Sample records for factors including availability

  1. Factors influencing food choices of adolescents: findings from focus-group discussions with adolescents.

    PubMed

    Neumark-Sztainer, D; Story, M; Perry, C; Casey, M A

    1999-08-01

    To assess adolescents' perceptions about factors influencing their food choices and eating behaviors. Data were collected in focus-group discussions. The study population included 141 adolescents in 7th and 10th grade from 2 urban schools in St Paul, Minn, who participated in 21 focus groups. Data were analyzed using qualitative research methodology, specifically, the constant comparative method. Factors perceived as influencing food choices included hunger and food cravings, appeal of food, time considerations of adolescents and parents, convenience of food, food availability, parental influence on eating behaviors (including the culture or religion of the family), benefits of foods (including health), situation-specific factors, mood, body image, habit, cost, media, and vegetarian beliefs. Major barriers to eating more fruits, vegetables, and dairy products and eating fewer high-fat foods included a lack of sense of urgency about personal health in relation to other concerns, and taste preferences for other foods. Suggestions for helping adolescents eat a more healthful diet include making healthful food taste and look better, limiting the availability of unhealthful options, making healthful food more available and convenient, teaching children good eating habits at an early age, and changing social norms to make it "cool" to eat healthfully. The findings suggest that if programs to improve adolescent nutrition are to be effective, they need to address a broad range of factors, in particular environmental factors (e.g., the increased availability and promotion of appealing, convenient foods within homes schools, and restaurants).

  2. Does information available at admission for delivery improve prediction of vaginal birth after cesarean?

    PubMed Central

    Grobman, William A.; Lai, Yinglei; Landon, Mark B.; Spong, Catherine Y.; Leveno, Kenneth J.; Rouse, Dwight J.; Varner, Michael W.; Moawad, Atef H.; Simhan, Hyagriv N.; Harper, Margaret; Wapner, Ronald J.; Sorokin, Yoram; Miodovnik, Menachem; Carpenter, Marshall; O'sullivan, Mary J.; Sibai, Baha M.; Langer, Oded; Thorp, John M.; Ramin, Susan M.; Mercer, Brian M.

    2010-01-01

    Objective To construct a predictive model for vaginal birth after cesarean (VBAC) that combines factors that can be ascertained only as the pregnancy progresses with those known at initiation of prenatal care. Study design Using multivariable modeling, we constructed a predictive model for VBAC that included patient factors known at the initial prenatal visit as well as those that only became evident as the pregancy progressed to the admission for delivery. Results 9616 women were analyzed. The regression equation for VBAC success included multiple factors that could not be known at the first prenatal visit. The area under the curve for this model was significantly greater (P < .001) than that of a model that included only factors available at the first prenatal visit. Conclusion A prediction model for VBAC success that incorporates factors that can be ascertained only as the pregnancy progresses adds to the predictive accuracy of a model that uses only factors available at a first prenatal visit. PMID:19813165

  3. What are the determinants of food security among regional and remote Western Australian children?

    PubMed

    Godrich, Stephanie L; Davies, Christina R; Darby, Jill; Devine, Amanda

    2017-01-22

    To explore how determinants of food security affect children in regional and remote Western Australia (WA), across food availability, access and utilisation dimensions. The Determinants of Food Security framework guided the thematic analysis (using NVivo 10) of semi-structured interviews with 20 key informants. Food availability factors included availability, price, promotion, quality, location of outlets and variety. Food access factors included social support, financial resources, transport to food outlets, distance to food outlets and mobility. Food utilisation factors included nutrition knowledge and skills, children's food preferences, storage facilities, preparation and cooking facilities and time to purchase food. Key food availability recommendations include increasing local food supply options. Food access recommendations include ensuring equitable formal social support and empowering informal support options. Food utilisation recommendations include prioritising food literacy programs focusing on quick, healthy food preparation and budgeting skills. Implications for public health: Policymakers should invest in local food supply options, equitable social support services and experiential food literacy programs. Practitioners should focus child/parent programs on improving attitude, knowledge and skills. © 2017 Public Health Association of Australia.

  4. Assessment of Cardiovascular Disease Risk in South Asian Populations

    PubMed Central

    Hussain, S. Monira; Oldenburg, Brian; Zoungas, Sophia; Tonkin, Andrew M.

    2013-01-01

    Although South Asian populations have high cardiovascular disease (CVD) burden in the world, their patterns of individual CVD risk factors have not been fully studied. None of the available algorithms/scores to assess CVD risk have originated from these populations. To explore the relevance of CVD risk scores for these populations, literature search and qualitative synthesis of available evidence were performed. South Asians usually have higher levels of both “classical” and nontraditional CVD risk factors and experience these at a younger age. There are marked variations in risk profiles between South Asian populations. More than 100 risk algorithms are currently available, with varying risk factors. However, no available algorithm has included all important risk factors that underlie CVD in these populations. The future challenge is either to appropriately calibrate current risk algorithms or ideally to develop new risk algorithms that include variables that provide an accurate estimate of CVD risk. PMID:24163770

  5. Neuromuscular Risk Factors for Knee and Ankle Ligament Injuries in Male Youth Soccer Players.

    PubMed

    Read, Paul J; Oliver, Jon L; De Ste Croix, Mark B A; Myer, Gregory D; Lloyd, Rhodri S

    2016-08-01

    Injuries reported in male youth soccer players most commonly occur in the lower extremities, and include a high proportion of ligament sprains at the ankle and knee with a lower proportion of overuse injuries. There is currently a paucity of available literature that examines age- and sex-specific injury risk factors for such injuries within youth soccer players. Epidemiological data have reported movements that lead to non-contact ligament injury include running, twisting and turning, over-reaching and landing. Altered neuromuscular control during these actions has been suggested as a key mechanism in females and adult populations; however, data available in male soccer players is sparse. The focus of this article is to review the available literature and elucidate prevalent risk factors pertaining to male youth soccer players which may contribute to their relative risk of injury.

  6. Exposure Factors Handbook (1996, External Review Draft)

    EPA Science Inventory

    This handbook provided a summary of the available statistical data on various factors used in assessing human exposure.

    Volume I, General Factors, includes an introduction and discussion of uncertainty and provides data for drinking water consumption, soil ingestion, inha...

  7. Neuromuscular Risk Factors for Knee and Ankle Ligament Injuries in Male Youth Soccer Players

    PubMed Central

    Read, Paul J.; Oliver, Jon L.; De Ste Croix, Mark B. A.; Myer, Gregory D.; Lloyd, Rhodri S.

    2017-01-01

    Injuries reported in male youth soccer players most commonly occur in the lower extremities, and include a high proportion of ligament sprains at the ankle and knee with a lower proportion of overuse injuries. There is currently a paucity of available literature that examines age- and sex-specific injury risk factors for such injuries within youth soccer players. Epidemiological data have reported movements that lead to non-contact ligament injury include running, twisting and turning, over-reaching and landing. Altered neuromuscular control during these actions has been suggested as a key mechanism in females and adult populations; however, data available in male soccer players is sparse. The focus of this article is to review the available literature and elucidate prevalent risk factors pertaining to male youth soccer players which may contribute to their relative risk of injury. PMID:26856339

  8. More ecological ERA: incorporating natural environmental factors and animal behavior.

    PubMed

    Bednarska, Agnieszka J; Jevtić, Dragan M; Laskowski, Ryszard

    2013-07-01

    We discuss the importance of selected natural abiotic and biotic factors in ecological risk assessment based on simplistic laboratory bioassays. Although it is impossible to include all possible natural factors in standard lower-tier ecotoxicological testing, neglecting them is not an option. Therefore, we try to identify the most important factors and advocate redesigning standard testing procedures to include theoretically most potent interactions. We also point out a few potentially important factors that have not been studied enough so far. The available data allowed us to identify temperature and O2 depletion as the most critical factors that should be included in ecotoxicity testing as soon as possible. Temporal limitations and fluctuations in food availability also appear important, but at this point more fundamental research in this area is necessary before making decisions on their inclusion in risk assessment procedures. We propose using specific experimental designs, such as Box-Behnken or Central Composite, which allow for simultaneous testing of 3 or more factors for their individual and interactive effects with greater precision and without increasing the effort and costs of tests dramatically. Factorial design can lead to more powerful tests and help to extend the validity of conclusions. Finally, ecological risk assessment procedures should include information on animal behavior, especially feeding patterns. This requires more basic studies, but already at this point adequate mechanistic effect models can be developed for some species. Copyright © 2013 SETAC.

  9. Spatial Variation of Surface Soil Available Phosphorous and Its Relation with Environmental Factors in the Chaohu Lake Watershed

    PubMed Central

    Gao, Yongnian; Gao, Junfeng; Chen, Jiongfeng

    2011-01-01

    The study presented in this paper attempts to evaluate the spatial pattern of soil available phosphorus, as well as the relation between soil available phosphorus and environment factors including elevation, slope, precipitation, percentage of cultivated land, percentage of forest land, percentage of construction land and NDVI using statistical methods and GIS spatial analysis techniques. The results showed that the Spline Tension method performed the best in the prediction of soil available phosphorus in the Chaohu Lake watershed. The spatial variation of surface soil available phosphorus was high in Chaohu Lake watershed and the upstream regions around Chaohu Lake, including the west of Chaohu lake (e.g., southwest of Feixi county, east of Shucheng county and north of Lujiang county) and to the north of Chaohu Lake (e.g., south of Hefei city, south of Feidong county, southwest of Juchao district), had the highest soil available phosphorus content. The mean and standard deviation of soil available phosphorus content gradually decreased as the elevation or slope increased. The cultivated land comprised 60.11% of the watershed and of that land 65.63% belonged to the medium to very high SAP level classes, and it played a major role in SAP availability within the watershed and a potential source of phosphorus to Chaohu Lake resulting in eutrophication. Among the land use types, paddy fields have some of the highest maximum values and variation of coefficients. Subwatershed scale soil available phosphorus was significantly affected by elevation, slope, precipitation, percentage of cultivated land and percentage of forest land and was decided by not only these environmental factors but also some other factors such as artificial phosphorus fertilizer application. PMID:21909308

  10. Exposure Factors Handbook Chapter 11 (Update): Intake of Meats, Dairy Products, and Fats

    EPA Science Inventory

    This update includes new information and factors needed to assess exposure to environmental agents that occur from ingestion of meats, dairy products, and fats that has become available since the Exposure Factors Handbook: 2011 Edition was released. The recommended value...

  11. 32 CFR 179.7 - Sequencing.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... and social factors. (3) Economic factors, including economic considerations pertaining to... maintenance; alternatives to removal or treatment of contamination when existing technology cannot achieve... availability of appropriate technology (e.g., technology to detect, discriminate, recover, and destroy UXO...

  12. 32 CFR 179.7 - Sequencing.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... and social factors. (3) Economic factors, including economic considerations pertaining to... maintenance; alternatives to removal or treatment of contamination when existing technology cannot achieve... availability of appropriate technology (e.g., technology to detect, discriminate, recover, and destroy UXO...

  13. 32 CFR 179.7 - Sequencing.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... and social factors. (3) Economic factors, including economic considerations pertaining to... maintenance; alternatives to removal or treatment of contamination when existing technology cannot achieve... availability of appropriate technology (e.g., technology to detect, discriminate, recover, and destroy UXO...

  14. Environmental, policy, and cultural factors related to physical activity among rural, African American women.

    PubMed

    Sanderson, Bonnie; Littleton, MaryAnn; Pulley, LeaVonne

    2002-01-01

    Sixty-one African American women (ages 20-50 years) from a rural community in Alabama participated in six focus groups. Barriers to and enablers of physical activity were identified and grouped into personal, environmental (social and physical), policy, and cultural themes for qualitative analyses. Personal factors included motivation, perceived health, feeling tired, and lack of time; social environmental factors included support from friends, family, and issues related to child care; physical environmental factors included weather, access to facilities, availability of sidewalks or other places to walk; policy factors included personal safety concerns (loose dogs, traffic, etc.) and inflexible work environments. Some, but not all, women perceived cultural differences as a factor affecting physical activity levels. Differences in socioeconomic levels and time demands among women of different cultures were identified as factors that may influence physical activity. Participants provided suggestions for community-based physical activity interventions using an environmental approach.

  15. Factors Affecting Retention in Online Courses

    ERIC Educational Resources Information Center

    Berling, Victoria L.

    2010-01-01

    The purpose of this study was to expand what is known regarding the factors that relate to successful completion of online, undergraduate college courses. It addressed 13 student factors available through archival data at Northern Kentucky University based on 1,493 students enrolled in fully online courses in fall 2008. It included programmatic…

  16. ADOT state-specific crash prediction models : an Arizona needs study.

    DOT National Transportation Integrated Search

    2016-12-01

    The predictive method in the Highway Safety Manual (HSM) includes a safety performance function (SPF), : crash modification factors (CMFs), and a local calibration factor (C), if available. Two alternatives exist for : applying the HSM prediction met...

  17. Towards understanding the availability of physiotherapy services in rural Australia.

    PubMed

    Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

    2016-01-01

    A recent exploration of factors affecting rural physiotherapy service provision revealed considerable variation in services available between communities of the study. Multiple factors combined to influence local service provision, including macro level policy and funding decisions, service priorities and fiscal constraints of regional health services and capacity and capabilities at the physiotherapy service level. The aim of this article is to describe the variation in local service provision, the factors influencing service provision and the impact on availability of physiotherapy services. A priority-sequence mixed methods design structured the collection and integration of qualitative and quantitative data. The investigation area, a large part of one Australian state, was selected for the number of physiotherapy services and feasibility of conducting site visits. Stratified purposive sampling permitted exploration of rural physiotherapy with subgroups of interest, including physiotherapists, their colleagues, managers, and other key decision makers. Participant recruitment commenced with public sector physiotherapists and progressed to include private practitioners, team colleagues and managers. Surveys were mailed to key physiotherapy contacts in each public sector service in the area for distribution to physiotherapists, their colleagues and managers within their facility. Private physiotherapist principals working in the same communities were invited by the researcher to complete the physiotherapy survey. The survey collected demographic data, rural experience, work setting and number of colleagues, services provided, perspectives on factors influencing service provision and decisions about service provision. Semi-structured interviews were conducted with consenting physiotherapists and other key decision makers identified by local physiotherapists. Quantitative survey data were recorded in spreadsheets and analysed using descriptive statistics. Interviews were recorded and transcribed verbatim, with transcripts provided to participants for review. Open-ended survey questions and interview transcripts were analysed thematically. Surveys were received from 11/25 (44%) of facilities in the investigation area, with a response rate of 29.4% (16/54) from public sector physiotherapists. A further 18 surveys were received: five from principals of private physiotherapy practices and 13 from colleagues and managers. Nineteen interviews were conducted: with 14 physiotherapists (nine public, five private), four other decision makers and one colleague. Three decision makers declined an interview. The variation in physiotherapy service availability between the 11 communities of this study prompted the researchers to consider how such variation could be reflected. The influential factors that emerged from participant comments included rurality and population, size and funding model of public hospitals, the number of public sector physiotherapists and private practices, and the availability of specialised paediatric and rehabilitation services. The factors described by participants were used to develop a conceptual framework or index of rural physiotherapy availability. It is important to make explicit the link between workforce maldistribution, the resultant rural workforce shortages and the implications for local service availability. This study sought to do so by investigating physiotherapy service provision within the rural communities of the investigation area. In doing so, varying levels of availability emerged within local communities. A conceptual framework combining key influencing factors is offered as a way to reflect the availability of physiotherapy services.

  18. Older Adults' Acceptance of Information Technology

    ERIC Educational Resources Information Center

    Wang, Lin; Rau, Pei-Luen Patrick; Salvendy, Gavriel

    2011-01-01

    This study investigated variables contributing to older adults' information technology acceptance through a survey, which was used to find factors explaining and predicting older adults' information technology acceptance behaviors. Four factors, including needs satisfaction, perceived usability, support availability, and public acceptance, were…

  19. Factors influencing kenaf harvesting and processing in the United States

    USDA-ARS?s Scientific Manuscript database

    The selection of the appropriate kenaf (Hibiscus cannabinus L., Malvaceae) production and harvest system is dependent on many factors, including location, equipment availability, storage options, processing plants, plant utilization, and economics. Since its first domestication, kenaf has consisten...

  20. 76 FR 69726 - Pyrethrins/Pyrethroid Cumulative Risk Assessment; Notice of Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-09

    ... to consider available information concerning the cumulative effects on human health resulting from... stakeholders including environmental, human health, farm worker, and agricultural advocates; the chemical... factors, may have atypical or disproportionately high and adverse human health impacts or environmental...

  1. Improving Ascertainment of Risk Factors for HIV Infection: Results of a Group-Randomized Evaluation

    ERIC Educational Resources Information Center

    Harrison, Kathleen McDavid; Pals, Sherri L.; Sajak, Tammy; Chase, Jennifer; Kajese, Tebitha

    2010-01-01

    To allow appropriate allocation of prevention and care funding, HIV/AIDS surveillance data must include risk factor information, currently available for less than 70% of cases reported in the United States. The authors evaluated an intervention consisting of provider training and materials to improve risk factor reporting. Facilities were matched…

  2. Factors Influencing Adoption of Hospital-Acquired Pressure Ulcer Prevention Programs in US Academic Medical Centers.

    PubMed

    Padula, William V; Valuck, Robert J; Makic, Mary Beth F; Wald, Heidi L

    2015-01-01

    Recent data show a decrease in hospital-acquired pressure ulcers (PUs) throughout US hospitals; these changes may be associated with increased success in implementing evidence-based practices for PU prevention. The purpose of this study was to identify wound care nurse perceptions of the primary factors that influenced the overall reduction of PUs. Cross-sectional descriptive survey. Surveys were sent to wound care nurses at 98 University HealthSystem Consortium (UHC) hospitals. The UHC consists of more than 120 academic medical centers and affiliated facilities across the United States. Responses solicited from this survey represented a geographically diverse set of hospitals from less than 200 beds to more than 1000 beds. The survey questionnaire used a framework of 7 internal and 5 external influential factors for implementing evidence-based practices for PU prevention. Internal influential factors queried included availability of nurse specialists, high nursing job turnover, high PU rates, and prevention campaigns. External influential factors included data sharing, Medicare nonpayment policy, and applications for Magnet recognition. Hospital-acquired PU prevention experts at UHC hospitals were contacted through the Wound, Ostomy and Continence Nurses Society membership directory to complete the questionnaire. Consenting participants were e-mailed a disclosure and online questionnaire; they were also sent monthly reminders until they either responded to the survey or declined participation. Fifty-five respondents (59% response rate) indicated several internal factors that influenced evidence-based practice: hospital prevention campaigns; the availability of nursing specialists; and the level of preventive knowledge among hospital staff. External influential factors included financial concerns; application for Magnet recognition; data sharing among peer institutions; and regulatory issues. These findings suggest that the Centers for Medicare & Medicaid Services nonpayment policy influenced a large majority of hospital's changes in practice. The availability of nursing specialists for wound consult influenced hospitals internally. These factors are informative of the impact policy has on changes in hospital prioritization of adopting evidence-based practices for PU prevention.

  3. 42 CFR 136.351 - Application and selection.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... factors: (1) The extent of the unmet health care needs of the urban Indians in the urban center involved..., in the urban center. Factors to be considered in determining relative accessibility include: (i...; (vi) Technical barriers created by State and local health agencies; (vii) Availability of...

  4. Exposure Factors Handbook Chapter 5 (Update): Soil and Dust Ingestion

    EPA Science Inventory

    This update includes new information on soil and dust ingestion that has become available since the Exposure Factors Handbook: 2011 Edition was released. The recommended values have also been revised, as needed, to reflect the new information. This chapter explains the ...

  5. Exposure Factors Handbook (Update): Chapter 5 Soil and Dust Ingestion

    EPA Science Inventory

    This update includes new information on soil and dust ingestion that has become available since the Exposure Factors Handbook: 2011 Edition was released. The recommended values have also been revised, as needed, to reflect the new information. This chapter explains the ...

  6. THE RESPONSE OF ANIMAL RANGE TO CLIMATIC AND LAND-USE CHANGES

    EPA Science Inventory

    The geographic ranges of animal taxa seem much more complex than those of plants, since mobile animals may be constrained by many factors other than readily measurable climatic conditions. These additional factors may include microclimate and availability of particular plant type...

  7. Availability of data for monitoring noncommunicable disease risk factors in India

    PubMed Central

    Dandona, Rakhi; Dandona, Lalit

    2012-01-01

    Abstract Objective To examine the availability of data measuring noncommunicable disease (NCD) risk factor indicators from household surveys conducted in India from 2000 to 2009. Methods Questionnaires and publications used in household surveys were identified through internet and PubMed searches and examined to determine which core NCD risk factor indicators recommended by the World Health Organization (WHO) for NCD monitoring were being measured. Surveys with a sample size of 5000 or more were included to ensure a certain level of precision. The completeness of core indicator measurement and the geographical representativeness of the surveys were assessed. Findings Twenty six surveys met the inclusion criteria. Among the WHO-recommended core behavioural risk factor indicators, those monitoring tobacco use were measured completely in national and subnational surveys; those assessing dietary intake and physical inactivity were measured only in subnational surveys, and those assessing alcohol use were not measured at all. Among WHO-recommended core biological risk factors, only body mass index was measured in national and subnational surveys, whereas blood pressure, fasting blood glucose and blood cholesterol were measured only in subnational surveys. Due to the use of non-standard indicator definitions, measurement of core indicators in some of the national and subnational surveys was incomplete. Conclusion The availability of data on core risk factor indicators to monitor the increasing burden of NCDs is inadequate in India. These indicators using standardized definitions should be included in the periodic national household health surveys to provide data at the national and disaggregated levels. PMID:22271961

  8. Ground-Water Availability Assessment for the Columbia Plateau Regional Aquifer System, Washington, Oregon, and Idaho

    USGS Publications Warehouse

    ,

    2008-01-01

    The U.S. Geological Survey (USGS) is assessing the availability and use of the Nation's water resources to gain a clearer understanding of the status of our water resources and the land-use, water-use, and climatic trends that affect them. The goal of the National assessment is to improve our ability to forecast water availability for future economic and environmental uses. Assessments will be completed for regional aquifer systems across the Nation to help characterize how much water we have now, how water availability is changing, and how much water we can expect to have in the future (Reilly and others, 2008). Water availability is a function of many factors, including the quantity and quality of water, and the laws, regulations, economics, and environmental factors that control its use. The focus of the Columbia Plateau regional ground-water availability assessment is to improve fundamental knowledge of the ground-water balance of the region, including the flows, storage, and ground-water use by humans. An improved quantitative understanding of the region's water balance not only provides key information about water quantity, but also can serve as a fundamental basis for many analyses of water quality and ecosystem health.

  9. Factors associated with patient and parent satisfaction after orthodontic treatment: a systematic review.

    PubMed

    Pachêco-Pereira, Camila; Pereira, José Roberto; Dick, Bruce D; Perez, Arnaldo; Flores-Mir, Carlos

    2015-10-01

    Our objective was to identify factors associated with orthodontic treatment satisfaction of patients and their caregivers, when applicable. MEDLINE via Ovid, PubMed, EBM Reviews and EMBASE via OVIDSP, LILACS, Web of Science, and Google Scholar were searched electronically. Reference lists of included articles were also screened for potential relevant studies missed during the electronic searches. Studies evaluating the satisfaction levels of patients or caregivers after orthodontic treatment were considered. Methodologic quality of the included studies was assessed using a modified Newcastle-Ottawa scale. Eighteen studies satisfied the inclusion criteria, representing 2891 patients and 464 parents. The risk of bias was moderate in 13 and low in 4 of the included articles. The studies used different questionnaires and timings to assess postorthodontic treatment satisfaction. Based on the available limited evidence, satisfaction was associated with perceived esthetic outcomes, psychological benefits, and quality of care. The latter was specifically linked to dentist-staff-patient interactions. Dissatisfaction was associated with treatment duration, pain levels and discomfort, and the use of retention appliances. When both assessments were available, the patient's and the parent's satisfaction levels were strongly correlated. Based on the limited available evidence with moderate risk of bias, we identified factors that appear to be more commonly associated with a high or low level of satisfaction. Consideration of these factors could be important for practitioners attempting to set realistic expectations of their patients and caregivers regarding orthodontic treatment outcomes. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  10. Factors Affecting the Choice of Anesthesiology by Medical Students for Specialty Training.

    ERIC Educational Resources Information Center

    Chandra, Phool; Hughes, Mark

    1984-01-01

    A study of medical students' choice of anesthesiology as a specialty and the quality of clerkships available established several factors in students' choice, including the negative effect of certified registered nurse anesthetists on the operating room floor. A study of relationships with nurse practitioners, physician's assistants, and…

  11. 48 CFR 1352.215-70 - Proposal preparation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... evaluation factor.] Evaluation Factor 1—Technical Approach. Provide information on how the project is to be... time each individual will be available for this project, and, if necessary, explain why the key person... person or labor category including number of labor-hours and current actual average hourly rates based on...

  12. 48 CFR 1352.215-70 - Proposal preparation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... evaluation factor.] Evaluation Factor 1—Technical Approach. Provide information on how the project is to be... time each individual will be available for this project, and, if necessary, explain why the key person... person or labor category including number of labor-hours and current actual average hourly rates based on...

  13. 48 CFR 1352.215-70 - Proposal preparation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... evaluation factor.] Evaluation Factor 1—Technical Approach. Provide information on how the project is to be... time each individual will be available for this project, and, if necessary, explain why the key person... person or labor category including number of labor-hours and current actual average hourly rates based on...

  14. Maturity of hospital information systems: Most important influencing factors.

    PubMed

    Vidal Carvalho, João; Rocha, Álvaro; Abreu, António

    2017-07-01

    Maturity models facilitate organizational management, including information systems management, with hospital organizations no exception. This article puts forth a study carried out with a group of experts in the field of hospital information systems management with a view to identifying the main influencing factors to be included in an encompassing maturity model for hospital information systems management. This study is based on the results of a literature review, which identified maturity models in the health field and relevant influencing factors. The development of this model is justified to the extent that the available maturity models for the hospital information systems management field reveal multiple limitations, including lack of detail, absence of tools to determine their maturity and lack of characterization for stages of maturity structured by different influencing factors.

  15. Limiting excessive postoperative blood transfusion after cardiac procedures. A review.

    PubMed Central

    Ferraris, V A; Ferraris, S P

    1995-01-01

    Analysis of blood product use after cardiac operations reveals that a few patients (< or = 20%) consume the majority of blood products (> 80%). The risk factors that predispose a minority of patients to excessive blood use include patient-related factors, transfusion practices, drug-related causes, and procedure-related factors. Multivariate studies suggest that patient age and red blood cell volume are independent patient-related variables that predict excessive blood product transfusion after cardiac procedures. Other factors include preoperative aspirin ingestion, type of operation, over- or underutilization of heparin during cardiopulmonary bypass, failure to correct hypothermia after cardiopulmonary bypass, and physician overtransfusion. A survey of the currently available blood conservation techniques reveals 5 that stand out as reliable methods: 1) high-dose aprotinin therapy, 2) preoperative erythropoietin therapy when time permits adequate dosage before operation, 3) hemodilution by harvest of whole blood immediately before cardiopulmonary bypass, 4) autologous predonation of blood, and 5) salvage of oxygenator blood after cardiopulmonary bypass. Other methods, such as the use of epsilon-aminocaproic acid or desmopressin, cell saving devices, reinfusion of shed mediastinal blood, and hemofiltration have been reported to be less reliable and may even be harmful in some high-risk patients. Consideration of the available data allows formulation of a 4-pronged plan for limiting excessive blood transfusion after surgery: 1) recognize the causes of excessive transfusion, including the importance of red blood cell volume, type of procedure being performed, preoperative aspirin ingestion, etc.; 2) establish a quality management program, including a survey of transfusion practices that emphasizes physician education and availability of real-time laboratory testing to guide transfusion therapy; 3) adopt a multimodal approach using institution-proven techniques; and 4) continually reassess blood product use and analyze the cost-benefits of blood conservation interventions. PMID:7580359

  16. Old PCs: Upgrade or Abandon?

    ERIC Educational Resources Information Center

    Perez, Ernest

    1997-01-01

    Examines the practical realities of upgrading Intel personal computers in libraries, considering budgets and technical personnel availability. Highlights include adding RAM; putting in faster processor chips, including clock multipliers; new hard disks; CD-ROM speed; motherboards and interface cards; cost limits and economic factors; and…

  17. Selection of emission factor standards for estimating emissions from diesel construction equipment in building construction in the Australian context.

    PubMed

    Zhang, Guomin; Sandanayake, Malindu; Setunge, Sujeeva; Li, Chunqing; Fang, Jun

    2017-02-01

    Emissions from equipment usage and transportation at the construction stage are classified as the direct emissions which include both greenhouse gas (GHG) and non-GHG emissions due to partial combustion of fuel. Unavailability of a reliable and complete inventory restricts an accurate emission evaluation on construction work. The study attempts to review emission factor standards readily available worldwide for estimating emissions from construction equipment. Emission factors published by United States Environmental Protection Agency (US EPA), Australian National Greenhouse Accounts (AUS NGA), Intergovernmental Panel on Climate Change (IPCC) and European Environmental Agency (EEA) are critically reviewed to identify their strengths and weaknesses. A selection process based on the availability and applicability is then developed to help identify the most suitable emission factor standards for estimating emissions from construction equipment in the Australian context. A case study indicates that a fuel based emission factor is more suitable for GHG emission estimation and a time based emission factor is more appropriate for estimation of non-GHG emissions. However, the selection of emission factor standards also depends on factors like the place of analysis (country of origin), data availability and the scope of analysis. Therefore, suitable modifications and assumptions should be incorporated in order to represent these factors. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Market factors and the availability of community pharmacies.

    PubMed

    Doucette, W R; Brooks, J M; Sorofman, B A; Wong, H

    1999-07-01

    The purpose of this study was to examine the relationships between the availability of community pharmacies and 4 types of market factors. A composite data set was created that linked, at the county level, data on: (1) type and number of pharmacies; (2) population characteristics; (3) payer variables; (4) health care system factors; and (5) competitive factors. In this exploratory study, secondary data were used to assess the association between the availability of community pharmacies and the influence of market factors. To assess the market influences on availability of community pharmacies, 2 regressions were performed. In 1 model, the number of community pharmacies per 10,000 population was the dependent variable, whereas the dependent variable in the other regression was the proportion of independently owned community pharmacies. The independent variables in each regression were the market factors--population characteristics, payer variables, health care system factors, and competitive variables. Squared terms were included for 8 of 15 market factors to account for nonlinearities in the relationships. Multiple market factors were correlated with both the number of community pharmacies and the proportion of independently owned pharmacies in an area. Several of the relationships were not linear and changed direction within the range of data. Counties with either a low or a high percentage of elderly people had fewer pharmacies and a lower proportion of independently owned pharmacies compared with counties with a moderate percentage of elderly people. Counties that were scarcely or highly rural had fewer community pharmacies but a higher proportion of independently owned pharmacies than counties that were moderately rural. Areas with a greater percentage of the population earning less than the poverty level had more pharmacies, especially independently owned ones. Fewer community pharmacies were found in areas with higher health maintenance organization penetration rates. The number of hospital admissions was positively associated with the number of pharmacies but negatively associated with the proportion of independently owned pharmacies. The availability of community pharmacies varies across the country. In light of the trend toward fewer independently owned pharmacies, potential problems in accessing pharmacy services could develop in certain areas, including those that are highly rural and those with a high percentage of people earning less than the poverty level. Future research and policy issues are identified.

  19. The clinical content of preconception care: genetics and genomics.

    PubMed

    Solomon, Benjamin D; Jack, Brian W; Feero, W Gregory

    2008-12-01

    The prevalence of paternal and maternal genetic conditions that affect pregnancy varies according to many factors that include parental age, medical history, and family history. Although some genetic conditions that affect pregnancy are identified easily early in life, other conditions are not and may require additional diagnostic testing. A complete 3-generation family medical history that includes ethnicity information about both sides of the family is arguably the single best genetic "test" that is applicable to preconception care. Assessment of genetic risk by an experienced professional has been shown to improve the detection rate of identifiable risk factors. Learning about possible genetic issues in the preconception period is ideal, because knowledge permits patients to make informed reproductive decisions. Options that are available to couples before conception include adoption, surrogacy, use of donor sperm, in vitro fertilization after preimplantation genetic diagnosis, and avoidance of pregnancy. Future technologic advances will increase the choices that are available to couples.

  20. The Clinical Content of Preconception Care: Genetics and Genomics

    PubMed Central

    SOLOMON, Benjamin D.; JACK, Brian; FEERO, W. Gregory

    2008-01-01

    The prevalence of paternal and maternal genetic conditions that affect pregnancy varies according to many factors, including parental age, medical history, and family history. While some genetic conditions that affect pregnancy are easily identified early in life, others are not and may require additional diagnostic testing. A complete three-generation family medical history that includes ethnicity information about both sides of the family is arguably the single best genetic “test” applicable to preconception care. Assessment of genetic risk by an experienced professional has been shown to improve the detection rate of identifiable risk factors. Learning about possible genetic issues in the pre-conception period is ideal, as knowledge permits patients to make informed reproductive decisions. Options available to couples before conception include adoption, surrogacy, use of donor sperm, in vitro fertilization after pre-implantation genetic diagnosis, and avoidance of pregnancy. Future technological advances will increase the choices available to couples. PMID:19081428

  1. Socio-environmental, personal and behavioural predictors of fast-food intake among adolescents.

    PubMed

    Bauer, Katherine W; Larson, Nicole I; Nelson, Melissa C; Story, Mary; Neumark-Sztainer, Dianne

    2009-10-01

    To identify the socio-environmental, personal and behavioural factors that are longitudinally predictive of changes in adolescents' fast-food intake. Population-based longitudinal cohort study. Participants from Minnesota schools completed in-class assessments in 1999 (Time 1) while in middle school and mailed surveys in 2004 (Time 2) while in high school. A racially, ethnically and socio-economically diverse sample of adolescents (n 806). Availability of unhealthy food at home, being born in the USA and preferring the taste of unhealthy foods were predictive of higher fast-food intake after 5 years among both males and females. Among females, personal and behavioural factors, including concern about weight and use of healthy weight-control techniques, were protective against increased fast-food intake. Among males, socio-environmental factors, including maternal and friends' concern for eating healthy food and maternal encouragement to eat healthy food, were predictive of lower fast-food intake. Sports team participation was a strong risk factor for increased fast-food intake among males. Our findings suggest that addressing socio-environmental factors such as acculturation and home food availability may help reduce fast-food intake among adolescents. Additionally, gender-specific intervention strategies, including working with boys' sports teams, family members and the peer group, and for girls, emphasizing the importance of healthy weight-maintenance strategies and the addition of flavourful and healthy food options to their diet, may help reduce fast-food intake.

  2. The Propensity of Permanently Disabled Workers to Hire Lawyers.

    ERIC Educational Resources Information Center

    Borba, Philip S.; Appel, David

    1987-01-01

    This study examined 1,060 California workers with permanent injuries to identify the factors that influence the propensity to hire an attorney for the purpose of contesting their benefit awards. These factors include (1) educational level, (2) union membership, (3) seriousness of the injury, and (4) availability of additional income sources.…

  3. Available clinical markers of treatment outcome integrated in mathematical models to guide therapy in HIV infection.

    PubMed

    Vergu, Elisabeta; Mallet, Alain; Golmard, Jean-Louis

    2004-02-01

    Because treatment failure in many HIV-infected persons may be due to multiple causes, including resistance to antiretroviral agents, it is important to better tailor drug therapy to individual patients. This improvement requires the prediction of treatment outcome from baseline immunological or virological factors, and from results of resistance tests. Here, we review briefly the available clinical factors that have an impact on therapy outcome, and discuss the role of a predictive modelling approach integrating these factors proposed in a previous work. Mathematical and statistical models could become essential tools to address questions that are difficult to study clinically and experimentally, thereby guiding decisions in the choice of individualized drug regimens.

  4. Organizational Silence and Hidden Threats to Patient Safety

    PubMed Central

    Henriksen, Kerm; Dayton, Elizabeth

    2006-01-01

    Organizational silence refers to a collective-level phenomenon of saying or doing very little in response to significant problems that face an organization. The paper focuses on some of the less obvious factors contributing to organizational silence that can serve as threats to patient safety. Converging areas of research from the cognitive, social, and organizational sciences and the study of sociotechnical systems help to identify some of the underlying factors that serve to shape and sustain organizational silence. These factors have been organized under three levels of analysis: (1) individual factors, including the availability heuristic, self-serving bias, and the status quo trap; (2) social factors, including conformity, diffusion of responsibility, and microclimates of distrust; and (3) organizational factors, including unchallenged beliefs, the good provider fallacy, and neglect of the interdependencies. Finally, a new role for health care leaders and managers is envisioned. It is one that places high value on understanding system complexity and does not take comfort in organizational silence. PMID:16898978

  5. Organizational silence and hidden threats to patient safety.

    PubMed

    Henriksen, Kerm; Dayton, Elizabeth

    2006-08-01

    Organizational silence refers to a collective-level phenomenon of saying or doing very little in response to significant problems that face an organization. The paper focuses on some of the less obvious factors contributing to organizational silence that can serve as threats to patient safety. Converging areas of research from the cognitive, social, and organizational sciences and the study of sociotechnical systems help to identify some of the underlying factors that serve to shape and sustain organizational silence. These factors have been organized under three levels of analysis: (1) individual factors, including the availability heuristic, self-serving bias, and the status quo trap; (2) social factors, including conformity, diffusion of responsibility, and microclimates of distrust; and (3) organizational factors, including unchallenged beliefs, the good provider fallacy, and neglect of the interdependencies. Finally, a new role for health care leaders and managers is envisioned. It is one that places high value on understanding system complexity and does not take comfort in organizational silence.

  6. Identifying social factors amongst older individuals in linked electronic health records: An assessment in a population based study

    PubMed Central

    van Hoek, Albert J.; Walker, Jemma L.; Mathur, Rohini; Smeeth, Liam; Thomas, Sara L.

    2017-01-01

    Identification and quantification of health inequities amongst specific social groups is a pre-requisite for designing targeted healthcare interventions. This study investigated the recording of social factors in linked electronic health records (EHR) of individuals aged ≥65 years, to assess the potential of these data to identify the social determinants of disease burden and uptake of healthcare interventions. Methodology was developed for ascertaining social factors recorded on or before a pre-specified index date (01/01/2013) using primary care data from Clinical Practice Research Datalink (CPRD) linked to hospitalisation and deprivation data in a cross-sectional study. Social factors included: religion, ethnicity, immigration status, small area-level deprivation, place of residence (including communal establishments such as care homes), marital status and living arrangements (e.g. living alone, cohabitation). Each social factor was examined for: completeness of recording including improvements in completeness by using other linked EHR, timeliness of recording for factors that might change over time and their representativeness (compared with English 2011 Census data when available). Data for 591,037 individuals from 389 practices from England were analysed. The completeness of recording varied from 1.6% for immigration status to ~80% for ethnicity. Linkages provided the deprivation data (available for 82% individuals) and improved completeness of ethnicity recording from 55% to 79% (when hospitalisation data were added). Data for ethnicity, deprivation, living arrangements and care home residence were comparable to the Census data. For time-varying variables such as residence and living alone, ~60% and ~35% respectively of those with available data, had this information recorded within the last 5 years of the index date. This work provides methods to identify social factors in EHR relevant to older individuals and shows that factors such as ethnicity, deprivation, not living alone, cohabitation and care home residence can be ascertained using these data. Applying these methodologies to routinely collected data could improve surveillance programmes and allow assessment of health equity in specific healthcare studies. PMID:29190680

  7. Toward a Multicultural Model of the Stress Process.

    ERIC Educational Resources Information Center

    Slavin, Lesley A.; And Others

    1991-01-01

    Attempts to expand Lazarus and Folkman's stress model to include culture-relevant dimensions. Discusses cultural factors that influence each component of the stress model, including types and frequency of events experienced, appraisals of stressfulness of events, appraisals of available coping resources, selection of coping strategies, and…

  8. Periorbital Hyperpigmentation: A Comprehensive Review

    PubMed Central

    Sarkar, Rashmi; Ranjan, Rashmi; Garg, Shilpa; Garg, Vijay K.; Sonthalia, Sidharth; Bansal, Shivani

    2016-01-01

    Periorbital hyperpigmentation is a commonly encountered condition. There is very little scientific data available on the clinical profile and pathogenesis of periorbital hyperpigmentation. Periorbital hyperpigmentation is caused by various exogenous and endogenous factors. The causative factors include genetic or heredity, excessive pigmentation, postinflammatory hyperpigmentation secondary to atopic and allergic contact dermatitis, periorbital edema, excessive vascularity, shadowing due to skin laxity and tear trough associated with aging. There are a number of treatment options available for periorbital hyperpigmentation. Among the available alternatives to treat dark circles are topical depigmenting agents, such as hydroquinone, kojic acid, azelaic acid, and topical retinoic acid, and physical therapies, such as chemical peels, surgical corrections, and laser therapy, most of which are tried scientifically for melasma, another common condition of hyperpigmentation that occurs on the face. The aim of treatment should be to identify and treat the primary cause of hyperpigmentation as well as its contributing factors. PMID:26962392

  9. Southwest Hispanic Community -- The Absence of Homeland Security Threats

    DTIC Science & Technology

    2012-12-01

    The capacity to act collectively is based upon internal environmental factors, such as leadership, level of available resources, group size, and...degree of internal organization. External environmental factors include the level of societal repression, extent of external sympathizers and number and...states: California (Mexicans, Salvadorans and Guatemalans), Florida (Cubans, Colombians , Hondurans and Peruvians) or New York (Puerto Ricans

  10. Soil-Site Factors Affecting Southern Upland Oak Managment and Growth

    Treesearch

    John K. Francis

    1980-01-01

    Soil supplies trees with physical support, moisture, oxygen, and nutrients. Amount of moisture most limits tree growth; and soil and topographic factors such as texture and aspect, which influence available soil moisture. are most useful in predicting growth. Equations that include soil and topographic variables can be used to predict site index. Foresters can also...

  11. College Teaching as a Profession: The Doctor of Arts Degree.

    ERIC Educational Resources Information Center

    Dressel, Paul L.

    The history of the Doctor of Arts (D.A.) degree and issues related to its development are briefly traced, and D.A. programs presently available and the success of degree recipients are addressed. Attention is also directed to other types of degree programs that are available, including their advantages and disadvantages, factors involved in…

  12. Development of an Advanced Respirometer for Experimental Studies of Benthic Rate Processes

    NASA Astrophysics Data System (ADS)

    Barry, J. P.; Buck, K. R.; Okuda, C.; Risi, M.; Parker, M.; Levesque, C.

    2005-05-01

    Rates of carbon remineralization and nutrient cycling by seafloor biotic assemblages are influenced by the availability of organic material, temperature, and oxygen availability, among other factors. The relative importance of various factors in controlling carbon cycling by the sediment community is poorly constrained, in part by technological limits on experiments that evaluate independently the effects of these factors. We have developed an advanced respiration chamber system capable of repeated rate measurements during a single deployment, with added capabilities for manipulating conditions within replicate chambers to test hypotheses concerning biogeochemical cycling by the benthos. The ROV-deployed respiration system has 12 syringes for tracer injection or sample withdrawal from 3 respiration chambers, pH, oxygen, and temperature sensors, stirring paddles, and a recirculation pump. The pump system is used to flush each chamber at preprogrammed intervals or oxygen tensions. Areas of investigation that are enabled by the system include the effects various factors on benthic oxygen consumptions (e.g. hypercapnia (elevated CO2), acidosis, ambient oxygen availability, temperature, organic carbon availability), rates of nutrient regeneration by the benthos in response to organic enrichments (labile and refractory organic carbon), time lags in carbon uptake and trophic pathways in responses to organic enrichment.

  13. Clinical decision making in dermatology: observation of consultations and the patients' perspectives.

    PubMed

    Hajjaj, F M; Salek, M S; Basra, M K A; Finlay, A Y

    2010-01-01

    Clinical decision making is a complex process and might be influenced by a wide range of clinical and non-clinical factors. Little is known about this process in dermatology. The aim of this study was to explore the different types of management decisions made in dermatology and to identify factors influencing those decisions from observation of consultations and interviews with the patients. 61 patient consultations were observed by a physician with experience in dermatology. The patients were interviewed immediately after each consultation. Consultations and interviews were audio recorded, transcribed and their content analysed using thematic content analysis. The most common management decisions made during the consultations included: follow-up, carrying out laboratory investigation, starting new topical treatment, renewal of systemic treatment, renewal of topical treatment, discharging patients and starting new systemic treatment. Common influences on those decisions included: clinical factors such as ineffectiveness of previous therapy, adherence to prescribing guidelines, side-effects of medications, previous experience with the treatment, deterioration or improvement in the skin condition, and chronicity of skin condition. Non-clinical factors included: patient's quality of life, patient's friends or relatives, patient's time commitment, travel or transportation difficulties, treatment-related costs, availability of consultant, and availability of treatment. The study has shown that patients are aware that management decisions in dermatology are influenced by a wide range of clinical and non-clinical factors. Education programmes should be developed to improve the quality of decision making. Copyright © 2010 S. Karger AG, Basel.

  14. Contextual factors in maternal and newborn health evaluation: a protocol applied in Nigeria, India and Ethiopia.

    PubMed

    Sabot, Kate; Marchant, Tanya; Spicer, Neil; Berhanu, Della; Gautham, Meenakshi; Umar, Nasir; Schellenberg, Joanna

    2018-01-01

    Understanding the context of a health programme is important in interpreting evaluation findings and in considering the external validity for other settings. Public health researchers can be imprecise and inconsistent in their usage of the word "context" and its application to their work. This paper presents an approach to defining context, to capturing relevant contextual information and to using such information to help interpret findings from the perspective of a research group evaluating the effect of diverse innovations on coverage of evidence-based, life-saving interventions for maternal and newborn health in Ethiopia, Nigeria, and India. We define "context" as the background environment or setting of any program, and "contextual factors" as those elements of context that could affect implementation of a programme. Through a structured, consultative process, contextual factors were identified while trying to strike a balance between comprehensiveness and feasibility. Thematic areas included demographics and socio-economics, epidemiological profile, health systems and service uptake, infrastructure, education, environment, politics, policy and governance. We outline an approach for capturing and using contextual factors while maximizing use of existing data. Methods include desk reviews, secondary data extraction and key informant interviews. Outputs include databases of contextual factors and summaries of existing maternal and newborn health policies and their implementation. Use of contextual data will be qualitative in nature and may assist in interpreting findings in both quantitative and qualitative aspects of programme evaluation. Applying this approach was more resource intensive than expected, in part because routinely available information was not consistently available across settings and more primary data collection was required than anticipated. Data was used only minimally, partly due to a lack of evaluation results that needed further explanation, but also because contextual data was not available for the precise units of analysis or time periods of interest. We would advise others to consider integrating contextual factors within other data collection activities, and to conduct regular reviews of maternal and newborn health policies. This approach and the learnings from its application could help inform the development of guidelines for the collection and use of contextual factors in public health evaluation.

  15. The uptake of plutonium-238, 239, 240, americium-241, strontium-90 and caesium-137 into potatoes.

    PubMed

    Popplewell, D S; Ham, G J; Johnson, T E; Stather, J W; Sumner, S A

    1984-09-01

    Transfer factors have been measured for 239 Pu + 240 Pu, 241 Am, 90 Sr and 137 Cs into potatoes grown in a blend of soil which included silt polluted with radioactive waste discharged into the Irish Sea. The experiment has been carried out over four seasons and attempts to assess the radiological consequences to the consumer which would arise if potatoes were to be grown in land heavily contaminated with the silt. During the course of the experiment plutonium and americium became less available for uptake, 90 Sr became slightly more available and 137 Cs remained nearly constant in its availability. The values of the transfer factors are among the lowest reported for these radionuclides into potatoes.

  16. Aviation and climate change

    DOT National Transportation Integrated Search

    2010-01-27

    This report provides background on aviation emissions and the factors affecting them; it discusses the tools available to control emissions, including existing authority under the Clean Air Act and proposed economy-wide cap-and-trade legislation; and...

  17. Open Availability of Patient Medical Photographs in Google Images Search Results: Cross-Sectional Study of Transgender Research

    PubMed Central

    Brunger, Fern; Welch, Vivian; Asghari, Shabnam; Kaposy, Chris

    2018-01-01

    Background This paper focuses on the collision of three factors: a growing emphasis on sharing research through open access publication, an increasing awareness of big data and its potential uses, and an engaged public interested in the privacy and confidentiality of their personal health information. One conceptual space where this collision is brought into sharp relief is with the open availability of patient medical photographs from peer-reviewed journal articles in the search results of online image databases such as Google Images. Objective The aim of this study was to assess the availability of patient medical photographs from published journal articles in Google Images search results and the factors impacting this availability. Methods We conducted a cross-sectional study using data from an evidence map of research with transgender, gender non-binary, and other gender diverse (trans) participants. For the original evidence map, a comprehensive search of 15 academic databases was developed in collaboration with a health sciences librarian. Initial search results produced 25,230 references after duplicates were removed. Eligibility criteria were established to include empirical research of any design that included trans participants or their personal information and that was published in English in peer-reviewed journals. We identified all articles published between 2008 and 2015 with medical photographs of trans participants. For each reference, images were individually numbered in order to track the total number of medical photographs. We used odds ratios (OR) to assess the association between availability of the clinical photograph on Google Images and the following factors: whether the article was openly available online (open access, Researchgate.net, or Academia.edu), whether the article included genital images, if the photographs were published in color, and whether the photographs were located on the journal article landing page. Results We identified 94 articles with medical photographs of trans participants, including a total of 605 photographs. Of the 94 publications, 35 (37%) included at least one medical photograph that was found on Google Images. The ability to locate the article freely online contributes to the availability of at least one image from the article on Google Images (OR 2.99, 95% CI 1.20-7.45). Conclusions This is the first study to document the existence of medical photographs from peer-reviewed journals appearing in Google Images search results. Almost all of the images we searched for included sensitive photographs of patient genitals, chests, or breasts. Given that it is unlikely that patients consented to sharing their personal health information in these ways, this constitutes a risk to patient privacy. Based on the impact of current practices, revisions to informed consent policies and guidelines are required. PMID:29483069

  18. The effect of social geographic factors on the untreated tooth decay among head start children.

    PubMed

    Heima, Masahiro; Ferretti, Margaret; Qureshi, Mehveen; Ferretti, Gerald

    2017-10-01

    Disparities among untreated dental caries exist for children from low-income families in the United States. Understanding of the mechanism of the disparities is required to reduce it and social geographic factors are one of the important influences. Although the effect of fluoridated water has been well reported, studies of other sociogeograpic factors, such as the density of available dentists, are still very limited. The objective of this study is to explore the effect of sociogeographic factors on the number of primary teeth with untreated dental caries among children from low-income families who are enrolled in Head Start programs throughout Northeast Ohio of the United States. This was a cross-sectional chart review study. Three hundred-eighty-eight charts were reviewed, and the number of primary teeth with untreated dental caries (dt) and the children's addresses were retrieved. The sociogeographic variables, including fluoridated water availability and the density of available dentists who accept a government-supported insurance (Medicaid dentists), were collected. The mean (standard deviation) of children's age was 3.51 (1.14) years with a range of 7 months to 5 years. A negative binomial regression model analysis, which used dt as a dependent variable and children's characteristic factors (i.e. age, gender, insurance type, and total number of primary teeth) and sociogeographic factors (i.e. Population, total number of Medicaid dentists, density of Medicaid dentist, and Fluoride water availability) of cities, as independent variables, demonstrated that only the density of Medicaid dentist in the sociogeographic factors indicated a significant effect (Estimated ß-Coefficients (Standard Errors)=-0.003 (0.002), p =0.030). This study demonstrated a significant negative association between the density of available dentists and untreated dental caries among children from low-income families in Head Start programs in Northeast Ohio. Increasing available dentists may be a strategy to reduce the number of early childhood caries. Key words: Child, poverty, dental caries, Health Services Accessibility.

  19. PlantTFDB: a comprehensive plant transcription factor database

    PubMed Central

    Guo, An-Yuan; Chen, Xin; Gao, Ge; Zhang, He; Zhu, Qi-Hui; Liu, Xiao-Chuan; Zhong, Ying-Fu; Gu, Xiaocheng; He, Kun; Luo, Jingchu

    2008-01-01

    Transcription factors (TFs) play key roles in controlling gene expression. Systematic identification and annotation of TFs, followed by construction of TF databases may serve as useful resources for studying the function and evolution of transcription factors. We developed a comprehensive plant transcription factor database PlantTFDB (http://planttfdb.cbi.pku.edu.cn), which contains 26 402 TFs predicted from 22 species, including five model organisms with available whole genome sequence and 17 plants with available EST sequences. To provide comprehensive information for those putative TFs, we made extensive annotation at both family and gene levels. A brief introduction and key references were presented for each family. Functional domain information and cross-references to various well-known public databases were available for each identified TF. In addition, we predicted putative orthologs of those TFs among the 22 species. PlantTFDB has a simple interface to allow users to search the database by IDs or free texts, to make sequence similarity search against TFs of all or individual species, and to download TF sequences for local analysis. PMID:17933783

  20. Leading quality improvement in primary care: recommendations for success.

    PubMed

    Van Hoof, Thomas J; Bisognano, Maureen; Reinertsen, James L; Meehan, Thomas P

    2012-09-01

    Leadership is increasingly recognized as a potential factor in the success of primary care quality improvement efforts, yet little is definitively known about which specific leadership behaviors are most important. Until more research is available, the authors suggest that primary care clinicians who are committed to developing their leadership skills should commit to a series of actions. These actions include embracing a theory of leadership, modeling the approach for others, focusing on the goal of improving patient outcomes, encouraging teamwork, utilizing available sources of power, and reflecting on one's approach in order to improve it. Primary care clinicians who commit themselves to such actions will be more effective leaders and will be more prepared as new research becomes available on this important factor. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Modification of the Fosberg fire weather index to include drought

    Treesearch

    Scott L. Goodrick

    2002-01-01

    The Fosberg fire weather index is a simple tool for evaluating the potential influence of weather on a wildland fire based on temperature, relative humidity and wind speed. A modification to this index that includes the impact of precipitation is proposed. The Keetch-Byram drought index is used to formulate a 'fuel availability' factor that modifies the...

  2. Orbital design strategy for domestic communication satellite systems.

    NASA Technical Reports Server (NTRS)

    Ramji, S.; Sawitz, P.

    1973-01-01

    Review of some of the considerations pertinent to efficient orbit utilization in the design of domestic communications satellite systems. A strategy is developed to efficiently locate a heterogeneous system of satellites within the available arc and provide room for future growth. A practical design is illustrated, using a computer simulation model, for the placement of 25 satellites within 73% of the available arc employing frequency and polarization coordination techniques. A number of widely variable factors that influence satellite spacing are examined. These factors include such critical system elements as telephony and television interference noise limits, frequency plan coordination, polarization plan coordination, ground antenna diameter, signal protection ratio, and satellite station keeping.

  3. INTEGRATING EPIDEMIOLOGY AND TOXICOLOGY IN NEUROTOXICITY RISK ASSESSMENT.

    EPA Science Inventory

    Neurotoxicity risk assessments depend on the best available scientific information, including data from animal toxicity, human experimental studies and human epidemiology studies. There are several factors to consider when evaluating the comparability of data from studies. Reg...

  4. LIFE CYCLE IMPACT ASSESSMENT SOPHISTICATION

    EPA Science Inventory

    An international workshop was held in Brussels on 11/29-30/1998, to discuss LCIA Sophistication. LCA experts from North America, Europs, and Asia attended. Critical reviews of associated factors, including current limitations of available assessment methodologies, and comparison...

  5. Comparative studies of energy sources in gynecologic laparoscopy.

    PubMed

    Law, Kenneth S K; Lyons, Stephen D

    2013-01-01

    Energy sources incorporating "vessel sealing" capabilities are being increasingly used in gynecologic laparoscopic surgery although conventional monopolar and bipolar electrosurgery remain popular. The preference for one device over another is based on a combination of factors, including the surgeon's subjective experience, availability, and cost. Although comparative clinical studies and meta-analyses of laparoscopic energy sources have reported small but statistically significant differences in volumes of blood loss, the clinical significance of such small volumes is questionable. The overall usefulness of the various energy sources available will depend on a number of factors including vessel burst pressure and seal time, lateral thermal spread, and smoke production. Animal studies and laboratory-based trials are useful in providing a controlled environment to investigate such parameters. At present, there is insufficient evidence to support the use of one energy source over another. Copyright © 2013 AAGL. All rights reserved.

  6. Spatially Characterizing Effective Timber Supply

    NASA Technical Reports Server (NTRS)

    Berry, J. K.; Sailor, J.

    1982-01-01

    The structure of a computer-oriented cartographic model for assessing roundwood supply for generation of base load electricity is discussed. The model provides an analytical procedure for coupling spatial information of harvesting economics and owner willingness to sell stumpages. Supply is characterized in terms of standing timber; of accessibility considering various harvesting and hauling factors; and of availability as affected by ownership and residential patterns. Factors governing accessibility to timber include effective harvesting distance to haulic roads as modified by barriers and slopes. Haul distance is expressed in units that take into account the relative ease of travel along various road types to a central processing facility. Areas of accessible timber are grouped into spatial units, termed 'timbersheds', of common access to particular haul road segments that belong to unique 'transport zones'. Timber availability considerations include size of ownership parcels, housing density and excluded areas. The analysis techniques are demonstrated for a cartographic data base in western Massachusetts.

  7. [Culture and mental health in Haiti : a literature review].

    PubMed

    Pierre, Andrena; Minn, Pierre; Sterlin, Carlo; Annoual, Pascale C; Jaimes, Annie; Raphaël, Frantz; Raikhel, Eugene; Whitley, Rob; Rousseau, Cécile; Kirmayer, Laurence J

    2010-01-01

    This paper reviews and summarizes the available literature on Haitian mental health and mental health services. This review was conducted in light of the Haitian earthquake in January 2010. We searched Medline, Google Scholar and other available databases to gather scholarly literature relevant to mental health in Haiti. This was supplemented by consultation of key books and grey literature relevant to Haiti. The first part of the review describes historical, economic, sociological and anthropological factors essential to a basic understanding of Haiti and its people. This includes discussion of demography, family structure, Haitian economics and religion. The second part of the review focuses on mental health and mental health services. This includes a review of factors such as basic epidemiology of mental illness, common beliefs about mental illness, explanatory models, idioms of distress, help-seeking behavior, configuration of mental health services and the relationship between religion and mental health.

  8. Plant allocation of carbon to defense as a function of herbivory, light and nutrient availability

    USGS Publications Warehouse

    DeAngelis, Donald L.; Ju, Shu; Liu, Rongsong; Bryant, John P.; Gourley, Stephen A.

    2012-01-01

    We use modeling to determine the optimal relative plant carbon allocations between foliage, fine roots, anti-herbivore defense, and reproduction to maximize reproductive output. The model treats these plant components and the herbivore compartment as variables. Herbivory is assumed to be purely folivory. Key external factors include nutrient availability, degree of shading, and intensity of herbivory. Three alternative functional responses are used for herbivory, two of which are variations on donor-dependent herbivore (models 1a and 1b) and one of which is a Lotka–Volterra type of interaction (model 2). All three were modified to include the negative effect of chemical defenses on the herbivore. Analysis showed that, for all three models, two stable equilibria could occur, which differs from most common functional responses when no plant defense component is included. Optimal strategies of carbon allocation were defined as the maximum biomass of reproductive propagules produced per unit time, and found to vary with changes in external factors. Increased intensity of herbivory always led to an increase in the fractional allocation of carbon to defense. Decreases in available limiting nutrient generally led to increasing importance of defense. Decreases in available light had little effect on defense but led to increased allocation to foliage. Decreases in limiting nutrient and available light led to decreases in allocation to reproduction in models 1a and 1b but not model 2. Increases in allocation to plant defense were usually accompanied by shifts in carbon allocation away from fine roots, possibly because higher plant defense reduced the loss of nutrients to herbivory.

  9. Human Reliability Assessments: Using the Past (Shuttle) to Predict the Future (ORION)

    NASA Technical Reports Server (NTRS)

    Mott, Diana L.; Bigler, Mark A.

    2017-01-01

    NASA uses two HRA assessment methodologies. The first is a simplified method which is based on how much time is available to complete the action, with consideration included for environmental and personal factors that could influence the human's reliability. This method is expected to provide a conservative value or placeholder as a preliminary estimate. This preliminary estimate is used to determine which placeholder needs a more detailed assessment. The second methodology is used to develop a more detailed human reliability assessment on the performance of critical human actions. This assessment needs to consider more than the time available, this would include factors such as: the importance of the action, the context, environmental factors, potential human stresses, previous experience, training, physical design interfaces, available procedures/checklists and internal human stresses. The more detailed assessment is still expected to be more realistic than that based primarily on time available. When performing an HRA on a system or process that has an operational history, we have information specific to the task based on this history and experience. In the case of a PRA model that is based on a new design and has no operational history, providing a "reasonable" assessment of potential crew actions becomes more problematic. In order to determine what is expected of future operational parameters, the experience from individuals who had relevant experience and were familiar with the system and process previously implemented by NASA was used to provide the "best" available data. Personnel from Flight Operations, Flight Directors, Launch Test Directors, Control Room Console Operators and Astronauts were all interviewed to provide a comprehensive picture of previous NASA operations. Verification of the assumptions and expectations expressed in the assessments will be needed when the procedures, flight rules and operational requirements are developed and then finalized.

  10. The CoFactor database: organic cofactors in enzyme catalysis.

    PubMed

    Fischer, Julia D; Holliday, Gemma L; Thornton, Janet M

    2010-10-01

    Organic enzyme cofactors are involved in many enzyme reactions. Therefore, the analysis of cofactors is crucial to gain a better understanding of enzyme catalysis. To aid this, we have created the CoFactor database. CoFactor provides a web interface to access hand-curated data extracted from the literature on organic enzyme cofactors in biocatalysis, as well as automatically collected information. CoFactor includes information on the conformational and solvent accessibility variation of the enzyme-bound cofactors, as well as mechanistic and structural information about the hosting enzymes. The database is publicly available and can be accessed at http://www.ebi.ac.uk/thornton-srv/databases/CoFactor.

  11. Volatile substance misuse among street children in India: a preliminary report.

    PubMed

    Sharma, Shridhar; Lal, Rakesh

    2011-01-01

    Although substance misuse among children in India has been documented for over a decade, volatile substance misuse (VSM) is a comparatively recent phenomenon there. This paper reviews available Indian studies about VSM among street children and documents the extent of misuse, experienced benefits and harms, and risk factors. Reported perceived benefits include enhanced physical strength, decreased shyness, sleep induction, feeling good, and numbing physical and psychological pain. Identified risk factors include domestic violence, a dictatorial father, presence of stepparents, migrant status, and substance use in the family. Limitations of the current paper and the need for further research are discussed.

  12. Gambling Disorder and Minority Populations: Prevalence and Risk Factors.

    PubMed

    Okuda, Mayumi; Liu, Weiwei; Cisewski, Jodi A; Segura, Luis; Storr, Carla L; Martins, Silvia S

    2016-09-01

    Previous studies demonstrate disparities in health and health services including gambling disorders (GD) among ethnic and racial minority groups. In this review, we summarize studies examining the prevalence of GD across different ethnic and racial minorities. We describe the sociodemographic subgroup variations at heightened risk for GD and factors associated with GD in racial and ethnic minority groups including gambling availability, comorbid substance use, psychiatric conditions, stress, acculturation, and differences in cultural values and cognitions. We found that research of GD among minority groups is scant, and the prevalence of GD among these groups is at a magnitude of concern. Racial and ethnic minority status in it of itself is not a risk factor for GD but may be a proxy for underlying potential risk factors. The need for prevention and treatment programs for different cultural group remains unmet.

  13. Management of haemophilia in the developing world.

    PubMed

    Srivastava, A; Chuansumrit, A; Chandy, M; Duraiswamy, G; Karagus, C

    1998-07-01

    The problems with management of haemophilia in developing countries are poor awareness, inadequate diagnostic facilities and scarce factor concentrates for therapy. The priorities in establishing services for haemophilia include training care providers, setting up care centres, initiating a registry, educating affected people and their families about the condition, providing low-cost factor concentrates, improving social awareness and developing a comprehensive care team. A coagulation laboratory capable of reliably performing clotting times with correction studies using normal pooled, FVIII and FIX deficient patient plasma and factor assay is most essential for diagnosis. More advanced centralized laboratories are also needed. Molecular biology techniques for mutation detection and gene tracking should be established in each country for accurate carrier detection and antenatal diagnosis. Different models of haemophilia care exists. In India, there is no support from the government. Services, including import of factor concentrates, are organized by the Haemophilia Federation of India, with support from other institutions. Haemophilia is managed with minimal replacement therapy (about 2000 i.u./PWH/year). In Malaysia, where the system is fully supported by the government, facilities are available at all public hospitals and moderate levels of factor concentrates are available 'on-demand' (about 11,000 i.u./PWH/year) at the hospitals. Haemophilia care in South Africa is provided through major public hospitals. Intermediate purity factor concentrates are locally produced (about 12,000 i.u./PWH/year) at low cost. The combined experience in the developing world in providing haemophilia services should be used to define standards for care and set achievable goals.

  14. Facilitating factors and barriers to malaria research utilization for policy development in Malawi.

    PubMed

    Mwendera, Chikondi A; de Jager, Christiaan; Longwe, Herbert; Phiri, Kamija; Hongoro, Charles; Mutero, Clifford M

    2016-10-19

    Research on various determinants of health is key in providing evidence for policy development, thereby leading to successful interventions. Utilization of research is an intricate process requiring an understanding of contextual factors. The study was conducted to assess enhancing factors and barriers of research utilization for malaria policy development in Malawi. Qualitative research approach was used through in-depth interviews with 39 key informants that included malaria researchers, policy makers, programme managers, and key stakeholders. Purposive sampling and snowballing techniques were used in identifying key informants. Interview transcripts were entered in QSR Nvivo 11 software for coding and analysis. Respondents identified global efforts as key in advancing knowledge translation, while local political will has been conducive for research utilization. Other factors were availability of research, availability of diverse local researchers and stakeholders supporting knowledge translation. While barriers included: lack of platforms for researcher-public engagement, politics, researchers' lack of communication skills, lack of research collaborations, funder driven research, unknown World Health Organization policy position, and the lack of a malaria research repository. Overall, the study identified facilitating factors to malaria research utilization for policy development in Malawi. These factors need to be systematically coordinated to address the identified barriers and improve on malaria research utilization in policy development. Malaria research can be key in the implementation of evidence-based interventions to reduce the malaria burden and assist in the paradigm shift from malaria control to elimination in Malawi.

  15. Risk factors for mobility limitation in community-dwelling older adults: a social ecological perspective.

    PubMed

    Yeom, Hye A; Fleury, Julie; Keller, Colleen

    2008-01-01

    Although a variety of risk factors for mobility limitation in older adults have been examined, a collective review of relevant literature has not been reported. The purposes of this review are to report the intrapersonal, interpersonal, environmental, and organizational risk factors related to mobility limitation using a social ecological perspective and to discuss the direction of future clinical practice consistent with current literature on mobility limitation of community-dwelling older adults. Intrapersonal risk factors related to mobility limitation include advanced age, female gender, low socioeconomic status, comorbidity, lack of motivation (i.e., dependent personality, decreased self-efficacy), lifestyle factors (i.e., sedentary lifestyle, smoking, obesity), and physiological factors (i.e., vitamin D deficiency, inflammation, poor nutritional status). Interpersonal risk factors related to mobility limitation include weak social networks and limited social activities. Geriatric clients may also experience a decline in mobility when they encounter environmental challenges such as an inconvenient home environment and lack of availability of services in their community, as well as lack of organizational resources stemming from social policy. Potential intervention strategies focused on modifiable risk factors may include lifestyle modifications, social networking programs, and enhancing awareness of environmental and organizational resources in the community for older adults at risk for mobility limitation.

  16. Receptivity of Librarians to Optical Information Technologies and Products.

    ERIC Educational Resources Information Center

    Eaton, Nancy

    1986-01-01

    Examines factors which may affect the receptivity of librarians to the use of optical disk technologies, including hardware and software issues, the content of currently available databases, and the integration of optical technologies into existing library services. (CLB)

  17. Human factors analysis of road weather advisory and control information : final report.

    DOT National Transportation Integrated Search

    2010-03-31

    The amount of available weather information and the methods by which this information can be disseminated to travelers have grown considerably in recent years. This growth includes weather gathering devices (sensors, satellites), models and forecasti...

  18. Family Relationships, Parenting Practices, the Availability of Male Family Members, and the Behavior of Inner-City Boys in Single-Mother and Two-Parent Families.

    ERIC Educational Resources Information Center

    Florsheim, Paul; Tolan, Patrick; Gorman-Smith, Deborah

    1998-01-01

    Examined if and how differences in functioning of single-mother and two-parent families relate to occurrence of behavioral problems among inner-city boys ages 10-15. Findings included (1) multiple family risk factors contribute to occurrence of behavior problems; (2) most family risk factors were generalizable to both single-mother and two-parent…

  19. A review of factors affecting patient satisfaction with nurse led triage in emergency departments.

    PubMed

    Rehman, Salma Abdul; Ali, Parveen Azam

    2016-11-01

    To determine the factors that affect patient satisfaction with nurse-led-triage in EDs using a systematic review. Nurses' involvement in the triage services provided in the Emergency Department has been an integral part of practice for several decades in some countries. Although studies exploring patient satisfaction with nurse-led ED triage exist, no systematic review of this evidence is available. MEDLINE, CINAHL, PsycInfo, EMBASE, the Cochrane Library, Joanna Briggs Library and Google Scholar were searched (January 1980-June 2013). Eighteen studies that met the inclusion criteria were reviewed. Factors that affect patient satisfaction with nurse-led-triage include nurses' abilities to provide patient centred care, communication skills, nurses' caring abilities, concern for the patient and competence in diagnosing and treating the health problem. Other factors include availability and visibility of nurses, provision of appropriate health related information in a jargon-free language, nurses' ability to answer questions, and an ability to provide patients with an opportunity to ask questions. There is continued scope for nurse-led-triage services in the ED. Patients are generally satisfied with the service provided by nurses in EDs and report a willingness to see the same professional again in the future if needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Exploring the Relationship Between Surgical Capacity and Output in Ghana: Current Capacity Assessments May Not Tell the Whole Story.

    PubMed

    Stewart, Barclay T; Gyedu, Adam; Gaskill, Cameron; Boakye, Godfred; Quansah, Robert; Donkor, Peter; Volmink, Jimmy; Mock, Charles

    2018-03-13

    Capacity assessments serve as surrogates for surgical output in low- and middle-income countries where detailed registers do not exist. The relationship between surgical capacity and output was evaluated in Ghana to determine whether a more critical interpretation of capacity assessment data is needed on which to base health systems strengthening initiatives. A standardized surgical capacity assessment was performed at 37 hospitals nationwide using WHO guidelines; availability of 25 essential resources and capabilities was used to create a composite capacity score that ranged from 0 (no availability of essential resources) to 75 (constant availability) for each hospital. Data regarding the number of essential operations performed over 1 year, surgical specialties available, hospital beds, and functional operating rooms were also collected. The relationship between capacity and output was explored. The median surgical capacity score was 37 [interquartile range (IQR) 29-48; range 20-56]. The median number of essential operations per year was 1480 (IQR 736-1932) at first-level hospitals; 1545 operations (IQR 984-2452) at referral hospitals; and 11,757 operations (IQR 3769-21,256) at tertiary hospitals. Surgical capacity and output were not correlated (p > 0.05). Contrary to current understanding, surgical capacity assessments may not accurately reflect surgical output. To improve the validity of surgical capacity assessments and facilitate maximal use of available resources, other factors that influence output should also be considered, including demand-side factors; supply-side factors and process elements; and health administration and management factors.

  1. Estimating Escherichia coli loads in streams based on various physical, chemical, and biological factors

    PubMed Central

    Dwivedi, Dipankar; Mohanty, Binayak P.; Lesikar, Bruce J.

    2013-01-01

    Microbes have been identified as a major contaminant of water resources. Escherichia coli (E. coli) is a commonly used indicator organism. It is well recognized that the fate of E. coli in surface water systems is governed by multiple physical, chemical, and biological factors. The aim of this work is to provide insight into the physical, chemical, and biological factors along with their interactions that are critical in the estimation of E. coli loads in surface streams. There are various models to predict E. coli loads in streams, but they tend to be system or site specific or overly complex without enhancing our understanding of these factors. Hence, based on available data, a Bayesian Neural Network (BNN) is presented for estimating E. coli loads based on physical, chemical, and biological factors in streams. The BNN has the dual advantage of overcoming the absence of quality data (with regards to consistency in data) and determination of mechanistic model parameters by employing a probabilistic framework. This study evaluates whether the BNN model can be an effective alternative tool to mechanistic models for E. coli loads estimation in streams. For this purpose, a comparison with a traditional model (LOADEST, USGS) is conducted. The models are compared for estimated E. coli loads based on available water quality data in Plum Creek, Texas. All the model efficiency measures suggest that overall E. coli loads estimations by the BNN model are better than the E. coli loads estimations by the LOADEST model on all the three occasions (three-fold cross validation). Thirteen factors were used for estimating E. coli loads with the exhaustive feature selection technique, which indicated that six of thirteen factors are important for estimating E. coli loads. Physical factors included temperature and dissolved oxygen; chemical factors include phosphate and ammonia; biological factors include suspended solids and chlorophyll. The results highlight that the LOADEST model estimates E. coli loads better in the smaller ranges, whereas the BNN model estimates E. coli loads better in the higher ranges. Hence, the BNN model can be used to design targeted monitoring programs and implement regulatory standards through TMDL programs. PMID:24511166

  2. Real-time RT-PCR profiling of transcription factors including 34 MYBs and signaling components in white lupin reveals their P status dependent and organ-specific expression

    USDA-ARS?s Scientific Manuscript database

    Phosphorus (P) is often a limiting macronutrient because of its low availability in soils. White lupin (Lupinus albus L.) plants are well adapted to growth under P-deficient conditions. White lupin acclimation to P-deficiency includes changes in root architecture and enhanced expression of numerous ...

  3. Open Availability of Patient Medical Photographs in Google Images Search Results: Cross-Sectional Study of Transgender Research.

    PubMed

    Marshall, Zack; Brunger, Fern; Welch, Vivian; Asghari, Shabnam; Kaposy, Chris

    2018-02-26

    This paper focuses on the collision of three factors: a growing emphasis on sharing research through open access publication, an increasing awareness of big data and its potential uses, and an engaged public interested in the privacy and confidentiality of their personal health information. One conceptual space where this collision is brought into sharp relief is with the open availability of patient medical photographs from peer-reviewed journal articles in the search results of online image databases such as Google Images. The aim of this study was to assess the availability of patient medical photographs from published journal articles in Google Images search results and the factors impacting this availability. We conducted a cross-sectional study using data from an evidence map of research with transgender, gender non-binary, and other gender diverse (trans) participants. For the original evidence map, a comprehensive search of 15 academic databases was developed in collaboration with a health sciences librarian. Initial search results produced 25,230 references after duplicates were removed. Eligibility criteria were established to include empirical research of any design that included trans participants or their personal information and that was published in English in peer-reviewed journals. We identified all articles published between 2008 and 2015 with medical photographs of trans participants. For each reference, images were individually numbered in order to track the total number of medical photographs. We used odds ratios (OR) to assess the association between availability of the clinical photograph on Google Images and the following factors: whether the article was openly available online (open access, Researchgate.net, or Academia.edu), whether the article included genital images, if the photographs were published in color, and whether the photographs were located on the journal article landing page. We identified 94 articles with medical photographs of trans participants, including a total of 605 photographs. Of the 94 publications, 35 (37%) included at least one medical photograph that was found on Google Images. The ability to locate the article freely online contributes to the availability of at least one image from the article on Google Images (OR 2.99, 95% CI 1.20-7.45). This is the first study to document the existence of medical photographs from peer-reviewed journals appearing in Google Images search results. Almost all of the images we searched for included sensitive photographs of patient genitals, chests, or breasts. Given that it is unlikely that patients consented to sharing their personal health information in these ways, this constitutes a risk to patient privacy. Based on the impact of current practices, revisions to informed consent policies and guidelines are required. ©Zack Marshall, Fern Brunger, Vivian Welch, Shabnam Asghari, Chris Kaposy. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.02.2018.

  4. Association of Individual and Neighborhood Factors with Home Food Availability: Evidence from the National Health and Nutrition Examination Survey.

    PubMed

    Chai, Weiwen; Fan, Jessie X; Wen, Ming

    2018-05-01

    Accumulating evidence suggests the important role of the home food environment in an individual's dietary intake. This study examined the associations of individual and neighborhood-level factors with the availability of healthy and unhealthy foods in the home using a nationally representative sample from the 2007 to 2008 and 2009 to 2010 National Health and Nutrition Examination Surveys (NHANES). A cross-sectional study design was used with NHANES merged with the 2000 census data. Food availability was measured through self-report questionnaire regarding the frequency of foods or drinks available in the home. The analysis included 8,975 participants aged 19 to 65 years. Associations of individual and neighborhood factors with home food availability (always or most of the time available) were assessed using logistic regression modeling accounting for NHANES' complex survey design and weights. Individual-level and neighborhood-level factors were simultaneously included in the analysis. Family income-to-needs ratio was positively associated with the availability of dark green vegetables (odds ratio [OR]=1.07; 95% CI=1.00 to 1.13), fat-free or low-fat milk (OR=1.16; 95% CI=1.07 to 1.25), and salty snacks (OR=1.12; 95% CI=1.04 to 1.20) in the home. College graduates were more likely to have fruits (OR=1.96, 95% CI=1.48 to 2.60), vegetables (OR=1.48; 95% CI=1.16 to 1.88), and fat-free or low-fat milk (OR=1.81; 95% CI=1.55 to 2.12) and less likely to have salty snacks (OR=0.77; 95% CI=0.63 to 0.95) and sugary drinks (OR=0.46, 95% CI=0.37 to 0.57) available compared with non-college graduates. Tract socioeconomic status (SES) scores were positively associated with fruit (OR=1.15; 95% CI=1.02 to 1.29), vegetable (OR=1.14; 95% CI=1.03 to 1.26), and fat-free or low-fat milk (OR=1.25; 95% CI=1.10 to 1.42) availability. Urban residents were associated with greater availability of fruits (OR=1.47; 95% CI=1.05 to 2.08) and fat-free or low-fat milk (OR=1.33; 95% CI=1.02 to 1.73) in the home compared with rural residents. Food desert status was not associated with home food availability. The results show that SES at both individual (education, income) and neighborhood level was linked to home food availability, suggesting a need to improve the home food environment for socioeconomically disadvantaged individuals and neighborhoods. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  5. Factors associated with geographic variation in cost per episode of care for three medical conditions

    PubMed Central

    2014-01-01

    Objective To identify associations between market factors, especially relative reimbursement rates, and the probability of surgery and cost per episode for three medical conditions (cataract, benign prostatic neoplasm, and knee degeneration) with multiple treatment options. Methods We use 2004–2006 Medicare claims data for elderly beneficiaries from sixty nationally representative communities to estimate multivariate models for the probability of surgery and cost per episode of care as a function local market factors, including Medicare physician reimbursement for surgical versus non-surgical treatment and the availability of primary care and specialty physicians. We used Symmetry’s Episode Treatment Groups (ETG) software to group claims into episodes for the three conditions (n = 540,874 episodes). Results Higher Medicare reimbursement for surgical episodes and greater availability of the relevant specialists are significantly associated with more surgery and higher cost per episode for all three conditions, while greater availability of primary care physicians is significantly associated with less frequent surgery and lower cost per episode. Conclusion Relative Medicare reimbursement rates for surgical vs. non-surgical treatments and the availability of both primary care physicians and relevant specialists are associated with the likelihood of surgery and cost per episode. PMID:24949281

  6. Blackberry cultivation in the world

    USDA-ARS?s Scientific Manuscript database

    Blackberries have now become a common fruit in marketing outlets, particularly in North America and the European Union. Blackberries have enjoyed expansion due to a combination of factors including improved cultivars, expanded marketing efforts and fruit availability, and an overall increase in berr...

  7. Measuring Alexithymia via Trait Approach-I: A Alexithymia Scale Item Selection and Formation of Factor Structure

    PubMed Central

    TATAR, Arkun; SALTUKOĞLU, Gaye; ALİOĞLU, Seda; ÇİMEN, Sümeyye; GÜVEN, Hülya; AY, Çağla Ebru

    2017-01-01

    Introduction It is not clear in the literature whether available instruments are sufficient to measure alexithymia because of its theoretical structure. Moreover, it has been reported that several measuring instruments are needed to measure this construct, and all the instruments have different error sources. The old and the new forms of Toronto Alexithymia Scale are the only instruments available in Turkish. Thus, the purpose of this study was to develop a new scale to measure alexithymia, selecting items and constructing the factor structure. Methods A total of 1117 patients aged from 19 to 82 years (mean = 35.05 years) were included. A 100-item pool was prepared and applied to 628 women and 489 men. Data were analyzed using Explanatory Factor Analysis, Confirmatory Factor Analysis, and Item Response Theory and 28 items were selected. The new form of 28 items was applied to 415 university students, including 271 women and 144 men aged from 18 to 30 (mean=21.44). Results The results of Explanatory Factor Analysis revealed a five-factor construct of “Solving and Expressing Affective Experiences,” “External Locused Cognitive Style,” “Tendency to Somatize Affections,” “Imaginary Life and Visualization,” and “Acting Impulsively,” along with a two-factor construct representing the “Affective” and “Cognitive” components. All the components of the construct showed good model fit and high internal consistency. The new form was tested in terms of internal consistency, test-retest reliability, and concurrent validity using Toronto Alexithymia Scale as criteria and discriminative validity using Five-Factor Personality Inventory Short Form. Conclusion The results showed that the new scale met the basic psychometric requirements. Results have been discussed in line with related studies. PMID:29033633

  8. Differential growth responses of soil bacterial taxa to carbon substrates of varying chemical recalcitrance

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

    Goldfarb, K.C.; Karaoz, U.; Hanson, C.A.

    2011-04-18

    Soils are immensely diverse microbial habitats with thousands of co-existing bacterial, archaeal, and fungal species. Across broad spatial scales, factors such as pH and soil moisture appear to determine the diversity and structure of soil bacterial communities. Within any one site however, bacterial taxon diversity is high and factors maintaining this diversity are poorly resolved. Candidate factors include organic substrate availability and chemical recalcitrance, and given that they appear to structure bacterial communities at the phylum level, we examine whether these factors might structure bacterial communities at finer levels of taxonomic resolution. Analyzing 16S rRNA gene composition of nucleotide analog-labeledmore » DNA by PhyloChip microarrays, we compare relative growth rates on organic substrates of increasing chemical recalcitrance of >2,200 bacterial taxa across 43 divisions/phyla. Taxa that increase in relative abundance with labile organic substrates (i.e., glycine, sucrose) are numerous (>500), phylogenetically clustered, and occur predominantly in two phyla (Proteobacteria and Actinobacteria) including orders Actinomycetales, Enterobacteriales, Burkholderiales, Rhodocyclales, Alteromonadales, and Pseudomonadales. Taxa increasing in relative abundance with more chemically recalcitrant substrates (i.e., cellulose, lignin, or tannin-protein) are fewer (168) but more phylogenetically dispersed, occurring across eight phyla and including Clostridiales, Sphingomonadalaes, Desulfovibrionales. Just over 6% of detected taxa, including many Burkholderiales increase in relative abundance with both labile and chemically recalcitrant substrates. Estimates of median rRNA copy number per genome of responding taxa demonstrate that these patterns are broadly consistent with bacterial growth strategies. Taken together, these data suggest that changes in availability of intrinsically labile substrates may result in predictable shifts in soil bacterial composition.« less

  9. Contributing Causes of Injury or Death in Grain Entrapment, Engulfment, and Extrication.

    PubMed

    Issa, Salah Fuad; Field, William E; Schwab, Charles V; Issa, Fadi S; Nauman, Eric A

    2017-01-01

    Grain entrapments and engulfments are one of most common hazards associated with grain storage facilities, with over 1,140 such entrapments/engulfments documented since the 1970s. The objective of the study was to determine the factors that contribute to injury or death in grain entrapment, engulfment, and extrication cases. A literature review, including data contained in the Purdue Agricultural Confined Spaces Incident Database (PACSID), was conducted to determine the conditions that the body experiences during an entrapment or engulfment in grains and during extrication efforts. Based on the review, the conditions a human body faces during an entrapment, engulfment, or extraction can be split into two broad categories-environmental and physiological/psychological. The environmental factors depend on the grain's properties, depth of entrapment or engulfment, position of the victim's body, and characteristics of the storage unit, which include the grain's lateral pressure, vertical pressure, and weight, as well as friction, oxygen availability and diffusion rate, and grain temperature. The physiological and psychological factors are related to the individual's age and physical and psychological conditions, and manifest themselves in terms of oxygen consumption, asphyxiation (including aspiration, lack of oxygen, compression or splinting of the thorax), blood flow, and heart rate. Of all the above factors, a review of fatality data contained in the PACSID indicate that aspiration, asphyxiation, grain weight, and lateral pressure are most likely the primary cause of death for most entrapment victims. Research gaps found by this study include an understanding of the impact of lateral pressure on lung expansion and oxygen availability and consumption rate, and the need for more case studies to accurately determine cause of death.

  10. The effect of social geographic factors on the untreated tooth decay among head start children

    PubMed Central

    Ferretti, Margaret; Qureshi, Mehveen; Ferretti, Gerald

    2017-01-01

    Background Disparities among untreated dental caries exist for children from low-income families in the United States. Understanding of the mechanism of the disparities is required to reduce it and social geographic factors are one of the important influences. Although the effect of fluoridated water has been well reported, studies of other sociogeograpic factors, such as the density of available dentists, are still very limited. The objective of this study is to explore the effect of sociogeographic factors on the number of primary teeth with untreated dental caries among children from low-income families who are enrolled in Head Start programs throughout Northeast Ohio of the United States. Material and Methods This was a cross-sectional chart review study. Three hundred-eighty-eight charts were reviewed, and the number of primary teeth with untreated dental caries (dt) and the children’s addresses were retrieved. The sociogeographic variables, including fluoridated water availability and the density of available dentists who accept a government-supported insurance (Medicaid dentists), were collected. Results The mean (standard deviation) of children’s age was 3.51 (1.14) years with a range of 7 months to 5 years. A negative binomial regression model analysis, which used dt as a dependent variable and children’s characteristic factors (i.e. age, gender, insurance type, and total number of primary teeth) and sociogeographic factors (i.e. Population, total number of Medicaid dentists, density of Medicaid dentist, and Fluoride water availability) of cities, as independent variables, demonstrated that only the density of Medicaid dentist in the sociogeographic factors indicated a significant effect (Estimated ß-Coefficients (Standard Errors)=-0.003 (0.002), p=0.030). Conclusions This study demonstrated a significant negative association between the density of available dentists and untreated dental caries among children from low-income families in Head Start programs in Northeast Ohio. Increasing available dentists may be a strategy to reduce the number of early childhood caries. Key words:Child, poverty, dental caries, Health Services Accessibility. PMID:29167713

  11. Towards a framework for analyzing determinants of performance of community health workers in malaria prevention and control: a systematic review.

    PubMed

    Chipukuma, Helen Mwiinga; Zulu, Joseph Mumba; Jacobs, Choolwe; Chongwe, Gershom; Chola, Mumbi; Halwiindi, Hikabasa; Zgambo, Jessy; Michelo, Charles

    2018-05-08

    Community health workers (CHWs) are an important human resource in improving coverage of and success to interventions aimed at reducing malaria incidence. Evidence suggests that the performance of CHWs in malaria programs varies in different contexts. However, comprehensive frameworks, based on systematic reviews, to guide the analysis of determinants of performance of CHWs in malaria prevention and control programs are lacking. We systematically searched Google Scholar, Science Direct, and PubMed including reference lists that had English language publications. We included 16 full text articles that evaluated CHW performance in malaria control. Search terms were used and studies that had performance as an outcome of interest attributed to community-based interventions done by CHWs were included. Sixteen studies were included in the final review and were mostly on malaria Rapid Diagnosis and Treatment, as well as adherence to referral guidelines. Factors determining performance and effective implementation of CHW malaria programs included health system factors such as nature of training of CHWs; type of supervision including feedback process; availability of stocks, supplies, and job aids; nature of work environment and reporting systems; availability of financial resources and transport systems; types of remuneration; health staff confidence in CHWs; and workload. In addition, community dynamics such as nature of community connectedness and support from the community and utilization of services by the community also influenced performance. Furthermore, community health worker characteristics such marital status, sex, and CHW confidence levels also shaped CHW performance. Effectively analyzing and promoting the performance of CHWs in malaria prevention and control programs may require adopting a framework that considers health systems and community factors as well as community health worker characteristics.

  12. Etiopathogenesis of cataract: An appraisal

    PubMed Central

    Gupta, Varun B; Rajagopala, Manjusha; Ravishankar, Basavaiah

    2014-01-01

    Natural eye lens is a crystalline substance to produce a clear passage for light. Cataract is opacity within the clear lens of the eye and is the dominant cause of socio-medical problem i.e., blindness worldwide. The only available treatment of cataract is surgery. However, insufficient surgical facilities in poor and developing countries and post-operative complications inspire researchers to find out other modes of treatment for cataract. In this review, an attempt has been made to appraise various etiological factors of cataract to make their perception clear to build up counterpart treatment. Present study is an assortment of various available literatures and electronic information in view of cataract etiopathogenesis. Various risk factors have been identified in development of cataracts. They can be classified in to genetic factors, ageing (systemic diseases, nutritional and trace metals deficiencies, smoking, oxidative stress etc.), traumatic, complicated (inflammatory and degenerative diseases of eye), metabolic (diabetes, galactosemia etc.), toxic substances including drugs abuses, alcohol etc., radiation (ultraviolet, electromagnetic waves etc.) are implicated as significant risk factors in the development of cataract. PMID:24618482

  13. Legionnaire's Disease in Compromised Hosts.

    PubMed

    Lanternier, Fanny; Ader, Florence; Pilmis, Benoit; Catherinot, Emilie; Jarraud, Sophie; Lortholary, Olivier

    2017-03-01

    Legionnaire's disease (LD) is mainly reported in apparently immunocompetent patients. Among them, risk factors include chronic lung disease and smoking. However, LD is also well reported among immunocompromised patients, particularly those treated with anti-tumor necrosis factor alpha therapy, patients with hematological malignancy, and transplant patients. This article discusses the available data on immunity against Legionella spp, epidemiology, clinical presentation, diagnosis, and treatment of LD in immunocompromised patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. 10 CFR 431.422 - Prescriptions of a rule.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... costs, benefits, burdens, and reliability of alternative approaches to energy savings or production... factors including: The extent to which the State regulation will increase manufacturing or distribution...)(vii) of this section, and shall be available for public review, except for confidential or proprietary...

  15. Multifocal intraocular lenses: Types, outcomes, complications and how to solve them

    PubMed Central

    Salerno, Liberdade C.; Tiveron, Mauro C.; Alió, Jorge L.

    2017-01-01

    The multifocal intraocular lenses (IOLs) available are often able to restore visual function and allow spectacle independence after their implantation with great levels of patient satisfaction. The factors associated with the postoperatory success include the careful selection of the patient, the knowledge about the IOLs’ design, and their visual performance added to the proper surgical technique and management of possible complications as demonstrated by the evidence available. PMID:29296549

  16. Spatial and Temporal Epidemiology of Nephropathia Epidemica Incidence and Hantavirus Seroprevalence in Rodent Hosts: Identification of the Main Environmental Factors in Europe.

    PubMed

    Monchatre-Leroy, E; Crespin, L; Boué, F; Marianneau, P; Calavas, D; Hénaux, V

    2017-08-01

    In Europe, the increasing number of nephropathia epidemica (NE) infections in humans, caused by Puumala virus carried by bank voles (Myodes glareolus), has triggered studies of environmental factors driving these infections. NE infections have been shown to occur in specific geographical areas characterized by environmental factors that influence the distribution and dynamics of host populations and virus persistence in the soil. Here, we review the influence of environmental conditions (including climate factors, food availability and habitat conditions) with respect to incidence in humans and seroprevalence in rodents, considering both direct and indirect transmission pathways. For each type of environmental factor, results and discrepancies between studies are presented and examined in the light of biological hypotheses. Overall, food availability and temperature appear to be the main drivers of host seroprevalence and NE incidence, but data quality and statistical approaches varied greatly among studies. We highlight the issues that now need to be addressed and suggest improvements for study design in regard to the current knowledge on hantavirus epidemiology. © 2016 Blackwell Verlag GmbH.

  17. Binge drinking among Arab/Chaldeans: an exploratory study.

    PubMed

    Arfken, Cynthia L; Owens, Darlene; Said, Manal

    2012-01-01

    Focus groups were conducted with young Arab/Chaldeans (N = 82) from different ethno-religious groups (Chaldeans, Orthodox Christians, and Muslims) to explore the potential risk and the protective factors associated with the high level of binge (or episodic heavy) drinking among Arab/Chaldeans reported by general population surveys. Most of the participants were aware of and knowledgeable about the problem in their community. Themes identified as contributory factors consistent across ethno-religious groups included the availability of alcohol, the importance of family, conformity to group behavior, and social reasons. Differences included the context for drinking and gender roles. These findings can be used to tailor culturally appropriate interventions.

  18. Current review of injuries sustained in mixed martial arts competition.

    PubMed

    Walrod, Bryant

    2011-01-01

    Mixed martial arts (MMA) have enjoyed a tremendous growth in popularity over the past 10 years, yet there remains a paucity of information with respect to common injuries sustained in MMA competitions. In the available studies, certain trends pertaining to risk factors for injury, as well as the most common injuries sustained in MMA competition, were noted. Common risk factors include being the losing fighter, history of knockout or technical knockout, and longer fight duration. Common injuries that were noted include lacerations and abrasions, followed by injuries to the face and ocular region. Concussions with or without loss of consciousness also were noted in MMA competition.

  19. Effect of prenatal programming on heifer development.

    PubMed

    Funston, Richard N; Summers, Adam F

    2013-11-01

    In beef cattle, the main factors influencing nutrient partitioning between the dam and fetus include age of the dam, number of fetuses, production demand, and environmental stress. These factors play a critical role in programming the fetus for its future environment and available resources. Fetal programming reportedly affects neonatal mortality and morbidity, postnatal growth rate, body composition, health, and reproduction. Two main mechanisms responsible for fetal programming include DNA methylation and histone modifications. Alterations in the genome can be passed through multiple generations. Maternal environment (nutrition, age, physiologic status) can program progeny heifer growth and reproductive performance. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Job Accommodations Availability and Utilization Among People With Lupus: An Examination of Workplace Activity Limitations and Work Context Factors.

    PubMed

    Al Dhanhani, Ali M; Gignac, Monique A M; Beaton, Dorcas E; Su, Jiandong; Fortin, Paul R

    2015-11-01

    The aim of this study was to examine the availability of diverse job accommodations (or flexible working arrangements) and to describe their use among people with systemic lupus erythematosus (lupus), as well as to examine factors associated with the use of job accommodations. A mail survey was sent to adult lupus patients receiving care from a lupus clinic based in Toronto, Canada. The survey assessed demographic information, self-reported disease activity, work history, workplace activity limitations, job strain, and the availability and use of job accommodations. Standard multivariable linear regression analysis was used to examine factors associated with the use of job accommodations. We received 362 responses of 604 mailed surveys (60% response rate). Participants who were employed within the last 5 years, but who were not currently working, were less likely than currently employed participants to report having had job accommodations available to them at their last place of employment. The use of job accommodations was reported by 70% of currently employed respondents and by 72% of those not currently employed. The most common job accommodation used was sick leave days. Factors positively associated with the use of job accommodations among those who were employed included higher levels of education, being diagnosed with fibromyalgia, at least 1 episode of short-term work disability, not belonging to a union, greater workplace activity limitations, and greater job strain. The use of job accommodations among people with lupus is common. Work context factors, such as workplace activity limitations and job strain, are the main factors associated with the use of job accommodations. © 2015, American College of Rheumatology.

  1. Impact of Demographic Siting Criteria and Environmental Suitability on Land Availability for Nuclear Reactor Siting

    NASA Technical Reports Server (NTRS)

    Hansen, K. L.

    1982-01-01

    The effect of population and certain environmental characteristics on the availability of land for siting nuclear power plants was assessed. The study area, consisting of the 48 contiguous states, was divided into 5 kilometer (km) square grid cells yielding a total of 600,000 cells. Through the use of a modern geographic information system, it was possible to provide a detailed analysis of a quite large area. Numerous maps and statistical tables were produced, the detail of which were limited only by available data. Evaluation issues included population density, restricted lands, seismic hardening, site preparation, water availability, and cost factors.

  2. Clinical Bioinformatics: challenges and opportunities

    PubMed Central

    2012-01-01

    Background Network Tools and Applications in Biology (NETTAB) Workshops are a series of meetings focused on the most promising and innovative ICT tools and to their usefulness in Bioinformatics. The NETTAB 2011 workshop, held in Pavia, Italy, in October 2011 was aimed at presenting some of the most relevant methods, tools and infrastructures that are nowadays available for Clinical Bioinformatics (CBI), the research field that deals with clinical applications of bioinformatics. Methods In this editorial, the viewpoints and opinions of three world CBI leaders, who have been invited to participate in a panel discussion of the NETTAB workshop on the next challenges and future opportunities of this field, are reported. These include the development of data warehouses and ICT infrastructures for data sharing, the definition of standards for sharing phenotypic data and the implementation of novel tools to implement efficient search computing solutions. Results Some of the most important design features of a CBI-ICT infrastructure are presented, including data warehousing, modularity and flexibility, open-source development, semantic interoperability, integrated search and retrieval of -omics information. Conclusions Clinical Bioinformatics goals are ambitious. Many factors, including the availability of high-throughput "-omics" technologies and equipment, the widespread availability of clinical data warehouses and the noteworthy increase in data storage and computational power of the most recent ICT systems, justify research and efforts in this domain, which promises to be a crucial leveraging factor for biomedical research. PMID:23095472

  3. #KidsAnxiety and Social Media: A Review.

    PubMed

    Glover, Jenna; Fritsch, Sandra L

    2018-04-01

    This article reviews the available literature regarding the interaction between child and adolescent anxiety and electronic media. It reviews current research contributing to understanding of the correlation of youth anxiety with engagement in social media and other online platforms, including risk and protective factors. mHealth and eHealth prevention and treatment options, available via various digital resources, are discussed. Suggestions for mental health clinicians' assessment of client's online behaviors and a review of novel treatment options are provided. The article concludes with proposing healthy online technology interventions, including popups for overuse and identification of digitally enhanced posts. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Human systems integration in remotely piloted aircraft operations.

    PubMed

    Tvaryanas, Anthony P

    2006-12-01

    The role of humans in remotely piloted aircraft (RPAs) is qualitatively different from manned aviation, lessening the applicability of aerospace medicine human factors knowledge derived from traditional cockpits. Aerospace medicine practitioners should expect to be challenged in addressing RPA crewmember performance. Human systems integration (HSI) provides a model for explaining human performance as a function of the domains of: human factors engineering; personnel; training; manpower; environment, safety, and occupational health (ESOH); habitability; and survivability. RPA crewmember performance is being particularly impacted by issues involving the domains of human factors engineering, personnel, training, manpower, ESOH, and habitability. Specific HSI challenges include: 1) changes in large RPA operator selection and training; 2) human factors engineering deficiencies in current RPA ground control station design and their impact on human error including considerations pertaining to multi-aircraft control; and 3) the combined impact of manpower shortfalls, shiftwork-related fatigue, and degraded crewmember effectiveness. Limited experience and available research makes it difficult to qualitatively or quantitatively predict the collective impact of these issues on RPA crewmember performance. Attending to HSI will be critical for the success of current and future RPA crewmembers. Aerospace medicine practitioners working with RPA crewmembers should gain first-hand knowledge of their task environment while the larger aerospace medicine community needs to address the limited information available on RPA-related aerospace medicine human factors. In the meantime, aeromedical decisions will need to be made based on what is known about other aerospace occupations, realizing this knowledge may have only partial applicability.

  5. Clinical experience with three-factor prothrombin complex concentrate to reverse warfarin anticoagulation in intracranial hemorrhage.

    PubMed

    Switzer, Jeffrey A; Rocker, Jody; Mohorn, Phillip; Waller, Jennifer L; Hughes, Douglas; Bruno, Askiel; Nichols, Fenwick T; Hess, David C; Natarajan, Kavita; Fagan, Susan C

    2012-09-01

    The effectiveness of prothrombin complex concentrate (PCC) products available in the United States that contain low levels of factor VII (3-factor PCC) has not been tested. The purpose of this study was to review our experience with 3-factor PCC (Profilnine) in the setting of warfarin-associated intracranial hemorrhage (wICH). In November 2007, we implemented a protocol for reversal of anticoagulation in wICH using Profilnine. Additional treatment with fresh-frozen plasma was at the discretion of the treating physician. Medical records of all patients receiving PCC for wICH between November 1, 2007, and December 7, 2011 were reviewed. Correction of the international normalized rate (INR) was defined as an INR <1.4. Seventy wICH patients were treated with Profilnine, including 46 (66%) with intraparenchymal hemorrhage, 22 (31%) with subdural hemorrhage, and 2 (3%) with subarachnoid hemorrhage. Mean INR was reduced from 3.36 to 1.96, and in 44 (62.9%) patients the INR corrected to <1.4. Baseline INR ≥3.0 decreased the likelihood of INR correction. Concomitant administration of fresh-frozen plasma (mean, 2.6 U) did not increase the likelihood of INR correction. Seven (10%) patients had serious adverse events during their hospital course, including 2 sudden deaths from suspected pulmonary embolism. Reversal of coagulopathy in wICH with Profilnine was incomplete and associated with serious adverse events. In the absence of available 4-factor PCC, options for urgent reversal of anticoagulation in wICH remain limited.

  6. Burns in low- and middle-income countries: a review of available literature on descriptive epidemiology, risk factors, treatment, and prevention.

    PubMed

    Forjuoh, S N

    2006-08-01

    Burn prevention requires adequate knowledge of the epidemiological characteristics and associated risk factors. While much has been accomplished in the areas of primary and secondary prevention of fires and burns in many developed or high-income countries (HICs), such as the United States, due to sustained research on the descriptive epidemiology and risk factors, the same cannot be said of developing or low- and middle-income countries (LMICs). To move from data to action and assist preventive efforts in LMICs, a review of the available literature was conducted to assess the current status of burn preventive efforts. A MEDLINE search (1974-2003) was conducted on empirical studies published in English on the descriptive epidemiology, risk factors, treatment, and prevention of burns in LMICs. Review of the 117 identified studies revealed basically the same descriptive epidemiological characteristics but slightly different risk factors of burns including the presence of pre-existing impairments in children, lapses in child supervision, storage of flammable substances in the home, low maternal education, and overcrowding as well as several treatment modalities and preventive efforts including immediate application of cool water to a burned area. Continuous evaluation of promising interventions and those with unknown efficacy that have been attempted in LMICs, along with testing interventions that have proven effective in HICs in these LIMC settings, is needed to spearhead the move from data to action in preventing burns in LMICs.

  7. Genetic Factors in Tendon Injury: A Systematic Review of the Literature

    PubMed Central

    Vaughn, Natalie H.; Stepanyan, Hayk; Gallo, Robert A.; Dhawan, Aman

    2017-01-01

    Background: Tendon injury such as tendinopathy or rupture is common and has multiple etiologies, including both intrinsic and extrinsic factors. The genetic influence on susceptibility to tendon injury is not well understood. Purpose: To analyze the published literature regarding genetic factors associated with tendon injury. Study Design: Systematic review; Level of evidence, 3. Methods: A systematic review of published literature was performed in concordance with the Preferred Reporting Items of Systematic Reviews and Meta-analysis (PRISMA) guidelines to identify current evidence for genetic predisposition to tendon injury. PubMed, Ovid, and ScienceDirect databases were searched. Studies were included for review if they specifically addressed genetic factors and tendon injuries in humans. Reviews, animal studies, or studies evaluating the influence of posttranscription factors and modifications (eg, proteins) were excluded. Results: Overall, 460 studies were available for initial review. After application of inclusion and exclusion criteria, 11 articles were ultimately included for qualitative synthesis. Upon screening of references of these 11 articles, an additional 15 studies were included in the final review, for a total of 26 studies. The genetic factors with the strongest evidence of association with tendon injury were those involving type V collagen A1, tenascin-C, matrix metalloproteinase–3, and estrogen-related receptor beta. Conclusion: The published literature is limited to relatively homogenous populations, with only level 3 and level 4 data. Additional research is needed to make further conclusions about the genetic factors involved in tendon injury. PMID:28856171

  8. Characterization of primary standards for use in the HPLC analysis of the procyanidin content of cocoa and chocolate containing products.

    PubMed

    Hurst, William J; Stanley, Bruce; Glinski, Jan A; Davey, Matthew; Payne, Mark J; Stuart, David A

    2009-10-15

    This report describes the characterization of a series of commercially available procyanidin standards ranging from dimers DP = 2 to decamers DP = 10 for the determination of procyanidins from cocoa and chocolate. Using a combination of HPLC with fluorescence detection and MALDI-TOF mass spectrometry, the purity of each standard was determined and these data were used to determine relative response factors. These response factors were compared with other response factors obtained from published methods. Data comparing the procyanidin analysis of a commercially available US dark chocolate calculated using each of the calibration methods indicates divergent results and demonstrate that previous methods may significantly underreport the procyanidins in cocoa-containing products. These results have far reaching implications because the previous calibration methods have been used to develop data for a variety of scientific reports, including food databases and clinical studies.

  9. Influence of Biological Factors on Connectivity Patterns for Concholepas concholepas (loco) in Chile.

    PubMed

    Garavelli, Lysel; Colas, François; Verley, Philippe; Kaplan, David Michael; Yannicelli, Beatriz; Lett, Christophe

    2016-01-01

    In marine benthic ecosystems, larval connectivity is a major process influencing the maintenance and distribution of invertebrate populations. Larval connectivity is a complex process to study as it is determined by several interacting factors. Here we use an individual-based, biophysical model, to disentangle the effects of such factors, namely larval vertical migration, larval growth, larval mortality, adults fecundity, and habitat availability, for the marine gastropod Concholepas concholepas (loco) in Chile. Lower transport success and higher dispersal distances are observed including larval vertical migration in the model. We find an overall decrease in larval transport success to settlement areas from northern to southern Chile. This spatial gradient results from the combination of current direction and intensity, seawater temperature, and available habitat. From our simulated connectivity patterns we then identify subpopulations of loco along the Chilean coast, which could serve as a basis for spatial management of this resource in the future.

  10. Influence of Biological Factors on Connectivity Patterns for Concholepas concholepas (loco) in Chile

    PubMed Central

    Garavelli, Lysel; Colas, François; Verley, Philippe; Kaplan, David Michael; Yannicelli, Beatriz; Lett, Christophe

    2016-01-01

    In marine benthic ecosystems, larval connectivity is a major process influencing the maintenance and distribution of invertebrate populations. Larval connectivity is a complex process to study as it is determined by several interacting factors. Here we use an individual-based, biophysical model, to disentangle the effects of such factors, namely larval vertical migration, larval growth, larval mortality, adults fecundity, and habitat availability, for the marine gastropod Concholepas concholepas (loco) in Chile. Lower transport success and higher dispersal distances are observed including larval vertical migration in the model. We find an overall decrease in larval transport success to settlement areas from northern to southern Chile. This spatial gradient results from the combination of current direction and intensity, seawater temperature, and available habitat. From our simulated connectivity patterns we then identify subpopulations of loco along the Chilean coast, which could serve as a basis for spatial management of this resource in the future. PMID:26751574

  11. Ebola Virus Disease in Children, Sierra Leone, 2014–2015

    PubMed Central

    Naveed, Asad; Wing, Kevin; Gbessay, Musa; Ross, J.C.G.; Checchi, Francesco; Youkee, Daniel; Jalloh, Mohammed Boie; Baion, David; Mustapha, Ayeshatu; Jah, Hawanatu; Lako, Sandra; Oza, Shefali; Boufkhed, Sabah; Feury, Reynold; Bielicki, Julia A.; Gibb, Diana M.; Klein, Nigel; Sahr, Foday; Yeung, Shunmay

    2016-01-01

    Little is known about potentially modifiable factors in Ebola virus disease in children. We undertook a retrospective cohort study of children <13 years old admitted to 11 Ebola holding units in the Western Area, Sierra Leone, during 2014–2015 to identify factors affecting outcome. Primary outcome was death or discharge after transfer to Ebola treatment centers. All 309 Ebola virus–positive children 2 days–12 years old were included; outcomes were available for 282 (91%). Case-fatality was 57%, and 55% of deaths occurred in Ebola holding units. Blood test results showed hypoglycemia and hepatic/renal dysfunction. Death occurred swiftly (median 3 days after admission) and was associated with younger age and diarrhea. Despite triangulation of information from multiple sources, data availability was limited, and we identified no modifiable factors substantially affecting death. In future Ebola virus disease epidemics, robust, rapid data collection is vital to determine effectiveness of interventions for children. PMID:27649367

  12. The Relationship Between Shift Work and Metabolic Risk Factors: A Systematic Review of Longitudinal Studies.

    PubMed

    Proper, Karin I; van de Langenberg, Daniëlla; Rodenburg, Wendy; Vermeulen, Roel C H; van der Beek, Allard J; van Steeg, Harry; van Kerkhof, Linda W M

    2016-05-01

    Although the metabolic health effects of shift work have been extensively studied, a systematic synthesis of the available research is lacking. This review aimed to systematically summarize the available evidence of longitudinal studies linking shift work with metabolic risk factors. A systematic literature search was performed in 2015. Studies were included if (1) they had a longitudinal design; (2) shift work was studied as the exposure; and (3) the outcome involved a metabolic risk factor, including anthropometric, blood glucose, blood lipid, or blood pressure measures. Eligible studies were assessed for their methodologic quality in 2015. A best-evidence synthesis was used to draw conclusions per outcome. Thirty-nine articles describing 22 studies were included. Strong evidence was found for a relation between shift work and increased body weight/BMI, risk for overweight, and impaired glucose tolerance. For the remaining outcomes, there was insufficient evidence. Shift work seems to be associated with body weight gain, risk for overweight, and impaired glucose tolerance. Overall, lack of high-methodologic quality studies and inconsistency in findings led to insufficient evidence in assessing the relation between shift work and other metabolic risk factors. To strengthen the evidence, more high-quality longitudinal studies that provide more information on the shift work schedule (e.g., frequency of night shifts, duration in years) are needed. Further, research to the (mediating) role of lifestyle behaviors in the health effects of shift work is recommended, as this may offer potential for preventive strategies. Copyright © 2016. Published by Elsevier Inc.

  13. HIV susceptibility among clients of female sex workers in Indonesia: a qualitative inquiry.

    PubMed

    Mwanri, Lillian; Fauk, Nelsensius Klau; Kustanti, Christina Yeni; Ambarwati, Atik; Merry, Maria Silvia

    2018-02-15

    Background: The spread of HIV infection among men in Indonesia continues to increase every year. Clients of female sex workers (FSWs) are a group at higher risk of acquiring HIV infection due to their frequent engagement in sexual acts with sex workers. This study aimed to identify factors of susceptibility to HIV infection among clients of FSWs. Methods: A qualitative inquiry using one-on-one in-depth interviews was conducted in the Belu and Malaka districts of Indonesia from January to April 2017. The study participants (n =42) were the clients of FSWs recruited using the snowball sampling technique. The inclusion criteria were: being a client of FSWs and being aged 18 years or more. Data were analysed using a framework analysis. Results: Findings were grouped into two main emerging themes that included behavioural and socioeconomic factors. Behavioural factors that mediated HIV susceptibility among clients of FSWs were: frequent engagement in unsafe sex with multiple sex workers; low perceptions of the relevance of available HIV and AIDS services and limited access to these services; and HIV stigma or fear of being labelled as HIV positive. Socioeconomic factors included: participants' economic situation; and individuals' household responsibility and ability to afford FSWs services. Conclusions: The study results indicate the need to reformulate and improve HIV and AIDS-related services, including increasing the level of availability of HIV service points and the dissemination of knowledge and information about HIV and AIDS and condom use and making them accessible to both FSWs and their clients in Belu and Malaka districts.

  14. [Development of the Feelings toward Nature Scale and relationship between feelings toward nature and proximity to nature].

    PubMed

    Shibata, Seiji

    2016-04-01

    In the field of environmental psychology, there is rapidly growing interest in the concept of connectivity with nature, describing an individual's sense of being connected with nature. The author developed a new scale for assessing feelings toward nature, including connectedness. Confirmatory factor analysis indicated a five-factor model consisting of restorativeness, oneness, mystery, care, and aversion. Then, the relationships among availability of nature in respondents' neighborhood, age, and each subscale score of the Feelings toward Nature Scale, were analyzed using structural equation modeling. The availability of nature in neighborhoods was assessed using a geographic information system and respondents' subjective evaluations. Results indicate that overall connectedness to nature is weaker as availability of nature decreases, as assessed by subjective evaluation. Results also suggest that aversion toward nature in younger people is relatively stronger than in older generations.

  15. 78 FR 31554 - Proposed Data Collections Submitted for Public Comment and Recommendations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-24

    ... Brief Description Cardiovascular disease (CVD), which includes heart disease, myocardial infarction, and... assess the effectiveness of the WISEWOMAN program in reducing the burden of cardiovascular disease risk... incidence, cardiovascular disease risk-factors, health promotion, to improve the availability of screening...

  16. 7 CFR 3550.53 - Eligibility requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... available will be determined based on factors including, but not limited to: Distance, travel time... requirements. (a) Income eligibility. At the time of loan approval, the household's adjusted income must not... unless the applicant will be discharged within a reasonable period of time. (2) Because of the...

  17. Healthy casetas: A potential strategy to improve the food environment in low-income schools to reduce obesity in children in Guatemala City.

    PubMed

    Pehlke, Elisa L; Letona, Paola; Ramirez-Zea, Manuel; Gittelsohn, Joel

    2016-01-01

    Developing countries have undergone transitions driven by globalization and development, accelerating increases in prevalence of overweight and obesity among children. Schools have been identified as effective settings for interventions that target children's dietary behaviors. In Guatemala, public schools commonly have food kiosks (Casetas) that sell products to children. From July through October 2013, observations during recess, in-depth interviews with school principals (n = 4) and caseta vendors (n = 4), and focus groups with children (n = 48) were conducted. This article explores products available to children at casetas. Factors that affect what casetas offer include regulations and enforcement, vendor investment and earnings, vendor resources, product demand, pricing, and children's preferences. These factors influence the products that are available and children's tendency to purchase them. Potential strategies for improvement include healthy food preparation, price manipulation and promotions, raffles and games to encourage healthier choices, and policy to push toward development of healthier products.

  18. Behavior Correlates of Post-Stroke Disability Using Data Mining and Infographics.

    PubMed

    Yoon, Sunmoo; Gutierrez, Jose

    Disability is a potential risk for stroke survivors. This study aims to identify disability risk factors associated with stroke and their relative importance and relationships from a national behavioral risk factor dataset. Data of post-stroke individuals in the U.S (n=19,603) including 397 variables were extracted from a publically available national dataset and analyzed. Data mining algorithms including C4.5 and linear regression with M5s methods were applied to build association models for post-stroke disability using Weka software. The relative importance and relationship of 70 variables associated with disability were presented in infographics for clinicians to understand easily. Fifty-five percent of post-stroke patients experience disability. Exercise, employment and satisfaction of life were relatively important factors associated with disability among stroke patients. Modifiable behavior factors strongly associated with disability include exercise (OR: 0.46, P<0.01) and good rest (OR 0.37, P<0.01). Data mining is promising to discover factors associated with post-stroke disability from a large population dataset. The findings can be potentially valuable for establishing the priorities for clinicians and researchers and for stroke patient education. The methods may generalize to other health conditions.

  19. The global burden of respiratory infections in indigenous children and adults: A review.

    PubMed

    Basnayake, Thilini L; Morgan, Lucy C; Chang, Anne B

    2017-11-01

    This review article focuses on common lower respiratory infections (LRIs) in indigenous populations in both developed and developing countries, where data is available. Indigenous populations across the world share some commonalities including poorer health and socio-economic disadvantage compared with their non-indigenous counterparts. Generally, acute and chronic respiratory infections are more frequent and more severe in both indigenous children and adults, often resulting in substantial consequences including higher rates of bronchiectasis and poorer outcomes for patients with chronic obstructive pulmonary disease (COPD). Risk factors for the development of respiratory infections require recognition and action. These risk factors include but are not limited to socio-economic factors (e.g. education, household crowding and nutrition), environmental factors (e.g. smoke exposure and poor access to health care) and biological factors. Risk mitigation strategies should be delivered in a culturally appropriate manner and targeted to educate both individuals and communities at risk. Improving the morbidity and mortality of respiratory infections in indigenous people requires provision of best practice care and awareness of the scope of the problem by healthcare practitioners, governing bodies and policy makers. © 2017 Asian Pacific Society of Respirology.

  20. Behavior Correlates of Post-Stroke Disability Using Data Mining and Infographics

    PubMed Central

    Yoon, Sunmoo; Gutierrez, Jose

    2015-01-01

    Purpose Disability is a potential risk for stroke survivors. This study aims to identify disability risk factors associated with stroke and their relative importance and relationships from a national behavioral risk factor dataset. Methods Data of post-stroke individuals in the U.S (n=19,603) including 397 variables were extracted from a publically available national dataset and analyzed. Data mining algorithms including C4.5 and linear regression with M5s methods were applied to build association models for post-stroke disability using Weka software. The relative importance and relationship of 70 variables associated with disability were presented in infographics for clinicians to understand easily. Results Fifty-five percent of post-stroke patients experience disability. Exercise, employment and satisfaction of life were relatively important factors associated with disability among stroke patients. Modifiable behavior factors strongly associated with disability include exercise (OR: 0.46, P<0.01) and good rest (OR 0.37, P<0.01). Conclusions Data mining is promising to discover factors associated with post-stroke disability from a large population dataset. The findings can be potentially valuable for establishing the priorities for clinicians and researchers and for stroke patient education. The methods may generalize to other health conditions. PMID:26835413

  1. Factors that influence case managers' resource allocation decisions in pediatric home care: an ethnographic study.

    PubMed

    Fraser, Kimberly D; Estabrooks, Carole; Allen, Marion; Strang, Vicki

    2009-03-01

    Case managers make decisions that directly affect the amount and type of services home care clients receive and subsequently affect the overall available health care resources of home care programs. A recent systematic review of the literature identified significant knowledge gaps with respect to resource allocation decision-making in home care. Using Spradley's methodology, we designed an ethnographic study of a children's home care program in Western Canada. The sample included 11 case managers and program leaders. Data sources included interviews, card sorts, and participant observation over a 5-month period. Data analyses included open coding, domain, taxonomic, and componential analysis. One of the key findings was a taxonomy of factors that influence case manager resource allocation decisions. The factors were grouped into one of four main categories: system-related, home care program-related, family related, or client-related. Family related factors have not been previously reported as influencing case manager resource allocation decision-making and nor has the team's role been reported as an influencing factor. The findings of this study are examined in light of Daniels and Sabin's Accountability for Reasonableness framework, which may be useful for future knowledge development about micro-level resource allocation theory.

  2. Emerging growth factor receptor antagonists for the treatment of renal cell carcinoma.

    PubMed

    Zahoor, Haris; Rini, Brian I

    2016-12-01

    The landscape of systemic treatment for metastatic renal cell carcinoma (RCC) has dramatically changed with the introduction of targeted agents including vascular endothelial growth factor (VEGF) inhibitors. Recently, multiple new agents including growth factor receptor antagonists and a checkpoint inhibitor were approved for the treatment of refractory metastatic RCC based on encouraging benefit shown in clinical trials. Areas covered: The background and biological rationale of existing treatment options including a brief discussion of clinical trials which led to their approval, is presented. This is followed by reviewing the limitations of these therapeutic options, medical need to develop new treatments and major goals of ongoing research. We then discuss two recently approved growth factor receptor antagonists i.e. cabozantinib and lenvatinib, and a recently approved checkpoint inhibitor, nivolumab, and issues pertaining to drug development, and future directions in treatment of metastatic RCC. Expert opinion: Recently approved growth factor receptor antagonists have shown encouraging survival benefit but associated drug toxicity is a major issue. Nivolumab, a programmed death 1 (PD-1) checkpoint inhibitor, has similarly shown survival benefit and is well tolerated. With multiple options now available in this patient population, the right sequence of these agents remains to be determined.

  3. Downscaling Land Surface Temperature in Complex Regions by Using Multiple Scale Factors with Adaptive Thresholds

    PubMed Central

    Yang, Yingbao; Li, Xiaolong; Pan, Xin; Zhang, Yong; Cao, Chen

    2017-01-01

    Many downscaling algorithms have been proposed to address the issue of coarse-resolution land surface temperature (LST) derived from available satellite-borne sensors. However, few studies have focused on improving LST downscaling in urban areas with several mixed surface types. In this study, LST was downscaled by a multiple linear regression model between LST and multiple scale factors in mixed areas with three or four surface types. The correlation coefficients (CCs) between LST and the scale factors were used to assess the importance of the scale factors within a moving window. CC thresholds determined which factors participated in the fitting of the regression equation. The proposed downscaling approach, which involves an adaptive selection of the scale factors, was evaluated using the LST derived from four Landsat 8 thermal imageries of Nanjing City in different seasons. Results of the visual and quantitative analyses show that the proposed approach achieves relatively satisfactory downscaling results on 11 August, with coefficient of determination and root-mean-square error of 0.87 and 1.13 °C, respectively. Relative to other approaches, our approach shows the similar accuracy and the availability in all seasons. The best (worst) availability occurred in the region of vegetation (water). Thus, the approach is an efficient and reliable LST downscaling method. Future tasks include reliable LST downscaling in challenging regions and the application of our model in middle and low spatial resolutions. PMID:28368301

  4. Insight into implementation of facility-based integrated management of childhood illness strategy in a rural district of Sindh, Pakistan.

    PubMed

    Pradhan, Nousheen Akber; Rizvi, Narjis; Sami, Neelofar; Gul, Xaher

    2013-07-05

    Integrated management of childhood illnesses (IMCI) strategy has been proven to improve health outcomes in children under 5 years of age. Pakistan, despite being in the late implementation phase of the strategy, continues to report high under-five mortality due to pneumonia, diarrhea, measles, and malnutrition - the main targets of the strategy. The study determines the factors influencing IMCI implementation at public-sector primary health care (PHC) facilities in Matiari district, Sindh, Pakistan. An exploratory qualitative study with an embedded quantitative strand was conducted. The qualitative part included 16 in-depth interviews (IDIs) with stakeholders which included planners and policy makers at a provincial level (n=5), implementers and managers at a district level (n=3), and IMCI-trained physicians posted at PHC facilities (n=8). Quantitative part included PHC facility survey (n=16) utilizing WHO health facility assessment tool to assess availability of IMCI essential drugs, supplies, and equipments. Qualitative content analysis was used to interpret the textual information, whereas descriptive frequencies were calculated for health facility survey data. The major factors reported to enhance IMCI implementation were knowledge and perception about the strategy and need for separate clinic for children aged under 5 years as potential support factors. The latter can facilitate in strategy implementation through allocated workforce and required equipments and supplies. Constraint factors mainly included lack of clear understanding of the strategy, poor planning for IMCI implementation, ambiguity in defined roles and responsibilities among stakeholders, and insufficient essential supplies and drugs at PHC centers. The latter was further substantiated through health facilities' survey findings, which indicated that none of the facilities had 100% stock of essential supplies and drugs. Only one out of all 16 surveyed facilities had 75% of the total supplies, while 4 out of 16 facilities had 56% of the required IMCI drug stock. The mean availability of supplies ranged from 36.6 to 66%, while the mean availability of drugs ranged from 45.8 to 56.7%. Our findings indicate that the Matiari district has sound implementation potential; however, bottlenecks at health care facility and at health care management level have badly constrained the implementation process. An interdependency exists among the constraining factors, such as lack of sound planning resulting in unclear understanding of the strategy; leading to ambiguous roles and responsibilities among stakeholders which manifest as inadequate availability of supplies and drugs at PHC facilities. Addressing these barriers is likely to have a cumulative effect on facilitating IMCI implementation. On the basis of these findings, we recommend that the provincial Ministry of Health (MoH) and provincial Maternal Neonatal and Child Health (MNCH) program jointly assess the situation and streamline IMCI implementation in the district through sound planning, training, supervision, and logistic support.

  5. Evolutionary insights from Erwinia amylovora genomics.

    PubMed

    Smits, Theo H M; Rezzonico, Fabio; Duffy, Brion

    2011-08-20

    Evolutionary genomics is coming into focus with the recent availability of complete sequences for many bacterial species. A hypothesis on the evolution of virulence factors in the plant pathogen Erwinia amylovora, the causative agent of fire blight, was generated using comparative genomics with the genomes E. amylovora, Erwinia pyrifoliae and Erwinia tasmaniensis. Putative virulence factors were mapped to the proposed genealogy of the genus Erwinia that is based on phylogenetic and genomic data. Ancestral origin of several virulence factors was identified, including levan biosynthesis, sorbitol metabolism, three T3SS and two T6SS. Other factors appeared to have been acquired after divergence of pathogenic species, including a second flagellar gene and two glycosyltransferases involved in amylovoran biosynthesis. E. amylovora singletons include 3 unique T3SS effectors that may explain differential virulence/host ranges. E. amylovora also has a unique T1SS export system, and a unique third T6SS gene cluster. Genetic analysis revealed signatures of foreign DNA suggesting that horizontal gene transfer is responsible for some of these differential features between the three species. Copyright © 2010 Elsevier B.V. All rights reserved.

  6. Risk Factors for Opioid-Use Disorder and Overdose.

    PubMed

    Webster, Lynn R

    2017-11-01

    Opioid analgesics are recognized as a legitimate medical therapy for selected patients with severe chronic pain that does not respond to other therapies. However, opioids are associated with risks for patients and society that include misuse, abuse, diversion, addiction, and overdose deaths. Therapeutic success depends on proper candidate selection, assessment before administering opioid therapy, and close monitoring throughout the course of treatment. Risk assessment and prevention include knowledge of patient factors that may contribute to misuse, abuse, addiction, suicide, and respiratory depression. Risk factors for opioid misuse or addiction include past or current substance abuse, untreated psychiatric disorders, younger age, and social or family environments that encourage misuse. Opioid mortality prevalence is higher in people who are middle aged and have substance abuse and psychiatric comorbidities. Suicides are probably undercounted or frequently misclassified in reports of opioid-related poisoning deaths. Greater understanding and better assessment are needed of the risk associated with suicide risk in patients with pain. Clinical tools and an evolving evidence base are available to assist clinicians with identifying patients whose risk factors put them at risk for adverse outcomes with opioids.

  7. Can health indicators help policy-makers? Experience from European system of urban health indicators (EURO-URHIS).

    PubMed

    Torun, Perihan; Heller, Richard F; Harrison, Annie; Verma, Arpana

    2017-05-01

    This paper proposes that Population Impact Measures (PIMs), the Population Impact Number of Eliminating a Risk Factor over a time period (PIN-ER-t) and the number of events prevented in your population (NEPP), can assist in policy making as they include relevant information which describes the impact or benefits to the population of risk factors and interventions. In this study, we explore the utilization of the indicators from European System of Urban Health Indicators System to produce the two PIMs. We identified from the indicators list the health determinants, health status and health interventions which can be linked, and searched Medline for evidence of association. We then investigated whether the type of frequency measure available for the indicator match with the measure used in PIMs, and explored data availability for the City of Manchester (UK) as an urban area. Of the 39 indicators relevant to socio-economic factors, health determinants and health status, it was possible to calculate the population impact of a risk factor, i.e. the PIN-ER-t, for only six associations, and the population impact of health interventions, i.e. NEPP, for only one out of the three listed indicators, as the relevant health conditions were not included. The results of this study suggest that if an indicator system is intended to play a part in the policy making process, then the method of presentation to policy-makers should be decided before setting up the system, as it is likely that some indicators which would be essential might not be available. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  8. Climate change impacts on food system

    NASA Astrophysics Data System (ADS)

    Zhang, X.; Cai, X.; Zhu, T.

    2014-12-01

    Food system includes biophysical factors (climate, land and water), human environments (production technologies and food consumption, distribution and marketing), as well as the dynamic interactions within them. Climate change affects agriculture and food systems in various ways. Agricultural production can be influenced directly by climatic factors such as mean temperature rising, change in rainfall patterns, and more frequent extreme events. Eventually, climate change could cause shift of arable land, alteration of water availability, abnormal fluctuation of food prices, and increase of people at risk of malnutrition. This work aims to evaluate how climate change would affect agricultural production biophysically and how these effects would propagate to social factors at the global level. In order to model the complex interactions between the natural and social components, a Global Optimization model of Agricultural Land and Water resources (GOALW) is applied to the analysis. GOALW includes various demands of human society (food, feed, other), explicit production module, and irrigation water availability constraint. The objective of GOALW is to maximize global social welfare (consumers' surplus and producers' surplus).Crop-wise irrigation water use in different regions around the world are determined by the model; marginal value of water (MVW) can be obtained from the model, which implies how much additional welfare benefit could be gained with one unit increase in local water availability. Using GOALW, we will analyze two questions in this presentation: 1) how climate change will alter irrigation requirements and how the social system would buffer that by price/demand adjustment; 2) how will the MVW be affected by climate change and what are the controlling factors. These results facilitate meaningful insights for investment and adaptation strategies in sustaining world's food security under climate change.

  9. Development of new geomagnetic storm ground response scaling factors for utilization in hazard assessments

    NASA Astrophysics Data System (ADS)

    Pulkkinen, A. A.; Bernabeu, E.; Weigel, R. S.; Kelbert, A.; Rigler, E. J.; Bedrosian, P.; Love, J. J.

    2017-12-01

    Development of realistic storm scenarios that can be played through the exposed systems is one of the key requirements for carrying out quantitative space weather hazards assessments. In the geomagnetically induced currents (GIC) and power grids context, these scenarios have to quantify the spatiotemporal evolution of the geoelectric field that drives the potentially hazardous currents in the system. In response to the Federal Energy Regulatory Commission (FERC) order 779, a team of scientists and engineers that worked under the auspices of North American Electric Reliability Corporation (NERC), has developed extreme geomagnetic storm and geoelectric field benchmark(s) that use various scaling factors that account for geomagnetic latitude and ground structure of the locations of interest. These benchmarks, together with the information generated in the National Space Weather Action Plan, are the foundation for the hazards assessments that the industry will be carrying out in response to the FERC order and under the auspices of the National Science and Technology Council. While the scaling factors developed in the past work were based on the best available information, there is now significant new information available for parts of the U.S. pertaining to the ground response to external geomagnetic field excitation. The significant new information includes the results magnetotelluric surveys that have been conducted over the past few years across the contiguous US and results from previous surveys that have been made available in a combined online database. In this paper, we distill this new information in the framework of the NERC benchmark and in terms of updated ground response scaling factors thereby allowing straightforward utilization in the hazard assessments. We also outline the path forward for improving the overall extreme event benchmark scenario(s) including generalization of the storm waveforms and geoelectric field spatial patterns.

  10. Joint effects of climate variability and socioecological factors on dengue transmission: epidemiological evidence.

    PubMed

    Akter, Rokeya; Hu, Wenbiao; Naish, Suchithra; Banu, Shahera; Tong, Shilu

    2017-06-01

    To assess the epidemiological evidence on the joint effects of climate variability and socioecological factors on dengue transmission. Following PRISMA guidelines, a detailed literature search was conducted in PubMed, Web of Science and Scopus. Peer-reviewed, freely available and full-text articles, considering both climate and socioecological factors in relation to dengue, published in English from January 1993 to October 2015 were included in this review. Twenty studies have met the inclusion criteria and assessed the impact of both climatic and socioecological factors on dengue dynamics. Among those, four studies have further investigated the relative importance of climate variability and socioecological factors on dengue transmission. A few studies also developed predictive models including both climatic and socioecological factors. Due to insufficient data, methodological issues and contextual variability of the studies, it is hard to draw conclusion on the joint effects of climate variability and socioecological factors on dengue transmission. Future research should take into account socioecological factors in combination with climate variables for a better understanding of the complex nature of dengue transmission as well as for improving the predictive capability of dengue forecasting models, to develop effective and reliable early warning systems. © 2017 John Wiley & Sons Ltd.

  11. Prognostic factors for return-to-work following surgery for carpal tunnel syndrome: a systematic review.

    PubMed

    Peters, Susan; Johnston, Venerina; Hines, Sonia; Ross, Mark; Coppieters, Michel

    2016-09-01

    Carpal tunnel syndrome (CTS) is a common problem, that can be effectively managed by surgery. Screening for prognostic factors is important to identify workers who are at a greater risk of a poor work outcome in order to implement tailored interventions to facilitate their return-to-work. To synthesize the best available evidence on the association of preoperative prognostic factors with work-related outcomes in people who have undergone carpal tunnel surgery. Participants included those who were employed at the time of surgery, underwent carpal tunnel surgery and planned to return-to-work. The primary outcome was return-to-work. Quantitative studies investigating at least one prognostic factor for a work-related outcome in studies of workers who had carpal tunnel surgery were considered. Eleven electronic databases were searched from their respective inception date up to July 2015. A total of 3893 publications were reviewed. The quality of the included studies was assessed by two reviewers using a modified version of an appraisal tool (Joanna Briggs Institute Meta-analysis of Statistical Assessment and Review Instrument [JBI-MAStARI]). The following criteria were evaluated: study population representativeness, clearly defined prognostic factors and outcomes, potential confounding variables and appropriate statistical analysis. Data extraction was performed using a modified version of the standardized extraction tool from JBI-MAStARI. Statistical pooling was not possible. Findings are presented in tables and narrative format. Eleven studies (13 publications) investigating 93 prognostic factors for delayed return-to-work or prolonged work disability outcomes and 27 prognostic factors for work role functioning in 4187 participants were identified.Prognostic factors associated with workers' increased likelihood of an earlier return-to-work in a moderate-to-high-quality study included worker expected or desired fewer days off work, occupation, lower pain anxiety and if CTS had not altered their work role.Prognostic factors for a poorer work-related outcome included older age, lower household income, greater upper extremity functional limitation, greater than two musculoskeletal pain sites, lower recovery expectations, worse mental health status, job accommodation availability, high job strain, high job demands with high job control, poor co-worker relationships, poor baseline work role functioning, less-supportive workplace policies, preoperative work absence due to CTS or work disability of any cause, workers' compensation status, attorney involvement, and post-diagnosis surgical wait time. For workers who have had carpal tunnel surgery, there are a number of factors which may be modified in order to improve return-to-work times.

  12. Aspect has a greater impact on alpine soil bacterial community structure than elevation.

    PubMed

    Wu, Jieyun; Anderson, Barbara J; Buckley, Hannah L; Lewis, Gillian; Lear, Gavin

    2017-03-01

    Gradients in environmental conditions, including climate factors and resource availability, occur along mountain inclines, providing a 'natural laboratory' to explore their combined impacts on microbial distributions. Conflicting spatial patterns observed across elevation gradients in soil bacterial community structure suggest that they are driven by various interacting factors at different spatial scales. Here, we investigated the relative impacts of non-resource (e.g. soil temperature, pH) and resource conditions (e.g. soil carbon and nitrogen) on the biogeography of soil bacterial communities across broad (i.e. along a 1500 m mountain elevation gradient) and fine sampling scales (i.e. along sunny and shady aspects of a mountain ridge). Our analysis of 16S rRNA gene data confirmed that when sampling across distances of < 1000 m, bacterial community composition was more closely related to the aspect of a site than its elevation. However, despite large differences in climate and resource-availability factors across elevation- and aspect-related gradients, bacterial community composition and richness were most strongly correlated with soil pH. These findings highlight the need to incorporate knowledge of multiple factors, including site aspect and soil pH for the appropriate use of elevation gradients as a proxy to explore the impacts of climate change on microbial community composition. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Sources of Free and Open Source Spatial Data for Natural Disasters and Principles for Use in Developing Country Contexts

    NASA Astrophysics Data System (ADS)

    Taylor, Faith E.; Malamud, Bruce D.; Millington, James D. A.

    2016-04-01

    Access to reliable spatial and quantitative datasets (e.g., infrastructure maps, historical observations, environmental variables) at regional and site specific scales can be a limiting factor for understanding hazards and risks in developing country settings. Here we present a 'living database' of >75 freely available data sources relevant to hazard and risk in Africa (and more globally). Data sources include national scientific foundations, non-governmental bodies, crowd-sourced efforts, academic projects, special interest groups and others. The database is available at http://tinyurl.com/africa-datasets and is continually being updated, particularly in the context of broader natural hazards research we are doing in the context of Malawi and Kenya. For each data source, we review the spatiotemporal resolution and extent and make our own assessments of reliability and usability of datasets. Although such freely available datasets are sometimes presented as a panacea to improving our understanding of hazards and risk in developing countries, there are both pitfalls and opportunities unique to using this type of freely available data. These include factors such as resolution, homogeneity, uncertainty, access to metadata and training for usage. Based on our experience, use in the field and grey/peer-review literature, we present a suggested set of guidelines for using these free and open source data in developing country contexts.

  14. Considerations Before Establishing an Environmental Health Registry

    PubMed Central

    Muravov, Oleg I.; Sapp, James; Larson, Theodore C.; Pallos, L. Laszlo; Sanchez, Marchelle E.; Williamson, G. David; Horton, D. Kevin

    2015-01-01

    Public health registries can provide valuable information when health consequences of environmental exposures are uncertain or will likely take long to develop. They can also aid research on diseases that may have environmental causes that are not completely well defined. We discuss factors to consider when deciding whether to create an environmental health registry. Those factors include public health significance, purpose and outcomes, duration and scope of data collection and availability of alternative data sources, timeliness, availability of funding and administrative capabilities, and whether the establishment of a registry can adequately address specific health concerns. We also discuss difficulties, limitations, and benefits of exposure and disease registries, based on the experience of the Agency for Toxic Substances and Disease Registry. PMID:26066912

  15. Methodological advances: using greenhouses to simulate climate change scenarios.

    PubMed

    Morales, F; Pascual, I; Sánchez-Díaz, M; Aguirreolea, J; Irigoyen, J J; Goicoechea, N; Antolín, M C; Oyarzun, M; Urdiain, A

    2014-09-01

    Human activities are increasing atmospheric CO2 concentration and temperature. Related to this global warming, periods of low water availability are also expected to increase. Thus, CO2 concentration, temperature and water availability are three of the main factors related to climate change that potentially may influence crops and ecosystems. In this report, we describe the use of growth chamber - greenhouses (GCG) and temperature gradient greenhouses (TGG) to simulate climate change scenarios and to investigate possible plant responses. In the GCG, CO2 concentration, temperature and water availability are set to act simultaneously, enabling comparison of a current situation with a future one. Other characteristics of the GCG are a relative large space of work, fine control of the relative humidity, plant fertirrigation and the possibility of light supplementation, within the photosynthetic active radiation (PAR) region and/or with ultraviolet-B (UV-B) light. In the TGG, the three above-mentioned factors can act independently or in interaction, enabling more mechanistic studies aimed to elucidate the limiting factor(s) responsible for a given plant response. Examples of experiments, including some aimed to study photosynthetic acclimation, a phenomenon that leads to decreased photosynthetic capacity under long-term exposures to elevated CO2, using GCG and TGG are reported. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Factors influencing the occupational trajectory of patients with systemic sclerosis: a qualitative study.

    PubMed

    Decuman, Saskia; Smith, Vanessa; Grypdonck, Maria; De Keyser, Filip; Verhaeghe, Sofie

    2015-01-01

    To describe, from the patient's point of view, the factors influencing the occupational trajectory of patients with systemic sclerosis (SSc). This was a qualitative study designed using grounded theory with constant comparison. Data were collected through semi-structured interviews with 14 patients who fulfilled the American College of Rheumatology or Leroy-Medsger criteria for SSc. Based on our interviews, we found that the occupational trajectory of patients with SSc is influenced by the continuous interplay between four groups of factors. The first group concerns the values patients attribute to work, including identity, normality, financial value, social contact, and structure. The meaning of these values and how they relate to each other underlies the desire to work. A second group of factors is those influencing the balance between daily life, work participation, and medical condition (e.g. job content, flexibility in organising work, and the willingness to ask for accommodations at work). The occupational trajectory is also influenced by external factors, including availability of support, know-ledge of the disease, pressure to work, contact with medical professionals, and existing regulations and the patient's knowledge about them. Finally, the occupational trajectory is influenced by personal factors, including socio-demographics, psychological assets, and disease- and work-related personal factors. The decisions patients with SSc take concerning work depend on an interplay between many factors and, especially, on the patients' personal interpretation of these factors. These need to be taken into account when helping patients with SSc determine their occupational trajectory.

  17. How to address data gaps in life cycle inventories: a case study on estimating CO2 emissions from coal-fired electricity plants on a global scale.

    PubMed

    Steinmann, Zoran J N; Venkatesh, Aranya; Hauck, Mara; Schipper, Aafke M; Karuppiah, Ramkumar; Laurenzi, Ian J; Huijbregts, Mark A J

    2014-05-06

    One of the major challenges in life cycle assessment (LCA) is the availability and quality of data used to develop models and to make appropriate recommendations. Approximations and assumptions are often made if appropriate data are not readily available. However, these proxies may introduce uncertainty into the results. A regression model framework may be employed to assess missing data in LCAs of products and processes. In this study, we develop such a regression-based framework to estimate CO2 emission factors associated with coal power plants in the absence of reported data. Our framework hypothesizes that emissions from coal power plants can be explained by plant-specific factors (predictors) that include steam pressure, total capacity, plant age, fuel type, and gross domestic product (GDP) per capita of the resident nations of those plants. Using reported emission data for 444 plants worldwide, plant level CO2 emission factors were fitted to the selected predictors by a multiple linear regression model and a local linear regression model. The validated models were then applied to 764 coal power plants worldwide, for which no reported data were available. Cumulatively, available reported data and our predictions together account for 74% of the total world's coal-fired power generation capacity.

  18. The transcription factor encyclopedia.

    PubMed

    Yusuf, Dimas; Butland, Stefanie L; Swanson, Magdalena I; Bolotin, Eugene; Ticoll, Amy; Cheung, Warren A; Zhang, Xiao Yu Cindy; Dickman, Christopher T D; Fulton, Debra L; Lim, Jonathan S; Schnabl, Jake M; Ramos, Oscar H P; Vasseur-Cognet, Mireille; de Leeuw, Charles N; Simpson, Elizabeth M; Ryffel, Gerhart U; Lam, Eric W-F; Kist, Ralf; Wilson, Miranda S C; Marco-Ferreres, Raquel; Brosens, Jan J; Beccari, Leonardo L; Bovolenta, Paola; Benayoun, Bérénice A; Monteiro, Lara J; Schwenen, Helma D C; Grontved, Lars; Wederell, Elizabeth; Mandrup, Susanne; Veitia, Reiner A; Chakravarthy, Harini; Hoodless, Pamela A; Mancarelli, M Michela; Torbett, Bruce E; Banham, Alison H; Reddy, Sekhar P; Cullum, Rebecca L; Liedtke, Michaela; Tschan, Mario P; Vaz, Michelle; Rizzino, Angie; Zannini, Mariastella; Frietze, Seth; Farnham, Peggy J; Eijkelenboom, Astrid; Brown, Philip J; Laperrière, David; Leprince, Dominique; de Cristofaro, Tiziana; Prince, Kelly L; Putker, Marrit; del Peso, Luis; Camenisch, Gieri; Wenger, Roland H; Mikula, Michal; Rozendaal, Marieke; Mader, Sylvie; Ostrowski, Jerzy; Rhodes, Simon J; Van Rechem, Capucine; Boulay, Gaylor; Olechnowicz, Sam W Z; Breslin, Mary B; Lan, Michael S; Nanan, Kyster K; Wegner, Michael; Hou, Juan; Mullen, Rachel D; Colvin, Stephanie C; Noy, Peter John; Webb, Carol F; Witek, Matthew E; Ferrell, Scott; Daniel, Juliet M; Park, Jason; Waldman, Scott A; Peet, Daniel J; Taggart, Michael; Jayaraman, Padma-Sheela; Karrich, Julien J; Blom, Bianca; Vesuna, Farhad; O'Geen, Henriette; Sun, Yunfu; Gronostajski, Richard M; Woodcroft, Mark W; Hough, Margaret R; Chen, Edwin; Europe-Finner, G Nicholas; Karolczak-Bayatti, Magdalena; Bailey, Jarrod; Hankinson, Oliver; Raman, Venu; LeBrun, David P; Biswal, Shyam; Harvey, Christopher J; DeBruyne, Jason P; Hogenesch, John B; Hevner, Robert F; Héligon, Christophe; Luo, Xin M; Blank, Marissa Cathleen; Millen, Kathleen Joyce; Sharlin, David S; Forrest, Douglas; Dahlman-Wright, Karin; Zhao, Chunyan; Mishima, Yuriko; Sinha, Satrajit; Chakrabarti, Rumela; Portales-Casamar, Elodie; Sladek, Frances M; Bradley, Philip H; Wasserman, Wyeth W

    2012-01-01

    Here we present the Transcription Factor Encyclopedia (TFe), a new web-based compendium of mini review articles on transcription factors (TFs) that is founded on the principles of open access and collaboration. Our consortium of over 100 researchers has collectively contributed over 130 mini review articles on pertinent human, mouse and rat TFs. Notable features of the TFe website include a high-quality PDF generator and web API for programmatic data retrieval. TFe aims to rapidly educate scientists about the TFs they encounter through the delivery of succinct summaries written and vetted by experts in the field. TFe is available at http://www.cisreg.ca/tfe.

  19. A Concept Mapping Study of Physicians' Perceptions of Factors Influencing Management and Control of Hypertension in Sub-Saharan Africa

    PubMed Central

    Iwelunmor, Juliet; Blackstone, Sarah; Gyamfi, Joyce; Airhihenbuwa, Collins; Plange-Rhule, Jacob; Tayo, Bamidele; Adanu, Richard; Ogedegbe, Gbenga

    2015-01-01

    Hypertension, once a rare problem in Sub-Saharan Africa (SSA), is predicted to be a major cause of death by 2020 with mortality rates as high as 75%. However, comprehensive knowledge of provider-level factors that influence optimal management is limited. The objective of the current study was to discover physicians' perceptions of factors influencing optimal management and control of hypertension in SSA. Twelve physicians attending the Cardiovascular Research Training (CaRT) Institute at the University of Ghana, College of Health Sciences, were invited to complete a concept mapping process that included brainstorming the factors influencing optimal management and control of hypertension in patients, sorting and organizing the factors into similar domains, and rating the importance and feasibility of efforts to address these factors. The highest ranked important and feasible factors include helping patients accept their condition and availability of adequate equipment to enable the provision of needed care. The findings suggest that patient self-efficacy and support, physician-related factors, policy factors, and economic factors are important aspects that must be addressed to achieve optimal hypertension management. Given the work demands identified by physicians, future research should investigate cost-effective strategies of shifting physician responsibilities to well-trained no-physician clinicians in order to improve hypertension management. PMID:26550488

  20. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2013-04

    DOT National Transportation Integrated Search

    2013-04-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  1. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2014-03

    DOT National Transportation Integrated Search

    2014-03-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  2. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2013-07

    DOT National Transportation Integrated Search

    2013-07-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  3. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2013-10

    DOT National Transportation Integrated Search

    2013-10-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  4. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2012-07

    DOT National Transportation Integrated Search

    2012-07-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  5. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2011-03

    DOT National Transportation Integrated Search

    2011-03-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  6. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2011-07

    DOT National Transportation Integrated Search

    2011-07-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  7. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2012-02

    DOT National Transportation Integrated Search

    2012-02-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  8. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2011-04

    DOT National Transportation Integrated Search

    2011-04-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  9. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2012-03

    DOT National Transportation Integrated Search

    2012-03-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  10. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2006-12

    DOT National Transportation Integrated Search

    2006-12-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  11. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2009-02

    DOT National Transportation Integrated Search

    2009-02-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  12. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2011-05

    DOT National Transportation Integrated Search

    2011-05-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  13. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2014-06

    DOT National Transportation Integrated Search

    2014-06-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  14. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2013-09

    DOT National Transportation Integrated Search

    2013-09-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  15. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2010-03

    DOT National Transportation Integrated Search

    2010-03-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  16. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2012-12

    DOT National Transportation Integrated Search

    2012-12-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  17. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2011-06

    DOT National Transportation Integrated Search

    2011-06-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  18. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2009-07

    DOT National Transportation Integrated Search

    2009-07-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  19. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2009-08

    DOT National Transportation Integrated Search

    2009-08-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  20. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2014-02

    DOT National Transportation Integrated Search

    2014-02-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  1. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2013-05

    DOT National Transportation Integrated Search

    2013-05-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  2. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2013-03

    DOT National Transportation Integrated Search

    2013-03-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  3. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2009-01

    DOT National Transportation Integrated Search

    2009-01-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  4. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2008-12

    DOT National Transportation Integrated Search

    2008-12-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  5. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2010-01

    DOT National Transportation Integrated Search

    2010-01-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  6. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2010-10

    DOT National Transportation Integrated Search

    2010-10-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  7. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2011-02

    DOT National Transportation Integrated Search

    2011-02-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  8. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2005-12

    DOT National Transportation Integrated Search

    2005-12-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  9. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2011-01

    DOT National Transportation Integrated Search

    2011-01-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  10. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2011-12

    DOT National Transportation Integrated Search

    2011-12-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  11. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2010-12

    DOT National Transportation Integrated Search

    2010-12-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  12. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2009-10

    DOT National Transportation Integrated Search

    2009-10-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  13. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2010-02

    DOT National Transportation Integrated Search

    2010-02-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  14. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2012-06

    DOT National Transportation Integrated Search

    2012-06-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  15. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2011-08

    DOT National Transportation Integrated Search

    2011-08-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  16. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2012-10

    DOT National Transportation Integrated Search

    2012-10-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  17. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2014-04

    DOT National Transportation Integrated Search

    2014-04-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  18. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2013-08

    DOT National Transportation Integrated Search

    2013-08-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  19. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2009-12

    DOT National Transportation Integrated Search

    2009-12-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  20. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2012-08

    DOT National Transportation Integrated Search

    2012-08-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  1. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2010-08

    DOT National Transportation Integrated Search

    2010-08-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  2. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2010-06

    DOT National Transportation Integrated Search

    2010-06-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  3. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2011-10

    DOT National Transportation Integrated Search

    2011-10-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  4. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2012-04

    DOT National Transportation Integrated Search

    2012-04-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  5. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2010-04

    DOT National Transportation Integrated Search

    2010-04-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  6. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2010-05

    DOT National Transportation Integrated Search

    2010-05-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  7. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2012-11

    DOT National Transportation Integrated Search

    2012-11-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  8. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2007-12

    DOT National Transportation Integrated Search

    2007-12-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  9. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2009-04

    DOT National Transportation Integrated Search

    2009-04-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  10. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2011-09

    DOT National Transportation Integrated Search

    2011-09-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  11. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2009-06

    DOT National Transportation Integrated Search

    2009-06-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  12. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2009-05

    DOT National Transportation Integrated Search

    2009-05-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  13. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2014-01

    DOT National Transportation Integrated Search

    2014-01-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  14. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2013-02

    DOT National Transportation Integrated Search

    2013-02-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  15. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2012-01

    DOT National Transportation Integrated Search

    2012-01-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  16. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2010-07

    DOT National Transportation Integrated Search

    2010-07-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  17. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2013-12

    DOT National Transportation Integrated Search

    2013-12-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  18. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2013-01

    DOT National Transportation Integrated Search

    2013-01-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  19. Data Bank 20 - Form 41 Schedule T-1 (T-100) - Monthly US Air Carrier Capacity and Traffic Data : [2009-03

    DOT National Transportation Integrated Search

    2009-03-01

    This CD presents traffic data for all certificated and commuter air carriers, both scheduled and nonscheduled. Data includes passenger-miles, ton-miles, seat-miles, load factors, hours, enplanements, and performance. Data are available since 1974.

  20. Interactive Educational Multimedia: Coping with the Need for Increasing Data Storage.

    ERIC Educational Resources Information Center

    Malhotra, Yogesh; Erickson, Ranel E.

    1994-01-01

    Discusses the storage requirements for data forms used in interactive multimedia education and presently available storage devices. Highlights include characteristics of educational multimedia; factors determining data storage requirements; storage devices for video and audio needs; laserdiscs and videodiscs; compact discs; magneto-optical drives;…

  1. Malignant Tumors of the Female Reproductive System

    PubMed Central

    Labrèche, France

    2012-01-01

    This review summarizes the epidemiology of cancer of the female reproductive system and associated lifestyle factors. It also assesses the available evidence for occupational factors associated with these cancers. Cervical, endometrial, and ovarian cancers are relatively common, and cause significant cancer morbidity and mortality worldwide, whereas vulvar, vaginal, fallopian tube cancers, and choriocarcinomas are very rare. As several lifestyle factors are known to play a major role in the etiology of these cancers, very few published studies have investigated possible relationships with occupational factors. Some occupational exposures have been associated with increased risks of these cancers, but apart from the available evidence on the relationships between asbestos fibers and ovarian cancer, and tetrachloroethylene and cervical cancer, the data is rather scarce. Given the multifactorial nature of cancers of the female reproductive system, it is of the utmost importance to conduct occupational studies that will gather detailed data on potential individual confounding factors, in particular reproductive history and other factors that influence the body's hormonal environment, together with information on socio-economic status and lifestyle factors, including physical activity from multiple sources. Studies on the mechanisms of carcinogenesis in the female reproductive organs are also needed in order to elucidate the possible role of chemical exposures in the development of these cancers. PMID:23019529

  2. Context matters: a multicountry analysis of individual- and neighbourhood-level factors associated with women's sanitation use in sub-Saharan Africa.

    PubMed

    Winter, Samantha; Dreibelbis, Robert; Barchi, Francis

    2018-02-01

    To identify cross-national trends in factors associated with women's sanitation use in sub-Saharan Africa. Using data from Demographic and Health Surveys conducted in 14 SSA countries between 2008 and 2014, we modelled women's sanitation use in relation to various individual- and neighbourhood-level factors. Substantial variation exists between countries in the strength and direction of factors associated with sanitation use. Particularly significant associations across the region included access to different water sources, years of education, family size, age, living in a female-headed household, being married and wealth. Neighbourhood-level poverty, ethnic diversity and urbanisation were important factors in a majority of countries. International development goals for sanitation are frequently framed in terms of availability, implicitly suggesting that if facilities are accessible, they will be used. A more nuanced view that takes into account not only the existence of facilities but also the factors influencing their use is needed to understand the dynamics of women's sanitation use in the region. Policies focused on availability may not yield the desired public health benefits from improved sanitation in sub-Saharan Africa. Context-relevant factors must be addressed concurrently to achieve sanitation development goals. © 2017 John Wiley & Sons Ltd.

  3. Factors affecting length of stay after isolated femoral shaft fractures.

    PubMed

    Pendleton, Albert M; Cannada, Lisa K; Guerrero-Bejarano, Maria

    2007-03-01

    Controlling escalating health care costs is important for hospitals and has far reaching implications for society. Hospital length of stay (LOS) is one of the most reliable predictors of cost after trauma. Our purpose was to establish LOS after isolated femur fractures treated by intramedullary (IM) nail. The trauma registry was queried to identify patients. Patients were excluded if they required assistive ambulatory devices before injury, had chronic/terminal illness or compromised brain function. There were 102 patients with an average age of 27 years. Statistical analysis was completed. The average LOS was 3.9 days. In all, 27 patients stayed longer than 4 days. Reasons included social (7), medical (10), and hospital delays (10). The average time from arrival to surgery was 17 hours. The average time from surgery to physical therapy was 1.3 days. Patients who had surgery more than 24 hours after arrival stayed longer. Patients requiring placement stayed 2.4 days longer until placement was found. Factors the hospital can control to reduce LOS include time to surgery, time for physical therapy evaluation, and radiology delays (for spine clearance radiographs). Physical therapy availability within 24 hours of surgery is important and should include weekends and holidays. Early evaluation of social factors including homelessness or obstacles to independent living may reduce time to find placement. LOS reduction after femur fractures will decrease the cost of trauma to the hospital. In addition, LOS reduction will possibly increase bed availability and minimize the time spent on diversion yielding greater revenues and increasing patient satisfaction.

  4. A review of factors influencing the availability of dissolved oxygen to incubating salmonid embryos

    NASA Astrophysics Data System (ADS)

    Greig, S. M.; Sear, D. A.; Carling, P. A.

    2007-01-01

    Previous investigations into factors influencing incubation success of salmonid progeny have largely been limited to the development of empirical relationships between characteristics of the incubation environment and survival to emergence. It is suggested that adopting a process-based approach to assessing incubation success aids identification of the precise causes of embryonic mortalities, and provides a robust framework for developing and implementing managerial responses.Identifying oxygen availability within the incubation environment as a limiting factor, a comprehensive review of trends in embryonic respiration, and processes influencing the flux of oxygenated water through gravel riverbeds is provided. The availability of oxygen to incubating salmonid embryos is dependent on the exchange of oxygenated water with the riverbed, and the ability of the riverbed gravel medium to transport this water at a rate and concentration appropriate to support embryonic respiratory requirements. Embryonic respiratory trends indicate that oxygen consumption varies with stage of development, ambient water temperature and oxygen availability. The flux of oxygenated water through the incubation environment is controlled by a complex interaction of intragravel and extragravel processes and factors. The processes driving the exchange of channel water with gravel riverbeds include bed topography, bed permeability, and surface roughness effects. The flux of oxygenated water through riverbed gravels is controlled by gravel permeability, coupling of surface-subsurface flow and oxygen demands imposed by materials infiltrating riverbed gravels. Temporally and spatially variable inputs of groundwater can also influence the oxygen concentration of interstitial water. Copyright

  5. Human Reliability Assessments: Using the Past (Shuttle) to Predict the Future (Orion)

    NASA Technical Reports Server (NTRS)

    DeMott, Diana L.; Bigler, Mark A.

    2017-01-01

    NASA (National Aeronautics and Space Administration) Johnson Space Center (JSC) Safety and Mission Assurance (S&MA) uses two human reliability analysis (HRA) methodologies. The first is a simplified method which is based on how much time is available to complete the action, with consideration included for environmental and personal factors that could influence the human's reliability. This method is expected to provide a conservative value or placeholder as a preliminary estimate. This preliminary estimate or screening value is used to determine which placeholder needs a more detailed assessment. The second methodology is used to develop a more detailed human reliability assessment on the performance of critical human actions. This assessment needs to consider more than the time available, this would include factors such as: the importance of the action, the context, environmental factors, potential human stresses, previous experience, training, physical design interfaces, available procedures/checklists and internal human stresses. The more detailed assessment is expected to be more realistic than that based primarily on time available. When performing an HRA on a system or process that has an operational history, we have information specific to the task based on this history and experience. In the case of a Probabilistic Risk Assessment (PRA) that is based on a new design and has no operational history, providing a "reasonable" assessment of potential crew actions becomes more challenging. To determine what is expected of future operational parameters, the experience from individuals who had relevant experience and were familiar with the system and process previously implemented by NASA was used to provide the "best" available data. Personnel from Flight Operations, Flight Directors, Launch Test Directors, Control Room Console Operators, and Astronauts were all interviewed to provide a comprehensive picture of previous NASA operations. Verification of the assumptions and expectations expressed in the assessments will be needed when the procedures, flight rules, and operational requirements are developed and then finalized.

  6. Human Reliability Assessments: Using the Past (Shuttle) to Predict the Future (Orion)

    NASA Technical Reports Server (NTRS)

    DeMott, Diana; Bigler, Mark

    2016-01-01

    NASA (National Aeronautics and Space Administration) Johnson Space Center (JSC) Safety and Mission Assurance (S&MA) uses two human reliability analysis (HRA) methodologies. The first is a simplified method which is based on how much time is available to complete the action, with consideration included for environmental and personal factors that could influence the human's reliability. This method is expected to provide a conservative value or placeholder as a preliminary estimate. This preliminary estimate or screening value is used to determine which placeholder needs a more detailed assessment. The second methodology is used to develop a more detailed human reliability assessment on the performance of critical human actions. This assessment needs to consider more than the time available, this would include factors such as: the importance of the action, the context, environmental factors, potential human stresses, previous experience, training, physical design interfaces, available procedures/checklists and internal human stresses. The more detailed assessment is expected to be more realistic than that based primarily on time available. When performing an HRA on a system or process that has an operational history, we have information specific to the task based on this history and experience. In the case of a Probabilistic Risk Assessment (PRA) that is based on a new design and has no operational history, providing a "reasonable" assessment of potential crew actions becomes more challenging. In order to determine what is expected of future operational parameters, the experience from individuals who had relevant experience and were familiar with the system and process previously implemented by NASA was used to provide the "best" available data. Personnel from Flight Operations, Flight Directors, Launch Test Directors, Control Room Console Operators and Astronauts were all interviewed to provide a comprehensive picture of previous NASA operations. Verification of the assumptions and expectations expressed in the assessments will be needed when the procedures, flight rules and operational requirements are developed and then finalized.

  7. Locus of decision making in multinational corporations and its relationship to subsidiary performance

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

    Goehle, D.G.

    1978-01-01

    A conceptual model was developed which drew from the existing research in organization theory, comparative management, and international business which assisted in the delineation of the relevant variables and suggested the nature of their relationship to the locus of decision making. The conceptual model incorporated certain corporate and subsidiary factors considered an influence on the determination of the locus of decision making. Corporate factors included product line or industry, size and complexity of international operations, organization structure, availability of managerial talent, and corporate philosophy. Subsidiary characteristics included subsidiary age and size, availability of local managerial talent, geographic distance from headquartersmore » and other affiliated units, and subsidiary environmental characteristics. The locus of desicion making was measured by the level of participation the headquarters and subsidiary management had in decision making for twenty-nine decisions, representing six functional areas. Levels of participation for headquarters and subsidiary managers were measured for each decision based on responses to a five-point scale of decision process categories which indicated varying levels of headquarters and subsidiary participation. The sample included ten US multinational corporations representing five industries: pharmaceuticals, tire and rubber, automobiles, capital equipment, and food processing.« less

  8. Epidemiology of venous thromboembolism

    PubMed Central

    Heit, John A.

    2015-01-01

    Thrombosis can affect any venous circulation. Venous thromboembolism (VTE) includes deep-vein thrombosis of the leg or pelvis, and its complication, pulmonary embolism. VTE is a fairly common disease, particularly in older age, and is associated with reduced survival, substantial health-care costs, and a high rate of recurrence. VTE is a complex (multifactorial) disease, involving interactions between acquired or inherited predispositions to thrombosis and various risk factors. Major risk factors for incident VTE include hospitalization for surgery or acute illness, active cancer, neurological disease with leg paresis, nursing-home confinement, trauma or fracture, superficial vein thrombosis, and—in women—pregnancy and puerperium, oral contraception, and hormone therapy. Although independent risk factors for incident VTE and predictors of VTE recurrence have been identified, and effective primary and secondary prophylaxis is available, the occurrence of VTE seems to be fairly constant, or even increasing. PMID:26076949

  9. Epidemiology of venous thromboembolism.

    PubMed

    Heit, John A

    2015-08-01

    Thrombosis can affect any venous circulation. Venous thromboembolism (VTE) includes deep-vein thrombosis of the leg or pelvis, and its complication, pulmonary embolism. VTE is a fairly common disease, particularly in older age, and is associated with reduced survival, substantial health-care costs, and a high rate of recurrence. VTE is a complex (multifactorial) disease, involving interactions between acquired or inherited predispositions to thrombosis and various risk factors. Major risk factors for incident VTE include hospitalization for surgery or acute illness, active cancer, neurological disease with leg paresis, nursing-home confinement, trauma or fracture, superficial vein thrombosis, and-in women-pregnancy and puerperium, oral contraception, and hormone therapy. Although independent risk factors for incident VTE and predictors of VTE recurrence have been identified, and effective primary and secondary prophylaxis is available, the occurrence of VTE seems to be fairly constant, or even increasing.

  10. Skin rejuvenation using cosmetic products containing growth factors, cytokines, and matrikines: a review of the literature

    PubMed Central

    Aldag, Caroline; Nogueira Teixeira, Diana; Leventhal, Phillip S

    2016-01-01

    Skin aging is primarily due to alterations in the dermal extracellular matrix, especially a decrease in collagen I content, fragmentation of collagen fibrils, and accumulation of amorphous elastin material, also known as elastosis. Growth factors and cytokines are included in several cosmetic products intended for skin rejuvenation because of their ability to promote collagen synthesis. Matrikines and matrikine-like peptides offer the advantage of growth factor-like activities but better skin penetration due to their much smaller molecular size. In this review, we summarize the commercially available products containing growth factors, cytokines, and matrikines for which there is evidence that they promote skin rejuvenation. PMID:27877059

  11. Why Employed Latinos Lack Health Insurance: A Study in California

    ERIC Educational Resources Information Center

    Greenwald, Howard P.; O'Keefe, Suzanne; DiCamillo, Mark

    2005-01-01

    This article assesses the relative importance of several factors believed to reduce the likelihood of health insurance coverage among working Latinos in California, including cost, immigration history, availability of insurance, beliefs about insurance, and beliefs about health and health care. According to a survey of 1,000 randomly selected…

  12. Japanese Fathers of Preschoolers and Their Involvement in Child Care

    ERIC Educational Resources Information Center

    Ishii-kuntz, Masako; Makino, Katsuko; Kato, Kuniko; Tsuchiya, Michiko

    2004-01-01

    We examine how relative resources, time availability, gender ideology, living arrangement, child-care demand, and job satisfaction are associated with the levels of younger Japanese fathers involvement in child care for preschoolers. A theoretical model that includes these factors is tested using 1994 data collected from Japanese fathers and…

  13. 32 CFR 1700.2 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... not include overhead factors such as space; (c) Pages means paper copies of standard office size or... that may be responsive to a request utilizing available paper and electronic indices and finding aids..., that operates a program of scholarly research. To be in this category, a requester must show that the...

  14. 32 CFR 1700.2 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... not include overhead factors such as space; (c) Pages means paper copies of standard office size or... that may be responsive to a request utilizing available paper and electronic indices and finding aids..., that operates a program of scholarly research. To be in this category, a requester must show that the...

  15. Engineered and Other Wood Products - An Opportunity to "Grow the Pie"

    Treesearch

    Albert Schuler; Craig Adair

    2003-01-01

    The market for engineered wood products (EWP) is being driven by a number of factors including: technology; reduced availability of old-growth timber; construction activity, and globalization. Specifically, technological developments have allowed the industry to "engineer" or "design" improved performance properties and to utilize former "weed...

  16. Assessing transportation infrastructure impacts on rangelands: Test of a standard rangeland assessment protocol

    USDA-ARS?s Scientific Manuscript database

    Linear disturbances associated with on and off-road vehicle use on rangelands has increased dramatically throughout the world in recent decades. This increase is due to a variety of factors including increased availability of all-terrain vehicles, infrastructure development (oil, gas, renewable ene...

  17. A Study of the Integration of Military Personnel into the Fort Gordon Occupational Health Program.

    DTIC Science & Technology

    1980-05-01

    manpower data should be readily available to determine resource requirements. The other limiting factors which could bear on the problem include both...physical examinations and appropriate eyeglasses are provided based on both visual and safety requirements. Hazard inven- tories in areas jointly worked by

  18. Establishing Adaptive Sports Programs for Youth with Moderate to Severe Disabilities

    ERIC Educational Resources Information Center

    Ryan, Joseph B.; Katsiyannis, Antonis; Cadorette, Deborah; Hodge, Janie; Markham, Michelle

    2014-01-01

    Children with disabilities are at increased risk of health risk factors including obesity, often because of low levels of physical activity and limited participation in sports. However, organized adaptive sports programs are increasingly available for individuals with disabilities. This article provides recommendations for establishing successful…

  19. Communications Satellite Receiver Systems for Public Schools: A Technical Primer.

    ERIC Educational Resources Information Center

    Texas Education Agency, Austin.

    Designed to aid school districts contemplating use of some of the telecommunications services now available by satellite, this document contains information on home satellite receiving dishes (Television Receive-Only--TVROs), which can receive radio signals carrying television, sound, and data. This information includes: some factors involved in…

  20. 47 CFR 43.43 - Reports of proposed changes in depreciation rates.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... all depreciable plant, (i) the book cost of plant at the most recent date available, (ii) the... supplement the data required by paragraph (b) of this section) with copies of the underlying studies... basic factors, including company plans of forecasted retirements and additions, recent annual...

  1. Everywoman's Guide to College.

    ERIC Educational Resources Information Center

    Gray, Eileen

    Information and advice in this guide focuses on the emotional, financial, and academic realities of women returning to school. Chapter One examines the opportunities available today, including such topics as special programs for returning women and the societal factors causing women to return to school. In Chapter Two the decision-making process…

  2. What is the "Sense" of Prepositions?

    ERIC Educational Resources Information Center

    Dreike, Beate

    1975-01-01

    Examines the semantics of certain prepositions to show that the interpretation of relationships between linguistic units in a sentence is not always deducible from the logical structure underlying it, if this study does not include the study of pragmatic factors. Available from Liber Laeromedel, Box 1205, S-22105 Lund, Sweden. (Author/TL)

  3. Evaluation of performance based approach for determining contribution of environmental factors to pavement deterioration : H P & R implementation study.

    DOT National Transportation Integrated Search

    1990-11-01

    State Legislation requires that cost responsibility studies be available for the 1991 and 1993 Legislative sessions. Part of this legislative requirement includes the need to re-evaluate and establish a sound basis for the weight-mile tax. To be fair...

  4. 40 CFR 192.20 - Guidance for implementation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... judgments and include use of available empirical information. The consideration of possible failure modes... should be removed from buildings exceeding 0.03 WL so that future replacement buildings will not pose a... modeling of the dynamics of the groundwater system. All of these factors should be incorporated into the...

  5. 40 CFR 192.20 - Guidance for implementation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... judgments and include use of available empirical information. The consideration of possible failure modes... should be removed from buildings exceeding 0.03 WL so that future replacement buildings will not pose a... modeling of the dynamics of the groundwater system. All of these factors should be incorporated into the...

  6. Cockpit automation

    NASA Technical Reports Server (NTRS)

    Wiener, Earl L.

    1988-01-01

    The aims and methods of aircraft cockpit automation are reviewed from a human-factors perspective. Consideration is given to the mixed pilot reception of increased automation, government concern with the safety and reliability of highly automated aircraft, the formal definition of automation, and the ground-proximity warning system and accidents involving controlled flight into terrain. The factors motivating automation include technology availability; safety; economy, reliability, and maintenance; workload reduction and two-pilot certification; more accurate maneuvering and navigation; display flexibility; economy of cockpit space; and military requirements.

  7. Bacteriophages and dairy fermentations

    PubMed Central

    Marcó, Mariángeles Briggiler; Moineau, Sylvain; Quiberoni, Andrea

    2012-01-01

    This review highlights the main strategies available to control phage infection during large-scale milk fermentation by lactic acid bacteria. The topics that are emphasized include the factors influencing bacterial activities, the sources of phage contamination, the methods available to detect and quantify phages, as well as practical solutions to limit phage dispersion through an adapted factory design, the control of air flow, the use of adequate sanitizers, the restricted used of recycled products, and the selection and growth of bacterial cultures. PMID:23275866

  8. The inverse of winnowing: a FORTRAN subroutine and discussion of unwinnowing discrete data

    USGS Publications Warehouse

    Bracken, Robert E.

    2004-01-01

    This report describes an unwinnowing algorithm that utilizes a discrete Fourier transform, and a resulting Fortran subroutine that winnows or unwinnows a 1-dimensional stream of discrete data; the source code is included. The unwinnowing algorithm effectively increases (by integral factors) the number of available data points while maintaining the original frequency spectrum of a data stream. This has utility when an increased data density is required together with an availability of higher order derivatives that honor the original data.

  9. Factors influencing the delivery of the fundamentals of care: Perceptions of nurses, nursing leaders and healthcare consumers.

    PubMed

    Conroy, Tiffany

    2017-11-17

    To explore the factors described by nurses and consumer representatives influencing the delivery of the fundamentals of care. An ongoing challenge facing nursing is ensuring the "basics" or fundamentals of care are delivered optimally. The way nurses and patients perceive the delivery of the fundamentals of care had not been explored. Once identified, the factors that promote the delivery of the fundamentals of care may be facilitated. Inductive content analysis of scenario based focus groups. A qualitative approach was taken using three stages, including direct observation, focus groups and interviews. This paper reports the second stage. Focus groups discussed four patient care scenarios derived from the observational data. Focus groups were conducted separately for registered nurses, nurses in leadership roles and consumer representatives. Content analysis was used. The analysis of the focus group data resulted in three themes: Organisational factors; Individual nurse or patient factors; and Interpersonal factors. Organisational factors include nursing leadership, the context of care delivery and the availability of time. Individual nurse and patient factors include the specific care needs of the patient and the individual nurse and patient characteristics. Interpersonal factors include the nurse-patient relationship; involving the patient in their care, ensuring understanding and respecting choices; communication; and setting care priorities. Seeking the perspective of the people involved in delivering and receiving the fundamentals of care showed a shared understanding of the factors influencing the delivery of the fundamentals of care. The influence of nursing leadership and the quality of the nurse-patient relationship were perceived as important factors. Nurses and consumers share a common perspective of the factors influencing the delivery of the fundamentals of care and both value a therapeutic nurse-patient relationship. Clinical nursing leaders must understand the impact of their role in shaping the delivery of the fundamentals of care. © 2017 John Wiley & Sons Ltd.

  10. Implementing new care models: learning from the Greater Manchester demonstrator pilot experience.

    PubMed

    Elvey, Rebecca; Bailey, Simon; Checkland, Kath; McBride, Anne; Parkin, Stephen; Rothwell, Katy; Hodgson, Damian

    2018-06-19

    Current health policy focuses on improving accessibility, increasing integration and shifting resources from hospitals to community and primary care. Initiatives aimed at achieving these policy aims have supported the implementation of various 'new models of care', including general practice offering 'additional availability' appointments during evenings and at weekends. In Greater Manchester, six 'demonstrator sites' were funded: four sites delivered additional availability appointments, other services included case management and rapid response. The aim of this paper is to explore the factors influencing the implementation of services within a programme designed to improve access to primary care. The paper consists of a qualitative process evaluation undertaken within provider organisations, including general practices, hospitals and care homes. Semi-structured interviews, with the data subjected to thematic analysis. Ninety-one people participated in interviews. Six key factors were identified as important for the establishment and running of the demonstrators: information technology; information governance; workforce and organisational development; communications and engagement; supporting infrastructure; federations and alliances. These factors brought to light challenges in the attempt to provide new or modify existing services. Underpinning all factors was the issue of trust; there was consensus amongst our participants that trusting relationships, particularly between general practices, were vital for collaboration. It was also crucial that general practices trusted in the integrity of anyone external who was to work with the practice, particularly if they were to access data on the practice computer system. A dialogical approach was required, which enabled staff to see themselves as active rather than passive participants. The research highlights various challenges presented by the context within which extended access is implemented. Trust was the fundamental underlying issue; there was consensus amongst participants that trusting relationships were vital for effective collaboration in primary care.

  11. Factors facilitating and inhibiting the use of female condoms among female university students in Durban, KwaZulu-Natal, South Africa.

    PubMed

    Mahlalela, Nomsa Brightness; Maharaj, Pranitha

    2015-01-01

    The study aimed to explore the factors facilitating and inhibiting female condom use among female university students in South Africa. This qualitative study drew on 15 individual, in-depth interviews with female university students in Durban, South Africa. The results of the study highlight several factors that facilitate and inhibit female condom use. Protection from sexually transmitted infections (including HIV/AIDS) and prevention of pregnancy facilitated use of the device among female students. In addition, students expressed positive attitudes towards the female condom and preferred it to hormonal contraceptives because it offered them dual protection. Absence of side effects and greater power and autonomy to initiate safer sex were other factors that facilitated use. Inadequate availability, partner objection, stigma, insertion difficulties and lack of awareness served as significant barriers to consistent female condom use. Although the female condom can protect female students from infections and pregnancy, there are several barriers to its use. Interventions should aim to increase availability of the female condom, and male involvement should be increased to facilitate consistent use of the method.

  12. Scientific, economic, regulatory, and ethical challenges of bringing science-based pediatric nutrition products to the U.S. market and ensuring their availability for patients.

    PubMed

    Merritt, Russell J; Goldsmith, Arthur H

    2014-11-01

    Many nutrition products and related drugs are unavailable or not consistently available to clinicians despite a body of clinical data and experience supporting their use. Many of these can be related to drug shortages that have increased since 2009. In addition, there are potentially useful products that are not approved for a specific use or are no longer being manufactured. This review broadly examines the product availability gap from the perspectives of a clinician/former nutrition industry medical director and an economist. The process of pediatric nutrition product and related drug innovation, as well as its drivers and the steps involved in bringing a product to market, is first described. This is followed by an assessment of factors influencing product availability beyond the innovation process, including regulatory issues, manufacturing compliance, purchasing practices, and other factors related to drug and nutrition product pricing and reimbursement. Three pediatric case examples are reviewed and placed in the context of the prior review. Last, recent and future possible steps toward closing the product availability gap are discussed. © 2014 American Society for Parenteral and Enteral Nutrition.

  13. Factors Linked to Substance Use Disorder Counselors’ (Non)Implementation Likelihood of Tobacco Cessation 5 A's, Counseling, and Pharmacotherapy

    PubMed Central

    Laschober, Tanja C.; Muilenburg, Jessica L.; Eby, Lillian T.

    2015-01-01

    Study Background Despite efforts to promote the use of tobacco cessation services (TCS), implementation extensiveness remains limited. This study investigated three factors (cognitive, behavioral, environmental) identified by social cognitive theory as predictors of substance use disorder counselors’ likelihood of use versus non-use of tobacco cessation (TC) 5 A's (ask patients about tobacco use, advise to quit, assess willingness to quit, assist in quitting, arrange for follow-up contact), counseling, and pharmacotherapy with their patients who smoke cigarettes. Methods Data were collected in 2010 from 942 counselors working in 257 treatment programs that offered TCS. Cognitive factors included perceived job competence and TC attitudes. Behavioral factors encompassed TC-related skills and general training. External factors consisted of TC financial resource availability and coworker TC attitudes. Data were analyzed using logistic regression models with nested data. Results Approximately 86% of counselors used the 5 A's, 76% used counseling, and 53% used pharmacotherapy. When counselors had greater TC-related skills and greater general training they were more likely to implement the 5 A's. Implementation of counseling was more likely when counselors had more positive attitudes toward TC treatment, greater general training, greater financial resource availability, and when coworkers had more positive attitudes toward TC treatment. Implementation of pharmacotherapy was more likely when counselors had more positive attitudes toward TC treatment, greater general training, and greater financial resource availability. Conclusion Findings indicate that interventions to promote TCS implementation should consider all three factors simultaneously as suggested by social cognitive theory. PMID:26005696

  14. Caregivers' perception of factors associated with a healthy diet among people with intellectual disability living in community residences: A Concept mapping method.

    PubMed

    Ruud, Marte Pilskog; Raanaas, Ruth Kjærsti; Bjelland, Mona

    2016-12-01

    Many people with intellectual disabilities (ID) living in community-based residences have been found to have unhealthy diet and weight disturbances. In Norway, a majority of people with ID live in such residences. The aim of the study was to examine factors affecting the caregivers' opportunity to promote a healthy diet among the residents. A concept mapping methodology was adopted, including group-based brainstorming, idea synthesising, sorting, rating and analysis of the results. Informants were caregivers in four different community residences for people with mild to moderate ID in the southeast of Norway. A total of 13 informants were recruited (12 females and 1 male), and 10 informants completed two sessions. Eight clusters were identified as affecting the caregivers' ability to promote a healthy diet: "Availability and accessibility", "Guidance and autonomy", "Competence among staff", "Planning and involvement", "Customization", "External conditions affecting staff", "Legislation, rules and structure" and "Everyday challenges", each including both barriers and facilitators. Multiple factors affect the caregivers' ability to promote a healthy diet. Caregivers' opportunity to promote a healthy diet is complex. Availability and accessibility of healthy food is crucial, but a healthy diet also requires time and competence among the caregivers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Determinants of healthy eating: motivation, abilities and environmental opportunities.

    PubMed

    Brug, Johannes

    2008-12-01

    In order to promote healthful nutrition, insight is needed in the behavioural determinants of nutrition behaviours. Most research on behavioural determinants has been restricted to individual-level motivational factors. However, health behaviour is influenced by individual motivation and abilities, as well as environmental opportunities. To provide an overview of motivation, ability and opportunity-related potential determinants of nutrition behaviours and of the evidence for associations of potential environmental determinants with nutrition behaviour. A narrative review informed by a series of six systematic reviews including more than 400 original studies and recent original studies on associations of environmental factors with nutrition behaviours. Although the number of studies on potential environmental determinants of nutrition as well as physical activity behaviour has increased steeply over the last decades, these include only few well-designed studies with validated measures. Preliminary evidence from the available systematic reviews indicates that social support and modelling, availability and accessibility of healthy and less healthy foods as well as socio-economic status are important for nutrition behaviours; schools and worksites offer good settings for improving healthful nutrition opportunities. Although the evidence to date is inconclusive due to lack of well-designed studies, specific social-cultural, physical and economical environmental factors appear of importance for healthful nutrition.

  16. Variability in pesticides residues--the US experience.

    PubMed

    Suhre, F B

    2000-07-01

    The evolution of US Environmental Protection Agency's (EPA) process for estimating potential health risks from pesticide residues in or on food is examined in light of changes in US Legislation and the variability of residue data and assumptions used to estimate dietary exposure. In the 86 years since enactment of the Insecticide Act, pesticide laws have become progressively more health-based. Passage of the 1996 Food Quality Protection Act (FQPA) requires EPA to place particular emphasis on assessing potential risk from pesticides to infants and children. Primary factors affecting the actual pesticide residues in food include frequency of application, percentage of crop treated, and the interval from treatment to harvest. Primary factors affecting the estimated pesticide residues in food include the source of the residue data, calculation techniques for non-detected residues, and the availability of data reflecting post-harvest treatments. Risk assessors must thoroughly consider these factors when assessing dietary risk to pesticides. Risk managers will need to consider these factors as a means of mitigating dietary risk from pesticides.

  17. Ventilator associated pneumonia: risk factors and preventive measures.

    PubMed

    Vincent, J L; Lobo, S; Struelens, M

    2001-11-01

    Ventilator-associated pneumonia (VAP) is a common nosocomial infection associated with considerable morbidity and mortality. Various risk factors for VAP have been identified and include the duration of ICU stay and of mechanical ventilation, a diagnosis of trauma, and severity of illness. Knowledge of these factors can promote early diagnosis and hence treatment. In addition to simple, but very effective, basic hygiene, different preventative strategies have been suggested, and can be divided into those that aim to limit airway colonization, and those that improve host defense mechanisms. Of the former, non-invasive ventilation is effective but not always applicable or available, nursing the patient in the semi-recumbent position is also associated with a reduced incidence of VAP but carries its own problems, stress ulcer prophylaxis remains controversial, and selective digestive decontamination is probably only relevant to certain subgroups of patients. Methods to improve host defense include early nutrition. Immunostimulatory therapies, such as interferon and granulocyte colony stimulating factor, require further research to confirm their place in the prevention or management of VAP.

  18. Epidemiology and Factors Related to Clinical Severity of Acute Gastroenteritis in Hospitalized Children after the Introduction of Rotavirus Vaccination.

    PubMed

    Kim, Ahlee; Chang, Ju Young; Shin, Sue; Yi, Hana; Moon, Jin Soo; Ko, Jae Sung; Oh, Sohee

    2017-03-01

    We aimed to investigate epidemiology and host- and pathogen-related factors associated with clinical severity of acute gastroenteritis (AGE) in children after rotavirus vaccination introduction. Factors assessed included age, co-infection with more than 2 viruses, and virus-toxigenic Clostridium difficile co-detection. Fecal samples and clinical information, including modified Vesikari scores, were collected from hospitalized children with AGE. The presence of enteric viruses and bacteria, including toxigenic C. difficile, was detected by polymerase chain reaction (PCR). Among the 415 children included, virus was detected in stool of 282 (68.0%) children. Co-infection with more than 2 viruses and toxigenic C. difficile were found in 24 (8.5%) and 26 (9.2%) children with viral AGE, respectively. Norovirus (n = 130) infection, including norovirus-associated co-infection, was the most frequent infection, especially in children aged < 24 months (P < 0.001). In the severity-related analysis, age < 24 months was associated with greater diarrheal severity (P < 0.001) and modified Vesikari score (P = 0.001), after adjustment for other severity-related factors including rotavirus status. Although the age at infection with rotavirus was higher than that for other viruses (P = 0.001), rotavirus detection was the most significant risk factor for all severity parameters, including modified Vesikari score (P < 0.001). Viral co-infection and toxigenic C. difficile co-detection were not associated with any severity-related parameter. This information will be helpful in the management of childhood AGE in this era of rotavirus vaccination and availability of molecular diagnostic tests, which often lead to the simultaneous detection of multiple pathogens.

  19. [Socio- and psychotherapy in patients with Alzheimer disease].

    PubMed

    Hirsch, R D

    2001-04-01

    Symptoms presented by patients with Alzheimer-type dementia do not only reflect organic disturbances only but require a holistic and person-oriented view. Affective and behavioral disturbances are not necessarily secondary to cognitive impairment. Guidelines are presented for a multidimensional treatment involving the significant other. Socio- and psychotherapy are essential for this treatment. Their approaches have greatly increased in number and diversity in the past few years. Sociotherapy is based on milieu therapy and includes different training- and group activities. Several psychosocial treatment modalities are available, including validation, dementia care mapping, reminiscence therapy, cognitive training and psychoeducational group work. Psychotherapeutic approaches include relaxation techniques, and psychodynamic oriented- and behavioral modalities. The indication for a specific modality is based on an assessment of the disturbances present and available resources. Of special importance are also services to family carers, including counseling, psychotherapy, as well as support and modification of the care-setting. Even though there are only limited empirical data available on the effects of socio- and psychotherapy for patients with Alzheimer-type dementia, the available evidence is indicative of a positive influence on symptoms of this illness. Diversity of symptoms and individualized, variable course of the illness may point to the importance of psychological and social factors in this illness, by far larger than presently recognized.

  20. Considerations in the use of microneedles: pain, convenience, anxiety and safety.

    PubMed

    Jeong, Hye-Rin; Lee, Han-Sol; Choi, In-Jeong; Park, Jung-Hwan

    2017-01-01

    Transdermal delivery using microneedles is gaining increasing attention from pharmaceutical and cosmetic companies as one of the promising drug delivery methods. Microneedle products have recently become available on the market, and some of them are under evaluation for efficacy and safety. To be available in the market for cosmetic and therapeutic use, several factors should be considered, including pain, anxiety, convenience and safety. These factors are summarized and reviewed in this article according to type of microneedle. Various kinds of materials have been used for manufacturing microneedles and developing drug formulations for microneedles. Safety information about materials used for microneedles is summarized in terms of type of microneedles. In addition to their biocompatibility, mechanical safety is also discussed. This review can provide guidelines for designing microneedle products for proper use.

  1. On the effective implementation of a boundary element code on graphics processing units unsing an out-of-core LU algorithm

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

    D'Azevedo, Ed F; Nintcheu Fata, Sylvain

    2012-01-01

    A collocation boundary element code for solving the three-dimensional Laplace equation, publicly available from \\url{http://www.intetec.org}, has been adapted to run on an Nvidia Tesla general purpose graphics processing unit (GPU). Global matrix assembly and LU factorization of the resulting dense matrix were performed on the GPU. Out-of-core techniques were used to solve problems larger than available GPU memory. The code achieved over eight times speedup in matrix assembly and about 56~Gflops/sec in the LU factorization using only 512~Mbytes of GPU memory. Details of the GPU implementation and comparisons with the standard sequential algorithm are included to illustrate the performance ofmore » the GPU code.« less

  2. Parental Factors Influencing the Development of Early Childhood Caries in Developing Nations: A Systematic Review.

    PubMed

    Rai, Nayanjot Kaur; Tiwari, Tamanna

    2018-01-01

    Early childhood caries (ECC) is one of the most prevalent and chronic conditions of childhood. Various factors including biological and dietary factors along with an overlay of parental social factors have been found to be associated with the progression of ECC. The objective of this systematic review is to synthesize available literature and to identify parent-level proximal and distal risk factors associated with the development of ECC in developing nations. Studies conducted in developing nations, published between 2005 and 2017 in English, that included children younger than 6 years and examined ECC were included. The outcome of interest were parental risk factors, which included parental knowledge, behavior, attitudes, sense of coherence (SOC), stress, socioeconomic status (SES), education, and breastfeeding duration. The studies were retrieved from MEDLINE, Ovid Medline, and PubMed. The search yielded 325 studies, of which 18 were considered eligible for inclusion in this review. Ten studies found maternal education, and seven studies found parental education to be significantly associated with ECC. SES was significantly associated with ECC in 13 studies in the form of annual household income and occupation level. Four studies observed the significant association between oral health knowledge and attitudes with ECC, whereas only two studies found maternal attitude to be associated with ECC. Breastfeeding duration was a significant risk factor in four studies. One study each found significant associations of SOC, parental distress, and secondary smoke with ECC. To date, most of the researches done in developing countries have reported distal parental factors such as income and education being significant risk factors in caries development compared to proximal risk factors in low-income groups. Only a few studies analyzed the psychosocial and behavioral factors. Interventions could be designed to improve parental oral health knowledge and behaviors in these nations.

  3. Soils: man-caused radioactivity and radiation forecast

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

    Gablin, Vassily

    2007-07-01

    Available in abstract form only. Full text of publication follows: One of the main tasks of the radiation safety guarantee is non-admission of the excess over critical radiation levels. In Russia they are man-caused radiation levels. Meanwhile any radiation measurement represents total radioactivity. That is why it is hard to assess natural and man-caused contributions to total radioactivity. It is shown that soil radioactivity depends on natural factors including radioactivity of rocks and cosmic radiation as well as man-caused factors including nuclear and non-nuclear technologies. Whole totality of these factors includes unpredictable (non-deterministic) factors - nuclear explosions and radiation accidents,more » and predictable ones (deterministic) - all the rest. Deterministic factors represent background radioactivity whose trends is the base of the radiation forecast. Non-deterministic factors represent man-caused radiation treatment contribution which is to be controlled. This contribution is equal to the difference in measured radioactivity and radiation background. The way of calculation of background radioactivity is proposed. Contemporary soils are complicated technologically influenced systems with multi-leveled spatial and temporary inhomogeneity of radionuclides distribution. Generally analysis area can be characterized by any set of factors of soil radioactivity including natural and man-caused factors. Natural factors are cosmic radiation and radioactivity of rocks. Man-caused factors are shown on Fig. 1. It is obvious that man-caused radioactivity is due to both artificial and natural emitters. Any result of radiation measurement represents total radioactivity i.e. the sum of activities resulting from natural and man-caused emitters. There is no gauge which could separately measure natural and man-caused radioactivity. That is why it is so hard to assess natural and man-caused contributions to soil radioactivity. It would have been possible if human activity had led to contamination of soil only by artificial radionuclides. But we can view a totality of soil radioactivity factors in the following way. (author)« less

  4. Factors affecting caregivers' ability to make environmental modifications.

    PubMed

    Messecar, D C

    2000-12-01

    This study explored factors that family caregivers described as affecting their ability to use environmental modifications. Intensive interviews and participant observation were used to collect detailed data from 24 primary family caregivers. Several factors that affect the caregivers' ability to implement modification strategies were identified in the analysis. These factors included attributes of the elderly individual, attributes of the modification, quality of the caregiver-elderly relationship, caregivers' skills, personal resources of the caregiver, and the informal and formal supports available. Of these factors, the most important were the salient skills that caregivers need to implement environmental modifications. These findings point to the importance of caregivers receiving skills training in this important dimension of caregiving. Intervention should be based on a collaborative approach that ensures the caregiver and care receiver's needs and preferences are respected.

  5. Introducing the Postsecondary Instructional Practices Survey (PIPS): A Concise, Interdisciplinary, and Easy-to-Score Survey.

    PubMed

    Walter, Emily M; Henderson, Charles R; Beach, Andrea L; Williams, Cody T

    Researchers, administrators, and policy makers need valid and reliable information about teaching practices. The Postsecondary Instructional Practices Survey (PIPS) is designed to measure the instructional practices of postsecondary instructors from any discipline. The PIPS has 24 instructional practice statements and nine demographic questions. Users calculate PIPS scores by an intuitive proportion-based scoring convention. Factor analyses from 72 departments at four institutions (N = 891) support a 2- or 5-factor solution for the PIPS; both models include all 24 instructional practice items and have good model fit statistics. Factors in the 2-factor model include (a) instructor-centered practices, nine items; and (b) student-centered practices, 13 items. Factors in the 5-factor model include (a) student-student interactions, six items; (b) content delivery, four items; (c) formative assessment, five items; (d) student-content engagement, five items; and (e) summative assessment, four items. In this article, we describe our development and validation processes, provide scoring conventions and outputs for results, and describe wider applications of the instrument. © 2016 E. M. Walter et al. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  6. Including the spatial variability of metal speciation in the effect factor in life cycle impact assessment: Limits of the equilibrium partitioning method.

    PubMed

    Tromson, Clara; Bulle, Cécile; Deschênes, Louise

    2017-03-01

    In life cycle assessment (LCA), the potential terrestrial ecotoxicity effect of metals, calculated as the effect factor (EF), is usually extrapolated from aquatic ecotoxicological data using the equilibrium partitioning method (EqP) as it is more readily available than terrestrial data. However, when following the AMI recommendations (i.e. with at least enough species that represents three different phyla), there are not enough terrestrial data for which soil properties or metal speciation during ecotoxicological testing are specified to account for the influence of soil property variations on metal speciation when using this approach. Alternatively, the TBLM (Terrestrial Biotic Ligand Model) has been used to determine an EF that accounts for speciation, but is not available for metals; hence it cannot be consistently applied to metals in an LCA context. This paper proposes an approach to include metal speciation by regionalizing the EqP method for Cu, Ni and Zn with a geochemical speciation model (the Windermere Humic Aqueous Model 7.0), for 5213 soils selected from the Harmonized World Soil Database. Results obtained by this approach (EF EqP regionalized ) are compared to the EFs calculated with the conventional EqP method, to the EFs based on available terrestrial data and to the EFs calculated with the TBLM (EF TBLM regionalized ) when available. The spatial variability contribution of the EF to the overall spatial variability of the characterization factor (CF) has been analyzed. It was found that the EFs EqP regionalized show a significant spatial variability. The EFs calculated with the two non-regionalized methods (EqP and terrestrial data) fall within the range of the EFs EqP regionalized . The EFs TBLM regionalized cover a larger range of values than the EFs EqP regionalized but the two methods are not correlated. This paper highlights the importance of including speciation into the terrestrial EF and shows that using the regionalized EqP approach is not an acceptable proxy for terrestrial ecotoxicological data even if it can be applied to all metals. Copyright © 2016. Published by Elsevier B.V.

  7. Physician, Patient and Contextual Factors Affecting Treatment Decisions in Older Adults with Cancer: A Literature Review

    PubMed Central

    Tariman, J. D.; Berry, D. L.; Cochrane, B.; Doorenbos, A.; Schepp, K.

    2010-01-01

    Purpose/Objectives To review physician, patient, and contextual factors that affect treatment decision-making in older adults diagnosed with cancer and relate these factors to theoretical models of decision-making. Data Sources PubMed (1966-April 2010), PsycINFO (1967-April 2010) and CINAHL (1982-April 2010) databases were searched to access relevant medical, psychological and nursing literature. Data Synthesis Physician factors in treatment decisions include physician personal beliefs and values, expertise, practice type, perception of lowered life expectancy, medical factors, power, and communication style. Patient factors include personal beliefs and values, ethnicity, decisional control preferences, previous health-related experience, perception of the decision-making process, and personal factors. Contextual factors include availability of caregiver, lack of insurance, poor financial status, and geographical barrier. The interplay of physician, patient, and contextual factors are not well understood. Existing models of decision-making are not sufficient to explicate TDM process in older adults diagnosed with cancer. Conclusions Clinical studies in older adult patient population using a longitudinal and prospective design are needed to examine real-time interplay of patient, physician, and contextual factors and to better understand how these divergent factors influenced actual treatment decisions. Implications for Nursing Oncology nurses can advocate for a patient’s autonomy during TDM by coaching them to seek evidence-based discussion of various treatment options, benefits and risks assessments, and truthful discussion of the probability of success for each treatment option from their physicians. Oncology nurses must promote an informed treatment decisions that are consistent with a patient’s personal preference and values within the limits of the patient’s personal contexts. PMID:22201670

  8. [Accessibility of health services for users].

    PubMed

    Sousa-Fragoso, M A; Villarreal-Ríos, E

    2000-01-01

    To measure the accessibility to health services and determine a model to explain this accessibility. All states of the Mexican Republic were included. The measurement of accessibility considers the availability of resources and the perception of barriers. Place of residence, education, participation in the work forces and household conditions were included in the model. The average of availability resources was 64.59% sd 15.68 (range 42 to 100) and the average corresponding to perception of barriers, 87.61% SD 4.04 (range 79.23 to 95.65). Accessibility was 71.50% SD 10.74 (range 56 to 96). The states with highest accessibility were the Federal District and Baja California Sur and the lowest, Chiapas and Oaxaca. The model included education and labor participation (R2 = 0.67, p < 0.05). Accessibility was determined by socioeconomic factors.

  9. The gj factor of a bound electron and the hyperfine structure splitting in hydrogenlike ions

    NASA Astrophysics Data System (ADS)

    Beier, Thomas

    2000-12-01

    The comparison between theory and experiment of the hyperfine structure splitting and the electronic gj factor in heavy highly charged ions provides a unique testing ground for quantum electrodynamics in the presence of strong electric and magnetic fields. A theoretical evaluation is presented of all quantum electrodynamical contributions to the ground-state hfs splitting in hydrogenlike and lithiumlike atoms as well as to the gj factor. Binding and nuclear effects are discussed as well. A comparison with the available experimental data is performed, and a detailed discussion of theoretical sources of uncertainty is included which is mainly due to insufficiently known nuclear properties.

  10. The Transcription Factor Encyclopedia

    PubMed Central

    2012-01-01

    Here we present the Transcription Factor Encyclopedia (TFe), a new web-based compendium of mini review articles on transcription factors (TFs) that is founded on the principles of open access and collaboration. Our consortium of over 100 researchers has collectively contributed over 130 mini review articles on pertinent human, mouse and rat TFs. Notable features of the TFe website include a high-quality PDF generator and web API for programmatic data retrieval. TFe aims to rapidly educate scientists about the TFs they encounter through the delivery of succinct summaries written and vetted by experts in the field. TFe is available at http://www.cisreg.ca/tfe. PMID:22458515

  11. Image-guided intervention in the coagulopathic patient.

    PubMed

    Kohli, Marc; Mayo-Smith, William; Zagoria, Ronald; Sandrasegaran, Kumar

    2016-04-01

    Determining practice parameters for interventional procedures is challenging due to many factors including unreliable laboratory tests to measure bleeding risk, variable usage of standardized terminology for adverse events, poorly defined standards for administration of blood products, and the growing numbers of anticoagulant and antiplatelet medications. We aim to address these and other issues faced by radiologists performing invasive procedures through a review of available literature, and experiential guidance from three academic medical centers. We discuss the significant limitations with respect to using prothrombin-time and international normalized ratio to measure bleeding risk, especially in patients with synthetic defects due to liver function. Factors affecting platelet function including the impact of uremia; recent advances in laboratory testing, including platelet function testing; and thromboelastography are also discussed. A review of the existing literature of fresh-frozen plasma replacement therapy is included. The literature regarding comorbidities affecting coagulation including malignancy, liver failure, and uremia are also reviewed. Finally, the authors present a set of recommendations for laboratory thresholds, corrective transfusions, as well as withholding and restarting medications.

  12. Tea and Cardiovascular Disease

    PubMed Central

    Deka, Apranta; Vita, Joseph A.

    2011-01-01

    There is increasing evidence for a protective effect of tea consumption against cardiovascular disease. This review summarizes the available epidemiological data providing evidence for and against such an effect. We also review observational and intervention studies that investigated an effect of tea and tea extracts on cardiovascular risk factors, including blood pressure, serum lipids, diabetes mellitus, and obesity. Finally, we review potential mechanisms of benefit, including anti-inflammatory, anti-oxidant, and anti-proliferative effects, as well as favorable effects on endothelial function. Overall, the observational data suggest a benefit, but results are mixed and likely confounded by lifestyle and background dietary factors. The weight of evidence indicates favorable effects on risk factors and a number of plausible mechanisms have been elucidated in experimental and translational human studies. Despite the growing body evidence, it remains uncertain whether tea consumption should be recommended to the general population or to patients as a strategy to reduce cardiovascular risk. PMID:21477653

  13. PRODORIC2: the bacterial gene regulation database in 2018

    PubMed Central

    Dudek, Christian-Alexander; Hartlich, Juliane; Brötje, David; Jahn, Dieter

    2018-01-01

    Abstract Bacteria adapt to changes in their environment via differential gene expression mediated by DNA binding transcriptional regulators. The PRODORIC2 database hosts one of the largest collections of DNA binding sites for prokaryotic transcription factors. It is the result of the thoroughly redesigned PRODORIC database. PRODORIC2 is more intuitive and user-friendly. Besides significant technical improvements, the new update offers more than 1000 new transcription factor binding sites and 110 new position weight matrices for genome-wide pattern searches with the Virtual Footprint tool. Moreover, binding sites deduced from high-throughput experiments were included. Data for 6 new bacterial species including bacteria of the Rhodobacteraceae family were added. Finally, a comprehensive collection of sigma- and transcription factor data for the nosocomial pathogen Clostridium difficile is now part of the database. PRODORIC2 is publicly available at http://www.prodoric2.de. PMID:29136200

  14. “Respect the way I need to communicate with you”: Healthcare experiences of adults on the autism spectrum

    PubMed Central

    Nicolaidis, Christina; Raymaker, Dora M.; McDonald, Katherine E.; Baggs, W. Amelia E.V.; Dern, Sebastian; Kapp, Steven K.; Weiner, Michael; Boisclair, Cody; Ashkenazy, Elesia

    2016-01-01

    Our objective was to obtain an in-depth understanding of autistic adults’ experiences with healthcare and their recommendations for improving care. Our academic-community partnership used a community based participatory research (CBPR) approach to conduct semi-structured, open-ended interviews with 39 autistic adults and 16 people who had experience supporting autistic adults in healthcare settings. Participants identified patient-level, autism-related factors that impact healthcare interactions, including verbal communication skills, sensory sensitivities, challenges with body awareness, slow processing speed, atypical non-verbal communication, and challenges with organization. However, the success of healthcare interactions largely depended on the interplay between patient- and provider-level factors, as well as on the larger context in which patients were receiving care. Provider-level factors included providers’ knowledge about autism in adults, incorrect assumptions about individual patients, willingness to allow written communication, use of accessible language, openness to providing other accommodations, and skill in appropriately incorporating supporters. System-level factors included the availability of supporters, complexity of the healthcare system, accessibility of healthcare facilities, and stigma about autism. Further efforts are needed to empower patients, adequately train providers, increase the accessibility of the healthcare system, and decrease discrimination. PMID:25882392

  15. Metacognitive factors that impact student nurse use of point of care technology in clinical settings.

    PubMed

    Kuiper, RuthAnne

    2010-01-01

    The utility of personal digital assistants (PDA) as a point of care resource in health care practice and education presents new challenges for nursing faculty. While there is a plethora of PDA resources available, little is known about the variables that effect student learning and technology adoption. In this study nursing students used PDA software programs which included a drug guide, medical dictionary, laboratory manual and nursing diagnosis manual during acute care clinical experiences. Analysis of student journals comparative reflective statements about the PDA as an adjunct to other available resources in clinical practice are presented. The benefits of having a PDA included readily available data, validation of thinking processes, and facilitation of care plan re-evaluation. Students reported increased frequency of use and independence. Significant correlations between user perceptions and computer self-efficacy suggested greater confidence in abilities with technology resulting in increased self-awareness and achievement of learning outcomes.

  16. Climate change, extinction risks, and reproduction of terrestrial vertebrates.

    PubMed

    Carey, Cynthia

    2014-01-01

    This review includes a broad, but superficial, summary of our understanding about current and future climate changes, the predictions about how these changes will likely affect the risks of extinction of organisms, and how current climate changes are already affecting reproduction in terrestrial vertebrates. Many organisms have become extinct in the last century, but habitat destruction, disease and man-made factors other than climate change have been implicated as the causal factor in almost all of these. Reproduction is certain to be negatively impacted in all vertebrate groups for a variety of reasons, such as direct thermal and hydric effects on mortality of embryos, mismatches between optimal availability of food supplies, frequently determined by temperature, and reproductive capacities, sometimes determined by rigid factors such as photoperiod, and disappearance of appropriate foraging opportunities, such as melting sea ice. The numbers of studies documenting correlations between climate changes and biological phenomena are rapidly increasing, but more direct information about the consequences of these changes for species survival and ecosystem health is needed than is currently available.

  17. Radiosensitivity in plants

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

    Nauman, A F

    1979-01-01

    The report presents a compilation of available data on the sensitivity of plants to ionizing radiation, and provides basic information on methods of determining such sensitivities, or of estimating radiosensitivities by calcuation of the nuclear factors upon which they depend. The scope of the data presented here is necessarily limited to the most generally useful radiobiological end points and to the most commonly-used types of radiation. Many of the factors which influence radiosensitivity, particularly nuclear factors, will be discussed. Emphasis will be upon whole-plant studies done at Brookhaven National Laboratory by A.H. Sparrow and his associates, since these studies aremore » the source of most of the available radiosensitivity data and of all the sensitivity predictions listed here. Data presented here include summaries of experimentally-determined radiosensitivities at various end points for both herbaceous and woody higher plants, and for a few species of ferns and lower plants. The algae and fungi have not been considered here due to space limitations.« less

  18. The Obesity, Metabolic Syndrome, and Type 2 Diabetes Mellitus Pandemic: II. Therapeutic Management of Atherogenic Dyslipidemia

    PubMed Central

    Ginsberg, Henry N.; MacCallum, Paul R.

    2010-01-01

    Strategies for the effective management of cardiovascular risk factors in patients with the metabolic syndrome (MS) or type 2 diabetes mellitus (T2DM) are essential to help reduce cardiovascular morbidity and mortality. Treatment strategies should be multi-factorial and include the promotion of therapeutic lifestyle changes, as well as pharmacologic therapies to treat individual risk factors according to current guidelines. In an accompanying article, the importance of atherogenic dyslipidemia as a risk factor for the development of cardiovascular disease in patients with the MS or T2DM was highlighted. Current treatment options for managing this characteristic form of atherogenic dyslipidemia are limited and tend to be only moderately effective. The focus of this review is the current pharmacotherapies available for the management of atherogenic dyslipidemia in patients with the MS or T2DM, highlighting the rationale for combining available treatments. Novel strategies currently in clinical development are also discussed. PMID:19751468

  19. Word naming times and psycholinguistic norms for Italian nouns.

    PubMed

    Barca, Laura; Burani, Cristina; Arduino, Lisa S

    2002-08-01

    The present study describes normative measures for 626 Italian simple nouns. The database (LEXVAR.XLS) is freely available for down-loading on the Web site http://wwwistc.ip.rm.cnr.it/materia/database/. For each of the 626 nouns, values for the following variables are reported: age of acquisition, familiarity, imageability, concreteness, adult written frequency, child written frequency, adult spoken frequency, number of orthographic neighbors, mean bigram frequency, length in syllables, and length in letters. A classification of lexical stress and of the type of word-initial phoneme is also provided. The intercorrelations among the variables, a factor analysis, and the effects of variables and of the extracted factors on word naming are reported. Naming latencies were affected primarily by a factor including word length and neighborhood size and by a word frequency factor. Neither a semantic factor including imageability, concreteness, and age of acquisition nor a factor defined by mean bigram frequency had significant effects on pronunciation times. These results hold for a language with shallow orthography, like Italian, for which lexical nonsemantic properties have been shown to affect reading aloud. These norms are useful in a variety of research areas involving the manipulation and control of stimulus attributes.

  20. Insight into implementation of facility-based integrated management of childhood illness strategy in a rural district of Sindh, Pakistan

    PubMed Central

    Akber Pradhan, Nousheen; Rizvi, Narjis; Sami, Neelofar; Gul, Xaher

    2013-01-01

    Background Integrated management of childhood illnesses (IMCI) strategy has been proven to improve health outcomes in children under 5 years of age. Pakistan, despite being in the late implementation phase of the strategy, continues to report high under-five mortality due to pneumonia, diarrhea, measles, and malnutrition – the main targets of the strategy. Objective The study determines the factors influencing IMCI implementation at public-sector primary health care (PHC) facilities in Matiari district, Sindh, Pakistan. Design An exploratory qualitative study with an embedded quantitative strand was conducted. The qualitative part included 16 in-depth interviews (IDIs) with stakeholders which included planners and policy makers at a provincial level (n=5), implementers and managers at a district level (n=3), and IMCI-trained physicians posted at PHC facilities (n=8). Quantitative part included PHC facility survey (n=16) utilizing WHO health facility assessment tool to assess availability of IMCI essential drugs, supplies, and equipments. Qualitative content analysis was used to interpret the textual information, whereas descriptive frequencies were calculated for health facility survey data. Results The major factors reported to enhance IMCI implementation were knowledge and perception about the strategy and need for separate clinic for children aged under 5 years as potential support factors. The latter can facilitate in strategy implementation through allocated workforce and required equipments and supplies. Constraint factors mainly included lack of clear understanding of the strategy, poor planning for IMCI implementation, ambiguity in defined roles and responsibilities among stakeholders, and insufficient essential supplies and drugs at PHC centers. The latter was further substantiated through health facilities’ survey findings, which indicated that none of the facilities had 100% stock of essential supplies and drugs. Only one out of all 16 surveyed facilities had 75% of the total supplies, while 4 out of 16 facilities had 56% of the required IMCI drug stock. The mean availability of supplies ranged from 36.6 to 66%, while the mean availability of drugs ranged from 45.8 to 56.7%. Conclusion Our findings indicate that the Matiari district has sound implementation potential; however, bottlenecks at health care facility and at health care management level have badly constrained the implementation process. An interdependency exists among the constraining factors, such as lack of sound planning resulting in unclear understanding of the strategy; leading to ambiguous roles and responsibilities among stakeholders which manifest as inadequate availability of supplies and drugs at PHC facilities. Addressing these barriers is likely to have a cumulative effect on facilitating IMCI implementation. On the basis of these findings, we recommend that the provincial Ministry of Health (MoH) and provincial Maternal Neonatal and Child Health (MNCH) program jointly assess the situation and streamline IMCI implementation in the district through sound planning, training, supervision, and logistic support. PMID:23830574

  1. Occupational risk factors for skin cancer and the availability of sun protection measures at German outdoor workplaces.

    PubMed

    Ruppert, Linda; Ofenloch, Robert; Surber, Christian; Diepgen, Thomas

    2016-08-01

    Germany implemented a new occupational disease "squamous cell carcinoma or multiple actinic keratosis due to natural UV radiation (UVR)" into the German ordinance on occupational diseases. Since primary prevention is very important, the aim of this study was to assess the provision of sun protection measures by the employers in vocational school students for outdoor professions. We conducted a cross-sectional study on the availability of sun protection measures at German workplaces and the risk of occupational sunburn by surveying 245 vocational school students working in outdoor occupations. More than 40 % of the students did not receive any sun protection measures by their employer, and 34.5 % of the students got sunburned during work. Working in the shade was a protective factor for occupational sunburn but was merely available for 23.7 % of the outdoor workers. Our study reveals a strong need for effective sun protection measures, including both administrative controls like education and personal protection measures at German outdoor workplaces.

  2. Identifying Links Between Sexual Violence and Youth Violence Perpetration: New Opportunities for Sexual Violence Prevention

    PubMed Central

    DeGue, Sarah; Massetti, Greta M.; Holt, Melissa K.; Tharp, Andra Teten; Valle, Linda Anne; Matjasko, Jennifer L.; Lippy, Caroline

    2018-01-01

    Objective One promising opportunity for advancing sexual violence (SV) research and identifying new avenues for prevention involves examining other forms of violence that may share risk factors with SV. Youth violence (YV) is ideal for consideration given evidence of overlap in SV and YV risk factors, a large set of established YV risk factors across the social ecology, and the number of evidence-based YV prevention strategies available. The current paper identifies shared and unique risk factors for SV and YV and highlights evidence-based YV prevention strategies that impact these shared risk factors. Conclusions Researchers and program developers should consider adapting and evaluating evidence-based YV prevention strategies to prevent SV. Modifying these programs to address SV’s unique risk factors may maximize their potential effectiveness. In addition, expanding SV research at the outer levels of the social ecology is critical to developing community-level prevention strategies. The YV literature suggests several potential risk factors at these levels in need of research for SV, including school connectedness, social disorganization, and availability of alcohol and drugs. Using the YV literature as a starting point for expanding SV research leverages prior investments in YV research, may help identify new SV prevention strategies at a limited cost, and moves the field more quickly toward implementation of cost-effective, multidomain violence prevention strategies in communities. PMID:29644117

  3. The Current Situation in Latin American Education. Bulletin, 1963, No. 21. OE-14060

    ERIC Educational Resources Information Center

    Hauch, Charles C.

    1962-01-01

    The brief description of education in Latin American presented here is based on information available to the Office of Education, much of it in unpublished form, and provides an overview of the general situation of education in Latin America. Document contents include: (1) Introduction: Some Background Factors--historical,…

  4. Increasing Access and Relevance in Distance Education

    ERIC Educational Resources Information Center

    Mendenhall, Robert W.

    2009-01-01

    Access to higher education is subject to many factors including affordability, time and geography. Distance education can deliver education to those that live far from a campus. Some of that distance education may be synchronous, or live, requiring students to be available at certain times. Flexibility and access are increased when the instruction…

  5. Getting It Published: The Pleasures and Pitfalls of Self-Publishing.

    ERIC Educational Resources Information Center

    Wahab, Shaista; Boyer, Janice

    Although many methods of publishing scholarly work are available to the author, self-publishing is sometimes the most appropriate avenue to provide the work to the intended audience particularly if the scope of the material is of interest to a limited number of scholars. Topics include: copyright issues; cataloging data; factors influencing the…

  6. "Are We Almost There, Captain?" The Geographical Errors of Christopher Columbus.

    ERIC Educational Resources Information Center

    Edwards, Glenn M.

    1992-01-01

    Discusses the scientific knowledge available to Christopher Columbus and how it influenced his geographically flawed, yet historically significant, decision to sail west in order to travel east. Factors discussed include Aristotle's conclusion that the earth was round, early measurements of latitude and longitude, and early map-making attempts.…

  7. Bacillus thuringiensis Resistance Influences European Corn Borer (Lepidoptera: Crambidae) Larval Behavior after Exposure to Cry1Ab

    USDA-ARS?s Scientific Manuscript database

    The behavior of target pests has been recognized as an important factor to appropriately define resistance management plans for Bacillus thuringiensis (Bt) crops. However, most data available do not include the possible impact resistance alleles may have on the behavior of pest larvae or adults. To ...

  8. Has Bedside Teaching Had Its Day?

    ERIC Educational Resources Information Center

    Qureshi, Zeshan; Maxwell, Simon

    2012-01-01

    Though a diverse array of teaching methods is now available, bedside teaching is arguably the most favoured. Students like it because it is patient-centred, and it includes a high proportion of relevant skills. It is on the decline, coinciding with declining clinical skills of junior doctors. Several factors might account for this: busier…

  9. Wood fuel potential from harvested areas in the eastern United States.

    Treesearch

    Eugene M. Carpenter

    1980-01-01

    Estimates amount of wood fiber that could be available for fuel from forest residues on harvested areas in the eastern United States. Includes a key to resource data published by the USDA Forest Service and factors for estimating amounts of cull, bark, tops, and limbs from inventory and product output tabulations.

  10. 40 CFR 1051.625 - What special provisions apply to unique snowmobile designs for small-volume manufacturers?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... standards in § 1051.103, considering technology, cost, and other factors. (2) Identify the level of compliance you can achieve, including a description of available emission-control technologies and any constraints that may prevent more effective use of these technologies. (c) You must give us other relevant...

  11. 39 CFR 241.4 - Expansion, relocation, and construction of post offices.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... factors, environmental causes, or any other actions that would force an immediate relocation from an... of the project, in writing. (3) Send an initial news release to local communications media. (4)(i... the news release, or, space permitting, both. If such information is available at the time, include in...

  12. 39 CFR 241.4 - Expansion, relocation, and construction of post offices.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... factors, environmental causes, or any other actions that would force an immediate relocation from an... of the project, in writing. (3) Send an initial news release to local communications media. (4)(i... the news release, or, space permitting, both. If such information is available at the time, include in...

  13. 39 CFR 241.4 - Expansion, relocation, and construction of post offices.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... factors, environmental causes, or any other actions that would force an immediate relocation from an... of the project, in writing. (3) Send an initial news release to local communications media. (4)(i... the news release, or, space permitting, both. If such information is available at the time, include in...

  14. 39 CFR 241.4 - Expansion, relocation, and construction of post offices.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... factors, environmental causes, or any other actions that would force an immediate relocation from an... of the project, in writing. (3) Send an initial news release to local communications media. (4)(i... the news release, or, space permitting, both. If such information is available at the time, include in...

  15. 39 CFR 241.4 - Expansion, relocation, and construction of post offices.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... factors, environmental causes, or any other actions that would force an immediate relocation from an... of the project, in writing. (3) Send an initial news release to local communications media. (4)(i... the news release, or, space permitting, both. If such information is available at the time, include in...

  16. Staying Close to Home: Women's Life-Choices and the Superintendency

    ERIC Educational Resources Information Center

    Sperandio, Jill; Devdas, Lavanya

    2015-01-01

    Purpose: The purpose of this paper is to examine the importance of lifestyle factors including geographical relocation, accommodation for dual earner careers, and availability of family or non-family domestic help on the career choices of women assistant superintendents and superintendents in school districts in the USA. Women's access to the…

  17. 77 FR 9916 - California State Motor Vehicle and Nonroad Engine Pollution Control Standards; Mobile Cargo...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-21

    ... safety factors (including the potential increased risk of burn or fire) associated with compliance with... that improper sizing of VDECS with engines may be occurring. This coupled with a lack of concrete... available, etc.). Based on the lack of concrete evidence from the commenters that it has incurred...

  18. Ecological genetics of floret mass variation in Bromus tectorum (Poaceae)

    Treesearch

    Susan E. Meyer

    2010-01-01

    Bromus tectorum L. (cheatgrass, downy brome) is a highly invasive inbreeding annual grass that dominates millions of hectares of former shrubland in interior western North America. Factors contributing to its success include strong genetic regulation of key adaptive traits coupled with high phenotypic plasticity in response to resource availability (Meyer and Allen...

  19. The 1993 RPA timber assessment update

    Treesearch

    Richard W. Haynes; Darius M. Adams; John R. Mills

    1995-01-01

    This update reports changes in the Nation's timber resource since the 1989 RPA timber assessment. The timber resource situation is analyzed to provide projections for future cost and availability of timber products to meet demands. Prospective trends in demands for and supplies of timber, and the factors that affect these trends are examined. These include changes...

  20. Bridging national and reference definitions for harmonizing forest statistics

    Treesearch

    Göran ​Ståhl; Emil Cienciala; Gherardo Chirici; Adrian Lanz; Claude Vidal; Susanne Winter; Ronald E. McRoberts; Jacques Rondeux; Klemens Schadauer; Erkki Tomppo

    2012-01-01

    Harmonization is the process of making information and estimates comparable across administrative borders. The degree to which harmonization succeeds depends on many factors, including the conciseness of the definitions, the availability and quality of data, and the methods used to convert an estimate according to a local definition to an estimate according to the...

  1. Examining Correlates of Part-Time Faculty Affective Commitment and Job Satisfaction

    ERIC Educational Resources Information Center

    Duhn, Samantha Tiffany

    2013-01-01

    Changes in a multitude of factors including the economy, student enrollment, university goals and policies, and the available talent pool have created an imbalance in the supply and demand for qualified part-time faculty. The unmet demand has prompted university leaders to seek an understanding of part-time faculty affective commitment, job…

  2. Living well with dementia: a systematic review and correlational meta-analysis of factors associated with quality of life, well-being and life satisfaction in people with dementia.

    PubMed

    Martyr, Anthony; Nelis, Sharon M; Quinn, Catherine; Wu, Yu-Tzu; Lamont, Ruth A; Henderson, Catherine; Clarke, Rachel; Hindle, John V; Thom, Jeanette M; Jones, Ian Rees; Morris, Robin G; Rusted, Jennifer M; Victor, Christina R; Clare, Linda

    2018-05-08

    Current policy emphasises the importance of 'living well' with dementia, but there has been no comprehensive synthesis of the factors related to quality of life (QoL), subjective well-being or life satisfaction in people with dementia. We examined the available evidence in a systematic review and meta-analysis. We searched electronic databases until 7 January 2016 for observational studies investigating factors associated with QoL, well-being and life satisfaction in people with dementia. Articles had to provide quantitative data and include ⩾75% people with dementia of any type or severity. We included 198 QoL studies taken from 272 articles in the meta-analysis. The analysis focused on 43 factors with sufficient data, relating to 37639 people with dementia. Generally, these factors were significantly associated with QoL, but effect sizes were often small (0.1-0.29) or negligible (<0.09). Factors reflecting relationships, social engagement and functional ability were associated with better QoL. Factors indicative of poorer physical and mental health (including depression and other neuropsychiatric symptoms) and poorer carer well-being were associated with poorer QoL. Longitudinal evidence about predictors of QoL was limited. There was a considerable between-study heterogeneity. The pattern of numerous predominantly small associations with QoL suggests a need to reconsider approaches to understanding and assessing living well with dementia.

  3. Neighbor-Dependent Ramachandran Probability Distributions of Amino Acids Developed from a Hierarchical Dirichlet Process Model

    PubMed Central

    Mitra, Rajib; Jordan, Michael I.; Dunbrack, Roland L.

    2010-01-01

    Distributions of the backbone dihedral angles of proteins have been studied for over 40 years. While many statistical analyses have been presented, only a handful of probability densities are publicly available for use in structure validation and structure prediction methods. The available distributions differ in a number of important ways, which determine their usefulness for various purposes. These include: 1) input data size and criteria for structure inclusion (resolution, R-factor, etc.); 2) filtering of suspect conformations and outliers using B-factors or other features; 3) secondary structure of input data (e.g., whether helix and sheet are included; whether beta turns are included); 4) the method used for determining probability densities ranging from simple histograms to modern nonparametric density estimation; and 5) whether they include nearest neighbor effects on the distribution of conformations in different regions of the Ramachandran map. In this work, Ramachandran probability distributions are presented for residues in protein loops from a high-resolution data set with filtering based on calculated electron densities. Distributions for all 20 amino acids (with cis and trans proline treated separately) have been determined, as well as 420 left-neighbor and 420 right-neighbor dependent distributions. The neighbor-independent and neighbor-dependent probability densities have been accurately estimated using Bayesian nonparametric statistical analysis based on the Dirichlet process. In particular, we used hierarchical Dirichlet process priors, which allow sharing of information between densities for a particular residue type and different neighbor residue types. The resulting distributions are tested in a loop modeling benchmark with the program Rosetta, and are shown to improve protein loop conformation prediction significantly. The distributions are available at http://dunbrack.fccc.edu/hdp. PMID:20442867

  4. Childhood Sexual Violence in Indonesia: A Systematic Review.

    PubMed

    Rumble, Lauren; Febrianto, Ryan Fajar; Larasati, Melania Niken; Hamilton, Carolyn; Mathews, Ben; Dunne, Michael P

    2018-01-01

    There has been relatively little research into the prevalence of childhood sexual violence (CSV) as well as the risk and protective factors for CSV in low- and middle-income countries including Indonesia. Systematic searches conducted in English and Bahasa Indonesia in this review identified 594 records published between 2006 and 2016 in peer-reviewed journals and other literature including 299 Indonesian records. Fifteen studies, including nine prevalence studies, met the quality appraisal criteria developed for this review. The review found that CSV research is scarce: Only one study included nationally representative prevalence estimates. Varying definitions for CSV, survey methods, and sample characteristics limited the generalizability of the data. The available evidence points to significant risk of sexual violence affecting both girls and boys across many geographical and institutional settings. Married adolescent girls are vulnerable to sexual violence by partners in their homes. Children in schools are vulnerable to CSV by peers and adults. Victims seldom disclose incidents and rarely seek support. In addition, early childhood experiences of trauma were strongly associated with later perpetration of sexual violence and revictimization. Limited information is available about protective factors. This review synthesizes evidence about what is currently known about CSV in Indonesia and identifies the strengths and weaknesses of the existing research. A more robust evidence base regarding CSV is required to better inform policy and justify investment into prevention programs.

  5. Reframing family-centred obesity prevention using the Family Ecological Model.

    PubMed

    Davison, Kirsten K; Jurkowski, Janine M; Lawson, Hal A

    2013-10-01

    According to the Family Ecological Model (FEM), parenting behaviours are shaped by the contexts in which families are embedded. In the present study, we utilize the FEM to guide a mixed-methods community assessment and summarize the results. Additionally, we discuss the utility of the FEM and outline possible improvements. Using a cross-sectional design, qualitative and quantitative methods were used to examine the ecologies of parents’ cognitions and behaviours specific to children’s diet, physical activity and screen-based behaviours. Results were mapped onto constructs outlined in the FEM. The study took place in five Head Start centres in a small north-eastern city. The community assessment was part of a larger study to develop and evaluate a family-centred obesity prevention programme for low-income families. Participants included eighty-nine low-income parents/caregivers of children enrolled in Head Start. Parents reported a broad range of factors affecting their parenting cognitions and behaviours. Intrafamilial factors included educational and cultural backgrounds, family size and a lack of social support from partners. Organizational factors included staff stability at key organizations, a lack of service integration and differing school routines. Community factors included social connectedness to neighbours/friends, shared norms around parenting and the availability of safe public housing and play spaces. Policy- and media-related factors included requirements of public assistance programmes, back-to-work policies and children’s exposure to food advertisements. Based on these findings, the FEM was refined to create an evidence-based,temporally structured logic model to support and guide family-centred research in childhood obesity prevention.

  6. Reframing family-centred obesity prevention using the Family Ecological Model

    PubMed Central

    Davison, Kirsten K; Jurkowski, Janine M; Lawson, Hal A

    2017-01-01

    Objective According to the Family Ecological Model (FEM), parenting behaviours are shaped by the contexts in which families are embedded. In the present study, we utilize the FEM to guide a mixed-methods community assessment and summarize the results. Additionally, we discuss the utility of the FEM and outline possible improvements. Design Using a cross-sectional design, qualitative and quantitative methods were used to examine the ecologies of parents’ cognitions and behaviours specific to children’s diet, physical activity and screen-based behaviours. Results were mapped onto constructs outlined in the FEM. Setting The study took place in five Head Start centres in a small north-eastern city. The community assessment was part of a larger study to develop and evaluate a family-centred obesity prevention programme for low-income families. Subjects Participants included eighty-nine low-income parents/caregivers of children enrolled in Head Start. Results Parents reported a broad range of factors affecting their parenting cognitions and behaviours. Intrafamilial factors included educational and cultural backgrounds, family size and a lack of social support from partners. Organizational factors included staff stability at key organizations, a lack of service integration and differing school routines. Community factors included social connectedness to neighbours/friends, shared norms around parenting and the availability of safe public housing and play spaces. Policy- and media-related factors included requirements of public assistance programmes, back-to-work policies and children’s exposure to food advertisements. Conclusions Based on these findings, the FEM was refined to create an evidence-based, temporally structured logic model to support and guide family-centred research in childhood obesity prevention. PMID:23089267

  7. [Environment and cancer risk].

    PubMed

    Boffetta, Paolo

    2013-10-01

    Several environmental factors, defined as pollutants present in air, water or other media, have been shown to be carcinogenic, including residential exposure to asbestos and radon, second-hand tobacco smoke, diesel engine emissions, and arsenic contamination of drinking water. Other factors, such as outdoor air pollution and water chlorination byproducts, are suspected carcinogens. In the case of pesticides and electromagnetic fields, including the use of cell phones, the available evidence does not suggest an increased risk of cancer. Overall, environmental causes of cancer are responsible for a limited proportion of the total burden of cancer in France and other high-income countries. Because of the involuntary nature of the exposure and the possibility to implement preventive measures, research into environmental cancer remains an important priority.

  8. Factors that influence career choice in primary care among medical students starting social service in Honduras.

    PubMed

    Puertas, E Benjamín; Rivera, Tamara Y

    2016-11-01

    To 1) describe patterns of specialty choice; 2) investigate relationships between career selection and selected demographic indicators; and 3) identify salary perception, factors that influence career choice in primary care, and factors that influence desired location of future medical practice. The study used a mixed-methods approach that included a cross-sectional questionnaire survey applied to 234 last-year medical students in Honduras (September 2014), and semi-structured interviews with eight key informants (October 2014). Statistical analysis included chi-square and factor analysis. An alpha level of 0.05 was used to determine significance. In the qualitative analysis, several codes were associated with each other, and five major themes emerged. Primary care careers were the preferred choice for 8.1% of students, who preferred urban settings for future practice location. The perceived salary of specialties other than primary care was significantly higher than those of general practitioners, family practitioners, and pediatricians (P < 0.001). Participants considered "making a difference," income, teaching, prestige, and challenging work the most important factors influencing career choice. Practice in ambulatory settings was significantly associated with a preference for primary care specialties (P = < 0.05). Logistic regression analysis found that factors related to patient-based care were statistically significant for selecting primary care (P = 0.006). The qualitative analysis further endorsed the survey findings, identifying additional factors that influence career choice (future work option; availability of residency positions; and social factors, including violence). Rationales behind preference of a specialty appeared to be based on a combination of ambition and prestige, and on personal and altruistic considerations. Most factors that influence primary care career choice are similar to those found in the literature. There are several factors distinctive to medical students in Honduras-most of them barriers to primary care career choice.

  9. Scaffolds in Tendon Tissue Engineering

    PubMed Central

    Longo, Umile Giuseppe; Lamberti, Alfredo; Petrillo, Stefano; Maffulli, Nicola; Denaro, Vincenzo

    2012-01-01

    Tissue engineering techniques using novel scaffold materials offer potential alternatives for managing tendon disorders. Tissue engineering strategies to improve tendon repair healing include the use of scaffolds, growth factors, cell seeding, or a combination of these approaches. Scaffolds have been the most common strategy investigated to date. Available scaffolds for tendon repair include both biological scaffolds, obtained from mammalian tissues, and synthetic scaffolds, manufactured from chemical compounds. Preliminary studies support the idea that scaffolds can provide an alternative for tendon augmentation with an enormous therapeutic potential. However, available data are lacking to allow definitive conclusion on the use of scaffolds for tendon augmentation. We review the current basic science and clinical understanding in the field of scaffolds and tissue engineering for tendon repair. PMID:22190961

  10. Cardiovascular services and human resources in Puerto Rico - 2008.

    PubMed

    García-Palmieri, Mario R

    2009-01-01

    Available information (2004-2008) concerning population statistics, the occurrence of cardiovascular disease, cardiovascular services and human resources in Puerto Rico is presented. Relevant information concerning life expectancy at birth, death by specific causes in a recent four years period, the commonest causes of death, and the related cardiovascular risk factors prevalence data available is included. The surgical and medical interventional services rendered to cardiovascular patients in different institutions and their locations in Puerto Rico in the year 2008 is presented. Some remarks concerning the productivity of physicians by our Schools of Medicine is included. Information about ACGME accredited postgraduate cardiovascular training programs conducted in Puerto Rico is presented. Data concerning the prevalence of hypertension, diabetes mellitus, overweight and obesity obtained by BRFSS in presented.

  11. Establishing reference values for central blood pressure and its amplification in a general healthy population and according to cardiovascular risk factors.

    PubMed

    Herbert, Annie; Cruickshank, John Kennedy; Laurent, Stéphane; Boutouyrie, Pierre

    2014-11-21

    Estimated central systolic blood pressure (cSBP) and amplification (Brachial SBP-cSBP) are non-invasive measures potentially prognostic of cardiovascular (CV) disease. No worldwide, multiple-device reference values are available. We aimed to establish reference values for a worldwide general population standardizing between the different available methods of measurement. How these values were significantly altered by cardiovascular risk factors (CVRFs) was then investigated. Existing data from population surveys and clinical trials were combined, whether published or not. Reference values of cSBP and amplification were calculated as percentiles for 'Normal' (no CVRFs) and 'Reference' (any CVRFs) populations. We included 45,436 subjects out of 82,930 that were gathered from 77 studies of 53 centres. Included subjects were apparently healthy, not treated for hypertension or dyslipidaemia, and free from overt CV disease and diabetes. Values of cSBP and amplification were stratified by brachial blood pressure categories and age decade in turn, both being stratified by sex. Amplification decreased with age and more so in males than in females. Sex was the most powerful factor associated with amplification with 6.6 mmHg (5.8-7.4) higher amplification in males than in females. Amplification was marginally but significantly influenced by CVRFs, with smoking and dyslipidaemia decreasing amplification, but increased with increasing levels of blood glucose. Typical values of cSBP and amplification in a healthy population and a population free of traditional CVRFs are now available according to age, sex, and brachial BP, providing values included from different devices with a wide geographical representation. Amplification is significantly influenced by CVRFs, but differently in men and women. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  12. Factors promoting sustainability of education innovations: a comparison of faculty perceptions and existing frameworks.

    PubMed

    Loh, Lawrence C; Friedman, Stacey R; Burdick, William P

    2013-01-01

    Health professions education uses innovative projects to promote faculty development and institution change. Faculty perceptions of the factors that promote project sustainability affect how faculty conceptualize and implement their innovations, which influences whether and how they plan for sustainability. This paper compares educators' perceptions of factors that influence sustainability in innovative projects with factors identified in project sustainability literature, to identify areas of convergence and divergence. Using questionnaires, faculty development fellowship participants from Brazil and India shared their perceptions on factors influencing their project's sustainability. An analysis framework was developed from existing project sustainability literature; faculty responses were then coded through an iterative process. Key sustainability themes identified by faculty included project-level factors related to project design, stakeholder support, monitoring and evaluation, and project outcomes. Identified context level factors were related to institutional and governmental support as well as self-motivation and peer support. Availability of resources and funding were identified as relevant at both the project and context levels. Project-level factors were more often cited than context-level factors as key to ensuring sustainability. Faculty development efforts in health professions education should employ strategies to target these themes in promoting innovation sustainability. These include preengagement with institutional leaders, alignment with public sector goals, strategic diffusion of information, project expansion and transferability, capacity building in monitoring and evaluation, and creation of a community of educators for information exchange and support.

  13. Anti-cancer Effects of Metformin: Recent Evidences for its Role in Prevention and Treatment of Cancer.

    PubMed

    Kheirandish, Masoumeh; Mahboobi, Hamidreza; Yazdanparast, Maryam; Kamal, Warda; Kamal, Mohammad A

    2018-04-16

    Metformin is widely used for the management of type 2 diabetes mellitus (T2DM). Recently growing evidence has shown its anti-cancer effects. The results are mainly obtained from observational studies and thus, little information is available concerning the mechanisms of action. Adenosine monophosphate (AMP)-activated protein kinase (AMPK) plays an important role in the mechanism of action of metformin. The anti-cancer mechanisms of metformin include direct and indirect effects. The direct effects of metformin include AMPK-independent and AMPK-dependent effects, whereas the decrease in glucose level, hyperinsulinemia, and Insulin-like growth factor 1 (IGF-1) level was considered its indirect effects. Metformin also decreases both pro-inflammatory cytokines and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and improves the immune response to cancer cells. Although the results of recent trials confirm the efficacy of metformin in prevention and treatment of different cancers, the evidence is not adequate enough. This paper reviews recently available evidence on anti-cancer effects of metformin. The effects of metformin in specific cancers including colorectal, prostate, pancreatic, renal, cervical, endometrial, gastric, lung, breast, and ovarian cancer are also reviewed in this paper. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  14. Factors influencing African-American mothers' concerns about immunization safety: a summary of focus group findings.

    PubMed Central

    Shui, Irene; Kennedy, Allison; Wooten, Karen; Schwartz, Benjamin; Gust, Deborah

    2005-01-01

    OBJECTIVE: To examine the vaccine safety concerns of African-American mothers who, despite concerns, have their children immunized. METHODS: Six focus groups of Atlanta-area African-American mothers who were very concerned about vaccine safety but whose children were fully vaccinated were conducted. RESULTS: Major factors influencing participants' concerns about immunizations included: lack of information and mistrust of the medical community and government. Factors that convinced parents to have their child immunized despite their concerns included social norms and/or laws supporting immunization and fear of the consequences of not immunizing. Suggestions given to reduce concerns included improving available information that addressed their concerns and provider-patient communication. CONCLUSIONS: Addressing mothers' concerns about immunization is important both from an ethical perspective, in assuring that they are fully informed of the risks and benefits of immunizations, as well as from a practical one, in reducing the possibility that they will decide not to immunize their child. Changes in the childhood immunization process should be made to reduce parental concern about vaccine safety. Some changes that may be considered include improved provider communication about immunizations and additional tailored information about the necessity and safety of vaccines. PMID:15926642

  15. Vaccine vial monitor availability and use in low- and middle-income countries: A systematic review.

    PubMed

    Eriksson, Pär; Gessner, Bradford D; Jaillard, Philippe; Morgan, Christopher; Le Gargasson, Jean Bernard

    2017-04-19

    The vaccine vial monitor (VVM) registers cumulative heat exposure on vaccines over time. As low- and lower-middle-income countries transition beyond support from the Global Alliance for Vaccines and Immunization (Gavi), they will assume full responsibility for vaccine financing and procurement. It is unclear to what extent countries transitioning out of Gavi support will continue to include VVMs on their vaccines. This paper aims to systematically review evidence on VVM availability and use in low- and middle-income countries to document factors behind global access to and country demand for VVMs. Such results could help identify actions needed to ensure continued use of VVMs in countries that transition out of Gavi support. We performed a systematic review of electronic databases, reference lists, and grey literature in English and French languages with publication dates from 2005 onwards. The studies included were analyzed for the following outcomes: (1) availability and deployment of VVM-labeled vaccines; (2) VVM practices and perceptions in the immunization system; (3) vaccine introduction and decision-making processes; (4) Gavi graduation and vaccine program sustainability. The study found that VVM availability and use was affected by multiple sourcing of vaccines and the extent to which VVM was included in the vaccine specification in the tendering documents when procuring vaccines. Knowledge about VVM and its impact on the EPI program was found to be high among health workers as well as decision-makers. However, the study also found that weak capacity in key national institutions such as NRA and NPA might impact on demand for VVM. As countries take decisions regarding the adoption of new vaccines, factors such as disease burden and vaccine price may assume greater importance than vaccine characteristics and presentation. Finally, the study found that countries rely largely on the advice and recommendations from technical partners such as WHO and PAHO. The study concludes that global access to and country demand for VVM are dependent on policy statements and recommendations about VVM by key policy institutions such as WHO and UNICEF. The study also concludes that despite Gavi-eligible countries having access to VVM-labeled vaccines, inclusion is often below 100%. Weak institutional capacity in key national agencies such as NRA and NPA seems to be a contributing factor, while other factors include the procurement of clear national policies on the inclusion of VVM on vaccines, along with the capacity to enforce the policy. Finally, the study concludes that knowledge about VVM and its impact on vaccine program efficiency, safety, and cost is critical for transitioning countries' continuous demand for VVM. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  16. Trends in childhood cancer incidence: review of environmental linkages.

    PubMed

    Buka, Irena; Koranteng, Samuel; Osornio Vargas, Alvaro R

    2007-02-01

    Cancer in children is rare and accounts for about 1% of all malignancies. In the developed world, however, it is the commonest cause of disease-related deaths in childhood, carrying with it a great economic and emotional cost. Cancers are assumed to be multivariate, multifactorial diseases that occur when a complex and prolonged process involving genetic and environmental factors interact in a multistage sequence. This article explores the available evidence for this process, primarily from the environmental linkages perspective but including some evidence of the genetic factors.

  17. The Role of Health Systems Factors in Facilitating Access to Psychotropic Medicines: A Cross-Sectional Analysis of the WHO-AIMS in 63 Low- and Middle-Income Countries

    PubMed Central

    McBain, Ryan; Norton, Daniel J.; Morris, Jodi; Yasamy, M. Taghi; Betancourt, Theresa S.

    2012-01-01

    Background Neuropsychiatric conditions comprise 14% of the global burden of disease and 30% of all noncommunicable disease. Despite the existence of cost-effective interventions, including administration of psychotropic medicines, the number of persons who remain untreated is as high as 85% in low- and middle-income countries (LAMICs). While access to psychotropic medicines varies substantially across countries, no studies to date have empirically investigated potential health systems factors underlying this issue. Methods and Findings This study uses a cross-sectional sample of 63 LAMICs and country regions to identify key health systems components associated with access to psychotropic medicines. Data from countries that completed the World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS) were included in multiple regression analyses to investigate the role of five major mental health systems domains in shaping medicine availability and affordability. These domains are: mental health legislation, human rights implementations, mental health care financing, human resources, and the role of advocacy groups. Availability of psychotropic medicines was associated with features of all five mental health systems domains. Most notably, within the domain of mental health legislation, a comprehensive national mental health plan was associated with 15% greater availability; and in terms of advocacy groups, the participation of family-based organizations in the development of mental health legislation was associated with 17% greater availability. Only three measures were related with affordability of medicines to consumers: level of human resources, percentage of countries' health budget dedicated to mental health, and availability of mental health care in prisons. Controlling for country development, as measured by the Human Development Index, health systems features were associated with medicine availability but not affordability. Conclusions Results suggest that strengthening particular facets of mental health systems might improve availability of psychotropic medicines and that overall country development is associated with affordability. Please see later in the article for the Editors' Summary PMID:22303288

  18. Risk factors for leptospirosis infection in humans and implications for public health intervention in Indonesia and the Asia-Pacific region.

    PubMed

    Sakundarno, Mateus; Bertolatti, Dean; Maycock, Bruce; Spickett, Jeffery; Dhaliwal, Satvinder

    2014-01-01

    Prevention and control of leptospirosis require an understanding of risk factors. This review identifies risk factors associated with leptospirosis infection from countries in the Asia-Pacific region, and compares and contrasts these data with those available from Indonesia. MEDLINE, PubMed, and Scopus databases were used to search for relevant articles. Indonesian gray literature was searched for leptospirosis risk factor studies in Indonesia. A total of 34 articles were included in this review. The contrast between peer-reviewed publications and Indonesian gray literature revealed that the variety of risk factors associated with leptospirosis infection is region or area specific. The presence of skin wounds, the existence of rodents, especially rats, and activities related to contact with contaminated surface water are factors frequently reported to have significant association with leptospirosis infection in human in Indonesia and in other Asia-Pacific countries.

  19. Assessing groundwater availability in the Northern Atlantic Coastal Plain aquifer system

    USGS Publications Warehouse

    Masterson, John P.; Pope, Jason P.; Monti, Jack; Nardi, Mark R.

    2011-01-01

    The U.S. Geological Survey's Groundwater Resources Program is conducting an assessment of groundwater availability throughout the United States to gain a better understanding of the status of the Nation's groundwater resources and how changes in land use, water use, and climate may affect those resources. The goal of this National assessment is to improve our ability to forecast water availability for future economic and environmental uses. Assessments will be completed for the Nation's principal aquifer systems to help characterize how much water is currently available, how water availability is changing, and how much water we can expect to have in the future (Reilly and others, 2008). The concept of groundwater availability is more than just how much water can be pumped from any given aquifer. Groundwater availability is a function of many factors, including the quantity and quality of water and the laws, regulations, economics, and environmental factors that control its use. The primary objective of the North Atlantic Coastal Plain groundwater-availability study is to identify spatial and temporal changes in the overall water budget by more fully determining the natural and human processes that control how water enters, moves through, and leaves the groundwater system. Development of tools such as numerical models can help hydrologists gain an understanding of this groundwater system, allowing forecasts to be made about the response of this system to natural and human stresses, and water quality and ecosystem health to be analyzed, throughout the region.

  20. Emission factors for hydraulically fractured gas wells derived using well- and battery-level reported data for Alberta, Canada.

    PubMed

    Tyner, David R; Johnson, Matthew R

    2014-12-16

    A comprehensive technical analysis of available industry-reported well activity and production data for Alberta in 2011 has been used to derive flaring, venting, and diesel combustion greenhouse gas and criteria air contaminant emission factors specifically linked to drilling, completion, and operation of hydraulically fractured natural gas wells. Analysis revealed that in-line ("green") completions were used at approximately 53% of wells completed in 2011, and in other cases the majority (99.5%) of flowback gases were flared rather than vented. Comparisons with limited analogous data available in the literature revealed that reported total flared and vented natural gas volumes attributable to tight gas well-completions were ∼ 6 times larger than Canadian Association of Petroleum Producers (CAPP) estimates for natural gas well-completion based on wells ca. 2000, but 62% less than an equivalent emission factor that can be derived from U.S. EPA data. Newly derived emission factors for diesel combustion during well drilling and completion are thought to be among the first such data available in the open literature, where drilling-related emissions for tight gas wells drilled in Alberta in 2011 were found to have increased by a factor of 2.8 relative to a typical well drilled in Canada in 2000 due to increased drilling lengths. From well-by-well analysis of production phase flared, vented, and fuel usage natural gas volumes reported at 3846 operating tight gas wells in 2011, operational emission factors were developed. Overall results highlight the importance of operational phase GHG emissions at upstream well sites (including on-site natural gas fuel use), and the critical levels of uncertainty in current estimates of liquid unloading emissions.

  1. Olfactory dysfunction and its measurement in the clinic and workplace.

    PubMed

    Doty, Richard L

    2006-04-01

    To provide an overview of practical means for quantitatively assessing the sense of smell in both the clinic and workplace. To address basic measurement issues, including those of test sensitivity, specificity, and reliability. To describe and discuss factors that influence olfactory function, including airborne toxins commonly found in industrial settings. Selective review and discussion. A number of well-validated practical threshold and suprathreshold tests are available for assessing smell function. The reliability, sensitivity, and specificity of such techniques vary, being influenced by such factors as test length and type. Numerous subject factors, including age, sex, health, medications, and exposure to environmental toxins, particularly heavy metals, influence the ability to smell. Modern advances in technology, in conjunction with better occupational medicine practices, now make it possible to reliably monitor and limit occupational exposures to hazardous chemicals and their potential adverse influences on the sense of smell. Quantitative olfactory testing is critical to establish the presence or absence of such adverse influences, as well as to (a) detect malingering, (b) establish disability compensation, and (c) monitor function over time.

  2. Lipoprotein (a) and cardiovascular risk factors in children and adolescents.

    PubMed

    Palmeira, Ástrid Camêlo; Leal, Adriana Amorim de F; Ramos, Nathaly de Medeiros N; Neto, José de Alencar F; Simões, Mônica Oliveira da S; Medeiros, Carla Campos M

    2013-12-01

    To review the relationship between lipoprotein (a) [Lp(a)] and other risk factors for cardiovascular disease (CVD) in children and adolescents. This systematic review included studies from 2001 to 2011, a ten-year time period. Epidemiological studies with children and/or adolescents published in English, Portuguese or Spanish and fully available online were included. The searches were performed in Science Direct, PubMed/Medline, BVS (Biblioteca Virtual em Saúde) and Cochrane Library databases, using the following combination of key-words: "lipoprotein a" and "cardiovascular diseases" and "obesity". Overall, 672 studies were obtained but only seven were included. Some studies assessed the family history for CVD. In all of them, Lp(a) levels were increased in patients with family history for CVD. There was also a positive correlation between Lp(a) and LDL-cholesterol, total cholesterol, and apolipoprotein B levels, suggesting an association between Lp(a) levels and the lipid profile. The evidence that CVD may originate in childhood and adolescence leads to the need for investigating the risk factors during this period in order to propose earlier and possibly more effective interventions to reduce morbidity and mortality rates.

  3. Assessment of progress towards universal health coverage for people with disabilities in Afghanistan: a multilevel analysis of repeated cross-sectional surveys.

    PubMed

    Trani, Jean-Francois; Kumar, Praveen; Ballard, Ellis; Chandola, Tarani

    2017-08-01

    Since 2002, Afghanistan has made much effort to achieve universal health coverage. According to the UN Sustainable Development Goal 3, target eight, the provision of quality care to all must include usually underserved groups, including people with disabilities. We investigated whether a decade of international investment in the Afghan health system has brought quality health care to this group. We used data from two representative household surveys, one done in 2005 and one in 2013, in 13 provinces of Afghanistan, that included questions about activity limitations and functioning difficulties, socioeconomic factors, perceived availability of health care, and experience with coverage of health-care needs. We used multilevel modelling and tests for interaction to investigate factors associated with differences in perception between timepoints and whether village remoteness affected changes in perception. The 2005 survey included 334 people, and the 2013 survey included 961 people. Mean age, employment, and asset levels of participants with disabilities increased slightly between 2005 and 2013, but the level of education decreased. Formal education and higher asset level were associated with improved availability of health care and positive experience with coverage of health-care needs, whereas being employed was only associated with the latter. Perceived availability of health care and positive experience with coverage of health-care needs significantly worsened in 2013 compared with in 2005 (227 [69%] perceived that services were available in 2005 vs 405 [44%] in 2013, p<0·0001; 255 [78%] perceived a positive experience in 2005 vs 410 [45%] in 2013, p<0·0001). Village remoteness increased in 2013 (no connectivity by paved road 186 [57%] in 2005 vs 797 [87%] in 2013, p<0·0001; mean time to reach health-care facility 64·3 min [SD 167·7] vs 84·4 min [107·7], p<0·0001) and negatively affected perception of health-care availability. Perceived availability of health care and experience with health-care coverage have not greatly improved for people with disabilities in Afghanistan, particularly in remote areas. Health policy in Afghanistan will need to address attitudinal, social, and accessibility barriers to health care. Swedish International Development Agency. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

  4. Modeling the Ebola zoonotic dynamics: Interplay between enviroclimatic factors and bat ecology

    PubMed Central

    Johnson, Kaylynn

    2017-01-01

    Understanding Ebola necessarily requires the characterization of the ecology of its main enzootic reservoir, i.e. bats, and its interplay with seasonal and enviroclimatic factors. Here we present a SIR compartmental model where we implement a bidirectional coupling between the available resources and the dynamics of the bat population in order to understand their migration patterns. Our compartmental modeling approach and simulations include transport terms to account for bats mobility and spatiotemporal climate variability. We hypothesize that environmental pressure is the main driving force for bats’ migration and our results reveal the appearance of sustained migratory waves of Ebola virus infected bats coupled to resources availability. Ultimately, our study can be relevant to predict hot spots of Ebola outbreaks in space and time and suggest conservation policies to mitigate the risk of spillovers. PMID:28604813

  5. Risk factors affecting survival in heart transplant patients.

    PubMed

    Almenar, L; Cardo, M L; Martínez-Dolz, L; García-Palomar, C; Rueda, J; Zorio, E; Arnau, M A; Osa, A; Palencia, M

    2005-11-01

    Certain cardiovascular risk factors have been linked to morbidity and mortality in heart transplant (HT) patients. The sum of various risk factors may have a large cumulative negative effect, leading to a substantially worse prognosis and the need to consider whether HT is contraindicated. The objective of this study was to determine whether the risk factors usually available prior to HT result in an excess mortality in our setting that contraindicates transplantation. Consecutive patients who underwent heart transplantation from November 1987 to January 2004 were included. Heart-lung transplants, retransplants, and pediatric transplants were excluded. Of the 384 patients, 89% were men. Mean age was 52 years (range, 12 to 67). Underlying disease included ischemic heart disease (52%), idiopathic dilated cardiomyopathy (36%), valvular disease (8%), and other (4%). Variables considered risk factors were obesity (BMI >25), dyslipidemia, hypertension, prior thoracic surgery, diabetes, and history of ischemic heart disease. Survival curves by number of risk factors using Kaplan-Meier and log-rank for comparison of curves. Overall patient survival at 1, 5, 10, and 13 years was 76%, 68%, 54%, and 47%, respectively. Survival at 10 years, if fewer than two risk factors were present, was 69%; 59% if two or three factors were present; and 37% if more than three associated risk factors were present (P = .04). The presence of certain risk factors in patients undergoing HT resulted in lower survival rates. The combination of various risk factors clearly worsened outcomes. However, we do not believe this should be an absolute contraindication for transplantation.

  6. Polycythemia Vera: An Appraisal of the Biology and Management 10 Years After the Discovery of JAK2 V617F

    PubMed Central

    Stein, Brady L.; Oh, Stephen T.; Berenzon, Dmitriy; Hobbs, Gabriela S.; Kremyanskaya, Marina; Rampal, Raajit K.; Abboud, Camille N.; Adler, Kenneth; Heaney, Mark L.; Jabbour, Elias J.; Komrokji, Rami S.; Moliterno, Alison R.; Ritchie, Ellen K.; Rice, Lawrence; Mascarenhas, John; Hoffman, Ronald

    2015-01-01

    Polycythemia vera (PV) is a chronic myeloproliferative neoplasm that is associated with a substantial symptom burden, thrombohemorrhagic complications, and impaired survival. A decade after the seminal discovery of an activating mutation in the tyrosine kinase JAK2 in nearly all patients with PV, new treatment options are finally beginning to emerge, necessitating a critical reappraisal of the underlying pathogenesis and therapeutic modalities available for PV. Herein, we comprehensively review clinical aspects of PV including diagnostic considerations, natural history, and risk factors for thrombosis. We summarize recent studies delineating the genetic basis of PV, including their implications for evolution to myelofibrosis and secondary acute myeloid leukemia. We assess the quality of evidence to support the use of currently available therapies, including aspirin, phlebotomy, hydroxyurea, and interferon. We analyze recent studies evaluating the safety and efficacy of JAK inhibitors, such as ruxolitinib, and evaluate their role in the context of other available therapies for PV. This review provides a framework for practicing hematologists and oncologists to make rational treatment decisions for patients with PV. PMID:26324368

  7. Barriers associated with the treatment of hepatitis C virus infection among illicit drug users.

    PubMed

    Grebely, Jason; Genoway, Krista A; Raffa, Jesse D; Dhadwal, Gurbir; Rajan, Tasleem; Showler, Grey; Kalousek, Kate; Duncan, Fiona; Tyndall, Mark W; Fraser, Chris; Conway, Brian; Fischer, Benedikt

    2008-01-11

    Illicit drug users account for the majority of cases of HCV infection in the developed world, but few have received treatment. We evaluated barriers to initiating HCV treatment -- including general treatment willingness -- and factors associated with these among HCV infected illicit drug users. Participants were recruited via convenience sampling from two community clinics in Canada. Individuals age >18 years with a history of illicit drug use completed interviewer-administered surveys. Those reporting positive HCV testing underwent additional questioning on willingness, uptake and barriers to treatment for HCV. Of 188 HCV positive illicit drug users, 16% (n=30) had received treatment for HCV. Factors associated with a decreased treatment uptake included current heroin use and HIV/HCV co-infection. Among those not having received therapy, 77% (117/153) indicated a willingness to receive HCV treatment. Factors associated with treatment willingness included not being infected with HIV, having not recently used drugs by injection and having reported physical health problems. Among those not having sought HCV treatment (n=107), the major reasons for not doing so were: lack of information about HCV or knowledge that treatment was available (23%), the absence of symptoms (20%) and the perceived side effects of treatment (14%). Among illicit drug users attending inner city clinics, we have observed a low uptake of HCV treatment, but a high willingness to receive therapy. An increased focus on improving education about the long-term consequences of HCV and the availability of effective treatment are important components for expanding HCV treatment among illicit drug users.

  8. Application of Radar Altimetry Methods to Monitoring of Parasitic Disease Transmission: Schistosomiasis in Poyang Lake, China

    NASA Astrophysics Data System (ADS)

    McCandless, M.; Ibaraki, M.; Shum, C.; Lee, H.; Liang, S.

    2008-12-01

    Schistosomiasis is the second-most prevalent tropical disease after malaria affecting two-hundred million people annually world-wide; it shortens lifespan on average by ten years in endemic areas and no vaccine exists. The current control methods of human host chemotherapy and application of molluscicides to the environment do not break the disease transmission cycle. Schistosomiasis transmission in southern China involves an amphibious intermediate host snail for which hydrology is a key factor because the adults need moist vegetation while the juveniles are fully aquatic. Thus, hydrology is a key factor in schistosomiasis transmission and understanding its role can inform control measures. Our objective is to integrate hydrologic, ecologic, and other environmental factors to determine the changes in available snail habitat through space and time. We use radar altimetry measurements to determine water level every 35 days when the Envisat (Environmental Satellite) passes over the lake. The radar altimetry readings have been calibrated to levels from in-situ gauging stations and will support remote analysis of disease transmission potential without the need for gauging station data. A geographic information system was used to combine key factors including water level, topography, and air temperature data to identify areas of available snail habitat. In order to accomplish this, we conducted three steps including: delineating the watershed, specifying potential snail habitat areas through topography and air temperature classification, and calculating the intersection between potential snail habitat and non-flooded areas in the watershed. Statistical analyses of total available habitat area are also conducted. These maps and statistics analyses can be used by public health agencies to monitor snail habitat trends over time. Coupling remote sensing of water levels with a geographic information system model will continue to be important as the hydrology of the lake changes due to the completion of the upstream Three Gorges Dam project.

  9. Quality of life of Turkish type 2 diabetics in Germany and Turkey--a comparison between Hamburg and Istanbul.

    PubMed

    Kofahl, Christopher; Doğan, Mustafa; Doğan, Gülsün; Mnich, Eva; von dem Knesebeck, Olaf

    2014-01-01

    The analyses address the following research questions: (1) Do Turkish diabetics in Germany and Turkey differ in terms of quality of life? (2) If yes, can these differences (in part) be explained by social factors (age, gender, education, household size), functional limitations and availability of support? (3) Are social factors, functional limitations and availability of support differently associated with quality of life among Turkish diabetics in Germany and Turkey? For this comparative cross-sectional study, 111 patients with type 2 diabetes were personally interviewed in Istanbul (Turkey) and 294 Turkish patients in Hamburg (Germany). For quality of life measurement we have used the Turkish version of the WHOQOL-Bref-26. Sociodemographics included age, sex, education and household-size. Health related functional limitations were assessed on the basis of an index of (instrumental) activities of daily living including the availability of help. Statistical analyses were conducted on group comparisons with Chi-square- and T-tests as well as linear regressions. There are no significant differences between Turkish diabetics in Germany and Turkey in the physical and the psychological dimensions of the WHOQOL-Bref. However, in the WHOQOL-domains 'social QoL' and 'environmental QoL' Turkish diabetics living in Hamburg have a significantly better quality of life than their counterparts in Istanbul. These differences cannot be explained by individual sociodemographic factors, functional limitations and availability of support. Furthermore, we found much stronger positive associations between education and quality of life in Istanbul than in Hamburg. Beyond strong similarities between the two samples in sociodemographics, physical and mental health the social and environmental quality of life was significantly assessed better by the Turkish diabetics living in Hamburg. This is most likely an effect of public investment in social security, infrastructure and health care which is also influencing the decision as to where to spend life in retirement.

  10. U.S. Heat Demand by Sector for Potential Application of Direct Use Geothermal

    DOE Data Explorer

    Katherine Young

    2016-06-23

    This dataset includes heat demand for potential application of direct use geothermal broken down into 4 sectors: agricultural, commercial, manufacturing and residential. The data for each sector are organized by county, were disaggregated specifically to assess the market demand for geothermal direct use, and were derived using methodologies customized for each sector based on the availability of data and other sector-specific factors. This dataset also includes a paper containing a full explanation of the methodologies used.

  11. GRBase, a new gene regulation data base available by anonymous ftp.

    PubMed Central

    Collier, B; Danielsen, M

    1994-01-01

    The Gene Regulation Database (GRBase) is a compendium of information on the structure and function of proteins involved in the control of gene expression in eukaryotes. These proteins include transcription factors, proteins involved in signal transduction, and receptors. The database can be obtained by FTP in Filemaker Pro, text, and postscript formats. The database will be expanded in the coming year to include reviews on families of proteins involved in gene regulation and to allow online searching. PMID:7937071

  12. Physics and chemistry of antimicrobial behavior of ion-exchanged silver in glass.

    PubMed

    Borrelli, N F; Senaratne, W; Wei, Y; Petzold, O

    2015-02-04

    The results of a comprehensive study involving the antimicrobial activity in a silver ion-exchanged glass are presented. The study includes the glass composition, the method of incorporating silver into the glass, the effective concentration of the silver available at the glass surface, and the effect of the ambient environment. A quantitative kinetic model that includes the above factors in predicting the antimicrobial activity is proposed. Finally, experimental data demonstrating antibacterial activity against Staphylococcus aureus with correlation to the predicted model is shown.

  13. Health risks of including alcohol and tobacco in PICTA free trade.

    PubMed

    Hill, Linda

    2004-03-01

    In April 2005 Pacific Forum leaders will decide whether to include alcohol and tobacco in the Pacific Island Countries Trade Agreement (PICTA). This article presents arguments for keeping alcohol out of regional free trade agreements. Inclusion will allow regional rationalisation of production, increased alcohol availability, competition and marketing, and lower prices. These trade goals are inappropriate for alcohol and tobacco. Pacific public health organisations are concerned that official advice has focused on fiscal impacts, not health and social impacts. The World Health Organization has identified alcohol as the leading factor in injury and disease for low-mortality developing countries. Effective policies to reduce alcohol related harm include restrictions on availability, as well as excise taxes affecting price. Under trade agreements elsewhere, national alcohol policies have been challenged as 'non-tariff barriers to trade'. Hazardous drinking is of increasingly concern in the Pacific and decisions about alcohol should not reflect commercial interests.

  14. Captive audience? Strategies for acquiring food in two Detroit neighborhoods.

    PubMed

    Rose, Daniel J

    2011-05-01

    Research has shown elevated rates of diet-related health problems in Detroit, Michigan compared to state and national averages. Using 47 in-depth interviews of African American residents in two Detroit neighborhoods, I examine the interplay between agency and social structure in food acquisition. Participants discussed numerous difficulties obtaining food, including availability, cost, quality, and accessibility. Residents employed many strategies to address these issues, including carefully examining food before purchase, sharing transportation to leave the neighborhood, and using multiple sources. However, the potential to pursue food acquisition strategies varied, in part, according to community contextual factors, including resident concerns about safety, the availability of food banks, and resources in surrounding areas. Nutritional knowledge among participants was sophisticated, suggesting that health education efforts, as opposed to addressing lack of access to high-quality food, might be misguided. I found that accounting for both agency and structural context aids in understanding diet-related behaviors.

  15. Prognostic factors in non-surgically treated sciatica: a systematic review.

    PubMed

    Ashworth, Julie; Konstantinou, Kika; Dunn, Kate M

    2011-09-25

    When present sciatica is considered an obstacle to recovery in low back pain patients, yet evidence is limited regarding prognostic factors for persistent disability in this patient group. The aim of this study is to describe and summarise the evidence regarding prognostic factors for sciatica in non-surgically treated cohorts. Understanding the prognostic factors in sciatica and their relative importance may allow the identification of patients with particular risk factors who might benefit from early or specific types of treatment in order to optimise outcome. A systematic literature search was conducted using Medline, EMBASE and CINAHL electronic databases. Prospective cohort studies describing subjects with sciatica and measuring pain, disability or recovery outcomes were included. Studies of cohorts comprised entirely of surgically treated patients were excluded and mixed surgically and conservatively treated cohorts were included only if the results were analysed separately by treatment group or if the analysis was adjusted for treatment. Seven adequate or high quality eligible studies were identified. There were conflicting but mainly negative results regarding the influence of baseline pain severity, neurological deficit, nerve root tension signs, duration of symptoms and radiological findings on outcome. A number of factors including age, gender, smoking, previous history of sciatica and heaviness of work do not appear to influence outcome. In contrast to studies of low back pain and purely surgically treated sciatica cohorts, psychological factors were rarely investigated. At present, the heterogeneity of the available studies makes it difficult to draw firm conclusions about sciatica prognosis, and highlights the need for further research for this group of patients. Large scale prospective studies of high methodological quality, using a well-defined, consistent definition of sciatica and investigating psychosocial factors alongside clinical and radiological findings are recommended to identify prognostic factors in this population.

  16. Prognostic factors in non-surgically treated sciatica: A systematic review

    PubMed Central

    2011-01-01

    Background When present sciatica is considered an obstacle to recovery in low back pain patients, yet evidence is limited regarding prognostic factors for persistent disability in this patient group. The aim of this study is to describe and summarise the evidence regarding prognostic factors for sciatica in non-surgically treated cohorts. Understanding the prognostic factors in sciatica and their relative importance may allow the identification of patients with particular risk factors who might benefit from early or specific types of treatment in order to optimise outcome. Methods A systematic literature search was conducted using Medline, EMBASE and CINAHL electronic databases. Prospective cohort studies describing subjects with sciatica and measuring pain, disability or recovery outcomes were included. Studies of cohorts comprised entirely of surgically treated patients were excluded and mixed surgically and conservatively treated cohorts were included only if the results were analysed separately by treatment group or if the analysis was adjusted for treatment. Results Seven adequate or high quality eligible studies were identified. There were conflicting but mainly negative results regarding the influence of baseline pain severity, neurological deficit, nerve root tension signs, duration of symptoms and radiological findings on outcome. A number of factors including age, gender, smoking, previous history of sciatica and heaviness of work do not appear to influence outcome. In contrast to studies of low back pain and purely surgically treated sciatica cohorts, psychological factors were rarely investigated. Conclusions At present, the heterogeneity of the available studies makes it difficult to draw firm conclusions about sciatica prognosis, and highlights the need for further research for this group of patients. Large scale prospective studies of high methodological quality, using a well-defined, consistent definition of sciatica and investigating psychosocial factors alongside clinical and radiological findings are recommended to identify prognostic factors in this population. PMID:21943339

  17. Miners' return to work following injuries in coal mines.

    PubMed

    Bhattacherjee, Ashis; Kunar, Bijay Mihir

    2016-12-22

    The occupational injuries in mines are common and result in severe socio-economical consequences. Earlier studies have revealed the role of multiple factors such as demographic factors, behavioral factors, health-related factors, working environment, and working conditions for mine injuries. However, there is a dearth of information about the role of some of these factors in delayed return to work (RTW) following a miner's injury. These factors may likely include personal characteristics of injured persons and his or her family, the injured person's social and economic status, and job characteristics. This study was conducted to assess the role of some of these factors for the return to work following coal miners' injuries. A study was conducted for 109 injured workers from an underground coal mine in the years 2000-2009. A questionnaire, which was completed by the personnel interviews, included among others age, height, weight, seniority, alcohol consumption, sleeping duration, presence of diseases, job stress, job satisfaction, and injury type. The data was analyzed using the Kaplan-Meier estimates and the Cox proportional hazard model. According to Kaplan-Meier estimate it was revealed that a lower number of dependents, longer sleep duration, no job stress, no disease, no alcohol addiction, and higher monthly income have a great impact on early return to work after injury. The Cox regression analysis revealed that the significant risk factors which influenced miners' return to work included presence of disease, job satisfaction and injury type. The mine management should pay attention to significant risk factors for injuries in order to develop effective preventive measures. Med Pr 2016;67(6):729-742. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  18. Factors parents use in selecting play spaces for young children.

    PubMed

    Sallis, J F; McKenzie, T L; Elder, J P; Broyles, S L; Nader, P R

    1997-04-01

    The amount of time children spend in play spaces (ie, physical locations that are appropriate for children's physical activity) near their homes is correlated with their level of physical activity. To examine factors used in parents' decisions about the selection of play spaces for their children. Parents (primarily mothers) of 178 Mexican American and 122 white children who were a mean age of 4.9 years old at the first measurement. In individual interviews, parents rated 24 factors on their importance in selecting for their children a play space that is away from their home or yard. Decision factors were rated from 1 (ie, not important at all) to 5 (ie, very important). The most important factors, with ratings ranging from 4.8 to 4.2, were safety and availability of toilets, drinking water, lighting, and shade. Mexican American parents rated 8 of 24 items significantly higher than did white parents, including lighted at night, organized activities, play supplies, and drinking water. White parents rated 5 of 24 items significantly higher than did Mexican American parents, including distance from home, cost of admission, and child's friends go there. The rated importance of 7 of 24 items increased during 1 year, including play supplies, drinking water, distance from home, and parents' friends or relatives go there. These results indicate that parents can identify factors they use in selecting places for their young children to play, and selection factors differ somewhat by ethnicity or socioeconomic status. Further studies are needed to determine whether improvements on the most important selection factors might be effective in increasing the use of play spaces by children and their parents. Clinicians may be able to use the most highly rated decision factors to help parents assess the acceptability of play spaces in their areas.

  19. A systematic review of risk factors associated with accidental falls, outcome measures and interventions to manage fall risk in non-ambulatory adults.

    PubMed

    Rice, Laura A; Ousley, Cherita; Sosnoff, Jacob J

    2015-01-01

    To systematically review peer-reviewed literature pertaining to risk factors, outcome measures and interventions managing fall risk in non-ambulatory adults. Twenty-one papers were selected for inclusion from databases including PubMed/Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Scopus, Consumer Health Complete and Web of Science. Selected studies involved a description of fall related risk factors, outcomes to assess fall risk and intervention studies describing protocols to manage fall risk in non-ambulatory adults. Studies were selected by two reviewers and consultation provided by a third reviewer. The most frequently cited risk factors/characteristics associated with falls included: wheelchair related characteristics, transfer activities, impaired seated balance and environmental factors. The majority of the outcomes were found to evaluate seated postural control. One intervention study was identified describing a protocol targeting specific problems of individual participants. A global fall prevention program was not identified. Several risk factors associated with falls were identified and must be understood by clinicians to better serve their clients. To improve objective assessment, a comprehensive outcome assessment specific to non-ambulatory adults is needed. Finally, additional research is needed to examine the impact of structured protocols to manage fall risk in non-ambulatory adults. Falls are a common health concern for non-ambulatory adults. Risk factors commonly associated with falls include wheelchair related characteristics, transfer activities, impaired seated balance and environmental factors. Limited outcome measures are available to assess fall risk in non-ambulatory adults. Clinicians must be aware of the known risk factors and provide comprehensive education to their clients on the potential for falls. Additional research is needed to develop and evaluate protocols to clinically manage fall risk.

  20. Factors Related to Medicaid Payment Acceptance at Outpatient Substance Abuse Treatment Programs

    PubMed Central

    Terry-McElrath, Yvonne M; Chriqui, Jamie F; McBride, Duane C

    2011-01-01

    Objective To examine factors associated with Medicaid acceptance for substance abuse (SA) services by outpatient SA treatment programs. Data Sources Secondary analysis of 2003–2006 National Survey of Substance Abuse Treatment Services data combined with state Medicaid policy and usage measures and other publicly available data. Study Design We used cross-sectional analyses, including state fixed effects, to assess relationships between SA treatment program Medicaid acceptance and (1) program-level factors, (2) county-level sociodemographics and treatment program density, and (3) state-level population characteristics, SA treatment-related factors, and Medicaid policy and usage. Data Extraction Methods State Medicaid policy data were compiled based on reviews of state Medicaid-related statutes/regulations and Medicaid plans. Other data were publicly available. Principal Findings Medicaid acceptance was significantly higher for programs: (a) that were publicly funded and in states with Medicaid policy allowing SA treatment coverage; (b) with accreditation/licensure and nonprofit/government ownership, as well as mental- and general-health focused programs; and (c) in counties with lower household income. Conclusions SA treatment program Medicaid acceptance related to program-, county, and state-level factors. The data suggest the importance of state policy and licensure/accreditation requirements in increasing SA program Medicaid access. PMID:21105870

  1. TauFactor: An open-source application for calculating tortuosity factors from tomographic data

    NASA Astrophysics Data System (ADS)

    Cooper, S. J.; Bertei, A.; Shearing, P. R.; Kilner, J. A.; Brandon, N. P.

    TauFactor is a MatLab application for efficiently calculating the tortuosity factor, as well as volume fractions, surface areas and triple phase boundary densities, from image based microstructural data. The tortuosity factor quantifies the apparent decrease in diffusive transport resulting from convolutions of the flow paths through porous media. TauFactor was originally developed to improve the understanding of electrode microstructures for batteries and fuel cells; however, the tortuosity factor has been of interest to a wide range of disciplines for over a century, including geoscience, biology and optics. It is still common practice to use correlations, such as that developed by Bruggeman, to approximate the tortuosity factor, but in recent years the increasing availability of 3D imaging techniques has spurred interest in calculating this quantity more directly. This tool provides a fast and accurate computational platform applicable to the big datasets (>108 voxels) typical of modern tomography, without requiring high computational power.

  2. Factors affecting ethical behavior in pediatric occupational therapy: A qualitative study

    PubMed Central

    Kalantari, Minoo; Kamali, Mohammad; Joolaee, Soodabeh; Shafarodi, Narges; Rassafiani, Mehdi

    2015-01-01

    Background: It is the responsibility of each occupational therapist to always act ethically and professionally in a clinical setting. However, there is little information available concerning the factors influencing ethical behavior of occupational therapists at work. Since no study has been conducted in Iran on this topic, this qualitative study aimed to identify the factors influencing ethical behavior of pediatric occupational therapists. Methods: Twelve pediatric occupational therapists participated in this study. The sampling was purposeful, and the interviews continued until reaching data saturation. All interviews were recorded and transcribed. The data were analyzed by qualitative content analysis, and the ethics of qualitative research was considered. Results: The factors influencing ethical behavior were classified into four main categories including organizational factors, therapist related factors, client’s family issues, and social factors. Conclusion: This study identified numerous factors influencing the ethical behavior of pediatric occupational therapists that could be used to train occupational therapists, human resources managers, professional policy makers, and could also be used to conduct future researches, and produce tools. PMID:26913245

  3. Nutrition of mangroves.

    PubMed

    Reef, Ruth; Feller, Ilka C; Lovelock, Catherine E

    2010-09-01

    Mangrove forests dominate the world's tropical and subtropical coastlines. Similar to other plant communities, nutrient availability is one of the major factors influencing mangrove forest structure and productivity. Many mangrove soils have extremely low nutrient availability, although nutrient availability can vary greatly among and within mangrove forests. Nutrient-conserving processes in mangroves are well developed and include evergreeness, resorption of nutrients prior to leaf fall, the immobilization of nutrients in leaf litter during decomposition, high root/shoot ratios and the repeated use of old root channels. Both nitrogen-use efficiency and nutrient resorption efficiencies in mangroves are amongst the highest recorded for angiosperms. A complex range of interacting abiotic and biotic factors controls the availability of nutrients to mangrove trees, and mangroves are characteristically plastic in their ability to opportunistically utilize nutrients when these become available. Nitrogen and phosphorus have been implicated as the nutrients most likely to limit growth in mangroves. Ammonium is the primary form of nitrogen in mangrove soils, in part as a result of anoxic soil conditions, and tree growth is supported mainly by ammonium uptake. Nutrient enrichment is a major threat to marine ecosystems. Although mangroves have been proposed to protect the marine environment from land-derived nutrient pollution, nutrient enrichment can have negative consequences for mangrove forests and their capacity for retention of nutrients may be limited.

  4. From Calculus to Dynamical Systems through DGS and CAS

    ERIC Educational Resources Information Center

    García, Jeanett López; Zamudio, Jorge Javier Jiménez

    2015-01-01

    Several factors have motivated the use of CAS or DGS in the teaching-learning process, such as: the development of new technologies, the availability of computers, and the widespread use of the Internet, among others. Even more, the trend to include CAS and DGS in the curricula of some undergraduate studies has resulted in the instruction of the…

  5. The Synthesis of 2-acetyl-1,4-naphthoquinone: A Multi-step Synthesis.

    ERIC Educational Resources Information Center

    Green, Ivan R.

    1982-01-01

    Outlines 2 procedures for synthesizing 2-acetyl-1,4-naphthoquinone to compare relative merits of the two pathways. The major objective of the exercise is to demonstrate that certain factors should be considered when selecting a pathway for synthesis including availability of starting materials, cost of reagents, number of steps involved,…

  6. Whose Time Is It? The Effect of Employment and Work/Family Stress on Children's Housework

    ERIC Educational Resources Information Center

    Gager, Constance T.; Sanchez, Laura A.; Demaris, Alfred

    2009-01-01

    Children's time use--and specifically the time they spend on household chores--is an important arena for understanding social change. However, few studies accurately depict the multiple factors influencing children's household labor, including parent's and children's available time and parent's levels of work/family stress. We address these gaps…

  7. A new immunoassay for detecting all subtypes of Shiga toxins produced by Shiga toxin-producing E. coli in ground beef

    USDA-ARS?s Scientific Manuscript database

    Background Shiga toxin (Stx) is a common virulence factor of all Shiga toxin producing E. coli (STEC) that cause a wide spectrum of disease, including hemorrhagic colitis and hemolytic uremic syndrome (HUS). Although several commercial kits are available for detection of Stx produced by STEC, none o...

  8. Orientation to Commercial and Advertising Art; Commercial and Advertising Art--Basic: 9183.01.

    ERIC Educational Resources Information Center

    Dade County Public Schools, Miami, FL.

    This outline is presented as an introduction to help the student become familiar with the many facets and requirements to be adhered to in the field of Commercial and Advertising Art. The student is given an in-depth orientation to the entire course content, including rules, regulations, safety factors, and employment opportunities available in…

  9. Systems Performance Analyses of Alaska Wind-Diesel Projects; St. Paul, Alaska (Fact Sheet)

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

    Baring-Gould, I.

    2009-04-01

    This fact sheet summarizes a systems performance analysis of the wind-diesel project in St. Paul, Alaska. Data provided for this project include load data, average wind turbine output, average diesel plant output, dump (controlling) load, average net capacity factor, average net wind penetration, estimated fuel savings, and wind system availability.

  10. Predicting the Adoption of E-Learning Management System: A Case of Selected Private Universities in Nigeria

    ERIC Educational Resources Information Center

    Nicholas-Omoregbe, Olanike Sharon; Azeta, Ambrose Agbon; Chiazor, Idowu Aigbovo; Omoregbe, Nicholas

    2017-01-01

    Despite the availability of studies on e-learning management system (eLMS) using information system models, its theoretical foundations have not yet captured social constructs that are peculiar to developing countries including Nigeria. This study was undertaken with the aim of investigating factors that could influence eLMS adoption in higher…

  11. Systematic literature review of determinants of sedentary behaviour in older adults: a DEDIPAC study.

    PubMed

    Chastin, Sebastien F M; Buck, Christoph; Freiberger, Ellen; Murphy, Marie; Brug, Johannes; Cardon, Greet; O'Donoghue, Grainne; Pigeot, Iris; Oppert, Jean-Michel

    2015-10-06

    Older adults are the most sedentary segment of society and high sedentary time is associated with poor health and wellbeing outcomes in this population. Identifying determinants of sedentary behaviour is a necessary step to develop interventions to reduce sedentary time. A systematic literature review was conducted to identify factors associated with sedentary behaviour in older adults. Pubmed, Embase, CINAHL, PsycINFO and Web of Science were searched for articles published between 2000 and May 2014. The search strategy was based on four key elements: (a) sedentary behaviour and its synonyms; (b) determinants and its synonyms (e.g. correlates, factors); (c) types of sedentary behaviour (e.g. TV viewing, sitting, gaming) and (d) types of determinants (e.g. environmental, behavioural). Articles were included in the review if specific information about sedentary behaviour in older adults was reported. Studies on samples identified by disease were excluded. Study quality was rated by means of QUALSYST. The full review protocol is available from PROSPERO (PROSPERO 2014: CRD42014009823). The analysis was guided by the socio-ecological model framework. Twenty-two original studies were identified out of 4472 returned by the systematic search. These included 19 cross-sectional, 2 longitudinal and 1 qualitative studies, all published after 2011. Half of the studies were European. The study quality was generally high with a median of 82 % (IQR 69-96 %) using Qualsyst tool. Personal factors were the most frequently investigated with consistent positive association for age, negative for retirement, obesity and health status. Only four studies considered environmental determinants suggesting possible association with mode of transport, type of housing, cultural opportunities and neighbourhood safety and availability of places to rest. Only two studies investigated mediating factors. Very limited information was available on contexts and sub-domains of sedentary behaviours. Few studies have investigated determinants of sedentary behaviour in older adults and these have to date mostly focussed on personal factors, and qualitative studies were mostly lacking. More longitudinal studies are needed as well as inclusion of a broader range of personal and contextual potential determinants towards a systems-based approach, and future studies should be more informed by qualitative work.

  12. EUCLID: an outcome analysis tool for high-dimensional clinical studies

    NASA Astrophysics Data System (ADS)

    Gayou, Olivier; Parda, David S.; Miften, Moyed

    2007-03-01

    Treatment management decisions in three-dimensional conformal radiation therapy (3DCRT) and intensity-modulated radiation therapy (IMRT) are usually made based on the dose distributions in the target and surrounding normal tissue. These decisions may include, for example, the choice of one treatment over another and the level of tumour dose escalation. Furthermore, biological predictors such as tumour control probability (TCP) and normal tissue complication probability (NTCP), whose parameters available in the literature are only population-based estimates, are often used to assess and compare plans. However, a number of other clinical, biological and physiological factors also affect the outcome of radiotherapy treatment and are often not considered in the treatment planning and evaluation process. A statistical outcome analysis tool, EUCLID, for direct use by radiation oncologists and medical physicists was developed. The tool builds a mathematical model to predict an outcome probability based on a large number of clinical, biological, physiological and dosimetric factors. EUCLID can first analyse a large set of patients, such as from a clinical trial, to derive regression correlation coefficients between these factors and a given outcome. It can then apply such a model to an individual patient at the time of treatment to derive the probability of that outcome, allowing the physician to individualize the treatment based on medical evidence that encompasses a wide range of factors. The software's flexibility allows the clinicians to explore several avenues to select the best predictors of a given outcome. Its link to record-and-verify systems and data spreadsheets allows for a rapid and practical data collection and manipulation. A wide range of statistical information about the study population, including demographics and correlations between different factors, is available. A large number of one- and two-dimensional plots, histograms and survival curves allow for an easy visual analysis of the population. Several visual and analytical methods are available to quantify the predictive power of the multivariate regression model. The EUCLID tool can be readily integrated with treatment planning and record-and-verify systems.

  13. EUCLID: an outcome analysis tool for high-dimensional clinical studies.

    PubMed

    Gayou, Olivier; Parda, David S; Miften, Moyed

    2007-03-21

    Treatment management decisions in three-dimensional conformal radiation therapy (3DCRT) and intensity-modulated radiation therapy (IMRT) are usually made based on the dose distributions in the target and surrounding normal tissue. These decisions may include, for example, the choice of one treatment over another and the level of tumour dose escalation. Furthermore, biological predictors such as tumour control probability (TCP) and normal tissue complication probability (NTCP), whose parameters available in the literature are only population-based estimates, are often used to assess and compare plans. However, a number of other clinical, biological and physiological factors also affect the outcome of radiotherapy treatment and are often not considered in the treatment planning and evaluation process. A statistical outcome analysis tool, EUCLID, for direct use by radiation oncologists and medical physicists was developed. The tool builds a mathematical model to predict an outcome probability based on a large number of clinical, biological, physiological and dosimetric factors. EUCLID can first analyse a large set of patients, such as from a clinical trial, to derive regression correlation coefficients between these factors and a given outcome. It can then apply such a model to an individual patient at the time of treatment to derive the probability of that outcome, allowing the physician to individualize the treatment based on medical evidence that encompasses a wide range of factors. The software's flexibility allows the clinicians to explore several avenues to select the best predictors of a given outcome. Its link to record-and-verify systems and data spreadsheets allows for a rapid and practical data collection and manipulation. A wide range of statistical information about the study population, including demographics and correlations between different factors, is available. A large number of one- and two-dimensional plots, histograms and survival curves allow for an easy visual analysis of the population. Several visual and analytical methods are available to quantify the predictive power of the multivariate regression model. The EUCLID tool can be readily integrated with treatment planning and record-and-verify systems.

  14. Model selection and averaging in the assessment of the drivers of household food waste to reduce the probability of false positives.

    PubMed

    Grainger, Matthew James; Aramyan, Lusine; Piras, Simone; Quested, Thomas Edward; Righi, Simone; Setti, Marco; Vittuari, Matteo; Stewart, Gavin Bruce

    2018-01-01

    Food waste from households contributes the greatest proportion to total food waste in developed countries. Therefore, food waste reduction requires an understanding of the socio-economic (contextual and behavioural) factors that lead to its generation within the household. Addressing such a complex subject calls for sound methodological approaches that until now have been conditioned by the large number of factors involved in waste generation, by the lack of a recognised definition, and by limited available data. This work contributes to food waste generation literature by using one of the largest available datasets that includes data on the objective amount of avoidable household food waste, along with information on a series of socio-economic factors. In order to address one aspect of the complexity of the problem, machine learning algorithms (random forests and boruta) for variable selection integrated with linear modelling, model selection and averaging are implemented. Model selection addresses model structural uncertainty, which is not routinely considered in assessments of food waste in literature. The main drivers of food waste in the home selected in the most parsimonious models include household size, the presence of fussy eaters, employment status, home ownership status, and the local authority. Results, regardless of which variable set the models are run on, point toward large households as being a key target element for food waste reduction interventions.

  15. Model selection and averaging in the assessment of the drivers of household food waste to reduce the probability of false positives

    PubMed Central

    Aramyan, Lusine; Piras, Simone; Quested, Thomas Edward; Righi, Simone; Setti, Marco; Vittuari, Matteo; Stewart, Gavin Bruce

    2018-01-01

    Food waste from households contributes the greatest proportion to total food waste in developed countries. Therefore, food waste reduction requires an understanding of the socio-economic (contextual and behavioural) factors that lead to its generation within the household. Addressing such a complex subject calls for sound methodological approaches that until now have been conditioned by the large number of factors involved in waste generation, by the lack of a recognised definition, and by limited available data. This work contributes to food waste generation literature by using one of the largest available datasets that includes data on the objective amount of avoidable household food waste, along with information on a series of socio-economic factors. In order to address one aspect of the complexity of the problem, machine learning algorithms (random forests and boruta) for variable selection integrated with linear modelling, model selection and averaging are implemented. Model selection addresses model structural uncertainty, which is not routinely considered in assessments of food waste in literature. The main drivers of food waste in the home selected in the most parsimonious models include household size, the presence of fussy eaters, employment status, home ownership status, and the local authority. Results, regardless of which variable set the models are run on, point toward large households as being a key target element for food waste reduction interventions. PMID:29389949

  16. Caregivers' psychosocial factors underlying sugar-sweetened beverage intake among non-Hispanic black preschoolers: an elicitation study.

    PubMed

    Tipton, Julia A

    2014-01-01

    The purpose of this study was to explore caregivers' beliefs and perceptions regarding serving sugar-sweetened beverages (SSBs) to non-Hispanic black preschoolers. The Theory of Planned Behavior (TpB) was used as the framework for conducting elicitation interviews among a sample of (n = 19) caregivers. Thematic coding of interview transcripts revealed that the decision to serve SSBs to preschoolers is driven by numerous individual, familial, cultural, and environmental factors. Salient factors associated with serving SSBs included convenience, cost, taste, potential health consequences, availability, and pressure from other parents. Population-specific interventions aimed at reducing SSB intake among non-Hispanic preschoolers are discussed. © 2013.

  17. Physiotherapists' Perceptions of and Experiences with the Discharge Planning Process in Acute-Care General Internal Medicine Units in Ontario

    PubMed Central

    Uyeno, Jennifer; Heck, Carol S.

    2014-01-01

    ABSTRACT Purpose: To examine discharge planning of patients in general internal medicine units in Ontario acute-care hospitals from the perspective of physiotherapists. Methods: A cross-sectional study using an online questionnaire was sent to participants in November 2011. Respondents' demographic characteristics and ranking of factors were analyzed using descriptive statistics; t-tests were performed to determine between-group differences (based on demographic characteristics). Responses to open-ended questions were coded to identify themes. Results: Mobility status was identified as the key factor in determining discharge readiness; other factors included the availability of social support and community resources. While inter-professional communication was identified as important, processes were often informal. Discharge policies, timely availability of other discharge options, and pressure for early discharge were identified as affecting discharge planning. Respondents also noted a lack of training in discharge planning; accounts of ethical dilemmas experienced by respondents supported these themes. Conclusions: Physiotherapists consider many factors beyond the patient's physical function during the discharge planning process. The improvement of team communication and resource allocation should be considered to deal with the realities of discharge planning. PMID:25125778

  18. Systematic Review of Voluntary Participation in Simulation-Based Laparoscopic Skills Training: Motivators and Barriers for Surgical Trainee Attendance.

    PubMed

    Gostlow, Hannah; Marlow, Nicholas; Babidge, Wendy; Maddern, Guy

    To examine and report on evidence relating to surgical trainees' voluntary participation in simulation-based laparoscopic skills training. Specifically, the underlying motivators, enablers, and barriers faced by surgical trainees with regard to attending training sessions on a regular basis. A systematic search of the literature (PubMed; CINAHL; EMBASE; Cochrane Collaboration) was conducted between May and July 2015. Studies were included on whether they reported on surgical trainee attendance at voluntary, simulation-based laparoscopic skills training sessions, in addition to qualitative data regarding participant's perceived barriers and motivators influencing their decision to attend such training. Factors affecting a trainee's motivation were categorized as either intrinsic (internal) or extrinsic (external). Two randomised control trials and 7 case series' met our inclusion criteria. Included studies were small and generally poor quality. Overall, voluntary simulation-based laparoscopic skills training was not well attended. Intrinsic motivators included clearly defined personal performance goals and relevance to clinical practice. Extrinsic motivators included clinical responsibilities and available free time, simulator location close to clinical training, and setting obligatory assessments or mandated training sessions. The effect of each of these factors was variable, and largely dependent on the individual trainee. The greatest reported barrier to attending voluntary training was the lack of available free time. Although data quality is limited, it can be seen that providing unrestricted access to simulator equipment is not effective in motivating surgical trainees to voluntarily participate in simulation-based laparoscopic skills training. To successfully encourage participation, consideration needs to be given to the factors influencing motivation to attend training. Further research, including better designed randomised control trials and large-scale surveys, is required to provide more definitive answers to the degree in which various incentives influence trainees' motivations and actual attendance rates. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  19. Essential Nutrients for Bone Health and a Review of their Availability in the Average North American Diet

    PubMed Central

    Price, Charles T; Langford, Joshua R; Liporace, Frank A

    2012-01-01

    Osteoporosis and low bone mineral density affect millions of Americans. The majority of adults in North America have insufficient intake of vitamin D and calcium along with inadequate exercise. Physicians are aware that vitamin D, calcium and exercise are essential for maintenance of bone health. Physicians are less likely to be aware that dietary insufficiencies of magnesium, silicon, Vitamin K, and boron are also widely prevalent, and each of these essential nutrients is an important contributor to bone health. In addition, specific nutritional factors may improve calcium metabolism and bone formation. It is the authors’ opinion that nutritional supplements should attempt to provide ample, but not excessive, amounts of factors that are frequently insufficient in the typical American diet. In contrast to dietary insufficiencies, several nutrients that support bone health are readily available in the average American diet. These include zinc, manganese, and copper which may have adverse effects at higher levels of intake. Some multivitamins and bone support products provide additional quantities of nutrients that may be unnecessary or potentially harmful. The purpose of this paper is to identify specific nutritional components of bone health, the effects on bone, the level of availability in the average American diet, and the implications of supplementation for each nutritional component. A summary of recommended dietary supplementation is included. PMID:22523525

  20. Differences in beliefs and home environments regarding energy balance behaviors according to parental education and ethnicity among schoolchildren in Europe: the ENERGY cross sectional study.

    PubMed

    Brug, Johannes; Uijtdewilligen, Léonie; van Stralen, Maartje M; Singh, Amika S; ChinAPaw, Mai J M; De Bourdeaudhuij, Ilse; Lien, Nanna; Bere, Elling; Maes, Lea; Fernández-Alvira, Juan M; Jan, Nataša; Kovacs, Eva; Dössegger, Alain; Manios, Yannis; te Velde, Saskia J

    2014-06-17

    To explore differences in personal and home environmental factors that are regarded as determinants of energy balance-related behaviors (EBRBs) according to parental education and ethnic background among 10-12 year old schoolchildren across Europe. A school-based survey among 10-12 year olds was conducted in eight countries across Europe. A range of personal and home environment variables relevant for soft drink consumption, daily breakfast, sport participation and TV time was assessed by means of child report. Personal factors included attitude, health beliefs, and preference/liking. Home environment factors included parental subjective norm, modeling, support, practices and home availability. Children were classified based on parental education (i.e., low vs. high) and ethnic background (i.e., native vs. non-native). Data from 6018 children originating from 83 schools were included in the analyses. Multilevel logistic regression analyses showed that the majority of the factors tested -and especially home environment variables- were more favorable among children from higher educated parents and from native ethnicity. None of the personal and home environment factors was found to be more favorable among children from lower educated parents or non-native ethnicity. The present study indicates that schoolchildren from lower educated and non-native parents across Europe have EBRB-related beliefs and are exposed to home environments that are less favorable for engagement in healthy EBRBs.

  1. The cross-national structure of mental disorders: results from the World Mental Health Surveys.

    PubMed

    de Jonge, Peter; Wardenaar, Klaas J; Lim, Carmen C W; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Andrade, Laura Helena; Bunting, Brendan; Chatterji, Somnath; Ciutan, Marius; Gureje, Oye; Karam, Elie G; Lee, Sing; Medina-Mora, Maria Elena; Moskalewicz, Jacek; Navarro-Mateu, Fernando; Pennell, Beth-Ellen; Piazza, Marina; Posada-Villa, José; Torres, Yolanda; Kessler, Ronald C; Scott, Kate

    2017-12-19

    The patterns of comorbidity among mental disorders have led researchers to model the underlying structure of psychopathology. While studies have suggested a structure including internalizing and externalizing disorders, less is known with regard to the cross-national stability of this model. Moreover, little data are available on the placement of eating disorders, bipolar disorder and psychotic experiences (PEs) in this structure. We evaluated the structure of mental disorders with data from the World Health Organization Composite International Diagnostic Interview, including 15 lifetime mental disorders and six PEs. Respondents (n = 5478-15 499) were included from 10 high-, middle- and lower middle-income countries across the world aged 18 years or older. Confirmatory factor analyses (CFAs) were used to evaluate and compare the fit of different factor structures to the lifetime disorder data. Measurement invariance was evaluated with multigroup CFA (MG-CFA). A second-order model with internalizing and externalizing factors and fear and distress subfactors best described the structure of common mental disorders. MG-CFA showed that this model was stable across countries. Of the uncommon disorders, bipolar disorder and eating disorder were best grouped with the internalizing factor, and PEs with a separate factor. These results indicate that cross-national patterns of lifetime common mental-disorder comorbidity can be explained with a second-order underlying structure that is stable across countries and can be extended to also cover less common mental disorders.

  2. Burnout Among Direct-Care Workers in Nursing Homes: Influences of Organizational, Work Place, Interpersonal, and Personal Characteristics.

    PubMed

    Yeatts, Dale E; Seckin, Gul; Shen, Yuying; Thompson, Michael; Auden, Dana; Cready, Cynthia M

    2018-01-10

    The many negative effects of burnout have prompted researchers to better understand the factors contributing to it. The purpose of this paper is to add to this body of knowledge through the study of burnout among direct care workers (DCWs) in nursing homes (NH). Perhaps the factor most often associated with employee burnout is the level of staffing-insufficient staffing results in work overload and eventually employee burnout. A closer look at research findings suggest that there are many other factors also contributing to burnout. These range from those at the organizational level, such as availability of training and resources to individual characteristics such as self-esteem and length of employment. A self-administered survey instrument was completed by 410 DCWs working within 11 NHs in the north Texas region. Regression analyses were performed, adjusting for clustering by NH. Beta coefficients and structure coefficients are reported. Burnout was measured through three dimensions: emotional exhaustion, depersonalization, and personal accomplishment. Organizational, work design, interpersonal, and individual characteristics were found to be associated with one or more dimensions of burnout. The analyses largely support previous research. Organizational variables of significance included the availability of resources to do the work, available training, and fair pay. Work design variables of significance included adequate staffing. The individual characteristic, self-esteem, appeared to have the strongest impact on burnout. Commitment to the organization also had a large impact. While the data do not allow for the testing of causal relationships, the data do suggest that providing adequate staffing, perceived fair pay, sufficient work resources (e.g., towels, gowns), management support, and adequate training may result in less DCW burnout on the job. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  3. Establishing a Program for Individuals at High Risk for Breast Cancer

    PubMed Central

    Cadiz, Fernando; Kuerer, Henry M.; Puga, Julio; Camacho, Jamile; Cunill, Eduardo; Arun, Banu

    2013-01-01

    Our need to create a program for individuals at high risk for breast cancer development led us to research the available data on such programs. In this paper, we summarize our findings and our thinking process as we developed our own program. Breast cancer incidence is increasing worldwide. Even though there are known risk factors for breast cancer development, approximately 60% of patients with breast cancer have no known risk factor, although this situation will probably change with further research, especially in genetics. For patients with risk factors based on personal or family history, different models are available for assessing and quantifying risk. Assignment of risk levels permits tailored screening and risk reduction strategies. Potential benefits of specialized programs for women with high breast cancer risk include more cost -effective interventions as a result of patient stratification on the basis of risk; generation of valuable data to advance science; and differentiation of breast programs from other breast cancer units, which can result in increased revenue that can be directed to further improvements in patient care. Guidelines for care of patients at high risk for breast cancer are available from various groups. However, running a high-risk breast program involves much more than applying a guideline. Each high-risk program needs to be designed by its institution with consideration of local resources and country legislation, especially related to genetic issues. Development of a successful high-risk program includes identifying strengths, weaknesses, opportunities, and threats; developing a promotion plan; choosing a risk assessment tool; defining “high risk”; and planning screening and risk reduction strategies for the specific population served by the program. The information in this article may be useful for other institutions considering creation of programs for patients with high breast cancer risk. PMID:23833688

  4. European nursing students' academic success or failure: a post-Bologna Declaration systematic review.

    PubMed

    Dante, Angelo; Petrucci, Cristina; Lancia, Loreto

    2013-01-01

    The aim of this systematic review is to synthesise the available evidence in the European scientific literature produced after the Bologna Declaration and to evaluate studies that quantify and examine the factors associated with the academic success or failure of nursing students. A systematic review of the literature was conducted. Major health literature databases were searched for studies published from 2000 to 2011. This review includes only European observational studies that were submitted to a quality assessment by two researchers before inclusion. Only five studies were included in this review. There are discordant results regarding the predictors of success or failure, which were common objects of study (gender, age, qualification on entry, ethnic group). other factors were studied individually (student personality, gendered view of nursing careers, intention to leave, family commitments, working while on course, student performance, clinical learning environment) need to be confirmed in additional studies. Although the predictors may be relevant at the local level, given their low external validity and the conflicting results, it is not possible to state with certainty that these factors are effectively predictive of success or failure in the context of post-Bologna Declaration Europe. This review showed that over the last ten years, in the European context, only a few high-quality observational studies have been performed. In this regard, given the small number and heterogeneity of the available studies, there is little useful evidence available for Higher Education Institutions (HEIs) to effectively address the problem. In the future, European researchers should focus not only on the documentation of the predictors but also on the documentation of the outcomes produced by the HEI strategies that have been implemented to prevent avoidable academic failure and contain physiological academic failure. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Methods and options in vitro dialyzability; benefits and limitations.

    PubMed

    Sandberg, Ann-Sofie

    2005-11-01

    In vitro dialyzability methods involve a two-step digestion process simulating the gastric and intestinal phase, and dialysis through a semi-permeable membrane with a selected molecular weight cut-off. Dialyzable iron/zinc is used as an estimation of available mineral. Final pH adjustment and use of a strict time schedule were found to be critical factors for standardization. In addition the selected cut-off of the dialysis membrane and the method used for iron and zinc determination influence the results. For screening purposes, simple solubility or dialyzability methods seem preferable to the more sophisticated computer-controlled gastrointestinal model. This is likely more valuable in studies of different transit times and sites of dialyzability. In vitro solubility/dialyzability methods correlate in most cases with human absorption studies in ranking iron and zinc availability from different meals. Exceptions may be that effects of milk, certain proteins, tea, and organic acids cannot be predicted. The dialyzability methods exclude iron bound to large molecules, which in some cases is available and include iron bound to small molecules, which is not always available. In vitro experiments based on solubility/dialyzability are tools to understand factors that may affect subsequent mineral absorption.

  6. Factors Affecting Availability of Essential Medicines among Community Health Workers in Ethiopia, Malawi, and Rwanda: Solving the Last Mile Puzzle

    PubMed Central

    Chandani, Yasmin; Noel, Megan; Pomeroy, Amanda; Andersson, Sarah; Pahl, Michelle K.; Williams, Timothy

    2012-01-01

    To understand how supply chain factors affect product availability at the community level, the Improving Supply Chains for Community Case Management of Pneumonia and Other Common Diseases of Childhood Project developed a theory of change (TOC) framework for gathering, organizing, and interpreting evidence about supply constraints to community case management (CCM). Baseline assessments in Ethiopia, Malawi, and Rwanda conducted in 2010 provided information on the strengths and weaknesses of existing CCM supply chains for five main products: antibiotics for pneumonia, oral rehydration solution, ready to use therapeutic food, zinc, and artemether/lumefantrine. The assessments tested the strength and validity of causal pathways identified in the TOC that were believed to influence availability of CCM products among community health workers (CHWs) for treating common childhood illnesses. Results of the assessments showed product availability to be weak in each country, with more than half of CHWs stocked out of at least one tracer product on the day of the assessment. This report will focus on the findings related to three key preconditions of the TOC and how these were used to inform the design of the CCM supply chain improvement strategy in each country. The three key preconditions include product availability at CHW resupply points, supply chain knowledge and capacity among CHWs and their supervisors, and availability of appropriate transportation. PMID:23136287

  7. Factors affecting availability of essential medicines among community health workers in Ethiopia, Malawi, and Rwanda: solving the last mile puzzle.

    PubMed

    Chandani, Yasmin; Noel, Megan; Pomeroy, Amanda; Andersson, Sarah; Pahl, Michelle K; Williams, Timothy

    2012-11-01

    To understand how supply chain factors affect product availability at the community level, the Improving Supply Chains for Community Case Management of Pneumonia and Other Common Diseases of Childhood Project developed a theory of change (TOC) framework for gathering, organizing, and interpreting evidence about supply constraints to community case management (CCM). Baseline assessments in Ethiopia, Malawi, and Rwanda conducted in 2010 provided information on the strengths and weaknesses of existing CCM supply chains for five main products: antibiotics for pneumonia, oral rehydration solution, ready to use therapeutic food, zinc, and artemether/lumefantrine. The assessments tested the strength and validity of causal pathways identified in the TOC that were believed to influence availability of CCM products among community health workers (CHWs) for treating common childhood illnesses. Results of the assessments showed product availability to be weak in each country, with more than half of CHWs stocked out of at least one tracer product on the day of the assessment. This report will focus on the findings related to three key preconditions of the TOC and how these were used to inform the design of the CCM supply chain improvement strategy in each country. The three key preconditions include product availability at CHW resupply points, supply chain knowledge and capacity among CHWs and their supervisors, and availability of appropriate transportation.

  8. Supervised normalization of microarrays

    PubMed Central

    Mecham, Brigham H.; Nelson, Peter S.; Storey, John D.

    2010-01-01

    Motivation: A major challenge in utilizing microarray technologies to measure nucleic acid abundances is ‘normalization’, the goal of which is to separate biologically meaningful signal from other confounding sources of signal, often due to unavoidable technical factors. It is intuitively clear that true biological signal and confounding factors need to be simultaneously considered when performing normalization. However, the most popular normalization approaches do not utilize what is known about the study, both in terms of the biological variables of interest and the known technical factors in the study, such as batch or array processing date. Results: We show here that failing to include all study-specific biological and technical variables when performing normalization leads to biased downstream analyses. We propose a general normalization framework that fits a study-specific model employing every known variable that is relevant to the expression study. The proposed method is generally applicable to the full range of existing probe designs, as well as to both single-channel and dual-channel arrays. We show through real and simulated examples that the method has favorable operating characteristics in comparison to some of the most highly used normalization methods. Availability: An R package called snm implementing the methodology will be made available from Bioconductor (http://bioconductor.org). Contact: jstorey@princeton.edu Supplementary information: Supplementary data are available at Bioinformatics online. PMID:20363728

  9. Lipid-load in peripheral blood mononuclear cells: Impact of food-consumption, dietary-macronutrients, extracellular lipid availability and demographic factors.

    PubMed

    Ameer, Fatima; Munir, Rimsha; Usman, Hina; Rashid, Rida; Shahjahan, Muhammad; Hasnain, Shahida; Zaidi, Nousheen

    2017-04-01

    Lipid-load in peripheral blood mononuclear cells (PBMCs) has recently gained attention of the researchers working on nutritional regulation of metabolic health. Previous works have indicated that the metabolic circuitries in the circulating PBMCs are influenced by dietary-intake and macronutrient composition of diet. In the present work, we analyzed the impact of diet and dietary macronutrients on PBMCs' lipid-load. The overall analyses revealed that dietary carbohydrates and fats combinatorially induce triglyceride accumulation in PBMCs. On the other hand, dietary fats were shown to induce significant decrease in PBMCs' cholesterol-load. The effects of various demographic factors -including age, gender and body-weight- on PBMCs' lipid-load were also examined. Body-weight and age were both shown to affect PBMC's lipid-load. Our study fails to provide any direct association between extracellular lipid availability and cholesterol-load in both, freshly isolated and cultured PBMCs. The presented work significantly contributes to the current understanding of the impact of food-consumption, dietary macronutrients, extracellular lipid availability and demographic factors on lipid-load in PBMCs. Copyright © 2017 Elsevier B.V. and Société Française de Biochimie et Biologie Moléculaire (SFBBM). All rights reserved.

  10. A Multivariate Twin Study of the DSM-IV Criteria for Antisocial Personality Disorder

    PubMed Central

    Kendler, Kenneth S.; Aggen, Steven H.; Patrick, Christopher J.

    2012-01-01

    BACKGROUND Many assessment instruments for psychopathy are multidimensional, suggesting that distinguishable factors are needed to effectively capture variation in this personality domain. However, no prior study has examined the factor structure of the DSM-IV criteria for antisocial personality disorder (ASPD). METHODS Self-report questionnaire items reflecting all A criteria for DSM-IV ASPD were available from 4,291 twins (including both members of 1,647 pairs) from the Virginia Adult Study of Psychiatric and Substance Use Disorders. Exploratory factor analysis and twin model fitting were performed using, respectively, Mplus and Mx. RESULTS Phenotypic factor analysis produced evidence for 2 correlated factors: aggressive-disregard and disinhibition. The best-fitting multivariate twin model included two genetic and one unique environmental common factor, along with criteria-specific genetic and environmental effects. The two genetic factors closely resembled the phenotypic factors and varied in their prediction of a range of relevant criterion variables. Scores on the genetic aggressive-disregard factor score were more strongly associated with risk for conduct disorder, early and heavy alcohol use, and low educational status, whereas scores on the genetic disinhibition factor score were more strongly associated with younger age, novelty seeking, and major depression. CONCLUSION From a genetic perspective, the DSM-IV criteria for ASPD do not reflect a single dimension of liability but rather are influenced by two dimensions of genetic risk reflecting aggressive-disregard and disinhibition. The phenotypic structure of the ASPD criteria results largely from genetic and not from environmental influences. PMID:21762879

  11. Doctor Shopping

    PubMed Central

    Sansone, Lori A.

    2012-01-01

    Doctor shopping is defined as seeing multiple treatment providers, either during a single illness episode or to procure prescription medications illicitly. According to the available literature, prevalence rates of doctor shopping vary widely, from 6.3 to 56 percent. However, this variability is partially attributable to research methodology, including the study definition of doctor shopping as well as the patient sample. The reasons for doctor shopping are varied. Some patient explanations for this phenomenon relate to clinician factors, such as inconvenient office hours or locations, long waiting times, personal characteristics or qualities of the provider, and/or insufficient communication time between the patient and clinician. Some patient explanations relate to personal factors and include both illness factors (e.g., symptom persistence, lack of understanding or nonacceptance of the diagnosis or treatment) as well as psychological factors (e.g., somatization, prescription drug-seeking). Importantly, not all doctor shopping is driven by suspect motivations. Being aware of these various patient justifications for doctor shopping is important in understanding and managing these challenging patients in the clinical setting, whether they emerge in psychiatric or primary care environments. PMID:23346518

  12. Patient satisfaction at accredited antiretroviral treatment sites in the Gert Sibande District

    PubMed Central

    Ogunsanwo, Damilola A.; Helberg, Elvera A.

    2014-01-01

    Background Patient satisfaction has been used as a significant indicator of quality services provided by healthcare personnel. With the largest antiretroviral therapy (ART) programme in the world, the healthcare industry is struggling increasingly with challenges of meeting patients’ requirements and expectations for quality ART service provision. This study was conducted in order to identify the importance of factors contributing to satisfaction or dissatisfaction. Aim This study sought to explore and describe the general satisfaction or dissatisfaction of patients with accredited ART hospital sites at public health facilities in the Gert Sibande District, Mpumalanga and to identify factors contributing to either satisfaction or dissatisfaction. Setting Six hospitals that initiated ART in the district, participated in the study. Method The study was conducted using a sample of 300 patients. Proportional random sampling was used in selecting the number of patients from each facility. A structured interview with each participating patient was conducted using a standardised structured questionnaire. The first available required number of patients that complied with requirements from each of the six hospitals was selected for the interview. Descriptive statistics were used to analyse data and data with qualitative aspects were captured and categorised manually. Results The major factors contributing to satisfaction included the availability of medicines and knowledge regarding how to take medication. Factors contributing to dissatisfaction on the part of the patients included confidentiality issues, long waiting periods, shortage of staff and dirty toilets. Conclusion This study indicated general satisfaction with the ART-related services at the accredited ART hospital sites in the Gert Sibande District. Regular monitoring and evaluation are recommended. PMID:26245422

  13. Determination of the efficiency of commercially available dose calibrators for beta-emitters.

    PubMed

    Valley, Jean-François; Bulling, Shelley; Leresche, Michel; Wastiel, Claude

    2003-03-01

    The goals of this investigation are to determine whether commercially available dose calibrators can be used to measure the activity of beta-emitting radionuclides used in pain palliation and to establish whether manufacturer-supplied calibration factors are appropriate for this purpose. Six types of commercially available dose calibrators were studied. Dose calibrator response was controlled for 5 gamma-emitters used for calibration or typically encountered in routine use. For the 4 most commonly used beta-emitters ((32)P, (90)Sr, (90)Y, and (169)Er) dose calibrator efficiency was determined in the syringe geometry used for clinical applications. Efficiency of the calibrators was also measured for (153)Sm and (186)Re, 2 beta-emitters with significant gamma-contributions. Source activities were traceable to national standards. All calibrators measured gamma-emitters with a precision of +/-10%, in compliance with Swiss regulatory requirements. For beta-emitters, dose calibrator intrinsic efficiency depends strongly on the maximal energy of the beta-spectrum and is notably low for (169)Er. Manufacturer-supplied calibration factors give accurate results for beta-emitters with maximal beta-energy in the middle-energy range (1 MeV) but are not appropriate for use with low-energy ((169)Er) or high-energy ((90)Y) beta-emitters. beta-emitters with significant gamma-contributions behave like gamma-emitters. Commercially available dose calibrators have an intrinsic efficiency that is sufficient for the measurement of beta-emitters, including beta-emitters with a low maximum beta-energy. Manufacturer-supplied calibration factors are reliable for gamma-emitters and beta-emitters in the middle-energy range. For low- and high-energy beta-emitters, the use of manufacturer-supplied calibration factors introduces significant measurement inaccuracy.

  14. How Informative are the Plastic Surgery Residency Websites to Prospective Applicants?

    PubMed

    Hashmi, Asra; Policherla, Rohan; Campbell, Hector; Khan, Faraz A; Schumaier, Adam; Al-Mufarrej, Faisal

    To evaluate the comprehensiveness of plastic surgery program websites. American Medical Association interactive database was accessed for the list of integrated plastic surgery programs, in June 2015. Since then, 67 plastic surgery program websites were accessed and searched for the presence or absence of 31 criteria, which were further grouped into 5 categories: First, program contact information; second, training and research; third, program setup; fourth, benefits and facilities; and fifth, information for applicants. Programs were categorized based on US census bureau designated regions, and number of residency positions available. One-way ANOVA test was used for comparison. Only 25% (17) program website had information available on more than two-thirds (21 or more of 31) of the criteria. The 3 least factors commonly available by program websites were: operative log (10%), contract (10%), and information on night float (25%). The 3 most commonly available factors included: coordinator information (92%), number of residents (92%), and comprehensive faculty list (88%). Less than 50% of the programs provided information regarding fellowship opportunities, active and previous research projects, and operative logs. There was no difference in amount of information on program websites when analyzed for program size or program geographic location. Programs should consider revising their websites to include aforementioned 31 criteria. This would make applicants and potential resident physicians better informed of the programs before the interview process such that they would be more likely to apply to only those programs that match their specific aspirations. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  15. A review of the application of inflammatory biomarkers in epidemiologic cancer research

    PubMed Central

    Brenner, Darren R.; Scherer, Dominique; Muir, Kenneth; Schildkraut, Joellen; Boffetta, Paolo; Spitz, Margaret R.; LeMarchand, Loic; Chan, Andrew T.; Goode, Ellen L.; Ulrich, Cornelia M.; Hung, Rayjean J.

    2014-01-01

    Inflammation is a facilitating process for multiple cancer types. It is believed to affect cancer development and progression through several etiologic pathways including increased levels of DNA adduct formation, increased angiogenesis and altered anti-apoptotic signaling. This review highlights the application of inflammatory biomarkers in epidemiologic studies and discusses the various cellular mediators of inflammation characterizing the innate immune system response to infection and chronic insult from environmental factors. Included is a review of six classes of inflammation-related biomarkers: cytokines/chemokines, immune-related effectors, acute phase proteins, reactive oxygen and nitrogen species, prostaglandins and cyclooxygenase-related factors, and mediators such as transcription factors and growth factors. For each of these biomarkers we provide a brief overview of the etiologic role in the inflammation response and how they have been related to cancer etiology and progression within the literature. We provide a discussion of the common techniques available for quantification of each marker including strengths, weaknesses and potential pitfalls. Subsequently, we highlight a few under-studied measures to characterize the inflammatory response and their potential utility in epidemiologic studies of cancer. Finally, we suggest integrative methods for future studies to apply multi-faceted approaches to examine the relationship between inflammatory markers and their roles in cancer development. PMID:24962838

  16. Aerodynamic analysis of the Darrieus rotor including secondary effects

    NASA Astrophysics Data System (ADS)

    Paraschivoiu, I.; Delclaux, F.; Fraunie, P.; Beguier, C.

    1983-10-01

    An aerodynamic analysis is made of two variants of the two-actuator-disk theory for modeling the Darrieus wind turbine. The double-multiple-streamtube model with constant and variable interference factors, including secondary effects, is examined for a Darrieus rotor. The influence of the secondary effects, namely, the blade geometry and profile type, the rotating tower, and the presence of struts and aerodynamic spoilers, is relatively significant, especially at high tip-speed ratios. Variation of the induced velocity as a function of the azimuthal angle allows a more accurate calculation of the aerodynamic loads on the downwind zone of the rotor with respect to the assumed constant interference factors. The theoretical results were compared with available experimental data for the Magdalen Islands wind turbine and Sandia-type machines (straight-line/circular-arc shape).

  17. [Chronic Pancreatitis and Pancreatic Cancer - Tumor Risk and Screening].

    PubMed

    Beyer, Georg; D'Haese, Jan G; Ormanns, Steffen; Mayerle, Julia

    2018-06-01

    Chronic pancreatitis is a fibroinflammatory syndrome of the exocrine pancreas, which is characterized by an increasing incidence, high morbidity and lethality. Common etiologies besides alcohol and nicotine consumption include genetic causes and risk factors. The life time risk for the development of pancreatic cancer is elevated 13- to 45-fold depending on the underlying etiology. In patients with chronic pancreatitis clinical, laboratory and imaging surveillance for early detection of complications, including pancreatic cancer, is recommended, although the available methods lack the desired sensitivity and specificity. In this article we review the epidemiology, etiologies and risk factors for chronic pancreatitis and pancreatic cancer and discuss current recommendations for screening and management of patients at risk for tumor development. © Georg Thieme Verlag KG Stuttgart · New York.

  18. New concepts in the prevention of pressure sores.

    PubMed

    Bogie, Kath; Powell, Heather L; Ho, Chester H

    2012-01-01

    Pressure sores are a serious, and costly, complication for many patients with reduced mobility and sensation. Some populations, such as those with spinal cord injury (SCI), remain at high risk throughout their lifetime. Prevention is highly preferable and while the concept is readily definable, it is much more challenging to develop valid preventative measures. Subjective and objective approaches to risk factor assessment before pressure sores develop are reviewed, including risk status scales and emerging techniques to assess deep tissue injury. Devices to prevent pressure sores have traditionally focused on pressure-relieving cushions and mattresses. Technological advances being applied in the development of new pressure sore prevention devices are presented. Clinical evidence-based practice is integral to pressure sore prevention. Comprehensive assessment must include evaluation of systemic diseases, anatomical and physiological factors, together with environmental and psychosocial factors, which can all contribute to pressure sore development. Extrinsic factors need to be considered in conjunction with intrinsic tissue health factors and are reviewed together with an evaluation of currently available clinical practice guidelines. This chapter presents the broad diversity of factors associated with pressure sore development and highlights the need for an interdisciplinary team approach in order to maximize successful prevention of pressure sores. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. Human body burdens of chemicals used in plastic manufacture

    PubMed Central

    Koch, Holger M.; Calafat, Antonia M.

    2009-01-01

    In the last decades, the availability of sophisticated analytical chemistry techniques has facilitated measuring trace levels of multiple environmental chemicals in human biological matrices (i.e. biomonitoring) with a high degree of accuracy and precision. As biomonitoring data have become readily available, interest in their interpretation has increased. We present an overview on the use of biomonitoring in exposure and risk assessment using phthalates and bisphenol A as examples of chemicals used in the manufacture of plastic goods. We present and review the most relevant research on biomarkers of exposure for phthalates and bisphenol A, including novel and most comprehensive biomonitoring data from Germany and the United States. We discuss several factors relevant for interpreting and understanding biomonitoring data, including selection of both biomarkers of exposure and human matrices, and toxicokinetic information. PMID:19528056

  20. Self-harm.

    PubMed

    Skegg, Keren

    The term self-harm is commonly used to describe a wide range of behaviours and intentions including attempted hanging, impulsive self-poisoning, and superficial cutting in response to intolerable tension. As with suicide, rates of self-harm vary greatly between countries. 5-9% of adolescents in western countries report having self-harmed within the previous year. Risk factors include socioeconomic disadvantage, and psychiatric illness--particularly depression, substance abuse, and anxiety disorders. Cultural aspects of some societies may protect against suicide and self-harm and explain some of the international variation in rates of these events. Risk of repetition of self-harm and of later suicide is high. More than 5% of people who have been seen at a hospital after self-harm will have committed suicide within 9 years. Assessment after self-harm includes careful consideration of the patient's intent and beliefs about the lethality of the method used. Strong suicidal intent, high lethality, precautions against being discovered, and psychiatric illness are indicators of high suicide risk. Management after self-harm includes forming a trusting relationship with the patient, jointly identifying problems, ensuring support is available in a crisis, and treating psychiatric illness vigorously. Family and friends may also provide support. Large-scale studies of treatments for specific subgroups of people who self-harm might help to identify more effective treatments than are currently available. Although risk factors for self-harm are well established, aspects that protect people from engaging in self-harm need to be further explored.

  1. Quantifying Fast and Slow Responses of Terrestrial Carbon Exchange across a Water Availability Gradient in North American Flux Sites

    NASA Astrophysics Data System (ADS)

    Biederman, J. A.; Scott, R. L.; Goulden, M.

    2014-12-01

    Climate change is predicted to increase the frequency and severity of water limitation, altering terrestrial ecosystems and their carbon exchange with the atmosphere. Here we compare site-level temporal sensitivity of annual carbon fluxes to interannual variations in water availability against cross-site spatial patterns over a network of 19 eddy covariance flux sites. This network represents one order of magnitude in mean annual productivity and includes western North American desert shrublands and grasslands, savannahs, woodlands, and forests with continuous records of 4 to 12 years. Our analysis reveals site-specific patterns not identifiable in prior syntheses that pooled sites. We interpret temporal variability as an indicator of ecosystem response to annual water availability due to fast-changing factors such as leaf stomatal response and microbial activity, while cross-site spatial patterns are used to infer ecosystem adjustment to climatic water availability through slow-changing factors such as plant community and organic carbon pools. Using variance decomposition, we directly quantify how terrestrial carbon balance depends on slow- and fast-changing components of gross ecosystem production (GEP) and total ecosystem respiration (TER). Slow factors explain the majority of variance in annual net ecosystem production (NEP) across the dataset, and their relative importance is greater at wetter, forest sites than desert ecosystems. Site-specific offsets from spatial patterns of GEP and TER explain one third of NEP variance, likely due to slow-changing factors not directly linked to water, such as disturbance. TER and GEP are correlated across sites as previously shown, but our site-level analysis reveals surprisingly consistent linear relationships between these fluxes in deserts and savannahs, indicating fast coupling of TER and GEP in more arid ecosystems. Based on the uncertainty associated with slow and fast factors, we suggest a framework for improved prediction of terrestrial carbon balance. We will also present results of ongoing work to quantify fast and slow contributions to the relationship between evapotranspiration and precipitation across a precipitation gradient.

  2. Use of Placental Membranes for the Treatment of Chronic Diabetic Foot Ulcers

    PubMed Central

    Brantley, Jonathan N.; Verla, Thomas D.

    2015-01-01

    Significance: Chronic diabetic foot ulcers (DFUs) remain a challenge for physicians to treat. High mortality rates for DFU patients have pointed to the low effectiveness of standard care and lack of quality wound care products. The composition (collagen-rich tissue matrix and endogenous growth factors and cells) and functional properties (anti-inflammatory, anti-bacterial, and angiogenic) of placental membranes are uniquely suited to address the needs of chronic wounds. This led to the commercialization of placental membranes, which are now widely available to physicians as a new advanced wound treatment option. Recent Advances: Progress in tissue processing and preservation methods has facilitated the development of placental products for wounds. Currently, a variety of commercial placental products are available to physicians for the treatment of chronic DFUs and other wounds. This review summarizes the key factors that negatively impact DFU healing (including social factors, such as smoking, vascular deficiencies, hyperglycemia, and other metabolic abnormalities), describes the structure and biology of placental membranes, and overviews commercially available placental products for wounds and data from the most recent DFU clinical trials utilizing commercial placental membranes. Critical Issues: Although the effects of diabetes on wound healing are complex and not fully understood, some of the key factors and pathways that interfere with healing have been identified. However, a multidisciplinary approach for the assessment of patients with chronic DFUs and guidelines for selection of appropriate treatment modalities remain to be implemented. Future Directions: The biological properties of placental membranes show benefits for the treatment of chronic DFUs, but scientific and clinical data for commercially available placental products are limited. Therefore, we need (1) more randomized, controlled clinical trials for commercial placental products; (2) studies that help to understand the timing of placental products' application and criteria for patient selection; and (3) studies comparing the functional properties of different commercially available placental products. PMID:26339533

  3. Does energy availability predict gastropod reproductive strategies?

    PubMed Central

    McClain, Craig R.; Filler, Ryan; Auld, Josh R.

    2014-01-01

    The diversity of reproductive strategies in nature is shaped by a plethora of factors including energy availability. For example, both low temperatures and limited food availability could increase larval exposure to predation by slowing development, selecting against pelagic and/or feeding larvae. The frequency of hermaphroditism could increase under low food availability as population density (and hence mate availability) decreases. We examine the relationship between reproductive/life-history traits and energy availability for 189 marine gastropod families. Only larval type was related to energy availability with the odds of having planktotrophic larvae versus direct development decreasing by 1% with every one-unit increase in the square root of carbon flux. Simultaneous hermaphroditism also potentially increases with carbon flux, but this effect disappears when accounting for evolutionary relationships among taxa. Our findings are in contrast to some theory and empirical work demonstrating that hermaphroditism should increase and planktotrophic development should decrease with decreasing productivity. Instead, they suggest that some reproductive strategies are too energetically expensive at low food availabilities, or arise only when energy is available, and others serve to capitalize on opportunities for aggregation or increased energy availability. PMID:25009058

  4. Increasing availability of illicit drugs among people who inject drugs in Bangkok, Thailand.

    PubMed

    Hayashi, Kanna; Nosyk, Bohdan; Ti, Lianping; Suwannawong, Paisan; Kaplan, Karyn; Wood, Evan; Kerr, Thomas

    2013-09-01

    In recent years, the Thai government has strengthened drug law enforcement as a strategy to address a continuing epidemic of illicit drug use. We sought to assess temporal trends in street-level availability of illicit drugs among injection drug users (IDUs) in Bangkok, Thailand. Using univariate statistics and multivariate logistic regression, we assessed changes in the availability of five substances (heroin, methamphetamine, crystal methamphetamine, midazolam, and illicit methadone) between 2009 and 2011 and examined social, structural and individual factors influencing availability among community-recruited samples of IDUs in Bangkok. Availability was measured in three levels: immediate (available in ≤10 min); moderate (available in 10-90 min); and delayed (available in >90 min; our reference category). The analyses included 718 IDUs, including 165 (23.0%) women. Controlling for changes in participant characteristics between assessments, and in a period of constant nominal illicit drug prices, moderate availability of all substances increased significantly between 2009 and 2011, with adjusted odds ratios ranging between 2.36 (illicit methadone) and 4.61 (crystal methamphetamine) (all p<0.01). Immediate availability of all substances but heroin also increased (all p<0.01). More immediate availability of methamphetamine was also associated with a history of incarceration (p<0.05). Despite the Thai government's intensified drug suppression efforts, the availability of illicit drugs among IDUs in Bangkok increased significantly between 2009 and 2011. The findings raise concern about the overreliance on drug law enforcement-based approaches and point to the need for greater investment in evidence-based drug policies. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  5. The societal benefits of reducing six behavioural risk factors: an economic modelling study from Australia

    PubMed Central

    2011-01-01

    Background A large proportion of disease burden is attributed to behavioural risk factors. However, funding for public health programs in Australia remains limited. Government and non-government organisations are interested in the productivity effects on society from reducing chronic diseases. We aimed to estimate the potential health status and economic benefits to society following a feasible reduction in the prevalence of six behavioural risk factors: tobacco smoking; inadequate fruit and vegetable consumption; high risk alcohol consumption; high body mass index; physical inactivity; and intimate partner violence. Methods Simulation models were developed for the 2008 Australian population. A realistic reduction in current risk factor prevalence using best available evidence with expert consensus was determined. Avoidable disease, deaths, Disability Adjusted Life Years (DALYs) and health sector costs were estimated. Productivity gains included workforce (friction cost method), household production and leisure time. Multivariable uncertainty analyses and correction for the joint effects of risk factors on health status were undertaken. Consistent methods and data sources were used. Results Over the lifetime of the 2008 Australian adult population, total opportunity cost savings of AUD2,334 million (95% Uncertainty Interval AUD1,395 to AUD3,347; 64% in the health sector) were found if feasible reductions in the risk factors were achieved. There would be 95,000 fewer DALYs (a reduction of about 3.6% in total DALYs for Australia); 161,000 less new cases of disease; 6,000 fewer deaths; a reduction of 5 million days in workforce absenteeism; and 529,000 increased days of leisure time. Conclusions Reductions in common behavioural risk factors may provide substantial benefits to society. For example, the total potential annual cost savings in the health sector represent approximately 2% of total annual health expenditure in Australia. Our findings contribute important new knowledge about productivity effects, including the potential for increased household and leisure activities, associated with chronic disease prevention. The selection of targets for risk factor prevalence reduction is an important policy decision and a useful approach for future analyses. Similar approaches could be applied in other countries if the data are available. PMID:21689461

  6. "Now drugs in Libya are much cheaper than food": A qualitative study on substance use among young Libyans in post-revolution Tripoli, Libya.

    PubMed

    Elamouri, Fauzi Muftah; Musumari, Patou Masika; Techasrivichien, Teeranee; Farjallah, Anwer; Elfandi, Sufian; Alsharif, Osama Fathi; Benothman, Hussein; Suguimoto, S Pilar; Ono-Kihara, Masako; Kihara, Masahiro

    2018-03-01

    Libya is facing a rapidly growing epidemic of illicit drug use and HIV. This situation is fueled by a complex array of factors, mainly the consequences of the political and military turmoil of the Arab Spring. Although it is extensively documented in other settings that young people are one of the most vulnerable groups to both HIV and illicit drug use, no study has explored this issue among young people in Libya. The current study addresses this research gap. This study is a qualitative study using in-depth interviews guided by a semi-structured questionnaire. We used a maximum variation, purposive sampling strategy to recruit male and female participants, aged 14-18 years, from schools, prisons, and community-based informal re-education and rehabilitation centers in Tripoli, Libya. In total, 31 participants were recruited: 6 females and 25 males. Sixteen participants were prisoners and residents of community-based informal re-education and rehabilitation centers, and 15 were recruited in schools. Risk factors for drug use included peer influence, the increased availability and affordability of drugs, disruption of social life and healthy recreational activities, and the distress and casualties of the war. Protective factors were religious beliefs and practices, good parent-child connectedness, and high self-esteem and future aspiration. Risk factors for HIV were insufficient knowledge related to HIV transmission and unsafe injection practices, such as sharing needles and syringes. We found individual, interpersonal, family, and structural-level factors that interplayed to shape the vulnerability of young people to drug use and HIV infection in Tripoli, Libya. Structural factors, including the increased availability and affordability of drugs, provided the frame within which other factors, such as peer influence, insufficient knowledge of substance use, and HIV, operated to increase the vulnerability of young people to drugs and HIV, while religious beliefs and parent-child connectedness acted as protective factors. Multisectoral efforts and studies to quantitatively evaluate the magnitude and distribution of these problems are urgently needed. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Setting-related influences on physical inactivity of older adults in residential care settings: a review.

    PubMed

    Douma, Johanna G; Volkers, Karin M; Engels, Gwenda; Sonneveld, Marieke H; Goossens, Richard H M; Scherder, Erik J A

    2017-04-28

    Despite the detrimental effects of physical inactivity for older adults, especially aged residents of residential care settings may spend much time in inactive behavior. This may be partly due to their poorer physical condition; however, there may also be other, setting-related factors that influence the amount of inactivity. The aim of this review was to review setting-related factors (including the social and physical environment) that may contribute to the amount of older adults' physical inactivity in a wide range of residential care settings (e.g., nursing homes, assisted care facilities). Five databases were systematically searched for eligible studies, using the key words 'inactivity', 'care facilities', and 'older adults', including their synonyms and MeSH terms. Additional studies were selected from references used in articles included from the search. Based on specific eligibility criteria, a total of 12 studies were included. Quality of the included studies was assessed using the Mixed Methods Appraisal Tool (MMAT). Based on studies using different methodologies (e.g., interviews and observations), and of different quality (assessed quality range: 25-100%), we report several aspects related to the physical environment and caregivers. Factors of the physical environment that may be related to physical inactivity included, among others, the environment's compatibility with the abilities of a resident, the presence of equipment, the accessibility, security, comfort, and aesthetics of the environment/corridors, and possibly the presence of some specific areas. Caregiver-related factors included staffing levels, the available time, and the amount and type of care being provided. Inactivity levels in residential care settings may be reduced by improving several features of the physical environment and with the help of caregivers. Intervention studies could be performed in order to gain more insight into causal effects of improving setting-related factors on physical inactivity of aged residents.

  8. A resource for characterizing genome-wide binding and putative target genes of transcription factors expressed during secondary growth and wood formation in Populus.

    PubMed

    Liu, Lijun; Ramsay, Trevor; Zinkgraf, Matthew; Sundell, David; Street, Nathaniel Robert; Filkov, Vladimir; Groover, Andrew

    2015-06-01

    Identifying transcription factor target genes is essential for modeling the transcriptional networks underlying developmental processes. Here we report a chromatin immunoprecipitation sequencing (ChIP-seq) resource consisting of genome-wide binding regions and associated putative target genes for four Populus homeodomain transcription factors expressed during secondary growth and wood formation. Software code (programs and scripts) for processing the Populus ChIP-seq data are provided within a publically available iPlant image, including tools for ChIP-seq data quality control and evaluation adapted from the human Encyclopedia of DNA Elements (ENCODE) project. Basic information for each transcription factor (including members of Class I KNOX, Class III HD ZIP, BEL1-like families) binding are summarized, including the number and location of binding regions, distribution of binding regions relative to gene features, associated putative target genes, and enriched functional categories of putative target genes. These ChIP-seq data have been integrated within the Populus Genome Integrative Explorer (PopGenIE) where they can be analyzed using a variety of web-based tools. We present an example analysis that shows preferential binding of transcription factor ARBORKNOX1 to the nearest neighbor genes in a pre-calculated co-expression network module, and enrichment for meristem-related genes within this module including multiple orthologs of Arabidopsis KNOTTED-like Arabidopsis 2/6. © 2015 Society for Experimental Biology and John Wiley & Sons Ltd This article has been contributed to by US Government employees and their work is in the public domain in the USA.

  9. Awareness of cervical cancer risk factors and symptoms: cross-sectional community survey in post-conflict northern Uganda.

    PubMed

    Mwaka, Amos D; Orach, Christopher G; Were, Edward M; Lyratzopoulos, Georgios; Wabinga, Henry; Roland, Martin

    2016-08-01

    Lack of awareness of risk factors and symptoms for cancer may lead to late diagnosis and poor prognosis. We assessed community awareness about cervical cancer risk factors and symptoms and perceptions about prevention and cure of cervical cancer in order to contribute data to inform interventions to improve cervical cancer survival. Cross-sectional population-based survey. We conducted this study in Gulu, a post-conflict district in Uganda in 2012. The sample included 448 persons aged 18 years and above, selected through a multi-stage stratified cluster sampling process. We collected data using a pretested structured questionnaire. Logistic regressions were used to determine magnitudes of associations between socio-demographic and outcome variables. Most participants (444/448) had heard about cervical cancer. Known risk factors including multiple sexual partners, human papillomavirus infection, and early onset of sexual activity, were recognized by 88%, 82%, and 78% of respondents respectively. 63% of participants believed that prolonged use of family planning pills and injections caused cervical cancer. The majority of participants recognized symptoms of cervical cancer including inter-menstrual bleeding (85%), post-menopausal bleeding (84%), and offensive vaginal discharge (83%). 70% of participants believed that cervical cancer is preventable and 92% believed that it could be cured if diagnosed at an early stage. Recognition of cervical cancer risk factors and symptoms was high among study participants. Targeted interventions including increasing availability of HPV vaccination, population-based cervical screening and diagnostic services can translate high awareness into actual benefits. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  10. Motivation and Perception of Tourists as Push and Pull Factors to Visit National Park

    NASA Astrophysics Data System (ADS)

    Said, Jumrin; Maryono

    2018-02-01

    Push-pull theoretical framework is a popular theory to explain the reason why the tourists decide to visit the destination rather than other place, the kind of experience they want to get and the type of activity they want to do. In this paper, it is explained the motivation as push factors and the perception as pull factors of the tourist in deciding the destination based on previous literature and research using descriptive method. The framework asumed that tourists are motivated to fulfill their needs, including to reduce the psychological imbalance and to gain recognition of social status. National Park is one of destination based on nature or commonly knowns as ecotourism. In choosing the destination, the tourists tend to classify their alternative choice based on several criteria, such as the domination perception of tourist from one destination (pull factor), self motivation (push factor) and the available time and money (situational constraints).

  11. Home food environment in relation to children's diet quality and weight status.

    PubMed

    Couch, Sarah C; Glanz, Karen; Zhou, Chuan; Sallis, James F; Saelens, Brian E

    2014-10-01

    The objective of this cohort study was to explore relationships among the home food environment (HFE), child/parent characteristics, diet quality, and measured weight status among 699 child-parent pairs from King County, WA, and San Diego County, CA. HFE variables included parenting style/feeding practices, food rules, frequency of eating out, home food availability, and parents' perceptions of food costs. Child dietary intake was measured by 3-day recall and diet quality indicators included fruits and vegetables, sweet/savory snacks, high-calorie beverages, and Dietary Approaches to Stop Hypertension (DASH) score. Individual linear regression models were run in which child BMI z score and child diet quality indicators were dependent variables and HFE variables and child/parent characteristics were independent variables of interest. Fruit and vegetable consumption was associated with parental encouragement/modeling (β=.68, P<0.001) and unhealthful food availability (-0.27, P<0.05); DASH score with food availability (healthful: 1.3, P<0.01; unhealthful: -2.25, P<0.001), food rules (0.45, P<0.01), and permissive feeding style (-1.04, P<0.05); high-calorie beverages with permissive feeding style (0.14, P<0.01) and unhealthful food availability (0.21, P<0.001); and sweet/savory snacks with healthful food availability (0.26, P<0.05; unexpectedly positive). Children's BMI z score was positively associated with parent's use of food restriction (0.21, P<0.001), permissive feeding style (0.16, P<0.05), and concern for healthy food costs (0.10, P<0.01), but negatively with verbal encouragement/modeling (-0.17, P<0.05), and pressure to eat (-0.34, P<0.001). Various HFE factors associated with parenting around eating and food availability are related to child diet quality and weight status. These factors should be considered when designing interventions for improving child health. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  12. Beyond Negative Affectivity: A Hierarchical Model of Global and Transdiagnostic Vulnerabilities for Emotional Disorders.

    PubMed

    Paulus, Daniel J; Talkovsky, Alexander M; Heggeness, Luke F; Norton, Peter J

    2015-01-01

    Negative affectivity (NA) has been linked to anxiety and depression (DEP). Identifying the common factors between anxiety and DEP is important when explaining their overlap and comorbidity. However, general factors such as NA tend to have differential relationships with different disorders, suggesting the need to identify mediators in order to explicate these relationships. The current study tests a theoretically and empirically derived hierarchical model of emotional disorders including both a general factor (NA) and transdiagnostic risk factors [anxiety sensitivity (AS) and intolerance of uncertainty (IoU)] using structural equation modeling. AS was tested as a mid-level factor between NA and panic disorder/agoraphobia, while IoU was tested as a mid-level factor between NA and social phobia, generalized anxiety disorder, obsessive-compulsive disorder, and DEP. Data from 642 clinical outpatients with a heterogeneous presentation of emotional disorders were available for analysis. The hierarchical model fits the data adequately. Moreover, while a simplified model removing AS and IoU fits the data well, it resulted in a significant loss of information for all latent disorder constructs. Data were unavailable to estimate post-traumatic stress disorder or specific phobias. Future work will need to extend to other emotional disorders. This study demonstrates the importance of both general factors that link disorders together and semi-specific transdiagnostic factors partially explaining their heterogeneity. Including these mid-level factors in hierarchical models of psychopathology can help account for additional variance and help to clarify the relationship between disorder constructs and NA.

  13. Muscle Mass and Weight Gain Nutritional Supplements

    NASA Astrophysics Data System (ADS)

    Campbell, Bill

    There are numerous sports supplements available that claim to increase lean body mass. However, for these sports supplements to exert any favorable changes in lean body mass, they must influence those factors regulating skeletal muscle hypertrophy (i.e., satellite cell activity, gene transcription, protein translation). If a given sports supplement does favorably influence one of these regulatory factors, the result is a positive net protein balance (in which protein synthesis exceeds protein breakdown). Sports supplement categories aimed at eliciting a positive net protein balance include anabolic hormone enhancers, nutrient timing pre- and postexercise workout supplements, anticatabolic supplements, and nitric oxide boosters. Of all the sports supplements available, only a few have been subject to multiple clinical trials with repeated favorable outcomes relative to increasing lean body mass. This chapter focuses on these supplements and others that have a sound theoretical rationale in relation to increasing lean body mass.

  14. Rural Trends in Diagnosis and Services for Autism Spectrum Disorder

    PubMed Central

    Antezana, Ligia; Scarpa, Angela; Valdespino, Andrew; Albright, Jordan; Richey, John A.

    2017-01-01

    Rural communities face significant challenges regarding the adequate availability of diagnostic-, treatment-, and support-services for individuals with autism spectrum disorder (ASD). Specifically, a variety of factors, including geographic distance between families and service providers, low reliance on health care professionals, and cultural characteristics, contribute to the diminished availability and utilization of services. Together, these factors lead to risks for delayed ASD screening and diagnosis, yielding lower educational and functional outcomes. The purpose of this review is to outline the specific diagnosis and treatment barriers that affect individuals with ASD and their families in rural settings. Telehealth feasibility and efficacy research is also reviewed, suggesting that telecommunication services may offer an inroad for addressing the specific service barriers faced by rural communities. Together, the current review identifies specific needs for both research and support services that address the specific access barriers characteristic of rural settings. PMID:28473784

  15. Factors affecting proppant flowback with resin coated proppants

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

    Almond, S.W.; Penny, G.S.; Conway, M.W.

    1995-12-31

    Resin coated proppants (RCPs) have been used to prevent proppant flowback for several years in the hydraulic fracturing of oil and gas wells. Proppant flowback problems, however, still exist with the commercially available RCPs and several operators report failures around the world under a variety of well conditions. To date, a clear explanation of the RCP failure mechanisms and the conditions under which failure occurs has not been presented in the industry. A correlation between the unconfined compressive strength (UCS) of RCP materials and the proppant flowback potential has been previously presented by Vreeburg, et al. This paper will presentmore » the results of a study on a variety of factors which effect the proppant flowback of a number of commercially available RCP materials. These factors include (1) the effect of fluid pH (7 to 12) and fluid type (KCL, seawater and a HPG/Borate fracturing fluid), (2) the effect of fluid/proppant slurry shear, (3) the effect of closure pressure during RCP curing, (4) the effect of stress cycling and (5) the effect of downhole flow conditions on proppant flowback.« less

  16. Risk management for outsourcing biomedical waste disposal - using the failure mode and effects analysis.

    PubMed

    Liao, Ching-Jong; Ho, Chao Chung

    2014-07-01

    Using the failure mode and effects analysis, this study examined biomedical waste companies through risk assessment. Moreover, it evaluated the supervisors of biomedical waste units in hospitals, and factors relating to the outsourcing risk assessment of biomedical waste in hospitals by referring to waste disposal acts. An expert questionnaire survey was conducted on the personnel involved in waste disposal units in hospitals, in order to identify important factors relating to the outsourcing risk of biomedical waste in hospitals. This study calculated the risk priority number (RPN) and selected items with an RPN value higher than 80 for improvement. These items included "availability of freezing devices", "availability of containers for sharp items", "disposal frequency", "disposal volume", "disposal method", "vehicles meeting the regulations", and "declaration of three lists". This study also aimed to identify important selection factors of biomedical waste disposal companies by hospitals in terms of risk. These findings can serve as references for hospitals in the selection of outsourcing companies for biomedical waste disposal. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Attention deficit/hyperactivity-disorder and obesity: A review and model of current hypotheses explaining their comorbidity.

    PubMed

    Hanć, Tomasz; Cortese, Samuele

    2018-05-19

    Available meta-analyses point to a significant association between attention-deficit/hyperactivity disorder (ADHD) and obesity. The possible mechanisms underlying this relationship are unclear. Here, we overview the studies aimed at identifying the factors contributing to the comorbidity between ADHD and obesity, including genetic factors, fetal programming, executive dysfunctions, psychosocial stress, factors directly related to energy balance, and sleep patterns alterations. The bulk of current research has focused on reduced physical activity and abnormal eating patterns as possible causes of weight gain in individuals with ADHD. Further research is needed to explore the specific role of executive dysfunctions. None of the available published studies have evaluated physiological mechanisms such as hormonal and metabolic disorders or inappropriate neurobiological regulation of appetite. Research exploring the genetic basis for the coexistence of ADHD and obesity and epigenetic mechanisms, with particular emphasis on stress, both pre- and postnatal, seems particularly promising. Here, we propose a biopsychosocial model to integrate current findings and move the field forward to gain insight into the ADHD-obesity relationship. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. Factors Associated with Use of Interactive Cancer Communication System: An Application of the Comprehensive Model of Information Seeking

    PubMed Central

    Han, Jeong Yeob; Wise, Meg; Kim, Eunkyung; Pingree, Ray; Hawkins, Robert P.; Pingree, Suzanne; McTavish, Fiona; Gustafson, David H.

    2011-01-01

    In order to provide insights about cancer patients’ online information seeking behaviors, the present study analyzes individuals’ transaction log data and reports on how demographics, disease-related factors, and psychosocial needs predict patterns of service use within a particular Interactive Cancer Communication System (ICCS). Study sample included 294 recently diagnosed breast cancer patients. Data included pretest survey scores of demographic, disease-related, and psychosocial factors and automatically collected ICCS use data over the 4-month intervention. Statistical analyses correlated pre-test survey scores with subsequent, specific types of ICCS service usage. Patterns of online cancer information seeking differed according to the patients’ characteristics, suggesting that lower income, less educated women and those lacking in information-seeking competence use the computer and online services to the same or a greater degree if those services are made available to them. Results of this study can inform more effective resource development for future eHealth applications. PMID:21760702

  19. Suicidality and veterans with a history of traumatic brain injury: precipitants events, protective factors, and prevention strategies.

    PubMed

    Brenner, Lisa A; Homaifar, Beeta Y; Adler, Lawrence E; Wolfman, Jessica H; Kemp, Jan

    2009-11-01

    To increase understanding regarding precipitating and preventative factors of suicidal behavior and to highlight past experiences and recommendations regarding services aimed at suicide prevention among Veterans with a history of traumatic brain injury (TBI). Qualitative. Sample of 13 Veterans with a history of TBI, and a history of clinically significant suicidal ideation or behavior. In-person interviews were conducted and data were analyzed using a hermeneutic approach. Shared precipitants noted included loss-of-self post-TBI, cognitive sequelae, and psychiatric and emotional disturbances. Common protective factors noted included social supports, a sense of purpose regarding the future, religion and spirituality, and mental health care. Means of improving care were also identified (e.g., increasing the availability of services and mental health professionals' knowledge regarding TBI, providing more structured treatment). Findings highlight potential areas of importance in the assessment and treatment of suicidal Veterans with a history of TBI. Recommendations regarding means of improving care are also presented.

  20. A statistical model to estimate the local vulnerability to severe weather

    NASA Astrophysics Data System (ADS)

    Pardowitz, Tobias

    2018-06-01

    We present a spatial analysis of weather-related fire brigade operations in Berlin. By comparing operation occurrences to insured losses for a set of severe weather events we demonstrate the representativeness and usefulness of such data in the analysis of weather impacts on local scales. We investigate factors influencing the local rate of operation occurrence. While depending on multiple factors - which are often not available - we focus on publicly available quantities. These include topographic features, land use information based on satellite data and information on urban structure based on data from the OpenStreetMap project. After identifying suitable predictors such as housing coverage or local density of the road network we set up a statistical model to be able to predict the average occurrence frequency of local fire brigade operations. Such model can be used to determine potential hotspots for weather impacts even in areas or cities where no systematic records are available and can thus serve as a basis for a broad range of tools or applications in emergency management and planning.

  1. Cost and Selection of Ophthalmic Anti-Vascular Endothelial Growth Factor Agents.

    PubMed

    Li, Emily; Greenberg, Paul B; Voruganti, Indu; Krzystolik, Magdalena G

    2016-05-02

    Anti-vascular endothelial growth factor (anti-VEGF) drugs - ranibizumab, aflibercept, and off-label bevacizumab - are vital to the treatment of common retinal diseases, including exudative age-related macular degeneration (AMD), diabetic macular edema (DME), and macular edema (ME) associated with retinal vein occlusion (RVO). Given the high prevalence of AMD and retinal vascular diseases, anti-VEGF agents represent a large cost burden to the United States (US) healthcare system. Although ranibizumab and aflibercept are 30-fold more expensive per injection than bevacizumab, the two more costly medications are commonly used in the US, even though all three have been shown to be effective and safe for treatment of these retinal diseases. We investigated the availability and content of professional ophthalmic guidelines on cost consideration in the selection of anti-VEGF agents. We found that current professional guidelines were limited in availability and lacked specific guidance on cost-based anti-VEGF drug selection. This represents a missed opportunity to encourage the practice of value-based medicine. [Full article available at http://rimed.org/rimedicaljournal-2016-05.asp, free with no login].

  2. The influence of soil properties and nutrients on conifer forest growth in Sweden, and the first steps in developing a nutrient availability metric

    NASA Astrophysics Data System (ADS)

    Van Sundert, Kevin; Horemans, Joanna A.; Stendahl, Johan; Vicca, Sara

    2018-06-01

    The availability of nutrients is one of the factors that regulate terrestrial carbon cycling and modify ecosystem responses to environmental changes. Nonetheless, nutrient availability is often overlooked in climate-carbon cycle studies because it depends on the interplay of various soil factors that would ideally be comprised into metrics applicable at large spatial scales. Such metrics do not currently exist. Here, we use a Swedish forest inventory database that contains soil data and tree growth data for > 2500 forests across Sweden to (i) test which combination of soil factors best explains variation in tree growth, (ii) evaluate an existing metric of constraints on nutrient availability, and (iii) adjust this metric for boreal forest data. With (iii), we thus aimed to provide an adjustable nutrient metric, applicable for Sweden and with potential for elaboration to other regions. While taking into account confounding factors such as climate, N deposition, and soil oxygen availability, our analyses revealed that the soil organic carbon concentration (SOC) and the ratio of soil carbon to nitrogen (C : N) were the most important factors explaining variation in normalized (climate-independent) productivity (mean annual volume increment - m3 ha-1 yr-1) across Sweden. Normalized forest productivity was significantly negatively related to the soil C : N ratio (R2 = 0.02-0.13), while SOC exhibited an empirical optimum (R2 = 0.05-0.15). For the metric, we started from a (yet unvalidated) metric for constraints on nutrient availability that was previously developed by the International Institute for Applied Systems Analysis (IIASA - Laxenburg, Austria) for evaluating potential productivity of arable land. This IIASA metric requires information on soil properties that are indicative of nutrient availability (SOC, soil texture, total exchangeable bases - TEB, and pH) and is based on theoretical considerations that are also generally valid for nonagricultural ecosystems. However, the IIASA metric was unrelated to normalized forest productivity across Sweden (R2 = 0.00-0.01) because the soil factors under consideration were not optimally implemented according to the Swedish data, and because the soil C : N ratio was not included. Using two methods (each one based on a different way of normalizing productivity for climate), we adjusted this metric by incorporating soil C : N and modifying the relationship between SOC and nutrient availability in view of the observed relationships across our database. In contrast to the IIASA metric, the adjusted metrics explained some variation in normalized productivity in the database (R2 = 0.03-0.21; depending on the applied method). A test for five manually selected local fertility gradients in our database revealed a significant and stronger relationship between the adjusted metrics and productivity for each of the gradients (R2 = 0.09-0.38). This study thus shows for the first time how nutrient availability metrics can be evaluated and adjusted for a particular ecosystem type, using a large-scale database.

  3. [Demographic pressure: a factor in political instability].

    PubMed

    Tallon, F

    1991-01-01

    A review of population trends in Rwanda is presented. They include the growing pressure on available land and resources due to an increase in the numbers of people and cattle. The author finds that this pressure, combined with ethnic tensions, has created an explosive political situation. He concludes that political stability is possible only if a vigorous population policy is implemented.

  4. The Contextual Motivational Conditions for L2 Pedagogy: A Case Study from the Arabian Gulf

    ERIC Educational Resources Information Center

    Shah, Muhammad Athar

    2017-01-01

    This article reports on a mixed-method research study into situated motivational conditions available for the English language (L2) pedagogy at a university in Saudi Arabia. The current study evaluated the L2 Learning Experience of the students by focusing on the key contextual factors that included teachers' pedagogical practices, group dynamics…

  5. Correlations between tree crown condition and shade tolerance, crown form, and light availability

    Treesearch

    KaDonna C. Randolph

    2007-01-01

    Individual tree crown condition is the result of a combination of many factors including genetic traits, growing site characteristics, and past and present external stresses (e.g., drought, insect outbreaks, fire, etc.). Shade tolerance and the extent to which terminal buds control the length and orientation of lateral branches (epinastic control) are the two primary...

  6. Species performance: The relationship between nutrient availability, life history traits and stress [Chapter 8

    Treesearch

    Jeremy J. James

    2012-01-01

    Differences in species performance (i.e. how a species captures and utilizes resources to maintain and increase population size), influences the rate and direction of plant community change (Sheley et al., 2006). Species performance is determined by a number of interacting factors. This includes resource supply rates, physiological traits that determine how a species...

  7. Holistic Sustainability as Key to Emiratization: Links between Job Satisfaction in the Private Sector and Young Emirati Adult Unemployment

    ERIC Educational Resources Information Center

    Daleure, Georgia M.

    2016-01-01

    This study examines factors leading to unemployment among young Emirati adults and new entrants to the workforce despite the abundant employment opportunities available in the UAE private sector. The study points out that new entrants to the workforce, including a growing number of college graduates, find few opportunities in the preferred but…

  8. Growth, Distribution, and Poverty in Africa: Messages from the 1990s. Poverty Dynamics in Africa.

    ERIC Educational Resources Information Center

    Christiaensen, Luc; Demery, Lionel; Paternostro, Stefano

    This book reviews trends in household well-being in Africa during the 1990s. Using the better data sets now available, the main factors behind observed poverty changes are examined in eight countries: Ethiopia, Ghana, Madagascar, Mauritania, Nigeria, Uganda, Zambia, and Zimbabwe. A broad view of poverty is taken, which includes income poverty and…

  9. Validation of the Crime and Violence Scale (CVS) against the Rasch Measurement Model Including Differences by Gender, Race, and Age

    ERIC Educational Resources Information Center

    Conrad, Kendon J.; Riley, Barth B.; Conrad, Karen M.; Chan, Ya-Fen; Dennis, Michael L.

    2010-01-01

    In assessing criminality, researchers have used counts of crimes, arrests, and so on, because interval measures were not available. Additionally, crime seriousness varies depending on demographic factors. This study examined the Crime and Violence Scale (CVS) regarding psychometric quality using item response theory (IRT) and invariance of the…

  10. Signal transduction during wheat grain development.

    PubMed

    Kong, Lingan; Guo, Honghai; Sun, Mingze

    2015-04-01

    This review examines the signaling pathways from the developmental and environmental point of view and the interactions among external conditions, hormonal regulations, and sugarsensing in wheat. Grain development is the key phase of reproductive growth that is closely associated with vegetative organ senescence, initiation of grain filling, pre-stored assimilates remobilization, and maturation. Senescence is characterized by loss of chlorophyll and the degradation of proteins, nucleic acids, lipids as well as nutrient exports to the sink. The initiation and progression of vegetative organ senescence are under the control of an array of environmental signals (such as biotic and abiotic stresses, darkness, and nutrient availability) and endogenous factors (including aging, multiple hormones, and sugar availability). This review will discuss the major breakthroughs in signal transduction for the wheat (Triticum aestivum) grain development achieved in the past several years, with focuses on the regulation of senescence, reserves remobilization and biosynthesis of main components of the grain. Different mechanisms of diverse signals in controlling different phrases of wheat grain development, and cross talks between different signaling pathways will also be discussed. For perspectives, key signaling networks for grain development remain to be elucidated, including cross talks and the interactions between various environmental factors and internal signals.

  11. Influence of children pedestrian behaviour on pedestrian space usage

    NASA Astrophysics Data System (ADS)

    Makalew, F. P.; Adisasmita, S. A.; Wunas, S.; Hamid, S.

    2017-11-01

    School children pedestrian behaviour can be seen along their journey to and from school. Pedestrian spaces used by children are places available in urban and rural areas including streets with and without pedestrian pathways. Samples data are collected from 23 elementary schools in urban and rural areas in North Sulawesi, Indonesia in the form of video records and photos taken. The aim of this research is to analyse children pedestrian behaviour and its influence on the space usage on pedestrian areas. Method of analysis is a comparative study on urban and rural areas. Results of this research are types of behaviour, factors that influence the behaviour, physical condition of pedestrian areas and space usage by children. The behaviours are duck-line walking, running, playing, walking backward and walking with bare foot in which running is the main behaviour. These behaviours are influenced by factors including following friends and responding to acts. There are similarities and differences between pedestrian space usage in urban and rural areas. Space use by children pedestrian demonstrates the way pedestrian areas should be planned. Space usage by children pedestrian indicates that there is a need of evaluation of the space available considering pedestrian children behaviour.

  12. Prevalence, determinants and systems-thinking approaches to optimal hypertension control in West Africa

    PubMed Central

    2014-01-01

    Background In West Africa, hypertension, once rare, has now emerged as a critical health concern and the trajectory is upward and factors are complex. The true magnitude of hypertension in some West African countries, including in-depth knowledge of underlying risk factors is not completely understood. There is also a paucity of research on adequate systems-level approaches designed to mitigate the growing burden of hypertension in the region. Aims In this review, we thematically synthesize available literature pertaining to the prevalence of hypertension in West Africa and discuss factors that influence its diagnosis, treatment and control. We aimed to address the social and structural determinants influencing hypertension in the sub-region including the effects of urbanization, health infrastructure and healthcare workforce. Findings The prevalence of hypertension in West Africa has increased over the past decade and is rising rapidly with an urban-rural gradient that places higher hypertension prevalence on urban settings compared to rural settings. Overall levels of awareness of one’s hypertension status remain consistently low in West African. Structural and economic determinants related to conditions of poverty such as insufficient finances have a direct impact on adherence to prescribed antihypertensive medications. Urbanization contributes to the increasing incidence of hypertension in the sub-region and available evidence indicates that inadequate health infrastructure may act as a barrier to optimal hypertension control in West Africa. Conclusion Given that optimal hypertension control in West Africa depends on multiple factors that go beyond simply modifying the behaviors of the individuals alone, we conclude by discussing the potential role systems-thinking approaches can play to achieve optimal control in the sub-region. In the context of recent advances in hypertension management including new therapeutic options and innovative solutions to expand health workforce so as to meet the high demand for healthcare, the success of these strategies will rely on a new understanding of the complexity of human behaviors and interactions most aptly framed from a systems-thinking perspective. PMID:24886649

  13. Differential regulation of the transcriptional activity of the glucocorticoid receptor through site-specific phosphorylation.

    PubMed

    Kumar, Raj; Calhoun, William J

    2008-12-01

    Post-translational modifications such as phosphorylation are known to play an important role in the gene regulation by the transcription factors including the nuclear hormone receptor superfamily of which the glucocorticoid receptor (GR) is a member. Protein phosphorylation often switches cellular activity from one state to another. Like many other transcription factors, the GR is a phosphoprotein, and phosphorylation plays an important role in the regulation of GR activity. Cell signaling pathways that regulate phosphorylation of the GR and its associated proteins are important determinants of GR function under various physiological conditions. While the role of many phosphorylation sites in the GR is still not fully understood, the role of others is clearer. Several aspects of transcription factor function, including DNA binding affinity, interaction of transactivation domains with the transcription initiation complex, and shuttling between the cytoplasmic compartments, have all been linked to site-specific phosphorylation. All major phosphorylation sites in the human GR are located in the N-terminal domain including the major transactivation domain, AF1. Available literature clearly indicates that many of these potential phosphorylation sites are substrates for multiple kinases, suggesting the potential for a very complex regulatory network. Phosphorylated GR interacts favorably with critical coregulatory proteins and subsequently enhances transcriptional activity. In addition, the activities and specificities of coregulators may be subject to similar regulation by phosphorylation. Regulation of the GR activity due to phosphorylation appears to be site-specific and dependent upon specific cell signaling cascade. Taken together, site-specific phosphorylation and related kinase pathways play an important role in the action of the GR, and more precise mechanistic information will lead to fuller understanding of the complex nature of gene regulation by the GR- and related transcription factors. This review provides currently available information regarding the role of GR phosphorylation in its action, and highlights the possible underlying mechanisms of action.

  14. Computational tools and resources for metabolism-related property predictions. 1. Overview of publicly available (free and commercial) databases and software.

    PubMed

    Peach, Megan L; Zakharov, Alexey V; Liu, Ruifeng; Pugliese, Angelo; Tawa, Gregory; Wallqvist, Anders; Nicklaus, Marc C

    2012-10-01

    Metabolism has been identified as a defining factor in drug development success or failure because of its impact on many aspects of drug pharmacology, including bioavailability, half-life and toxicity. In this article, we provide an outline and descriptions of the resources for metabolism-related property predictions that are currently either freely or commercially available to the public. These resources include databases with data on, and software for prediction of, several end points: metabolite formation, sites of metabolic transformation, binding to metabolizing enzymes and metabolic stability. We attempt to place each tool in historical context and describe, wherever possible, the data it was based on. For predictions of interactions with metabolizing enzymes, we show a typical set of results for a small test set of compounds. Our aim is to give a clear overview of the areas and aspects of metabolism prediction in which the currently available resources are useful and accurate, and the areas in which they are inadequate or missing entirely.

  15. Preoperative prognostic factors for mortality in peptic ulcer perforation: a systematic review.

    PubMed

    Møller, Morten Hylander; Adamsen, Sven; Thomsen, Reimar Wernich; Møller, Ann Merete

    2010-08-01

    Mortality and morbidity following perforated peptic ulcer (PPU) is substantial and probably related to the development of sepsis. During the last three decades a large number of preoperative prognostic factors in patients with PPU have been examined. The aim of this systematic review was to summarize available evidence on these prognostic factors. MEDLINE (January 1966 to June 2009), EMBASE (January 1980 to June 2009), and the Cochrane Library (Issue 3, 2009) were screened for studies reporting preoperative prognostic factors for mortality in patients with PPU. The methodological quality of the included studies was assessed. Summary relative risks with 95% confidence intervals for the identified prognostic factors were calculated and presented as Forest plots. Fifty prognostic studies with 37 prognostic factors comprising a total of 29,782 patients were included in the review. The overall methodological quality was acceptable, yet only two-thirds of the studies provided confounder adjusted estimates. The studies provided strong evidence for an association of older age, comorbidity, and use of NSAIDs or steroids with mortality. Shock upon admission, preoperative metabolic acidosis, tachycardia, acute renal failure, low serum albumin level, high American Society of Anaesthesiologists score, and preoperative delay >24 h were associated with poor prognosis. In patients with PPU, a number of negative prognostic factors can be identified prior to surgery, and many of these seem to be related to presence of the sepsis syndrome.

  16. Investigating risk factors for slips, trips and falls in New Zealand residential construction using incident-centred and incident-independent methods.

    PubMed

    Bentley, Tim A; Hide, Sophie; Tappin, David; Moore, Dave; Legg, Stephen; Ashby, Liz; Parker, Richard

    2006-01-15

    Slip, trip and fall (STF) incidents, particularly falls from a height, are a leading cause of injury in the New Zealand residential construction industry. The most common origins of falls from a height in this sector are ladders, scaffolding and roofs, while slipping is the most frequent fall initiating event category. The study aimed to provide detailed information on construction industry STF risk factors for high-risk tasks, work equipment and environments, as identified from an earlier analysis of STF claims data, together with information to be used in the development of interventions to reduce STF risk in New Zealand residential construction. The study involved the use of both incident-centred and incident-independent methods of investigation, including detailed follow-up investigations of incidents and observations and interviews with workers on construction sites, to provide data on a wide range of risk factors. A large number of risk factors for residential construction STFs were identified, including factors related to the work environment, tasks and the use and availability of appropriate height work equipment. The different methods of investigation produced complementary information on factors related to equipment design and work organization, which underlie some of the site conditions and work practices identified as key risk factors for residential construction STFs. A conceptual systems model of residential construction STF risk is presented.

  17. Aviation human factors research in U.S. universities: Potential contributions to national needs

    NASA Technical Reports Server (NTRS)

    Key Dismukes, R.

    1994-01-01

    Univesity research can make vital contributions to national needs in aviation human factors (AHF). This article examines the types of expertise and facilities available in universities and explores how university capabilities complement the work of government laboratories. The AHF infrastructure is discussed and compared to other fields of applied research. Policy and funding issues are also examined. This study is based on a survey conducted by the author, which included site visits to several universities, telephone interviews with faculty members at other universities, and a search of the AHF research literature.

  18. Neural Compensations After Lesion of the Cerebral Cortex

    PubMed Central

    Kolb, Bryan; Brown, Russell; Witt-Lajeunesse, Alane; Gibb, Robbin

    2001-01-01

    Functional improvement after cortical injury can be stimulated by various factors including experience, psychomotor stimulants, gonadal hormones, and neurotrophic factors. The, timing of the administration of these factors may be critical, however. For example, factors such as gonadal hormones, nerve growth factor, or psychomotor stimulants may act to either enhance or retard recovery, depending upon the timing of administration. Nicotine, for instance, stimulates recovery if given after an injury but is without neuroprotective effect and may actually retard recovery if it is given only preinjury. A related timing problem concerns the interaction of different treatments. For example, behavioral therapies may act, in part, via their action in stimulating the endogenous production of trophic factors. Thus, combining behavioral therapies with pharmacological administration of compounds to increase the availability of trophic factors enhances functional outcome. Finally, anatomical evidence suggests that the mechanism of action of many treatments is through changes in dendritic arborization, which presumably reflects changes in synaptic organization. Factors that enhance dendritic change stimulate functional compensation, whereas factors that retard or block dendritic change block or retard compensation. PMID:11530881

  19. [Spatial variability of soil nutrients based on geostatistics combined with GIS--a case study in Zunghua City of Hebei Province].

    PubMed

    Guo, X; Fu, B; Ma, K; Chen, L

    2000-08-01

    Geostatistics combined with GIS was applied to analyze the spatial variability of soil nutrients in topsoil (0-20 cm) in Zunghua City of Hebei Province. GIS can integrate attribute data with geographical data of system variables, which makes the application of geostatistics technique for large spatial scale more convenient. Soil nutrient data in this study included available N (alkaline hydrolyzing nitrogen), total N, available K, available P and organic matter. The results showed that the semivariograms of soil nutrients were best described by spherical model, except for that of available K, which was best fitted by complex structure of exponential model and linear with sill model. The spatial variability of available K was mainly produced by structural factor, while that of available N, total N, available P and organic matter was primarily caused by random factor. However, their spatial heterogeneity degree was different: the degree of total N and organic matter was higher, and that of available P and available N was lower. The results also indicated that the spatial correlation of the five tested soil nutrients at this large scale was moderately dependent. The ranges of available N and available P were almost same, which were 5 km and 5.5 km, respectively. The range of total N was up to 18 km, and that of organic matter was 8.5 km. For available K, the spatial variability scale primarily expressed exponential model between 0-3.5 km, but linear with sill model between 3.5-25.5 km. In addition, five soil nutrients exhibited different isotropic ranges. Available N and available P were isotropic through the whole research range (0-28 km). The isotropic range of available K was 0-8 km, and that of total N and organic matter was 0-10 km.

  20. Suicide and deliberate self-harm in Pakistan: a scoping review.

    PubMed

    Shekhani, Sualeha S; Perveen, Shagufta; Hashmi, Dur-E-Sameen; Akbar, Khawaja; Bachani, Sara; Khan, Murad M

    2018-02-12

    Suicide is a major global public health problem with more than 800,000 incidents worldwide annually. Seventy-five percent of the global suicides occur in low and middle-income countries (LMICs). Pakistan is a LMIC where information on suicidal behavior is limited. The aim of the review is to map available literature on determinants, risk factors and other variables of suicidal behavior in Pakistan. This study was based on Arksey and O'Malley's methodological framework of scoping review, combining peer reviewed publications with grey literature. Ten databases including Applied Social Sciences Index and Abstracts (ASSIA), Cochrane Trials Register (CRG), Cumulative Index to Nursing and Allied Health (CINAHL), National Library of Medicine Gateway (NLMG), ExcerptaMedica (EMBASE), National Library of Medicine's MEDLINE (PUBMED), PSYCHINFO, Social Science Citation Index and Science Citation Index (SCI) and Pakmedinet.com were searched from the beginning of their time frames until December 2016 using a combination of key terms. The inclusion criteria included studies of various study designs covering different aspects of suicidal behavior in English language. Six hundred and twenty three articles were initially retrieved from all ten databases. Two independent reviewers screened the titles and abstracts for relevance. One hundred and eighteen articles were read in full, out of which 11 were excluded because they did not fit the eligibility criteria. One hundred and ten articles, including two student theses and one report, were included in the final review. Most studies were descriptive in nature, with only three that used a case-control design. Majority of the studies were from urban areas, and addressed determinants rather than risk factors. Gender differences and age were predominantly reported, with more males committing suicide. Suicidal behavior was more common among individuals younger than 30 years of age. The three most common methods for suicides were hanging, poisoning and use of firearms. Mental illness as a risk factor for suicides was mentioned in only three studies. This review is the first attempt to synthesize available literature on suicidal behavior in Pakistan. The evidence is limited, and calls for more robust analytical research designs, along with a focus on risk factors.

  1. Comparison of sunscreen availability in Chicago Hispanic and non-Hispanic neighborhoods.

    PubMed

    Hernandez, Claudia; Calero, Diana; Robinson, Gina; Mermelstein, Robin; Robinson, June K

    2012-10-01

    Poorer survival rates from melanoma among Hispanics have been previously reported. There is little information regarding sunscreen acquisition behaviors or availability/access to products that may help reduce the risk of skin cancer in Hispanic communities. This study sought to understand perceptions regarding sun protection and skin cancer risk and whether the availability of over-the-counter sunscreen products differed in three Chicago neighborhoods with different ethnic compositions. We drew on interviews with 65 adult Spanish speaking Hispanics (23-72 years) recruited from faith-based institutions to better understand sunscreen use perceptions. Commercial establishments open to the general public were physically canvassed to determine whether there were any differences in sunscreen products availability. Stores carrying sun protection products are nearly twice as common in non Hispanic White neighborhoods versus Hispanic. In addition, when sunscreens are available for sale, Hispanics have fewer sunscreens to choose from. Emergent themes that were elicited during the interviews revealed that barriers to increased sunscreen use include economic and erroneous perceptions regarding skin cancer incidence and risk. Environmental factors that may reinforce these beliefs include lower availability and variety of sun protection products in Hispanic neighborhoods. These findings indicate that providing culturally appropriate public health information encouraging the use of sunscreen and improving its availability in Hispanic communities are potential points of intervention in attempts to improve morbidity from skin cancer. © 2012 John Wiley & Sons A/S.

  2. Clinical outcome and molecular characterization of brain metastases from esophageal and gastric cancer: a systematic review.

    PubMed

    Ghidini, Michele; Petrelli, Fausto; Hahne, Jens Claus; De Giorgi, Annamaria; Toppo, Laura; Pizzo, Claudio; Ratti, Margherita; Barni, Sandro; Passalacqua, Rodolfo; Tomasello, Gianluca

    2017-04-01

    The aim of the study was to collect the available data on central nervous system (CNS) metastases from esophageal and gastric cancer. A PubMed, EMBASE, SCOPUS, Web of Science, LILACS, Ovid and Cochrane Library search was performed. Thirty-seven studies including 779 patients were considered. Among the data extracted, treatment of tumor and brain metastases (BMs), time to BMs development, number and subsite, extracerebral metastases rate, median overall survival (OS) and prognostic factors were included. For esophageal cancer, the median OS from diagnosis of BMs was 4.2 months. Prognostic factors for OS included: performance status, multimodal therapy, adjuvant chemotherapy, single BM, brain only disease and surgery. For gastric cancer, median OS was 2.4 months. Prognostic factors for OS included: recursive partitioning analysis class 2, stereotactic radiosurgery (SRT) and use of intrathecal therapy. HER2-positive gastric cancer was shown to be associated with a higher risk and shorter time to CNS relapse. Patients harboring BMs from gastric and esophageal tumors, except cases with single lesions that are treated aggressively, have a poor prognosis. SRT (plus or minus surgery and whole brain radiotherapy) seems to give better results in terms of longer OS after brain relapse.

  3. Food hygiene practices and its associated factors among model and non model households in Abobo district, southwestern Ethiopia: Comparative cross-sectional study.

    PubMed

    Okugn, Akoma; Woldeyohannes, Demelash

    2018-01-01

    In developing country most of human infectious diseases are caused by eating contaminated food. Estimated nine out ten of the diarrheal disease is attributable to the environment and associated with risk factors of poor food hygiene practice. Understanding the risk of eating unsafe food is the major concern to prevent and control food borne diseases. The main goal of this study was to assessing food hygiene practices and its associated factors among model and non model households at Abobo district. This study was conducted from 18 October 2013 to 13 June 2014. A community-based comparative cross-sectional study design was used. Pretested structured questionnaire was used to collect data. A total of 1247 households (417 model and 830 non model households) were included in the study from Abobo district. Bivariate and multivariate logistic regression analysis was used to identify factors associated with outcome variable. The study revealed that good food hygiene practice was 51%, of which 79% were model and 36.70% were non model households. Type of household [AOR: 2.07, 95% CI: (1.32-3.39)], sex of household head [AOR: 1.63, 95% CI: (1.06-2.48)], Availability of liquid wastes disposal pit [AOR: 2.23, 95% CI: (1.39,3.63)], Knowledge of liquid waste to cause diseases [AOR: 1.95, 95% (1.23,3.08)], and availability of functional hand washing facility [AOR: 3.61, 95% CI: (1.86-7.02)] were the factors associated with food handling practices. This study revealed that good food handling practice is low among model and non model households. While type of household (model versus non model households), sex, knowledge of solid waste to cause diseases, availability of functional hand washing facility, and availability of liquid wastes disposal pit were the factors associated with outcome variable. Health extension workers should play a great role in educating households regarding food hygiene practices to improve their knowledge and practices of the food hygiene.

  4. The NHLBI Retrovirus Epidemiology Donor Studies (REDS and REDS-II): Twenty years of research to advance blood product safety and availability

    PubMed Central

    Kleinman, Steven; King, Melissa R; Busch, Michael P; Murphy, Edward L; Glynn, Simone A.

    2012-01-01

    The Retrovirus Epidemiology Donor Study (REDS), conducted from 1989–2001, and the Retrovirus Epidemiology Donor Study-II (REDS-II), conducted from 2004–2012, were National Heart Lung and Blood Institute (NHLBI) funded multicenter programs focused on improving blood safety and availability in the United States. REDS-II also included international study sites in Brazil and China. The three major research domains of REDS/REDS-II have been infectious disease risk evaluation, blood donation availability, and blood donor characterization. Both programs have made significant contributions to transfusion medicine research methodology by the use of mathematical modeling, large-scale donor surveys, innovative methods of repository sample storage, and establishing an infrastructure that responded to potential emerging blood safety threats such as XMRV. Blood safety studies have included protocols evaluating epidemiologic and/or laboratory aspects of HIV, HTLV I/II, HCV, HBV, WNV, CMV, HHV-8, B19V, malaria, CJD, influenza, and T. cruzi infections. Other analyses have characterized: blood donor demographics, motivations to donate, factors influencing donor return, behavioral risk factors, donors’ perception of the blood donation screening process, and aspects of donor deferral. In REDS-II, two large-scale blood donor protocols examined iron deficiency in donors and the prevalence of leukocyte antibodies. This review describes the major study results from over 150 peer-reviewed articles published by these two REDS programs. In 2011, a new seven year program, the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III), was launched. REDS-III expands beyond donor-based research to include studies of blood transfusion recipients in the hospital setting, and adds a third country, South Africa, to the international program. PMID:22633182

  5. Studies of social group dynamics under isolated conditions. Objective summary of the literature as it relates to potential problems of long duration space flight

    NASA Technical Reports Server (NTRS)

    Vinograd, S. P.

    1974-01-01

    Scientific literature which deals with the study of human behavior and crew interaction in situations simulating long term space flight is summarized and organized. A bibliography of all the pertinent U.S. literature available is included, along with definitions of the behavioral characteristics terms employed. The summarized studies are analyzed according to behavioral factors and environmental conditions. The analysis consist of two matrices. (1) The matrix of factors studied correlates each research study area and individual study with the behavioral factors that were investigated in the study. (2) The matrix of conclusions identifies those studies whose investigators appeared to draw specific conclusions concerning questions of importance to NASA.

  6. Melasma update

    PubMed Central

    Sarkar, Rashmi; Arora, Pooja; Garg, Vijay Kumar; Sonthalia, Sidharth; Gokhale, Narendra

    2014-01-01

    Melasma is an acquired pigmentary disorder characterized by symmetrical hyperpigmented macules on the face. Its pathogenesis is complex and involves the interplay of various factors such as genetic predisposition, ultraviolet radiation, hormonal factors, and drugs. An insight into the pathogenesis is important to devise treatment modalities that accurately target the disease process and prevent relapses. Hydroquinone remains the gold standard of treatment though many newer drugs, especially plant extracts, have been developed in the last few years. In this article, we review the pathogenetic factors involved in melasma. We also describe the newer treatment options available and their efficacy. We carried out a PubMed search using the following terms “melasma, pathogenesis, etiology, diagnosis, treatment” and have included data of the last few years. PMID:25396123

  7. Long-term dietary sodium, potassium and fluid intake; exploring potential novel risk factors for renal cell cancer in the Netherlands Cohort Study on diet and cancer.

    PubMed

    Deckers, I A G; van den Brandt, P A; van Engeland, M; Soetekouw, P M M B; Baldewijns, M M L L; Goldbohm, R A; Schouten, L J

    2014-02-04

    As sodium, potassium and fluid intake are related to hypertension, an established risk factor for renal cell cancer (RCC), they may be independent risk factors for RCC. The Netherlands Cohort Study (NLCS) with case-cohort design included 120,852 participants aged 55-69 years. At baseline, diet and lifestyle were assessed with questionnaires. After 17.3 years of follow-up, 485 RCC cases and 4438 subcohort members were available for analyses. Sodium intake increased RCC risk (P-trend=0.03), whereas fluid and potassium intake did not. For high sodium and low fluid intake, the RCC risk additionally increased (P-interaction=0.02). Sodium intake is a potential risk factor for RCC, particularly if fluid consumption is low.

  8. Some findings on prospect and refuge theory: II.

    PubMed

    Stamps, Arthur E

    2008-08-01

    This article presents four new studies on the efficacy of predictions based on prospect and refuge theory and summarizes the results over eight studies. New data covered 49 participants and 36 environments. The eight studies included in the summary covered 144 participants and 80 widely diverse environments (Japanese Tatami rooms, Western rooms, porch, meadow, neighborhood commercial, shopping mall, vacation landscapes). Data were available for hypotheses about five factors: prospect, refuge, light, venue, and spatial transition. Efficacy was represented by correlations for the levels of the factors with responses of preference or comfort. Overall, venue was the most efficacious factor (r = .42, 95% CI = .14, .64). Efficacies for the other factors were very near zero. It is suggested that a considerable amount of additional formal inquiry be conducted before assuming the utility of prospect and refuge theory.

  9. Functional considerations in evaluation and treatment of the client with low vision.

    PubMed

    Lampert, J; Lapolice, D J

    1995-10-01

    In evaluating and treating clients who have low vision, the occupational therapist must consider factors in addition to typical measures of the client's visual acuity, field loss, and oculomotor control. It is important to consider the functional implications of the client's ocular pathology, including illumination needs, contrast sensitivity, sensitivity to glare, and need for magnification as well as environmental factors such as the amount of pattern in a visual task, the amount of lighting and contrast available, and the conditions under which the task is performed. These factors are all relevant to occupational therapy low vision rehabilitation because each may influence the way in which a client uses his or her residual vision and achieves successful adaptation. This article provides an overview of these factors and presents a suggested protocol for evaluation of the client with low vision.

  10. The Iron-Dependent Regulation of the Candida albicans Oxidative Stress Response by the CCAAT-Binding Factor

    PubMed Central

    Chakravarti, Ananya; Camp, Kyle; McNabb, David S.

    2017-01-01

    Candida albicans is the most frequently encountered fungal pathogen in humans, capable of causing mucocutaneous and systemic infections in immunocompromised individuals. C. albicans virulence is influenced by multiple factors. Importantly, iron acquisition and avoidance of the immune oxidative burst are two critical barriers for survival in the host. Prior studies using whole genome microarray expression data indicated that the CCAAT-binding factor is involved in the regulation of iron uptake/utilization and the oxidative stress response. This study examines directly the role of the CCAAT-binding factor in regulating the expression of oxidative stress genes in response to iron availability. The CCAAT-binding factor is a heterooligomeric transcription factor previously shown to regulate genes involved in respiration and iron uptake/utilization in C. albicans. Since these pathways directly influence the level of free radicals, it seemed plausible the CCAAT-binding factor regulates genes necessary for the oxidative stress response. In this study, we show the CCAAT-binding factor is involved in regulating some oxidative stress genes in response to iron availability, including CAT1, SOD4, GRX5, and TRX1. We also show that CAT1 expression and catalase activity correlate with the survival of C. albicans to oxidative stress, providing a connection between iron obtainability and the oxidative stress response. We further explore the role of the various CCAAT-binding factor subunits in the formation of distinct protein complexes that modulate the transcription of CAT1 in response to iron. We find that Hap31 and Hap32 can compensate for each other in the formation of an active transcriptional complex; however, they play distinct roles in the oxidative stress response during iron limitation. Moreover, Hap43 was found to be solely responsible for the repression observed under iron deprivation. PMID:28122000

  11. Interactions of cytokines, growth factors, and the extracellular matrix in the cellular biology of uterine leiomyomata.

    PubMed

    Sozen, Ibrahim; Arici, Aydin

    2002-07-01

    To review the available information regarding the role of cytokines, growth factors, and the extracellular matrix in the pathophysiology of uterine leiomyomata and to integrate this information in a suggested model of disease at the cellular level. A thorough literature and MEDLINE search was conducted to identify the relevant studies in the English literature published between January, 1966 and October, 2001. A model of disease at the cellular level was developed using the most likely cytokines to be involved in the pathogenesis of leiomyomata as determined by our assessment of the available literature. A number of cytokines and growth factors, including transforming growth factor-beta (TGF-beta), epidermal growth factor, monocyte chemotactic protein-1, insulin-like growth factors 1 and 2, prolactin, parathyroid-hormone-related peptide, basic fibroblast growth factor, platelet-derived growth factor, interleukin-8, and endothelin, have been investigated in myometrium and leiomyoma. Among these cytokines, TGF-beta appears to be the only growth factor that has been shown to be overexpressed in leiomyoma vs. myometrium, be hormonally-regulated both in vivo and in vitro, and be both mitogenic and fibrogenic in these tissues. In addition to the cytokines, extracellular matrix components such as collagen, fibronectin, proteoglycans, matrix metalloproteinases, and tissue inhibitors of metalloproteinases seem to play pivotal roles in the pathogenesis of leiomyomata. We believe that, given the extent and depth of the current research on the cellular biology of leiomyomata, the cellular mechanisms responsible in the pathogenesis of leiomyomata will be identified clearly within the foreseeable future. This will enable researchers to develop therapy directed against the molecules and mechanisms at the cellular level.

  12. Binge-eating disorder: emerging treatments for a new diagnosis.

    PubMed

    Tsappis, Michael; Freizinger, Melissa; Forman, Sara F

    2016-08-01

    This review provides an update on the new Diagnostic and Statistical Manual (DSM) diagnosis of binge-eating disorder (BED) by presenting diagnostic criteria, associated risk factors and co-morbidities, and tools for assessment. An update on the currently available evidence-based treatments for adolescent BED is provided to help with the coordination of treatment planning for identified patients with this condition. BED is now officially included in the DSM. Research with youth has begun to show improvement from treatments such as cognitive behavioral therapy, previously shown to be useful in adults. BED is common and often begins during youth. The availability of diagnostic criteria, along with increasing knowledge about the condition and available treatments, is expected to result in improved identification and management in younger patients.

  13. Assessing doses to terrestrial wildlife at a radioactive waste disposal site: inter-comparison of modelling approaches.

    PubMed

    Johansen, M P; Barnett, C L; Beresford, N A; Brown, J E; Černe, M; Howard, B J; Kamboj, S; Keum, D-K; Smodiš, B; Twining, J R; Vandenhove, H; Vives i Batlle, J; Wood, M D; Yu, C

    2012-06-15

    Radiological doses to terrestrial wildlife were examined in this model inter-comparison study that emphasised factors causing variability in dose estimation. The study participants used varying modelling approaches and information sources to estimate dose rates and tissue concentrations for a range of biota types exposed to soil contamination at a shallow radionuclide waste burial site in Australia. Results indicated that the dominant factor causing variation in dose rate estimates (up to three orders of magnitude on mean total dose rates) was the soil-to-organism transfer of radionuclides that included variation in transfer parameter values as well as transfer calculation methods. Additional variation was associated with other modelling factors including: how participants conceptualised and modelled the exposure configurations (two orders of magnitude); which progeny to include with the parent radionuclide (typically less than one order of magnitude); and dose calculation parameters, including radiation weighting factors and dose conversion coefficients (typically less than one order of magnitude). Probabilistic approaches to model parameterisation were used to encompass and describe variable model parameters and outcomes. The study confirms the need for continued evaluation of the underlying mechanisms governing soil-to-organism transfer of radionuclides to improve estimation of dose rates to terrestrial wildlife. The exposure pathways and configurations available in most current codes are limited when considering instances where organisms access subsurface contamination through rooting, burrowing, or using different localised waste areas as part of their habitual routines. Crown Copyright © 2012. Published by Elsevier B.V. All rights reserved.

  14. Malodorous consequences: what comprises negligence in anosmia litigation?

    PubMed

    Svider, Peter F; Mauro, Andrew C; Eloy, Jean Anderson; Setzen, Michael; Carron, Michael A; Folbe, Adam J

    2014-03-01

    Our objectives were to evaluate factors raised in malpractice litigation in which plaintiffs alleged that physician negligence led to olfactory dysfunction. We analyzed publically available federal and court records using Westlaw, a widely used computerized legal database. Pertinent jury verdicts and settlements were comprehensively examined for alleged causes of malpractice (including procedures for iatrogenic causes), defendant specialty, patient demographics, and other factors raised in legal proceedings. Of 25 malpractice proceedings meeting inclusion criteria, 60.0% were resolved for the defendant, 12.0% were settled, and 28.0% had jury-awarded damages. Median payments were significant ($300,000 and $412,500 for settlements and awards, respectively). Otolaryngologists were the most frequently named defendants (68.0%), with the majority of iatrogenic cases (55.0%) related to rhinologic procedures. Associated medical events accompanying anosmia included dysgeusia, cerebrospinal fluid leaks, and meningitis. Other alleged factors included requiring additional surgery (80.0%), unnecessary procedures (47.4% of iatrogenic procedural cases), untimely diagnosis leading to anosmia (44.0%), inadequate informed consent (35.0%), dysgeusia (56.0%), and psychological sequelae (24.0%). Olfactory dysfunction can adversely affect quality of life and thus is a potential area for malpractice litigation. This is particularly true for iatrogenic causes of anosmia, especially following rhinologic procedures. Settlements and damages awarded were considerable, making an understanding of factors detailed in this analysis of paramount importance for the practicing otolaryngologist. This analysis reinforces the importance of explicitly including anosmia in a comprehensive informed consent process for any rhinologic procedure. © 2013 ARS-AAOA, LLC.

  15. Advancing drug availability-experiences from Africa.

    PubMed

    Powell, Richard A; Kaye, Richard Mugula; Ddungu, Henry; Mwangi-Powell, Faith

    2010-07-01

    International health and drug regulatory authorities acknowledge that analgesics (especially opioids) are insufficiently available for pain management in many countries. In Africa, reported morphine consumption is far below the global mean, with multiple factors hampering opioid supply. Since 2006, the African Palliative Care Association has hosted three regional drug availability workshops across the continent to address this issue. Using an interactive format, the workshops have identified country-specific barriers to opioid and other essential medication accessibility before supporting participants to develop action plans to address recognized impediments. Despite multiple challenges, a number of successes have arisen from the implementation of the plans. However, key issues remain, including the introduction of supportive policy environments, effective educational initiatives, and measures to address supply-chain obstacles impeding drug availability. Copyright 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  16. Critically Evaluated Energy Levels, Spectral Lines, Transition Probabilities, and Intensities of Neutral Vanadium (V i)

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

    Saloman, Edward B.; Kramida, Alexander

    2017-08-01

    The energy levels, observed spectral lines, and transition probabilities of the neutral vanadium atom, V i, have been compiled. Also included are values for some forbidden lines that may be of interest to the astrophysical community. Experimental Landé g -factors and leading percentage compositions for the levels are included where available, as well as wavelengths calculated from the energy levels (Ritz wavelengths). Wavelengths are reported for 3985 transitions, and 549 energy levels are determined. The observed relative intensities normalized to a common scale are provided.

  17. Ecology of micro-organisms in a small closed system - Potential benefits and problems for Space Station

    NASA Technical Reports Server (NTRS)

    Rodgers, E. B.; Seale, D. B.; Boraas, M. E.; Sommer, C. V.

    1989-01-01

    The probable sources and implications of microbial contamination on the proposed Space Station are discussed. Because of the limited availability of material, facilities and time on the Space Station, we are exploring the feasibility of replacing traditional incubation methods for assessing microbial contamination with rapid, automated methods. Some possibilities include: ATP measurement, microscopy and telecommunications, and molecular techniques such as DNA probes or monoclonal antibodies. Some of the important ecological factors that could alter microbes in space include microgravity, exposure to radiation, and antibiotic resistance.

  18. [Global brain metastases management strategy: a multidisciplinary-based approach].

    PubMed

    Métellus, P; Tallet, A; Dhermain, F; Reyns, N; Carpentier, A; Spano, J-P; Azria, D; Noël, G; Barlési, F; Taillibert, S; Le Rhun, É

    2015-02-01

    Brain metastases management has evolved over the last fifteen years and may use varying strategies, including more or less aggressive treatments, sometimes combined, leading to an improvement in patient's survival and quality of life. The therapeutic decision is subject to a multidisciplinary analysis, taking into account established prognostic factors including patient's general condition, extracerebral disease status and clinical and radiological presentation of lesions. In this article, we propose a management strategy based on the state of current knowledge and available therapeutic resources. Copyright © 2015. Published by Elsevier SAS.

  19. Environmental Determinants of Cardiovascular Diseases Risk Factors: A Qualitative Directed Content Analysis

    PubMed Central

    Sabzmakan, Leila; Mohammadi, Eesa; Morowatisharifabad, Mohammad Ali; Afaghi, Ahmad; Naseri, Mohammad Hassan; Mirzaei, Masoud

    2014-01-01

    Background: Cardiovascular diseases (CVDs) are the number one cause of death in the world. In most analyses of health problems, environment plays a significant and modifiable role in causing the problem either directly or indirectly through behavior. Objectives: This study aims to understand the patients and healthcare providers’ experiences about the environmental determinants of CVD risk factors based on the Precede Model. Patients and Methods: This qualitative study conducted over six months in 2012 at Diabetes Units of Health Centers associated with Alborz University of Medical Sciences and Health Services which is located in Karaj, Iran. The data were collected based on individual semi-structured interviews with 50 patients and 12 healthcare providers. Data analysis was performed simultaneous with data collection using the content analysis directed method. Results: Lack of behaviors like stress control, healthy eating and physical activity were the roots of the risk factors for CVD. The environmental factor is one of the barriers for conducting these behaviors. The environmental barriers included of structural environment including “availability and accessibility of health resources”, “new skills”, and “law and policies” which are located in enabling category and social environment including “social support”, “motivation to comply” and “consequences of behavior” which are located in reinforcing category. The most barriers to performing health behaviors were often structural. Conclusions: The environmental factors were barriers for doing healthy behaviors. These factors need to be considered to design health promotion interventions. Policymakers should not only focus on patients’ education but also should provide specific facilities to enhance economic, social and cultural status. PMID:25031848

  20. Mortality and economic instability: detailed analyses for Britain and comparative analyses for selected industrialized countries.

    PubMed

    Brenner, M H

    1983-01-01

    This paper discusses a first-stage analysis of the link of unemployment rates, as well as other economic, social and environmental health risk factors, to mortality rates in postwar Britain. The results presented represent part of an international study of the impact of economic change on mortality patterns in industrialized countries. The mortality patterns examined include total and infant mortality and (by cause) cardiovascular (total), cerebrovascular and heart disease, cirrhosis of the liver, and suicide, homicide and motor vehicle accidents. Among the most prominent factors that beneficially influence postwar mortality patterns in England/Wales and Scotland are economic growth and stability and health service availability. A principal detrimental factor to health is a high rate of unemployment. Additional factors that have an adverse influence on mortality rates are cigarette consumption and heavy alcohol use and unusually cold winter temperatures (especially in Scotland). The model of mortality that includes both economic changes and behavioral and environmental risk factors was successfully applied to infant mortality rates in the interwar period. In addition, the "simple" economic change model of mortality (using only economic indicators) was applied to other industrialized countries. In Canada, the United States, the United Kingdom, and Sweden, the simple version of the economic change model could be successfully applied only if the analysis was begun before World War II; for analysis beginning in the postwar era, the more sophisticated economic change model, including behavioral and environmental risk factors, was required. In France, West Germany, Italy, and Spain, by contrast, some success was achieved using the simple economic change model.

  1. Health behaviours of young, rural residents: a case study.

    PubMed

    Bourke, Lisa; Humphreys, John; Lukaitis, Fiona

    2009-04-01

    To analyse self-reported health behaviours of young people from a rural community and the factors influencing their behaviours. Interviews were conducted with 19 young people, 11 parents and 10 key informants from a small rural Victorian community, asking about teenage health behaviours and the factors influencing these behaviours. Young people ate both healthy and unhealthy foods, most participated in physical activity, few smoked and most drank alcohol. The study found that community level factors, including community norms, peers, access issues and geographic isolation, were particularly powerful in shaping health behaviours, especially alcohol consumption. Smoking was influenced by social participation in the community and national media health campaigns. Diet and exercise behaviour were influenced by access and availability, convenience, family, peers and local and non-local cultural influences. The rural context, including less access to and choice of facilities and services, lower incomes, lack of transport and local social patterns (including community norms and acceptance), impact significantly on young people's health behaviours. Although national health promotion campaigns are useful aspects of behaviour modification, much greater focus on the role and importance of the local contexts in shaping health decisions of young rural people is required.

  2. Lipoprotein (a) and cardiovascular risk factors in children and adolescents

    PubMed Central

    Palmeira, Ástrid Camêlo; Leal, Adriana Amorim de F.; Ramos, Nathaly de Medeiros N.; de Alencar F., José; Simões, Mônica Oliveira da S.; Medeiros, Carla Campos M.

    2013-01-01

    OBJECTIVE: To review the relationship between lipoprotein (a) [Lp(a)] and other risk factors for cardiovascular disease (CVD) in children and adolescents. DATA SOURCES: This systematic review included studies from 2001 to 2011, a ten-year time period. Epidemiological studies with children and/or adolescents published in English, Portuguese or Spanish and fully available online were included. The searches were performed in Science Direct, PubMed/Medline, BVS (Biblioteca Virtual em Saúde) and Cochrane Library databases, using the following combination of key-words: "lipoprotein a" and "cardiovascular diseases" and "obesity". DATA SYNTHESIS: Overall, 672 studies were obtained but only seven were included. Some studies assessed the family history for CVD. In all of them, Lp(a) levels were increased in patients with family history for CVD. There was also a positive correlation between Lp(a) and LDL-cholesterol, total cholesterol, and apolipoprotein B levels, suggesting an association between Lp(a) levels and the lipid profile. CONCLUSIONS: The evidence that CVD may originate in childhood and adolescence leads to the need for investigating the risk factors during this period in order to propose earlier and possibly more effective interventions to reduce morbidity and mortality rates. PMID:24473960

  3. Environmental risk factors for dementia: a systematic review.

    PubMed

    Killin, Lewis O J; Starr, John M; Shiue, Ivy J; Russ, Tom C

    2016-10-12

    Dementia risk reduction is a major and growing public health priority. While certain modifiable risk factors for dementia have been identified, there remains a substantial proportion of unexplained risk. There is evidence that environmental risk factors may explain some of this risk. Thus, we present the first comprehensive systematic review of environmental risk factors for dementia. We searched the PubMed and Web of Science databases from their inception to January 2016, bibliographies of review articles, and articles related to publically available environmental data. Articles were included if they examined the association between an environmental risk factor and dementia. Studies with another outcome (for example, cognition), a physiological measure of the exposure, case studies, animal studies, and studies of nutrition were excluded. Data were extracted from individual studies which were, in turn, appraised for methodological quality. The strength and consistency of the overall evidence for each risk factor identified was assessed. We screened 4784 studies and included 60 in the review. Risk factors were considered in six categories: air quality, toxic heavy metals, other metals, other trace elements, occupational-related exposures, and miscellaneous environmental factors. Few studies took a life course approach. There is at least moderate evidence implicating the following risk factors: air pollution; aluminium; silicon; selenium; pesticides; vitamin D deficiency; and electric and magnetic fields. Studies varied widely in size and quality and therefore we must be circumspect in our conclusions. Nevertheless, this extensive review suggests that future research could focus on a short list of environmental risk factors for dementia. Furthermore, further robust, longitudinal studies with repeated measures of environmental exposures are required to confirm these associations.

  4. Factors influencing U.S. canine heartworm (Dirofilaria immitis) prevalence.

    PubMed

    Wang, Dongmei; Bowman, Dwight D; Brown, Heidi E; Harrington, Laura C; Kaufman, Phillip E; McKay, Tanja; Nelson, Charles Thomas; Sharp, Julia L; Lund, Robert

    2014-06-06

    This paper examines the individual factors that influence prevalence rates of canine heartworm in the contiguous United States. A data set provided by the Companion Animal Parasite Council, which contains county-by-county results of over nine million heartworm tests conducted during 2011 and 2012, is analyzed for predictive structure. The goal is to identify the factors that are important in predicting high canine heartworm prevalence rates. The factors considered in this study are those envisioned to impact whether a dog is likely to have heartworm. The factors include climate conditions (annual temperature, precipitation, and relative humidity), socio-economic conditions (population density, household income), local topography (surface water and forestation coverage, elevation), and vector presence (several mosquito species). A baseline heartworm prevalence map is constructed using estimated proportions of positive tests in each county of the United States. A smoothing algorithm is employed to remove localized small-scale variation and highlight large-scale structures of the prevalence rates. Logistic regression is used to identify significant factors for predicting heartworm prevalence. All of the examined factors have power in predicting heartworm prevalence, including median household income, annual temperature, county elevation, and presence of the mosquitoes Aedes trivittatus, Aedes sierrensis and Culex quinquefasciatus. Interactions among factors also exist. The factors identified are significant in predicting heartworm prevalence. The factor list is likely incomplete due to data deficiencies. For example, coyotes and feral dogs are known reservoirs of heartworm infection. Unfortunately, no complete data of their populations were available. The regression model considered is currently being explored to forecast future values of heartworm prevalence.

  5. Factors influencing U.S. canine heartworm (Dirofilaria immitis) prevalence

    PubMed Central

    2014-01-01

    Background This paper examines the individual factors that influence prevalence rates of canine heartworm in the contiguous United States. A data set provided by the Companion Animal Parasite Council, which contains county-by-county results of over nine million heartworm tests conducted during 2011 and 2012, is analyzed for predictive structure. The goal is to identify the factors that are important in predicting high canine heartworm prevalence rates. Methods The factors considered in this study are those envisioned to impact whether a dog is likely to have heartworm. The factors include climate conditions (annual temperature, precipitation, and relative humidity), socio-economic conditions (population density, household income), local topography (surface water and forestation coverage, elevation), and vector presence (several mosquito species). A baseline heartworm prevalence map is constructed using estimated proportions of positive tests in each county of the United States. A smoothing algorithm is employed to remove localized small-scale variation and highlight large-scale structures of the prevalence rates. Logistic regression is used to identify significant factors for predicting heartworm prevalence. Results All of the examined factors have power in predicting heartworm prevalence, including median household income, annual temperature, county elevation, and presence of the mosquitoes Aedes trivittatus, Aedes sierrensis and Culex quinquefasciatus. Interactions among factors also exist. Conclusions The factors identified are significant in predicting heartworm prevalence. The factor list is likely incomplete due to data deficiencies. For example, coyotes and feral dogs are known reservoirs of heartworm infection. Unfortunately, no complete data of their populations were available. The regression model considered is currently being explored to forecast future values of heartworm prevalence. PMID:24906567

  6. A multivariate twin study of the DSM-IV criteria for antisocial personality disorder.

    PubMed

    Kendler, Kenneth S; Aggen, Steven H; Patrick, Christopher J

    2012-02-01

    Many assessment instruments for psychopathy are multidimensional, suggesting that distinguishable factors are needed to effectively capture variation in this personality domain. However, no prior study has examined the factor structure of the DSM-IV criteria for antisocial personality disorder (ASPD). Self-report questionnaire items reflecting all A criteria for DSM-IV ASPD were available from 4291 twins (including both members of 1647 pairs) from the Virginia Adult Study of Psychiatric and Substance Use Disorders. Exploratory factor analysis and twin model fitting were performed using, respectively, Mplus and Mx. Phenotypic factor analysis produced evidence for two correlated factors: aggressive-disregard and disinhibition. The best-fitting multivariate twin model included two genetic and one unique environmental common factor, along with criteria-specific genetic and environmental effects. The two genetic factors closely resembled the phenotypic factors and varied in their prediction of a range of relevant criterion variables. Scores on the genetic aggressive-disregard factor score were more strongly associated with risk for conduct disorder, early and heavy alcohol use, and low educational status, whereas scores on the genetic disinhibition factor score were more strongly associated with younger age, novelty seeking, and major depression. From a genetic perspective, the DSM-IV criteria for ASPD do not reflect a single dimension of liability but rather are influenced by two dimensions of genetic risk reflecting aggressive-disregard and disinhibition. The phenotypic structure of the ASPD criteria results largely from genetic and not from environmental influences. Copyright © 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  7. Risk Factor Analysis in Low-Temperature Geothermal Play Fairway Analysis for the Appalachian Basin (GPFA-AB)

    DOE Data Explorer

    Teresa E. Jordan

    2015-09-30

    This submission contains information used to compute the risk factors for the GPFA-AB project (DE-EE0006726). The risk factors are natural reservoir quality, thermal resource quality, potential for induced seismicity, and utilization. The methods used to combine the risk factors included taking the product, sum, and minimum of the four risk factors. The files are divided into images, rasters, shapefiles, and supporting information. The image files show what the raster and shapefiles should look like. The raster files contain the input risk factors, calculation of the scaled risk factors, and calculation of the combined risk factors. The shapefiles include definition of the fairways, definition of the US Census Places, the center of the raster cells, and locations of industries. Supporting information contains details of the calculations or processing used in generating the files. An image of the raster will have the same name except *.png as the file ending instead of *.tif. Images with “fairways” or “industries” added to the name are composed of a raster with the relevant shapefile added. The file About_GPFA-AB_Phase1RiskAnalysisTask5DataUpload.pdf contains information the citation, special use considerations, authorship, etc. More details on each file are given in the spreadsheet “list_of_contents.csv” in the folder “SupportingInfo”. Code used to calculate values is available at https://github.com/calvinwhealton/geothermal_pfa under the folder “combining_metrics”.

  8. Factors influencing healthcare service quality

    PubMed Central

    Mosadeghrad, Ali Mohammad

    2014-01-01

    Background: The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context. Methods: Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations. Results: Quality in healthcare is a production of cooperation between the patient and the healthcare provider in a supportive environment. Personal factors of the provider and the patient, and factors pertaining to the healthcare organisation, healthcare system, and the broader environment affect healthcare service quality. Healthcare quality can be improved by supportive visionary leadership, proper planning, education and training, availability of resources, effective management of resources, employees and processes, and collaboration and cooperation among providers. Conclusion: This article contributes to healthcare theory and practice by developing a conceptual framework that provides policy-makers and managers a practical understanding of factors that affect healthcare service quality. PMID:25114946

  9. Factor Structure of the PTSD Checklist for DSM-5: Relationships Among Symptom Clusters, Anger, and Impulsivity.

    PubMed

    Armour, Cherie; Contractor, Ateka; Shea, Tracie; Elhai, Jon D; Pietrzak, Robert H

    2016-02-01

    Scarce data are available regarding the dimensional structure of Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) posttraumatic stress disorder (PTSD) symptoms and how factors relate to external constructs. We evaluated six competing models of DSM-5 PTSD symptoms, including Anhedonia, Externalizing Behaviors, and Hybrid models, using confirmatory factor analyses in a sample of 412 trauma-exposed college students. We then examined whether PTSD symptom clusters were differentially related to measures of anger and impulsivity using Wald chi-square tests. The seven-factor Hybrid model was deemed optimal compared with the alternatives. All symptom clusters were associated with anger; the strongest association was between externalizing behaviors and anger (r = 0.54). All symptom clusters, except re-experiencing and avoidance, were associated with impulsivity, with the strongest association between externalizing behaviors and impulsivity (r = 0.49). A seven-factor Hybrid model provides superior fit to DSM-5 PTSD symptom data, with the externalizing behaviors factor being most strongly related to anger and impulsivity.

  10. Development of a general equation to determine the transfer factor feed-to-meat for radiocesium on the basis of the body mass of domestic animals

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

    Nalezinski, S.; Ruehm, W.; Wirth, E.

    1996-05-01

    Transfer factors from feed to meat (5{sub {integral}}), taken from literature for monogastric animals and ruminants have been correlated to their corresponding animal body mass (m{sub b}). Taking all data into account, a close relationship between both transfer factor and body mass becomes evident, yielding a regression function of (T{sub {integral}} = 8.0 x m{sub b}{sup {minus}0.91}) (r = -0.97). For monogastric animals (including poultry), the corresponding relationships are T{sub {integral}} = 1.9 x m{sub b}{sup {minus}0.72} (r = 0.78). The equations offer the opportunity to estimate the transfer factor for individual animals more precisely taking individual body masses intomore » account. They are of interest for animals, on which no or only poor data concerning radiocesium transfer factors are available. The determination of radiocesium transfer factors are reduced to a simple weighing process. 17 refs., 1 fig., 2 tabs.« less

  11. The effects of internal and external control factors on college students' marijuana use and cessation of use.

    PubMed

    Lo, C C; Globetti, G

    1995-01-01

    The purpose of this study was to examine how selected internal and external control variables influence lifetime use, frequency of use, and cessation of use of marijuana. The internal control factor, comprising the variables 1) perceived risk of marijuana use and 2) attitudes toward prohibition of marijuana use, refers to a built-in personal tendency toward conventionality. The external control factor refers to social-environmental forces which discourage marijuana use. External control is indicated by factors including the number of extra-curricular activities in which an individual is involved; place of residence; the availability of marijuana; peer attitudes toward marijuana use; the number of an individual's friends who use marijuana; and the number of occasions on which an individual has observed others using marijuana. The study's results show that both internal and external control factors are significant predictors of the frequency of marijuana use. The external control factor, however, plays a more important role in explaining lifetime marijuana use and cessation of marijuana use.

  12. Selecting a provider: what factors influence patients' decision making?

    PubMed

    Abraham, Jean; Sick, Brian; Anderson, Joseph; Berg, Andrea; Dehmer, Chad; Tufano, Amanda

    2011-01-01

    Each year consumers make a variety of decisions relating to their healthcare. Some experts argue that stronger consumer engagement in decisions about where to obtain medical care is an important mechanism for improving efficiency in healthcare delivery and financing. Consumers' ability and motivation to become more active decision makers are affected by several factors, including financial incentives and access to information. This study investigates the set of factors that consumers consider when selecting a provider, including attributes of the provider and the care experience and the reputation of the provider. Additionally, the study evaluates consumers awareness and use of formal sources of provider selection information. Our results from analyzing data from a survey of 467 patients at four clinics in Minnesota suggest that the factors considered of greatest importance include reputation of the physician and reputation of the healthcare organization. Contractual and logistical factors also play a role, with respondents highlighting the importance of seeing a provider affiliated with their health plan and appointment availability. Few respondents indicated that advertisements or formal sources of quality information affected their decision making. The key implication for provider organizations is to carefully manage referral sources to ensure that they consistently meet the needs of referrers. Excellent service to existing patients and to the network of referring physicians yields patient and referrer satisfaction that is critical to attracting new patients. Finally, organizations more generally may want to explore the capabilities of new media and social networking sites for building reputation.

  13. A scoping review of traditional food security in Alaska.

    PubMed

    Walch, Amanda; Bersamin, Andrea; Loring, Philip; Johnson, Rhonda; Tholl, Melissa

    2018-12-01

    Food insecurity is a public health concern. Food security includes the pillars of food access, availability and utilisation. For some indigenous peoples, this may also include traditional foods. To conduct a scoping review on traditional foods and food security in Alaska. Google Scholar and the High North Research Documents were used to search for relevant primary research using the following terms: "traditional foods", "food security", "access", "availability", "utilisation", "Alaska", "Alaska Native" and "indigenous". Twenty four articles from Google Scholar and four articles from the High North Research Documents were selected. The articles revealed three types of research approaches, those that quantified traditional food intake (n=18), those that quantified food security (n=2), and qualitative articles that addressed at least one pillar of food security (n=8). Limited primary research is available on food security in Alaskan. Few studies directly measure food security while most provide a review of food security factors. Research investigating dietary intake of traditional foods is more prevalent, though many differences exist among participant age groups and geographical areas. Future research should include direct measurements of traditional food intake and food security to provide a more complete picture of traditional food security in Alaska.

  14. Creativity and psychopathology: a shared vulnerability model.

    PubMed

    Carson, Shelley H

    2011-03-01

    Creativity is considered a positive personal trait. However, highly creative people have demonstrated elevated risk for certain forms of psychopathology, including mood disorders, schizophrenia spectrum disorders, and alcoholism. A model of shared vulnerability explains the relation between creativity and psychopathology. This model, supported by recent findings from neuroscience and molecular genetics, suggests that the biological determinants conferring risk for psychopathology interact with protective cognitive factors to enhance creative ideation. Elements of shared vulnerability include cognitive disinhibition (which allows more stimuli into conscious awareness), an attentional style driven by novelty salience, and neural hyperconnectivity that may increase associations among disparate stimuli. These vulnerabilities interact with superior meta-cognitive protective factors, such as high IQ, increased working memory capacity, and enhanced cognitive flexibility, to enlarge the range and depth of stimuli available in conscious awareness to be manipulated and combined to form novel and original ideas.

  15. Quantitative super-resolution single molecule microscopy dataset of YFP-tagged growth factor receptors.

    PubMed

    Lukeš, Tomáš; Pospíšil, Jakub; Fliegel, Karel; Lasser, Theo; Hagen, Guy M

    2018-03-01

    Super-resolution single molecule localization microscopy (SMLM) is a method for achieving resolution beyond the classical limit in optical microscopes (approx. 200 nm laterally). Yellow fluorescent protein (YFP) has been used for super-resolution single molecule localization microscopy, but less frequently than other fluorescent probes. Working with YFP in SMLM is a challenge because a lower number of photons are emitted per molecule compared with organic dyes, which are more commonly used. Publically available experimental data can facilitate development of new data analysis algorithms. Four complete, freely available single molecule super-resolution microscopy datasets on YFP-tagged growth factor receptors expressed in a human cell line are presented, including both raw and analyzed data. We report methods for sample preparation, for data acquisition, and for data analysis, as well as examples of the acquired images. We also analyzed the SMLM datasets using a different method: super-resolution optical fluctuation imaging (SOFI). The 2 modes of analysis offer complementary information about the sample. A fifth single molecule super-resolution microscopy dataset acquired with the dye Alexa 532 is included for comparison purposes. This dataset has potential for extensive reuse. Complete raw data from SMLM experiments have typically not been published. The YFP data exhibit low signal-to-noise ratios, making data analysis a challenge. These datasets will be useful to investigators developing their own algorithms for SMLM, SOFI, and related methods. The data will also be useful for researchers investigating growth factor receptors such as ErbB3.

  16. A study of pressure losses in residential air distribution systems

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

    Abushakra, Bass; Walker, Iain S.; Sherman, Max H.

    2002-07-01

    An experimental study was conducted to evaluate the pressure drop characteristics of residential duct system components that are either not available or not thoroughly (sometimes incorrectly) described in existing duct design literature. The tests were designed to imitate cases normally found in typical residential and light commercial installations. The study included three different sizes of flexible ducts, under different compression configurations, splitter boxes, supply boots, and a fresh air intake hood. The experimental tests conformed to ASHRAE Standard 120P--''Methods of Testing to Determine Flow Resistance of HVAC Air Ducts and Fittings''. The flexible duct study covered compressibility and bending effectsmore » on the total pressure drop, and the results showed that the available published references tend to underestimate the effects of compression in flexible ducts that can increase pressure drops by up to a factor of nine. The supply boots were tested under different configurations including a setup where a flexible duct elbow connection was considered as an integral part of the supply boot. The supply boots results showed that diffusers can increase the pressure drop by up to a factor of two in exit fittings, and the installation configuration can increase the pressure drop by up to a factor of five. The results showed that it is crucial for designers and contractors to be aware of the compressibility effects of the flexible duct, and the installation of supply boots and diffusers.« less

  17. What patients think about choice in healthcare? A study on primary care services in Finland.

    PubMed

    Aalto, Anna-Mari; Elovainio, Marko; Tynkkynen, Liina-Kaisa; Reissell, Eeva; Vehko, Tuulikki; Chydenius, Miisa; Sinervo, Timo

    2018-06-01

    The ongoing Finnish health and social service reform will expand choice by opening the market for competition between public and private service providers. This study examined the attitudes of primary care patients towards choice and which patient-related factors are associated with these attitudes. A sample of attenders during one week in health centres of 12 big cities and municipal consortiums (including seven outsourced local units) and in primary care units of one private company providing outsourced services for municipalities (aged 18-95, n=8128) was used. The questionnaire included questions on choice-related attitudes, sociodemographic factors, health status, use of health services and patient satisfaction. Of the responders, 77% regarded choice to be important, 49% perceived genuine opportunities to make choices and 35% were satisfied with the choice-relevant information. Higher age, low education, having a chronic illness, frequent use of services, having a personal physician and being satisfied with the physician and with waiting times were related to assigning more importance on choice. Younger patients, those with higher education as well as those with chronic illness regarded their opportunities of choosing the service provider and availability of choice-relevant information poorer. The Finnish primary care patients value choice, but they are critical of the availability of choice-relevant information. Choices of patients with complex health care needs should be supported by developing integrated care alternatives and by increasing the availability of information on existing care alternatives to meet their needs.

  18. Solar Pond Potential as A New Renewable Energy in South Sulawesi

    NASA Astrophysics Data System (ADS)

    Fadliah Baso, Nur; Chaerah Gunadin, Indar; Yusran

    2018-03-01

    Renewable energy sources need to be developed to maintain the electric energy availability by utilizing oceanic energy, namely solar pond energy. This energy is highly influenced by several factors including salinity, air temperature and solar radiation. This study was focused on finding the potential of solar pond in South Sulawesi, a region with fairly high solar radiation and abundant salt water raw materials availability. The method used in this study was analyzing the values from the mathematic models of daily horizontal solar radiation, air temperature, wind speed, relative humidity and atmospheric pressure for the last 22 years which were finalized using MATLAB. The findings of this study will show the areas with good potentials to apply solar pond in South Sulawesi that can be utilized in various fields including power generator, industrial heating process, desalination and heating for biomass conversion.

  19. Challenges in Identifying Refugees in National Health Data Sets.

    PubMed

    Semere, Wagahta; Yun, Katherine; Ahalt, Cyrus; Williams, Brie; Wang, Emily A

    2016-07-01

    To evaluate publicly available data sets to determine their utility for studying refugee health. We searched for keywords describing refugees in data sets within the Society of General Internal Medicine Dataset Compendium and the Inter-University Consortium for Political and Social Research database. We included in our analysis US-based data sets with publicly available documentation and a self-defined, health-related focus that allowed for an examination of patient-level factors. Of the 68 data sets that met the study criteria, 37 (54%) registered keyword matches related to refugees, but only 2 uniquely identified refugees. Few health data sets identify refugee status among participants, presenting barriers to understanding refugees' health and health care needs. Information about refugee status in national health surveys should include expanded demographic questions and focus on mental health and chronic disease.

  20. Prioritizing Health: A Systematic Approach to Scoping Determinants in Health Impact Assessment.

    PubMed

    McCallum, Lindsay C; Ollson, Christopher A; Stefanovic, Ingrid L

    2016-01-01

    The determinants of health are those factors that have the potential to affect health, either positively or negatively, and include a range of personal, social, economic, and environmental factors. In the practice of health impact assessment (HIA), the stage at which the determinants of health are considered for inclusion is during the scoping step. The scoping step is intended to identify how the HIA will be carried out and to set the boundaries (e.g., temporal and geographical) for the assessment. There are several factors that can help to inform the scoping process, many of which are considered in existing HIA tools and guidance; however, a systematic method of prioritizing determinants was found to be lacking. In order to analyze existing HIA scoping tools that are available, a systematic literature review was conducted, including both primary and gray literature. A total of 10 HIA scoping tools met the inclusion/exclusion criteria and were carried forward for comparative analysis. The analysis focused on minimum elements and practice standards of HIA scoping that have been established in the field. The analysis determined that existing approaches lack a clear, systematic method of prioritization of health determinants for inclusion in HIA. This finding led to the development of a Systematic HIA Scoping tool that addressed this gap. The decision matrix tool uses factors, such as impact, public concern, and data availability, to prioritize health determinants. Additionally, the tool allows for identification of data gaps and provides a transparent method for budget allocation and assessment planning. In order to increase efficiency and improve utility, the tool was programed into Microsoft Excel. Future work in the area of HIA methodology development is vital to the ongoing success of the practice and utilization of HIA as a reliable decision-making tool.

  1. Small-scale barriers mitigate desertification processes and enhance plant recruitment in a degraded semiarid grassland

    USGS Publications Warehouse

    Fick, Stephen E; Decker, Cheryl E.; Duniway, Michael C.; Miller, Mark E.

    2016-01-01

    Anthropogenic desertification is a problem that plagues drylands globally; however, the factors which maintain degraded states are often unclear. In Canyonlands National Park on the Colorado Plateau of southeastern Utah, many degraded grasslands have not recovered structure and function >40 yr after release from livestock grazing pressure, necessitating active restoration. We hypothesized that multiple factors contribute to the persistent degraded state, including lack of seed availability, surficial soil-hydrological properties, and high levels of spatial connectivity (lack of perennial vegetation and other surface structure to retain water, litter, seed, and sediment). In combination with seeding and surface raking treatments, we tested the effect of small barrier structures (“ConMods”) designed to disrupt the loss of litter, seed and sediment in degraded soil patches within the park. Grass establishment was highest when all treatments (structures, seed addition, and soil disturbance) were combined, but only in the second year after installation, following favorable climatic conditions. We suggest that multiple limiting factors were ameliorated by treatments, including seed limitation and microsite availability, seed removal by harvester ants, and stressful abiotic conditions. Higher densities of grass seedlings on the north and east sides of barrier structures following the summer months suggest that structures may have functioned as artificial “nurse-plants”, sheltering seedlings from wind and radiation as well as accumulating wind-blown resources. Barrier structures increased the establishment of both native perennial grasses and exotic annuals, although there were species-specific differences in mortality related to spatial distribution of seedlings within barrier structures. The unique success of all treatments combined, and even then only under favorable climatic conditions and in certain soil patches, highlights that restoration success (and potentially, natural regeneration) often is contingent on many interacting factors.

  2. Policy analysis for deciding on a malaria vaccine RTS,S in Tanzania.

    PubMed

    Romore, Idda; Njau, Ritha J A; Semali, Innocent; Mwisongo, Aziza; Ba Nguz, Antoinette; Mshinda, Hassan; Tanner, Marcel; Abdulla, Salim

    2016-03-08

    Traditionally, it has taken decades to introduce new interventions in low-income countries. Several factors account for these delays, one of which is the absence of a framework to facilitate comprehensive understanding of policy process to inform policy makers and stimulate the decision-making process. In the case of the proposed introduction of malaria vaccines in Tanzania, a specific framework for decision-making will speed up the administrative process and shorten the time until the vaccine is made available to the target population. Qualitative research was used as a basis for developing the Policy Framework. Interviews were conducted with government officials, bilateral and multilateral partners and other stakeholders in Tanzania to assess malaria treatment policy changes and to draw lessons for malaria vaccine adoption. The decision-making process for adopting malaria interventions and new vaccines in general takes years, involving several processes: meetings and presentations of scientific data from different studies with consistent results, packaging and disseminating evidence and getting approval for use by the Ministry of Health and Social Welfare (MOHSW). It is influenced by contextual factors; Promoting factors include; epidemiological and intervention characteristics, country experiences of malaria treatment policy change, presentation and dissemination of evidence, coordination and harmonization of the process, use of international scientific evidence. Barriers factors includes; financial sustainability, competing health and other priorities, political will and bureaucratic procedures, costs related to the adoption and implementations of interventions, supply and distribution and professional compliance with anti-malarial drugs. The framework facilitates the synthesis of information in a coherent way, enabling a clearer understanding of the policy process, thereby speeding up the policy decision-making process and shortening the time for a malaria vaccine to become available.

  3. Genome wide predictions of miRNA regulation by transcription factors.

    PubMed

    Ruffalo, Matthew; Bar-Joseph, Ziv

    2016-09-01

    Reconstructing regulatory networks from expression and interaction data is a major goal of systems biology. While much work has focused on trying to experimentally and computationally determine the set of transcription-factors (TFs) and microRNAs (miRNAs) that regulate genes in these networks, relatively little work has focused on inferring the regulation of miRNAs by TFs. Such regulation can play an important role in several biological processes including development and disease. The main challenge for predicting such interactions is the very small positive training set currently available. Another challenge is the fact that a large fraction of miRNAs are encoded within genes making it hard to determine the specific way in which they are regulated. To enable genome wide predictions of TF-miRNA interactions, we extended semi-supervised machine-learning approaches to integrate a large set of different types of data including sequence, expression, ChIP-seq and epigenetic data. As we show, the methods we develop achieve good performance on both a labeled test set, and when analyzing general co-expression networks. We next analyze mRNA and miRNA cancer expression data, demonstrating the advantage of using the predicted set of interactions for identifying more coherent and relevant modules, genes, and miRNAs. The complete set of predictions is available on the supporting website and can be used by any method that combines miRNAs, genes, and TFs. Code and full set of predictions are available from the supporting website: http://cs.cmu.edu/~mruffalo/tf-mirna/ zivbj@cs.cmu.edu Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  4. Hemophilia and von Willebrand's disease: 2. Management. Association of Hemophilia Clinic Directors of Canada.

    PubMed Central

    1995-01-01

    OBJECTIVE: To present current strategies for the treatment of hemophilia and von Willebrand's disease. OPTIONS: Prophylactic and corrective therapy with hemostatic and adjunctive agents: DDAVP (1-desamino-8-D-arginine vasopressin [desmopressin acetate]), recombinant coagulation products (human Factor VIII and human Factor VIIa) or virally inactivated plasma-derived products (high- or ultra-high-purity human Factor VIII or human Factor VIII concentrate containing von Willebrand factor activity, porcine Factor VIII, high-purity human Factor IX, human prothrombin-complex concentrate, human activated prothrombin-complex concentrate), adjunctive antifibrinolytic agents, topical thrombin and fibrin sealant. The induction of immune tolerance in patients in whom inhibitors develop should also be considered. OUTCOMES: Morbidity and quality of life associated with bleeding and treatment. EVIDENCE: Relevant clinical studies and reports published from 1974 to 1994 were examined. A search was conducted of our reprint files, MEDLINE, citations in the articles reviewed and references provided by colleagues. In the MEDLINE search the following terms were used singly or in combination: "hemophilia," "von Willebrand's disease," "Factor VIII," "Factor IX," "von Willebrand factor," "diagnosis," "management," "home care," "comprehensive care," "inhibitor," "AIDS," "hepatitis," "life expectancy," "complications," "practice guidelines," "consensus statement" and "controlled trial." The in-depth review included only articles written in English from North America and Europe that were relevant to human disease and pertinent to a predetermined outline. The availability of treatment products in Canada was also considered. VALUES: Minimizing morbidity and maximizing functional status and quality of life were given a high value. BENEFITS, HARMS AND COSTS: Proper prophylactic or early treatment with appropriate hemostatic agents minimizes morbidity and functional disability and improves quality of life. Economic gains are realized through the reduction of mortality and morbidity and their associated costs. The patient has a better opportunity to contribute to society through gainful employment and the fulfillment of social roles. Potential harms include HIV infection, hepatitis B, hepatitis C and the development of inhibitor antibodies to clotting-factor concentrates. The risk of viral transmission has been minimized through the development of procedures for the viral inactivation of plasma-derived clotting-factor concentrates and through the use of recombinant coagulation-factor concentrates and other non-plasma-derived hemostatic agents. RECOMMENDATIONS: DDAVP is the drug of choice for patients with mild hemophilia or type 1 or 2 (except 2B) von Willebrand's disease whose response to DDAVP in previous testing has been found to be adequate. Therapeutic blood components of choice include recombinant products and virally inactivated plasma-derived products. In Canada the recommended products are recombinant Factor VIII for hemophilia A, high-purity plasma-derived Factor IX for hemophilia B and plasma-derived Factor VIII concentrates containing adequate von Willebrand factor (e.g., Haemate P) for von Willebrand's disease. Dosages vary according to specific indications. Adjunctive antifibrinolytic agents, topical thrombin and fibrin sealant are useful for the treatment of oral or dental bleeds and localized bleeds in accessible sites. In patients with inhibitor antibodies, high-dose human or porcine Factor VIII is usually effective when the inhibitor titre is less than 5 Bethesda units/mL. In nonresponsive patients, or in those whose inhibitor titre is higher, "bypassing" agents (e.g., activated prothrombin-complex concentrate and recombinant Factor VIIa) are useful. Long-term management may include immune-tolerance induction.VALIDATION: These recommendations were reviewed and approved by the Association of Hemophilia Clinic Directors of Canada (AHCDC) and the Medical and Scientific Advisory Committee of the Canadian Hemophilia Society. No similar consensus statements or practice guidelines are available for comparison. SPONSORS: These recommendations were developed at the request of the Canadian Blood Agency, which funds the provision of all coagulation-factor concentrates for people with congenital bleeding disorders, and were developed and endorsed by the AHCDC and the Medical and Scientific Advisory Committee of the Canadian Hemophilia Society. PMID:7600466

  5. Polymeric and Inorganic Fibers

    NASA Astrophysics Data System (ADS)

    This series presents critical reviews of the present and future trends in polymer and biopolymer science including chemistry, physical chemistry, physics and materials science. It is addressed to all scientists at universities and in industry who wish to keep abreast of advances in the topics covered. Impact Factor Ranking: Always number one in Polymer Science. More information as well as the electronic version of the whole content available at: www.springerlink.

  6. Alliance for a Healthier Generation's Competitive Beverage and Food Guidelines: Do Elementary School Administrators Know about Them and Do They Report Implementing Them?

    ERIC Educational Resources Information Center

    Ohri-Vachaspati, Punam; Turner, Lindsey; Chaloupka, Frank J.

    2012-01-01

    Background: The availability of competitive foods in schools is a modifiable factor in efforts to prevent childhood obesity. The Alliance for a Healthier Generation launched the Healthy Schools Program in 2006 to encourage schools to create healthier food environments, including the adoption of nutritional guidelines for competitive beverages and…

  7. Advancement of Tools Supporting Improvement of Work Safety in Selected Industrial Company

    NASA Astrophysics Data System (ADS)

    Gembalska-Kwiecień, Anna

    2018-03-01

    In the presented article, the advancement of tools to improve the safety of work in the researched industrial company was taken into consideration. Attention was paid to the skillful analysis of the working environment, which includes the available technologies, work organization and human capital. These factors determine the development of the best prevention activities to minimize the number of accidents.

  8. Do individual cognitions mediate the association of socio-cultural and physical environmental factors with adolescent sports participation?

    PubMed

    van der Horst, Klazine; Oenema, Anke; te Velde, Saskia J; Brug, Johannes

    2010-10-01

    To examine the associations of perceived physical environmental factors (availability of physical activity (PA) attributes at home, PA facilities in the neighbourhood, neighbourhood pleasantness and safety) and social environmental factors (parental sports behaviour and parental rule regarding sports participation) with adolescent leisure-time sports participation, and to explore whether the associations found were mediated by individual cognitions as derived from the theory of planned behaviour (TPB). Cross-sectional study. In school-year 2005/2006 adolescents from seventeen schools in Rotterdam, the Netherlands, completed a questionnaire during school hours that included self-reported measures of leisure-time sports participation, perceived physical environmental factors and TPB variables. Information about parental sports behaviour and parental rule was obtained from a questionnaire that was completed by one parent of the adolescents. Data were collected from 584 adolescent-parent combinations. Data were analysed with multi-level logistic regression analyses. Availability of PA attributes at home (OR = 1·26), parents' sports behaviour (OR = 2·03) and parental rule (OR = 1·64) were associated with a higher likelihood of adolescents' leisure-time sports participation. These associations were partly mediated by attitude and intention. Adolescents were more likely to engage in leisure-time sports when PA attributes were available at home, when parents participated in sports activities and had a rule about their offspring participation in sports activities. These associations were partly mediated by attitude and intention. These results suggest that parents can importantly promote sports participation among their offspring by making sports activities accessible and a family routine.

  9. Factors That Impact the Success of Interorganizational Health Promotion Collaborations: A Scoping Review.

    PubMed

    Seaton, Cherisse L; Holm, Nikolai; Bottorff, Joan L; Jones-Bricker, Margaret; Errey, Sally; Caperchione, Cristina M; Lamont, Sonia; Johnson, Steven T; Healy, Theresa

    2018-05-01

    To explore published empirical literature in order to identify factors that facilitate or inhibit collaborative approaches for health promotion using a scoping review methodology. A comprehensive search of MEDLINE, CINAHL, ScienceDirect, PsycINFO, and Academic Search Complete for articles published between January 2001 and October 2015 was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. To be included studies had to: be an original research article, published in English, involve at least 2 organizations in a health promotion partnership, and identify factors contributing to or constraining the success of an established (or prior) partnership. Studies were excluded if they focused on primary care collaboration or organizations jointly lobbying for a cause. Data extraction was completed by 2 members of the author team using a summary chart to extract information relevant to the factors that facilitated or constrained collaboration success. NVivo 10 was used to code article content into the thematic categories identified in the data extraction. Twenty-five studies across 8 countries were identified. Several key factors contributed to collaborative effectiveness, including a shared vision, leadership, member characteristics, organizational commitment, available resources, clear roles/responsibilities, trust/clear communication, and engagement of the target population. In general, the findings were consistent with previous reviews; however, additional novel themes did emerge.

  10. Safety update on the use of recombinant activated factor VII in approved indications.

    PubMed

    Neufeld, Ellis J; Négrier, Claude; Arkhammar, Per; Benchikh el Fegoun, Soraya; Simonsen, Mette Duelund; Rosholm, Anders; Seremetis, Stephanie

    2015-06-01

    This updated safety review summarises the large body of safety data available on the use of recombinant activated factor VII (rFVIIa) in approved indications: haemophilia with inhibitors, congenital factor VII (FVII) deficiency, acquired haemophilia and Glanzmann's thrombasthenia. Accumulated data up to 31 December 2013 from clinical trials as well as post-marketing data (registries, literature reports and spontaneous reports) were included. Overall, rFVIIa has shown a consistently favourable safety profile, with no unexpected safety concerns, in all approved indications. No confirmed cases of neutralising antibodies against rFVIIa have been reported in patients with congenital haemophilia, acquired haemophilia or Glanzmann's thrombasthenia. The favourable safety profile of rFVIIa can be attributed to the recombinant nature of rFVIIa and its localised mechanism of action at the site of vascular injury. Recombinant FVIIa activates factor X directly on the surface of activated platelets, which are present only at the site of injury, meaning that systemic activation of coagulation is avoided and the risk of thrombotic events (TEs) thus reduced. Nonetheless, close monitoring for signs and symptoms of TE is warranted in all patients treated with any pro-haemostatic agent, including rFVIIa, especially the elderly and any other patients with concomitant conditions and/or predisposing risk factors to thrombosis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Pre-resuscitation factors associated with mortality in 49,130 cases of in-hospital cardiac arrest: a report from the National Registry for Cardiopulmonary Resuscitation.

    PubMed

    Larkin, Gregory Luke; Copes, Wayne S; Nathanson, Brian H; Kaye, William

    2010-03-01

    To evaluate key pre-arrest factors and their collective ability to predict post-cardiopulmonary arrest mortality. CPR is often initiated indiscriminately after in-hospital cardiopulmonary arrest. Improved understanding of pre-arrest factors associated with mortality may inform advance care planning. A cohort of 49,130 adults who experienced pulseless cardiopulmonary arrest from January 2000 to September 2004 was obtained from 366 US hospitals participating in the National Registry for Cardiopulmonary Resuscitation (NRCPR). Logistic regression with bootstrapping was used to model in-hospital mortality, which included those discharged in unfavorable and severely worsened neurologic state (Cerebral Performance Category >/=3). Overall in-hospital mortality was 84.1%. Advanced age, black race, non-cardiac, non-surgical illness category, pre-existing malignancy, acute stroke, trauma, septicemia, hepatic insufficiency, general floor or Emergency Department location, and pre-arrest use of vasopressors or assisted/mechanical ventilation were independently predictive of in-hospital mortality. Retained peri-arrest factors including cardiac monitoring, and shockable initial pulseless rhythms, were strongly associated with survival. The validation model's AUROC curve (0.77) revealed fair performance. Predictive pre-resuscitation factors may supplement patient-specific information available at bedside to assist in revising resuscitation plans during the patient's hospitalization. Copyright 2009. Published by Elsevier Ireland Ltd.

  12. Cost-savings for biosimilars in the United States: a theoretical framework and budget impact case study application using filgrastim.

    PubMed

    Grewal, Simrun; Ramsey, Scott; Balu, Sanjeev; Carlson, Josh J

    2018-05-18

    Biosimilars can directly reduce the cost of treating patients for whom a reference biologic is indicated by offering a highly similar, lower priced alternative. We examine factors related to biosimilar regulatory approval, uptake, pricing, and financing and the potential impact on drug expenditures in the U.S. We developed a framework to illustrate how key factors including regulatory policies, provider and patient perception, pricing, and payer policies impact biosimilar cost-savings. Further, we developed a budget impact cost model to estimate savings from filgrastim biosimilars under various scenarios. The model uses publicly available data on disease incidence, treatment patterns, market share, and drug prices to estimate the cost-savings over a 5-year time horizon. We estimate five-year cost savings of $256 million, of which 18% ($47 million) are from reduced patient out-of-pocket costs, 34% ($86 million) are savings to commercial payers, and 48% ($123 million) are savings for Medicare. Additional scenarios demonstrate the impact of uncertain factors, including price, uptake, and financing policies. A variety or interrelated factors influence the development, uptake, and cost-savings for Biosimilars use in the U.S. The filgrastim case is a useful example that illustrates these factors and the potential magnitude of costs savings.

  13. Using ecological propensity score to adjust for missing confounders in small area studies.

    PubMed

    Wang, Yingbo; Pirani, Monica; Hansell, Anna L; Richardson, Sylvia; Blangiardo, Marta

    2017-11-09

    Small area ecological studies are commonly used in epidemiology to assess the impact of area level risk factors on health outcomes when data are only available in an aggregated form. However, the resulting estimates are often biased due to unmeasured confounders, which typically are not available from the standard administrative registries used for these studies. Extra information on confounders can be provided through external data sets such as surveys or cohorts, where the data are available at the individual level rather than at the area level; however, such data typically lack the geographical coverage of administrative registries. We develop a framework of analysis which combines ecological and individual level data from different sources to provide an adjusted estimate of area level risk factors which is less biased. Our method (i) summarizes all available individual level confounders into an area level scalar variable, which we call ecological propensity score (EPS), (ii) implements a hierarchical structured approach to impute the values of EPS whenever they are missing, and (iii) includes the estimated and imputed EPS into the ecological regression linking the risk factors to the health outcome. Through a simulation study, we show that integrating individual level data into small area analyses via EPS is a promising method to reduce the bias intrinsic in ecological studies due to unmeasured confounders; we also apply the method to a real case study to evaluate the effect of air pollution on coronary heart disease hospital admissions in Greater London. © The Author 2017. Published by Oxford University Press.

  14. Strategic Assessment of Trauma Care Capacity in Ghana.

    PubMed

    Stewart, Barclay T; Quansah, Robert; Gyedu, Adam; Ankomah, James; Donkor, Peter; Mock, Charles

    2015-10-01

    This study aimed to assess availability of trauma care technology in Ghana. In addition, factors contributing to deficiencies were evaluated. By doing so, potential solutions to inefficient aspects of health systems management and maladapted technology for trauma care in low- and middle-income countries (LMICs) could be identified. Thirty-two items were selected from the World Health Organization's Guidelines for Essential Trauma Care. Direct inspection and structured interviews with administrative, clinical, and biomedical engineering staff were used to assess the challenges and successes of item availability at 40 purposively sampled district, regional, and tertiary hospitals. Hospital assessments demonstrated marked deficiencies. Some of these were low cost, such as basic airway supplies, chest tubes, and cervical collars. Item non-availability resulted from several contributing factors, namely equipment absence, lack of training, frequent stock-outs, and technology breakage. A number of root causes for these factors were identified, including ineffective healthcare financing by way of untimely national insurance reimbursements, procurement and stock-management practices, and critical gaps in local biomedical engineering and trauma care training. Nonetheless, local examples of successfully overcoming deficiencies were identified (e.g., public-private partnering, ensuring company engineers trained technicians on-the-job during technology installation or servicing). While availability of several low-cost items could be better supplied by improvements in stock-management and procurement policies, there is a critical need for redress of the national insurance reimbursement system and trauma care training of district hospital staff. Further, developing local service and technical support capabilities is more and more pressing as technology plays an increasingly important role in LMIC healthcare systems.

  15. Cytotoxic chemotherapy in the home: a study of community nurses' attitudes and concerns.

    PubMed

    Gavin, Noel; How, Chris; Condliffe, Barbara; Depledge, Jane

    2004-01-01

    Cytotoxic chemotherapy initiated in a hospital setting and continued in the home is an expanding service. The evolution of such a service received a boost with the publication of the NHS Cancer Plan (Department of Health (DH), 2000a) and the NHS Manual of Cancer Service Standards (DH, 2000b). The literature claims a range of benefits of such a service including enhanced standards of care and cost savings. Effective care depends on a number of key factors including assessment, management of risk and support, i.e. appropriate policies and the availability of adequate resources. This study among community nurses reveals a number of key findings including the incremental nature of the development of policy and practice, the general acceptance that changes in community practice are inevitable and welcome where the changes enhance the care of patients, and a level of concern about the availability of appropriate resources and structures necessary for safe and effective practice.

  16. Publication efficiency among the higher impact factor nursing journals in 2009: a retrospective analysis.

    PubMed

    Palese, Alvisa; Coletti, Sonia; Dante, Angelo

    2013-04-01

    Knowledge translation is attracting different professional, educational and institutional strategies mainly focused on how new knowledge should be tailored and transferred at bedside. Less attention is dedicated to the antecedent of knowledge translation, which is the availability of the knowledge itself. Knowledge diffusion is a process by which an innovation is communicated through certain channels among members of a social system over time. Publishing in peer review journals is recognised as the main method for knowledge diffusion: nevertheless publication efficiency has received little attention to date. Describing publication efficiency via nursing journals as the time occurring between data collection and manuscript publication was the main aim of the study. The secondary aim was to discover the differences, if any, in publication efficiency within manuscripts reporting results from different study designs. A retrospective study design was adopted in 2010. The 2009 Impact Factor List of Nursing Journals published by the ISI web of Knowledge in 2010 was obtained. The first top ten IF Nursing Journals available as a full text and for which the overall ISI 5-Year Impact Factor was also available, was eligible. The articles published on paper by the selected journals, from 1st January to 31st December 2009, were then included. Commentaries, editorials and book reviews were excluded. For each article included, the following were evaluated: (a) the time occurring between each step of publication, from data collection to article submission, acceptance and publication online and on paper; and (b) the differences in the publication efficiency within articles reporting different study designs. 1152 articles were included. From the end of data collection to manuscript publication online/on paper it takes an average of 981 days [CI95% 929-1032] (2.5-3 years). Meta-analysis and systematic reviews have demonstrated the fastest process, requiring an average 1.3 years and 1.9 years respectively. Case-control, cohort and quasi-experimental studies have required more time to enjoy publication in nursing journals, 4 years, 3.5 years and 3.2 years respectively. The production time of an article from its data collection involves significant processes and skills. However, the time may also be lengthened by factors not related to the processes of research, such as the time available to researchers. The scientific world needs to reflect on publication efficiency because lateness can potentially have a negative impact on patients and on further research. In the future, the same emphasis given to the evaluation of knowledge translation effectiveness should be given also to the complex process of knowledge diffusion, discovering facilitators and barriers. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Evolution of chemical-specific adjustment factors (CSAF) based on recent international experience; increasing utility and facilitating regulatory acceptance.

    PubMed

    Bhat, Virunya S; Meek, M E Bette; Valcke, Mathieu; English, Caroline; Boobis, Alan; Brown, Richard

    2017-10-01

    The application of chemical-specific toxicokinetic or toxicodynamic data to address interspecies differences and human variability in the quantification of hazard has potential to reduce uncertainty and better characterize variability compared with the use of traditional default or categorically-based uncertainty factors. The present review summarizes the state-of-the-science since the introduction of the World Health Organization/International Programme on Chemical Safety (WHO/IPCS) guidance on chemical-specific adjustment factors (CSAF) in 2005 and the availability of recent applicable guidance including the WHO/IPCS guidance on physiologically-based pharmacokinetic (PBPK) modeling in 2010 as well as the U.S. EPA guidance on data-derived extrapolation factors in 2014. A summary of lessons learned from an analysis of more than 100 case studies from global regulators or published literature illustrates the utility and evolution of CSAF in regulatory decisions. Challenges in CSAF development related to the adequacy of, or confidence in, the supporting data, including verification or validation of PBPK models. The analysis also identified issues related to adequacy of CSAF documentation, such as inconsistent terminology and often limited and/or inconsistent reporting, of both supporting data and/or risk assessment context. Based on this analysis, recommendations for standardized terminology, documentation and relevant interdisciplinary research and engagement are included to facilitate the continuing evolution of CSAF development and guidance.

  18. The Differential Effects of Eicosapentaenoic Acid and Docosahexaenoic Acid on Cardiometabolic Risk Factors: A Systematic Review

    PubMed Central

    Innes, Jacqueline K.; Calder, Philip C.

    2018-01-01

    A large body of evidence supports the cardioprotective effects of the long-chain omega-3 polyunsaturated fatty acids (PUFAs), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). There is increasing interest in the independent effects of EPA and DHA in the modulation of cardiometabolic risk factors. This systematic review aims to appraise the latest available evidence of the differential effects of EPA and DHA on such risk factors. A systematic literature review was conducted up to May 2017. Randomised controlled trials were included if they met strict eligibility criteria, including EPA or DHA > 2 g/day and purity ≥ 90%. Eighteen identified articles were included, corresponding to six unique studies involving 527 participants. Both EPA and DHA lowered triglyceride concentration, with DHA having a greater triglyceride-lowering effect. Whilst total cholesterol levels were largely unchanged by EPA and DHA, DHA increased high-density lipoprotein (HDL) cholesterol concentration, particularly HDL2, and increased low-density lipoprotein (LDL) cholesterol concentration and LDL particle size. Both EPA and DHA inhibited platelet activity, whilst DHA improved vascular function and lowered heart rate and blood pressure to a greater extent than EPA. The effects of EPA and DHA on inflammatory markers and glycaemic control were inconclusive; however both lowered oxidative stress. Thus, EPA and DHA appear to have differential effects on cardiometabolic risk factors, but these need to be confirmed by larger clinical studies. PMID:29425187

  19. A streamlined method for transposon mutagenesis of Rickettsia parkeri yields numerous mutations that impact infection.

    PubMed

    Lamason, Rebecca L; Kafai, Natasha M; Welch, Matthew D

    2018-01-01

    The rickettsiae are obligate intracellular alphaproteobacteria that exhibit a complex infectious life cycle in both arthropod and mammalian hosts. As obligate intracellular bacteria, rickettsiae are highly adapted to living inside a variety of host cells, including vascular endothelial cells during mammalian infection. Although it is assumed that the rickettsiae produce numerous virulence factors that usurp or disrupt various host cell pathways, they have been challenging to genetically manipulate to identify the key bacterial factors that contribute to infection. Motivated to overcome this challenge, we sought to expand the repertoire of available rickettsial loss-of-function mutants, using an improved mariner-based transposon mutagenesis scheme. Here, we present the isolation of over 100 transposon mutants in the spotted fever group species Rickettsia parkeri. Transposon insertions disrupted genes whose products are implicated in a variety of pathways, including bacterial replication and metabolism, the type IV secretion system, factors with previously established roles in host cell interactions and pathogenesis, or are of unknown function. Given the need to identify critical virulence factors, forward genetic screens such as this will provide an excellent platform to more directly investigate rickettsial biology and pathogenesis.

  20. Is crisis stability still achievable?

    NASA Astrophysics Data System (ADS)

    Pollack, Joshua

    During the Cold War, the idea of crisis stability concerned whether the United States and the Soviet Union would be faced with powerful incentives to strike each other first with their nuclear weapons during periods of tension. This idea influenced the design of nuclear forces and guided aspects of nuclear arms control. The United States and Russia continue to operate large, alert nuclear forces, but at least three new factors have emerged that add significantly greater complexity to this picture. The first new factor consists of the development and deployment of new strategic military technologies that are entangled with nuclear weapons. These include strategic ballistic missile defenses, counter-space weapons, and strategic conventional weapons. The second new factor consists of new dyads of interacting strategic forces beyond US-Russia. These include US-China, US-North Korea, India-Pakistan, and India-China. The third new factor consists of the emergence of three-actor crisis stability dynamics, where the third actor is not necessarily nuclear-armed. This paper illustrates the concept with the US-North Korea-South Korea triangle. It briefly discusses the implications of these developments and reflects on the broad policy options that may be available.

  1. Sustaining health education research programs in Aboriginal communities.

    PubMed

    Wisener, Katherine; Shapka, Jennifer; Jarvis-Selinger, Sandra

    2017-09-01

    Despite evidence supporting the ongoing provision of health education interventions in First Nations communities, there is a paucity of research that specifically addresses how these programs should be designed to ensure sustainability and long-term effects. Using a Community-Based Research approach, a collective case study was completed with three Canadian First Nations communities to address the following research question: What factors are related to sustainable health education programs, and how do they contribute to and/or inhibit program success in an Aboriginal context? Semi-structured interviews and a sharing circle were completed with 19 participants, including members of community leadership, external partners, and program staff and users. Seven factors were identified to either promote or inhibit program sustainability, including: 1) community uptake; 2) environmental factors; 3) stakeholder awareness and support; 4) presence of a champion; 5) availability of funding; 6) fit and flexibility; and 7) capacity and capacity building. Each factor is provided with a working definition, influential moderators, and key evaluation questions. This study is grounded in, and builds on existing research, and can be used by First Nations communities and universities to support effective sustainability planning for community-based health education interventions.

  2. Photokeratitis induced by ultraviolet radiation in travelers: A major health problem

    PubMed Central

    Izadi, M; Jonaidi-Jafari, N; Pourazizi, M; Alemzadeh-Ansari, MH; Hoseinpourfard, MJ

    2018-01-01

    Ultraviolet (UV) irradiation is one of the several environmental hazards that may cause inflammatory reactions in ocular tissues, especially the cornea. One of the important factors that affect how much ultraviolet radiation (UVR) humans are exposed to is travel. Hence, traveling is considered to include a more acute UVR effect, and ophthalmologists frequently evaluate and manage the ocular manifestations of UV irradiation, including UV-induced keratitis. The purpose of this paper is to provide an evidence-based analysis of the clinical effect of UVR in ocular tissues. An extensive review of English literature was performed to gather all available articles from the National Library of Medicine PubMed database of the National Institute of Health, the Ovid MEDLINE database, Scopus, and ScienceDirect that had studied the effect of UVR on the eye and its complications, between January 1970 and June 2014. The results show that UVR at 300 nm causes apoptosis in all three layers of the cornea and induces keratitis. Apoptosis in all layers of the cornea occurs 5 h after exposure. The effect of UVR intensity on the eye can be linked to numerous factors, including solar elevation, time of day, season, hemisphere, clouds and haze, atmospheric scattering, atmospheric ozone, latitude, altitude, longitudinal changes, climate, ground reflection, and geographic directions. The most important factor affecting UVR reaching the earth's surface is solar elevation. Currently, people do not have great concern over eye protection. The methods of protection against UVR include avoiding direct sunlight exposure, using UVR-blocking eyewear (sunglasses or contact lenses), and wearing hats. Hence, by identifying UVR intensity factors, eye protection factors, and public education, especially in travelers, methods for safe traveling can be identified. PMID:29067921

  3. Photokeratitis induced by ultraviolet radiation in travelers: A major health problem.

    PubMed

    Izadi, M; Jonaidi-Jafari, N; Pourazizi, M; Alemzadeh-Ansari, M H; Hoseinpourfard, M J

    2018-01-01

    Ultraviolet (UV) irradiation is one of the several environmental hazards that may cause inflammatory reactions in ocular tissues, especially the cornea. One of the important factors that affect how much ultraviolet radiation (UVR) humans are exposed to is travel. Hence, traveling is considered to include a more acute UVR effect, and ophthalmologists frequently evaluate and manage the ocular manifestations of UV irradiation, including UV-induced keratitis. The purpose of this paper is to provide an evidence-based analysis of the clinical effect of UVR in ocular tissues. An extensive review of English literature was performed to gather all available articles from the National Library of Medicine PubMed database of the National Institute of Health, the Ovid MEDLINE database, Scopus, and ScienceDirect that had studied the effect of UVR on the eye and its complications, between January 1970 and June 2014. The results show that UVR at 300 nm causes apoptosis in all three layers of the cornea and induces keratitis. Apoptosis in all layers of the cornea occurs 5 h after exposure. The effect of UVR intensity on the eye can be linked to numerous factors, including solar elevation, time of day, season, hemisphere, clouds and haze, atmospheric scattering, atmospheric ozone, latitude, altitude, longitudinal changes, climate, ground reflection, and geographic directions. The most important factor affecting UVR reaching the earth's surface is solar elevation. Currently, people do not have great concern over eye protection. The methods of protection against UVR include avoiding direct sunlight exposure, using UVR-blocking eyewear (sunglasses or contact lenses), and wearing hats. Hence, by identifying UVR intensity factors, eye protection factors, and public education, especially in travelers, methods for safe traveling can be identified.

  4. Room to Live: the sizing of Lunar and Martian Habitats

    NASA Technical Reports Server (NTRS)

    McGregor, Walter L.

    2006-01-01

    In order for man to return to space or extra terrestrial bodies for long duration missions it is important that adequate habitat volume be defined early to avoid costly delays and redesign. To properly define a habitat volume two major factors need to be considered. The first factor is the free or open space. This is the space that allows the crew room to move about the habitat. This space will vary based on crew size and length of the mission. The second major factor is the stowage space required for equipment and supplies. This includes both fixed volumes and consumables. Fixed volumes include items such as tools, communication equipment, Advanced Life Support (ALS) equipment, and support equipment. Consumables include items like filters, food, water and oxygen. This space is also dependent on crew size and mission length. A review of past missions into alien environments, such as deep sea habitats as well as space based habitats will be used to validate the assumption made in this paper. Once these key factors are defined trades must be run to optimize the overall volume of a habitat. This includes trades of disposable vs. reusable for items such as clothing, dishes, and water. Another factor to consider is the availability of in situ resources to aid in the construction of the habitat structure as well as re-supply of consumable items. A review of past missions into alien environments, such as deep sea habitats as well as space based habitats will be used to validate the assumption made in this paper. The result is a habitat sizing tool to provide a first order estimate of habitat volumes for extended mission to the surface of the moon and Mars.

  5. Lack of tolerable treatment options for patients with schizophrenia.

    PubMed

    Citrome, Leslie; Eramo, Anna; Francois, Clement; Duffy, Ruth; Legacy, Susan N; Offord, Steve J; Krasa, Holly B; Johnston, Stephen S; Guiraud-Diawara, Alice; Kamat, Siddhesh A; Rohman, Patricia

    2015-01-01

    Atypical antipsychotics (AAs), an effective treatment for schizophrenia, have a range of pharmacologic properties leading to differences in tolerability as well as heterogeneity in treatment response. Individual patient characteristics must be considered when making treatment choices, especially from an adverse event (AE) or tolerability perspective. Despite the availability of numerous AAs, after appraising patient characteristics at the time of treatment selection, physicians may quickly run out of tolerable treatment options. AE risk factors, defined as having either a prior history of an AE or a risk factor for that AE, were determined for Medicaid-insured and Commercially insured patients using database analysis. Patients receiving AA treatment between January 1, 2010 and December 31, 2012 defined the index date of first observed AA prescription during this period. Nine AAs were evaluated for association with AE risk factors as informed by drug prescribing information from the different manufacturers and published meta-analyses. The proportion of patients with pre-index AE risk factors prescribed an AA associated with that risk factor was then determined. A high proportion of patients (>80%) were prescribed an AA associated with extrapyramidal symptoms or akathisia despite experiencing extrapyramidal symptoms or akathisia prior to AA treatment initiation. Similar trends were observed among patients with diabetes (>60%) and obesity (>40%). From the nine treatment options available, the number of optimal choices for individual patient segments were limited based on their prior history, including those with cardiometabolic and cardiovascular comorbidities (four); experiencing prolactin elevation-related problems (seven); needing to avoid excessive sedation (four); or at risk of extrapyramidal symptoms or akathisia (two). Options were then further restricted among patients in more than one segment when multiple pre-index AE risk factors were combined. When combining patient risk profile with antipsychotic AE profile, physicians may quickly run out of tolerable treatment options for individual patients, despite the availability of many AAs, suggesting a need for additional treatment options with better tolerability and without compromising efficacy.

  6. Race/ethnicity and income in relation to the home food environment in US youth aged 6 to 19 years.

    PubMed

    Masters, Melissa A; Stanek Krogstrand, Kaye L; Eskridge, Kent M; Albrecht, Julie A

    2014-10-01

    The home food environment is complex and has the potential to influence dietary habit development in young people. Several factors may influence the home food environment, including income and race/ethnicity. To examine the relationship of income and race/ethnicity with three home food environment factors (ie, food availability frequency, family meal patterns [frequency of family and home cooked meals], and family food expenditures). A cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES). A total of 5,096 youth aged 6 to 19 years from a nationally representative sample of US individuals participating in NHANES 2007-10. Prevalence of food availability frequency was assessed for the entire sample, race/ethnicity, poverty income ratio (PIR), and race/ethnicity stratified by PIR. Mean values of family meal patterns and food expenditures were calculated based on race/ethnicity, PIR, and race/ethnicity stratified by PIR using analysis of variance and least squares means. Tests of main effects were used to assess differences in food availability prevalence and mean values of family meal patterns and food expenditures. Non-Hispanic whites had the highest prevalence of salty snacks (51.1%±1.5%) and fat-free/low-fat milk (39.2%±1.7%) always available. High-income homes had the highest prevalence of fruits (75.4%±2.4%) and fat-free/low-fat milk (38.4%±2.1%) always available. Differences were found for prevalence of food availability when race/ethnicity was stratified by PIR. Non-Hispanic blacks had the lowest prevalence of fat-free/low-fat milk always available across PIR groups. Differences in mean levels of family meal patterns and food expenditures were found for race/ethnicity, PIR, and race/ethnicity stratified by PIR. Race/ethnicity and PIR appear to influence food availability, family meal patterns, and family food expenditures in homes of youth. Knowledge of factors that influence the home food environment could assist in developing effective strategies to improve food environments for young people. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  7. Determinants of daily path length in black and gold howler monkeys (Alouatta caraya) in northeastern Argentina.

    PubMed

    Raño, Mariana; Kowalewski, Martin M; Cerezo, Alexis M; Garber, Paul A

    2016-08-01

    Models used to explain the social organization of primates suggest that variation in daily path length (DPL) is a response to variation in resource distribution and the intensity of intragroup feeding competition. However, daily path length may be affected by a number of other factors including the availability and distribution of nutritionally complementary food items, temperature which can influence activity budget, patterns of subgrouping, and the frequency and function of intergroup encounters. In this 6-month study (total 495 hr of quantitative data), we examined daily path lengths in two neighboring groups of black and gold howler monkeys (Alouatta caraya) inhabiting a semi-deciduous gallery forest in San Cayetano (27° 30'S, 58° 41'W), in the northwest province of Corrientes, Argentina. Both study groups were of similar size and composition. We identified relationships across groups between time spent feeding on fruits, leaves, and flowers, the number of trees visited, group spread, frequency of intergroup encounters, mean daily temperature, and DPL. Our results suggest that variation in food availability had a significant impact on howler ranging behavior by increasing DPL under conditions of high immature and mature fruit availability, and by decreasing DPL with increased availability and increased time invested in feeding on mature leaves. These results do not support the contention that a reduction in food availability or an increase in within-group feeding competition increased DPL in black and gold howler monkeys. DPL in black and gold howlers is influenced by several interrelated factors. In this regard we suggest that models of socio-ecology and ecological constraints need to reconsider how factors such as individual nutritional requirements, social tolerance and group cohesion, and the spatial and temporal availability of preferred and nearby food resources influence primate ranging behavior. Am. J. Primatol. 78:825-837, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  8. PS2-23: Cardiovascular Disease Surveillance to Optimize Care: Pros and Cons of a Managed Care Research Network System

    PubMed Central

    Kottke, Thomas E; Peacock, James M; Milberger, Sharon; Gunter, Margaret J

    2010-01-01

    Background: With the goal of identifying where care process improvement could mitigate the impact of heart disease, we have developed a heart disease analysis model, The Perfect Care Model. Accounting for all individuals, all deaths, and all cardiac events in a population, this model estimates the number of deaths that might be prevented or postponed (DPP) with improved care. With data that are usually available in the electronic medical record or health assessment of a managed care organization (MCO), the model can calculate the potential impact of changing any risk factor level, risk factor intervention, or any evidence-based therapy. Methods: To assess the feasibility and benefits of basing a CVD surveillance system like the one advocated by the National Forum for Heart Disease & Stroke Prevention in an MCO research network (MCORN) or state health department (SHD), we compared the data available to an MCORN to the data available to an SHD. Results: Data available to the SHD included hospital discharges, case fatality rates by diagnosis for hospitalized patients, counts of surgical procedures, and death certificate data. The disadvantage of organizing a surveillance system through an SHD is that hospitalizations are not linked to services provided during the hospitalization or survival after discharge. Likewise, behavioral risk factor data, medication data and data on ventricular function of patients with heart disease are not available. While MCOs have these data and data linkages, the disadvantage of organizing a surveillance system through an MCORN is that, although covering a significant segment of the US population, the surveillance system would not be strictly population- based. Conclusions: The data required to identify clinical opportunities to prevent and postpone deaths are available to a greater extent through MCOs than an SHD. The large populations covered by MCORNs, their geographic range, the relatively stable populations, and the implementation of electronic medical records all make large MCORNs attractive alternatives to SHD surveillance systems.

  9. A systematic review of prognostic factors for return to work following work-related traumatic hand injury.

    PubMed

    Shi, Qiyun; Sinden, Kathryn; MacDermid, Joy C; Walton, David; Grewal, Ruby

    2014-01-01

    Systematic review. Traumatic hand injuries are frequent cause of work related injuries and can result in prolonged durations of time loss from work. To systematically review available evidence to determine which prognostic factors predict return-to-work (RTW) following work-related traumatic hand injuries. We searched Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL and PsycINFO from 1980 to September 2013 and reference lists of articles. Studies investigating any prognostic factors of RTW after traumatic hand injury were included. Two reviewers performed study selection, assessment of methodological quality and data extraction independently of each other. Identified factors were grouped into conceptual prognostic factor categories. We assessed 8 studies, which addressed 11 potential prognostic factors (i.e., sociodemographic factors, occupation, work compensation status, treatment related factors, impairment severity, location of injury, etc.). The quality of the studies was low to moderate. Across all included studies, RTW (original or modified work) occurred in over 60% of individuals by 6 months. There was consistent low-moderate quality evidence that individuals with more severe impairments and lower pre-injury income were less likely to RTW, and low-moderate quality evidence that age, gender and level of education had no impact on RTW. Evidence on other commonly cited prognostic factors were limited in the literature. Impairment severity and lower pre-injury income showed a consistent association with RTW following occupational hand injury, while other factors demonstrated no or variable effects across studies. Additional high-quality studies are warranted toward improving our understanding of the complex factors that mediate RTW following a traumatic work-related hand injury. 2a. Copyright © 2014 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  10. Pressure Injury Prevention in a Saudi Arabian Intensive Care Unit: Registered Nurse Attitudes Toward Prevention Strategies and Perceived Facilitators and Barriers to Evidence Implementation.

    PubMed

    Tayyib, Nahla; Coyer, Fiona; Lewis, Peter

    2016-01-01

    The purpose of this study was to examine RNs' attitudes toward pressure injury (PI) prevention strategies. Barriers and facilitators perceived by RNs to potentially impact on the adoption and implementation of PI prevention interventions in the intensive care unit (ICU) were examined. Descriptive cross-sectional survey. The target population was RNs practicing in an intensive care unit (ICU) of a major tertiary hospital, King Abdul-Aziz, Mecca, in Saudi Arabia. Fifty-six of the available 60 ICU RNs participated in this study. Data were collected via survey using the Attitude towards Pressure injury Prevention instrument, which included 13 items rated with 4-point Likert scale, and the modified Barriers and Facilitators tool, which included 27 items. The survey was organized into 3 parts: demographic information, potential barriers to optimal skin care, and potential facilitators to skin care. The survey took 10 to 15 minutes to complete. Data were analyzed with descriptive-correlation statistics and multiple regression analysis. Thematic analysis was undertaken for qualitative data. Participants demonstrated positive attitudes toward PI prevention (μ = 38.19/52; 73.44%). No significant differences were found between demographic characteristics of the participants with the RNs' Attitude subscale and perceived barriers and facilitators associated with implementing PI prevention in the critical care setting. Several barriers influenced the ability of RNs to implement PI prevention strategies including time demands (β = .388; P = .011), limitation of RNs' knowledge (β = -.632; P = .022), and current documentation format (β = .344; P = .046). Statistically significant facilitating factors that increased respondents ability to undertake PI prevention were ease of obtaining pressure-reduction surfaces (β = -.388; P = .007), collaboration with interdisciplinary teams (β = .37; P = .02), and availability of appropriate skin care products (β = .44; P = .015). Thematic analysis of open-ended questions highlighted workload as a barrier that impedes the implementation of care specific to PI prevention. Findings from this study highlighted that ICU RNs had a positive attitude toward PI prevention. This study also identified perceived factors influencing PI prevention in the ICU, both facilitators and barriers. Perceived facilitators included availability of pressure-relieving support surfaces and appropriate skin care products and collaboration with the healthcare professional team. However, perceived barriers included limited PI prevention knowledge of the nurse and RN workflow (time demands and documentation format). Findings from this study provide important information identifying context-specific factors that may influence the adoption and implementation of PI prevention interventions in the ICU.

  11. Facilitators for the development and implementation of health promoting policy and programs - a scoping review at the local community level.

    PubMed

    Weiss, Daniel; Lillefjell, Monica; Magnus, Eva

    2016-02-11

    Health promotion, with a focus on multidimensional upstream factors and an ecological, life-course approach, is establishing itself as the guiding philosophy for addressing public health. Action at the political and programmatic level on the Social Determinants of Health has proven effective for promoting and building public health at all levels but has been particularly evident at the national and international levels - due in large part to available documents and guidelines. Although research and experience establish that health promotion is most effective when settings-based, the development of health promoting policies and programs at the local level is still difficult. This study intended to investigate available knowledge on the development and implementation of health promoting policies and programs at the local level and identify factors most important for facilitating capacity building and outcome achievement. We used a scoping review in order to review the current literature on local policy development and program implementation. Keywords were chosen based on results of a previous literature review. A total of 53 articles were divided into two categories: policy and implementation. Critical analysis was conducted for each article and a summary assembled. Data was charted with specific focus on the aims of the study, data acquisition, key theories/concepts/frameworks used, outcome measures, results, and conclusions. The articles included in this study primarily focused on discussing factors that facilitate the development of health promoting policy and the implementation of health promotion programs. Most significant facilitators included: collaborative decision-making, agreement of objectives and goals, local planning and action, effective leadership, building and maintaining trust, availability of resources, a dynamic approach, a realistic time-frame, and trained and knowledgeable staff. Within each of these important facilitating factors, various elements supporting implementation were discussed and highlighted in this study. Our results indicate that clear and consistent facilitators exist for supporting health promoting policy development and program implementation at the local level. These results offer a starting point for local action on the Social Determinants of Health and have the potential to contribute to the development of a framework for improving action at the local level.

  12. Exploring factors impacting early childhood health among Aboriginal and Torres Strait Islander families and communities: protocol for a population-based cohort study using data linkage (the ‘Defying the Odds’ study)

    PubMed Central

    Gubhaju, Lina; Jorm, Louisa; Preen, David; Jones, Jocelyn; Joshy, Grace; Shepherd, Carrington; McAullay, Daniel; Eades, Sandra; Ball, Stephen

    2018-01-01

    Introduction Empirical evidence on family and community risk and protective factors influencing the comparatively high rates of potentially preventable hospitalisations and deaths among Aboriginal and Torres Strait Islander infants and children is limited. As is evidence on geographical variation in these risks. The ‘Defying the Odds’ study aims to explore the impact of perinatal outcomes, maternal social and health outcomes and level of culturally secure service availability on the health outcomes of Western Australian (WA) Aboriginal infants and children aged 0–5 years. Methods and analysis The study combines a retrospective cohort study that uses state-wide linked health and administrative data from 12 data sources for multiple generations within Aboriginal families in WA, with specifically collected survey data from health and social services supporting Aboriginal families in regions of WA. Data sources include perinatal/birth registration, hospital, emergency department, mental health services, drug and alcohol service use, mortality, infectious disease notifications, and child protection and family services. Multilevel regression models will be used to examine the intensity of admissions and presentations, mortality, intensity of long stays and morbidity-free survival (no admissions) for Aboriginal children born in WA in 2000–2013. Relationships between maternal (and grand-maternal) health and social factors and child health outcomes will be quantified. Community-level variation in outcomes for Aboriginal children and factors contributing to this variation will be examined, including the availability of culturally secure services. Online surveys were sent to staff members at relevant services to explore the scope, reach and cultural security of services available to support Aboriginal families across selected regions of WA. Ethics and dissemination Ethics approvals have been granted for the study. Interpretation and dissemination are guided by the study team’s Aboriginal leadership and reference groups. Dissemination will be through direct feedback and reports to health services in the study and via scientific publications and policy recommendations. PMID:29599395

  13. The use of psychotropic substances among students: The prevalence, factor association, and abuse

    PubMed Central

    Mamat, Che Fadhilah bt; Jamshed, Shazia Qasim; El Syed, Tarek; Khan, Tahir Mehmood; Othman, Noordin; Al-Shami, Abdul Kareem; Zaini, Syahrir Bin; Siddiqui, Mohammad Jamshed

    2015-01-01

    This detailed review analyzed the previously published studies related to the prevalence of psychotropic substances use, associated factors, and the misuse of the psychotropics among students. A comprehensive literature search covering six databases was performed. References from published articles and reports were extracted. This helped in identifying the available information on the use of psychotropic drugs. A total of 16 articles were included in this review. There is an upsurge of using psychotropics with the preceding years. More students are exposed to the risk of using psychotropic substances due to the multiple factors like stress, increased academic workload, etc. The misuse is found to be common with prescribed psychotropic substances. Students need to be aware of the bad outcomes of using psychotropic substances. Participation of every stakeholder to curb this menace needs to be emphasized. More extensive studies are required to know about the increasing prevalence, factors, and misuse of psychotropics. PMID:26229351

  14. Human factors of intelligent computer aided display design

    NASA Technical Reports Server (NTRS)

    Hunt, R. M.

    1985-01-01

    Design concepts for a decision support system being studied at NASA Langley as an aid to visual display unit (VDU) designers are described. Ideally, human factors should be taken into account by VDU designers. In reality, although the human factors database on VDUs is small, such systems must be constantly developed. Human factors are therefore a secondary consideration. An expert system will thus serve mainly in an advisory capacity. Functions can include facilitating the design process by shortening the time to generate and alter drawings, enhancing the capability of breaking design requirements down into simpler functions, and providing visual displays equivalent to the final product. The VDU system could also discriminate, and display the difference, between designer decisions and machine inferences. The system could also aid in analyzing the effects of designer choices on future options and in ennunciating when there are data available on a design selections.

  15. Mannitol-Enhanced Delivery of Stem Cells and Their Growth Factors Across the Blood–Brain Barrier

    PubMed Central

    Gonzales-Portillo, Gabriel S.; Sanberg, Paul R.; Franzblau, Max; Gonzales-Portillo, Chiara; Diamandis, Theo; Staples, Meaghan; Sanberg, Cyndy D.; Borlongan, Cesar V.

    2014-01-01

    Ischemic brain injury in adults and neonates is a significant clinical problem with limited therapeutic interventions. Currently, clinicians have only tPA available for stroke treatment and hypothermia for cerebral palsy. Owing to the lack of treatment options, there is a need for novel treatments such as stem cell therapy. Various stem cells including cells from embryo, fetus, perinatal, and adult tissues have proved effective in preclinical and small clinical trials. However, a limiting factor in the success of these treatments is the delivery of the cells and their by-products (neurotrophic factors) into the injured brain. We have demonstrated that mannitol, a drug with the potential to transiently open the blood–brain barrier and facilitate the entry of stem cells and trophic factors, as a solution to the delivery problem. The combination of stem cell therapy and mannitol may improve therapeutic outcomes in adult stroke and neonatal cerebral palsy. PMID:24480552

  16. Risk factors for community-acquired bacterial meningitis.

    PubMed

    Lundbo, Lene Fogt; Benfield, Thomas

    2017-06-01

    Bacterial meningitis is a significant burden of disease and mortality in all age groups worldwide despite the development of effective conjugated vaccines. The pathogenesis of bacterial meningitis is based on complex and incompletely understood host-pathogen interactions. Some of these are pathogen-specific, while some are shared between different bacteria. We searched the database PubMed to identify host risk factors for bacterial meningitis caused by the pathogens Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type b, because they are three most common causative bacteria beyond the neonatal period. We describe a number of risk factors; including socioeconomic factors, age, genetic variation of the host and underlying medical conditions associated with increased susceptibility to invasive bacterial infections in both children and adults. As conjugated vaccines are available for these infections, it is of utmost importance to identify high risk patients to be able to prevent invasive disease.

  17. GPFA-AB_Phase1RiskAnalysisTask5DataUpload

    DOE Data Explorer

    Teresa E. Jordan

    2015-09-30

    This submission contains information used to compute the risk factors for the GPFA-AB project (DE-EE0006726). The risk factors are natural reservoir quality, thermal resource quality, potential for induced seismicity, and utilization. The methods used to combine the risk factors included taking the product, sum, and minimum of the four risk factors. The files are divided into images, rasters, shapefiles, and supporting information. The image files show what the raster and shapefiles should look like. The raster files contain the input risk factors, calculation of the scaled risk factors, and calculation of the combined risk factors. The shapefiles include definition of the fairways, definition of the US Census Places, the center of the raster cells, and locations of industries. Supporting information contains details of the calculations or processing used in generating the files. An image of the raster will have the same name except *.png as the file ending instead of *.tif. Images with “fairways” or “industries” added to the name are composed of a raster with the relevant shapefile added. The file About_GPFA-AB_Phase1RiskAnalysisTask5DataUpload.pdf contains information the citation, special use considerations, authorship, etc. More details on each file are given in the spreadsheet “list_of_contents.csv” in the folder “SupportingInfo”. Code used to calculate values is available at https://github.com/calvinwhealton/geothermal_pfa under the folder “combining_metrics”.

  18. LUNG CANCER IN NEVER SMOKERS: CLINICAL EPIDEMIOLOGY AND ENVIRONMENTAL RISK FACTORS

    PubMed Central

    Samet, Jonathan M.; Avila-Tang, Erika; Boffetta, Paolo; Hannan, Lindsay M.; Olivo-Marston, Susan; Thun, Michael J.; Rudin, Charles M.

    2011-01-01

    More than 161,000 lung cancer deaths are projected to occur in the U.S. in 2008. Of these, an estimated 10–15% will be caused by factors other than active smoking, corresponding to 16,000–24,000 deaths annually. Thus lung cancer in never smokers would rank among the most common causes of cancer mortality in the U.S. if considered to be a separate category. Slightly more than half of the lung cancers caused by factors other than active smoking occur in never smokers. As summarized in the accompanying article, lung cancers that occur in never smokers differ from those that occur in smokers in their molecular profile and response to targeted therapy. These recent laboratory and clinical observations highlight the importance of defining the genetic and environmental factors responsible for the development of lung cancer in never-smokers. This article summarizes available data on the clinical epidemiology of lung cancer in never smokers, and the several environmental risk factors that population-based research has implicated in the etiology of these cancers. Primary factors closely tied to lung cancer in never smokers include exposure to known and suspected carcinogens including radon, second-hand tobacco smoke, and other indoor air pollutants. Several other exposures have been implicated. However, a large fraction of lung cancers occurring in never-smokers cannot be definitively associated with established environmental risk factors, highlighting the need for additional epidemiologic research in this area. PMID:19755391

  19. Reading component skills of learners in adult basic education.

    PubMed

    MacArthur, Charles A; Konold, Timothy R; Glutting, Joseph J; Alamprese, Judith A

    2010-01-01

    The purposes of this study were to investigate the reliability and construct validity of measures of reading component skills with a sample of adult basic education (ABE) learners, including both native and nonnative English speakers, and to describe the performance of those learners on the measures. Investigation of measures of reading components is needed because available measures were neither developed for nor normed on ABE populations or with nonnative speakers of English. The study included 486 students, 334 born or educated in the United States (native) and 152 not born or educated in the United States (nonnative) but who spoke English well enough to participate in English reading classes. All students had scores on 11 measures covering five constructs: decoding, word recognition, spelling, fluency, and comprehension. Confirmatory factor analysis (CFA) was used to test three models: a two-factor model with print and meaning factors; a three-factor model that separated out a fluency factor; and a five-factor model based on the hypothesized constructs. The five-factor model fit best. In addition, the CFA model fit both native and nonnative populations equally well without modification, showing that the tests measure the same constructs with the same accuracy for both groups. Group comparisons found no difference between the native and nonnative samples on word recognition, but the native sample scored higher on fluency and comprehension and lower on decoding than did the nonnative sample. Students with self-reported learning disabilities scored lower on all reading components. Differences by age and gender were also analyzed.

  20. Rawhide Energy Station, Fort Collins, Colorado

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

    Peltier, R.

    2008-10-15

    The staff of Platte River Power Authority's Rawhide Energy Station have been racking up operating stats and an environmental performance record that is the envy of other plant managers. In the past decade Rawhide has enjoyed an equivalent availability factor in the mid to high 90s and an average capacity factor approaching 90%. Still not content with this performance, Rawhide invested in new technology and equipment upgrades to further optimise performance, reduce emissions, and keep cost competitive. The Energy Station includes four GE France 7EA natural gas-fired turbines totalling 260 MW and a 274 MW coal-fired unit located in northeasternmore » Colorado. 7 figs.« less

  1. Time-dependent spin-density-functional-theory description of He+-He collisions

    NASA Astrophysics Data System (ADS)

    Baxter, Matthew; Kirchner, Tom; Engel, Eberhard

    2017-09-01

    Theoretical total cross-section results for all ionization and capture processes in the He+-He collision system are presented in the approximate impact energy range of 10-1000 keV/amu. Calculations were performed within the framework of time-dependent spin-density functional theory. The Krieger-Li-Iafrate approximation was used to determine an accurate exchange-correlation potential in the exchange-only limit. The results of two models, one where electron translation factors in the orbitals used to calculate the potential are ignored and another where partial electron translation factors are included, are compared with available experimental data as well as a selection of previous theoretical calculations.

  2. Elbow ulnar collateral ligament injuries in athletes: Can we improve our outcomes?

    PubMed Central

    Redler, Lauren H; Degen, Ryan M; McDonald, Lucas S; Altchek, David W; Dines, Joshua S

    2016-01-01

    Injury to the ulnar collateral ligament (UCL) most commonly occurs in the overhead throwing athlete. Knowledge surrounding UCL injury pathomechanics continues to improve, leading to better preventative treatment strategies and rehabilitation programs. Conservative treatment strategies for partial injuries, improved operative techniques for reconstruction in complete tears, adjunctive treatments, as well as structured sport specific rehabilitation programs including resistive exercises for the entire upper extremity kinetic chain are all important factors in allowing for a return to throwing in competitive environments. In this review, we explore each of these factors and provide recommendations based on the available literature to improve outcomes in UCL injuries in athletes. PMID:27114930

  3. The importance of culture in treating abused and neglected children: an empirical review.

    PubMed

    Cohen, J A; Deblinger, E; Mannarino, A P; de Arellano, M A

    2001-05-01

    There is growing evidence that cultural factors may influence symptom development and treatment referral patterns among abused and neglected children. To date, few treatment outcome studies have specifically examined the impact of race, culture, or ethnicity on treatment response among maltreated children. Those that have attempted to include these factors have typically suffered from lack of clarity of the meaning of these terms. This article reviews the available empirical evidence that addresses the influence of culture on symptom formation, treatment-seeking behaviors, treatment preference, and response following child maltreatment. Hypotheses regarding these findings are addressed, and implications for practice, research, and public policy are discussed.

  4. Methods for analysis of cracks in three-dimensional solids

    NASA Technical Reports Server (NTRS)

    Raju, I. S.; Newman, J. C., Jr.

    1984-01-01

    Analytical and numerical methods evaluating the stress-intensity factors for three-dimensional cracks in solids are presented, with reference to fatigue failure in aerospace structures. The exact solutions for embedded elliptical and circular cracks in infinite solids, and the approximate methods, including the finite-element, the boundary-integral equation, the line-spring models, and the mixed methods are discussed. Among the mixed methods, the superposition of analytical and finite element methods, the stress-difference, the discretization-error, the alternating, and the finite element-alternating methods are reviewed. Comparison of the stress-intensity factor solutions for some three-dimensional crack configurations showed good agreement. Thus, the choice of a particular method in evaluating the stress-intensity factor is limited only to the availability of resources and computer programs.

  5. [Non transmissible chronic diseases. A preventive approach].

    PubMed

    Berríos, X

    1991-03-01

    Non transmissible chronic diseases, accidents and violence cause 70-80% of deaths in developed countries and 40-50% in underdeveloped ones, including Chile. Their relative contribution to mortality in Chile has increased from 34% to 64% in the last 30 years. Prevention is possible by controlling risk factors such as smoking, alcohol, obesity, hypertension and hypercholesterolemia. Preventive programs should be implemented based on available studies of the epidemiology of risk factors in our country. Population intervention to obtain better health habits and special actions for individuals with risks factors must be employed. Local health services, the community and the media must participate, the cornerstone of the program being population education, particularly those of younger age. A model to be followed is the Interhealth Project, sponsored by WHO and led by Finland (North Karelia).

  6. [Maintaining mechanism of species diversity of land plant communities].

    PubMed

    Shang, Wenyan; Wu, Gang; Fu, Xiao; Liu, Yang

    2005-03-01

    The maintaining mechanism of species diversity of land plant communities is a key and advancing edge in biodiversity study. Botanists and ecologists have presented many hypotheses and theories with controversies, and no general theory system was available. In this paper, the problem was reviewed mainly on two scales. The first was big spatial scale, aiming at the physical and natural factors that affect the species diversity, including histories and ages of plant communities, gradient changes such as latitude gradient, water gradient, altitude gradient and soil nutrients gradient, area effect, and isolation; and the second was concentrated on a special plant community, and mainly discussed the relationships of biodiversity with biotic factors (primary productivity, relationship between species, and gap dynamics) and abiotic factors (succession, disturbance and spatial heterogeneity, and human activity).

  7. Spices Coffee : Innovation Strategy To Increase Quality On Powder Coffee Farmers

    NASA Astrophysics Data System (ADS)

    Amir, I. T.; Indah, P. N.; Widayanti, S.

    2018-01-01

    The purpose of the study is a) to analyze the condition of internal environment industry spices coffee, b) to analyze the condition of the external environment industry spices coffee, and c) to determine the technological innovation strategy spices coffee in order to improve the competitiveness of the coffee people. Most of the coffee grown in Tutur district is cultivated by smallholder farms, resulting in low quality. The strategy of coffee spice agro-industry aims to increase the added value of the products so that farmers obtain higher coffee prices. Activities include the provision of raw materials, processing, supply of final products, and marketing.The results showed that the internal environmental conditions that have the highest value is the strengthen factors. The highest score of strengthen factors is the availability of coffee, availability of labor and communications group. The highest score of opportunity factors is technological assistance from the government and other government support for the development of people’s coffee industry and high market potential. The development of agrotourism should improve as well as expand the network to seize market. The strategy should be applied in the development of spices coffee industry is to support aggressive growth (Growth-oriented strategy).

  8. Cognitive and Neural Correlates of Mathematical Giftedness in Adults and Children: A Review

    PubMed Central

    Myers, Timothy; Carey, Emma; Szűcs, Dénes

    2017-01-01

    Most mathematical cognition research has focused on understanding normal adult function and child development as well as mildly and moderately impaired mathematical skill, often labeled developmental dyscalculia and/or mathematical learning disability. In contrast, much less research is available on cognitive and neural correlates of gifted/excellent mathematical knowledge in adults and children. In order to facilitate further inquiry into this area, here we review 40 available studies, which examine the cognitive and neural basis of gifted mathematics. Studies associated a large number of cognitive factors with gifted mathematics, with spatial processing and working memory being the most frequently identified contributors. However, the current literature suffers from low statistical power, which most probably contributes to variability across findings. Other major shortcomings include failing to establish domain and stimulus specificity of findings, suggesting causation without sufficient evidence and the frequent use of invalid backward inference in neuro-imaging studies. Future studies must increase statistical power and neuro-imaging studies must rely on supporting behavioral data when interpreting findings. Studies should investigate the factors shown to correlate with math giftedness in a more specific manner and determine exactly how individual factors may contribute to gifted math ability. PMID:29118725

  9. An update on childhood bone health: mineral accrual, assessment and treatment.

    PubMed

    Sopher, Aviva B; Fennoy, Ilene; Oberfield, Sharon E

    2015-02-01

    To update the reader's knowledge about the factors that influence bone mineral accrual and to review the advances in the assessment of bone health and treatment of bone disorders. Maternal vitamin D status influences neonatal calcium levels, bone mineral density (BMD) and bone size. In turn, BMD z-score tends to track in childhood. These factors highlight the importance of bone health as early as fetal life. Dual-energy x-ray absorptiometry is the mainstay of clinical bone health assessment in this population because of the availability of appropriate reference data. Recently, more information has become available about the assessment and treatment of bone disease in chronically ill pediatric patients. Bone health must become a health focus starting prenatally in order to maximize peak bone mass and to prevent osteoporosis-related bone disease in adulthood. Vitamin D, calcium and weight-bearing activity are the factors of key importance throughout childhood in achieving optimal bone health as BMD z-score tracks through childhood and into adulthood. Recent updates of the International Society for Clinical Densitometry focus on the appropriate use of dual-energy x-ray absorptiometry in children of all ages, including children with chronic disease, and on the treatment of pediatric bone disease.

  10. Cohort Profile: Mysore Parthenon Birth Cohort

    PubMed Central

    Krishnaveni, Ghattu V; Veena, Sargoor R; Hill, Jacqueline C; Karat, Samuel C; Fall, Caroline HD

    2015-01-01

    The Mysore Parthenon Birth Cohort was established to examine the long-term effects of maternal glucose tolerance and nutritional status on cardiovascular disease risk factors in the offspring. During 1997–98, 830 of 1233 women recruited from the antenatal clinics of the Holdsworth Memorial Hospital (HMH), Mysore, India, underwent an oral glucose tolerance test. Of these, 667 women delivered live babies at HMH. Four babies with major congenital anomalies were excluded, and the remaining 663 were included for further follow-up. The babies had detailed anthropometry at birth and at 6–12-monthly intervals subsequently. Detailed cardiovascular investigations were done at ages 5, 9.5 and 13.5 years in the children, and in the parents at the 5-year and 9.5-year follow-ups. This ongoing study provides extensive data on serial anthropometry and body composition, physiological and biochemical measures, dietary intake, nutritional status, physical activity measures, stress reactivity measures and cognitive function, and socio-demographic parameters for the offspring. Data on anthropometry, cardiovascular risk factors and nutritional status are available for mothers during pregnancy. Anthropometry and risk factor measures are available for both parents at follow-up. PMID:24609067

  11. Accelerated telomere attrition is associated with relative household income, diet and inflammation in the pSoBid cohort.

    PubMed

    Shiels, Paul G; McGlynn, Liane M; MacIntyre, Alan; Johnson, Paul C D; Batty, G David; Burns, Harry; Cavanagh, Jonathan; Deans, Kevin A; Ford, Ian; McConnachie, Alex; McGinty, Agnes; McLean, Jennifer S; Millar, Keith; Sattar, Naveed; Tannahill, Carol; Velupillai, Yoga N; Packard, Chris J

    2011-01-01

    It has previously been hypothesized that lower socio-economic status can accelerate biological ageing, and predispose to early onset of disease. This study investigated the association of socio-economic and lifestyle factors, as well as traditional and novel risk factors, with biological-ageing, as measured by telomere length, in a Glasgow based cohort that included individuals with extreme socio-economic differences. A total of 382 blood samples from the pSoBid study were available for telomere analysis. For each participant, data was available for socio-economic status factors, biochemical parameters and dietary intake. Statistical analyses were undertaken to investigate the association between telomere lengths and these aforementioned parameters. The rate of age-related telomere attrition was significantly associated with low relative income, housing tenure and poor diet. Notably, telomere length was positively associated with LDL and total cholesterol levels, but inversely correlated to circulating IL-6. These data suggest lower socio-economic status and poor diet are relevant to accelerated biological ageing. They also suggest potential associations between elevated circulating IL-6, a measure known to predict cardiovascular disease and diabetes with biological ageing. These observations require further study to tease out potential mechanistic links.

  12. Using association rule mining to identify risk factors for early childhood caries.

    PubMed

    Ivančević, Vladimir; Tušek, Ivan; Tušek, Jasmina; Knežević, Marko; Elheshk, Salaheddin; Luković, Ivan

    2015-11-01

    Early childhood caries (ECC) is a potentially severe disease affecting children all over the world. The available findings are mostly based on a logistic regression model, but data mining, in particular association rule mining, could be used to extract more information from the same data set. ECC data was collected in a cross-sectional analytical study of the 10% sample of preschool children in the South Bačka area (Vojvodina, Serbia). Association rules were extracted from the data by association rule mining. Risk factors were extracted from the highly ranked association rules. Discovered dominant risk factors include male gender, frequent breastfeeding (with other risk factors), high birth order, language, and low body weight at birth. Low health awareness of parents was significantly associated to ECC only in male children. The discovered risk factors are mostly confirmed by the literature, which corroborates the value of the methods. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. A Segment Level Study of Defense Industry Capital Investment.

    DTIC Science & Technology

    1985-12-01

    examines the econcinic factors that are influencial for encouraging capital investment in the defense industry. A group of candidate variables are...and disguises useful information that is available from the data. The reduced average data for first year group included 130 segments from 34...individually against capital expendi- Ie tures, using the averaged data for the same first year group , the coef- ficient was positive. This indicates

  14. Selenium

    USGS Publications Warehouse

    Franson, J.C.

    1999-01-01

    Selenium is a naturally occurring element that is present in some soils. Unlike mercury and lead, which also are natural environmental components, selenium is an essential nutrient in living systems. The amount of dietary selenium required by animals depends upon many factors, including the availability of certain other metals such as zinc and copper, as well as vitamin E and other nutrients. Muscle damage results if dietary selenium is deficient, but dietary excess can be toxic.

  15. Human Engineering Guidelines for Management Information Systems. Change 1,

    DTIC Science & Technology

    1983-06-09

    beginner . chapter offers guidelines concerning training. 0 A brief review available for the infrequent user. Major training factors * A program for a...the training include a program specifically designed L Li LL for the beginner or naive user? 8. Is there a brief review for the intermittent user? Ei Li...250 pages of text. Flowchart - A graphic representation, using standard symbols, which portrays logical data and process- ing requirements. Formatting

  16. Woody vegetation and soil characteristics of residential forest patches and open spaces along an urban-to-rural gradient

    Treesearch

    Benjamin L. Reichert; Sharon R. Jean-Philippe; Christopher Oswalt; Jennifer Franklin; Mark Radosevich

    2015-01-01

    As the process of urbanization advances across the country, so does the importance of urban forests, which include both trees and the soils in which they grow. Soil microbial biomass, which plays a critical role in nutrient transformation in urban ecosystems, is affected by factors such as soil type and the availability of water, carbon, and nitrogen. The aim of this...

  17. Fate of residual canopy trees following harvesting to underplant longleaf pine seedlings in loblolly pine stands in Georgia

    Treesearch

    Benjamin O. Knapp; G. Geoff Wang; Joan L. Walker; Robert N. Addington

    2016-01-01

    Over the past few decades, reports of forest health problems have concerned scientists and forest managers in loblolly pine forests of the southeastern United States. Several interacting factors likely contribute to observed reductions in loblolly pine health, including low resource availability on many upland sites that were once dominated by longleaf pine. Currently...

  18. Motivational and Productivity Factors that Influence the Naval Construction Force

    DTIC Science & Technology

    1990-08-01

    rework, unavailability of tools and equipment, disrespectful treatment, lack of recognition, little participation in decision-making, M 0 T I V A M(l...can be used by management as a motivating tool for workers. Herzberg recommends the following guidelines to for an effective job enrichment program...misconception is to focus solely on labor. One must consider all resources available within the work environment, including tools , equipment, materials

  19. Ciclopirox shampoo for treating seborrheic dermatitis.

    PubMed

    Gupta, A K; Bluhm, R

    2004-01-01

    Seborrheic dermatitis is a common inflammatory skin disease, affecting between 1% and 3% of immunocompetent adults. While its cause is unknown, a number of predisposing factors have been reported, including the implications of Malassezia yeasts. Various treatment options are available, such as ciclopirox shampoo, which combines anti-Malassezia activity with an anti-inflammatory action. This agent has been shown to be an effective and safe treatment for seborrheic dermatitis of the scalp.

  20. The attitudes of health care staff to information technology: a comprehensive review of the research literature.

    PubMed

    Ward, Rod; Stevens, Christine; Brentnall, Philip; Briddon, Jason

    2008-06-01

    What does the publicly available literature tell us about the attitudes of health care staff to the development of information technology in practice, including the factors which influence them and the factors which may be used to change these attitudes? Twelve databases were searched for literature published between 2000 and 2005 that identified research related to information technology (IT), health professionals and attitude. English language studies were included which described primary research relating to the attitudes of one or more health care staff groups towards IT. Letters, personal viewpoints, reflections and opinion pieces were not included. Complex factors contribute to the formation of attitudes towards IT. Many of the issues identified were around the flexibility of the systems and whether they were 'fit for purpose', along with the confidence and experience of the IT users. The literature suggests that attitudes of practitioners are a significant factor in the acceptance and efficiency of use of IT in practice. The literature also suggested that education and training was a factor for encouraging the use of IT systems. A range of key issues, such as the need for flexibility and usability, appropriate education and training and the need for the software to be 'fit for purpose', showed that organizations need to plan carefully when proposing the introduction of IT-based systems into work practices. The studies reviewed did suggest that attitudes of health care professionals can be a significant factor in the acceptance and efficiency of use of IT in practice. Further qualitative and quantitative research is needed into the approaches that have most effect on the attitudes of health care staff towards IT.

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