An exploratory study of the health harms and utilisation of health services of frequent legal high users under the interim regulated legal high market in central Auckland.

PubMed

Wilkins, Chris; Prasad, Jitesh; Wong, K C; Rychert, Marta; Graydon-Guy, Thomas

2016-03-11

To explore health problems and the accessing of health services by frequent legal high users under an interim regulated legal market in central Auckland. Frequent legal high users (monthly+) were recruited from outside eight randomly-selected, licensed, legal high stores in central Auckland from 23 April-7 May, 2014. Eligible participants were emailed a unique invitation to complete an on-line survey; 105 completed the survey. Twenty-seven percent had suffered mental illness during their lifetimes. Eighty percent used synthetic cannabinoids (SC), and 20% 'party pills'. Forty-seven percent of SC users used daily or more often. Other drugs used included alcohol (80%), cannabis (59%), 'ecstasy' (18%) and methamphetamine (15%). Fifty-eight percent of SC users were classified as SC dependent. The most common problems reported from SC use were: insomnia (29%); 'vomiting/nausea' (25%); 'short temper/agitation' (21%); 'anxiety' (21%); 'strange thoughts' (16%); and 'heart palpitations' (14%). The health services most commonly accessed by SC users were: a 'doctor/GP' (9%); 'counsellor' (9%); 'DrugHelp/MethHelp' websites (7%); 'Alcohol & Drug Helpline' (4%); 'ambulance' (3%); 'A&E' (3%); and hospitalisation (3%). Frequent use of interim licensed SC products was associated with health problems, including dependency. Further research is required to determine the health risks of these products.

Characteristics of 32 supercentenarians.

PubMed

Schoenhofen, Emily A; Wyszynski, Diego F; Andersen, Stacy; Pennington, Jaemi; Young, Robert; Terry, Dellara F; Perls, Thomas T

2006-08-01

To report phenotypic characteristics of 32 age-validated supercentenarians. Case series. U.S.-based recruitment effort. Thirty-two supercentenarians. Multiple forms of proof were used to validate age claims. Sociodemographic, activities of daily living, and medical history data were collected. Age range was 110 to 119. Fifty-nine percent had Barthel Index scores in the partially to totally dependent range, whereas 41% required minimal assistance or were independent. Few subjects had a history of clinically evident vascular-related diseases, including myocardial infarction (n=2, 6%) and stroke (n=4, 13%). Twenty-two percent (n=7) were taking medications for hypertension. Twenty-five percent (n=8) had a history of cancer (all cured). Diabetes mellitus (n=1, 3%) and Parkinson's disease (n=1, 3%) were rare. Osteoporosis (n=14, 44%) and cataract history (n=28, 88%) were common. Data collected thus far suggest that supercentenarians markedly delay and even escape clinical expression of vascular disease toward the end of their exceptionally long lives. A surprisingly substantial proportion of these individuals were still functionally independent or required minimal assistance.

Giftedness and Intuition

ERIC Educational Resources Information Center

Karwowski, Maciej

2008-01-01

Two studies were conducted to show connections between giftedness and intuition. The first study was exploratory. A sample of 194 gifted adolescent students (N=194) included fifty-five students identified as gifted by their teachers and fifty-six percent who were female. Using the Polish version of the Myers Briggs Type Indicator, the students…

Sugar maple provenance study: West Virginia outplanting - 10-year results

Treesearch

G. W. Wendel; W. J. Gabriel

1980-01-01

After 10 years, survival of sugar maple (Acer saccharum Marsh.) provenances outplanted in West Virginia did not differ significantly. Total height, height growth and dbh measurements were significantly different among provenances. Fifty percent of the trees had major forks below 9.0 feet. Thirty-eight percent of the trees had no forks but 71 percent...

Effects of Serum Zinc Supplementation on Pica Behavior of Persons with Mental Retardation.

ERIC Educational Resources Information Center

Lofts, Ronald H.; And Others

1990-01-01

Of 806 institutionalized adults with mental retardation, 15.5 percent exhibited pica. Fifty-four percent of the pica group had serum zinc levels below normal range, whereas 7 percent of a control group had serum zinc levels below the normal range. After supplementation with chelated zinc, residents had significant reductions in pica. (Author/JDD)

Epidemiology of sepsis in pediatric intensive care units: first Colombian multicenter study.

PubMed

Jaramillo-Bustamante, Juan C; Marín-Agudelo, Alejandro; Fernández-Laverde, Mauricio; Bareño-Silva, José

2012-09-01

In 2002, the Surviving Sepsis Campaign pointed out the need to recognize sepsis as an important cause of death and high economic and social costs. There are few epidemiologic studies of this disease in pediatrics and none in Colombia. The objective of this study was to describe the sociodemographic and clinical characteristics of patients with sepsis who were admitted at participating pediatric intensive care units. Prospective study. A Web site, http://www.sepsisencolombia.com, was created, in which 19 pediatric intensive care units from the ten principal cities in the country reported epidemiologic data about patients with sepsis between March 1, 2009, and February 28, 2010. None. There were 1,051 patients. Of these, 55% were male. Fifty-six percent came from urban areas. Fifty-six percent were <2 yrs of age. Seventy-six percent belonged to a low socioeconomic strata and 44% received government-subsidized health insurance. Forty-eight percent of patients had septic shock, 25% severe sepsis, and 27% sepsis. Forty-three percent were diagnosed with multiple organ dysfunction syndrome. In 54%, the infection was of respiratory origin followed by the abdomen as the site of origin in 18% of the patients. In almost 50%, the etiological agent was detected with Gram-negative bacteria being the most frequent and of highest mortality. Fifty percent had some type of relevant pathologic antecedent. Eleven percent had an invasive device on admission. Sixty-eight percent of the patients required mechanical ventilation. Mortality rate was 18%. The most important risk factors for mortality were age under 2 yrs, presence of shock or multiple organ dysfunction syndrome, and presence of Gram-negative bacteria. Sepsis is common in Colombian pediatric intensive care units. Clear risk factors for getting sick and dying from this disease were identified. Mortality resulting from this disease is considerable for a developing society like ours.

Gender shifts and effects on behavior guidance.

PubMed

Wells, Martha; McTigue, Dennis J; Casamassimo, Paul S; Adair, Steven

2014-01-01

Women's presence in pediatric dentistry has dramatically increased over the past several decades. Women now comprise almost 50 percent of AAPD membership and almost 75 percent of new members. The purpose of this investigation was to determine differences between male and female pediatric dentists relative to practice patterns and use of behavior guidance techniques (BGTs). A web-based survey was sent to 511 pediatric dentists who had been recruited by the AAPD to participate in a series of surveys related to pediatric dentistry. Fifty-nine percent of dentists responded. Fifty-two percent of the respondents were male and 48 percent were female. Female respondents were significantly younger than male respondents. Males were more likely to own a practice and hold leadership positions in dentistry while females were more likely to work as faculty, staff dentists, or part-time in private practice. No significant differences were noted between the genders relative to the use of BGTs, though females tended to involve parents more and were more likely to report the use of protective stabilization in selected situations. Both genders reported that parenthood had an effect on their behavior guidance styles.

A Cognitive Analysis of Developmental Mathematics Students' Errors and Misconceptions in Real Number Computations and Evaluating Algebraic Expressions

ERIC Educational Resources Information Center

Titus, Freddie

2010-01-01

Fifty percent of college-bound students graduate from high school underprepared for mathematics at the post-secondary level. As a result, thirty-five percent of college students take developmental mathematics courses. What is even more shocking is the high failure rate (ranging from 35 to 42 percent) of students enrolled in developmental…

Women, Work and Age: A Report on Older Women and Employment.

ERIC Educational Resources Information Center

Stentzel, Cathy; Steenland, Sally, Ed.

Fifty-four percent of all midlife and older American women are in the work force. Like their younger counterparts, most older women work in nonprofessional occupations. Regardless of their age, working women earn less than men. Sixty-five percent of working women aged 45 to 64 are married; 30 percent are widowed, divorced, or separated; and 5…

Myelodysplasia

PubMed Central

Shurtleff, David B.; Hayden, Patricia W.; Chapman, Warren H.; Broy, Arline B.; Hill, Margaret L.

1975-01-01

Problems of ninety-eight patients with myelodysplasia, ages 13 to 72, were reviewed. They were grouped as follows: Those having thoracic and high lumbar level (L2↑) lesions and confined to wheel chairs, those with intermediate paralysis (L3-5 nerve roots) as walking with aids and those with less paralysis (S1↓) as fully ambulatory. Fifty-two percent of the L2↑ and only 15 percent of of the less severely paralyzed patients were retarded below an IQ level 70 (P<0.01). Thirty-six patients (62 percent) were fully and 26 partially, but appropriately, self-sufficient. Thirty-six patients were found in some form of dependent care. Two of the 71 more paralyzed patients (L3-5 and L2↑) and five of the 28 S1↓ patients were “naturally continent” but reported stress incontinence of urine. Thirteen of 23 female and five of 28 male patients between ages 16 and 72 years reported sexual activity and accounted for 17 normal offspring. All 23 retarded patients were in some form of custodial care. Dependency among the normal intellect patients could be attributed to neglect of physically deforming complications and emotional disorders, primarily low self-esteem centering around social and sexual identity problems associated with excrement soiling. PMID:807042

UK Renal Registry 16th annual report: chapter 12 biochemical variables amongst UK adult dialysis patients in 2012: national and centre-specific analyses.

PubMed

Nicholas, Johann; Shaw, Catriona; Pitcher, David; Dawnay, Anne

2013-01-01

The UK Renal Association clinical practice guidelines include clinical performance measures for biochemical variables in dialysis patients. The UK Renal Registry (UKRR) annually audits dialysis centre performance against these measures as part of its role in promoting continuous quality improvement. Cross sectional performance analyses were undertaken to compare dialysis centre achievement of clinical audit measures for prevalent haemodialysis (HD) and peritoneal dialysis (PD) cohorts in 2012. The biochemical variables studied were phosphate, adjusted calcium, parathyroid hormone, bicarbonate and total cholesterol. In addition, longitudinal analyses were performed (2002-2012) to show changes in achievement of clinical performance measures over time. Fifty-six percent of HD and 61% of PD patients achieved a phosphate within the range recommended by the RA clinical practice guidelines. Seventy-seven percent of HD and 78% of PD patients had adjusted calcium between 2.2-2.5 mmol/L. Fifty-eight percent of HD and 65% of PD patients had parathyroid hormone between 16-72 pmol/L. Fifty-nine percent of HD and 80% of PD patients achieved the audit measure for bicarbonate. There was significant inter-centre variation for all variables studied. The UKRR consistently demonstrates significant inter-centre variation in achievement of biochemical clinical audit measures. Understanding the causes of this variation is an important part of improving the care of dialysis patients in the UK.

Use of Discriminatory Questions in Screening Interviews.

ERIC Educational Resources Information Center

Jablin, Fredric M.

1982-01-01

Fifty-six college placement directors perceived that five percent of the on-campus job recruiters ask illegal questions concerning applicants' sex, age, national origin, race or color, handicaps, or religion. Forty percent of the student applicants are judged to be unaware of illegal questioning. (Author/MLF)

The Pulmonary Clearance of Bacteria by Calves and Mice

PubMed Central

Lillie, L. E.; Thomson, R. G.

1972-01-01

Using a modified aerosol generator, white mice and calves were exposed to aerosols of viable Staphylococcus aureus and Pasteurella haemolytica and the clearance of the inhaled organisms by the lungs of the experimental animals was measured. Fifty-seven percent of inhaled S. aureus were cleared in two hours by the mouse lungs, 79% were cleared in four hours and 93% were cleared in eight hours. Fifty-six percent of inhaled P. haemolytica were cleared in two hours by the mouse lungs, 76% were cleared in four hours and 93% were cleared in eight hours. Seventy percent of inhaled S. aureus were cleared in two hours by the calf lungs, 90% were cleared in four hours and 95% were cleared in eight hours. Seventy-five percent of inhaled P.haemolytica were cleared in two hours by the calf lungs, 90% were cleared in four hours and 92% were cleared in eight hours. ImagesFig. 1.Fig. 2.Fig. 4.Fig. 5. PMID:4259926

Parents' Attitudes toward Sterilization of Their Mentally Retarded Children.

ERIC Educational Resources Information Center

Wolf, Lucille; Zarfas, Donald E.

1982-01-01

One hundred fifty-seven parents' attitudes toward sterilization and the sexuality of their retarded offspring were identified. Parent and child characteristics associated with these attitudes were investigated. Findings indicated that parents substantially concurred with the principle of sterilization (71 percent for involuntary, 67 percent for…

Harvest Activity and Residual Pine Stocking on Prvate Timberland in Arkansas, 1978-88

Treesearch

William H. McWilliams

1989-01-01

Commercial harvesting, carried out on 39 percent of the privately owned timberland (5.3 million acres) in Arkansas from 1978-88, had a heavy impact on forest industry timberland. On a percentage basis, cutting was heaviest in pine forest types. Fifty-four percent of the heavily cut pine and mixed pine-hardwood stands were at least 60 percent stocked with pine following...

Characteristics of 32 Supercentenarians

PubMed Central

Schoenhofen, Emily A.; Wyszynski, Diego F.; Andersen, Stacy; Pennington, JaeMi; Young, Robert; Terry, Dellara F.; Perls, Thomas T.

2010-01-01

OBJECTIVES To report phenotypic characteristics of 32 age-validated supercentenarians. DESIGN Case series. SETTING U.S.-based recruitment effort. PARTICIPANTS Thirty-two supercentenarians. MEASUREMENTS Multiple forms of proof were used to validate age claims. Sociodemographic, activities of daily living, and medical history data were collected. RESULTS Age range was 110 to 119. Fifty-nine percent had Barthel Index scores in the partially to totally dependent range, whereas 41% required minimal assistance or were independent. Few subjects had a history of clinically evident vascular-related diseases, including myocardial infarction (n = 2, 6%) and stroke (n = 4, 13%). Twenty-two percent (n = 7) were taking medications for hypertension. Twenty-five percent (n = 8) had a history of cancer (all cured). Diabetes mellitus (n = 1, 3%) and Parkinson’s disease (n = 1, 3%) were rare. Osteoporosis (n = 14, 44%) and cataract history (n = 28, 88%) were common. CONCLUSION Data collected thus far suggest that supercentenarians markedly delay and even escape clinical expression of vascular disease toward the end of their exceptionally long lives. A surprisingly substantial proportion of these individuals were still functionally independent or required minimal assistance. PMID:16913991

A cooperative effort to pass tobacco control ordinances in Wichita, Kansas.

PubMed

Pippert, K; Jecha, L; Coen, S; MacDonald, P; Francisco, J; Pickard, S

1995-01-01

In October 1993, the Tobacco-Free Wichita Coalition proposed ordinances to the Wichita City Council that would tightly control access of minors to tobacco and prohibit smoking in public places. The subsequent successful change in local health policy required the collaborative efforts of local and state organizations and health agencies. A simple random telephone survey commissioned and financed by the coalition demonstrated that 76 percent (95 percent CI = 72 percent to 80 percent) of adult Wichita-Sedgwick County residents favored enforced penalties for merchants selling tobacco to minors, and 62 percent (95 percent CI = 58 percent to 66 percent) favored a ban on tobacco vending machines. Fifty-four percent (95 percent CI = 50 percent to 58 percent) favored a smoking ban in all public places.

Student Loan Default Rates in Minnesota, 2007

ERIC Educational Resources Information Center

Grimes, Tricia

2010-01-01

While Minnesota undergraduates are more likely to take out student loans, they are substantially less likely than their peers nationally to default on federal student loans. Fifty-four percent of Minnesota undergraduates took out student loans in 2007-2008, compared to 39 percent of undergraduates across the U.S. Minnesota undergraduates were also…

46 CFR 42.20-9 - Initial conditions of loading.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Fifty percent of the total capacity of all tanks and spaces fitted to contain consumable liquids or stores must be assumed to be distributed to accomplish the following: (i) Each tank and space fitted to... only partially filled. In the case of liquid cargoes, fully loaded means 98 percent full. (3) If the...

46 CFR 42.20-9 - Initial conditions of loading.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) Fifty percent of the total capacity of all tanks and spaces fitted to contain consumable liquids or stores must be assumed to be distributed to accomplish the following: (i) Each tank and space fitted to... only partially filled. In the case of liquid cargoes, fully loaded means 98 percent full. (3) If the...

46 CFR 42.20-9 - Initial conditions of loading.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) Fifty percent of the total capacity of all tanks and spaces fitted to contain consumable liquids or stores must be assumed to be distributed to accomplish the following: (i) Each tank and space fitted to... only partially filled. In the case of liquid cargoes, fully loaded means 98 percent full. (3) If the...

46 CFR 42.20-9 - Initial conditions of loading.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) Fifty percent of the total capacity of all tanks and spaces fitted to contain consumable liquids or stores must be assumed to be distributed to accomplish the following: (i) Each tank and space fitted to... only partially filled. In the case of liquid cargoes, fully loaded means 98 percent full. (3) If the...

46 CFR 42.20-9 - Initial conditions of loading.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Fifty percent of the total capacity of all tanks and spaces fitted to contain consumable liquids or stores must be assumed to be distributed to accomplish the following: (i) Each tank and space fitted to... only partially filled. In the case of liquid cargoes, fully loaded means 98 percent full. (3) If the...

Sexuality and sexual reproductive health of disabled young people in Ethiopia.

PubMed

Kassa, Tigist Alemu; Luck, Tobias; Birru, Samuel Kinde; Riedel-Heller, Steffi G

2014-10-01

In Ethiopia, young people with disabilities (YPWD) are often marginalized and not recognized as being sexual, and only little is known about their sexual reproductive health (SRH) status. We therefore aimed to assess the SRH status and associated factors among 426 YPWD in Addis Ababa, Ethiopia. A cross-sectional survey was conducted in 2012. Data were collected by trained interviewers using a structured questionnaire. Fifty-two percent of YPWD ever had sexual intercourse. Seventy-five percent started sex between 15 and 19 years. Only 35% had used contraceptive during their first sexual encounter. Fifty-nine percent of the sexually experienced YPWD had multiple lifetime sexual partners; 19%, a casual sexual partner; and 21%, a commercial sexual partner. Only 48% consistently used condoms with their casual or commercial sexual partners. Twenty-four percent of the sexually experienced YPWD had a history of sexually transmitted infections. Our findings indicate that YPWD in Ethiopia are sexually active, but also highly involved in risky sexual practices. There is a need for in-depth research to better understand the determinants of risky sexual behavior and to propose preventive approaches.

Opportunity Costs in Paediatric Training: The Specialist Registrars Experience.

PubMed

O'Neill, M B; Nabialek, T; Kandamany, N

2017-08-08

In the training process, there is a tension between the work life and home life of trainees. This study explored both the personal impact and the opportunity costs of training from the Specialist Paediatric Registrar (SPR) perspective. The survey explored 1) career progression, 2) perceived functional effectiveness at work, 3) psychological impact of hospital based training, and 4) the personal and social cost of training. Fifty-three (71%) SPRs responded of whom 47 (89%)were married or in long term relationships. Seventy-five percent of trainees had a definite career plan with 86% intending to undertake fellowship training. Seventy percent believed they were efficient time managers but 53% had difficulty in making time for academic pursuits and fifty percent experienced negative feelings, which lingered after work and interfered with their relationships at home. Seventy-four percent stated training was undertaken at significant personal cost with only 21% achieving a very satisfactory work/life balance. To address these difficulties trainee wellbeing should be addressed at the Basic Specialist Training (BST) level and the career path clearly explained outlining the challenges that are likely to be encountered.

Evaluation of Experimental Four-Day Week Class Schedule, January Through April 1974 at Lake City Community College.

ERIC Educational Resources Information Center

Hardman, Clark

Due to the energy disturbance during the fall and winter of 1973-74, Lake City Community College experimented with a 4-days-per-week schedule of classes. a student evaluation of the 4-day week was completed by 58 percent of the full-time students. Fifty-one percent of the total student sample preferred the 4-day week, and 30 percent preferred the…

[A nationwide investigation needs for rehabilitation of schizophrenic outpatients--the patients' attribute and actual conditions of living].

PubMed

Yamashita, T; Kuroda, K; Hirano, W; Ueno, M; Yoshizumi, A; Inomata, Y; Komine, K

1996-01-01

In Japan we are very short of community resources for persons with mental disability. The authors, a board of resettlement, thought patients' actual conditions of living and needs for rehabilitation to let them live in the community had to be evaluated. Then in March 1993 the actual conditions of living and needs for rehabilitation of schizophrenic outpatients were investigated nationally. This article is the report on the patients' actual conditions of living. Investigation papers were sent to 358 institutions (286 hospitals and 72 clinics) which agreed to cooperate with the investigation. The 5186 investigation papers were received from 313 institutions. All of the papers except 18, which were lack of their ages, were analyzed. All of the schizophrenic outpatients, who consulted psychiatrists on one day during investigation, were considered objects of this research. Those who consented were included the research and psychiatrists filled in investigation papers. These institutions had a policy of intensive social resettlement activities and so on. Male patients were 55% and females were 45%. There were patients in the forties and females were older than males. Thirty-nine percent of them had been hospitalized once or twice. Thirty-four percent of them had been hospitalized for less than one year. Eighteen percent of them had not been hospitalized. Fifty percent of patients answered there was no friend and acquaintance, and had a tendency to stand alone. Fifty-three percent of patients lived with their parents, 21% with their spouses, and 17% alone. But 32% of females lived with their husbands. Sixteen percent worked for full-time jobs, 8% worked part-time jobs, 12% attended day care center 4% went to sheltered-workshops and only 1% went to rehabilitation-workshops for outpatients. While 13% didn't have a right to receive disability pension, the sources of income were job (30%), disability pension (30%), and welfare benefits (12%). Regarding the ability for living, both socially independent patients and daily independent were 36%. On the other hand, patients who needed support in daily life were 27%. This ability wasn't related to sex and age significantly (chi-square test). It is clear most of the patients were in isolation and depended on their families, so they needed support in income, accommodation and daily life.

New Hampshire's Forests 2007

Treesearch

Randall S. Morin; Chuck J. Barnett; Gary J. Brand; Brett J. Butler; Grant M. Domke; Susan Francher; Mark H. Hansen; Mark A. Hatfield; Cassandra M. Kurtz; W. Keith Moser; Charles H. Perry; Ron Piva; Rachel Riemann; Chris W. Woodall

2011-01-01

The first full annual inventory of New Hampshire's forests reports nearly 4.8 million acres of forest land with an average volume of nearly 2,200 cubic feet per acre. Forest land is dominated by the maple/beech/birch forest-type group, which occupies 53 percent of total forest land area. Fifty-seven percent of forest land consists of large-diameter trees, 32...

A clinical study on the feasibility of autologous cord blood transfusion for anemia of prematurity.

PubMed

Khodabux, Chantal M; von Lindern, Jeannette S; van Hilten, Joost A; Scherjon, Sicco; Walther, Frans J; Brand, Anneke

2008-08-01

The objective was to investigate the use of autologous red blood cells (RBCs) derived from umbilical cord blood (UCB), as an alternative for allogeneic transfusions in premature infants admitted to a tertiary neonatal center. UCB collection was performed at deliveries of less than 32 weeks of gestation and processed into autologous RBC products. Premature infants requiring a RBC transfusion were randomly assigned to an autologous or allogeneic product. The primary endpoint was an at least 50 percent reduction in allogeneic transfusion needs. Fifty-seven percent of the collections harvested enough volume (> or =15 mL) for processing. After being processed, autologous products (> or =10 mL/kg) were available for 36 percent of the total study population and for 27 percent of the transfused infants and could cover 58 percent (range, 25%-100%) of the transfusion needs within the 21-day product shelf life. Availability of autologous products depended most on the gestational age. Infants born between 24 and 28 weeks had the lowest availability (17%). All products, however, would be useful in view of their high (87%) transfusion needs. Availability was highest (48%) for the infants born between 28 and 30 weeks. For 42 percent of the infants with transfusion needs in this group, autologous products were available. For the infants born between 30 and 32 weeks, autologous products were available for 36 percent of the infants. Transfusion needs in this group were, however, much lower (19%) compared to the other gestational groups. Autologous RBCs derived from UCB could not replace 50 percent of allogeneic transfusions due to the low UCB volumes collected and subsequent low product availability.

Health benefits in 2014: stability in premiums and coverage for employer-sponsored plans.

PubMed

Claxton, Gary; Rae, Matthew; Panchal, Nirmita; Whitmore, Heidi; Damico, Anthony; Kenward, Kevin

2014-10-01

The annual Kaiser Family Foundation/Health Research and Educational Trust Employer Health Benefits Survey found that in 2014 the average annual premium (employer and worker contributions combined) for single coverage was $6,025, similar to 2013. The premium for family coverage was $16,834--3 percent higher than a year ago. Average deductibles and most other cost-sharing amounts were similar to those in 2013. On average, in 2014 covered workers paid nearly $5,000 per year for family health insurance premiums, and 18 percent of covered workers were in a plan with an annual single coverage deductible of $2,000 or more. Fifty-five percent of employers offered health benefits in 2014, similar to 2013. The Affordable Care Act has not yet led to substantial changes in the employer-based market. However, the next few years could present a different picture as delayed provisions and other changes take effect. This year's survey included new questions on firms' policies related to enrolling spouses and dependents, enrollment in private exchanges, and the use of narrow networks and financial incentives for wellness programs. Project HOPE—The People-to-People Health Foundation, Inc.

Oregon Women. A Report on Their Education, Employment and Economic Status.

ERIC Educational Resources Information Center

Oregon State Dept. of Education, Salem.

The greatest percentage of increase for women participating in the labor force in Oregon was among those between the ages of 25 and 44. The percentage of women with some postsecondary education has more than doubled in two generations. Women now represent 47 percent of full-time postsecondary students in Oregon. Fifty-seven percent of the state's…

A Preliminary Report on the Status of Women at Princeton University.

ERIC Educational Resources Information Center

National Organization for Women, Princeton, NJ. Central New Jersey Chapter.

Women are under-represented at all levels of the Princeton faculty (3.27%) and are most noticeably absent from the highest levels. Fifty-five percent of the men and 11.5% of the women are in the top two professorial ranks. Eighty percent of the men, in contrast to 40% of the women, hold regular faculty positions. The "visiting" faculty…

Comparison of lifestyle and practice patterns between male and female Canadian ophthalmologists.

PubMed

McAlister, Chryssa; Jin, Ya-Ping; Braga-Mele, Rosa; DesMarchais, Beatrice F; Buys, Yvonne M

2014-06-01

To identify sex differences in lifestyle and practice patterns of Canadian ophthalmologists. Web-based national survey. Members of the Canadian Ophthalmological Society. A 48-item questionnaire was sent electronically. Analysis of results was completed using χ(2) and Fisher's exact tests where appropriate. Of 385 respondents (30%), 102 were female and 283 male. Several statistically significant differences exist in lifestyle and practice patterns. Fifty-one percent of females operate less than 2 days per month as compared with 36% of males (p = 0.01) despite similar clinical hours. No statistically significant differences were found in other practice pattern parameters including laser refractive surgery, hospital affiliation, university appointment/rank, and number of peer-review publications. Ninety percent of males and 81% of females report having ≥1 children, but males report greater number of children (p < 0.001). Females are commonly the primary caregiver, whereas males report their partner as primary caregiver (p < 0.001). Fifty-two percent of females are unhappy with the amount of parental leave (p < 0.001). Fifty-one percent of females believe that childbearing slowed or markedly slowed career progress, as compared with 15% of males (p < 0.001). Both female (83%) and male (87%) ophthalmologists report high career satisfaction (p = 0.43). Differences in practice patterns between males and females in our analysis surround surgical time, with no difference seen in other practice patterns or academic achievements. Differences in family patterns surround household and childrearing duties. Despite differences, both males and females report high satisfaction across several professional and personal parameters. Compared with previous studies, this suggests a change in practice patterns over time. Copyright © 2014 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Incidence of tooth sensitivity after home whitening treatment.

PubMed

Jorgensen, Michael G; Carroll, William B

2002-08-01

A potential side effect of dentist-dispensed home tooth-whitening systems is tooth sensitivity. The authors conducted a randomized prospective double-blind study to determine the incidence of tooth sensitivity after home whitening treatment. Fifty adult subjects used a gel containing 15 percent carbamide peroxide and 0.11 percent fluoride ion; an additional 50 adult subjects used a placebo gel daily for four weeks. Each subject's plaque index score, gingival recession status, caries status, current dentifrice and smoking history were recorded at baseline. The researchers evaluated sensitivity weekly by interview for four weeks. Fifty-four percent of subjects in both test and control groups reported mild sensitivity; 10 percent of test subjects and 2 percent of control subjects reported moderate sensitivity; 4 percent of test subjects and no control subjects reported severe sensitivity. Sensitivity decreased with time; by the second week, no severe sensitivity was reported, and by the fourth week, no moderate sensitivity was reported. The authors found a statistically significant positive correlation between reported sensitivity and gingival recession. They found no statistically significant correlations between sensitivity and any of the other recorded parameters. Mild tooth sensitivity can be expected in approximately one-half of patients who undergo home whitening treatment using the gel studied. Approximately 10 percent of patients may experience moderate sensitivity, and 4 percent of patients may experience severe sensitivity for one to two weeks. Patients with gingival recession appear more likely to experience tooth sensitivity during home whitening treatment. Patients considering home whitening treatment should be advised that mild tooth sensitivity is a common side effect and that severe tooth sensitivity occasionally occurs. If gingival recession is present, the probability of tooth sensitivity increases, and tooth sensitivity tends to decrease as treatment progresses.

Human albumin solders for clinical application during laser tissue welding.

PubMed

Poppas, D P; Wright, E J; Guthrie, P D; Shlahet, L T; Retik, A B

1996-01-01

Fifty percent human albumin solder significantly improves weld strength when compared to lower concentrations [Wright et al., ASLMS meeting, April, 1995]. We developed a method for preparing 50% human albumin that may be considered compatible for clinical applications. Fifty percent human albumin solder was prepared from 25% commercially available human albumin using a lyophilization technique. Assessment of sterility, viscosity, pH, and peak absorption wavelength were performed. This report describes the methodology used to prepare a 50% human albumin solder that is compatible with clinical use. Maintenance of the structural integrity of the albumin was confirmed by polyacrylamide gel electrophoresis. This solder preparation can be used alone or with the addition of exogenous chromophores. The final product is sterile, incorporates viral free protocols, maintains high viscosity, and can be applied easily during open or laparoscopic procedures.

Properties of wood from ice-storm damaged loblolly pine trees

Treesearch

David W. Patterson; Jonathan Hartly

2007-01-01

Fifty-sex trees were harvested to determine the properties of the wood produced by ice-storm damaged trees. There were 12 trees each for three classes of bend: () to 15. 16 to 30. and more than 30 degrees from the vertical. Also. 10 trees were selected for each of two classes of crown loss: 20 percent or less and more than 20 percent loss. Samples were taken from three...

Religious Beliefs in Schizophrenia: Their Relevance for Adherence to Treatment

PubMed Central

Borras, L; Mohr, S; Brandt, P-Y; Gilliéron, C; Eytan, A; Huguelet, P

2007-01-01

The study examined how religious beliefs and practices impact upon medication and illness representations in chronic schizophrenia. One hundred three stabilized patients were included in Geneva's outpatient public psychiatric facility in Switzerland. Interviews were conducted to investigate spiritual and religious beliefs and religious practices and religious coping. Medication adherence was assessed through questions to patients and to their psychiatrists and by a systematic blood drug monitoring. Thirty-two percent of patients were partially or totally nonadherent to oral medication. Fifty-eight percent of patients were Christians, 2% Jewish, 3% Muslim, 4% Buddhist, 14% belonged to various minority or syncretic religious movements, and 19% had no religious affiliation. Two thirds of the total sample considered spirituality as very important or even essential in everyday life. Fifty-seven percent of patients had a representation of their illness directly influenced by their spiritual beliefs (positively in 31% and negatively in 26%). Religious representations of illness were prominent in nonadherent patients. Thirty-one percent of nonadherent patients and 27% of partially adherent patients underlined an incompatibility or contradiction between their religion and taking medication, versus 8% of adherent patients. Religion and spirituality contribute to shaping representations of disease and attitudes toward medical treatment in patients with schizophrenia. This dimension should be on the agenda of psychiatrists working with patients with schizophrenia. PMID:17213479

Fifty years of entomological publications in the Revista de Biología Tropical.

PubMed

Hanson, Paul

2002-01-01

Over its fifty year history nearly twenty percent of the papers published in the Revista de Biología Tropical have been about insects and arachnids. In the 1950's papers on arthropods of medical importance were dominant, in the 1960's there was a poliferation of papers on bees, and in more recent years the subjects have become increasingly diverse. In terms of nationality of contributing authors, the journal appears to have become increasingly international in later years.

Other Skin Conditions Often Present in Rosacea Patients

MedlinePlus

... or Rosacea? Accurate Diagnosis Is Key to Treatment Survey: Other Skin Conditions Often Present in Rosacea Patients ... reduce rosacea flare-ups, according to a new survey by the National Rosacea Society. Fifty-five percent ...

Motor carrier effectiveness : feedback report

DOT National Transportation Integrated Search

2005-01-01

Questionnaire data were obtained from 326 top managers of large trucking companies; : these data were supplemented with information from the TTS Blue Book of Trucking : Companies and the SAFER database. : Fifty-six percent of the companies in...

Adult consequences of spina bifida: a cohort study.

PubMed

Roach, James W; Short, Barbara F; Saltzman, Hanna M

2011-05-01

Patients with spina bifida potentially experience social isolation with limited employment opportunities and restriction of independent living, neurologic and intellectual impairment, and orthopaedic and urologic consequences of their condition. However, the degree of disability as these individuals age into adulthood has not been completely delineated. In adults with spina bifida we determined the cause of death for those who had died, IQ, level of education, work history, independent living status, physical disabilities, and urologic status; we then identified surgical procedures that led to better adult function. We retrospectively reviewed 84 individuals with myelomeningocele, examining social, cognitive, and physical disabilities. The minimum age at followup was 20 years (mean, 31 years; range, 20-64 years). Forty-two percent had normal IQs. Seventy percent never needed a neurosurgical shunt and those without shunts had higher IQs. Forty-four percent had regular education and 8% achieved college degrees. Fifty-six percent were unemployed. Thirty percent lived independently. Twenty-three percent were either married or divorced with nine normal offspring. Eighty-five percent dressed themselves, 65% shopped independently, 54% drove. Thirty-one percent were at the thoracic neurologic level (all used wheelchairs), 12% were at L1-L3 (all used a wheelchair except one), 33% were at L4-L5 (78% used a wheelchair at least part-time), and 24% were at S1 and below (all walked). Fifty-four percent experienced decubiti and as a consequence, four required major extremity amputations. Spinal fusions protected sitting balance, but hip surgery did not produce congruent hips and occasionally resulted in debilitating stiffness. Pressure sores resulted in partial foot amputations despite plantigrade feet. Our observations confirm the consequences associated with the physical and cognitive disabilities of patients with spina bifida. Many of these consequences can likely be mitigated by modern multidisciplinary care and special education to increase independence.

48 CFR 731.205-71 - Salary supplements for Host Government employees.

Code of Federal Regulations, 2013 CFR

2013-10-01

... fifty percent of its financial support from the government. (b) General. Salary supplement occurs when... accordance with USAID policy established in the cable State 119780 dated April 15, 1988 (on ADS-CD under...

48 CFR 731.205-71 - Salary supplements for Host Government employees.

Code of Federal Regulations, 2012 CFR

2012-10-01

... fifty percent of its financial support from the government. (b) General. Salary supplement occurs when... accordance with USAID policy established in the cable State 119780 dated April 15, 1988 (on ADS-CD under...

48 CFR 731.205-71 - Salary supplements for Host Government employees.

Code of Federal Regulations, 2014 CFR

2014-10-01

... fifty percent of its financial support from the government. (b) General. Salary supplement occurs when... accordance with USAID policy established in the cable State 119780 dated April 15, 1988 (on ADS-CD under...

US Army Evaluations: A Study of Inaccurate and Inflated Reporting

DTIC Science & Technology

2012-04-26

decisions such as promotions directly impacting the careers of tens of thousands of the Anny’s leaders, both officer and NCO, has few equals in the...accurate, and equitable perfonnance ratings throughout the Army.13 Many ofthe revisions were caused by the inability of selection boards to discern a...should be : assigned a numerical percentage; superior equals top ten percent, excellence equals top twenty- five percent, success equals top fifty

Substantial Churn In Health Insurance Offerings By Small Employers, 2014-15.

PubMed

Vistnes, Jessica P; Rohde, Frederick; Miller, G Edward; Cooper, Philip F

2017-09-01

New data for 2014-15 from the Medical Expenditure Panel Survey-Insurance Component longitudinal survey show substantial churn in insurance offers by small employers (those with fifty or fewer workers), with 14.6 percent of employers that offered insurance in 2014 having dropped it in 2015 and 5.5 percent of those that did not offer it adding coverage. Project HOPE—The People-to-People Health Foundation, Inc.

The National Survey of Stroke. Economic impact.

PubMed

Adelman, S M

1981-01-01

The estimated economic costs of stroke in 1976 amounted to $7,363,784,000 (based on a 6 percent gross, or 4 percent net, discount rate). Almost half were direct costs, the majority of these were related to inpatient hospital and nursing facility care. Only about six percent of the total were morbidity costs, and the remaining fifty percent consisted of mortality costs, stated in terms of the present value of future earnings. Direct costs include charges by short-term hospitals, extended care facilities, physicians and other medical and allied health personnel, and the costs of aids and appliances. Indirect costs include both morbidity and mortality costs. These costs are distributed as follows. [Formula: see text].

Levels of desertification risk in the Sicilian forests according to MEDALUS-ESPI protocol

NASA Astrophysics Data System (ADS)

Ragusa, M. A.; Rapicavoli, V.

2017-07-01

The authors estimated the desertification risk in a specific area of the Mediterranean, analyzing the main types of forests and reforestation. Through the Environmentally Sensitive Patch Index (ESPI), the authors have made an overall risk ranking in the woods, in the Sicily Region, simulated up to 2030. It is inferred that the risk of desertification in the forests of Sicily region is now reduced. In the last fifty years the forests were reduced by 17.4 percent, they remained unchanged for 21 percent, were up 61.6 percent at the end of the twentieth century.

Measuring Burnout Among Psychiatry Clerkship Directors.

PubMed

Rakofsky, Jeffrey J; Dallaghan, Gary Beck; Balon, Richard

2018-02-01

The primary purpose of this study was to determine the prevalence of burnout among Psychiatry clerkship directors. Psychiatry clerkship directors were solicited via email to complete an electronic version of the Maslach Burnout Inventory-General Survey and the Respondent Information Form. Fifty-four out of 110 surveys (49%) were completed. Fourteen percent of respondents scored in the "high exhaustion" category, 21.6% scored in the "low professional efficacy" category, 20.4% scored in the "high cynicism" category, and 15.1% of respondents met threshold for at least two of the three categories. Those who scored in the "low professional efficacy" category reported higher levels of salary support for research, while those who scored in the "high cynicism" category reported lower levels of salary support at a trend level. Those who scored in the "high cynicism" category were younger. Approximately 14-22 percent of psychiatry clerkship directors reported some level of burnout depending on the subscale used. Future studies should aim to better identify those clerkship directors who are at greatest risk for becoming burned out by their educational role and to clarify the link between salary support for research, age, and burnout.

A survey of tobacco dependence treatment guidelines in 121 countries

PubMed Central

Piné-Abata, Hembadoon; McNeill, Ann; Raw, Martin; Bitton, Asaf; Rigotti, Nancy; Murray, Rachael

2013-01-01

Aims To report progress among Parties to the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) in developing national tobacco treatment guidelines in accordance with FCTC Article 14 guideline recommendations. Design Cross-sectional study. Setting Electronic survey from December 2011 to August 2012; participants were asked to complete either an online or attached Microsoft Word questionnaire. Participants One hundred and sixty-three of the 173 Parties to the FCTC at the time of our survey. Measurements The 51-item questionnaire contained 30 items specifically on guidelines. Questions covered the areas of guidelines writing process, content, key recommendations and other characteristics. Findings One hundred and twenty-one countries (73%) responded. Fifty-three countries (44%) had guidelines, ranging from 75% among high-income countries to 11% among low-income countries. Nearly all guidelines recommended brief advice (93%), intensive specialist support (93%) and medications (96%), while 66% recommended quitlines. Fifty-seven percent had a dissemination strategy, 76% stated funding source and 68% had professional endorsement. Conclusion Fewer than half of the Parties to the WHO FCTC have developed national tobacco treatment guidelines, but, where guidelines exist, they broadly follow FCTC Article 14 guideline recommendations. PMID:23437892

7 CFR 929.22 - Nomination.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE CRANBERRIES GROWN IN STATES OF... than fifty percent of the total volume of cranberries produced during the fiscal period in which... growers who market their cranberries through entities other than the major cooperative marketing...

7 CFR 929.22 - Nomination.

Code of Federal Regulations, 2012 CFR

2012-01-01

... and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE CRANBERRIES GROWN IN STATES OF... than fifty percent of the total volume of cranberries produced during the fiscal period in which... growers who market their cranberries through entities other than the major cooperative marketing...

7 CFR 929.22 - Nomination.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE CRANBERRIES GROWN IN STATES OF... than fifty percent of the total volume of cranberries produced during the fiscal period in which... growers who market their cranberries through entities other than the major cooperative marketing...

7 CFR 929.22 - Nomination.

Code of Federal Regulations, 2011 CFR

2011-01-01

... and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE CRANBERRIES GROWN IN STATES OF... than fifty percent of the total volume of cranberries produced during the fiscal period in which... growers who market their cranberries through entities other than the major cooperative marketing...

Forest statistics for Arkansas

Treesearch

Philip r. Wheeler

1953-01-01

Arkansas has a land area of 33.7 million acres. Fifty-seven percent, or 19.4 million acres, is in forest. Virtually all the forest land is capable of producing commercial timber, and less than 20,000 acres is withdraw from this use.

Informed Consent for Interventional Radiology Procedures: A Survey Detailing Current European Practice

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

O'Dwyer, H.M.; Lyon, S.M.; Fotheringham, T.

Purpose: Official recommendations for obtaining informed consent for interventional radiology procedures are that the patient gives their consent to the operator more than 24 hr prior to the procedure. This has significant implications for interventional radiology practice. The purpose of this study was to identify the proportion of European interventional radiologists who conform to these guidelines. Methods: A questionnaire was designed consisting of 12 questions on current working practice and opinions regarding informed consent. These questions related to where, when and by whom consent was obtained from the patient. Questions also related to the use of formal consent forms andmore » written patient information leaflets. Respondents were asked whether they felt patients received adequate explanation regarding indications for intervention,the procedure, alternative treatment options and complications. The questionnaire was distributed to 786 European interventional radiologists who were members of interventional societies. The anonymous replies were then entered into a database and analyzed. Results: Two hundred and fifty-four (32.3%) questionnaires were returned. Institutions were classified as academic (56.7%),non-academic (40.5%) or private (2.8%). Depending on the procedure,in a significant proportion of patients consent was obtained in the outpatient department (22%), on the ward (65%) and in the radiology day case ward (25%), but in over half (56%) of patients consent or re-consent was obtained in the interventional suite. Fifty percent of respondents indicated that they obtain consent more than 24 hr before some procedures, in 42.9% consent is obtained on the morning of the procedure and 48.8% indicated that in some patients consent is obtained immediately before the procedure. We found that junior medical staff obtained consent in 58% of cases. Eighty-two percent of respondents do not use specific consent forms and 61% have patient information leaflets. The majority of respondents were satisfied with their level of explanation regarding indications for treatment (69.3%) and the procedure (78.7%). Fifty-nine percent felt patients understood alternative treatment options. Only 37.8% of radiologists document possible complications in the patient's chart. Comments from respondents indicated that there is insufficient time for radiologists to obtain consent in all patients. Suggestions to improve current local policies included developing the role of radiology nursing staff and the use of radiology outpatient clinics. Conclusions: More than 50% of respondents are unhappy with their policies for obtaining informed consent. Interventional societies have a role to play in advocating formal consent guidelines.« less

Assessment of fish assemblages and minimum sampling effort required to determine botic integrity of large rivers in southern Idaho, 2002

USGS Publications Warehouse

Maret, Terry R.; Ott, D.S.

2004-01-01

width was determined to be sufficient for collecting an adequate number of fish to estimate species richness and evaluate biotic integrity. At most sites, about 250 fish were needed to effectively represent 95 percent of the species present. Fifty-three percent of the sites assessed, using an IBI developed specifically for large Idaho rivers, received scores of less than 50, indicating poor biotic integrity.

Perception and personal protective measures toward mosquito bites by communities in Jaffna District, northern Sri Lanka.

PubMed

Surendran, S N; Kajatheepan, A

2007-06-01

Mosquito-borne diseases are of public health importance in war-torn northern Sri Lanka. The severity of mosquito bites and attitudes of the public toward mosquito problems were investigated using a structured questionnaire among communities in 3 administrative divisions in Jaffna District. One hundred fifty-four households were interviewed during this study. Sixty-four percent of the respondents reported that the mosquito problem was severe in their localities. Fifty-two percent stated that mosquito-biting activity was severe in the evening (1500 h-1900 h), 41% at night (after 1900 h), and 7% throughout the day. Severity of mosquito menace was found to have no association with type of house construction. Seventy-seven percent were able to name at least 1 disease transmitted by mosquitoes. Statistical analysis showed no association between education level and public awareness on mosquito-borne diseases. Nearly 88% were able to identify at least a breeding source of mosquitoes and most of them practice measures to eliminate suitable environments for mosquito breeding. Ninety-six percent used personal protective measures against mosquito bites during some seasons or throughout the year. Mosquito coils were the most commonly used personal protective method followed by bed nets. The monthly expenditure for personal protective measures varied from US$0.19 (LKR 20) to US$3.40 (LKR 350).

Characteristics of hepatocellular carcinoma in cirrhotic and non-cirrhotic non-alcoholic fatty liver disease

PubMed Central

Leung, Christopher; Yeoh, Sern Wei; Patrick, Desmond; Ket, Shara; Marion, Kaye; Gow, Paul; Angus, Peter W

2015-01-01

AIM: To determine characteristics and prognostic predictors of patients with hepatocellular carcinoma (HCC) in association with non-alcoholic fatty liver disease (NAFLD). METHODS: We reviewed the records of all patients with NAFLD associated HCC between 2000 and 2012. Data collected included demographics; histology; presence or absence of cirrhosis, size and number of HCC, alpha-fetoprotein, body mass index (BMI), and the presence of diabetes, hypertension, or dyslipidaemia. RESULTS: Fifty-four patients with NAFLD associated HCC were identified. Mean age was 64 years with 87% male. Fifteen percent (8/54) were not cirrhotic. 11%, 24% and 50% had a BMI of < 25 kg/m2, 25-29 kg/m2 and ≥ 30 kg/m2 respectively. Fifty-nine percent were diabetic, 44% hypertensive and 26% hyperlipidaemic. Thirty-four percent of the patients had ≤ 1 of these risk factors. Non-cirrhotics had a significantly larger mean tumour diameter at diagnosis than cirrhotics (P = 0.041). Multivariate analysis did not identify any other patient characteristics that predicted the size or number of HCC. CONCLUSION: HCC can develop in NAFLD without cirrhosis. At diagnosis such tumours are larger than those in cirrhotics, conferring a poorer prognosis. PMID:25632192

Heavy Testosterone Use Among Bodybuilders: An Uncommon Cohort of Illicit Substance Users.

PubMed

Westerman, Mary E; Charchenko, Cameron M; Ziegelmann, Matthew J; Bailey, George C; Nippoldt, Todd B; Trost, Landon

2016-02-01

To identify and characterize patterns of use among a contemporary cohort of current anabolic-androgenic steroid (AAS) users. An anonymous, self-administered, 49-item questionnaire was posted on message boards of Internet websites popular among AAS users and administered via SurveyMonkey from February 1, 2015, to June 1, 2015. Thirty-seven questions were analyzed for this study. A total of 231 male respondents met the inclusion criteria. Most were white, were older than 25 years, were employed with above average income, and had received a formal education beyond high school. Ninety-three percent began using AAS after the age of 18 years, and 81% reported using 400 mg or more of testosterone per week. Factors associated with longer duration of use (>5 years) included higher incomes (≥$75,000, P=.003), increased testosterone dosages (>600 mg per week, P=.007), older age (≥35 years, P<.001), being married (P<.001), and being self-employed (P<.001). The Internet was the most common source of testosterone (53%). Ninety-three percent used at least one additional performance-enhancing drug. Seventy-seven percent had routine laboratory tests performed, and 38% reported laboratory abnormalities at some point. Nearly all experienced subjective adverse effects while using and not using testosterone. Fifty-three percent reported use of other illegal substances, most commonly (90%) beginning before AAS initiation. Ten percent had a criminal conviction, 91% of which preceded AAS use. Fifty percent were felonies. The population of AAS users is disparate from that of other drugs of abuse. Laboratory test abnormalities and adverse effects are common and should be taken into account when counseling patients who may be using AASs. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Portal vein thrombosis in the district general hospital: management and clinical outcomes.

PubMed

Farmer, Adam D; Saadeddin, Abid; Holt, Caroline E M Bruckner; Bateman, Jeffrey M; Ahmed, Monz; Syn, Wyn King

2009-05-01

Portal vein thrombosis (PVT) refers to a thrombosis that occurs in the extrahepatic portal venous system in the presence or absence of underlying liver disease. The clinical presentation of PVT is extremely variable and there is no absolute consensus on its investigation and management. A paucity of literature examining this clinical entity in the district general hospital is observed. We reviewed the experience of two medium-sized district general hospitals in the UK. Twenty-five patients, who were diagnosed with PVT, were identified from the electronic databases of the two hospitals from 1994 to 2007. Fifty-six percent of patients were females with a median age of 59 years. Seventy-six percent of patients had an identifiable comorbidity at presentation, the most common being chronic liver disease. The most frequently presenting symptom was abdominal pain and distension (60%). Twenty-four percent of patients presented with upper gastrointestinal bleeding secondary to oesophageal and/or gastric varices. Abdominal ultrasound and computed tomographical imaging were the imaging modalities most commonly used to diagnose PVT, although abdominal ultrasound missed 12% of patients subsequently diagnosed by other methods. Fifty percent of patients, who had a thrombophilia screen, were found to have a coagulopathy. Twenty-eight percent of patients were anticoagulated with warfarin with no adverse bleeding events observed. Forty-four percent of patients were placed on an endoscopic variceal band ligation programme. Nine patients died over the study period from either upper gastrointestinal bleeding, end-stage liver failure or biliary sepsis. The acturial 5-year survival was 72%. The mortality from PVT is low and survival is related to the underlying cause. Although the diagnosis of PVT remains uncommon outside the specialist centre, both specialist and nonspecialist physicians must remain mindful of this important condition.

Mineral composition of Atriplex hymenelytra growing in the northern Mojave Desert

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

Wallace, A.; Romney, E.M.; Hunter, R.B.

1980-01-01

Fifty samples of Atriplex hymenelytra (Torr.) S. Wats. were collected from several different locations in southern Nevada and California to test variability in mineral composition. Only Na, V, P, Ca, Mg, Mn, and Sr in the samples appeared to represent a uniform population resulting in normal curves for frequency distribution. Even so, about 40 percent of the variance for these elements was due to location. All elements differed enough with location so that no element really represented a uniform population. The coefficient of variation for most elements was over 40 percent and one was over 100 percent. The proportion ofmore » variance due to analytical variation averaged 16.2 +- 13.1 percent (standard deviation), that due to location was 43.0 +- 13.4 percent, and that due to variation of plants within location was 40.7 +- 13.0 percent.« less

The health of U.S. agricultural worker families: A descriptive study of over 790,000 migratory and seasonal agricultural workers and dependents.

PubMed

Boggess, Bethany; Bogue, Hilda Ochoa

2016-01-01

Migratory and seasonal agricultural workers (MSAWs) are a historically under-served population that experience poor access to health care. The aim of this study was to describe the demographic, socioeconomic, and health status of U.S. agricultural workers and their dependents who were patients of a Migrant Health Center in 2012. The authors used the Uniform Data System to examine demographic, socioeconomic, and health variables for 793,188 patients of 164 Migrant Health Centers during 2012. Means, proportions, and period prevalence was calculated for all variables. Results showed that 80% of MSAWs earned family incomes below 100% of federal poverty level. Among the reported diagnoses, the most common were hypertension, diabetes mellitus, and mental health conditions. Fifty-three percent of all MSAWs and 71% of adult MSAWs were uninsured, indicating that Migrants Health Centers continue to play a vital role in providing access to primary health care for MSAWs and their families.

Colonoscopy capacity in Tennessee: potential response to an increased demand for colorectal cancer screening.

PubMed

Cattau, Edward L

2010-03-01

To determine the potential colonoscopy capacity in Tennessee, a questionnaire was sent to the 162 members of the American College of Gastroenterology in Tennessee. Fifty-three (32.7 percent) were returned. Respondents had performed 49,680 colonoscopies in 2006. They indicated how they could and would increase capacity to 70,060 (39.5 percent increase) if demand increased. Nearly 76 percent of this increase would be committed to non-Medicare insured patients. Extrapolating these results to the number of known gastroenterologists in Tennessee reveals the ability of the healthcare system to meet the anticipated increased demand that would result from universal coverage.

The Safety of Cardiac and Thoracic Magnetic Resonance Imaging in Patients with Cardiac Implantable Electronic Devices.

PubMed

Dandamudi, Sanjay; Collins, Jeremy D; Carr, James C; Mongkolwat, Pat; Rahsepar, Amir A; Tomson, Todd T; Verma, Nishant; Arora, Rishi; Chicos, Alex B; Kim, Susan S; Lin, Albert C; Passman, Rod S; Knight, Bradley P

2016-12-01

Studies reporting the safety of magnetic resonance imaging (MRI) in patients with a cardiac implantable electronic device (CIED) have mostly excluded examinations with the device in the magnet isocenter. The purpose of this study was to describe the safety of cardiac and thoracic spine MRI in patients with a CIED. The medical records of patients with a CIED who underwent a cardiac or thoracic spine MRI between January 2011 and December 2014 were reviewed. Devices were interrogated before and after imaging with reprogramming to asynchronous pacing in pacemaker-dependent patients. The clinical interpretability of the MRI and peak and average specific absorption rates (SARs, W/kg) achieved were determined. Fifty-eight patients underwent 51 cardiac and 11 thoracic spine MRI exams. Twenty-nine patients had a pacemaker and 29 had an implantable cardioverter defibrillator. Seventeen percent (n = 10) were pacemaker dependent. Fifty-one patients (89%) had non-MRI-conditional devices. There were no clinically significant changes in atrial and ventricular sensing, impedance, and threshold measurements. There were no episodes of device mode changes, arrhythmias, therapies delivered, electrical reset, or battery depletion. One study was prematurely discontinued due to a patient complaint of chest pain of which the etiology was not determined. Across all examinations, the average peak SAR was 2.0 ± 0.85 W/kg with an average SAR of 0.35 ± 0.37 W/kg. Artifact significantly limiting the clinical interpretation of the study was present in 33% of cardiac MRI studies. When a comprehensive CIED magnetic resonance safety protocol is followed, the risk of performing 1.5-T magnetic resonance studies with the device in the magnet isocenter, including in patients who are pacemaker dependent, is low. Copyright © 2016. Published by Elsevier Inc.

Military engine computational structures technology

NASA Technical Reports Server (NTRS)

Thomson, Daniel E.

1992-01-01

Integrated High Performance Turbine Engine Technology Initiative (IHPTET) goals require a strong analytical base. Effective analysis of composite materials is critical to life analysis and structural optimization. Accurate life prediction for all material systems is critical. User friendly systems are also desirable. Post processing of results is very important. The IHPTET goal is to double turbine engine propulsion capability by the year 2003. Fifty percent of the goal will come from advanced materials and structures, the other 50 percent will come from increasing performance. Computer programs are listed.

Prostitution in Vancouver: violence and the colonization of First Nations women.

PubMed

Farley, Melissa; Lynne, Jacqueline; Cotton, Ann J

2005-06-01

We interviewed 100 women prostituting in Vancouver, Canada. We found an extremely high prevalence of lifetime violence and post-traumatic stress disorder (PTSD). Fifty-two percent of our interviewees were women from Canada's First Nations, a significant overrepresentation in prostitution compared with their representation in Vancouver generally (1.7-7%). Eighty-two percent reported a history of childhood sexual abuse, by an average of four perpetrators. Seventy-two percent reported childhood physical abuse, 90% had been physically assaulted in prostitution, 78% had been raped in prostitution. Seventy-two percent met DSM-IV criteria for PTSD. Ninety-five percent said that they wanted to leave prostitution. Eighty-six percent reported current or past homelessness with housing as one of their most urgent needs. Eighty-two percent expressed a need for treatment for drug or alcohol addictions. Findings are discussed in terms of the legacy of colonialism, the intrinsically traumatizing nature of prostitution and prostitution's violations of basic human rights.

Efficacy of a ketogenic diet in resistant myoclono-astatic epilepsy: A French multicenter retrospective study.

PubMed

Stenger, Elodie; Schaeffer, Mickael; Cances, Claude; Motte, Jacques; Auvin, Stéphane; Ville, Dorothée; Maurey, Hélène; Nabbout, Rima; de Saint-Martin, Anne

2017-03-01

Recent studies have suggested that the early introduction of a ketogenic diet (KD) could improve seizure control in myoclono-astatic epilepsy (MAE). This multicenter study sought to identify the benefits of KD use on seizure control and epilepsy and on developmental outcomes in children with resistant MAE. Fifty children who were diagnosed with severe MAE in the French network of Reference Centers for Rare Epilepsies and who were treated with KD between 2000 and 2013 were included in this study. The seizure frequency and EEG recordings were assessed two weeks before KD introduction, 2 and 6 months after, and during the last follow-up, which also included an assessment of developmental outcome. Patients had a median follow up of 52 months (range 13-136) and received 4.3 antiepileptic drugs [2-9] before KD introduction. Fifty-four percent (54%) of our patients were seizure-free after 6 months of KD or more, and 86% experienced more than a 70% seizure reduction after 2 months of KD. Forty-four percent (44%) of them had a clear benefit of early KD treatment (after four AEDs failed). Early KD treatment did not result in a greater seizure reduction (p=0.055), but significantly resulted in remission (p<0.028). Fifty percent of patients with resistant MAE had normal development outcomes. Earlier KD treatment, after three AEDs failed, was correlated with a better cognitive outcome (p<0.01). Early introduction of KD treatment in resistant MAE has a strong, persistent anticonvulsant effect with long-term remission and better cognitive outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

Rates of Ethanol Metabolism Decrease in Sons of Alcoholics Following a Priming Dose of Ethanol

PubMed Central

Bradford, Blair U.; Jackson, Jennifer K.; Powell, Linda L.; Garbutt, James C.

2007-01-01

Rapid changes in rates of ethanol metabolism in response to acute ethanol administration have been observed in animals and humans. To examine whether this phenomenon might vary by risk for alcoholism, 23 young men with a positive family history of alcoholism (FHP) were compared to 15 young men without a family history of alcoholism (FHN). Rates of ethanol metabolism were measured in all subjects first after an initial ethanol dose (0.85 g/kg) and then, several hours later, a second dose (0.3 g/kg), and the two rates were compared. The two groups of subjects were similar in their histories of ethanol consumption. FHP subjects demonstrated faster initial rates of ethanol metabolism, 148 ± 36 mg/kg/hr, compared to FHN subjects, 124 ± 18 mg/kg/hr, p=.01. However, FHN subjects increased their rate of metabolism by 10 ± 27 percent compared to a decrease of -15 ± 24 percent in FHP subjects, p =.007. Fifty-two percent of the FHP and none of the FHN subjects exhibited a decline in metabolic rate of 20% or more, p=.0008. Since a significant proportion of FHP subjects exhibited a decrease in the second rate of ethanol metabolism, these preliminary data might help to partly explain why FHP individuals differ in their sensitivity to ethanol and are more likely to develop alcohol dependence. PMID:17521843

Nitrogen

USGS Publications Warehouse

Kramer, D.A.

2004-01-01

Ammonia is the principal source of fixed nitrogen. It was produced by 17 companies at 34 plants in the United States during 2003. Fifty-three percent of U.S. ammonia production capacity was centered in Louisiana, Oklahoma and Texas because of their large reserves of natural gas, the dominant domestic feedstock.

28 CFR 70.22 - Payment.

Code of Federal Regulations, 2013 CFR

2013-07-01

... the national goal of expanding the opportunities for women-owned and minority-owned business enterprises, recipients are encouraged to use women-owned and minority-owned banks (a bank which is owned at least fifty percent by women or minority group members). (k) Recipients must maintain advances of the...

NRCS-EQIP Tree Fruit IPM Program

USDA-ARS?s Scientific Manuscript database

In 2008, the WVU Extension Service partnered with the Natural Resources Conservation Service (NRCS) to develop and implement a cost-share IPM program for the commercial tree fruit growers in West Virginia. Fifty percent of implementation costs were paid by NRCS through the Environmental Quality Ince...

7 CFR 959.84 - Termination.

Code of Federal Regulations, 2010 CFR

2010-01-01

... majority of producers who, during a representative period, have been engaged in the production of onions... and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE ONIONS GROWN IN SOUTH TEXAS Order... more than fifty percent of the volume of such onions produced for market. (d) The Secretary shall...

Using a Drug Interaction Program (Drug Interactions Advisor™) in a Community Hospital

PubMed Central

Harvey, A. C.; Diehl, G. R.; Finlayson, W. B.

1987-01-01

To test the usefulness of a drugs-interaction program in a community hospital one hundred patients in three medical wards were surveyed with respect to their drug regime. The drugs listed for each patient were entered into Drug Interactions Advisor™ a commercial interactions program running on an Apple IIE. Interacting drugs were listed with the severity of the interaction in each case. Of one hundred patients fifty-one had drugs which could potentially interact and in fifty-one percent of cases a change in therapy would have been advised by Drug Interactions Advisor™. The completeness of the data base was assessed as to its inclusion of drugs actually given and it dealt with eighty-nine percent. The program was tested against ten known interactions and it identified six. Multiple drug therapy is a major problem nowadays and will increase with the aging of the population. Drug interactions programs exploit computer technology to make drug surveillance easier. Without computers such surveillance is difficult if not impossible.

Multidrug-resistant Strains of Salmonella enterica Typhimurium, United States, 1997–19981

PubMed Central

Whichard, Jean; Rossiter, Shannon; Holland, Ben; Stamey, Karen; Headrick, Marcia L.; Barrett, Timothy J.; Angulo, Frederick J.

2004-01-01

To evaluate multidrug-resistant strains of Salmonella enterica Typhimurium, including definitive type 104 (DT104) in the United States, we reviewed data from the National Antimicrobial Resistance Monitoring System (NARMS). In 1997–1998, 25% (703) of 2,767 serotyped Salmonella isolates received at NARMS were S. Typhimurium; antimicrobial susceptibility testing and phage typing were completed for 697. Fifty-eight percent (402) were resistant to >1 antimicrobial agent. Three multidrug-resistant (>5 drugs) strains accounted for 74% (296) of all resistant isolates. Ceftriaxone resistance was present in 3% (8), and nalidixic acid resistance in 1% (4), of these multidrug-resistant strains. By phage typing, 37% (259) of S. Typhimurium isolates were DT104, 30% (209) were of undefined type and 15% (103) were untypable. Fifty percent (202) of resistant (>1 drug) isolates were DT104. Multidrug-resistant S. Typhimurium isolates, particularly DT104, account for a substantial proportion of S. Typhimurium isolates; ceftriaxone resistance is exhibited by some of these strains. PMID:15200811

Multidrug-resistant strains of Salmonella enterica Typhimurium, United States, 1997-1998.

PubMed

Rabatsky-Ehr, Therese; Whichard, Jean; Rossiter, Shannon; Holland, Ben; Stamey, Karen; Headrick, Marcia L; Barrett, Timothy J; Angulo, Frederick J

2004-05-01

To evaluate multidrug-resistant strains of Salmonella enterica serotype Typhimurium, including definitive type 104 (DT104) in the United States, we reviewed data from the National Antimicrobial Resistance Monitoring System (NARMS). In 1997 to 1998, 703 (25%) of 2,767 serotyped Salmonella isolates received at NARMS were S. Typhimurium; antimicrobial susceptibility testing and phage typing were completed for 697. Fifty-eight percent (402) were resistant to > or = 1 antimicrobial agent. Three multidrug-resistant (> or = 5 drugs) strains accounted for (74%) 296 of all resistant isolates. Ceftriaxone resistance was present in 8 (3%), and nalidixic acid resistance in 4 (1%), of these multidrug-resistant strains. By phage typing, 259 (37%) of S. Typhimurium isolates were DT104, 209 (30%) were of undefined type and 103 (15%) were untypable. Fifty percent (202) of resistant (> or = 1 drug) isolates were DT104. Multidrug-resistant S. Typhimurium isolates, particularly DT104, account for a substantial proportion of S. Typhimurium isolates; ceftriaxone resistance is exhibited by some of these strains.

[Evaluation of mental and communication functions in mapuche and non mapuche elderly subjects in rural communities in Southern Chile].

PubMed

Mella, Rebeca; Alvear, María; Carrillo, Berta; Caire, Victor

2003-11-01

The main predictors of functional impairment in the elderly are alterations in mental or communication functions. To study mental and communication functions in rural elderly subjects of Mapuche and non Mapuche origin. Elderly subjects coming from a rural Mapuche community and a non Mapuche community were studied. Subjects were interviewed at their homes. The communication and mental function assessments of the Functional Autonomy Measurement System were applied. Fifty one Mapuche and 49 non Mapuche subjects with a mean age of 71 +/- 7 and 74 +/- 8 years respectively, were studied. Fifty four percent were female and 31% were illiterate. Twenty six percent had impairment in mental functions. The item with the highest difficulty was memory. The visual function was the most severely impaired among communication items. Mapuche elderly subjects had significantly higher degrees of impairment in mental and communication functions. There is a higher degree of mental and communication impairment among rural Mapuche elderly subjects than in their non Mapuche counterparts.

Examining the Environmental Effects of Athletic Training: Perceptions of Waste and the Use of Green Techniques.

PubMed

Potteiger, Kelly; Pitney, William A; Cappaert, Thomas A; Wolfe, Angela

2017-12-01

  Environmental sustainability is a critical concern in health care. Similar to other professions, the practice of athletic training necessitates the use of a large quantity of natural and manufactured resources.   To examine the perceptions of the waste produced by the practice of athletic training and the green practices currently used by athletic trainers (ATs) to combat this waste.   Mixed-methods study.   Field setting.   A total of 442 ATs completed the study. Sixteen individuals participated in the qualitative portion.   Data from sections 2 and 3 of the Athletic Training Environmental Impact Survey were analyzed. Focus groups and individual interviews were used to determine participants' views of waste and the efforts used to combat waste. Descriptive statistics were used to examine types of waste. Independent t tests, χ 2 tests, and 1-way analyses of variance were calculated to identify any differences between the knowledge and use of green techniques. Interviews and focus groups were transcribed verbatim and analyzed inductively.   Participants reported moderate knowledge of green techniques (3.18 ± 0.53 on a 5-point Likert scale). Fifty-eight percent (n = 260) of survey participants perceived that a substantial amount of waste was produced by the practice of athletic training. Ninety-two percent (n = 408) admitted they thought about the waste produced in their daily practice. The types of waste reported most frequently were plastics (n = 111, 29%), water (n = 88, 23%), and paper for administrative use (n = 81, 21%). Fifty-two percent (n = 234) agreed this waste directly affected the environment. The qualitative aspect of the study reinforced recognition of the large amount of waste produced by the practice of athletic training. Types of conservation practices used by ATs were also explored.   Participants reported concern regarding the waste produced by athletic training. The amount of waste varies depending on practice size and setting. Future researchers should use direct measures to determine the amount of waste created by the practice of athletic training.

The natural course of anxiety symptoms in early adolescence: factors related to persistence.

PubMed

Voltas, Núria; Hernández-Martínez, Carmen; Arija, Victoria; Canals, Josefa

2017-11-01

Anxiety disorders are the most common mental health problems during childhood and adolescence. This study examined the course of anxiety symptoms in early adolescents from the general population over three phases. Prospective cohort study. Two hundred and forty-two participants (mean-age of 13.52) from a baseline sample of 1514 (mean-age of 10.23) were followed up three times. Of the 1514 children, those with emotional risk and controls without risk constituted the second-phase sample (n = 562; mean-age of 11.25). The Screen for Child Anxiety Related Emotional Disorders-SCARED was administered in all three phases. Fifty-six percent and 32% of respondents showed total scores above the SCARED cutoff point at one and three years follow-up, respectively. Eight percent showed fluctuating symptoms. Fifty-five percent of respondents showed high scores for any subtype of anxiety over three years. Social phobia and generalized anxiety symptoms were the most prevalent and persistent. Participants with persistent separation anxiety showed the highest co-occurrence with symptoms of other psychopathological disorders. Participants with persistent anxiety showed lower academic performance. Being male was a protective factor against persistence. The data support anxiety maintenance during early adolescence. Early adolescence is a critical period which may involve other serious academic, social, and family problems.

7 CFR 634.5 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... portion of the 208 water-quality management plan. (s) OMB Circular A-34. “Instructions on Budget Execution... needed to attain water quality standards or water quality goals. Fifty (50) percent of the adequate level... agency. A soil conservation district, State soil and water conservation agency, or State water quality...

7 CFR 634.5 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... portion of the 208 water-quality management plan. (s) OMB Circular A-34. “Instructions on Budget Execution... needed to attain water quality standards or water quality goals. Fifty (50) percent of the adequate level... agency. A soil conservation district, State soil and water conservation agency, or State water quality...

Survey of aviation medical examiners : information and attitudes about the pre-employment and pre-appointment drug testing program.

DOT National Transportation Integrated Search

1992-03-01

Aviation medical examiners who are designated to collect urine specimens were surveyed to collect information and assess attitudes about different aspects of the pre-employment and pre-appointment drug testing program. Fifty-seven percent of the samp...

Assessment of evidence-based dental prophylaxis education in postdoctoral pediatric dentistry programs.

PubMed

Redford-Badwal, Deborah A; Nainar, S M Hashim

2002-09-01

The objective of the study was to investigate various aspects of evidence-based dental prophylaxis education in postdoctoral pediatric dentistry training programs in the United States. An anonymous nationwide postal survey of fifty-two postdoctoral pediatric dentistry program directors was conducted in September 2001. The survey had a response rate of 75 percent with all geographic regions of the nation represented and with a preponderance of university-based programs (62 percent). Most of the training programs (74 percent) routinely recommended dental prophylaxis for all recall patients. The proportion of programs that recommended dental prophylaxis for the following indications were: plaque, stain and/or calculus removal--97 percent; caries prevention--59 percent; prior to topical fluoride application--67 percent; prior to sealant application--62 percent; and for behavioral modification--77 percent. Most training programs (77 percent) defined dental prophylaxis as both rubber cup pumice prophylaxis and toothbrush prophylaxis. However, only one-half of the training programs (51 percent) had modified their teaching to substitute toothbrush prophylaxis in lieu of rubber cup pumice prophylaxis. In conclusion, only one half of postdoctoral pediatric dentistry training programs in the United States teach evidence-based practice of dental prophylaxis for recall patients.

Web-based survey of fertility issues in young women with breast cancer.

PubMed

Partridge, Ann H; Gelber, Shari; Peppercorn, Jeffrey; Sampson, Ebonie; Knudsen, Katherine; Laufer, Marc; Rosenberg, Randi; Przypyszny, Michele; Rein, Alison; Winer, Eric P

2004-10-15

Young women with breast cancer often seek advice about whether treatment will affect their fertility. We sought to gain a better understanding of women's attitudes about fertility and how these concerns affect decision making. We developed a survey about fertility issues for young women with a history of early-stage breast cancer. The survey was e-mailed to all registered Young Survival Coalition survivor members (N = 1,702). E-mail reminders were used. Six hundred fifty-seven eligible respondents completed the survey. Mean age at breast cancer diagnosis was 32.9 years; mean current age was 35.8 years. Ninety percent of women were white; 62% were married; 76% were college graduates. Stages at diagnosis were as follows: 0, 10%; I, 27%; II, 47%; III, 13%. Sixty-two percent of women were within 2 years of diagnosis. Fifty-seven percent recalled substantial concern at diagnosis about becoming infertile with treatment. In multivariate logistic regression, greater concern about infertility was associated with wish for children/more children (odds ratio [OR], 120; P < .0001), number of prior pregnancies (OR, 0.78; P = .01), and prior difficulty conceiving (OR, 1.86; P = .08). Twenty-nine percent of women reported that infertility concerns influenced treatment decisions. Seventy-two percent of women reported discussing fertility concerns with their doctors; 51% felt their concerns were addressed adequately. Women seemed to overestimate their risk of becoming postmenopausal with treatment. Fertility after treatment is a major concern for young women with breast cancer. There is a need to communicate with and educate young patients regarding fertility issues at diagnosis and a need for future research directed at preserving fertility for young breast cancer survivors.

Carcinoma of the middle ear and external auditory canal

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

Hahn, S.S.; Kim, J.A.; Goodchild, N.

1983-07-01

Thirty-one patients with malignant tumors of the middle ear and external auditory canal (EAC) were observed at the University of Virginia Hospital from 1956 through 1980. Of 27 patients with carcinoma, 21 had squamous cell carcinoma, 4 had basal cell carcinoma and 2 had adenoid cystic carcinoma. The 27 patients with carcinoma are reviewed with regard to clinical presentation, treatment modality, results and complications. The majority (67%) of patients had a history of chronic ear drainage, 22% had a previous mastoidectomy or polypectomy and 7% had an associated cholesteatoma. Eighty percent of patients with carcinoma limited to EAC were alivemore » and well at 5 years, compared to 43% of patients with involvement of the middle ear. Fifty-six percent of patients without invasion of the petrous bone were alive at 5 years compared to only 20% of patients with petrous bone involvement. The data strongly suggest that survival depends on the extent of disease. The corrected disease free 5 year survival rates were 14% for patients who had surgery alone and 50% for those who had surgery and radiotherapy. Of the three patients with advanced disease who received radiotherapy alone, none survived five years.« less

Force degradation of orthodontic latex elastics: An in-vivo study.

PubMed

Qodcieh, Sadeq M Adel; Al-Khateeb, Susan N; Jaradat, Ziad W; Abu Alhaija, Elham S J

2017-03-01

Our objectives were to assess the force degradation of orthodontic latex elastics over 48 hours in vivo and to study the relationship between the amount of mouth opening and the degree of force decay. Fifty-two orthodontic patients wearing fixed appliances using Class II elastics were asked to wear premeasured-force 3/16-in heavy and medium intermaxillary elastics. The force amounts were measured and compared at different time intervals. Fifty percent of the force was lost after 3.9 hours for the medium elastics and after 4.9 hours for the heavy elastics. A continuous significant force drop in all elastics was seen at all time intervals (P <0.05, P <0.001). There was greater force loss in the heavy elastics compared with the medium elastics in vivo at all time intervals (P <0.001); the rates of force loss, however, were similar. Fifty percent of force degradation occurred in the first 4 to 5 hours. Because of breakage and for oral hygiene purposes, orthodontic elastics should be changed daily; otherwise, elastics can be used for 48 hours. Force decay of the elastics was correlated to the lateral distance between the maxillary canine and the mandibular first molar in occlusion. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

National Program for Inspection of Non-Federal Dams. Bird Pond Dam (MA 00804), Neponset River Basin, Walpole, Massachusetts. Phase I Inspection Report.

DTIC Science & Technology

1980-04-01

generally fair condition because of the seepage through the left spillway training wall and because the low level outlet has not been operated in many...that a dam of this class which does not have sufficient spillway capacity to discharge fifty percent of the PKF , should be adjudged as having a...2,070 cfs or about 14 percent of the test flood outflow without overtopping the dam. The dam is judged to be in generally fair condition because of the

Free-space microwave-power transmission

NASA Technical Reports Server (NTRS)

Brown, W. C.

1976-01-01

Laboratory-scale wireless transmission of microwave power approaches fifty-four percent efficiency. DC is converted to a 2.45-GHz signal and is transmitted through horn antenna array; microwave signal is received at rectenna and is simultaneously collected and rectified back to dc at receiving sites; dc is then processed for wired distribution.

Drinking Attitudes and Behavior of Incoming Freshmen.

ERIC Educational Resources Information Center

Johnson, Deborah H.; Sedlacek, William E.

An anonymous questionnaire on demographic characteristics, alcohol usage and drinking attitudes, and college-related attitudes was administered to 466 incoming freshmen (236 males, 230 females) at the University of Maryland, College Park. Fifty-five percent of all freshmen reported having taken their first drink with friends by age 15; 10 percent…

Sexual Harassment among Students with Educational Disabilities: Perspectives of Special Educators

ERIC Educational Resources Information Center

Young, Ellie L.; Heath, Melissa Allen; Ashbaker, Betty Y.; Smith, Barbara

2008-01-01

This study investigated the perceptions of special education teachers about the prevalence and characteristics of sexual harassment among students identified with educational disabilities. Utah special education teachers (250) were randomly selected from the state's database. Fifty-two percent (n = 129) of the surveys were returned. Approximately…

Children with Epilepsy in School: Special Service Usage and Assessment Practices

ERIC Educational Resources Information Center

Wodrich, David L.; Kaplan, Allen M.; Deering, William M.

2006-01-01

Special services usage and related assessment procedures were investigated for 50 students with epilepsy. Fifty-six percent of students with epilepsy received special education services, with mental retardation designation and self-contained placement common, especially among individuals with epilepsy plus a coexisting neurological diagnosis.…

Promoting Positive Parenting Practices through Parenting Education

ERIC Educational Resources Information Center

Zepeda, Marlene; Varela, Frances; Morales, Alex

2004-01-01

The family is the crucible of a young child's development. The 2000 Institute of Medicine report From Neurons to Neighborhoods shows that positive developmental interactions with parents improve young children's social competence and their overall capacity to learn. Fifty-four percent of parents want more information on how they can help their…

Blood feeding of Ornithodoros turicata larvae using an artificial membrane system

USDA-ARS?s Scientific Manuscript database

An artificial membrane system was adapted to feed Ornithodoros turicata larvae from a laboratory colony using defibrinated swine blood. Aspects related to larval feeding and molting to the 1st nymphal instar were evaluated. Fifty-five percent of all larvae exposed to the artificial membrane in two e...

Internet Use for Health Information among College Students.

ERIC Educational Resources Information Center

Escoffery, Cam; Miner, Kathleen R.; Adame, Daniel D.; Butler, Susan; McCormick, Laura; Mendell, Elizabeth

2005-01-01

Use of the Internet to retrieve health information is increasingly common. The authors surveyed 743 undergraduate students at 2 academic institutions to examine their Internet use, health-seeking behaviors, and attitudes related to the use of the Internet to obtain health information. Fifty-three percent of the respondents indicated that they…

48 CFR 731.205-71 - Salary supplements for Host Government employees.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Salary supplements for... Contracts With Commercial Organizations 731.205-71 Salary supplements for Host Government employees. (a... fifty percent of its financial support from the government. (b) General. Salary supplement occurs when...

50 CFR 253.16 - Fees.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Fees. 253.16 Section 253.16 Wildlife and... Fees. (a) Application fee. The Division will not accept an application without the application fee. Fifty percent of the application fee is fully earned at application acceptance, and is not refundable...

Thyrotoxicosis in the Elderly

PubMed Central

Finch, Mark J.; Woodbury, David

1983-01-01

Charts of 28 hyperthyroid patients over 60 years old were retrospectively analyzed and compared with charts of 14 patients under 30 years old. The mean duration of symptoms prior to diagnosis was 16 months in the elderly and five months in the younger group. Heart rate was substantially lower in the older (107 beats/min) vs younger (117 beats/min) study group. The symptom of weakness or fatigue was more prevalent in the elderly group (94 percent) than in the younger group (57 percent). Cardiac palpitation was more prevalent in the elderly patients whereas insomnia, irritability, dysphagia, hyperphagia, and heat intolerance were more prevalent in the younger patients. Fifty percent of the elderly patients complained of chest pain. Cachexia (62 percent), thin, fine hair (50 percent), and weakness (58 percent) were prominent physical findings in the elderly group. Twenty-six percent of the elderly patients had atrial fibrillation. These findings confirm previous studies that show some differences in presentation of hyperthyroidism in elderly patients when compared with younger patients. The authors recommend that thyroid function tests be obtained for broad indications in the elderly. PMID:6644837

Survey of American Academy of Pediatric Dentistry on Nitrous Oxide and Sedation: 20 Years Later.

PubMed

Wilson, Stephen; Gosnell, Elizabeth S

2016-10-15

The purpose of this study was to survey the membership of the American Academy of Pediatric Dentistry (AAPD) and determine the current status of nitrous oxide (N2O) utilization in their dental practices while also comparing the findings to a similar survey completed 20 years ago. A 55-item questionnaire on the use of N2O was sent to the AAPD membership. The total number of respondents was 1,632 (26 percent). Sixty-two percent are board-certified, 97 percent use N2O in their office, 18 percent indicated greater than 80 percent of their patient pool required N2O versus six percent in 1996. Fifty percent of parents expressed concerns about N2O use. Changes have occurred in the use of nitrous oxide since 1996, including: (1) a greater percentage of practitioners using N2O; (2) perceptions that more pediatric patients need N2O; (3) a shift in use of N2O by duration of practitioner experience; (4) an increased percentage of board-certified respondents; and (5) possible increasing parental concerns about N2O.

Practices and Attitudes Regarding Women Undergoing Fertility Preservation: A Survey of the National Physicians Cooperative.

PubMed

Bortoletto, Pietro; Confino, Rafael; Smith, Brigid M; Woodruff, Teresa K; Pavone, Mary Ellen

2017-09-01

To describe physician attitudes and variations in oncofertility treatment strategies. An exploratory online survey administered between December 1, 2014 and January 27, 2015 to 185 members of the National Physicians Cooperative (NPC). Twenty-eight percent (52 of 185) of NPC members responded to the online survey. Fifty percent of respondents were obstetrician-gynecologists working largely in academic medical centers. Thirty-eight percent stated that 14 was the youngest age they felt comfortable performing oocyte retrievals with 35% stating that any age was acceptable as long as they were postpubertal. Short stimulation protocols, utilizing a gonadotropin-releasing hormone (GnRH) antagonist (86%), were more common than long stimulation or microdose Lupron flare protocols (23% and 18%), respectively, which utilize a GnRH agonist. Random start protocols were used by 77% and over 90% perform luteal phase starts. When using random start protocols, 64% use gonadotropins only and 32% start GnRH antagonists alone for several days before starting gonadotropins. Fifty-five percent of physicians were comfortable stimulating ovarian cancer patients only after clearance from an oncologist. Aromatase inhibitors (77%) were significantly more common than tamoxifen (24%) for stimulation in breast cancer patients (p = 0.0006). When considering ovarian stimulation after chemotherapy, 24% expressed comfort only if blood counts are normal, 38% tend to wait 3 months. Regarding experimental treatment, 83% report discussing the use of GnRH agonists alone and 64% of clinics offer ovarian tissue cryopreservation. This study underlines the wide variation that exists in stimulation and phase start techniques, patient selection, comfort levels, and cancer type-specific decision making.

Growth in US health spending remained slow in 2010; health share of gross domestic product was unchanged from 2009.

PubMed

Martin, Anne B; Lassman, David; Washington, Benjamin; Catlin, Aaron

2012-01-01

Medical goods and services are generally viewed as necessities. Even so, the latest recession had a dramatic effect on their utilization. US health spending grew more slowly in 2009 and 2010-at rates of 3.8 percent and 3.9 percent, respectively-than in any other years during the fifty-one-year history of the National Health Expenditure Accounts. In 2010 extraordinarily slow growth in the use and intensity of services led to slower growth in spending for personal health care. The rates of growth in overall US gross domestic product (GDP) and in health spending began to converge in 2010. As a result, the health spending share of GDP stabilized at 17.9 percent.

Survey of controversial issues of end-of-life treatment decisions in Korea: similarities and discrepancies between healthcare professionals and the general public

PubMed Central

2013-01-01

Introduction End-of-life (EOL) treatment issues have recently gained societal attention after the Korean Supreme Court’s ruling that the presumed wishes of an elderly woman in a persistent vegetative state (PVS) should be honored. We tried to evaluate what Koreans thought about controversial issues regarding EOL treatments. Methods We surveyed Koreans with the following questions: 1) are ventilator-dependent PVS patients candidates for end-of life treatment decisions? 2) Is withholding and withdrawing EOL treatment the same thing? 3) In an unconscious, terminally ill patient, whose wishes are unknown, how should EOL decisions be made? 4) How should we settle disagreement amongst medical staff and the patient’s family on EOL decisions? Results One thousand Koreans not working in healthcare and five hundred healthcare professionals responded to the survey. Fifty-seven percent of Koreans not working in healthcare and sixty seven percent of Korean healthcare professionals agreed that ventilator-dependent PVS patients are candidates for EOL treatment decisions. One quarter of all respondents regarded withholding and withdrawing EOL treatment as equal. Over 50% thought that EOL treatment decisions should be made through discussions between the physician and the patient’s family. For conflict resolution, 75% of Koreans not working in healthcare preferred direct settlement between the medical staff and the patient’s family while 55% of healthcare professionals preferred the hospital ethics committee. Conclusions Unsettled issues in Korea regarding EOL treatment decision include whether to include ventilator-dependent PVS patients as candidates of EOL treatment decision and how to sort out disagreements regarding EOL treatment decisions. Koreans viewed withholding and withdrawing EOL treatment issues differently. PMID:24093519

Activities of daily living, instrumental activities for daily living and predictors of functional capacity of older men in Jamaica

PubMed Central

Bourne, Paul Andrew

2009-01-01

Background: An extensive search of the literature found no studies that have examined functional capacity [Activities of Daily Living (ADL) and Instrumental Activities for Daily Living (I) ADL)] of Jamaican older men as well as factors that determine their functional capacity. Aims: The current study examines 1) ADL, 2) (I) ADL), 3) self-reported health status, 4) functional capacity, and 5) factors that determine functional capacity of older men. Methods and Method: Stratified multistage probability sampling technique was used to draw a sample of 2,000 55+ year men. A132-item questionnaire was used to collect the data. Descriptive statistics provide background information on the sample, cross tabulations were used to examine non-metric variables and logistic regression provides a model of predictors of functional capacity. Result: Fifty-five percent of sample indicated good current health status. Four percent was mostly satisfied with life; 21.7% had moderate dependence; 77.1% had high dependence (i.e. independence); 1.2% had low dependence; 21.9% were ages 75 years and older; 35.6% were ages 65 to 74 years and 42.6% reported ages 55 to 64 years. Functional capacity can be determined by church attendance (β=0.245; 95% CI: 0.264, 1.291); social support (β=0.129; 95% CI: 0.129, 0.258), area of residence (β=-0.060; 95% CI: -0.427, -0.061) and lastly by age of respondents. Conclusion: Ageing in explains deterioration in their (I) ADL, suggesting the challenges of ageing men's independence. More rural men were rarely satisfied with life; but more of them had a greater functional capacity than urban men. Depression was found to negatively relate to functional capacity, and church attendees had a greater functional status than non-attendees. PMID:22666693

Downhill Skiing Injuries.

PubMed

McKay, D H

1981-01-01

In brief: Lower extremity injuries are common in downhill skiing. Fifty-three percent of the skiing injuries in one study, and 81% in another, were below the knee. Twelve case reports are presented and their treatment is discussed. The author suggests that skiers undertake a physical fitness program to increase stamina and elasticity of muscles and ligaments.

Surveying Adult Education Practitioners about Ethical Issues.

ERIC Educational Resources Information Center

McDonald, Kimberly S.; Wood, George S., Jr.

1993-01-01

An Indiana survey of 113 of 248 adult basic educators, 113 of 117 trainers, and 23 of 29 continuing educators identified ethical dilemmas they face. Fifty-two percent believed a code of ethics should be created and enforced by professional associations, covering broad issues. Those who had experience with codes were positive about them. (SK)

Ohio Schools Cautiously Rebuild: Uncertainty in State and Local Funds Affects Strategies. Budget

ERIC Educational Resources Information Center

Patton, Wendy

2015-01-01

Policy Matters Ohio periodically surveys schools about fiscal conditions and operational strategies. The Ohio Association of School Business Officials provided a link to such a survey in their newsletter of December 2014 through February 2015. Fifty-three respondents, representing 8.6 percent of districts and including representatives from all…

Viable Blastocystis Cysts in Scottish and Malaysian Sewage Samples

PubMed Central

Suresh, K.; Smith, H. V.; Tan, T. C.

2005-01-01

Blastocystis cysts were detected in 38% (47/123) (37 Scottish, 17 Malaysian) of sewage treatment works. Fifty percent of influents (29% Scottish, 76% Malaysian) and 28% of effluents (9% Scottish, 60% Malaysian) contained viable cysts. Viable cysts, discharged in effluent, provide further evidence for the potential for waterborne transmission of Blastocystis. PMID:16151162

Handwriting Deficits in Children with Minimal Brain Dysfunction: Effects of Methylphenidate (Ritalin) and Placebo.

ERIC Educational Resources Information Center

Lerer, Robert J.; And Others

1979-01-01

Fifty hyperactive and learning disabled children (8 to 12 years old) were selected for study because of severe handwriting difficulties. The children received methylphenidate (Ritalin) or placebo under double blind conditions. Twenty-six students (52 percent) showed improvement in overall handwriting following the administration of methylphenidate…

12 CFR 517.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

...- and/or women-owned (small and large) businesses and entities owned by minorities and women means firms at least fifty-one (51) percent owned by individuals who are members of the minority group or women... or by one or more women, who are citizens of the United States. In the case of partnerships, at least...

Screening and Brief Intervention for Tobacco Use by Student Health Providers on College Campuses

ERIC Educational Resources Information Center

Sutfin, Erin L.; McNamara, Robert S.; Blocker, Jill N.; Ip, Edward H.; O'Brien, Mary Claire; Wolfson, Mark

2012-01-01

Objective: This study assessed college students' reports of tobacco screening and brief intervention by student health center providers. Participants: Participants were 3,800 students from 8 universities in North Carolina. Methods: Web-based survey of a stratified random sample of undergraduates. Results: Fifty-three percent reported ever visiting…

Employee Training Practices on Large New York Dairy Farms.

ERIC Educational Resources Information Center

Maloney, Thomas R.

Fifty percent of 60 farm managers responded to a survey regarding training practices and their attitudes toward training on the farm. The 30 respondents were primarily managers of larger farms with freestall barns and milking parlors, managers of dairies with above average production and profitability, and dairy farm owner-operators. Participants…

12 CFR 517.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

...- and/or women-owned (small and large) businesses and entities owned by minorities and women means firms at least fifty-one (51) percent owned by individuals who are members of the minority group or women... or by one or more women, who are citizens of the United States. In the case of partnerships, at least...

12 CFR 517.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

...- and/or women-owned (small and large) businesses and entities owned by minorities and women means firms at least fifty-one (51) percent owned by individuals who are members of the minority group or women... or by one or more women, who are citizens of the United States. In the case of partnerships, at least...

12 CFR 517.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

...- and/or women-owned (small and large) businesses and entities owned by minorities and women means firms at least fifty-one (51) percent owned by individuals who are members of the minority group or women... or by one or more women, who are citizens of the United States. In the case of partnerships, at least...

12 CFR 517.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

...- and/or women-owned (small and large) businesses and entities owned by minorities and women means firms at least fifty-one (51) percent owned by individuals who are members of the minority group or women... or by one or more women, who are citizens of the United States. In the case of partnerships, at least...

Introduction

Treesearch

Stephen R. Shifley; Francisco X. Aguilar; Nianfu Song; Susan I. Stewart; David J. Nowak; Dale D. Gormanson; W. Keith Moser; Sherri Wormstead; Eric J. Greenfield

2012-01-01

The twenty states that make up the U.S. North are bounded by Maine, Maryland, Missouri, and Minnesota. Compared to the rest of the country, the North has a higher population density, relatively little public forest land, and many private forest owners with small forest tracts. Fifty-five percent of northern forest land belongs to nearly 5 million family forest owners....

The Fifties Revival.

ERIC Educational Resources Information Center

Kodz, J.; Kersley, B.; Bates, P.

By 2011, 53 percent of the total population in Great Britain will be aged over 45; however, in recent years the proportion of labor market participants over 50 has declined significantly. Older workers have access to fewer training and development opportunities at work but are less likely to take short-term sickness absence and more likely to be…

Understanding Genetic and Environmental Influences on the Development of Reading: Reaching for Higher Fruit

ERIC Educational Resources Information Center

Wagner, Richard K.

2005-01-01

The transition from first-generation to second-generation studies of genetic and environmental influences on the development of reading is underway. The first generation of quantitative genetic studies yielded an extraordinary conclusion: Fifty percent or more of the variance in most constructs, including reading, is attributable to genetic…

Intimate Partner Violence Exposure, Salivary Cortisol, and Childhood Asthma

ERIC Educational Resources Information Center

Bair-Merritt, Megan H.; Johnson, Sara B.; Okelo, Sande; Page, Gayle

2012-01-01

Parents were given supplies to collect 3 child salivary cortisol samples (awakening, 30-min after awakening, bedtime) at home on a typical day, and return them via mail. Medical records also were abstracted. Results: Fifty-three percent (n = 29) returned child salivary samples. Families who returned samples typically returned them within 2 weeks,…

Striving Together: Early Lessons in Achieving Collective Impact in Education

ERIC Educational Resources Information Center

Edmondson, Jeff; Zimpher, Nancy L.

2014-01-01

In 2006, Cincinnati and Northern Kentucky had been suffering from many of the same challenges facing metro regions across the country. Despite significant investments in education from the public and private sectors, outcomes were alarming: Kindergarten readiness was below fifty percent, and nearly half of the students in the Cincinnati Public…

34 CFR 600.7 - Conditions of institutional ineligibility.

Code of Federal Regulations, 2012 CFR

2012-07-01

... than fifty percent of its regular enrolled students had neither a high school diploma nor the recognized equivalent of a high school diploma, and the institution does not provide a four-year or two-year... high school and who are available for study in preparation for entering the labor market” under section...

Effectiveness of a Corequisite Delivery Model for Developmental Mathematics

ERIC Educational Resources Information Center

Fair, Katherine Eileen

2017-01-01

The purpose of this quantitative quasi-experimental study is to determine the effectiveness of a corequisite delivery model for developmental math students at a 4-year public institution. Nationally, close to fifty percent of incoming college students are placed in non-credit bearing remedial courses (Complete College America, 2012). Students must…

Leading from the Middle: Preparing Leaders for New Roles

ERIC Educational Resources Information Center

Ebbers, Larry; Conover, Kitty S.; Samuels, Anisha

2010-01-01

Many community college presidents, upper-level administrators, and experienced faculty who began their careers in the sixties, seventies, and even eighties are nearing the end of their career, leaving key leadership openings to be filled. The average age of sitting community college presidents is fifty-eight, and nearly 84 percent of current…

[Resident evaluation of general surgery training programs].

PubMed

Espinoza G, Ricardo; Danilla E, Stefan; Valdés G, Fabio; San Francisco R, Ignacio; Llanos L, Osvaldo

2009-07-01

The profile of the general surgeon has changed, aiming to incorporate new skills and to develop new specialties. To assess the quality of postgraduate General Surgery training programs given by Chilean universities, the satisfaction of students and their preferences after finishing the training period. A survey with multiple choice and Likert type questions was designed and applied to 77 surgery residents, corresponding to 59% of all residents of general surgery specialization programs of Chilean universities. Fifty five per cent of residents financed with their own resources the specialization program. Thirty nine percent disagreed partially or totally with the objectives and rotations of programs. The opportunity to perform surgical interventions and the support by teachers was well evaluated. However, 23% revealed teacher maltreatment. Fifty six percent performed research activities, 73% expected to continue training in a derived specialty and 69% was satisfied with the training program. Residents considered that the quality and dedication of professors and financing of programs are issues that must be improved. The opportunity to perform surgical interventions, obtaining a salary for their work and teacher support is considered of utmost importance.

Assessment of the epidemiology and burden of measles in Southern Mozambique.

PubMed

Mandomando, Inácio; Naniche, Denise; Pasetti, Marcela F; Cuberos, Lilian; Sanz, Sergi; Vallès, Xavier; Sigauque, Betuel; Macete, Eusébio; Nhalungo, Delino; Kotloff, Karen L; Levine, Myron M; Alonso, Pedro L

2011-07-01

Measles has been a major killer among vaccine-preventable diseases in children < 5 years of age in developing countries. Despite progress in global efforts to reduce mortality, measles remains a public health problem. Hospital-based measles surveillance was conducted in Manhica, Mozambique (July 2001-September 2004). Suspected cases and community-based controls were enrolled, and blood was collected for immunoglobulin M (IgM) confirmation. Two hundred fifty-three suspected cases and 477 controls were enrolled, with 85% (216 of 253) cases reported during a measles outbreak. Measles-IgM confirmation was 30% among suspected cases and 5% in controls. Fifty-eight percent (14 of 24) of laboratory-confirmed cases had records indicating previous measles vaccination. Mortality was 3% (8 of 246) among cases and 1% among controls (6 of 426). Forty-five percent (33 of 74) of cases were < 24 months of age and 22% occurred in infants < 9 months of age and were associated with a high case-fatality rate (25%). Our data suggest that improved diagnostics, new tools to protect infants < 9 months of age, and a supplemental dose of measles vaccine could assist measles control.

A survey of U.S. dental school programs that help students consider academic careers.

PubMed

McAndrew, Maureen; Brunson, W David; Kamboj, Karanjit

2011-11-01

The faculty shortage in dental education has been reported for many years and is expected to increase. Some dental schools have developed "grow your own" programs that introduce students to academic careers and give them teaching experiences. These programs generally consist of teaching assistant, fellowship, and peer tutoring opportunities. In this study, a nineteen-item survey was sent to fifty-six U.S. dental schools to determine the extent to which such programs were being implemented. Thirty-six out of fifty-six dental schools responded, a response rate of 64 percent. Twenty-five schools or 69 percent of the respondents reported the existence of a formal teaching assistant, fellowship, or peer tutoring program in which students teach in some capacity. The main reasons reported for implementing these programs were to expose students to academia and to address faculty shortages. The respondents reported that positive outcomes for dental student teachers and their students were academic benefits and increased interest in academic life. Among the barriers reported were securing faculty and financial support and problems with scheduling.

Effect of social networking on academic achievement of dental students, Jazan University, Saudi Arabia.

PubMed

Halboub, E; Othathi, F; Mutawwam, F; Madkhali, S; Somaili, D; Alahmar, N

2017-02-01

We investigated the effect of social networking (SN) on academic achievement of dental students at Jazan University, Saudi Arabia. A self-administered questionnaire was distributed during the 2015/16 academic year to all dental students and data were analysed by SPSS version 21. There were 348 participants (70% response rate) and 53% were male. Fifty-one percent of participants reported that they studied just before examinations, and 51% scored 3.5-4.5 Grade Point Average (GPA) in the last semester. Up to 98% of the participants reported using their smartphones/ computers for SN, with 93% doing so on a daily basis, and 66% reported SN during lectures, laboratories and clinics. Fifty-seven percent thought that SN affected their study negatively, and 65% thought that their GPA would improve if they stopped or reduced SN. Students who spent more hours each day on SN had lower GPA scores. SN negatively affected the academic achievement of dental students. Further evaluation and tailored educational programmes are needed to increase students' awareness about the negative effects of SN.

Tobacco, Alcohol, and Other Risk Behaviors in Film: How Well Do MPAA Ratings Distinguish Content?

PubMed Central

Tickle, Jennifer J.; Beach, Michael L.; Dalton, Madeline L.

2009-01-01

To evaluate the usefulness of MPAA ratings for parental selection of appropriate films for children, the 100 top grossing movies each year from 1996 through 2004 (N=900) were content analyzed to measure risk behaviors in each film. More restrictive MPAA ratings (R and PG-13) were associated with increased mean seconds of portrayals of tobacco use, alcohol use, and sexual content; increased frequency of violent content; and increased salience of drug use. However, MPAA ratings did not clearly distinguish films based on tobacco or alcohol use. Fifty percent of R-rated movies contained 124 seconds or more of tobacco use, comparable to 26% of PG-13 and 17% of PG movies. Fifty percent of R-rated movies contained 162 seconds or more of alcohol use, comparable to 49% of PG-13 and 25% of PG movies. Because of the high degree of overlap in alcohol and tobacco content between rating categories, the MPAA rating system, as currently defined, is not adequate for parents who wish to limit their children’s exposure to tobacco or alcohol content in movies. PMID:20029709

Tobacco, alcohol, and other risk behaviors in film: how well do MPAA ratings distinguish content?

PubMed

Tickle, Jennifer J; Beach, Michael L; Dalton, Madeline A

2009-12-01

To evaluate the usefulness of Motion Picture Association of America (MPAA) ratings for parental selection of appropriate films for children, the 100 top grossing movies each year from 1996 through 2004 (N = 900) were content analyzed to measure risk behaviors in each film. More restrictive MPAA ratings (R and PG-13) were associated with increased mean seconds of portrayals of tobacco use, alcohol use, and sexual content; increased frequency of violent content; and increased salience of drug use. MPAA ratings, however, did not clearly distinguish films based on tobacco or alcohol use. Fifty percent of R-rated movies contained 124 seconds or more of tobacco use, comparable with 26% of PG-13 and 17% of PG movies. Fifty percent of R-rated movies contained 162 seconds or more of alcohol use, comparable with 49% of PG-13 and 25% of PG movies. Because of the high degree of overlap in alcohol and tobacco content between rating categories, the MPAA rating system, as currently defined, is not adequate for parents who wish to limit their children's exposure to tobacco or alcohol content in movies.

Pesticides use by smallholder farmers in vegetable production in Northern Tanzania.

PubMed Central

Ngowi, A.V.F.; Mbise, T.J.; Ijani, A.S.M.; London, L.; Ajayi, O. C.

2007-01-01

Small-scale farmers in Northern Tanzania grow vegetables that include tomatoes, cabbages and onions and use many types of pesticides to control pests and diseases that attack these crops. Based on the use of questionnaires and interviews that were conducted in Arumeru, Monduli, Karatu, and Moshi rural districts, this study investigates farmers’ practices on vegetable pest management using pesticides and related cost and health effects. The types of pesticides used by the farmers in the study areas were insecticides (59%), fungicides (29%) and herbicides (10%) with the remaining 2% being rodenticides. About a third of the farmers applied pesticides in mixtures. Up to 90% had a maximum of 3 pesticides in a mixture. In all cases there were no specific instructions either from the labels or extension workers regarding these tank mixtures. Fifty three percent of the farmers reported that the trend of pesticide use was increasing, while 33% was constant and 14% was decreasing. More than 50 percent of the respondents applied pesticides up to 5 times or more per cropping season depending on the crop. Insecticides and fungicides were routinely applied by 77% and 7%, respectively by these farmers. Sixty eight percent of farmers reported having felt sick after routine application of pesticides. Pesticide-related health symptoms that were associated with pesticides use included skin problems and neurological system disturbances (dizziness, headache). Sixty one percent of farmers reported spending no money on health due to pesticides. These results can be used to develop a tool to quantify the cost of pesticide use in pest management by small-scale vegetable farmers in Northern Tanzania and contribute to the reformation of pesticide policy for safe and effective use of pesticides. PMID:18528532

Supplementary motor area activation in patients with frontal lobe tumors and arteriovenous malformations.

PubMed

Sailor, Janet; Meyerand, M Elizabeth; Moritz, Chad H; Fine, Jason; Nelson, Lindsey; Badie, Behnam; Haughton, Victor M

2003-10-01

Some patients who undergo surgical resection of portions of the supplementary motor area (SMA) have severe postoperative motor and language deficits, whereas others have no deficits. We tested the hypothesis that in some patients with lesions affecting the SMA, the contralateral SMA exhibits some of the activation normally associated with the ipsilateral SMA. Functional MR imaging studies in seven healthy volunteers and 19 patients with frontal lobe tumors or arteriovenous malformations were reviewed retrospectively. The hemisphere in which the SMA activation predominated was tabulated for right and left motor tasks. The relative hemispheric dominance in the SMA for the right and left motor tasks was compared in the healthy and patient groups and with the location of the lesion in the patient group. None of the control subjects performing a right hand motor task activated predominantly the right SMA. Fifty percent of the patients with lesions overlapping the left SMA performing the right motor task activated predominantly the right SMA. Fifty-seven percent of control subjects performing the left hand motor task activated the left SMA predominantly. One hundred percent of patients with lesions overlapping the right frontal SMA performing the left motor task activated the left SMA predominantly. Differences between patients and controls were statistically significant. A lesion that contacts or overlaps the SMA is associated with an increased functional MR imaging response within the contralateral SMA.

Cone beam computed tomography in dental education: a survey of US, UK, and Australian dental schools.

PubMed

Parashar, Vijay; Whaites, Eric; Monsour, Paul; Chaudhry, Jahanzeb; Geist, James R

2012-11-01

Cone beam computed tomography (CBCT) is an excellent three-dimensional (3D) imaging modality. Traditional dental education has focused on teaching conventional (2D) imaging. The aims of this survey-based study were therefore to evaluate the incorporation of CBCT teaching in both the predoctoral/undergraduate (D.D.S./D.M.D./B.D.S.) and postgraduate/residency specialty training curricula in dental schools in the United States, the United Kingdom, and Australia. A nine-question survey form was electronically mailed to fifty-seven schools in the United States, sixteen schools in the United Kingdom, and seven schools in Australia. Fifty U.S. dental schools (89 percent), ten U.K. dental schools (62.5 percent), and one Australian dental school (14 percent) presently have CBCT equipment. The majority of responding schools do not include instruction in higher level use of this technology for undergraduate/predoctoral students, raising questions as to whether these students are adequately trained on qualification. Larger numbers of schools reported providing this training to residents in specialty programs. A similar trend was noticed in U.S., British, and Australian dental education. If general dentists are to be permitted to purchase and use CBCT equipment, inclusion of CBCT in dental education is an absolute requirement to prepare future dental practitioners to apply 3D imaging appropriately for diagnosis and treatment planning.

Morphological changes in carotid arteries in stroke cases.

PubMed

Thapa, Guna Bahadur; Sundas, Alin; Rauniyar, Raj Kumar

2013-01-01

Majority of stroke is due to ischemic infarction and occurs in carotid artery territory. The extra cranial parts of carotid arteries are the common sites for the atherosclerotic plaque formation. Ultrasonography is the first line of investigation for screening of the carotid artery diseases to localize and characterize the plaques. Objective was to study the morphological changes in extra cranial part of carotid arteries in cases of ischemic infarction using Ultrasonography. It was an institution based prospective study and convenience sampling method was used. Computed Tomography proven ischemic infarct, lacunar infarction and transient ischemic infarction cases were included in the study. Fifty four cases were included in the study. Mean of Intimo-medial Complex Thickness was 0.89 mm and 0.88 mm in right and left side respectively. Sixty five percent cases had plaque in extra cranial part of carotid artery. Ninety three percent of plaque was found in and adjacent to the carotid bulb region. Ipsilateral plaque was found in 76% and 65% cases on right and left side respectively. Fifty three percent of cases had soft plaque. Majority of cases had less than 50% narrowing of the lumen diameter in term of cross-sectional area due to plaque. Thirteen (24%) cases had plaque in internal carotid artery. Carotid ultrasound can be used for screening of the asymptomatic but high-risk cases and following up of the symptomatic cases to plan for necessary management as required.

[Patient complaints in a hospital emergency department in Belgium].

PubMed

Ngongo, B Tchuyap; Carlier, A; Mols, P

2011-04-01

Patients express their dissatisfaction through complaints. This study analyzed the frequency and chief complaints of patients presenting to the emergency department (ED). The end point was find ways to improve patient satisfaction after their ED visit. In this retrospective, seven years study, we reviewed 155 chief complaints of patients presenting to the ED of a university hospital. The chief complaints were either from the patients or a family member. One hundred and fifty five chief complaints collected from 496.816 patients presenting to the ED were reviewed over a period of seven years. Complaints case rate was 3.1 per 10.000 visits. Complaints came from patients between the age of 20 to 60 years old (75.0 percent). Complains involved a physician (79.0 percent). The complaints were related a lack of communication (39.0 percent), long waiting time (14.0 percent), wrong diagnosis (22.0 percent), wrong treatment (13.0 percent) and ED disposition of the patient (12.0 percent). Two types of pathology represented more than 15 percent of the complaints: the traumatology (22.0 percent) and the psychiatry (17.0 percent). The traumatology and psychiatry represented respectively 30.0 percent and 10.0 percent of ED visits. Most complaints were addressed and resolved through a hospital mediator, Chief of service or Chief of staff. The rate of complains is low. Most complaints can be prevented if the physician improves communication with patients.

Medically indigent women seeking abortion prior to legalization: New York City, 1969-1970.

PubMed

Belsky, J E

1992-01-01

If the efforts now underway to limit access to abortion services in the United States are successful, their greatest impact will be on women who lack the funds to obtain abortions elsewhere. There is little published information, however, about the experience of medically indigent women who sought abortions under the old, restrictive state laws. This article details the psychiatric evaluation of 199 women requesting a therapeutic abortion at a large municipal hospital in New York City under a restrictive abortion law. Thirty-nine percent had tried to abort the pregnancy. Fifty-seven percent had concrete evidence of serious psychiatric disorder. Forty-eight percent had been traumatized by severe family disruption, gross emotional deprivation or abuse during childhood. Seventy-nine percent lacked emotional support from the man responsible for the pregnancy, and the majority were experiencing overwhelming stress from the interplay of multiple problems exacerbated by their unwanted pregnancy.

Patients' knowledge and expectations regarding dental implants: assessment by questionnaire.

PubMed

Rustemeyer, J; Bremerich, A

2007-09-01

Today, modern implant dentistry appeals to a wide population, but the decision for and the success of implants depend on the knowledge and expectations of patients. The aim of this study was, with the help of a questionnaire, to evaluate the level of patient knowledge before a professional consultation was performed, and hence to be better prepared in the interests of patient awareness. Fifty-eight percent of 315 patients questioned thought that implants require the same care as natural teeth, 61% expected an additional payment of 2000 Euro or less, 80% held the function of an implant-supported overdenture as very important and 54% attached great importance to the aesthetics. The expectations that patients have for an implant-supported set are high in contrast to their willingness to make additional payments. There are still misconceptions regarding costs, and these must be resolved individually in practice.

Comparison of the Carlsson-Dent and GERD-Q questionnaires for gastroesophageal reflux disease symptom detection in a general population.

PubMed

Contreras-Omaña, R; Sánchez-Reyes, O; Ángeles-Granados, E

Gastroesophageal reflux disease (GERD) is an extremely common pathology in the general population and one of the main reasons for consultation in gastroenterology. There are different instruments for detecting its symptoms, but few studies comparing one tool with another have been conducted in Mexico. To compare the effectiveness of the Carlsson-Dent questionnaire (CDQ) and the GERD-Q questionnaire (GQQ) in detecting GERD symptoms in a general population. A prospective, descriptive, cross-sectional study was conducted on 220 individuals in an open population within the time frame of May-June 2015. The subjects were evaluated through the self-assessment CDQ and GQQ. The positive scores from the CDQ (≥ 4) were compared with those of the GQQ (≥ 8), to determine which of the two instruments more easily detected patients with GERD symptoms. Fifty-seven percent of the patients were men and the mean patient age was 38.1 years. Fifty percent of the subjects presented with GERD symptoms with a positive score in at least one questionnaire; 45% had positive CDQ results and 23% had positive GQQ results. Fifty-seven percent of the patients with a positive CDQ score presented with overweight/obesity, as did 72% of the patients with a positive GQQ result. Finally, 20% of the individuals had positive results for reflux symptoms in both questionnaires. There was a prevalence of GERD symptoms in 50% of the individuals studied from a general population. The GQQ detected a greater number of GERD symptoms in patients that presented with overweight/obesity and the CDQ was considered easier for patients to understand and answer. It is striking that there was only 20% agreement between the two questionnaires, suggesting that they may be useful for identifying GERD symptoms in different populations. Copyright © 2016 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

Tanning Bed Perception Survey

PubMed Central

Mcquinn, Donna; Lohse, Christine; Hassani, John

2015-01-01

Objective: This study was intended to investigate the perception of tanning bed use among college students. Design: A 15-question survey was given to young adults regarding tanning perceptions. Setting: Rochester Community College in Rochester, Minnesota. Participants: Forty-four respondents between 18 and 51 years of age. Measurements: Data was collected via a self-reported questionnaire. Results: In this study, 50 percent of participants were not educated on the risks of melanoma, and 68 percent were not interested in receiving information on melanoma and completing a follow-up survey. More specifically, 63 percent versus 89 percent of participants with no tanning bed versus some tanning bed use did not want information regarding melanoma, respectively. This study also shows that more tanning bed users believe tanning helps prevent burning than non-tanning bed users. Fifty-seven percent of the 35 participants who had never used a tanning bed thought that they never prevent sunburn, while only 11 percent of the nine participants who had used a tanning bed in the past thought that they never prevent sunburn, which was statistically significant. PMID:25852811

Level of Adoption of Quality Management Systems Into the Mexican Pork Industry

NASA Astrophysics Data System (ADS)

Maldonado-Siman, Em; Ruíz-Flores, Agustín; Núñez-Domínguez, Rafael; González-Alcorta, Mariano; Hernández-Rodríguez, Bertha Alicia

This research studies the characteristics of the Mexican pork sector; adoption status of quality management systems, and product destinations. Ninety six percent of fifty enterprises have fully answered a questionnaire. Ninety percent are small and medium-sized, the rest are large-sized firms. Nineteen percent of them have totally adopted HACCP, sixty three percent are implementing or planning to do it, the rest have no plans to adopt it. Thirteen percent of the enterprises had ISO 9000. Thirty four percent of their sales go to supermarkets, 57% to other retail chains and 9% to exportation. Product destinations are mainly Central America, United States of America, Asia and Mexico. To improve efficiency and the quality of process it is necessary to implement HACCP. Besides, customers and legal requirements are the external factors, which result in this adoption. In the process of implementing, there are some problems, such as staff motivation and training. The results suggest that HACCP system operating is important for the Mexican pork industry. It also has relevant implications in domestic trade. It is necessary to encourage adoption of quality management systems in the sector.

Water quality of the Quaternary and Ada-Vamoosa aquifers on the Osage Reservation, Osage County, Oklahoma, 1997

USGS Publications Warehouse

Abbott, Marvin M.

2000-01-01

The project was to provide information on the quality of ground water from rural-domestic-water wells within the Osage Reservation and compare the water-quality to proximity to oil wells. About 38,500 oil wells have been drilled in the Reservation since drilling began in 1896. About 1,480 square miles or 64 percent of the Reservation is within a quarter mile of an oil well. The unconfined Quaternary sand aquifer covers about 315 square miles or about 14 percent of the Reservation and the confined Ada-Vamoosa sandstone aquifer covers about 800 square miles or about 35 percent of the Reservation. Fifty-eight percent of the Quaternary aquifer and 69 percent of the outcrop area of the Ada-Vamoosa aquifer are within a quarter mile of an oil well . One hundred twenty domestic ground-water wells were sampled from the Quaternary and Ada-Vamoosa aquifers. Forty-nine percent of the Reservation is underlain by the aquifers. Ground-water quality is good on most of the Reservation, but the use of domestic water-supply wells tend to minimize water-quality problems. Existing water-supply wells commonly are located in areas that produce usable volumes of potable water. Several constituents in samples from the Ada-Vamoosa-aquifer within a quarter mile of an oil well were significantly greater than from the aquifer not near oil wells. The constituents include specific conductance, dissolved solids, sodium, sulfate, chloride, bromide, and silica. These ions are probably derived from brine water. In the Ada-Vamoosa aquifer subgroups, 57 percent of the samples near oil wells and 24 percent of the samples not near oil wells had dissolved-solids concentrations greater than 500 milligrams per liter. The water quality in the Quaternary and Ada-Vamoosa aquifers is similar in areas where no oil wells have been drilled but is significantly different for several constituents. Median concentrations of major constituents from the Ada-Vamoosa aquifer not near oil wells were less than or equal to values from the Quaternary aquifer. Sixty-four percent of the water-quality samples from the Quaternary and 51 percent from the Ada-Vamoosa aquifers have dissolved-solids concentrations less than the secondary drinking water regulations of 500 milligrams per liter. Fifty-nine percent of the aquifer samples in the Quaternary aquifer subgroups not near oil wells and 70 percent of the samples near oil wells had dissolved solids less than 500 milligrams per liter. Areas in the Ada-Vamoosa aquifer near Hominy, Pershing, and Hula Lake have dissolved-solids concentrations greater than the secondary drinking water regulations. Water-quality samples from the Quaternary aquifer in these areas also have dissolved-solids concentrations greater than 500 milligrams per liter.

Posttraumatic stress in immigrants from Central America and Mexico.

PubMed

Cervantes, R C; Salgado de Snyder, V N; Padilla, A M

1989-06-01

International migration has been associated with increased levels of psychological disturbance, particularly among refugees who have fled from war or political unrest. This study examined self-reported symptoms of depression, anxiety, somatization, generalized distress, and posttraumatic stress disorder (PTSD) in a community sample of 258 immigrants from Central America and Mexico and 329 native-born Mexican Americans and Anglo Americans. Immigrants were found to have higher levels of generalized distress than native-born Americans. Fifty-two percent of Central American immigrants who migrated as a result of war or political unrest reported symptoms consistent with a diagnosis of PTSD, compared with 49 percent of Central Americans who migrated for other reasons and 25 percent of Mexican immigrants. The authors call for more research to document the psychosocial aspects of migration.

Nitrogen

USGS Publications Warehouse

Kramer, D.A.

2007-01-01

Ammonia was produced by 15 companies at 25 plants in 16 states in the United States during 2006. Fifty-seven percent of U.S. ammonia production capacity was centered in Louisiana, Oklahoma and Texas because of their large reserves of natural gas, the dominant domestic feedstock. In 2006, U.S. producers operated at about 72 percent of their rated capacity (excluding plants that were idle for the entire year). Five companies, Koch Nitrogen, Terra Industries, CF Industries, PCS Nitro-gen, and Agrium, in descending order, accounted for 79 percent U.S. ammonia production capacity. The United States was the world's fourth-ranked ammonia producer and consumer following China, India and Russia. Urea, ammonium nitrate, ammonium phosphates, nitric acid and ammonium sulfate were the major derivatives of ammonia in the United States, in descending order of importance.

Quiet Clean Short-Haul Experimental Engine (QCSEE) ball spline pitch-change mechanism whirligig test report

NASA Technical Reports Server (NTRS)

1978-01-01

The component testing of a ball spline variable pitch mechanism is described including a whirligig test. The variable pitch actuator successfully completed all planned whirligig tests including a fifty cycle endurance test at actuation rates up to 125 deg per second at up to 102 percent fan speed (3400 rpm).

The Development and Validation of the School-Based Counseling Self-Efficacy Scale

ERIC Educational Resources Information Center

Boughfman, Erica M.

2010-01-01

The purpose of this study was to develop and validate the School-Based Counseling Self-Efficacy Scale (SB-SES). Two hundred sixty-five (N = 265) licensed mental health professionals participated in this study. Fifty-eight percent of the participants reported experience working as a school-based counselor with the remaining 42% reporting no…

Mineral resource of the month: kyanite

USGS Publications Warehouse

Potter, Michael J.

2007-01-01

Kyanite and related minerals are used in making refractories, which are materials that can withstand high-temperature environments, generally in excess of 1,100 degrees Celsius. Refractories form an inner lining to furnaces, kilns and other containers with which molten metals and glass come into contact. Fifty to 70 percent of global refractory consumption is related to the steel industry.

Ohio Schools Cautiously Rebuild: Uncertainty of State and Local Funds Affects Quality. Budget. Executive Summary

ERIC Educational Resources Information Center

Patton, Wendy

2015-01-01

Policy Matters Ohio periodically surveys schools about fiscal conditions and operational strategies. The Ohio Association of School Business Officials provided a link to such a survey in their newsletter of December 2014 through February 2015. Fifty-three respondents, representing 8.6 percent of districts and including representatives from all…

Meta-Travel: A Critical Inquiry into a China Study Tour

ERIC Educational Resources Information Center

Riggan, Jennifer; Gwak, Sonya; Lesnick, Joy; Jackson, Kara; Olitsky, Stacey

2011-01-01

Short-term study tours are among the fastest growing of study abroad experiences and serve the largest percentage of students choosing to study abroad. Fifty-six percent of students studying abroad go on short-term study trips lasting anywhere from two to eight weeks. These trips have the advantage of being able to provide study travel experiences…

25 CFR 700.335 - Grouping and granting of applications for life estate leases.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false Grouping and granting of applications for life estate... OPERATIONS AND RELOCATION PROCEDURES Life Estate Leases § 700.335 Grouping and granting of applications for... least 50% (fifty percent) disabled shall be ranked in order of their age with the oldest listed first...

Forests of western Oregon: an overview.

Treesearch

Sally Campbell; Dave Azuma; Dale. Weyermann

2002-01-01

This publication provides highlights of forest inventories and surveys from 1993 to 2000. It presents both traditional and nontraditional information about western Oregon’s forests.The amount of forest land in western Oregon has changed little since the earliest inventory in 1930. About 80 percent of western Oregon is forested. Fifty tree species were tallied in forest...

Factors Associated with Participation in HIV Antibody Screening and Results Disclosure.

ERIC Educational Resources Information Center

Silvestre, Anthony J.; And Others

1993-01-01

Identified differences among 110 gay and bisexual men who decided whether to be tested for antibodies to human immunodeficiency virus (HIV) and, if so, whether to return for results. Fifty percent refused testing. Of those tested, only 35% returned to obtain test results. Education was significantly and inversely related to being tested and to…

Access and Financial Aid: How American-Indian Students Pay for College

ERIC Educational Resources Information Center

Tierney, William G.; Sallee, Margaret W.; Venegas, Kristan M.

2007-01-01

American Indians are among the most underrepresented and underserved groups in higher education. Fifty-one out of every 100 American Indians graduate from high school. Of these 1, only 7 percent will enroll in college and ultimately earn a bachelor's degree within six years. Some American-Indian students fail to complete their studies for…

Provision of Hepatitis C Education in a Nationwide Sample of Drug Treatment Programs.

ERIC Educational Resources Information Center

Astone, Janetta; Strauss, Shiela M.; Vassilev, Zdravko P.; Des Jarlais, Don C.

2003-01-01

Using a nationwide sample of drug treatment programs, reports the results of an analysis that differentiates programs providing Hepatitis C virus (HCV) education to all of their patients versus programs that do not. Fifty-four percent of the programs provide HCV education to all of their patients. Findings indicate a need to increase HCV…

43 CFR 3190.3 - Sharing of civil penalties.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Sharing of civil penalties. 3190.3 Section... Contracts for Oil and Gas Inspections: General § 3190.3 Sharing of civil penalties. Fifty percent of any civil penalty collected by the United States as a result of activities carried out by a State under a...

Adaptive Management Tools for Nitrogen: Nitrogen Index, Nitrogen Trading Tool and Nitrogen Losses Environmental Assessment Package (NLEAP-GIS)

USDA-ARS?s Scientific Manuscript database

Average nitrogen (N) use efficiencies are approximately fifty percent and can be even lower for shallower rooted systems grown on irrigated sandy soils. These low N use efficiencies need to be increased if reactive N losses to the environmental are to be reduced. Recently, USDA-NRCS identified Adapt...

Restaurant staff's knowledge of anaphylaxis and dietary care of people with allergies.

PubMed

Bailey, S; Albardiaz, R; Frew, A J; Smith, H

2011-05-01

Deaths caused by food-induced anaphylactic reactions are increasing, with most caused by food purchased outside the home. Primary prevention by allergen avoidance is desirable, but is easier in the home than when eating out, where the responsibility is shared with restaurant staff. To investigate restaurant staff's knowledge about food allergies. A structured telephone questionnaire was administered to a member of staff at 90 table-service restaurants in Brighton. Fifty-six percent (90/162) restaurants that were contacted agreed to participate. Responders included seven owners, 48 managers, 20 waiters and 15 chefs. Ninety per cent (81/90) reported food hygiene training; 33% (30/90) reported specific food allergy training. Fifty-six percent (50/90) could name three or more food allergens. Eighty-one percent reported confidence (very or somewhat) in providing a safe meal to a food-allergic customer. Answers to true-false questions indicated some frequent misunderstandings: 38% believed an individual experiencing a reaction should drink water to dilute the allergen; 23% thought consuming a small amount of an allergen is safe; 21% reported allergen removal from a finished meal would render it safe; 16% agreed cooking food prevents it causing allergy and 12% were unaware allergy could cause death. Forty-eight percent expressed interest in further training on food allergy. Despite a high confidence level, there are obvious gaps in restaurant staff's knowledge of allergy. Food-allergic patients need to be aware of this and adapt their behaviour accordingly. Our data challenge the impact of current food allergy training practice for restaurant staff, and support the need for more rigorous and accessible training. © 2011 Blackwell Publishing Ltd.

Management of pediatric cholesteatoma based on presentations, complications, and outcomes.

PubMed

McGuire, J K; Wasl, H; Harris, T; Copley, G J; Fagan, J J

2016-01-01

To highlight important aspects and paradigms in the management of paediatric cholesteatoma in a developing world setting. A retrospective audit was conducted of paediatric cholesteatomas that underwent tympanomastoid surgery between 2008 and 2012 at the Red Cross War Memorial Children's Hospital in Cape Town. The following was audited: initial presentation; cholesteatoma complications; types of surgery, intraoperative findings and outcomes of surgery in terms of hearing, otorrhoea and recidivism; and the reliability of follow-up and how this might influence the type of surgery. Fifty-seven children aged 2-13 years with 61 cholesteatomas (4 bilateral) were reviewed. Fifty-five mastoidectomies were done; 11% presented with complicated cholesteatoma. Referrals from primary care were significantly delayed (>6 months) in 76%. Canal wall down surgery was done in 71%. Forty-five percent had improved hearing (within 15dB of better hearing ear) and a further 15% had no or only mild hearing loss. Ossicular chain involvement and ossicles encased in inflammatory tissue were associated with poorer hearing outcomes. Sixty-four percent of ears remained dry. Forty-five percent of the canal wall up, and 23% of canal wall down mastoidectomies had recidivism. Twenty-six percent of patients were lost to follow-up. Children are likely to present with advanced cholesteatoma with ossicular chain involvement. The children present with high rates of complications, poor pre-operative hearing and have high recurrence rates post-surgery. Referral from primary health care is delayed. Canal wall down procedures may be appropriate in a setting where patient follow-up is unreliable and access to operating theatre is limited. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Ethical decisions in dental treatment planning using the Ozar model: a descriptive study of fifty-two consecutive patients.

PubMed

Schuman, N J; Turner, J E

1997-01-01

Chairside dental ethics necessitates special consideration by the faculty member-dentist, the dental student, and the patient. The patient must always be aware of treatment options, in addition to learning the health status of the oral hard and soft tissues, costs, and time to be involved to accomplish proposed treatment. What may seem like a burden to an individual practitioner is actually only the necessities incurred by any self governing profession. Fifty-two consecutive dental patients had their cases reviewed for the ethical behavior of the dentist-practitioner, student, and patient. Categories reviewed were informed consent (100%), agreement, compromise, economic issues, conflict, and institutional issues. The results were: 1. Agreement: 17 cases, 2. Compromise: 21 cases, 3. Economic Issues: 4 cases, 4. Conflict: 6 cases, and 5. Institutional Issues: 4 cases. Fourteen percent of all patients were minors. Ninety percent of the patients were treated. Of those 10% not treated, five percent were for medical reasons, and five percent of the patients refused treatment. These results were placed in the Ozar Model 9 and were categorized as follows: 1. Appropriate pain free oral function: 22 cases, 2. Patient Autonomy: 14 cases, 3. Life and health: 9 cases, 4. Preferred practice values: 6 cases, and 5. Other external considerations: 1 case. This template demonstrated appropriate ethical behavior on the part of dentists, students, and patients, especially with a 90% treatment group, and only 5% refusing treatment. The 52 consecutive patients were characteristic of the University of Tennessee's overall patient pool. No identifiable differences were found between patients regardless of gender, age, or race.

Structure, Process, and Culture of Intensive Care Units Treating Patients with Severe Traumatic Brain Injury: Survey of Centers Participating in the American College of Surgeons Trauma Quality Improvement Program.

PubMed

Alali, Aziz S; McCredie, Victoria A; Mainprize, Todd G; Gomez, David; Nathens, Avery B

2017-10-01

Outcome after severe traumatic brain injury (TBI) differs substantially between hospitals. Explaining this variation begins with understanding the differences in structures and processes of care, particularly at intensive care units (ICUs) where acute TBI care takes place. We invited trauma medical directors (TMDs) from 187 centers participating in the American College of Surgeons Trauma Quality Improvement Program (ACS TQIP) to complete a survey. The survey domains included ICU model, type, availability of specialized units, staff, training programs, standard protocols and order sets, approach to withdrawal of life support, and perceived level of neurosurgeons' engagement in the ICU management of TBI. One hundred forty-two TMDs (76%) completed the survey. Severe TBI patients are admitted to dedicated neurocritical care units in 52 hospitals (37%), trauma ICUs in 44 hospitals (31%), general ICUs in 34 hospitals (24%), and surgical ICUs in 11 hospitals (8%). Fifty-seven percent are closed units. Board-certified intensivists directed 89% of ICUs, whereas 17% were led by neurointensivists. Sixty percent of ICU directors were general surgeons. Thirty-nine percent of hospitals had critical care fellowships and 11% had neurocritical care fellowships. Fifty-nine percent of ICUs had standard order sets and 61% had standard protocols specific for TBI, with the most common protocol relating to intracranial pressure management (53%). Only 43% of TMDs were satisfied with the current level of neurosurgeons' engagement in the ICU management of TBI; 46% believed that neurosurgeons should be more engaged; 11% believed they should be less engaged. In the largest survey of North American ICUs caring for TBI patients, there is substantial variation in the current approaches to ICU care for TBI, highlighting multiple opportunities for comparative effectiveness research.

Experience with Health Coach-Mediated Physician Referral in an Employed Insured Population

PubMed Central

Rao, Sowmya R.; Rogers, Robert S.; Mailhot, Johanna R.; Galvin, Robert

2010-01-01

BACKGROUND Given increasing interest in helping consumers choose high-performing (higher quality, lower cost) physicians, one approach chosen by several large employers is to provide assistance in the form of a telephonic “health coach” — a registered nurse who assists with identifying appropriate and available providers. OBJECTIVE To evaluate the health coach’s influence on provider choice and the quality of the user experience in the early introduction of this service. DESIGN Cross-sectional survey of 3490 employees and covered dependents of a large national firm that offered health coach services to all employees and covered dependents. The survey began in September 2007 with proportionate stratified sampling of 1750 employees and covered dependents who used the services between October 2007 and February 2008, and 1740 non-users. PARTICIPANTS Insured adults (ages 21–64) employed by a large national firm or covered dependents of employees. MEASUREMENTS Awareness of the service, reason for using service, visits to providers recommended by service, use of health advice provided by service, user satisfaction. MAIN RESULTS The primary reason for using the service was to obtain provider referrals (73%). Fifty-two percent of users sought a specialist referral, 33% a PCP referral and 9% a hospital referral. Eighty-nine percent of users seeking a provider referral were referred in-network; 81% of those referred visited the referred provider. Measures of satisfaction with both the service and the care delivered by recommended providers were over 70%. CONCLUSIONS Customers largely follow the provider recommendation of the health coach. Users express general satisfaction with existing health coach services, but differences in performance between vendors highlight the need for the services to be well implemented. Electronic supplementary material The online version of this article (doi:10.1007/s11606-010-1428-4) contains supplementary material, which is available to authorized users. PMID:20556533

Opinions about the new law on end-of-life issues in a sample of french patients receiving palliative care.

PubMed

Boulanger, Augustin; Chabal, Théo; Fichaux, Marie; Destandau, Mireille; La Piana, Jean Marc; Auquier, Pascal; Baumstarck, Karine; Salas, Sébastien

2017-01-21

In February 2nd 2016, the French government enacted the Claeys-Leonetti law that forbade euthanasia and established the right to deep and continuous sedation for end-of-life patients. Moreover, the law also obliges clinicians to abide by any advance directives regarding treatment and investigation, except in cases where they are "obviously inappropriate" in a given medical situation, or in cases of emergency, in order to allow medical staff to take time to assess the patient's situation. Artificial feeding and hydration are considered as treatment. The aim of this report is to investigate individuals receiving palliative care about their opinion about euthanasia, about advance directives, about the right to deep and continuous sedation, and the right to stopping artificial feeding and hydration. The study was an opinion survey conducted among patients treated in two different palliative care institutions: a palliative care unit at the University Hospital (Timone, Marseille, France) and a non-profit association palliative care home ("La Maison", Gardanne, France). Face-to-face interviews were performed by two investigators. The survey included sociodemographics, clinical data, and opinions about euthanasia, deep and continuous sedation, stopping artificial feeding and hydration, and advance directives. Forty patients were interviewed. The mean age was 59.8 years (standard deviation 12). Fifty three percent reported opposition to legalized euthanasia. Eighty three percent were in favour of the right to deep and continuous sedation in patients with refractory pain, 75% when it concerns a patient unable to express their wishes, and 68% when the patient decides to stop vital treatment. Fifty eight percent reported that artificial nutrition and hydration should be considered as care. Fifty eight percent of the patients interviewed would like to see doctors follow the express wishes contained in advance care directives and 53% that advance directives should be subject to a validity period. This work demonstrates the feasibility of discussing sensitive issues such as euthanasia, continuous and deep sedation and cessation of care with patients receiving palliative care. These preliminary results point to the need to perform a larger study in order to find determinant factors in this specific situation and to incorporate them into thinking about end-of-life laws.

Factors influencing surgical career choices and advancement in Ireland and Britain.

PubMed

Corrigan, Mark A; Shields, Conor J; Redmond, Henry P

2007-10-01

The aim of this study was to analyze the factors that influence the advancement and the career choices of doctors and medical students. Using the combined databases of the iformix and surgent websites, 450 doctors and medical students were invited to complete an internet-based survey. Surgent (http://www.surgent.ie) and iformix (http://www.iformix.com) are two free internet services administered by the authors. Surgent is a medical educational website, while iformix facilitates the online submission of abstracts to surgical and medical conferences across Britain and Ireland. The combined database of these two websites is approximately 4500 entries. Four hundred and fifty users represented a 10% sample based on an expected 40%-45% response rate. This was anticipated to yield between 180 and 202 respondents, statistically sufficient to analyze the data. A detailed Likert scale assessed the importance of "academic," "clinical," and "lifestyle" factors in determining career choice and progression. Analysis included descriptive statistics and inferential testing. Fifty percent (N = 222) of surveys were returned; 142 men and 78 women. Thirty-seven percent of respondents were Irish, 28% British, and 35% non-European. Fifteen percent were undergraduates, 4% interns, 12% had 2-4 years of clinical experience, while 69% had completed more than 4 years. Fifty-six percent had decided upon a career in general surgery. Overall, the most important factors for career choice were intellectual challenge (95%), academic opportunities (61%), and research opportunities(54%). Doctors with more than 4 years of experience deemed duration of training (p = 0.002), lifestyle during training (p = 0.02), and stress (0.005) as less important factors when considering career choice. Correlation analyses demonstrated that prestige (p = 0.002), patient relationships (p = 0.006), and advice from friends or family (p = 0.01) were more important influencing factors for interns. In terms of career advancement, 66% of non-Europeans considered family contacts important as opposed to 20% of British and 45% of Irish doctors (p < 0.001). In addition, 47% of females felt gender was important for career advancement as opposed to 31% of males (p = 0.01). Academic and clinical factors play an important role in career choice. However, it is clear that lifestyle factors predominate in determining an individual's career decisions in surgery.

Sociodemographic profile and career decisions of Australian oral health profession students.

PubMed

Mariño, Rodrigo; Au-Yeung, Winnie; Habibi, Elmira; Morgan, Michael

2012-09-01

This study collected and analyzed recent information regarding the sociodemographic profile and career decisions of Australian oral health profession students (earning B.D.Sc. and B.O.H. degrees) and the reasons for their career choice. Data were collected during the 2009-10 academic year via a web-based survey. A total of 829 students participated; the response rates for each oral health course at the seven participating universities ranged from 15.0 percent to 88.7 percent. The respondents had an average age of 21.4 years, ranging from eighteen to fifty-one. The majority of the respondents were female (61.4 percent), single (91.0 percent), and of Asian ethnicity (65.0 percent), and almost half had attended a public secondary school (49.7 percent). Most of the responding students either lived in rented accommodation (44.0 percent) or with their parents (28.6 percent), and 41.5 percent reported having an urban address. Most respondents' fathers (67.2 percent) and mothers (54.8 percent) had completed undergraduate or postgraduate education and were employed in managerial or professional occupations (68.5 percent and 54.9 percent, respectively). Most of the students said they had selected their course in high school (66.8 percent) and were most influenced in their career choice by self-motivation (85.3 percent) and caring for and helping other people (86.6 percent). The majority of the respondents reported wishing to work in a city (51.5 percent), practicing general dentistry (31.8 percent) in either the public or private sector (40.2 percent each). This article provides a preliminary look at the future dental workforce of Australia, identifying issues for further analysis and assisting each university to address current inequalities and challenges.

Associations Between Compulsive Buying and Substance Dependence/Abuse, Major Depressive Episode, and Generalized Anxiety Disorder Among Men and Women

PubMed Central

Zhang, Chenshu; Brook, Judith S.; Leukefeld, Carl G.; Brook, David W.

2016-01-01

Aims The objective of this study was to examine the associations between compulsive buying (CB) and substance dependence/abuse, major depressive episode (MDE), and generalized anxiety disorder (GAD) at mean age 43. Methods Participants came from a community-based random sample of residents in two New York counties (N=548). The participants were followed from adolescence to early midlife. The mean age of participants at the most recent interview was 43.0 (SD=2.8). Fifty five percent of the participants were females. Over 90% of the participants were white. The prevalence of substance dependence/abuse, MDE, and GAD (during the past 5 years before the interviews) was 6.6%, 13.7, and 11.5%, respectively. Results Logistic regression analyses showed that CB was significantly associated with substance dependence/abuse [Adjusted Odds Ratio (A.O.R.) = 1.60], MDE (A.O.R. = 1.70), and GAD (A.O.R. = 1.63), despite controlling for substance dependence/abuse, MDE, and GAD, respectively, at mean age 37, and demographic factors. Discussion Since the study sample is limited to predominantly white participants (over 90%) with a close association to a small geographic area, the findings may not be generalizable to racial/ethnic minority groups or individuals living in other parts of the country. Nevertheless, it is important that clinicians treating substance dependence/abuse, MDE, and GAD consider the role of CB. PMID:27215919

TASAR Flight Trial 2: Assessment of Air Traffic Controller Acceptability of TASAR Requests

NASA Technical Reports Server (NTRS)

Idris, Husni; Enea, Gabriele

2016-01-01

In support of the Flight Trial (FT-2) of NASA's prototype of the Traffic Aware Strategic Aircrew Requests (TASAR) concept, observations were conducted at the air traffic facilities to identify and assess the main factors that affect the acceptability of pilot requests by air traffic controllers. Two observers shadowed air traffic controllers at the Atlanta (ZTL) and Jacksonville (ZJX) air traffic control centers as the test flight pilot made pre-scripted requests to invoke acceptability issues and then they interviewed the observed and other controllers voluntarily. Fifty controllers were interviewed with experience ranging from one to thirty-five years. All interviewed controllers were enthusiastic about the technology and accounting for sector boundaries in pilot requests, particularly if pilots can be made aware of high workload situations. All interviewed controllers accept more than fifty percent of pilot requests; forty percent of them reject less than ten percent of requests. The most common reason for rejecting requests is conflicting with traffic followed by violating letters of agreement (LOAs) and negatively impacting neighboring sector workload, major arrival and departure flows and flow restrictions. Thirty-six requests were made during the test, eight of which were rejected due to: the aircraft already handed off to another sector, violating LOA, opposing traffic, intruding into an active special use airspace (SUA), intruding into another center, weather, and unfamiliarity with the requested waypoint. Nine requests were accepted with delay mostly because the controller needed to locate unfamiliar waypoints or to coordinate with other controllers.

Leisure-time activities of patients with ICDs: findings of a survey with respect to sports activity, high altitude stays, and driving patterns.

PubMed

Kobza, Richard; Duru, Firat; Erne, Paul

2008-07-01

Physicians who are caring for patients with implantable cardioverter-defibrillators (ICDs) are regularly confronted with questions concerning daily activities. This study evaluates the habits of ICD patients with respect to sports activities, stays at high-altitude, and driving patterns. A survey was performed in 387 patients with ICDs who were followed at two hospitals in Switzerland. The special-designed questionnaire addressed lifestyle practices concerning sports activity, high-altitude visits, and driving motor vehicles. Fifty-nine percent of ICD patients participated in some kind of sports activity; an ICD shock was experienced in 14% of these patients. Fifty-six percent of the patients reported a stay at high altitudes at least 2,000 m above the sea level; 11% of them stayed regularly above 2,500 m; 4% of these patients experienced an ICD shock during high altitude stay. Seventy-nine percent of the patients drove a motor vehicle; 2% of them experienced an ICD shock during driving, but none of them reported loss of consciousness or a traffic accident. It is accepted that ICD patients disqualify for competitive sports. However, the patients may be encouraged to continue leisure-time physical activities at low-to-moderate intensity. Staying at high altitudes and driving motor vehicles are very rarely associated with ICD shocks. Therefore, these activities that are likely to contribute to a better quality of life should not be discouraged in most ICD recipients in the absence of other medical reasons.

OK-432 sclerotherapy in head and neck lymphangiomas: long-term follow-up result.

PubMed

Yoo, Jae Chul; Ahn, Youngjin; Lim, Yune Syung; Hah, J Hun; Kwon, Tack-Kyun; Sung, Myung-Whun; Kim, Kwang Hyun

2009-01-01

Nonsurgical treatments, such as sclerotherapy have been attempted for head and neck lymphagiomas. Of the available sclerosing agents, picibanil has shown satisfactory short-term treatment results in many studies, but no study has presented long-term treatment results. Accordingly, in the present study, the authors retrospectively reviewed the long-term treatment results of picibanil sclerotherapy. Fifty-five lymphangioma patients who underwent picibanil sclerotherapy were enrolled. Data about initial and long-term response, recurrence, and excision rate were collected. Initial response rates were 83.5 percent and long-term response rates were 76.3 percent. Initial and the long-term response rate were equally good for lymphangioma.

A new method to evaluate the biocontrol potential of single spore isolates of fungal entomopathogens

PubMed Central

Posada, Francisco J.; Vega, Fernando E.

2005-01-01

Fifty Beauveria bassiana (Balsamo) Vuillemin (Ascomycota: Hypocreales) strains isolated from the coffee berry borer were used to develop a novel screening method aimed at selecting strains with the highest biocontrol potential. The screening method is based on percent insect mortality, average survival time, mortality distribution, percent spore germination, fungal life cycle duration, and spore production on the insect. Based on these parameters, only 11 strains merited further study. The use of a sound scientific protocol for the selection of promising fungal entomopathogens should lead to more efficient use of time, labor, and financial resources in biological control programs. PMID:17119619

Do traditional risk factors predict whether men who have sex with men engage in unprotected anal intercourse? The need for locally based research to guide interventions.

PubMed

Berg, Rigmor C; Grimes, Richard

2011-09-01

A great deal of research effort has been expended in an effort to identify the variables which most influence men who have sex with men's (MSM) unsafe sexual behaviors.While a set of predictor variables has emerged, these predict the unsafe behaviors of MSM in some locations but not in others, suggesting the need to investigate the predictive ability of these variables among MSM in previously understudied populations. Therefore, this study examined the ability of previously identified factors to predict unsafe sexual behaviors among MSM in Houston, Texas. Data were collected through a short self-report survey completed by MSM attending the Houston pride festival. The multiethnic participants (N = 109) represented a range of age, educational, and income backgrounds. Fifty-seven percent of the survey respondents had been drunk and/or high in sexual contexts, 19 percent evidenced alcohol dependency, 26 percent reported finding sex partners online and sex with serodiscordant or unknown serostatus partners was common. Compared to men who did not report unprotected anal intercourse (UAI) in the preceding two months, MSM who engaged in UAI were younger and more likely to use alcohol in sexual contexts, meet men online for offline sex, and perceive lower safer sex norms in their community. Although these results were statistically significant, the strength of the relationships was too small to have any practical value. The lack of useful explanatory power underscores the importance of accelerated HIV research that identifies the unique, local factors associated with unsafe sex in other previously understudied populations.

Health technology assessment agencies: an international overview of organizational aspects.

PubMed

Martelli, Francesco; La Torre, Giuseppe; Di Ghionno, Elena; Staniscia, Tommaso; Neroni, Massimo; Cicchetti, Americo; Von Bremen, Konrade; Ricciardi, Walter

2007-01-01

The aim of the study is to make an international comparison of Health Technology Assessment (HTA) Agencies, to show their similarities and differences. An e-mail questionnaire was sent to thirty HTA agencies internationally. Questions related to the structure of the agency, the relationship with health-related institutions, the prescriptiveness of the decisions taken, the main core and the modalities to spread the assessment, and the type of funding. Twenty-four HTA Agencies answered the questionnaire: 25 percent in America, 4.2 percent in Australia, and 70.8 percent in Europe. Fifty-four percent of HTA Agencies are governmental institutions (83.3 percent have central government funding), while 62.5 percent have relationships with health-related governmental institutions. Of the agencies, 87 percent reported that their decisions are not prescriptive, while for 20.8 percent and 8.3 percent of them stated that this was the case totally or partially, respectively, especially for the governmental and American Agencies. Seventeen agencies (70.8 percent) declared their work on multiannual programs (77 percent of the governmental HTA Agencies and 100 percent of the American ones). The assessments mainly addressed diagnostic procedures (85.7 percent) and pharmaceuticals (25 percent). The most common way to disseminate results is by means of paper report (91.7 percent), followed by the Internet (16.7 percent), and seminars to expert audiences (12.5 percent). The comparative analysis of HTA Agencies showed that governmental and American Agencies have a profound impact on the prescriptiveness of their assessment, and this could be linked to the fact that these types of Agencies work on multiannual programs. European and American HTA Agencies have many similarities in terms of type of assessment, funding, and dissemination of results.

Biomass statistics for New Hampshire - 1983

Treesearch

Thomas S. Frieswyk; Anne M. Malley

1986-01-01

A new measure of the forest resource has been added to the fourth forest inventory of New Hampshire. The inventory, which was conducted in 1982-83, included estimates of aboveground tree biomass on timberland. There are approximately 502 million green tons of wood and bark in the aboveground portion of all trees, or 104 green tons per acre. Fifty-five percent or 275...

Effects of compost amended lead-arsenate contaminated soils on total and inorganic arsenic concentration in rice

USDA-ARS?s Scientific Manuscript database

Rice (Oryza sativa L.), a staple crop for over fifty percent of the world’s population, is also a source of dietary arsenic because of its efficiency at accumulating As. Pesticides containing As were once widely used in agriculture, and some soils in which these pesticides were used are now being u...

Beyond the Border: Mexico’s Internal Conflict Is the United States’ Problem

DTIC Science & Technology

2013-05-23

environmental degradation” in new areas.18 Additionally, governmental resources continue to...solidified themselves as reliable transporters of Colombian cocaine. By late 1980s, the Mexican- Colombian agreement settled on a “payment-in-product...method of compensation for transporting Colombian merchandise, which comprised of thirty-five to fifty percent of the market price per shipment.31

Tulane University: From Recovery to Renewal

ERIC Educational Resources Information Center

Cowen, Scott

2007-01-01

Hurricane Katrina took more than 1,500 lives. Most of those people died in their homes because they could not escape, or they died trying to escape the flood waters. The hurricane submerged 80 percent of the parish, a land mass seven times the size of Manhattan. The flood lasted for fifty-seven days and destroyed over 160,000 homes and apartments.…

Wildfire risk and optimal investments in watershed protection

Treesearch

Travis Warziniack; Matthew Thompson

2013-01-01

Following what was then one of the most destructive fire years on record, President Bush signed into law the Healthy Forests Restoration Act of 2003. The law requires no less than fifty percent of all funds allocated for hazardous fuels reductions to occur in the wildland-urban interface (WUI), with the aim of enhancing the protection of homes and reducing the costs of...

Fifty-One Percent Minority. Connecticut Conference on the Status of Women.

ERIC Educational Resources Information Center

Connecticut Education Association, Storrs.

The articles presented in this document stem from taped presentations or post summations of speeches presented at a conference on the status of women held in the spring of 1972 by the Connecticut Education Association. The book can serve as a guide to three major problems: (1) sexual stereotypes; (2) the legal and economic status of women; and (3)…

The Effects of Self Regulated Strategy Development (SRSD) on Reading Comprehension for Secondary Students with Emotional and Behavioral Disabilities (EBD)

ERIC Educational Resources Information Center

Hoyt, Lisa R.

2010-01-01

Students with Emotional and Behavioral Disabilities (EBD) in the United States are characterized by behavioral deficits that impact their academic performance and social relationships. Students with EBD have lower academic performance in reading and math, more failed courses, higher rates of grade retention, and fewer than fifty percent graduate…

26 CFR 1.1348-2 - Computation of the fifty-percent maximum tax on earned income.

Code of Federal Regulations, 2010 CFR

2010-04-01

... compensation for A's personal services rendered by him in his laundry business would be $12,000. The net... earned income. 1.1348-2 Section 1.1348-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE... account in determining the net profits of a trade or business in which both personal services and capital...

AFMC Customer Satisfaction Study at the Air Logistics Centers

DTIC Science & Technology

2008-03-01

research was guided by a previous Graduate Research Project (GRP) effort, which sought to determine how customer relationship management ( CRM ...and effectively. To accomplish this, AFMC is implementing Customer Relationship Management ( CRM ) as one of its initiatives. Problem Statement...for improvement. More than fifty-one percent of the participants were not aware that Customer Relationship Management ( CRM ) was a transformation

State government regulation of forestry practices applied to nonfederal forests: extent and intensity of agency involvement

Treesearch

Paul V. Ellefson; Michael A. Kilgore; James E. Granskog

2006-01-01

In 2003, 276 state governmental agencies regulated forestry practices applied to nonfederal forests. Fifty-four percent of these agencies were moderately to extensively involved in such regulation, and 68% engaged in moderate to extensive regulatory coordination with a state's lead forestry agency. The agencies employed an estimates 1,047 full-time equivalents (...

Assessment of the Epidemiology and Burden of Measles in Southern Mozambique

PubMed Central

Mandomando, Inácio; Naniche, Denise; Pasetti, Marcela F.; Cuberos, Lilian; Sanz, Sergi; Vallès, Xavier; Sigauque, Betuel; Macete, Eusébio; Nhalungo, Delino; Kotloff, Karen L.; Levine, Myron M.; Alonso, Pedro L.

2011-01-01

Measles has been a major killer among vaccine-preventable diseases in children < 5 years of age in developing countries. Despite progress in global efforts to reduce mortality, measles remains a public health problem. Hospital-based measles surveillance was conducted in Manhica, Mozambique (July 2001–September 2004). Suspected cases and community-based controls were enrolled, and blood was collected for immunoglobulin M (IgM) confirmation. Two hundred fifty-three suspected cases and 477 controls were enrolled, with 85% (216 of 253) cases reported during a measles outbreak. Measles-IgM confirmation was 30% among suspected cases and 5% in controls. Fifty-eight percent (14 of 24) of laboratory-confirmed cases had records indicating previous measles vaccination. Mortality was 3% (8 of 246) among cases and 1% among controls (6 of 426). Forty-five percent (33 of 74) of cases were < 24 months of age and 22% occurred in infants < 9 months of age and were associated with a high case-fatality rate (25%). Our data suggest that improved diagnostics, new tools to protect infants < 9 months of age, and a supplemental dose of measles vaccine could assist measles control. PMID:21734140

The preparedness of hospital Health Information Services for system failures due to internal disasters.

PubMed

Lee, Cheens; Robinson, Kerin M; Wendt, Kate; Williamson, Dianne

The unimpeded functioning of hospital Health Information Services (HIS) is essential for patient care, clinical governance, organisational performance measurement, funding and research. In an investigation of hospital Health Information Services' preparedness for internal disasters, all hospitals in the state of Victoria with the following characteristics were surveyed: they have a Health Information Service/ Department; there is a Manager of the Health Information Service/Department; and their inpatient capacity is greater than 80 beds. Fifty percent of the respondents have experienced an internal disaster within the past decade, the majority affecting the Health Information Service. The most commonly occurring internal disasters were computer system failure and floods. Two-thirds of the hospitals have internal disaster plans; the most frequently occurring scenarios provided for are computer system failure, power failure and fire. More large hospitals have established back-up systems than medium- and small-size hospitals. Fifty-three percent of hospitals have a recovery plan for internal disasters. Hospitals typically self-rate as having a 'medium' level of internal disaster preparedness. Overall, large hospitals are better prepared for internal disasters than medium and small hospitals, and preparation for disruption of computer systems and medical record services is relatively high on their agendas.

Brachioplasty outcomes: a review of a multipractice cohort.

PubMed

Zomerlei, Terri A; Neaman, Keith C; Armstrong, Shannon D; Aitken, Marguerite E; Cullen, William T; Ford, Ronald D; Renucci, John D; VanderWoude, Douglas L

2013-04-01

Upper arm deformities secondary to massive weight loss or senile elastosis have led to an increased demand for aesthetic contouring procedures such as brachioplasty. The records of all patients who underwent a brachioplasty procedure from a multipractice medical center were reviewed. Outcomes measured included patient demographics, operative interventions, and postoperative course. Ninety-six patients were analyzed. Fifty-three patients (55.2 percent) underwent a concomitant procedure, with 53.1 percent undergoing arm liposuction at the time of brachioplasty. Major and minor complications rates were 17.7 percent and 44.8 percent, respectively. Common complications included hypertrophic scarring (24.0 percent) and infection (14.6 percent). The total revision rate was 22.9 percent, with residual contour deformity (40.9 percent of revisions) and hypertrophic scarring (36.4 percent of revisions) representing the most common causes for revision. Patients who underwent a previous bariatric procedure were at an increased risk of developing a major complication (p = 0.02). Concomitant upper arm liposuction and concomitant procedures were not associated with a significantly increased complication rate. Brachioplasty, despite being an effective treatment for contour irregularities of the upper arm, is associated with significant revision and complication rates. Post-bariatric surgery patients should be informed of the potential for increased complications. Additional procedures performed at the time of brachioplasty do not significantly increase complications. Liposuction of the upper arm can be performed safely in conjunction with brachioplasty.

The effect of alloying on gamma and gamma prime in nickel-base superalloys

NASA Technical Reports Server (NTRS)

Dreshfield, R. L.; Wallace, J. F.

1972-01-01

An investigation was conducted to determine the compositional limits of gamma and gamma prime phases in nickel-base superalloys. Fifty-one nickel-base alloys were melted under vacuum and heat treated for 4 hours at 1190 C followed by 1008 hours at 850 C. The alloys had the following composition ranges: A1 4.0 to 13 atomic percent, Cr 6.5 to 20.5 percent, Ti 0.25 to 4.75 percent, Mo 0.0 to 6.0 percent, and W 0.0 to 4.0 percent. The residues from the ammonium sulfate electrolytic extraction for the two-phase alloys were analyzed chemically and by X-ray diffraction. The results of the investigation were used to assemble a mathematical model of the gamma-gamma prime region of the Ni-Al-Cr-Ti-Mo-W system. A computer program was written to analyze the model of the phase diagram. Some of these results are also presented graphically. The resulting model is capable of satisfactorily predicting the compositions of conjugate gamma-gamma prime phases in the alloys investigated and twelve of fifteen commercial superalloys studied.

Chronic acceleration and egg production in domestic fowl

NASA Technical Reports Server (NTRS)

Smith, A. H.; Besch, E. L.; Burton, R. R.

1985-01-01

A study of the influence of chronic acceleration on egg production of commercially raised hens placed on a large animal centrifuge at 90 days of age, was performed. S8 generation hens were stepped up from 1.25 G to 2 G, which was maintained for 30 days. Fifty percent ceased to be in the laying condition at 1.5 G, and 10.8 percent suffered oviduct prolapse above 1.8 G. S21 generation hens had no incidents of oviduct prolapse despite 170-day retention at 2 G, and, assuming a 30 percent population not in the laying condition, approximated the commercial production rate. Chronic acceleration did not appear to affect the relative sizes of albumen or yolk, but it did appear to reduce the relative shell size, consistent with a decrease in plasma calcium. Dry matter content was not affected.

A Questionnaire of Parental Perceptions of Conscious Sedation in Pediatric Dentistry.

PubMed

White, Jason; Wells, Martha; Arheart, Kristopher L; Donaldson, Martin; Woods, Marjorie A

2016-01-01

The purpose of this study was to determine the opinions of parents about oral sedation in pediatric dentistry. A 21-question questionnaire, administered to parents of children presenting for care in four pediatric dental practices, collected demographic information, media exposure to sedation, and parental knowledge/opinions regarding sedation procedures, such as NPO (nothing by mouth) guidelines, need for restraint, parental presence, and parental acceptance of treatment scenarios. Among 256 questionnaires completed, 235 were usable. Fifty-eight percent of respondents reported using public insurance. Parents agreed/strongly agreed (75 percent) that protective stabilization should not be necessary during sedation, and 87 percent preferred to stay with their child during the appointment. No parents perceived sedation as unsafe. Seventy-three percent of parents were unaware of media coverage of sedation; 82 percent reported it was acceptable for their child to sleep through a sedation appointment, while only 18 percent found it acceptable for the child to be highly reactive. Parents prefer to remain with their child, believe that sedation is safe and restraint should not be necessary, and are more accepting of the child sleeping during treatment. Most parents are unaware of media coverage of dental sedation for children.

Introduction of implants into postdoctoral endodontic residency programs.

PubMed

Aminoshariae, Anita; Montagnese, Thomas A; Solanki, Poonam D; Mickel, Andre K

2011-09-01

The purpose of this study was to survey the directors of postdoctoral endodontic programs in the United States to ascertain their attitudes and approaches regarding incorporation of implants into the endodontic curriculum. We hypothesized that program directors would agree that implant training should be incorporated into the endodontic curriculum. We also hypothesized that they would all prefer apical surgeries and retreatment over implants when plausible. A twenty-item online survey was emailed to all fifty-two postdoctoral endodontic program directors in the United States. A 100 percent response was received. The results showed that 78.6 percent agreed that implant training should be incorporated, 85.7 percent preferred the didactic approach, and 42.9 percent preferred clinical implant training. One hundred percent preferred apical surgeries and retreatment over implants when plausible, and 53.8 percent did not prefer implants over endodontic treatment for teeth with a questionable prognosis. This survey indicates that implant training has been incorporated into postdoctoral endodontic programs and that the Commission on Dental Accreditation standards are being met. The trend may be to become more hands-on in the future if program directors believe there is a need to provide training in actual placement of implants.

Analytical approaches used in stream benthic macroinvertebrate biomonitoring programs of State agencies in the United States

USGS Publications Warehouse

Carter, James L.; Resh, Vincent H.

2013-01-01

Biomonitoring programs based on benthic macroinvertebrates are well-established worldwide. Their value, however, depends on the appropriateness of the analytical techniques used. All United States State, benthic macroinvertebrate biomonitoring programs were surveyed regarding the purposes of their programs, quality-assurance and quality-control procedures used, habitat and water-chemistry data collected, treatment of macroinvertebrate data prior to analysis, statistical methods used, and data-storage considerations. State regulatory mandates (59 percent of programs), biotic index development (17 percent), and Federal requirements (15 percent) were the most frequently reported purposes of State programs, with the specific tasks of satisfying the requirements for 305b/303d reports (89 percent), establishment and monitoring of total maximum daily loads, and developing biocriteria being the purposes most often mentioned. Most states establish reference sites (81 percent), but classify them using State-specific methods. The most often used technique for determining the appropriateness of a reference site was Best Professional Judgment (86 percent of these states). Macroinvertebrate samples are almost always collected by using a D-frame net, and duplicate samples are collected from approximately 10 percent of sites for quality assurance and quality control purposes. Most programs have macroinvertebrate samples processed by contractors (53 percent) and have identifications confirmed by a second taxonomist (85 percent). All States collect habitat data, with most using the Rapid Bioassessment Protocol visual-assessment approach, which requires ~1 h/site. Dissolved oxygen, pH, and conductivity are measured in more than 90 percent of programs. Wide variation exists in which taxa are excluded from analyses and the level of taxonomic resolution used. Species traits, such as functional feeding groups, are commonly used (96 percent), as are tolerance values for organic pollution (87 percent). Less often used are tolerance values for metals (28 percent). Benthic data are infrequently modified (34 percent) prior to analysis. Fixed-count subsampling is used widely (83 percent), with the number of organisms sorted ranging from 100 to 600 specimens. Most programs include a step during sample processing to acquire rare taxa (79 percent). Programs calculate from 2 to more than100 different metrics (mean 20), and most formulate a multimetric index (87 percent). Eleven of the 112 metrics reported represent 50 percent of all metrics considered to be useful, and most of these are based on richness or percent composition. Biotic indices and tolerance metrics are most oftenused in the eastern U.S., and functional and habitat-type metrics are most often used in the western U.S. Sixty-nine percent of programs analyze their data in-house, typically performing correlations and regressions, and few use any form of data transformation (34 percent). Fifty-one percent of the programs use multivariate analyses, typically non-metric multi-dimensional scaling. All programs have electronic data storage. Most programs use the Integrated Taxonomic Information System (75 percent) for nomenclature and to update historical data (78 percent). State procedures represent a diversity of biomonitoring approaches which likely compromises comparability among programs. A national-state consensus is needed for: (1) developing methods for the identification of reference conditions and reference sites, (2) standardization in determining and reporting species richness, (3) testing and documenting both the theoretical and mechanistic basis of often-used metrics, (4) development of properly replicated point-source study designs, and (5) curation of benthic macroinvertebrate data, including reference and voucher collections, for successful evaluation of future environmental changes.

[Discriminating power of socio-demographic and psychological variables on addictive use of cellular phones among middle school students].

PubMed

Lee, Haejung; Kim, Myoung Soo; Son, Hyun Kyung; Ahn, Sukhee; Kim, Jung Soon; Kim, Young Hae

2007-10-01

The purpose of this study was to examine the degrees of cellular phone usage among middle school students and to identify discriminating factors of addictive use of cellular phones among sociodemographic and psychological variables. From 123 middle schools in Busan, potential participants were identified through stratified random sampling and 747 middle school students participated in the study. The data was collected from December 1, 2004 to December 30, 2004. Descriptive and discriminant analyses were used. Fifty seven percent of the participants were male and 89.7% used cellular phones at school. The participants were grouped into three groups depending on the levels of the cellular phone usage: addicted (n=117), dependent (n=418), non-addicted (n=212). Within the three groups, two functions were produced and only one function was significant, discriminating the addiction group from non-addiction group. Additional discriminant analysis with only two groups produced one function that classified 81.2% of the participants correctly into the two groups. Impulsiveness, anxiety, and stress were significant discriminating factors. Based on the findings of this study, developing intervention programs focusing on impulsiveness, anxiety and stress to reduce the possible addictive use of cellular phones is suggested.

Vascular flora of the Fernow Experimental Forest and adjacent portions of the Otter Creek Wilderness Area

Treesearch

Robert B. Coxe; Steven L. Stephenson; Darlene M. Madarish; Gary W. Miller

2006-01-01

The vascular flora of the region we considered include 94 families representing at least 461 species. Fifty-four of these or nearly 12 percent are species known to have been introduced. Asteraceae (46 species) is the single largest family; Cyperaceae (31), Liliaceae (29), Poaceae and Rosaceae (20 each) also are important families in the general study area. The 461...

Kink-bands: Shock deformation of biotite resulting from a nuclear explosion

USGS Publications Warehouse

Cummings, D.

1965-01-01

Microscopic examination of granodiorite samples from the shock region around a nuclear explosion reveals sharply folded lens-shaped zones (kink-bands) in the mineral biotite. Fifty percent of these zones are oriented approximately 90?? to the direction of shock-wave propagation, but other zones are symmetrically concentrated at shear angles of 50?? and 70?? to the direction of shock-wave propagation.

Early indications of soil recovery from acidic deposition in U.S. red spruce forests

Treesearch

Gregory B. Lawrence; Walter C. Shortle; Mark B. David; Kevin T. Smith; Richard A. Warby; Andrei G. Lapenis

2012-01-01

Forty to fifty percent decreases in acidic deposition through the 1980s and 1990s led to partial recovery of acidified surface waters in the northeastern United States; however, the limited number of studies that have assessed soil change found increased soil acidification during this period. From existing data, it's not clear whether soils continued to worsen in...

Early Social Experience and Individual Differences in Infants' Joint Attention

ERIC Educational Resources Information Center

Gaffan, Elizabeth A.; Martins, Carla; Healy, Sarah; Murray, Lynne

2010-01-01

Fifty-nine healthy infants were filmed with their mothers and with a researcher at two, four, six and nine months in face-to-face play, and in toy-play at six and nine months. During toy-play at both ages, two indices of joint attention (JA)--infant bids for attention, and percent of time in shared attention--were assessed, along with other…

Analysis of Interactive Conflict Resolution Tool Usage in a Mixed Equipage Environment

NASA Technical Reports Server (NTRS)

Homola, Jeffrey; Morey, Susan; Cabrall, Christopher; Martin, Lynne; Mercer, Joey; Prevot, Thomas

2013-01-01

A human-in-the-loop simulation was conducted that examined separation assurance concepts in varying levels of traffic density with mixtures of aircraft equipage and automation. This paper's analysis focuses on one of the experimental conditions in which traffic levels were approximately fifty percent higher than today, and approximately fifty percent of the traffic within the test area were equipped with data communications (data comm) capabilities. The other fifty percent of the aircraft required control by voice much like today. Within this environment, the air traffic controller participants were provided access to tools and automation designed to support the primary task of separation assurance that are currently unavailable. Two tools were selected for analysis in this paper: 1) a pre-probed altitude fly-out menu that provided instant feedback of conflict probe results for a range of altitudes, and 2) an interactive auto resolver that provided on-demand access to an automation-generated conflict resolution trajectory. Although encouraged, use of the support tools was not required; the participants were free to use the tools as they saw fit, and they were also free to accept, reject, or modify the resolutions offered by the automation. This mode of interaction provided a unique opportunity to examine exactly when and how these tools were used, as well as how acceptable the resolutions were. Results showed that the participants used the pre-probed altitude fly-out menu in 14% of conflict cases and preferred to use it in a strategic timeframe on data comm equipped and level flight aircraft. The interactive auto resolver was also used in a primarily strategic timeframe on 22% of conflicts and that their preference was to use it on conflicts involving data comm equipped aircraft as well. Of the 258 resolutions displayed, 46% were implemented and 54% were not. The auto resolver was rated highly by participants in terms of confidence and preference. Factors such as aircraft equipage, ownership, and location of predicted separation loss appeared to play a role in the decision of controllers to accept or reject the auto resolver's resolutions.

Increasing incidence of hypothyroidism within one year after radioiodine therapy for toxic diffuse goiter. [/sup 131/I

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

Von Hofe, S.E.; Dorfman, S.G.; Carrette, R.F.

1978-02-01

Patients treated with 10 mCi of I-131 for toxic diffuse goiter in the period January 1974--June 1976 were evaluated for development of hypothyroidism. Fifty percent were hypothyroid within 3 months and 69 percent within 1 year of treatment. Our data suggest that there is a higher incidence of hypothyroidism after standard doses of I-131 in the 1970s as contrasted with treatment groups in the 1950s and 1960s. The pathophysiology of this increased incidence is not known with certainty; however, infrequent use of thionamide medication, together with recent increases in dietary iodine, may render the gland more radiosensitive.

The Quantity and Quality of Scientific Graphs in Pharmaceutical Advertisements

PubMed Central

Cooper, Richelle J; Schriger, David L; Wallace, Roger C; Mikulich, Vladislav J; Wilkes, Michael S

2003-01-01

We characterized the quantity and quality of graphs in all pharmaceutical advertisements, in the 10 U.S. medical journals. Four hundred eighty-four unique advertisements (of 3,185 total advertisements) contained 836 glossy and 455 small-print pages. Forty-nine percent of glossy page area was nonscientific figures/images, 0.4% tables, and 1.6% scientific graphs (74 graphs in 64 advertisements). All 74 graphs were univariate displays, 4% were distributions, and 4% contained confidence intervals for summary measures. Extraneous decoration (66%) and redundancy (46%) were common. Fifty-eight percent of graphs presented an outcome relevant to the drug's indication. Numeric distortion, specifically prohibited by FDA regulations, occurred in 36% of graphs. PMID:12709097

Ear molding in newborn infants with auricular deformities.

PubMed

Byrd, H Steve; Langevin, Claude-Jean; Ghidoni, Lorraine A

2010-10-01

A review of a single physician's experience in managing over 831 infant ear deformities (488 patients) is presented. The authors' methods of molding have advanced from the use of various tapes, glues, and stents, to a comprehensive yet simple system that shapes the antihelix, the triangular fossa, the helical rim, and the overly prominent conchal-mastoid angle (EarWell Infant Ear Correction System). The types of deformities managed, and their relative occurrence, are as follows: (1) prominent/cup ear, 373 ears (45 percent); (2) lidding/lop ear, 224 ears (27 percent); (3) mixed ear deformities, 83 ears (10 percent) (all had associated conchal crus); (4) Stahl's ear, 66 ears (8 percent); (5) helical rim abnormalities, 58 ears (7 percent); (6) conchal crus, 25 ears (3 percent); and (7) cryptotia, two ears (0.2 percent). Bilateral deformities were present in 340 patients (70 percent), with unilateral deformities in 148 patients (30 percent). Fifty-eight infant ears (34 patients) were treated using the final version of the EarWell Infant Ear Correction System with a success rate exceeding 90 percent (good to excellent results). The system was found to be most successful when begun in the first week of the infant's life. When molding was initiated after 3 weeks from birth, only approximately half of the infants had a good response. Congenital ear deformities are common and only approximately 30 percent self-correct. These deformities can be corrected by initiating appropriate molding in the first week of life. Neonatal molding reduces the need for surgical correction with results that often exceed what can be achieved with the surgical alternative.

A comparison of two search methods for determining the scope of systematic reviews and health technology assessments.

PubMed

Forsetlund, Louise; Kirkehei, Ingvild; Harboe, Ingrid; Odgaard-Jensen, Jan

2012-01-01

This study aims to compare two different search methods for determining the scope of a requested systematic review or health technology assessment. The first method (called the Direct Search Method) included performing direct searches in the Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE) and the Health Technology Assessments (HTA). Using the comparison method (called the NHS Search Engine) we performed searches by means of the search engine of the British National Health Service, NHS Evidence. We used an adapted cross-over design with a random allocation of fifty-five requests for systematic reviews. The main analyses were based on repeated measurements adjusted for the order in which the searches were conducted. The Direct Search Method generated on average fewer hits (48 percent [95 percent confidence interval {CI} 6 percent to 72 percent], had a higher precision (0.22 [95 percent CI, 0.13 to 0.30]) and more unique hits than when searching by means of the NHS Search Engine (50 percent [95 percent CI, 7 percent to 110 percent]). On the other hand, the Direct Search Method took longer (14.58 minutes [95 percent CI, 7.20 to 21.97]) and was perceived as somewhat less user-friendly than the NHS Search Engine (-0.60 [95 percent CI, -1.11 to -0.09]). Although the Direct Search Method had some drawbacks such as being more time-consuming and less user-friendly, it generated more unique hits than the NHS Search Engine, retrieved on average fewer references and fewer irrelevant results.

Predictive Factors of Mortality in Burn Patients

PubMed Central

Fazeli, Shahram; Karami-Matin, Reza; Kakaei, Neda; Pourghorban, Samira; Safari-Faramani, Roya; Safari-Faramani, Bahare

2014-01-01

Background: Burn injuries impose a considerable burden on healthcare systems in Iran. It is among the top ten causes of mortality and a main cause of disability. Objectives: This study aimed to examine factors influencing mortality in burn patients admitted to the main educational tertiary referral hospital in Kermanshah. Patients and Methods: All patients admitted to the Imam Khomeini Hospital (from March 2011 to March 2012), due to thermal burn injuries were included in the study. We applied multiple logistic regressions to identify risk and protective factors of mortality. Also we calculated lethal area fifty percent (LA50), as an aggregate index for hospital quality. Results: During the study period, 540 burn patients were admitted. Male to female ratio was 1.12:1. Twenty three percent of the patients were less than 15 years-old. Median of age was 25 years (Inter Quartile Range, 16 - 37). Overall, probability of death was 25.8%. Lethal area fifty percent (LA50) was 50.82 (CI 95%: 47.76 - 54.48). In the final model, after adjustment of sex, age, total body surface area (TBSA), cause of burn and it’s severity, female gender (P < 0.05), age ≥ 60 years (in comparison with age less than 15 years, P < 0.05) and larger burn size (P < 0.0001) were identified as the main risk factors of death in these patients. Conclusions: Findings showed that the main risk factors of death were female gender, burn size and old age. Directing more attention to these vulnerable patients is required to reduce mortality and improve patient survival. PMID:24719826

Neurologic and developmental disability after extremely preterm birth. EPICure Study Group.

PubMed

Wood, N S; Marlow, N; Costeloe, K; Gibson, A T; Wilkinson, A R

2000-08-10

Small studies show that many children born as extremely preterm infants have neurologic and developmental disabilities. We evaluated all children who were born at 25 or fewer completed weeks of gestation in the United Kingdom and Ireland from March through December 1995 at the time when they reached a median age of 30 months. Each child underwent a formal assessment by an independent examiner. Development was evaluated with use of the Bayley Scales of Infant Development, and neurologic function was assessed by a standardized examination. Disability and severe disability were defined by predetermined criteria. At a median age of 30 months, corrected for gestational age, 283 (92 percent) of the 308 surviving children were formally assessed. The mean (+/-SD) scores on the Bayley Mental and Psychomotor Developmental Indexes, referenced to a population mean of 100, were 84+/-12 and 87+/-13, respectively. Fifty-three children (19 percent) had severely delayed development (with scores more than 3 SD below the mean), and a further 32 children (11 percent) had scores from 2 SD to 3 SD below the mean. Twenty-eight children (10 percent) had severe neuromotor disability, 7 (2 percent) were blind or perceived light only, and 8 (3 percent) had hearing loss that was uncorrectable or required aids. Overall, 138 children had disability (49 percent; 95 percent confidence interval, 43 to 55 percent), including 64 who met the criteria for severe disability (23 percent; 95 percent confidence interval, 18 to 28 percent). When data from 17 assessments by local pediatricians were included, 155 of the 314 infants discharged (49 percent) had no disability. Severe disability is common among children born as extremely preterm infants.

Infrared skin damage thresholds from 1319-nm continuous-wave laser exposures

NASA Astrophysics Data System (ADS)

Oliver, Jeffrey W.; Vincelette, Rebecca; Noojin, Gary D.; Clark, Clifton D.; Harbert, Corey A.; Schuster, Kurt J.; Shingledecker, Aurora D.; Kumru, Semih S.; Maughan, Justin; Kitzis, Naomi; Buffington, Gavin D.; Stolarski, David J.; Thomas, Robert J.

2013-12-01

A series of experiments were conducted in vivo using Yucatan miniature pigs (Sus scrofa domestica) to determine thermal damage thresholds to the skin from 1319-nm continuous-wave Nd:YAG laser irradiation. Experiments employed exposure durations of 0.25, 1.0, 2.5, and 10 s and beam diameters of ˜0.6 and 1 cm. Thermal imagery data provided a time-dependent surface temperature response from the laser. A damage endpoint of fifty percent probability of a minimally visible effect was used to determine threshold for damage at 1 and 24 h postexposure. Predicted thermal response and damage thresholds are compared with a numerical model of optical-thermal interaction. Resultant trends with respect to exposure duration and beam diameter are compared with current standardized exposure limits for laser safety. Mathematical modeling agreed well with experimental data, predicting that though laser safety standards are sufficient for exposures <10 s, they may become less safe for very long exposures.

Dental student attitudes towards communication skills instruction and clinical application.

PubMed

McKenzie, Carly T

2014-10-01

This study investigated dental students' attitudes towards communication skills instruction and clinical application and explored the impact of a one-semester course and year in school on students' attitudes, measured by the Communication Skills Attitude Scale. Demographic characteristics and self-assessment of communication skills were also analyzed. The study employed a pretest-posttest survey design combined with cross-sectional data. Participants were first- and fourth-year students at a U.S. dental school. Out of a possible 120 students, 106 (fifty-seven D1 and forty-nine D4) participated in the pretest, an 88 percent response rate; out of a possible 121 students, 115 (fifty-seven D1 and fifty-eight D4) participated in the posttest, a 95 percent response rate. In the results, D4 students consistently demonstrated less positive attitudes towards communication skills instruction and more negative attitudes regarding the importance of interpersonal skills in clinical encounters than did their D1 counterparts. A single communications course had no discernible effect on attitudes or self-assessments for either cohort. Females reported more positive attitudes towards clinical application of interpersonal skills than did males. Gender significantly interacted with two demographic variables: primary language and parent as health care professional. Female children of health care professionals reported poorer attitudes towards clinical communication skills training and application than did their male counterparts. Generally, parental occupation in health care moderated the decrease in positive attitudes over time towards clinical usefulness of communication skills. The D4 students rated their communication skills higher than did the D1 students. Students who demonstrated more positive attitudes towards communication skills training and application were more likely to say their own skills needed improvement.

A survey of parental opinions on corporal punishment in schools.

PubMed

Kelly, P C; Weir, M R; Fearnow, R G

1985-06-01

Forty-three states permit corporal punishment in schools. This practice continues despite the universal opposition of professional organizations, including the American Academy of Pediatrics. This study determines parental attitudes concerning the use of physical punishment in schools. The surveyed sample is drawn from parents of military dependents who brought their children to this clinic for routine physical examinations. One hundred and twenty-nine of 132 questionnaires were returned for a 98% response rate. Fifty-one percent of the parents supported the use of corporal punishment in schools, 37% disagreed (77% of these strongly), 11% had no opinion, and 1% did not respond to the question. Analysis of the responses displayed a relationship between parental attitudes on the use of corporal punishment and opinion of the positive effects of physical punishment on children's behavior (p less than 0.0001). No relationship was found between position on corporal punishment and the respondent (mother, father, or both), the age of parents, the military rank of the sponsor (the individual whose military service makes the child eligible for military medical care, i.e., father, mother, guardian, etc.), the sex of the children, the marital status of the parents, or the schools attended by the children (public or private). Thirty-four percent of parents believed corporal punishment would improve behavior, and 20% of parents felt that physical punishment would improve their child's academic performance.

Pig islet xenotransplantation acceptance in a Latin-American diabetic population.

PubMed

Abalovich, Adrián; Wechsler, Carlos; Lara, Silvia; Bervottini, Miguel

2010-01-01

Progress in porcine islet xenotransplantation has been accompanied by studies on acceptance of this new procedure by patients, health professionals or the general public. Such studies have not been done in the Latin-American population. We conducted a questionnaire in 108 diabetes patients (insulin-dependent, n = 53; insulin-independent, n = 55) in a public hospital in Argentina. The questions addressed the general perception of the xenotransplant procedure and specific items related to the outcome (achieving insulin independence, improvement in metabolic control, delay in emergence of diabetic complications, need for repeat procedures, potential of transfer of infectious viruses, association with psychological problems, and anticipated success in relation to achieving a cure). Eighty-six (79%) of the patients accepted islet xenotransplantation; this incidence was not different for insulin-dependent or insulin-independent patients, patients with or without complications, or patients with good or poor metabolic control. Also, over 75% of patients accepted the procedure if this is only associated with a reduction in insulin requirement, if the procedure just delays but not prevents the onset of complications, or if the procedure needs to be performed every 6 months. Fifty-seven percent of patients indicated acceptance even if the potential transmission of a virus infection cannot be completely ruled out: this outcome was not affected by the outbreak of the H1N1 flu epidemic during the conduct of this study. Forty percent of patients indicated that living with porcine cells in their body could give psychological problems. We conclude that this population of Latin-American diabetic patients shows a high acceptance rate of a porcine islet xenotransplantation product. (c) 2010 John Wiley & Sons A/S.

Moderating the Enthusiasm of Sleeve Gastrectomy: Up to Fifty Percent of Reflux Symptoms After Ten Years in a Consecutive Series of One Hundred Laparoscopic Sleeve Gastrectomies.

PubMed

Mandeville, Yannick; Van Looveren, Ruth; Vancoillie, Peter-Jan; Verbeke, Xander; Vandendriessche, Katrien; Vuylsteke, Patrick; Pattyn, Paul; Smet, Bart

2017-07-01

Laparoscopic sleeve gastrectomy (LSG) has become a popular one-stage bariatric procedure with a proven efficacy on weight loss. However, the relationship between LSG and gastroesophageal reflux disease (GERD) remains a subject of debate. The objective is to determine the long-term effect of LSG on weight loss and reflux disease. A retrospective analysis of 100 consecutive patients who underwent an LSG between January 2005 and March 2009 was performed. The effect of LSG on weight evolution and the relationship between preoperative and postoperative GERD symptoms and PPI dependency was analyzed. A mean follow-up of 8.48 years (range 6.1-10.3) was achieved. We observed a long-term % excess weight loss (%EWL) of 60%. A significant increase in reflux symptoms and use of PPIs was seen. Seventeen percent suffered from reflux disease preoperatively versus 50% at the end of the postoperative follow-up (RR = 2.5882, 95% CI [1.6161-4.1452], p value = 0.0001). The chance of developing de novo reflux after LSG was 47.8% (32/67). Reflux disease was present in 7 of the 26 patients who underwent a secondary Roux-en-Y gastric bypass (RYGB). In four of these seven patients, reflux disease disappeared completely after the secondary RYGB (57.1%). A satisfactory long-term effect on weight loss was achieved. However, a significant increase in GERD and PPI dependency after LSG was noted. New onset GERD was seen in more than 40% of the study population. Conversion to RYGB is a good option in patients with refractory reflux disease after LSG.

PHYSICIANS' KNOWLEDGE ABOUT RADIATION DOSE AND POSSIBLE RISKS OF COMMON MEDICAL TESTS: A SURVEY IN IRAN.

PubMed

Zakeri, Farideh; Shakeri, Mahsa; Rajabpour, Mohammad Reza; Farshidpour, Mohammad Reza; Mianji, Fereidoun

2016-12-01

Recent data suggest that knowledge of radiation exposures among physicians is inadequate. This study, therefore, aimed to evaluate their knowledge of the radiation doses their patients received and awareness of associated biological risks of radiation exposure. A questionnaire in multiple-choice format consisted of four sections with a total of 10 questions based on the literature review. A total of 136 questionnaires were returned from 69 general practitioners and 67 physicians in various specialties from 10 different hospitals in the capital city of Tehran, Iran. Fifty-four percent of general practitioners and twenty-five percent of specialties declared that they are not aware of biological risks of radiation exposure. Fifty-six percent of physicians did not know the correct definition of absorbed dose. Only 33% of physicians knew the dose exposure of a chest X-ray and only 31% knew the approximate doses of various procedures relative to a chest X-ray. Forty-seven percent of physicians incorrectly distinguished the stochastic effects of radiation from the deterministic effects, and thirty-eight of physicians did not know the organs of the body that are most sensitive to ionizing radiation. Only 23.5% of physicians were aware of the one in 2000 risk of induction of fatal carcinoma from computed tomography of the abdomen. Seventy-nine percent of physicians incorrectly underestimated the contribution of nuclear and radiological tests in exposure of an average person. The mean score of the specialties trended toward being more accurate than general practitioners (4.18 ± 1.28 vs. 3.89 ± 1.46, respectively, from a potential accurate total score of 9), but these differences were not statistically significant. Among specialists, orthopedics had the highest scores. The present study demonstrated the limited knowledge of radiation exposures among general practitioners and specialists and a need to improve their knowledge by means of targeted training and re-education. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[Teenager counselling in primary care].

PubMed

Millán, Teresa; Morera, Iván; Vargas, Nelson A

2007-04-01

Teenager counseling to recognize risks and reinforce strengths is carried out in a primary care outpatient clinic since 2003. To describe the epidemiology and causes for consultation in this teenage counseling program. Retrospective review of the records of 116 teenagers (median age 13 years, 67% females) that received teenager counseling. Seventy percent of women and 50% of men came from nuclear families. More than two thirds were primogenital. Most adolescents were accompanied by their mother, that were the main adult raw model. Fifty percent had dysfunctional families. All were attending school regularly and 21% of women and 29% of men had repeated a school level. Sixty eight percent of women and 62% of men declared to have a life project. Twenty percent were worried about their physical appearance. Seventy seven percent of women and 62% of men considered themselves as happy. Thirty six percent of women and 14% of men smoked. The figures for alcohol consumption were 21% and 14%, respectively. The causes for consultation were obesity, overweight, unspecific symptoms, behavioral problems, bad school achievement, communication problems or pregnancy. Reasons for counseling were family dysfunction, low self esteem, bad school achievement and information about sexuality. The information obtained could help to improve the interdisciplinary work and to coordinate counseling with the family and schools.

Effects of the Voice over Internet Protocol on Perturbation Analysis of Normal and Pathological Phonation

PubMed Central

Zhu, Yanmei; Witt, Rachel E.; MacCallum, Julia K.; Jiang, Jack J.

2010-01-01

Objective In this study, a Voice over Internet Protocol (VoIP) communication based on G.729 protocol was simulated to determine the effects of this system on acoustic perturbation parameters of normal and pathological voice signals. Patients and Methods: Fifty recordings of normal voice and 48 recordings of pathological voice affected by laryngeal paralysis were transmitted through a VoIP communication system. The acoustic analysis programs of CSpeech and MDVP were used to determine the percent jitter and percent shimmer from the voice samples before and after VoIP transmission. The effects of three frequently used audio compression protocols (MP3, WMA, and FLAC) on the perturbation measures were also studied. Results It was found that VoIP transmission disrupts the waveform and increases the percent jitter and percent shimmer of voice samples. However, after VoIP transmission, significant discrimination between normal and pathological voices affected by laryngeal paralysis was still possible. It was found that the lossless compression method FLAC does not exert any influence on the perturbation measures. The lossy compression methods MP3 and WMA increase percent jitter and percent shimmer values. Conclusion This study validates the feasibility of these transmission and compression protocols in developing remote voice signal data collection and assessment systems. PMID:20588051

Local indigenous knowledge about some medicinal plants in and around Kakamega forest in western Kenya.

PubMed

Otieno, Nickson Erick; Analo, Caleb

2012-01-01

Kakamega forest is Kenya's only rainforest and is distinguishably rich in biodiversity but threatened by agricultural encroachment and other forms of human activity. It is also one of Kenya's Important Bird Areas and a significant source of natural products to neighboring rural communities, such as medicinal plants, food, wood and other fibers. By using structured questionnaires for direct interviews, local indigenous knowledge was tapped through involvement of a focal group of elderly key informants in three blocks of the forest. Forty key species of medicinal plants used by local people were identified and recorded. Fifty-five percent of these were shrubs, thirty-two percent trees, seven-and-a-half percent lower plants such as herbs or forbs while five percent were climbers. About seventy percent of the medicinal plants occurred inside the forest itself and thirty percent around the edge and the immediate surroundings outside the forest. Thirty-eight (95%) of the plants were indigenous to Kenya and two (5%) exotic. Such extensive indigenous knowledge of the medicinal uses of the plants, including their distribution trends in the forest, may be tapped for decision support in rural health service planning, policy formulation for conserving the forest, tracking and mitigation of climate change impacts.

An exploratory study of factors that affect the performance and usage of rapid diagnostic tests for malaria in the Limpopo Province, South Africa.

PubMed

Moonasar, Devanand; Goga, Ameena Ebrahim; Frean, John; Kruger, Philip; Chandramohan, Daniel

2007-06-02

Malaria rapid diagnostic tests (RDTs) are relatively simple to perform and provide results quickly for making treatment decisions. However, the accuracy and application of RDT results depends on several factors such as quality of the RDT, storage, transport and end user performance. A cross sectional survey to explore factors that affect the performance and use of RDTs was conducted in the primary care facilities in South Africa. This study was conducted in three malaria risk sub-districts of the Limpopo Province, in South Africa. Twenty nurses were randomly selected from 17 primary health care facilities, three nurses from hospitals serving the study area and 10 other key informants, representing the managers of the malaria control programmes, routine and research laboratories, were interviewed, using semi-structured questionnaires. There was a high degree of efficiency in ordering and distribution of RDTs, however only 13/20 (65%) of the health facilities had appropriate air-conditioning and monitoring of room temperatures. Sixty percent (12/20) of the nurses did not receive any external training on conducting and interpreting RDT. Fifty percent of nurses (10/20) reported RDT stock-outs. Only 3/20 nurses mentioned that they periodically checked quality of RDT. Fifteen percent of nurses reported giving antimalarial drugs even if the RDT was negative. Storage, quality assurance, end user training and use of RDT results for clinical decision making in primary care facilities in South Africa need to be improved. Further studies of the factors influencing the quality control of RDTs, their performance of RDTs and the ways to improve their use of RDTs are needed.

An exploratory study of factors that affect the performance and usage of rapid diagnostic tests for malaria in the Limpopo Province, South Africa

PubMed Central

Moonasar, Devanand; Goga, Ameena Ebrahim; Frean, John; Kruger, Philip; Chandramohan, Daniel

2007-01-01

Background Malaria rapid diagnostic tests (RDTs) are relatively simple to perform and provide results quickly for making treatment decisions. However, the accuracy and application of RDT results depends on several factors such as quality of the RDT, storage, transport and end user performance. A cross sectional survey to explore factors that affect the performance and use of RDTs was conducted in the primary care facilities in South Africa. Methods This study was conducted in three malaria risk sub-districts of the Limpopo Province, in South Africa. Twenty nurses were randomly selected from 17 primary health care facilities, three nurses from hospitals serving the study area and 10 other key informants, representing the managers of the malaria control programmes, routine and research laboratories, were interviewed, using semi-structured questionnaires. Results There was a high degree of efficiency in ordering and distribution of RDTs, however only 13/20 (65%) of the health facilities had appropriate air-conditioning and monitoring of room temperatures. Sixty percent (12/20) of the nurses did not receive any external training on conducting and interpreting RDT. Fifty percent of nurses (10/20) reported RDT stock-outs. Only 3/20 nurses mentioned that they periodically checked quality of RDT. Fifteen percent of nurses reported giving antimalarial drugs even if the RDT was negative. Conclusion Storage, quality assurance, end user training and use of RDT results for clinical decision making in primary care facilities in South Africa need to be improved. Further studies of the factors influencing the quality control of RDTs, their performance of RDTs and the ways to improve their use of RDTs are needed. PMID:17543127

The Hispanic and Latino dentist workforce in the United States.

PubMed

Mertz, Elizabeth; Wides, Cynthia; Calvo, Jean; Gates, Paul

2017-03-01

The purpose of this paper is to describe the Hispanic/Latino (H/L) dentist workforce, their general practice patterns, and their contributions to oral health care for H/L and underserved patients. A national sample survey of underrepresented minority dentists was conducted in 2012 and received a 35.4 percent response rate for self-reported H/L dentists. Data were weighted for selection and response bias to be nationally representative. A workforce profile of H/L dentists was created using descriptive and multivariable statistics and published data. Among all H/L dentists (weighted n = 5,748), 31.9 percent self-identify their origin as Mexican, 13.4 percent as Puerto Rican, 13.0 percent as Cuban, and 41.7 percent as another H/L group. The largest share of H/L dentists are male, married, and have children under age 18. Fifty percent of H/L dentists are foreign-born and 25 percent are foreign-trained. H/L dentists report higher than average educational debt, with those completing International Dentist Programs reporting the highest debt load. Sixty-nine percent of clinically active H/L dentists own their own practices, and 85 percent speak Spanish in their practice. Among clinical H/L dentists, 7 percent work in safety-net settings, 40 percent primarily treat underserved populations, and, on average, 42 percent of their patient population is H/L. H/L dental providers are underrepresented in the dentist population, and those that are in practice shoulder a disproportionate share of dental care for minority and underserved communities. Improving the workforce diversity of dental providers is a critical part of strategy to address the high burden of dental disease in the H/L population. © 2016 American Association of Public Health Dentistry.

Work, family and social environment in patients with Fibromyalgia in Spain: an epidemiological study: EPIFFAC study.

PubMed

Collado, Antonio; Gomez, Emili; Coscolla, Rosa; Sunyol, Ruth; Solé, Emília; Rivera, Javier; Altarriba, Emília; Carbonell, Jordi; Castells, Xavier

2014-11-11

Fibromyalgia (FM) is a condition characterized by widespread pain, estimated to affect 2.4% of the Spanish population. Nowadays, there are no consistent epidemiological studies on the actual impact of the disease on work and family of these patients in a representative manner; therefore, the purpose of the study is to analyze the impact on family, employment and social environment in a representative sample of patients with FM attending Primary Public Care Centers in Spain. We carried out an epidemiological study, with a probability sampling procedure, stratified, relative to the municipality size and the number of health centres, seeking territorial representation. The survey was conducted using a self-administered structured questionnaire. A sample of 325 patients with FM was studied in 35 Primary Health Care Centers (PHCCs). The sample is composed of 96.6% of women, 51.9 (8) years of mean (standard deviation- sd) age. Ninety-three percent of the patients have worked throughout their life. Mean (sd) age onset of symptoms was 37 (11) years and diagnosis of FM was established 6.6 (8) years later. Family Environment: Fifty-nine percent of patients have difficulties with their partner. Forty-four percent of the patients report to be fairly or totally dependent on a family member in household chores. The household income decreased a mean (sd) of 708 (504) Euros/month in 65% of the patients. In 81% of the patients, there was an increase in extra expenses related to the disease with a mean (sd) of 230 (192) Euros/month. Working environment: At the moment of the study, 45% of the patients had work activity (34% were working and 11% were at sick leave), 13% were unemployed seeking job and 42% were not in the labor force. Twenty-three percent of patients had some degree of permanent work disability pension. Social Environment: The degree of satisfaction with health care professionals was low and twenty-six percent of the patients were members of specific patients associations. This study finds that people with FM who visit PHCCs of Spain experience a high impact on families and employment with heavy loss of ability to work.

Attitudes towards students who plagiarize: a dental hygiene faculty perspective.

PubMed

Patel-Bhakta, Hemali G; Muzzin, Kathleen B; Dewald, Janice P; Campbell, Patricia R; Buschang, Peter H

2014-01-01

The purpose of this study was to examine baccalaureate dental hygiene faculty members' attitudes and practices regarding student plagiarism. An email containing a link to a thirty-two-item survey was sent to fifty-two baccalaureate dental hygiene program directors in the United States; thirty of those agreed for their faculty members to participate. Of the 257 faculty members who received the survey link, 106 completed the survey, for a response rate of 41.2 percent. The responding faculty members reported thinking plagiarism is a rising concern in their dental hygiene programs (54.5 percent, 54/99). The majority said they check for plagiarism on student class assignment/projects (67.1 percent, 53/79). For those who did not check for plagiarism, 45.8 percent (11/24) stated it took "too much time to check" or it was "too hard to prove" (16.6 percent, 4/24). The most frequent form of student plagiarism observed by the respondents was "copying directly from a source electronically" (78.0 percent, 39/50). Most respondents reported checking for plagiarism through visual inspection (without technological assistance) (73.0 percent, 38/52). Of those who said they use plagiarism detection software/services, 44.4 percent (16/36) always recommended their students use plagiarism detection software/services to detect unintentional plagiarism. For those faculty members who caught students plagiarizing, 52.9 percent (27/51) reported they "always or often" handled the incident within their dental hygiene department, and 76.5 percent (39/51) said they had never reported the student's violation to an academic review board.

NORAD: A Model to Address Gaps in US-Mexico Security Coordination

DTIC Science & Technology

2016-05-26

37 slow economic recovery throughout the 1930s by creating a national investment bank , accelerating land reforms, and nationalizing the...population formed in northern Mexico, with unemployment rates rising as high as fifty percent in border cities such as Ciudad Juárez, Tijuana, and...Mexicali.178 To address unemployment in the historically volatile border region, the Mexican government instituted a series of economic development

Extensive transmission of Mycobacterium tuberculosis among children on a school bus.

PubMed

Neira-Munoz, Edmundo; Smith, Janette; Cockcroft, Paul; Basher, Damian; Abubakar, Ibrahim

2008-09-01

We report a tuberculosis outbreak in school children caused by exposure to a sputum-smear positive school bus driver. Exposed children were assessed using 2 versions of interferon-gamma release assays. Fifty-five percent (18/34) had a positive interferon-gamma release assays and 4 children developed tuberculosis. This suggests that transmission may be very efficient in this setting and highlights the need for early diagnosis.

The Attitudes of Members of the Association for the Treatment of Sexual Abusers towards Treatment, Release, and Recidivism of Violent Sex Offenders: An Exploratory Study

ERIC Educational Resources Information Center

Engle, Michael J.; McFalls, Joseph A., Jr.; Gallagher, Bernard J., III

2007-01-01

Attitudes of members of the Association for the Treatment of Sexual Abusers (ATSA) towards treatment, release, and recidivism of sexual predators are assessed through an anonymous questionnaire. Fifty-two percent (540 members) responded. A large majority report little hope for cure (63%) and fear of recidivism after treatment (88%). No differences…

A Comparison of Diabetes Management in a Federal Prison With the National Standards of Care Published by the ADA in 1998

DTIC Science & Technology

2000-05-01

their annual visit. More than half the patients studied did not have periodic HbA1c testing, and one-third of the NIDDM patients did not have an...electrocardiogram and 44% to a registered dietitian. Fifty-seven percent of the records indicated only annual testing of HbA1c and 23% not being tested at

A Comparison of Diabetes Management in a Federal Prison with the National Standards of Care Published by the ADA in 1998

DTIC Science & Technology

2000-05-01

patients studied did not have periodic HbA1c testing, and one-third of the NIDDM patients did not have an annual lipid screening or urinalysis. Despite...dietitian. Fifty-seven percent of the records indicated only annual testing of HbA1c and 23% not being tested at all. Furthermore, 32% of records had no

Screening for and Prevalence of HIV and Hepatitis C among an Outpatient Urban Sample of People with Serious Mental Illness and Co-Occurring Substance Abuse

ERIC Educational Resources Information Center

Himelhoch, Seth; Goldberg, Richard; Calmes, Christine; Medoff, Deborah; Slade, Eric; Dixon, Lisa; Gallucci, Gerard; Rosenberg, Stanley

2011-01-01

Background: To assess rates of screening and testing of HIV and HCV among those with serious mental illness and co-occurring substance use disorders. Methods: One hundred fifty-three people with serious mental illness and co-occurring substance use disorders completed measures and were screened for HIV and HCV. Results: Six percent were HIV…

Food and eating environments: in Canadian schools.

PubMed

Browning, H Frances; Laxer, Rachel E; Janssen, Ian

2013-01-01

This national study was conducted to examine healthy eating programs, healthy eating education, and the food retail environments of schools. A total of 436 Canadian schools were studied. Administrators completed a questionnaire designed to assess school healthy eating programs, healthy eating education, and food retail environment. The number of chain fast food restaurants, chain cafés/coffee shops, and convenience stores within 1 km of schools was measured using geographic information systems food retailer measures from DMTI Spatial Inc. and the Yellow Pages. During the preceding year, 67% of schools had initiated healthy eating lunch programs while 18% had junk food-free days. The majority of schools offered cooking classes (59%) and healthy eating media literacy education (67%), while a minority offered gardening activities (15%) and field trips to farmers' markets (27%) and grocery stores (36%). Fifty-three percent had a school cafeteria, and most had a school tuck shop (75%) and pop/juice vending machines (76%). Fifty percent had a chain fast food restaurant, 33% had a chain café/coffee shop, and 41% had a convenience store within 1 km. An important aspect of addressing childhood obesity will be improving the food environments of schools and their surrounding neighbourhoods, and providing healthy eating education for all students.

Fundus autofluorescence imaging in an ocular screening program.

PubMed

Kolomeyer, A M; Nayak, N V; Szirth, B C; Khouri, A S

2012-01-01

Purpose. To describe integration of fundus autofluorescence (FAF) imaging into an ocular screening program. Methods. Fifty consecutive screening participants were included in this prospective pilot imaging study. Color and FAF (530/640 nm exciter/barrier filters) images were obtained with a 15.1MP Canon nonmydriatic hybrid camera. A clinician evaluated the images on site to determine need for referral. Visual acuity (VA), intraocular pressure (IOP), and ocular pathology detected by color fundus and FAF imaging modalities were recorded. Results. Mean ± SD age was 47.4 ± 17.3 years. Fifty-two percent were female and 58% African American. Twenty-seven percent had a comprehensive ocular examination within the past year. Mean VA was 20/39 in the right eye and 20/40 in the left eye. Mean IOP was 15 mmHg bilaterally. Positive color and/or FAF findings were identified in nine (18%) individuals with diabetic retinopathy or macular edema (n = 4), focal RPE defects (n = 2), age-related macular degeneration (n = 1), central serous retinopathy (n = 1), and ocular trauma (n = 1). Conclusions. FAF was successfully integrated in our ocular screening program and aided in the identification of ocular pathology. Larger studies examining the utility of this technology in screening programs may be warranted.

Fundus Autofluorescence Imaging in an Ocular Screening Program

PubMed Central

Kolomeyer, A. M.; Nayak, N. V.; Szirth, B. C.; Khouri, A. S.

2012-01-01

Purpose. To describe integration of fundus autofluorescence (FAF) imaging into an ocular screening program. Methods. Fifty consecutive screening participants were included in this prospective pilot imaging study. Color and FAF (530/640 nm exciter/barrier filters) images were obtained with a 15.1MP Canon nonmydriatic hybrid camera. A clinician evaluated the images on site to determine need for referral. Visual acuity (VA), intraocular pressure (IOP), and ocular pathology detected by color fundus and FAF imaging modalities were recorded. Results. Mean ± SD age was 47.4 ± 17.3 years. Fifty-two percent were female and 58% African American. Twenty-seven percent had a comprehensive ocular examination within the past year. Mean VA was 20/39 in the right eye and 20/40 in the left eye. Mean IOP was 15 mmHg bilaterally. Positive color and/or FAF findings were identified in nine (18%) individuals with diabetic retinopathy or macular edema (n = 4), focal RPE defects (n = 2), age-related macular degeneration (n = 1), central serous retinopathy (n = 1), and ocular trauma (n = 1). Conclusions. FAF was successfully integrated in our ocular screening program and aided in the identification of ocular pathology. Larger studies examining the utility of this technology in screening programs may be warranted. PMID:23316224

Prevalence and Predictors of Depression among Type 2 Diabetes Mellitus Outpatients in Eastern Province, Saudi Arabia.

PubMed

El Mahalli, A A

2015-04-01

Diabetes Mellitus is frequently accompanied by serious complications. Less known is the increased risk for depression. Undiagnosed depression prevents initiation of treatment, thereby contributing to poor clinical outcomes. Study aimed to determine prevalence and predictors of depression among type 2 diabetes mellitus patients. Study was cross-sectional. It was conducted in the outpatient clinics of diabetes mellitus in a governmental hospital in Eastern Province, Saudi Arabia in 2013. Patients with type 2 diabetes mellitus (260 participants) were selected using systematic random sampling technique. One interview questionnaire was designed to collect demographic and health factors. Two self- administered instruments were used to assess perceived social support and depression. Assessment of the relationship between depression and its predictors was done using Univariate analysis. Multivariable analysis was used to evaluate the combined effect of several factors associated with depression among type 2 diabetes mellitus patients after adjusting for confounding variables. Almost fifty percent of diabetics were depressed (49.6%). Patients with poor diabetes mellitus control (OR 3.221, P.000) and unmarried (OR 3.206, P .025) were more risky for developing depression and difference was significant. Prevalence of depression among Type 2 diabetes mellitus patients was almost fifty percent. So, diabetics should be regularly examined for signs and symptoms of depression.

Use of coolant for high-speed tooth preparation: a survey of pediatric dentistry residency program directors in the United States.

PubMed

Kupietzky, Ari; Vargas, Karen G; Waggoner, William F; Fuks, Anna B

2010-01-01

To determine current teaching policies regarding the use of coolant type during tooth preparation with high-speed hand-pieces in pediatric dental residency programs in the US. A 17-question survey was electronically mailed to 63 program directors with one follow-up. Multiple-choice questions asked about school and program teaching of cavity preparation with or without water coolant, including hypothetical clinical situations. Fifty-two (83%) program directors returned the survey. Fifty-two percent taught both dry and water coolant methods, 6% taught dry cutting exclusively, and 42% did not teach the dry method and always used water coolant. Dry techniques were used primarily for special needs patients with poor swallow reflexes (50%) and for young children undergoing sedation (41%). Air coolant was taught more frequently in programs in the Midwest (77%) and South (85%) vs. the Northeast (32%) and West (50%) (P<.01). Forty-four percent of combined programs and 60% of hospital programs taught water spray use exclusively, while all university programs taught the dry cutting technique (P<.01). A majority of program directors teach the use of air coolant alone for high-speed preparation of teeth. University and combined programs were more likely to teach the method compared with hospital based ones.

Transformation of metals speciation in a combined landfill leachate treatment.

PubMed

Wu, Yanyu; Zhou, Shaoqi; Chen, Dongyu; Zhao, Rong; Li, Huosheng; Lin, Yiming

2011-04-01

Landfill leachate was treated by a combined sequential batch reactor (SBR), coagulation, Fenton oxidation and biological aerated filter (BAF) technology. The metals in treatment process were fractionated into three fractions: particulate and colloidal (size charge filtration), free ion/labile (cation exchange) and non-labile fractions. Fifty percent to 66% Cu, Ni, Zn, Mn, Pb and Cd were present as particulate/colloidal matter in raw leachate, whereas Cr was present 94.9% as non-labile complexes. The free ion/labile fractions of Ni, Zn, Mg, Mn, Pb and Cd increased significantly after treatment except Cr. Fifty-nine percent to 100% of Al was present mainly as particulate/colloidal matter >0.45 μm and the remaining portions were predicted as non-labile complexes except in coagulation effluent. The speciation of Fe varied significantly in various individual processes. Visual MINTEQ simulation showed that 95-100% colloidal species for Cu, Cd and Pb were present as metal-humic complexes even with the lower dissolved organic carbon. Optimum agreements for the free ion/labile species were within acidic solution, whereas under-estimated in alkaline effluents. Overestimated particulate/colloidal fraction consisted with the hypothesis that a portion of colloids in fraction <0.45 μm were considered as dissolved. Copyright © 2011 Elsevier B.V. All rights reserved.

Pectus carinatum treatment in Canada: current practices.

PubMed

Emil, Sherif; Laberge, Jean-Martin; Sigalet, David; Baird, Robert

2012-05-01

Multiple treatment options currently exist for the correction of pectus carinatum (PC). We performed a survey of Canadian pediatric surgeons to define current practices. All active members of Canadian Association of Paediatric Surgeons were surveyed online during winter 2011 through the Canadian Association of Paediatric Surgeons Web site. The survey assessed multiple facets of PC evaluation and treatment, with particular emphasis on the practice of bracing. Forty-five active members (85%) responded, of whom 32 (71%) currently treat PC. Fifty-three percent of practices are low volume (<5 patients annually). In terms of preferred or most used treatment modality, 69% of surgeons used bracing, 25% performed Ravitch repairs, 3% performed open minimal cartilage resections, and 3% performed reverse Nuss procedures. Of 23 surgeons (72%) who used bracing, 83% used it for most or the patients. Fifty-seven percent judged their bracing results as good or excellent, and 74% felt that most or all patients braced were satisfied; 80% and 88% agreed or strongly agreed that bracing was generally preferable to surgical repair and that bracing should be first line treatment, respectively. Bracing is the preferred treatment for PC by most Canadian pediatric surgeons, despite lack of prospective outcome data. This presents an opportunity for a multicenter prospective study. Copyright © 2012 Elsevier Inc. All rights reserved.

Frequency of parent-supervised outdoor play of US preschool-aged children.

PubMed

Tandon, Pooja S; Zhou, Chuan; Christakis, Dimitri A

2012-08-01

To characterize preschoolers’ daily parent-supervised outdoor play frequency and associated factors. Cross-sectional using data from the Early Childhood Longitudinal Study–Birth Cohort. Nationally representative US sample. Preschool-aged children. Parent-reported outdoor play frequency. The sample size of 8950 represented approximately 4 million children. Sixty percent of mothers worked outside the home, 79% exercised 0 to 3 days per week, and 93% perceived their neighborhood to be safe. Forty-four percent of mothers and 24% of fathers reported taking their child outside to play at least once per day. Fifty-one percent of children were reported to go outside to play at least once per day with either parent. Fifty-eight percent of children who were not in child care went outside daily. A child’s odds of going outside daily were associated with sex (odds ratio [OR] for girls, 0.85;95% CI, 0.75-0.95), having more regular playmates (OR for ≥ 3 playmates, 2.03; 95% CI, 1.72-2.38), mother’s race/ethnicity (OR for Asian, 0.51, 95% CI, 0.43-0.61; black,0.59, 95% CI, 0.49-0.70; Hispanic, 0.80, 95% CI, 0.67-0.95), mother’s employment (OR for full time, 0.70; 95%CI, 0.62-0.81), and parent’s exercise frequency of 4 days or more per week (OR, 1.50; 95% CI, 1.28-1.75). We did not find significant association of outdoor play with child’s time spent watching television, household income, mother’s marital status, or parent’s perceptions of neighborhood safety. About half the preschoolers in this sample did not have even 1 parent-supervised outdoor play opportunity per day. Efforts to increase active outdoor play should especially target children who are girls and nonwhite. Outdoor play opportunities at child care are critical for children of parents who work outside the home.

78 FR 79410 - Fair Credit Reporting Act Disclosures

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-30

...The Bureau of Consumer Financial Protection (Bureau) announces that the ceiling on allowable charges under Section 612(f) of the Fair Credit Reporting Act (FCRA) will remain unchanged at $11.50 for 2014. The Bureau is required to increase the $8.00 amount referred to in Section 612(f)(1)(A)(i) of the FCRA on January 1 of each year, based proportionally on changes in the Consumer Price Index for All Urban Consumers (CPI-U), with fractional changes rounded to the nearest fifty cents. The CPI-U increased 45.25 percent between September 1997, the date the FCRA amendments took effect, and September 2013. This increase in the CPI-U, and the requirement that any increase be rounded to the nearest fifty cents, results in no change in the maximum allowable charge of $11.50.

INFLUENCE OF HEALTH TECHNOLOGY ASSESSMENT AND ITS MEASUREMENT.

PubMed

Hailey, David; Werkö, Sophie; Rosén, Måns; Macpherson, Karen; Myles, Susan; Gallegos Rivero, Verónica; Hipólito-Olivares, Cecilia; Sihvo, Sinikka; Pwu, Jasmine; Yang, Wen-Wen; Chen, Yong-Chen; Perez Galán, Ana; Aleman, Alicia; Villamil, Elena

2016-01-01

The aim of this study was to obtain information on methods used to measure health technology assessment (HTA) influence, decisions that were influenced, and outcomes linked to HTA. Electronic databases were used to locate studies in which HTA influence had been demonstrated. Inclusion criteria were studies that reliably reported consideration by decision makers of HTA findings; comparative studies of technology use before and after HTA; and details of changes in policy, health outcomes, or research that could be credibly linked to an HTA. Fifty-one studies were selected for review. Settings were national (24), regional (12), both national and regional (3) hospitals (9), and multinational (3). The most common approach to appraisal of influence was review of policy or administrative decisions following HTA recommendations (51 percent). Eighteen studies (35 percent) reported interview or survey findings, thirteen (26 percent) reviewed administrative data, and six considered the influence of primary studies. Of 142 decisions informed by HTA, the most common types were on routine clinical practice (67 percent of studies), coverage (63 percent), and program operation (37 percent). The most frequent indications of HTA influence were on decisions related to resource allocation (59 percent), change in practice pattern (31 percent), and incorporation of HTA details in reference material (18 percent). Few publications assessed the contribution of HTA to changing patient outcomes. The literature on HTA influence remains limited, with little on longer term effects on practice and outcomes. The reviewed publications indicated how HTA is being used in different settings and approaches to measuring its influence that might be more widely applied, such as surveys and monitoring administrative data.

Evaluation and selection of security products for authentication of computer software

NASA Astrophysics Data System (ADS)

Roenigk, Mark W.

2000-04-01

Software Piracy is estimated to cost software companies over eleven billion dollars per year in lost revenue worldwide. Over fifty three percent of all intellectual property in the form of software is pirated on a global basis. Software piracy has a dramatic effect on the employment figures for the information industry as well. In the US alone, over 130,000 jobs are lost annually as a result of software piracy.

Sterility Testing of Prototype Plastic Aseptic Docking Tubes

DTIC Science & Technology

1982-09-01

Bacillus stearothermophilus CL21. AmerRACT (Coat~e- aeids uIf 8" niev teIi by block n"Unbee) Fifty-nine pairs of sterile docking tabs, manufactured...of Bacillus stearothermophilus , _J sealed, and flushed with sterile culture medium. Twenty five percent of the LA_.. seals failed because of...were similarly attached to sterile tubes of Becton Dickenson supplemented peptone broth. A 25 ul aliquot of Bacillus stearothermophilus spores (Ix]O

Iran Nuclear Threat - An Environmental Perspective

DTIC Science & Technology

2008-01-01

Hibakusha is the term widely used in Japan referring to the victims of the atomic bombing of Hiroshima and Nagasaki, the Japanese word translates...literally to "explosion-affected people.,,29 Researchers have studied and followed the lives of more than fifty thousand Hibakusha over the last sixty years...who have significant exposure to the bombs’ effects, Studies have revealed that these Hibakusha have about a 30 percent higher than normal chance of

A Neighborhood-Based Intervention to Reduce Prostate Cancer Disparities

DTIC Science & Technology

2016-10-01

of patients was 10,802. The median age was 65. Fifty-seven percent were married at diagnosis. The majority of patients were Black (44%), White...younger and less likely to be married compared to White patients. Tumor grade and stage were highest among Black patients. o Graphs were created to...patient age. (Table 4) However, all other variables of interest were significantly different (pɘ.001). High SMR areas were more Black and unmarried

A Neighborhood-Based Intervention to Reduce Prostate Cancer Disparities

DTIC Science & Technology

2016-10-01

computed. The total number of patients was 10,802. The median age was 65. Fifty-seven percent were married at diagnosis. The majority of...Hispanic patients were younger and less likely to be married compared to White patients. Tumor grade and stage were highest among Black patients...were more Black and unmarried . There was a higher percentage of high grade and high stage prostate cancer at diagnosis. There were fewer men, lower

Language, Literacy, and Communication Regarding Medication in an Anticoagulation Clinic: Are Pictures Better Than Words?

DTIC Science & Technology

2005-05-01

visual concordance rates varied with the patient’s language and level of health literacy . Fifty percent of patients achieved verbal concordance and...and having inadequate health literacy were associated with a lower odds ratio for verbal concordance compared to being an English speaker and having...adequate health literacy . Neither language nor health literacy was associated with visual discordance. The authors conclude that clinician-patient

ABCs and AYP Results, Wake County Public School System (WCPSS): 2009-10. Measuring Up. E&R Report No. 10.20

ERIC Educational Resources Information Center

Haynie, Glenda

2011-01-01

In 2009-10, 92% of WCPSS schools met Expected or High Growth as measured by the North Carolina ABCs program, a 3.5 percentage point increase from 2008-09. Fifty-four percent of the schools made High Growth and 38% made Expected Growth. All subgroups saw their percentages of students meeting growth increase to above 55% in 2009-10; with the…

Prevalence of Multidrug-Resistant Organisms Recovered at a Military Burn Center

DTIC Science & Technology

2010-01-01

baumannii isolates, 92 (95%) were not susceptible to imipenem . Fifty- seven of the 96 (59%) MDR A. baumannii isolates were found to be MDR-4. In...revealed that A. baumannii were most susceptible to imipenem (42%) and amikacin (31%), P. aeruginosa were most susceptible to piperacillin/tazobactam...pip/tazo) (76%) and gentamicin (58%), K. pneumoniae were most susceptible to imipenem (82%) and pip/tazo (68%). Thirty-four percent of S. aureus

Effectiveness of a direct-to-consumer written health education program in the reduction of benzodiazepine and sedative-hypnotic use in an elderly population at a single Veterans Affairs medical center

PubMed Central

2018-01-01

Introduction: The use of benzodiazepines and sedative-hypnotics in the elderly is associated with a significant risk of delirium, falls, fractures, cognitive impairment, and motor vehicle accidents. This quality improvement project applies a direct-to-consumer intervention to an elderly veteran population to reduce the use of these medications. Methods: Patients aged 75 and older currently taking a benzodiazepine and/or a sedative-hypnotic were included in the project. Direct-to-consumer education intervention letters were mailed to patients within 30 days of their next appointment. Their providers were emailed a questionnaire after the patient's appointment. Providers were asked if the letter prompted a conversation regarding medication use, whether the provider initiated discussion regarding a taper, and whether a specific taper plan was developed. Medical records were reviewed to determine if a reduction in dose or discontinuation occurred. Results: Fifty-nine direct-to-consumer education letters were mailed to the patients. Follow-up questionnaires were e-mailed to 44 providers, and 27 providers responded. Twenty-two percent of patients had their benzodiazepine and/or sedative hypnotic dose reduced or discontinued after their follow-up appointment. Sixty-seven percent of veterans initiated a conversation with their provider regarding their medication with 74% of providers discussing dose reduction. Fifty-six percent of recipients developed a specific taper plan with their provider. Discussion: The data from this project suggests that direct-to-consumer patient education can reduce the exposure to benzodiazepines and sedative-hypnotics in an elderly veteran population. More data is needed on larger populations to further explore the benefit of direct-to-consumer interventions.

Alcohol consumption patterns among vocational school students in central Thailand.

PubMed

Chaveepojnkamjorn, Wisit

2012-11-01

The objective of this study was to evaluate alcohol consumption patterns among vocational school students in central Thailand. We conducted a cross sectional study among 1,803 vocational students (80.4 % aged < 17 years) in central Thailand using a self-administered questionnaire which consisted of 2 parts: sociodemographic factors and alcohol drinking behavior from December 2007 to February 2008. Descriptive statistics, a chi-square test and multiple logistic regression were used to analyze the data. The results of this study showed 40.9% of male students and 20.9% of female students drank alcoholic beverages. Multiple logistic regression analysis revealed 2 factors were associated with alcohol consumption among male subjects: field of study (OR 1.5, 95% CI 1.1-2.0), and GPA (OR < 2 = 1.8; 95% CI 1.2-2.7; OR > 3 = 0.6; 95% CI 0.4-0.9). The three most popular venues for drinking were at parties (43.1%), at home/in the dormitory (34.9%) and in bars or saloons near the school (20.9%). Fifty-three point two percent of males drinks alcohol 1-2 times per month and time, 47% drank > 2 times per month. Nearly 78% of female students drink alcohol 1-2 times per month and 22% drink alcohol > 2 time per month. Forty point nine percent of male students consumed 1-2 drinks per time and 36% consumed more than 4 drinks per time. Fifty point four percent of females drank 2 drinks per month. One-third of male students said they engaged in binge drinking in a 2-week period and 14% of girls said they binge drank in a 2-week period. Alcohol consumption is a significant problem among Thai vocational school students. Measures for managing this problem are discussed.

Impact of patient satisfaction ratings on physicians and clinical care

PubMed Central

Zgierska, Aleksandra; Rabago, David; Miller, Michael M

2014-01-01

Background Although patient satisfaction ratings often drive positive changes, they may have unintended consequences. Objective The study reported here aimed to evaluate the clinician-perceived effects of patient satisfaction ratings on job satisfaction and clinical care. Methods A 26-item survey, developed by a state medical society in 2012 to assess the effects of patient satisfaction surveys, was administered online to physician members of a state-level medical society. Respondents remained anonymous. Results One hundred fifty five physicians provided responses (3.9% of the estimated 4,000 physician members of the state-level medical society, or approximately 16% of the state’s emergency department [ED] physicians). The respondents were predominantly male (85%) and practicing in solo or private practice (45%), hospital (43%), or academia (15%). The majority were ED (57%), followed by primary care (16%) physicians. Fifty-nine percent reported that their compensation was linked to patient satisfaction ratings. Seventy-eight percent reported that patient satisfaction surveys moderately or severely affected their job satisfaction; 28% had considered quitting their job or leaving the medical profession. Twenty percent reported their employment being threatened because of patient satisfaction data. Almost half believed that pressure to obtain better scores promoted inappropriate care, including unnecessary antibiotic and opioid prescriptions, tests, procedures, and hospital admissions. Among 52 qualitative responses, only three were positive. Conclusion These pilot-level data suggest that patient satisfaction survey utilization may promote, under certain circumstances, job dissatisfaction, attrition, and inappropriate clinical care among some physicians. This is concerning, especially in the context of the progressive incorporation of patient satisfaction ratings as a quality-of-care metric, and highlights the need for a rigorous evaluation of the optimal methods for survey implementation and utilization. PMID:24729691

Smoking habits and smoking cessation among North Carolina nurses.

PubMed

Swenson, I E

1989-01-01

A 1987 questionnaire survey of a 1% random sample (n = 356) of registered nurses in North Carolina provided data on the smoking habits and smoking cessation. Fifty-six percent were never smokers; 19% were current smokers. Among the ever smokers, 31% had quit smoking for at least one year. Twenty-two percent of the former smokers had smoked less than 5 years and 39% less than 10 years before quitting. Anecdotal notes from never smokers suggested that their major deterrent to smoking was their own parents smoking. Concerns about the addictive smoking behavior and health effects of smoking observed in their parents as well as concerns about potential health risks to themselves deterred them from smoking. Concerns about the adverse consequences of smoking was the most influential factor influencing smoking cessation and reduction of cigarette smoking. Friends' and family's encouragement to stop smoking was the most influential external factor motivating nurses to quit or reduce cigarette consumption. Fifty-seven percent of the former smokers quit smoking after one or two attempts while 53 of the current smokers had tried to quit 3 or more times - 90% had tried at least once to quit smoking; however, only 18% of the current smokers had abstained for more than one year during any of their attempts to quit. Implications of the results include: (1) smoking cessation programs for nurses in the workplace may have considerable impact since the majority of nurses who smoke are tying to quit; (2) relapse prevention strategies need to be an integral part of such smoking cessation programs including involvement of family and friends to support the smokers in their cessation efforts.

Proctalgia fugax: demographic and clinical characteristics. What every doctor should know from a prospective study of 54 patients.

PubMed

de Parades, Vincent; Etienney, Isabelle; Bauer, Pierre; Taouk, Milad; Atienza, Patrick

2007-06-01

This prospective study was designed to describe a typical attack of proctalgia fugax. Patients were recruited from May 2003 to June 2004. Whatever the reason for consultation, they were systematically asked: "Do you ever suffer intermittent and recurring anorectal pain lasting for at least three seconds?" If the answer was yes, they were interviewed with a questionnaire and had a proctologic examination. The criterion for proctalgia fugax was a positive answer with a negative examination. The study included 1,809 patients. Fifty-four of these patients (3 percent) had proctalgia fugax and 83 percent of them had never sought medical advice for this problem. The mean age was 51 (range, 18-87) years. Thirty-seven patients were females (69 percent). The onset of pain was sudden and without a trigger factor in 85 percent of cases. Attacks occurred in the daytime (33 percent) as well as at night (35 percent). The pain was described as cramping, spasm-like, or stabbing in 76 percent of cases. It did not radiate in 93 percent of cases. There were no concomitant symptoms in 81 percent of cases. Attacks stopped spontaneously in 67 percent of cases. The average duration was 15 minutes (range, 5 seconds to 90 minutes). The average annual number of attacks was 13 (range, 1-180). Proctalgia fugax affects twice as many females as males at approximately aged 50 years. Commonly the roughly once-monthly attack occurs as a sudden pain with no trigger factor, diurnally as often as nocturnally. The nonradiating cramp, spasm, or stabbing pain, without concomitant symptoms, is most severe on average after 15 minutes and declines spontaneously.

EXAMINING EVIDENCE IN U.S. PAYER COVERAGE POLICIES FOR MULTI-GENE PANELS AND SEQUENCING TESTS

PubMed Central

Chambers, James D.; Saret, Cayla J.; Anderson, Jordan E.; Deverka, Patricia A.; Douglas, Michael P.; Phillips, Kathryn A.

2017-01-01

Objectives The aim of this study was to examine the evidence payers cited in their coverage policies for multi-gene panels and sequencing tests (panels), and to compare these findings with the evidence payers cited in their coverage policies for other types of medical interventions. Methods We used the University of California at San Francisco TRANSPERS Payer Coverage Registry to identify coverage policies for panels issued by five of the largest US private payers. We reviewed each policy and categorized the evidence cited within as: clinical studies, systematic reviews, technology assessments, cost-effectiveness analyses (CEAs), budget impact studies, and clinical guidelines. We compared the evidence cited in these coverage policies for panels with the evidence cited in policies for other intervention types (pharmaceuticals, medical devices, diagnostic tests and imaging, and surgical interventions) as reported in a previous study. Results Fifty-five coverage policies for panels were included. On average, payers cited clinical guidelines in 84 percent of their coverage policies (range, 73–100 percent), clinical studies in 69 percent (50–87 percent), technology assessments 47 percent (33–86 percent), systematic reviews or meta-analyses 31 percent (7–71 percent), and CEAs 5 percent (0–7 percent). No payers cited budget impact studies in their policies. Payers less often cited clinical studies, systematic reviews, technology assessments, and CEAs in their coverage policies for panels than in their policies for other intervention types. Payers cited clinical guidelines in a comparable proportion of policies for panels and other technology types. Conclusions Payers in our sample less often cited clinical studies and other evidence types in their coverage policies for panels than they did in their coverage policies for other types of medical interventions. PMID:29065945

EXAMINING EVIDENCE IN U.S. PAYER COVERAGE POLICIES FOR MULTI-GENE PANELS AND SEQUENCING TESTS.

PubMed

Chambers, James D; Saret, Cayla J; Anderson, Jordan E; Deverka, Patricia A; Douglas, Michael P; Phillips, Kathryn A

2017-01-01

The aim of this study was to examine the evidence payers cited in their coverage policies for multi-gene panels and sequencing tests (panels), and to compare these findings with the evidence payers cited in their coverage policies for other types of medical interventions. We used the University of California at San Francisco TRANSPERS Payer Coverage Registry to identify coverage policies for panels issued by five of the largest US private payers. We reviewed each policy and categorized the evidence cited within as: clinical studies, systematic reviews, technology assessments, cost-effectiveness analyses (CEAs), budget impact studies, and clinical guidelines. We compared the evidence cited in these coverage policies for panels with the evidence cited in policies for other intervention types (pharmaceuticals, medical devices, diagnostic tests and imaging, and surgical interventions) as reported in a previous study. Fifty-five coverage policies for panels were included. On average, payers cited clinical guidelines in 84 percent of their coverage policies (range, 73-100 percent), clinical studies in 69 percent (50-87 percent), technology assessments 47 percent (33-86 percent), systematic reviews or meta-analyses 31 percent (7-71 percent), and CEAs 5 percent (0-7 percent). No payers cited budget impact studies in their policies. Payers less often cited clinical studies, systematic reviews, technology assessments, and CEAs in their coverage policies for panels than in their policies for other intervention types. Payers cited clinical guidelines in a comparable proportion of policies for panels and other technology types. Payers in our sample less often cited clinical studies and other evidence types in their coverage policies for panels than they did in their coverage policies for other types of medical interventions.

76 FR 63987 - Fifty-Fifth Meeting: RTCA Special Committee 186: Automatic Dependent Surveillance-Broadcast (ADS-B)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-14

... Committee 186: Automatic Dependent Surveillance--Broadcast (ADS-B) AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of RTCA Special Committee 186: Automatic Dependent Surveillance Broadcast... Special Committee 186: Automatic Dependent Surveillance--Broadcast (ADS-B). DATES: The meeting will be...

76 FR 3932 - Fifty-Third Meeting: RTCA Special Committee 186: Automatic Dependent Surveillance-Broadcast (ADS-B)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-21

... Committee 186: Automatic Dependent Surveillance--Broadcast (ADS-B) AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of RTCA Special Committee 186: Automatic Dependent Surveillance--Broadcast... Special Committee 186: Automatic Dependent Surveillance--Broadcast (ADS-B). DATES: The meeting will be...

76 FR 22160 - Fifty-Fourth Meeting: RTCA Special Committee 186: Automatic Dependent Surveillance-Broadcast (ADS-B)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-20

... Committee 186: Automatic Dependent Surveillance--Broadcast (ADS-B) AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of RTCA Special Committee 186: Automatic Dependent Surveillance--Broadcast... Special Committee 186: Automatic Dependent Surveillance--Broadcast (ADS-B). DATES: The meeting will be...

Palliative Care Leadership Centers Are Key To The Diffusion Of Palliative Care Innovation.

PubMed

Cassel, J Brian; Bowman, Brynn; Rogers, Maggie; Spragens, Lynn H; Meier, Diane E

2018-02-01

Between 2000 and 2015 the proportion of US hospitals with more than fifty beds that had palliative care programs tripled, from 25 percent to 75 percent. The rapid adoption of this high-value program, which is voluntary and runs counter to the dominant culture in US hospitals, was catalyzed by tens of millions of dollars in philanthropic support for innovation, dissemination, and professionalization in the palliative care field. We describe the dissemination strategies of the Center to Advance Palliative Care in the context of the principles of social entrepreneurship, and we provide an in-depth look at its hallmark training initiative, Palliative Care Leadership Centers. Over 1,240 hospital palliative care teams have trained at the Leadership Centers to date, with 80 percent of them instituting palliative care services within two years. We conclude with lessons learned about the role of purposeful technical assistance in promoting the rapid diffusion of high-value health care innovation.

Improved reaction sintered silicon nitride. [protective coatings to improve oxidation resistance

NASA Technical Reports Server (NTRS)

Baumgartner, H. R.

1978-01-01

Processing treatments were applied to as-nitrided reaction sintered silicon nitride (RSSN) with the purposes of improving strength after processing to above 350 MN/m2 and improving strength after oxidation exposure. The experimental approaches are divided into three broad classifications: sintering of surface-applied powders; impregnation of solution followed by further thermal processing; and infiltration of molten silicon and subsequent carburization or nitridation of the silicon. The impregnation of RSSN with solutions of aluminum nitrate and zirconyl chloride, followed by heating at 1400-1500 C in a nitrogen atmosphere containing silicon monoxide, improved RSSN strength and oxidation resistance. The room temperature bend strength of RSSN was increased nearly fifty percent above the untreated strength with mean absolute strengths up to 420 MN/m2. Strengths of treated samples that were measured after a 12 hour oxidation exposure in air were up to 90 percent of the original as-nitrided strength, as compared to retained strengths in the range of 35 to 60 percent for untreated RSSN after the same oxidation exposure.

Prerequisites in behavioral science and business: opportunities for dental education.

PubMed

Dunning, David G; Lange, Brian M; Madden, Robert D; Tacha, Koko K

2011-01-01

There is increasing pressure on recent dental school graduates to understand and successfully utilize patient management and business management strategies to run a productive dental office. Dental schools are faced with the dilemma to either add more credit hours in their already crowded curriculum or adjust predental school requirements. All fifty-nine U.S. dental schools were assessed online to determine admission requirements in the areas of behavioral science and business education. Results show that only 11.9 percent of the schools require prerequisite course work in behavioral science and no school requires prerequisite course work in business. However, 64.4 percent and 30.5 percent of schools encouraged or recommended prerequisite course work in behavioral science and business, respectively. We suggest that the dental education community involve key stakeholders to discuss the incorporation of prerequisite course work in behavioral science and business. Additional courses in these disciplines would provide dental students better backgrounds from which the dental curriculum could build a more advanced and applied perspective to better prepare students for practice.

The presentation of seizures and epilepsy in YouTube videos.

PubMed

Wong, Victoria S S; Stevenson, Matthew; Selwa, Linda

2013-04-01

We evaluated videos on the social media website, YouTube, containing references to seizures and epilepsy. Of 100 videos, 28% contained an ictal event, and 25% featured a person with epilepsy recounting his or her personal experience. Videos most commonly fell into categories of Personal Experience/Anecdotal (44%) and Informative/Educational (38%). Fifty-one percent of videos were judged as accurate, and 9% were inaccurate; accuracy was not an applicable attribute in the remainder of the videos. Eighty-five percent of videos were sympathetic towards those with seizures or epilepsy, 9% were neutral, and only 6% were derogatory. Ninety-eight percent of videos were thought to be easily understood by a layperson. The user-generated content on YouTube appears to be more sympathetic and accurate compared to other forms of mass media. We are optimistic that with a shifting ratio towards sympathetic content about epilepsy, the amount of stigma towards epilepsy and seizures will continue to lessen. Copyright © 2013 Elsevier Inc. All rights reserved.

Availability of behavioral health treatment for women in prison.

PubMed

Blitz, Cynthia L; Wolff, Nancy; Paap, Kris

2006-03-01

This study examined whether women with behavioral health needs are more likely to receive treatment for these problems in prison or in the community and to what extent prison disrupts or establishes involvement in treatment for these women. Data were collected in August 2004 as part of a population survey of female inmates in the only state correctional facility for women in New Jersey. A total of 908 women were surveyed. Fifty-six percent of the women surveyed reported needing behavioral health treatment before incarceration, but only 62 percent of this group reported receiving such treatment in the community. The rate at which treatment matched need within this population before incarceration varied by type of treatment needed: it was the highest (58 percent) for women who needed treatment for mental health problems, lower (52 percent) for those who needed substance abuse treatment, and lowest (44 percent) for those who needed treatment for comorbid mental health and substance abuse problems. In comparison, the rate of match between need for and receipt of treatment in prison was higher for all three types of behavioral health treatment (78 percent, 57 percent, and 65 percent, respectively). Additionally, the findings suggest that prison did not disrupt the type of behavioral health treatment that inmates had previously received in the community. At least in New Jersey, prison appears to improve access to behavioral health treatment among female inmates. Although this conclusion is consistent with the rehabilitation goals of incarceration, it also suggests that some women may have been able to avoid prison if treatment had been provided in the community, especially for substance-related problems.

[The role of spirometry in encouraging smoking cessation in general practice. A pilot study using "lung age"].

PubMed

Lorenzo, A; Noël, F; Lorenzo, M; Van Den Broucke, J

2017-09-01

Our aim was to investigate whether spirometry, performed in general practitioners' offices would change non-motivated smokers' attitudes toward smoking cessation. We performed an interventional, prospective, before-after single-center study, approved by a research ethics committee. We included 74 smokers older than 18years old, who reported no intention to quit smoking, whatever they were visiting general practitioners for. We performed spirometry and gave them their results, FEV 1 /FVC and lung age together with a comment on it. Nine months later, we called them for another assessment. Fifty-six percent were women with an average-age of 46.5, who smoked 26.3 pack-years. Eighty-two percent of them had normal FEV 1 /FVC but lung age was pathological among 38% of them. Nine months later, 61.1% reported an increased motivation to quit smoking. They smoked 10.9 cigarettes per day versus 13,3 at baseline (P=0.0254). Increase in motivation was not statistically related to age, gender, previous smoking cessations, daily smoking, nicotine dependence or an abnormal FEV 1 /VC ratio (P>0.75) but was significantly related to the presence of an abnormal lung age status (P<0.03). This study suggests that spirometry in general practice, combined with the determination of the lung age, may increase motivation towards smoking cessation in smokers who lack motivation. Copyright © 2016 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Photodetector with enhanced light absorption

DOEpatents

Kane, James

1985-01-01

A photodetector including a light transmissive electrically conducting layer having a textured surface with a semiconductor body thereon. This layer traps incident light thereby enhancing the absorption of light by the semiconductor body. A photodetector comprising a textured light transmissive electrically conducting layer of SnO.sub.2 and a body of hydrogenated amorphous silicon has a conversion efficiency about fifty percent greater than that of comparative cells. The invention also includes a method of fabricating the photodetector of the invention.

Feasibility of Creating a Comprehensive Real Property Database for Colombia

DTIC Science & Technology

2002-08-01

practices familiar to conservationists can be effective in areas where private property dominates or where it is mixed with public lands. These practices...broadly accurate. According to many familiar with the system of appraisals and the market for real property, an appraisal of around fifty percent of...Geografía de la Violencia ) 27 Regional and Local GIS data The feasibility study considered local GIS efforts in Bogotá, Cali, Medellín, Popayán and

Prenatal correlates of indigent mothers' attitudes about spoiling their young infants: a longitudinal study.

PubMed

Pascoe, J M; Solomon, R

1994-10-01

The purpose of this study was to investigate factors associated with indigent mothers' attitudes about spoiling their young infants. Mothers who believe that young infants can be spoiled may be more likely to misperceive their infants' basic needs for nurturing and thus undermine their infants' sense of security and trust. One hundred twenty-nine consecutive pregnant women who were at approximately 15 weeks' gestation completed measures to assess depressive symptoms (Center for Epidemiologic Studies Depression Scale) and social support (Maternal Social Support Index). One hundred seventeen mothers (91%) completed a simple three-question Spoiling Index when their infants were about 1 month old. Fifty-eight percent were single, never married, 73% multiparous, 66% Euro-American, 28% African-American, and 84% at least 20 years old. Fifty-eight percent of mothers believed infants younger than 5 months old could be spoiled. After including maternal age, race, marital status, prenatal social support, and number of prenatal clinic visits in the hierarchical logistic regression model, "spoilers" were more likely to be primigravida mothers (odds ratio = 2.71; 95% confidence interval, 1.05 to 7.06) and more likely to be depressed during pregnancy (odds ratio = 2.83; 95% confidence interval, 1.29 to 6.19). Primigravida indigent mothers and mothers with higher levels of prenatal depressive symptoms are more likely to believe they can spoil their young infants.

[Teaching pediatrics to residents via conventional lectures in France: A national survey from students].

PubMed

Girard, B; Bendavid, M; Faivre, J-C; Salleron, J; Debillon, T; Claris, O; Chabrol, B; Schweitzer, C; Gajdos, V

2017-08-01

To assess the point of view of young physicians training in pediatrics in France on their theoretical courses during residency. A free-access electronic anonymous survey was sent three times by e-mail to the 1215 residents in pediatrics, from July to October 2015. Fifty-seven percent of French residents in pediatrics responded to the survey. It was established that they took part in six (range, 3-10) half-days of specific theoretical teaching in pediatrics from November 2014 to mid-April 2015. Only 54% participated in more than 75% of regional theoretical training. The main self-declared reason for their absence was that they could not leave their clinical activities. Fifty-three per cent of the residents took part in additional training, 45% of them because they found the primary theoretical training insufficient. The overall quality of the theoretical teaching was rated 5 (range, 3-7) out of 10. Eighty-five percent of residents expected to be evaluated on their knowledge during their residency. In pediatrics, additional training is individually undertaken because they deemed their initial training insufficient during their residency. An evaluation of knowledge is requested by residents. The reform of the national residency program must take into account these results in redesigning the theoretical training in pediatrics, integrating innovative teaching techniques to daily practice, for example. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Infection prevention needs assessment in Colorado hospitals: rural and urban settings.

PubMed

Reese, Sara M; Gilmartin, Heather; Rich, Karen L; Price, Connie S

2014-06-01

The purpose of our study was to conduct a needs assessment for infection prevention programs in both rural and urban hospitals in Colorado. Infection control professionals (ICPs) from Colorado hospitals participated in an online survey on training, personnel, and experience; ICP time allocation; and types of surveillance. Responses were evaluated and compared based on hospital status (rural or urban). Additionally, rural ICPs participated in an interview about resources and training. Surveys were received from 62 hospitals (77.5% response); 33 rural (75.0% response) and 29 urban (80.6% response). Fifty-two percent of rural ICPs reported multiple job responsibilities compared with 17.2% of urban ICPs. Median length of experience for rural ICPs was 4.0 years compared with 11.5 years for urban ICPs (P = .008). Fifty-one percent of rural ICPs reported no access to infectious disease physicians (0.0% urban) and 81.8% of rural hospitals reported no antimicrobial stewardship programs (31.0% urban). Through the interviews it was revealed that priorities for rural ICPs were training and communication. Our study revealed numerous differences between infection prevention programs in rural versus urban hospitals. An infection prevention outreach program established in Colorado could potentially address the challenges faced by rural hospital infection prevention departments. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Direct medical costs for partial refractory epilepsy in Mexico.

PubMed

García-Contreras, Fernando; Constantino-Casas, Patricia; Castro-Ríos, Angélica; Nevárez-Sida, Armando; Estrada Correa, Gloria del Carmen; Carlos Rivera, Fernando; Guzmán-Caniupan, Jorge; Torres-Arreola, Laura del Pilar; Contreras-Hernández, Iris; Mould-Quevedo, Joaquin; Garduño-Espinosa, Juan

2006-04-01

The aim was to determine the direct medical costs in patients with partial refractory epilepsy at the Mexican Institute of Social Security (IMSS) in Mexico. We carried out a multicenter, retrospective-cohort partial-economic evaluation study of partial refractory epilepsy (PRE) diagnosed patients and analyzed patient files from four secondary- and tertiary-level hospitals. PRE patients >12 years of age with two or more antiepileptic drugs and follow-up for at least 1 year were included. The perspective was institutional (IMSS). Only direct healthcare costs were considered, and the timeline was 1 year. Cost techniques were microcosting, average per-service cost, and per-day cost, all costs expressed in U.S. dollars (USD, 2004). We reviewed 813 files of PRE patients: 133 had a correct diagnosis, and only 72 met study inclusion criteria. Fifty eight percent were females, 64% were <35 years of age, 47% were students, in 73% maximum academic level achieved was high school, and 53% were single. Fifty one percent of cases experienced simple partial seizures and 94% had more than one monthly seizure. Annual healthcare cost of the 72 patients was 190,486 USD, ambulatory healthcare contributing 76% and hospital healthcare with 24%. Annual mean healthcare cost per PRE patient was 2,646 USD; time of disease evolution and severity of the patient's illness did not affect costs significantly.

Socio-economic effects of khat chewing in north eastern Kenya.

PubMed

Aden, A; Dimba, E A O; Ndolo, U M; Chindia, M L

2006-03-01

The khat habit is a widespread phenomenon which has in the past two decades spread to parts of Western Europe and North America from Eastern Africa and the Arabian Peninsula. Although khat has been identified as one of the most commonly abused substances in Kenya, restrictions on cultivation, trade and usage have been non-existent since its legalisation in 1977. To describe the socio-economic effects of khat chewing in Ijara District in the North Eastern Province of Kenya. Cross sectional study. Ijara District, North Eastern Kenya. Fifty respondents were interviewed. Eighty eight percent of the respondents were khat chewers, and the majority (80%) had family members who engaged in the khat habit. There was a general lack of education on the negative effects of khat chewing. Due to reported mood changes and withdrawal symptoms when not chewing khat, many respondents used more than half of their domestic budgets on khat, but few (28%) perceived this as a waste of resources. Fifty four percent of khat chewers typically started the habit during the day, implying a waste of time for productive work. However, only 40% of the persons interviewed admitted that the drug affected work performance negatively. The khat habit was associated with strain on family relationships, anti-social behaviour and health effects such as insomnia. In spite of the negative socio-economic impact of khat in Ijara District, khat consumption remains a widespread habit.

The extreme risk of personal data breaches and the erosion of privacy

NASA Astrophysics Data System (ADS)

Wheatley, Spencer; Maillart, Thomas; Sornette, Didier

2016-01-01

Personal data breaches from organisations, enabling mass identity fraud, constitute an extreme risk. This risk worsens daily as an ever-growing amount of personal data are stored by organisations and on-line, and the attack surface surrounding this data becomes larger and harder to secure. Further, breached information is distributed and accumulates in the hands of cyber criminals, thus driving a cumulative erosion of privacy. Statistical modeling of breach data from 2000 through 2015 provides insights into this risk: A current maximum breach size of about 200 million is detected, and is expected to grow by fifty percent over the next five years. The breach sizes are found to be well modeled by an extremely heavy tailed truncated Pareto distribution, with tail exponent parameter decreasing linearly from 0.57 in 2007 to 0.37 in 2015. With this current model, given a breach contains above fifty thousand items, there is a ten percent probability of exceeding ten million. A size effect is unearthed where both the frequency and severity of breaches scale with organisation size like s0.6. Projections indicate that the total amount of breached information is expected to double from two to four billion items within the next five years, eclipsing the population of users of the Internet. This massive and uncontrolled dissemination of personal identities raises fundamental concerns about privacy.

Relative toxicity of pyrolysis products of some materials used in home furnishings

NASA Technical Reports Server (NTRS)

Hilado, C. J.; Furst, A.

1976-01-01

Seventy samples of cushioning and upholstery materials used in home furnishings were evaluated for relative toxicity by means of the USF/NASA toxicity screening test. The materials were variably toxic under pyrolysis conditions, and this test appeared suitable for discriminating among them on the bases of time to incapacitation and time to death. The addition of fire retardants to these materials to comply with flammability regulations either had no significant effect on toxicity, or resulted in a reduction in relative toxicity. The modification of materials to comply with California upholstered furniture flammability regulations appears to have resulted in desirable limitations on toxicity. Fifty percent of the 70 materials tested caused incapacitation earlier than did the materials in compliance, and 30 percent caused death earlier.

Homicide-Followed-by-Suicide Incidents Involving Child Victims

PubMed Central

Logan, Joseph E.; Walsh, Sabrina; Patel, Nimeshkumar; Hall, Jeffrey E.

2015-01-01

Objectives To describe homicide-followed-by-suicide incidents involving child victims Methods Using 2003–2009 National Violent Death Reporting System data, we characterized 129 incidents based on victim and perpetrator demographic information, their relationships, the weapons/mechanisms involved, and the perpetrators’ health and stress-related circumstances. Results These incidents accounted for 188 child deaths; 69% were under 11 years old, and 58% were killed with a firearm. Approximately 76% of perpetrators were males, and 75% were parents/caregivers. Eighty-one percent of incidents with paternal perpetrators and 59% with maternal perpetrators were preceded by parental discord. Fifty-two percent of incidents with maternal perpetrators were associated with maternal psychiatric problems. Conclusions Strategies that resolve parental conflicts rationally and facilitate detection and treatment of parental mental conditions might help prevention efforts. PMID:23985234

Current Heavy Alcohol Consumption is Associated with Greater Cognitive Impairment in Older Adults

PubMed Central

Woods, Adam J.; Porges, Eric C.; Bryant, Vaughn E.; Seider, Talia; Gongvatana, Assawin; Kahler, Christopher W.; de la Monte, Suzanne; Monti, Peter M.; Cohen, Ronald A.

2016-01-01

Background The acute consumption of excessive quantities of alcohol causes well-recognized neurophysiological and cognitive alterations. As people reach advanced age, they are more prone to cognitive decline. To date, the interaction of current heavy alcohol (ETOH) consumption and aging remain unclear. The current paper tested the hypothesis that negative consequences of current heavy alcohol consumption on neurocognitive function are worse with advanced age. Further, we evaluated the relations between lifetime history of alcohol dependence and neurocognitive function Methods Sixty-six participants underwent a comprehensive neurocognitive battery. Current heavy ETOH drinkers were classified using NIAAA criteria (ETOH Heavy, n = 21) based on the Timeline follow-back and a structured clinical interview and compared to non-drinkers, and moderate drinkers (ETOH Low, n = 45). Fifty-three-point-three percent of the total population had a lifetime history of alcohol dependence. Neurocognitive data were grouped and analyzed relative to global and domain scores assessing: global cognitive function, attention/executive function, learning, memory, motor function, verbal function, and speed of processing. Results Heavy current ETOH consumption in older adults was associated with poorer global cognitive function, learning, memory, and motor function (p’s<.05). Furthermore, lifetime history of alcohol dependence was associated with poorer function in the same neurocognitive domains, in addition to the attention/executive domain, irrespective of age (p’s<.05). Conclusions These data suggest that while heavy current alcohol consumption is associated with significant impairment in a number of neurocognitive domains, history of alcohol dependence, even in the absence of heavy current alcohol use, is associated with lasting negative consequences for neurocognitive function. PMID:27658235

Modern management of salivary calculi.

PubMed

McGurk, M; Escudier, M P; Brown, J E

2005-01-01

The aim was to investigate the results of a minimally invasive approach to the management of salivary calculi. Four hundred and fifty-five salivary calculi (323 submandibular and 132 parotid) were treated using extracorporeal shock-wave lithotripsy (ECSWL), fluoroscopically guided basket retrieval or intraoral stone removal under general anaesthesia. The techniques were used either alone or in combination. ECSWL achieved complete success (stone and symptom free) in 87 (39.4 percent) of 221 patients (84 of 218 primary and all of three secondary procedures; 43 of 131 submandibular, 44 of 90 parotid). Basket retrieval cured 124 (74.7 percent) of 166 patients (103 of 136 primary and 21 of 30 secondary procedures; 80 of 109 submandibular, 44 of 57 parotid). Intraoral surgical removal was successful in a further 137 (95.8 percent) of 143 patients with submandibular stones (99 of 101 primary, 36 of 38 secondary and two of four tertiary procedures). The overall success rate for the three techniques was 348 (76.5 percent) of 455. A minimally invasive approach to the management of salivary calculi is to be encouraged. All three techniques described have low morbidity and afford the possibility of retaining a functional gland.

How Children Use Active Videogames and the Association Between Screen Time and Physical Activity.

PubMed

Forde, Cuisle; Hussey, Juliette

2015-08-01

The energy required to play active videogames (AVGs) has been reported on in the literature; however, little is known about how children use such games in their home environment. The aim of this study was to investigate children's use of AVGs and the association among AVG use, other screen-based activities, and physical activity levels. Eight hundred and twenty children 12.1 (0.6) years of age participated. Physical activity levels, sedentary screen-based activities, and AVG use were investigated. Differences across genders and deprivation indices were also analyzed. Fifty-eight percent of children met minimal physical activity guidelines. Forty-seven percent of children exceeded screen time recommendations. Of those who had access to AVGs, more children played sedentary games (or active games in a sedentary manner [68 percent]) than active games (55 percent) on AVG consoles. Furthermore, sedentary games were played for longer than active games. AVG play was positively correlated with reported time spent watching television (P=0.02). In free-living conditions AVG consoles are being used by more children and for longer durations as sedentary screen-based devices rather than active screen-based devices.

Differentially expressed genes of Coptotermes formosanus (Isoptera: Rhinotermitidae) challenged by chemical insecticides.

PubMed

Zhang, Yi; Zhao, Yuanyuan; Qiu, Xuehong; Han, Richou

2013-08-01

Coptotermes formosanus Shiraki (Isoptera: Rhinotermitidae) termites are harmful social insects to wood constructions. The current control methods heavily depend on the chemical insecticides with increasing resistance. Analysis of the differentially expressed genes mediated by chemical insecticides will contribute to the understanding of the termite resistance to chemicals and to the establishment of alternative control measures. In the present article, a full-length cDNA library was constructed from the termites induced by a mixture of commonly used insecticides (0.01% sulfluramid and 0.01% triflumuron) for 24 h, by using the RNA ligase-mediated Rapid Amplification cDNA End method. Fifty-eight differentially expressed clones were obtained by polymerase chain reaction and confirmed by dot-blot hybridization. Forty-six known sequences were obtained, which clustered into 33 unique sequences grouped in 6 contigs and 27 singlets. Sixty-seven percent (22) of the sequences had counterpart genes from other organisms, whereas 33% (11) were undescribed. A Gene Ontology analysis classified 33 unique sequences into different functional categories. In general, most of the differential expression genes were involved in binding and catalytic activity.

Statistical activities during 1976 and the design and initial analysis of nuclear site studies. [/sup 241/Am, /sup 137/Cs, /sup 239/Pu, /sup 240/Pu

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

Gilbert, R O; Essington, E H; Brady, D N

Statistical design and analysis activities for the Nevada Applied Ecology Group (NAEG) during 1976 are briefly outlined. This is followed by a description of soil data collected thus far at nuclear study sites. Radionuclide concentrations in surface soil collected along a transect from ground zero (GZ) along the main fallout pattern are given for Nuclear Site (NS) 201. Concentrations in soil collected at 315 locations on a grid system at 200 foot spacings are also given for this site. The /sup 241/Am to /sup 137/Cs ratios change over NS 201 depending on location relative to GZ. They range from lessmore » than one where /sup 241/Am is at low levels, to more than fifty where /sup 241/Am levels are high (near GZ). The estimated median /sup 239/ /sup 240/Pu to /sup 241/Am ratio is 11 and appears to be relatively constant over the area (the 95 percent lower and upper limits on the true median ratio are about 8 and 14).« less

Caffeine dependence in combination with a family history of alcoholism as a predictor of continued use of caffeine during pregnancy.

PubMed

Svikis, Dace S; Berger, Nathan; Haug, Nancy A; Griffiths, Roland R

2005-12-01

The purpose of the study was to examine whether caffeine dependence and a family history of alcoholism are associated with continued use of caffeine during pregnancy. Forty-four women seeking obstetrical care in an office-based practice completed questionnaires and provided saliva samples at three prenatal visits occurring 2-3, 3-4, and 7 months postconception. On visit 1, the patients received the physician's instructions to stop using caffeine. Structured interviews were used to assign a diagnosis of caffeine dependence (lifetime) and to identify family history of alcoholism. Outcome measures included self-reported levels of caffeine use and saliva caffeine levels at the three prenatal visits. Although most women eliminated or substantially reduced their caffeine consumption between pregnancy awareness and prenatal visit 1, those with a lifetime diagnosis of caffeine dependence and a family history of alcoholism had higher levels of caffeine use and lower rates of abstinence throughout pregnancy. Saliva caffeine levels confirmed these effects. Withdrawal symptoms, functional impairment, and craving were cited as reasons they failed to eliminate or cut back on caffeine use. Fifty percent of the women with both a lifetime diagnosis of caffeine dependence and a family history of alcoholism continued to use caffeine in amounts (>300 mg/day) greater than those considered safe during pregnancy, compared to none of the women without caffeine dependence and a family history of alcoholism. Women with a lifetime diagnosis of caffeine dependence and a family history of alcoholism also reported higher rates of past cigarette smoking and problematic alcohol use. Caffeine-dependent women with a family history of alcoholism were not able to follow their physician's advice to reduce or eliminate caffeine consumption during pregnancy, despite their wanting to do so. This subgroup may require more intensive intervention to ensure caffeine abstinence and may be at greater risk for abuse of or dependence on other drugs.

Characteristics and treatment patterns of US commercially insured and Medicaid patients with opioid dependence or abuse.

PubMed

Wollschlaeger, Bernd A; Willson, Tina M; Montejano, Leslie B; Ronquest, Naoko A; Nadipelli, Vijay R

To identify the demographic and clinical characteristics of commercially insured and Medicaid patients with a diagnosis of opioid dependence or abuse and to describe the pharmacological and nonpharmacological treatments received by these patients. This was a retrospective observational study using de-identified administrative claims data. The analysis included commercially insured and Medicaid patient data extracted from the Truven Health MarketScan® Commercial and Medicaid Databases. Patients with a diagnosis of opioid dependence or abuse from 2008 to 2014 (earliest diagnosis = index date) and a minimum of 6 months of pre-index and postindex continuous enrollment in the database. Baseline demographic and clinical characteristics, medication-assisted treatment (MAT), and treatment other than MAT received following diagnosis, and the clinical practice setting in which patients received any opioid dependence-related care were reported. Data from commercially insured (N = 103,768) and Medicaid (N = 50,552) patients were analyzed. Common comorbid conditions included chronic pain (48.6 percent Commercial, 56.8 percent Medicaid), depressive disorder (24.0 percent Commercial, 32.8 percent Medicaid), and other substance abuse disorders (13.3 percent Commercial, 23.7 percent Medicaid). Nearly one third of both Commercial (31.6 percent) and Medicaid (33.6 percent) patients did not have any claims for psychosocial therapy or MAT during the follow-up period. Only 24.3 percent of Commercial patients and 20.4 percent of Medicaid patients had evidence of claims for both MAT and psychosocial treatment anytime following diagnosis. The results suggest that there are opportunities to improve care through comprehensive and coordinated treatment for opioid dependence/abuse. Policies aimed at improving treatment access may be warranted.

Final year MBBS students' perception for observed structured clinical examination.

PubMed

Siddiqui, Faisal Ghani

2013-01-01

To determine perceptions of final year students about observed structured clinical examination (OSCE) and to determine its acceptance among these students. Sequential mixed method design using survey questionnair and in-depth interviews. The study constituted a one-time survey and in-depth interviews conducted over a period of three consecutive days during final year MBBS annual examination at OSCE centre, from April 04, 2010 to April 06, 2010. Three hundred and fifty final year MBBS students, selected through non-probability convenience sampling, were asked to fill the 12-item questionnaire. Three hundred and thirty one students returned the forms. In-depth, structured interviews with 22 students, selected by non-probability purposive sampling, were conducted. The interviews were tape recorded for subsequent transcription. The statistical analysis was done using SPSS 17. The qualitative data was analyzed through content analysis techniques. Three hundred and thirty one final year MBBS students (50.6% females) filled the questionnaire (response rate 94.6%). Fifty three percent respondents agreed that the OSCE tasks were taught during clinical rotations. The experience was stressful for 67.9% respondents. Inadequate prior guidelines, inadequate time for stations, newness of the assessment format and vague instructions were the main causes for stress. Over 70% of the students felt that OSCE helped them identify areas of weakness in their practical and clinical skills; 56.5% felt that the stations dealt with practical skills. Seventy nine percent students were happy with the attitude of the examiners while 19% students felt that the facilitators were uncooperative; failure of the examiners to observe the students during performance of the tasks was the major cause for dissatisfaction. Nearly thirty percent (29.9%) respondent felt that the stations were difficult to understand. Over forty nine percent (49.7%) complained that adequate guidelines were not given prior to the examination. Overall, 67% students were satisfied with this new method of assessment. The overall acceptance of the students for OSCE was low. Reforms such as redesigning of curriculum and learning objectives, training the faculty in conduct of OSCE, involving more external examiners and establishment of a skill's lab would help improve this assessment tool.

Method for making a photodetector with enhanced light absorption

DOEpatents

Kane, James

1987-05-05

A photodetector including a light transmissive electrically conducting layer having a textured surface with a semiconductor body thereon. This layer traps incident light thereby enhancing the absorption of light by the semiconductor body. A photodetector comprising a textured light transmissive electrically conducting layer of SnO.sub.2 and a body of hydrogenated amorphous silicon has a conversion efficiency about fifty percent greater than that of comparative cells. The invention also includes a method of fabricating the photodetector of the invention.

Using a Systems Engineering Initiative for Patient Safety to Evaluate a Hospital-wide Daily Chlorhexidine Bathing Intervention.

PubMed

Caya, Teresa; Musuuza, Jackson; Yanke, Eric; Schmitz, Michelle; Anderson, Brooke; Carayon, Pascale; Safdar, Nasia

2015-01-01

We undertook a systems engineering approach to evaluate housewide implementation of daily chlorhexidine bathing. We performed direct observations of the bathing process and conducted provider and patient surveys. The main outcome was compliance with bathing using a checklist. Fifty-seven percent of baths had full compliance with the chlorhexidine bathing protocol. Additional time was the main barrier. Institutions undertaking daily chlorhexidine bathing should perform a rigorous assessment of implementation to optimize the benefits of this intervention.

Predictors of outcome after temporal lobectomy for the treatment of intractable epilepsy.

PubMed

Jeha, L E; Najm, I M; Bingaman, W E; Khandwala, F; Widdess-Walsh, P; Morris, H H; Dinner, D S; Nair, D; Foldvary-Schaeffer, N; Prayson, R A; Comair, Y; O'Brien, R; Bulacio, J; Gupta, A; Lüders, H O

2006-06-27

To assess short- and long-term seizure freedom, the authors reviewed 371 patients who underwent anterior temporal lobectomy to treat pharmacoresistant epilepsy. The mean follow-up duration was 5.5 years (range 1 to 14.1 years). Fifty-three percent of patients were seizure free at 10 years. The authors identified multiple predictors of recurrence. Results of EEG performed 6 months postoperatively correlated with occurrence and severity of seizure recurrence, in addition to breakthrough seizures with discontinuation of antiepileptic drugs.

The Proceedings of the Conference on Assessment of Ecological Impacts of Oil Spills Held 14-17 Jun 1978, Keystone, Colorado.

DTIC Science & Technology

1978-01-01

the physical and chemical principles involved in the combustion of hydrocarbons is beyond the scope of this study . But, two factors , temperature and...In this study fifty-five saturated and aromatic hydrocarbons were Individually quantitated. Percent recoveries and relative response factors for the...FROM THE SUPERTANKER ‘M~~ULA’, Roy W . Hann 354 BIOLOGICAL STUDIES OF THE METULA OIL SPILL , Dale Straughan 364 SINKING OF OIL IN LOS ANGELES HARBOR

Rehabilitation of Permeable Breakwaters and Jetties by Void Sealing: Summary Report. Repair, Evaluation, Maintenance, and Rehabilitation Research Program

DTIC Science & Technology

1990-10-01

able sealing material that has promising characteristics for coastal engineer- ing applications. Microfine Cement, a company which markets ultrafine...cement, claims the product can penetrate fine sand and is strong and durable with a 4- to 5-hr set tine. Fifty percent of Microfine Cement’s...sealant. The casing can be pierced at any selected point by firing an explosive-impelled projectile from a device lowered into the casing. d. Tubes A

Changing knowledge and beliefs through an oral health pregnancy message.

PubMed

Bates, S Brady; Riedy, Christine A

2012-01-01

Pregnancy can be a critical and important period in which to intervene to improve oral health in both the mother and her child. This study examined an online approach for promoting awareness of oral health messages targeted at pregnant women, and whether this type of health messaging impacts oral health knowledge and beliefs. The study was conducted in three parts: production and pilot testing of a brief commercial, Web site/commercial launch and testing, and dissemination and monitoring of the commercial on a video-sharing site. The brief commercial and pre- and postsurveys were produced and pilot tested among a convenience sample of pregnant women (n = 13). The revised commercial and surveys were launched on a newly created Web site and monitored for activity. After 2 months, the commercial was uploaded to a popular video-sharing Web site. Fifty-five individuals completed both the pre- and postsurveys after the Web site was launched. No one responded 100 percent correctly on the presurvey; 77.4 percent responded correctly about dental visits during pregnancy, 66.0 percent about cavity prevention, and 50.9 percent about transmission of bacteria by saliva. Most respondents recalled the correct information on the posttest; 100 percent or close to 100 percent accurately responded about visiting the dentist during pregnancy and preventing cavities, while 79.2 percent responded correctly to the transmission question. Social media can effectively provide dental health messages during pregnancy. This approach can play an important role in increasing awareness and improving oral health of both mother and child. © 2011 American Association of Public Health Dentistry.

Properties of publications on anatomy in medical education literature.

PubMed

Vorstenbosch, Marc; Bolhuis, Sanneke; van Kuppeveld, Sascha; Kooloos, Jan; Laan, Roland

2011-01-01

Publications on anatomy in medical education appear to be largely anecdotal. To explore this, we investigated the literature on anatomy in medical education, aiming first to evaluate the contribution of the literature on anatomy in medical education to "best evidence medical education" (BEME) and second to evaluate the development of this literature toward more "best evidence" between 1985 and 2009. Four databases were searched for publications on anatomy in medical education published between 1985 and 2009, resulting in 525 references. Hundred publications were characterized by five variables (journal category, paper subject, paper category, author perspective, and paper perspective). Statements from these publications were characterized by two variables (category and foundation). The publications contained 797 statements that involved the words "anatomy," "anatomical," or "anatomist." Forty-five percent of the publications contained no explicit research question. Forty percent of the statements made were about "teaching methods" and 17% about "teaching content," 8% referred to "practical value," and 10% to "side effects" of anatomy education. Ten percent of the statements were "positional," five percent "traditional," four percent "self-evident," and two percent referred to "quality of care." Fifty-six percent of the statements had no foundation, 17% were founded on empirical data, and 27% by references. These results substantiated the critical comments about the anecdotal nature of the literature. However, it is encouraging to see that between 1985 and 2009 the number of publications is rising that these publications increasingly focus on teaching methods and that an academic writing style is developing. This suggests a growing body of empirical literature about anatomy education. Copyright © 2011 American Association of Anatomists.

Teaching atraumatic restorative treatment in U.S. dental schools: a survey of predoctoral pediatric dentistry program directors.

PubMed

Kateeb, Elham T; Warren, John J; Damiano, Peter; Momany, Elizabeth; Kanellis, Michael; Weber-Gasparoni, Karin; Ansley, Tim

2013-10-01

The International Dental Federation and World Health Organization have promoted the use of Atraumatic Restorative Treatment (ART) in modern clinical settings worldwide. In the United States, the practice of ART is not believed to be widely used, which may be a result of little attention given to ART training in predoctoral pediatric dentistry curricula in U.S. dental schools. This study investigated the extent of clinical and didactic instruction on ART provided in U.S. dental schools by surveying the predoctoral pediatric dentistry programs in 2010. Of the fifty-seven directors asked to complete the survey, forty-four responded for a response rate of 77 percent. Of these forty-four programs, 66 percent reported providing clinical training on ART, though only 14 percent provide this training often or very often. The types of ART training provided often or very often included interim treatment (18 percent) and single-surface cavities (14 percent) in primary teeth. However, ART was said to be rarely taught as a definitive treatment in permanent teeth (2 percent). Attitude was a major predictor, for clinical training provided and using professional guidelines in treatment decisions were associated with a positive attitude towards ART. These predoctoral pediatric dentistry programs used ART mainly in primary, anterior, and single-surface cavities and as interim treatment. As ART increases access of children to dental care, the incorporation of the ART approach into the curricula of U.S. dental schools should be facilitated by professional organizations.

Availability of Behavioral Health Treatment for Women in Prison

PubMed Central

Blitz, Cynthia L.; Wolff, Nancy; Paap, Kris

2010-01-01

Objectives This study examined whether women with behavioral health needs are more likely to receive treatment for these problems in prison or in the community and to what extent prison disrupts or establishes involvement in treatment for these women. Methods Data were collected in August 2004 as part of a population survey of female inmates in the only state correctional facility for women in New Jersey. Results A total of 908 women were surveyed. Fifty-six percent of the women surveyed reported needing behavioral health treatment before incarceration, but only 62 percent of this group reported receiving such treatment in the community. The rate at which treatment matched need within this population before incarceration varied by type of treatment needed: it was the highest (58 percent) for women who needed treatment for mental health problems, lower (52 percent) for those who needed substance abuse treatment, and lowest (44 percent) for those who needed treatment for comorbid mental health and substance abuse problems. In comparison, the rate of match between need for and receipt of treatment in prison was higher for all three types of behavioral health treatment (78 percent, 57 percent, and 65 percent, respectively). Additionally, the findings suggest that prison did not disrupt the type of behavioral health treatment that inmates had previously received in the community. Conclusions At least in New Jersey, prison appears to improve access to behavioral health treatment among female inmates. Although this conclusion is consistent with the rehabilitation goals of incarceration, it also suggests that some women may have been able to avoid prison if treatment had been provided in the community, especially for substance-related problems. PMID:16524993

Geoscience salaries up by 10.8%

NASA Astrophysics Data System (ADS)

Bell, Peter M.

According to a recent salary survey of over 4000 scientists in all fields by Research and Development (March 1984) geoscientists ranked fourth place for 1984. Mathematics, aeronautical engineering, and metallurgy had higher median salaries, but the discipline of geoscience had a higher median salary than that of physics, chemical engineering, mechanical engineering, electrical engineering, ceramics, chemistry, industrial engineering, biology, and other fields of research and development. The 1984 median salary for geoscientists was $40,950, up from the median value by 10.8%. In 1983, geoscience was ranked in ninth place.The geoscientist profile for 1984 was not unusual. The median age was 47.5 years, and the median years of experience was 18. Geoscientists are the best educated. Eighty-two percent of the geoscientists polled had advanced degrees beyond the bachelor's degree. Fifty-six percent of the geoscientists had the Ph.D. degree.

Cancer Screening Practices among Physicians Serving Chinese Immigrants

PubMed Central

Aragones, Abraham; Trinh-Shevrin, Chau; Gany, Francesca

2012-01-01

Chinese immigrants in the United States are broadly affected by cancer health disparities. We examined the cancer screening attitudes and practices of physicians serving Chinese immigrants in the New York City (NYC) area by mailing a cancer screening survey, based on current guidelines, to a random sample of physicians serving this population. Fifty three physicians (44%) completed the survey. Seventy-two percent reported following the guidelines for breast cancer, 35% for cervical cancer screening, and 45% for all colorectal cancer screening tests. Sixty-eight percent of physicians were satisfied with their current rates of cancer screening with their Chinese immigrant patient population. Physicians serving the Chinese community in NYC follow cancer screening guidelines inadequately. Cancer screening rates in this population could likely be increased by interventions that target physicians and improve awareness of guidelines and recommended best practices. PMID:19202247

The Placebo Effect in Clinical Trials for Alcohol Dependence: An Exploratory Analysis of 51 Naltrexone and Acamprosate Studies

PubMed Central

Litten, Raye Z.; Castle, I-Jen P.; Falk, Daniel; Ryan, Megan; Fertig, Joanne; Chen, Chiung M.; Yi, Hsiao-ye

2013-01-01

Background The placebo effect often undermines efforts to determine treatment effectiveness in clinical trials. A significant placebo response occurs in alcohol trials, but it is not well understood. The purpose of this study was to characterize the placebo response across multiple naltrexone and acamprosate studies. Methods Fifty-one trials, 3 with a naltrexone and an acamprosate arm, 31 with at least 1 naltrexone arm, and 17 with at least 1 acamprosate arm, were identified from Cochrane reviews and PubMed search. To be included in this study, patients had to be at least 18 years old, abstinent from alcohol before randomization, and meet a diagnosis of alcohol dependence. Pearson correlation coefficients (rp) and simple linear regression were used to describe the strength of linear relationships between placebo response and treatment effect size. Spearman’s rank correlation coefficients (rs) were used to examine the strength of associations between study characteristics and placebo response. Results For the end-point measures of percent days abstinent and total abstinence, a negative relationship was evident between placebo response and treatment effect size in the naltrexone trials (rp = −0.55, p < 0.01 and rp = −0.20, p = 0.35, respectively) as well as in the acamprosate trials (rp = −0.45, p = 0.09 and rp = −0.56, p = 0.01, respectively). The placebo response for percent days abstinent was negatively correlated with mean age of participants (rs = −0.42, p = 0.05) across naltrexone trials and positively correlated with publication year (rs = 0.57, p = 0.03) across acamprosate trials. However, these two study characteristics were not significantly correlated with treatment effect size. Conclusion The placebo response varied considerably across trials and was negatively correlated with the treatment effect size. Additional studies are required to fully understand the complex nature of the placebo response and to evaluate approaches to minimize its effects. PMID:23889231

Current practices are variable in the evaluation and management of patients with anomalous aortic origin of a coronary artery: Results of a survey.

PubMed

Agrawal, Hitesh; Mery, Carlos M; Day, Patrick E; Sexson Tejtel, S Kristen; McKenzie, E Dean; Fraser, Charles D; Qureshi, Athar M; Molossi, Silvana

2017-09-01

Anomalous aortic origin of a coronary artery (AAOCA) is the second leading cause of sudden cardiac death in young athletes in the USA. Long-term outcome data for these patients are lacking to date. There is insufficient knowledge on the best approach to these patients and they are managed in a nonuniform manner. An online survey of 15 questions regarding management of AAOCA was sent out to 198 cardiac healthcare providers. The goal was to define gaps in knowledge to justify a dedicated scientific forum for discussion of AAOCA. Descriptive statistics were performed. A total of 91 providers (46%) completed the survey including pediatric cardiology subspecialists (40%), general pediatric cardiologists (24%), cardiovascular (CV) surgeons (22%), adult cardiologists (10%), nurse practitioners (8%), cardiology fellows (3%) and CV anesthesiologist (1%). Forty-eight percent had been practicing for over 15 years and 28% were in their first 5 years of practice. Fifty-two percent of the providers cared for adults and 93% cared for children/adolescents. Eighty-eight percent were affiliated with an academic institution. All but one provider practiced in the USA, 62% practiced in Texas. Half of participants (50%) were very comfortable managing AAOCA patients and 36% were somewhat comfortable. Providers utilized various imaging tests to confirm the anatomy including computed tomography angiography 88%, cardiac magnetic resonance imaging 70%, cardiac catheterization 60%, echocardiogram 12%, IVUS 2% and myocardial perfusion scan 1%. The majority felt comfortable in counseling the families and felt that depending on the type of lesion these patients should get surgical referral (85%) vs clinical follow up (67%) with exercise restriction (65%). There is heterogeneity in the way AAOCA patients are currently evaluated and managed. A knowledge gap exists even with participants from academic institutions. Long-term data with a defined approach to management of these patients may help to improve outcomes and prevent unnecessary exercise restriction or surgery. © 2017 Wiley Periodicals, Inc.

Factors affecting career choice among the next generation of academic vascular surgeons.

PubMed

Danczyk, Rachel C; Sevdalis, Nick; Woo, Karen; Hingorani, Anil P; Landry, Gregory J; Liem, Timothy K; Moneta, Gregory L; Mitchell, Erica L

2012-05-01

Few studies have examined factors that influence an individual's decision to enter an academic medical career after residency training. We sought to evaluate whether sex, ethnicity, child care issues, and debt burden influenced residents' choice for a career in academic vascular surgery. A 39-item Web survey, designed to elucidate which factors motivated residents to seek a career in academic vascular surgery, was sent to 295 vascular surgery residents currently enrolled in Accreditation Council on Graduate Medical Education-accredited training programs. A total of 128 responses (43%) were received. Of these, 53% of respondents were white and 47% were nonwhite and 34 (27%) were women and 94 (73%) were men. Fifty-seven percent of minorities anticipate a career in academic vascular surgery. There were no statistical differences between sex and ethnicity for factors influencing career choice, including training paradigm, presence of a life partner or dependents, mentorship role, participation in research, service, and teaching, anticipated salary, and debt burden (P > .05). Seventy-seven percent of respondents carry significant debt; of those with debt, 81% owe >$100,000 and 40% owe >$200,000. Seventy-three percent of 0+5 trainees anticipated choosing an academic practice compared with 42% of 5+2 trainees (P < .01). Respondents planning an academic career cited procedural variation, breadth and depth of practice/tertiary referral experience, and research opportunities as the most important drivers of career choice. Income potential, strength of the job market, and child care needs were deemed less important. This study shows that academic vascular surgery is a popular career option for current vascular surgery trainees, especially those in 0+5 programs. Choosing a career in academic vascular surgery appears not to be influenced by sex, ethnicity, child care concerns, salary expectations, or debt burden, even though most trainees carry enormous debt. The data imply future academic vascular surgeons will likely have greater gender and ethnic variability than is currently seen. Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

Physician opinions regarding elective bilateral salpingectomy with hysterectomy and for sterilization.

PubMed

Gill, Sarah E; Mills, Benjie B

2013-01-01

To gather opinions about the benefits and concerns of performing bilateral salpingectomy without oophorectomy during hysterectomy for benign indications and as a sterilization procedure. Survey study (Canadian Task Force classification III). Practicing physicians in US institutions that have obstetrics and gynecology residency programs listed on the FREIDA website were surveyed electronically. A validated, standardized questionnaire designed to gather opinions about bilateral salpingectomy performed during hysterectomy or for sterilization was administered via SurveyMonkey to practitioners of obstetrics and gynecology. Results were compiled and presented as percentages of total responders. A total of 234 surveys were returned. Fifty-four percent of physicians perform bilateral salpingectomy during hysterectomy, most commonly to reduce the risks of cancer (75%) and repeat operation (49.1%). Of the 45.5% of physicians who do not perform bilateral salpingectomy during hysterectomy, most (69.4%) believe there is no benefit. Fifty-eight percent of practitioners believe that bilateral salpingectomy is the most effective method of sterilization after age 35 years but choose this method only in patients in whom one sterilization procedure has failed or because of tubal disease. Only 7.2% of surgeons prefer it as an interval sterilization procedure. Most practitioners believe that bilateral salpingectomy is beneficial. Most also believe that bilateral salpingectomy is the most effective sterilization procedure; however, only 7.2% use this method as an interval procedure. More data are needed to evaluate the prophylactic effect of bilateral salpingectomy against postoperative sequelae. Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.

[Hyperfrequent consultations: is there a relationship with the mother's personality?].

PubMed

Igual Rosado, R; Castro Nicolau, E; Alonso Martínez, I; Terradas Corominas, M; de Frutos Gallego, E; Cebrià Andreu, J

2003-01-01

To study the psychological profile of mothers who overuse pediatric services and associated social and demographic characteristics, as well as to evaluate the association between maternal personality profile and greater use of pediatric services. Cross-sectional descriptive study, at the Basic Health Areas of Granollers Sud and Granollers Oest-Canovelles in Barcelona (Spain). Forty-four mothers, representing 21.5 % of the population meeting the inclusion criteria were studied. The population consisted of mothers of children who visited the center on an equal or higher number of occasions as two standard deviations. One-hour interviews were conducted. A data sheet to assess social and demographic variables, Milton's Multiaxial Inventory II, and Goldberg's Anxiety and Depression Scale to detect symptoms of depression and anxiety were administered. Forty-four mothers (21.5 %) attended the interviews. The mean age was 36.6 years. Most of the mothers (90.9 %) were married, 73 % had completed primary studies, 5 % were housewives, and 75 % had no family support. Fifty percent of the children were the youngest in their family, and 30 % were only children. Concerning personality disorders, 55.8 % of overusing mothers showed compulsive personality, 30.23 % schizoid personality, and 14 % dependent personality while 47.7 % of mothers presented significant symptoms of anxiety. Sociodemographic profile, anxiety, and maternal personality profile are related to overuse of pediatric services. Compulsive, schizoid and dependent personality disorders seem to be associated with overuse.

Labour exploitation and health: a case series of men and women seeking post-trafficking services.

PubMed

Turner-Moss, Eleanor; Zimmerman, Cathy; Howard, Louise M; Oram, Siân

2014-06-01

Research on the health of trafficked men and on the health problems associated with trafficking for labor exploitation are extremely limited. This study analysed data from a case series of anonymised case records of a consecutive sample of 35 men and women who had been trafficked for labor exploitation in the UK and who were receiving support from a non-governmental service between June 2009 and July 2010. Over three-quarters of our sample was male (77 %) and two-thirds aged between 18 and 35 years (mean 32.9 years, SD 10.2). Forty percent reported experiencing physical violence while they were trafficked. Eighty-one percent (25/31) reported one or more physical health symptoms. Fifty-seven percent (17/30) reported one or more post-traumatic stress symptoms. A substantial proportion of men and women who are trafficked for labor exploitation may experience violence and abuse, and have physical and mental health symptoms. People who have been trafficked for forced labor need access to medical assessment and treatment.

[Knowledge and attitude towards diabetes mellitus in Argentina].

PubMed

Rodríguez, Martín; Puchulu, Félix

2015-01-01

A population survey was conducted in 9 provinces of Argentina in 2012 aimed at determining the level of knowledge of diabetes mellitus and the risk of developing the disease. This was a cross-sectional study based on the general population and including men and women aged 18-70 years from all socioeconomic backgrounds. Results showed that 30.5% of participants without diabetes mellitus were at risk of developing the disease. Fifty-nine percent of participants had a body mass index = 25 kg/m2. Forty-nine percent did less than 30 minutes of daily physical activity. Only 34% of the population ate fruits and vegetables every day. Ninety-eight percent of participants had once heard of diabetes, and 67% defined it as a severe or very severe disease. In view of the findings resulting from this survey, healthcare services are expected to improve prevention and effective control of cardiovascular risk factors as well as to enhance preventive actions in order to encourage the adoption of healthier lifestyles from an earlier age and to achieve greater knowledge not only among patients living with diabetes, but also within the general population.

Evaluation of Dietary Choices, Preferences, Knowledge and Related Practices Among Pregnant Women Living in An Indian Setting.

PubMed

Ajantha; Singh, Awnish K; Malhotra, Bhavya; Mohan, Surapaneni Krishna; Joshi, Ashish

2015-08-01

Healthy and nutritious diet is very essential component of Antenatal care along with clinical advice. The objective of this study was to understand the dietary choices, preferences, knowledge and related practices among pregnant women living in an Indian setting. Hundred pregnant women were enrolled in this cross-sectional study. Information about Socio-demographic profile, food item price and approach during inflation, nutrition related knowledge, attitude and practices and 24 hour dietary recall was acquired. Majority of the participants (87%) reported regular antenatal care visits and intake of iron and folic acid tablets. Eighty two percent of the participants were acquainted with standardized marks on food items and 64% of them reported checking of these marks before purchasing. Thirty two percent of the participants did not know about balanced diet. Fifty eight percent of the participants felled in fair category of dietary recall final scores. There is still vast room for improvement of the nutritional status of pregnant women as none of the participants were able to achieve excellent status on 24 hour food record scoring sheet.

The nonuse of free health-screening by rural elderly.

PubMed

Williams, G O; Dueker, D L

1985-01-01

We studied the population of noninstitutionalized elderly persons in Iowa County, Iowa, who had not used a well-elderly clinic offering free home or clinic assessments by a nurse. Questionnaires were administered by trained interviewers to a sample of the nonuser population, 60 years of age and over (n = 360). Fifty-five percent did not know that there was a well-elderly clinic in the county in spite of widespread advertising. Nonusers who had heard of the clinic were more highly educated and had more transportation problems than nonusers who were aware of the clinic. Sixty percent of those who saw no point in going to a doctor if they were feeling well were unaware of the clinic. Nonusers tended to be older, living on farms, mobile, long-time residents, and 54 percent had less than a high school education. The cost of health care was not a problem. The major reason given for not using the clinic was that the person was "under a doctor's care." Those who had no regular doctor did not plan to use the clinic because they felt healthy.

Restaurant and Bar Owners’ Exposure to Secondhand Smoke and Attitudes Regarding Smoking Bans in Five Chinese Cities

PubMed Central

Liu, Ruiling; Hammond, S. Katharine; Hyland, Andrew; Travers, Mark J.; Yang, Yan; Nan, Yi; Feng, Guoze; Li, Qiang; Jiang, Yuan

2011-01-01

Despite the great progress made towards smoke-free environments, only 9% of countries worldwide mandate smoke-free restaurants and bars. Smoking was generally not regulated in restaurants and bars in China before 2008. This study was designed to examine the public attitudes towards banning smoking in these places in China. A convenience sample of 814 restaurants and bars was selected in five Chinese cities and all owners of these venues were interviewed in person by questionnaire in 2007. Eighty six percent of current nonsmoking subjects had at least one-day exposure to secondhand smoke (SHS) at work in the past week. Only 51% of subjects knew SHS could cause heart disease. Only 17% and 11% of subjects supported prohibiting smoking completely in restaurants and in bars, respectively, while their support for restricting smoking to designated areas was much higher. Fifty three percent of subjects were willing to prohibit or restrict smoking in their own venues. Of those unwilling to do so, 82% thought smoking bans would reduce revenue, and 63% thought indoor air quality depended on ventilation rather than smoking bans. These results showed that there was support for smoking bans among restaurant or bar owners in China despite some knowledge gaps. To facilitate smoking bans in restaurants and bars, it is important to promote health education on specific hazards of SHS, provide country-specific evidence on smoking bans and hospitality revenues, and disseminate information that restricting smoking and ventilation alone cannot eliminate SHS hazards. PMID:21655134

Incorporating Anthropogenic Influences into Fire Probability Models: Effects of Human Activity and Climate Change on Fire Activity in California.

PubMed

Mann, Michael L; Batllori, Enric; Moritz, Max A; Waller, Eric K; Berck, Peter; Flint, Alan L; Flint, Lorraine E; Dolfi, Emmalee

2016-01-01

The costly interactions between humans and wildfires throughout California demonstrate the need to understand the relationships between them, especially in the face of a changing climate and expanding human communities. Although a number of statistical and process-based wildfire models exist for California, there is enormous uncertainty about the location and number of future fires, with previously published estimates of increases ranging from nine to fifty-three percent by the end of the century. Our goal is to assess the role of climate and anthropogenic influences on the state's fire regimes from 1975 to 2050. We develop an empirical model that integrates estimates of biophysical indicators relevant to plant communities and anthropogenic influences at each forecast time step. Historically, we find that anthropogenic influences account for up to fifty percent of explanatory power in the model. We also find that the total area burned is likely to increase, with burned area expected to increase by 2.2 and 5.0 percent by 2050 under climatic bookends (PCM and GFDL climate models, respectively). Our two climate models show considerable agreement, but due to potential shifts in rainfall patterns, substantial uncertainty remains for the semiarid inland deserts and coastal areas of the south. Given the strength of human-related variables in some regions, however, it is clear that comprehensive projections of future fire activity should include both anthropogenic and biophysical influences. Previous findings of substantially increased numbers of fires and burned area for California may be tied to omitted variable bias from the exclusion of human influences. The omission of anthropogenic variables in our model would overstate the importance of climatic ones by at least 24%. As such, the failure to include anthropogenic effects in many models likely overstates the response of wildfire to climatic change.

Medical School Outcomes, Primary Care Specialty Choice, and Practice in Medically Underserved Areas by Physician Alumni of MEDPREP, a Postbaccalaureate Premedical Program for Underrepresented and Disadvantaged Students.

PubMed

Metz, Anneke M

2017-01-01

Minorities continue to be underrepresented as physicians in medicine, and the United States currently has a number of medically underserved communities. MEDPREP, a postbaccalaureate medical school preparatory program for socioeconomically disadvantaged or underrepresented in medicine students, has a stated mission to increase the numbers of physicians from minority or disadvantaged backgrounds and physicians working with underserved populations. This study aims to determine how MEDPREP enhances U.S. physician diversity and practice within underserved communities. MEDPREP recruits disadvantaged and underrepresented in medicine students to complete a 2-year academic enhancement program that includes science coursework, standardized test preparation, study/time management training, and emphasis on professional development. Five hundred twenty-five disadvantaged or underrepresented students over 15 years completed MEDPREP and were tracked through entry into medical practice. MEDPREP accepts up to 36 students per year, with two thirds coming from the Midwest region and another 20% from nearby states in the South. Students complete science, test preparation, academic enhancement, and professionalism coursework taught predominantly by MEDPREP faculty on the Southern Illinois University Carbondale campus. Students apply broadly to medical schools in the region and nation but are also offered direct entry into our School of Medicine upon meeting articulation program requirements. Seventy-nine percent of students completing MEDPREP became practicing physicians. Fifty-eight percent attended public medical schools, and 62% attended medical schools in the Midwest. Fifty-three percent of program alumni chose primary care specialties compared to 34% of U.S. physicians, and MEDPREP alumni were 2.7 times more likely to work in medically underserved areas than physicians nationally. MEDPREP increases the number of disadvantaged and underrepresented students entering and graduating from medical school, choosing primary care specialties, and working in medically underserved areas. MEDPREP may therefore serve as a model for increasing physician diversity and addressing the needs of medically underserved communities.

Current practice of antibiotic prophylaxis for surgical fixation of closed long bone fractures: a survey of 297 members of the Orthopaedic Trauma Association.

PubMed

Gans, Itai; Jain, Amit; Sirisreetreerux, Norachart; Haut, Elliott R; Hasenboehler, Erik A

2017-01-01

The risk of postoperative surgical site infection after long bone fracture fixation can be decreased with appropriate antibiotic use. However, there is no agreement on the superiority of a single- or multiple-dose perioperative regimen of antibiotic prophylaxis. The purpose of this study is to determine the following: 1) What are the current practice patterns of orthopaedic trauma surgeons in using perioperative antibiotics for closed long bone fractures? 2) What is the current knowledge of published antibiotic prophylaxis guidelines among orthopaedic trauma surgeons? 3) Are orthopaedic surgeons willing to change their current practices? A questionnaire was distributed via email between September and December 2015 to 955 Orthopaedic Trauma Association members, of whom 297 (31%) responded. Most surgeons (96%) use cefazolin as first-line infection prophylaxis. Fifty-nine percent used a multiple-dose antibiotic regimen, 39% used a single-dose regimen, and 2% varied this decision according to patient factors. Thirty-six percent said they were unfamiliar with Centers for Disease Control and Prevention (CDC) antibiotic prophylaxis guidelines; only 30% were able to select the correct CDC recommendation from a multiple-choice list. However, 44% of surgeons said they followed CDC recommendations. Fifty-six percent answered that a single-dose antibiotic prophylaxis regimen was not inferior to a multiple-dose regimen. If a level-I study comparing a single preoperative dose versus multiple perioperative antibiotic dosing regimen for treatment of closed long bone fractures were published, most respondents (64%) said they would fully follow these guidelines, and 22% said they would partially change their practice to follow these guidelines. There is heterogeneity in the use of single- versus multiple-dose antibiotic prophylaxis for surgical repair of closed long bone fractures. Many surgeons were unsure of current evidence-based recommendations regarding perioperative antibiotic use. Most respondents indicated they would be receptive to high-level evidence regarding the single- versus multiple-dose perioperative prophylactic antibiotics for the treatment of closed long bone fractures.

The Mayo Clinic Biobank: a building block for individualized medicine.

PubMed

Olson, Janet E; Ryu, Euijung; Johnson, Kiley J; Koenig, Barbara A; Maschke, Karen J; Morrisette, Jody A; Liebow, Mark; Takahashi, Paul Y; Fredericksen, Zachary S; Sharma, Ruchi G; Anderson, Kari S; Hathcock, Matthew A; Carnahan, Jason A; Pathak, Jyotishman; Lindor, Noralane M; Beebe, Timothy J; Thibodeau, Stephen N; Cerhan, James R

2013-09-01

To report the design and implementation of the first 3 years of enrollment of the Mayo Clinic Biobank. Preparations for this biobank began with a 4-day Deliberative Community Engagement with local residents to obtain community input into the design and governance of the biobank. Recruitment, which began in April 2009, is ongoing, with a target goal of 50,000. Any Mayo Clinic patient who is 18 years or older, able to consent, and a US resident is eligible to participate. Each participant completes a health history questionnaire, provides a blood sample, and allows access to existing tissue specimens and all data from their Mayo Clinic electronic medical record. A community advisory board provides ongoing advice and guidance on complex decisions. After 3 years of recruitment, 21,736 individuals have enrolled. Fifty-eight percent (12,498) of participants are female and 95% (20,541) of European ancestry. Median participant age is 62 years. Seventy-four percent (16,171) live in Minnesota, with 42% (9157) from Olmsted County, where the Mayo Clinic in Rochester, Minnesota, is located. The 5 most commonly self-reported conditions are hyperlipidemia (8979, 41%), hypertension (8174, 38%), osteoarthritis (6448, 30%), any cancer (6224, 29%), and gastroesophageal reflux disease (5669, 26%). Among patients with self-reported cancer, the 5 most common types are nonmelanoma skin cancer (2950, 14%), prostate cancer (1107, 12% in men), breast cancer (941, 4%), melanoma (692, 3%), and cervical cancer (240, 2% in women). Fifty-six percent (12,115) of participants have at least 15 years of electronic medical record history. To date, more than 60 projects and more than 69,000 samples have been approved for use. The Mayo Clinic Biobank has quickly been established as a valuable resource for researchers. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Spanish travelers to high-risk areas in the tropics: airport survey of travel health knowledge, attitudes, and practices in vaccination and malaria prevention.

PubMed

Lopez-Velez, Rogelio; Bayas, Jose-Maria

2007-01-01

To evaluate travel health knowledge, attitudes, and practices on vaccination and malaria prevention among Spanish travelers to the tropics. A cross-sectional survey was carried out in the departure lounge of the two main Spanish international airports in the summer of 2004. A questionnaire was administered to 1,206 Spanish citizens traveling to high-risk areas of tropical South America, 635 travelers (52.6%); Southeast Asia, 251 (20.8%); Sub-Saharan Africa, 181 (15.0%), and the Indian subcontinent, 139 (11.6%). Risk areas were defined according to published sources. Travelers were asked about their attitudes to travel vaccines and malaria prophylaxis and whether they had received either or both on this or previous trips. Adequate malaria prophylaxis was considered as the correct drugs for the destination as indicated by the World Health Organization. Fifty-eight percent of travelers were male and the mean age was 38 years. Thirty-six percent were traveling to tropical areas for the first time. The main reason for travel was tourism (82%) or business (12%). The mean time preparing the trip was 39 days; 73% looked for information a mean of 19 days in advance and 54% were advised in travelers' clinics. Fifty-five percent received no travel vaccines. A total of 48.1% of tourists and 30.1% of business travelers were vaccinated (p<0.00006). The most frequent vaccines administered were as follows: typhoid fever, 32%; yellow fever, 29%; tetanus-diphtheria, 24%; and hepatitis A, 14%. Malaria prophylaxis was taken by 422 travelers including mefloquine (44%), atovaquone-proguanil (17%), chloroquine (16%), chloroquine-proguanil (15%), doxycycline (3%), and unknown (5%). More than half of travelers to risk areas received no vaccinations before the trip. More than a third of travelers to Sub-Saharan Africa received no malaria prophylaxis.

Incorporating Anthropogenic Influences into Fire Probability Models: Effects of Human Activity and Climate Change on Fire Activity in California

PubMed Central

Batllori, Enric; Moritz, Max A.; Waller, Eric K.; Berck, Peter; Flint, Alan L.; Flint, Lorraine E.; Dolfi, Emmalee

2016-01-01

The costly interactions between humans and wildfires throughout California demonstrate the need to understand the relationships between them, especially in the face of a changing climate and expanding human communities. Although a number of statistical and process-based wildfire models exist for California, there is enormous uncertainty about the location and number of future fires, with previously published estimates of increases ranging from nine to fifty-three percent by the end of the century. Our goal is to assess the role of climate and anthropogenic influences on the state’s fire regimes from 1975 to 2050. We develop an empirical model that integrates estimates of biophysical indicators relevant to plant communities and anthropogenic influences at each forecast time step. Historically, we find that anthropogenic influences account for up to fifty percent of explanatory power in the model. We also find that the total area burned is likely to increase, with burned area expected to increase by 2.2 and 5.0 percent by 2050 under climatic bookends (PCM and GFDL climate models, respectively). Our two climate models show considerable agreement, but due to potential shifts in rainfall patterns, substantial uncertainty remains for the semiarid inland deserts and coastal areas of the south. Given the strength of human-related variables in some regions, however, it is clear that comprehensive projections of future fire activity should include both anthropogenic and biophysical influences. Previous findings of substantially increased numbers of fires and burned area for California may be tied to omitted variable bias from the exclusion of human influences. The omission of anthropogenic variables in our model would overstate the importance of climatic ones by at least 24%. As such, the failure to include anthropogenic effects in many models likely overstates the response of wildfire to climatic change. PMID:27124597

Temporally contiguous pencast instruction promotes meaningful learning for dental and dental hygiene students in physiology.

PubMed

Roesch, Darren M

2014-01-01

Smartpens allow for the creation of computerized "pencasts" that combine voice narration with handwritten notes and illustrations. The purpose of this study was to test the effects of voluntary participation in extracurricular instruction with a pencast on student learning. Dental and dental hygiene students were given instruction in a complex physiological topic using lecture and static slides. An Internet link to a pencast that covered the complex topic in a more temporally contiguous fashion was also provided for voluntary review. The students were given a multiple-choice exam that consisted of retention and transfer test questions. Sixty-nine percent of the students who did not watch the pencast and 89 percent of the students who watched the pencast answered the retention test question correctly (p=0.08). Fifty-four percent of the students who did not watch the pencast and 90 percent of the students who watched the pencast answered the transfer test question correctly (p=0.005). This finding indicates that students who watched the pencast performed better on a transfer test, a measurement of meaningful learning, than students who received only the narrated instruction with static images. This supports the hypothesis that temporally contiguous instruction promotes more meaningful learning than lecture accompanied only by static slide images.

Assessing the content, presentation, and readability of dental informed consents.

PubMed

Glick, Aaron; Taylor, David; Valenza, John A; Walji, Muhammad F

2010-08-01

Informed consents are important aids in helping patients make optimal decisions. Little knowledge exists about the quality of dental informed consents. Fifty-two informed consents used throughout the University of Texas Health Science Center at Houston Dental Branch were evaluated based on the quality of their content, readability, and presentation. Content quality was judged on four basic elements: description of procedure, risk, benefits, and alternatives. Of the clinical consents, 26 percent of forms contained all four of the basic content elements, 48 percent contained three of four elements, 16 percent contained two of four elements, and 10 percent contained one of four elements. Presentation quality was judged on twelve criteria items. The average clinical consent included seven out of twelve presentation items, and the average nonclinical consent included eight out of twelve items. Readability was judged using three standard instruments for rating readability: Flesch Reading Ease, Flesch-Kincaid Grade-Level, and Simple Measure of Gobbledygook (SMOG) grading. Average Flesch-Kincaid Grade-Level was 12.7 (range, 7.4 to 19.1), significantly higher than the recommended ninth grade level (p<.001). The results suggest that many existing dental informed consents may be improved by 1) increasing the comprehensiveness of the content, 2) improving the design and layout, and 3) reducing the readability levels for patient comprehension.

[Reproductive health in adolescent students: knowledge, attitudes, and behavior in both sexes, in a community of Santiago].

PubMed

Millán, T; Valenzuela, S; Vargas, N A

1995-03-01

Nine hundred forty eight teenagers (600 females) from a public school of one of the poorest communities of Santiago were surveyed about knowledge and practices on sexuality and reproductive health. Twenty four percent of females and 40% of males did not talk about their problems at home, instead they talked preferentially with their friends. Half of the sample attributed a risk a pregnancy to the first sexual intercourse; 67% did not know the infertile phase of the menstrual cycle and 20% did not identify two sexually transmitted diseases. Sixty percent considered rhythm technique as a safe fertility control method, 60% of males and 50% of females considered masturbation as risky, 57% of males and 49% of females estimated that condoms could be reused and between 5 and 16% of the sample correctly identified AIDS modes of transmission. Fifty percent had a couple and 23% of males and 17% of females had a sexual intercourse in the last six months; of these, 45% of women and 27% of men used a contraceptive method. Four percent of women and 6% of men became involved in a pregnancy and 57% of these terminated in abortions. It is concluded that knowledge about sexuality and reproductive biology among low income teenagers is scanty.

Infertility treatment: when is it time to give up? An Internet-based survey.

PubMed

Marcus, Diana; Marcus, Adam; Johnson, Antoinette; Marcus, Samuel

2011-03-01

Many factors have been suggested that influence a couple's decision to stop infertility treatment despite not achieving their goal of having a baby. This Internet-based questionnaire study aims to shed light on these reasons by surveying patients who have received treatment from a variety of different centres. Registered users of an independent infertility website were invited to participate in the survey by filling in a structured questionnaire. Eighty users completed the questionnaire. Fifty-eight percent of patients received treatment in just one centre. Seventy-eight percent of the patients paid for the treatment themselves. Forty-two percent of couples intended to have only one treatment cycle and 60% of couples reported undergoing more cycles than they had originally intended. Ten percent of patients regretted not stopping their treatment earlier. The most common reasons why patients opted against further treatment cycles were financial constraints (46%), emotional burden (35%), poor response to treatment (29%) and poor egg quality (19%). The decision to stop treatment despite poor outcomes is a difficult one and unique to the couple. The findings of this study are consistent with the widely held belief that in vitro fertilization is a stressful, expensive process, given that almost all women cited these as reasons to stop treatment.

Determination of Rolling-Element Fatigue Life From Computer Generated Bearing Tests

NASA Technical Reports Server (NTRS)

Vlcek, Brian L.; Hendricks, Robert C.; Zaretsky, Erwin V.

2003-01-01

Two types of rolling-element bearings representing radial loaded and thrust loaded bearings were used for this study. Three hundred forty (340) virtual bearing sets totaling 31400 bearings were randomly assembled and tested by Monte Carlo (random) number generation. The Monte Carlo results were compared with endurance data from 51 bearing sets comprising 5321 bearings. A simple algebraic relation was established for the upper and lower L(sub 10) life limits as function of number of bearings failed for any bearing geometry. There is a fifty percent (50 percent) probability that the resultant bearing life will be less than that calculated. The maximum and minimum variation between the bearing resultant life and the calculated life correlate with the 90-percent confidence limits for a Weibull slope of 1.5. The calculated lives for bearings using a load-life exponent p of 4 for ball bearings and 5 for roller bearings correlated with the Monte Carlo generated bearing lives and the bearing data. STLE life factors for bearing steel and processing provide a reasonable accounting for differences between bearing life data and calculated life. Variations in Weibull slope from the Monte Carlo testing and bearing data correlated. There was excellent agreement between percent of individual components failed from Monte Carlo simulation and that predicted.

Combined therapy for small cell undifferentiated carcinoma of the lung.

PubMed

Mandelbaum, I; Williams, S D; Hornback, N B; Joe, B T; Einhorn, L H

1978-09-01

Fifty-eight patients with small cell lung cancer were treated from September, 1974, to March, 1976, with combined chemotherapy and radiotherapy. Surgical resection of the lung lesion was performed in three patients, and a number of surgical diagnostic methods were carried out in the remaining patients with unresectable of disseminated lesions. Nineteen patients were from the Veterans Administration Hospital and 39 from Indiana University Medical Center. The median Karnofsky performance status was 60. Thirty-nine patients had extensive disease, and 19 had disease limited to the chest and supraclavicular area. All patients received chest radiotherapy and prophylactic whole brain radiation. Adriamycin, cyclophosphamide, and vincristine were given on day 1 and continued every 3 weeks. There were 27 (48 percent) partial remissions of a median duration of 26 weeks. There were 25 patients (43 percent) with complete remission. The median survival for the entire group was 51 weeks. Six of 58 patients (10 percent) are alive and disease free from 24 to 38 months after treatment. Six of 19 patients with limited disease (32 percent) are presently alive and disease free. This includes one patient in whom surgical resection was performed. Combined therapy influences favorably the prognosis of small cell cancer of the ling, expecially in those patients with limited disease and favorable performance status.

Senior dental students' experience with Cariogram in a pediatric dentistry clinic.

PubMed

Gonzalez, Cesar D; Okunseri, Christopher

2010-02-01

The study objective was to assess predoctoral dental students' experience with a caries risk assessment computer program in the pediatric dentistry clinic at Marquette University School of Dentistry. In 2005, spring semester sophomore dental students (class of 2008) were introduced to the caries risk assessment computer program "Cariogram." The students received a fifty-minute lecture on caries risk assessment and a demonstration on how to use Cariogram in the clinic. After two years of clinical exposure to Cariogram, sixty-six out of eighty senior dental students completed an anonymous eleven-item questionnaire on their experience with the tool. Each item on the questionnaire was scored on a five-point Likert scale with the exception of two questions. Full- and part-time faculty members in the pediatric dentistry clinic were involved in teaching and supervising students in the use of Cariogram for caries risk assessment after their training and calibration. Forty-five percent of the students who participated in the study agreed that Cariogram was easy to understand, and 18 percent disagreed. Thirty-six percent felt that it was easy to apply, and 25 percent reported that it was useful in determining caries preventive procedures. The students reported that 60 percent of full-time and 33 percent of part-time faculty were knowledgeable about Cariogram use. A majority of the students felt that Cariogram was not easy to understand, and eighty-two percent of them reported that they would not be using Cariogram in their private offices. Future studies should explore reasons why students do not feel inclined to use Cariogram as a caries risk assessment tool in their private practices even after being exposed to the tool in dental school.

Problematic Video Gaming in a Young Spanish Population: Association with Psychosocial Health.

PubMed

Buiza-Aguado, Carlos; Alonso-Canovas, Araceli; Conde-Mateos, Celia; Buiza-Navarrete, Juan Jose; Gentile, Douglas

2018-06-01

Problematic video gaming (PVG) is a concern for psychologists attending children and adolescents. Uniform diagnostic criteria are lacking, and risk factors are poorly understood. Internet gaming disorder (IGD) was included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and scales derived from its diagnostic criteria may be helpful to assess PVG. A multicenter study was conducted in secondary schools using an IGD-derived scale (dichotomous Nine-Item Internet Gaming Disorder Scale [IGD-9]), analyzing PVG-related variables. Seven hundred eight students (55.8 percent male) with mean age 15.6 ± 2.7 years were included. Seventy-three percent were gamers and 22 percent heavy gamers (HGs). Forty-five percent reported online gaming and 6.6 percent massive multiplayer online role-playing games (MMORPGs). Fifty-nine students (8.3 percent) scored 5 or more in IGD-9 and were classified as IGD+. HG and IGD+ subjects were more frequently male and online and MMORPG gamers (p < 0.01). However, IGD+ subjects had significantly worse psychosocial scores than IGD- (p < 0.001), while HGs did not significantly differ from casual gamers (p > 0.01). The multivariate analysis showed that IGD+ scores were significantly associated with worse psychosocial health and adjustment (p < 0.001), while the other variables (male sex, online and MMORPG gaming, and HG) were not significantly associated (p > 0.01). The IGD-9 scale scored positive in 8.3 percent of our sample. Unlike gaming time, this scale was associated with psychosocial disturbances, making it potentially useful as a screening method to detect candidates for clinical intervention.

Gastroenterologist perceptions of faecal microbiota transplantation.

PubMed

Paramsothy, Sudarshan; Walsh, Alissa J; Borody, Thomas; Samuel, Douglas; van den Bogaerde, Johan; Leong, Rupert Wl; Connor, Susan; Ng, Watson; Mitchell, Hazel M; Kaakoush, Nadeem O; Kamm, Michael A

2015-10-14

To explore gastroenterologist perceptions towards and experience with faecal microbiota transplantation (FMT). A questionnaire survey consisting of 17 questions was created to assess gastroenterologists' attitude towards and experience with FMT. This was anonymously distributed in hard copy format amongst attendees at gastroenterology meetings in Australia between October 2013 and April 2014. Basic descriptive statistical analyses were performed. Fifty-two clinicians participated. Twenty one percent had previously referred patients for FMT, 8% more than once. Ninety percent would refer patients with Clostridium difficile infection (CDI) for FMT if easily available, 37% for ulcerative colitis, 13% for Crohn's disease and 6% for irritable bowel syndrome. Six percent would not refer any indication, including recurrent CDI. Eighty-six percent would enroll patients in FMT clinical trials. Thirty-seven percent considered the optimal mode of FMT administration transcolonoscopic, 17% nasoduodenal, 13% enema and 8% oral capsule. The greatest concerns regarding FMT were: 42% lack of evidence, 12% infection risk, 10% non infectious adverse effects/lack of safety data, 10% aesthetic, 10% lack of efficacy, 4% disease exacerbation, and 2% inappropriate use; 6% had no concerns. Seventy seven percent believed there is a lack of accessibility while 52% had an interest in learning how to provide FMT. Only 6% offered FMT at their institution. Despite general enthusiasm, most gastroenterologists have limited experience with, or access to, FMT. The greatest concerns were lack of supportive evidence and safety issues. However a significant proportion would refer indications other than CDI for FMT despite insufficient evidence. These data provide guidance on where education and training are required.

U.S. predoctoral education in pediatric dentistry: its impact on access to dental care.

PubMed

Seale, N Sue; Casamassimo, Paul S

2003-01-01

This study sought to identify faculty, organization, patient pool, and procedures taught in predoctoral pediatric dentistry programs using a questionnaire sent to all fifty-five U.S. dental schools in 2001. Forty-eight (87 percent) programs reported an average of 3.9 full-time and 2.1 part-time FTE faculty, resulting in a mean faculty to student ratio of 1:6.4. One-third employ general dentists to teach pediatric dentistry, and 36 percent report fewer faculty than five years ago. Two-thirds were stand-alone departments. Over half (55 percent) reported increases in patient pools, but also a lack of patients with restorative needs. Half of the programs supplemented school-based pools with special populations, and two-thirds sent students on external rotations, most often to treat high-caries children. Those not using external rotations cited lack of faculty. Accepted patients averaged about four years, with only 6 percent of the pool under three years. Low-income or Medicaid-covered children accounted for 88 percent of school patient pools. Half of the schools felt the pool inadequate to meet competencies, attributable to lack of patients' restorative needs or inadequate intake numbers. Fewer than half of the programs (48 percent) provided hands-on experience with disabled patients, and one-third afforded every student with this experience. Pediatric dentistry was mentioned in fewer than half of the competency documents. Results suggest that U.S. pediatric dentistry predoctoral programs have faculty and patient pool limitations that affect competency achievement and adversely affect training and practice.

Step free energies at faceted solid surfaces: Theory and atomistic calculations for steps on the Cu(111) surface

NASA Astrophysics Data System (ADS)

Freitas, Rodrigo; Frolov, Timofey; Asta, Mark

2017-04-01

A theory for the thermodynamic properties of steps on faceted crystalline surfaces is presented. The formalism leads to the definition of step excess quantities, including an excess step stress that is the step analogy of surface stress. The approach is used to develop a relationship between the temperature dependence of the step free energy (γst) and step excess quantities for energy and stress that can be readily calculated by atomistic simulations. We demonstrate the application of this formalism in thermodynamic-integration (TI) calculations of the step free energy, based on molecular-dynamics simulations, considering <110 > steps on the {111 } surface of a classical potential model for elemental Cu. In this application we employ the Frenkel-Ladd approach to compute the reference value of γst for the TI calculations. Calculated results for excess energy and stress show relatively weak temperature dependencies up to a homologous temperature of approximately 0.6, above which these quantities increase strongly and the step stress becomes more isotropic. From the calculated excess quantities we compute γst over the temperature range from zero up to the melting point (Tm). We find that γst remains finite up to Tm, indicating the absence of a roughening temperature for this {111 } surface facet, but decreases by roughly fifty percent from the zero-temperature value. The strongest temperature dependence occurs above homologous temperatures of approximately 0.6, where the step becomes configurationally disordered due to the formation of point defects and appreciable capillary fluctuations.

USE IT OR LOSE IT: EAT AND EXERCISE DURING RADIOTHERAPY OR CHEMORADIOTHERAPY FOR PHARYNGEAL CANCERS

PubMed Central

Hutcheson, Katherine A.; Bhayani, Mihir K.; Beadle, Beth M.; Gold, Kathryn A.; Shinn, Eileen H.; Lai, Stephen Y.; Lewin, Jan

2014-01-01

Objective Proactive swallowing therapy promotes ongoing use of the swallowing mechanism during radiotherapy through 2 goals: eat and exercise. The purpose of this study was to evaluate the independent effects of maintaining oral intake throughout treatment and preventive swallowing exercise. Design Retrospective observational study. Setting The University of Texas MD Anderson Cancer Center, Houston. Patients The study included 497 patients treated with definitive radiotherapy (RT) or chemoradiation (CRT) for pharyngeal cancer (458 oropharynx, 39 hypopharynx) between 2002 and 2008. Main Outcome Measures Swallowing-related endpoints were: final diet after RT/CRT and length of gastrostomy-dependence. Primary independent variables included per oral (PO) status at the end of RT/CRT (nothing per oral [NPO], partial PO, 100% PO) and swallowing exercise adherence. Multiple linear regression and ordered logistic regression models were analyzed. Results At the conclusion of RT/CRT, 131 (26%) were NPO, 74% were PO (167 [34%] partial, 199 [40%] full). Fifty-eight percent (286/497) reported adherence to swallowing exercises. Maintenance of PO intake during RT/CRT and swallowing exercise adherence were independently associated (p<0.05) with better long-term diet after RT/CRT and shorter length of gastrostomy dependence in models adjusted for tumor and treatment burden. Conclusions Data indicate independent, positive associations between maintenance of PO intake throughout RT/CRT and swallowing exercise adherence with long-term swallowing outcomes. Patients who either eat or exercise fare better than those who do neither. Patients who both eat and exercise have the highest return to a regular diet and shortest gastrostomy dependence. PMID:24051544

Impact of gender and sleep position on relationships between anthropometric parameters and obstructive sleep apnea syndrome.

PubMed

Jeong, Jong In; Gu, Seonhye; Cho, Juhee; Hong, Sang Duk; Kim, Su Jin; Dhong, Hun-Jong; Chung, Seung-Kyu; Kim, Hyo Yeol

2017-05-01

Considering the mechanisms by which obesity affects obstructive sleep apnea syndrome (OSAS) and the differences of fat distribution depending on gender, associations between anthropometric parameters, and OSAS may differ depending on gender or sleep position. We analyzed the impact of gender and sleep position on the relationship between fat distribution and development of OSAS. One thousand thirty-two consecutive subjects were analyzed. Recorded anthropometric measurements and overnight polysomnographic data of the subjects were reviewed retrospectively. The presence of OSAS was defined by the respiratory disturbance index (RDI) ≥5 with documented symptoms of excessive daytime sleepiness. Eight hundred fifty-eight males and 174 females were included. Male subjects had significantly higher body mass index (BMI), larger waist circumference (WC), and lower percent of overall body fat (P < 0.0001, P < 0.0001, and P < 0.0001, respectively). The severity of OSAS was significantly higher in male subjects (RDI 26.9 ± 22.4 in males vs. 10.2 ± 13.8 in females, P < 0.0001). In male subjects, BMI, WC, and overall body fat were significantly associated with severity of OSAS and had larger impacts on supine RDI than lateral RDI. Overall body fat was not associated with severity of OSAS in female subjects, and there were no significant differences of the associations between all anthropometric parameters and RDIs depending on sleep position. Evaluation of the correlation of anthropometric data with severity of OSAS should consider sleep position as well as gender.

Food avoidance in athletes: FODMAP foods on the list.

PubMed

Lis, Dana; Ahuja, Kiran D K; Stellingwerff, Trent; Kitic, Cecilia M; Fell, James

2016-09-01

We surveyed 910 athletes to assess behaviours towards self-selected food/ingredient avoidance to minimize gastrointestinal distress. Fifty-five percent eliminated at least 1 high fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) food/category, with up to 82.6% reporting symptom improvement. In athletes indicating that high FODMAP foods trigger gastrointestinal symptoms, lactose (86.5%) was most frequently eliminated, followed by galactooligosaccharides (23.9%), fructose (23.0%), fructans (6.2%), and polyols (5.4%). Athletes avoid predominantly lactose and to a lesser extent other high FODMAP foods to reduce gastrointestinal distress.

Etiology of oral habits.

PubMed

Bayardo, R E; Mejia, J J; Orozco, S; Montoya, K

1996-01-01

The pedodontic admission histories of 1600 Mexican children were analyzed, to determine general epidemiologic factors or oral habits, as well as their relationship with identifiable biopsychosociologic factors. Fifty-six percent of the children gave evidence of an oral habit, with significant predisposition among female patients, single children, subjects in poor physical health (particularly from allergies), as well as children with histories of chronic health problems. Oral habits should be considered a major health hazard because of their high incidence. Successful treatment requires a multidisciplinary approach to the basic cause of the problem.

18F-FDG PET/CT Finding of Drop Metastases from Germ Cell Tumor of Pineal Gland.

PubMed

Jain, Tarun K; Basher, Rajender K; Sood, Ashwani; Mittal, Bhagwant R; Prakash, Gaurav; Bhatia, Anmol

2017-06-01

Tumors of the pineal region are rare, accounting for fewer than 1% of all intracranial neoplasms. Fifty percent of pineal region tumors are germ cell tumors (GCTs). However, spinal seeding and extracranial metastases from intracranial GCTs are uncommon. We present a case of pineal gland GCT in which 18 F-FDG PET/CT imaging demonstrated drop metastases to the spinal cord in addition to tracer uptake in the primary lesion. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

Soviet News and Propaganda Analysis Based on RED STAR (The Official Newspaper of the Soviet Defense Establishment) for the Period 1-30 November 1984. Volume 4, Number 11.

DTIC Science & Technology

1984-11-30

government. * Many innocent women and children are killed as a result of American sponsored military raids into Nicaragua. Fifty-six percent of Red...goals (in regard to the arms race): -- To gain a first-strike advantage. -- To double the number of nuclear weapons. -- To refuse to freeze arms...international issues/events. It addresses the issues important to the political elite.c-- .. Men and women in the Soviet armed forces receive political

Repair, Evaluation, Maintenance, and Rehabilitation Research Program. State-of-the-Art Procedures for Sealing Coastal Structures with Grouts and Concretes

DTIC Science & Technology

1989-04-01

the shape it had as it was ex- truded from the grout tube . Figure 3 shows the type of voids in which the ma- terial is expected to form a barrier...has promising characteristics for coastal engi- neering applications. Microfine Cement, a company which markets ultrafine ce- ment, claims the product...can penetrate fine sand, and is strong and durable with a 4- to 5-hr set time. Fifty percent of Microfine Cement’s particles are less than 4 microns

Photodissociation in the atmosphere of Mars - Impact of high resolution, temperature-dependent CO2 cross-section measurements

NASA Technical Reports Server (NTRS)

Anbar, A. D.; Allen, M.; Nair, H. A.

1993-01-01

We have investigated the impact of high resolution, temperature-dependent CO2 cross-section measurements, reported by Lewis and Carver (1983), on calculations of photodissociation rate coefficients in the Martian atmosphere. We find that the adoption of 50 A intervals for the purpose of computational efficiency results in errors in the calculated values for photodissociation of CO2, H2O, and O2 which are generally not above 10 percent, but as large as 20 percent in some instances. These are acceptably small errors, especially considering the uncertainties introduced by the large temperature dependence of the CO2 cross section. The inclusion of temperature-dependent CO2 cross sections is shown to lead to a decrease in the diurnally averaged rate of CO2 photodissociation as large as 33 percent at some altitudes, and increases of as much as 950 percent and 80 percent in the photodissociation rate coefficients of H2O and O2, respectively. The actual magnitude of the changes depends on the assumptions used to model the CO2 absorption spectrum at temperatures lower than the available measurements, and at wavelengths longward of 1970 A.

Body dissatisfaction and dieting in young children.

PubMed

Schur, E A; Sanders, M; Steiner, H

2000-01-01

To develop a broader understanding of young children's knowledge and beliefs about dieting and body dissatisfaction. Sixty-two third through sixth-grade boys and girls completed audiotaped interviews and questionnaires regarding eating behavior, attitudes toward dieting, and body dissatisfaction. Fifty percent of all children wanted to weigh less and 16% reported attempting weight loss. Children were well informed about dieting and were most likely to believe that dieting meant changing food choices and exercising as opposed to restricting intake. Their primary source of information was the family. Seventy-seven percent of children mentioned hearing about dieting from a family member, usually a parent. Young children are knowledgeable about dieting and the concept of dieting does not necessarily mean caloric restriction to them. These data suggest that the family can play a powerful role in countering the development of eating concerns and body dissatisfaction in children. Copyright 2000 by John Wiley & Sons, Inc.

The relationship of physique and body composition to strength in a group of physical education students.

PubMed Central

Bale, P.

1980-01-01

Fifty-three specialist women physical education students were measured anthropometrically and from these measurements somatotype and body composition were estimated. Leg, back and grip strength dynamometers were used to measure strength indices. Arm strength was calculated from each subject's pull-ups and push-ups and lung capacity was measured using a spirometer. The somatotype ratings and percent fat measurements indicate that the P.E. students are generally more muscular and less fat for their age than non-P.E. students. There was a strong relationship between percent fat and the endomorphy rating and a moderate relationship between lean body weight and mesomorphy. The moderate relationship of the strength variables with the muscular rating, whether expressed as mesomorphy or lean body weight, suggests that the higher a subject's muscular component the greater their dynamic strength. Images p193-a PMID:7448485

Gynaecologists' attitude to abortion provision in 2015.

PubMed

Savage, Wendy Diane; Francome, Colin

2017-04-01

We aimed to ascertain the attitude of consultant gynaecologists towards the working of the 1967 Abortion Act, women's choice and decriminalisation of abortion, and whether they had requests on the grounds of foetal sex in the last five years. A postal questionnaire was sent to a 20% random sample of NHS gynaecologists, coded and analysed using SPSS. 286 doctors replied, 78%. 60% considered the abortion act was working satisfactorily. Ninety percent thought the woman should decide whether to continue the pregnancy in consultation with her doctor. However, 15% thought it too easy to obtain. Fifty-six percent of those with an opinion agreed that abortion should be decriminalised and treated like any other medical procedure. It is time to consider decriminalisation of abortion. About half performed abortions and 152 (97%) had never had a request for an abortion on the grounds of foetal sex. Sex selection is not a major problem in the UK.

Audit of prostate cancer: lessons learnt for current clinical practice, surrogates for quality of care and standardisation and quality assurance.

PubMed

Silcocks, P; Needham, P; Hemsley, F

1999-07-01

Two-hundred and fifty-one prostate cancer patients first registered during 1994 were sampled from a Regional Cancer Registry. In the six months after diagnosis, 39% received drug treatment alone, while 37% had no active treatment. Eighty-one percent of cases were histologically proven. Seventy-six percent had a prostate specific antigen (PSA) test and in 3% the PSA test was the basis for diagnosis. Of histologically proven cases 29% had a Gleason grade. None were staged by clinicians. Key lessons were: The result was a snapshot of current clinical practice which suggested other possible surrogates for quality of care, such as basis of stage and timing of investigations; There is a need for standardisation and quality assurance of the content of pathology reports; Standard treatment protocols would aid recording and comparison of treatments.

Factors associated to continuing breastfeeding after returning to work in a group of mothers in Puerto Rico.

PubMed

García-Fragoso, Lourdes; Medina, Mariel; Ortiz, Nerian

2012-01-01

Working outside the home is related to lower rates of breastfeeding initiation and duration. Enacted laws promote and support breastfeeding in working places. To determine factors associated to breastfeeding after returning to work. Anonymous questionnaires distributed among breastfeeding working mothers. The study subjects were 100 mothers. Most of them (77%) worked for the government. Fifty-six percent continued breastfeeding after returning to work. In 33% of the workplaces there was an area designated for milk extraction.Thirty-six percent of employers allowed the 30 minute periods mandated by law for extraction. Factors associated to continuing breastfeeding were: working in the private setting, having a place designated for extraction, knowing that employers were mandated to have such a place, being allowed time for extraction, and knowing the laws protecting breastfeeding. There is need for more education to working mothers about their rights to continue breastfeeding after returning to work.

Use and safety perceptions regarding herbal supplements: a study of older persons in southeast Idaho.

PubMed

Snyder, Frank J; Dundas, Mary L; Kirkpatrick, Carol; Neill, Karen S

2009-01-01

Herbal supplements (HS) are used by older persons and are often perceived as safe, although there is limited research that examines why this perception exists. A questionnaire was developed and pilot tested to investigate the use and perceived safety of HS among a convenience sample of 112 adults aged 60 to 92 in southeast Idaho. Fifty-five percent of the participants (n = 62) reported using HS in the past. Ninety-five percent (n = 59) of those using HS and 75% (n = 37) of nonusers reported they believed most or some HS were safe. Perception of herbal supplement safety was greatly influenced by family and friends, and HS users had a greater perception of safety than nonusers (p < or = .001). The top reasons for perceived safety given by HS users were that HS: (1) can be purchased without a prescription, (2) can be purchased in many locations, and (3) are natural.

Grade inflation in the internal medicine clerkship: a national survey.

PubMed

Fazio, Sara B; Papp, Klara K; Torre, Dario M; Defer, Thomas M

2013-01-01

Grade inflation is a growing concern, but the degree to which it continues to exist in 3rd-year internal medicine (IM) clerkships is unknown. The authors sought to determine the degree to which grade inflation is perceived to exist in IM clerkships in North American medical schools. A national survey of all Clerkship Directors in Internal Medicine members was administered in 2009. The authors assessed key aspects of grading. Response rate was 64%. Fifty-five percent of respondents agreed that grade inflation exists in the Internal Medicine clerkship at their school. Seventy-eight percent reported it as a serious/somewhat serious problem, and 38% noted students have passed the IM clerkship at their school who should have failed. A majority of clerkship directors report that grade inflation still exists. In addition, many note students who passed despite the clerkship director believing they should have failed. Interventions should be developed to address both of these problems.

Pregnancy and the Plastic Surgery Resident.

PubMed

Garza, Rebecca M; Weston, Jane S; Furnas, Heather J

2017-01-01

Combining pregnancy with plastic surgery residency has historically been difficult. Two decades ago, 36 percent of plastic surgery program directors surveyed actively discouraged pregnancy among residents, and 33 percent of women plastic surgeons suffered from infertility. Most alarmingly, 26 percent of plastic surgery trainees had had an elective abortion during residency. With increasing numbers of women training in plastic surgery, this historical lack of support for pregnancy deserves further attention. To explore the current accommodations made for the pregnant plastic surgery resident, an electronic survey was sent to 88 plastic surgery program directors in the United States. Fifty-four responded, for a response rate of 61.36 percent. On average, a director trained a total of 7.91 women among 17.28 residents trained over 8.19 years. Of the women residents, 1.43 were pregnant during a director's tenure, with 1.35 of those residents taking maternity leave. An average 1.75 male residents took paternity leave. Approximately one-third of programs had a formal maternity/paternity leave policy (36.54 percent) which, in most cases, was limited to defining allowed weeks of leave, time required to fulfill program requirements, and remuneration during leave. This survey of plastic surgery directors is a first step in defining the challenges training programs face in supporting the pregnant resident. Directors provided comments describing their challenges accommodating an absent resident in a small program and complying with the American Board of Plastic Surgery's required weeks of training per year. A discussion of these challenges is followed by suggested solutions.

Botox therapy for ischemic digits.

PubMed

Neumeister, Michael W; Chambers, Christopher B; Herron, Margo S; Webb, Kelli; Wietfeldt, Joel; Gillespie, Jessica N; Bueno, Rueben A; Cooney, Carisa M

2009-07-01

Treating patients with Raynaud's phenomenon who have chronic pain and ulcerations is extremely challenging. Unrelenting pain can lead to dysfunction and disuse, rendering the patient debilitated and/or chronically depressed. Pharmacologic vasodilators and surgical sympathectomies offer variable benefits. Outcomes of symptomatic patients treated with botulinum toxin type A (Botox) injections for Raynaud's phenomenon are presented. A retrospective study focused on patient outcomes was performed on 19 patients diagnosed with Raynaud's phenomenon. Patients suffered from chronic ischemic hand pain. All patients had vascular studies to rule out occlusive disease. Fifty to 100 units of Botox were injected into the palm around each involved neurovascular bundle. Preinjection and postinjection laser Doppler scanning was performed on most patients to measure blood flow. Sixteen of 19 patients (84 percent) reported pain reduction at rest. Thirteen patients reported immediate relief; three reported more gradual pain reduction over 1 to 2 months. Three patients had no or minimal pain relief. Tissue perfusion results demonstrated a marked change in blood flow (-48.15 percent to 425 percent) to the digits. All patients with chronic finger ulcers healed within 60 days. Most patients [n = 12 (63 percent)] remained pain-free (13 to 59 months) with a single-injection schedule. Four patients (21 percent) required repeated injections because of recurrent pain. Vascular function is abnormal in patients with Raynaud's phenomenon. Although its mechanism is unknown, Botox yielded a distinct improvement in perfusion and reduction in pain in patients failing conservative management. Continued research may lead to more specific and reliable treatment for Raynaud's patients.

U.S. dental students' attitudes toward research and science: impact of research experience.

PubMed

Holman, Shaina Devi; Wietecha, Mateusz S; Gullard, Angela; Peterson, Jon M B

2014-03-01

This study aimed to provide a first nationwide assessment of dental students' attitudes toward the importance of research and its integration into the dental curriculum. For this purpose, the American Association for Dental Research National Student Research Group developed an online survey that was distributed to 89 percent of U.S. dental students in May 2012. The survey consisted of twenty-one Likert-type items divided into three groups: importance of research in dentistry, barriers to research involvement, and exposure to research in the dental curriculum. There were 733 responses (3.9 percent response rate), including students in all stages of education representing fifty-eight out of sixty-one dental schools. Age and race/ethnic distributions corresponded with U.S. dental school enrollees. Results showed that 63 percent of respondents had conducted research before matriculation, and of the 34 percent that participated in research during dental school, only 27 percent were newcomers. Respondents strongly agreed that scientific research enabled their progress in dentistry. Inadequate time in the curriculum was an obstacle they perceived to research involvement during dental school. Respondents agreed that dental curricula emphasize evidence-based practices but may be inadequately teaching biostatistics and research methodologies. Students with research experience tended to have stronger positive opinions about the importance of research in dental education. Efforts to foster research in schools have been well received by students, but several issues remain for enriching dental education through greater involvement of students in research.

Quality of wastewater reuse in agricultural irrigation and its impact on public health.

PubMed

Al-Hammad, Bushra Ahmed; Abd El-Salam, Magda Magdy; Ibrahim, Sahar Yassin

2014-11-01

This study is planned to perform a sanitary survey of the largest sewage treatment plant in Riyadh, KSA, fortnightly for 6 months to examine its effluent quality as an example for the growing dependence on reuse of treated municipal wastewater in agricultural irrigation purposes to cope with increasing water shortage. The biological and physico-chemical parameters of 12 wastewater samples from the plant were examined using standard methods. The physico-chemical analysis indicated that the surveyed municipal wastewater treatment plant contained some of the studied parameters, such as turbidity, total suspended solids, biochemical oxygen demand, chemical oxygen demand and residual chlorine above the maximum permissible wastewater limits set by the Saudi Standards. However, heavy metal concentrations in all samples were lower than the recommended standards. Total and faecal coliform counts were above the permissible limits indicating poor sanitation level. Fifty percent of all wastewater samples were contaminated with faecal coliforms but, surprisingly, Escherichia coli were only detected in 8.3 % of the samples. Regular monitoring and enhancement of microbial and physico-chemical parameters of the wastewater quality served by different wastewater treatment plants for reuse in agricultural irrigation is recommended to preserve the environment and public health.

The desirability of an Intensive Care Unit (ICU) clinician-led bereavement screening and support program for family members of ICU Decedents (ICU Bereave).

PubMed

Downar, James; Barua, Reeta; Sinuff, Tasnim

2014-04-01

Many bereaved family members (FMs) of intensive care unit decedents experience symptoms of complicated grief (CG) or social distress, but there is no standard screening or follow-up for these individuals. We determined the desirability and need for an intensive care unit-based bereavement screening and support program for these FMs. We surveyed bereaved FMs to measure symptoms of CG, prolonged grief disorder, and social difficulties and the desire for support; and staff physicians and nurses at 2 teaching hospitals in Toronto, Canada, to determine comfort and interest in providing routine bereavement support. We could not contact 69% of FMs largely because of inaccuracies in the patient record. Of the 64 who were contacted, 32 (50%) agreed to be surveyed a mean (SD) of 7.4 (2.2) months after the loss of their relative. Among eligible staff, 57 (61%) of 94 completed the questionnaire. Nine (28%) FMs met subthreshold criteria for CG or prolonged grief disorder, and 7 (22%) met criteria for social distress. Only 10 (31%) had received professional support for emotional symptoms, and 2 (6%) received professional assistance for their social difficulties. Fifty-eight percent supported routine screening, and 68% wanted to receive (or receive more) support. Fifty-five percent of FMs expressed a strong willingness to meet with the medical team to review events surrounding the death of the patient, which was the type of support that the health care staff were most comfortable providing. Most staff (85%) reported providing emotional support at the time of death, but few provided any support afterwards. Fifty-six (98%) of 57 would be willing to support or participate in a formal bereavement screening and support program. Respondents cited the need for training and dedicated time to carry out such a program. An ICU-based bereavement screening and support program for FMs of ICU decedents is both needed and desirable, although there are important needs and barriers. Future studies should evaluate the effectiveness for such a program at improving outcomes among bereaved FMs. Copyright © 2014 Elsevier Inc. All rights reserved.

Spinal cord processing of cardiac nociception: are there sex differences between male and proestrous female rats?

PubMed

Little, Janine M; Qin, Chao; Farber, Jay P; Foreman, Robert D

2011-09-21

Sex differences in the characteristics of cardiac pain have been reported from clinical studies. For example, women experience chest pain less frequently than men. Women describe their chest pain as sharp and stabbing, while men have chest pain that is felt as a pressure or heaviness. Pain is also referred to the back more often in women than men. The mechanisms underlying sex differences in cardiac pain are unknown. One possible mechanism for the observed differences could be related to plasma estradiol. This study investigated the actions of estradiol on the activity of T(3) spinal neurons that process cardiosomatic information in male and female rats. Extracellular potentials of T(3) spinal neurons were recorded in response to mechanical somatic stimulation and noxious chemical cardiac stimulation in pentobarbital-anesthetized male and proestrous female rats. Fifty one percent and fifty percent of neurons responded to intrapericardial algogenic chemicals (0.2 ml) in male and female rats, respectively. Somatic fields were located by applying brush, pressure, and pinch to the upper body. Of those neurons receiving cardiac input, 54% in female and 55% in male rats also received somatic input. In both male and female rats, 81% of neurons responding to somatic stimuli had somatic fields located on the side of the upper body, while 19% of neurons had somatic fields located on the chest. These results indicate there are no significant differences in the responses of T(3) spinal neurons to cardiosomatic stimulation between male and proestrous female rats, despite differences in estradiol levels. Published by Elsevier B.V.

Nutritional Supplement Habits of Athletes With an Impairment and Their Sources of Information.

PubMed

Graham-Paulson, Terri Susan; Perret, Claudio; Smith, Brett; Crosland, Jeanette; Goosey-Tolfrey, Victoria Louise

2015-08-01

The consumption of nutritional supplements (NS) is common among able-bodied (AB) athletes yet little is known about NS use by athletes with an impairment. This study examined the: (i) prevalence of NS use by athletes with an impairment; (ii) reasons for use/ nonuse; (iii) sources of information regarding NS; and (iv) whether age, gender, impairment, performance level and sport category influence NS use. The questionnaire was completed by 399 elite (n = 255) and nonelite (n = 144) athletes (296 M, 103 F) online or at a sporting event/training camp. Data were evaluated using chi-square analyses. Fifty-eight percent (n = 232) of athletes used NS in the previous 6-month period and 41% (n = 102) of these followed the instructions on the label to determine dose. Adherence to these AB recommendations may partly explain why 9% (n = 37) experienced negative effects from NS use. As expected, the most popular NS were: protein, sports drinks, multivitamins and carbohydrate supplements, which were obtained from health food/sport shops, internet and supermarkets (top 3) where evidence-based, impairment-specific advice is limited. The nutritionist/dietitian was the most used and trusted source of information, which is a promising finding. The most prevalent reasons for use were to support exercise recovery, support the immune system and provide energy. Elite athletes were more likely to use NS, which may reflect greater training hours and/or access to nutritionists. Fifty-two percent of athletes (n = 209) requested more information/ education regarding NS. NS use is prevalent in this population. Education on dosage and appropriate sources of information is required.

Phase II study of erlotinib in patients with advanced biliary cancer.

PubMed

Philip, Philip A; Mahoney, Michelle R; Allmer, Cristine; Thomas, James; Pitot, Henry C; Kim, George; Donehower, Ross C; Fitch, Tom; Picus, Joel; Erlichman, Charles

2006-07-01

Epidermal growth factor receptor/human epidermal growth factor receptor 1 and ligand expression is common in biliary cancers (BILI) and may be associated with worse outcome. The primary objective of this study was to determine the proportion of patients with advanced BILI who were progression-free at 6 months. Patients with either unresectable or metastatic disease were studied. Only one prior systemic or locoregional therapy was allowed. Erlotinib was administered continuously at a dose of 150 mg per day orally. Forty-two patients with BILI were enrolled. The median age was 67 years (range, 33 to 82 years). Fifty-two percent of patients had Eastern Cooperative Oncology Group performance status of 1. Fifty-seven percent of patients had received prior chemotherapy for advanced BILI. HER1/EGFR expression by immunohistochemistry in tumor cells was detected in 29 (81%) of the 36 assessable patients. Seven of the patients (17%; 95% CI, 7% to 31%) were progression free at 6 months. Three patients had partial response by Response Evaluation Criteria in Solid Tumors Group classification of duration 4, 4, and 14 months, respectively. All responding patients had mild (grade 1/2) skin rash and two patients had positive tumoral HER1/EGFR expression. Three patients (7%) had toxicity-related dose reductions of erlotinib due to grade 2/3 skin rash. Results suggest a therapeutic benefit for EGFR blockade with erlotinib in patients with biliary cancer. Additional studies with erlotinib as a single agent and in combination with other targeted agents are warranted in this disease.

Increases in efficiency and enhancements to the Mars Observer non-stored commanding process

NASA Technical Reports Server (NTRS)

Brooks, Robert N., Jr.; Torgerson, J. Leigh

1994-01-01

The Mars Observer team was, until the untimely loss of the spacecraft on August 21, 1993, performing flight operations with greater efficiency and speed than any previous JPL mission of its size. This level of through-put was made possible by a mission operations system which was composed of skilled personnel using sophisticated sequencing and commanding tools. During cruise flight operations, however, it was realized by the project that this commanding level was not going to be sufficient to support the activities planned for mapping operations. The project had committed to providing the science instrument principle investigators with a much higher level of commanding during mapping. Thus, the project began taking steps to enhance the capabilities of the flight team. One mechanism used by project management was a tool available from total quality management (TQM). This tool is known as a process action team (PAT). The Mars Observer PAT was tasked to increase the capacity of the flight team's nonstored commanding process by fifty percent with no increase in staffing and a minimal increase in risk. The outcome of this effort was, in fact, to increase the capacity by a factor of 2.5 rather than the desired fifty percent and actually reduce risk. The majority of these improvements came from the automation of the existing command process. These results required very few changes to the existing mission operations system. Rather, the PAT was able to take advantage of automation capabilities inherent in the existing system and make changes to the existing flight team procedures.

Interlibrary loan in US and Canadian health sciences libraries 2005: update on journal article use.

PubMed

Lacroix, Eve-Marie; Collins, Maria Elizabeth

2007-04-01

The authors analyzed 2.48 million interlibrary loan (ILL) requests entered in the National Library of Medicine's (NLM's) DOCLINE system from 3,234 US and Canadian medical libraries during fiscal year (FY) 2005 to study their distribution and nature and the journals in which requested articles were published. Data from DOCLINE and NLM's indexing system and online catalog were used to analyze all DOCLINE ILL transactions acted on from October 2004 to September 2005. The authors compared results from this analysis to previous data collected in FY 1992. Overall ILL volume in the United States and Canada is at about the same level as FY 1992 despite marked growth in online searching, knowledge discovery tools, and journals available online. Over 21,000 unique journal titles and 1.4 million unique articles were used to fill 2.2 million ILL requests in FY 2005. Over 1 million of the articles were requested only once by any network library. Fifty-two percent (11,022) of journals had 5 or fewer requests for articles from all the years of a journal by all libraries in the network. Fifty-two percent of the articles requested were published within the most recent 5 years. The overall ILL profile in the libraries studied has changed little since FY 1992, notable given other changes in publishing. Small changes, however, may reveal developing trends. Total ILL traffic has been declining in recent years following a peak in 2002, and fewer of the articles requested were published in the most recent five years compared to requests from 1992.

[Psychiatric disorders in adult form of Niemann-Pick disease type C].

PubMed

Maubert, A; Hanon, C; Sedel, F

2016-06-01

Niemann-Pick type C disease (NPC) is a rare genetic disease with an extremely heterogeneous clinical presentation. The adult form of this disease is usually expressed with neurological symptoms; however, non-specific psychiatric disorders are often associated. This article presents a retrospective study on a cohort of NPC patients diagnosed in France with the objectives of researching the presence of psychiatric disorders and qualifying these disorders. After carrying out a research within hospital records, a questionnaire was sent to patients or their relatives and their doctors. The cohort was made up of 22 patients. Fifty-two questionnaires were sent to 47 different doctors. We received 67% of answers from the doctors, with 42% of positive answers. The answer rate of the families was 27%. Among the 22 patients, we found the presence of psychiatric disorders in 86% of cases. Seventy-three percent of the patients presented behavior disorders. Among them, 27% exhibited psychomotor excitation or agitation, 23% aggressiveness, 18% intolerance to frustration, 27% sleep disorders and 23% apathy, listlessness and/or clinophilia. Fifty-five percent of patients presented psychotic symptoms, with 45% with delusions and 36% with hallucinations. Seventy-seven percent of patients presented with mood disorders: 36% suffered from depression and 27% from emotional lability or mood swings. Of the 22 patients, a diagnosis of psychiatric disease was made in 50% of cases. The main diagnoses were schizophrenia (27%) and depression (23%). The other diagnoses identified were acute delirium, dysthymia, infantile psychosis, intellectual disharmonic disability and personality disorder. The average age of emergence of the troubles was 17.1 years old for neurological symptoms and 20.9 years old for psychiatric symptoms. The median age was 18 years old for neurological symptoms and 20 years old for psychiatric ones. In 45% of cases, psychiatric occurred after neurological symptoms; in 27%, they occurred before and they were concomitant in 9%. In 50% of cases, psychiatric symptoms existed before the early diagnosis of NPC; in 9%, they occurred after and in 5%, they occurred during the diagnostic process. Fifty-five percent of the patients were followed by a psychiatrist, 50% of patients had been hospitalized at least once in a psychiatric department. Fifty-five percent of the patients received neuroleptics or antipsychotics, 41% received antidepressants, 41% received mood stabilizers or anticonvulsants, 45% received anxiolytics and 23% hypnotics. Whilst a small cohort, the low incidence of NPC (1/120,000 to 1/150,000) and the scale of a single-center study make the findings important. In our cohort, we found psychiatric disorders in most of the patients. The symptoms were varied and non-specific, and mainly found in late-onset forms of the disease. This incidence of disorder is much higher than the literature suggests, generally describing psychiatric disorders in approximately one third of NPC adult form. On the other hand, our results on schizophrenia are consistent with the updated recommendations for the diagnosis and management of NPC. According to our results, a retrospective study to develop a suspicion index to aid diagnosis of NPC suggests that psychotic symptoms are underestimated in this disease. In our cohort, we also found a significant rate of psychiatric hospitalizations and psychotropic drugs prescription that had not been previously described in the international literature. We did not have sufficient data on the effectiveness of symptomatic treatment in NPC; the literature was contradictory. It should be noted that despite the high rate of psychiatric patients in our cohort, only half of patients consulted a psychiatrist and a few of them have regular follow-up. To conclude, our study is in line with the current literature that suggests an under-estimation of psychiatric disorders in NPC, but also a likely under-diagnosis of NPC in psychiatric departments. All this data encourage us to keep alerting psychiatrists to identifying this disease in order to promote early and optimal care. Copyright © 2015 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Variations in Community Exposure and Sensitivity to Tsunami Hazards in the State of Hawai'i

USGS Publications Warehouse

Wood, Nathan; Church, Alyssia; Frazier, Tim; Yarnal, Brent

2007-01-01

Hawai`i has experienced numerous destructive tsunamis and the potential for future events threatens the safety and economic well being of its coastal communities. Although tsunami-evacuation zones have been delineated, what is in these areas and how communities have chosen to develop within them has not been documented. A community-level vulnerability assessment using geographic-information-system tools was conducted to describe tsunami-prone landscapes on the Hawaiian coast and to document variations in land cover, demographics, economic assets, and critical facilities among 65 communities. Results indicate that the Hawai`i tsunami-evacuation zone contains approximately 56,678 residents (five percent of the total population), 67,113 employees (eleven percent of the State labor force), and 50,174 average daily visitors to hotels (44 percent of the State total). With regards to economic conditions, the tsunami-evacuation zone contains 5,779 businesses that generate $10.1 billion in annual sales volume (both eleven percent of State totals), and tax parcels with a combined total value of $36.1 billion (18 percent of the State total). Although occupancy values are not known for each facility, the tsunami-evacuation zone also contains numerous dependent-population facilities (for example, child-day-care facilities and schools), public venues (for example, religious organizations and parks) and critical facilities (for example, fire stations). The residential population in tsunami-prone areas is racially diverse, with most residents identifying themselves as White, Asian, or Native Hawaiian and Other Pacific Islander, either alone or in combination with one or more race. Fifty-one percent of the households in the tsunami-evacuation zone are renter occupied. The employee population in the tsunami-evacuation zone is largely in accommodation and food services, health services, and retail-trade sectors. Results indicate that community vulnerability, described here by exposure (the amount of assets in tsunami-prone areas) and sensitivity (the relative percentage of assets in tsunami-prone areas) varies considerably among 65 coastal communities in Hawai`i. Honolulu has the highest exposure, Punalu`u has the highest sensitivity, and Ka`anapali has the highest combination of exposure and sensitivity to tsunamis. Results also indicate that the level of community-asset exposure to tsunamis is not determined by the amount of a community's land that is in tsunami-evacuation zones. Community sensitivity, however, is related to the percentage of a community's land that is in the tsunami-prone areas. This report will further the dialogue on societal risk to tsunami hazards in Hawai`i and help identify future preparedness, mitigation, response, and recovery planning needs within coastal communities and economic sectors of the State of Hawai`i.

Evaluation of Dietary Choices, Preferences, Knowledge and Related Practices Among Pregnant Women Living in An Indian Setting

PubMed Central

Ajantha; Singh, Awnish K; Malhotra, Bhavya; Joshi, Ashish

2015-01-01

Introduction Healthy and nutritious diet is very essential component of Antenatal care along with clinical advice. The objective of this study was to understand the dietary choices, preferences, knowledge and related practices among pregnant women living in an Indian setting. Materials and Methods Hundred pregnant women were enrolled in this cross-sectional study. Information about Socio-demographic profile, food item price and approach during inflation, nutrition related knowledge, attitude and practices and 24 hour dietary recall was acquired. Results Majority of the participants (87%) reported regular antenatal care visits and intake of iron and folic acid tablets. Eighty two percent of the participants were acquainted with standardized marks on food items and 64% of them reported checking of these marks before purchasing. Thirty two percent of the participants did not know about balanced diet. Fifty eight percent of the participants felled in fair category of dietary recall final scores. Conclusion There is still vast room for improvement of the nutritional status of pregnant women as none of the participants were able to achieve excellent status on 24 hour food record scoring sheet. PMID:26435972

Report on Honduras: ripples in the pond--the financial crisis and remittances to chronically ill patients in Honduras.

PubMed

Piette, John D; Mendoza-Avelares, Milton O; Chess, Laura; Milton, Evan C; Matiz Reyes, Armando; Rodriguez-Saldaña, Joel

2012-01-01

The U.S. financial crisis has affected employment opportunities for Latino immigrants, and this could affect their ability to send financial assistance, or "remittances", to chronically ill family members in their home country. In a cross-sectional survey of 624 chronically ill adults conducted in Honduras between June and August 2009, respondents reported their receipt of remittances, health service use, and cost-related access barriers. Fifty-four percent of respondents reported relatives living outside the country, and of this group, 66 percent (37% of the overall sample) received remittances. Seventy-four percent of respondents receiving remittances reported a decrease over the prior year, mostly due to job losses among their relatives abroad. Respondents reporting reductions in remittances received significantly less per month, on average, than those without a reduction (US $170 vs. $234; p = 0.01). In multivariate models, respondents experiencing a reduction in remittances used fewer health services and medications due to cost concerns. Remittance payments from relatives resident in the United States are a major source of income for chronically ill individuals in Latin America. Most recipients of remittances reported a reduction during the financial downturn that affected their access to care.

HIV vaccine trials: will intravenous drug users enroll?

PubMed Central

Meyers, K; Metzger, D S; Navaline, H; Woody, G E; McLellan, A T

1994-01-01

OBJECTIVES. The purpose of this study was to assess the willingness of intravenous drug users to participate in a preventive human immunodeficiency virus (HIV) vaccine efficacy trial. METHODS. Of the 347 intravenous drug users in methadone treatment who were approached for participation, 257 completed a battery of self-administered questionnaires assessing risk behaviors, interest in vaccine trials, and other vaccine-related information. Data from 16 known seropositives and 1 inconsistent responder were dropped from analyses (n = 240). RESULTS. Fifty-two percent of the subjects expressed a willingness to be one of the first individuals to participate in a preventive HIV vaccine efficacy trial. Subjects who had recently shared needles or works and subjects who trusted the government to ensure vaccine safety were both twice as likely to report interest in participation. Twenty-two percent of subjects reported that they would increase needle sharing if vaccinated. Thirty percent did not know what a vaccine was. CONCLUSIONS. These findings suggest that some in-treatment intravenous drug users would volunteer for a preventive HIV vaccine efficacy trial. Education and counseling will be required to ensure that subjects fully understand the trial's purposes, methods, risks and benefits. PMID:8179045

Taking the pulse: medical student workforce intentions and the impact of debt.

PubMed

Perry, William R G; Wilkinson, Tim J

2010-07-16

To define what factors are important to medical students as they make decisions about where they will live, work and train after graduation, and to explore the effects of student debt A mixed quantitative-qualitative questionnaire to all 5th and 6th year medical students residing in New Zealand in 2008. Questions related to students' perspectives of the workforce, debt, and workforce intentions. 372 medical students completed the survey (55% response rate from those in NZ at the time of the survey). Fifty-two percent of students planned to leave New Zealand at the start of PGY2 or 3. The average debt was $75,752. Thirty-six percent said their debt would influence their choice of vocation, 39% their choice of location of work in New Zealand and 64% their choice of locality of work in the world. Twenty-six percent and 25% believed that they would be valued by the hospital management and government respectively. Students most commonly cited financial incentives to work overseas and to locum. Strategies to counter emigration trends in the New Zealand health workforce need an holistic approach. Debt levels need to be countered, and the perceived lack of value of graduates needs to be rectified.

A study of perceptual and verbal skills of disabled readers in grades 4, 5 and 6.

PubMed

Solan, H A; Ficarra, A P

1990-08-01

This investigation addresses the role of the optometrist in diagnosing and treating children in grades 4, 5, and 6 who have been identified as reading disabled. Fifty-one subjects with average intelligence, but whose reading comprehension skills were below the 31st percentile (mean, 20th percentile), were evaluated using verbal and perceptual tests. When the performance of this experimental group was compared with the mean scores from standardized test norms for each of the various tasks, the disabled readers scored significantly lower in seven of the eight perceptual and five of the six verbal tasks. These results lend support to the hypothesis that both perceptual and verbal deficits are related to reading comprehension. Using step-wise multiple correlation analysis, three perceptual factors; eye-movements, Auditory-Visual Integration Test (AVIT), and grooved peg-board, contributed 38 percent of the variance whereas the addition of two verbal factors (digit span and token test) provided just 2 percent. That is, 38 percent of the variations in reading comprehension could be accounted for by variations in perceptual skills in the disabled readers. The results were interpreted in terms of spatial-simultaneous and verbal-successive processing skills.

Electronic Follow-Up of Developing World Cleft Patients: A Digital Dream?

PubMed

Walker, Tom W M; Chadha, Ambika; Rodgers, William; Mills, Caroline; Ayliffe, Peter

2017-10-01

To identify potential access to telemedicine follow-up of children with clefts operated on a humanitarian mission. A cross-sectional study of parents of children presenting to a humanitarian cleft lip and palate mission in a Provincial Hospital in the Philippines. A purpose designed questionnaire was used to assess access to electronic and digital resources that could be used to aid follow-up. Forty-five (N = 45) parents of children having primary cleft lip and or palate surgery participated. There were no interventions. Access to the Internet was through Parent Perceived Affordability of Internet Access and Parent Owned Devices. Thirty-one (N = 31) respondents were female. There was 93% mobile phone ownership. The mean distance traveled to the clinic was 187 km. Majority (56%) were fluent in English. Thirty-one percent accessed the Internet daily. Sixteen percent reported use of e-mail. Fifty-one percent accessed the Internet on a mobile device, and short message service use was the most affordable means of communication. Due to perceived unaffordability and low levels of access to devices with cameras and the Internet, as well as issues with privacy, we cannot recommend relying on electronic follow-up of patients in the developing world.

Prevention for College Students Who Suffer Alcohol-Induced Blackouts Could Deter High-Cost Emergency Department Visits

PubMed Central

Mundt, Marlon P.; Zakletskaia, Larissa I.

2012-01-01

Fifty percent of college students who drink report alcohol-induced blackouts, and alcohol abusers in general put a heavy burden on the medical care system. Using data drawn from a randomized, controlled alcohol intervention trial at five university sites, our study quantified the costs of visits to emergency departments by college students who experienced blackouts from drinking alcohol. Of 954 students in the study, 52 percent of males and 50 percent of females at the outset of the study had experienced an alcohol-induced blackout in the past year. Of 404 emergency department visits among the study participants over a two-year observation period, about one in eight were associated with blackout drinking. Injuries ranged from broken bones to head and brain injuries requiring computed tomography. We calculate that on a large university campus having more than 40,000 students, blackout-associated emergency department visit costs would range from $469,000 to $546,000 per year. We conclude that blackouts are a strong predictor of emergency department visits for college drinkers and that prevention efforts aimed at students with a history of blackouts might reduce injuries and emergency department costs. PMID:22422503

[Urgent retinal detachment management by the National Health System of Spain. Project Retina 2].

PubMed

Rojas, J; Fernández, I; Pastor, J C; Gómez-Ulla, F; Piñero, A

2007-05-01

To identify problems in the urgent management of retinal detachments (RD) in hospitals of the Spanish National Health System (NHS). A questionnaire was submitted confidentially to the heads of Ophthalmic Departments of 217 hospitals of the NHS to obtain information on the management of urgent RD during the last year. Data was stored in a Microsoft Access database and statistically analyzed by Excel and Statgraphics. Qualitative variables were analyzed by Chi-Square and Fisher exact tests and quantitative variables by the Kruskall-Wallis test. A global response rate of 54.8% was achieved with higher participation of the Teaching Hospitals (TH). District Hospital and non-Teaching Hospital responses were similar and grouped as non-TH. Eighteen percent of centers, mostly non-TH, had no ophthalmologist on duty. Thirty-six percent had a vitreoretinal specialist on call. Eighty percent of centres admitted to have problems handling urgent RD during weekends. Twenty-four had no ophthalmic surgical theatre available. Fifty percent referred to have problems having an anaesthesiologist available and only 22% had ophthalmic trained personnel (nurses) available. Sixty-four percent of centres performed pars plana vitrectomy (PPV) and 77% of those were able to perform an urgent PPV. Ninety percent admitted that a patient with a macula-threatening RD occurring at the beginning of the week-end would not be treated until at least 24 hours had elapsed, although 84% considered this to be inadequate. Despite the methodological problems and bias of this questionnaire, we did identify several important problems in the management of urgent RD by NHS hospitals. The data obtained provides useful information to enable the quality of the NHS care of RD to be improved, particularly that available at the week-end.

Pediatric Educational Needs Assessment for Urban and Rural Emergency Medical Technicians

PubMed Central

Fleischman, Ross J.; Yarris, Lalena M.; Curry, Merlin T.; Yuen, Stephanie C.; Breon, Alia R.; Meckler, Garth D.

2011-01-01

Objective To identify past experiences, present needs, barriers, and desired methods of training for urban and rural EMTs. Methods This 62-question pilot-tested written survey was administered at the 2008 Oregon EMS and 2009 EMS for Children conferences. Respondents were compared to registration lists and the state EMS database to assess for non-responder bias. Agencies more than 10 miles from a population of 40,000 were defined as rural. Results Two-hundred nineteen of 313 EMS personnel (70%) returned surveys. Respondents were 3% first responders, 27% EMT-basics, 20% intermediates, and 47% paramedics. Sixty-eight percent were rural and 32% urban. Sixty-eight percent reported fewer than 10% pediatric transports. Overall, respondents rated their comfort caring for pediatric patients as 3.1 on a 5 point likert scale (95%CI 3.1–3.2). Seventy-two percent reported a mean rating of less than “comfortable” (four on the scale) across 17 topics in pediatric care, which did not differ by certification level. Seven percent reported no pediatric training in the last two years and 76% desired more. The “quality of available trainings” was ranked as the most important barrier to training. 26% of rural versus 7% of urban EMS personnel ranked distance as the most significant barrier (p<0.01). Fifty-one percent identified highly realistic simulations as the method that helped them learn best. In the past two years, 19% percent had trained on a highly realistic pediatric simulator. One to three hours was the preferred duration for trainings. Conclusions Except for distance as a barrier, there were no significant differences between urban and rural responses. Both urban and rural providers desire resources, in particular highly realistic simulation, to address the infrequency of pediatric transports and limited training. PMID:22134229

Fish quarantine: current practices in public zoos and aquaria.

PubMed

Hadfield, Catherine A; Clayton, Leigh A

2011-12-01

The primary goal of quarantine is to reduce the risk of introducing infectious diseases into established collections. Fish quarantine is inherently complex because of the variety of species, environmental requirements, and facilities. To examine current practices, questionnaires were submitted to 60 public zoos and aquaria, predominantly in North America. Questions reviewed system type (closed, flow-through), quarantine length, diagnostics, treatments, and cleaning and disinfection. Forty-two of the 60 institutions responded. Most institutions had separate quarantine protocols for freshwater teleosts, marine teleosts, and elasmobranchs. Ninety-five percent of institutions had a minimum quarantine period of 30 days or more. Sixty-four percent of institutions used isolated areas for some or all of their fish quarantine. Twenty-five percent had designated fish quarantine staff. All institutions used regular visual examinations to assess animal health. Fifty-four percent of the institutions carried out routine hands-on diagnostics on some fish; this was more common for elasmobranchs than teleosts. All institutions carried out necropsies on mortalities. Fifteen percent of institutions performed histopathology on almost all fresh mortalities; 54% percent performed histopathology on less than 10% of mortalities. Prophylactic treatments were common in closed systems, in particular, formalin immersion for teleosts, freshwater dips and copper sulfate immersion for marine teleosts, and praziquantel immersion for marine teleosts and elasmobranchs. Institutions using dips generally did so at the start or end of quarantine. Fenbendazole- and praziquantel-medicated foods were used commonly in teleosts, but dosages varied greatly. Cleaning and disinfection of systems and equipment increased in response to known pathogens. These results can be used to compare and discuss fish quarantine practices at display facilities in order to improve quarantine success.

Iron deficiency anaemia in Nigerian infants.

PubMed

Akinkugbe, F M; Ette, S I; Durowoju, T A

1999-01-01

Hematological parameters and the iron status of 50 randomly selected infants who were attending the research infant welfare clinic of the Institute of Child Health, Ibadan (ICHI), for routine immunization were studied. Investigations included estimations of packed cell volume (PCV), haemoglobin (Hb), serum iron (Fe), unsaturated iron-binding capacity (UIBC) and total iron-binding Capacity (TIBC). Forty percent of the infants had PCVs below 0.32, 48% had Hbs below 10 g/dl and 27% had mean corpuscular volume (MVC) less that 70fl. Thirty-seven percent of the children had serum Fe below 3.58 mmol/l, but only 4% had UIBC above 320 mmol/l. Fifty-two percent had Transferin Saturation Index (TSI) below 10%. Eighteen percent had MCV below 70fl associated with TSI below 10% and 67% of these had Hbs below 10 g/dl. The prevalence of iron deficiency anaemia in infants as shown in this study is very high. The ill effects of iron deficiency in childhood have been well documented. It is suggested that screening for anaemia should be offered at 9 months as part of a Child Survival Programme and that infants found to be anaemic should be treated. However, for cost-effectiveness and taking into consideration the high prevalence rate of iron deficiency in this age group, it might be preferable to give iron and weekly prophylactic antimalarias routinely to infants aged 9 to 15 months in lieu of screening.

Functional outcome following an ankle or subtalar arthrodesis in adults.

PubMed

Faraj, Adnan A; Loveday, David T

2014-06-01

Arthrodesis surgery aims to give pain relief by abolishing the movement of the joint concerned. Few studies describe the outcome as appreciated by the patient. This was the major concern of the authors, when they set up this retrospective study about the outcome after ankle fusion or subtalar fusion. Inclusion criteria were: pre-existing idiopathic and posttraumatic osteoarthritis, leading to joint pain unresponsive to conservative treatment, clinically and radiologically fused with an open approach between 2007 and 2011. Exclusion criteria were: preexisting joint infection, diabetes, rheumatoid arthritis, nonunion, age below 18 years, decease, and arthroscopic fusion. Fifteen ankle fusions and 18 subtalar fusions fulfilled the criteria. The mean age of the patients was 77 and 69 years, respectively; the average follow-up period was 3 and 4 years. A telephone questionnaire showed that the average patients' satisfaction was 7.86/10 in the ankle group and 7.94/10 in the subtalar group. All patients driving a car prior to surgery were able to do so afterwards. Forty percent walked unaided and without problems (excellent). Fifty-one percent were able to mobilise, but their walking distance was limited and a stick was required (good or fair). Nine percent were unable to mobilise out of their homes (poor), however it was generalized osteoarthritis which limited their mobility. Forty-five percent were involved in sports including judo, swimming, cycling, jogging, gardening, bowling, golf, and boules.

Relationship between alcohol intake, body fat, and physical activity – a population-based study

PubMed Central

Liangpunsakul, Suthat; Crabb, David W.; Qi, Rong

2010-01-01

Objectives Aside from fat, ethanol is the macronutrient with the highest energy density. Whether the energy derived from ethanol affects the body composition and fat mass is debatable. We investigated the relationship between alcohol intake, body composition, and physical activity in the US population using the third National Health and Nutrition Examination Survey (NHANES III). Methods Ten thousand five hundred and fifty subjects met eligible criteria and constituted our study cohort. Estimated percent body fat and resting metabolic rate were calculated based on the sum of the skinfolds. Multivariate regression analyses were performed accounting for the study sampling weight. Results In both genders, moderate and hazardous alcohol drinkers were younger (p<0.05), had significantly lower BMI (P<0.01) and body weight (p<0.01) than controls, non drinkers. Those with hazardous alcohol consumption had significantly less physical activity compared to those with no alcohol use and moderate drinkers in both genders. Female had significantly higher percent body fat than males. In the multivariate linear regression analyses, the levels of alcohol consumption were found to be an independent predictor associated with lower percent body fat only in male subjects. Conclusions Our results showed that alcoholics are habitually less active and that alcohol drinking is an independent predictor of lower percent body fat especially in male alcoholics. PMID:20696406

Chapter 9 Biochemical variables amongst UK adult dialysis patients in 2010: national and centre-specific analyses.

PubMed

Pruthi, Rishi; Pitcher, David; Dawnay, Anne

2012-01-01

The UK Renal Association clinical practice guidelines include clinical performance measures for biochemical variables in dialysis patients. The UK Renal Registry (UKRR) annually audits dialysis centre performance against these measures as part of its role in promoting continuous quality improvement. Cross sectional performance analyses were undertaken to compare dialysis centre achievement of clinical audit measures for prevalent haemodialysis (HD) and peritoneal dialysis (PD) cohorts in 2010. The biochemical variables studied were phosphate, adjusted calcium, parathyroid hormone, bicarbonate and total cholesterol. In addition longitudinal analyses were performed (2000-2010) to show changes in achievement of clinical performance measures over time. Fifty-six percent of HD and 69% of PD patients achieved a phosphate within the range recommended by the RA clinical practice guidelines. Seventy-five percent of HD and 76% of PD patients had adjusted calcium between 2.2-2.5 mmol/L. Twenty-eight percent of HD and 31% of PD patients had parathyroid hormone between 16- 32 pmol/L. Sixty percent of HD and 80% of PD patients achieved the audit measure for bicarbonate. There was significant inter-centre variation for all variables studied. The UKRR consistently demonstrates significant inter-centre variation in achievement of biochemical clinical audit measures. Understanding the causes of this variation is an important part of improving the care of dialysis patients in the UK. Copyright © 2012 S. Karger AG, Basel.

75 FR 3434 - Fisheries of the Northeastern United States; Northeast Skate Complex Fishery; Amendment 3

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-21

... analysis of dependency on the skate fishery indicates that almost 75 percent of the vessels included in the analysis have less than a 5-percent dependency on the skate fishery. The estimated impact on gross sales increases markedly in relation to dependency on the skate fishery among the 127 vessels estimated to be...

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

None

This document provides information on ethanol fuel properties, standards, codes, best practices, and equipment information for those who blend, distribute, store, sell, or use E15 (gasoline blended with 10.5 percent - 15 percent ethanol), E85 (marketing term for ethanol-gasoline blends containing 51 percent - 83 percent ethanol, depending on geography and season), and other ethanol blends.

Interocular difference and duration for doubling of the minimal angle of visual resolution in patients with Stargardt disease.

PubMed

Hajali, Manal; Fishman, Gerald A; Anderson, Robert J; McAnany, J Jason

2009-07-01

To determine the extent of interocular difference in visual acuity (VA) and the time to at least double the minimal angle of resolution (MAR) in a cohort of patients with Stargardt disease. One hundred fifty patients with Stargardt disease who were examined at least four times over a minimum period of 3 years were identified and their VA and age at each visit recorded. The maximum interocular difference of VA was determined by whether the MAR between the two eyes differed by less than a factor of 2 or by a factor of 2 or greater. Differences in maximum VA between the two eyes were also examined according to a Bland-Altman-type approach. One hundred thirty-one eyes from 76 patients were subjected to survival analysis to determine whether the time to at least double the MAR was dependent on age at baseline or starting VA. Of the 150 patients, 48% had interocular MAR that differed maximally by a factor of less than 2. Thirty-five percent showed a maximum interocular difference in their Snellen VA of less than one line. The Bland-Altman- type analysis showed that maximum interocular acuity difference was dependent on the mean acuity of the two eyes. The hazard for at least doubling the MAR was related to baseline vision and patient age. This information has clinical significance for patient counseling and for monitoring possible benefits and patient selection in future treatment trials.

Chromium(III) and chromium(VI) release from leather during 8 months of simulated use.

PubMed

Hedberg, Yolanda S; Lidén, Carola

2016-08-01

Chromium (Cr) release from Cr-tanned leather articles is a major cause of Cr contact dermatitis. It has been suggested that Cr(VI) release from leather is not necessarily an intrinsic property of the leather, but is strongly dependent on environmental conditions. To test this hypothesis for long-term (8 months) simulated use. The release of total Cr and Cr(VI) from Cr-tanned, unfinished leather was analysed in subsequent phosphate buffer (pH 8.0) immersions for a period of 7.5 months. The effect of combined ultraviolet treatment and alkaline solution (pH 12.1) was tested. Dry storage [20% relative humidity (RH)] was maintained between immersions. Atomic absorption spectroscopy, X-ray fluorescence and diphenylcarbazide tests were used. Cr(VI) release was dependent on previous dry storage or alkaline treatment, but not on duration or number of previous immersions. Cr(III) release decreased with time. Fifty-two percent of the total Cr released during the last immersion period was Cr(VI). Cr(VI) release exceeded 9 mg/kg in all immersion periods except in the first 10-day immersion (2.6 mg/kg). Cr(VI) release is primarily determined by environmental factors (RH prior to immersion, solution pH, and antioxidant content). The RH should be kept low prior to testing Cr(VI) release from leather. © 2016 The Authors. Contact Dermatitis published by John Wiley & Sons Ltd.

African American and Caucasian Attempters Compared for Suicide Risk Factors: A Preliminary Study

ERIC Educational Resources Information Center

Roy, Alec

2003-01-01

The aim of the study was to compare African American and Caucasian substance dependent suicide attempters for risk factors for suicidal behavior. One hundred and fifty-eight African American and 95 Caucasian substance dependent patients who had attempted suicide were interviewed and their family history of suicidal behavior recorded. Patients…

Radon concentrations in ground and drinking water in the state of Chihuahua, Mexico.

PubMed

Villalba, L; Colmenero Sujo, L; Montero Cabrera, M E; Cano Jiménez, A; Rentería Villalobos, M; Delgado Mendoza, C J; Jurado Tenorio, L A; Dávila Rangel, I; Herrera Peraza, E F

2005-01-01

This paper reports (222)Rn concentrations in ground and drinking water of nine cities of Chihuahua State, Mexico. Fifty percent of the 114 sampled wells exhibited (222)Rn concentrations exceeding 11Bq/L, the maximum contaminant level (MCL) recommended by the USEPA. Furthermore, around 48% (123 samples) of the tap-water samples taken from 255 dwellings showed radon concentrations over the MCL. There is an apparent correlation between total dissolved solids and radon concentration in ground-water. The high levels of (222)Rn found may be entirely attributed to the nature of aquifer rocks.

Graphic-output temperature data loggers for monitoring vaccine refrigeration: implications for pertussis.

PubMed

McColloster, Patrick; Vallbona, Carlos

2011-01-01

We conducted the first US study using graphic-output temperature data loggers in quantifying cold chain failure. Fifty-four vaccine refrigerators of a county outpatient health system were studied. Forty-eight percent maintained temperatures of 2°C to 8°C and 24% had protracted periods of temperatures less than 0°C. The correlation between the percentage of refrigerators with freezing temperatures and the pertussis rate for each health region was r = 0.76. The findings suggest that improper vaccine storage may have contributed to recent increases in pertussis rates.

Implementing a successful senior/geriatric health care program for veterinarians, veterinary technicians, and office managers.

PubMed

Fortney, William D

2012-07-01

Geriatrics and gerontology have emerged as one of the fastest growing portions of a progressive small animal practice. A critical component of geriatric medicine is a senior/geriatric health care program with senior profiling. Fifty percent of small animal practices have some form of senior/geriatric health care program and the percentage is growing. Armed with the knowledge gleaned from a successful health care program, the progressive veterinarian is better positioned to prevent and/or manage problems in the earliest stages, increasing the options available plus improving the overall outcome.

Simultaneous isolation of anaerobic bacteria from udder abscesses and mastitic milk in lactating dairy cows.

PubMed

Greeff, A S; du Preez, J H

1985-12-01

A variety of non-sporulating anaerobic bacterial species were isolated from udder abscesses in 10 lactating dairy cows. Fifty percent of the abscesses yielded multiple anaerobic species and the other 50% only 1 species. The anaerobic bacteria, however, were always accompanied by classical facultative anaerobic mastitogenic bacteria. In four of the five cows also afflicted with mastitis in the quarters with abscesses, the anaerobic and facultative anaerobic bacteria were identical. Peptococcus indolicus was the most commonly isolated organism followed by Eubacterium and Bacteroides spp. Bacteroides fragilis was resistant to penicillin, ampicillin and tetracycline.

Leukoedema: an epidemiological study in white and African Americans.

PubMed

Martin, J L

1997-01-01

Leukoedema, a benign grayish-white lesion which characteristically involves the oral mucosa of humans, was once indicated as a probable precursor to leukoplakia. The author reports an incidence of fifty-three percent in a population of 13,000 white and African Americans who reside in the Southeastern region of the United States. This longitudinal study revealed that the incidence of leukoedema per 1,000 persons increased with age in both ethnic groups up to ages 40-49 and then declined systematically. There was no sex predilection. The occurrence of leukoedema was significantly greater in African Americans.

Nutrition recommendations and the Children's Food and Beverage Advertising Initiative's 2014 approved food and beverage product list.

PubMed

Schermbeck, Rebecca M; Powell, Lisa M

2015-04-23

We compare the Children's Food and Beverage Advertising Initiative's (CFBAI's) April 2014 list of food and beverage products approved to be advertised on children's television programs with the federal Interagency Working Group's nutrition recommendations for such advertised products. Products were assessed by using the nutrients to limit (saturated fat, trans fat, sugar, and sodium) component of the Interagency Working Group's recommendations. Fifty-three percent of the listed products did not meet the nutrition recommendations and, therefore, were ineligible to be advertised. We recommend continued monitoring of food and beverage products marketed to children.

Accuracy of body mass index in volunteer firefighters.

PubMed

Ode, J; Knous, J; Schlaff, R; Hemenway, J; Peterson, J; Lowry, J

2014-04-01

Obesity is prevalent among career firefighters and may contribute to heart attacks, a leading cause of on-duty fatalities. The US National Fire Protection Association estimates that 800 000 of 1.1 million firefighters are volunteers. Body mass index (BMI) is commonly used to assess obesity, but little is known about its accuracy in volunteer firefighters, in whom muscle mass may be higher, given firefighting's physical demands, reducing its accuracy in identifying obesity. To evaluate the accuracy of BMI in identifying obese volunteer firefighters. Height, weight and body composition were measured in 73 male volunteer firefighters (mean age 40±12). The proportions with BMI ≥ 25kg/m(2), ≥30kg/ m(2) and percent fat ≤ 20th percentile were determined. Using the age-specific 20th percentile for percent fat (Cooper Clinic) as the criterion for being over-fat, the accuracy of BMI was assessed using sensitivity and specificity calculations. The means ± standard deviation of BMI and percent fat were 32±6 and 25±5, respectively. The proportions with a BMI ≥ 25 and ≥30 were 90% and 60%, respectively. Fifty-one percent had a percent fat ≤ 20th percentile. The measure BMI ≥ 25 had a perfect sensitivity (1.0) and low specificity (0.19) and BMI ≥ 30 had a high sensitivity (0.89) and moderate specificity (0.69). Although BMI ≥ 30 accurately predicted being over-fat, it misclassified large and lean firefighters. Although BMI should be used cautiously, it can identify over-fat firefighters at risk of cardiovascular disease, and its measurement is cost-effective and simple.

Once is not enough: withholding postoperative prophylactic antibiotics in prosthetic breast reconstruction is associated with an increased risk of infection.

PubMed

Clayton, John L; Bazakas, Andrea; Lee, Clara N; Hultman, C Scott; Halvorson, Eric G

2012-09-01

There has been a trend toward limiting perioperative prophylactic antibiotics, based on research not conducted in plastic surgery patients. The authors' university hospital instituted antibiotic prescribing guidelines based on the Surgical Care Improvement Project. An increased rate of surgical-site infections was noted in breast reconstruction patients. The authors sought to determine whether the change in antibiotic prophylaxis regimen affected rates of surgical-site infections. A retrospective study compared patients undergoing breast reconstruction who received preoperative and postoperative prophylactic antibiotics with a group who received only a single dose of preoperative antibiotic. Type of reconstruction and known risk factors for implant infection were noted. Two hundred fifty patients were included: 116 in the pre-Surgical Care Improvement Project group and 134 in the Surgical Care Improvement Project group. The overall rate of surgical-site infections increased from 18.1 percent to 34.3 percent (p = 0.004). Infections requiring reoperation increased from 4.3 percent to 16.4 percent (p = 0.002). Multivariate logistic regression demonstrated that patients in the Surgical Care Improvement group were 4.74 times more likely to develop a surgical-site infection requiring reoperation (95 percent CI, 1.69 to 13.80). Obesity, history of radiation therapy, and reconstruction with tissue expanders were associated with increased rates of surgical-site infection requiring reoperation. Withholding postoperative prophylactic antibiotics in prosthetic breast reconstruction is associated with an increased risk of surgical-site infection, reoperation, and thus reconstructive failure. The optimal duration of postoperative prophylactic antibiotic use is the subject of future study.

The Experiences of Violence and Occupational Health Risks of Sex Workers Working in Brothels in Ankara

PubMed Central

Odabaşı, Aysun Balseven; Şahinoglu, Serap; Genç, Yasemin; Bilge, Yaşar

2012-01-01

Objective: The aim of this study was to reveal and discuss occupational health risks, violence against sex workers working in brothels and their working conditions in Ankara. Materials and Methods: The study included 138 sex workers. Data were collected at face to face interviews with a questionnaire composed of 40 questions about socio-demographic features, familial characteristics, reasons for becoming a sex worker, experiences of violence and occupational health risks. Results: Twenty-two point five percent of the women were aged 21–30 years and 39.9% were aged 31–40 years. The mean time of education was 5.9±3.5 (0–14) years. Forty-eight point five percent of the women were exposed to physical abuse and 13% of the women had been exposed to sexual abuse in their childhood. Fifty-five point eight percent of the women reported that their clients always used condoms, but 97.1% of the women noted that their clients insisted on not using a condom. Fourteen point five percent and 70.3% of the women were exposed to physical and verbal violence respectively from their clients. Ten point one percent of the women suffered sexual assault while working. Conclusion: Sex workers, like other people, should have human rights, all types of violence that they face should be eliminated and the social conditions they are exposed to should be improved. Sexually transmitted diseases, the most important health risk of sex workers, should be considered as occupational diseases in the new regulations. PMID:25206986

[Nutritional status and risk in hospitalized children].

PubMed

Hankard, R; Bloch, J; Martin, P; Randrianasolo, H; Bannier, M F; Machinot, S; Cézard, J P

2001-11-01

A few studies report malnutrition in hospitalized patients. This one-day cross-sectional survey performed in January 1999 assessed nutritional status and protein-energy intake in a pediatric population hospitalized in medicine or surgery units. Every child older than six months, hospitalized for more than 48 h and free of nutritional support (parenteral, enteral, or special regimens for metabolic diseases) was included. Fifty-eight children among the 183 present the day of the study met the inclusion criteria and were included in the statistical analysis. They were hospitalized in medicine (48%), psychiatry (31%) and surgery (21%). The body mass index (BMI) was below -2 standard deviations (DS) in 21% of them. Excluding patients with anorexia nervosa, BMI was < -2 SD, > +2 SD, or in between these limits in respectively 12, 14 and 74%. Energy intake measured at the hospital was below 75% of the recommended dietary allowances in two-thirds of the children whether malnourished or not. Fifty percent of the malnourished children had been referred to a dietician the day of the study. Malnutrition is frequent in a population of hospitalized children. Energy intake and referral to a dietician are insufficient.

Where do we go from here? Interim analysis to forge ahead in violence prevention.

PubMed

Dicker, Rochelle A; Jaeger, Sebastian; Knudson, Mary M; Mackersie, Robert C; Morabito, Diane J; Antezana, Javier; Texada, Michael

2009-12-01

The severity and disparity of interpersonal violent injury is staggering. Fifty-three per 100,000 African Americans (AA) die of homicide yearly, 20 per 100,000 in Latinos, whereas the rate is 3 per 100,000 in Caucasians. With the ultimate goal of reducing injury recidivism, which now stands at 35% to 50%, we have designed and implemented a hospital-based, case-managed violence prevention program uniquely applicable to trauma centers. The Wraparound Project (WP) seizes the "teachable moment" after injury to implement culturally competent case management (CM) and shepherd clients through risk reduction resources with city and community partners. The purpose of this study was to perform a detailed intermediate evaluation of this multi-modal violence prevention program. We hypothesized that this evaluation would demonstrate feasibility and early programmatic efficacy. We looked to identify areas of programmatic weakness that, if corrected, could strengthen the project and enhance its effectiveness. We performed intermediate evaluation on the 18-month-old program. We selected the Centers for Disease Control and Prevention-recommended instrument used for unintentional injury prevention programs and applied it to the WP. The four sequential stages in this methodology are formative, process, impact, and outcome. To test feasibility of WP, we used process evaluation. To evaluate intermediate goals of risk reduction and early efficacy, we used impact evaluation. Four hundred thirty-five people met screening criteria. The two case managers were able to make contact and screen 73% of gun shot victims, and 57% of stab wound victims. Of those not seen, 48% were in the hospital for 6 h/wk with the client. Forty-one percent of the time, they spent 3 hours to 6 hours. Seventeen of 18 people who required >6 hours had two to three needs. Attrition rate is only 4%. The table demonstrates percent success thus far in providing risk reduction resources. WP case managers served high-risk clients by developing trust, credibility, and a risk reduction plan. Cultural competency has been vital. Six of seven major needs were successfully addressed at least 50% of the time. The value of reporting these results has led WP to gain credibility with municipal stakeholders, who have now agreed to fund a third CM position. Intermediate evaluation provided a framework in our effort to achieve the ultimate goal of reducing recidivism through culturally competent CM and risk factor modification.

Current status of predoctoral geriatric education in U.S. dental schools.

PubMed

Mohammad, Abdel R; Preshaw, Philip M; Ettinger, Ronald L

2003-05-01

The elderly constitute the fastest growing segment of the U.S. population. Dental schools must educate dental students so that they are competent and confident in managing the treatment needs of elderly patients. Programs in geriatric dentistry have been developed in response to the changing oral health needs of growing numbers of older adults. The purpose of this online survey was to identify the current status of predoctoral geriatric dental education in U.S. dental schools. A questionnaire relating to the teaching of geriatric dentistry was posted on the World Wide Web, and fifty-four US. dental schools were invited to complete the form. Data from completed questionnaires were submitted to the investigators via email. Following repeated phone calls and emails to urge school administrators to respond to the electronic questionnaire, a 100 percent response rate was achieved. All schools reported teaching at least some aspects of geriatric dentistry, and 98 percent had curricula that contain required didactic material. Sixty-seven percent of schools reported having a clinical component to geriatric dental teaching. Of these schools, the clinical content was required in 77 percent and elective in the rest. Thirty percent of schools reported a specific geriatric dentistry clinic within the school, and 11 percent had a remote clinical site. Sixty-three percent of schools have a geriatric program director or a chairman of a geriatric section. Over a third of schools indicated that they plan to extend the teaching of geriatric dentistry in the future. Geriatric dental education has continued to expand over the last twenty years and has established itself in the U.S. predoctoral dental curriculum. The format of teaching the subject varies considerably among the dental schools. Although didactic teaching of geriatric dentistry has increased markedly in the last two decades, clinical experience, both intramurally and extramurally, did not keep pace.

Small employers and the challenge of sponsoring a retirement plan: results of the 1998 Small Employer Retirement Survey.

PubMed

Yakoboski, P; Ostuw, P

1998-10-01

Forty-two million individuals work for small employers; 9 million are participating in an employment-based retirement plan, while 33 million are not participating in a plan. This Issue Brief examines the barriers that prevent small employers from sponsoring a retirement plan, their level of knowledge about plans, and changes that might lead to plan sponsorship. It also examines the motivations of small employers that sponsor retirement plans. Small employers identify three main reasons for not offering a plan: employees' preferences for wages and/or other benefits, administrative costs, and uncertain revenue that makes it difficult to commit to a plan. Small employers without plans report being familiar with 401(k) and profit-sharing plans, but little else. Forty-seven percent report never having heard of the savings incentive match plan for employees (SIMPLE), and 55 percent report never having heard of simplified employee pensions (SEPs). There is apparent misunderstanding about retirement plans among small employers that do not sponsor one, especially with regard to costs. For example, 35 percent do not know that a plan can be set up for less than $2,000. What changes would lead to serious consideration of retirement plan sponsorship? In order of reported importance: increased company profits (66 percent), a business tax credit (64 percent), reduced administrative requirements (50 percent), demand from employees (49 percent), allowing key executives to save more in the plan (49 percent), and easing, i.e., lengthening, of vesting requirements (40 percent). Many small employers that sponsor a retirement plan cite business reasons among their motivations. Sixty-eight percent cite a "positive effect on employee attitude and performance" as a major reason for offering a plan. Fifty-six percent cite a "competitive advantage in employee recruitment and retention" as a major reason. Small employers with a retirement plan report direct benefits from sponsorship, but many of those without plans appear unaware of these potential benefits. The 1998 SERS indicates that effective public policy must educate workers regarding the need to make retirement planning and saving a priority, in addition to addressing employer concerns about offering plans. Furthermore, there is a need to educate small employers about the options available to them and what these options entail. Finally, it appears that many employers need to be informed of the potential benefits from plan sponsorship.

Self-guided Change: The most common form of long-term, maintained health behavior change

PubMed Central

Bishop, F Michler

2018-01-01

Millions of people change risky, health-related behaviors and maintain those changes. However, they often take years to change, and their unhealthy behaviors may harm themselves and others and constitute a significant cost to society. A review—similar in nature to a scoping review—was done of the literature related to long-term health behavior change in six areas: alcohol, cocaine and heroin misuse, gambling, smoking, and overeating. Based on the limited research available, reasons for change and strategies for changing and for maintaining change were also reviewed. Fifty years of research clearly indicate that as people age, in the case of alcohol, heroin and cocaine misuse, smoking, and gambling, 80–90 percent moderate or stop their unhealthy behaviors. The one exception is overeating; only 20 percent maintain their weight loss. Most of these changes, when they occur, appear to be the result of self-guided change. More ways to accelerate self-guided, health-related behavior change need to be developed and disseminated. PMID:29375888

The relationship of intravascular bubbles to bends at altitude

NASA Technical Reports Server (NTRS)

Krutz, R. W.; Dixon, G. A.; Olson, R. M.; Moore, A. A.

1986-01-01

In response to recent findings attesting to a correlation between intravehicular bubbling and decompression sickness at intermediate altitudes, an attempt was made to define a minimum pressure for a pressure suit which would obviate the need for prebreathing 100 percent oxygen prior to extravehicular activity (EVA). Fifty-seven male subjects were exposed to altitudes ranging from 16,000 to 30,000 ft in two separate protocols. The first was designed to determine a pressure at which no bends occurred if a crewmember were decompressed from a sea level space station pressure just prior to EVA without prebreathing 100 percent oxygen. The other study was designed to define an altitude and exercise regimen at which bends-susceptible and bends-resistant crewmembers could be separated. It is shown that the close association which exists between severe bubbling and bends at a pressure altitude of 4.3 psia (30,000 ft) decreases as pressure is increased and essentially disappears at pressures less than or equal to 7.8 psia (16,000 ft).

[Use of contraception and reasons for choosing abortion among abortion applicants].

PubMed

Hansen, S K; Birkebaek, J S; Husfeldt, C; Munck, C B; Nøddebo, S M; Petersson, B H

1996-10-07

The object of this study was to describe a group of women applying for legal abortion in relation to their use of contraception and reasons for choosing an abortion. During a period of 13 months (1991-92) a questionnaire was distributed to women applying for legal abortion at Hillerød Hospital in Denmark. Three hundred and thirty-nine women participated. Fifty-nine percent of the women had become pregnant although they had used contraception. As seen in other studies, women still state demographic factors as their most important reasons for choosing an abortion. Women with two or more children do not want to have more children. Single women do not want children without being in a stable relationship. Furthermore occupation and education were frequently stated as important reasons for having an abortion. Economy and housing were not main reasons but contributory factors. Thirty percent of the women expressed ambivalence about the choice of abortion at the time when the abort was due.

Diffusion of a Nurse-led Healthcare Innovation: Describing Certified Clinical Nurse Leader Integration Into Care Delivery.

PubMed

Bender, Miriam; Williams, Marjory; Su, Wei

2016-01-01

The Clinical Nurse Leader™ (CNL) initiative is in its 2nd decade. Despite a growing theoretical and empirical body of CNL knowledge, little is known about CNLs themselves or where and how their competencies are being integrated into care delivery across the country. The aim of this study was to describe certified CNL characteristics and roles as part of a larger study validating a model for CNL practice. This study used a descriptive analysis of survey data from a national sample of certified CNLs. Survey response rate was 19%. Sixty percent have greater than 10 years of RN experience, and 75% have additional specialty certifications. Fifty-eight percent are practicing in a formal CNL role and report a high degree of accountability for all 9 CNL essential competencies. Findings help understand the extent of CNL adoption and spread across the country and the level to which the initial vision of CNL practice is being achieved.

Hypoglycemia-occipital syndrome: a specific neurologic syndrome following neonatal hypoglycemia?

PubMed

Karimzadeh, Parvaneh; Tabarestani, Sepideh; Ghofrani, Mohammad

2011-02-01

This study attempted to elaborate the existence of a specific neurologic pattern observed in children who experienced neonatal hypoglycemia. Twenty-seven patients with seizure and history of neonatal hypoglycemia were compared with 28 children suffering from idiopathic occipital epilepsy. In both groups the most common type of seizure activities included eye movements and impaired consciousness responding well to treatment; however, ictal vomiting was more common in controls. Subjects were in epileptic and nonepileptic groups. Ninety percent of cases showed abnormal signal of the posterior head region on magnetic resonance imaging (MRI). A large number showed posterior abnormalities on electroencephalography (EEG). Visual loss with abnormal visual evoked potential was the most frequent visual finding. Fifty-five percent showed mild psychomotor retardation. This study demonstrates that neonatal hypoglycemia can induce a syndrome with a specific clinical spectrum consisting of epilepsy, visual disturbances, and psychomotor retardation. Hypoglycemia-occipital syndrome is an entity without statistically significant semiologic differences from the idiopathic type.

Nutrition education: a survey of practices and perceptions in undergraduate dietetics education.

PubMed

Short, Joy E; Chittooran, Mary M

2004-10-01

Electronic mail messages linked to an online survey were sent to 281 directors of didactic and coordinated programs in dietetics to investigate coverage of nutrition education in undergraduate curriculua, perceived importance of topics, and perceived trends. Descriptive statistics and content analysis were performed on responses from 117 programs. Programs addressed nutrition education through a variety of methods and materials. Fifty-three percent (n=62) offered a course dedicated to nutrition education. The most common teaching methods were didactic (88%) and experiential learning (87%). Most of the topics investigated, including those addressed by the Commission on Accreditation for Dietetics Education Accreditation Manual, were viewed as important, very important, or essential. Perceived trends included increased use of technology, theories/models, client-centered education, cultural awareness, and behavior change. Eighty-eight percent of respondents indicated satisfaction with nutrition education curriculum strategies. Dissatisfaction was associated with inadequate time and resources, need for course improvement, and lack of control over experiences. Results may aid in curriculum development.

Methods of use of calcium hexa aluminate refractory linings and/or chemical barriers in high alkali or alkaline environments

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

McGowan, Kenneth A; Cullen, Robert M; Keiser, James R

A method for improving the insulating character/and or penetration resistance of a liner in contact with at least one of an alkali and/or alkaline environments is provided. The method comprises lining a surface that is subject to wear by an alkali environment and/or an alkaline environment with a refractory composition comprising a refractory aggregate consisting essentially of a calcium hexa aluminate clinker having the formula CA.sub.6, wherein C is equal to calcium oxide, wherein A is equal to aluminum oxide, and wherein the hexa aluminate clinker has from zero to less than about fifty weight percent C.sub.12A.sub.7, and wherein greatermore » than 98 weight percent of the calcium hexa aluminate clinker having a particle size ranging from -20 microns to +3 millimeters, for forming a liner of the surface. This method improves the insulating character/and or penetration resistance of the liner.« less

Visual speech information: a help or hindrance in perceptual processing of dysarthric speech.

PubMed

Borrie, Stephanie A

2015-03-01

This study investigated the influence of visual speech information on perceptual processing of neurologically degraded speech. Fifty listeners identified spastic dysarthric speech under both audio (A) and audiovisual (AV) conditions. Condition comparisons revealed that the addition of visual speech information enhanced processing of the neurologically degraded input in terms of (a) acuity (percent phonemes correct) of vowels and consonants and (b) recognition (percent words correct) of predictive and nonpredictive phrases. Listeners exploited stress-based segmentation strategies more readily in AV conditions, suggesting that the perceptual benefit associated with adding visual speech information to the auditory signal-the AV advantage-has both segmental and suprasegmental origins. Results also revealed that the magnitude of the AV advantage can be predicted, to some degree, by the extent to which an individual utilizes syllabic stress cues to inform word recognition in AV conditions. Findings inform the development of a listener-specific model of speech perception that applies to processing of dysarthric speech in everyday communication contexts.

Ground reaction force comparison of controlled resistance methods to isoinertial loading of the squat exercise - biomed 2010.

PubMed

Paulus, David C; Reynolds, Michael C; Schilling, Brian K

2010-01-01

The ground reaction force during the concentric (raising) portion of the squat exercise was compared to that of isoinertial loading (free weights) for three pneumatically controlled resistance methods: constant resistance, cam force profile, and proportional force control based on velocity. Constant force control showed lower ground reaction forces than isoinertial loading throughout the range of motion (ROM). The cam force profile exhibited slightly greater ground reaction forces than isoinertial loading at 10 and 40% ROM with fifty-percent greater loading at 70% ROM. The proportional force control consistently elicited greater ground reaction force than isoinertial loading, which progressively ranged from twenty to forty percent increase over isoinertial loading except for being approximately equal at 85% ROM. Based on these preliminary results, the proportional control shows the most promise for providing loading that is comparable in magnitude to isoinertial loading. This technology could optimize resistance exercise for sport-specific training or as a countermeasure to atrophy during spaceflight.

Recent Ice Loss from the Fleming and Other Glaciers, Wordie Bay, West Antarctic Peninsula

NASA Technical Reports Server (NTRS)

Rignot, E.; Casassa, G.; Gogineni, S.; Kanagaratnam, P.; Krabill, W.; Pritchard, H.; Rivera, A.; Thomas, R.; Turner, J.; Vaughan, D.

2005-01-01

Satellite radar interferometry data from 1995 to 2004, and airborne ice thickness data from 2002, reveal that the glaciers flowing into former Wordie Ice Shelf, West Antarctic Peninsula, discharge 6.8 +/- 0.3 km(exp 3)/yr of ice, which is 84 +/- 30 percent larger than a snow accumulation of 3.7 +/- 0.8 km(exp 3)/yr over a 6,300 km(exp 2) drainage basin. Airborne and ICESat laser altimetry elevation data reveal glacier thinning at rates up to 2 m/yr. Fifty km from its ice front, Fleming Glacier flows 50 percent faster than it did in 1974 prior to the main collapse of Wordie Ice Shelf. We conclude that the glaciers accelerated following ice shelf removal, and have been thinning and losing mass to the ocean over the last decade. This and other observations suggest that the mass loss from the northern part of the Peninsula is not negligible at present.

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

Shahidehpour, Mohammad

Starting in October 2008, Illinois Institute of Technology (IIT), in collaboration with over 20 participating members, led an extensive effort to develop, demonstrate, promote, and commercialize a microgrid system and offer supporting technologies that will achieve Perfect Power at the main campus of IIT. A Perfect Power system, as defined by the Galvin Electricity Initiative (GEI), is a system that cannot fail to meet the electric needs of the individual end-user. The Principle Investigator of this Perfect Power project was Dr. Mohammad Shahidehpour, Director of the Robert W. Galvin Center for Electricity Innovation at IIT. There were six overall objectivesmore » of the Perfect Power project: (1) Demonstrate the higher reliability introduced by the microgrid system at IIT; (2) Demonstrate the economics of microgrid operations; (3) Allow for a decrease of fifty percent (50%) of grid electricity load; (4) Create a permanent twenty percent (20%) decrease in peak load from 2007 level; (5) Defer planned substation through load reduction; (6) Offer a distribution system design that can be replicated in urban communities.« less

Self-guided Change: The most common form of long-term, maintained health behavior change.

PubMed

Bishop, F Michler

2018-01-01

Millions of people change risky, health-related behaviors and maintain those changes. However, they often take years to change, and their unhealthy behaviors may harm themselves and others and constitute a significant cost to society. A review-similar in nature to a scoping review-was done of the literature related to long-term health behavior change in six areas: alcohol, cocaine and heroin misuse, gambling, smoking, and overeating. Based on the limited research available, reasons for change and strategies for changing and for maintaining change were also reviewed. Fifty years of research clearly indicate that as people age, in the case of alcohol, heroin and cocaine misuse, smoking, and gambling, 80-90 percent moderate or stop their unhealthy behaviors. The one exception is overeating; only 20 percent maintain their weight loss. Most of these changes, when they occur, appear to be the result of self-guided change. More ways to accelerate self-guided, health-related behavior change need to be developed and disseminated.

Vocal warm-up practices and perceptions in vocalists: a pilot survey.

PubMed

Gish, Allison; Kunduk, Melda; Sims, Loraine; McWhorter, Andrew J

2012-01-01

Investigated in a pilot study the type, duration, and frequency of vocal warm-up regimens in the singing community using a survey. One hundred seventeen participants completed an online survey. Participants included voice students from undergraduate, masters, and doctoral music programs and professional singers. Fifty-four percent of participants reported always using vocal warm-up before singing. Twenty-two percent of the participants used vocal cool down. The most preferred warm-up duration was of 5-10 minutes in duration. Despite using vocal warm-up, 26% of the participants reported experiencing voice problems. Females tended to use vocal warm-up more frequently than males. Females also tended to use longer warm-up sessions than males. Education of the participants did not appear to have any noticeable effect on the vocal warm-up practices. The most commonly used singing warm-up exercises were ascending/descending five-note scales, ascending/descending octave scales, legato arpeggios, and glissandi. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

ACA dependent coverage provision reduced high out-of-pocket health care spending for young adults.

PubMed

Busch, Susan H; Golberstein, Ezra; Meara, Ellen

2014-08-01

Since September 2010 the Affordable Care Act (ACA) has required that insurers allow children to remain as dependents on their parents' private insurance plans until age twenty-six. Studies have shown that this provision increased coverage rates among young adults. In this article we analyze whether the provision also protected young adults from large and uncertain out-of-pocket expenses. We found that the policy was associated with a statistically significant reduction in the share of young adults facing annual out-of-pocket expenditures greater than $1,500 (decreasing from 4.2 percent to 2.9 percent), compared to an increase in the proportion of their slightly older peers facing such expenditures (increasing from 4.4 percent to 5.4 percent), a net difference of -2.4 percentage points, or 57 percent. We conclude that the dependent coverage provision in the ACA provides financial protection for young adults at a time when they often face high debt burden but low wages. Project HOPE—The People-to-People Health Foundation, Inc.

Combining eastern and western practices for safe and effective endoscopic resection of large complex colorectal lesions.

PubMed

Emmanuel, Andrew; Gulati, Shraddha; Burt, Margaret; Hayee, Bu'Hussain; Haji, Amyn

2018-05-01

Endoscopic resection of large colorectal polyps is well established. However, significant differences in technique exist between eastern and western interventional endoscopists. We report the results of endoscopic resection of large complex colorectal lesions from a specialist unit that combines eastern and western techniques for assessment and resection. Endoscopic resections of colorectal lesions of at least 2 cm were included. Lesions were assessed using magnification chromoendoscopy supplemented by colonoscopic ultrasound in selected cases. A lesion-specific approach to resection with endoscopic mucosal resection or endoscopic submucosal dissection (ESD) was used. Surveillance endoscopy was performed at 3 (SC1) and 12 (SC2) months. Four hundred and sixty-six large (≥20 mm) colorectal lesions (mean size 54.8 mm) were resected. Three hundread and fifty-six were resected using endoscopic mucosal resection and 110 by ESD or hybrid ESD. Fifty-one percent of lesions had been subjected to previous failed attempts at resection or heavy manipulation (≥6 biopsies). Nevertheless, endoscopic resection was deemed successful after an initial attempt in 98%. Recurrence occurred in 15% and could be treated with endoscopic resection in most. Only two patients required surgery for perforation. Nine patients had postprocedure bleeding; only two required endoscopic clips. Ninety-six percent of patients without invasive cancer were free from recurrence and had avoided surgery at last follow-up. Combining eastern and western practices for assessment and resection results in safe and effective organ-conserving treatment of complex colorectal lesions. Accurate assessment before and after resection using magnification chromoendoscopy and a lesion-specific approach to resection, incorporating ESD where appropriate, are important factors in achieving these results.

An Assessment of Pathology Resident Access to and Use of Technology: A Nationwide Survey.

PubMed

Vallangeon, Bethany D; Hawley, Jeffrey S; Sloane, Richard; Bean, Sarah M

2017-03-01

- Current technologies including digital slide scanners and handheld devices can revolutionize clinical practice and pathology graduate medical education (GME). The extent to which these technologies are used in pathology GME is unknown. - To determine the types of technologies used, usage amount, and how they are integrated into pathology residency/fellowship programs nationwide. - A 40-question online survey for residents/fellows was developed and administered via the Research Electronic Data Capture System after institutional review board approval. - Fifty-two program directors (37%) gave permission for participation. One-hundred seventy-one responses were received (18% response rate). Most respondents have access to personal technology (laptop = 78% [134 of 171]), smartphone = 81% [139 of 171], tablet = 49% [84 of 171]), and Web-based digital slide collections (82%, 141 of 171). Few residents are provided electronic devices by their programs (laptop = 22% [38 of 171], smartphone = 0.5% [1 of 171], and tablet = 12% [21 of 171]). Fifty-nine percent have access to digital slide scanners, 33% have access to a program-created database of digitized slides, and 52% use telepathology. Fifteen percent have access to asynchronous learning. Of those with access to video-recorded conferences, 89% review them. Program size was significantly positively correlated with resident access to program-provided laptops (P = .02) and tablets (P < .001), digital slide scanners (P = .01), and telepathology (P = .001). Of all devices, program-provided laptops are used most for professional work (60.5% use this device for more than 5 hours per day). - Most residents report access to multiple types of innovative technology, but incorporation of these tools within pathology training programs is highly variable. Opportunities for incorporating innovative technologies exist and could be further explored.

Evaluation of family history of permanent hearing loss in childhood as a risk indicator in universal screening.

PubMed

Valido Quintana, Mercedes; Oviedo Santos, Ángeles; Borkoski Barreiro, Silvia; Santana Rodríguez, Alfredo; Ramos Macías, Ángel

Sixty percent of prelingual hearing loss is of genetic origin. A family history of permanent childhood hearing loss is a risk factor. The objective of the study is to determine the relationship between this risk factor and hearing loss. We have evaluated clinical and epidemiological characteristics and related nonsyndromic genetic variation. This was a retrospective, descriptive and observational study of newborns between January 2007 and December 2010 with family history as risk factor for hearing loss using transient evoked otoacoustic emissions and auditory brainstem response. A total of 26,717 children were born. Eight hundred and fifty-seven (3.2%) had family history. Fifty-seven(0.21%) failed to pass the second test. A percentage of 29.1 (n=16) had another risk factor, and 17.8% (n=9) had no classical risk factor. No risk factor was related to the hearing loss except heart disease. Seventy-six point four percent had normal hearing and 23.6% hearing loss. The mean of family members with hearing loss was 1.25. On genetic testing, 82.86% of homozygotes was normal, 11.43% heterozygosity in Connexin 26 gene (35delG), 2.86% R143W heterozygosity in the same gene and 2.86% mutant homozygotes (35delG). We found no relationship between hearing loss and mutated allele. The percentage of children with a family history and hearing loss is higher than expected in the general population. The genetic profile requires updating to clarify the relationship between hearing loss and heart disease, family history and the low prevalence in the mutations analyzed. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Interlibrary loan in US and Canadian health sciences libraries 2005: update on journal article use

PubMed Central

Lacroix, Eve-Marie; Collins, Maria Elizabeth

2007-01-01

Purpose: The authors analyzed 2.48 million interlibrary loan (ILL) requests entered in the National Library of Medicine's (NLM's) DOCLINE system from 3,234 US and Canadian medical libraries during fiscal year (FY) 2005 to study their distribution and nature and the journals in which requested articles were published. Methods: Data from DOCLINE and NLM's indexing system and online catalog were used to analyze all DOCLINE ILL transactions acted on from October 2004 to September 2005. The authors compared results from this analysis to previous data collected in FY 1992. Results: Overall ILL volume in the United States and Canada is at about the same level as FY 1992 despite marked growth in online searching, knowledge discovery tools, and journals available online. Over 21,000 unique journal titles and 1.4 million unique articles were used to fill 2.2 million ILL requests in FY 2005. Over 1 million of the articles were requested only once by any network library. Fifty-two percent (11,022) of journals had 5 or fewer requests for articles from all the years of a journal by all libraries in the network. Fifty-two percent of the articles requested were published within the most recent 5 years. Conclusion: The overall ILL profile in the libraries studied has changed little since FY 1992, notable given other changes in publishing. Small changes, however, may reveal developing trends. Total ILL traffic has been declining in recent years following a peak in 2002, and fewer of the articles requested were published in the most recent five years compared to requests from 1992. PMID:17443252

Perspectives of Immunization Program Managers on 2009-10 H1N1 Vaccination in the United States: A National Survey

PubMed Central

Seib, Katherine; Wells, Katelyn; Hannan, Claire; Orenstein, Walter A.; Whitney, Ellen A. S.; Hinman, Alan R.; Berkelman, Ruth L.; Omer, Saad B.

2012-01-01

Abstract In June and July 2010, we conducted a national internet-based survey of 64 city, state, and territorial immunization program managers (IPMs) to assess their experiences in managing the 2009-10 H1N1 influenza vaccination campaign. Fifty-four (84%) of the managers or individuals responsible for an immunization program responded to the survey. To manage the campaign, 76% indicated their health department activated an incident command system (ICS) and 49% used an emergency operations center (EOC). Forty percent indicated they shared the leadership of the campaign with their state-level emergency preparedness program. The managers' perceptions of the helpfulness of the emergency preparedness staff was higher when they had collaborated with the emergency preparedness program on actual or simulated mass vaccination events within the previous 2 years. Fifty-seven percent found their pandemic influenza plan helpful, and those programs that mandated that vaccine providers enter data into their jurisdiction's immunization information system (IIS) were more likely than those who did not mandate data entry to rate their IIS as valuable for facilitating registration of nontraditional providers (42% vs. 25%, p<0.05) and tracking recalled influenza vaccine (50% vs. 38%, p<0.05). Results suggest that ICS and EOC structures, pandemic influenza plans, collaborations with emergency preparedness partners during nonemergencies, and expanded use of IIS can enhance immunization programs' ability to successfully manage a large-scale vaccination campaign. Maintaining the close working relationships developed between state-level immunization and emergency preparedness programs during the H1N1 influenza vaccination campaign will be especially important as states prepare for budget cuts in the coming years. PMID:22360580

Risks to young volunteers in international social projects.

PubMed

Martin, Jennifer; Rieke, Burkhard; Neppach, Klemens; Hillebrandt, David; Küpper, Thomas

2012-03-01

The number of young volunteers in international social projects has increased significantly with governmental and non-governmental project support. This paper investigates the hypothesis that the preventative medical advice currently given prior to departure is inadequate because the risk profile of young persons (<30 years) differs from that of the general population. A retrospective cross-sectional study was performed with participants of international social projects. A specific questionnaire was developed; inclusion criteria were age between 18 and 30 years at departure and a duration with the project of at least 6 months. One hundred and fifty-three data sets could be evaluated. Fifty-three percent were females; the destinations were as follows: 65.4% to Asia, 14.4% to Africa, and 10.5% to Latin America. The mean age was 20 years. Ninety percent of the participants received some kind of advice in travel medicine prior to departure. The vaccination rate was quite good, but pertussis (13.7%), yellow fever (80%), typhoid fever (54%), and rabies (49.7%) should be improved when travelling to high-risk regions. Food is a very important potential source of problems as 66% receive catering by the project, 56.2% from street stalls, and 44% were regularly invited to dine with locals. In Africa, only two-thirds of the participants of projects had regular access to safe water and the sanitary facilities were also poor; 51.7% of respondents reported new sexual contacts (one to more than six new partners). In most cases, condoms were used, but there were two unintended pregnancies. We conclude that young people need to be targeted with specialized advice for health and safety while abroad. This should highlight age-specific risks compared to advice for a more general population. Vaccination status should be improved for some regions and diseases.

Risk perception and knowledge about osteoporosis: well informed but not aware? A cross-sectional study.

PubMed

Clark, Patricia; Lavielle, Pilar

2015-04-01

Identify the level of knowledge and risk perception of developing osteoporosis (OP) and its association with socio-demographic variables and risk factors. Individuals older than 18 years living in Mexico City were surveyed. The sample, which was designed to be representative of this population, was randomly selected and stratified by socioeconomic level, age, and sex. The Multiple Osteoporosis Prevention Survey, designed to assess OP-related knowledge, risk perception, was used. Four hundred and fifty-five individuals, homogeneously distributed according to defined strata, were surveyed. Almost 29 % (28.9 %) of subjects consumed tobacco, and 13.4 % had a family history of OP. Most subjects reported a lower-than-recommended calcium daily intake. Fifty-three and a half percent identified most risk factors adequately, and almost all (97.9 %) had received some sort of information about OP. Sixty-six and a half percent of subjects perceived OP as a serious disease; 51.5 % considered themselves to be personally responsible for acquiring it; 50.2 % were concerned about suffering from it; and 47.1 % considered it likely they would develop it. The most important variables associated with the perception of risk were age (<45 years), gender (female), and family history of OP. Subjects considered it more likely, more serious, and felt more worried and personally responsible about developing a heart condition or cancer than OP; they felt less concerned, less personally responsible, and less likely to contract AIDS or develop Alzheimer's. Individuals know a lot about OP, but they engage in risky behaviors and lack perception of their risk in developing it. Interventions should aim at raising awareness about personal responsibility and about the likelihood of developing this condition.

Phenotypical characteristics of idiopathic infantile nystagmus with and without mutations in FRMD7.

PubMed

Thomas, Shery; Proudlock, Frank A; Sarvananthan, Nagini; Roberts, Eryl O; Awan, Musarat; McLean, Rebecca; Surendran, Mylvaganam; Kumar, A S Anil; Farooq, Shegufta J; Degg, Chris; Gale, Richard P; Reinecke, Robert D; Woodruff, Geoffrey; Langmann, Andrea; Lindner, Susanne; Jain, Sunila; Tarpey, Patrick; Raymond, F Lucy; Gottlob, Irene

2008-05-01

Idiopathic infantile nystagmus (IIN) consists of involuntary oscillations of the eyes. The familial form is most commonly X-linked. We recently found mutations in a novel gene FRMD7 (Xq26.2), which provided an opportunity to investigate a genetically defined and homogeneous group of patients with nystagmus. We compared clinical features and eye movement recordings of 90 subjects with mutation in the gene (FRMD7 group) to 48 subjects without mutations but with clinical IIN (non-FRMD7 group). Fifty-eight female obligate carriers of the mutation were also investigated. The median visual acuity (VA) was 0.2 logMAR (Snellen equivalent 6/9) in both groups and most patients had good stereopsis. The prevalence of strabismus was also similar (FRMD7: 7.8%, non-FRMD7: 10%). The presence of anomalous head posture (AHP) was significantly higher in the non-FRMD7 group (P < 0.0001). The amplitude of nystagmus was more strongly dependent on the direction of gaze in the FRMD7 group being lower at primary position (P < 0.0001), compared to non-FRMD7 group (P = 0.83). Pendular nystagmus waveforms were also more frequent in the FRMD7 group (P = 0.003). Fifty-three percent of the obligate female carriers of an FRMD7 mutation were clinically affected. The VA's in affected females were slightly better compared to affected males (P = 0.014). Subnormal optokinetic responses were found in a subgroup of obligate unaffected carriers, which may be interpreted as a sub-clinical manifestation. FRMD7 is a major cause of X-linked IIN. Most clinical and eye movement characteristics were similar in the FRMD7 group and non-FRMD7 group with most patients having good VA and stereopsis and low incidence of strabismus. Fewer patients in the FRMD7 group had AHPs, their amplitude of nystagmus being lower in primary position. Our findings are helpful in the clinical identification of IIN and genetic counselling of nystagmus patients.

[Acute myocardial infarction in Morocco: FES-AMI registry data].

PubMed

Akoudad, H; El Khorb, N; Sekkali, N; Mechrafi, A; Zakari, N; Ouaha, L; Lahlou, I

2015-12-01

Acute myocardial infarction is the most dangerous complication of coronary atherothrombosis. There are several disparities in regard to its management around the world. The aim of this study is to analyze the specificities of management of acute myocardial infarction in Morocco. FES-AMI (Fès Acute Myocardial Infarction) is a prospective monocentric registry conducted in cardiology department of Hassan II university hospital in Fès. In this registry, we enrolled patients with acute myocardial infarction who presented within 5 days after symptom onset. From January 2005 to August 2015, we enrolled 1835 patients. Seventy-five percent of patients were males and mean age was 60 years old. Fifty-one percent of patients were smokers, 27% were hypertensives and 14% were diabetics. Sixty-six percent of patients had more than 2 risk factors. Time from symptom onset to hospital admission was less than six hours for 40% of the patients. Thirty-six percent of patients were admitted more than twelve hours after the onset of chest pain. Only 37% of patients received reperfusion therapy, 31% with in-hospital thrombolysis and 6% with primary angioplasty. In-hospital mortality was 7.6%. The patients enrolled in our registry have late presentation of acute myocardial infarction and less rate of reperfusion therapy. Furthermore, the majority of our patients have multiple risk factors and this result underlines the failure of preventive interventions. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Occupational concerns associated with regular use of microscope.

PubMed

Jain, Garima; Shetty, Pushparaja

2014-08-01

Microscope work can be strenuous both to the visual system and the musculoskeletal system. Lack of awareness or indifference towards health issues may result in microscope users becoming victim to many occupational hazards. Our objective was to understand the occupational problems associated with regular use of microscope, awareness regarding the hazards, attitude and practice of microscope users towards the problems and preventive strategies. a questionnaire based survey done on 50 professionals and technicians who used microscope regularly in pathology, microbiology, hematology and cytology laboratories. Sixty two percent of subjects declared that they were suffering from musculoskeletal problems, most common locations being neck and back. Maximum prevalence of musculoskeletal problems was noted in those using microscope for 11-15 years and for more than 30 h/week. Sixty two percent of subjects were aware of workplace ergonomics. Fifty six percent of microscope users took regular short breaks for stretching exercises and 58% took visual breaks every 15-30 min in between microscope use sessions. As many as 94% subjects reported some form of visual problem. Fourty four percent of microscope users felt stressed with long working hours on microscope. The most common occupational concerns of microscope users were musculoskeletal problems of neck and back regions, eye fatigue, aggravation of ametropia, headache, stress due to long working hours and anxiety during or after microscope use. There is an immediate need for increasing awareness about the various occupational hazards and their irreversible effects to prevent them.

An Assessment of Direct Restorative Material Use in Posterior Teeth by American and Canadian Pediatric Dentists: III. Preferred Level of Participation in Decision-making.

PubMed

Varughese, Rae E; Andrews, Paul; Sigal, Michael J; Azarpazhooh, Amir

2016-11-15

The purpose of this study was to assess Canadian and American pediatric dentists' preferred level of participation in clinical decision-making. A web-based survey was used to collect the opinions of all active Royal College of Dentists of Canada members and American Academy of Pediatric Dentistry members on the use of direct restorative materials in posterior teeth (n equals 4,648; 19.3 percent response rate). The main survey also included a domain to elicit participants' preferred role in clinical decision-making, ranging from an active role (the dentist takes the primary role in decision-making while considering patients/caregivers opinions) to a passive role (the dentist prefers to have the patient guide the decision-making). Bivariate and multivariate analyses for the preferred role and its predictor were performed (two-tailed P<0.05). Fifty-eight percent of participants preferred an active role. The passive role was chosen three times more by those who worked in a hospital-based setting (odds ratio [OR] equals 3.15, 95 percent confidence interval [CI] equals 1.13 to 8.79) or a university-based setting versus a combined setting (OR equals 3.61, 95 percent CI equals 1.11 to 11.77). The majority of participants preferred an active role in decision-making, a role that may not be consistent with a patient-centered practice that emphasizes patient autonomy in decision-making.

[Socioeconomic determinants in immigrant families].

PubMed

Benítez Robredo, T; Llerena Achútegui, P; López Giménez, R; Brugera Moreno, C; Lasheras Lozano, L

2004-01-01

In the last few years, the number of immigrant families in Spain has greatly increased, which has challenged healthcare services and posed new health problems. To determine the main social risk factors present in an immigrant population group in order to take active measures to ensure the appropriate development of children in this population. A descriptive cross-sectional study consisting of interviews with 179 foreign women with children under 1 year of age attending a public healthcare program. Most of the women were from Latin America (80 %), 11 % were from Morocco, and the remaining women were from other countries. A total of 14.5 % had university studies. In general, the women worked in domestic service and only 36 % had the documents required to live in Spain. Fifty-five percent of the women had lost their jobs because of their pregnancy. Most of the families lived in apartments with an average of 2.3 people per room, and 88 % shared their residence with other people. Twenty-five percent of the women had their first child before the age of 18 years. Pregnancy was unwanted in 50 % of the women. Seventy-one percent of deliveries were normal, and 83 % of the women breast-fed their children. Ninety-eight percent of the children were correctly vaccinated and 95 % visited a pediatrician regularly. The immigrant population is concentrated in the most disadvantaged social strata. Measures that provide adequate social support and healthcare to this population should be established to encourage the appropriate development of their children

Handbook for Handling, Storing, and Dispensing E85 and Other Ethanol-Gasoline Blends

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

This document provides information on ethanol fuel properties, standards, codes, best practices, and equipment information for those who blend, distribute, store, sell, or use E15 (gasoline blended with 10.5 percent - 15 percent ethanol), E85 (marketing term for ethanol-gasoline blends containing 51 percent - 83 percent ethanol, depending on geography and season), and other ethanol blends.

Estimated use of water in the United States in 1970

USGS Publications Warehouse

Murray, Charles Richard; Reeves, E. Bodette

1972-01-01

The average annual streamflow--simplified measure of the total available water supply--is approximately 1,200 bgd in the conterminous United States. Total water withdrawn in 1970 for off-channel uses (withdrawals other than for hydroelectric power) amounted to about 30 percent of the average annual streamflow: 7 percent of the 1,200 bgd basic supply was consumed. However, comparisons of Water Resources Council regions indicate that the rate of withdrawal was higher than the locally dependable supply in the Middle Atlantic, Texas-Gulf, Rio Grande, Lower Colorado, and California-South Pacific regions. Consumption amounted to nearly 25 percent of withdrawals in the conterminous United States; however, fresh-water consumption amounted to only 14 percent of off-channel withdrawals in the 31 Eastern States and ranged from 30 percent to nearly 70 percent of off-channel withdrawals in the Water Resources Council regions in the West. In the Rio Grande and Lower Colorado regions, fresh-water consumption in 1970 exceeded the estimated dependable supply of fresh water.

Factors Which Influence Owners When Deciding to Use Chemotherapy in Terminally Ill Pets

PubMed Central

Williams, Jane; Phillips, Catherine; Byrd, Hollie Marie

2017-01-01

Simple Summary Cancer is as common amongst pets as it in humans. Chemotherapy can be integrated into treatment regimes for terminally ill pets to attempt to shrink tumours to extend life expectancy, but it does not cure cancer and it can have negative side effects including vomiting, depression and behavioral changes. To date, little research has been undertaken to explore owners’ decisions whether or not to treat their animals with chemotherapy. Seventy-eight dog and cat owners completed an online questionnaire to determine if they would opt for chemotherapy if their pet was diagnosed with cancer, and asked how they thought their pet’s quality of life would be affected. Fifty-eight percent of respondents would not use chemotherapy largely due to their previous experience of it. Seventy-two percent over estimated pet survival time post chemotherapy, with most people believing it would lead to remission or a cure. Owners expected their pets to be less active, sleep more and play less, reducing their quality of life. Common side effects associated with chemotherapy were not rated as acceptable. The results suggest pet owners would benefit from an increased understanding of the positive and negative impacts of chemotherapy when initially discussing treatment options with the veterinary team. Abstract Chemotherapy is a commonly integrated treatment option within human and animal oncology regimes. Limited research has investigated pet owners’ treatment decision-making in animals diagnosed with malignant neoplasia. Dog and cat owners were asked to complete an online questionnaire to elucidate factors which are key to the decision making process. Seventy-eight respondents completed the questionnaire in full. Fifty-eight percent of pet owners would not elect to treat pets with chemotherapy due to the negative impact of the associated side effects. Seventy-two percent of respondents over estimated pet survival time post chemotherapy, indicating a general perception that it would lead to remission or a cure. Vomiting was considered an acceptable side effect but inappetence, weight loss and depression were considered unacceptable. Owners did expect animals’ to be less active, sleep more and play less, but common side effects were not rated as acceptable despite the potential benefits of chemotherapy. Based on the results, veterinary teams involved with oncology consultations should establish if clients have prior experience of cancer treatments and their expectations of survival time. Quality of life assessments should also be implemented during initial oncology consultations and conducted regularly during chemotherapy courses to inform client decision making and to safe guard animal welfare. PMID:28272340

The knowledge and attitudes of Thai obstetrics and gynaecology residents towards Down syndrome screening.

PubMed

Kor-anantakul, Ounjai; Awapark, Penwadee; Suwanrath, Chitkasaem; Suntharasaj, Thitima; Hanprasertpong, Tharangrut

2013-01-01

To survey the knowledge and attitudes towards Down syndrome screening in the final year of training of Thai obstetrics and gynaecology residents. A self-administered structured questionnaire of knowledge and attitudes towards Down syndrome screening was developed One hundred thirty six residents were asked to respond to the questionnaire on their last day of the Thai board examination in the year 2006 and 2007. The data was analyzed using SPSS for windows version 15.0. Eighty-two completed questionnaires surveys were returned (60% response rate). The mean total score of knowledge of Down syndrome and its screening test was 81%. Eighty percent of respondents (65/82) had positive attitudes towards counseling for screening Down syndrome for all pregnant women. Fifty-four percent (44/82) had negative attitudes towards Down syndrome screening for all pregnant women. Sixty percent (49/82) favored nuchal translucency measurement by ultrasonography for screening in the first trimester Training institutes, age, sex, and the counseling experience of residents did not affect the attitudes. The final-year Thai Obstetrics and Gynaecology residents had good knowledge and positive attitudes towards Down syndrome screening. More than half of the residents had negative attitudes towards the screening of all pregnant women. Educational programs and training are needed to address these deficiencies before screening programs are widely implemented.

Cell phone use among homeless youth: potential for new health interventions and research.

PubMed

Rice, Eric; Lee, Alex; Taitt, Sean

2011-12-01

Cell phone use has become nearly ubiquitous among adolescents in the United States. Despite the potential for cell phones to facilitate intervention, research, and care for homeless youth, no data exists to date on cell phone use among this population. In 2009, a survey of cell phone use was conducted among a non-probability sample of 169 homeless youth in Los Angeles, CA. Levels of ownership and use, instrumental uses (connecting to case workers, employers) and patterns of connecting to various network types were assessed (family, home-based peers, street-based peers). Differences in socio-demographic characteristics and cell phone ownership were assessed via t test and chi-square statistics. Sixty-two percent of homeless youth own a cell phone; 40% have a working phone. Seventeen percent used their phone to call a case manager, 36% to call either a potential or current employer. Fifty-one percent of youth connected with home-based peers on the phone and 41% connected to parents. Cell phones present new opportunities for intervention research, connecting homeless youth to family and home-based peers who can be sources of social support in times of need. Moreover, cell phones provide researchers and providers with new avenues to maintain connections with these highly transient youth.

Children and firearms in the home: a Southwestern Ohio Ambulatory Research Network (SOAR-Net) study.

PubMed

Forbis, Shalini G; McAllister, Terence R; Monk, Susan M; Schlorman, Christopher A; Stolfi, Adrienne; Pascoe, John M

2007-01-01

To ascertain the prevalence of gun ownership, gun safety education, and parental attitudes on gun counseling in a Midwestern sample. Parents seeking care at participating practices in the Southwestern Ohio Ambulatory Research Network were recruited to complete a survey about gun ownership, gun safety education, and gun counseling attitudes. Attitudes and beliefs were compared between gun owners and non-gun owners. Twenty-four percent of respondents had at least 1 gun in the home. Military families were more likely to own a gun than civilian families (28% vs 18%, P = .001). Fifty-two percent of sample children have received gun safety education. Eight percent indicated that a physician had asked about guns or discussed gun safety issues during an office visit. A majority of parents indicated that physicians should ask about guns in the home (69%) and advise parents on safe storage (75%), but they should not advise parents to remove guns from the home (12% of gun owners, 42% of non-gun owners). Despite the morbidity and mortality associated with guns, physicians in this study do not seem to be addressing this risk with families. A majority of gun owners do not agree that physicians should counsel the removal of guns from the home but agree that they should discuss safe gun storage information.

Penetrating trauma; experience from Southwest Finland between 1997 and 2011, a retrospective descriptive study.

PubMed

Inkinen, J; Kirjasuo, K; Gunn, J; Kuttila, K

2015-08-01

(1) There is lack of epidemiological data on penetrating trauma in European countries. (2) In Finland most acts of violence are performed under the influence of alcohol. The aim of this study was to determine the incidence and types of injury, treatment and survival of patients with penetrating injuries to the thorax and abdomen. This study includes two trauma centers with combined catchment area of approximately 720,000 patients. Patients were identified from patient records using ICD-10 codes. Patients were predominantly young males and they were stab victims. The average yearly incidence for penetrating trauma was 0.9/100,000 inhabitants. Thirteen percent of patients admitted gave a negative toxicology screen or breathalyzer test for alcohol. Twenty two percent of wounds were self-inflicted. Fifty five percent of patients received a chest tube and 30 patients (23%) underwent emergent thoracotomy after sustaining critical injury to the thorax. A considerable proportion (12%) of the study group also later died due to alcohol and/or violence, highlighting the psychosocial co-morbidity among penetrating trauma victims. Chest tube insertion is a skill to be mastered by any on-call physician. This simple procedure can be potentially life-saving. There is also a call for assessment of psychosocial well-being among penetrating trauma victims.

Formative assessment of oncology trainees' communication with cancer patients about internet information.

PubMed

Bylund, Carma L; Sperka, Miryam; D'Agostino, Thomas A

2015-04-01

Cancer patients and their caregivers often turn to the internet for information and support following a cancer diagnosis. Research shows a need for improvement in doctors' communication with patients about internet information. The purpose of this formative assessment was to evaluate oncology trainees' skills in talking about internet information with cancer patients. Thirty-nine oncology trainees were evaluated in a baseline standardized patient assessment as part of their participation in the Comskil Training Program. As part of the assessment, standardized patients were instructed to raise the topic of internet information they had read. Transcriptions of the video-recorded assessments were coded for patient statements and trainee responses. Fifty-six percent of trainees used a probe to get more information before addressing the content of the internet search, while 18% addressed it immediately. Eighteen percent of trainees warned the patient about using the internet, and 8% warned about and also encouraged internet use. Thirteen percent of trainees praised the patient for seeking out information on the internet. This formative assessment indicated that the majority of trainees addressed the content of the internet search, while a minority addressed the internet as a tool and praised patients' efforts. Research in this area should examine the effectiveness of educational interventions for trainees to improve discussions about internet information.

Small employer perspectives on the Affordable Care Act's premiums, SHOP exchanges, and self-insurance.

PubMed

Gabel, Jon R; Whitmore, Heidi; Pickreign, Jeremy; Satorius, Jennifer L; Stromberg, Sam

2013-11-01

Beginning January 1, 2014, small businesses having no more than fifty full-time-equivalent workers will be able to obtain health insurance for their employees through Small Business Health Options Program (SHOP) exchanges in every state. Although the Affordable Care Act intended the exchanges to make the purchasing of insurance more attractive and affordable to small businesses, it is not yet known how they will respond to the exchanges. Based on a telephone survey of 604 randomly selected private firms having 3-50 employees, we found that both firms that offered health coverage and those that did not rated most features of SHOP exchanges highly but were also very price sensitive. More than 92 percent of nonoffering small firms said that if they were to offer coverage, it would be "very" or "somewhat" important to them that premium costs be less than they are today. Eighty percent of offering firms use brokers who commonly perform functions of benefit managers--functions that the SHOP exchanges may assume. Twenty-six percent of firms using brokers reported discussing self-insuring with their brokers. An increase in the number of self-insured small employers could pose a threat to SHOP exchanges and other small-group insurance reforms.

Survey of Current Clinical and Curriculum Practices of Postgraduate Pediatric Dentistry Programs in Nonintravenous Conscious Sedation in the United States.

PubMed

Morin, Aline; Ocanto, Romer; Drukteinis, Lesbia; Hardigan, Patrick C

2016-10-15

The purposes of this study were to: (1) describe the sedation protocols of postgraduate pediatric dentistry programs (PPDPs) in the U.S.; (2) evaluate how consistent they were with current American Academy of Pediatric Dentistry sedation guidelines and Commission on Dental Accreditation (CODA) sedation curriculum requirements; (3) identify barriers to and tools for implementing these guidelines; and (4) determine the independent association between PPDPs' adherence to guidelines and the program setting. In February 2015, a 40-item questionnaire was e-mailed to all postgraduate pediatric dentistry program directors (PPDPDs) of CODA-accredited programs in the U.S. (n equals 74). Data were analyzed using descriptive statistics and Kruskal-Wallis and pairwise Nemenyi tests. Fifty-two PPDPDs responded (70 percent). Since the 2013 change in CODA sedation requirements, only a limited number of PPDPs (36 percent) were found to be noncompliant with CODA standards. PPDPDs trained at hospital-based programs were found to direct programs that were more compliant with CODA sedation standards (P<.05). A major perceived barrier to increasing the number of sedation cases was the lack of a patient pool (37 percent). Further efforts should be made by teaching institutions for programs to be compliant with American Academy of Pediatric Dentistry and Commission on Dental Accreditation sedation standards.

[A study to evaluate the lifestyle of medical students in Palermo (Italy)].

PubMed

Cerame, Giuseppe; Meli, Valentina; Vitale, Francesco; Firenze, Alberto; Viviano, Enza; Mazzucco, Walter; Romano, Nino

2008-01-01

Scientific evidence confirms that unhealthy life habits play an important role in the development of many disorders in all age groups. This study evaluated the lifestyles of 445 first-year medical students in Palermo and Caltanissetta (Italy) by using an anonymous self-administered multiple choice questionnaire Approximately 97% of participants believe that a healthy diet is either "very important" or "extremely important" but only 44% follow a healthy diet. Fifty eight percent frequently perform sports/physical activities while eight percent report being sedentary. A peak in alcohol consumption was found to generally occur in one single day of the week. Twelve percent of those interviewed report smoking regularly (14% males vs 11% females) and 23% report using or having made use of cannabinoids (32%males vs 16% females). The percentage of regular smokers who use cannabinoids was found to be 68%. A higher percentage of males with respect to females reports having had occasional sex (29% vs 5%). According to 69% of interviewed students, AIDS is the most frequent sexually transmitted infection (STD). Only 1.6% believe that genital warts are the most frequent STD. These results suggest that implementing pre-university courses regarding lifestyles and how these affect health may positively influence students' life habits and lead them to healthier life styles.

Emergency preparedness in a sample of persons with disabilities.

PubMed

Gershon, Robyn R M; Kraus, Lewis E; Raveis, Victoria H; Sherman, Martin F; Kailes, June I

2013-01-01

The objective of this study was to characterize emergency preparedness in this vulnerable population, and to ascertain the role of the personal assistant (PA) and the potential impact of prior emergency experience on preparedness efforts. Cross-sectional Internet-based survey conducted in 2011. Convenience sample. Two-hundred fifty-three community residents with cognitive and /or physical disabilities, all receiving personal assistance services. Emergency preparedness, operationalized as responses to a seven-item scale. The mean score for the emergency preparedness scale was 2.32 (SD = 2.74), range 0-7. Even though 62.8 percent (n = 159) of the participants had previously experienced one or more large-scale emergencies, only 47.4 percent (n = 120) of the entire sample and 55.3 percent (n = 88) of those with actual emergency experience reported preparing an emergency plan. Sixty-three percent (n = 76) of those reporting a plan had involved their PA in its development. Participants who reported such involvement were significantly more likely to have higher scores on the emergency preparedness scale (p < 0.001). Participants who had experienced a prior emergency were also more likely to score higher on the emergency preparedness scale (p < 0.001). In general, participants reported limited attention to other basic preparedness recommendations: only 28 percent (n = 70) had prepared a "go-bag" with necessary supplies, 29 percent (n = 74) had developed a strategy for communicating with their PA during emergencies, and 32 percent (n = 81) had stockpiled emergency supplies. Of particular importance, only 26 percent (n = 66) had made alternative back-up plans for personal assistance. Involving the PA in the planning process and experiencing an emergency were both significantly associated with higher emergency preparedness scores in this sample of people living with disabilities. However, critical deficiencies in preparedness were noted, such as lack of back-up plans for replacing their PA. Despite a concerted national effort to improve preparedness in the population of people living with disabilities, important preparedness gaps remain. These findings highlight the need for additional study on emergency preparedness barriers in people living with disabilities so that effective strategies to reduce vulnerabilities can be identified.

Navy-Wide Personnel Survey (NPS) 1992: Graphic Presentation of Results for Officers

DTIC Science & Technology

1993-08-01

DEPENDENTS? (TOTAL-OFFICERS) LIVING WITH4 NOT LIVING WITHm LEGAL WARDS WTH DEPENDENT PARENTS J 0 10 2D 30 40 so 60 70 s0 90 100 Percent NPS-92 MULTIPLE...RESPONSE QUESTION S 07 DEPENDENTS (IF HAVE MILITARY SPOUSE) BY 020 PAY GRADE (OFFICERS) LIVING : NOT LIVING E LEGAL WARDS WMT-" [Zýcwo DEPENDENT PARENTS ...SPOUSE CHILDREN WITH • CHILDREN NOT WITH LEGAL WARDS WITH PARENTS W 0 10 20 30 40 o SD o 70 o 0 1,00 Percent NPS-92 MULTIPLE RESPONSE QUESTION 08 DO

Substance Use and Dependency Disorders in Adolescent Girls in Group Living Programs: Prevalence and Associations with Milieu Factors

ERIC Educational Resources Information Center

Baker, Amy J. L.; Ashare, Caryn; Charvat, Benjamin J.

2009-01-01

Fifty-three adolescent girls residing in community-based group-living child welfare programs were administered a standardized measure (SASS-2) in order to assess probability of a substance use/dependency disorder in this highly vulnerable population. Findings revealed that one third of the sample, and one half of the nonpregnant/parenting girls,…

Oral hygiene status among orthodontic patients.

PubMed

Atassi, Farhad; Awartani, Fatin

2010-07-01

The aim of this study was to evaluate the oral hygiene status of patients with fixed orthodontic appliances. The following indices were used to evaluate the oral hygiene status of patients in orthodontic treatment: gingival bleeding index (GBI), plaque index (PI), and ortho-plaque index (OPI). A self-administrated questionnaire was prepared covering oral hygiene practice, oral hygiene cleaning aids, and number of visits to a dental hygienist. Fifty patients (15-30 years old) were selected for the study from among the orthodontic patients treated at the King Saud University College of Dentistry, Riyadh, Saudi Arabia. Results showed that the PI and OPI were high with mean scores of 65.24 (SD 16.43) and 53.56 (SD 8.74) respectively, while the average GBI was a much lower value at 19.14 (SD 7.95). No significant difference was observed between male and female patients for the PI (p=0.925) and for the OPI (p=0.072), but a significant difference was observed for the GBI at the 5 percent significance level (p=0.033). The result of OPI showed that 20 (40 percent) of the patients had fair oral hygiene, whereas 30 (60 percent) had poor oral hygiene. Only 16 (32 percent) of the participants reported visiting the dental hygienist during their orthodontic treatment, while the remaining 34 (68 percent) did not. The oral home care of the orthodontic patients surveyed was not at an optimal level, which indicated the need to establish an oral hygiene maintenance program. Inadequate oral home care among orthodontic patients may make them more prone to develop gingivitis during orthodontic treatment. It is, therefore, essential that oral hygiene instructions and a hygiene maintenance program not be overlooked during orthodontic treatment.

Once Is Not Enough: Withholding Postoperative Prophylactic Antibiotics in Prosthetic Breast Reconstruction Is Associated with an Increased Risk of Infection

PubMed Central

Clayton, John L.; Bazakas, Andrea; Lee, Clara N.; Hultman, C. Scott; Halvorson, Eric G.

2014-01-01

Background There has been a trend toward limiting perioperative prophylactic antibiotics, based on research not conducted in plastic surgery patients. The authors’ university hospital instituted antibiotic prescribing guidelines based on the Surgical Care Improvement Project. An increased rate of surgical-site infections was noted in breast reconstruction patients. The authors sought to determine whether the change in antibiotic prophylaxis regimen affected rates of surgical-site infections. Methods A retrospective study compared patients undergoing breast reconstruction who received preoperative and postoperative prophylactic antibiotics with a group who received only a single dose of preoperative antibiotic. Type of reconstruction and known risk factors for implant infection were noted. Results Two hundred fifty patients were included: 116 in the pre–Surgical Care Improvement Project group and 134 in the Surgical Care Improvement Project group. The overall rate of surgical-site infections increased from 18.1 percent to 34.3 percent (p = 0.004). Infections requiring reoperation increased from 4.3 percent to 16.4 percent (p = 0.002). Multivariate logistic regression demonstrated that patients in the Surgical Care Improvement group were 4.74 times more likely to develop a surgical-site infection requiring reoperation (95 percent CI, 1.69 to 13.80). Obesity, history of radiation therapy, and reconstruction with tissue expanders were associated with increased rates of surgical-site infection requiring reoperation. Conclusions Withholding postoperative prophylactic antibiotics in prosthetic breast reconstruction is associated with an increased risk of surgical-site infection, reoperation, and thus reconstructive failure. The optimal duration of postoperative prophylactic antibiotic use is the subject of future study. PMID:22575852

An end-of-life practice survey among clinical nephrologists associated with a single nephrology fellowship training program

PubMed Central

Ceckowski, Kevin A.; Little, Dustin J.; Merighi, Joseph R.; Browne, Teri

2017-01-01

Abstract Background Our nephrology fellowship requires specific training in recognition and referral of end-stage renal disease patients likely to benefit from palliative and hospice care. Methods To identify end-of-life (EOL) referral barriers that require greater training emphasis, we performed a cross-sectional, 17-item anonymous online survey (August–October 2015) of 93 nephrologists associated with the program since 1987. Results There was a 61% response rate (57/93 surveys). Ninety-five percent practiced clinical nephrology (54/57). Of these, 51 completed the survey (55% completion rate), and their responses were analyzed. Sixty-four percent were in practice >10 years; 65% resided in the Southern USA. Ninety-two percent felt comfortable discussing EOL care, with no significant difference between those with ≤10 versus  >10 years of practice experience (P = 0.28). Thirty-one percent reported referring patients to EOL care ‘somewhat’ or ‘much less often’ than indicated. The most frequent referral barriers were: time-consuming nature of EOL discussions (27%); difficulty in accurately determining prognosis for <6-month survival (35%); patient (63%) and family (71%) unwillingness; and patient (69%) and family (73%) misconceptions. Fifty-seven percent would refer more patients if dialysis or ultrafiltration could be performed in hospice. Some reported that local palliative care resources (12%) and hospice resources (6%) were insufficient. Conclusions The clinical nephrologists surveyed were comfortable with EOL care discussion and referral. Patient, family, prognostic and system barriers exist, and many reported lower than indicated referral rates. Additional efforts, including, but not limited to, EOL training during fellowship, are needed to overcome familial and structural barriers to facilitate nephrologist referral for EOL care. PMID:28852478

Understanding Barriers to Participation in Cost-Share Programs For Pollinator Conservation by Wisconsin (USA) Cranberry Growers.

PubMed

Gaines-Day, Hannah R; Gratton, Claudio

2017-08-01

The expansion of modern agriculture has led to the loss and fragmentation of natural habitat, resulting in a global decline in biodiversity, including bees. In many countries, farmers can participate in cost-share programs to create natural habitat on their farms for the conservation of beneficial insects, such as bees. Despite their dependence on bee pollinators and the demonstrated commitment to environmental stewardship, participation in such programs by Wisconsin cranberry growers has been low. The objective of this study was to understand the barriers that prevent participation by Wisconsin cranberry growers in cost-share programs for on-farm conservation of native bees. We conducted a survey of cranberry growers (n = 250) regarding farming practices, pollinators, and conservation. Although only 10% of growers were aware of federal pollinator cost-share programs, one third of them were managing habitat for pollinators without federal aid. Once informed of the programs, 50% of growers expressed interest in participating. Fifty-seven percent of growers manage habitat for other wildlife, although none receive cost-share funding to do so. Participation in cost-share programs could benefit from outreach activities that promote the programs, a reduction of bureaucratic hurdles to participate, and technical support for growers on how to manage habitat for wild bees.

Understanding Barriers to Participation in Cost-Share Programs For Pollinator Conservation by Wisconsin (USA) Cranberry Growers

PubMed Central

Gratton, Claudio

2017-01-01

The expansion of modern agriculture has led to the loss and fragmentation of natural habitat, resulting in a global decline in biodiversity, including bees. In many countries, farmers can participate in cost-share programs to create natural habitat on their farms for the conservation of beneficial insects, such as bees. Despite their dependence on bee pollinators and the demonstrated commitment to environmental stewardship, participation in such programs by Wisconsin cranberry growers has been low. The objective of this study was to understand the barriers that prevent participation by Wisconsin cranberry growers in cost-share programs for on-farm conservation of native bees. We conducted a survey of cranberry growers (n = 250) regarding farming practices, pollinators, and conservation. Although only 10% of growers were aware of federal pollinator cost-share programs, one third of them were managing habitat for pollinators without federal aid. Once informed of the programs, 50% of growers expressed interest in participating. Fifty-seven percent of growers manage habitat for other wildlife, although none receive cost-share funding to do so. Participation in cost-share programs could benefit from outreach activities that promote the programs, a reduction of bureaucratic hurdles to participate, and technical support for growers on how to manage habitat for wild bees. PMID:28763038

[Simultaneous kidney and pancreas transplantation (SKPT) in patients with type 1 diabetes and chronic renal failure: experience in 12 patients in Chile].

PubMed

Alba, Andrea; Morales, Jorge; Ferrario, Mario; Zehnder, Carlos; Aguiló, Jorge; Zavala, Carlos; Herzog, Cristina; Calabran, Lorena; Contreras, Luis; Espinoza, Ricardo; Buckel, Erwin; Fierro, Juan Alberto

2011-01-01

Simultaneous kidney and pancreas transplantation (SKPT) is the best alternative for end stage renal disease among patients with insulin dependent diabetes mellitus. To report our experience with SKPT. Retrospective analysis of 12 recipients of SKPT transplanted in one center starting in 1994, with a mean follow-up period of 6.8 years (2-15). Eleven of 12 recipients were in chronic hemodialysis before SKPT. Mean A, B, DR and HLA mismatch was 4.3. Mean preformed anti HLA antibodies was 3.3 %. Mean cold ischemia times for pancreas and kidney were 6 and 10 hours, respectively. In the first eight cases, the pancreas was drained to the bladder, and in the last four, an enteric drainage was performed. Eleven recipients were induced with antibodies, and maintenance immunosuppression consisted of cyclosporin or tacrolimus plus an antiproliferative agent. Ten year patient survival was 70%. Pancreas and kidney survival, defined by insulin and dialysis independence, were 72 and 73% respectively. Fifty percent of recipients experienced acute graft rejection (cellular or humoral), with good response to treatment except in one case. This experience shows that SKPT is associated with an excellent patient survival associated to insulin and dialysis independence in 70% of patients at 10 years.

Drug Use, Dependence, and Addiction at a British Columbia University: Good News and Bad News.

ERIC Educational Resources Information Center

Alexander, Bruce K.

1985-01-01

Two studies of perceived and actual drug use at Simon Fraser University found students estimating greater drug use among friends than for themselves, but 31 percent reported dependence and 5 percent reported current addiction, especially to caffeine and nicotine. An approach to drug abuse focusing on familiar substances is recommended. (MSE)

Prospective survey of veterinary practitioners’ primary assessment of equine colic: clinical features, diagnoses, and treatment of 120 cases of large colon impaction

PubMed Central

2014-01-01

Background Large colon impactions are a common cause of colic in the horse. There are no scientific reports on the clinical presentation, diagnostic tests and treatments used in first opinion practice for large colon impaction cases. The aim of this study was to describe the presentation, diagnostic approach and treatment at the primary assessment of horses with large colon impactions. Methods Data were collected prospectively from veterinary practitioners on the primary assessment of equine colic cases over a 12 month period. Inclusion criteria were a diagnosis of primary large colon impaction and positive findings on rectal examination. Data recorded for each case included history, signalment, clinical and diagnostic findings, treatment on primary assessment and final case outcome. Case outcomes were categorised into three groups: simple medical (resolved with single treatment), complicated medical (resolved with multiple medical treatments) and critical (required surgery, were euthanased or died). Univariable analysis using one-way ANOVA and Tukey’s post-hoc test, Kruskal Wallis with Dunn’s post-hoc test and Chi squared analysis were used to compare between different outcome categories. Results 1032 colic cases were submitted by veterinary practitioners: 120 cases met the inclusion criteria for large colon impaction. Fifty three percent of cases were categorised as simple medical, 36.6% as complicated medical, and 9.2% as critical. Most cases (42.1%) occurred during the winter. Fifty nine percent of horses had had a recent change in management, 43% of horses were not ridden, and 12.5% had a recent / current musculoskeletal injury. Mean heart rate was 43bpm (range 26-88) and most cases showed mild signs of pain (67.5%) and reduced gut sounds (76%). Heart rate was significantly increased and gut sounds significantly decreased in critical compared to simple medical cases (p<0.05). Fifty different treatment combinations were used, with NSAIDs (93%) and oral fluids (71%) being administered most often. Conclusions Large colon impactions typically presented with mild signs of colic; heart rate and gut sounds were the most useful parameters to distinguish between simple and critical cases at the primary assessment. The findings of seasonal incidence and associated management factors are consistent with other studies. Veterinary practitioners currently use a wide range of different treatment combinations for large colon impactions. PMID:25238179

[Behavioral risk factors of chronic non-communicable diseases in medical doctors].

PubMed

Исаева, Анна С; Резник, Лариса А; Вовченко, Марина Н; Буряковская, Алена А; Довганюк, Инна Э

Introdukcion: Group of chronic communicable disease is the main cause of mobility and mortality in industrially and development countries. The same behavioral risk factors are in the basis of these diseases. On the one side medical doctors are completely aware about risk factors management, from the other side, they are mainly unable to maintain healthy life style. The aim of the present study was to assess behavioral risk factors in medical doctors and awareness of need to maintain healthy life style. Fifty one medical doctors of different specialties were included in the study. Anthropometric parameters (high, weight, waist circumference, body mass index, body composition, smoking status, nutrition habits, sleep quality and physical activity were studied. The body composition was assessed with Omron Body Composition Monitor BF511. Physical activity was measurement by pedometer Omron Walking style III step counter HJ-203-EK. The status of smoking, nutrition habits and sleep quality were analyzed with standardized questionnaires. Materials and Methods:Fifty one medical doctors of different specialties were included in the study. Anthropometric parameters (high, weight, waist circumference, body mass index, body composition, smoking status, nutrition habits, sleep quality and physical activity were studied. The body composition was assessed with Omron Body Composition Monitor BF511. Physical activity was measurement by pedometer Omron Walking style III step counter HJ-203-EK. The status of smoking, nutrition habits and sleep quality were analyzed with standardized questionnaires. Results: very low level of physical activity was found in medical doctors. Median of steps per day in male subjects was8462 [5742÷10430] and 7479 [5574÷10999] in female. Such physical activity was associated with overweight; low muscular and high fat tissue as well as with increased level of visceral fat. Different sleep disorders and associated day symptoms were detected in investigated medical doctors. Absence of continuous sleep and early awakenings dominated between diagnosed sleep disorders. Fifty three percent of women and 47 percent of men had early awakenings. Conclusions: the main part of medical doctors in present study had low physical activity, sleep disorders and unhealthy nutrition behavior. So, special programs designed for medical professionals are needed to correct risk of chronic non-communicable disease related to behavioral factors.

Effects of coffee processing residues on anaerobic microorganisms and corresponding digestion performance.

PubMed

Rojas-Sossa, Juan Pablo; Murillo-Roos, Mariana; Uribe, Lidieth; Uribe-Lorio, Lorena; Marsh, Terence; Larsen, Niels; Chen, Rui; Miranda, Alberto; Solís, Kattia; Rodriguez, Werner; Kirk, Dana; Liao, Wei

2017-12-01

The objective of this study was to delineate the effects of different coffee processing residues on the anaerobic microbes and corresponding digestion performance. The results elucidated that mucilage-rich feed enhanced the accumulation of methanogens, which consequently led to better digestion performance of biogas production. Fifty percent more methane and up to 3 times more net energy (heat and electricity) output were achieved by the digestion of the mucilage-rich feed (M3). The microbial community and statistical analyses further elucidated that different residues in the feed had significant impact on microbial distribution and correspondingly influenced the digestion performance. Copyright © 2017 Elsevier Ltd. All rights reserved.

Outcomes of a Freedom of Choice Reform in Community Mental Health Day Center Services.

PubMed

Eklund, Mona; Markström, Urban

2015-11-01

A freedom-of-choice reform within mental health day center services was evaluated. The reform aimed to (1) facilitate users' change between units and (2) increase the availability of service providers. Seventy-eight users responded to questionnaires about the reform, empowerment, social network, engagement and satisfaction and were followed-up after 15 months. Fifty-four percent knew about the reform. A majority stated the reform meant nothing to them; ~25 % had a negative and ~20 % a positive opinion. Satisfaction with the services had decreased after 15 months. Empowerment decreased for a more intensively followed subgroup. No positive consequences of the reform could thus be discerned.

Lip cancer in Zimbabwe. Report of 14 cases.

PubMed

Chidzonga, M M

2005-03-01

Lip cancer, relatively common among fair-skinned males, is uncommon among Black-skinned males. In a 10-year review period of 358 Black African patients with orofacial squamous cell carcinoma, 3.9% (n = 14) were found on the lip with a male to female ratio of 2.5:1. Fifty percent (n = 7) of the patients were albinos and two were children with xeroderma pigmentosum. The lower lip was most commonly affected (78.6%). The well-differentiated and moderately differentiated histopathologic types each comprised 42.9% of the lesions. Alcohol consumption and tobacco usage was admitted to in 42.9% (n = 6) of the patients.

Attitudes towards HPV immunization of Italian mothers of adolescent girls and potential role of health professionals in the immunization program.

PubMed

Tozzi, Alberto E; Ravà, Lucilla; Stat, D; Pandolfi, Elisabetta; Marino, Maria G; Ugazio, Alberto G

2009-04-28

We assessed the knowledge of Italian mothers of adolescent girls about HPV and HPV vaccination, their willingness to immunize their daughters, and their perception of the role of different medical specialists in the HPV immunization strategy by a telephone interview. Fifty-four percent of the 807 interviewed mothers reported to have ever heard about HPV, and 84% of them were willing to immunize their daughters. Pediatricians most frequently provided information on HPV vaccine (31%), and were perceived as the preferred immunization providers (77%). Acceptance of HPV immunization was high and was not associated with knowledge of HPV.

Laboratory stress: what causes it?

PubMed

Griffin, P; Klun, C L

1980-07-01

One hundred-fifty questionnaires were distributed to gather specific information about the causes of stress in the hospital-employed medical technologist (MT). Sixty-four percent were returned. The results were analyzed using Friedman's two-way analysis of variance by ranks. Although the causes of stress to the medical laboratorian are many and they are affected by variables within the worker, certain items are more significant causes of stress than others. Physicians, stats, the need for accuracy, lack of communication, errors, and overwork are major causes of stress. These are the stressors that must be controlled or modified to reduce stress to the MT employed in a hospital laboratory.

Lower extremity lawn-mower injuries in children.

PubMed

Farley, F A; Senunas, L; Greenfield, M L; Warschausky, S; Loder, R T; Kewman, D G; Hensinger, R N

1996-01-01

Lower extremity lawn-mower injuries in children result in significant morbidity with a significant financial burden to the family and society. We reviewed 24 children with lower extremity lawn-mower injuries; all mothers completed standardized psychologic assessments of their children, and 18 children were interviewed. Fifty percent of the mothers had defensive profiles on the standardized psychologic assessment, suggesting the likelihood of denial or underreporting of the child's psychologic difficulties. Therefore, we found the interview with the child to be a more accurate measure of psychologic distress. Prevention measures aimed at parents must emphasize that a child must not be allowed in a yard that is being mowed with a riding mower.

Old women's self perceptions of dependency and some implications for service provision.

PubMed Central

Evers, H

1984-01-01

Fifty women aged 75 years or older who were living alone were visited to determine their self perception of dependency. There was a wide variety in reported capacity for self care but two patterns are isolated: those who were active initiators with a self perception of independence and passive responders with a perception of dependence. Service providers should take cognisance of the woman's self perception in the effective delivery of services. PMID:6512483

Dependence of hydrogen arcjet operation on electrode geometry

NASA Technical Reports Server (NTRS)

Pencil, Eric J.; Sankovic, John M.; Sarmiento, Charles J.; Hamley, John A.

1992-01-01

The dependence of 2kW hydrogen arcjet performance on cathode to anode electrode spacing was evaluated at specific impulses of 900 and 1000 s. Less than 2 absolute percent change in efficiency was measured for the spacings tested which did not repeat the 14 absolute percent variation reported in earlier work with similar electrode designs. A different nozzle configuration was used to quantify the variation in hydrogen arcjet performance over an extended range of electrode spacing. Electrode gap variation resulted in less than 3 absolute percent change in efficiency. These null results suggested that electrode spacing is decoupled from hydrogen arcjet ignition. The dependence of breakdown voltage on mass flow rate and electrode agreed with Paschen curves for hydrogen. Preliminary characterization of the dependence of hydrogen arcjet ignition on rates of pulse repetition and pulse voltage rise were also included for comparison with previous results obtained using simulated hydrazine.

JCAHO gets lukewarm reviews from its CEO opinion survey.

PubMed

Koska, M T

1990-05-05

CEOs from 923 hospitals gave the JCAHO mixed reviews in a recent survey: 38 percent thought JCAHO's performance had improved over the past five years; 26 percent thought it had worsened; and 27 percent saw no change. Depending upon who you talk to, the results are either good or bad.

Endocrine Dysfunction in Diamond-Blackfan Anemia (DBA): A Report from the DBA Registry (DBAR).

PubMed

Lahoti, Amit; Harris, Yael T; Speiser, Phyllis W; Atsidaftos, Evangelia; Lipton, Jeffrey M; Vlachos, Adrianna

2016-02-01

Diamond-Blackfan anemia (DBA) is a rare inherited bone marrow failure syndrome. The mainstays of treatment involve chronic red cell transfusions, long-term glucocorticoid therapy, and stem cell transplantation. Systematic data concerning endocrine function in DBA are limited. We studied patients in the DBA Registry (DBAR) of North America to assess the prevalence of various endocrinopathies. In a pilot study, retrospective data were collected for 12 patients with DBA. Subsequently, patients with DBA aged 1-39 years were recruited prospectively. Combined, 57 patients were studied; 38 chronically transfused, 12 glucocorticoid-dependent, and seven in remission. Data were collected on anthropometric measurements, systematic screening of pituitary, thyroid, parathyroid, adrenal, pancreatic, and gonadal function, and ferritin levels. Descriptive statistics were tabulated and group differences were assessed. Fifty-three percent of patients had ≥ 1 endocrine disorder, including adrenal insufficiency (32%), hypogonadism (29%), hypothyroidism (14%), growth hormone dysfunction (7%), diabetes mellitus (2%), and/or diabetes insipidus (2%). Ten of the 33 patients with available heights had height standard deviation less than -2. Low 25-hydroxy vitamin D (25(OH)D) levels were present in 50%. A small proportion also had osteopenia, osteoporosis, or hypercalciuria. Most with adrenal insufficiency were glucocorticoid dependent; other endocrinopathies were more common in chronically transfused patients. Endocrine dysfunction is common in DBA, as early as the teenage years. Although prevalence is highest in transfused patients, patients taking glucocorticoids or in remission also have endocrine dysfunction. Longitudinal studies are needed to better understand the etiology and true prevalence of these disorders. © 2015 Wiley Periodicals, Inc.

Therapeutic activity of glycoengineered anti-GM2 antibodies against malignant pleural mesothelioma

PubMed Central

Li, Qi; Wang, Wei; Machino, Yusuke; Yamada, Tadaaki; Kita, Kenji; Oshima, Masanobu; Sekido, Yoshitaka; Tsuchiya, Mami; Suzuki, Yui; Nan-ya, Ken-ichiro; Iida, Shigeru; Nakamura, Kazuyasu; Iwakiri, Shotaro; Itoi, Kazumi; Yano, Seiji

2015-01-01

Malignant pleural mesothelioma (MPM) is a rare and highly aggressive neoplasm that arises from the pleural, pericardial, or peritoneal lining. Although surgery, chemotherapy, radiotherapy, and combinations of these therapies are used to treat MPM, the median survival of such patients is dismal. Therefore, there is a compelling need to develop novel therapeutics with different modes of action. Ganglioside GM2 is a glycolipid that has been shown to be overexpressed in various types of cancer. However, there are no published reports regarding the use of GM2 as a potential therapeutic target in cases of MPM. In this study, we evaluated the efficacy of the anti-GM2 antibody BIW-8962 as an anti-MPM therapeutic using in vitro and in vivo assays. Consequently, the GM2 expression in the MPM cell lines was confirmed using flow cytometry. In addition, eight of 11 cell lines were GM2-positive (73%), although the GM2 expression was variable. BIW-8962 showed a significant antibody-dependent cellular cytotoxicity activity against the GM2-expressing MPM cell line MSTO-211H, the effect of which depended on the antibody concentration and effector/target ratio. In an in vivo orthotropic mouse model using MSTO-211H cells, BIW-8962 significantly decreased the incidence and size of tumors. Additionally, the GM2 expression was confirmed in the MPM clinical specimens. Fifty-eight percent of the MPM tumors were positive for GM2, with individual variation in the intensity and frequency of staining. These data suggest that anti-GM2 antibodies may become a therapeutic option for MPM patients. PMID:25421609

Acute and preventive management of anaphylaxis in German primary school and kindergarten children.

PubMed

Kilger, Magdalena; Range, Ursula; Vogelberg, Christian

2015-10-15

Anaphylaxis is a severe, life-threatening situation. However, little is known about real-life anaphylactic management in children, especially in kindergarten and school settings, where a large number of anaphylaxes take place. Parents, school teachers and child-care providers of 86 primary schools and kindergartens in the city of Dresden, Germany, received questionnaires to report their experience with anaphylaxis in children. The main foci of interest were symptoms, allergens, sites of occurrence, acute treatment and emergency sets. Out of 6352 returned questionnaires, 87 cases of anaphylaxis were identified. Prevalence was calculated at 1.5%. Average age of the patients was 7 years, 58% were boys. The majority of reactions occurred at home (67%/58 children). Fourty seven percent (41 children) had recurrent episodes of anaphylaxis. Eighty two percent (71 children) showed cutaneous symptoms, 40% (35 children) respiratory symptoms, 29% (25 children) gastrointestinal symptoms, and 3.4% (3 children) cardiovascular symptoms. Fourty seven percent were classified as mild reactions. Foods were the most common cause (60%/52 cases). Out of these 52, tree-nuts (23%/12 cases) and peanuts (16%/8 cases) were the most frequent triggers. Sixty percent (52 cases) of reactions were treated by a physician, 35% (30 cases) were treated by non-medical professionals only. Fifty one percent (44 children) received antihistamines, 37% (32 children) corticosteroids, 1% (1 child) intramuscular adrenaline. Sixty one percent of children (53 cases) received an emergency kit. Content were corticosteroids (70%/37 cases) and antihistamines (62%/33 cases). Adrenaline auto-injectors were prescribed to 26% (14 cases). Concerning school and kindergarten-staff, 13% of the child-care providers had no knowledge about the emergency kit's content, compared to 34% of teachers. This study might support the impression of severe under-treatment of anaphylactic children in the use of adrenaline and prescription of incomplete equipped emergency sets. Knowledge of school and kindergarten staff must be improved through enhanced education.

75 FR 54001 - Fifty-Second Meeting: RTCA Special Committee 186: Automatic Dependent Surveillance-Broadcast (ADS-B)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-02

... unless stated otherwise. ADDRESSES: The meeting will be held at the Dutch National Aerospace Laboratory... Items/Work Programs. Adjourn Plenary. Attendance is open to the interested public but limited to space...

Antibiotic resistance and population structure of cystic fibrosis Pseudomonas aeruginosa isolates from a Spanish multi-centre study.

PubMed

López-Causapé, Carla; de Dios-Caballero, Juan; Cobo, Marta; Escribano, Amparo; Asensio, Óscar; Oliver, Antonio; Del Campo, Rosa; Cantón, Rafael; Solé, Amparó; Cortell, Isidoro; Asensio, Oscar; García, Gloria; Martínez, María Teresa; Cols, María; Salcedo, Antonio; Vázquez, Carlos; Baranda, Félix; Girón, Rosa; Quintana, Esther; Delgado, Isabel; de Miguel, María Ángeles; García, Marta; Oliva, Concepción; Prados, María Concepción; Barrio, María Isabel; Pastor, María Dolores; Olveira, Casilda; de Gracia, Javier; Álvarez, Antonio; Escribano, Amparo; Castillo, Silvia; Figuerola, Joan; Togores, Bernat; Oliver, Antonio; López, Carla; de Dios Caballero, Juan; Tato, Marta; Máiz, Luis; Suárez, Lucrecia; Cantón, Rafael

2017-09-01

The first Spanish multi-centre study on the microbiology of cystic fibrosis (CF) was conducted from 2013 to 2014. The study involved 24 CF units from 17 hospitals, and recruited 341 patients. The aim of this study was to characterise Pseudomonas aeruginosa isolates, 79 of which were recovered from 75 (22%) patients. The study determined the population structure, antibiotic susceptibility profile and genetic background of the strains. Fifty-five percent of the isolates were multi-drug-resistant, and 16% were extensively-drug-resistant. Defective mutS and mutL genes were observed in mutator isolates (15.2%). Considerable genetic diversity was observed by pulsed-field gel electrophoresis (70 patterns) and multi-locus sequence typing (72 sequence types). International epidemic clones were not detected. Fifty-one new and 14 previously described array tube (AT) genotypes were detected by AT technology. This study found a genetically unrelated and highly diverse CF P. aeruginosa population in Spain, not represented by the epidemic clones widely distributed across Europe, with multiple combinations of virulence factors and high antimicrobial resistance rates (except for colistin). Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

Electronic Cigarette Retail Outlets and Proximity to Schools.

PubMed

Hahn, Ellen J; Begley, Kathy; Gokun, Yevgeniya; Johnson, Andrew O; Mundy, Monica E; Rayens, Mary Kay

2015-01-01

To compare the retail distribution and density per population of electronic and conventional cigarettes in smoke-free communities with and without e-cigarette restrictions. A cross-sectional study with field observations of retail tobacco stores. Two Central Kentucky counties with 100% smoke-free workplace regulations; counties selected on the basis of whether e-cigarette use was restricted. Fifty-seven tobacco retailers in two counties, including conventional retailers and stand-alone e-cigarette stores. Type and location of store and products sold; addresses of stores and schools geocoded with ArcGIS. Bivariate comparisons between counties, rates and confidence intervals for frequency of tobacco retailers and e-cigarette stores per population. Fifty-three percent of tobacco retailers sold e-cigarettes. E-cigarette availability did not differ by whether smoke-free regulation covered e-cigarettes. Rates of tobacco retailers and e-cigarette distributors per 10,000 were 8.29 and 4.40, respectively, in the two-county area. Of the 40 schools, 88% had a tobacco retailer and 68% had an e-cigarette distributor within 1 mile. In this exploratory study, e-cigarette use restriction was not related to store availability. For a relatively new product, e-cigarettes were readily available in retail outlets and close to schools.

75 FR 14482 - Fifty-First Meeting: RTCA Special Committee 186: Automatic Dependent Surveillance-Broadcast (ADS-B)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-25

..., WG-1, Wake Vortex, ARINC Room. RTCA--All Day, WG-4, Application Technical Requirements, Colson Board... Vortex, MacIntosh-NBAA Room & Hilton-ATA Room. RTCA--All Day, WG-4, Application Technical Requirements...

Paddle-boarding: Fun, New Sport or an Accident Waiting to Happen?

PubMed Central

Waydia, Shree-Eesh; Woodacre, Timothy

2016-01-01

Background Stand-up paddle-boarding is an increasingly popular water sport; however no published data to our knowledge exists on the nature and type of injuries sustained in this sport. Objectives This study aims to describe the frequency, pattern, and mechanism of paddle-boarding injuries. Materials and Methods Descriptive data of paddle-boarding injuries were collected using an interactive website-based, multiple-choice survey. Data were collected from May 2012 over a 6-month period. Results Completed surveys were obtained from 142 individuals, 20 paddle-boarders reporting 18 injuries and 122 surfers reporting 4 paddleboard-related injuries. Fifty percent of responding paddle-boarders reported an injury. For all injuries sustained paddle-boarding, sprains accounted for 50% (n = 9), lacerations for 22% (n = 4), contusions 17% (n = 3) and fractures 5% (n = 1). Seventy-eight percent of injuries were to the lower extremity, and 17% to the head and neck. Seventeen percent (n = 3) sustained recurrent injuries, 2 sustained 2 twisting knee injuries resulting in sprains, one sustained > 3 ankle injuries, resulting in sprains. Seventeen percent of injuries resulted from contact with one’s own paddle-board, 17% from another paddle-board, and 5% from the sea floor. Conclusions All paddle-boarding injuries were sustained by individuals who surf waves on a paddle-board, rather than paddle on calm water. Despite concerns, paddle-board related injuries only accounted for 1% of 326 injuries suffered by surfers. We suggest equipment and practice modifications that may decrease the risk for injury and challenge the anecdotal theory that paddle-boarding injuries are sustained due to inexperience. PMID:28180114

The newborn butterfly project: a shortened treatment protocol for ear molding.

PubMed

Doft, Melissa A; Goodkind, Alison B; Diamond, Shawn; DiPace, Jennifer I; Kacker, Ashutosh; LaBruna, Anthony N

2015-03-01

Secondary to circulating maternal estrogens, a baby's ear cartilage is unusually plastic during the first few weeks of life, providing an opportunity to correct ear deformities by molding. If molding is initiated during the first days of life with a more rigid molding system than previously described in the literature, the authors hypothesized that treatment time would be reduced and the correction rate would increase. An interdisciplinary team identified and assessed all infants born with ear deformities at New York-Presbyterian Hospital/Weill Cornell Medical Center. The authors conducted a prospective, institutional review board-approved study on the first consecutive 100 infants identified. Parents were surveyed initially, immediately after treatment, and at 6 and 12 months. One hundred fifty-eight ears in 96 patients underwent ear molding using the EarWell Infant Ear Correction System. Eighty-two percent of the children had the device placed in the newborn nursery and 95 percent had it placed before 2 weeks of life. Average treatment time was 14 days, and 96 percent of the deformities were corrected. Complications were limited to mild pressure ulcerations. Ninety-nine percent of parents stated that they would have the procedure repeated. The molding period can be reduced from 6 to 8 weeks to 2 weeks by initiating molding during the first weeks of life and using a more secure and rigid device. Through an interdisciplinary approach, the authors were able to identify patients and to correct the deformity earlier and faster than has been previously published, eliminating the need for surgical correction in many children. Therapeutic, IV.

Early Integration of Palliative Care in Oncology Practice: Results of the Italian Association of Medical Oncology (AIOM) Survey.

PubMed

Zagonel, Vittorina; Torta, Riccardo; Franciosi, Vittorio; Brunello, Antonella; Biasco, Guido; Cattaneo, Daniela; Cavanna, Luigi; Corsi, Domenico; Farina, Gabriella; Fioretto, Luisa; Gamucci, Teresa; Lanzetta, Gaetano; Magarotto, Roberto; Maltoni, Marco; Mastromauro, Cataldo; Melotti, Barbara; Meriggi, Fausto; Pavese, Ida; Piva, Erico; Sacco, Cosimo; Tonini, Giuseppe; Trentin, Leonardo; Ermacora, Paola; Varetto, Antonella; Merlin, Federica; Gori, Stefania; Cascinu, Stefano; Pinto, Carmine

2016-01-01

Early integration of palliative care in oncology practice ("simultaneous care", SC) has been shown to provide better care resulting in improved quality-of-life and also survival. We evaluated the opinions of Italian Association of Medical Oncology (AIOM) members. A 37-item questionnaire was delivered to 1119 AIOM members. Main areas covered were: social, ethical, relational aspects of disease and communication, training, research, organizational and management models in SC. Three open questions explored the definition of Quality of Life, Medical Oncologist and Palliative Care. Four hundred and forty-nine (40.1%) medical oncologists returned the questionnaires. Forty-nine percent stated they address non-curability when giving a diagnosis of metastatic tumor, and 43% give the information only to patients who clearly ask for it. Fifty-five percent say the main formative activity in palliative medicine came from attending meetings and 90% agree that specific palliative care training should be part of the core curriculum in oncology. Twenty-two percent stated they consulted guidelines for symptom management, 45% relied upon personal experience and 26% make a referral to a palliative care specialist. Seventy-four percent were in favor of more research in palliative medicine. An integration between Units of Oncology and Palliative Care Services early in the course of advanced disease was advocated by 86%. Diverse and multifaceted definitions were given for the concepts of Quality of Life, Palliative Care and Medical Oncologist. SC is felt as an important task, as well as training of medical oncologists in symptom management and research in this field.

Internet and computer access and use for health information in an underserved community.

PubMed

Kind, Terry; Huang, Zhihuan J; Farr, Deeonna; Pomerantz, Karyn L

2005-01-01

The "digital divide" is the gap between those with access to information tools such as the Internet and those without access. The gap has been described by income, education, age, and race. Little information exists on computer and Internet access and use for health information by parents, particularly among populations of low income and low education level. To describe computer and Internet access and use, including health information retrieval, among low-income, urban, African American caregivers (parents). Cross-sectional survey administered in pediatric waiting rooms of urban community-based health centers in a low-income area. Caregivers of pediatric outpatients. Access to computers, Internet access, and use of Internet for health information. In 2003, among 260 African Americans who completed surveys, 58% had a computer and 41% had home Internet access. Fifty-two percent had used the Internet for finding health information. Ninety-three percent agreed or strongly agreed that there is useful health information on the Internet. Ninety-two percent agreed or strongly agreed that they would want to talk with a medical professional about health information on the Internet. Sixty-five percent of respondents had no additional schooling after high school. Annual household income was

Perspectives of Orthopedic Surgeons on Racial/Ethnic Disparities in Care.

PubMed

Adelani, Muyibat A; O'Connor, Mary I

2017-08-01

Racial/ethnic disparities in healthcare, including orthopedics, have been extensively documented. However, the level of knowledge among orthopedic surgeons regarding racial/ethnic disparities is unknown. The purpose of this study is to determine the views of orthopedic surgeons on (1) the extent of racial/ethnic disparities in orthopedic care, (2) patient and system factors that may contribute, and (3) the potential role of orthopedic surgeons in the reduction of disparities. Three hundred five members of the American Orthopaedic Association completed a survey to assess their knowledge of racial/ethnic disparities and their perceptions about the underlying causes. Twelve percent of respondents believe that patients often receive different care based on race/ethnicity in healthcare in general, while 9 % believe that differences exist in orthopedic care in general, 3 % believe that differences exist within their hospitals/clinics, and 1 % reported differences in their own practices. Despite this, 68 % acknowledge that there is evidence of disparities in orthopedic care. Fifty-one percent believe that a lack of insurance significantly contributes to disparities. Thirty-five percent believe that diversification of the orthopedic workforce would be a "very effective" strategy in addressing disparities, while 25 % percent believe that research would be "very effective" and 24 % believe that surgeon education would be "very effective." Awareness regarding racial/ethnic disparities in musculoskeletal care is low among orthopedic surgeons. Additionally, respondents were more likely to acknowledge disparities within the practices of others than their own. Increased diversity, research, and education may help improve knowledge of this problem.

An Internet survey of marijuana and hot shower use in adults with cyclic vomiting syndrome (CVS).

PubMed

Venkatesan, Thangam; Sengupta, Jyotirmoy; Lodhi, Atena; Schroeder, Abigail; Adams, Kathleen; Hogan, Walter J; Wang, Yanzhi; Andrews, Christopher; Storr, Martin

2014-08-01

Cyclic vomiting syndrome (CVS) is a chronic disorder characterized by episodic nausea and vomiting. A large proportion of patients use marijuana to control their symptoms. Several case reports implicate marijuana as a cause of intractable vomiting with compulsive hot water bathing considered pathognomonic of "cannabinoid hyperemesis." We sought to examine the relationship between marijuana use and CVS. Patients >18 years of age diagnosed by a health care provider were invited to participate in an anonymous internet-based survey. A total of 514 patients participated and 437 completed questions about marijuana use. Mean age was 34 ± 12 years with patients being predominantly female (63%), Caucasian (92%) and from the USA (82%). Nineteen percent never used marijuana and 81% did. Fifty-four percent used marijuana for health issues and 43% for recreational purposes. Users stated that it improved nausea, appetite, general well-being, stress levels and vomiting. Users were more likely to be male and have an associated anxiety disorder. Sixty-seven percent of patients reported taking hot showers/baths for symptom relief, and this was associated with marijuana use. (OR 2.54, CI 1.50-4.31, P = 0.0006). Eighty-one percent of patients with CVS who completed an internet survey reported frequent use of marijuana. With marijuana use, patients noted the greatest improvement with stress levels, appetite and nausea. Marijuana users were more likely to be male and have associated anxiety. Hot showers were not pathognomonic of marijuana use though they were more likely to be associated with its use.

Gender issues in clinical dental education.

PubMed

Tiwana, Karen K; Kutcher, Mark J; Phillips, Ceib; Stein, Margot; Oliver, Jessica

2014-03-01

In spring 2011, a study was initiated to investigate the nature and extent of gender issues in clinical dental education at the University of North Carolina at Chapel Hill School of Dentistry. Surveys were sent to 236 dental students in the second, third, and fourth years; eighty-six (36.4 percent) responded. Surveys were also sent to seventy-one full-time dental faculty members who had clinical contact with students, and thirty-four (47.9 percent) responded. Of the student respondents, fifty-one were female and thirty-five were male; the faculty respondents were ten women and twenty-four men. A significantly greater proportion of female than male student respondents reported that issues related to gender affected clinical training. The female students also responded that mentorship was less available and less in content for them compared to males, and significantly more female than male students reported lower self-confidence in clinical settings. Among faculty respondents, a higher proportion of women than men reported insufficient awareness of gender issues. These faculty members also reported thinking that female students showed more empathy toward patients than males. Both faculty and student respondents said that female faculty members received less respect from students than did male faculty members. Forty-eight percent of the students reported experiencing or witnessing gender-based prejudice in clinical settings, and 7.0 percent reported experiencing or witnessing unwelcome sexual advances or conduct. A more robust study to include other dental institutions is needed. With confirmation of specific gender issues, corrective measures could be recommended to improve the climate for both females and males in the clinical component of dental education.

Barriers and facilitators influencing ethical evaluation in health technology assessment.

PubMed

Assasi, Nazila; Schwartz, Lisa; Tarride, Jean-Eric; O'Reilly, Daria; Goeree, Ron

2015-01-01

The objective of this study was to explore barriers and facilitators influencing the integration of ethical considerations in health technology assessment (HTA). The study consisted of two complementary approaches: (a) a systematic review of the literature; and (b) an eighteen-item online survey that was distributed to fifty-six HTA agencies affiliated with the International Network of Agencies for Health Technology Assessment. The review identified twenty-six relevant articles. The most often cited barriers in the literature were: scarcity, heterogeneity and complexity of ethical analysis methods; challenges in translating ethical analysis results into knowledge that is useful for decision makers; and lack of organizational support in terms of required expertise, time and financial resources. The most frequently cited facilitators included: usage of value-based appraisal methods, stakeholder and public engagement, enhancement of practice guidelines, ethical expertise, and educational interventions. Representatives of twenty-six (46.5 percent) agencies from nineteen countries completed the survey. A median of 10 percent (interquartile range, 5 percent to 50 percent) of the HTA products produced by the agencies was reported to include an assessment of ethical aspects. The most commonly perceived barriers were: limited ethical knowledge and expertise, insufficient time and resources, and difficulties in finding ethical evidence or using ethical guidelines. Educational interventions, demand by policy makers, and involvement of ethicists in HTA were the most commonly perceived facilitators. Our results emphasize the importance of simplification of ethics methodology and development of good practice guidelines in HTA, as well as capacity building for engaging HTA practitioners in ethical analyses.

The Natural History of Flare-Ups in Fibrodysplasia Ossificans Progressiva (FOP): A Comprehensive Global Assessment.

PubMed

Pignolo, Robert J; Bedford-Gay, Christopher; Liljesthröm, Moira; Durbin-Johnson, Blythe P; Shore, Eileen M; Rocke, David M; Kaplan, Frederick S

2016-03-01

Fibrodysplasia ossificans progressiva (FOP) leads to disabling heterotopic ossification (HO) from episodic flare-ups. However, the natural history of FOP flare-ups is poorly understood. A 78-question survey on FOP flare-ups, translated into 15 languages, was sent to 685 classically-affected patients in 45 countries (six continents). Five hundred patients or knowledgeable informants responded (73%; 44% males, 56% females; ages: 1 to 71 years; median: 23 years). The most common presenting symptoms of flare-ups were swelling (93%), pain (86%), or decreased mobility (79%). Seventy-one percent experienced a flare-up within the preceding 12 months (52% spontaneous; 48% trauma-related). Twenty-five percent of those who had received an intramuscular injection reported an immediate flare-up at the injection site, 84% of whom developed HO. Axial flare-ups most frequently involved the back (41.6%), neck (26.4%), or jaw (19.4%). Flare-ups occurred more frequently in the upper limbs before 8 years of age, but more frequently in the lower limbs thereafter. Appendicular flare-ups occurred more frequently at proximal than at distal sites without preferential sidedness. Seventy percent of patients reported functional loss from a flare-up. Thirty-two percent reported complete resolution of at least one flare-up and 12% without any functional loss (mostly in the head or back). The most disabling flare-ups occurred at the shoulders or hips. Surprisingly, 47% reported progression of FOP without obvious flare-ups. Worldwide, 198 treatments were reported; anti-inflammatory agents were most common. Seventy-five percent used short-term glucocorticoids as a treatment for flare-ups at appendicular sites. Fifty-five percent reported that glucocorticoids improved symptoms occasionally whereas 31% reported that they always did. Only 12% reported complete resolution of a flare-up with glucocorticoids. Forty-three percent reported rebound symptoms within 1 to 7 days after completing a course of glucocorticoids. This study is the first comprehensive global assessment of FOP flare-ups and establishes a critical foundation for the design and evaluation of future clinical trials. © 2015 American Society for Bone and Mineral Research.

Long-term follow-up study of bilateral above-the-knee amputees from the Vietnam War.

PubMed

Dougherty, P J

1999-10-01

Because caring for patients who have combat-related amputations is a discontinuous practice, military surgeons must relearn treatment techniques during each conflict. The purpose of the present long-term study (average duration of follow-up, 27.5 years) was to document the status of patients who had sustained a bilateral above-the-knee amputation in Vietnam and had been managed by the only separate amputee service in the United States Army. A review of the records of 484 battle amputees identified thirty individuals (6 percent) who had a bilateral above-the-knee amputation. Twenty-six (87 percent) of the thirty patients had been injured by a land mine or a booby trap. Fifty-three (88 percent) of the sixty limbs were amputated because of trauma, and the other seven (12 percent) were amputated secondarily because of infection. Data regarding education, employment, marriage and family life, prosthetic use, and psychological care were collected by mail or telephone for twenty-three (85 percent) of the twenty-seven surviving patients. Respondents also completed the Short Form-36 (SF-36) Health Survey. At the time of the study, five (22 percent) of the twenty-three respondents used prostheses for walking; the devices were used for an average of 7.7 hours per day. Sixteen respondents (70 percent) were or had been employed outside of the home since the time of discharge. The physical functioning score on the SF-36 questionnaire was significantly lower for the study group than it was for a group of age and gender-matched controls (p < 0.001; Student two-tailed t test). With the numbers available, no significant differences could be detected between the groups with regard to physical role functioning (p = 0.377), bodily pain (p = 0.603), general health (p = 0.407), vitality (p = 0.949), social functioning (p = 0.460), emotional role functioning (p = 0.029), or mental health (p = 0.102). The patients in the present study have led relatively normal, productive lives within the context of their physical limitations.

An analysis of factors influencing the teaching of biological evolution in Louisiana public secondary schools

NASA Astrophysics Data System (ADS)

Aguillard, Donald Wayne

Louisiana public school biology teachers were surveyed to investigate their attitudes toward biological evolution. A mixed method investigation was employed using a questionnaire and open-ended interviews. Results obtained from 64 percent of the sample receiving the questionnaire indicate that although teachers endorse the study of evolution as important, instructional time allocated to evolution is disproportionate with its status as a unifying concept of science. Two variables, number of college courses specifically devoted to evolution and number of semester credit hours in biology, produced a significant correlation with emphasis placed on evolution. The data suggest that teachers' knowledge base emerged as the most significant factor in determining degree of classroom emphasis on evolution. The data suggest a need for substantive changes in the training of biology teachers. Thirty-five percent of teachers reported pursuing fewer than 20 semester credit hours in biology and 68 percent reported fewer than three college courses in which evolution was specifically discussed. Fifty percent reported a willingness to undergo additional training about evolution. In spite of the fact that evolution has been identified as a major conceptual theme across all of the sciences, there is strong evidence that Louisiana biology teachers de-emphasize evolutionary theory. Even when biology teachers allocate instructional time to evolutionary theory, many avoid discussion of human evolution. The research data show that only ten percent of teachers reported allocating more than sixty minutes of instructional time to human evolution. Louisiana biology teachers were found to hold extreme views on the subject of creationism as a component of the biology curriculum. Twenty-nine percent indicated that creationism should be taught in high school biology and 25--35 percent allocated instructional time to discussions of creationism. Contributing to the de-emphasis of evolutionary theory, as a unifying theme of biology, is the courtesy extended to classroom teachers to determine what topics are emphasized. The inclusion of evolution in curriculum documents is not sufficient to ensure that evolutionary theory is regarded as a unifying theme of biology. School administrators, science supervisors, and local school boards have a clear responsibility to articulate strong support for requiring classroom discussions of evolutionary theory.

Time-Temperature Dependent Response of Filament Wound Composites for Flywheel Rotors

NASA Technical Reports Server (NTRS)

Thesken, John C.; Bowman, Cheryl L.; Arnold, Steven M.; Thompson, Richard C.

2004-01-01

Flywheel energy storage offers an attractive alternative to battery systems used in space applications such as the International Space Station. Rotor designs capable of high specific energies benefit from the load carrying capacity of hoop wound carbon fibers but their long-term durability may be limited by time-temperature dependent radial deformations. This was investigated for the carbon/epoxy rotor material, IM7/8552. Coupon specimens were sectioned from filament wound panels. These were tested in compression and tension at room temperature (RT), 95 and 135 C for strain rates from 5x10(exp -6) per second to 5x10(exp -3) per second. Time, temperature and load sign dependent effects were significant transverse to the fiber. At -0.5 percent strain for 72 hr, compressive stresses relaxed 16.4 percent at 135 C and 13 percent at 95 C. Tensile stresses relaxed only 7 percent in 72 hr at 135 C for 0.5 percent strain. Using linear hereditary material response and Boltzmann s principle of superposition to describe this behavior is problematic if not intractable. Micromechanics analysis including the effects of processing residual stresses is needed to resolve the paradoxes. Uniaxial compressive stress relaxation data may be used to bound the loss of radial pre-load stresses in flywheel rotors.

Ripple Effects of PPS on Nursing Homes: Swimming or Drowning in the Funding Stream?

ERIC Educational Resources Information Center

Swan, James H.; And Others

1990-01-01

Of 189 nursing homes, 83 percent reported that Medicare's hospital Prospective Payment System (PPS) affected patient needs, 53 percent said it affected patients and services provided, and 25 percent said it affected referrals to hospitals. PPS effects depended on facility factors of size, Medicare certification, tax status, and on local market…

Psychosocial work factors and shoulder pain in hotel room cleaners.

PubMed

Burgel, Barbara J; White, Mary C; Gillen, Marion; Krause, Niklas

2010-07-01

Hotel room cleaners have physically demanding jobs that place them at high risk for shoulder pain. Psychosocial work factors may also play a role in shoulder pain, but their independent role has not been studied in this group. Seventy-four percent (941 of 1,276) of hotel room cleaners from five Las Vegas hotels completed a 29-page survey assessing health status, working conditions, and psychosocial work factors. For this study, 493 of the 941 (52%) with complete data for 21 variables were included in multivariate logistic regression analyses. Fifty-six percent reported shoulder pain in the prior four weeks. Room cleaners with effort-reward imbalance (ERI) were three times as likely to report shoulder pain (OR 2.99, 95% CI 1.95-4.59, P = 0.000) even after adjustment for physical workload and other factors. After adjustment for physical workload, job strain and iso-strain were not significantly associated with shoulder pain. ERI is independently associated with shoulder pain in hotel room cleaners even after adjustment for physical workload and other risk factors. 2010 Wiley-Liss, Inc.

Mechlorethamine, vincristine, melphalan and prednisone (MOMP) for the treatment of relapsed lymphoma in dogs.

PubMed

Back, A R; Schleis, S E; Smrkovski, O A; Lee, J; Smith, A N; Phillips, J C

2015-12-01

Eighty-eight dogs with relapsed lymphoma were treated with the MOMP (mechlorethamine, vincristine, melphalan and prednisone) protocol on a 28-day treatment cycle. The overall response rate (ORR) to the MOMP protocol was 51.1% for a median of 56 days (range 7-858 days). Twelve percent of dogs experienced a complete response for a median of 81 days (range 42-274 days) and 38.6% experienced a partial response for a median of 49 days (range 7-858 days). Dogs with T-cell lymphoma had an ORR of 55% for a median of 60 days (range 49-858 days) while those with B-cell lymphoma had an ORR of 57% for a median of 81 days (range 7-274 days) (P = 0.783). The overall survival time for all dogs was 183 days (range 17-974 days). Fifty-four percent of dogs experienced toxicity with the majority classified as grade I. The MOMP protocol seems well-tolerated and is an option for dogs with relapsed lymphoma. © 2013 John Wiley & Sons Ltd.

EFFECT OF RELIGIOUS BELIEFS ON SUBSTANCE USE AMONG SOUTH AFRICAN HIGH SCHOOL STUDENTS.

PubMed

Ghuman, S; Hoque, M E

2015-03-01

Substance use is a common problem among South African youth. We conducted this study to determine whether religious beliefs influenced substance use among South African youth. We conducted a cross sectional study of 704 students from five high schools in South Africa. We used a questionnaire to assess self reported substance use and religious beliefs among the study subjects. We used binary logistic regression analysis to evaluate the relationship between the subjects' religious beliefs and substance use. Thirty-six point six percent of students reported being very religious. More female students reported being very religious than male students (p = 0.039). Fifty-four percent of students had ever consumed alcohol. Comparing alcohol and drug use between religious and non-religious students, it was found that alcohol and drug use were more common among non-religious students (28.3%, 30.4%) than very religious students (8.4%, 11.5%) (p < 0.05). Those who considered themselves religious had lower odds of substance use. Religious beliefs had an influence on substance use among South African youth in our study.

Premenstrual symptoms and associated morbidity in a family practice setting.

PubMed

Tippy, P K; Falvo, D R; Smaga, S A

1986-01-01

Women at two family practice clinics were given questionnaires to determine the nature, severity, and treatment of symptoms experienced premenstrually; the degree to which symptoms affected activities of daily living; the relationship of selected variables to women's perception of their symptoms; and the degree of physician involvement in discussion and/or treatment of symptoms. From the study group of 219 women, 76% reported symptoms severe enough to interfere with daily activities every month. The activity most affected by symptoms was relationship with family and friends, while work activities were affected least. Women's perception of the degree to which their mothers' activities had been affected by premenstrual symptoms was significantly related to their own incapacitation by them. Fifty-eight percent of women experiencing symptoms took medication for their symptoms, with over-the-counter medication being the most frequent treatment. Only 14% of the total sample had discussed these symptoms with their physician. Sixty-nine percent of the sample believed they had premenstrual syndrome (PMS). There was a significant relationship between women's belief that they had PMS and the degree of incapacitation experienced from their symptoms.

Prospective data, experience, and lessons learned at a surgically augmented brigade medical company (Level II+) during the 2007 Iraq surge.

PubMed

Lesho, Emil

2011-07-01

Provide data and experience at a surgically augmented brigade medical support company during the Iraq surge for future deployments. Data were prospectively aggregated. Eight thousand and eighty-three patients consisting of 52% coalition military, 19% U.S. military, and 29% U.S. or local civilians were evaluated. Ninety-four percent had disease nonbattle injuries and 4% had battle injuries. Ninety-five percent returned to duty, 2.5% admitted, 2% evacuated, and < 1% died of wounds. Total occupied bed days were 416. Predominate trauma and surgical conditions included burns, explosive injury, extremity trauma, and predominate medical conditions included infections, musculoskeletal injuries, and mental health issues. One hundred and fifty-eight air evacuations were required (80% trauma and 20% medical). Challenges included lack of mental health providers, cardiac and chronic medications, and exercise electrocardiogram capability. Without physical therapists, experienced nurses, and ancillary medical care, approximately 1500 more air evacuations would have been required, and return-to-duty would have been significantly delayed for approximately 300 patients.

Cigarette smoking and lesbian and bisexual women in the Bronx.

PubMed

Sanchez, John P; Meacher, Peter; Beil, Robert

2005-02-01

This study investigated the prevalence of cigarette smoking, smoking patterns, and smoking cessation efforts of Black and Hispanic lesbian and bisexual women from a poor, urban community. One-on-one interviews were conducted with a convenience sample of 130 self-identified Black and Hispanic lesbian and bisexual women from the Bronx, NY. Bivariate statistics were used to determine differences between Black and Hispanic respondents in smoking prevalence, frequency, desire to quit, and impact on family unit. Fifty-five percent of Black respondents and sixty-two percent of Hispanic respondents were current smokers. Hispanics were more likely than Blacks to have a partner (p < 0.04), 2 or more children (p < 0.05), and an asthmatic in their household (p < 0.02). Hispanics were less likely than Blacks to have ever attempted to quit (p < 0.04) and to have made a serious attempt to quit in the past year (p < 0.02). Culturally sensitive interventions are needed to help Hispanic lesbian and bisexual women move from the pre-contemplative to action stage of quitting. The large proportion of current smokers requires greater access to effective smoking cessation tools.

Authorship Issues and Conflict in the U.S. Academic Chemical Community

PubMed Central

Seeman, Jeffrey I.; House, Mark C.

2015-01-01

A survey on credit issues and related “responsible conduct of research” (RCR) behaviors was conducted with academic chemists in Ph.D. granting institutions in the U.S. Six hundred faculty members responded. Fifty percent of the respondents reported not receiving appropriate credit for contributions they had made to projects the results of which had been published, including when they themselves were students. Thirty percent of these individuals discussed this lack of credit with the “offending” individual, and as a consequence of those discussions, a small percentage of individuals were provided either co-authorship or an acknowledgment. The majority who did not enter into a discussion with the “offending” individual reported two primary reasons for not doing so: that they “could not imagine any good coming from such a conversation” and “I was afraid of being in a compromised situation.” A discussion of relationship asymmetry in the academic setting is provided. Confronting one’s colleague regarding credit is compared with whistleblowing, and the possible consequences of blacklisting are discussed. A number of recommendations for minimizing authorship disputes are provided. PMID:26155731

Breast cancer in a multi-ethnic Asian setting: results from the Singapore-Malaysia hospital-based breast cancer registry.

PubMed

Pathy, Nirmala Bhoo; Yip, Cheng Har; Taib, Nur Aishah; Hartman, Mikael; Saxena, Nakul; Iau, Philip; Bulgiba, Awang M; Lee, Soo Chin; Lim, Siew Eng; Wong, John E L; Verkooijen, Helena M

2011-04-01

Two hospital-based breast cancer databases (University Malaya Medical Center, Malaysia [n = 1513] and National University Hospital, Singapore [n = 2545]) were merged into a regional registry of breast cancer patients diagnosed between 1990 and 2007. A review of the data found 51% of patients diagnosed before the age of 50 years. and 72% percent of the women were Chinese followed by Malays (16%), Indians (8%), and other races (4%). Median tumor size at presentation was 26 mm and about 25% of patients presented with TNM stage III or IV disease. Most tumors were of ductal histology (87%). Fifty-seven percent of tumors were estrogen receptor positive and 40% were poorly differentiated. Of those patients who had surgery, 70% had mastectomy while 30% had breast conserving surgery. Overall, chemotherapy was administered to 56% of patients and hormonal treatment to 60%. Five-year overall survival was 82.5% in patients with TNM stage 0 to stage II cancer, and 30.2% in those with later stages. Copyright © 2011 Elsevier Ltd. All rights reserved.

Quantifying multi-temporal urban development characteristics in Las Vegas from Landsat and ASTER data

USGS Publications Warehouse

Xian, G.; Crane, M.; McMahon, C.

2008-01-01

Urban development has expanded rapidly in Las Vegas, Nevada of the United States, over the last fifty years. A major environmental change associated with this urbanization trend is the transformation of the landscape from natural cover types to increasingly anthropogenic impervious surface. This research utilizes remote sensing data from both the Landsat and Terra-Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) instruments in conjunction with digital orthophotography to estimate urban extent and its temporal changes by determining sub-pixel impervious surfaces. Percent impervious surface area has shown encouraging agreement with urban land extent and development density. Results indicate that total urban land-use increases approximately 110 percent from 1984 to 2002. Most of the increases are associated with medium-to high-density urban development. Places having significant increases in impervious surfaces are in the northwestern and southeastern parts of Las Vegas. Most high-density urban development, however, appears in central Las Vegas. Impervious surface conditions for 2002 measured from Landsat and ASTER satellite data are compared in terms of their accuracy.

Newborn transport in South Australia, 1978-80: experience of the Queen Victoria Hospital, Adelaide.

PubMed

Davies, A G; Fitzgerald, A M; Dahlenburg, G W

1982-01-23

389 infants were transported to the Queen Victoria Hospital, Adelaide between 1978 and 1980. Twenty-three percent (99) of the infants were ventilated, and 49% (189) received intravenous or intra-arterial therapy. Fifty-six percent (217) of the infants required transport because of prematurity; 11% (46) because of perinatal asphyxia in babies weighing more than 2,500 g. Only one baby died during transport, while 14% of the babies died subsequently. A core temperature of less than 36 degrees C in either hospital is important; a cold baby is 3.5 times more likely to die (X2=25.46, P less than 0.001). The transport of babies over distances greater than 300 kilometres is peculiar to Australia. Significantly more of these babies were cold than those retrieved from hospitals near Adelaide (X2=4.7, P less than 0.05), and significantly more died. Difficulty in transferring mothers in preterm labour may be another reason these babies did relatively badly. Better education and facilities will be important if we are to improve their survival chances.

Clinical, nutritional and immunological characteristics of HIV-infected children in an area of high HIV prevalence.

PubMed

Pedrini, Maura; Moraleda, Cinta; Macete, Eusebio; Gondo, Kizito; Brabin, Bernard J; Menéndez, Clara

2015-08-01

To evaluate the clinical, nutritional and neurodevelopment status of HIV-infected children in a high HIV prevalence area. All HIV-infected children under 15 years of age attending an outpatient clinic of Mozambique between April and May 2010 were recruited. Clinical data were collected and physical examination was performed. In all, 140 children were recruited. The median age at HIV diagnosis was 2.1 years. Fifty-one percent of the children were classified in WHO clinical Stages 3 or 4. Median age of antiretroviral treatment commencement was 3.9 years. Overall, 68% were undernourished, mainly stunted. Forty-four percent failed to pass the national psychomotor developmental test. The pathways for early HIV diagnosis and start of antiretrovirals in children should be improved in Mozambique. Malnutrition, especially stunting, and developmental delay were highly prevalent. Further research focused on early diagnosis of neurocognitive disorders and on the indications of antiretroviral treatment commencement based on chronic malnutrition is required. © The Author [2015]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Susceptibility of Clostridium perfringens strains from broiler chickens to antibiotics and anticoccidials.

PubMed

Martel, A; Devriese, L A; Cauwerts, K; De Gussem, K; Decostere, A; Haesebrouck, F

2004-02-01

Clostridium perfringens strains isolated in 2002 from the intestines of broiler chickens from 31 different farms located in Belgium were tested for susceptibility to 12 antibiotics used for therapy, growth promotion or prevention of coccidiosis. All strains were uniformly sensitive to the ionophore antibiotics monensin, lasalocid, salinomycin, maduramycin and narasin. All were sensitive to avilamycin, tylosin and amoxicillin, while flavomycin (bambermycin) showed low or no activity. Chlortetracycline and oxytetracycline were active at very low concentrations, but low-level acquired resistance was detected in 66% of the strains investigated. Fifty percent of these strains carried the tetP(B) resistance gene, while the tet(Q) gene was detected in only one strain. One strain with high-level resistance against tetracyclines carried the tet(M) gene. Sixty-three percent of the strains showed low-level resistance to lincomycin. The lnu(A) and lnu(B) genes were each only found in one strain. Compared with a similar investigation carried out in 1980, an increase was seen in resistance percentages with lincomycin (63% against 49%) and a slight decrease with tetracycline (66% against 74%).

Neck and shoulder disorders in medical secretaries. Part I. Pain prevalence and risk factors.

PubMed

Kamwendo, K; Linton, S J; Moritz, U

1991-01-01

420 medical secretaries took part in a cross-sectional study at examining the prevalence of musculoskeletal disorders as well as the relationship between neck and shoulder pain and possible risk factors. Sixty-three percent had experienced neck pain sometime during the previous year and while 15% had suffered almost constant pain 32% had experienced neck pain only occasionally. Shoulder pain during the previous year had been experienced by 62%, 17% had suffered almost constant pain while 29% experienced pain only occasionally. Fifty-one percent had experienced low back pain. Age and length of employment were significantly related to neck and shoulder pain. Furthermore, working with office machines 5 hours or more per day was associated with a significantly increased risk for neck pain (OR 1.7), shoulder pain (OR 1.9) and headache (OR 1.8). Finally, a poorly experienced psychosocial work environment was significantly related to headache, neck, shoulder and low back pain. The results of this study suggest that work with office machines as well as the psychosocial work environment are important factors in neck and shoulder pain.

The visual perception of distance ratios in physical space.

PubMed

Norman, J Farley; Adkins, Olivia C; Pedersen, Lauren E

2016-06-01

Past studies have consistently demonstrated that human observers cannot accurately perceive environmental distances. Even so, we obviously detect sufficient spatial information to meet the demands of everyday life. In the current experiment, ten younger adults (mean age was 21.8years) and ten older adults (mean age was 72.3years) estimated distance ratios in physical space. On any given trial, observers judged how long one distance interval was relative to another. The 18 stimulus ratios ranged from 1.0 to 9.5; the observers judged each stimulus ratio three times. The average correlation coefficient relating actual distance ratios to perceived ratios was identical (r=0.87) for both younger and older age groups. Despite this strong relationship between perception and reality, the judgments of many individual observers were inaccurate. For example, ten percent of the observers overestimated the stimulus ratios, while fifty percent underestimated the stimulus ratios. Although both under- and overestimation occurred in the current experiment, the results nevertheless demonstrate that human adults can reliably compare environmental distances in different directions. Copyright © 2016 Elsevier Ltd. All rights reserved.

VIN 3: a clinicopathologic review.

PubMed

McNally, O M; Mulvany, N J; Pagano, R; Quinn, M A; Rome, R M

2002-01-01

A retrospective review of the management of vulvar intraepithelial neoplasia 3 (VIN 3) over a 16-year period from 1981 to 1997 was conducted. Complete information was available for analysis on 101 patients. The mean age was 53.9 years (range 14-102 years). The mean duration of follow-up was 36 months (range 2-184 months). Fifty-eight percent of patients presented with pruritus. The disease was multifocal in 51% and unifocal in 49% of cases and the left labium majus was the most frequently affected site (27%). Co-existent or previous genital disease was identified in 39% of patients and 8% had a history of invasive gynecological cancer. Histologic evidence of human papillomavirus (HPV) infection was found in 31% of patients. Wide local excision was the most frequently used treatment modality (78%). Thirty-eight percent of patients required at least one further treatment for recurrent disease. Smoking, multifocality, HPV effect, and positive surgical margins were not found to be significant predictors of recurrence. There were three (3%) cases of progression to invasive squamous cell carcinoma of the vulva, one at 6, 7, and 7 years after initial treatment.

Urinary conduits in gynecologic oncology

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

Hancock, K.C.; Copeland, L.J.; Gershenson, D.M.

1986-05-01

Over an 11-year period (1971 to 1981), 212 urinary conduit surgeries were performed by the Department of Gynecology at the University of Texas, M. D. Anderson Hospital and Tumor Institute at Houston. The urinary diversions were performed as part of the pelvic exenteration operation in 154 patients, for radiation injury in 48 patients, and for palliation of disease recurrence in ten patients. Ninety-three percent had prior pelvic radiotherapy. Various segments of the gastrointestinal tract were used, including the ileum (102), sigmoid colon (99), transverse colon (four), jejunum (four), and others (three). Fifty percent of abnormal preoperative intravenous pyelograms reverted tomore » normal after urinary diversion. Revision of the stoma was required in 6%. Other complications included infection (18%), renal loss (17%), and urinary leaks and fistulae (3%). The overall perioperative mortality was 7%, decreasing from 11% in the first five years to 3% during the last six years. Ureteral stents were routinely used. When selecting a segment of bowel for a urinary conduit, both tissue quality and mobility are important. Mortality and morbidity of urinary conduit surgery continues to decrease with experience.« less

Nutrition Recommendations and the Children’s Food and Beverage Advertising Initiative’s 2014 Approved Food and Beverage Product List

PubMed Central

Powell, Lisa M.

2015-01-01

We compare the Children’s Food and Beverage Advertising Initiative’s (CFBAI’s) April 2014 list of food and beverage products approved to be advertised on children’s television programs with the federal Interagency Working Group’s nutrition recommendations for such advertised products. Products were assessed by using the nutrients to limit (saturated fat, trans fat, sugar, and sodium) component of the Interagency Working Group’s recommendations. Fifty-three percent of the listed products did not meet the nutrition recommendations and, therefore, were ineligible to be advertised. We recommend continued monitoring of food and beverage products marketed to children. PMID:25906434

Analysis of the Causes of Inflight Refueling Mishaps with the KC-135

DTIC Science & Technology

1989-09-01

Air Service. During the spring of 1923 in San Diego , California, a Do Havilland DH -4 biplane was modified S with a 50 foot home. This ’banker...The remaining 15 were considered to be fighter/attack aircraft. Overall, the F-4, B-52, C-141, and F- 106 were involved in over fifty percent of the...AIRCRAFT 1 2 3 4 5 6 7 TYPE AIRCRAFT F-4 34 0 8 6 0 8 3 59 21.15 B-52 18 0 10 4 1 6 0 39 13.98 C-141 14 0 1 1 3 4 2 25 8.96 F- 106 13 0 2 0 0 1 2 18

Purging sensitive science instruments with nitrogen in the STS environment

NASA Technical Reports Server (NTRS)

Lumsden, J. M.; Noel, M. B.

1983-01-01

Potential contamination of extremely sensitive science instruments during prelaunch, launch, and earth orbit operations are a major concern to the Galileo and International Solar Polar Mission (ISPM) Programs. The Galileo Program is developing a system to purify Shuttle supplied nitrogen gas for in-flight purging of seven imaging and non-imaging science instruments. Monolayers of contamination deposited on critical surfaces can degrade some instrument sensitivities as much as fifty percent. The purging system provides a reliable supply of filtered and fried nitrogen gas during these critical phases of the mission when the contamination potential is highest. The Galileo and ISPM Programs are including the system as Airborne Support Equipment (ASE).

Indications and results of omental pedicle grafts in oncology

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

Petit, J.Y.; Lacour, J.; Margulis, A.

1979-12-01

Sixty omental grafts were performed in our department. Sixty-two percent concerned breast cancer patients. Other grafts were undertaken for other cancers: head and neck, gynecologic urologic and intestinal, skin and soft tissue tumors. These grafts were indicated for radionecrosis or chemonecrosis in 33 cases and for cancer recurrence in 26 cases (among whom 24 were previously irradiated). Only one graft was performed for lymphoedema treatment. Overall, fifty four patients (83.5%) had successful grafts, and six (16.5%) had graft failures. According to the treated lesion we obtained 82% of successful treatment among patients treated for radio or chemonecrosis, and 92% formore » patients treated for recurrences.« less

Ionization tube simmer current circuit

DOEpatents

Steinkraus, R.F. Jr.

1994-12-13

A highly efficient flash lamp simmer current circuit utilizes a fifty percent duty cycle square wave pulse generator to pass a current over a current limiting inductor to a full wave rectifier. The DC output of the rectifier is then passed over a voltage smoothing capacitor through a reverse current blocking diode to a flash lamp tube to sustain ionization in the tube between discharges via a small simmer current. An alternate embodiment of the circuit combines the pulse generator and inductor in the form of an FET off line square wave generator with an impedance limited step up output transformer which is then applied to the full wave rectifier as before to yield a similar simmer current. 6 figures.

[Family vulnerability index in the municipality of Pasto, Colombia, 2012].

PubMed

Hidalgo-Troya, Arsenio; Guerrero-Díaz, Gissela Fernanda; Estupiñan-Ferrín, Vivian Liseth; Rocha-Buelvas, Anderson

2017-04-03

This study's objective was to measure the vulnerability index of families in the municipality of Pasto, Colombia. In a sample of 270 families of all socioeconomic strata (239 urban and 31 rural), a confidential survey was conducted using the vulnerability index, consisting of five dimensions: demographic, social, economic, environmental, and geography, forecasting, and prevention. The families in strata 1 and 2 and the houses in the center, west, northwest, and northeast of the urban area showed high vulnerability, even higher than those in rural areas. Fifty percent of the families showed low vulnerability and 42% medium vulnerability. The poorest families were the most vulnerable, but poor families were also vulnerable in the municipality of Pasto.

Wilderness experience in Rocky Mountain National Park 2002: Report to RMNP

USGS Publications Warehouse

Schuster, Elke; Johnson, S. Shea; Taylor, Jonathan G.

2004-01-01

The social science technique of Visitor Employed Photography [VEP] was used to obtain information from visitors about wilderness experiences. Visitors were selected at random from Park-designated wilderness trails, in proportion to their use, and asked to participate in the survey. Respondents were given single-use, 10-exposure cameras and photo-log diaries to record experiences. A total of 293 cameras were distributed, with a response rate of 87%. Following the development of the photos, a copy of the photos, two pertinent pages from the photo-log, and a follow-up survey were mailed to respondents. Fifty six percent of the follow-up surveys were returned. Findings from the two surveys were analyzed and compared.

High Temperature Composite Heat Exchangers

NASA Technical Reports Server (NTRS)

Eckel, Andrew J.; Jaskowiak, Martha H.

2002-01-01

High temperature composite heat exchangers are an enabling technology for a number of aeropropulsion applications. They offer the potential for mass reductions of greater than fifty percent over traditional metallics designs and enable vehicle and engine designs. Since they offer the ability to operate at significantly higher operating temperatures, they facilitate operation at reduced coolant flows and make possible temporary uncooled operation in temperature regimes, such as experienced during vehicle reentry, where traditional heat exchangers require coolant flow. This reduction in coolant requirements can translate into enhanced range or system payload. A brief review of the approaches and challengers to exploiting this important technology are presented, along with a status of recent government-funded projects.

Ionization tube simmer current circuit

DOEpatents

Steinkraus, Jr., Robert F.

1994-01-01

A highly efficient flash lamp simmer current circuit utilizes a fifty percent duty cycle square wave pulse generator to pass a current over a current limiting inductor to a full wave rectifier. The DC output of the rectifier is then passed over a voltage smoothing capacitor through a reverse current blocking diode to a flash lamp tube to sustain ionization in the tube between discharges via a small simmer current. An alternate embodiment of the circuit combines the pulse generator and inductor in the form of an FET off line square wave generator with an impedance limited step up output transformer which is then applied to the full wave rectifier as before to yield a similar simmer current.

Brief report.

PubMed

Colnerud, Gunnel

2013-10-01

Most accounts of the ethical problems facing researchers across a broad spectrum of research fields come from ethicists, ethics committees, and specialists committed to the study of ethics in human research. In contrast, this study reports on the ethical questions that researchers, themselves, report facing in their everyday practice. Fifty-five Swedish researchers contributed 109 examples of ethical dilemmas, conflicts, and problems in research. They were all researchers at the postdoctoral level in the fields of medicine, the humanities, education, and the social sciences, who devoted at least 50 percent of their working hours to research. They reported issues they face before, during, and after gathering data. Their range of issues is broader than generally discussed and points to the importance of researchers' ethical sensitivity.

Changes to pediatric clerkships' nighttime structure after introduction of the 2011 ACGME resident duty hour standards.

PubMed

Smith, Andrew; Stevenson, Adam

2014-01-01

To report changes in pediatric clerkship nighttime clinical structures before and after implementation of the 2011 Accreditation Council for Graduate Medical Education (ACGME) resident duty hour standards. As part of the 2011 Council on Medical Student Education in Pediatrics (COMSEP) member annual survey, we surveyed leaders of pediatric undergraduate medical education on their medical school's current nighttime clinical structure, changes in nighttime structure between 2010 and 2011, and their school's student duty hour standards. Fifty-six percent (n = 83) of Liaison Committee for Medical Education (LCME)-accredited medical schools responded to the survey. Of received responses, 98% of pediatric clerkships have some form of nighttime clinical experience; 49% of clerkships have medical students stay late, 24% of clerkships utilize night shifts, and 16% use a traditional call structure. Forty-five percent of clerkships report changing their nighttime clinical experience after implementation of the 2011 ACGME duty hour standards; 46% of clerkships that changed had previously used traditional call. Seventy-six percent of clerkships report having medical student duty hour standards at their medical school. The majority of pediatric clerkships in our survey include nighttime clinical experiences in their curriculum, although variability exists in the type of structure. Additionally, the new ACGME duty hour standards appear to affect clerkships directors' choice of structure. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Assessing change in health professions volunteers' perceptions after participating in Special Olympics healthy athlete events.

PubMed

Freudenthal, Jacqueline J; Boyd, Linda D; Tivis, Rick

2010-09-01

This study assessed perceptions of health professions student and faculty volunteers who participated with athletes at the 2009 Special Olympics World Winter Games in Healthy Athlete venues. The volunteers' perceptions and expectations of the abilities of intellectually disabled athletes were measured by administering pre-event and post-event questionnaires consisting of demographic questions and the Prognostic Belief Scale (PBS). Invitations to participate in the study were sent to 165 students and faculty members; of those, eighty (48.5 percent response rate) responded to the pre-event questionnaire, and sixty-seven (40.6 percent response rate) responded to the post-event questionnaire. Of the eighty respondents to the pre-event questionnaire, fifty-five (68.7 percent) also completed the post-event questionnaire. The ANOVA comparing pre- and post-event PBS scores between groups found a trend towards higher scores among the volunteers, but analysis did not demonstrate a significant effect in either group (p=.68) or the interaction of group by time (p=.46). Despite the findings from the PBS, participants' statements suggest the experience had an impact on their perceptions and expectations. Although not statistically significant, this study found a positive trend pre- to post-event in the volunteers' perceptions of the abilities of athletes with intellectual disabilities. In addition to didactic and clinical education, volunteer experiences may enhance care providers' knowledge, skill, and confidence levels for treating clients with intellectual disabilities.

California Wellness Study: American Indians and Obesity

PubMed Central

Hodge, Felicia Schanche; Kotkin-Jaszi, Suzanne T.

2011-01-01

This paper identifies the prevalence and predictors of obesity among California’s American Indian adults. A cross-sectional study was conducted at 13 rural sites. Indian healthcare clinics served as the sampling frame and were selected because of their proximity and access to the target population. Four-hundred and fifty adult American Indians participated; 74 percent were female and 26 percent were male. The average age was 40, ranging from 18–74. Measures included socio-demographics, general health, BMI, type 2 diabetes, exercise and dietary habits. Eighty-two percent were overweight, obese or morbidly obese. Chi-square tests revealed three variables significantly associated with BMI categories: having type 2 diabetes, female gender and poor general health status. A logistic regression model for obese/morbidly obese (BMI > 30) versus overweight/normal (BMI < 30) persons found gender and diabetes status as significant predictors, while general health status showed trend. Females had 1.59 greater odds of being obese than males (p=0.04). Those that do not have diabetes are less likely to be obese (p=0.02). Those that do not have good general health were 2.5 times more likely to be obese than those that have good general health (p=0.06). Overall goodness of fit was significant (p=0.0009). It is important to identify individuals and population who are normal/overweight, obese/morbidly obese so support and interventions can be planned and implemented. PMID:21625381

Newly Diagnosed Meniere's Disease: Clinical Course With Initiation of Noninvasive Treatment Including an Accounting of Vestibular Migraine.

PubMed

Sbeih, Firas; Christov, Florian; Gluth, Michael B

2018-05-01

To describe the course of Meniere's disease with noninvasive treatment during the first few years after initial diagnosis. A retrospective review of consecutive patients with newly diagnosed definite Meniere's disease between 2013 and 2016 and a minimum follow-up of 1 year. Patients received a written plan for low sodium, water therapy, and treatment with a diuretic and/or betahistine. Subjects were screened and treated for vestibular migraine as needed. Vertigo control and hearing status at most recent follow-up were assessed. Forty-four subjects had an average follow up of 24.3 months. Thirty-four percent had Meniere's disease and vestibular migraine, and 84% had unilateral Meniere's disease. Seventy-five percent had vertigo well controlled at most recent follow-up, with only noninvasive treatments. Age, gender, body mass index, presence of vestibular migraine, bilateral disease, and duration of follow-up did not predict noninvasive treatment failure. Worse hearing threshold at 250 Hz and lower pure tone average (PTA) at the time of diagnosis did predict failure. Fifty-two percent of ears had improved PTA at most recent visit, 20% had no change, and 28% were worse Conclusions: Encountering excellent vertigo control and stable hearing after a new diagnosis of Meniere's disease is possible with noninvasive treatments. Worse hearing status at diagnosis predicted treatment failure.

Survey Finds That Many Prisons And Jails Have Room To Improve HIV Testing And Coordination Of Postrelease Treatment

PubMed Central

Solomon, Liza; Montague, Brian T.; Beckwith, Curt G.; Baillargeon, Jacques; Costa, Michael; Dumont, Dora; Kuo, Irene; Kurth, Ann; Rich, Josiah D.

2014-01-01

Early diagnosis of HIV and effective antiretroviral treatment are key elements in efforts to reduce the morbidity and mortality associated with HIV. Incarcerated populations are disproportionately affected by HIV, with the disease’s prevalence among inmates estimated to be three to five times higher than among the general population. Correctional institutions offer important opportunities to test for HIV and link infected people to postrelease treatment services. To examine HIV testing and policies that help HIV-positive people obtain treatment in the community after release, we administered a survey to the medical directors of the fifty state prison systems and of forty of the largest jails in the United States. We found that 19 percent of prison systems and 35 percent of jails provide opt-out HIV testing, which is recommended by the Centers for Disease Control and Prevention (CDC). Additionally, fewer than 20 percent of prisons and jails conform to the CDC’s recommendations regarding discharge planning services for inmates transitioning to the community: making an appointment with a community health care provider, assisting with enrollment in an entitlement program, and providing a copy of the medical record and a supply of HIV medications. These findings suggest that opportunities for HIV diagnosis and linking HIV-positive inmates to community care after release are being missed in the majority of prison systems and jails. PMID:24590942

AN INVESTIGATION OF VISION PROBLEMS AND THE VISION CARE SYSTEM IN RURAL CHINA.

PubMed

Bai, Yunli; Yi, Hongmei; Zhang, Linxiu; Shi, Yaojiang; Ma, Xiaochen; Congdon, Nathan; Zhou, Zhongqiang; Boswell, Matthew; Rozelle, Scott

2014-11-01

This paper examines the prevalence of vision problems and the accessibility to and quality of vision care in rural China. We obtained data from 4 sources: 1) the National Rural Vision Care Survey; 2) the Private Optometrists Survey; 3) the County Hospital Eye Care Survey; and 4) the Rural School Vision Care Survey. The data from each of the surveys were collected by the authors during 2012. Thirty-three percent of the rural population surveyed self-reported vision problems. Twenty-two percent of subjects surveyed had ever had a vision exam. Among those who self-reported having vision problems, 34% did not wear eyeglasses. Fifty-four percent of those with vision problems who had eyeglasses did not have a vision exam prior to receiving glasses. However, having a vision exam did not always guarantee access to quality vision care. Four channels of vision care service were assessed. The school vision examination program did not increase the usage rate of eyeglasses. Each county-hospital was staffed with three eye-doctors having one year of education beyond high school, serving more than 400,000 residents. Private optometrists often had low levels of education and professional certification. In conclusion, our findings shows that the vision care system in rural China is inadequate and ineffective in meeting the needs of the rural population sampled.

32 CFR 48.508 - Certain 100 percent disability retirement.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., MILITARY AND CIVILIAN RETIRED SERVICEMAN'S FAMILY PROTECTION PLAN Annuity § 48.508 Certain 100 percent... duty as a direct result of armed conflict, or (b) His widow or children are not entitled to dependency...

Assessment of productivity of hospitals in Botswana: a DEA application.

PubMed

Tlotlego, Naomi; Nonvignon, Justice; Sambo, Luis G; Asbu, Eyob Z; Kirigia, Joses M

2010-11-05

Botswana national health policy states that the Ministry of Health shall from time to time review and revise its organization and management structures to respond to new developments and challenges in order to achieve and sustain a high level of efficiency in the provision of health care. Even though the government clearly views assuring efficiency in the health sector as one of its leadership and governance responsibilities, to date no study has been undertaken to measure the technical efficiency of hospitals which consume the majority of health sector resources. The specific objectives of this study were to quantify the technical and scale efficiency of hospitals in Botswana, and to evaluate changes in productivity over a three year period in order to analyze changes in efficiency and technology use. DEAP software was used to analyze technical efficiency along with the DEA-based Malmquist productivity index which was applied to a sample of 21 non-teaching hospitals in the Republic of Botswana over a period of three years (2006 to 2008). The analysis revealed that 16 (76.2 percent), 16 (76.2 percent) and 13 (61.9 percent) of the 21 hospitals were run inefficiently in 2006, 2007 and 2008, with average variable returns to scale (VRS) technical efficiency scores of 70.4 percent, 74.2 percent and 76.3 percent respectively. On average, Malmquist Total Factor Productivity (MTFP) decreased by 1.5 percent. Whilst hospital efficiency increased by 3.1 percent, technical change (innovation) regressed by 4.5 percent. Efficiency change was thus attributed to an improvement in pure efficiency of 4.2 percent and a decline in scale efficiency of 1 percent. The MTFP change was the highest in 2008 (MTFP = 1.008) and the lowest in 2007 (MTFP = 0.963). The results indicate significant inefficiencies within the sample for the years under study. In 2008, taken together, the inefficient hospitals would have needed to increase the number of outpatient visits by 117627 (18 percent) and inpatient days by 49415 (13 percent) in order to reach full efficiency. Alternatively, inefficiencies could have been reduced by transferring 264 clinical staff and 39 beds to health clinics, health posts and mobile posts. The transfer of excess clinical staff to those facilities which are closest to the communities may also contribute to accelerating progress towards the Millennium Development Goals related to child and maternal health.Nine (57.1 percent) of the 21 hospitals experienced MTFP deterioration during the three years. We found the sources of inefficiencies to be either adverse change in pure efficiency, scale efficiency and/or technical efficiency.In line with the report Health financing: A strategy for the African Region, which was adopted by the Fifty-sixth WHO Regional Committee for Africa, it might be helpful for Botswana to consider institutionalizing efficiency monitoring of health facilities within health management information systems.

Learning from developing countries in strengthening health systems: an evaluation of personal and professional impact among global health volunteers at Addis Ababa University's Tikur Anbessa Specialized Hospital (Ethiopia).

PubMed

Busse, Heidi; Aboneh, Ephrem A; Tefera, Girma

2014-09-05

The positive impact of global health activities by volunteers from the United States in low-and middle-income countries has been recognized. Most existing global health partnerships evaluate what knowledge, ideas, and activities the US institution transferred to the low- or middle-income country. However, what this fails to capture are what kinds of change happen to US-based partners due to engagement in global health partnerships, both at the individual and institutional levels. "Reverse innovation" is the term that is used in global health literature to describe this type of impact. The objectives of this study were to identify what kinds of impact global partnerships have on health volunteers from developed countries, advance this emerging body of knowledge, and improve understanding of methods and indicators for assessing reverse innovation. The study population consisted of 80 US, Canada, and South Africa-based health care professionals who volunteered at Tikur Anbessa Specialized Hospital in Ethiopia. Surveys were web-based and included multiple choice and open-ended questions to assess global health competencies. The data were analyzed using IBRM SPSS® version 21 for quantitative analysis; the open-ended responses were coded using constant comparative analysis to identify themes. Of the 80 volunteers, 63 responded (79 percent response rate). Fifty-two percent of the respondents were male, and over 60 percent were 40 years of age and older. Eighty-three percent reported they accomplished their trip objectives, 95 percent would participate in future activities and 96 percent would recommend participation to other colleagues. Eighty-nine percent reported personal impact and 73 percent reported change on their professional development. Previous global health experience, multiple prior trips, and the desire for career advancement were associated with positive impact on professional development. Professionally and personally meaningful learning happens often during global health outreach. Understanding this impact has important policy, economic, and programmatic implications. With the aid of improved monitoring and evaluation frameworks, the simple act of attempting to measure "reverse innovation" may represent a shift in how global health partnerships are perceived, drawing attention to the two-way learning and benefits that occur and improving effectiveness in global health partnership spending.