseases associated with disorders of the RPE. Selective RPE cell damage is achieved by applying a train of 1.7 μs laser pulses at 527 nm. The treatment of retinal diseases as e.g. diabetic maculopathy (DMP), is currently investigated within clinical studies, however 200 ns pulse durations are under investigation. Transient micro bubbles in the retinal pigment epithelium (RPE) are expected to be the origin of cell damage due to irradiation with laser pulses shorter than 50 μs. The bubbles emerge at the strongly absorbing RPE melanosomes. Cell membrane disruption caused by the transient associated volume increase is expected to be the origin of the angiographically observed RPE leakage. We investigate micro bubble formation and dynamics in porcine RPE using pulse durations of 150 ns. A laser interferometry system at 830 nm with the aim of an online dosimetry control for SRT was developed. Bubble formation was detected interferometrically and by fast flash photography. A correlation to cell damage observed with a vitality stain is found. A bubble detection algorithm is presented.

Comparison of piezosurgery and conventional rotative instruments in direct sinus lifting.

PubMed

Delilbasi, Cagri; Gurler, Gokhan

2013-12-01

The purpose of this study was to compare the intraoperative and postoperative effects of Piezosurgery and conventional rotative instruments in direct sinus lifting procedure. Twenty-three patients requiring direct sinus lifting were enrolled. The osteotomy and sinus membrane elevation were performed either with Piezosurgery tips or rotative diamond burs and manual membrane elevators. Time elapsed between bony window opening and completion of membrane elevation (duration), incidence of membrane perforation, visibility of the operation site, postoperative pain, swelling, sleeping, eating, phonetics, daily routine, and missed work as well as patient's expectation before and experience after the operation were evaluated. There was no significant difference between Piezosurgery and conventional groups regarding incidence of membrane perforation, duration, and operation site visibility as well as patient's expectation before and experience after the operation (P > 0.05). However, there were significantly more pain and swelling in the conventional group compared with the Piezosurgery group (P ≤ 0.05). Sinus lifting procedure performed with Piezosurgery causes less pain and swelling postoperatively compared with conventional technique. Patients' daily life activities and experience about the operation are not affected from the surgical technique.

Should the IDEFICS outcomes have been expected?

USDA-ARS?s Scientific Manuscript database

The Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study evaluated with a large sample a comprehensive carefully planned obesity prevention intervention targeting multiple levels of influence that were culturally adapted to the situat...

Estimating the duration of intracellular action potentials in muscle fibres from single-fibre extracellular potentials.

PubMed

Rodríguez, Javier; Navallas, Javier; Gila, Luis; Dimitrova, Nonna Alexandrovna; Malanda, Armando

2011-04-30

In situ recording of the intracellular action potential (IAP) of human muscle fibres is not yet possible, and consequently, knowledge concerning certain IAP characteristics is still limited. According to the core-conductor theory, close to a fibre, a single fibre action potential (SFAP) can be assumed to be proportional to the IAP second derivative. Thus, we might expect to be able to derive some characteristics of the IAP, such as the duration of its spike, from the SFAP waveform. However, SFAP properties not only depend on the IAP shape but also on the fibre-to-electrode (radial) distance and other physiological properties of the fibre. In this paper we, first, propose an SFAP parameter (the negative phase duration, NPD) appropriate for estimating the IAP spike duration and, second, show that this parameter is largely independent of changes in radial distance and muscle fibre propagation velocity. Estimation of the IAP spike duration from a direct measurement taken from the SFAP waveform provides a possible way to enhance the accuracy of SFAP models. Because IAP spike duration is known to be sensitive to the effects of fatigue and calcium accumulation, the proposed SFAP parameter, the NPD, has potential value in electrodiagnosis and as an indicator of IAP profile changes due to peripheral fatigue. Copyright © 2011 Elsevier B.V. All rights reserved.

Cluster randomised controlled trial of a financial incentive for mothers to improve breast feeding in areas with low breastfeeding rates: the NOSH study protocol

PubMed Central

Relton, Clare; Strong, Mark; Renfrew, Mary J; Thomas, Kate; Burrows, Julia; Whelan, Barbara; Whitford, Heather M; Scott, Elaine; Fox-Rushby, Julia; Anoyke, Nana; Sanghera, Sabina; Johnson, Maxine; Sue, Easton; Walters, Stephen

2016-01-01

Introduction Breast feeding can promote positive long-term and short-term health outcomes in infant and mother. The UK has one of the lowest breastfeeding rates (duration and exclusivity) in the world, resulting in preventable morbidities and associated healthcare costs. Breastfeeding rates are also socially patterned, thereby potentially contributing to health inequalities. Financial incentives have been shown to have a positive effect on health behaviours in previously published studies. Methods and analysis Based on data from earlier development and feasibility stages, a cluster (electoral ward) randomised trial with mixed-method process and content evaluation was designed. The ‘Nourishing Start for Health’ (NOSH) intervention comprises a financial incentive programme of up to 6 months duration, delivered by front-line healthcare professionals, in addition to existing breastfeeding support. The intervention aims to increase the prevalence and duration of breast feeding in wards with low breastfeeding rates. The comparator is usual care (no offer of NOSH intervention). Routine data on breastfeeding rates at 6–8 weeks will be collected for 92 clusters (electoral wards) on an estimated 10 833 births. This sample is calculated to provide 80% power in determining a 4% point difference in breastfeeding rates between groups. Content and process evaluation will include interviews with mothers, healthcare providers, funders and commissioners of infant feeding services. The economic analyses, using a healthcare provider's perspective, will be twofold, including a within-trial cost-effectiveness analysis and beyond-trial modelling of longer term expectations for cost-effectiveness. Results of economic analyses will be expressed as cost per percentage point change in cluster level in breastfeeding rates between trial arms. In addition, we will present difference in resource use impacts for a range of acute conditions in babies aged 0–6 months. Ethics and dissemination Participating organisations Research and Governance departments approved the study. Results will be published in peer-reviewed journals and at conference presentations. Trial registration number ISRCTN44898617; Pre-results. PMID:27067889

Cluster randomised controlled trial of a financial incentive for mothers to improve breast feeding in areas with low breastfeeding rates: the NOSH study protocol.

PubMed

Relton, Clare; Strong, Mark; Renfrew, Mary J; Thomas, Kate; Burrows, Julia; Whelan, Barbara; Whitford, Heather M; Scott, Elaine; Fox-Rushby, Julia; Anoyke, Nana; Sanghera, Sabina; Johnson, Maxine; Easton, Sue; Walters, Stephen

2016-04-11

Breast feeding can promote positive long-term and short-term health outcomes in infant and mother. The UK has one of the lowest breastfeeding rates (duration and exclusivity) in the world, resulting in preventable morbidities and associated healthcare costs. Breastfeeding rates are also socially patterned, thereby potentially contributing to health inequalities. Financial incentives have been shown to have a positive effect on health behaviours in previously published studies. Based on data from earlier development and feasibility stages, a cluster (electoral ward) randomised trial with mixed-method process and content evaluation was designed. The 'Nourishing Start for Health' (NOSH) intervention comprises a financial incentive programme of up to 6 months duration, delivered by front-line healthcare professionals, in addition to existing breastfeeding support. The intervention aims to increase the prevalence and duration of breast feeding in wards with low breastfeeding rates. The comparator is usual care (no offer of NOSH intervention). Routine data on breastfeeding rates at 6-8 weeks will be collected for 92 clusters (electoral wards) on an estimated 10,833 births. This sample is calculated to provide 80% power in determining a 4% point difference in breastfeeding rates between groups. Content and process evaluation will include interviews with mothers, healthcare providers, funders and commissioners of infant feeding services. The economic analyses, using a healthcare provider's perspective, will be twofold, including a within-trial cost-effectiveness analysis and beyond-trial modelling of longer term expectations for cost-effectiveness. Results of economic analyses will be expressed as cost per percentage point change in cluster level in breastfeeding rates between trial arms. In addition, we will present difference in resource use impacts for a range of acute conditions in babies aged 0-6 months. Participating organisations Research and Governance departments approved the study. Results will be published in peer-reviewed journals and at conference presentations. ISRCTN44898617; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

A stable dynamic cohort analysis of installing cost-effective rollover protective structures (CROPS).

PubMed

Owusu-Edusei, K; Biddle, E A

2007-04-01

Cost-effective rollover protective structures (CROPS) are less costly model-specific rollover protective structure (ROPS) retrofits that are being developed and evaluated with the hope of increasing adoption and eventually preventing or mitigating injuries due to tractor overturns. A dynamic cohort of the estimated retrofittable non-ROPS tractors (accounting for attrition due to aging) was tracked over a 20-year period to determine the expected costs, as well as the expected number of fatal and non-fatal injuries resulting from tractor overturns. Two alternatives were tracked: No-ROPS and Install-CROPS. For a starting cohort size of 1,065,164 (an estimate for the year 2004), the Install-CROPS option prevented an estimated total of 878 (192 fatal and 686 non-fatal) injuries over the 20-year period. Expected costs were $513 million (cost of installing CROPS on all the non-ROPS tractors plus cost of the associated injuries) and $284 million (cost of injuries resulting from the No-ROPS option) over the same time period. Thus, the net cost per injury prevented was $260,820. When the cost of intervention ($1000 for purchasing, shipping, and installation of existing ROPS retrofit) was used in the analysis, the cost-effectiveness ratio was $927,000 per injury prevented over the 20-year period. Thus, installing CROPS instead of existing ROPS retrofits improved the cost-effectiveness ratio substantially, with a 72% reduction in the net cost per injury prevented.

Automatic generation of efficient orderings of events for scheduling applications

NASA Technical Reports Server (NTRS)

Morris, Robert A.

1994-01-01

In scheduling a set of tasks, it is often not known with certainty how long a given event will take. We call this duration uncertainty. Duration uncertainty is a primary obstacle to the successful completion of a schedule. If a duration of one task is longer than expected, the remaining tasks are delayed. The delay may result in the abandonment of the schedule itself, a phenomenon known as schedule breakage. One response to schedule breakage is on-line, dynamic rescheduling. A more recent alternative is called proactive rescheduling. This method uses statistical data about the durations of events in order to anticipate the locations in the schedule where breakage is likely prior to the execution of the schedule. It generates alternative schedules at such sensitive points, which can be then applied by the scheduler at execution time, without the delay incurred by dynamic rescheduling. This paper proposes a technique for making proactive error management more effective. The technique is based on applying a similarity-based method of clustering to the problem of identifying similar events in a set of events.

Prevention of post-partum hemorrhage by rectal Misoprostol: A randomized clinical trial

PubMed Central

Firouzbakht, Mozhgan; Kiapour, Azadeh; Omidvar, Shabnam

2013-01-01

Background: Post-partum hemorrhage (PPH) is a common cause of maternal mortality in developing countries. This trial was conducted to study the effectiveness and safety of rectal misoprostol for PPH. Aim: To assess the effectiveness and safety of misoprostol and comparing with oxytocin for prevention of PPH. Materials and Methods: Women were randomized to receive either two 200 μg rectal misoprostol tablets (study group) or 20 units oxytocin in 1000 cc normal saline intravenously (control group). The outcomes were incidence of PPH, amount of blood loss, duration of labor, incidence of side effects, pre- and post-delivery hemoglobin, and use of additional uterotonics. Finding: The incidence of PPH was 12% in the study group and 10% in the control group (P > 0.05). No significant difference was observed between the groups hematocrit (P > 0.05). Other variables including severe PPH and duration of the third stage of labor were similar in both groups. Conclusion: Rectal misoprostol was as effective as intravenous oxytocin for preventing post-partum hemorrhage with the same incidence of side effects and is recommended to be use as an uterotonic agent to manage third stage of labor routinely. PMID:23633849

A feasible repetitive transcranial magnetic stimulation clinical protocol in migraine prevention.

PubMed

Zardouz, Shawn; Shi, Lei; Leung, Albert

2016-01-01

This case series was conducted to determine the clinical feasibility of a repetitive transcranial magnetic stimulation protocol for the prevention of migraine (with and without aura). Five patients with migraines underwent five repetitive transcranial magnetic stimulation sessions separated in 1- to 2-week intervals for a period of 2 months at a single tertiary medical center. Repetitive transcranial magnetic stimulation was applied to the left motor cortex with 2000 pulses (20 trains with 1s inter-train interval) delivered per session, at a frequency of 10 Hz and 80% resting motor threshold. Pre- and post-treatment numerical rating pain scales were collected, and percent reductions in intensity, frequency, and duration were generated. An average decrease in 37.8%, 32.1%, and 31.2% were noted in the intensity, frequency, and duration of migraines post-repetitive transcranial magnetic stimulation, respectively. A mean decrease in 1.9±1.0 (numerical rating pain scale ± standard deviation; range: 0.4-2.8) in headache intensity scores was noted after the repetitive transcranial magnetic stimulation sessions. The tested repetitive transcranial magnetic stimulation protocol is a well-tolerated, safe, and effective method for migraine prevention.

Modifiable Risk Factors and Interventions for Childhood Obesity Prevention within the First 1,000 Days.

PubMed

Dattilo, Anne M

2017-01-01

Worldwide, the prevalence of childhood obesity has increased, amounting to 42 million overweight or obese children, and there is increasing evidence that the origins are within the first 1,000 days: the period of conception through 2 years. Antecedents of early childhood obesity are multifactorial, and associations of varying strength have been documented for genetic/epigenetic, biologic, dietary, environmental, social, and behavioral influences. Modifiable factors in pregnancy and early infancy associated with childhood obesity include maternal overweight/obesity, maternal smoking, gestational weight gain, infant and young child feeding, caregiver responsive feeding practices, as well as sleep duration, and physical activity. Promising obesity prevention interventions include those beginning during the first 1,000 days, using a multicomponent approach, with roots in nutrition education theories or behavior change communication that can continue over time. However, the limited number of completed interventions to date (within pediatric clinics or in home-based or community settings) may not be scalable to the magnitude needed for sustainable obesity prevention. Scale-up interventions that can be maintained for the durations needed, addressing infant and young child feeding and other modifiable risk factors associated with childhood obesity are needed. © 2017 Nestec Ltd., Vevey/S. Karger AG, Basel.

Current Legislative Initiatives and Geophysics

NASA Astrophysics Data System (ADS)

Stephan, S. G.

2002-05-01

Geophysical research will be most effective in the fight against terrorism if it is done in cooperation with the expectations of local, state and federal policy makers. New tools to prevent, prepare for, and respond to acts of terrorism are coming from all fields, including geoscience. Globally, monitoring the land, oceans, atmosphere, and space for unusual and suspicious activities can help prevent terrorist acts. Closer to home, geoscience research is used to plan emergency transportation routes and identify infrastructure vulnerabilities. As important as it is for Congress and other policy makers to appreciate the promises and limitations of geophysical research, scientists need to be aware of legislative priorities and expectations. What does Congress expect from the geoscience community in the fight against terrorism and how well does reality meet these expectations? What tools do the 44 different federal agencies with stated Homeland Security missions need from geoscientists? I will address these questions with an overview of current legislative antiterrorism initiatives and policies that relate to the geoscience community.

Evidence that spinal segmental nitric oxide mediates tachyphylaxis to peripheral local anesthetic nerve block.

PubMed

Wang, C; Sholas, M G; Berde, C B; DiCanzio, J; Zurakowski, D; Wilder, R T

2001-09-01

Tachyphylaxis to sciatic nerve blockade in rats correlates with hyperalgesia. Spinal inhibition of nitric oxide synthase with N(G)nitro-L-arginine methyl ester (L-NAME) has been shown to prevent hyperalgesia. Given systemically, L-NAME also prevents tachyphylaxis. The action of L-NAME in preventing tachyphylaxis therefore may be mediated at spinal sites. We compared systemic versus intrathecal potency of L-NAME in modulating tachyphylaxis to sciatic nerve block. Rats were prepared with intrathecal catheters. Three sequential sciatic nerve blocks were placed. Duration of block of thermal nocifensive, proprioceptive and motor responses was recorded. We compared spinal versus systemic dose-response to L-NAME, and examined effects of intrathecal arginine on tachyphylaxis. An additional group of rats underwent testing after T10 spinal cord transection. In these rats duration of sciatic nerve block was assessed by determining the heat-induced flexion withdrawal reflex. L-NAME was 25-fold more potent in preventing tachyphylaxis given intrathecally than intraperitoneally. Intrathecal arginine augmented tachyphylaxis. Spinalized rats exhibited tachyphylaxis to sciatic block. The increased potency of intrathecal versus systemic L-NAME suggests a spinal site of action in inhibiting tachyphylaxis. Descending pathways are not necessary for the development of tachyphylaxis since it occurs even after T10 spinal cord transection. Thus tachyphylaxis, like hyperalgesia, is mediated at least in part by a spinal site of action.

Acute cell death rate of vascular smooth muscle cells during or after short heating up to 20s ranging 50 to 60°C as a basic study of thermal angioplasty

NASA Astrophysics Data System (ADS)

Shinozuka, Machiko; Shimazaki, Natsumi; Ogawa, Emiyu; Machida, Naoki; Arai, Tsunenori

2014-02-01

We studied the relations between the time history of smooth muscle cells (SMCs) death rate and heating condition in vitro to clarify cell death mechanism in heating angioplasty, in particular under the condition in which intimal hyperplasia growth had been prevented in vivo swine experiment. A flow heating system on the microscope stage was used for the SMCs death rate measurement during or after the heating. The cells were loaded step-heating by heated flow using a heater equipped in a Photo-thermo dynamic balloon. The heating temperature was set to 37, 50-60°C. The SMCs death rate was calculated by a division of PI stained cell number by Hoechst33342 stained cell number. The SMCs death rate increased 5-10% linearly during 20 s with the heating. The SMCs death rate increased with duration up to 15 min after 5 s heating. Because fragmented nuclei were observed from approximately 5 min after the heating, we defined that acute necrosis and late necrosis were corresponded to within 5 min after the heating and over 5 min after the heating, respectively. This late necrosis is probably corresponding to apoptosis. The ratio of necrotic interaction divided the acute necrosis rate by the late necrosis was calculated based on this consideration as 1.3 under the particular condition in which intimal hyperplasia growth was prevented in vivo previous porcine experiment. We think that necrotic interaction rate is larger than expected rate to obtain intimal hyperplasia suppression.

Incidence and nature of adverse reactions to antibiotics used as endocarditis prophylaxis

PubMed Central

Thornhill, Martin H.; Dayer, Mark J.; Prendergast, Bernard; Baddour, Larry M.; Jones, Simon; Lockhart, Peter B.

2015-01-01

Objectives Antibiotic prophylaxis (AP) administration prior to invasive dental procedures has been a leading focus of infective endocarditis prevention. However, there have been long-standing concerns about the risk of adverse drug reactions as a result of this practice. The objective of this study was to identify the incidence and nature of adverse reactions to amoxicillin and clindamycin prophylaxis to prevent infective endocarditis. Methods We obtained AP prescribing data for England from January 2004 to March 2014 from the NHS Business Services Authority, and adverse drug reaction data from the Medicines and Healthcare Products Regulatory Agency's Yellow Card reporting scheme for prescriptions of the standard AP protocol of a single 3 g oral dose of amoxicillin or a single 600 mg oral dose of clindamycin for those allergic to penicillin. Results The reported adverse drug reaction rate for amoxicillin AP was 0 fatal reactions/million prescriptions (in fact 0 fatal reactions for nearly 3 million prescriptions) and 22.62 non-fatal reactions/million prescriptions. For clindamycin, it was 13 fatal and 149 non-fatal reactions/million prescriptions. Most clindamycin adverse drug reactions were Clostridium difficile infections. Conclusions AP adverse drug reaction reporting rates in England were low, particularly for amoxicillin, and lower than previous estimates. This suggests that amoxicillin AP is comparatively safe for patients without a history of amoxicillin allergy. The use of clindamycin AP was, however, associated with significant rates of fatal and non-fatal adverse drug reactions associated with C. difficile infections. These were higher than expected and similar to those for other doses, durations and routes of clindamycin administration. PMID:25925595

Cochrane Commentary: Probiotics For Prevention of Acute Upper Respiratory Infection.

PubMed

Quick, Melissa

2015-01-01

Probiotics may improve a person's health by regulating their immune function. Some trials have shown that probiotic strains can prevent respiratory infections. Even though the previous version of our review showed benefits of probiotics for acute upper respiratory tract infections (URTIs), several new studies have been published. To assess the effectiveness and safety of probiotics (any specified strain or dose), compared with placebo, in the prevention of acute URTIs in people of all ages, who are at risk of acute URTIs. We searched CENTRAL (2014, Issue 6), MEDLINE (1950 to July week 3, 2014), EMBASE (1974 to July 2014), Web of Science (1900 to July 2014), the Chinese Biomedical Literature Database, which includes the China Biological Medicine Database (from 1978 to July 2014), the Chinese Medicine Popular Science Literature Database (from 2000 to July 2014) and the Masters Degree Dissertation of Beijing Union Medical College Database (from 1981 to July 2014). We also searched the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov for completed and ongoing trials on 31 July 2014. Randomised controlled trials (RCTs) comparing probiotics with placebo to prevent acute URTIs. Two review authors independently assessed the eligibility and quality of trials, and extracted data using the standard methodological procedures expected by The Cochrane Collaboration. We included 13 RCTs, although we could only extract data to meta-analyze 12 trials, which involved 3720 participants including children, adults (aged around 40 years) and older people. We found that probiotics were better than placebo when measuring the number of participants experiencing episodes of acute URTI [at least one episode: odds ratio (OR): 0.53; 95% CI = 0.37-0.76, P < .001, low quality evidence; at least three episodes: OR: 0.53; 95% CI = 0.36-0.80, P = .002, low quality evidence]; the mean duration of an episode of acute URTI [mean difference (MD): -1.89; 95% CI = -2.03 to -1.75, P < .001, low quality evidence]; reduced antibiotic prescription rates for acute URTIs (OR: 0.65; 95% CI = 0.45-0.94, moderate quality evidence) and cold-related school absence (OR: 0.10; 95% CI = 0.02-0.47, very low quality evidence). Probiotics and placebo were similar when measuring the rate ratio of episodes of acute URTI (rate ratio: 0.83; 95% CI = 0.66-1.05, P = .12, very low quality evidence) and adverse events (OR: 0.88; 95% CI = 0.65-1.19, P = .40, low quality evidence). Side effects of probiotics were minor and gastrointestinal symptoms were the most common. We found that some subgroups had a high level of heterogeneity when we conducted pooled analyses and the evidence level was low or very low quality. Probiotics were better than placebo in reducing the number of participants experiencing episodes of acute URTI, the mean duration of an episode of acute URTI, antibiotic use and cold-related school absence. This indicates that probiotics may be more beneficial than placebo for preventing acute URTIs. However, the quality of the evidence was low or very low. Copyright © 2015. Published by Elsevier Inc.

Probiotics for preventing acute upper respiratory tract infections.

PubMed

Hao, Qiukui; Dong, Bi Rong; Wu, Taixiang

2015-02-03

Probiotics may improve a person's health by regulating their immune function. Some trials have shown that probiotic strains can prevent respiratory infections. Even though the previous version of our review showed benefits of probiotics for acute upper respiratory tract infections (URTIs), several new studies have been published. To assess the effectiveness and safety of probiotics (any specified strain or dose), compared with placebo, in the prevention of acute URTIs in people of all ages, at risk of acute URTIs. We searched CENTRAL (2014, Issue 6), MEDLINE (1950 to July week 3, 2014), EMBASE (1974 to July 2014), Web of Science (1900 to July 2014), the Chinese Biomedical Literature Database, which includes the China Biological Medicine Database (from 1978 to July 2014), the Chinese Medicine Popular Science Literature Database (from 2000 to July 2014) and the Masters Degree Dissertation of Beijing Union Medical College Database (from 1981 to July 2014). We also searched the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov for completed and ongoing trials on 31 July 2014. Randomised controlled trials (RCTs) comparing probiotics with placebo to prevent acute URTIs. Two review authors independently assessed the eligibility and quality of trials, and extracted data using the standard methodological procedures expected by The Cochrane Collaboration. We included 13 RCTs, although we could only extract data to meta-analyse 12 trials, which involved 3720 participants including children, adults (aged around 40 years) and older people. We found that probiotics were better than placebo when measuring the number of participants experiencing episodes of acute URTI (at least one episode: odds ratio (OR) 0.53; 95% confidence interval (CI) 0.37 to 0.76, P value < 0.001, low quality evidence; at least three episodes: OR 0.53; 95% CI 0.36 to 0.80, P value = 0.002, low quality evidence); the mean duration of an episode of acute URTI (mean difference (MD) -1.89; 95% CI -2.03 to -1.75, P value < 0.001, low quality evidence); reduced antibiotic prescription rates for acute URTIs (OR 0.65; 95% CI 0.45 to 0.94, moderate quality evidence) and cold-related school absence (OR 0.10; 95% CI 0.02 to 0.47, very low quality evidence). Probiotics and placebo were similar when measuring the rate ratio of episodes of acute URTI (rate ratio 0.83; 95% CI 0.66 to 1.05, P value = 0.12, very low quality evidence) and adverse events (OR 0.88; 95% CI 0.65 to 1.19, P value = 0.40, low quality evidence). Side effects of probiotics were minor and gastrointestinal symptoms were the most common. We found that some subgroups had a high level of heterogeneity when we conducted pooled analyses and the evidence level was low or very low quality. Probiotics were better than placebo in reducing the number of participants experiencing episodes of acute URTI, the mean duration of an episode of acute URTI, antibiotic use and cold-related school absence. This indicates that probiotics may be more beneficial than placebo for preventing acute URTIs. However, the quality of the evidence was low or very low.

30 CFR 250.450 - What are the recordkeeping requirements for BOP tests?

Code of Federal Regulations, 2014 CFR

2014-07-01

..., DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Drilling Operations Blowout Preventer (bop) System Requirements § 250.450 What are the... the duration of drilling. ...

30 CFR 250.450 - What are the recordkeeping requirements for BOP tests?

Code of Federal Regulations, 2012 CFR

2012-07-01

..., DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Drilling Operations Blowout Preventer (bop) System Requirements § 250.450 What are the... the duration of drilling. ...

30 CFR 250.450 - What are the recordkeeping requirements for BOP tests?

Code of Federal Regulations, 2013 CFR

2013-07-01

..., DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Drilling Operations Blowout Preventer (bop) System Requirements § 250.450 What are the... the duration of drilling. ...

Efficacy and safety of haloperidol for in-hospital delirium prevention and treatment: A systematic review of current evidence.

PubMed

Schrijver, E J M; de Graaf, K; de Vries, O J; Maier, A B; Nanayakkara, P W B

2016-01-01

Haloperidol is generally considered the drug of choice for in-hospital delirium management. We conducted a systematic review to evaluate the evidence for the efficacy and safety of haloperidol for the prevention and treatment of delirium in hospitalized patients. PubMed, Embase, Cumulative Index to Nursing and Allied Health (CINAHL), PsycINFO, and the Cochrane Library were systematically searched up to April 21, 2015. We included English full-text randomized controlled trials using haloperidol for the prevention or treatment of delirium in adult hospitalized patients reporting on delirium incidence, duration, or severity as primary outcome. Quality of evidence was graded. Meta-analysis was not conducted because of between-study heterogeneity. Twelve studies met our inclusion criteria, four prevention and eight treatment trials. Methodological limitations decreased the graded quality of included studies. Results from placebo-controlled prevention studies suggest a haloperidol-induced protective effect for delirium in older patients scheduled for surgery: two studies reported a significant reduction in ICU delirium incidence and one study found a significant reduction in delirium severity and duration. Although placebo-controlled trials are missing, pharmacological treatment of established delirium reduced symptom severity. Haloperidol administration was not associated with treatment-limiting side-effects, but few studies used a systematic approach to identify adverse events. Although results on haloperidol for delirium management seem promising, current prevention trials lack external validity and treatment trials did not include a placebo arm on top of standard nonpharmacological care. We therefore conclude that the current use of haloperidol for in-hospital delirium is not based on robust and generalizable evidence. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Inhibition of potassium currents is involved in antiarrhythmic effect of moderate ethanol on atrial fibrillation.

PubMed

Yang, Baode; Li, Chenxing; Sun, Junyi; Wang, Xinghui; Liu, Xinling; Yang, Chun; Chen, Lina; Zhou, Jun; Hu, Hao

2017-05-01

Excessive consumption of alcohol is a well-established risk factor of atrial fibrillation (AF). However, the effects of moderate alcohol drinking remain to be elucidated. This study was designed to determine the effects of moderate ethanol ingestion on atrial fibrillation and the electrophysiological mechanisms. In acetylcholine-induced canine and mouse AF models, the moderate ethanol prevented the generation and persistence of AF through prolonging the latent period of AF and shortening the duration of AF. The action potential duration (APD) was remarkably prolonged under the concentration range of 12.5-50.0mM ethanol in guinea pig atrial myocytes. Ultra-rapid delayed rectified potassium currents (I Kv1.5 ) were markedly inhibited by 12.5-50.0mM ethanol in a concentration-dependent manner. Ethanol with 50.0mM could inhibit rapid delayed rectifier potassium currents (I hERG ). Ethanol under 6.25-50.0mM did not affect on inward rectifier potassium currents (I Kir2.1 ). Collectively, the present study provided an evidence that moderate ethanol intake can prolong the APD of atrial myocytes by inhibition of I Kv1.5 and I hERG , which contributed to preventing the development and duration of AF. Copyright © 2017 Elsevier Inc. All rights reserved.

Protective effects of isorhynchophylline on cardiac arrhythmias in rats and guinea pigs.

PubMed

Gan, Runtao; Dong, Guo; Yu, Jiangbo; Wang, Xu; Fu, Songbin; Yang, Shusen

2011-09-01

As one important constituent extracted from a traditional Chinese medicine, Uncaria Rhynchophylla Miq Jacks, isorhynchophylline has been used to treat hypertension, epilepsy, headache, and other illnesses. Whether isorhynchophylline protects hearts against cardiac arrhythmias is still incompletely investigated. This study was therefore aimed to examine the preventive effects of isorhynchophylline on heart arrhythmias in guinea pigs and rats and then explore their electrophysiological mechanisms. In vivo, ouabain and calcium chloride were used to establish experimental arrhythmic models in guinea pigs and rats. In vitro, the whole-cell patch-lamp technique was used to study the effect of isorhynchophylline on action potential duration and calcium channels in acutely isolated guinea pig and rat cardiomyocytes. The dose of ouabain required to induce cardiac arrhythmias was much larger in guinea pigs administered with isorhynchophylline. Additionally, the onset time of cardiac arrhythmias induced by calcium chloride was prolonged, and the duration was shortened in rats pretreated with isorhynchophylline. The further study showed that isorhynchophylline could significantly decrease action potential duration and inhibit calcium currents in isolated guinea pig and rat cardiomyocytes in a dose-dependent manner. In summary, isorhynchophylline played a remarkably preventive role in cardiac arrhythmias through the inhibition of calcium currents in rats and guinea pigs. © Georg Thieme Verlag KG Stuttgart · New York.

Economics and extended longevity: a case study.

PubMed

Gori, G B; Richter, B J; Yu, W K

1984-07-01

Preventive and therapeutic advances have brought life expectancy in the United States to well over 70 years and have shifted mortality causes from acute to chronic diseases, the determinants of which are genetics, lifestyle, the environment, and aging itself. Plausible approaches to chronic disease prevention are likely to increase longevity further, with some foreseeable effects on demographic and economic projections. Primarily, longevity advances would swell forecasts of population size, and would thus have to be met by production advances in order to maintain or improve living standards. This study, a restricted example, considers the probable demographic and economic consequences of a limited prevention program in the context of the Ford Motor Company, based on actual experience and certain expectations up to the year 2000. According to the results, prevention would reduce outlays for life insurance, disability, and health care, but would also generate the higher costs of extending pension plans. Undoubtedly, prevention will continue to be highly ranked in society's pursuit of happiness, and society must prepare to meet its effects with appropriate social and economic policies.

Personal gambling expectancies among Asian American and White American college students.

PubMed

Chan, Alan Ka Ki; Zane, Nolan; Wong, Gloria M; Song, Anna V

2015-03-01

Many college students are involved in gambling behavior as a recreational activity. Their involvement could potentially develop into problem gambling, an issue of increasing concern to student health. At the same time, evidence suggests that Asian Americans are overrepresented amongst problem gamblers in this age period. Research on factors related to initiation and development of problem gambling in college students is necessary to inform the development of effective and culturally-sensitive prevention efforts against gambling. The relationships between personal gambling expectancies at two levels of specificity (two general and six specific types of expectancies) and college student gambling at two levels of behavior (initiation and problems) were examined in a sample of 813 Asian American and White American college students. The study aimed to address (a) whether expectancies explained ethnic differences in gambling, (b) ethnic similarities and differences in the pattern of relationships between expectancies and gambling, and (c) whether expectancies that emerged in both ethnic groups have a greater risk or protective effect for one group than another. Results showed that Asian American students reported more problem gambling than White American students, but expectancies did not account for this group difference. Risk and protective factors for initiation were relatively similar between groups, but different patterns of risk emerged for each group for problem gambling. Implications for college primary prevention and harm reduction programs are discussed.

Personal Gambling Expectancies among Asian American and White American College Students

PubMed Central

Chan, Alan Ka Ki; Zane, Nolan; Wong, Gloria; Song, Anna

2013-01-01

Many college students are involved in gambling behavior as a recreational activity. Their involvement could potentially develop into problem gambling, an issue of increasing concern to student health. At the same time, evidence suggests that Asian Americans are overrepresented amongst problem gamblers in this age period. Research on factors related to initiation and development of problem gambling in college students is necessary to inform the development of effective and culturally-sensitive prevention efforts against gambling. The relationships between personal gambling expectancies at two levels of specificity (two general and six specific types of expectancies) and college student gambling at two levels of behavior (initiation and problems) were examined in a sample of 813 Asian American and White American college students. The study aimed to address (a) whether expectancies explained ethnic differences in gambling, (b) ethnic similarities and differences in the pattern of relationships between expectancies and gambling, and (c) whether expectancies that emerged in both ethnic groups have a greater risk or protective effect for one group than another. Results showed that Asian American students reported more problem gambling than White American students, but expectancies did not account for this group difference. Risk and protective factors for initiation were relatively similar between groups, but different patterns of risk emerged for each group for problem gambling. Implications for college primary prevention and harm reduction programs are discussed. PMID:23832755

The influence of PTSD, sleep fears, and neighborhood stress on insomnia and short sleep duration in urban, young adult, African Americans.

PubMed

Hall Brown, Tyish; Mellman, Thomas A

2014-01-01

African Americans residing in stressful urban environments have high rates of insomnia and short sleep duration, both of which are associated with adverse health outcomes. However, limited data exist that explore factors influencing inadequate sleep in this high-risk population. This study sought to evaluate the contributions of demographics, trauma, posttraumatic stress disorder (PTSD) symptoms, sleep fears, and neighborhood stress to both insomnia and short sleep in urban African American young adults. Data were analyzed from self-report measures completed by 378 participants 18-35 years of age. PTSD symptom severity and sleep fears were independently associated with insomnia severity, and sleep fears was associated with sleep duration. Results have implications for preventative health intervention strategies for urban African American young adults.

Large-amplitude acoustic solitary waves in a Yukawa chain

NASA Astrophysics Data System (ADS)

Sheridan, T. E.; Gallagher, James C.

2017-06-01

We experimentally study the excitation and propagation of acoustic solitary waves in a one-dimensional dusty plasma (i.e. a Yukawa chain) with particles interacting through a screened Coulomb potential. The lattice constant mm. Waves are launched by applying a 100 mW laser pulse to one end of the chain for laser pulse durations from 0.10 to 2.0 s. We observe damped solitary waves which propagate for distances with an acoustic speed s=11.5\\pm 0.2~\\text{mm}~\\text{s}-1$ . The maximum velocity perturbation increases with laser pulse duration for durations s and then saturates at . The wave speed is found to be independent of the maximum amplitude, indicating that the formation of nonlinear solitons is prevented by neutral-gas damping.

Treatment Expectation for Pain Coping Skills Training: Relationship to Osteoarthritis Patients' Baseline Psychosocial Characteristics

PubMed Central

Broderick, Joan E.; Junghaenel, Doerte U.; Schneider, Stefan; Bruckenthal, Patricia; Keefe, Francis J.

2010-01-01

Objectives This study examined predictors of treatment expectation among osteoarthritis (OA) patients in a multi-site clinical trial of pain coping strategies training (CST). Methods Patients (N=171) completed a pre-treatment assessment battery that asked questions about treatment expectations, pain coping variables, pain, physical function, psychological distress, quality of life, and depression as well as background demographic and medical variables. Results Regression analyses indicated that several variables accounted for 21% of the variance in treatment expectations (p < .0001). Patients who were classified as adaptive copers, reported higher self efficacy and social interaction, had higher quality of life, and who had lower levels of affective distress and depression had more positive expectations about engaging in pain coping skills training. Variables that were not associated with treatment expectation were level of pain and physical dysfunction, duration of disease, and disability status as well as demographic variables. Discussion Thus, while many OA patients will approach pain coping skills training with positive expectations, others have lower expectations. This study suggests that a multidimensional assessment of OA patients with chronic pain can identify those who have higher expectations versus lower expectations. The results suggest that patients who are psychologically distressed are less optimistic about engaging in treatment and that these patients, in particular, may benefit from and need pre-treatment motivational interviewing to enhance their uptake of pain coping skills PMID:21178591

Minimizing electrode contamination in an electrochemical cell

DOEpatents

Kim, Yu Seung; Zelenay, Piotr; Johnston, Christina

2014-12-09

An electrochemical cell assembly that is expected to prevent or at least minimize electrode contamination includes one or more getters that trap a component or components leached from a first electrode and prevents or at least minimizes them from contaminating a second electrode.

Preventive malaria treatment for contacts of patients with Ebola virus disease in the context of the west Africa 2014-15 Ebola virus disease response: an economic analysis.

PubMed

Carias, Cristina; Greening, Bradford; Campbell, Caresse G; Meltzer, Martin I; Hamel, Mary J

2016-04-01

After the detection of an Ebola virus disease outbreak in west Africa in 2014, one of the elements of the response was to contact trace and isolate patients in specialised Ebola treatment units (ETUs) at onset of fever. We aimed to assess the economic feasibility of administering preventive malaria treatment to all contacts of patients with Ebola virus disease, to prevent the onset of febrile malaria and subsequent admission to ETUs. We used a decision tree model to analyse the costs of preventive malaria treatment (artemisinin-based combination treatment [ACT]) for all contacts of patients with Ebola virus disease (in terms of administration and averted ETU-stay costs) and benefits (in terms of averted ETU admissions) in west Africa, from a health-care provider perspective. The period of analyses was 1 year, which is roughly similar to the duration of the 2014-15 west Africa Ebola outbreak response. We calculated the intervention's cost per ETU admission averted (average cost-effectiveness ratio) by season (wet and dry), country (Liberia, Sierra Leone, and Guinea), and age of contact (<5 years, 5-14 years, and ≥15 years). We did sensitivity analyses to assess how results varied with malaria parasite prevalence (in children aged 2-10 years), daily cost of ETU stay (for Liberian malaria incidence levels), and compliance and effectiveness of preventive malaria treatment. Administration of ACTs to contacts of patients with Ebola virus disease was cost saving for contacts of all ages in Liberia, Sierra Leone, and Guinea, in both seasons, from a health-care provider perspective. In the wet season, preventive malaria treatment was estimated to reduce the probability of a contact being admitted to an ETU by a maximum of 36% (in Guinea, for contacts aged <5 years), and a minimum of 10% (in Guinea and Sierra Leone, for those aged ≥15 years). Assuming 85% compliance and taking into account the African population pyramid, the intervention is expected to be cost saving in contacts of all age groups in areas with malaria parasite prevalence in children aged 2-10 years as low as 10%. In Liberia during the wet season, malaria preventive treatment was cost saving even when average daily bed-stay costs were as low as US$5 for children younger than 5 years, $9 for those aged 5-14 years, and $22 for those aged 15 years or older. Administration of preventive malaria treatment to contacts of patients with Ebola virus disease should be considered by public health officials when addressing Ebola virus disease outbreaks in countries and seasons where malaria reaches high levels of transmission. Centers for Disease Control and Prevention. Copyright © 2016 Elsevier Ltd. All rights reserved.

Impact of climatic and environmental changes on flood-duration-frequencies in the Fengle Rriver (YangTze Basin, China)

NASA Astrophysics Data System (ADS)

Salles, Christian; Chu, Yin; Tournoud, Marie-George; Ou, Mengli; Perrin, Jean-Louis; Cres, François-Noël; Ma, Youhua

2016-04-01

Future water management challenges such as flood risk are highly relevant to climate and land use changes. Climate change is expected to lead to an ongoing intensification of effects on changes in precipitation and evapotranspiration which could exacerbate flooding issues. Land use changes, modifications of agricultural practices and urbanization alter the apportionment of the different hydrological processes at the basin scale and could significantly affect the seasonality of streamflow. At the local scale, the consequences of climate and land use changes on flood occurrence and magnitude are a major issue for the economic development and management policy of basin area. This study apply a methodology for investigating the potential consequences of land use ,as well as precipitation and temperature changes on flood occurrence, duration and magnitude, accounting for uncertainties in scenario data and hydrological model parameters. The discharge time series predicted for the future were simulated from a calibrated and validated distributed hydrological model. The model was run from inputs which are -predicted rainfall time series based on scenarios of changes identified from a literature review, -future evapotranspiration rates assessed from temperature changes identified from a literature review -and scenarios of land-use changes The study area, the Fengle River basin (1500 km2), is located in the northeast part of Yangtze basin. The river is one of the main tributaries of the Chao Lake, the fifth largest natural lake of China. The lake catchment is 9130 km2 in area, including the city of Hefei and a large extent of agricultural and rural areas. Many changes are expected in land use and agricultural practices in the future, due to the touristic appeal of the Chao Lake shore and the growth of the city of Hefei. Climate changes are also expected in this region, with a high impact on rainfall regime. In the current period heavy storms and floods occur predominantly during summer. Using the above methodology the future dynamics of the Fengle River is characterized on discharge-duration-frequency curves. Results will be discussed with regards to the sensitivity of predicted flood occurrence, duration and magnitude by quantifying the impact of rainfall, temperature and land-use changes.

Landscape metrics as predictors of hydrologic connectivity between Coastal Plain forested wetlands and streams

PubMed Central

Epting, Steven M.; Hosen, Jacob D.; Alexander, Laurie C.; Lang, Megan W.; Armstrong, Alec W.

2018-01-01

Abstract Geographically isolated wetlands, those entirely surrounded by uplands, provide numerous landscape‐scale ecological functions, many of which are dependent on the degree to which they are hydrologically connected to nearby waters. There is a growing need for field‐validated, landscape‐scale approaches for classifying wetlands on the basis of their expected degree of hydrologic connectivity with stream networks. This study quantified seasonal variability in surface hydrologic connectivity (SHC) patterns between forested Delmarva bay wetland complexes and perennial/intermittent streams at 23 sites over a full‐water year (2014–2015). Field data were used to develop metrics to predict SHC using hypothesized landscape drivers of connectivity duration and timing. Connection duration was most strongly related to the number and area of wetlands within wetland complexes as well as the channel width of the temporary stream connecting the wetland complex to a perennial/intermittent stream. Timing of SHC onset was related to the topographic wetness index and drainage density within the catchment. Stepwise regression modelling found that landscape metrics could be used to predict SHC duration as a function of wetland complex catchment area, wetland area, wetland number, and soil available water storage (adj‐R 2 = 0.74, p < .0001). Results may be applicable to assessments of forested depressional wetlands elsewhere in the U.S. Mid‐Atlantic and Southeastern Coastal Plain, where climate, landscapes, and hydrological inputs and losses are expected to be similar to the study area. PMID:29576682

Cost effectiveness of herpes zoster vaccine in Canada.

PubMed

Najafzadeh, Mehdi; Marra, Carlo A; Galanis, Eleni; Patrick, David M

2009-01-01

Herpes zoster (HZ), or shingles, results from reactivation of latent varicella zoster virus in the sensory ganglia of adults, and results in significant morbidity in the elderly, including the development of post-herpetic neuralgia (PHN). The lifetime risk of HZ is about 20-30% and the incidence increases with age. The protective effect of the HZ vaccine has been shown in a large clinical trial; however, the effectiveness of the vaccine decreased with age of vaccination. We sought to compare the incremental cost and health benefits of HZ vaccine over status quo (no HZ vaccine) from the perspective of the Canadian healthcare payer. We developed a discrete-event simulation model comparing the costs and QALYs accrued to patients receiving HZ vaccine to those who did not. The effect of the vaccine on the (i) incidence of severe, moderate or mild HZ; (ii) severity and duration of HZ; (iii) incidence of PHN among patients with HZ; (iv) duration of PHN; and (v) costs associated with treating HZ and PHN were modelled. Data from published literature, including the Shingle Prevention Study, were used for transition probabilities. Health resource utilizations were estimated using administrative data retrieved from the British Columbia Medical Services Plan and hospital separation databases in British Columbia from 1994 to 2003. Utility estimates were obtained from various published sources. Canadian 2008 costs were used and both cost and QALYs were discounted at a 5% annual rate in the base-case analyses. On average, receiving the vaccination lowered mean direct medical costs (excluding the vaccine costs) by $Can35 per person. The incremental cost and QALYs per person receiving the vaccine versus no vaccination were $Can115 and 0.0028 QALYs, respectively, resulting in an incremental cost-effectiveness ratio of $Can41 709 per QALY gained for a cohort of elderly subjects aged >or=60 years. Results were robust in probabilistic and univariate sensitivity analyses. Expected value of perfect information was estimated at $Can47.72 per person, reflecting the expected monetary losses that could be avoided by having perfect information on all model parameters. HZ vaccination of adults, especially for individuals aged 60-75 years, seems to be a cost-effective intervention and might be considered by Canadian decision makers.

Who Are You More Likely to Help? The Effects of Expected Outcomes and Regulatory Focus on Prosocial Performance.

PubMed

Xiao, Fengqiu; Zheng, Zhiwei; Zhang, Heyi; Xin, Ziqiang; Chen, Yinghe; Li, Yiwei

2016-01-01

Prosocial behavior refers to a broad category of actions that benefit other people or the society. Compared with other factors that affect prosocial performance, prosocial outcomes, consisting of prosocial gains and prosocial non-losses have received less attention up to now. In the current research, we explored the influences of different types of expected outcomes and regulatory focus on prosocial performance. Studies 1a and 1b examined the differences in prosocial performance elicited by prosocial gain (e.g., enhancing others' access to clean water) and prosocial non-loss outcomes (e.g., protecting others from suffering dirty water). We found that the expected prosocial non-loss outcomes induced greater prosocial performance compared with the expected prosocial gain outcomes. Studies 2a and 2b examined the effects of dispositional and situational regulatory focus on prosocial loss aversion. We found that differences in prosocial performance between two expected prosocial outcomes were reduced when promotion focus was primed; whereas a primed prevention focus did not significantly increase this difference. Additionally, participants displayed a greater prosocial loss aversion in the prevention focus condition than in the promotion focus condition. The reason for the non-significant interaction between regulatory focus and expected prosocial outcome was discussed.

Who Are You More Likely to Help? The Effects of Expected Outcomes and Regulatory Focus on Prosocial Performance

PubMed Central

Xiao, Fengqiu; Zheng, Zhiwei; Zhang, Heyi; Xin, Ziqiang; Chen, Yinghe; Li, Yiwei

2016-01-01

Prosocial behavior refers to a broad category of actions that benefit other people or the society. Compared with other factors that affect prosocial performance, prosocial outcomes, consisting of prosocial gains and prosocial non-losses have received less attention up to now. In the current research, we explored the influences of different types of expected outcomes and regulatory focus on prosocial performance. Studies 1a and 1b examined the differences in prosocial performance elicited by prosocial gain (e.g., enhancing others’ access to clean water) and prosocial non-loss outcomes (e.g., protecting others from suffering dirty water). We found that the expected prosocial non-loss outcomes induced greater prosocial performance compared with the expected prosocial gain outcomes. Studies 2a and 2b examined the effects of dispositional and situational regulatory focus on prosocial loss aversion. We found that differences in prosocial performance between two expected prosocial outcomes were reduced when promotion focus was primed; whereas a primed prevention focus did not significantly increase this difference. Additionally, participants displayed a greater prosocial loss aversion in the prevention focus condition than in the promotion focus condition. The reason for the non-significant interaction between regulatory focus and expected prosocial outcome was discussed. PMID:27824909

[Non work-related sickness absence in 2013 in a Spanish banking sector company].

PubMed

Reinoso-Barbero, Luis; Díaz-Garrido, Ramón; González-Gómez, María Fernanda; Jaureguizar-Cervera, Enrique; Piñaga-Solé, Montserrat; Reyes-García, Rocío

2015-01-01

To describe the incidence and duration of episodes of non work-related temporary sickness absence (SA) between January and December of 2013, by diagnostic groups, in a banking sector company. Cross-sectional study of 3.193 episodes of SA (≥ day), excluding work-related injuries and illnesses. The distribution of the duration of SA episodes by medical diagnosis was analyzed by calculating the median duration, 25th and 75th percentiles, mean and standard deviation. The median duration of SA was 9 days for cases where there was a medical diagnosis (n=2.931, 91.8%); the 25th and 75th percentiles were 4 and 32 days, respectively. The most frequent pathologies were respiratory (19.9%), followed by musculoskeletal (19.1%) and pregnancy-related disorders (17.3%). Neoplasms had the longest median duration (49 days), followed by pregnancy-related disorders (39 days) and psychiatric disorders (23 days). Overall sickness absence incidence in our study population was lower, but had a longer duration, as compared to similar studies. The incidence and duration by diagnostic groups were very similar to that reported in the literature, except for pregnancy-related disorders, where both were clearly higher (incidence 4 to 11 times and duration 0.4 times larger) in our company (<0.001). This analysis is useful from a prevention perspective, and suggests the need to prioritize the study to the control of potential workplace exposures that might be affecting pregnant workers' health. Copyright belongs to the Societat Catalana de Salut Laboral.

Comparison between orogastric tube/bougie and a suction calibration system for effects on operative duration, staple-line corkscrewing, and esophageal perforation during laparoscopic sleeve gastrectomy.

PubMed

Gagner, Michel; Huang, Rose Y

2016-04-01

Placement of a bougie for sleeve sizing during laparoscopic sleeve gastrectomy (LSG) is recommended. We compared this standard with a suction calibration system (SCS) that performs all functions with one insertion, and measured each step's duration. Primary LSG was performed using a bougie and SCS in alternating order. Number of tube movements to achieve optimal placement, durations of decompression, leak testing, and overall operative time, and remnant linear measurements were obtained. LSG was performed in 26 patients (15 women, 11 men; mean age 36.8 years; mean BMI 45.3 kg/m(2)). The mean number of tube movements was significantly greater for the bougie than for the SCS (8.13 vs. 3.58; p < 0.0001). Percent reductions achieved using the SCS were: time to full decompression of the stomach, 62% (21 vs. 8 s; p < 0.138); tube placement, 51% (101 vs. 49 s; p < 0.0001); leak testing, 78% (119 vs. 26 s; p < 0.0003); and mean operative duration (from tube insertion to end of stapling), 21% (875 vs. 697 s; p < 0.019). Variance of the staple-line distance, measured from the greater curvature to the staple line, was 1.64 and 0.92 for the bougie and SCS, respectively, indicating a reduction in corkscrewing, for a 43.9% straighter sleeve. SCS maintained the gastric wall in place, thereby preventing corkscrewing, and reducing total operating time. Reducing the number of tube insertions may prevent esophageal damage and accidental tube stapling.

[Clinical re-evaluation of effects of different treatments to prevent from phlebitis induced by Chansu injection].

PubMed

Zhao, Yubin; Hao, Zhe; Zhang, Hongdan; Shi, Jian; Xie, Yanming

2011-10-01

To re-evaluate the effects of different treatments to prevent from phlebitis induced by Chansu injection. Patients treated with Chansu injection were divided randomly into 4 groups with 50 per group, control group, the magnesium sulfate group, phentolaminum group, and anisodamine group. Patients in the control group only received the routine nursing treatment, and patients in the various experiment group received different interventions. The comparison was made in the morbidity and the starting time of occurrence of phlebitis, the severity of pain, duration of pain. The morbidity of phlebitis was 8%, 8%, 6% respectively. The starting time of phlebitis occurrence was (21 +/- 9.31) , (22.34 +/- 10.15), (20.19 +/- 11.23) h, respectively. The NRS of pain was (4. 15 +/- 1.03), (3.26 +/- 1.17), (4.32 +/- 1.36), respectively. The duration time of pain was (4.05 +/- 1.21), (3.37 +/- 1.17), (3.19 +/- 1.67) d, respectively. In control group, the morbidity of phlebitis, the starting time of occurrence of phlebitis, the severity of pain, duration of pain was 24%, (17 +/- 6.32) h, (6.58 +/- 1.29), (5.32 +/- 1.12) d, respectively. As compared with the control group, a significance difference was found between every group in three test groups and control group respectively (P<0.05). The morbidity and the starting time of occurrence of phlebitis, the severity of pain, duration of pain was significantly reduced respectively by external appication of magnesium sulfate, anisodamine, and intravenous drip infusion of phentolaminum.

Expectant Parent Classes: A Case Study

ERIC Educational Resources Information Center

Beebe, E. Rick

1978-01-01

Mental health problems among children resulting from poor parenting, a high neonatal death rate, and a low level of medical education in the county provided impetus for developing a primary prevention program--Expectant Parent Program. This article summarizes the development, content, staff, funding, and results of the program. (Author)

The Combined Effect of Sleep Duration and Quality on Mental Health Among Republic of Korea Armed Forces.

PubMed

Kim, Tae Kyung; Lee, Hee-Choon; Lee, Sang Gyu; Han, Kyu-Tae; Park, Eun-Cheol

2016-11-01

Sleep problems in the Republic of Korea Armed Forces have increased. This study analyzed the mental health impact of sleep duration and quality on personnel of the Republic of Korea Armed Forces. Data from the 2014 Military Health Survey were used. Degree of sleep duration and quality were measured by this self-reported questionnaire. Analysis of variance was carried out to compare Kessler Psychological Distress Scale 10 (K10) scores. Multiple logistic regression analysis identified associations between sleep duration, quality, and K10 scores. Among the personnel studied, 2.5% reported severe sleep difficulties. The average sleep duration was 6.83 ± 1.12 hours. Short sleep duration and sleep difficulty were associated with poorer K10 scores. Higher K10 scores among individuals with short sleep duration and low sleep quality were identified in the isolated military area group, the over 53 working hours/week group, and the enlisted soldier group. The factors listed were not by themselves associated with poorer mental health scores. Rather, specific workplaces and specific rank groups were more prone to poorer mental health. These results provide helpful information to minimize the negative psychological effects of sleep factors and to promote a sleep problem prevention and management policy. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Impact of a smoking and alcohol intervention programme on lung and breast cancer incidence in Denmark: An example of dynamic modelling with Prevent.

PubMed

Soerjomataram, Isabelle; de Vries, Esther; Engholm, Gerda; Paludan-Müller, Georg; Brønnum-Hansen, Henrik; Storm, Hans H; Barendregt, Jan J

2010-09-01

Among the known risk factors, smoking is clearly related to the incidence of lung cancer and alcohol consumption is to breast cancer. In this manuscript we modelled the potential benefits of reductions in smoking or alcohol prevalence for the burden of these cancers. We used Prevent v.3.01 to assess the changes in incidence as a result of risk factor changes. Incidence of lung and breast cancer until 2050 was predicted under two scenarios: ideal (total elimination of smoking and reduction of alcohol intake to maximum 1 units/d for women) and optimistic (decreasing prevalence of risk factors because of a 10% increase in cigarette and alcohol beverage price, repeated every 5 years). Danish data from the household surveys, cancer registration and Eurostat were used. Up to 49% less new lung cancer cases can be expected in 2050 if smoking were to be completely eliminated. Five-yearly 10% price increases may prevent 521 new lung cancer cases in 2050 (21% less cases). An intervention that immediately reduces population alcohol consumption to the recommended level (below 12 g/d) may lower breast cancer by 7%, preventing 445 out of the 6060 expected new cases in 2050. Five-yearly 10% price increases in alcoholic beverages achieved a reduction of half as expected by the ideal scenario, i.e. 4% (262) preventable cases in 2050. The future burden of lung and breast cancer could be markedly reduced by intervening in their risk factors. Prevent illustrates the benefit of interventions and may serve as guidance in political decision-making. Copyright © 2010 Elsevier Ltd. All rights reserved.

Individualized Statin Benefit for Determining Statin Eligibility in the Primary Prevention of Cardiovascular Disease.

PubMed

Thanassoulis, George; Williams, Ken; Altobelli, Kathleen Kimler; Pencina, Michael J; Cannon, Christopher P; Sniderman, Allan D

2016-04-19

Current guidelines recommend statins in the primary prevention of cardiovascular disease on the basis of predicted cardiovascular risk without directly considering the expected benefits of statin therapy based on the available randomized, controlled trial evidence. We included 2134 participants representing 71.8 million American residents potentially eligible for statins in primary prevention from the National Health and Nutrition Examination Survey for the years 2005 to 2010. We compared statin eligibilities using 2 separate approaches: a 10-year risk-based approach (≥7.5% 10-year risk) and an individualized benefit approach (ie, based on predicted absolute risk reduction over 10 years [ARR10] ≥2.3% from randomized, controlled trial data). A risk-based approach led to the eligibility of 15.0 million (95% confidence interval, 12.7-17.3 million) Americans, whereas a benefit-based approach identified 24.6 million (95% confidence interval, 21.0-28.1 million). The corresponding numbers needed to treat over 10 years were 21 (range, 9-44) and 25 (range, 9-44). The benefit-based approach identified 9.5 million lower-risk (<7.5% 10-year risk) Americans not currently eligible for statin treatment who had the same or greater expected benefit from statins (≥2.3% ARR10) compared with higher-risk individuals. This lower-risk/acceptable-benefit group includes younger individuals (mean age, 55.2 versus 62.5 years; P<0.001 for benefit based versus risk based) with higher low-density lipoprotein cholesterol (140 versus133 mg/dL; P=0.01). Statin treatment in this group would be expected to prevent an additional 266 508 cardiovascular events over 10 years. An individualized statin benefit approach can identify lower-risk individuals who have equal or greater expected benefit from statins in primary prevention compared with higher-risk individuals. This approach may help develop guideline recommendations that better identify individuals who meaningfully benefit from statin therapy. © 2016 American Heart Association, Inc.

[Hiatal hernias: why and how should they be surgically treated].

PubMed

Braghetto, Italo; Csendes, Attila; Korn, Owen; Musleh, Maher; Lanzarini, Enrique; Saure, Alex; Hananias, Baydir; Valladares, Héctor

2013-01-01

There is controversy in the literature about the choice of expectant medical treatment versus surgical treatment of hiatal hernias, depending on the presence or absence of symptoms. This study presents the results obtained by our group, considering disease duration and postoperative results. A total of 121 patients were included and divided by age, disease duration, type of hiatal hernia and postoperative outcome. In 32% of the patients younger than 70 years, symptom duration was longer than 11 years and 68% of those aged more than 71 years had long-term symptoms (p<.05). Type iv hernias (complex) and those with diameters measuring more than 16 cm were observed in the group with longer symptom duration. Complications were more frequent in the older age group, in those with longer symptom duration and in those with type iv complex hernias. There was no postoperative mortality and only one patient (0.8%) with a type iii hernia and severe oesophagitis required reoperation. We recommend that patients with hiatal hernia undergo surgery at diagnosis to avoid complications and risks. Older patients should not be excluded from surgical indication but should undergo a complete multidisciplinary evaluation to avoid complications and postoperative mortality. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

Adaptive match filter based method for time vs. amplitude characterization of microvolt ECG T-wave alternans.

PubMed

Burattini, Laura; Zareba, Wojciech; Burattini, Roberto

2008-09-01

To develop a new method for non-invasive identification of patients prone to ventricular tachyarrhythmia and sudden cardiac death, an adaptive match-filter (AMF) was applied to detect and characterize T-wave alternans (TWA) in 200 coronary artery diseased (CAD) patients compared with 176 healthy (H) subjects. TWA was characterized in terms of duration (TWAD), amplitude (TWAA), and magnitude (TWAM, defined as the product of TWAD times TWAA). A criterion derived from these parameters, estimated over the H-population, allowed discrimination between a risk (TWA+) and a normality (NO TWA) zone in the TWAD-TWAA plane. To gain further ability to discriminate among different risk levels, the TWA+ zone was divided into four sub-zones respectively characterized by low duration and low amplitude (LDLA), low duration and high amplitude (LDHA), high duration and low amplitude (HDLA), and high duration and high amplitude (HDHA). With our methodology, 21 CAD-patients (10.5%) were identified as TWA+, 9 falling in the LDLA zone, 4 in the HDLA, 7 in the LDHA, and 1 in the HDHA. These results are in agreement with clinical expectations and pave the way to further clinical follow-up studies finalized to analyze pathophysiological implications and risk factors associated to each TWA+ zone.

[Obstacles for the use of early childhood prevention services : The role of expected ability to control sources].

PubMed

Neumann, Anna; Renner, Ilona

2016-10-01

It is well established that preventive measures for pregnant women and families with small children do not reach all families alike. Often enough, it is those families, who due to heightened stresses and strains might gain the most from these measures, who cannot be reached (dilemma of prevention). This investigation explores whether parents can be grouped according to their views on health, prevention and measures available to young families, and whether belonging to one of the identified groups explains differences in the use of (primary and secondary) preventive measures for pregnant women and young families. In the context of home visits, parents of children aged two to four years (N = 273) completed questionnaires. Additionally, 203 parents took part in qualitative interviews. Based on interview data, parents from different sociocultural backgrounds could be grouped along their expected ability to control sources for parental support (Steuerungskompetenz). Parents high and low in Steuerungskompetenz differ regarding their knowledge of, use of, and satisfaction with (primary) preventive measures. Steuerungskompetenz explains the use of primary preventive measures above and beyond socioeconomic control variables as well as family stresses and strains. The use of secondary preventive measures is better explained by family stresses and strains. Results are discussed in terms of untapped services, needs and possibilities of target group-oriented approach.

Adjustable long duration high-intensity point light source

NASA Astrophysics Data System (ADS)

Krehl, P.; Hagelweide, J. B.

1981-06-01

A new long duration high-intensity point light source with adjustable light duration and a small light spot locally stable in time has been developed. The principle involved is a stationary high-temperature plasma flow inside a partly constrained capillary of a coaxial spark gap which is viewed end on through a terminating Plexiglas window. The point light spark gap is operated via a resistor by an artificial transmission line. Using two exchangeable inductance sets in the line, two ranges of photoduration 10-130 μs and 100-600 μs can be covered. For a light spot size of 1.5 mm diameter the corresponding peak light output amounts to 5×106 and 1.6×106 candelas, respectively. Within these ranges the duration is controlled by an ignitron crowbar to extinguish the plasma. The adjustable photoduration is very useful for the application of continuous writing rotating mirror cameras, thus preventing multiple exposures. The essentially uniform exposure within the visible spectral range makes the new light source suitable for color cinematography.

Osteoporosis Prevention and Management.

PubMed

Pai, Muralidhar V

2017-08-01

Osteoporosis, defined by BMD at the hip or lumbar spine that is less than or equal to 2.5 standard deviations below the mean BMD of a young-adult reference population, is the most common bone disease in humans affecting both sexes and all races. It's a silent killer affecting the quality of life due to fractures and postural changes. In osteoporosis there is an imbalance between bone formation and bone resorption in favor of latter. Preventive measures and treatments are available to combat this evil. Counseling is the integral part of prevention as well as treatment of osteoporosis. Preventive strategy includes life style changes, exercise, intake of calcium and vitamin D, avoiding alcohol, smoking and excessive intake of salt. Estrogen therapy/estrogen+progesterone therapy (ET/EPT) is no longer recommended as a first-line therapy for the prevention of osteoporosis. They may be used in the therapy for osteoporosis in women under 60. Diagnosis and classification are made by assessment of BMD using DEXA or ultrasound and laboratory investigations. Management includes estimation of 10-year fracture risk using FRAX, life style and diet modification and pharmacological therapy. The drugs used in osteoporosis may be those that inhibit bone resorption-bisphosphonates, denosumab, calcitonin, SERMs, estrogen and progesterone-or that stimulate bone formation-PTH, Teriparatide. Combination therapies are not recommended as they do not have proven additional BMD/fracture benefits. No therapy should be indefinite in duration. There are no uniform recommendations to all patients. Duration decisions need to be individualized. While on treatment monitoring should be done with BMD assessment by DEXA/ultrasound and bone turnover markers.

Dexamethasone for Prevention of Postoperative Shivering: A Randomized Double-Blind Comparison with Pethidine

PubMed Central

Entezariasl, Masood; Isazadehfar, Khatereh

2013-01-01

Background: Postoperative shivering is very common and followed by many problems such as increasing oxygen consumption, blood pressure, intracranial and intraocular pressure, and postoperative pain. Therefore, prevention of shivering is important, especially in elderly and ischemic heart disease patients. The goal of this study was to compare the effect of pethidine (meperidine), dexamethasone, and placebo on prevention of shivering. Methods: This double-blind clinical trial study was carried out on 120 patients who were candidates for surgery under general anesthesia. The patients were randomly divided into three groups. Induction and maintenance of anesthesia for all patients were similar. Temperature of patients was measured every 5 min interval. After induction, saline 0.9%, dexamethasone and pethidine were injected to groups a, b, and c, respectively. In recovery, patients were controlled for visible shivering. All data were statistically analyzed by analysis of variance (ANOVA) and Chi-square tests. Results: There were no significant differences among three mentioned groups regarding gender, age, duration of surgery and anesthesia, extubation time, duration of recovery, and basic clinical characteristics. Nineteen cases (47.5%) of placebo group had postoperative shivering, whereas in dexamethasone group only four cases (10%) had shivering and the difference between the two groups was significant. Also in pethidine group, 15 cases (37.5%) had shivering and the difference with placebo group was significant (P value = 0.001). Conclusion: The present study showed that pethidine and dexamethasone are effective drugs for prevention of postoperative shivering in elective surgery and the effect of dexamethasone in preventing the postoperative shivering is better than pethidine. PMID:24049601

Effective Practices for Evaluating Education and Public Outreach Programs

NASA Astrophysics Data System (ADS)

Wilkerson, S.

2013-12-01

Stephanie Baird Wilkerson, PhD Carol Haden EdD Magnolia Consulting,LLC Education and public outreach (EPO) program developers and providers seeking insights regarding effective practices for evaluating EPO activities programs benefit from understanding why evaluation is critical to the success of EPO activities and programs, what data collection methods are appropriate, and how to effectively communicate and report findings. Based on our extensive experience evaluating EPO programs, we will share lessons learned and examples of how these practices play out in actual evaluation studies. EPO program developers, providers, and evaluators must consider several factors that influence which evaluation designs and data collection methods will be most appropriate, given the nature of EPO programs. Effective evaluation practices of EPO programs take into account a program's phase of development, duration, and budget as well as a program's intended outcomes. EPO programs that are just beginning development will have different evaluation needs and priorities than will well-established programs. Effective evaluation practices consider the 'life' of a program with an evaluation design that supports a program's growth through various phases including development, revision and refinement, and completion. It would be premature and inappropriate to expect the attainment of longer-term outcomes of activities during program development phases or early stages of implementation. During program development, EPO providers should clearly define program outcomes that are feasible and appropriate given a program's scope and expected reach. In many respects, this directly relates to the amount of time, or duration, intended audiences participate in EPO programs. As program duration increases so does the likelihood that the program can achieve longer-term outcomes. When choosing which outcomes are reasonable to impact and measure, program duration should be considered. Effective evaluation practices include selecting appropriate data collection methods given a program's duration and corresponding intended outcomes. Data collection methods for programs of short duration might involve simple evaluation activities, whereas programs of longer duration might involve ongoing data collection measures including longitudinal student surveys, implementation logs, student journals, and student achievement measures. During our presentation, we will share examples from our own experience to illustrate how effective evaluation practices can be applied to various EPO programs based on program duration. Irrespective of duration, we find that EPO program developers and providers want both formative feedback to guide improvements and summative feedback on outcomes. More often than not, evaluation budgets for EPO programs are meager at best, yet come with the same information needs and priorities as programs with larger evaluation budgets. So how do program providers get the information they need given their limited funds for evaluation? We will offer several recommendations for helping EPO program providers work with evaluators to become better-informed consumers of evaluation by maximizing evaluation offerings and minimizing costs. During our presentation we also will share examples of communicating and reporting results for EPO program developers, EPO facilitators and practitioners, and funders.

The effectiveness of a trauma-focused psycho-educational secondary prevention program for children exposed to interparental violence: study protocol for a randomized controlled trial.

PubMed

Overbeek, Mathilde M; de Schipper, J Clasien; Lamers-Winkelman, Francien; Schuengel, Carlo

2012-02-06

Children who witness interparental violence are at a heightened risk for developing psychosocial, behavioral and cognitive problems, as well as posttraumatic stress symptoms. For these children the psycho-educational secondary prevention program 'En nu ik...!' ('It's my turn now!') has been developed. This program includes specific therapeutic factors focused on emotion awareness and expression, increasing feelings of emotional security, teaching specific coping strategies, developing a trauma narrative, improving parent-child interaction and psycho-education. The main study aim is to evaluate the effectiveness of the specific therapeutic factors in the program. A secondary objective is to study mediating and moderating factors. This study is a prospective multicenter randomized controlled trial across cities in the Netherlands. Participants (N = 140) are referred to the secondary preventive intervention program by police, social work, women shelters and youth (mental health) care. Children, aged 6-12 years, and their parents, who experienced interparental violence are randomly assigned to either the intervention program or the control program. The control program is comparable on nonspecific factors by offering positive attention, positive expectations, recreation, distraction, warmth and empathy of the therapist, and social support among group participants, in ways that are similar to the intervention program. Primary outcome measures are posttraumatic stress symptoms and emotional and behavioral problems of the child. Mediators tested are the ability to differentiate and express emotions, emotional security, coping strategies, feelings of guilt and parent-child interaction. Mental health of the parent, parenting stress, disturbances in parent-child attachment, duration and severity of the domestic violence and demographics are examined for their moderating effect. Data are collected one week before the program starts (T1), and one week (T2) and six months (T3) after finishing the program. Both intention-to-treat and completer analyses will be done. Adverse outcomes after witnessing interparental violence are highly diverse and may be explained by multiple risk factors. An important question for prevention programs is therefore to what extent a specific focus on potential psychotrauma is useful. This trial may point to several directions for optimizing public health response to children's exposure to interparental violence.

Effects of bite size and duration of oral processing on retro-nasal aroma release - features contributing to meal termination.

PubMed

Ruijschop, Rianne M A J; Zijlstra, Nicolien; Boelrijk, Alexandra E M; Dijkstra, Annereinou; Burgering, Maurits J M; Graaf, Cees de; Westerterp-Plantenga, Margriet S

2011-01-01

The brain response to a retro-nasally sensed food odour signals the perception of food and it is suggested to be related to satiation. It is hypothesised that consuming food either in multiple small bite sizes or with a longer durations of oral processing may evoke substantial oral processing per gram consumed and an increase in transit time in the oral cavity. This is expected to result in a higher cumulative retro-nasal aroma stimulation, which in turn may lead to increased feelings of satiation and decreased food intake. Using real-time atmospheric pressure chemical ionisation-MS, in vivo retro-nasal aroma release was assessed for twenty-one young, healthy and normal-weight subjects consuming dark chocolate-flavoured custard. Subjects were exposed to both free or fixed bite size (5 and 15 g) and durations of oral processing before swallowing (3 and 9 s) in a cross-over design. For a fixed amount of dark chocolate-flavoured custard, consumption in multiple small bite sizes resulted in a significantly higher cumulative extent of retro-nasal aroma release per gram consumed compared with a smaller amount of large bite sizes. In addition, a longer duration of oral processing tended to result in a higher cumulative extent of retro-nasal aroma release per gram consumed compared with a short duration of oral processing. An interaction effect of bite size and duration of oral processing was not observed. In conclusion, decreasing bite size or increasing duration of oral processing led to a higher cumulative retro-nasal aroma stimulation per gram consumed. Hence, adapting bite size or duration of oral processing indicates that meal termination can be accelerated by increasing the extent of retro-nasal aroma release and, subsequently, the satiation.

What stellar orbit is needed to measure the spin of the Galactic centre black hole from astrometric data?

NASA Astrophysics Data System (ADS)

Waisberg, Idel; Dexter, Jason; Gillessen, Stefan; Pfuhl, Oliver; Eisenhauer, Frank; Plewa, Phillip M.; Bauböck, Michi; Jimenez-Rosales, Alejandra; Habibi, Maryam; Ott, Thomas; von Fellenberg, Sebastiano; Gao, Feng; Widmann, Felix; Genzel, Reinhard

2018-05-01

Astrometric and spectroscopic monitoring of individual stars orbiting the supermassive black hole in the Galactic Center offer a promising way to detect general relativistic effects. While low-order effects are expected to be detected following the periastron passage of S2 in Spring 2018, detecting higher order effects due to black hole spin will require the discovery of closer stars. In this paper, we set out to determine the requirements such a star would have to satisfy to allow the detection of black hole spin. We focus on the instrument GRAVITY, which saw first light in 2016 and which is expected to achieve astrometric accuracies 10-100 μas. For an observing campaign with duration T years, total observations Nobs, astrometric precision σx, and normalized black hole spin χ, we find that a_orb(1-e^2)^{3/4} ≲ 300 R_S √{T/4 {yr}} (N_obs/120)^{0.25} √{10 μ as/σ _x} √{χ /0.9} is needed. For χ = 0.9 and a potential observing campaign with σ _x = 10 μas, 30 observations yr-1 and duration 4-10 yr, we expect ˜0.1 star with K < 19 satisfying this constraint based on the current knowledge about the stellar population in the central 1 arcsec. We also propose a method through which GRAVITY could potentially measure radial velocities with precision ˜50 km s-1. If the astrometric precision can be maintained, adding radial velocity information increases the expected number of stars by roughly a factor of 2. While we focus on GRAVITY, the results can also be scaled to parameters relevant for future extremely large telescopes.

Sexual health of male cardiac patients – present status and expectations of patients with coronary heart disease

PubMed Central

Karpiński, Łukasz; Gebala, Jana; Rusiecki, Lesław; Biełous-Wilk, Anna; Krauz, Ewa S.; Piłot, Magdalena; Womperski, Krzysztof; Rusiecka, Małgorzata; Pilecki, Witold

2017-01-01

Introduction Due to the pathogenetic association between erectile disorders and cardiovascular diseases, cardiologists consult many patients with erectile dysfunction (ED). The aim of the study was to evaluate sexual function in patients with coronary heart disease (CHD) and the use of sexual knowledge in cardiology practice, both current use and that expected by patients. Material and methods One thousand one hundred and thirty-six patients (average age: 60.73 ±9.20) underwent a dedicated survey which encompassed demographic data and the presence of modifiable ED risk factors. The presence of ED was assessed using the International Index of Erectile Function (IIEF-5) Questionnaire. Results Sexual problems were discussed by cardiologists with 45 (3.96%) patients. The frequency of initiating the topic was significantly associated with the respondents’ education level (p = 0.0031); however, it was not associated with the patients’ age, duration of CHD, presence of ED, or modifiable risk factors. Four hundred and sixteen (36.62%) respondents indicated that they expect their cardiologist to take an interest in their ED. Nine hundred and twenty-six (81.51%) patients claimed good sexual function to be important or very important to them. Attitude to sexual function was significantly associated with age (p < 0.0001), duration of CHD (p = 0.0018), education (p = 0.0011), presence of ED (p = 0.0041), diabetes (p = 0.0283) and hyperlipidaemia (p = 0.0014). Conclusions The low frequency with which cardiologists initiate the topic of ED is in contrast to the expectations of patients with CHD. The majority of these patients regard good sexual maintenance as an important part of their life. PMID:28261282

Structured settlement annuities, part 2: mortality experience 1967--95 and the estimation of life expectancy in the presence of excess mortality.

PubMed

Singer, R B; Schmidt, C J

2000-01-01

the mortality experience for structured settlement (SS) annuitants issued both standard (Std) and substandard (SStd) has been reported twice previously by the Society of Actuaries (SOA), but the 1995 mortality described here has not previously been published. We describe in detail the 1995 SS mortality, and we also discuss the methodology of calculating life expectancy (e), contrasting three different life-table models. With SOA permission, we present in four tables the unpublished results of its 1995 SS mortality experience by Std and SStd issue, sex, and a combination of 8 age and 6 duration groups. Overall results on mortality expected from the 1983a Individual Annuity Table showed a mortality ratio (MR) of about 140% for Std cases and about 650% for all SStd cases. Life expectancy in a group with excess mortality may be computed by either adding the decimal excess death rate (EDR) to q' for each year of attained age to age 109 or multiplying q' by the decimal MR for each year to age 109. An example is given for men age 60 with localized prostate cancer; annual EDRs from a large published cancer study are used at duration 0-24 years, and the last EDR is assumed constant to age 109. This value of e is compared with e from constant initial values of EDR or MR after the first year. Interrelations of age, sex, e, and EDR and MR are discussed and illustrated with tabular data. It is shown that a constant MR for life-table calculation of e consistently overestimates projected annual mortality at older attained ages and underestimates e. The EDR method, approved for reserve calculations, is also recommended for use in underwriting conversion tables.

The Role of the Dynamic Sensory Perception in the Reformulation of Shakes: Use of TDS for Studying the Effect of Milk, Fiber, and Flavor Addition.

PubMed

Tomadoni, Barbara; Fiszman, Susana; Moreira, María R; Tarrega, Amparo

2018-01-01

Various factors need to be taken into account when reformulating a food or beverage. The food components, not only macronutrients but also minor ingredients such as flavoring agents, could affect the perception of the sensory sensations, importantly their dynamic aspects, as rising and duration, which are not normally considered. The novelty of this approach is the study of the effects of the addition of several ingredients (fiber, extra milk powder, and strawberry flavoring) on the dynamic perception of a food item (strawberry shakes) using the temporal dominance of sensations (TDS) technique. The occurrence and duration of the key sensory sensations (acid, natural strawberry flavor, thick, sweet, candy strawberry flavor, and milk flavor) extracted from the TDS curves were analyzed and linked to the composition factors and liking and expectations of satiety scores. For example, the addition of flavoring increased the liking scores (increments ranging from 0.3 to 1.1) that was linked to the attenuation of acid sensation; and the addition of extra milk powder increased the expectation of satiety scores (increments ranging from 0.5 to 0.7) that was linked to the perception of early thick sensation in the mouth. In general, the more complex sensory profiles the higher liking and expectations of satiety. This work is a case study on how temporal sensory methods can contribute important information on the actual perception of food during consumption. Depending on the ingredients added these sensory properties appear at different times and with different dominance during evaluation affecting liking or fullness expectations. In consequence, the temporal sensory properties should be taken into account when designing or reformulating food. © 2017 Institute of Food Technologists®.

Sleep duration and insulin resistance in individuals without type 2 diabetes: the PPP-Botnia study.

PubMed

Pyykkönen, Antti-Jussi; Isomaa, Bo; Pesonen, Anu-Katriina; Eriksson, Johan G; Groop, Leif; Tuomi, Tiinamaija; Räikkönen, Katri

2014-08-01

Both short and long sleep duration may increase risk of type 2 diabetes (diabetes). We studied if short and long sleep durations were associated with insulin resistance (IR) and insulin secretion in individuals without diabetes, and if the associations remained after we excluded individuals who reported more frequent and severe complaints of sleep apnea and insomnia. An oral glucose tolerance test (OGTT) was performed for 722 adults without diabetes. Indices of IR and insulin secretion were calculated. Sleep duration and complaints of sleep apnea and insomnia were self-reported. In comparison to average sleepers (6-9 h/night), short sleepers (< 6 h/night) had higher 120-min insulin and AUC glucose, and long sleepers (≥ 9 h/night) had higher fasting and 120-min insulin, 120-min glucose, and HOMAIR and lower Insulin Sensitivity Index. After adjusting for confounders and after excluding individuals who reported more frequent and severe complaints of sleep apnea and insomnia, long sleep duration remained significantly associated with IR and insulin secretion. Long but not short sleep duration is associated with IR and insulin secretion in individuals without diabetes whether or not accompanied by sleep complaints. Long sleepers may benefit from targeted preventions and interventions that aim at reducing risk of future diabetes.

Protect Your Eyes: Age-Related Macular Degeneration (AMD) Facts and Prevention Tips

MedlinePlus

PROTECT YOUR EYES Age-Related Macular Degeneration ( AMD ) FACTS & PREVENTION TIPS A LEADING CAUSE OF VISION LOSS IN THE U.S . AMD is a ... Black 2% Other 89% White As the population ages, the number of cases is expected to increase ...

Stress and Burnout: An Organizational Synthesis.

ERIC Educational Resources Information Center

McLean, Leslie H.; Clouse, R. Wilburn

In the care, prevention, and treatment, of burnout, the reoccurring theme is "control and balance" between expectation and performance. Burnout is treatable and preventable, but changes and interventions must occur on all levels, (individual, organizational, and societal). Recent research, which has expanded the already complex definition of…

Prevention of space flight induced soft tissue calcification and disuse osteoporosis

NASA Technical Reports Server (NTRS)

Schneider, Victor S.; Leblanc, Adrian; Huntoon, Carolyn L.

1990-01-01

Medical complications such as renal stone formation, increased uric acid output, and disuse osteoporosis are discussed. A series of experiments was conducted in order to study and eventually reduce these flight hazards. Attempts to prevent the negative calcium balance and loss of calcaneal density during prolonged bed rest had only a limited success. Of the five biochemical regiments tested, only diphosphonate applied in a high dose had a positive effect in elliminating mineral losses. It is found that clodronate can prevent disuse osteoporosis and that fluoride can enhance bone formation. It is concluded that exercises, combined with pharmaceutical agents, are beneficial during long-duration space missions.

Baclofen to prevent agitation in alcohol-addicted patients in the ICU: study protocol for a randomised controlled trial.

PubMed

Vourc'h, Mickael; Feuillet, Fanny; Mahe, Pierre-Joachim; Sebille, Véronique; Asehnoune, Karim

2016-08-19

Alcohol is the leading psychoactive substance consumed in France, with about 15 million regular consumers. The National institute on Alcohol Abuse and Alcoholism (NIAAA) considers alcohol abuse to be more than 14 units of alcohol a week for men and 7 units for women. The specific complication of alcoholism is the alcohol withdrawal syndrome. Its incidence reaches up to 30 % and its main complications are delirium tremens, restlessness, extended hospital stay, higher morbidity, and psychiatric and cognitive impairment. Without appropriate treatment, delirium tremens can lead to death in up to 50 % of patients. This prospective, double-blind, randomised controlled study versus placebo will be conducted in twelve French intensive care units (ICU). Patients with an alcohol intake level higher than the NIAAA threshold, who are under mechanical ventilation, will be included. The primary objective is to determine whether baclofen is more efficient than placebo in preventing restlessness-related side effects in the ICU. Secondary outcomes include mechanical ventilation duration, length of ICU stay, and cumulative doses of sedatives and painkillers received within 28 days of ICU admission. Restlessness-related side effects in the ICU are defined as unplanned extubation, medical disposal removal (such as urinary catheter, venous or arterial line or surgical drain), falling out of bed, ICU runaway (leaving ICU without physician's approval), immobilisation device removal, self-aggression or aggression towards medical staff. Daily doses of baclofen/placebo will be guided by daily creatinine clearance assessment. Restlessness in alcoholic patients is a life-threatening issue in ICUs. BACLOREA is a randomised study assessing the capacity of baclofen to prevent agitation in mechanically ventilated patients. Enrolment of 314 patients will begin in June 2016 and is expected to end in October 2018. ClinicalTrials.gov Identifier: NCT02723383 , registered on 3 March 2016.

Differentiated Staffing: Expectations and Pitfalls.

ERIC Educational Resources Information Center

Barbee, Don

Once a differentiated staffing pattern has been adopted--with the understanding that it is not a panacea--staff members have an obligation to minimize distinctions of rank and prevent organizational rigidity by contributing in role areas other than their own and sharing in decisionmaking. Teacher aides are not expected to be substitutes for…

30 CFR 250.616 - Blowout prevention equipment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... pressure rating of the BOP system and system components shall exceed the expected surface pressure to which they may be subjected. If the expected surface pressure exceeds the rated working pressure of the... pressure limitations that will be applied during each mode of pressure control. (b) The minimum BOP system...

30 CFR 250.616 - Blowout prevention equipment.

Code of Federal Regulations, 2013 CFR

2013-07-01

... pressure rating of the BOP system and system components shall exceed the expected surface pressure to which they may be subjected. If the expected surface pressure exceeds the rated working pressure of the... pressure limitations that will be applied during each mode of pressure control. (b) The minimum BOP system...

30 CFR 250.615 - Blowout prevention equipment.

Code of Federal Regulations, 2012 CFR

2012-07-01

... pressure rating of the BOP system and system components shall exceed the expected surface pressure to which they may be subjected. If the expected surface pressure exceeds the rated working pressure of the... pressure limitations that will be applied during each mode of pressure control. (b) The minimum BOP system...

Decreasing Bullying Behaviors in Middle School: Expect Respect

ERIC Educational Resources Information Center

Nese, Rhonda N. T.; Horner, Robert H.; Dickey, Celeste Rossetto; Stiller, Brianna; Tomlanovich, Anne

2014-01-01

A nonconcurrent multiple baseline across 3 middle schools was used to assess the impact that teaching all students to follow the" Bullying and Harassment Prevention in Positive Behavior Support: Expect Respect" intervention had on bullying behaviors. The 3 schools were using School-Wide Positive Behavioral Interventions and Supports and…

FROM GARBAGE TO GOURMET: SUSTAINABLE WASTE PREVENTION AND MUSHROOM CULTIVATION FROM USED COFFEE GROUNDS

EPA Science Inventory

The expected outputs of the project will include: 1) compost, 2) mushrooms for demonstration 3) report and website documenting recommendations for gourmet mushroom cultivation and results of the pilot study, and 4) tri-fold displays. The expected outcomes of the project wil...

Benchmarking statewide trauma mortality using Agency for Healthcare Research and Quality's patient safety indicators.

PubMed

Ang, Darwin; McKenney, Mark; Norwood, Scott; Kurek, Stanley; Kimbrell, Brian; Liu, Huazhi; Ziglar, Michele; Hurst, James

2015-09-01

Improving clinical outcomes of trauma patients is a challenging problem at a statewide level, particularly if data from the state's registry are not publicly available. Promotion of optimal care throughout the state is not possible unless clinical benchmarks are available for comparison. Using publicly available administrative data from the State Department of Health and the Agency for Healthcare Research and Quality (AHRQ) patient safety indicators (PSIs), we sought to create a statewide method for benchmarking trauma mortality and at the same time also identifying a pattern of unique complications that have an independent influence on mortality. Data for this study were obtained from State of Florida Agency for Health Care Administration. Adult trauma patients were identified as having International Classification of Disease ninth edition codes defined by the state. Multivariate logistic regression was used to create a predictive inpatient expected mortality model. The expected value of PSIs was created using the multivariate model and their beta coefficients provided by the AHRQ. Case-mix adjusted mortality results were reported as observed to expected (O/E) ratios to examine mortality, PSIs, failure to prevent complications, and failure to rescue from death. There were 50,596 trauma patients evaluated during the study period. The overall fit of the expected mortality model was very strong at a c-statistic of 0.93. Twelve of 25 trauma centers had O/E ratios <1 or better than expected. Nine statewide PSIs had failure to prevent O/E ratios higher than expected. Five statewide PSIs had failure to rescue O/E ratios higher than expected. The PSI that had the strongest influence on trauma mortality for the state was PSI no. 9 or perioperative hemorrhage or hematoma. Mortality could be further substratified by PSI complications at the hospital level. AHRQ PSIs can have an integral role in an adjusted benchmarking method that screens at risk trauma centers in the state for higher than expected mortality. Stratifying mortality based on failure to prevent PSIs may identify areas of needed improvement at a statewide level. Copyright © 2015 Elsevier Inc. All rights reserved.

Clustering of energy balance-related behaviors and parental education in European children: the ENERGY-project.

PubMed

Fernández-Alvira, Juan M; De Bourdeaudhuij, Ilse; Singh, Amika S; Vik, Frøydis N; Manios, Yannis; Kovacs, Eva; Jan, Natasa; Brug, Johannes; Moreno, Luis A

2013-01-15

Recent research and literature reviews show that, among schoolchildren, some specific energy balance-related behaviors (EBRBs) are relevant for overweight and obesity prevention. It is also well known that the prevalence of overweight and obesity is considerably higher among schoolchildren from lower socio-economic backgrounds. This study examines whether sugared drinks intake, physical activity, screen time and usual sleep duration cluster in reliable and meaningful ways among European children, and whether the identified clusters could be characterized by parental education. The cross-sectional study comprised a total of 5284 children (46% male), from seven European countries participating in the ENERGY-project ("EuropeaN Energy balance Research to prevent excessive weight Gain among Youth"). Information on sugared drinks intake, physical activity, screen time and usual sleep duration was obtained using validated self-report questionnaires. Based on these behaviors, gender-specific cluster analysis was performed. Associations with parental education were identified using chi-square tests and odds ratios. Five meaningful and stable clusters were found for both genders. The cluster with high physical activity level showed the highest proportion of participants with highly educated parents, while clusters with high sugared drinks consumption, high screen time and low sleep duration were more prevalent in the group with lower educated parents. Odds ratio showed that children with lower educated parents were less likely to be allocated in the active cluster and more likely to be allocated in the low activity/sedentary pattern cluster. Children with lower educated parents seemed to be more likely to present unhealthier EBRBs clustering, mainly characterized by their self-reported time spent on physical activity and screen viewing. Therefore, special focus should be given to lower educated parents and their children in order to develop effective primary prevention strategies.

Impact and cost-effectiveness of new tuberculosis vaccines in low- and middle-income countries

PubMed Central

Knight, Gwenan M.; Griffiths, Ulla K.; Sumner, Tom; Laurence, Yoko V.; Gheorghe, Adrian; Vassall, Anna; Glaziou, Philippe; White, Richard G.

2014-01-01

To help reach the target of tuberculosis (TB) disease elimination by 2050, vaccine development needs to occur now. We estimated the impact and cost-effectiveness of potential TB vaccines in low- and middle-income countries using an age-structured transmission model. New vaccines were assumed to be available in 2024, to prevent active TB in all individuals, to have a 5-y to lifetime duration of protection, to have 40–80% efficacy, and to be targeted at “infants” or “adolescents/adults.” Vaccine prices were tiered by income group (US $1.50–$10 per dose), and cost-effectiveness was assessed using incremental cost per disability adjusted life year (DALY) averted compared against gross national income per capita. Our results suggest that over 2024–2050, a vaccine targeted to adolescents/adults could have a greater impact than one targeted at infants. In low-income countries, a vaccine with a 10-y duration and 60% efficacy targeted at adolescents/adults could prevent 17 (95% range: 11–24) million TB cases by 2050 and could be considered cost-effective at $149 (cost saving to $387) per DALY averted. If targeted at infants, 0.89 (0.42–1.58) million TB cases could be prevented at $1,692 ($634–$4,603) per DALY averted. This profile targeted at adolescents/adults could be cost-effective at $4, $9, and $20 per dose in low-, lower-middle–, and upper-middle–income countries, respectively. Increased investments in adult-targeted TB vaccines may be warranted, even if only short duration and low efficacy vaccines are likely to be feasible, and trials among adults should be powered to detect low efficacies. PMID:25288770

[Travelers' diarrhea].

PubMed

Markwalder, K

2001-06-01

Diarrhea is the most common health problem of travelers to tropical destinations, affecting up to over 50%, with however considerable regional and seasonal variation. Orally acquired bacterial pathogens, particularly enterotoxigenic Escherichia coli, are the most frequent etiology of travelers' diarrhea occurring during the first three weeks of travel. Protozoal infections, e.g. giardia and Entamoeba histolytica, are more often the cause of diarrhea and prolonged problems of intestinal motility of the returning traveler--as are postinfectious irritable bowel syndromes. Prevention seems theoretically simple by avoiding any potentially contaminated food and drinks, but the principle of 'cook it, boil it, peel it, or avoid it is obviously a goal difficult to achieve. Several antibiotics have shown to be able to prevent diarrhea for a short period of time, but the potential of adverse effects and selection of resistant pathogens calls for a restrictive use for short trips of particularly vulnerable subjects only. The use of probiotics--e.g. Saccharomyces boulardi, Streptococcus faecium--gave conflicting results--both in prevention and treatment. The basics of treatment is appropriate fluid replacement--mostly by the oral route. Although this measure can safely bridge the time until spontaneous remission, it fails to reduce the duration of illness. Appropriate antibiotics are fairly effective to reduce the duration of travelers' diarrhea, especially if combined with loperamid. The administration of the later is contraindicated in small children. The most commonly used and well documented antibiotics belong to the fluoroquinolones. Alternatives for pediatric use are azithromycin and cotrimoxazole. Considering the mostly short duration of travelers' diarrhea the administration of antibiotics can be limited to cases of acute febrile dysentery and violent diarrhea when rapid relief is essential. In cases of febrile diarrhea malaria must be considered if the patient has been exposed to the risk of transmission.

[Associations of the work duration, sleep duration and number of holidays with an exaggerated blood pressure response during an exercise stress test among workers].

PubMed

Michishita, Ryoma; Ohta, Masanori; Ikeda, Masaharu; Jiang, Ying; Yamato, Hiroshi

2016-01-01

It has been reported that an exaggerated systolic blood pressure (ESBP) response during exercise, even if resting blood pressure is normal, is associated with an increased risk of future hypertension and cardiovascular disease (CVD). This study was designed to investigate the relationships of work duration, sleep duration and number of holidays with blood pressure response during an exercise stress test among normotensive workers. The subjects were 362 normotensive workers (79 males and 283 females; age, 49.1 years). A multi-stage graded submaximal exercise stress test was performed on each subject using an electric bicycle ergometer. The workload was increased every 3 minutes, and blood pressure was measured at rest and during the last 1 minute of each stage. In this study, an ESBP response during exercise was defined according to the criteria of the Framingham Study (peak systolic blood pressure ≥210 mmHg in males, or ≥190 mmHg in females). Working environments, work duration, sleep duration, number of holidays, and physical activity during commuting and work, and leisure time exercise duration were evaluated using a questionnaire. An ESBP response during exercise was observed in 94 (26.0%) workers. The adjusted odds ratio for the prevalence of an ESBP response during exercise was found to be significantly higher with an increase in work duration, decreases in sleep duration and number of holidays (p<0.05, respectively). Moreover, the highest work duration with lowest sleep duration and number of holidays groups had significantly higher adjusted odds ratio for the prevalence of an ESBP response during exercise than the lowest work duration with highest sleep duration and number of holidays groups (p<0.05, respectively). Based on our results, we consider that the assessment of blood pressure response during exercise and daily life are necessary to prevent the incidence of future hypertension, CVD and death due to overwork in workers with long-work duration, short sleep duration and small number of holidays.

Great expectations: Past wages and unemployment durations☆

PubMed Central

Böheim, Renè; Horvath, Gerard Thomas; Winter-Ebmer, Rudolf

2011-01-01

Decomposing wages into worker and firm wage components, we find that firm-fixed components are sizeable parts of workers' wages. If workers can only imperfectly observe the extent of firm-fixed components in their wages, they might be misled about the overall wage distribution. Such misperceptions may lead to unjustified high reservation wages, resulting in overly long unemployment durations. We examine the influence of previous wages on unemployment durations for workers after exogenous lay-offs and, using Austrian administrative data, we find that younger workers are, in fact, unemployed longer if they profited from high firm-fixed components in the past. We interpret our findings as evidence for overconfidence generated by imperfectly observed productivity. PMID:22211003

Long Duration Exposure Facility (LDEF) low-temperature heat pipe experiment package power system results

NASA Technical Reports Server (NTRS)

Tiller, Smith E.; Sullivan, David

1992-01-01

An overview of a self-contained Direct Energy Transfer Power System which was developed to provide power to the Long Duration Exposure Facility (LDEF) Low-Temperature Heat Pipe Experiment Package is presented. The power system operated successfully for the entire mission. Data recorded by the onboard recorder shows that the system operated within design specifications. Other than unanticipated overcharging of the battery, the power system operated as expected for nearly 32,000 low earth orbit cycles, and was still operational when tested after the LDEF recovery. Some physical damage was sustained by the solar array panels due to micrometeoroid hits, but there were not electrical failures.

Owners and Veterinary Surgeons in the United Kingdom Disagree about What Should Happen during a Small Animal Vaccination Consultation.

PubMed

Belshaw, Zoe; Robinson, Natalie J; Dean, Rachel S; Brennan, Marnie L

2018-01-18

Dog and cat vaccination consultations are a common part of small animal practice in the United Kingdom. Few data are available describing what happens during those consultations or what participants think about their content. The aim of this novel study was to investigate the attitudes of dog and cat owners and veterinary surgeons towards the content of small animal vaccination consultations. Telephone interviews with veterinary surgeons and pet owners captured rich qualitative data. Thematic analysis was performed to identify key themes. This study reports the theme describing attitudes towards the content of the consultation. Diverse preferences exist for what should be prioritised during vaccination consultations, and mismatched expectations may lead to negative experiences. Vaccination consultations for puppies and kittens were described to have a relatively standardised structure with an educational and preventative healthcare focus. In contrast, adult pet vaccination consultations were described to focus on current physical health problems with only limited discussion of preventative healthcare topics. This first qualitative exploration of UK vaccination consultation expectations suggests that the content and consistency of adult pet vaccination consultations may not meet the needs or expectations of all participants. Redefining preventative healthcare to include all preventable conditions may benefit owners, pets and veterinary surgeons, and may help to provide a clearer structure for adult pet vaccination consultations. This study represents a significant advance our understanding of this consultation type.

The Effect of Incorrect Reliability Information on Expectations, Perceptions, and Use of Automation.

PubMed

Barg-Walkow, Laura H; Rogers, Wendy A

2016-03-01

We examined how providing artificially high or low statements about automation reliability affected expectations, perceptions, and use of automation over time. One common method of introducing automation is providing explicit statements about the automation's capabilities. Research is needed to understand how expectations from such introductions affect perceptions and use of automation. Explicit-statement introductions were manipulated to set higher-than (90%), same-as (75%), or lower-than (60%) levels of expectations in a dual-task scenario with 75% reliable automation. Two experiments were conducted to assess expectations, perceptions, compliance, reliance, and task performance over (a) 2 days and (b) 4 days. The baseline assessments showed initial expectations of automation reliability matched introduced levels of expectation. For the duration of each experiment, the lower-than groups' perceptions were lower than the actual automation reliability. However, the higher-than groups' perceptions were no different from actual automation reliability after Day 1 in either study. There were few differences between groups for automation use, which generally stayed the same or increased with experience using the system. Introductory statements describing artificially low automation reliability have a long-lasting impact on perceptions about automation performance. Statements including incorrect automation reliability do not appear to affect use of automation. Introductions should be designed according to desired outcomes for expectations, perceptions, and use of the automation. Low expectations have long-lasting effects. © 2015, Human Factors and Ergonomics Society.

Susceptibility to mortality related to temperature and heat and cold wave duration in the population of Stockholm County, Sweden

PubMed Central

Rocklöv, Joacim; Forsberg, Bertil; Ebi, Kristie; Bellander, Tom

2014-01-01

Background Ambient temperatures can cause an increase in mortality. A better understanding is needed of how health status and other factors modify the risk associated with high and low temperatures, to improve the basis of preventive measures. Differences in susceptibility to temperature and to heat and cold wave duration are relatively unexplored. Objectives We studied the associations between mortality and temperature and heat and cold wave duration, stratified by age and individual and medical factors. Methods Deaths among all residents of Stockholm County between 1990 and 2002 were linked to discharge diagnosis data from hospital admissions, and associations were examined using the time stratified case-crossover design. Analyses were stratified by gender, age, pre-existing disease, country of origin, and municipality level wealth, and adjusted for potential confounding factors. Results The effect on mortality by heat wave duration was higher for lower ages, in areas with lower wealth, for hospitalized patients younger than age 65. Odds were elevated among females younger than age 65, in groups with a previous hospital admission for mental disorders, and in persons with previous cardiovascular disease. Gradual increases in summer temperatures were associated with mortality in people older than 80 years, and with mortality in groups with a previous myocardial infarction and with chronic obstructive pulmonary disease (COPD) in the population younger than 65 years. During winter, mortality was associated with a decrease in temperature particularly in men and with the duration of cold spells for the population older than 80. A history of hospitalization for myocardial infarction increased the odds associated with cold temperatures among the population older than 65. Previous mental disease or substance abuse increased the odds of death among the population younger than 65. Conclusion To increase effectiveness, we suggest preventive efforts should not assume susceptible groups are the same for warm and cold days and heat and cold waves, respectively. PMID:24647126

The loneliness of the long-duration astronaut.

PubMed

Cooper, H S

1996-01-01

This paper investigates the psychological implications of long duration spaceflight. Initial psychological problems associated with a heavy workload were identified during Skylab missions. Since then, most of our knowledge of psychological problems has come from experience onboard Russian spacecraft. Noted problems include anxiety, boredom, crew interactions, problems associated with isolation and confinement, and others. Efforts to alleviate or prevent these problems are discussed, as well as comparisons to similar environments such as arctic regions or submarines. As the U.S. participates in longer space missions, it will be wise to study psychological issues and to learn from our Russian counterparts.

Modelling the cost-effectiveness of electric stimulation therapy in non-healing venous leg ulcers.

PubMed

Taylor, R R; Sladkevicius, E; Guest, J F

2011-10-01

To estimate the cost-effectiveness of using electric stimulation (ES) therapy (Accel-Heal) plus dressings and compression bandaging compared with dressings and compression bandaging alone in treating chronic, non-healing venous leg ulcers (VLUs) of >6 months' duration from the perspective of the National Health Service (NHS) in the UK. A 5-month Markov model was constructed, depicting the management of a chronic, non-healing VLU of >6 months' duration. The model considers the decision by a clinician to continue with a patient's previous care plan (comprising dressings and compression bandaging) or treating with ES therapy plus dressings and compression bandaging. The model was used to estimate the relative cost-effectiveness of ES therapy at 2008-2009 prices. According to the model, 38% of VLUs are expected to heal within 5 months after starting ES therapy, with a further 57% expected to improve. This improvement in clinical outcome is expected to lead to a 6% health gain of 0.017 QALYs (from 0.299 to 0.316 QALYs) over 5 months. The model also showed that using ES therapy instead of continuing with a patient's previous care plan is expected to reduce the NHS cost of managing them by 15%, from £880 to £749, due in part to a 27% reduction in the requirement for nurse visits (from mean 49.0 to 35.9 visits per patient) over the first 5 months after the start of treatment. Hence, use of ES therapy was found to be a dominant treatment (improved outcome for less cost). Within the model's limitations, use of ES therapy potentially affords the NHS a cost-effective treatment, compared with patients remaining on their previous care plan in managing chronic, non-healing VLUs of >6 months' duration. However, this is dependant on the number of ES therapy units per treatment, the unit cost of the device, and the number of nurse visits required to manage patients in clinical practice. This study was sponsored by Synapse Microcurrent Ltd., manufacturers of Accel-Heal. The authors have no other conflicts of interest that are directly relevant to the content of this manuscript. In particular, Synapse Microcurrent Ltd. had no role in the study design, in the collection, analysis and interpretation of data, or in writing the manuscript.

Early stabilizing alveolar ventilation prevents acute respiratory distress syndrome: a novel timing-based ventilatory intervention to avert lung injury.

PubMed

Roy, Shreyas; Sadowitz, Benjamin; Andrews, Penny; Gatto, Louis A; Marx, William; Ge, Lin; Wang, Guirong; Lin, Xin; Dean, David A; Kuhn, Michael; Ghosh, Auyon; Satalin, Joshua; Snyder, Kathy; Vodovotz, Yoram; Nieman, Gary; Habashi, Nader

2012-08-01

Established acute respiratory distress syndrome (ARDS) is often refractory to treatment. Clinical trials have demonstrated modest treatment effects, and mortality remains high. Ventilator strategies must be developed to prevent ARDS. Early ventilatory intervention will block progression to ARDS if the ventilator mode (1) maintains alveolar stability and (2) reduces pulmonary edema formation. Yorkshire pigs (38-45 kg) were anesthetized and subjected to a "two-hit" ischemia-reperfusion and peritoneal sepsis. After injury, animals were randomized into two groups: early preventative ventilation (airway pressure release ventilation [APRV]) versus nonpreventative ventilation (NPV) and followed for 48 hours. All animals received anesthesia, antibiotics, and fluid or vasopressor therapy as per the Surviving Sepsis Campaign. Titrated for optimal alveolar stability were the following ventilation parameters: (1) NPV group--tidal volume, 10 mL/kg + positive end-expiratory pressure - 5 cm/H2O volume-cycled mode; (2) APRV group--tidal volume, 10 to 15 mL/kg; high pressure, low pressure, time duration of inspiration (Thigh), and time duration of release phase (Tlow). Physiological data and plasma were collected throughout the 48-hour study period, followed by BAL and necropsy. APRV prevented the development of ARDS (p < 0.001 vs. NPV) by PaO₂/FIO₂ ratio. Quantitative histological scoring showed that APRV prevented lung tissue injury (p < 0.001 vs. NPV). Bronchoalveolar lavage fluid showed that APRV lowered total protein and interleukin 6 while preserving surfactant proteins A and B (p < 0.05 vs. NPV). APRV significantly lowered lung water (p < 0.001 vs. NPV). Plasma interleukin 6 concentrations were similar between groups. Early preventative mechanical ventilation with APRV blocked ARDS development, preserved surfactant proteins, and reduced pulmonary inflammation and edema despite systemic inflammation similar to NPV. These data suggest that early preventative ventilation strategies stabilizing alveoli and reducing pulmonary edema can attenuate ARDS after ischemia-reperfusion and sepsis.

When Parents Ask ... about Preterm Birth, Breastfeeding Success, Breast Cancer, or Waterbirth.

PubMed

Moore, Mary Lou

2003-01-01

IN THIS COLUMN, THE AUTHOR REVIEWS RESEARCH ON FOUR SEPARATE TOPICS: the prevention of preterm birth, the effect of epidurals on breastfeeding success, the possible protective effect of lactation on breast cancer, and laboring in water. In two separate studies-a multisite study in the United States and a second study from Brazil-natural progesterone was shown to significantly reduce the incidence of preterm birth in women at high risk. A third study conducted in the United Kingdom examined the effect of clindamycin on preventing infection that can lead to preterm birth. A group of studies related to lactation found that early breastfeeding was more successful in women who did not have epidural anesthesia. In a Korean study, the lifetime duration of breastfeeding was associated with a significant reduction in breast cancer. Concerning waterbirth, Swiss researchers found that, when a woman labored in water, she regulated both water temperature and bathing duration to ensure that her body temperature and that of the fetus remained within a normal physiological range.

Pulsed voltage electrospray ion source and method for preventing analyte electrolysis

DOEpatents

Kertesz, Vilmos [Knoxville, TN; Van Berkel, Gary [Clinton, TN

2011-12-27

An electrospray ion source and method of operation includes the application of pulsed voltage to prevent electrolysis of analytes with a low electrochemical potential. The electrospray ion source can include an emitter, a counter electrode, and a power supply. The emitter can include a liquid conduit, a primary working electrode having a liquid contacting surface, and a spray tip, where the liquid conduit and the working electrode are in liquid communication. The counter electrode can be proximate to, but separated from, the spray tip. The power system can supply voltage to the working electrode in the form of a pulse wave, where the pulse wave oscillates between at least an energized voltage and a relaxation voltage. The relaxation duration of the relaxation voltage can range from 1 millisecond to 35 milliseconds. The pulse duration of the energized voltage can be less than 1 millisecond and the frequency of the pulse wave can range from 30 to 800 Hz.

Urolithiasis and Genitourinary Systems Issues for Spaceflight

NASA Astrophysics Data System (ADS)

Jones, Jeffrey A.; Sargsyan, Ashot; Pietryzk, Robert; Sams, C.; Stepaniak, Phillip; Whitson, P.

2008-09-01

Genitourinary medical events have shown to be an issue for both short duration and long duration spaceflight, and are anticipated to also be a potential issue for future exploration missions as well. This is based on actual historical pre-, in- and post-flight medical events, as well as assessment of what future flight challenges lay ahead. For this study, retrospective record review, as well as prospective studies of ultrasound and contingency management procedure development, and oral urinary stone prophylaxis were conducted. Results showed that the incidence of prior urinary calculi in- and post-flight was a risk driver for development of on-orbit countermeasures, as well as diagnostic and therapeutic methods for a possible in-flight calculus contingency. Oral potassium citrate and bisphosphonate preparations show promise for prophylaxis in spaceflight risk reduction. We conclude that a properly developed approach of selection, monitoring, and preventive medicine with effective countermeasures, along with early imaging diagnosis and minimally-invasive contingency intervention, should prevent issues such as urinary calculi from having a significant mission impact for exploration-class spaceflight.

Association between short sleep duration and body mass index in Australian Indigenous children.

PubMed

Deacon-Crouch, Melissa; Skinner, Isabelle; Tucci, Joseph; Skinner, Timothy

2018-01-01

Associations between short sleep duration and obesity and the relationship between obesity and chronic illness are well documented. Obese children are likely to become obese adults. To date, there is a paucity of information regarding sleep duration and quality for Indigenous Australian people. It may be that poor-quality, short sleep is contributing to the gap in health outcomes for Indigenous people compared with non-Indigenous adults and children. This study sought to investigate the possibility that poor sleep quality may be contributing to health outcomes for Indigenous children by exploring associations between sleep duration and body mass index (BMI). Participants included 1253 children aged 7-12 years in Wave 7 of the national Longitudinal Study of Indigenous Children survey. Interviewers asked primary carers about children's sleep times. BMI was derived from measurements of children made by researchers. Regardless of age, relative socio-economic disadvantage and level of remoteness, unhealthy weight was associated with less sleep duration than healthy weight for Indigenous children. The relationship between short sleep duration and BMI in Indigenous children has important implications for their future health outcomes. Both overweight conditions and short sleep are established modifiable risk factors for metabolic dysfunction and other chronic illnesses prominent in the Indigenous population. It is important to consider strategies to optimise both for Indigenous children in an attempt to help 'close the gap' in health outcomes and life expectancy between Indigenous and non-Indigenous people. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Axillary lymphadenectomy for breast cancer in elderly patients and fibrin glue

PubMed Central

2013-01-01

Background Axillary lymphadenectomy or sentinel biopsy is integral part of breast cancer treatment, yet seroma formation occurs in 15-85% of cases. Among methods employed to reduce seroma magnitude and duration, fibrin glue has been proposed in numerous studies with controversial results. Methods Thirty patients over 60 years underwent quadrantectomy or mastectomy with level I/II axillary lymphadenectomy; a suction drain was fitted in all patients. Fibrin glue spray were applied to the axillary fossa in 15 patients; the other 15 patients were treated with harmonic scalpel. Results Suction drainage was removed between post-operative Days 3 and 4. Seroma magnitude and duration were not significant in patients receiving fibrin glue compared with the harmonic scalpel group. Conclusions Use of fibrin glue does not always prevent seroma formation, but can reduce seroma magnitude, duration and necessary evacuative punctures. PMID:24266959

Patient-related barriers to hypertension control in a Nigerian population

PubMed Central

Okwuonu, Chimezie Godswill; Ojimadu, Nnamdi Ezekiel; Okaka, Enajite Ibiene; Akemokwe, Fatai Momodu

2014-01-01

Background Hypertension control is a challenge globally. Barriers to optimal control exist at the patient, physician, and health system levels. Patient-related barriers in our environment are not clear. The aim of this study was to identify patient-related barriers to control of hypertension among adults with hypertension in a semiurban community in South-East Nigeria. Methods This was a cross-sectional descriptive study of patients with a diagnosis of hypertension and on antihypertensive medication. Results A total of 252 participants were included in the survey, and comprised 143 males (56.7%) and 109 females (43.3%). The mean age of the participants was 56.6±12.7 years, with a diagnosis of hypertension for a mean duration of 6.1±3.3 years. Among these patients, 32.9% had controlled blood pressure, while 39.3% and 27.8%, respectively, had stage 1 and stage 2 hypertension according to the Seventh Report of the Joint National Committee on Prevention, Detection and Evaluation of High Blood Pressure. Only 23.4% knew the consequences of poor blood pressure control and 64% were expecting a cure from treatment even when the cause of hypertension was not known. Furthermore, 68.7% showed low adherence to medication, the reported reasons for which included forgetfulness (61.2%), financial constraints (56.6%), high pill burden (22.5%), side effects of medication (17.3%), and low measured blood pressure (12.1%). Finally, knowledge and practice of the lifestyle modifications necessary for blood pressure control was inadequate among the participants. Conclusion Poor knowledge regarding hypertension, unrealistic expectations of treatment, poor adherence with medication, unawareness of lifestyle modification, and failure to apply these were identified as patient-related barriers to blood pressure control in this study. PMID:25061335

Potential protective effect of L-cysteine against the toxicity of acrylamide and furan in exposed Xenopus laevis embryos: an interaction study.

PubMed

Williams, John Russell; Rayburn, James R; Cline, George R; Sauterer, Roger; Friedman, Mendel

2014-08-06

The embryo toxicities of two food-processing-induced toxic compounds, acrylamide and furan, with and without added L-cysteine were examined individually and in mixtures using the frog embryo teratogenesis assay-Xenopus (FETAX). The following measures of developmental toxicity were used: (a) 96 h LC50, the median concentration causing 50% embryo lethality; (b) 96 h EC50, the median concentration causing 50% malformations of the surviving embryos; and (c) teratogenic index (96 h LC50/96 h EC50), an estimate of teratogenic risk. Calculations of toxic units (TU) were used to assess possible antagonism, synergism, or response addition of several mixtures. The evaluated compounds demonstrated counterintuitive effects. Furan had lower than expected toxicity in Xenopus embryos and, unlike acrylamide, does not seem to be teratogenic. However, the short duration of the tests may not show the full effects of furan if it is truly primarily genotoxic and carcinogenic. L-Cysteine showed unexpected properties in the delay of hatching of the embryos. The results from the interaction studies between combination of two or three components (acrylamide plus L-cysteine; furan plus L-cysteine; acrylamide plus furan; acrylamide plus furan and L-cysteine) show that furan and acrylamide seem to have less than response addition at 1:1 toxic unit ratio in lethality. Acrylamide and L-cysteine show severe antagonism even at low 19 acrylamide/1 L-cysteine TU ratios. Data from the mixture of acrylamide, furan, and L-cysteine show a slight antagonism, less than would have been expected from binary mixture exposures. Bioalkylation mechanisms and their prevention are discussed. There is a need to study the toxicological properties of mixtures of acrylamide and furan concurrently formed in heat-processed food.

Time to clinical response and remission for therapeutics in inflammatory bowel diseases: What should the clinician expect, what should patients be told?

PubMed Central

Vasudevan, Abhinav; Gibson, Peter R; van Langenberg, Daniel R

2017-01-01

An awareness of the expected time for therapies to induce symptomatic improvement and remission is necessary for determining the timing of follow-up, disease (re)assessment, and the duration to persist with therapies, yet this is seldom reported as an outcome in clinical trials. In this review, we explore the time to clinical response and remission of current therapies for inflammatory bowel disease (IBD) as well as medication, patient and disease related factors that may influence the time to clinical response. It appears that the time to therapeutic response varies depending on the indication for therapy (Crohn’s disease or ulcerative colitis). Agents with the most rapid time to clinical response included corticosteroids, calcineurin inhibitors, exclusive enteral nutrition, aminosalicylates and anti-tumor necrosis factor therapy which will work in most patients within the first 2 mo. Vedolizumab, methotrexate and thiopurines had a longer time to clinical response and can take several months to achieve maximal efficacy. Factors affecting the time to clinical response of therapies included use of concomitant therapy, disease duration, smoking status, disease phenotype and advanced age. There appears to be marked variation in time to clinical response for therapies used in IBD which is further influenced by disease and patient related factors. Understanding the expected time to therapeutic response is integral to inform further decision making, maintain a patient-centered approach and ensure treatment is given an appropriate timeframe to achieve maximal benefit prior to cessation. PMID:29085188

Time to clinical response and remission for therapeutics in inflammatory bowel diseases: What should the clinician expect, what should patients be told?

PubMed

Vasudevan, Abhinav; Gibson, Peter R; van Langenberg, Daniel R

2017-09-21

An awareness of the expected time for therapies to induce symptomatic improvement and remission is necessary for determining the timing of follow-up, disease (re)assessment, and the duration to persist with therapies, yet this is seldom reported as an outcome in clinical trials. In this review, we explore the time to clinical response and remission of current therapies for inflammatory bowel disease (IBD) as well as medication, patient and disease related factors that may influence the time to clinical response. It appears that the time to therapeutic response varies depending on the indication for therapy (Crohn's disease or ulcerative colitis). Agents with the most rapid time to clinical response included corticosteroids, calcineurin inhibitors, exclusive enteral nutrition, aminosalicylates and anti-tumor necrosis factor therapy which will work in most patients within the first 2 mo. Vedolizumab, methotrexate and thiopurines had a longer time to clinical response and can take several months to achieve maximal efficacy. Factors affecting the time to clinical response of therapies included use of concomitant therapy, disease duration, smoking status, disease phenotype and advanced age. There appears to be marked variation in time to clinical response for therapies used in IBD which is further influenced by disease and patient related factors. Understanding the expected time to therapeutic response is integral to inform further decision making, maintain a patient-centered approach and ensure treatment is given an appropriate timeframe to achieve maximal benefit prior to cessation.

Comparison between the Health Belief Model and Subjective Expected Utility Theory: predicting incontinence prevention behaviour in post-partum women.

PubMed

Dolman, M; Chase, J

1996-08-01

A small-scale study was undertaken to test the relative predictive power of the Health Belief Model and Subjective Expected Utility Theory for the uptake of a behaviour (pelvic floor exercises) to reduce post-partum urinary incontinence in primigravida females. A structured questionnaire was used to gather data relevant to both models from a sample antenatal and postnatal primigravida women. Questions examined the perceived probability of becoming incontinent, the perceived (dis)utility of incontinence, the perceived probability of pelvic floor exercises preventing future urinary incontinence, the costs and benefits of performing pelvic floor exercises and sources of information and knowledge about incontinence. Multiple regression analysis focused on whether or not respondents intended to perform pelvic floor exercises and the factors influencing their decisions. Aggregated data were analysed to compare the Health Belief Model and Subjective Expected Utility Theory directly.

[Mexican adolescentes' goals as determinants in the prevention of early pregnancies].

PubMed

Atienzo, Erika E; Campero, Lourdes; Lozada, Ana Lilia; Herrera, Cristina

2014-01-01

This study aims to explore adolescents' intentions related to the early formation of a family. We administered a survey to students in eight schools in Morelos and Mexico City, in 2010. We analyzed intentions of marrying or having a child and fitted an exploratory path model to assess predictors of the intentions of having a child before the age of 20 (n=2974). Around 77% of adolescents expect to have their first child at 20 years or later; 21% show ambivalence or incongruence regarding this, whereas 2% expect to have a child before the age of 20. Parents' expectations for their child's education influence the importance that adolescents give to education. The latter promotes the idea of postponing childbearing until 20 years or later (β=0.13). In order to prevent early pregnancies, interventions and programs should encourage the construction of personal and professional goals.

Manufacturer-provided effective orifice area index charts and the prevention of prosthesis-patient mismatch.

PubMed

House, Chad M; Nelson, William B; Kroshus, Timothy J; Dahiya, Ranjan; Pibarot, Philippe

2012-01-01

Prosthesis-patient mismatch (PPM) occurs when an implanted prosthesis is too small relative to the patient's body surface area (BSA). However, mismatch can often be prevented by indexing the expected effective orifice area (EOA) of a prosthesis to the patient's BSA and then selecting the largest implantable prosthesis to avoid mismatch. Previously, prosthesis manufacturers have attempted to simplify this process by providing charts that include the expected EOA for their prosthesis, already indexed into an array of BSA values. One caveat with these charts is that the expected EOA data must truly be reliable, or the charts will misguide the implanting surgeon. Manufacturer-provided charts could be improved by standardizing the EOA data, with one potential source being the hemodynamic data submitted to the United States Food and Drug Administration. This review discusses PPM, manufacturer-provided EOA charts, and the regulation of EOA data.

Efficacy of a drug prevention CD-ROM intervention for adolescents.

PubMed

Williams, Christopher; Griffin, Kenneth W; Macaulay, Araxi P; West, Tara L; Gronewold, Elizabeth

2005-01-01

The purpose of the present study was to examine the efficacy of a substance abuse-preventive intervention using CD-ROM technology among adolescents in the sixth and seventh grades (12- to 13-years-old). The CD-ROM program used interactive audio and video content to teach social resistance skills, general personal and social competence skills, and normative education. Rates of substance-use behavior attitudes, knowledge, normative expectations, and related variables were examined. From approximately 23 schools, students (n = 123) were randomly assigned to either receive the CD-ROM preventive intervention (n = 61) or to serve as a control group (n = 62). Study participants were 50% male, predominantly white (75%), and 94% came from two-parent families. Self-report data were collected using a self-administered web-based survey. Findings indicated that there were significant intervention effects on pro-drug attitudes, normative expectations for peer and adult substance use, anxiety reduction skills, and relaxation skills knowledge, with intervention students reporting improved scores on these outcomes at the posttest relative to control students. Findings indicate that a substance abuse-preventive intervention derived from an effective, school-based prevention approach is efficacious when delivered using CD-ROM technology. Research is needed to determine potential differences in the efficacy of CD-ROM prevention tools delivered in schools compared to home settings.

An educational strategy for improving knowledge about breast and cervical cancer prevention among Mexican middle school students.

PubMed

Calderón-Garcidueñas, Ana Laura; Flores-Peña, Yolanda; De León-Leal, Silvia; Vázquez-Martínez, Carlos Alberto; Farías-Calderón, Ana Gabriela; Melo-Santiesteban, Guadalupe; Elizondo-Zapién, Rosa María; Hernandez-Hernandez, Dulce María; Garza-Moya, Rubén; Cerda-Flores, Ricardo Martín

2015-01-01

Prevention programs have not achieved the expected results in preventing mortality from breast and cervical cancer in Mexico. Therefore, we propose a complementary strategy. An educational strategy for high school students in Mexico (2011-2013) was designed (longitudinal design, two measurements and a single intervention). The postintervention assessment included: 1) knowledge acquired by students about cancer prevention and 2) The performance of the student as a health promoter in their household. The strategy was based on analysis of cases and developed in three sessions. An assessment tool was designed and validated (Test-Retest). The levels of knowledge according to the qualifications expected by chance were determined. Wilcoxon test compared results before and after intervention. An assessment instrument with 0.80 reliability was obtained. 831 high school students were analyzed. Wilcoxon rank-sum test showed a significant learning after the intervention (Z = - 2.64, p = 0.008) with improvement of levels of knowledge in a 154.5%. 49% of students had a good performance as health promoters. The learning in preventive measures is important to sensitize individuals to prevention campaigns against cancer. This strategy proved to improve the level of knowledge of students in an easy and affordable way.

An educational strategy for improving knowledge about breast and cervical cancer prevention among Mexican middle school students

PubMed Central

Calderón- Garcidueñas, Ana Laura; Flores-Peña, Yolanda; De León-Leal, Silvia; Vázquez-Martínez, Carlos Alberto; Farías-Calderón, Ana Gabriela; Melo-Santiesteban, Guadalupe; Elizondo-Zapién, Rosa María; Hernandez-Hernandez, Dulce María; Garza-Moya, Rubén; Cerda-Flores, Ricardo Martín

2015-01-01

Introduction Prevention programs have not achieved the expected results in preventing mortality from breast and cervical cancer in Mexico. Therefore, we propose a complementary strategy. Methodology An educational strategy for high school students in Mexico (2011–2013) was designed (longitudinal design, two measurements and a single intervention). The postintervention assessment included: 1) knowledge acquired by students about cancer prevention and 2) The performance of the student as a health promoter in their household. The strategy was based on analysis of cases and developed in three sessions. An assessment tool was designed and validated (Test–Retest). The levels of knowledge according to the qualifications expected by chance were determined. Wilcoxon test compared results before and after intervention. Results An assessment instrument with 0.80 reliability was obtained. 831 high school students were analyzed. Wilcoxon rank-sum test showed a significant learning after the intervention (Z = − 2.64, p = 0.008) with improvement of levels of knowledge in a 154.5%. 49% of students had a good performance as health promoters. Conclusions The learning in preventive measures is important to sensitize individuals to prevention campaigns against cancer. This strategy proved to improve the level of knowledge of students in an easy and affordable way. PMID:26844079

Implementing an Inpatient Social Early Warning System for Child Maltreatment

ERIC Educational Resources Information Center

Atabaki, Armita; Heddaeus, Daniela; Metzner, Franka; Schulz, Holger; Siefert, Sonke; Pawils, Silke

2013-01-01

Objectives: The current article describes the process evaluation of a social early warning system (SEWS) for the prevention of child maltreatment in the federal state of Hamburg. This prevention initiative targets expectant mothers and their partners including an initial screening of risk factors for child maltreatment, a subsequent structured…

Children with Health Issues

ERIC Educational Resources Information Center

Schuster, Mark A.; Chung, Paul J.; Vestal, Katherine D.

2011-01-01

All children, even the healthiest, have preventive and acute health care needs. Moreover, a growing number of children are chronically ill, with preventive, acute, and ongoing care needs that may be much more demanding than those for healthy children. Because children are unable to care for themselves, their parents are expected to provide a range…

Bullying Prevention

ERIC Educational Resources Information Center

Kemp, Patrice

2016-01-01

The focus of the milestone project is to focus on bridging the gap of bullying and classroom instruction methods. There has to be a defined expectations and level of accountability that has to be defined when supporting and implementing a plan linked to bullying prevention. All individuals involved in the student's learning have to be aware of…

Parent and teen agreement on driving expectations prior to teen licensure.

PubMed

Hamann, Cara J; Ramirez, Marizen; Yang, Jingzhen; Chande, Vidya; Peek-Asa, Corinne

2014-01-01

To examine pre-licensure agreement on driving expectations and predictors of teen driving expectations among parent-teen dyads. Cross-sectional survey of 163 parent-teen dyads. Descriptive statistics, weighted Kappa coefficients, and linear regression were used to examine expectations about post-licensure teen driving. Teens reported high pre-licensure unsupervised driving (N = 79, 48.5%) and regular access to a car (N = 130, 81.8%). Parents and teens had low agreement on teen driving expectations (eg, after dark, κw = 0.23). Each time teens currently drove to/from school, their expectation of driving in risky conditions post-licensure increased (β = 0.21, p = .02). Pre-licensure improvement of parent-teen agreement on driving expectations are needed to have the greatest impact on preventing teens from driving in high risk conditions.

Physician gender, patient gender, and primary care.

PubMed

Franks, Peter; Bertakis, Klea D

2003-01-01

Studies of the effects of physician gender on patient care have been limited by selected samples, examining a narrow spectrum of care, or not controlling for important confounders. We sought to examine the role of physician and patient gender across the spectrum of primary care in a nationally representative sample, large enough to examine the role of gender concordance and adjust for confounding variables. We examined the relationships between physician and patient gender using nationally representative samples (the U. S. National Ambulatory Medical Care Surveys from 1985 to 1992) of encounters of 41,292 adult patients with 1470 primary care physicians (internists, family physicians, and obstetrician/gynecologists). Factors examined included physician (age, gender, region, rural location), patient (age, gender, race, insurance), and visit characteristics (diagnoses, gender-specific and nonspecific prevention, duration, continuity, and disposition). After multivariate adjustment, female physicians were more likely to see female patients, had longer visit durations, and were more likely to perform female prevention procedures and make some follow-up arrangements and referrals. Female physicians were slightly more likely to check patients blood pressure, but there were no significant differences in other nongender-specific prevention procedures or use of psychiatric diagnoses. Among encounters without breast or pelvic examinations, visit length was not related to physician gender, but length was longer in gender concordant visits than gender-discordant visits. Female physicians were more likely to deliver female prevention procedures, but few other physician gender differences in primary care were observed. Physician-patient gender concordance was a key determinant of encounters.

Air bubbles and hemolysis of blood samples during transport by pneumatic tube systems.

PubMed

Mullins, Garrett R; Bruns, David E

2017-10-01

Transport of blood samples through pneumatic tube systems (PTSs) generates air bubbles in transported blood samples and, with increasing duration of transport, the appearance of hemolysis. We investigated the role of air-bubble formation in PTS-induced hemolysis. Air was introduced into blood samples for 0, 1, 3 or 5min to form air bubbles. Hemolysis in the blood was assessed by (H)-index, lactate dehydrogenase (LD) and potassium in plasma. In an effort to prevent PTS-induced hemolysis, blood sample tubes were completely filled, to prevent air bubble formation, and compared with partially filled samples after PTS transport. We also compared hemolysis in anticoagulated vs clotted blood subjected to PTS transport. As with transport through PTSs, the duration of air bubble formation in blood by a gentle stream of air predicted the extent of hemolysis as measured by H-index (p<0.01), LD (p<0.01), and potassium (p<0.02) in plasma. Removing air space in a blood sample prevented bubble formation and fully protected the blood from PTS-induced hemolysis (p<0.02 vs conventionally filled collection tube). Clotted blood developed less foaming during PTS transport and was partially protected from hemolysis vs anticoagulated blood as indicated by lower LD (p<0.03) in serum than in plasma after PTS sample transport. Prevention of air bubble formation in blood samples during PTS transport protects samples from hemolysis. Copyright © 2017 Elsevier B.V. All rights reserved.

Prostatic fossa gauze-packing in the prevention of blood clot obstruction of the bladder after transvesical prostatectomy.

PubMed

Umunna, J I

2010-01-01

Clot obstruction often complicates transvesical prostatectomy. Any measure that prevents this will be a great relief to both surgeon and patient. To demonstrate that packing the prostatic fossa with roller gauze bandage after transvesical prostatectomy can prevent post-operative clot blockage of bladder drainage . Charts of all patients who had transvesical prostatectomy at Jasman Hospital Udo by me from 1988 to 1997 were sorted into two groups , Group A, not packed and Group B, packed. Information sought included patient's age, type of prostatectomy performed, whether the prostatic fossa was packed or not , average duration of catheter drainage, and complications. There were 68 patients who had no fossa packing and 72 in Group B with fossa packing. The age range of the two groups A and B were respective 45-85 year-old and 50-83 years. In both groups the highest number of patients was in the 60 t0 79 age bracket (48 in group A , 70%, and 56 in group B (78%). Bladder blockage occurred in 32(47%) patients without packing and none (0%) in group B with packing. Average duration of bladder drainage was 14 days in each group. There was no persisting vesico-cutaneous fistula. Temporary urinary incontinence occurred in three (3%) patients who had no packing and in five (7%) with packing. Gauze-packing of the prostatic fossa during transvesical prostatectomy can prevent bladder obstruction from clot retention without undue complications.

Relative Contribution of Obesity, Sedentary Behaviors and Dietary Habits to Sleep Duration Among Kuwaiti Adolescents

PubMed Central

Al-Haifi, Ahmad A.; AlMajed, Hana Th.; Al-Hazzaa, Hazzaa M.; Musaiger, Abdulrahman O.; Arab, Mariam A.; Hasan, Rasha A.

2016-01-01

The aim of this study was to investigate whether body mass index (BMI), eating habits and sedentary behaviours were associated with sleep duration among Kuwaiti adolescents. The study is part of the Arab Teens Lifestyle Study (ATLS), which is a school-based cross-sectional multi-center collaborative study. A sample of 906 adolescents (boys and girls) aged 14-19 years was randomly selected from 6 Kuwaiti Governances using a multistage stratified cluster sampling technique. The findings revealed that the prevalence of overweight and obesity was 50.5% in boys and 46.5% in girls. The majority of boys (76%) and of girls (74%) fell into the short sleep duration category (6 hours/day or less). Sleep duration were found to be negatively associated with BMI (girls only). Watching television (boys and girls) and working on computers (boys only) were also negatively associated with sleep duration. While the consumption of breakfast (both genders) and milk (boys only) was positively associated with sleep duration (p<0.05). In contrast, the consumption of fast foods (both genders), sugar-sweetened drinks and sweets (boys only) potatoes (girls only) were negatively associated with sleep duration (p<0.05). It can be concluded that the majority of Kuwaiti adolescents exhibit insufficient sleep duration which was associated with obesity measure, a combination of poor eating habits and more sedentary behaviors. The findings also suggest gender differences in these associations. Therefore, adequate sleep is an important modifiable risk factor to prevent obesity and was positively associated with some unhealthy lifestyle habits. PMID:26234983

Teaching primary prevention of Alzheimer's disease: does it make a difference?

PubMed

Clevenger, Carolyn K; Cantey, Shileah; Quinn, Mary Ellen

2010-07-01

Alzheimer's disease (AD) is one of the most feared illnesses among older adults. Although no cure exists, an emerging body of literature has outlined potentially risk-reducing behaviors. As evidence has become available on risk reduction, community organizations and advocacy groups have developed health education courses on the topic. This study examines the impact of one educational program on the audience's efficacy expectations and outcome expectations for behavior change. Participants included 53 older adults residing in a continuing care retirement community. The study used a pretest-posttest design with an experimental group (n = 33) and a control group (n = 20). Topics on weekly classes included the relationship between cardiovascular factors and AD, dietary factors implicated in AD, and mental stimulation to reduce AD risk. Class sessions consisted of lecture, discussion, and demonstration. Between-group differences were found for both efficacy (P = .016) and outcome expectations (P = .000). Within-group differences were only significant for increased outcome expectations related to literature-derived behaviors (P = .000). Future work should focus on action and prevention and on replication of the educational program's evaluation in a more diverse population.

Modeling the Unites States government's economic cost of noise-induced hearing loss for a military population.

PubMed

Tufts, Jennifer B; Weathersby, Paul K; Rodriguez, Francisco A

2010-05-01

The purpose of this paper is to demonstrate the feasibility and utility of developing economic cost models for noise-induced hearing loss (NIHL). First, we outline an economic model of NIHL for a population of US Navy sailors with an "industrial"-type noise exposure. Next, we describe the effect on NIHL-related cost of varying the two central model inputs--the noise-exposure level and the duration of exposure. Such an analysis can help prioritize promising areas, to which limited resources to reduce NIHL-related costs should be devoted. NIHL-related costs borne by the US government were computed on a yearly basis using a finite element approach that took into account varying levels of susceptibility to NIHL. Predicted hearing thresholds for the population were computed with ANSI S3.44-1996 and then used as the basis for the calculation of NIHL-related costs. Annual and cumulative costs were tracked. Noise-exposure level and duration were systematically varied to determine their effects on the expected lifetime NIHL-related cost of a specific US Navy sailor population. Our nominal noise-exposure case [93 dB(A) for six years] yielded a total expected lifetime cost of US $13,472 per sailor, with plausible lower and upper bounds of US $2,500 and US $26,000. Starting with the nominal case, a decrease of 50% in exposure level or duration would yield cost savings of approximately 23% and 19%, respectively. We concluded that a reduction in noise level would be more somewhat more cost-effective than the same percentage reduction in years of exposure. Our economic cost model can be used to estimate the changes in NIHL-related costs that would result from changes in noise-exposure level and/or duration for a single military population. Although the model is limited at present, suggestions are provided for adapting it to civilian populations.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ford, S R; Walter, W R

The behavior of aftershock sequences around the Nevada Test Site in the southern Great Basin is characterized as a potential discriminant between explosions and earthquakes. The aftershock model designed by Reasenberg and Jones (1989, 1994) allows for a probabilistic statement of earthquake-like aftershock behavior at any time after the mainshock. We use this model to define two types of aftershock discriminants. The first defines M{sub X}, or the minimum magnitude of an aftershock expected within a given duration after the mainshock with probability X. Of the 67 earthquakes with M > 4 in the study region, 63 of them producemore » an aftershock greater than M{sub 99} within the first seven days after a mainshock. This is contrasted with only six of 93 explosions with M > 4 that produce an aftershock greater than M{sub 99} for the same period. If the aftershock magnitude threshold is lowered and the M{sub 90} criteria is used, then no explosions produce an aftershock greater than M{sub 90} for durations that end more than 17 days after the mainshock. The other discriminant defines N{sub X}, or the minimum cumulative number of aftershocks expected for given time after the mainshock with probability X. Similar to the aftershock magnitude discriminant, five earthquakes do not produce more aftershocks than N{sub 99} within 7 days after the mainshock. However, within the same period all but one explosion produce less aftershocks then N{sub 99}. One explosion is added if the duration is shortened to two days after than mainshock. The cumulative number aftershock discriminant is more reliable, especially at short durations, but requires a low magnitude of completeness for the given earthquake catalog. These results at NTS are quite promising and should be evaluated at other nuclear test sites to understand the effects of differences in the geologic setting and nuclear testing practices on its performance.« less

Duration on unemployment: geographic mobility and selectivity bias.

PubMed

Goss, E P; Paul, C; Wilhite, A

1994-01-01

Modeling the factors affecting the duration of unemployment was found to be influenced by the inclusion of migration factors. Traditional models which did not control for migration factors were found to underestimate movers' probability of finding an acceptable job. The empirical test of the theory, based on the analysis of data on US household heads unemployed in 1982 and employed in 1982 and 1983, found that the cumulative probability of reemployment in the traditional model was .422 and in the migration selectivity model was .624 after 30 weeks of searching. In addition, controlling for selectivity eliminated the significance of the relationship between race and job search duration in the model. The relationship between search duration and the county unemployment rate in 1982 became statistically significant, and the relationship between search duration and 1980 population per square mile in the 1982 county of residence became statistically insignificant. The finding that non-Whites have a longer duration of unemployment can better be understood as non-Whites' lower geographic mobility and lack of greater job contacts. The statistical significance of a high unemployment rate in the home labor market reducing the probability of finding employment was more in keeping with expectations. The findings assumed that the duration of employment accurately reflected the length of job search. The sample was redrawn to exclude discouraged workers and the analysis was repeated. The findings were similar to the full sample, with the coefficient for migration variable being negative and statistically significant and the coefficient for alpha remaining positive and statistically significant. Race in the selectivity model remained statistically insignificant. The findings supported the Schwartz model hypothesizing that the expansion of the radius of the search would reduce the duration of unemployment. The exclusion of the migration factor misspecified the equation for unemployment duration. Policy should be directed to the problems of geographic mobility, particularly among non-Whites.

Duration of U.S. stay and body mass index among Latino and Asian immigrants: A test of theoretical pathways.

PubMed

Ro, Annie; Bostean, Georgiana

2015-11-01

Studies find that longer-term immigrants have higher body mass index (BMI) than their more recently arrived counterparts. Most interpretations of these health patterns by duration of U.S. residence rely on theories of immigrant integration; they posit that with increasing time in the United States, immigrants incorporate economically, socially, and culturally into aspects of U.S. society, and that these changes impact health. Few studies empirically examine whether these aspects of integration are indeed mediators of the association between duration of U.S. stay and BMI, and if their patterns differ across immigrant subgroups. This study examines data from the National Latino and Asian American Survey, using path analytic methods to simultaneously test six hypothesized mediators between duration and BMI: household income, English language ability, ethnic identity, family cohesion, acculturative stress and discrimination for both Latino and Asian immigrants, stratified by gender. We find little evidence for an association between duration and BMI for either Latino or Asian men. For women, duration and BMI have a significant and positive relationship, although the pathways differ between the two ethnic groups. For Latina women, household income and acculturative stress are significant indirect pathways, although they work in opposing directions. For Asian women, English proficiency and discrimination are significant indirect pathways. Our findings reveal complex pathways between duration and BMI that vary by ethnicity and gender and highlight limitations in the negative acculturation theory, which suggests that exposure to the United States should have a net negative impact on health. In contrast, our findings suggest that not all groups show declining health with longer duration, as measured by BMI, and that integration processes do not always translate into health differences in the expected directions. Future research on duration patterns may need to consider alternative explanations beyond incorporation-based processes, such as cross-national health theories or age, period, cohort effects. Copyright © 2015 Elsevier Ltd. All rights reserved.

30 CFR 250.450 - What are the recordkeeping requirements for BOP tests?

Code of Federal Regulations, 2011 CFR

2011-07-01

... ENFORCEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Drilling Operations Blowout Preventer (bop) System Requirements § 250.450 What are the... the duration of drilling. [68 FR 8423, Feb. 20, 2003] ...

Preoperative use of granisetron plus dexamethasone and granisetron alone in prevention of post operative nausea and vomiting in tonsillectomy.

PubMed

Islam, M R; Haq, M F; Islam, M A; Meftahuzzaman, S M; Sarkar, S C; Rashid, H; Rashid, H U

2011-07-01

This prospective study was done for to see the efficacy of preoperative use of granisetron plus dexamethasone (Group A) & granisetron (Group B) alone for the postoperative prevention of nausea & vomiting after tonsillectomy operation. One hundred patients undergoing tonsillectomy & adenoidectomy operation under general anaesthesia who were admitted in the Mymensingh Medical College Hospital during the period from July 2008 to June 2009 with American Society of Anaesthesiologists (ASA) grade I & II with age 3-40 years, body weight 10-60 kgs, were studied. Observation of this study was analyzed in the light of comparison between the two groups. All results were expressed as mean±SEM. Age in Group A 15.98±1.028 & Group B 17.18±0.961 years; Weight in Group A 38.40±1.492 & Group B 39.76±1.561 kgs and operational duration in Group A 52.60±0.786 & Group B 52.70±0.823 minutes. The studied groups were statistically matched for age, weight, duration of surgery. We observed that the effects of combination of granisetron & dexamthasone are more than granisetron alone in prevention of nausea & vomiting after tonsillectomy operation. The frequency of vomiting was 4% in combination & 16% in single therapy which is statically significant (p<0.05).

Performance of acidified 14C-urea capsule breath test during pantoprazole and ranitidine treatment.

PubMed

Oztürk, Emel; Yeşilova, Zeki; Ilgan, Seyfettin; Ozgüven, Mehmet; Dağalp, Kemal

2009-07-01

Urea breath test (UBT) results could be false negative in patients taking antisecretory drugs. This effect would be prevented by citric acid administration during UBT. We prospectively investigated whether acidified 14C-urea capsule prevents false negative UBT results in patients taking antisecretory drugs and show interference with the duration of medications. Sixty Helicobacter pylori positive patients were included. Pantoprazole (40 mg/day) was given to 27 patients for 28 days and ranitidine (300 mg. o.d.) to 33 patients for 60 days. Urea breath tests were repeated on days 14 and 28 in both groups and on day 60 in the ranitidine group. The baseline mean breath counts of two groups did not show any significant difference. Pantoprazole led to a significant decrease in mean breath counts on day 14 (P < 0.005). Six of 27 and 3 of 25 patients taking pantoprazole developed negative or equivocal UBT results on days 14 and 28, respectively. Two of 32, 2 of 32 and 3 of 21 patients taking ranitidine developed negative or equivocal UBT results on days 14, 28 and 60, respectively. The use of acidified 14C-urea capsule did not prevent false negative UBT results in patients taking pantoprazole and ranitidine, and the duration of medication does not affect the test results.

Dexamethasone as Adjuvant to Bupivacaine Prolongs the Duration of Thermal Antinociception and Prevents Bupivacaine-Induced Rebound Hyperalgesia via Regional Mechanism in a Mouse Sciatic Nerve Block Model

PubMed Central

An, Ke; Elkassabany, Nabil M.; Liu, Jiabin

2015-01-01

Background Dexamethasone has been studied as an effective adjuvant to prolong the analgesia duration of local anesthetics in peripheral nerve block. However, the route of action for dexamethasone and its potential neurotoxicity are still unclear. Methods A mouse sciatic nerve block model was used. The sciatic nerve was injected with 60ul of combinations of various medications, including dexamethasone and/or bupivacaine. Neurobehavioral changes were observed for 2 days prior to injection, and then continuously for up to 7 days after injection. In addition, the sciatic nerves were harvested at either 2 days or 7 days after injection. Toluidine blue dyeing and immunohistochemistry test were performed to study the short-term and long-term histopathological changes of the sciatic nerves. There were six study groups: normal saline control, bupivacaine (10mg/kg) only, dexamethasone (0.5mg/kg) only, bupivacaine (10mg/kg) combined with low-dose (0.14mg/kg) dexamethasone, bupivacaine (10mg/kg) combined with high-dose (0.5mg/kg) dexamethasone, and bupivacaine (10mg/kg) combined with intramuscular dexamethasone (0.5mg/kg). Results High-dose perineural dexamethasone, but not systemic dexamethasone, combined with bupivacaine prolonged the duration of both sensory and motor block of mouse sciatic nerve. There was no significant difference on the onset time of the sciatic nerve block. There was “rebound hyperalgesia” to thermal stimulus after the resolution of plain bupivacaine sciatic nerve block. Interestingly, both low and high dose perineural dexamethasone prevented bupivacaine-induced hyperalgesia. There was an early phase of axon degeneration and Schwann cell response as represented by S-100 expression as well as the percentage of demyelinated axon and nucleus in the plain bupivacaine group compared with the bupivacaine plus dexamethasone groups on post-injection day 2, which resolved on post-injection day 7. Furthermore, we demonstrated that perineural dexamethasone, but not systemic dexamethasone, could prevent axon degeneration and demyelination. There was no significant caspase-dependent apoptosis process in the mouse sciatic nerve among all study groups during our study period. Conclusions Perineural, not systemic, dexamethasone added to a clinical concentration of bupivacaine may not only prolong the duration of sensory and motor blockade of sciatic nerve, but also prevent the bupivacaine-induced reversible neurotoxicity and short-term “rebound hyperalgesia” after the resolution of nerve block. PMID:25856078

Variability in Word Duration as a Function of Probability, Speech Style, and Prosody

PubMed Central

Baker, Rachel E.; Bradlow, Ann R.

2010-01-01

This article examines how probability (lexical frequency and previous mention), speech style, and prosody affect word duration, and how these factors interact. Participants read controlled materials in clear and plain speech styles. As expected, more probable words (higher frequencies and second mentions) were significantly shorter than less probable words, and words in plain speech were significantly shorter than those in clear speech. Interestingly, we found second mention reduction effects in both clear and plain speech, indicating that while clear speech is hyper-articulated, this hyper-articulation does not override probabilistic effects on duration. We also found an interaction between mention and frequency, but only in plain speech. High frequency words allowed more second mention reduction than low frequency words in plain speech, revealing a tendency to hypo-articulate as much as possible when all factors support it. Finally, we found that first mentions were more likely to be accented than second mentions. However, when these differences in accent likelihood were controlled, a significant second mention reduction effect remained. This supports the concept of a direct link between probability and duration, rather than a relationship solely mediated by prosodic prominence. PMID:20121039

Duration-response association between exercise and HDL in both male and female Taiwanese adults aged 40 years and above

PubMed Central

Jan, Cheng-Feng; Chang, Hui-Chin; Tantoh, Disline Manli; Chen, Pei-Hsin; Liu, Wen- Hsiu; Huang, Jing-Yang; Wu, Min-Chen; Liaw, Yung-Po

2018-01-01

Background Exercise is an important cardiovascular risk reducing therapy. Objective The aim of this study was to assess the relationship between weekly exercise duration and high-density lipoprotein cholesterol (HDL-c) in Taiwanese men and women. Methods Data were retrieved from the dataset of the national adult preventive medical services which is recorded under the Health Promotion Administration (HPA). The lipid profiles of 194528 eligible participants aged 40 years and above who completed a questionnaire on recent health behavior including smoking, drinking, exercise and other factors in 2014 were determined. Weekly exercise durations of 0.0, <2.5 and ≥2.5 hours were classified as no, below recommended and recommended, respectively. The relationship between exercise and HDL-c was determined using linear regression. Results After multivariate adjustments, a duration-response association existed between exercise and HDL-c (P-trend <0.0001) in both sexes. Weekly exercise durations of <2.5 and ≥2.5 hours were both positively associated with HDL-c (P <0.0001) in both sexes. However, the associations were stronger in males than females in both exercise groups. Smoking (P <0.05) and BMI (P <0.0001) were negatively associated while drinking was positively associated with HDL-c in both sexes. Conclusion This study demonstrated a duration-response association between exercise and HDL-c. Exercise at durations below the minimum weekly recommendation of 2.5 hours was positively associated with HDL-c. PMID:29416758

Meeting the goal of concurrent adolescent and adult licensure of HIV prevention and treatment strategies.

PubMed

Hume, Michelle; Lewis, Linda L; Nelson, Robert M

2017-12-01

The ability of adolescents to access safe and effective new products for HIV prevention and treatment is optimised by adolescent licensure at the same time these products are approved and marketed for adults. Many adolescent product development programmes for HIV prevention or treatment products may proceed simultaneously with adult phase III development programmes. Appropriately implemented, this strategy is not expected to delay licensure as information regarding product efficacy can often be extrapolated from adults to adolescents, and pharmacokinetic properties of drugs in adolescents are expected to be similar to those in adults. Finally, adolescents enrolled in therapeutic HIV prevention and treatment research can be considered adults, based on US Food and Drug Administration (FDA) regulations and the appropriate application of state law. The FDA permits local jurisdictions to apply state and local HIV/sexually transmitted infection minor treatment laws so that adolescents who are HIV-positive or at risk of contracting HIV may be enrolled in therapeutic or prevention trials without obtaining parental permission. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Stochastic characteristics of different duration annual maximum rainfall and its spatial difference in China based on information entropy

NASA Astrophysics Data System (ADS)

Li, X.; Sang, Y. F.

2017-12-01

Mountain torrents, urban floods and other disasters caused by extreme precipitation bring great losses to the ecological environment, social and economic development, people's lives and property security. So there is of great significance to floods prevention and control by the study of its spatial distribution. Based on the annual maximum rainfall data of 60min, 6h and 24h, the paper generate long sequences following Pearson-III distribution, and then use the information entropy index to study the spatial distribution and difference of different duration. The results show that the information entropy value of annual maximum rainfall in the south region is greater than that in the north region, indicating more obvious stochastic characteristics of annual maximum rainfall in the latter. However, the spatial distribution of stochastic characteristics is different in different duration. For example, stochastic characteristics of 60min annual maximum rainfall in the Eastern Tibet is smaller than surrounding, but 6h and 24h annual maximum rainfall is larger than surrounding area. In the Haihe River Basin and the Huaihe River Basin, the stochastic characteristics of the 60min annual maximum rainfall was not significantly different from that in the surrounding area, and stochastic characteristics of 6h and 24h was smaller than that in the surrounding area. We conclude that the spatial distribution of information entropy values of annual maximum rainfall in different duration can reflect the spatial distribution of its stochastic characteristics, thus the results can be an importantly scientific basis for the flood prevention and control, agriculture, economic-social developments and urban flood control and waterlogging.

Higher placental anti-inflammatory IL-10 cytokine expression in HIV-1 infected women receiving longer zidovudine prophylaxis associated with nevirapine.

PubMed

Pornprasert, Sakorn; Mary, Jean-Yves; Faye, Albert; Leechanachai, Pranee; Limtrakul, Aram; Rugpao, Sungwal; Sirivatanapa, Pannee; Gomuthbutra, Vorapin; Matanasaravoot, Wanmanee; Le Coeur, Sophie; Lallemant, Marc; Barré-Sinoussi, Françoise; Menu, Elisabeth; Ngo-Giang-Huong, Nicole

2009-03-01

Placental cytokine balance may be critical for the control of mother-to-child transmission (MTCT) of HIV. We assessed whether the type and duration of antiretrovirals used for prevention of HIV-1-MTCT modified the inflammatory cytokine profile. We investigated the levels of cytokine expression in the placentas of 61 HIV-1-infected women who received zidovudine (ZDV) plus single dose nevirapine (SD-NVP) or ZDV only for prevention of MTCT. Placentas of 38 HIV-1-uninfected women were included as controls. All placentas were obtained after vaginal delivery. Levels of mRNA and cytokine expression were quantified using real-time PCR and ELISA, respectively, in placental explants and 24-hour culture supernatants and analyzed in relation to the women's characteristics and the type and duration of antiretroviral prophylaxis. HIV-1-infected and uninfected women did not show any differences in the expression of placental cytokine secretion except for a trend toward lower TNF-alpha mRNA levels in HIV-1-infected women. Within the HIV-1-infected group, women who were exposed to a long duration of ZDV (>72 days) or received SD-NVP less than 5h prior to delivery, more frequently expressed detectable levels of IL-10 in their placentas (32% versus 7% (p = 0.01) and 32% versus 5% (p = 0.02), respectively). No infant was found to be HIV-1-infected. Our results showed a normalization of the placental cytokine balance in HIV-1-infected women receiving antiretroviral prophylaxis. Furthermore, the type and duration of antiretroviral prophylaxis have an impact on the placental anti-inflammatory IL-10 expression level, which may contribute to controlling HIV replication at the placental level, thus reducing MTCT of HIV-1.

Model-dependent effects of the gap junction conduction-enhancing antiarrhythmic peptide rotigaptide (ZP123) on experimental atrial fibrillation in dogs.

PubMed

Shiroshita-Takeshita, Akiko; Sakabe, Masao; Haugan, Ketil; Hennan, James K; Nattel, Stanley

2007-01-23

Abnormal intercellular communication caused by connexin dysfunction may be involved in atrial fibrillation (AF). The present study assessed the effect of the gap junctional conduction-enhancing peptide rotigaptide on AF maintenance in substrates that result from congestive heart failure induced by 2-week ventricular tachypacing (240 bpm), atrial tachypacing (ATP; 400 bpm for 3 to 6 weeks), and isolated atrial myocardial ischemia. Electrophysiological study and epicardial mapping were performed before and after rotigaptide administration in dogs with ATP and congestive heart failure, as well as in similarly instrumented sham dogs that were not tachypaced. For atrial myocardial ischemia, dogs administered rotigaptide before myocardial ischemia were compared with no-drug myocardial ischemia controls. ATP significantly shortened the atrial effective refractory period (P=0.003) and increased AF duration (P=0.008), with AF lasting >3 hours in all 6-week ATP animals. Rotigaptide increased conduction velocity in ATP dogs slightly but significantly (P=0.04) and did not affect the effective refractory period, AF duration, or atrial vulnerability. In dogs with congestive heart failure, rotigaptide also slightly increased conduction velocity (P=0.046) but failed to prevent AF promotion. Rotigaptide had no statistically significant effects in sham dogs. Myocardial ischemia alone increased AF duration and impaired conduction (based on conduction velocity across the ischemic border and indices of conduction heterogeneity). Rotigaptide prevented myocardial ischemia-induced conduction slowing and AF duration increases. Rotigaptide improves conduction in various AF models but suppresses AF only for the acute ischemia substrate. These results define the atrial antiarrhythmic profile of a mechanistically novel antiarrhythmic drug and suggest that gap junction dysfunction may be more important in ischemic AF than in ATP remodeling or congestive heart failure substrates.

[Suicidal ideation of prisoners : Influence of duration of imprisonment, personality traits and disorders].

PubMed

Ritter, D; Pesch, M; Lewitzka, U; Jabs, B

2016-05-01

Although in recent years many efforts have been made in suicide prevention, suicidal ideation in prison is still a major problem. The present study is part of a project being carried out in Saxony, Germany on the investigation and prevention of suicide in prisons. The aim of this study was to determine whether the duration of imprisonment, personality traits and personality disorders have an influence on the suicidal ideation of prisoners. In this study 113 volunteers among prisoners from 6 prisons in Saxony participated in a structured interview and filled out several questionnaires on sociodemographic details, personality using the personality style and disorder inventory (PSSI) and the assessment of DSM-IV personality disorders (ADP-IV) questionnaire as well as attitudes towards suicide using the questionnaire on stressful social experiences (FBS) and the Viennese instrument for suicidality on correctional institutions (VISCI). Significant correlations were found between personality traits and personality disorders and suicidal ideation and suicide attempts. A positive correlation was also found between personality disorders and scores in the VISCI. High scores in the PSSI were correlated with all aspects of suicidal ideation; however, length of time spent in prison and total duration of imprisonment appeared to have little impact on suicide parameters and were only correlated with the self-declared current suicidal ideation. Although there were some limitations, this study could confirm data in the literature that personality disorders are associated with an increased risk of suicidal ideation in prisoners. The lack of association of suicidal thoughts as measured in this study with the total time spent in prison and duration of imprisonment is in contradiction to the results of other studies and warrants further investigation.

[Prevention of refractory cough with mediastinal fat to fill the residual cavity after radical systematic mediastinal lymphadenectomy in patients with right lung cancer].

PubMed

Huang, Jia; Luo, Qingquan; Shentu, Yang; Zhao, Xiaojing

2010-10-01

The aim of this study is to analyze the impact on the cough after radical systematic mediastinal lymphadenectomy and prevention of refractory cough with mediastinal fat to fill the residual cavity after radical systematic mediastinal lymphadenectomy. Sixty patients clinically diagnosed of lung cancer were selected according to the adopt standardization, from January 2008 to December 2008. All of the patients were divided into two groups randomly: the filling-fat group and the non-filling-fat group. The surgical information such as operation duration time bleeding volume during operation, post-operation bleeding volume were recorded. After one month, FACT-L and LCQ were completed. There are no remarkably differences between the operation duration time, bleeding volume in operation and 1st postoperation day's drainage volume of the two groups. There's significant difference in the scores of cough at night after taking off the chest tube, as well as in the scores of LCQ after one month and in the scores of last items of FACT-L. Filling the fat of the mediastinal to cover the residual cavity left by completely systematic mediastinal lymphadenectomy can reduce the refractory cough after surgery, and can also improve the quality of the life. It has no effect on the the operation duration time, bleeding volume in operation and 1st post-operation day's drainage volume of the patients.

[Clinical efficacy of pulmonary surfactant combined with budesonide for preventing bronchopulmonary dysplasia in very low birth weight infants].

PubMed

Pan, Jing; Chen, Ming-Wu; Ni, Wen-Quan; Fang, Tao; Zhang, Hui; Chen, Ye; Pan, Jia-Hua

2017-02-01

To explore the clinical efficacy of intratracheal instillation of pulmonary surfactant (PS) combined with budesonide for preventing bronchopulmonary dysplasia (BPD) in very low birth weight (VLBW) infants. Thirty VLBW infants with gestational age <32 weeks who developed neonatal respiratory distress syndrome (NRDS) (grade III-IV) suffering from intrauterine infection were randomly assigned into a PS + budesonide group and a PS alone group. The changes were compared between the two groups in arterial blood gas indexes, oxygenation index (OI), duration of mechanical ventilation, duration of oxygen supplementation, incidence of BPD, mortality rate at 36 weeks corrected gestational age and incidences of other complications except BPD. Compared with the PS alone group, the PS+budesonide group had a lower incidence of BPD, shorter duration of mechanical ventilation and oxygen supplementation (P<0.05). On the 2nd to 6th day after treatment, the PS+budesonide group had higher pH value of arterial blood gas and OI and lower carbon dioxide partial pressure compared with the PS alone group (P<0.05). There were no significant differences in the mortality rate at 36 weeks corrected gestational age and the incidences of other complications except BPD between the two groups (P>0.05). Intratracheal instillation of PS combined with budesonide can effectively reduce the incidence of BPD in VLBW premature infants with severe NRDS.

Preventive Effect of Korean Red Ginseng for Acute Respiratory Illness: A Randomized and Double-Blind Clinical Trial

PubMed Central

Lee, Ju-Hyung; Oh, Mira; Choi, Kyung-Min; Jeong, Mi Ran; Park, Jong-Dae; Kwon, Dae Young; Ha, Ki-Chan; Park, Eun-Ock; Lee, Nuri; Kim, Sun-Young; Choi, Eun-Kyung; Kim, Min-Gul; Chae, Soo-Wan

2012-01-01

Korean Red Ginseng (KRG) is a functional food and has been well known for keeping good health due to its anti-fatigue and immunomodulating activities. However, there is no data on Korean red ginseng for its preventive activity against acute respiratory illness (ARI). The study was conducted in a randomized, double-blinded, placebo-controlled trial in healthy volunteers (Clinical Trial Number: NCT01478009). Our primary efficacy end point was the number of ARI reported and secondary efficacy end point was severity of symptoms, number of symptoms, and duration of ARI. A total of 100 volunteers were enrolled in the study. Fewer subjects in the KRG group reported contracting at least 1 ARI than in the placebo group (12 [24.5%] vs 22 [44.9%], P = 0.034), the difference was statistically significant between the two groups. The symptom duration of the subjects who experienced the ARI, was similar between the two groups (KRG vs placebo; 5.2 ± 2.3 vs 6.3 ± 5.0, P = 0.475). The symptom scores were low tendency in KRG group (KRG vs placebo; 9.5 ± 4.5 vs 17.6 ± 23.1, P = 0.241). The study suggests that KRG may be effective in protecting subjects from contracting ARI, and may have the tendency to decrease the duration and scores of ARI symptoms. PMID:23255845

Magnitude-Based Postfire Debris Flow Rainfall Accumulation-Duration Thresholds for Emergency-Response Planning

NASA Astrophysics Data System (ADS)

Cannon, S. H.; Boldt, E. M.; Laber, J. L.; Kean, J. W.; Staley, D. M.

2011-12-01

Following wildfires, emergency-response and public-safety agencies can be faced with evacuation and resource-deployment decisions well in advance of coming winter storms and during storms themselves. Information critical to these decisions is needed for recently burned areas in the San Gabriel Mountains of southern California. A compilation of information on the hydrologic response to winter storms from recently burned areas in southern California steeplands is used to develop a system for classifying magnitudes of hydrologic response in this setting. The four-class system describes combinations of reported volumes of individual debris flows, consequences of debris flows and floods in an urban setting, and spatial extents of the hydrologic response. Magnitude 0 events show a negligible response, while Magnitude I events are characterized by small (<1,000 m3) debris flows or low-discharge floods produced from one or two drainage basins. A few culverts and storm drains may be blocked, a few streets may be partially flooded or blocked by water and debris, and a few buildings near the mountain front may be damaged. Magnitude II events are characterized by two to five moderately-sized (1,000 to 10,000 m3) debris flows or one large (>10,000 m3) event. Several culverts or storm drains may be blocked or fail, several streets may be flooded or completely blocked by water and debris, and buildings, streets, and bridges may be damaged or destroyed. Magnitude III events consist of widespread and abundant debris flows of volumes >10,000 m3 and high discharge flooding causing significant impact to the built environment. Many streets, storm drains, and streets may be completely blocked by debris, making many streets unsafe for travel. Several large buildings, sections of infrastructure corridors and bridges may be damaged or destroyed. The range of rainfall conditions associated with different magnitude classes are defined by correlating local rainfall data with the response magnitude information. Magnitude 0 events can be expected when within-storm rainfall accumulations (A) of given durations (D) fall below the threshold A=0.4D0.5. Magnitude I events can be expected when storm rainfall conditions are above the threshold A=0.4D0.5 and below A=0.5D0.6 for durations greater than 1 hour. Magnitude II events will be generated in response to rainfall accumulations and durations between A=0.4D0.5 and A=0.9D0.5 for durations less than one hour, and between A=0.5D0.6 and A=0.9D0.5 for durations greater than one hour. Magnitude III events can be expected in response to rainfall conditions above the threshold A=0.9D 0.5. Rainfall threshold-magnitude relations are linked with potential emergency-response actions as an emergency-response decision chart, which leads a user through steps to determine potential event magnitudes and identify possible evacuation and resource-deployment levels. Use of this information in the planning and response decision-making process could result in increased safety for both the public and emergency responders.

The Foreign Language Writer's Strategic Behaviour in the Allocation of Time to Writing Processes

ERIC Educational Resources Information Center

Roca de Larios, Julio; Manchon, Rosa; Murphy, Liz; Marin, Javier

2008-01-01

Although composing has long been recognised as recursive, so far there have been few studies on the temporal dimension of writing processes. This is regrettable given that one might expect the predominance of certain processes at different stages of writing at the expense of others and/or differences among writers with respect to the duration and…

Optimizing the duration of point counts for monitoring trends in bird populations

Treesearch

Jared Verner

1988-01-01

Minute-by-minute analysis of point counts of birds in mixed-conifer forests in the Sierra National Forest, central California, showed that cumulative counts of species and individuals increased in a curvilinear fashion but did not reach asymptotes after 10 minutes of counting. Comparison of the expected number of individuals counted per hour with various combinations...

40 CFR 799.9539 - TSCA mammalian erythrocyte micronucleus test.

Code of Federal Regulations, 2011 CFR

2011-07-01

... one dose level of at least 2,000 mg/kg body weight using a single treatment, or as two treatments on... considered necessary. For studies of a longer duration, the limit dose is 2,000 mg/kg/body weight/day for treatment up to 14 days, and 1,000 mg/kg/body weight/day for treatment longer than 14 days. Expected human...

Physiological constraints on deceleration during the aerocapture of manned vehicles

NASA Technical Reports Server (NTRS)

Lyne, J. E.

1992-01-01

The peak deceleration load allowed for aerobraking of manned vehicles is a critical parameter in planning future excursions to Mars. However, considerable variation exists in the limits used by various investigators. The goal of this study was to determine the most appropriate level for this limit. Methods: Since previous U.S. space flights have been limited to 84 days duration, Soviet flight results were examined. Published details of Soviet entry trajectories were not available. However, personal communication with Soviet cosmonauts suggested that peak entry loads of 5-6 G had been encountered upon return from 8 months in orbit. Soyuz entry capsule's characteristics were established and the capsule's entry trajectory was numerically calculated. The results confirm a peak load of 5 to 6 G. Results: Although the Soviet flights were of shorter duration than expected Mars missions, evidence exists that the deceleration experience is applicable. G tolerance has been shown to stabilize after 1 to 3 months in space if adequate countermeasures are used. The calculated Soyuz deceleration histories are graphically compared with those expected for Mars aerobraking. Conclusions: Previous spaceflight experience supports the use of a 5 G limit for the aerocapture of a manned vehicle at Mars.

Icing Encounter Duration Sensitivity Study

NASA Technical Reports Server (NTRS)

Addy, Harold E., Jr.; Lee, Sam

2011-01-01

This paper describes a study performed to investigate how aerodynamic performance degradation progresses with time throughout an exposure to icing conditions. It is one of the first documented studies of the effects of ice contamination on aerodynamic performance at various points in time throughout an icing encounter. Both a 1.5 and 6 ft chord, two-dimensional, NACA-23012 airfoils were subjected to icing conditions in the NASA Icing Research Tunnel for varying lengths of time. At the end of each run, lift, drag, and pitching moment measurements were made. Measurements with the 1.5 ft chord model showed that maximum lift and pitching moment degraded more rapidly early in the exposure and degraded more slowly as time progressed. Drag for the 1.5 ft chord model degraded more linearly with time, although drag for very short exposure durations was slightly higher than expected. Only drag measurements were made with the 6 ft chord airfoil. Here, drag for the long exposures was higher than expected. Novel comparison of drag measurements versus an icing scaling parameter, accumulation parameter times collection efficiency was used to compare the data from the two different size model. The comparisons provided a means of assessing the level of fidelity needed for accurate icing simulation.

Rainfall characteristics for shallow landsliding in Seattle, Washington, USA

USGS Publications Warehouse

Godt, J.W.; Baum, R.L.; Chleborad, A.F.

2006-01-01

Shallow landsliding in the Seattle, Washington, area, has caused the occasional loss of human life and millions of dollars in damage to property. The effective management of the hazzard requires an understanding of the rainfall conditions that result in landslides. We present an empirical approach to quantify the antecedent moisture conditions and rainstorm intensity and duration that have triggered shallow landsliding using 25 years of hourly rainfull data and a complementary record of landslide occurrence. Our approach combines a simple water balance to estimate the antecedent moisture conditions of hillslope materials and a rainfall intensity-duration threshold to identify periods when shallow landsliding can be expected. The water balance is calibrated with field-monitoring data and combined with the rainfall intensity-duration threshold using a decision tree. Results are cast in terms of a hypothetical landslide warning system. Two widespread landslide events are correctly identified by the warning scheme; however, it is less accurate for more isolated landsliding. Copyright ?? 2005 John Wiley & Sons, Ltd.

Introduction (Special Issue on Scientific Balloon Capabilities and Instrumentation)

NASA Technical Reports Server (NTRS)

Gaskin, Jessica A.; Smith, I. S.; Jones, W. V.

2014-01-01

In 1783, the Montgolfier brothers ushered in a new era of transportation and exploration when they used hot air to drive an un-tethered balloon to an altitude of 2 km. Made of sackcloth and held together with cords, this balloon challenged the way we thought about human travel, and it has since evolved into a robust platform for performing novel science and testing new technologies. Today, high-altitude balloons regularly reach altitudes of 40 km, and they can support payloads that weigh more than 3,000 kg. Long-duration balloons can currently support mission durations lasting 55 days, and developing balloon technologies (i.e. Super-Pressure Balloons) are expected to extend that duration to 100 days or longer; competing with satellite payloads. This relatively inexpensive platform supports a broad range of science payloads, spanning multiple disciplines (astrophysics, heliophysics, planetary and earth science.) Applications extending beyond traditional science include testing new technologies for eventual space-based application and stratospheric airships for planetary applications.

Study of cancer incidence among 6363 male workers in four Norwegian ferromanganese and silicomanganese producing plants.

PubMed

Hobbesland, A; Kjuus, H; Thelle, D S

1999-09-01

Little has been known about the risk of cancer associated with occupational exposure to manganese. The objective of this study was therefore to examine the associations between duration of specific work and cancer incidence among employees in four Norwegian ferromanganese and silicomanganese producing plants. Among men first employed in 1933-91 and with at least 6 months in these plants, the incident cases of cancer during 1953-91 were obtained from The Cancer Registry of Norway. The numbers of various cancers were compared with expected figures calculated from age and calendar time specific rates for Norwegian men during the same period. Internal comparisons of rates were performed with Poisson regression analysis. The final cohort comprised 6363 men. A total of 607 cases of cancer were observed against 596 cases expected (standardised incidence ratio (SIR) 1.02). Internal comparisons of rates showed a positive trend between the rate of all cancers and duration of furnace work. A slightly weaker trend was also found for duration of blue collar non-furnace work when lags of 25 or 30 years were applied in the analyses. However, several results indicated that the incidence of all cancers among the non-furnace workers decreased during the period of active employment. Furnace and non-furnace workers may have exposures that increase the incidence of several cancers. The low incidence of cancer among non-furnace workers during the period of ongoing exposure cannot be explained. As this study cannot identify any causal factors, the role of exposure to manganese remains unclear.

Study of cancer incidence among 6363 male workers in four Norwegian ferromanganese and silicomanganese producing plants

PubMed Central

Hobbesland, A.; Kjuus, H.; Thelle, D. S.

1999-01-01

OBJECTIVES: Little has been known about the risk of cancer associated with occupational exposure to manganese. The objective of this study was therefore to examine the associations between duration of specific work and cancer incidence among employees in four Norwegian ferromanganese and silicomanganese producing plants. METHODS: Among men first employed in 1933-91 and with at least 6 months in these plants, the incident cases of cancer during 1953-91 were obtained from The Cancer Registry of Norway. The numbers of various cancers were compared with expected figures calculated from age and calendar time specific rates for Norwegian men during the same period. Internal comparisons of rates were performed with Poisson regression analysis. The final cohort comprised 6363 men. RESULTS: A total of 607 cases of cancer were observed against 596 cases expected (standardised incidence ratio (SIR) 1.02). Internal comparisons of rates showed a positive trend between the rate of all cancers and duration of furnace work. A slightly weaker trend was also found for duration of blue collar non-furnace work when lags of 25 or 30 years were applied in the analyses. However, several results indicated that the incidence of all cancers among the non- furnace workers decreased during the period of active employment. CONCLUSIONS: Furnace and non-furnace workers may have exposures that increase the incidence of several cancers. The low incidence of cancer among non-furnace workers during the period of ongoing exposure cannot be explained. As this study cannot identify any causal factors, the role of exposure to manganese remains unclear.   PMID:10615295

The fatigued anesthesiologist: A threat to patient safety?

PubMed Central

Sinha, Ashish; Singh, Avtar; Tewari, Anurag

2013-01-01

Universally, anesthesiologists are expected to be knowledgeable, astutely responding to clinical challenges while maintaining a prolonged vigilance for administration of safe anesthesia and critical care. A fatigued anesthesiologist is the consequence of cumulative acuity, manifesting as decreased motor and cognitive powers. This results in impaired judgement, late and inadequate responses to clinical changes, poor communication and inadequate record keeping. With rising expectations and increased medico-legal claims, anesthesiologists work round the clock to provide efficient and timely services, but are the "sleep provider" in a sleep debt them self? Is it the right time to promptly address these issues so that we prevent silent perpetuation of problems pertinent to anesthesiologist’s health and the profession. The implications of sleep debt on patient safety are profound and preventive strategies are quintessential. Anesthesiology governing bodies must ensure requisite laws to prevent the adverse outcomes of sleep debt before patient care is compromised. PMID:23878432

Should anti-D immunoglobulin be given antenatally?

PubMed

Tovey, G H

1980-08-30

A survey of 246 Rh-negative expectant mothers who had Rh antibodies for the first time has shown that in about 50% sensitisation might have been prevented had anti-D immunoglobulin (Ig) been injected after delivery of the previous Rh-positive baby. Sensitisation of the other mothers could have been prevented only by giving anti-D Ig antenatally during pregnancy. Perinatal mortality and morbidity in Britain from Rh-haemolytic disease in first-affected babies is now so low that an attempt to eliminate Rh-haemolytic disease by giving anti-D Ig to all expectant Rh-negative mothers during the antenatal period is not cost effective. If all Rh-negative mothers who abort or give birth to an Rh-positive baby are injected with an adequate dose of anti-D Ig within 72 h of delivery, the small number of mothers in whom measures to prevent sensitisation have failed can be reduced by 50%.

A childhood obesity prevention programme in Barcelona (POIBA Project): Study protocol of the intervention

PubMed Central

Sánchez-Martínez, Francesca; Juárez, Olga; Serral, Gemma; Valmayor, Sara; Puigpinós, Rosa; Pasarín, María Isabel; Díez, Élia; Ariza, Carles

2018-01-01

Background Childhood obesity preventive interventions should promote a healthy diet and physical activity at home and school. This study aims to describe a school-based childhood obesity preventive programme (POIBA Project) targeting 8-to-12- year-olds. Design and methods Evaluation study of a school-based intervention with a pre-post quasi-experimental design and a comparison group. Schools from disadvantaged neighbourhoods are oversampled. The intervention consists of 9 sessions, including 58 activities of a total duration between 9 and 13 hours, and the booster intervention of 2 sessions with 8 activities lasting 3 or 4 hours. They are multilevel (individual, family and school) and multicomponent (classroom, physical activity and family). Data are collected through anthropometric measurements, physical fitness tests and lifestyle surveys before and after the intervention and the booster intervention. In the intervention group, families complete two questionnaires about their children’s eating habits and physical activity. The outcome variable is the cumulative incidence rate of obesity, obtained from body mass index values and body fat assessed by triceps skinfold thickness. The independent variables are socio-demographic, contextual, eating habits, food frequency, intensity of physical activity and use of new technologies. Expected impact for public health It is essential to implement preventive interventions at early ages and to follow its effects over time. Interventions involving diet and physical activity are the most common, being the most effective setting the school. The POIBA Project intervenes in both the school and family setting and focuses on the most disadvantaged groups, in which obesity is most pronounced and difficult to prevent. Significance for public health Overweight and obesity are a major public health concern that predispose affected individuals to the development of chronic diseases. Of importance, obesity is more common among disadvantaged neighbourhoods and it is precisely these environments that have the lowest involvement in preventive interventions. Consequently, it is very important to target these populations when designing an intervention. This study will provide an evaluated childhood obesity intervention which includes the perspective of gender and social inequalities. In addition, a sustainability plan has been developed for the intervention. It is planned that, in the near future, the intervention and its reinforcement are part of the set of health educational programmes offered by the Agència de Salut Pública de Barcelona (Spain) to schools, with funding both the cost of the training and the materials borne by the Agència. PMID:29780761

Acarbose Monotherapy and Type 2 Diabetes Prevention in Eastern and Western Prediabetes: An Ethnicity-specific Meta-analysis.

PubMed

Hu, Ruijie; Li, Yi; Lv, Qingguo; Wu, Taixiang; Tong, Nanwei

2015-08-01

Acarbose is effective in delaying or preventing the progression of prediabetes to type 2 diabetes mellitus (T2DM). The aim of this study was to assess differences in the preventive effects of acarbose in Eastern and Western populations with prediabetes. We performed a systematic search of databases and reference lists of clinical trials conducted through August 2013. Randomized controlled trials of acarbose alone, with a minimum intervention duration of 3 years and which provided data on T2DM incidence, were included for analysis. Analyses were conducted by using Review Manager version 5.1 software. Eight randomized controlled trials with 2628 participants were included. Acarbose decreased the occurrence of T2DM (number needed to treat [NNT], 6.7). Compared with the control (placebo and/or lifestyle intervention), the incidence of T2DM was significantly lower in the Eastern group (NNT, 5.9) than in the Western group (NNT, 11.1) (P < 0.0001, I(2) = 94.7%). At the end of follow-up, reversal of prediabetes to normal glucose tolerance was more likely in the Eastern group (NNT, 4.3) than in the Western group (NNT, 25) (P = 0.004, I(2) = 92%). Among those remaining prediabetic, there was no significant difference between the subtotal estimates for the subgroups (P = 0.17, I(2) = 46.5%). There was no positive correlation between preventive effect and dose, and no difference in studies with varying follow-up durations within and across either ethnic group. The preventive effect of acarbose on the development of diabetes seems superior in Eastern populations with prediabetes compared with Western populations. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

[Medical and biological assessment of preventive drinks use among workers exposed to adverse working conditions].

PubMed

Nikanov, A N; Markova, O L; Frolova, N M; Kulikova, K S

2013-01-01

Studies on the assessment of the effect of treatment-and-preventive drinks, i.e. "Leovit" dietary kissels, and "Zosterin-Ultra" biologically active food additive, on copper, nickel and cobalt ion concentrations in urine and on lead blood concentrations in workers employed at the "Kola Mining Company" limited liability joint-stock company and exposed to long-term metal aerosol effects, were carried out. Dependence of ion concentrations of these metals in biological media on exposure duration was reported. The study findings reveal the advisability of use of the above-mentioned food additives, having detoxication properties, while carrying out preventive measures among workers exposed to heavy metals.

Diabetes Prevention Program Community Outreach Perspectives on Lifestyle Training and Translation

PubMed Central

Venditti, Elizabeth M.; Kramer, M. Kaye

2013-01-01

The gap between what is known from clinical efficacy research and the systematic community translation of diabetes prevention programs is narrowing. During the past 5 years, numerous randomized and nonrandomized dissemination studies have evaluated the modified delivery of structured Diabetes Prevention Program (DPP) interventions in diverse real-world settings. Programs of sufficient dose and duration, implemented with fidelity, have reported weight losses in the range of 4%–7% with associated improvements in cardiometabolic risk factors at 6 and 12 months from baseline. The current article describes some of the experiences and perspectives of a team of University of Pittsburgh researchers as they have engaged in these efforts. PMID:23498296

Consensus Document on Prevention and Treatment of Tuberculosis in Patients for Biological Treatment.

PubMed

Mir Viladrich, Isabel; Daudén Tello, Esteban; Solano-López, Guillermo; López Longo, Francisco Javier; Taxonera Samso, Carlos; Sánchez Martínez, Paquita; Martínez Lacasa, Xavier; García Gasalla, Mercedes; Dorca Sargatal, Jordi; Arias-Guillén, Miguel; García García, José Maria

2016-01-01

Tuberculosis risk is increased in patients with chronic inflammatory diseases receiving any immunosuppressive treatment, notably tumor necrosis factor (TNF) antagonists therapy. Screening for the presence of latent infection with Mycobacterium tuberculosis and targeted preventive treatment to reduce the risk of progression to TB is mandatory in these patients. This Consensus Document summarizes the current knowledge and expert opinion of biologic therapies including TNF-blocking treatments. It provides recommendations for the use of interferon-gamma release assays (IGRA) and tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection in these patients, and for the type and duration of preventive therapy. Copyright © 2015 SEPAR. Published by Elsevier Espana. All rights reserved.

Clients' psychosocial communication and midwives' verbal and nonverbal communication during prenatal counseling for anomaly screening.

PubMed

Martin, Linda; Gitsels-van der Wal, Janneke T; Pereboom, Monique T R; Spelten, Evelien R; Hutton, Eileen K; van Dulmen, Sandra

2016-01-01

This study focuses on facilitation of clients' psychosocial communication during prenatal counseling for fetal anomaly screening. We assessed how psychosocial communication by clients is related to midwives' psychosocial and affective communication, client-directed gaze and counseling duration. During 184 videotaped prenatal counseling consultations with 20 Dutch midwives, verbal psychosocial and affective behavior was measured by the Roter Interaction Analysis System (RIAS). We rated the duration of client-directed gaze. We performed multilevel analyses to assess the relation between clients' psychosocial communication and midwives' psychosocial and affective communication, client-directed gaze and counseling duration. Clients' psychosocial communication was higher if midwives' asked more psychosocial questions and showed more affective behavior (β=0.90; CI: 0.45-1.35; p<0.00 and β=1.32; CI: 0.18-2.47; p=0.025, respectively). Clients "psychosocial communication was not related to midwives" client-directed gaze. Additionally, psychosocial communication by clients was directly, positively related to the counseling duration (β=0.59; CI: 0.20-099; p=0.004). In contrast with our expectations, midwives' client-directed gaze was not related with psychosocial communication of clients. In addition to asking psychosocial questions, our study shows that midwives' affective behavior and counseling duration is likely to encourage client's psychosocial communication, known to be especially important for facilitating decision-making. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

On the Bimodality of ENSO Cycle Extremes

NASA Technical Reports Server (NTRS)

Wilson, Robert M.

1999-01-01

On the basis of sea surface temperature in the Nino 3.4 region (5 deg N-5 deg S, 120 deg- 170 deg W) during the interval of 1950-1997, Kevin Trenberth previously has identified some 16 El Nino and 10 La Nina, these 26 events representing the extremes of the quasi-periodic El Nino-Southern Oscillation (ENSO) cycle. Runs testing shows that the duration and recurrence period associated with these extremes vary randomly, as does the sequencing of the extremes. Hence, the frequency of occurrence of these events during the 1990s, especially, for El Nino should not be construed as being significantly different from that of previous epochs. Additionally, the distribution of duration for both El Nino and La Nina looks bimodal, consisting of two preferred modes - about 8 and 16 months in length for El Nino and about 9 and 18 months in length for La Nina. Likewise, the distribution of recurrence period, especially, for El Nino looks bimodal, consisting of two preferred modes - about 21 and 50 months in length. Scatter plots of the recurrence period versus duration for El Nino strongly suggest preferential associations between them, linking shorter (longer) duration with shorter (longer) recurrence period. Because the last known onset of El Nino occurred in April 1997 and the event was of longer than average duration, one infers that the onset of the next expected El Nino will not occur until February 2000 or later.

On the Bimodality of ENSO Cycle Extremes

NASA Technical Reports Server (NTRS)

Wilson, Robert M.

2000-01-01

On the basis of sea surface temperature in the El Nino 3.4 region (5 deg. N.,-5 deg. S., 120-170 deg. W.) during the interval of 1950-1997, Kevin Trenberth previously has identified some 16 El Nino and 10 La Nina, these 26 events representing the extremes of the quasi-periodic El Nino-Southern Oscillation (ENSO) cycle. Runs testing shows that the duration, recurrence period, and sequencing of these extremes vary randomly. Hence, the decade of the 1990's, especially for El Nino, is not significantly different from that of previous decadal epochs, at least, on the basis of the frequency of onsets of ENSO extremes. Additionally, the distribution of duration for both El Nino and La Nina looks strikingly bimodal, each consisting of two preferred modes, about 8- and 16-mo long for El Nino and about 9- and 18-mo long for La Nina, as does the distribution of the recurrence period for El Nino, consisting of two preferred modes about 21- and 50-mo long. Scatterplots of the recurrence period versus duration for El Nino are found to be statistically important, displaying preferential associations that link shorter (longer) duration with shorter (longer) recurrence periods. Because the last onset of El Nino occurred in April 1997 and the event was of longer than average duration, onset of the next anticipated El Nino is not expected until February 2000 or later.

On The Bimodality of ENSO Cycle Extremes

NASA Technical Reports Server (NTRS)

Wilson, Robert M.

2000-01-01

On the basis of sea surface temperature in the El Nino 3.4 region (5N.-5S., 120-170W.) during the interval of 1950-1997, Kevin Trenberth previously has identified some 16 El Nino and 10 La Nina, these 26 events representing the extremes of the quasi-periodic El Nino-Southern Oscillation (ENSO) cycle. Runs testing shows that the duration, recurrence period, and sequencing of these extremes vary randomly. Hence, the decade of the 1990's, especially for El Nino, is not significantly different from that of previous decadal epochs, at least, on the basis of the frequency of onsets of ENSO extremes. Additionally, the distribution of duration for both El Nino and La Nina looks strikingly bimodal, each consisting of two preferred modes, about 8- and 16-months long for El Nino and about 9- and 18-months long for La Nina, as does the distribution of the recurrence period for El Nino, consisting of two preferred modes about 21- and 50- mo long. Scatterplots of the recurrence period versus duration for El Nino are found to be statistically important, displaying preferential associations that link shorter (longer) duration with shorter (longer) recurrence periods. Because the last onset of El Nino occurred in April 1997 and the event was of longer than average duration, onset of the next anticipated El Nino is not expected until February 2000 or later.