Frequent video-game playing in young males is associated with central adiposity and high-sugar, low-fibre dietary consumption.

PubMed

Mario, Siervo; Hannah, Cameron; Jonathan, Wells C K; Jose, Lara

2014-12-01

Video-game playing is associated with an increased obesity risk. The association of video-game playing with body composition, physical activity and eating behaviour was investigated. A total of 45 young males (age range 18-27 years, BMI range 18.5-35.1 kg/m(2)) were recruited. Measurements of body composition and blood pressure were performed. The EPIC-FFQ questionnaire was used to assess dietary intake. A questionnaire battery was administered to assess physical activity, eating behaviour, sleep quality and frequency of video-game playing (hours/week). Subjects were categorised into frequent (>7 h/week) and non-frequent (≤7 h/week) players. Frequent video-game players had greater waist circumference and fat mass. Video-game playing was significantly associated with high added sugar and low fibre consumption. A higher level of dietary restraint was observed in non-frequent video-game users. These preliminary results identify frequent video-game playing as an important lifestyle behaviour which may have important implications for understanding obesity risk in young male adults.

Inside Story: A Guide to Indoor Air Quality

MedlinePlus

... to the outdoors or vacuums with high efficiency filters may also be of help. Take steps to ... that tell you how frequently to change the filter. If manufacturer's instructions are not readily available, change ...

Effects of silvicultural management on low gradient stream water quality in Louisiana

Treesearch

John Beebe; George Ice; Y. Jun Xu; Abram DaSilva; Richard Stich

2012-01-01

Oxygen depletion in rivers and streams is among the top 5 impairment types most frequently cited in state water quality reports in the U.S., especially in the South. Such impairments require the development of Total Maximum Daily Loads (TMDLs) or other strategies to ameliorate low dissolved oxygen (DO) levels or high biochemical oxygen demand (BOD). TMDLs allocated to...

Teacher Education in Finland: A Review of a National Effort for Preparing Teachers for the Future

ERIC Educational Resources Information Center

Malinen, Olli-Pekka; Vaisanen, Pertti; Savolainen, Hannu

2012-01-01

The quality of teachers is one of the most frequently cited factors explaining the quality of an education system. This article discusses the nature and role teacher education plays as a part of the Finnish education system. Teacher education in Finland is a highly competitive field of masters' degree university studies and is provided in…

Methods to Efficiently Achieve High-Quality Teaching of Accounting at the University--A Teaching Innovation Evaluation

ERIC Educational Resources Information Center

Hruška, Ing. Zdenek

2018-01-01

Teaching of accounting is specific due to its frequently updated content, because Czech legal regulations significantly change annually, either because of the legislative or harmonization modifications, hence there is a need to constantly seek new ways to ensure a good quality of teaching in the efficient education process. The paper is based on…

Water-quality assessment of the Kentucky River basin, Kentucky; results of investigations of surface-water quality, 1987-90

USGS Publications Warehouse

Haag, K.H.; Garcia, Rene; Jarrett, G.L.; Porter, S.D.

1995-01-01

The U.S. Geological Survey investigated the water quality of the Kentucky River Basin in Kentucky as part of the National Water-Quality Assessment program. Data collected during 1987-90 were used to describe the spatial and temporal variability of water-quality constituents including metals and trace elements, nutrients, sediments, pesticides, dissolved oxygen, and fecal-coliform bacteria. Oil-production activities were the source of barium, bromide, chloride, magnesium, and sodium in several watersheds. High concentrations of aluminum, iron, and zinc were related to surface mining in the Eastern Coal Field Region. High concentrations of lead and zinc occurred in streambed sediments in urban areas, whereas concentrations of arsenic, strontium, and uranium were associated with natural geologic sources. Concentrations of phosphorus were significantly correlated with urban and agricultural land use. The high phosphorus content of Bluegrass Region soils was an important source of phosphorus in streams. At many sites in urban areas, most of the stream nitrogen load was attributable to wastewater-treatment-plant effluent. Average suspended-sediment concentrations were positively correlated with discharge. There was a downward trend in suspended-sediment concentrations downstream in the Kentucky River main stem during the study. The most frequently detected herbicides in water samples were atrazine, 2,4-D, alachlor, metolachlor, and dicamba. Diazinon, malathion, and parathion were the most frequently detected organophosphate insecticides in water samples. Detectable concentrations of aldrin, chlordane, DDT, DDE, dieldrin, endrin, endosulfan, heptachlor, and lindane were found in streambed-sediment samples. Dissolved-oxygen concentrations were sometimes below the minimum concentration needed to sustain aquatic life. At some sites, high concentrations of fecal-indicator bacteria were found and water samples did not meet sanitary water-quality criteria.

Review series: Examples of chronic care model: the home-based chronic care model: redesigning home health for high quality care delivery.

PubMed

Suter, Paula; Hennessey, Beth; Florez, Donna; Newton Suter, W

2011-01-01

Individuals with chronic obstructive pulmonary disease (COPD) face significant challenges due to frequent distressing dyspnea and deficits related to activities of daily living. Individuals with COPD are often hospitalized frequently for disease exacerbations, negatively impacting quality of life and healthcare expenditure burden. The home-based chronic care model (HBCCM) was designed to address the needs of patients with chronic diseases. This model facilitates the re-design of chronic care delivery within the home health sector by ensuring patient-centered evidence-based care. This HBCCM foundation is Dr. Edward Wagner s chronic care model and has four additional areas of focus: high touch delivery, theory-based self management, specialist oversight and the use of technology. This article will describe this model in detail and outline how model use for patients with COPD can bring value to stakeholders across the health care continuum.

Limits on use of health economic assessments for rare diseases.

PubMed

Hyry, H I; Stern, A D; Cox, T M; Roos, J C P

2014-03-01

Funding of expensive treatments for rare (orphan) diseases is contentious. These agents fare poorly on 'efficiency' or health economic measures, such as the quality-adjusted life years, because of high cost and frequently poor gains in quality of life and survival. We show that cost-effectiveness assessments are flawed, and have only a limited role to play in reimbursement decisions for orphan drugs and beyond.

Service quality in health care setting.

PubMed

Rashid, Wan Edura Wan; Jusoff, Hj Kamaruzaman

2009-01-01

This paper attempts to explore the concept of service quality in a health care setting. This paper probes the definition of service quality from technical and functional aspects for a better understanding on how consumers evaluate the quality of health care. It adopts the conceptual model of service quality frequently used by the most researchers in the health care sector. The paper also discusses several service quality dimensions and service quality problems in order to provide a more holistic conception of hospital service quality. The paper finds that service quality in health care is very complex as compared to other services because this sector highly involves risk. The paper adds a new perspective towards understanding how the concept of service quality is adopted in a health care setting.

Monitoring outcomes with relational databases: does it improve quality of care?

PubMed

Clemmer, Terry P

2004-12-01

There are 3 key ingredients in improving quality of medial care: 1) using a scientific process of improvement, 2) executing the process at the lowest possible level in the organization, and 3) measuring the results of any change reliably. Relational databases when used within these guidelines are of great value in these efforts if they contain reliable information that is pertinent to the project and used in a scientific process of quality improvement by a front line team. Unfortunately, the data are frequently unreliable and/or not pertinent to the local process and is used by persons at very high levels in the organization without a scientific process and without reliable measurement of the outcome. Under these circumstances the effectiveness of relational databases in improving care is marginal at best, frequently wasteful and has the potential to be harmful. This article explores examples of these concepts.

High use of over-the-counter analgesic; possible warnings of reduced quality of life in adolescents - a qualitative study.

PubMed

Skarstein, Siv; Lagerløv, Per; Kvarme, Lisbeth Gravdal; Helseth, Sølvi

2016-01-01

Use of over-the-counter analgesics among adolescents has increased markedly. High consumption of over-the-counter analgesics among adolescents is associated with frequent pain, lower self-esteem, reduced sleep, lower educational ambition, binge drinking, higher caffeine consumption, and part-time employment. Knowledge about life experiences of adolescents who frequently use over-the-counter analgesics may be useful to prevent health problems. The purpose of the study was to increase knowledge about adolescents who suffer from frequent pain and have a high consumption of over-the-counter analgesics. A qualitative study, employing one-on-one, in-depth interviews using a thematic interview guide. Data were collected in Norway in 2013-2014. Three boys and sixteen girls; aged 14-16 years, who continuously consumed over-the-counter analgesics were recruited from ten high schools in urban and suburban districts. Candidate participants were excluded if they were medically diagnosed with an acute or chronic illness, requiring extended use of over-the-counter analgesics within the last year. The interviews were taped, transcribed and analysed as text according to Kvale's three contexts of interpretation: self-understanding, common sense and theory. All participants disclosed unresolved physical and psychosocial distress characterized as pain. Frequent pain from various body parts made everyday life challenging. Methods of pain self-appraisal and over-the-counter analgesics use often mimicked maternal patterns. Participants reported being raised under unpredictable circumstances that contributed to long lasting family conflicts and peer-group problems. Participants wanted to feel appreciated and to be socially and academically successful. However, pain reduced their ability to manage everyday life, hampered experienced possibilities for success, and made social settings difficult. Childhood experiences influence how adolescents experience pain and use over-the-counter analgesics. Coping with difficult situations or attempting to mask symptoms with over-the-counter analgesics can perpetuate and amplify underlying problems. High consumption of over-the-counter analgesics and frequent pain may be warning signs of adolescents with possible health threatening conditions and reduced quality of life. These adolescent might be in need of support from school nurses and General Practitioners. This study identifies new perspectives that may lead to novel approaches to identify, guide, and support adolescents with frequent pain and high consumption of over-the-counter analgesics.

Evolution of the methodological quality of controlled clinical trials for myofascial trigger point treatments for the period 1978-2015: A systematic review.

PubMed

Stoop, Rahel; Clijsen, Ron; Leoni, Diego; Soldini, Emiliano; Castellini, Greta; Redaelli, Valentina; Barbero, Marco

2017-08-01

The methodological quality of controlled clinical trials (CCTs) of physiotherapeutic treatment modalities for myofascial trigger points (MTrP) has not been investigated yet. To detect the methodological quality of CCTs for physiotherapy treatments of MTrPs and demonstrating the possible increase over time. Systematic review. A systematic search was conducted in two databases, Physiotherapy Evidence Database (PEDro) and Medicine Medical Literature Analysis and Retrieval System online (MEDLINE), using the same keywords and selection procedure corresponding to pre-defined inclusion criteria. The methodological quality, assessed by the 11-item PEDro scale, served as outcome measure. The CCTs had to compare at least two interventions, where one intervention had to lay within the scope of physiotherapy. Participants had to be diagnosed with myofascial pain syndrome or trigger points (active or latent). A total of n = 230 studies was analysed. The cervico-thoracic region was the most frequently treated body part (n = 143). Electrophysical agent applications was the most frequent intervention. The average methodological quality reached 5.5 on the PEDro scale. A total of n = 6 studies scored the value of 9. The average PEDro score increased by 0.7 points per decade between 1978 and 2015. The average PEDro score of CCTs for MTrP treatments does not reach the cut-off of 6 proposed for moderate to high methodological quality. Nevertheless, a promising trend towards an increase of the average methodological quality of CCTs for MTrPs was recorded. More high-quality CCT studies with thorough research procedures are recommended to enhance methodological quality. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

A tool for assessment of heart failure prescribing quality: A systematic review and meta-analysis.

PubMed

El Hadidi, Seif; Darweesh, Ebtissam; Byrne, Stephen; Bermingham, Margaret

2018-04-16

Heart failure (HF) guidelines aim to standardise patient care. Internationally, prescribing practice in HF may deviate from guidelines and so a standardised tool is required to assess prescribing quality. A systematic review and meta-analysis were performed to identify a quantitative tool for measuring adherence to HF guidelines and its clinical implications. Eleven electronic databases were searched to include studies reporting a comprehensive tool for measuring adherence to prescribing guidelines in HF patients aged ≥18 years. Qualitative studies or studies measuring prescription rates alone were excluded. Study quality was assessed using the Good ReseArch for Comparative Effectiveness Checklist. In total, 2455 studies were identified. Sixteen eligible full-text articles were included (n = 14 354 patients, mean age 69 ± 8 y). The Guideline Adherence Index (GAI), and its modified versions, was the most frequently cited tool (n = 13). Other tools identified were the Individualised Reconciled Evidence Recommendations, the Composite Heart Failure Performance, and the Heart Failure Scale. The meta-analysis included the GAI studies of good to high quality. The average GAI-3 was 62%. Compared to low GAI, high GAI patients had lower mortality rate (7.6% vs 33.9%) and lower rehospitalisation rates (23.5% vs 24.5%); both P ≤ .05. High GAI was associated with reduced risk of mortality (hazard ratio = 0.29, 95% confidence interval, 0.06-0.51) and rehospitalisation (hazard ratio = 0.64, 95% confidence interval, 0.41-1.00). No tool was used to improve prescribing quality. The GAI is the most frequently used tool to assess guideline adherence in HF. High GAI is associated with improved HF outcomes. Copyright © 2018 John Wiley & Sons, Ltd.

Living with psoriasis: prevalence of shame, anger, worry, and problems in daily activities and social life.

PubMed

Sampogna, Francesca; Tabolli, Stefano; Abeni, Damiano

2012-05-01

Psychosocial problems are frequent among patients with psoriasis. The aim of this study was to analyse the prevalence of some specific psychosocial issues. These were evaluated in 936 patients using the emotions and functioning scales of the Skindex-29 questionnaire. The problems most frequently experienced were: shame, anger, worry, difficulties in daily activities and social life. All problems were associated with the severity of psoriasis and with depression or anxiety. Shame, worry and annoyance were more frequent in women than in men, and shame and anger were associated with a low level of education. Impairment in work/hobbies was significantly higher in patients with palmoplantar psoriasis and those with arthro-pathic psoriasis. In conclusion, clinicians could gain important insights about their patients by looking at the single items of a quality of life instrument, to identify patients with high levels of emotional and social problems, in order to improve quality of care.

Management of source and drinking-water quality in Pakistan.

PubMed

Aziz, J A

2005-01-01

Drinking-water quality in both urban and rural areas of Pakistan is not being managed properly. Results of various investigations provide evidence that most of the drinking-water supplies are faecally contaminated. At places groundwater quality is deteriorating due to the naturally occurring subsoil contaminants or to anthropogenic activities. The poor bacteriological quality of drinking-water has frequently resulted in high incidence of waterborne diseases while subsoil contaminants have caused other ailments to consumers. This paper presents a detailed review of drinking-water quality in the country and the consequent health impacts. It identifies various factors contributing to poor water quality and proposes key actions required to ensure safe drinking-water supplies to consumers.

Hospital hydrotherapy pools treated with ultra violet light: bad bacteriological quality and presence of thermophilic Naegleria.

PubMed Central

De Jonckheere, J. F.

1982-01-01

The microbiological quality of eight halogenated and two u.v.-treated hydrotherapy pools in hospitals was investigated. The microbiological quality of halogenated hydrotherapy pools was comparable to halogenated public swimming pools, although in some Pseudomonas aeruginosa and faecal pollution indicators were more frequent due to bad management. On the other hand u.v.-treated hydrotherapy pools had very bad microbiological quality. Apart from faecal pollution indicators, P. aeruginosa was present in very high numbers. Halogenated hydrotherapy pools were not highly contaminated with amoebae, and Naegleria spp. were never detected. On the other hand u.v.-treated pools contained very high numbers of thermophilic Naegleria. The Naegleria isolated were identified as N. lovaniensis, a species commonly found in association with N. fowleri. Isoenzyme analysis showed a different type of N. lovaniensis was present in each of two u.v.-treated pools. Images Plate 1 PMID:7061835

Evaluation of commercial DNA and RNA extraction methods for high-throughput sequencing of FFPE samples.

PubMed

Kresse, Stine H; Namløs, Heidi M; Lorenz, Susanne; Berner, Jeanne-Marie; Myklebost, Ola; Bjerkehagen, Bodil; Meza-Zepeda, Leonardo A

2018-01-01

Nucleic acid material of adequate quality is crucial for successful high-throughput sequencing (HTS) analysis. DNA and RNA isolated from archival FFPE material are frequently degraded and not readily amplifiable due to chemical damage introduced during fixation. To identify optimal nucleic acid extraction kits, DNA and RNA quantity, quality and performance in HTS applications were evaluated. DNA and RNA were isolated from five sarcoma archival FFPE blocks, using eight extraction protocols from seven kits from three different commercial vendors. For DNA extraction, the truXTRAC FFPE DNA kit from Covaris gave higher yields and better amplifiable DNA, but all protocols gave comparable HTS library yields using Agilent SureSelect XT and performed well in downstream variant calling. For RNA extraction, all protocols gave comparable yields and amplifiable RNA. However, for fusion gene detection using the Archer FusionPlex Sarcoma Assay, the truXTRAC FFPE RNA kit from Covaris and Agencourt FormaPure kit from Beckman Coulter showed the highest percentage of unique read-pairs, providing higher complexity of HTS data and more frequent detection of recurrent fusion genes. truXTRAC simultaneous DNA and RNA extraction gave similar outputs as individual protocols. These findings show that although successful HTS libraries could be generated in most cases, the different protocols gave variable quantity and quality for FFPE nucleic acid extraction. Selecting the optimal procedure is highly valuable and may generate results in borderline quality specimens.

Health impairments arising from drinking water polluted with domestic sewage and excreta in China.

PubMed

Ling, B

2000-01-01

Raw water of poor quality still causes many drinking-water associated health problems all over China, largely because of poor sanitation, inadequate disposal of sewage and excreta. Eutrophication due to excess of total nitrogen and phosphorous in some sources for drinking-water has led to massive proliferation of cyanobacteria. The dominant species of cyanophyta can produce microcystins, a potent liver cancer promotor. As in previous studies, high incidence of liver cancer coincided with high microcystin concentration in the source water, especially in pond water. A frequent consequence of heavy pollution of source water is further the high incidence of infectious intestinal diseases, which are more than 10-100 times as frequent in China than in developed countries.

Does Viewing Pornography Reduce Marital Quality Over Time? Evidence from Longitudinal Data.

PubMed

Perry, Samuel L

2017-02-01

Numerous studies have examined the connection between pornography viewing and marital quality, with findings most often revealing a negative association. Data limitations, however, have precluded establishing directionality with a representative sample. This study is the first to draw on nationally representative, longitudinal data (2006-2012 Portraits of American Life Study) to test whether more frequent pornography use influences marital quality later on and whether this effect is moderated by gender. In general, married persons who more frequently viewed pornography in 2006 reported significantly lower levels of marital quality in 2012, net of controls for earlier marital quality and relevant correlates. Pornography's effect was not simply a proxy for dissatisfaction with sex life or marital decision-making in 2006. In terms of substantive influence, frequency of pornography use in 2006 was the second strongest predictor of marital quality in 2012. Interaction effects revealed, however, that the negative effect of porn use on marital quality applied to husbands, but not wives. In fact, post-estimation predicted values indicated that wives who viewed pornography more frequently reported higher marital quality than those who viewed it less frequently or not at all. The implications and limitations of this study are discussed.

Physical Fitness in the Secondary School.

ERIC Educational Resources Information Center

Conrad, C. Carson

The author, Executive Director of the President's Council on Physical Fitness and Sports, examines the state of physical education in secondary school programs and presents twelve commonalities of quality physical education programs. Those common characteristics are identified as: (1) high student and staff morale; (2) frequent methods…

Instructional Coaching as High-Quality Professional Development

ERIC Educational Resources Information Center

Desimone, Laura M.; Pak, Katie

2017-01-01

In response to policy initiatives calling for the implementation of evidence-based classroom practice, instructional coaches are frequently utilized as providers of professional development (PD). Despite the demand for instructional coaches, there is little empirical evidence that coaching improves teacher practice. We address this limitation by…

Neglected waterborne parasitic protozoa and their detection in water.

PubMed

Plutzer, Judit; Karanis, Panagiotis

2016-09-15

Outbreak incidents raise the question of whether the less frequent aetiological agents of outbreaks are really less frequent in water. Alternatively, waterborne transmission could be relevant, but the lack of attention and rapid, sensitive methods to recover and detect the exogenous stages in water may keep them under-recognized. High quality information on the prevalence and detection of less frequent waterborne protozoa, such as Cyclospora cayetanensis, Toxoplasma gondii, Isospora belli, Balantidium coli, Blastocystis hominis, Entamoeba histolytica and other free-living amoebae (FLA), are not available. This present paper discusses the detection tools applied for the water surveillance of the neglected waterborne protozoa mentioned above and provides future perspectives. Copyright © 2016 Elsevier Ltd. All rights reserved.

Clinical characteristics of persistent frequent attenders in primary care: case-control study.

PubMed

Patel, Shireen; Kai, Joe; Atha, Christopher; Avery, Anthony; Guo, Boliang; James, Marilyn; Malins, Samuel; Sampson, Christopher; Stubley, Michelle; Morriss, Richard

2015-12-01

Most frequent attendance in primary care is temporary, but persistent frequent attendance is expensive and may be suitable for psychological intervention. To plan appropriate intervention and service delivery, there is a need for research involving standardized psychiatric interviews with assessment of physical health and health status. To compare the mental and physical health characteristics and health status of persistent frequent attenders (FAs) in primary care, currently and over the preceding 2 years, with normal attenders (NAs) matched by age, gender and general practice. Case-control study of 71 FAs (30 or more GP or practice nurse consultations in 2 years) and 71 NAs, drawn from five primary care practices, employing standardized psychiatric interview, quality of life, health anxiety and primary care electronic record review over the preceding 2 years. Compared to NAs, FAs were more likely to report a lower quality of life (P < 0.001), be unmarried (P = 0.03) and have no educational qualifications (P = 0.009) but did not differ in employment status. FAs experienced greater health anxiety (P < 0.001), morbid obesity (P = 0.02), pain (P < 0.001) and long-term pathological and ill-defined physical conditions (P < 0.001). FAs had more depression including dysthymia, anxiety and somatoform disorders (all P < 0.001). Persistent frequent attendance in primary care was associated with poor quality of life and high clinical complexity characterized by diverse and often persistent physical and mental multimorbidity. A brokerage model with GPs working in close liaison with skilled psychological therapists is required to manage such persistent complexity. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Correlation between anthropometric indicators and sleep quality among Brazilian university students].

PubMed

de Vasconcelos, Hérica Cristina Alves; Fragoso, Luciana Vládia Carvalhêdo; Marinho, Niciane Bandeira Pessoa; de Araújo, Márcio Flávio Moura; de Freitas, Roberto Wagner Júnior Freire; Zanetti, Maria Lúcia; Damasceno, Marta Maria Coelho

2013-08-01

The current study investigated the correlation between anthropometric indicators and sleep quality among Brazilian university students using the Pittsburgh Sleep Quality Index. A cross-sectional assessment with 702 university students was conducted between March 2010 and June 2011. Results showed that cases of obesity were more frequent among students who were good sleepers. On the other hand, overweight and high cervical and abdominal circumference was most prominent among poor sleepers. Thus, apart from the damage caused by sleep disorders alone, additional risks due to the association between poor sleep quality and being overweight, central obesity, and increased cervical perimeter are highlighted.

Improving Quality of Care for Seriously Ill Patients: Opportunities for Hospitalists.

PubMed

Fail, Robin E; Meier, Diane E

2018-03-01

As the shift to value-based payment accelerates, hospitals are under increasing pressure to deliver high-quality, efficient services. Palliative care approaches improve quality of life and family well-being, and in doing so, reduce resource utilization and costs. Hospitalists frequently provide palliative care interventions to their patients, including pain and symptom management and engaging in conversations with patients and families about the realities of their illness and treatment plans that align with their priorities. Hospitalists are ideally positioned to identify patients who could most benefit from palliative care approaches and often refer the most complex cases to specialty palliative care teams. Though hospitalists are frequently called upon to provide palliative care, most lack formal training in these skills, which have not typically been included in medical education. Additional training in communication, safe and effective symptom management, and other palliative care knowledge and skills are available in both in-person and online formats. © 2017 Society of Hospital Medicine.

Microbial Community Structure in Relation to Water Quality in a Eutrophic Gulf of Mexico Estuary

EPA Science Inventory

Weeks Bay is a shallow, microtidal, eutrophic sub-estuary of Mobile Bay, AL. High watershed nutrient inputs to the estuary contribute to a eutrophic condition characterized by frequent summertime diel-cycling hypoxia and dissolved oxygen (DO) oversaturation. Spatial and seasonal ...

38 CFR 36.4347 - Lender Appraisal Processing Program.

Code of Federal Regulations, 2012 CFR

2012-07-01

... subsequent office case review requirements, routine reviews of LAPP cases will be made by VA staff based upon..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

38 CFR 36.4347 - Lender Appraisal Processing Program.

Code of Federal Regulations, 2013 CFR

2013-07-01

... subsequent office case review requirements, routine reviews of LAPP cases will be made by VA staff based upon..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

38 CFR 36.4347 - Lender Appraisal Processing Program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... subsequent office case review requirements, routine reviews of LAPP cases will be made by VA staff based upon..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

38 CFR 36.4347 - Lender Appraisal Processing Program.

Code of Federal Regulations, 2014 CFR

2014-07-01

... subsequent office case review requirements, routine reviews of LAPP cases will be made by VA staff based upon..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

Improved hairline crack detector and poor shell-quality eggs

USDA-ARS?s Scientific Manuscript database

Cracks frequently occur throughout various points of egg collection and processing and there are numerous high-speed online commercial crack detectors in use. The accuracy of crack detectors is validated by USDA human graders to ensure that they are in compliance with voluntary grade standards USDA...

Analysis of readability and quality of web pages addressing both common and uncommon topics in pediatric surgery.

PubMed

Adorisio, Ottavio; Silveri, Massimiliano; Rivosecchi, Massimo; Tozzi, Alberto Eugenio; Scottoni, Federico; Buonuomo, Paola Sabrina

2012-06-01

The quality medical information on Internet is highly variable. The aim of this study is to determine if Web pages addressing four common pediatric surgical topics (CT) and four uncommon pediatric surgical topics (UT) differ significantly in terms of quality and/or characteristics. We performed an Internet search regarding four CT, addressing more frequent clinical conditions with an incidence≤1:1.500 children (inguinal hernia, varicocele, umbilical hernia, and phimosis) and four UT addressing less frequent clinical conditions with an incidence≥1:1.500 children (anorectal malformation, intestinal atresia, gastroschisis, and omphalocele), using a popular search engine (Google). We evaluated readability with the Flesch reading ease (FRE) and the Flesch-Kincaid grade (FKG) and quality of content using the site checker of the HON Code of Conduct (HON code) for each website. In this study, 30/40 websites addressing CT versus 33/50 addressing UT responded to our criteria. No differences statistically significant in advertisements between the two groups were found (15 vs. 16%) (p>0.05). No differences were found in terms of time from last update, owner/author type, financial disclosure, accreditation, or advertising. CT had higher quality level according to the HON code (6.54±1.38 vs. 5.05±1.82) (p<0.05). Mean FRE was 47.38±14.27 versus 46.24±14.56, respectively, for CT and UT (p>0.05). The mean FKG was 8.1±1.9 for CT versus 8±1.9 for UT (p>0.05). Websites devoted to pediatric surgical topics have higher readability and quality information for disease diagnosis and natural history. Otherwise, the quality of pediatric surgical information on the Internet is high for CT and UT. A high reading level is required to use these resources. Copyright © 2012 by Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Evaluation of the quality and health literacy demand of online renal diet information.

PubMed

Lambert, K; Mullan, J; Mansfield, K; Koukomous, A; Mesiti, L

2017-10-01

Dietary modification is critical in the self-management of chronic kidney disease. The present study describes the accuracy, quality and health literacy demand of renal diet information for adults with kidney disease obtained from the Internet and YouTube (www.youtube.com). A comprehensive content analysis was undertaken in April and July 2015 of 254 eligible websites and 161 YouTube videos. The accuracy of the renal diet information was evaluated by comparing the key messages with relevant evidence-based guidelines for the dietary management of people with kidney disease. The DISCERN tool (www.discern.org.uk) was used to evaluate the quality of the material. Health literacy demand was evaluated using the Patient Education Material Assessment Tool (www.ahrq.gov/professionals/prevention-chronic-care/improve/self-mgmt/pemat/index.html) and seven validated readability calculators. The most frequent renal diet topic found online was generic dietary information for people with chronic kidney disease. The proportion of renal diet information obtained from websites that was accurate was 73%. However, this information was mostly of poor quality with extensive shortcomings, difficult to action and written with a high health literacy demand. By contrast, renal diet information available from YouTube was highly understandable and actionable, although only 18% of the videos were accurate, and a large proportion were of poor quality with extensive shortcomings. The most frequent authors of accurate, good quality, understandable, material were government bodies, dietitians, academic institutions and medical organisations. Renal diet information found online that is written by government bodies, dietitians, academic institutions and medical organisations is recommended. Further work is required to improve the quality and, most importantly, the actionability of renal diet information found online. © 2017 The British Dietetic Association Ltd.

Measuring the Jungian personality types of Hispanic high school students.

PubMed

Mittag, K C

1999-09-01

Measures of normal variations in personality, called psychological type, are frequently used in education (e.g., to identify learning styles) and counseling (e.g., in career counseling). However, the most frequently-used measure of types, developed by Myers and Briggs, has been criticized on various psychometric grounds. The present study investigated the psychometric properties of an alternative measure, the Personal Preferences Self-Description Questionnaire (PPSDQ), which employs normative rather than ipsative (forced-choice) items. Because previous studies of the measure have primarily used older and highly literate participants, the present study was conducted with 328 Hispanic high school students to determine whether the sound psychometric quality of PPSDQ scores was compromised by vocabulary or language issues. The results of reliability and factor analyses were generally favorable as regards PPSDQ score integrity.

7 CFR 657.5 - Identification of important farmlands.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the soil quality, growing season, and moisture supply needed to economically produce sustained high... frequently or are protected from flooding. Examples of soils that qualify as prime farmland are Palouse silt... section are defined in USDA publications: “Soil Taxonomy, Agriculture Handbook 436”; “Soil Survey Manual...

7 CFR 657.5 - Identification of important farmlands.

Code of Federal Regulations, 2011 CFR

2011-01-01

... the soil quality, growing season, and moisture supply needed to economically produce sustained high... frequently or are protected from flooding. Examples of soils that qualify as prime farmland are Palouse silt... section are defined in USDA publications: “Soil Taxonomy, Agriculture Handbook 436”; “Soil Survey Manual...

7 CFR 657.5 - Identification of important farmlands.

Code of Federal Regulations, 2013 CFR

2013-01-01

... the soil quality, growing season, and moisture supply needed to economically produce sustained high... frequently or are protected from flooding. Examples of soils that qualify as prime farmland are Palouse silt... section are defined in USDA publications: “Soil Taxonomy, Agriculture Handbook 436”; “Soil Survey Manual...

7 CFR 657.5 - Identification of important farmlands.

Code of Federal Regulations, 2014 CFR

2014-01-01

... the soil quality, growing season, and moisture supply needed to economically produce sustained high... frequently or are protected from flooding. Examples of soils that qualify as prime farmland are Palouse silt... section are defined in USDA publications: “Soil Taxonomy, Agriculture Handbook 436”; “Soil Survey Manual...

7 CFR 657.5 - Identification of important farmlands.

Code of Federal Regulations, 2012 CFR

2012-01-01

... the soil quality, growing season, and moisture supply needed to economically produce sustained high... frequently or are protected from flooding. Examples of soils that qualify as prime farmland are Palouse silt... section are defined in USDA publications: “Soil Taxonomy, Agriculture Handbook 436”; “Soil Survey Manual...

Vocabulary Development at Home: A Multimedia Elaborated Picture Supporting Parent-Toddler Interaction

ERIC Educational Resources Information Center

Gremmen, M. C.; Molenaar, I.; Teepe, R. C.

2016-01-01

Some children enter elementary school with large vocabulary delays, which negatively influence their later school performance. A rich home language environment can support vocabulary development through frequent high-quality parent-toddler interaction. Elaborated picture home activities can support this rich home language environment. This study…

Achieving Quality in e-Learning through Relational Coordination

ERIC Educational Resources Information Center

Margalina, Vasilica Maria; De-Pablos-Heredero, Carmen; Montes-Botella, Jose Luis

2017-01-01

In this research, the relational coordination model has been applied to prove learners' and instructors' high levels of satisfaction in e-learning. According to the model, organizations can obtain better results in terms of satisfaction by providing shared knowledge, shared goals and mutual respect mechanisms, supported by a frequent, timely and…

Impact of Grassed Waterways and Compost Filter Socks on the Quality of Surface Runoff from Corn Fields

USDA-ARS?s Scientific Manuscript database

Surface runoff from cropland frequently has high concentrations of nutrients and herbicides, particularly in the first few events after application. Grassed waterways can control erosion while transmitting this runoff offsite, but are generally ineffective in removing dissolved agrochemicals. In thi...

A Proposed Algebra Assessment for Use in a Problem-Analysis Framework

ERIC Educational Resources Information Center

Walick, Christopher M.; Burns, Matthew K.

2017-01-01

Algebra is critical to high school graduation and college success, but student achievement in algebra frequently falls significantly below expected proficiency levels. While existing research emphasizes the importance of quality algebra instruction, there is little research about how to conduct problem analysis for struggling secondary students.…

Response to Intervention Blueprints: District Level Edition

ERIC Educational Resources Information Center

Elliott, Judy; Morrison, Diane

2008-01-01

Response to Intervention (RtI) is the practice of providing high quality instruction and interventions matched to student need, monitoring progress frequently to make decisions about changes in instruction or goals and applying student response data to important educational decisions. RtI should be applied to decisions in general, remedial and…

Response to Intervention Blueprints: School Building Level Edition

ERIC Educational Resources Information Center

Kurns, Sharon; Tilly, W. David

2008-01-01

Response to Intervention (RtI) is the practice of providing high quality instruction and interventions matched to student need, monitoring progress frequently to make decisions about changes in instruction or goals and applying student response data to important educational decisions. RtI should be applied to decisions in general, remedial and…

Response to Intervention Implementation Guide: The South Dakota Model

ERIC Educational Resources Information Center

South Dakota Department of Education, 2012

2012-01-01

The National Association of State Directors of Special Education (NASDSE, 2005) defines response to intervention (RTI) as the practice of providing high-quality instruction and intervention based on a student's needs, changing instruction and/or goals through frequent monitoring of progress, and applying the student response data to important…

Structural Colour in Colourimetric Sensors and Indicators

DTIC Science & Technology

2013-07-11

for disease detection at a hospital).6–8 For these problems, many highly sophisticated chemical analysis technologies have emerged, such as high...fulls important functions in society such as disease diagnosis, health and safety monitoring, threat and hazard detection, and industrial quality...demand for devices that can detect and identify small mole- cules. Health-monitoring and disease diagnosis frequently require tracking the levels of

The effect of texture granularity on texture synthesis quality

NASA Astrophysics Data System (ADS)

Golestaneh, S. Alireza; Subedar, Mahesh M.; Karam, Lina J.

2015-09-01

Natural and artificial textures occur frequently in images and in video sequences. Image/video coding systems based on texture synthesis can make use of a reliable texture synthesis quality assessment method in order to improve the compression performance in terms of perceived quality and bit-rate. Existing objective visual quality assessment methods do not perform satisfactorily when predicting the synthesized texture quality. In our previous work, we showed that texture regularity can be used as an attribute for estimating the quality of synthesized textures. In this paper, we study the effect of another texture attribute, namely texture granularity, on the quality of synthesized textures. For this purpose, subjective studies are conducted to assess the quality of synthesized textures with different levels (low, medium, high) of perceived texture granularity using different types of texture synthesis methods.

Obesogenic dietary intake in families with 1-year-old infants at high and low obesity risk based on parental weight status: baseline data from a longitudinal intervention (Early STOPP).

PubMed

Svensson, Viktoria; Sobko, Tanja; Ek, Anna; Forssén, Michaela; Ekbom, Kerstin; Johansson, Elin; Nowicka, Paulina; Westerståhl, Maria; Riserus, Ulf; Marcus, Claude

2016-03-01

To compare dietary intake in 1-year-old infants and their parents between families with high and low obesity risk, and to explore associations between infant dietary intake and relative weight. Baseline analyses of 1-year-old infants (n = 193) and their parents participating in a longitudinal obesity intervention (Early STOPP) were carried out. Dietary intake and diet quality indicators were compared between high- and low-risk families, where obesity risk was based on parental weight status. The odds for high diet quality in relation to parental diet quality were determined. Associations between measured infant relative weight and dietary intake were examined adjusting for obesity risk, socio-demographics, and infant feeding. Infant dietary intake did not differ between high- and low-risk families. The parents in high-risk families consumed soft drinks, French fries, and low-fat spread more frequently, and fish and fruits less frequently (p < 0.05) compared to parents in low-risk families. Paternal intake of vegetables and fish increased the odds for children being consumers of vegetables (OR 1.7; 95 % CI 1.0-2.9) and fish, respectively (OR 2.5; 95 % CI 1.4-4.4). Infant relative weight was weakly associated with a high intake of milk cereal drink (r = 0.15; p < 0.05), but not with any other aspect of dietary intake, obesity risk, or early feeding patterns. At the age of one, dietary intake in infants is not associated with family obesity risk, nor with parental obesogenic food intake. Milk cereal drink consumption but no other infant dietary marker reflects relative weight at this young age.

Poor sleep quality and nightmares are associated with non-suicidal self-injury in adolescents.

PubMed

Liu, Xianchen; Chen, Hua; Bo, Qi-Gui; Fan, Fang; Jia, Cun-Xian

2017-03-01

Non-suicidal self-injury (NSSI) is prevalent and is associated with increased risk of suicidal behavior in adolescents. This study examined which sleep variables are associated with NSSI, independently from demographics and mental health problems in Chinese adolescents. Participants consisted of 2090 students sampled from three high schools in Shandong, China and had a mean age of 15.49 years. Participants completed a sleep and health questionnaire to report their demographic and family information, sleep duration and sleep problems, impulsiveness, hopelessness, internalizing and externalizing problems, and NSSI. A series of regression analyses were conducted to examine the associations between sleep variables and NSSI. Of the sample, 12.6 % reported having ever engaged in NSSI and 8.8 % engaged during the last year. Univariate logistic analyses demonstrated that multiple sleep variables including short sleep duration, insomnia symptoms, poor sleep quality, sleep insufficiency, unrefreshed sleep, sleep dissatisfaction, daytime sleepiness, fatigue, snoring, and nightmares were associated with increased risk of NSSI. After adjusting for demographic and mental health variables, NSSI was significantly associated with sleeping <6 h per night, poor sleep quality, sleep dissatisfaction, daytime sleepiness, and frequent nightmares. Stepwise logistic regression model demonstrated that poor sleep quality (OR = 2.18, 95 % CI = 1.37-3.47) and frequent nightmares (OR = 2.88, 95 % CI = 1.45-5.70) were significantly independently associated with NSSI. In conclusion, while multiple sleep variables are associated with NSSI, poor sleep quality and frequent nightmares are independent risk factors of NSSI. These findings may have important implications for further research of sleep self-harm mechanisms and early detection and prevention of NSSI in adolescents.

High dietary quality of non-toxic cyanobacteria for a benthic grazer and its implications for the control of cyanobacterial biofilms.

PubMed

Groendahl, Sophie; Fink, Patrick

2017-05-18

Mass occurrences of cyanobacteria frequently cause detrimental effects to the functioning of aquatic ecosystems. Consequently, attempts haven been made to control cyanobacterial blooms through naturally co-occurring herbivores. Control of cyanobacteria through herbivores often appears to be constrained by their low dietary quality, rather than by the possession of toxins, as also non-toxic cyanobacteria are hardly consumed by many herbivores. It was thus hypothesized that the consumption of non-toxic cyanobacteria may be improved when complemented with other high quality prey. We conducted a laboratory experiment in which we fed the herbivorous freshwater gastropod Lymnaea stagnalis single non-toxic cyanobacterial and unialgal diets or a mixed diet to test if diet-mixing may enable these herbivores to control non-toxic cyanobacterial mass abundances. The treatments where L. stagnalis were fed non-toxic cyanobacteria and a mixed diet provided a significantly higher shell and soft-body growth rate than the average of all single algal, but not the non-toxic cyanobacterial diets. However, the increase in growth provided by the non-toxic cyanobacteria diets could not be related to typical determinants of dietary quality such as toxicity, nutrient stoichiometry or essential fatty acid content. These results strongly contradict previous research which describes non-toxic cyanobacteria as a low quality food resource for freshwater herbivores in general. Our findings thus have strong implications to gastropod-cyanobacteria relationships and suggest that freshwater gastropods may be able to control mass occurrences of benthic non-toxic cyanobacteria, frequently observed in eutrophied water bodies worldwide.

A Systematic Review of the Level of Evidence in Economic Evaluations of Medical Devices: The Example of Vertebroplasty and Kyphoplasty.

PubMed

Martelli, Nicolas; Devaux, Capucine; van den Brink, Hélène; Pineau, Judith; Prognon, Patrice; Borget, Isabelle

2015-01-01

Economic evaluations are far less frequently reported for medical devices than for drugs. In addition, little is known about the quality of existing economic evaluations, particularly for innovative devices, such as those used in vertebroplasty and kyphoplasty. To assess the level of evidence provided by the available economic evaluations for vertebroplasty and kyphoplasty. A systematic review of articles in English or French listed in the MEDLINE, PASCAL, COCHRANE and National Health Service Economic Evaluation databases, with limits on publication date (up to the date of the review, March 2014). We included only economic evaluations of vertebroplasty or kyphoplasty. Editorial and methodological articles were excluded. Data were extracted from articles by two authors working independently and using two analysis grids to measure the quality of economic evaluations. Twenty-one studies met our inclusion criteria. All were published between 2008 and 2014. Eighteen (86%) were full economic evaluations. Cost-effectiveness analysis (CEA) was the most frequent type of economic evaluation, and was present in 11 (52%) studies. Only three CEAs complied fully with the British Medical Journal checklist. The quality of the data sources used in the 21 studies was high, but the CEAs conforming to methodological guidelines did not use high-quality data sources for all components of the analysis. This systematic review shows that the level of evidence in economic evaluations of vertebroplasty and kyphoplasty is low, despite the recent publication of a large number of studies. This finding highlights the challenges to be faced to improve the quality of economic evaluations of medical devices.

“Putting It All Together” to Improve Resuscitation Quality

PubMed Central

Sutton, Robert M.; Nadkarni, Vinay; Abella, Benjamin S.

2013-01-01

Cardiac arrest is a major public health problem affecting thousands of individuals each year in both the before hospital and in-hospital settings. However, although the scope of the problem is large, the quality of care provided during resuscitation attempts frequently does not meet quality of care standards, despite evidence-based cardiopulmonary resuscitation (CPR) guidelines, extensive provider training, and provider credentialing in resuscitation medicine. Although this fact may be disappointing, it should not be surprising. Resuscitation of the cardiac arrest victim is a highly complex task requiring coordination between various levels and disciplines of care providers during a stressful and relatively infrequent clinical situation. Moreover, it requires a targeted, high-quality response to improve clinical outcomes of patients. Therefore, solutions to improve care provided during resuscitation attempts must be multifaceted and targeted to the diverse number of care providers to be successful. PMID:22107978

Spatial resampling of IDR frames for low bitrate video coding with HEVC

NASA Astrophysics Data System (ADS)

Hosking, Brett; Agrafiotis, Dimitris; Bull, David; Easton, Nick

2015-03-01

As the demand for higher quality and higher resolution video increases, many applications fail to meet this demand due to low bandwidth restrictions. One factor contributing to this problem is the high bitrate requirement of the intra-coded Instantaneous Decoding Refresh (IDR) frames featuring in all video coding standards. Frequent coding of IDR frames is essential for error resilience in order to prevent the occurrence of error propagation. However, as each one consumes a huge portion of the available bitrate, the quality of future coded frames is hindered by high levels of compression. This work presents a new technique, known as Spatial Resampling of IDR Frames (SRIF), and shows how it can increase the rate distortion performance by providing a higher and more consistent level of video quality at low bitrates.

You Are Not Alone: Colleague Support and Goal-Oriented Cooperation as Resources to Reduce Teachers' Stress

ERIC Educational Resources Information Center

Wolgast, Anett; Fischer, Natalie

2017-01-01

The teaching profession is associated with high levels of perceived stress due to time constraints, heavy workload, and extra-curricular obligations. Teachers' perceived stress affects the quality of their instruction and consequently their students' motivation. According to social interdependence theory, frequent cooperative activities with…

Wood decay and the cleanup crew

Treesearch

Kevin T. Smith; Jessie A. Glaeser

2017-01-01

Arborists are encouraged to recognize the wood-decay process as an important factor in tree health and public safety. Technical experts who develop training materials to recognize wood-decay processes in living trees are frequently forest pathologists. Much of the history of forest pathology was to support production of sound, high-quality timber. That heritage is...

Exploring the Influences on Classroom-Based Contact via Shared Education in Northern Ireland

ERIC Educational Resources Information Center

Loader, Rebecca

2017-01-01

Initiatives in intercultural education have frequently involved the promotion of contact between members of different groups as a means of improving intergroup relations. Experience from Northern Ireland suggests, however, that such schemes have often been organised and delivered in such a way that opportunities for sustained, high-quality contact…

A Peer Assessment System to Improve Student Team Experiences

ERIC Educational Resources Information Center

Anson, Robert; Goodman, James A.

2014-01-01

Groups are frequently used in courses, but there is substantial evidence that insufficient attention is paid to creating conditions for successful teamwork. One key condition is high-quality, individual, and team-level feedback. An online peer assessment system and team improvement process was developed for this test case based on three design…

On the Home Front: Early Care and Education a Top Priority for Military Families

ERIC Educational Resources Information Center

Coleman, Alice

2011-01-01

Military parents with young children report that the need for early care and education services, including high-quality pre-kindergarten, tops their list of day-to-day needs. Frequent relocations and the cycle of deployment--preparation, separation and reunification--all cause disruptions that can have profound emotional and educational…

Re-Imagining the Nature of (Student-Focused) Learning through Digital Technology

ERIC Educational Resources Information Center

Hood, Nina

2018-01-01

Digital technology is frequently positioned as being central to the establishment of a 'future focused' education system that provides high quality student-focused learning opportunities and re-envisioned educational outcomes. While recognising the potential of technology, this paper explores some of the questions about its role in education and…

Pain in Parkinson disease: a cross-sectional survey of its prevalence, specifics, and therapy.

PubMed

Buhmann, Carsten; Wrobel, Nathalie; Grashorn, Wiebke; Fruendt, Odette; Wesemann, Katharina; Diedrich, Sabrina; Bingel, Ulrike

2017-04-01

We aimed to evaluate prevalence, phenotype, and therapeutic realities of pain in patients with Parkinson disease (PD). Therefore, we assessed 181 outpatients with PD using a cross-sectional approach applying the German Pain Questionaire (DSF), the PainDetect, and a self-developed Parkinson Disease Pain Questionaire (UPDPQ) covering detailed therapeutic aspects. Furthermore, we investigated the association between pain and PD-disease characteristics, quality of life (PDQ-39), depression, and anxiety (HADS-D, HADS-A). Overall, prevalence of pain was high (95.4%); 91.1% suffered from chronic pain, but in only 22.3% of them, pain disorder was diagnosed. Pain impaired everyday-life moderately to very severely in 48.4% of patients and was the most distressing symptom in 10.2% of all patients. Pain was localized mainly in the back (71.4%) or joints (52.4%), frequently occurred as pain attacks (79%) but appeared with neuropathic character in only 15.3% of patients. Most patients (74.2%) received some kind of pain treatment, mainly provided by orthopedists (62.0%) or general practitioners (50.0%). Physiotherapy (61.3%), pain killers (54.4%), or massage (35.5%) were the most frequent therapeutic measures. Rehabilitative therapy (96.3%) and physiotherapy (89.5%) were rated as most effective, but with vastly temporary effects. 53.3% of patients attributed PD as the main cause for their pain, but only 33.6% found relief from anti-parkinsonian drugs. High levels of pain were associated with higher scores of depression and anxiety, and lower quality of life. Results suggest that pain in PD is frequent, complex, and quality-of-life-impairing but under-diagnosed and unsystematically treated and indicate need to systematically investigate pathophysiology-based treatment strategies.

Paracetamol (acetaminophen) for acute treatment of episodic tension-type headache in adults.

PubMed

Stephens, Guy; Derry, Sheena; Moore, R Andrew

2016-06-16

Tension-type headache (TTH) affects about 1 person in 5 worldwide. It is divided into infrequent episodic TTH (fewer than one headache per month), frequent episodic TTH (two to 14 headaches per month), and chronic TTH (15 headache days a month or more). Paracetamol (acetaminophen) is one of a number of analgesics suggested for acute treatment of headaches in frequent episodic TTH. To assess the efficacy and safety of paracetamol for the acute treatment of frequent episodic TTH in adults. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (CRSO), MEDLINE, EMBASE, and the Oxford Pain Relief Database to October 2015, and also reference lists of relevant published studies and reviews. We sought unpublished studies by asking personal contacts and searching online clinical trial registers and manufacturers' websites. We included randomised, double-blind, placebo-controlled studies (parallel-group or cross-over) using oral paracetamol for symptomatic relief of an acute episode of TTH. Studies had to be prospective, with participants aged 18 years or over, and include at least 10 participants per treatment arm. Two review authors independently assessed studies for inclusion and extracted data. We used the numbers of participants achieving each outcome to calculate the risk ratio (RR) and number needed to treat for one additional beneficial outcome (NNT) or one additional harmful outcome (NNH) for oral paracetamol compared to placebo or an active intervention for a range of outcomes, predominantly those recommended by the International Headache Society (IHS).We assessed the evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation) and created 'Summary of findings' tables. We included 23 studies, all of which enrolled adults with frequent episodic TTH. Twelve studies used the IHS diagnostic criteria or similar, six used the older classification of the Ad Hoc Committee, and five did not describe specific diagnostic criteria but generally excluded participants with migraines. Participants had moderate or severe pain at the start of treatment. While 8079 people with TTH participated in these studies, the numbers available for any analysis were lower than this because outcomes were inconsistently reported and because many participants received active comparators.None of the included studies were at low risk of bias across all domains considered, although for most studies and domains this was likely to be due to inadequate reporting rather than poor methods. We judged five studies to be at high risk of bias for incomplete outcome reporting, and seven due to small size.For the IHS preferred outcome of being pain free at two hours the NNT for paracetamol 1000 mg compared with placebo was 22 (95% confidence interval (CI) 15 to 40) in eight studies (5890 participants; high quality evidence), with no significant difference from placebo at one hour. The NNT was 10 (7.9 to 14) for pain-free or mild pain at two hours in five studies (5238 participants; high quality evidence). The use of rescue medication was lower with paracetamol 1000 mg than with placebo, with an NNTp to prevent an event of 7.8 (6.0 to 11) in six studies (1856 participants; moderate quality evidence). On limited data, the efficacy of paracetamol 500 mg to 650 mg was not superior to placebo, and paracetamol 1000 mg was not different from either ketoprofen 25 mg or ibuprofen 400 mg (low quality evidence).Adverse events were not different between paracetamol 1000 mg and placebo (RR 1.1 (0.94 to 1.3); 5605 participants; 11 studies; high quality evidence). Studies reported no serious adverse events.The quality of the evidence using GRADE comparing paracetamol 1000 mg with placebo was moderate to high. Where evidence was downgraded it was because a minority of studies reported the outcome. For comparisons of paracetamol 500 mg to 650 mg with placebo, and of paracetamol 1000 mg with active comparators, we downgraded the evidence to low quality or very low quality because of the small number of studies and events. Paracetamol 1000 mg provided a small benefit in terms of being pain free at two hours for people with frequent episodic TTH who have an acute headache of moderate or severe intensity.

Experimental evaluation of ontology-based HIV/AIDS frequently asked question retrieval system.

PubMed

Ayalew, Yirsaw; Moeng, Barbara; Mosweunyane, Gontlafetse

2018-05-01

This study presents the results of experimental evaluations of an ontology-based frequently asked question retrieval system in the domain of HIV and AIDS. The main purpose of the system is to provide answers to questions on HIV/AIDS using ontology. To evaluate the effectiveness of the frequently asked question retrieval system, we conducted two experiments. The first experiment focused on the evaluation of the quality of the ontology we developed using the OQuaRE evaluation framework which is based on software quality metrics and metrics designed for ontology quality evaluation. The second experiment focused on evaluating the effectiveness of the ontology in retrieving relevant answers. For this we used an open-source information retrieval platform, Terrier, with retrieval models BM25 and PL2. For the measurement of performance, we used the measures mean average precision, mean reciprocal rank, and precision at 5. The results suggest that frequently asked question retrieval with ontology is more effective than frequently asked question retrieval without ontology in the domain of HIV/AIDS.

Diabetes quality of care and outpatient utilization associated with electronic patient-provider messaging: a cross-sectional analysis.

PubMed

Harris, Lynne T; Haneuse, Sebastien J; Martin, Diane P; Ralston, James D

2009-07-01

To test the hypothesis that electronic patient-provider messaging is associated with high care quality for diabetes and lower outpatient utilization. We conducted a cross-sectional analysis of electronic patient-provider messaging over a 15-month period between 1 January 2004 and 31 March 2005. The study was set at Group Health Cooperative--a consumer-governed, nonprofit health care system that operates in Washington and Idaho. Participants included all patients aged >or=18 years with a diagnosis of diabetes. In addition to usual care, all patients had the option to use electronic messaging to communicate with their care providers. The primary outcome measures were diabetes-related quality-of-care indicators (A1C, blood pressure, and LDL cholesterol) and outpatient visits (primary care, specialty care, and emergency). Nineteen percent of patients with diabetes used electronic messaging to communicate with their care providers during the study period (n = 2,924) (overall study cohort: 15,427 subjects). In multivariate models, frequent use of electronic messaging was associated with A1C <7% (relative risk [RR] 1.36 [95% CI 1.16-1.58]). Contrary to our hypothesis, frequent use of electronic messaging was also associated with a higher rate of outpatient visits (1.39 [1.26-1.53]). Frequent use of electronic secure messaging is associated with better glycemic control and increased outpatient utilization. Electronic patient-provider communication may represent one strategy to meet the health care needs of this unique population. More research is necessary to assess the effect of electronic messaging on care quality and utilization.

High and low neurobehavior disinhibition clusters within locales: implications for community efforts to prevent substance use disorder.

PubMed

Ridenour, Ty A; Reynolds, Maureen; Ahlqvist, Ola; Zhai, Zu Wei; Kirisci, Levent; Vanyukov, Michael M; Tarter, Ralph E

2013-05-01

Knowledge of where substance use and other such behavioral problems frequently occur has aided policing, public health, and urban planning strategies to reduce such behaviors. Identifying locales characterized by high childhood neurobehavioral disinhibition (ND), a strong predictor of substance use and consequent disorder (SUD), may likewise improve prevention efforts. The distribution of ND in 10-12-year olds was mapped to metropolitan Pittsburgh, PA, and tested for clustering within locales. The 738 participating families represented the population in terms of economic status, race, and population distribution. ND was measured using indicators of executive cognitive function, emotion regulation, and behavior control. Innovative geospatial analyzes statistically tested clustering of ND within locales while accounting for geographic barriers (large rivers, major highways), parental SUD severity, and neighborhood quality. Clustering of youth with high and low ND occurred in specific locales. Accounting for geographic barriers better delineated where high ND is concentrated, areas which also tended to be characterized by greater parental SUD severity and poorer neighborhood quality. Offering programs that have been demonstrated to improve inhibitory control in locales where youth have high ND on average may reduce youth risk for SUD and other problem behaviors. As demonstrated by the present results, geospatial analysis of youth risk factors, frequently used in community coalition strategies, may be improved with greater statistical and measurement rigor.

Robotic Prostatectomy on the Web: A Cross-Sectional Qualitative Assessment.

PubMed

Borgmann, Hendrik; Mager, René; Salem, Johannes; Bründl, Johannes; Kunath, Frank; Thomas, Christian; Haferkamp, Axel; Tsaur, Igor

2016-08-01

Many patients diagnosed with prostate cancer search for information on robotic prostatectomy (RobP) on the Web. We aimed to evaluate the qualitative characteristics of the mostly frequented Web sites on RobP with a particular emphasis on provider-dependent issues. Google was searched for the term "robotic prostatectomy" in Europe and North America. The mostly frequented Web sites were selected and classified as physician-provided and publically-provided. Quality was measured using Journal of the American Medical Association (JAMA) benchmark criteria, DISCERN score, and addressing of Trifecta surgical outcomes. Popularity was analyzed using Google PageRank and Alexa tool. Accessibility, usability, and reliability were investigated using the LIDA tool and readability was assessed using readability indices. Twenty-eight Web sites were physician-provided and 15 publically-provided. For all Web sites, 88% of JAMA benchmark criteria were fulfilled, DISCERN quality score was high, and 81% of Trifecta outcome measurements were addressed. Popularity was average according to Google PageRank (mean 2.9 ± 1.5) and Alexa Traffic Rank (median, 49,109; minimum, 7; maximum, 8,582,295). Accessibility (85 ± 7%), usability (92 ± 3%), and reliability scores (88 ± 8%) were moderate to high. Automated Readability Index was 7.2 ± 2.1 and Flesch-Kincaid Grade Level was 9 ± 2, rating the Web sites as difficult to read. Physician-provided Web sites had higher quality scores and lower readability compared with publically-provided Web sites. Websites providing information on RobP obtained medium to high ratings in all domains of quality in the current assessment. In contrast, readability needs to be significantly improved so that this content can become available for the populace. Copyright © 2015 Elsevier Inc. All rights reserved.

Clinical characteristics of pain in patients with pituitary adenomas.

PubMed

Dimopoulou, C; Athanasoulia, A P; Hanisch, E; Held, S; Sprenger, T; Toelle, T R; Roemmler-Zehrer, J; Schopohl, J; Stalla, G K; Sievers, C

2014-11-01

Clinical presentation of pituitary adenomas frequently involves pain, particularly headache, due to structural and functional properties of the tumour. Our aim was to investigate the clinical characteristics of pain in a large cohort of patients with pituitary disease. In a cross-sectional study, we assessed 278 patients with pituitary disease (n=81 acromegaly; n=45 Cushing's disease; n=92 prolactinoma; n=60 non-functioning pituitary adenoma). Pain was studied using validated questionnaires to screen for nociceptive vs neuropathic pain components (painDETECT), determine pain severity, quality, duration and location (German pain questionnaire) and to assess the impact of pain on disability (migraine disability assessment, MIDAS) and quality of life (QoL). We recorded a high prevalence of bodily pain (n=180, 65%) and headache (n=178, 64%); adrenocorticotropic adenomas were most frequently associated with pain (n=34, 76%). Headache was equally frequent in patients with macro- and microadenomas (68 vs 60%; P=0.266). According to painDETECT, the majority of the patients had a nociceptive pain component (n=193, 80%). Despite high prevalence of headache, 72% reported little or no headache-related disability (MIDAS). Modifiable factors including tumour size, genetic predisposition, previous surgery, irradiation or medical therapy did not have significant impact neither on neuropathic pain components (painDETECT) nor on headache-related disability (MIDAS). Neuropathic pain and pain-related disability correlated significantly with depression and impaired QoL. Pain appears to be a frequent problem in pituitary disease. The data suggest that pain should be integrated in the diagnostic and therapeutic work-up of patients with pituitary disease in order to treat them appropriately and improve their QoL. © 2014 European Society of Endocrinology.

Quality of Mental Health Care for Nursing Home Residents: A Literature Review

PubMed Central

Grabowski, David C.; Aschbrenner, Kelly A.; Rome, Vincent F.; Bartels, Stephen J.

2010-01-01

Because of the high proportion of nursing home residents with a mental illness other than dementia, the quality of mental health care in nursing homes is a major clinical and policy issue. The authors apply Donabedian's framework for assessing quality of care based on the triad of structure, process, and outcome-based measures in reviewing the literature on the quality of mental health care in nursing homes. Quality measures used within the literature include mental health consultations and hospitalizations, inappropriate use of medications, and mental health survey deficiencies. Factors related to the resident's welfare (nurse staffing), provider norms (locality), and financial factors (payer mix) were associated with the quality of mental health care. Although future research is necessary, the extant literature suggests that persons with mental illness are frequently admitted to nursing homes and their care is often of poor quality and related to a series of resident and facility factors. PMID:20223943

Using Ensemble-Based Methods for Directly Estimating Causal Effects: An Investigation of Tree-Based G-Computation

ERIC Educational Resources Information Center

Austin, Peter C.

2012-01-01

Researchers are increasingly using observational or nonrandomized data to estimate causal treatment effects. Essential to the production of high-quality evidence is the ability to reduce or minimize the confounding that frequently occurs in observational studies. When using the potential outcome framework to define causal treatment effects, one…

Seeding and fertilization effects on plant cover and community recovery following wildfire in the Eastern Cascade Mountains, USA

Treesearch

Erich Kyle Dodson; David W. Peterson

2009-01-01

Slope stabilization treatments are frequently applied following high severity wildfires to reduce erosion, protect water quality, and mitigate threats to human life and property. However, the effectiveness of many treatment options has not been well established. Furthermore, treatments may unintentionally inhibit natural vegetation recovery or facilitate exotic species...

Knowledge Is Power: The Issue of Censorship in Middle Grades Literacy Instruction

ERIC Educational Resources Information Center

Whitney, Jennifer D.

2007-01-01

Book challenges have become more and more frequent in recent years. In particular, those books that address issues most relevant to preteens and teenagers seem to be the object of many challenges. Many of the hundreds of challenged works represent literary classics and high-quality writing for young audiences. Teachers, administrators and other…

Video Use in Teacher Education: A Survey of Teacher-Educators' Practices across Disciplines

ERIC Educational Resources Information Center

Arya, Poonam; Christ, Tanya; Chiu, Ming Ming

2016-01-01

Video methods utilize tenets of high quality teacher education and support education students' learning and application of learning to teaching practices. However, how frequently video is used in teacher education, and in what ways is unknown. Therefore, this study used survey data to identify the extent to which 94 teacher-educators used video in…

A POC Clinical Trial for PTSD with a First-In-Class Vasopressin 1a Receptor Antagonist

DTIC Science & Technology

2016-10-01

benefit of SRX246 for the treatment of anger , irritability, and aggression; major depression ; disturbed sleep; and quality of life that frequently...treatment of major depression , anger , irritability, and aggression, disturbed sleep, and quality of life that frequently accompany PTSD. In this...BID) and ii) clinical benefit of SRX246 for the treatment of major depression ; anger , irritability, and aggression; disturbed sleep; and quality of

Effects of extreme climate events on tea (Camellia sinensis) functional quality validate indigenous farmer knowledge and sensory preferences in tropical China.

PubMed

Ahmed, Selena; Stepp, John Richard; Orians, Colin; Griffin, Timothy; Matyas, Corene; Robbat, Albert; Cash, Sean; Xue, Dayuan; Long, Chunlin; Unachukwu, Uchenna; Buckley, Sarabeth; Small, David; Kennelly, Edward

2014-01-01

Climate change is impacting agro-ecosystems, crops, and farmer livelihoods in communities worldwide. While it is well understood that more frequent and intense climate events in many areas are resulting in a decline in crop yields, the impact on crop quality is less acknowledged, yet it is critical for food systems that benefit both farmers and consumers through high-quality products. This study examines tea (Camellia sinensis; Theaceae), the world's most widely consumed beverage after water, as a study system to measure effects of seasonal precipitation variability on crop functional quality and associated farmer knowledge, preferences, and livelihoods. Sampling was conducted in a major tea producing area of China during an extreme drought through the onset of the East Asian Monsoon in order to capture effects of extreme climate events that are likely to become more frequent with climate change. Compared to the spring drought, tea growth during the monsoon period was up to 50% higher. Concurrently, concentrations of catechin and methylxanthine secondary metabolites, major compounds that determine tea functional quality, were up to 50% lower during the monsoon while total phenolic concentrations and antioxidant activity increased. The inverse relationship between tea growth and concentrations of individual secondary metabolites suggests a dilution effect of precipitation on tea quality. The decrease in concentrations of tea secondary metabolites was accompanied by reduced farmer preference on the basis of sensory characteristics as well as a decline of up to 50% in household income from tea sales. Farmer surveys indicate a high degree of agreement regarding climate patterns and the effects of precipitation on tea yields and quality. Extrapolating findings from this seasonal study to long-term climate scenario projections suggests that farmers and consumers face variable implications with forecasted precipitation scenarios and calls for research on management practices to facilitate climate adaptation for sustainable crop production.

Effects of Extreme Climate Events on Tea (Camellia sinensis) Functional Quality Validate Indigenous Farmer Knowledge and Sensory Preferences in Tropical China

PubMed Central

Ahmed, Selena; Stepp, John Richard; Orians, Colin; Griffin, Timothy; Matyas, Corene; Robbat, Albert; Cash, Sean; Xue, Dayuan; Long, Chunlin; Unachukwu, Uchenna; Buckley, Sarabeth; Small, David; Kennelly, Edward

2014-01-01

Climate change is impacting agro-ecosystems, crops, and farmer livelihoods in communities worldwide. While it is well understood that more frequent and intense climate events in many areas are resulting in a decline in crop yields, the impact on crop quality is less acknowledged, yet it is critical for food systems that benefit both farmers and consumers through high-quality products. This study examines tea (Camellia sinensis; Theaceae), the world's most widely consumed beverage after water, as a study system to measure effects of seasonal precipitation variability on crop functional quality and associated farmer knowledge, preferences, and livelihoods. Sampling was conducted in a major tea producing area of China during an extreme drought through the onset of the East Asian Monsoon in order to capture effects of extreme climate events that are likely to become more frequent with climate change. Compared to the spring drought, tea growth during the monsoon period was up to 50% higher. Concurrently, concentrations of catechin and methylxanthine secondary metabolites, major compounds that determine tea functional quality, were up to 50% lower during the monsoon while total phenolic concentrations and antioxidant activity increased. The inverse relationship between tea growth and concentrations of individual secondary metabolites suggests a dilution effect of precipitation on tea quality. The decrease in concentrations of tea secondary metabolites was accompanied by reduced farmer preference on the basis of sensory characteristics as well as a decline of up to 50% in household income from tea sales. Farmer surveys indicate a high degree of agreement regarding climate patterns and the effects of precipitation on tea yields and quality. Extrapolating findings from this seasonal study to long-term climate scenario projections suggests that farmers and consumers face variable implications with forecasted precipitation scenarios and calls for research on management practices to facilitate climate adaptation for sustainable crop production. PMID:25286362

A Systematic Review of the Level of Evidence in Economic Evaluations of Medical Devices: The Example of Vertebroplasty and Kyphoplasty

PubMed Central

van den Brink, Hélène; Pineau, Judith; Prognon, Patrice; Borget, Isabelle

2015-01-01

Context Economic evaluations are far less frequently reported for medical devices than for drugs. In addition, little is known about the quality of existing economic evaluations, particularly for innovative devices, such as those used in vertebroplasty and kyphoplasty. Objective To assess the level of evidence provided by the available economic evaluations for vertebroplasty and kyphoplasty. Data Sources A systematic review of articles in English or French listed in the MEDLINE, PASCAL, COCHRANE and National Health Service Economic Evaluation databases, with limits on publication date (up to the date of the review, March 2014). Study Selection We included only economic evaluations of vertebroplasty or kyphoplasty. Editorial and methodological articles were excluded. Data Extraction Data were extracted from articles by two authors working independently and using two analysis grids to measure the quality of economic evaluations. Data Synthesis Twenty-one studies met our inclusion criteria. All were published between 2008 and 2014. Eighteen (86%) were full economic evaluations. Cost-effectiveness analysis (CEA) was the most frequent type of economic evaluation, and was present in 11 (52%) studies. Only three CEAs complied fully with the British Medical Journal checklist. The quality of the data sources used in the 21 studies was high, but the CEAs conforming to methodological guidelines did not use high-quality data sources for all components of the analysis. Conclusions This systematic review shows that the level of evidence in economic evaluations of vertebroplasty and kyphoplasty is low, despite the recent publication of a large number of studies. This finding highlights the challenges to be faced to improve the quality of economic evaluations of medical devices. PMID:26661078

Efficient preparation of graphene liquid cell utilizing direct transfer with large-area well-stitched graphene

NASA Astrophysics Data System (ADS)

Sasaki, Yuki; Kitaura, Ryo; Yuk, Jong Min; Zettl, Alex; Shinohara, Hisanori

2016-04-01

By utilizing graphene-sandwiched structures recently developed in this laboratory, we are able to visualize small droplets of liquids in nanometer scale. We have found that small water droplets as small as several tens of nanometers sandwiched by two single-layer graphene are frequently observed by TEM. Due to the electron beam irradiation during the TEM observation, these sandwiched droplets are frequently moving from one place to another and are subjected to create small bubbles inside. The synthesis of a large area single-domain graphene of high-quality is essential to prepare the graphene sandwiched cell which safely encapsulates the droplets in nanometer size.

Health and Wellbeing of Occupants in Highly Energy Efficient Buildings: A Field Study.

PubMed

Wallner, Peter; Tappler, Peter; Munoz, Ute; Damberger, Bernhard; Wanka, Anna; Kundi, Michael; Hutter, Hans-Peter

2017-03-19

Passive houses and other highly energy-efficient buildings need mechanical ventilation. However, ventilation systems in such houses are regarded with a certain degree of skepticism by parts of the public due to alleged negative health effects. Within a quasi-experimental field study, we investigated if occupants of two types of buildings (mechanical vs. natural ventilation) experience different health, wellbeing and housing satisfaction outcomes and if associations with indoor air quality exist. We investigated 123 modern homes (test group: with mechanical ventilation; control group: naturally ventilated) built in the years 2010 to 2012 in the same geographic area and price range. Interviews of occupants based on standardized questionnaires and measurements of indoor air quality parameters were conducted twice (three months after moving in and one year later). In total, 575 interviews were performed (respondents' mean age 37.9 ± 9 years in the test group, 37.7 ± 9 years in the control group). Occupants of the test group rated their overall health status and that of their children not significantly higher than occupants of the control group at both time points. Adult occupants of the test group reported dry eyes statistically significantly more frequently compared to the control group (19.4% vs. 12.5%). Inhabitants of energy-efficient, mechanically ventilated homes rated the quality of indoor air and climate significantly higher. Self-reported health improved more frequently in the mechanically ventilated new homes ( p = 0.005). Almost no other significant differences between housing types and measuring time points were observed concerning health and wellbeing or housing satisfaction. Associations between vegetative symptoms (dizziness, nausea, headaches) and formaldehyde concentrations as well as between CO₂ levels and perceived stale air were observed. However, both associations were independent of the type of ventilation. In summary, occupants of the mechanically ventilated homes rated their health status slightly higher and their health improved significantly more frequently than in occupants of the control group. As humidity in homes with mechanical ventilation was lower, it seems plausible that the inhabitants reported dry eyes more frequently.

Understanding apple consumers' expectations in terms of likes and dislikes. Use of comment analysis in a cross-cultural study.

PubMed

Galmarini, M V; Symoneaux, R; Chollet, S; Zamora, M C

2013-03-01

Apple consumers' expectations in Argentina and France were studied by comment analysis of open-ended questions. In an on-line survey consumers stated: attributes which defined quality in an apple; visual, flavor and texture characteristics they liked/did not like to find in an apple. Influence of country, consumption frequency and cultivar knowledge were analyzed by contingency tables, Chi-square per cell tests and Multiple Factor Analysis. Consumers' quality expectations were not the same in both countries. Argentineans and French consumers agreed that quality apples should be juicy (most used term in both countries), tasty, firm and fresh. However, for Argentineans quality was more related to visual characteristics, whereas for French it was driven by flavor. Argentineans used more words but French were more specific, particularly for flavour description. Moreover, frequency of consumption, varieties knowledge and the number of terms given were highly related. Frequent consumers knew more varieties and were more prolific in relation to flavour. Less frequent consumers knew fewer apple varieties and gave more words in the visual category. The use of comment analysis allowed identifying the terms that consumers used in their day to day life to describe apples, finding separately likes and dislikes, in spite of the different languages. Copyright © 2012 Elsevier Ltd. All rights reserved.

Clinical nursing leaders' perceptions of nutrition quality indicators in Swedish stroke wards: a national survey.

PubMed

Persenius, Mona; Hall-Lord, Marie-Louise; Wilde-Larsson, Bodil; Carlsson, Eva

2015-09-01

To describe nursing leaders' perceptions of nutrition quality in Swedish stroke wards. A high risk of undernutrition places great demand on nutritional care in stroke wards. Evidence-based guidelines exist, but healthcare professionals have reported low interest in nutritional care. The Donabedian framework of structure, process and outcome is recommended to monitor and improve nutrition quality. Using a descriptive cross-sectional design, a web-based questionnaire regarding nutritional care quality was delivered to eligible participants. Most clinical nursing leaders reported structure indicators, e.g. access to dieticians. Among process indicators, regular assessment of patients' swallowing was most frequently reported in comprehensive stroke wards compared with other stroke wards. Use of outcomes to monitor nutrition quality was not routine. Wards using standard care plans showed significantly better results. Using the structure, process and outcome framework to examine nutrition quality, quality-improvement needs became visible. To provide high-quality nutrition, all three structure, process and outcome components must be addressed. The use of care pathways, standard care plans, the Senior Alert registry, as well as systematic use of outcome measures could improve nutrition quality. To assist clinical nursing leaders in managing all aspects of quality, structure, process and outcome can be a valuable framework. © 2013 John Wiley & Sons Ltd.

Comprehensive Strategies to Reduce Readmissions in Older Patients With Cardiovascular Disease.

PubMed

Dharmarajan, Kumar

2016-11-01

Older adults are frequently readmitted to the hospital soon after hospitalization for common cardiovascular conditions. Yet there are few high-quality data on the best strategies to reduce short-term readmissions because most studies have involved small numbers of participants, single-centre design, and strong susceptibility to bias. Despite these limitations in the literature, a clear signal exists that most studies involving a singular type of intervention, a singular type of health provider, or a low intensity of intervention have failed to reduce readmissions. In contrast, interventions that are most likely to lower readmissions have used comprehensive approaches, including combined hospital and postacute care, multimodal interventions, multidisciplinary teams, or frequent longitudinal contact. Components of a comprehensive approach with the highest level of evidence include high-quality, disease-specific care; multiple transitional care interventions; involvement of multidisciplinary teams; early and frequent outpatient follow-up; and, when possible, home visits. These findings are consistent with data demonstrating that older adults have multiple sources of vulnerability and experience elevated readmission risk from a broad spectrum of medical conditions for an extended time after hospital discharge. Because readmission reduction is difficult and requires new ways of conceptualizing links between inpatient and postacute care, financial incentives may ultimately be required to motivate hospitals and health systems to redesign care processes, deploy new resources, and collaborate with out-of-hospital providers and organizations. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Bullying as a risk for poor sleep quality among high school students in China.

PubMed

Zhou, Ying; Guo, Lan; Lu, Ci-yong; Deng, Jian-xiong; He, Yuan; Huang, Jing-hui; Huang, Guo-liang; Deng, Xue-qing; Gao, Xue

2015-01-01

To determine whether involvement in bullying as a bully, victim, or bully-victim was associated with a higher risk of poor sleep quality among high school students in China. A cross-sectional study was conducted. A total of 23,877 high school students were surveyed in six cities in Guangdong Province. All students were asked to complete the adolescent health status questionnaire, which included the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) and bullying involvement. Descriptive statistics were used to evaluate sleep quality and the prevalence of school bullying. Multi-level logistic regression analyses were conducted to examine the association between being victimized and bullying others with sleep quality. Among the 23,877 students, 6,127 (25.66%) reported having poor sleep quality, and 10.89% reported being involved in bullying behaviors. Of the respondents, 1,410 (5.91%) were pure victims of bullying, 401 (1.68%) were bullies and 784 (3.28%) were bully-victims. Frequently being involved in bullying behaviors (being bullied or bullying others) was related to increased risks of poor sleep quality compared with adolescents who were not involved in bullying behaviors. After adjusting for age, sex, and other confounding factors, the students who were being bullied (OR=2.05, 95%CI=1.81-2.32), bullied others (OR=2.30, 95%CI=1.85-2.86) or both (OR=2.58, 95%CI=2.20-3.03) were at a higher risk for poor sleep quality. Poor sleep quality among high school students is highly prevalent, and school bullying is prevalent among adolescents in China. The present results suggested that being involved in school bullying might be a risk factor for poor sleep quality among adolescents.

Bullying as a Risk for Poor Sleep Quality among High School Students in China

PubMed Central

Lu, Ci-yong; Deng, Jian-xiong; Huang, Jing-hui; Huang, Guo-liang; Deng, Xue-qing; Gao, Xue

2015-01-01

Objective To determine whether involvement in bullying as a bully, victim, or bully-victim was associated with a higher risk of poor sleep quality among high school students in China. Methods A cross-sectional study was conducted. A total of 23,877 high school students were surveyed in six cities in Guangdong Province. All students were asked to complete the adolescent health status questionnaire, which included the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) and bullying involvement. Descriptive statistics were used to evaluate sleep quality and the prevalence of school bullying. Multi-level logistic regression analyses were conducted to examine the association between being victimized and bullying others with sleep quality. Results Among the 23,877 students, 6,127 (25.66%) reported having poor sleep quality, and 10.89% reported being involved in bullying behaviors. Of the respondents, 1,410 (5.91%) were pure victims of bullying, 401 (1.68%) were bullies and 784 (3.28%) were bully-victims. Frequently being involved in bullying behaviors (being bullied or bullying others) was related to increased risks of poor sleep quality compared with adolescents who were not involved in bullying behaviors. After adjusting for age, sex, and other confounding factors, the students who were being bullied (OR=2.05, 95%CI=1.81-2.32), bullied others (OR=2.30, 95%CI=1.85-2.86) or both (OR=2.58, 95%CI=2.20-3.03) were at a higher risk for poor sleep quality. Conclusions Poor sleep quality among high school students is highly prevalent, and school bullying is prevalent among adolescents in China. The present results suggested that being involved in school bullying might be a risk factor for poor sleep quality among adolescents. PMID:25811479

Family physician-patient relationship and frequent attendance of primary and specialist health care: Results from a German population-based cohort study.

PubMed

Dinkel, Andreas; Schneider, Antonius; Schmutzer, Gabriele; Brähler, Elmar; Häuser, Winfried

2016-07-01

To investigate the association between the quality of the family physician-patient relationship and frequent attendance of primary and specialist health care. Cross-sectional survey of a representative German population sample (N=2.266). Family physician-patient relationship was assessed with the Patient Doctor Relationship Questionnaire (PDRQ-9). Determinants of frequent attendance were analyzed using logistic regression. Frequent attendance of family physicians was associated with lower income (OR 1.43, 95% CI 1.02-2.00), not being in paid work (OR 1.58, CI 1.08-2.30), psychological distress (OR 1.14, CI 1.07-1.22), somatic symptoms (OR 1.07, CI 1.04-1.11), and physical comorbidity (OR 1.54, CI 1.36-1.74) in the multivariate analysis. Frequent attendance of specialists was related to psychological distress (OR 1.12, CI 1.04-1.20), somatic symptoms (OR 1.08, CI 1.04-1.11), and physical comorbidity (OR 1.69, CI 1.48-1.93) in the multivariate analysis. Quality of the relationship was associated with frequent attendance only in the univariate analyses. A stronger relationship with the family physician was not associated with reduced contact with specialists. The quality of the family physician-patient relationship is not independently associated with frequent attendance. Family physicians should be aware that need factors, i.e. symptom burden and physical comorbidities, are main drivers of frequent attendance. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The influence of DNA degradation in formalin-fixed, paraffin-embedded (FFPE) tissue on locus-specific methylation assessment by MS-HRM.

PubMed

Daugaard, Iben; Kjeldsen, Tina E; Hager, Henrik; Hansen, Lise Lotte; Wojdacz, Tomasz K

2015-12-01

Readily accessible formalin-fixed paraffin embedded (FFPE) tissues are a highly valuable source of genetic material for molecular analyses in both research and in vitro diagnostics but frequently genetic material in those samples is highly degraded. With locus-specific methylation changes being widely investigated for use as biomarkers in various aspects of clinical disease management, we aimed to evaluate to what extent standard laboratory procedures can approximate the quality of the DNA extracted from FFPE samples prior to methylation analyses. DNA quality in 107 FFPE non-small cell lung cancer (NSCLC) samples was evaluated using spectrophotometry and gel electrophoresis. Subsequently, the quality assessment results were correlated with the results of locus specific methylation assessment with methylation sensitive high resolution melting (MS-HRM). The correlation of template quality with PCR amplification performance and HRM based methylation detection indicated a significant influence of DNA quality on PCR amplification but not on methylation assessment. In conclusion, standard laboratory procedures fairly well approximate DNA degradation of FFPE samples and DNA degradation does not seem to considerably affect locus-specific methylation assessment by MS-HRM. Copyright © 2015 Elsevier Inc. All rights reserved.

Occurrence of post traumatic stress symptoms and their relationship to professional quality of life (ProQoL) in nursing staff at a forensic psychiatric security unit: a cross-sectional study.

PubMed

Lauvrud, Christian; Nonstad, Kåre; Palmstierna, Tom

2009-04-16

Violence is frequent towards nurses in forensic mental health hospitals. Implications of this high risk environment have not been systematically explored. This paper explores occurrence of symptoms on post traumatic stress and their relationship to professional quality of life. Self report questionnaires assessing symptoms of post traumatic stress and professional quality of life were distributed among psychiatric nurses in a high security forensic psychiatric unit with high frequency of violent behaviour. Relationships between post traumatic stress symptoms, forensic nursing experience, type of ward and compassion satisfaction, burnout and compassion fatigue were explored. The prevalence of post traumatic stress symptoms was low. Low scores were found on compassion satisfaction. Length of psychiatric nursing experience and low scores on compassion satisfaction were correlated to increased post traumatic stress symptoms. Although high violence frequency, low rate of post traumatic stress symptoms and low compassion satisfaction scores was found. High staff/patient ratio and emotional distance between staff and patients are discussed as protective factors.

Occurrence of post traumatic stress symptoms and their relationship to professional quality of life (ProQoL) in nursing staff at a forensic psychiatric security unit: a cross-sectional study

PubMed Central

Lauvrud, Christian; Nonstad, Kåre; Palmstierna, Tom

2009-01-01

Background Violence is frequent towards nurses in forensic mental health hospitals. Implications of this high risk environment have not been systematically explored. This paper explores occurrence of symptoms on post traumatic stress and their relationship to professional quality of life. Methods Self report questionnaires assessing symptoms of post traumatic stress and professional quality of life were distributed among psychiatric nurses in a high security forensic psychiatric unit with high frequency of violent behaviour. Relationships between post traumatic stress symptoms, forensic nursing experience, type of ward and compassion satisfaction, burnout and compassion fatigue were explored. Results The prevalence of post traumatic stress symptoms was low. Low scores were found on compassion satisfaction. Length of psychiatric nursing experience and low scores on compassion satisfaction were correlated to increased post traumatic stress symptoms. Conclusion Although high violence frequency, low rate of post traumatic stress symptoms and low compassion satisfaction scores was found. High staff/patient ratio and emotional distance between staff and patients are discussed as protective factors. PMID:19371413

Exercise as an adjunct treatment for opiate agonist treatment: review of the current research and implementation strategies.

PubMed

Weinstock, Jeremiah; Wadeson, Heather K; VanHeest, Jaci L

2012-01-01

Opiate dependence is a significant public health concern linked to poor quality of life, comorbid psychiatric disorders, and high costs to society. Current opiate agonist treatments are an effective but limited intervention. Adjunctive interventions could improve and augment opiate agonist treatment outcomes, including drug abstinence, quality of life, and physical health. This article reviews exercise as an adjunctive intervention for opiate agonist treatment, especially in regards to improving mood and overall quality of life, while reducing other substance use. Poor adherence and dropout frequently prevent many individuals from garnering the many physical and mental health benefits of exercise. Strategies for implementing an exercise intervention, including safety considerations, are discussed.

A Multilevel, Statewide Investigation of School District Anti-Bullying Policy Quality and Student Bullying Involvement.

PubMed

Gower, Amy L; Cousin, Molly; Borowsky, Iris W

2017-03-01

Although nearly all states in the United States require school districts to adopt anti-bullying policies, little research examines the effect of these policies on student bullying and health. Using a statewide sample, we investigated associations between the quality of school district anti-bullying policies and student bullying involvement and adjustment. School district anti-bullying policies (N = 208) were coded for their quality based on established criteria. District-level data were combined with student reports of bullying involvement, emotional distress, and school connectedness from a state surveillance survey of 6th, 9th, and 12th grade students (N = 93,437). Results indicated that policy quality was positively related to bullying victimization. Furthermore, students reporting frequent perpetration/victimization who also attended districts with high-quality policies reported more emotional distress and less school connectedness compared with students attending districts with low quality policies. Although statistically significant, the magnitude of these associations was small. Having a high-quality school district anti-bullying policy is not sufficient to reduce bullying and protect bullying-involved young people. Future studies examining policy implementation will inform best practices in bullying prevention. © 2017, American School Health Association.

Quality assessment of economic evaluation studies in pediatric surgery: a systematic review.

PubMed

Fotso Kamdem, Arnaud; Nerich, Virginie; Auber, Frederic; Jantchou, Prévost; Ecarnot, Fiona; Woronoff-Lemsi, Marie-Christine

2015-04-01

To assess economic evaluation studies (EES) in pediatric surgery and to identify potential factors associated with high-quality studies. A systematic review of the literature using PubMed and Cochrane databases was conducted to identify EES in pediatric surgery published between 1 June 1993 and 30 June 2013. Assessment criteria are derived from the Drummond checklist. A high quality study was defined as a Drummond score ≥7. Logistic regression analysis was used to determine factors associated with high quality studies. 119 studies were included. 43.7% (n=52) of studies were full EES. Cost-effectiveness analysis was the most frequent (61.5%) type of full EES. Only 31.6% of studies had a Drummond score ≥7 and 73% of these were full EES. The factors associated with high quality were identification of costs (OR: 14.08; 95% CI: 3.38-100; p<0.001), estimation of utility value (OR: 8.13; 95% CI: 2.02-43.47; p=0.005) and study funding (OR: 3.50; 95% CI: 1.27-10.10; p=0.02). This review shows that the number and the quality of EES are low despite the increasing number of studies published in recent years. In the current context of budget constraints, our results should encourage pediatric surgeons to focus more on EES. Copyright © 2015 Elsevier Inc. All rights reserved.

Sources of practice knowledge among Australian fitness trainers.

PubMed

Bennie, Jason A; Wiesner, Glen H; van Uffelen, Jannique G Z; Harvey, Jack T; Biddle, Stuart J H

2017-12-01

Few studies have examined the sources of practice knowledge fitness trainers use to inform their training methods and update knowledge. This study aims to describe sources of practice knowledge among Australian fitness trainers. In July 2014, 9100 Australian fitness trainers were invited to complete an online survey. Respondents reported the frequency of use of eight sources of practice knowledge (e.g. fitness magazines, academic texts). In a separate survey, exercise science experts (n = 27) ranked each source as either (1) 'high-quality' or (2) 'low-quality'. Proportions of users of 'high-quality' sources were calculated across demographic (age, sex) and fitness industry-related characteristics (qualification, setting, role). A multivariate logistic regression analysis assessed the odds of being classified as a user of high-quality sources, adjusting for demographic and fitness industry-related factors. Out of 1185 fitness trainers (response rate = 13.0%), aged 17-72 years, 47.6% (95% CI, 44.7-50.4%) were classified as frequent users of high-quality sources of practice knowledge. In the adjusted analysis, compared to trainers aged 17-26 years, those aged ≥61 years (OR, 2.15; 95% CI, 1.05-4.38) and 40-50 years (OR, 1.54; 95% CI, 1.02-2.31) were more likely to be classified as a user of high-quality sources. When compared to trainers working in large centres, those working in outdoor settings (OR, 1.81; 95% CI, 1.23-2.65) and medium centres (OR, 1.59; 95% CI, 1.12-2.29) were more likely to be classified as users of high-quality sources. Our findings suggest that efforts should be made to improve the quality of knowledge acquisition among Australian fitness trainers.

GRADE guidelines: 5. Rating the quality of evidence--publication bias.

PubMed

Guyatt, Gordon H; Oxman, Andrew D; Montori, Victor; Vist, Gunn; Kunz, Regina; Brozek, Jan; Alonso-Coello, Pablo; Djulbegovic, Ben; Atkins, David; Falck-Ytter, Yngve; Williams, John W; Meerpohl, Joerg; Norris, Susan L; Akl, Elie A; Schünemann, Holger J

2011-12-01

In the GRADE approach, randomized trials start as high-quality evidence and observational studies as low-quality evidence, but both can be rated down if a body of evidence is associated with a high risk of publication bias. Even when individual studies included in best-evidence summaries have a low risk of bias, publication bias can result in substantial overestimates of effect. Authors should suspect publication bias when available evidence comes from a number of small studies, most of which have been commercially funded. A number of approaches based on examination of the pattern of data are available to help assess publication bias. The most popular of these is the funnel plot; all, however, have substantial limitations. Publication bias is likely frequent, and caution in the face of early results, particularly with small sample size and number of events, is warranted. Copyright © 2011 Elsevier Inc. All rights reserved.

Identifying well-formed biomedical phrases in MEDLINE® text.

PubMed

Kim, Won; Yeganova, Lana; Comeau, Donald C; Wilbur, W John

2012-12-01

In the modern world people frequently interact with retrieval systems to satisfy their information needs. Humanly understandable well-formed phrases represent a crucial interface between humans and the web, and the ability to index and search with such phrases is beneficial for human-web interactions. In this paper we consider the problem of identifying humanly understandable, well formed, and high quality biomedical phrases in MEDLINE documents. The main approaches used previously for detecting such phrases are syntactic, statistical, and a hybrid approach combining these two. In this paper we propose a supervised learning approach for identifying high quality phrases. First we obtain a set of known well-formed useful phrases from an existing source and label these phrases as positive. We then extract from MEDLINE a large set of multiword strings that do not contain stop words or punctuation. We believe this unlabeled set contains many well-formed phrases. Our goal is to identify these additional high quality phrases. We examine various feature combinations and several machine learning strategies designed to solve this problem. A proper choice of machine learning methods and features identifies in the large collection strings that are likely to be high quality phrases. We evaluate our approach by making human judgments on multiword strings extracted from MEDLINE using our methods. We find that over 85% of such extracted phrase candidates are humanly judged to be of high quality. Published by Elsevier Inc.

Acute optic neuritis

PubMed Central

Galetta, Steven L.; Villoslada, Pablo; Levin, Netta; Shindler, Kenneth; Ishikawa, Hiroshi; Parr, Edward; Cadavid, Diego

2015-01-01

Idiopathic demyelinating optic neuritis (ON) most commonly presents as acute unilateral vision loss and eye pain and is frequently associated with multiple sclerosis. Although emphasis is often placed on the good recovery of high-contrast visual acuity, persistent deficits are frequently observed in other aspects of vision, including contrast sensitivity, visual field testing, color vision, motion perception, and vision-related quality of life. Persistent and profound structural and functional changes are often revealed by imaging and electrophysiologic techniques, including optical coherence tomography, visual-evoked potentials, and nonconventional MRI. These abnormalities can impair patients' abilities to perform daily activities (e.g., driving, working) so they have important implications for patients' quality of life. In this article, we review the sequelae from ON, including clinical, structural, and functional changes and their interrelationships. The unmet needs in each of these areas are considered and the progress made toward meeting those needs is examined. Finally, we provide an overview of past and present investigational approaches for disease modification in ON. PMID:26236761

Sleep quality subtypes and obesity.

PubMed

Magee, Christopher A; Reddy, Prasuna; Robinson, Laura; McGregor, Alisha

2016-12-01

Poor sleep quality could be a risk factor for obesity. This article utilized a person-centered approach to investigate whether distinct sleep quality subtypes were associated with obesity directly, and indirectly via physical activity. The sample included 8,932 Australian employees who participated in the Household, Income and Labor Dynamics in Australia Survey. Structured interviews and self-report questionnaires collected information on sleep quality, obesity, and relevant demographic, health, and work-related variables. Latent class analysis identified distinct subtypes of sleep quality. General linear modeling examined the associations of sleep quality subtypes with body mass index (BMI) and waist circumference. Multicategorical mediation models examined indirect paths linking sleep quality classes with obesity via physical activity. Five distinct sleep quality subtypes were identified: Poor Sleepers (20.0%), Frequent Sleep Disturbances (19.2%), Minor Sleep Disturbances (24.5%), Long Sleepers (9.6%), and Good Sleepers (26.7%). BMI, waist circumference, and physical activity differed among the sleep quality subtypes, with similar results observed for males and females. For example, Poor Sleepers had the highest BMIs, followed by Frequent Sleep Disturbances and Minor Sleep Disturbances; Long Sleepers and Good Sleepers had the lowest BMIs. Mediation analyses indicated that low levels of physical activity linked the Poor Sleep, Frequent Sleep Disturbance, and Long Sleep classes with higher BMI. These results provide new insights into the nature of sleep quality in employees. In particular, distinct sleep quality patterns had differing associations with measures of obesity, suggesting the need for tailored workplace interventions. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Establishment and Growth of Cherrybark Oak Seedlings Underplanted Beneath a Partial Overstory in a Minor Bottom of Southwestern Arkansas: First Year Results

Treesearch

Emile S. Gardiner; Jimmie L. Yeiser

1999-01-01

Advance regeneration is frequently inadequate to sufficiently restock the oak component of many bottomland stands, especially on productive sites with high levels of competition. We initiated a study near Beime, AR to examine the effects of pre-plant control of Japanese honeysuckle (Lonicera japonica Thunberg) and seedling quality on establishment...

JPRS Report, Soviet Union: Political Affairs

DTIC Science & Technology

1988-03-22

or to secure high profits. The decisions that are made frequently differ from one another, heated debates ensue, and, as we know, the truth emerges... securely attached to production. An analysis conducted among workers in Frunze who were discharged showed that they were usually young people between...no improvement in contract discipline, the necessary growth rates of labor productivity and improvement in product quality are not secured , the

Prevalence and risk factors associated with dry eye syndrome among senior high school students in a county of Shandong Province, China.

PubMed

Zhang, Ying; Chen, Hongmei; Wu, Xinyi

2012-08-01

To determine the prevalence and risk factors for dry eye syndrome (DES) among senior high school students in Shouguang, a county of Shandong Province, China. A cross-sectional survey was conducted in July 2010, and 1902 senior high school students were selected by multi-stage sampling to answer a questionnaire assessing the prevalence and risk factors for DES. DES was defined as the presence of a previous clinical diagnosis of DES or severe symptoms (both dryness and irritation constantly or often). Risk factors associated with DES were evaluated with a χ(2) test and logistic regression analyses. The prevalence of DES was 23.7%. In univariate analysis, myopia (P < 0.0001), contact lens wear (P = 0.020), inadequate refractive correction (P < 0.0001), frequent self-administered topical ophthalmic medications (P < 0.0001), and poor sleep quality (P = 0.007) were significantly associated with DES. In multivariate analysis, inadequate refractive correction (P < 0.0001, odds ratio, OR 1.980; 95% confidence interval, CI 1.577-2.488), frequent self-administered topical ophthalmic medications (P < 0.0001, OR 1.838; 95% CI 1.399-2.410), and poor sleep quality (P = 0.001, OR 1.342; 95% CI 1.054-1.709) were significant risk factors for DES. Senior high school students are a neglected population with a high prevalence of DES. Preventive measures directed against risks factors for DES among senior high school students may help reduce the prevalence and provide a positive impact on students' health.

[Clinical applicability of evidence-based orthopedics--a cross-sectional study of the quality of orthopedic evidence].

PubMed

Vavken, P; Culen, G; Dorotka, R

2008-01-01

The demand to routinely apply evidence-based methods in orthopedic surgery increases steadily. In order to do so, however, the validity and reliability of the "evidence" has to be scrutinized. The object of this study was to assess the quality of the most recent orthopedic evidence and to determine variables that have an influence on quality. All 2006 controlled trials from orthopedic journals with high impact factors were analysed in a cross-sectional study. A score based on the CONSORT statement was used to assess study quality. Selected variables were tested for their influence on the quality of the study. Two independent blinded observers reviewed 126 studies. The overall quality was moderate to high. The most neglected parameters were power analysis, intention-to-treat, and concealment. The participation of a methodologically trained investigator increases study quality significantly. There was no difference in study quality irrespective of whether or not there was statistically significant result. Using our quality score we were able show fairly good results for recent orthopedic studies. The most frequently neglected issues in orthopedic research are blinding, power analysis, and intention-to-treat. This may distort the results of clinical investigations considerably and, especially, lack of concealment causes false-positive findings. Our data show furthermore that participation of a methodologist significantly increases quality of the study and consequently strengthens the reliability of results.

Content and Quality of Information Provided on Canadian Dementia Websites

PubMed Central

Dillon, Whitney A.; Prorok, Jeanette C.; Seitz, Dallas P.

2013-01-01

Purpose Information about dementia is important for persons with dementia (PWD) and their caregivers and the Internet has become the key source of health information. We reviewed the content and quality of information provided on Canadian websites for Alzheimer’s disease (AD). Methods We used the terms “dementia” and “Alzheimer” in Google to identify Canadian dementia websites. The contents of websites were compared to 16 guideline recommendations provided in Canadian Consensus Conference on Diagnosis and Treatment of Dementia. The quality of information provided on websites was evaluated using the DISCERN instrument. The content and quality of information provided on selected websites were then described. Results Seven websites were identified, three of which provided relatively comprehensive and high-quality information on dementia. Websites frequently provided information about diagnosis of dementia, its natural course, and types of dementia, while other topics were less commonly addressed. The quality of information provided on the websites varied, and many websites had several areas where the quality of information provided was relatively low according to the DISCERN instrument. Conclusions There is variation in the content and quality of dementia websites, although some websites provide high-quality and relatively comprehensive information which would serve as a useful resource for PWD, caregivers, and healthcare providers. Improvements in the content and quality of information provided on AD websites would provide PWD and their caregivers with access to better information. PMID:23440180

Prevalence of technical errors and periapical lesions in a sample of endodontically treated teeth: a CBCT analysis.

PubMed

Nascimento, Eduarda Helena Leandro; Gaêta-Araujo, Hugo; Andrade, Maria Fernanda Silva; Freitas, Deborah Queiroz

2018-01-21

The aims of this study are to identify the most frequent technical errors in endodontically treated teeth and to determine which root canals were most often associated with those errors, as well as to relate endodontic technical errors and the presence of coronal restorations with periapical status by means of cone-beam computed tomography images. Six hundred eighteen endodontically treated teeth (1146 root canals) were evaluated for the quality of their endodontic treatment and for the presence of coronal restorations and periapical lesions. Each root canal was classified according to dental groups, and the endodontic technical errors were recorded. Chi-square's test and descriptive analyses were performed. Six hundred eighty root canals (59.3%) had periapical lesions. Maxillary molars and anterior teeth showed higher prevalence of periapical lesions (p < 0.05). Endodontic treatment quality and coronal restoration were associated with periapical status (p < 0.05). Underfilling was the most frequent technical error in all root canals, except for the second mesiobuccal root canal of maxillary molars and the distobuccal root canal of mandibular molars, which were non-filled in 78.4 and 30% of the cases, respectively. There is a high prevalence of apical radiolucencies, which increased in the presence of poor coronal restorations, endodontic technical errors, and when both conditions were concomitant. Underfilling was the most frequent technical error, followed by non-homogeneous and non-filled canals. Evaluation of endodontic treatment quality that considers every single root canal aims on warning dental practitioners of the prevalence of technical errors that could be avoided with careful treatment planning and execution.

[Analysis of articles published in Chinese Journal of Burns winning high citation rate during 2000-2009].

PubMed

Mo, Yu; Luo, Qin; Wang, Xu; Xie, Qiu-hong

2010-06-01

To analyze the inherent quality of articles published in our journal enjoying high citation rate, and to explore strategies on improving impact of papers. Scientific papers published in Chinese Journal of Burns from February 2000 to December 2009, with citation rate equal to or higher than 20 times were collected for classification according to their publication year, publication form, subject distribution, regional and institutional distribution, frequency of authors appeared in those published papers, frequency of winning prizes, and sources of fund (national, ministerial, or provincial). Data were processed by Microsoft Excel software. Altogether 64 scientific papers with high citation rate were published from 2000 to 2006. Original articles and expert forum accounted for 55 (86.0%). Twenty-one articles of clinical study were cited frequently, among them one was cited for 79 times. Articles dealing with subjects with popular interest or cutting-edge problems were cited frequently. Most articles winning high citation rate were originated from institutions located in Chongqing, Beijing, Shanghai, and Xi'an, etc. Those scientific papers which were instructed by specialists, with high level foundation and won prizes were cited with high frequency. The top 20 articles were mainly cited by excellent doctoral dissertations and master theses originated from 11 institutions for higher education, and source journals of Chinese Scientific and Technical Papers and Citations Database. Authors should emphasize subject planning in order to compose papers with high quality. The editorial board should make arrangements with influential specialists with related skills for their contributions based on subjects of popular interest concerning the cutting-edge problems of the specific specialty, and pay close attention to papers on clinical study and those with funding from high levels, to improve impact of the articles.

Genetic divergence for high-molecular weight glutenin subunits (HMW-GS) in indigenous landraces and commercial cultivars of bread wheat of Pakistan.

PubMed

Yasmeen, F; Khurshid, H; Ghafoor, A

2015-05-11

Wheat flour quality is an important consideration in the breeding and development of new cultivars. A strong association between high-molecular weight glutenin subunits (HMW-GS) and bread making quality has resulted in the widespread utilization of HMW-GS in wheat breeding. In this study, we analyzed 242 lines of wheat, including landraces from the provinces of Punjab and Baluchistan, as well as the commercial varieties of Pakistan, to determine allelic variation in the Glu-A1, Glu-B1, and Glu-D1 loci encoding HMW-GS. Higher genetic diversity was observed for HMW-GS in landraces from Baluchistan, followed by landraces collected from Punjab and then commercial varieties. Rare and uncommon subunits were observed in Glu-B1, whereas Glu-A1 was less polymorphic. However, Glu-B1 was the highest contributor to overall diversity (78%), with a total of 31 rare alleles, followed by Glu-D1 (20%) with the high quality 5+10 allele and other variants. Commercial cultivars possessed favorable alleles, potentially from indirect selection for wheat flour quality by the breeders; however, this indirect selection has decreased the pedigree base of commercial cultivars. The allelic combinations, including 2*, 5+10, and 17+18, showing high quality scores were frequent among landraces, indicating their usefulness in future crop improvement and breeding programs.

Intergenerational Support and Marital Satisfaction: Implications of Beliefs About Helping Aging Parents

PubMed Central

Polenick, Courtney A.; Zarit, Steven H.; Birditt, Kira S.; Bangerter, Lauren R.; Seidel, Amber J.; Fingerman, Karen L.

2016-01-01

Everyday support given to aging parents is a salient aspect of married life that may have implications for marital quality. Among 132 middle-aged couples drawn from Wave 1 of the Family Exchanges Study, we examined the moderating effects of each spouse’s normative and motivational beliefs about helping parents on associations between the frequency of everyday support that wives and husbands gave to their own parents and marital satisfaction. Husbands' more frequent provision of support was linked to wives' greater marital satisfaction when reports of personal rewards linked to helping parents were high for wives or low for husbands. Conversely, wives’ more frequent provision of support was linked to husbands’ lower marital satisfaction when reports of filial obligation were low for husbands or high for wives. Findings highlight the interdependence within couples, and indicate that both spouses' perceptions are important in understanding linkages between intergenerational support and marital satisfaction. PMID:28154427

The physical environment mediates male harm and its effect on selection in females.

PubMed

Yun, Li; Chen, Patrick J; Singh, Amardeep; Agrawal, Aneil F; Rundle, Howard D

2017-07-12

Recent experiments indicate that male preferential harassment of high-quality females reduces the variance in female fitness, thereby weakening natural selection through females and hampering adaptation and purging. We propose that this phenomenon, which results from a combination of male choice and male-induced harm, should be mediated by the physical environment in which intersexual interactions occur. Using Drosophila melanogaster , we examined intersexual interactions in small and simple (standard fly vials) versus slightly more realistic (small cages with spatial structure) environments. We show that in these more realistic environments, sexual interactions are less frequent, are no longer biased towards high-quality females, and that overall male harm is reduced. Next, we examine the selective advantage of high- over low-quality females while manipulating the opportunity for male choice. Male choice weakens the viability advantage of high-quality females in the simple environment, consistent with previous work, but strengthens selection on females in the more realistic environment. Laboratory studies in simple environments have strongly shaped our understanding of sexual conflict but may provide biased insight. Our results suggest that the physical environment plays a key role in the evolutionary consequences of sexual interactions and ultimately the alignment of natural and sexual selection. © 2017 The Author(s).

Method Optimization for Extracting High-Quality RNA From the Human Pancreas Tissue.

PubMed

Jun, Eunsung; Oh, Juyun; Lee, Song; Jun, Hye-Ryeong; Seo, Eun Hye; Jang, Jin-Young; Kim, Song Cheol

2018-06-01

Nucleic acid sequencing is frequently used to determine the molecular basis of diseases. Therefore, proper storage of biological specimens is essential to inhibit nucleic acid degradation. RNA isolated from the human pancreas is generally of poor quality because of its high concentration of endogenous RNase. In this study, we optimized the method for extracting high quality RNA from paired tumor and normal pancreatic tissues obtained from eight pancreatic cancer patients post-surgery. RNA integrity number (RIN) was checked to evaluate the integrity of RNA, we tried to extract the RNA with an RIN value of 8 or higher that allows for the latest genetic analysis. The effect of several parameters, including the method used for tissue lysis, RNAlater treatment, tissue weight at storage, and the time to storage after surgical resection, on the quantity and quality of RNA extracted was examined. Data showed that the highest quantity of RNA was isolated using a combination of manual and mechanical methods of tissue lysis. Additionally, sectioning the tissues into small pieces (<100 mg) and treating them with RNAlater solution prior to storage increased RNA stability. Following these guidelines, high quality RNA was obtained from 100% (8/8) of tumor tissues and 75% (6/8) of normal tissues. High-quality RNA was still stable under repeated freezing and thawing. The application of these results during sample handling and storage in clinical settings will facilitate the genetic diagnosis of diseases and their subsequent treatment. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

High-Cost Patients: Hot-Spotters Don't Explain the Half of It.

PubMed

Lee, Natalie S; Whitman, Noah; Vakharia, Nirav; Taksler, Glen B; Rothberg, Michael B

2017-01-01

Understanding resource utilization patterns among high-cost patients may inform cost reduction strategies. To identify patterns of high-cost healthcare utilization and associated clinical diagnoses and to quantify the significance of hot-spotters among high-cost users. Retrospective analysis of high-cost patients in 2012 using data from electronic medical records, internal cost accounting, and the Centers for Medicare and Medicaid Services. K-medoids cluster analysis was performed on utilization measures of the highest-cost decile of patients. Clusters were compared using clinical diagnoses. We defined "hot-spotters" as those in the highest-cost decile with ≥4 hospitalizations or ED visits during the study period. A total of 14,855 Medicare Fee-for-service beneficiaries identified by the Medicare Quality Resource and Use Report as having received 100 % of inpatient care and ≥90 % of primary care services at Cleveland Clinic Health System (CCHS) in Northeast Ohio. The highest-cost decile was selected from this population. Healthcare utilization and diagnoses. The highest-cost decile of patients (n = 1486) accounted for 60 % of total costs. We identified five patient clusters: "Ambulatory," with 0 admissions; "Surgical," with a median of 2 surgeries; "Critically Ill," with a median of 4 ICU days; "Frequent Care," with a median of 2 admissions, 3 ED visits, and 29 outpatient visits; and "Mixed Utilization," with 1 median admission and 1 ED visit. Cancer diagnoses were prevalent in the Ambulatory group, care complications in the Surgical group, cardiac diseases in the Critically Ill group, and psychiatric disorders in the Frequent Care group. Most hot-spotters (55 %) were in the "frequent care" cluster. Overall, hot-spotters represented 9 % of the high-cost population and accounted for 19 % of their overall costs. High-cost patients are heterogeneous; most are not so-called "hot-spotters" with frequent admissions. Effective interventions to reduce costs will require a more multi-faceted approach to the high-cost population.

Health-Related Quality of Life for Pediatric NF1 Patients

DTIC Science & Technology

2004-08-01

writing, learning/cognitive v attendance, learning problems and/or disability, classroom classroom difficulties modifications Difficulties with family...not conclusive, there are data to suggest a high incidence of ADHD in children with NF (cf., Moore et al., 1996; North et al., 1997b) and participants...in our interviews frequently reported either a formal diagnosis of ADHD or symptoms consistent with this diagnosis. Reporting on an investigation

[Hygienic education in pupils from general educational establishments].

PubMed

Mirskaia, N B

2009-01-01

The high prevalence of the major behavioral factors of a risk to health: violation of the study leisure regimen, violation of dietary pattern and quality, low motor activity, smoking, frequent alcohol abuse, drug taste, and deteriorated family microclimate, was revealed in middle and senior schoolchildren from Moscow, Kaliningrad, and Murmansk. Proposals are given to mold healthy lifestyle in adolescents and to optimize their hygienic education at general educational establishments.

The oak woodland bird conservation plan: a strategy for protecting and managing oak woodland habitats and associated birds in California

Treesearch

Steve Zack; Mary K. Chase; Geoffrey R. Geupel

2002-01-01

Over 330 species of birds, mammals, reptiles, and amphibians depend on oak woodlands in California at some stage in their life cycle. California oak woodlands may rank among the top three habitat types in North America for bird richness. Oak woodlands are able to sustain such abundant wildlife primarily because they produce acorns, a high quality and frequently copious...

The Oak Woodland Bird Conservation Plan: A Strategy for Protecting and Managing Oak Woodland Habitats and Associated Birds in California

Treesearch

Steve Zack; Mary K. Chase; Geoffrey R. Geupel; Diana Stralberg

2005-01-01

Over 330 species of birds, mammals, reptiles, and amphibians depend on oak woodlands in California (fig. 1) at some stage in their life cycle (Barrett 1980; Verner 1980; Block and Morrison 1998). These woodlands are able to sustain such abundant wildlife primarily because they produce acorns, a high quality and frequently copious food supply. The birds of California?s...

[Clinical trial data management and quality metrics system].

PubMed

Chen, Zhao-hua; Huang, Qin; Deng, Ya-zhong; Zhang, Yue; Xu, Yu; Yu, Hao; Liu, Zong-fan

2015-11-01

Data quality management system is essential to ensure accurate, complete, consistent, and reliable data collection in clinical research. This paper is devoted to various choices of data quality metrics. They are categorized by study status, e.g. study start up, conduct, and close-out. In each category, metrics for different purposes are listed according to ALCOA+ principles such us completeness, accuracy, timeliness, traceability, etc. Some general quality metrics frequently used are also introduced. This paper contains detail information as much as possible to each metric by providing definition, purpose, evaluation, referenced benchmark, and recommended targets in favor of real practice. It is important that sponsors and data management service providers establish a robust integrated clinical trial data quality management system to ensure sustainable high quality of clinical trial deliverables. It will also support enterprise level of data evaluation and bench marking the quality of data across projects, sponsors, data management service providers by using objective metrics from the real clinical trials. We hope this will be a significant input to accelerate the improvement of clinical trial data quality in the industry.

Organizing the pantry: cache management improves quality of overwinter food stores in a montane mammal

USGS Publications Warehouse

Jakopak, Rhiannon P.; Hall, L. Embere; Chalfoun, Anna D.

2017-01-01

Many mammals create food stores to enhance overwinter survival in seasonal environments. Strategic arrangement of food within caches may facilitate the physical integrity of the cache or improve access to high-quality food to ensure that cached resources meet future nutritional demands. We used the American pika (Ochotona princeps), a food-caching lagomorph, to evaluate variation in haypile (cache) structure (i.e., horizontal layering by plant functional group) in Wyoming, United States. Fifty-five percent of 62 haypiles contained at least 2 discrete layers of vegetation. Adults and juveniles layered haypiles in similar proportions. The probability of layering increased with haypile volume, but not haypile number per individual or nearby forage diversity. Vegetation cached in layered haypiles was also higher in nitrogen compared to vegetation in unlayered piles. We found that American pikas frequently structured their food caches, structured caches were larger, and the cached vegetation in structured piles was of higher nutritional quality. Improving access to stable, high-quality vegetation in haypiles, a critical overwinter food resource, may allow individuals to better persist amidst harsh conditions.

[Prevalence and factors associated with frequent attendence in family medicine clinic].

PubMed

Parejo Maestre, N; Lendínez-de la Cruz, J M; Bermúdez-Torres, F M; Gónzalez-Contero, L; Gutierrez-Espinosa de Los Monteros, M P; Espejo-Almazán María, T

2016-01-01

The use of health services has seen a steep rise. The frequent users are responsible for significant economic, human and social impact. The objective is to analyze the characteristics of frequent attenders in our Health Center, in order to evaluate the possibility of taking corrective measures to improve the quality of care and efficiency in the use of resources. Descriptive observational study of a sample of 379 patients over 18 years old. The dependent variables were attendance (number of visits to their family doctor during the previous year), frequent attendance (10 or more visits to the family doctor in the last year), and persistent frequent attenders (10 or more visits to the family doctor in each of the last two years). Data were collected from medical records and by telephone interview. The mean attendance was 6.83 (95%CI: 6.13-7.53), frequent attendance reached 25.4% (95%CI: 21.4-29.6), and persistent frequent attenders, 1.6% (95%CI: 0.5-2.9). Frequent attendance was associated with sex, age, marital status, educational level, family structure, existence of chronic disease, use of anxiolytic and antidepressants, request for additional tests, and referrals to other specialists, proximity to the health center, and level of satisfaction with their family doctor. The low persistent frequent attenders found suggests that frequent attendance could be largely due to factors related to professional and organization. Studies are required to address the high level of consumption of psychotropic drugs, and improving professional skills in dealing with mental problems. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Timing of dialysis initiation, duration and frequency of hemodialysis sessions, and membrane flux: a systematic review for a KDOQI clinical practice guideline.

PubMed

Slinin, Yelena; Greer, Nancy; Ishani, Areef; MacDonald, Roderick; Olson, Carin; Rutks, Indulis; Wilt, Timothy J

2015-11-01

In 2006, NKF-KDOQI (National Kidney Foundation-Kidney Disease Outcomes Quality Initiative) published clinical practice guidelines for hemodialysis adequacy. Recent studies evaluating hemodialysis adequacy as determined by initiation timing, frequency, duration, and membrane type and prompted an update to the guideline. Systematic review and evidence synthesis. Patients with advanced chronic kidney disease receiving hemodialysis. We screened publications from 2000 to March 2014, systematic reviews, and references and consulted the NKF-KDOQI Hemodialysis Adequacy Work Group members. We included randomized or controlled clinical trials in patients undergoing long-term hemodialysis if they reported outcomes of interest. Early versus late dialysis therapy initiation; more frequent (>3 times a week) or longer duration (>4.5 hours) compared to conventional hemodialysis; low- versus high-flux dialyzer membranes. All-cause and cardiovascular mortality, myocardial infarction, stroke, hospitalizations, quality of life, depression or cognitive function scores, blood pressure, number of antihypertensive medications, left ventricular mass, interdialytic weight gain, and harms or complications related to vascular access or the process of dialysis. We included 32 articles reporting on 19 trials. Moderate-quality evidence indicated that earlier dialysis therapy initiation (at estimated creatinine clearance [eClcr] of 10-14mL/min) did not reduce mortality compared to later initiation (eClcr of 5-7mL/min). More than thrice-weekly hemodialysis and extended-length hemodialysis during a short follow-up did not improve clinical outcomes compared to conventional hemodialysis and resulted in a greater number of vascular access procedures (very low-quality evidence). Hemodialysis using high-flux membranes did not reduce all-cause mortality, but reduced cardiovascular mortality compared to hemodialysis using low-flux membranes (moderate-quality evidence). Few studies were adequately powered to evaluate mortality. Heterogeneity of study designs and interventions precluded pooling data for most outcomes. Limited data indicate that earlier dialysis therapy initiation and more frequent and longer hemodialysis did not improve clinical outcomes compared to conventional hemodialysis. Published by Elsevier Inc.

Errors in clinical laboratories or errors in laboratory medicine?

PubMed

Plebani, Mario

2006-01-01

Laboratory testing is a highly complex process and, although laboratory services are relatively safe, they are not as safe as they could or should be. Clinical laboratories have long focused their attention on quality control methods and quality assessment programs dealing with analytical aspects of testing. However, a growing body of evidence accumulated in recent decades demonstrates that quality in clinical laboratories cannot be assured by merely focusing on purely analytical aspects. The more recent surveys on errors in laboratory medicine conclude that in the delivery of laboratory testing, mistakes occur more frequently before (pre-analytical) and after (post-analytical) the test has been performed. Most errors are due to pre-analytical factors (46-68.2% of total errors), while a high error rate (18.5-47% of total errors) has also been found in the post-analytical phase. Errors due to analytical problems have been significantly reduced over time, but there is evidence that, particularly for immunoassays, interference may have a serious impact on patients. A description of the most frequent and risky pre-, intra- and post-analytical errors and advice on practical steps for measuring and reducing the risk of errors is therefore given in the present paper. Many mistakes in the Total Testing Process are called "laboratory errors", although these may be due to poor communication, action taken by others involved in the testing process (e.g., physicians, nurses and phlebotomists), or poorly designed processes, all of which are beyond the laboratory's control. Likewise, there is evidence that laboratory information is only partially utilized. A recent document from the International Organization for Standardization (ISO) recommends a new, broader definition of the term "laboratory error" and a classification of errors according to different criteria. In a modern approach to total quality, centered on patients' needs and satisfaction, the risk of errors and mistakes in pre- and post-examination steps must be minimized to guarantee the total quality of laboratory services.

Cooking at Home: A Strategy to Comply With U.S. Dietary Guidelines at No Extra Cost

PubMed Central

Tiwari, Arpita; Aggarwal, Anju; Tang, Wesley; Drewnowski, Adam

2017-01-01

Introduction Cooking at home is associated with better diet quality. This study examined the frequency of home-cooked dinners versus eating out in relation to the Healthy Eating Index (HEI), and food expenditures. Methods The Seattle Obesity Study used a stratified random sample of 437 King County adults. In-person computer-assisted interviews collected sociodemographic and behavioral data during 2011–2013. HEI-2010 and 2005 were computed using Food Frequency Questionnaires. Multivariable regression analyses, conducted in 2015, examined associations among HEI scores, food expenditures, and frequency of cooking at home versus eating out variables. Results Frequent home-cooked dinners were associated with being married, unemployed, larger households, presence of children aged <12 years, and lower frequency of eating out, but unrelated to education or income. In adjusted models, frequent at-home cooking was associated with higher HEI-2010 (β=7.4, p<0.001), whereas frequent eating out was associated with lower HEI-2010 (β= −6.6, p<0.001). Frequent home cooking was linked with reduced per capita food expenditures overall ($330/month among low vs $273/month among high cooking group, p<0.001), and reduced away-from-home expenditures ($133 and $65, respectively), without any significant increase in at-home food expenditures. However, frequent eating out was associated with significantly higher per capita food expenditures overall ($261 in low vs $364 among high eating out group, p=0.001), and higher away-from-home expenditures. Conclusions Home-cooked dinners were associated with greater dietary guideline compliance, without significant increase in food expenditures. By contrast, frequent eating out was associated with higher expenditures and lower compliance. Home cooking may be a component of nutrition resilience. PMID:28256283

Cooking at Home: A Strategy to Comply With U.S. Dietary Guidelines at No Extra Cost.

PubMed

Tiwari, Arpita; Aggarwal, Anju; Tang, Wesley; Drewnowski, Adam

2017-05-01

Cooking at home is associated with better diet quality. This study examined the frequency of home-cooked dinners versus eating out in relation to the Healthy Eating Index (HEI), and food expenditures. The Seattle Obesity Study used a stratified random sample of 437 King County adults. In-person computer-assisted interviews collected sociodemographic and behavioral data during 2011-2013. HEI-2010 and 2005 were computed using Food Frequency Questionnaires. Multivariable regression analyses, conducted in 2015, examined associations among HEI scores, food expenditures, and frequency of cooking at home versus eating out variables. Frequent home-cooked dinners were associated with being married, unemployed, larger households, presence of children aged <12 years, and lower frequency of eating out, but unrelated to education or income. In adjusted models, frequent at-home cooking was associated with higher HEI-2010 (β=7.4, p<0.001), whereas frequent eating out was associated with lower HEI-2010 (β= -6.6, p<0.001). Frequent home cooking was linked with reduced per capita food expenditures overall ($330/month among low vs $273/month among high cooking group, p<0.001), and reduced away-from-home expenditures ($133 and $65, respectively), without any significant increase in at-home food expenditures. However, frequent eating out was associated with significantly higher per capita food expenditures overall ($261 in low vs $364 among high eating out group, p=0.001), and higher away-from-home expenditures. Home-cooked dinners were associated with greater dietary guideline compliance, without significant increase in food expenditures. By contrast, frequent eating out was associated with higher expenditures and lower compliance. Home cooking may be a component of nutrition resilience. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Sibling relationship quality moderates the associations between parental interventions and siblings' independent conflict strategies and outcomes.

PubMed

Recchia, Holly E; Howe, Nina

2009-08-01

This study extends research on sibling conflict strategies and outcomes by examining unique and interactive associations with age, relative birth order, sibling relationship quality, and caregivers' interventions into conflict. Each of 62 sibling dyads (older sibling mean age = 8.39 years; younger sibling mean age = 6.06 years) discussed 1 recurring conflict alone (dyadic negotiation) and a 2nd conflict with their primary parental caregiver (triadic negotiation). Negotiations were coded for children's conflict strategies, outcomes, and caregiver interventions; each family member provided ratings of sibling relationship quality. Results revealed that age was associated with siblings' constructive strategies, particularly in the dyadic negotiation. With age controlled, younger siblings referred more frequently to their own perspective. Caregivers' future orientation in the triadic negotiation was associated with children's future orientation in the dyadic negotiation; however, this association was most evident when sibling relationship quality was high. Similarly, caregivers' past orientation was positively associated with dyadic compromise, especially when relationship quality was high. Results reveal the value of simultaneously considering associations among parental, affective, and developmental correlates of sibling conflict strategies. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Teacher’s sleep quality: linked to social job characteristics?

PubMed Central

KOTTWITZ, Maria U.; GERHARDT, Christin; PEREIRA, Diana; ISELI, Lionel; ELFERING, Achim

2017-01-01

Besides dealing with high workload, being a teacher is challenging with respect to the social context. There is increasing evidence that adverse social job characteristics challenge sleep quality. The current study tests whether restraint sleep quality (defined as worse sleep quality before than during vacation) is related to time-related job stressors, job resources, and social job characteristics. Forty-eight elementary school teachers (42% women) participated both during the last week before and the first week after vacation. Before vacation, teachers were asked for demographics and working conditions with reference to the last 30 d, and sleep quality with reference to the last 7 d. After vacation sleep quality during vacation was assessed and used as reference for working time sleep quality. Results showed mean levels of sleep quality increased during vacation. In teachers with restrained working time sleep quality (38%), experiences of failure at work, social exclusion, and emotional dissonance were more frequent than in teachers with unrestrained working time sleep quality (Ps<0.05). Groups did not differ in time-related stressors, time control and social support from supervisors. Emotion work, social exclusion and individual experience of failure seem to challenge sleep quality in teachers. PMID:28804097

Teacher's sleep quality: linked to social job characteristics?

PubMed

Kottwitz, Maria U; Gerhardt, Christin; Pereira, Diana; Iseli, Lionel; Elfering, Achim

2018-02-07

Besides dealing with high workload, being a teacher is challenging with respect to the social context. There is increasing evidence that adverse social job characteristics challenge sleep quality. The current study tests whether restraint sleep quality (defined as worse sleep quality before than during vacation) is related to time-related job stressors, job resources, and social job characteristics. Forty-eight elementary school teachers (42% women) participated both during the last week before and the first week after vacation. Before vacation, teachers were asked for demographics and working conditions with reference to the last 30 d, and sleep quality with reference to the last 7 d. After vacation sleep quality during vacation was assessed and used as reference for working time sleep quality. Results showed mean levels of sleep quality increased during vacation. In teachers with restrained working time sleep quality (38%), experiences of failure at work, social exclusion, and emotional dissonance were more frequent than in teachers with unrestrained working time sleep quality (Ps<0.05). Groups did not differ in time-related stressors, time control and social support from supervisors. Emotion work, social exclusion and individual experience of failure seem to challenge sleep quality in teachers.

Urinary incontinence in multiple sclerosis: prevalence, severity and impact on patients' quality of life.

PubMed

Zecca, C; Riccitelli, G C; Disanto, G; Singh, A; Digesu, G A; Panicari, L; Puccini, F; Mattioli, M; Tubaro, A; Gobbi, C

2016-07-01

Lower urinary tract symptoms (LUTS) including frequent urination, nocturia and urge urinary incontinence negatively impact quality of life. This project aimed at characterizing the prevalence and severity of urinary incontinence in multiple sclerosis (MS) patients and its association with demographic and clinical features. In all, 403 consecutive clinically stable MS patients answered the International Consultation on Incontinence Questionnaire (ICIQ) and the Patient Perception of Bladder Condition (PPBC) questionnaire. Demographic and clinical parameters including the Expanded Disability Status Scale (EDSS) were collected. Statistical analyses were performed using univariate and multivariate linear regression models. Females represented 72%, relapsing-remitting patients 82%. The mean (SD) disease duration and EDSS were 11.8 (8.6) years and 3.1 (1.9) respectively. Approximately 35% of patients reported urine incontinence. ICIQ scores were positively associated with EDSS, female gender, presence of LUTS therapies and absence of disease modifying treatments (P < 0.001). PPBC scores were positively associated with EDSS and the presence of LUTS therapies (P < 0.001). Urinary incontinence is frequent in MS, prevailing in more disabled and female patients. Currently available LUTS therapies appear insufficient in the treatment of this symptom. The negative impact of urinary incontinence on quality of life is high and requires more attention in clinical management and research. © 2016 EAN.

Technical errors in planar bone scanning.

PubMed

Naddaf, Sleiman Y; Collier, B David; Elgazzar, Abdelhamid H; Khalil, Magdy M

2004-09-01

Optimal technique for planar bone scanning improves image quality, which in turn improves diagnostic efficacy. Because planar bone scanning is one of the most frequently performed nuclear medicine examinations, maintaining high standards for this examination is a daily concern for most nuclear medicine departments. Although some problems such as patient motion are frequently encountered, the degraded images produced by many other deviations from optimal technique are rarely seen in clinical practice and therefore may be difficult to recognize. The objectives of this article are to list optimal techniques for 3-phase and whole-body bone scanning, to describe and illustrate a selection of deviations from these optimal techniques for planar bone scanning, and to explain how to minimize or avoid such technical errors.

Frequently Asked Questions about Energy Savings Plus Health

EPA Pesticide Factsheets

The Energy Savings Plus Health Guide equips school districts to integrate indoor air quality protections into school energy efficiency retrofits and other building upgrade projects. This page asks and answers Frequently-Asked Questions.

Ballast water as a vector of coral pathogens in the Gulf of Mexico: the case of the Cayo Arcas coral reef.

PubMed

Aguirre-Macedo, M Leopoldina; Vidal-Martinez, Victor M; Herrera-Silveira, Jorge A; Valdés-Lozano, David S; Herrera-Rodríguez, Miguel; Olvera-Novoa, Miguel A

2008-09-01

The discharge of nutrients, phytoplankton and pathogenic bacteria through ballast water may threaten the Cayo Arcas reef system. To assess this threat, the quality of ballast water and presence of coral reef pathogenic bacteria in 30 oil tankers loaded at the PEMEX Cayo Arcas crude oil terminal were determined. The water transported in the ships originated from coastal, oceanic or riverine regions. Statistical associations among quality parameters and bacteria were tested using redundancy analysis (RDA). In contrast with coastal or oceanic water, the riverine water had high concentrations of coliforms, including Vibrio cholerae 01 and, Serratia marcescens and Sphingomona spp., which are frequently associated with "white pox" and "white plague type II" coral diseases. There were also high nutrient concentrations and low water quality index values (WQI and TRIX). The presence of V. cholerae 01 highlights the need for testing ballast water coming from endemic regions into Mexican ports.

Sleep disturbance, psycho-social and medical symptoms—A pilot survey among persons exposed to high levels of road traffic noise

NASA Astrophysics Data System (ADS)

Öhrström, E.

1989-08-01

A pilot survey was undertaken to elucidate sleep quality, as well as psycho-social and medical symptoms and mood, among people who had lived for many years in an area with high levels of road traffic noise during night hours and inhabitants of a quiet control area: 106 personal interviews were performed and specific questionnaires on sleep and mood answered by 63 persons during three consecutive days. It was found that both sleep quality and mood (social orientation, activity, wellbeing and extroversion) were depressed in the noisy area as compared with a control area. Symptoms of tiredness, headache and nervous stomach disorders were more frequent. A significant relationship between sensitivity to noise and sleep quality was also found. From this pilot study hypotheses may be formulated about a relationship between environmental noise and different psycho-social and medical symptoms. It is suggested that similar studies on a larger scale are performed to elucidate long-term effects of noise.

Premenstrual syndrome in Turkish medical students and their quality of life.

PubMed

Goker, A; Artunc-Ulkumen, B; Aktenk, F; Ikiz, N

2015-04-01

This study aimed to analyse the frequency and symptoms of premenstrual syndrome (PMS) and its effect on quality of life in medical students. Sociodemographic data, a symptom calendar for the following consecutive two menstrual periods and SF-36 quality of life questionnaire were collected. A total of 228 students joined the survey. The average age of the students was 20.77 ± 1.90. The frequency of PMS was 91.8%. The most frequent symptoms were abdominal bloating (89.5%), irritability (88.3%) and breast tenderness (82.6%). Quality of life scores ranged from 17.00 to 97.00 and were lowest in the severe PMS group. Alcohol consumption, stress events and fat rich diets increased the severity of PMS. Family history significantly affected the severity of PMS and quality of life scores. Premenstrual syndrome was found to be a frequent entity among medical students and seemed to affect quality of life in a moderate way.

Neuroendocrine Disorders in Pediatric Craniopharyngioma Patients

PubMed Central

Daubenbüchel, Anna M. M.; Müller, Hermann L.

2015-01-01

Childhood-onset craniopharyngiomas are partly cystic embryonic malformations of the sellar/parasellar region. The therapy of choice in patients with favorable tumor localization is complete resection with a specific focus on maintaining optical and hypothalamic neuroendocrine functions. In patients with unfavorable tumor localization (i.e., hypothalamic involvement), a limited hypothalamus-sparing surgical strategy followed by local irradiation is recommended. Involvement and/or surgical lesions of posterior hypothalamic areas cause major neuroendocrine sequelae. The overall survival rates are high (92%) but neuroendocrine disorders such as obesity and metabolic syndrome due to involvement and/or treatment-related hypothalamic lesions have major negative impact on survival and quality of life. Recurrences and progressions are frequent post-surgical events. Because irradiation is efficient in preventing tumor progression, appropriate timing of post-surgical irradiation is currently under investigation in a randomized multinational trial (KRANIOPHARYNGEOM 2007). Childhood-onset craniopharyngioma should be recognized as a chronic disease requiring treatment and constant monitoring of the clinical and quality of life consequences, frequently impaired due to neuroendocrine disorders, by experienced multidisciplinary teams in order to provide optimal care of surviving patients. PMID:26239246

Quality Manual

NASA Astrophysics Data System (ADS)

Koch, Michael

The quality manual is the “heart” of every management system related to quality. Quality assurance in analytical laboratories is most frequently linked with ISO/IEC 17025, which lists the standard requirements for a quality manual. In this chapter examples are used to demonstrate, how these requirements can be met. But, certainly, there are many other ways to do this.

Understanding the role of sleep quality and sleep duration in commercial driving safety.

PubMed

Lemke, Michael K; Apostolopoulos, Yorghos; Hege, Adam; Sönmez, Sevil; Wideman, Laurie

2016-12-01

Long-haul truck drivers in the United States suffer disproportionately high injury rates. Sleep is a critical factor in these outcomes, contributing to fatigue and degrading multiple aspects of safety-relevant performance. Both sleep duration and sleep quality are often compromised among truck drivers; however, much of the efforts to combat fatigue focus on sleep duration rather than sleep quality. Thus, the current study has two objectives: (1) to determine the degree to which sleep impacts safety-relevant performance among long-haul truck drivers; and (2) to evaluate workday and non-workday sleep quality and duration as predictors of drivers' safety-relevant performance. A non-experimental, descriptive, cross-sectional design was employed to collect survey and biometric data from 260 long-haul truck drivers. The Trucker Sleep Disorders Survey was developed to assess sleep duration and quality, the impact of sleep on job performance and accident risk, and other relevant work organization characteristics. Descriptive statistics assessed work organization variables, sleep duration and quality, and frequency of engaging in safety-relevant performance while sleepy. Linear regression analyses were conducted to evaluate relationships between sleep duration, sleep quality, and work organization variables with safety composite variables. Drivers reported long work hours, with over 70% of drivers working more than 11h daily. Drivers also reported a large number of miles driven per week, with an average of 2,812.61 miles per week, and frequent violations of hours-of-service rules, with 43.8% of drivers "sometimes to always" violating the "14-h rule." Sleep duration was longer, and sleep quality was better, on non-workdays compared on workdays. Drivers frequently operated motor vehicles while sleepy, and sleepiness impacted several aspects of safety-relevant performance. Sleep quality was better associated with driving while sleepy and with job performance and concentration than sleep duration. Sleep duration was better associated with accidents and accident risk than sleep quality. Sleep quality appears to be better associated with safety-relevant performance among long-haul truck drivers than sleep duration. Comprehensive and multilevel efforts are needed to meaningfully address sleep quality among drivers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Do David and Goliath Play the Same Game? Explanation of the Abundance of Rare and Frequent Invasive Alien Plants in Urban Woodlands in Warsaw, Poland.

PubMed

Obidziński, Artur; Mędrzycki, Piotr; Kołaczkowska, Ewa; Ciurzycki, Wojciech; Marciszewska, Katarzyna

2016-01-01

Invasive Alien Plants occur in numbers differing by orders of magnitude at subsequent invasion stages. Effective sampling and quantifying niches of rare invasive plants are quite problematic. The aim of this paper is an estimation of the influence of invasive plants frequency on the explanation of their local abundance. We attempted to achieve it through: (1) assessment of occurrence of self-regenerating invasive plants in urban woodlands, (2) comparison of Random Forest modelling results for frequent and rare species. We hypothesized that the abundance of frequent species would be explained better than that of rare ones and that both rare and frequent species share a common hierarchy of the most important determinants. We found 15 taxa in almost two thirds of 1040 plots with a total number of 1068 occurrences. There were recorded 6 taxa of high frequency-Prunus serotina, Quercus rubra, Acer negundo, Robinia pseudoacacia, Impatiens parviflora and Solidago spp.-and 9 taxa of low frequency: Acer saccharinum, Amelanchier spicata, Cornus spp., Fraxinus spp., Parthenocissus spp., Syringa vulgaris, Echinocystis lobata, Helianthus tuberosus, Reynoutria spp. Random Forest's models' quality grows with the number of occurrences of frequent taxa but not of the rare ones. Both frequent and rare taxa share a similar hierarchy of predictors' importance: Land use > Tree stand > Seed source and, for frequent taxa, Forest properties as well. We conclude that there is an 'explanation jump' at higher species frequencies, but rare species are surprisingly similar to frequent ones in their determinant's hierarchy, with differences conforming with their respective stages of invasion.

Village Blue Frequently Asked Questions

EPA Pesticide Factsheets

EPA and the U.S. Geological Survey (USGS) initiated the Village Blue project to increase public awareness about local water quality in the Baltimore Harbor and the Chesapeake Bay. This document answers frequently asked questions about Village Blue.

Volume and methodological quality of randomized controlled trials in laparoscopic surgery: assessment over a 10-year period.

PubMed

Antoniou, Stavros A; Andreou, Alexandros; Antoniou, George A; Koch, Oliver O; Köhler, Gernot; Luketina, Ruzica-R; Bertsias, Antonios; Pointner, Rudolph; Granderath, Frank-Alexander

2015-11-01

Measures have been taken to improve methodological quality of randomized controlled trials (RCTs). This review systematically assessed the trends in volume and methodological quality of RCTs on minimally invasive surgery within a 10-year period. RCTs on minimally invasive surgery were searched in the 10 most cited general surgical journals and the 5 most cited journals of laparoscopic interest for the years 2002 and 2012. Bibliometric and methodological quality components were abstracted using the Scottish Intercollegiate Guidelines Network. The pooled number of RCTs from low-contribution regions demonstrated an increasing proportion of the total published RCTs, compensating for a concomitant decrease of the respective contributions from Europe and North America. International collaborations were more frequent in 2012. Acceptable or high quality RCTs accounted for 37.9% and 54.4% of RCTs published in 2002 and 2012, respectively. Components of external validity were poorly reported. Both the volume and the reporting quality of laparoscopic RCTs have increased from 2002 to 2012, but there seems to be ample room for improvement of methodological quality. Copyright © 2015 Elsevier Inc. All rights reserved.

[Schools, office buildings, leisure settings: diversity of indoor air quality issues. Global review on indoor air quality in these settings].

PubMed

Mandin, C; Derbez, M; Kirchner, S

2012-07-01

This review provides a global overview of indoor air quality issues in schools, office buildings and recreational settings. It presents the most recent scientific publications and the on-going work conducted in France in the frame of the indoor air quality Observatory. Monitoring campaigns on indoor air quality in schools have been carried out in the recent years in Europe. However, few studies have specifically addressed the role of exposure in these buildings on children's health. Indoor air quality in office buildings has been little studied so far. However, some specificities, such as emissions from electronic devices, frequent cleaning, impossibility to open windows in high-rise buildings, for example, should be examined and their role on the health and comfort studied. Finally, even if the time spent in recreational settings is short, the quality of indoor air should also be considered because of specific pollution. This is the case of indoor swimming pools (exposure to chlorination byproducts) and ice-rinks (exposure to exhaust from machines used to smooth the ice). Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Iranian Television Advertisement and Children's Food Preferences.

PubMed

Hajizadehoghaz, Masoomeh; Amini, Maryam; Abdollahi, Afsoun

2016-01-01

In this study, the nature of food commercials in children's television (TV) was monitored and analyzed; simultaneously, the relationship between recalling TV food commercials and children's interest in them and in the consumption of the same food products was evaluated. A total of 108 h children's programs broadcast on two channels (Two and Amouzesh) of Islamic Republic of Iran Broadcasting (IRIB) media organization were monitored (May 6-12, 2015). Simultaneously, a cross-sectional study using 403 primary schoolchildren (201 boys) in four schools of Shirvan, Northeast of Iran, was executed. The children were prompted to recall all TV commercials broadcast on IRIB. Meanwhile, they were directed to define in the list of recalled TV food commercials those were interested in and the commercials (food products) they actually were willing to consume. Regarding the frequency and duration of broadcasting, food commercials ranked fifth and sixth, respectively. Fruit leather and plum paste were the most frequently broadcast food commercials. "High quality" (19%), "good taste" (15%), "novelty", and "message on nutritional composition" (13%) were the most frequent messages used in promoting the sale of food products, respectively. In addition, focus on "high quality/precision in the preparation of the food products" was the most frequently used appeals in TV commercials. There was a significant relationship between recalling TV food commercials and the interest in five out of eight of the commercials (62.5%) ( P < 0.05). The relationship between recalling TV food commercials and the interest in the consumption of the same food product ("Tomato paste B") was statistically significant for 12.5% of the commercials ( P < 0.05). TV food commercials do not encourage healthy eating. The current study provides convincing evidence for policy-makers and researchers to pay more attention to this area.

Some Inspection Methods for Quality Control and In-service Inspection of GLARE

NASA Astrophysics Data System (ADS)

Sinke, J.

2003-07-01

Quality control of materials and structures is an important issue, also for GLARE. During the manufacturing stage the processes and materials should be monitored and checked frequently in order to obtain a qualified product. During the operation of the aircraft, frequent monitoring and inspections are performed to maintain the quality at a prescribed level. Therefore, in-service inspection methods are applied, and when necessary repair activities are conducted. For the quality control of the GLARE panels and components during manufacturing, the C-scan method proves to be an effective tool. For in-service inspection the Eddy Current Method is one of the suitable options. In this paper a brief overview is presented of both methods and their application on GLARE products.

Quality of information sources about mental disorders: a comparison of Wikipedia with centrally controlled web and printed sources.

PubMed

Reavley, N J; Mackinnon, A J; Morgan, A J; Alvarez-Jimenez, M; Hetrick, S E; Killackey, E; Nelson, B; Purcell, R; Yap, M B H; Jorm, A F

2012-08-01

Although mental health information on the internet is often of poor quality, relatively little is known about the quality of websites, such as Wikipedia, that involve participatory information sharing. The aim of this paper was to explore the quality of user-contributed mental health-related information on Wikipedia and compare this with centrally controlled information sources. Content on 10 mental health-related topics was extracted from 14 frequently accessed websites (including Wikipedia) providing information about depression and schizophrenia, Encyclopaedia Britannica, and a psychiatry textbook. The content was rated by experts according to the following criteria: accuracy, up-to-dateness, breadth of coverage, referencing and readability. Ratings varied significantly between resources according to topic. Across all topics, Wikipedia was the most highly rated in all domains except readability. The quality of information on depression and schizophrenia on Wikipedia is generally as good as, or better than, that provided by centrally controlled websites, Encyclopaedia Britannica and a psychiatry textbook.

Overcoming challenges: life with an ostomy.

PubMed

Popek, Sarah; Grant, Marcia; Gemmill, Robin; Wendel, Christopher S; Mohler, M Jane; Rawl, Susan M; Baldwin, Carol M; Ko, Clifford Y; Schmidt, C Max; Krouse, Robert S

2010-11-01

Studies have demonstrated decreased health-related quality of life in patients with stomas. Using US Department of Veterans Affairs electronic medical records, veterans with stomas were surveyed using the City of Hope Quality of Life-Ostomy questionnaire. Focus groups were conducted segregated by type of stoma (ileostomy vs colostomy) and quality-of-life score (high vs low). Qualitative analysis was performed on the basis of the City of Hope Quality of Life for Ostomates format of health-related quality of life (physical, psychological, social, and spiritual). The findings of the colostomy focus groups are reported. Two new domains emerged: colostomy specific and health care specific. The most common domains discussed were colostomy specific, psychological, and social. The most frequently discussed colostomy-specific theme was effective and ineffective solutions to colostomy care. Family and spousal relationships were the main theme from the psychological category. The predominant social issue was sexual relationships. Awareness of patients' social, psychological, and medical status allows surgeons to identify those likely to have problems and devote resources to those veterans. Published by Elsevier Inc.

Availability and quality of cause-of-death data for estimating the global burden of injuries

PubMed Central

Harrison, James E; Shahraz, Saeid; Fingerhut, Lois A

2010-01-01

Abstract Objective To assess the availability and quality of global death registration data used for estimating injury mortality. Methods The completeness and coverage of recent national death registration data from the World Health Organization mortality database were assessed. The quality of data on a specific cause of injury death was judged high if fewer than 20% of deaths were attributed to any of several partially specified causes of injury, such as “unspecified unintentional injury”. Findings Recent death registration data were available for 83 countries, comprising 28% of the global population. They included most high-income countries, most countries in Latin America and several in central Asia and the Caribbean. Categories commonly used for partially specified external causes of injury resulting in death included “undetermined intent,” “unspecified mechanism of unintentional injury,” “unspecified road injury” and “unspecified mechanism of homicide”. Only 20 countries had high-quality data. Nevertheless, because the partially specified categories do contain some information about injury mechanisms, reliable estimates of deaths due to specific external causes of injury, such as road injury, suicide and homicide, could be derived for many more countries. Conclusion Only 20 countries had high-quality death registration data that could be used for estimating injury mortality because injury deaths were frequently classified using imprecise partially specified categories. Analytical methods that can derive national estimates of injury mortality from alternative data sources are needed for countries without reliable death registration systems. PMID:21076564

Influence of raw milk quality on processed dairy products: How do raw milk quality test results relate to product quality and yield?

PubMed

Murphy, Steven C; Martin, Nicole H; Barbano, David M; Wiedmann, Martin

2016-12-01

This article provides an overview of the influence of raw milk quality on the quality of processed dairy products and offers a perspective on the merits of investing in quality. Dairy farmers are frequently offered monetary premium incentives to provide high-quality milk to processors. These incentives are most often based on raw milk somatic cell and bacteria count levels well below the regulatory public health-based limits. Justification for these incentive payments can be based on improved processed product quality and manufacturing efficiencies that provide the processor with a return on their investment for high-quality raw milk. In some cases, this return on investment is difficult to measure. Raw milks with high levels of somatic cells and bacteria are associated with increased enzyme activity that can result in product defects. Use of raw milk with somatic cell counts >100,000cells/mL has been shown to reduce cheese yields, and higher levels, generally >400,000 cells/mL, have been associated with textural and flavor defects in cheese and other products. Although most research indicates that fairly high total bacteria counts (>1,000,000 cfu/mL) in raw milk are needed to cause defects in most processed dairy products, receiving high-quality milk from the farm allows some flexibility for handling raw milk, which can increase efficiencies and reduce the risk of raw milk reaching bacterial levels of concern. Monitoring total bacterial numbers in regard to raw milk quality is imperative, but determining levels of specific types of bacteria present has gained increasing importance. For example, spores of certain spore-forming bacteria present in raw milk at very low levels (e.g., <1/mL) can survive pasteurization and grow in milk and cheese products to levels that result in defects. With the exception of meeting product specifications often required for milk powders, testing for specific spore-forming groups is currently not used in quality incentive programs in the United States but is used in other countries (e.g., the Netherlands). Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

A study of the relationship between resilience, burnout and coping strategies in doctors.

PubMed

McCain, R Scott; McKinley, Nicola; Dempster, Martin; Campbell, W Jeffrey; Kirk, Stephen J

2017-08-09

The aim of this study was to measure resilience, coping and professional quality of life in doctors. A cross-sectional study using an online questionnaire in a single National Health Service trust, including both primary and secondary care doctors. 283 doctors were included. Mean resilience was 68.9, higher than population norms. 100 (37%) doctors had high burnout, 194 (72%) doctors had high secondary traumatic stress and 64 (24%) had low compassion satisfaction. Burnout was positively associated with low resilience, low compassion satisfaction, high secondary traumatic stress and more frequent use of maladaptive coping mechanisms, including self-blame, behavioural disengagement and substance use. Non-clinical issues in the workplace were the main factor perceived to cause low resilience in doctors. Despite high levels of resilience, doctors had high levels of burnout and secondary traumatic stress. Doctors suffering from burnout were more likely to use maladaptive coping mechanisms. As doctors already have high resilience, improving personal resilience further may not offer much benefit to professional quality of life. A national study of professional Quality of Life, Coping And REsilience, which we are proposing to undertake, will for the first time assess the UK and Ireland medical workforce in this regard and guide future targeted interventions to improve professional quality of life. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Weight loss, dysphagia and supplement intake in patients with amyotrophic lateral sclerosis (ALS): impact on quality of life and therapeutic options

PubMed Central

2013-01-01

Background Weight loss is a frequent feature in the motor neuron disease Amyotrophic lateral sclerosis (ALS). In this study we investigated possible causes of weight loss in ALS, its impact on mood/quality of life (QOL) and the benefit of high calorie nutritional/other dietary supplements and percutaneous endoscopic gastrostomy (PEG). Methods 121 ALS patients were interviewed and answered standardized questionnaires (Beck depression inventory - II, SF36 Health Survey questionnaire, revised ALS functional rating scale). Two years after the initial survey we performed a follow-up interview. Results In our ALS-cohort, 56.3% of the patients suffered from weight loss. Weight loss had a negative impact on QOL and was associated with a shorter survival. Patients who took high calorie nutritional supplements respectively had a PEG stated a great benefit regarding weight stabilization and/or QOL. 38.2% of our patients had significant weight loss without suffering from dysphagia. To clarify the reasons for weight loss in these patients, we compared them with patients without weight loss. The two groups did not differ regarding severity of disease, depression, frontotemporal dementia or fasciculations, but patients with weight loss declared more often increased respiratory work. Conclusions Weight loss is a serious issue in ALS and cannot always be attributed to dysphagia. Symptomatic treatment of weight loss (high calorie nutritional supplements and/ or PEG) should be offered more frequently. PMID:23848967

Maternal and child nutrition in Sub-Saharan Africa: challenges and interventions.

PubMed

Lartey, Anna

2008-02-01

Women of child-bearing age (especially pregnant and lactating women), infants and young children are in the most nutritionally-vulnerable stages of the life cycle. Maternal malnutrition is a major predisposing factor for morbidity and mortality among African women. The causes include inadequate food intake, poor nutritional quality of diets, frequent infections and short inter-pregnancy intervals. Evidence for maternal malnutrition is provided by the fact that between 5 and 20% of African women have a low BMI as a result of chronic hunger. Across the continent the prevalence of anaemia ranges from 21 to 80%, with similarly high values for both vitamin A and Zn deficiency levels. Another challenge is the high rates of HIV infection, which compromise maternal nutritional status. The consequences of poor maternal nutritional status are reflected in low pregnancy weight gain and high infant and maternal morbidity and mortality. Suboptimal infant feeding practices, poor quality of complementary foods, frequent infections and micronutrient deficiencies have largely contributed to the high mortality among infants and young children in the region. Feeding children whose mothers are infected with HIV continues to remain an issue requiring urgent attention. There are successful interventions to improve the nutrition of mothers, infants and young children, which will be addressed. Interventions to improve the nutrition of infants and young children, particularly in relation to the improvement of micronutrient intakes of young children, will be discussed. The recent release by WHO of new international growth standards for assessing the growth and nutritional status of children provides the tool for early detection of growth faltering and for appropriate intervention.

The associations between yogurt consumption, diet quality, and metabolic profiles in children in the USA.

PubMed

Zhu, Yong; Wang, Huifen; Hollis, James H; Jacques, Paul F

2015-06-01

Recent studies have shown that yogurt consumption was associated with better diet quality and a healthier metabolic profile in adults. However, such associations have not been investigated in children. The present study examined the associations in children using data from a nationally representative survey. Data from 5,124 children aged 2-18 years, who participated in the National Health and Nutrition Examination Survey (NHANES) between 2003 and 2006 in the USA were analyzed. The frequency of yogurt consumption over 12 months was determined using a validated food frequency questionnaire. Diet quality was assessed by the Healthy Eating Index 2005 (HEI-2005) using one 24-HR dietary recall, and metabolic profiles were obtained from the NHANES laboratory data. It was found that only 33.1 % of children consumed yogurt at least once per week (frequent consumers). Adjusting for covariates, frequent consumers had better diet quality than infrequent consumers, as indicated by a higher HEI-2005 total score (P = 0.04). Frequent yogurt consumption was associated with a lower fasting insulin level (P < 0.001), a lower homeostatic model assessment of insulin resistance (P < 0.001), and a higher quantitative insulin sensitivity check index (P = 0.03). However, yogurt consumption was not associated with body weight, fasting glucose, serum lipid profiles, C-reactive protein, and blood pressures (all P > 0.05). These results suggest that frequent yogurt consumption may contribute to improved diet quality and a healthier insulin profile in children. Future longitudinal studies and clinical trials in children are warranted to explore the health benefits of yogurt consumption.

How are age-related differences in sleep quality associated with health outcomes? An epidemiological investigation in a UK cohort of 2406 adults

PubMed Central

Gadie, Andrew; Shafto, Meredith; Leng, Yue

2017-01-01

Objectives To examine age-related differences in self-reported sleep quality and their associations with health outcomes across four domains: physical health, cognitive health, mental health and neural health. Setting Cambridge Centre for Ageing and Neuroscience (Cam-CAN) is a cohort study in East Anglia/England, which collected self-reported health and lifestyle questions as well as a range of objective measures from healthy adults. Participants 2406 healthy adults (age 18–98) answered questions about their sleep quality (Pittsburgh Sleep Quality Index (PSQI)) and measures of physical, cognitive, mental and neural health. A subset of 641 individuals provided measures of brain structure. Main outcome measures PSQI scores of sleep and scores across tests within the four domains of health. Latent class analysis (LCA) is used to identify sleep types across the lifespan. Bayesian regressions quantify the presence, and absence, of relationships between sleep quality and health measures. Results Better self-reported sleep is generally associated with better health outcomes, strongly so for mental health, moderately for cognitive and physical health, but not for sleep quality and neural health. LCA identified four sleep types: ‘good sleepers’ (68.1%, most frequent in middle age), ‘inefficient sleepers’ (14.01%, most frequent in old age), ‘delayed sleepers’ (9.28%, most frequent in young adults) and ‘poor sleepers’ (8.5%, most frequent in old age). There is little evidence for interactions between sleep quality and age on health outcomes. Finally, we observe U-shaped associations between sleep duration and mental health (depression and anxiety) as well as self-reported general health, such that both short and long sleep were associated with poorer outcomes. Conclusions Lifespan changes in sleep quality are multifaceted and not captured well by summary measures, but instead should be viewed as as partially independent symptoms that vary in prevalence across the lifespan. Better self-reported sleep is associated with better health outcomes, and the strength of these associations differs across health domains. Notably, we do not observe associations between self-reported sleep quality and white matter. PMID:28760786

Reservoir vital signs monitoring, 1990: Physical and chemical characteristics of water and sediments

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

Meinert, D.L.

1991-05-01

As part of Tennessee Valley Authority's (TVA's) Reservoir Vital Signs Monitoring program, physical/chemical measurements of water and sediment were made in 1990 on twelve TVA reservoirs (the nine main steam Tennessee river reservoirs - Kentucky through Fort Loudoun and three major tributary reservoirs - Cherokee, Douglas, and Norris). The objective of this monitoring program is to assess the health or integrity of these aquatic ecosystems. The physical/chemical water quality data collected in 1990 showed the water quality of these reservoirs to be very good. However, hypolimnetic anoxia during the summer months in Watts bars, Douglas, and Cherokee reservoir continues tomore » be a concern. High concentrations of nutrients were measured in the transition zones of Cherokee and Douglas reservoirs, resulting in highly productive and eutrophic conditions in the transition zones of these reservoirs. Fecal coliform organisms were frequently detected in the forebay area of Guntersville reservoir, and higher than expected ammonia nitrogen concentrations were found at the transition zone of Wheeler reservoir. Elevated concentrations of mercury were found in Pickwick and Watts bar reservoir sediment, and high lead concentrations were found in a sediment sample collected from Guntersville reservoir. A TVA Reservoir Water Quality Index (RWQI) was developed and used to summarize water quality conditions on a scale from 0 (worst) to 100 (best).« less

A review of data quality assessment methods for public health information systems.

PubMed

Chen, Hong; Hailey, David; Wang, Ning; Yu, Ping

2014-05-14

High quality data and effective data quality assessment are required for accurately evaluating the impact of public health interventions and measuring public health outcomes. Data, data use, and data collection process, as the three dimensions of data quality, all need to be assessed for overall data quality assessment. We reviewed current data quality assessment methods. The relevant study was identified in major databases and well-known institutional websites. We found the dimension of data was most frequently assessed. Completeness, accuracy, and timeliness were the three most-used attributes among a total of 49 attributes of data quality. The major quantitative assessment methods were descriptive surveys and data audits, whereas the common qualitative assessment methods were interview and documentation review. The limitations of the reviewed studies included inattentiveness to data use and data collection process, inconsistency in the definition of attributes of data quality, failure to address data users' concerns and a lack of systematic procedures in data quality assessment. This review study is limited by the coverage of the databases and the breadth of public health information systems. Further research could develop consistent data quality definitions and attributes. More research efforts should be given to assess the quality of data use and the quality of data collection process.

A Review of Data Quality Assessment Methods for Public Health Information Systems

PubMed Central

Chen, Hong; Hailey, David; Wang, Ning; Yu, Ping

2014-01-01

High quality data and effective data quality assessment are required for accurately evaluating the impact of public health interventions and measuring public health outcomes. Data, data use, and data collection process, as the three dimensions of data quality, all need to be assessed for overall data quality assessment. We reviewed current data quality assessment methods. The relevant study was identified in major databases and well-known institutional websites. We found the dimension of data was most frequently assessed. Completeness, accuracy, and timeliness were the three most-used attributes among a total of 49 attributes of data quality. The major quantitative assessment methods were descriptive surveys and data audits, whereas the common qualitative assessment methods were interview and documentation review. The limitations of the reviewed studies included inattentiveness to data use and data collection process, inconsistency in the definition of attributes of data quality, failure to address data users’ concerns and a lack of systematic procedures in data quality assessment. This review study is limited by the coverage of the databases and the breadth of public health information systems. Further research could develop consistent data quality definitions and attributes. More research efforts should be given to assess the quality of data use and the quality of data collection process. PMID:24830450

Pesticides in streams of the United States : initial results from the National Water-Quality Assessment Program

USGS Publications Warehouse

Larson, Steven J.; Gilliom, Robert J.; Capel, Paul D.

1999-01-01

Water samples from 58 rivers and streams across the United States were analyzed for pesticides as part of the National Water-Quality Assessment Program of the U.S. Geological Survey. The sampling sites represent 37 diverse agricultural basins, 11 urban basins, and 10 basins with mixed land use. Forty-six pesticides and pesticide degradation products were analyzed in approximately 2,200 samples collected from 1992 to 1995. The target compounds account for approximately 70 percent of national agricultural use in terms of the mass of pesticides applied annually. All the target compounds were detected in one or more samples. Herbicides generally were detected more frequently and at higher concentrations than insecticides. Nationally, 11 herbicides, 1 herbicide degradation product, and 3 insecticides were detected in more than 10 percent of samples. The number of target compounds detected at each site ranged from 7 to 37. The herbicides atrazine, metolachlor, prometon, and simazine were detected most frequently; among the insecticides, carbaryl, chlorpyrifos, and diazinon were detected the most frequently. Distinct differences in pesticide occurrence were observed in streams draining the various agricultural settings. Relatively high levels of several herbicides occurred as seasonal pulses in corn-growing areas. Several insecticides were frequently detected in areas where the dominant crops consist of orchards and vegetables. The number of pesticides detected and their concentrations were lower in wheat-growing areas than in most other agricultural areas. In most urban areas, the herbicides prometon and simazine and the insecticides carbaryl, chlorpyrifos, diazinon, and malathion were commonly detected. Concentrations of pesticides rarely exceeded standards and criteria established for drinking water, but some pesticides commonly exceeded criteria established for the protection of aquatic life.

Seasonal temperature extremes in Potsdam

NASA Astrophysics Data System (ADS)

Kundzewicz, Zbigniew; Huang, Shaochun

2010-12-01

The awareness of global warming is well established and results from the observations made on thousands of stations. This paper complements the large-scale results by examining a long time-series of high-quality temperature data from the Secular Meteorological Station in Potsdam, where observation records over the last 117 years, i.e., from January 1893 are available. Tendencies of change in seasonal temperature-related climate extremes are demonstrated. "Cold" extremes have become less frequent and less severe than in the past, while "warm" extremes have become more frequent and more severe. Moreover, the interval of the occurrence of frost has been decreasing, while the interval of the occurrence of hot days has been increasing. However, many changes are not statistically significant, since the variability of temperature indices at the Potsdam station has been very strong.

Fostering High-Quality Teaching with an Enriched Curriculum and Professional Development Support: The Head Start REDI Program

PubMed Central

Domitrovich, Celene E.; Gest, Scott D.; Gill, Sukhdeep; Bierman, Karen L.; Welsh, Janet; Jones, Damon

2017-01-01

This randomized controlled trial tested whether teaching quality in Head Start classrooms could be improved with the addition of evidence-based curriculum components targeting emergent language/literacy and social-emotional development and the provision of associated professional development support. Participants were lead and assistant teachers in 44 Head Start classrooms. Teachers received 4 days of workshop training along with weekly in-class support from a mentor teacher. End-of-year observations indicated that, compared to the control group, intervention teachers talked with children more frequently and in more cognitively complex ways, established a more positive classroom climate, and used more preventive behavior management strategies. Results supported the conclusion that enriched curriculum components and professional development support can produce improvements in multiple domains of teaching quality. PMID:29081534

Desert amphibian selection of arid land breeding habitat undermines reproductive effort.

PubMed

Kiesow, Anja B; Griffis-Kyle, Kerry L

2017-12-01

Understanding how animals select habitat is important for understanding how to better conserve those species. As droughts become more frequent and water availability declines in many systems, understanding selection of water sources becomes even more important for conservation. Tinajas and anthropogenic catchments are critical ephemeral breeding sites for Sonoran Desert anurans. Tadpoles have been documented in both water types even though anthropogenic catchments can contain very high concentrations of ammonia. We currently do not know how amphibians are selecting breeding habitat. We tested three hypotheses of habitat selection based on resource quality, resource quality and territoriality, and proximity of water site to other water sites. Male Anaxyrus punctatus called from all sites regardless of habitat quality or male quality; however, they were found more often at sites within 2 km of other sites. This suggests that male desert anurans are selecting close breeding habitat regardless of quality for breeding, indicating ammoniated sites are likely either population sinks or ecological traps. Consequently, adding anthropogenic water sites, without managing to reduce ammonia, will provide low quality habitat that could cause long-term declines in desert anuran populations.

Quality of life and attitudes towards psychotropics and dependency: consumers vs. non-consumers aged 50 and over.

PubMed

Baumann, M; Bonnetain, F; Briançon, S; Alla, F

2004-10-01

To assess the relationships between socio-demographic factors, quality of life and attitudes towards psychotropic drugs and dependency and to compare those relationships in continuous consumers (CC), occasional consumers (OC) and non-consumers (NC) of those drugs. Quality of life (SF36) and attitudes (14 statements) were measured in 601 subjects (45-60 years old) from the SUVIMAX cohort (SUpplementation en VItamines et en sels Mineraux AntioXydants). Data were obtained on 334 NC, 142 CC, 125 OC from the inclusion questionnaire and the monthly consumption report notebooks kept by subjects between 1994 and 1998. Dichotomous and polychotomous logistic regressions were used for the analysis. The lower the quality of life score the more frequent was consumption. NC tended to be men, with high quality of life scores. They entertained negative attitudes towards psychotropics and dependency. OC tended to be women reporting a chronic pathology, with fairly high social status. They had intermediate quality of life and denied dependency. CC tended to be men with no professional activity and low quality of life scores in particular for mental health and perceived health. They had positive attitudes towards psychotropics and accept dependency. Assessment of patients' quality of life and understanding of their attitudes towards psychotropics can provide essential information for those in charge of health promotion programmes and may help in identifying new intervention strategies. Preventive education and follow-up of therapy may be better suited to the needs of patients.

Sleep patterns and sleep disturbances across pregnancy.

PubMed

Mindell, Jodi A; Cook, Rae Ann; Nikolovski, Janeta

2015-04-01

This study sought to characterize sleep patterns and sleep problems in a large sample of women across all months of pregnancy. A total of 2427 women completed an Internet-based survey that included the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, vitality scale of the Short Form 36 Health Survey (SF-36), Insomnia Severity Index (ISI), Berlin questionnaire, International Restless Legs Syndrome (IRLS) question set, and a short version of the Pregnancy Symptoms Inventory (PSI). Across all months of pregnancy, women experienced poor sleep quality (76%), insufficient nighttime sleep (38%), and significant daytime sleepiness (49%). All women reported frequent nighttime awakenings (100%), and most women took daytime naps (78%). Symptoms of insomnia (57%), sleep-disordered breathing (19%), and restless legs syndrome (24%) were commonly endorsed, with no difference across the month of pregnancy for insomnia, sleep-disorder breathing, daytime sleepiness, or fatigue. In addition, high rates of pregnancy-related symptoms were found to disturb sleep, especially frequent urination (83%) and difficulty finding a comfortable sleep position (79%). Women experience significant sleep disruption, inadequate sleep, and high rates of symptoms of sleep disorder throughout pregnancy. These results suggest that all women should be screened and treated for sleep disturbances throughout pregnancy, especially given the impact of inadequate sleep and sleep disorders on fetal, pregnancy, and postpartum outcomes. Copyright © 2014 Elsevier B.V. All rights reserved.

A systematic review of stakeholder engagement in comparative effectiveness and patient-centered outcomes research.

PubMed

Concannon, Thomas W; Fuster, Melissa; Saunders, Tully; Patel, Kamal; Wong, John B; Leslie, Laurel K; Lau, Joseph

2014-12-01

We conducted a review of the peer-reviewed literature since 2003 to catalogue reported methods of stakeholder engagement in comparative effectiveness research and patient-centered outcomes research. We worked with stakeholders before, during and after the review was conducted to: define the primary and key research questions; conduct the literature search; screen titles, abstracts and articles; abstract data from the articles; and analyze the data. The literature search yielded 2,062 abstracts. The review was conducted on 70 articles that reported on stakeholder engagement in individual research projects or programs. Reports of stakeholder engagement are highly variable in content and quality. We found frequent engagement with patients, modestly frequent engagement with clinicians, and infrequent engagement with stakeholders in other key decision-making groups across the healthcare system. Stakeholder engagement was more common in earlier (prioritization) than in later (implementation and dissemination) stages of research. The roles and activities of stakeholders were highly variable across research and program reports. To improve on the quality and content of reporting, we developed a 7-Item Stakeholder Engagement Reporting Questionnaire. We recommend three directions for future research: 1) descriptive research on stakeholder-engagement in research; 2) evaluative research on the impact of stakeholder engagement on the relevance, transparency and adoption of research; and 3) development and validation of tools that can be used to support stakeholder engagement in future work.

Petroleum Jelly: A Novel Medium for Ocular Ultrasound.

PubMed

Engelbert, Patrick R; Palma, James K

2015-08-01

Ocular ultrasound is a useful emergency department imaging modality for evaluation of many conditions, such as retinal detachment, vitreous detachment, vitreous hemorrhage, and elevated intracranial pressure. Obtaining satisfactory ocular ultrasound images requires the use of a medium that eliminates the air interface between the patient's eye and the transducer. Ultrasound gel is most commonly used; however, the use of a transparent dressing applied to the closed eye prior to the application of gel has also been described as a suitable technique. Ocular ultrasound is performed with the high-frequency linear array transducer using a medium to eliminate the air interface between the eye and the transducer. Although ultrasound gel is most frequently used, it can cause minor eye irritation. Placing a transparent dressing over a closed eye prior to application of gel can eliminate the eye irritation. However, our experience in training >500 students in ocular ultrasound has shown that air is frequently introduced underneath the dressing, which leads to poor-quality images. This article introduces petroleum jelly as a medium for ocular ultrasound. By applying a layer of petroleum jelly over the closed eye and allowing it to warm via body heat for 30 to 45 s, this medium can both minimize patient discomfort and provide easily obtainable, high-quality ocular ultrasound images. This article introduces petroleum jelly as a safe, comfortable, and effective medium for ocular ultrasound examination. Published by Elsevier Inc.

Lower gastrointestinal symptoms are associated with worse glycemic control and quality of life in type 1 diabetes mellitus.

PubMed

Leeds, John S; Hadjivassiliou, Marios; Tesfaye, Solomon; Sanders, David S

2018-01-01

Lower gastrointestinal symptoms are not well characterized in people with type 1 diabetes, and the effects on quality of life and glycemic control are unknown. This study aimed to determine the prevalence of lower gastrointestinal symptoms and the effects on glycemic control and quality of life, and to investigate for underlying causes. This is a prospective, cohort study in secondary care. Patients with type 1 diabetes completed a gastrointestinal symptom questionnaire and the Short Form 36 V.2 quality of life questionnaire and had their hemoglobin A1c measured. Patients with diarrhea were offered reassessment and investigation as per the national guidelines. Controls without diabetes were used to compare symptom prevalence and quality of life scores. 706 with type 1 diabetes (mean age 41.9 years) and 604 controls (mean age 41.9 years) were enrolled. Gastrointestinal symptoms were significantly more frequent in type 1 diabetes compared with controls, in particular constipation (OR 2.4), diarrhea (OR 2.5), alternating bowel habit (OR 2.1), abdominal pain (OR 1.4), floating stools (OR 2.7), bloating (OR 1.4) and flatulence (OR 1.3) (all p<0.05). Previous pancreatitis was more frequent in type 1 diabetes (OR 4.6), but other gastrointestinal conditions were not. Gastrointestinal symptoms were associated with poorer glycemic control (p<0.01) and worse quality of life particularly in those with diarrhea. Investigation of those with diarrhea, including those with alternating bowel habit, (n=105), identified a cause in 72.3% with subsequent change in management. Gastrointestinal symptoms are twice as common in type 1 diabetes and associated with poorer quality of life and glycemic control. Investigation of diarrhea in people with type 1 diabetes leads to a high yield of treatable conditions and a change in management in about three-quarters.

Reporting characteristics of meta-analyses in orthodontics: methodological assessment and statistical recommendations.

PubMed

Papageorgiou, Spyridon N; Papadopoulos, Moschos A; Athanasiou, Athanasios E

2014-02-01

Ideally meta-analyses (MAs) should consolidate the characteristics of orthodontic research in order to produce an evidence-based answer. However severe flaws are frequently observed in most of them. The aim of this study was to evaluate the statistical methods, the methodology, and the quality characteristics of orthodontic MAs and to assess their reporting quality during the last years. Electronic databases were searched for MAs (with or without a proper systematic review) in the field of orthodontics, indexed up to 2011. The AMSTAR tool was used for quality assessment of the included articles. Data were analyzed with Student's t-test, one-way ANOVA, and generalized linear modelling. Risk ratios with 95% confidence intervals were calculated to represent changes during the years in reporting of key items associated with quality. A total of 80 MAs with 1086 primary studies were included in this evaluation. Using the AMSTAR tool, 25 (27.3%) of the MAs were found to be of low quality, 37 (46.3%) of medium quality, and 18 (22.5%) of high quality. Specific characteristics like explicit protocol definition, extensive searches, and quality assessment of included trials were associated with a higher AMSTAR score. Model selection and dealing with heterogeneity or publication bias were often problematic in the identified reviews. The number of published orthodontic MAs is constantly increasing, while their overall quality is considered to range from low to medium. Although the number of MAs of medium and high level seems lately to rise, several other aspects need improvement to increase their overall quality.

Practical considerations for optimizing cardiac computed tomography protocols for comprehensive acquisition prior to transcatheter aortic valve replacement.

PubMed

Khalique, Omar K; Pulerwitz, Todd C; Halliburton, Sandra S; Kodali, Susheel K; Hahn, Rebecca T; Nazif, Tamim M; Vahl, Torsten P; George, Isaac; Leon, Martin B; D'Souza, Belinda; Einstein, Andrew J

2016-01-01

Transcatheter aortic valve replacement (TAVR) is performed frequently in patients with severe, symptomatic aortic stenosis who are at high risk or inoperable for open surgical aortic valve replacement. Computed tomography angiography (CTA) has become the gold standard imaging modality for pre-TAVR cardiac anatomic and vascular access assessment. Traditionally, cardiac CTA has been most frequently used for assessment of coronary artery stenosis, and scanning protocols have generally been tailored for this purpose. Pre-TAVR CTA has different goals than coronary CTA and the high prevalence of chronic kidney disease in the TAVR patient population creates a particular need to optimize protocols for a reduction in iodinated contrast volume. This document reviews details which allow the physician to tailor CTA examinations to maximize image quality and minimize harm, while factoring in multiple patient and scanner variables which must be considered in customizing a pre-TAVR protocol. Copyright © 2016 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

Do David and Goliath Play the Same Game? Explanation of the Abundance of Rare and Frequent Invasive Alien Plants in Urban Woodlands in Warsaw, Poland

PubMed Central

Mędrzycki, Piotr; Kołaczkowska, Ewa; Ciurzycki, Wojciech; Marciszewska, Katarzyna

2016-01-01

Invasive Alien Plants occur in numbers differing by orders of magnitude at subsequent invasion stages. Effective sampling and quantifying niches of rare invasive plants are quite problematic. The aim of this paper is an estimation of the influence of invasive plants frequency on the explanation of their local abundance. We attempted to achieve it through: (1) assessment of occurrence of self-regenerating invasive plants in urban woodlands, (2) comparison of Random Forest modelling results for frequent and rare species. We hypothesized that the abundance of frequent species would be explained better than that of rare ones and that both rare and frequent species share a common hierarchy of the most important determinants. We found 15 taxa in almost two thirds of 1040 plots with a total number of 1068 occurrences. There were recorded 6 taxa of high frequency–Prunus serotina, Quercus rubra, Acer negundo, Robinia pseudoacacia, Impatiens parviflora and Solidago spp.–and 9 taxa of low frequency: Acer saccharinum, Amelanchier spicata, Cornus spp., Fraxinus spp., Parthenocissus spp., Syringa vulgaris, Echinocystis lobata, Helianthus tuberosus, Reynoutria spp. Random Forest’s models’ quality grows with the number of occurrences of frequent taxa but not of the rare ones. Both frequent and rare taxa share a similar hierarchy of predictors’ importance: Land use > Tree stand > Seed source and, for frequent taxa, Forest properties as well. We conclude that there is an ‘explanation jump’ at higher species frequencies, but rare species are surprisingly similar to frequent ones in their determinant’s hierarchy, with differences conforming with their respective stages of invasion. PMID:27992516

Choices in recreational water quality monitoring: new opportunities and health risk trade-offs.

PubMed

Nevers, Meredith B; Byappanahalli, Muruleedhara N; Whitman, Richard L

2013-04-02

With the recent release of new recreational water quality monitoring criteria, there are more options for regulatory agencies seeking to protect beachgoers from waterborne pathogens. Included are methods that can reduce analytical time, providing timelier estimates of water quality, but the application of these methods has not been examined at most beaches for expectation of health risk and management decisions. In this analysis, we explore health and monitoring outcomes expected at Lake Michigan beaches using protocols for indicator bacteria including culturable Escherichia coli (E. coli; EC), culturable enterococci (ENT), and enterococci as analyzed by qPCR (QENT). Correlations between method results were generally high, except at beaches with historically high concentrations of EC. The "beach action value" was exceeded most often when using EC or ENT as the target indicator; QENT exceeded the limit far less frequently. Measured water quality between years was varied. Although methods with equivalent health expectation have been established, the lack of relationship among method outcomes and annual changes in mean indicator bacteria concentrations complicates the decision-making process. The monitoring approach selected by beach managers may be a combination of available tools that maximizes timely health protection, cost efficiency, and collaboration among beach jurisdictions.

Choices in recreational water quality monitoring: new opportunities and health risk trade-offs

USGS Publications Warehouse

Nevers, Meredith B.; Byappanahalli, Muruleedhara N.; Whitman, Richard L.

2013-01-01

With the recent release of new recreational water quality monitoring criteria, there are more options for regulatory agencies seeking to protect beachgoers from waterborne pathogens. Included are methods that can reduce analytical time, providing timelier estimates of water quality, but the application of these methods has not been examined at most beaches for expectation of health risk and management decisions. In this analysis, we explore health and monitoring outcomes expected at Lake Michigan beaches using protocols for indicator bacteria including culturable Escherichia coli (E. coli; EC), culturable enterococci (ENT), and enterococci as analyzed by qPCR (QENT). Correlations between method results were generally high, except at beaches with historically high concentrations of EC. The “beach action value” was exceeded most often when using EC or ENT as the target indicator; QENT exceeded the limit far less frequently. Measured water quality between years was varied. Although methods with equivalent health expectation have been established, the lack of relationship among method outcomes and annual changes in mean indicator bacteria concentrations complicates the decision-making process. The monitoring approach selected by beach managers may be a combination of available tools that maximizes timely health protection, cost efficiency, and collaboration among beach jurisdictions.

5 CFR 1315.3 - Responsibilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... vendors under this part are subject to periodic quality control validation to be conducted no less frequently than once annually. Quality control processes will be used to confirm that controls are effective and that processes are efficient. Each agency head is responsible for establishing a quality control...

5 CFR 1315.3 - Responsibilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... vendors under this part are subject to periodic quality control validation to be conducted no less frequently than once annually. Quality control processes will be used to confirm that controls are effective and that processes are efficient. Each agency head is responsible for establishing a quality control...

5 CFR 1315.3 - Responsibilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... vendors under this part are subject to periodic quality control validation to be conducted no less frequently than once annually. Quality control processes will be used to confirm that controls are effective and that processes are efficient. Each agency head is responsible for establishing a quality control...

Home nurses' turnover intentions: the impact of informal supervisory feedback and self-efficacy.

PubMed

Van Waeyenberg, Thomas; Decramer, Adelien; Anseel, Frederik

2015-12-01

To examine how home nurses' turnover intentions are affected by the quality and frequency of supervisory feedback and by their own self-efficacy. Little is known about effective retention strategies for the growing home healthcare sector that struggles to retain an adequate workforce. While the work environment and supervisors have been found to play a key-role in nurses' turnover intentions, home nurses mostly work autonomously and apart from their supervisors. These circumstances require a customized approach and need to be understood to ensure high-quality home health care. We used a correlational, cross-sectional survey design. A convenience sample of 312 home nurses was selected from a division of a large home health care organization in Flanders, Belgium. Data were collected in 2013 using structured questionnaires and analysed using descriptive statistics, structural equation modelling and relative weight analysis. The quality of feedback was related to lower levels of turnover intentions. This relationship was fully mediated by home nurses' self-efficacy. Frequent favourable feedback was directly related to lower turnover intentions while the relationship between frequent unfavourable feedback and turnover intentions was conditional on home nurses' level of self-efficacy. This study contributes to our understanding of home nurses' turnover intentions and the role of informal supervisory feedback and home nurses' self-efficacy. © 2015 John Wiley & Sons Ltd.

Cough in the Elderly Population: Relationships with Multiple Comorbidity

PubMed Central

Song, Woo-Jung; Morice, Alyn H.; Kim, Min-Hye; Lee, Seung-Eun; Jo, Eun-Jung; Lee, Sang-Min; Han, Ji-Won; Kim, Tae Hui; Kim, Sae-Hoon; Jang, Hak-Chul; Kim, Ki Woong; Cho, Sang-Heon; Min, Kyung-Up; Chang, Yoon-Seok

2013-01-01

Background The epidemiology of cough in the elderly population has not been studied comprehensively. The present study aimed to investigate the epidemiology of cough in a community elderly population, particularly in relation with their comorbidity. Methods A cross-sectional analysis was performed using a baseline dataset from the Korean Longitudinal Study on Health and Aging, a community-based elderly population cohort study. Three types of cough (frequent cough, chronic persistent cough, and nocturnal cough) were defined using questionnaires. Comorbidity was examined using a structured questionnaire. Health-related quality of life was assessed using the Short Form 36 questionnaire. Results The prevalence was 9.3% for frequent cough, 4.6% for chronic persistent cough, and 7.3% for nocturnal cough. In multivariate logistic regression analyses, smoking, asthma and allergic rhinitis were found to be risk factors for cough in the elderly. Interestingly, among comorbidities, constipation and uncontrolled diabetes mellitus (HbA1c ≥ 8%) were also found to have positive associations with elderly cough. In the Short Form 36 scores, chronic persistent cough was independently related to impairment of quality of life, predominantly in the mental component. Conclusions Cough has a high prevalence and is detrimental to quality of life in the elderly. Associations with smoking, asthma and rhinitis confirmed previous findings in younger populations. Previously unrecognised relationships with constipation and uncontrolled diabetes mellitus suggested the multi-faceted nature of cough in the elderly. PMID:24205100

Quality of care and patient satisfaction in hospitals with high concentrations of black patients.

PubMed

Brooks-Carthon, J Margo; Kutney-Lee, Ann; Sloane, Douglas M; Cimiotti, Jeannie P; Aiken, Linda H

2011-09-01

To examine the influence of nursing-specifically nurse staffing and the nurse work environment-on quality of care and patient satisfaction in hospitals with varying concentrations of Black patients. Cross-sectional secondary analysis of 2006-2007 nurse survey data collected across four states (Florida, Pennsylvania, New Jersey, and California), the Hospital Consumer Assessment of Healthcare Providers and Systems survey, and administrative data. Global analysis of variance and linear regression models were used to examine the association between the concentration of Black patients on quality measures (readiness for discharge, patient or family complaints, health care-associated infections) and patient satisfaction, before and after accounting for nursing and hospital characteristics. Nurses working in hospitals with higher concentrations of Blacks reported poorer confidence in patients' readiness for discharge and more frequent complaints and infections. Patients treated in hospitals with higher concentrations of Blacks were less satisfied with their care. In the fully adjusted regression models for quality and patient satisfaction outcomes, the effects associated with the concentration of Blacks were explained in part by nursing and structural hospital characteristics. This study demonstrates a relationship between nursing, structural hospital characteristics, quality of care, and patient satisfaction in hospitals with high concentrations of Black patients. Consideration of nursing factors, in addition to other important hospital characteristics, is critical to understanding and improving quality of care and patient satisfaction in minority-serving hospitals. © 2011 Sigma Theta Tau International.

High-LET radiation-induced aberrations in prematurely condensed G2 chromosomes of human fibroblasts

NASA Technical Reports Server (NTRS)

Kawata, T.; Gotoh, E.; Durante, M.; Wu, H.; George, K.; Furusawa, Y.; Cucinotta, F. A.; Dicello, J. F. (Principal Investigator)

2000-01-01

PURPOSE: To determine the number of initial chromatid breaks induced by low- or high-LET irradiations, and to compare the kinetics of chromatid break rejoining for radiations of different quality. MATERIAL AND METHODS: Exponentially growing human fibroblast cells AG1522 were irradiated with gamma-rays, energetic carbon (290MeV/u), silicon (490MeV/u) and iron (200 and 600 MeV/u). Chromosomes were prematurely condensed using calyculin A. Chromatid breaks and exchanges in G2 cells were scored. PCC were collected after several post-irradiation incubation times, ranging from 5 to 600 min. RESULTS: The kinetics of chromatid break rejoining following low- or high-LET irradiation consisted of two exponential components representing a rapid and a slow time constant. Chromatid breaks decreased rapidly during the first 10min after exposure, then continued to decrease at a slower rate. The rejoining kinetics were similar for exposure to each type of radiation. Chromatid exchanges were also formed quickly. Compared to low-LET radiation, isochromatid breaks were produced more frequently and the proportion of unrejoined breaks was higher for high-LET radiation. CONCLUSIONS: Compared with gamma-rays, isochromatid breaks were observed more frequently in high-LET irradiated samples, suggesting that an increase in isochromatid breaks is a signature of high-LET radiation exposure.

Nursing Sensitive Outcomes After Severe Traumatic Brain Injury: A Nationwide Study.

PubMed

Odgaard, Lene; Aadal, Lena; Eskildsen, Marianne; Poulsen, Ingrid

2018-06-01

Complications such as infections and conditions after immobilization are frequent after severe traumatic brain injury (TBI) due to compromised bodily functions. Traditionally, bodily functions are core elements in nursing, and therefore nurses in the rehabilitation departments are pivotal in the prevention of complications. Hence, the frequency of complications is an indicator of nursing care quality, which can be included in nursing-sensitive outcome indicators. To do so, it is necessary to know the frequency of the selected complications. The aim of this study was to quantify complications during the first year after severe TBI. This study included patients 15 years or older who received subacute neurorehabilitation after severe TBI from 2011 to 2015 (N = 469). This is a register-based follow-up study using data from the Danish Head Trauma Database, a national clinical quality database aimed at monitoring and improving the quality of rehabilitation for patients with severe TBI. The following complications were assessed: urinary tract infection, pneumonia, pressure ulcers, joint contractures, and deep venous thrombosis. The prevalence of each complication was calculated at admission, discharge, and 1 year postinjury and for the period from admission and during subacute rehabilitation. In addition, the frequency of complications that certainly developed during subacute rehabilitation was calculated. Complications were compared between age-specific subgroups using multivariable binominal regression analyses. Urinary tract infections (53%) and pneumonia (32%) were the most common complications in the period from admission and during subacute rehabilitation. Pressure ulcers (18%), joint contractures (18%), and deep venous thrombosis (4%) were less frequent. At discharge and 1 year postinjury, the prevalence was less than 4% for all complications, except for joint contractures (16% and 13% at discharge and 1 year postinjury, respectively). The prevalence of complications was high. The findings are important for future quality improvement of the rehabilitation trajectory and for further studies that explore the high frequency of complications.

Recreational Water Quality Criteria Limits

EPA Pesticide Factsheets

This set of Frequently Asked Questions (FAQ) provides an overview of NPDES permitting applicable to continuous dischargers (such as POTWs) based on water quality standards for pathogens and pathogen indicators associated with fecal contamination.

Professional burnout syndrome in doctors of surgical specialties in Ukraine: causes, consequences, labor optimization ways.

PubMed

Skurupii, Dmytro A; Kholod, Dmytro A; Sonnik, Evgen G

The professional burnout syndrome (PBS) affects quality of medical care provision for people, which is acquires the special actuality in terms of reforming the health care system. To study ways to improve the efficiency of doctors of surgical specialties based on analyzes of PBS and its consequences. A survey of psychological tests and 62 surgical doctors was carried out. It was found out that the PBS reaches a peak after 11 to 15 years of working experience. Anesthesiologists have high levels of PBS, emotional exhaustion, cynicism, low desire for career growth, frequent misunderstanding with the administration, they prefer 8-hour working day, and relieve stress by sleeping and consuming alcohol. Obstetrician-gynecologists show moderate level of PBS and emotional exhaustion, high degree of cynicism, strong desire for career growth, frequent misunderstandings with patients and their relatives, prefer 8-hour working day, relieve stress by smoking and socializing with family and friends. Traumatic surgeons have moderate level of PBS, emotional exhaustion, high degree of cynicism, strong desire for career growth, frequent misunderstandings with their colleagues of related specialties, prefer the 24-hour working day, and reli eve their stress with alcohol and sports. Surgeons have moderate level of PBS, emotional exhaustion, low degree of cynicism, moderate desire for career growth, frequent misunderstandings with their colleagues of related specialties, prefer the 8-hour working day, and relieve stress by smoking and sleeping. PBS is most expressed in doctors having working experience of 11 to 15 years and in anesthesiologists. They get professional deformations. These features should be considered in course of organization of working process of medical teams.

Predictors and dietary consequences of frequent intake of high-sugar, low-nutrient foods in 1-year-old children participating in the ABIS study.

PubMed

Brekke, Hilde K; van Odijk, Jenny; Ludvigsson, Johnny

2007-01-01

Foods rich in sugar have been suggested to contribute to the increasing prevalence of obesity in children. The aim of this report is to investigate the dietary pattern in 1-year-old children who frequently receive foods rich in sugar but low in nutrients and to study associated demographic and parental factors. During 1977-9, 21,700 infants were invited to participate in this prospective, population-based, longitudinal cohort study. Screening questionnaires were completed for 16,070 infants after delivery. Follow-up questionnaires from 10,762 children at 1 year of age are included in the analysis. It was found that 24% of the children received sweets/pastries more often than one or two times per week. They had a higher intake of French fries, potato crisps and cream as well as a lower intake of fruit and vegetables. A frequent intake of sugar-rich, low-nutrient foods was significantly associated with several maternal factors (high intake of sweets/pastries during pregnancy, young age, mother living alone) as well as presence of older siblings. Maternal smoking during pregnancy and maternal overweight were of borderline significance. Parental education level was inversely associated with the frequency of intake of sweets/pastries in the child. Children who frequently receive sweets/pastries also have an otherwise unfavourable dietary pattern. Several parental and demographic factors were associated with this feeding pattern, especially high intake of sweets/pastries during pregnancy. Screening of pregnant women for risk predictors like consumption of sweets/pastries, young age and smoking could be possible ways of identifying children at future risk for low dietary quality.

Compensating effect of the coherent synchrotron radiation in bunch compressors

NASA Astrophysics Data System (ADS)

Jing, Yichao; Hao, Yue; Litvinenko, Vladimir N.

2013-06-01

Typical bunch compression for a high-gain free-electron laser (FEL) requires a large compression ratio. Frequently, this compression is distributed in multiple stages along the beam transport line. However, for a high-gain FEL driven by an energy recovery linac (ERL), compression must be accomplished in a single strong compressor located at the beam line’s end; otherwise the electron beam would be affected severely by coherent synchrotron radiation (CSR) in the ERL’s arcs. In such a scheme, the CSR originating from the strong compressors could greatly degrade the quality of the electron beam. In this paper, we present our design for a bunch compressor that will limit the effect of CSR on the e-beam’s quality. We discuss our findings from a study of such a compressor, and detail its potential for an FEL driven by a multipass ERL developed for the electron-Relativistic Heavy Ion Collider.

Low Quality of Basic Caregiving Environments in Child Care: Actual Reality or Artifact of Scoring?

ERIC Educational Resources Information Center

Norris, Deborah J.; Guss, Shannon

2016-01-01

Quality Rating Improvement Systems (QRIS) frequently include the Infant-Toddler Environment Rating Scale-Revised (ITERS-R) as part of rating and improving child care quality. However, studies utilizing the ITERS-R consistently report low quality, especially for basic caregiving items. This research examined whether the low scores reflected the…

Quality Early Childhood Education and Care--The Role of Attitudes and Dispositions in Professional Development

ERIC Educational Resources Information Center

Campbell-Barr, Verity

2017-01-01

The early childhood workforce is routinely demonstrated as being central to the quality of early childhood education and care (ECEC). Frequently, discussions of quality focus on structural features of training, such as level and duration. However, the literature demonstrates that quality extends beyond the structural and that early childhood…

Database Quality and Access Issues Relevant to Research Using Anesthesia Information Management System Data.

PubMed

Epstein, Richard H; Dexter, Franklin

2018-07-01

For this special article, we reviewed the computer code, used to extract the data, and the text of all 47 studies published between January 2006 and August 2017 using anesthesia information management system (AIMS) data from Thomas Jefferson University Hospital (TJUH). Data from this institution were used in the largest number (P = .0007) of papers describing the use of AIMS published in this time frame. The AIMS was replaced in April 2017, making this finite sample finite. The objective of the current article was to identify factors that made TJUH successful in publishing anesthesia informatics studies. We examined the structured query language used for each study to examine the extent to which databases outside of the AIMS were used. We examined data quality from the perspectives of completeness, correctness, concordance, plausibility, and currency. Our results were that most could not have been completed without external database sources (36/47, 76.6%; P = .0003 compared with 50%). The operating room management system was linked to the AIMS and was used significantly more frequently (26/36, 72%) than other external sources. Access to these external data sources was provided, allowing exploration of data quality. The TJUH AIMS used high-resolution timestamps (to the nearest 3 milliseconds) and created audit tables to track changes to clinical documentation. Automatic data were recorded at 1-minute intervals and were not editable; data cleaning occurred during analysis. Few paired events with an expected order were out of sequence. Although most data elements were of high quality, there were notable exceptions, such as frequent missing values for estimated blood loss, height, and weight. Some values were duplicated with different units, and others were stored in varying locations. Our conclusions are that linking the TJUH AIMS to the operating room management system was a critical step in enabling publication of multiple studies using AIMS data. Access to this and other external databases by analysts with a high degree of anesthesia domain knowledge was necessary to be able to assess the quality of the AIMS data and ensure that the data pulled for studies were appropriate. For anesthesia departments seeking to increase their academic productivity using their AIMS as a data source, our experiences may provide helpful guidance.

Quality of care in for-profit and not-for-profit nursing homes: systematic review and meta-analysis

PubMed Central

Comondore, Vikram R; Zhou, Qi; Stone, Samuel B; Busse, Jason W; Ravindran, Nikila C; Burns, Karen E; Haines, Ted; Stringer, Bernadette; Cook, Deborah J; Walter, Stephen D; Sullivan, Terrence; Berwanger, Otavio; Bhandari, Mohit; Banglawala, Sarfaraz; Lavis, John N; Petrisor, Brad; Schünemann, Holger; Walsh, Katie; Bhatnagar, Neera; Guyatt, Gordon H

2009-01-01

Objective To compare quality of care in for-profit and not-for-profit nursing homes. Design Systematic review and meta-analysis of observational studies and randomised controlled trials investigating quality of care in for-profit versus not-for-profit nursing homes. Results A comprehensive search yielded 8827 citations, of which 956 were judged appropriate for full text review. Study characteristics and results of 82 articles that met inclusion criteria were summarised, and results for the four most frequently reported quality measures were pooled. Included studies reported results dating from 1965 to 2003. In 40 studies, all statistically significant comparisons (P<0.05) favoured not-for-profit facilities; in three studies, all statistically significant comparisons favoured for-profit facilities, and the remaining studies had less consistent findings. Meta-analyses suggested that not-for-profit facilities delivered higher quality care than did for-profit facilities for two of the four most frequently reported quality measures: more or higher quality staffing (ratio of effect 1.11, 95% confidence interval 1.07 to 1.14, P<0.001) and lower pressure ulcer prevalence (odds ratio 0.91, 95% confidence interval 0.83 to 0.98, P=0.02). Non-significant results favouring not-for-profit homes were found for the two other most frequently used measures: physical restraint use (odds ratio 0.93, 0.82 to 1.05, P=0.25) and fewer deficiencies in governmental regulatory assessments (ratio of effect 0.90, 0.78 to 1.04, P=0.17). Conclusions This systematic review and meta-analysis of the evidence suggests that, on average, not-for-profit nursing homes deliver higher quality care than do for-profit nursing homes. Many factors may, however, influence this relation in the case of individual institutions. PMID:19654184

Using a centrifuge for quality control of pre-wetted lightweight aggregate in internally cured concrete

NASA Astrophysics Data System (ADS)

Miller, Albert E.

Early age shrinkage of cementitious systems can result in an increased potential for cracking which can lead to a reduction in service life. Early age shrinkage cracking can be particularly problematic for high strength concretes, which are often specified due to their high strength and low permeability. However, these high strength concretes frequently exhibit a reduction in the internal relative humidity (RH) due to the hydration reaction (chemical shrinkage) and self-desiccation which results in a bulk shrinkage, termed autogenous shrinkage, which is substantial at early ages. Due to the low permeability of these concretes, standard external curing is not always efficient in addressing this reduction in internal RH since the penetration of water can be limited. Internal curing has been developed to reduce autogenous shrinkage. Internally cured mixtures use internal reservoirs filled with fluid (generally water) that release this fluid at appropriate times to counteract the effects of self-desiccation thereby maintaining a high internal RH. Internally cured concrete is frequently produced in North America using pre-wetted lightweight aggregate. One important aspect associated with preparing quality internally cured concrete is being able to determine the absorbed moisture and surface moisture associated with the lightweight aggregate which enables aggregate moisture corrections to be made for the concrete mixture. This thesis represents work performed to develop a test method using a centrifuge to determine the moisture state of pre-wetted fine lightweight aggregate. The results of the test method are then used in a series of worksheets that were developed to assist field technicians when performing the tests and applying the results to a mixture design. Additionally, research was performed on superabsorbent polymers to assess their ability to be used as an internal curing reservoir.

Effects of Acupuncture on Sensory Perception: A Systematic Review and Meta-Analysis

PubMed Central

Baeumler, Petra I.; Fleckenstein, Johannes; Takayama, Shin; Simang, Michael; Seki, Takashi; Irnich, Dominik

2014-01-01

Background The effect of acupuncture on sensory perception has never been systematically reviewed; although, studies on acupuncture mechanisms are frequently based on the idea that changes in sensory thresholds reflect its effect on the nervous system. Methods Pubmed, EMBASE and Scopus were screened for studies investigating the effect of acupuncture on thermal or mechanical detection or pain thresholds in humans published in English or German. A meta-analysis of high quality studies was performed. Results Out of 3007 identified articles 85 were included. Sixty five studies showed that acupuncture affects at least one sensory threshold. Most studies assessed the pressure pain threshold of which 80% reported an increase after acupuncture. Significant short- and long-term effects on the pressure pain threshold in pain patients were revealed by two meta-analyses including four and two high quality studies, respectively. In over 60% of studies, acupuncture reduced sensitivity to noxious thermal stimuli, but measuring methods might influence results. Few but consistent data indicate that acupuncture reduces pin-prick like pain but not mechanical detection. Results on thermal detection are heterogeneous. Sensory threshold changes were equally frequent reported after manual acupuncture as after electroacupuncture. Among 48 sham-controlled studies, 25 showed stronger effects on sensory thresholds through verum than through sham acupuncture, but in 9 studies significant threshold changes were also observed after sham acupuncture. Overall, there is a lack of high quality acupuncture studies applying comprehensive assessments of sensory perception. Conclusions Our findings indicate that acupuncture affects sensory perception. Results are most compelling for the pressure pain threshold, especially in pain conditions associated with tenderness. Sham acupuncture can also cause such effects. Future studies should incorporate comprehensive, standardized assessments of sensory profiles in order to fully characterize its effect on sensory perception and to explore the predictive value of sensory profiles for the effectiveness of acupuncture. PMID:25502787

Effects of acupuncture on sensory perception: a systematic review and meta-analysis.

PubMed

Baeumler, Petra I; Fleckenstein, Johannes; Takayama, Shin; Simang, Michael; Seki, Takashi; Irnich, Dominik

2014-01-01

The effect of acupuncture on sensory perception has never been systematically reviewed; although, studies on acupuncture mechanisms are frequently based on the idea that changes in sensory thresholds reflect its effect on the nervous system. Pubmed, EMBASE and Scopus were screened for studies investigating the effect of acupuncture on thermal or mechanical detection or pain thresholds in humans published in English or German. A meta-analysis of high quality studies was performed. Out of 3007 identified articles 85 were included. Sixty five studies showed that acupuncture affects at least one sensory threshold. Most studies assessed the pressure pain threshold of which 80% reported an increase after acupuncture. Significant short- and long-term effects on the pressure pain threshold in pain patients were revealed by two meta-analyses including four and two high quality studies, respectively. In over 60% of studies, acupuncture reduced sensitivity to noxious thermal stimuli, but measuring methods might influence results. Few but consistent data indicate that acupuncture reduces pin-prick like pain but not mechanical detection. Results on thermal detection are heterogeneous. Sensory threshold changes were equally frequent reported after manual acupuncture as after electroacupuncture. Among 48 sham-controlled studies, 25 showed stronger effects on sensory thresholds through verum than through sham acupuncture, but in 9 studies significant threshold changes were also observed after sham acupuncture. Overall, there is a lack of high quality acupuncture studies applying comprehensive assessments of sensory perception. Our findings indicate that acupuncture affects sensory perception. Results are most compelling for the pressure pain threshold, especially in pain conditions associated with tenderness. Sham acupuncture can also cause such effects. Future studies should incorporate comprehensive, standardized assessments of sensory profiles in order to fully characterize its effect on sensory perception and to explore the predictive value of sensory profiles for the effectiveness of acupuncture.

Care fragmentation, quality, and costs among chronically ill patients.

PubMed

Frandsen, Brigham R; Joynt, Karen E; Rebitzer, James B; Jha, Ashish K

2015-05-01

To assess the relationship between care fragmentation and both quality and costs of care for commercially insured, chronically ill patients. We used claims data from 2004 to 2008 for 506,376 chronically ill, privately insured enrollees of a large commercial insurance company to construct measures of fragmentation. We included patients in the sample if they had chronic conditions in any of the following categories: cardiovascular disease, diabetes, asthma, arthritis, or migraine. We assigned each patient a fragmentation index based on the patterns of care of their primary care provider (PCP), with care patterns spread across a higher number of providers considered to be more fragmented. We used regression analysis to examine the relationship between fragmentation and both quality and cost outcomes. Patients of PCPs in the highest quartile of fragmentation had a higher chance of having a departure from clinical best practice (32.8%, vs 25.9% among patients of PCPs in the lowest quartile of fragmentation; P < .001). Similarly, patients of PCPs with high fragmentation had higher rates of preventable hospitalizations (9.1% in highest quartile vs 7.1% in lowest quartile; P < .001). High fragmentation was associated with $4542 higher healthcare spending ($10,396 in the highest quartile vs $5854 in the lowest quartile; P < .001). We found similar or larger effects on quality and costs among patients when we examined the most frequently occurring disease groups individually. Chronically ill patients whose primary care providers offer highly fragmented care more often experience lapses in care quality and incur greater healthcare costs.

Promoting Good Clinical Laboratory Practices and Laboratory Accreditation to Support Clinical Trials in Sub-Saharan Africa

PubMed Central

Shott, Joseph P.; Saye, Renion; Diakité, Moussa L.; Sanogo, Sintry; Dembele, Moussa B.; Keita, Sekouba; Nagel, Mary C.; Ellis, Ruth D.; Aebig, Joan A.; Diallo, Dapa A.; Doumbo, Ogobara K.

2012-01-01

Laboratory capacity in the developing world frequently lacks quality management systems (QMS) such as good clinical laboratory practices, proper safety precautions, and adequate facilities; impacting the ability to conduct biomedical research where it is needed most. As the regulatory climate changes globally, higher quality laboratory support is needed to protect study volunteers and to accurately assess biological parameters. The University of Bamako and its partners have undertaken a comprehensive QMS plan to improve quality and productivity using the Clinical and Laboratory Standards Institute standards and guidelines. The clinical laboratory passed the College of American Pathologists inspection in April 2010, and received full accreditation in June 2010. Our efforts to implement high-quality standards have been valuable for evaluating safety and immunogenicity of malaria vaccine candidates in Mali. Other disease-specific research groups in resource-limited settings may benefit by incorporating similar training initiatives, QMS methods, and continual improvement practices to ensure best practices. PMID:22492138

Use, access, and equity in health care services in São Paulo, Brazil.

PubMed

Monteiro, Camila Nascimento; Beenackers, Mariëlle A; Goldbaum, Moisés; Barros, Marilisa Berti de Azevedo; Gianini, Reinaldo José; Cesar, Chester Luiz Galvão; Mackenbach, Johan P

2017-05-18

The study analyzed how socioeconomic factors are associated with seeking, access, use, and quality of health care services in São Paulo, Brazil. Data were obtained from two household health surveys in São Paulo. We used logistic regression to analyze associations between socioeconomic factors and seeking, access, use, and quality of health care services. Access to health care services was high among those who sought it (94.91% in 2003 and 94.98% in 2008). The proportion of access to and use of health care services did not change significantly from 2003 to 2008. Use of services in the public sector was more frequent in lower socioeconomic groups. There were some socioeconomic differences in seeking health care and resolution of health problems. The study showed almost universal access to health care services, but the results suggest problems in quality of services and differences in quality experienced by lower socioeconomic groups, who mostly use the Brazilian Unified National Health System (SUS).

Non-pest prey do not disrupt aphid predation by a web-building spider.

PubMed

Welch, K D; Whitney, T D; Harwood, J D

2016-02-01

A generalist predator's ability to contribute to biological control is influenced by the decisions it makes during foraging. Predators often use flexible foraging tactics, which allows them to pursue specific types of prey at the cost of reducing the likelihood of capturing other types of prey. When a pest insect has low nutritional quality or palatability for a predator, the predator is likely to reject that prey in favour of pursuing alternative, non-pest prey. This is often thought to limit the effectiveness of generalist predators in consuming aphids, which are of low nutritional quality for many generalist predators. Here, we report behavioural assays that test the hypothesis that the generalist predator, Grammonota inornata (Araneae: Linyphiidae), preferentially forages for a non-pest prey with high nutritional quality (springtails), and rejects a pest prey with low nutritional quality (aphids). In no-choice assays, molecular gut-content analysis revealed that spiders continued to feed on the low-quality aphids at high rates, even when high-quality springtails were readily available. When provided a choice between aphids and springtails in two-way choice tests, spiders did not show the expected preference for springtails. Decision-making by spiders during foraging therefore appears to be sub-optimal, possibly because of attraction to the less frequently encountered of two preys as part of a dietary diversification strategy. These results indicate that behavioural preferences alone do not necessarily compromise the pest-suppression capacity of natural enemies: even nutritionally sub-optimal pest prey can potentially be subject to predation and suppression by natural enemies.

Combinations of Quality and Frequency of Immunization Activities to Stop and Prevent Poliovirus Transmission in the High-Risk Area of Northwest Nigeria

PubMed Central

Duintjer Tebbens, Radboud J.; Pallansch, Mark A.; Wassilak, Steven G. F.; Cochi, Stephen L.; Thompson, Kimberly M.

2015-01-01

Background Frequent supplemental immunization activities (SIAs) with the oral poliovirus vaccine (OPV) represent the primary strategy to interrupt poliovirus transmission in the last endemic areas. Materials and Methods Using a differential-equation based poliovirus transmission model tailored to high-risk areas in Nigeria, we perform one-way and multi-way sensitivity analyses to demonstrate the impact of different assumptions about routine immunization (RI) and the frequency and quality of SIAs on population immunity to transmission and persistence or emergence of circulating vaccine-derived polioviruses (cVDPVs) after OPV cessation. Results More trivalent OPV use remains critical to avoid serotype 2 cVDPVs. RI schedules with or without inactivated polio vaccine (IPV) could significantly improve population immunity if coverage increases well above current levels in under-vaccinated subpopulations. Similarly, the impact of SIAs on overall population immunity and cVDPV risks depends on their ability to reach under-vaccinated groups (i.e., SIA quality). Lower SIA coverage in the under-vaccinated subpopulation results in a higher frequency of SIAs needed to maintain high enough population immunity to avoid cVDPVs after OPV cessation. Conclusions National immunization program managers in northwest Nigeria should recognize the benefits of increasing RI and SIA quality. Sufficiently improving RI coverage and improving SIA quality will reduce the frequency of SIAs required to stop and prevent future poliovirus transmission. Better information about the incremental costs to identify and reach under-vaccinated children would help determine the optimal balance between spending to increase SIA and RI quality and spending to increase SIA frequency. PMID:26068928

Combinations of Quality and Frequency of Immunization Activities to Stop and Prevent Poliovirus Transmission in the High-Risk Area of Northwest Nigeria.

PubMed

Duintjer Tebbens, Radboud J; Pallansch, Mark A; Wassilak, Steven G F; Cochi, Stephen L; Thompson, Kimberly M

2015-01-01

Frequent supplemental immunization activities (SIAs) with the oral poliovirus vaccine (OPV) represent the primary strategy to interrupt poliovirus transmission in the last endemic areas. Using a differential-equation based poliovirus transmission model tailored to high-risk areas in Nigeria, we perform one-way and multi-way sensitivity analyses to demonstrate the impact of different assumptions about routine immunization (RI) and the frequency and quality of SIAs on population immunity to transmission and persistence or emergence of circulating vaccine-derived polioviruses (cVDPVs) after OPV cessation. More trivalent OPV use remains critical to avoid serotype 2 cVDPVs. RI schedules with or without inactivated polio vaccine (IPV) could significantly improve population immunity if coverage increases well above current levels in under-vaccinated subpopulations. Similarly, the impact of SIAs on overall population immunity and cVDPV risks depends on their ability to reach under-vaccinated groups (i.e., SIA quality). Lower SIA coverage in the under-vaccinated subpopulation results in a higher frequency of SIAs needed to maintain high enough population immunity to avoid cVDPVs after OPV cessation. National immunization program managers in northwest Nigeria should recognize the benefits of increasing RI and SIA quality. Sufficiently improving RI coverage and improving SIA quality will reduce the frequency of SIAs required to stop and prevent future poliovirus transmission. Better information about the incremental costs to identify and reach under-vaccinated children would help determine the optimal balance between spending to increase SIA and RI quality and spending to increase SIA frequency.

Determinants, Health Problems, and Food Insecurity in Urban Areas of the Largest City in Cape Verde.

PubMed

Craveiro, Isabel; Alves, Daniela; Amado, Miguel; Santos, Zélia; Fortes, Argentina Tomar; Delgado, António Pedro; Correia, Artur; Gonçalves, Luzia

2016-11-22

Urbanization processes are intertwined with nutritional transition because there is easier access to food of low nutritional quality at reduced prices, changing dietary patterns and leading to an increase of non-communicable chronic diseases. This study aims to understand the perceptions for high blood pressure, obesity, and alcoholism, describing some interactions of these dimensions in the problem of food security in the city of Praia. A qualitative study was carried out under the framework of the research project "UPHI-STAT: Urban Planning and Health Inequalities-moving from macro to micro statistics". Ten focus groups were conducted in three urban areas with distinct characteristics in the city of Praia, with a total of 48 participants. Participants reported frequent consumption of foods with poor nutritional quality, understanding the potential danger in terms of food security in the city of Praia. Easy access to and high levels of alcohol consumption, and poor quality of traditional drinks were mentioned by participants in the study areas. The impact of the economic situation on the possibility of access to safe and healthy options emerged as a differentiating factor.

Cancer patterns, trends, and transitions in Peru: a regional perspective.

PubMed

Piñeros, Marion; Ramos, Willy; Antoni, Sébastien; Abriata, Graciela; Medina, Luis E; Miranda, J Jaime; Payet, Eduardo; Bray, Freddie

2017-10-01

Peru, like several other South American countries, is experiencing remarkable population growth, ageing, and urbanisation, which has given rise to profound changes in its epidemiological profile. Prostate and breast cancer are the most frequent cancers in men and women, respectively, in Lima and Arequipa, the two areas with population-based cancer registries. However, infection-associated cancers (cervix and stomach) are also common, and rank highest in the national cancer mortality profile. Although a foundation of surveillance informs cancer-control initiatives in Peru, improvements in the vital statistics system, and the quality and use of incidence data for the planning and assessment of cancer prevention and control actions, are needed. Existing population-based cancer registries in Lima and Arequipa, and linkages to the established national mandatory cancer reporting system, are crucial for the collection of high-quality data on national cancer incidence. The delivery of effective cancer prevention and control measures requires sustained investment in the collection of high-quality data capable of informing policies and driving research programmes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Climate Change Impact on Air Quality in High Resolution Simulation for Central Europe

NASA Astrophysics Data System (ADS)

Halenka, T.; Huszar, P.; Belda, M.

2009-04-01

Recently the effects of climate change on air-quality and vice-versa are studied quite extensively. In fact, even at regional and local scale especially the impact of climate change on the atmospheric composition and photochemical smog formation conditions can be significant when expecting e.g. more frequent appearance of heat waves etc. For the purpose of qualifying and quantifying the magnitude of such effects and to study the potential of climate forcing due to atmospheric chemistry/aerosols on regional scale, chemistry-transport model was coupled to RegCM on the Department of Meteorology and Environmental Protection, Faculty of Mathematics and Physics, Charles University in Prague, for the simulations in framework of the EC FP6 Project CECILIA. Off-line one way coupling enables the simulation of distribution of pollutants over 1991-2001 in very high resolution of 10 km is compared to the EMEP observations for the area of Central Europe. Simulations driven by climate change boundary conditions for time slices 1991-2000, 2041-2050 and 2091-2100 are presented to show the effect of climate change on the air quality in the region.

Hope, Coping, and Quality of Life in Adults with Myasthenia Gravis.

PubMed

Koopman, Wilma J; LeBlanc, Nicole; Fowler, Sue; Nicolle, Michael W; Hulley, Denise

2016-01-01

Myasthenia gravis significantly impacts quality of life. However, the relationship between hope, coping, and quality of life (QOL)in myasthenia patients has not been studied (Kulkantrakorn & Jarungkiatkul, 2009; Raggi et al., 2010). The aim of this study was to explore the relationship between hope, coping, and quality of life in adults with myasthenia gravis. Subjects with MG (n = 100) completed six questionnaires, including a demographic profile, the Myasthenia Gravis Activities of Daily Living Scale (MG-ADL), Herth Hope Index (HHI), Jalowiec Coping Scale (JCS), Myasthenia Gravis Quality-of-Life Scale (MG-QOL15), and Short Form Health Survey (SF-36v2). Mean hope scores indicated a high level of hope. An optimistic coping style was the most common and effective coping strategy identified by subjects. Positive thinking and humour were also frequently used strategies. Participants identified quality of life as good tolerability, above general population mental well-being, and below general populationphysical well-being. Participants who identified good quality of life had low scores on the MG-QOL15 scale and high scores on the SF36v2. Hope and independence for activities of daily living were found to correlate with improved quality of life and mental well-being(p < 0.001). Age and length of illness were not significant factors. There was no mediation by well-being or quality of life in the relationship between hope and coping. Hope and coping were not important factors for well-being or quality of life. Nurses caring for adults with myasthenia gravis should use interventions that continue to support hope, quality of life, and coping throughout the unpredictable and chronic course of MG.

Reproductive investment when mate quality varies: differential allocation versus reproductive compensation.

PubMed

Harris, W Edwin; Uller, Tobias

2009-04-27

Reproductive investment decisions form an integral part of life-history biology. Selection frequently favours plasticity in investment that can generate maternal effects on offspring development. For example, if females differentially allocate resources based on mate attractiveness or quality, this can create a non-genetic link between mate attractiveness and offspring fitness with potential consequences for ecological and evolutionary dynamics. It is therefore important to understand under what conditions differential investment into offspring in relation to male quality is expected to occur and the direction of the effect. Two opposite predictions, increased investment into offspring produced with high-quality mates (differential allocation (DA)) and increased investment with low-quality males (reproductive compensation (RC)) have been suggested but no formal theoretical treatment justifying the assumptions underlying these two hypotheses has been conducted to date. Here, we used a state-based approach to investigate the circumstances under which the variation in mate quality results in differential female investment into offspring and how this interacts with female energetic resource levels. We found that a pattern of increased investment when mating with high-quality mates (i.e. DA) was the most common optimal investment strategy for females in our model. By contrast, increased investment when mating with low-quality mates (i.e. RC) was predicted only when the relative impact of parental investment on offspring quality was low. Finally, we found that the specific pattern of investment in relation to male quality depends on female energetic state, the likelihood for future mating opportunities and the expected future distribution of mate quality. Thus, the female's age and body condition should be important factors mediating DA and RC, which may help to explain the equivocal results of empirical studies.

Feasibility of Group Schema Therapy for Outpatients with Severe Borderline Personality Disorder in Germany: A Pilot Study with Three Year Follow-Up

PubMed Central

Fassbinder, Eva; Schuetze, Maren; Kranich, Annika; Sipos, Valerija; Hohagen, Fritz; Shaw, Ida; Farrell, Joan; Arntz, Arnoud; Schweiger, Ulrich

2016-01-01

Borderline Personality Disorder (BPD) is a severe, challenging to treat mental disorder. Schema therapy (ST) as an individual therapy has been proven to be an effective psychological treatment for BPD. A group format of ST (GST) has been developed and evaluated in a randomized controlled trial in the United States and piloted in The Netherlands. These results suggest that GST speeds up and amplifies treatment effects of ST and might reduce delivery costs. However, feasibility in the German health care system and with BPD patients with high BPD severity and comorbidity, and frequent hospitalization, has not been tested to date. We investigated GST in 10 severely impaired, highly comorbid female patients with BPD, that needed frequent hospital admission. Patients received an outpatient ST-treatment program with weekly group and individual sessions for 1 year. Outcome measures including BPD severity, general psychopathology, psychosocial functioning, quality of life, happiness, schemas, and modes, and days of hospitalization were assessed at the start of treatment and 6, 12, and 36 months later with semi-structured interviews and self-report measures. We observed significant decreases in severity of BPD symptoms, general symptom severity, dysfunctional BPD-specific modes and schemas, and days of hospitalization. Functional modes, quality of live and happiness improved. The results of this feasibility study are promising and encourage further implementation of ST outpatient treatment programs even for patients with severe BPD and high hospitalization risk. However, small sample size and the missing of a control group do not allow the generalizability of these findings. PMID:27933020

What is a wiki, and how can it be used in resident education?

PubMed

Kohli, Marc D; Bradshaw, John K

2011-02-01

Training as a radiology resident is a complex task. Residents frequently encounter multiple hospital systems, each with unique workflow patterns and heterogenous information systems. We identified an opportunity to ease some of the resulting anxiety and frustration by centralizing high-quality resources using a wiki. In this manuscript, we describe our choice of wiki software, give basic information about hardware requirements, detail steps for configuration, outline information included on the wiki, and present the results of a resident acceptance survey.

Impact of the present-on-admission indicator on hospital quality measurement: experience with the Agency for Healthcare Research and Quality (AHRQ) Inpatient Quality Indicators.

PubMed

Glance, Laurent G; Osler, Turner M; Mukamel, Dana B; Dick, Andrew W

2008-02-01

The Agency for Healthcare Research and Quality (AHRQ) has constructed Inpatient Quality Indicator (IQI) mortality measures to measure hospital quality using routinely available administrative data. With the exception of California, New York State, and Wisconsin, administrative data do not include a present-on-admission (POA) indicator to distinguish between preexisting conditions and complications. The extent to which the lack of a POA indicator biases quality assessment based on the AHRQ mortality measures is unknown. To examine the impact of the POA indicator on hospital quality assessment based on the AHRQ mortality measures using enhanced administrative data from California, which includes a POA indicator. Retrospective cohort study based on 2.07 million inpatient admissions between 1998 and 2000 in the California State Inpatient Database. The AHRQ IQI software was used to calculate risk-adjusted mortality rates using either (1) routine administrative data that included all the International Classification of Diseases (ICD)-9-CM codes or (2) enhanced administrative data that included only the ICD-9-CM codes representing preexisting conditions. The inclusion of the POA indicator frequently results in changes in the quality ranking of hospitals classified as high-quality or low-quality using routine administrative data. Twenty-seven percent (stroke) to 94% (coronary artery bypass graft) of hospitals classified as high-quality using routine administrative data were reclassified as intermediate- or low-quality hospitals using the enhanced administrative data. Twenty-five percent (congestive heart failure) to 76% (percutaneous coronary intervention) of hospitals classified as low-quality hospitals using enhanced administrative data were misclassified as intermediate-quality hospitals using routine administrative data. Despite the fact that the AHRQ IQIs were primarily intended to serve as a screening tool, they are being increasingly used to publicly report hospital quality. Our findings emphasize the need to improve the "quality" of administrative data by including a POA indicator if these data are to serve as the information infrastructure for quality reporting.

How are age-related differences in sleep quality associated with health outcomes? An epidemiological investigation in a UK cohort of 2406 adults.

PubMed

Gadie, Andrew; Shafto, Meredith; Leng, Yue; Kievit, Rogier A

2017-07-31

To examine age-related differences in self-reported sleep quality and their associations with health outcomes across four domains: physical health, cognitive health, mental health and neural health. Cambridge Centre for Ageing and Neuroscience (Cam-CAN) is a cohort study in East Anglia/England, which collected self-reported health and lifestyle questions as well as a range of objective measures from healthy adults. 2406 healthy adults (age 18-98) answered questions about their sleep quality (Pittsburgh Sleep Quality Index (PSQI)) and measures of physical, cognitive, mental and neural health. A subset of 641 individuals provided measures of brain structure. PSQI scores of sleep and scores across tests within the four domains of health. Latent class analysis (LCA) is used to identify sleep types across the lifespan. Bayesian regressions quantify the presence, and absence, of relationships between sleep quality and health measures. Better self-reported sleep is generally associated with better health outcomes, strongly so for mental health, moderately for cognitive and physical health, but not for sleep quality and neural health. LCA identified four sleep types: 'good sleepers' (68.1%, most frequent in middle age), 'inefficient sleepers' (14.01%, most frequent in old age), 'delayed sleepers' (9.28%, most frequent in young adults) and 'poor sleepers' (8.5%, most frequent in old age). There is little evidence for interactions between sleep quality and age on health outcomes. Finally, we observe U-shaped associations between sleep duration and mental health (depression and anxiety) as well as self-reported general health, such that both short and long sleep were associated with poorer outcomes. Lifespan changes in sleep quality are multifaceted and not captured well by summary measures, but instead should be viewed as as partially independent symptoms that vary in prevalence across the lifespan. Better self-reported sleep is associated with better health outcomes, and the strength of these associations differs across health domains. Notably, we do not observe associations between self-reported sleep quality and white matter. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Brewer spectrometer total ozone column measurements in Sodankylä

NASA Astrophysics Data System (ADS)

Karppinen, Tomi; Lakkala, Kaisa; Karhu, Juha M.; Heikkinen, Pauli; Kivi, Rigel; Kyrö, Esko

2016-06-01

Brewer total ozone column measurements started in Sodankylä in May 1988, 9 months after the signing of The Montreal Protocol. The Brewer instrument has been well maintained and frequently calibrated since then to produce a high-quality ozone time series now spanning more than 25 years. The data have now been uniformly reprocessed between 1988 and 2014. The quality of the data has been assured by automatic data rejection rules as well as by manual checking. Daily mean values calculated from the highest-quality direct sun measurements are available 77 % of time with up to 75 measurements per day on clear days. Zenith sky measurements fill another 14 % of the time series and winter months are sparsely covered by moon measurements. The time series provides information to survey the evolution of Arctic ozone layer and can be used as a reference point for assessing other total ozone column measurement practices.

Sleep Quantity and Quality of Ontario Wildland Firefighters Across a Low-Hazard Fire Season

PubMed Central

McGillis, Zachary; Dorman, Sandra C.; Robertson, Ayden; Larivière, Michel; Leduc, Caleb; Eger, Tammy; Oddson, Bruce E.; Larivière, Céline

2017-01-01

Objective: The aim of the study was to assess the sleep quality, quantity, and fatigue levels of Canadian wildland firefighters while on deployment. Methods: Objective and subjective sleep and fatigue measures were collected using actigraphy and questionnaires during non-fire (Base) and fire (Initial Attack and Project) deployments. Results: Suboptimal sleep quality and quantity were more frequently observed during high-intensity, Initial Attack fire deployments. Suboptimal sleep was also exhibited during non-fire (Base) work periods, which increases the risk of prefire deployment sleep debt. Self-reported, morning fatigue scores were low-to-moderate and highest for Initial Attack fire deployments. Conclusions: The study highlights the incidence of suboptimal sleep patterns in wildland firefighters during non-fire and fire suppression work periods. These results have implications for the health and safety practices of firefighters given the link between sleep and fatigue, in a characteristically hazardous occupation. PMID:29216017

Colorful displays signal male quality in a tropical anole lizard

NASA Astrophysics Data System (ADS)

Cook, Ellee G.; Murphy, Troy G.; Johnson, Michele A.

2013-10-01

Parasites influence colorful ornaments and their behavioral display in many animal hosts. Because coloration and display behavior are often critical components of communication, variation in these traits may have important implications for individual fitness, yet it remains unclear whether such traits are signals of quality in many taxa. We investigated the association between ectoparasitic mite load and the color and behavioral use of the throat fan (dewlap) by male Anolis brevirostris lizards. We found that heavily parasitized lizards exhibited lower body condition, duller dewlaps, and less frequent dewlap displays than less parasitized individuals. Our results thus suggest that highly parasitized individuals invest less in both ornamental color and behavioral display of that color. Because the two components of the signal simultaneously provide information on male quality, this study provides novel support for the long-standing hypothesis that colorful traits may function as social or sexual signals in reptiles.

Field evaluation of a portable gyratory compactor : final report.

DOT National Transportation Integrated Search

2002-06-01

Application of quality management concepts to asphalt paving evolved because recipe specifications frequently proved inadequate for ensuring pavement performance. Quality management of asphalt concrete is founded on the premise that the producer cont...

Oral Complications in Hematopoietic Stem Cell Recipients: The Role of Inflammation

PubMed Central

Haverman, T. M.; Raber-Durlacher, J. E.; Rademacher, W. M. H.; Vokurka, S.; Epstein, J. B.; Huisman, C.; Hazenberg, M. D.; de Soet, J. J.; de Lange, J.; Rozema, F. R.

2014-01-01

Hematopoietic stem cell transplantation (HSCT) is widely used as a potentially curative treatment for patients with various hematological malignancies, bone marrow failure syndromes, and congenital immune deficiencies. The prevalence of oral complications in both autologous and allogeneic HSCT recipients remains high, despite advances in transplant medicine and in supportive care. Frequently encountered oral complications include mucositis, infections, oral dryness, taste changes, and graft versus host disease in allogeneic HSCT. Oral complications are associated with substantial morbidity and in some cases with increased mortality and may significantly affect quality of life, even many years after HSCT. Inflammatory processes are key in the pathobiology of most oral complications in HSCT recipients. This review article will discuss frequently encountered oral complications associated with HSCT focusing on the inflammatory pathways and inflammatory mediators involved in their pathogenesis. PMID:24817792

Reservoir vital signs monitoring, 1990: Physical and chemical characteristics of water and sediments

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

Meinert, D.L.

1991-05-01

As part of Tennessee Valley Authority`s (TVA`s) Reservoir Vital Signs Monitoring program, physical/chemical measurements of water and sediment were made in 1990 on twelve TVA reservoirs (the nine main steam Tennessee river reservoirs - Kentucky through Fort Loudoun and three major tributary reservoirs - Cherokee, Douglas, and Norris). The objective of this monitoring program is to assess the health or integrity of these aquatic ecosystems. The physical/chemical water quality data collected in 1990 showed the water quality of these reservoirs to be very good. However, hypolimnetic anoxia during the summer months in Watts bars, Douglas, and Cherokee reservoir continues tomore » be a concern. High concentrations of nutrients were measured in the transition zones of Cherokee and Douglas reservoirs, resulting in highly productive and eutrophic conditions in the transition zones of these reservoirs. Fecal coliform organisms were frequently detected in the forebay area of Guntersville reservoir, and higher than expected ammonia nitrogen concentrations were found at the transition zone of Wheeler reservoir. Elevated concentrations of mercury were found in Pickwick and Watts bar reservoir sediment, and high lead concentrations were found in a sediment sample collected from Guntersville reservoir. A TVA Reservoir Water Quality Index (RWQI) was developed and used to summarize water quality conditions on a scale from 0 (worst) to 100 (best).« less

Study quality on groin injury management remains low: a systematic review on treatment of groin pain in athletes

PubMed Central

Serner, Andreas; van Eijck, Casper H; Beumer, Berend R; Hölmich, Per; Weir, Adam; de Vos, Robert-Jan

2015-01-01

Background Groin pain in athletes is frequent and many different treatment options have been proposed. The current level of evidence for the efficacy of these treatments is unknown. Objective Systematically review the literature on the efficacy of treatments for groin pain in athletes. Methods Nine medical databases were searched in May 2014. Inclusion criteria: treatment studies in athletes with groin pain; randomised controlled trials, controlled clinical trials or case series; n>10; outcome measures describing number of recovered athletes, patient satisfaction, pain scores or functional outcome scores. One author screened search results, and two authors independently assessed study quality. A best evidence synthesis was performed. Relationships between quality score and outcomes were evaluated. Review registration number CRD42014010262. Results 72 studies were included for quality analysis. Four studies were high quality. There is moderate evidence that, for adductor-related groin pain, active exercises compared with passive treatments improve success, multimodal treatment with a manual therapy technique shortens the time to return to sports compared with active exercises and adductor tenotomy improves treatment success over time. There is moderate evidence that for athletes with sportsman's hernia, surgery results in better treatment success then conservative treatment. There was a moderate and inverse correlation between study quality and treatment success (p<0.001, r=−0.41), but not between study quality and publication year (p=0.09, r=0.20). Conclusions Only 6% of publications were high quality. Low-quality studies showed significantly higher treatment success and study quality has not improved since 1985. There is moderate evidence for the efficacy of conservative treatment (active exercises and multimodal treatments) and for surgery in patients with adductor-related groin pain. There is moderate evidence for efficacy of surgical treatment in sportsman's hernia. PMID:25633830

The quality and readability of online consumer information about gynecologic cancer.

PubMed

Sobota, Aleksandra; Ozakinci, Gozde

2015-03-01

The Internet has become an important source of health-related information for consumers, among whom younger women constitute a notable group. The aims of this study were (1) to evaluate the quality and readability of online information about gynecologic cancer using validated instruments and (2) to relate the quality of information to its readability. Using the Alexa Rank, we obtained a list of 35 Web pages providing information about 7 gynecologic malignancies. These were assessed using the Health on the Net (HON) seal of approval, the Journal of the American Medical Association (JAMA) benchmarks, and the DISCERN instrument. Flesch readability score was calculated for sections related to symptoms and signs and treatment. Less than 30% of the Web pages displayed the HON seal or achieved all JAMA benchmarks. The majority of the treatment sections were of moderate to high quality according to the DISCERN. There was no significant relationship between the presence of the HON seal and readability. Web pages achieving all JAMA benchmarks were significantly more difficult to read and understand than Web pages that missed any of the JAMA benchmarks. Treatment-related content of moderate to high quality as assessed by the DISCERN had a significantly better readability score than the low-quality content. The online information about gynecologic cancer provided by the most frequently visited Web pages is of variable quality and in general difficult to read and understand. The relationship between the quality and readability remains unclear. Health care providers should direct their patients to reliable material online because patients consider the Internet as an important source of information.

Can a combination of average of normals and "real time" External Quality Assurance replace Internal Quality Control?

PubMed

Badrick, Tony; Graham, Peter

2018-03-28

Internal Quality Control and External Quality Assurance are separate but related processes that have developed independently in laboratory medicine over many years. They have different sample frequencies, statistical interpretations and immediacy. Both processes have evolved absorbing new understandings of the concept of laboratory error, sample material matrix and assay capability. However, we do not believe at the coalface that either process has led to much improvement in patient outcomes recently. It is the increasing reliability and automation of analytical platforms along with improved stability of reagents that has reduced systematic and random error, which in turn has minimised the risk of running less frequent IQC. We suggest that it is time to rethink the role of both these processes and unite them into a single approach using an Average of Normals model supported by more frequent External Quality Assurance samples. This new paradigm may lead to less confusion for laboratory staff and quicker responses to and identification of out of control situations.

Designing a Method with Physician Participation to Assess and Improve Quality of Healthcare in Otolaryngology.

PubMed

Arce, José M; Martín Cleary, Catalina; Cenjor, Carlos; Ramos, Ángel; Ortiz, Alberto

2017-04-01

Patient choice of healthcare centers to be treated for specific diseases is compromised by the low accessibility of understandable information. Physicians are rarely involved in healthcare quality assessment, despite their potentially valuable input. The purpose of this study was to develop a methodology for evaluating the quality of care that specifically incorporates advice from medical specialists and provides accessible information for patients in search of high-quality healthcare. A pilot Delphi study was conducted among 28 Spanish otolaryngology experts, seeking their opinion on the quality-of-care indicators and on their ability to recommend the most suitable department for the treatment of specific otolaryngologic diseases. The average acceptance rate was 91.9% for quality-of-care indicator and 96.5% for the resources needed for improving the quality of care. Furthermore, 93% experts reported that patients frequently ask for physician advice on which center provides better care for a specific disease, 92.6% experts believe they could recommend the best centers for specific otolaryngologic diseases, and 80% experts agreed that expert opinion on the quality of care offered by different centers would be a valuable addition to quality-of-care assessment. The incorporation of physician advice into healthcare quality assessment may improve the usefulness of healthcare quality indicators for patients. Assessment tools incorporating physician advice should be developed and validated.

[Individual medical relevance of headaches. Comorbidities and quality of life].

PubMed

Haag, G

2014-08-01

In a multitude of cases, very frequent primary headaches lead to a clear deterioration in quality of life. Particularly in patients with chronic migraine, chronic tension headache, and cluster headache, quality of life is limited. This contradicts the preconception still encountered today that headaches are not a serious illness. Comorbidities with somatic and above all mental disorders are also very frequently observed in headache patients. In the foreground are the cardiovascular diseases of arterial hypertension, stroke, and coronary heart disease, as well as the mental disorders of depression, anxiety disorders, posttraumatic stress disorders, and sleep disorders. When such comorbidities are present, the quality of life of the sufferers is significantly reduced. Therefore, headache disorders should be taken seriously and sufferers should be provided with a consistent therapy. In cases of severe types of headache and in the presence of comorbidities, it is imperative that therapy is also prophylactic and multimodal in nature.

Scanners for analytic print measurement: the devil in the details

NASA Astrophysics Data System (ADS)

Zeise, Eric K.; Williams, Don; Burns, Peter D.; Kress, William C.

2007-01-01

Inexpensive and easy-to-use linear and area-array scanners have frequently substituted as colorimeters and densitometers for low-frequency (i.e., large area) hard copy image measurement. Increasingly, scanners are also being used for high spatial frequency, image microstructure measurements, which were previously reserved for high performance microdensitometers. In this paper we address characteristics of flatbed reflection scanners in the evaluation of print uniformity, geometric distortion, geometric repeatability and the influence of scanner MTF and noise on analytic measurements. Suggestions are made for the specification and evaluation of scanners to be used in print image quality standards that are being developed.

Impact of the Journal of Child Neurology: 2002 data.

PubMed

Brumback, Roger A

2003-11-01

The Journal of Child Neurology (JCN) began in 1986 as a quarterly publication focused on child neurology and the related clinical pediatric neuroscience areas of pediatric neurosurgery, child psychiatry, pediatric neuroradiology, and developmental and behavioral pediatrics. As submitted material increased, JCN expanded in publication frequency and now appears monthly. Article quality has always been high and many articles have been frequently cited. Over the years, the ratings produced for the ISI Journal Citation Reports have identified JCN as a high-ranking pediatric journal based upon the impact factor value. Currently (year 2002 figures), JCN (with its impact factor of 1.338) ranks 24th out of 68 pediatric journals.

Reforms, Leadership and Quality Management in Greek Higher Education

ERIC Educational Resources Information Center

Papadimitriou, Antigoni

2011-01-01

This article reports on research to form an understanding of how to account whether and how quality management (QM) has been adopted in Greek higher education. Greece only recently introduced quality assurance policies. In this study, I will describe governmental reforms related to QM policies until 2010. An issue that is frequently addressed…

Teacher Quality and Quality Teaching: Examining the Relationship of a Teacher Assessment to Practice

ERIC Educational Resources Information Center

Hill, Heather C.; Umland, Kristin; Litke, Erica; Kapitula, Laura R.

2012-01-01

Multiple-choice assessments are frequently used for gauging teacher quality. However, research seldom examines whether results from such assessments generalize to practice. To illuminate this issue, we compare teacher performance on a mathematics assessment, during mathematics instruction, and by student performance on a state assessment. Poor…

Combating Inhibitors of Quality Research Outputs at the University of Cape Town

ERIC Educational Resources Information Center

Masango, Charles Akwe

2015-01-01

This paper examines the debates about academic scholars' ability to produce quality research outputs both consistently and frequently. It examines whether it is possible for academic scholars to produce quality research outputs in their respective domains given obstacles that impede scholars to do so. The rationale for this examination stems from…

Addressing Quality Challenges in the Private University Sector in Bangladesh: From Policy Formulation to Institutional Implementation

ERIC Educational Resources Information Center

Blanco Ramírez, Gerardo; Jahirul Haque, H. M.

2016-01-01

Private higher education is growing, especially in developing and transitioning countries. Rapid growth frequently comes with concerns about quality. This article explores challenges and opportunities for higher education quality among private universities in Bangladesh. By presenting a vertical case study that explores interactions among actors…

Adolescents' drinking and drunkenness more likely in one-parent families and due to poor communication with mother.

PubMed

Tomčíková, Zuzana; Veselská, Zuzana Dankulincová; Gecková, Andrea Madarasová; van Dijk, Jitse P; Reijneveld, Sijmen A

2015-03-01

Alcohol use is a relatively common behaviour, particularly among adolescents, and has become a major public health concern. This study explores the associations between family composition, the quality of adolescents' communication with parents and adolescents' recent frequent alcohol drinking and lifetime drunkenness. Data were obtained from the Slovak part of the 2005-2006 Health Behaviour in School-aged Children (HBSC) study. The sample consisted of 3,882 students (46.3% males; mean age 13.3; ± 1.6). Data on drinking alcohol in the past week, lifetime drunkenness, communication and family composition were collected via anonymous questionnaires stratified for ages 11, 13 and 15 years and following the methodology of the HBSC study. The results showed that living in an incomplete family increased the risk of frequent drinking and drunkenness among adolescents as well as a low quality of communication between mothers and their children. Risks were higher for drunkenness than for frequent alcohol use and strongly increased by age, with the communication with parents worsening at increasing age. Our findings show the importance of the quality of communication between parents and adolescents in preventing the hazardous alcohol use among adolescents. Preventive interventions to reduce adolescents' use of alcohol should therefore also target the quality of communication in the family.

Health Related Quality of Life in Children with Nephrotic Syndrome in Bangladesh.

PubMed

Rahman, M; Afroz, S; Ali, R; Hanif, M

2016-10-01

Outcome of children with nephrotic syndrome has continued to improve over time. However minimal data exist to describe health-related quality of life in children with nephrotic syndrome. This cross sectional study was conducted over a period of six months to assess the health related quality of life in children with nephrotic syndrome in the Department of Pediatric Nephrology, Dhaka Medical College Hospital, Bangladesh. Fifty children (age ranged 2-12 years) with nephrotic syndrome who had three or more relapses diagnosed at least one year back receiving treatment and on follow up were included in this study. Quality of Life scores were collected using Bengali translated instruments- the Pediatric Quality of Life Inventory™ (PedsQL™) version 4.0 Generic Scale and the Pediatric Quality of Life Questionnaire for Nephrotic Syndrome proxy-report from parents. Medical data and Demographic data were collected from medical records, and from parents in outpatient department or hospital ward. Interviews of eligible guardians were performed individually to collect quality of life (QoL) scores. Among 50 children, mean±SD age of the children was 7±2.92 years. Most children were male (58%). Female parents respondent during interview were 62%, most parents (48%) were very poor in socioeconomic condition. Most children had frequent relapses (60%). Median time since diagnosis was 2 years. Regarding PedsQL scores, child age with physical summary score (p value <0.001), child age with social summary score (p value 0.003), frequent relapse with kidney disease summary score (p value 0.04) and time since diagnosis (p value <0.001) were statistically significant. In conclusion physical and social summary score were worst. Frequent relapse found to be an important factor in impaired QoL. Prolonged duration of the disease activity was associated with significant impairment of QoL.

Automated ground-water monitoring with Robowell: case studies and potential applications

NASA Astrophysics Data System (ADS)

Granato, Gregory E.; Smith, Kirk P.

2002-02-01

Robowell is an automated system and method for monitoring ground-water quality. Robowell meets accepted manual- sampling protocols without high labor and laboratory costs. Robowell periodically monitors and records water-quality properties and constituents in ground water by pumping a well or multilevel sampler until one or more purge criteria have been met. A record of frequent water-quality measurements from a monitoring site can indicate changes in ground-water quality and can provide a context for the interpretation of laboratory data from discrete samples. Robowell also can communicate data and system performance through a remote communication link. Remote access to ground-water data enables the user to monitor conditions and optimize manual sampling efforts. Six Robowell prototypes have successfully monitored ground-water quality during all four seasons of the year under different hydrogeologic conditions, well designs, and geochemical environments. The U.S. Geological Survey is seeking partners for research with robust and economical water-quality monitoring instruments designed to measure contaminants of concern in conjunction with the application and commercialization of the Robowell technology. Project publications and information about technology transfer opportunities are available on the Internet at URL http://ma.water.usgs.gov/automon/

Automated ground-water monitoring with robowell-Case studies and potential applications

USGS Publications Warehouse

Granato, G.E.; Smith, K.P.; ,

2001-01-01

Robowell is an automated system and method for monitoring ground-water quality. Robowell meets accepted manual-sampling protocols without high labor and laboratory costs. Robowell periodically monitors and records water-quality properties and constituents in ground water by pumping a well or multilevel sampler until one or more purge criteria have been met. A record of frequent water-quality measurements from a monitoring site can indicate changes in ground-water quality and can provide a context for the interpretation of laboratory data from discrete samples. Robowell also can communicate data and system performance through a remote communication link. Remote access to ground-water data enables the user to monitor conditions and optimize manual sampling efforts. Six Robowell prototypes have successfully monitored ground-water quality during all four seasons of the year under different hydrogeologic conditions, well designs, and geochemical environments. The U.S. Geological Survey is seeking partners for research with robust and economical water-quality monitoring instruments designed to measure contaminants of concern in conjunction with the application and commercialization of the Robowell technology. Project publications and information about technology transfer opportunities are available on the Internet at URL http://ma.water.usgs.gov/automon/.

Quality of Life of Nepalese Women Post Mastectomy

PubMed

Maharjan, Muna; Thapa, Niresh; Adhikari, Raj Devi; Petrini, Marcia A; Amatya, Kapendra Shekhar

2018-04-25

Introduction: Worldwide breast cancer is the common invasive cancer among the females. The quality of life of women after treatment, which is often a mastectomy, is frequently decreased. Objective: To determine the life quality of Nepalese women post mastectomy. Materials and Methods: One hundred seven women after a mastectomy were selected and interviewed by using the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire and its Breast Specific Module to assess women’s quality of life. Result: The study findings revealed a good score on global health status/quality of life. The respondents performed well on functional and symptom scales. In the Breast Specific Module, all respondents performed poor regarding sexual function and sexual enjoyment. Global Health Status was found useful among the women involved in service/business/agriculture and the survivors using breast prosthesis. In Breast Specific Module, systemic therapy side effects showed strong statistical associations with age, marital status, occupation, education, use of breast prosthesis and co-morbidity. Body image was highly significant with age, occupation, education, use of breast prosthesis and co-morbidity. Conclusion: Based on the study findings, counseling, and a structured educational programme is recommended to improve the QOL of women after a mastectomy. Creative Commons Attribution License

Quality versus Quantity Debate in Swimming: Perceptions and Training Practices of Expert Swimming Coaches.

PubMed

Nugent, Frank J; Comyns, Thomas M; Warrington, Giles D

2017-06-01

The debate over low-volume, high-intensity training versus high-volume, low-intensity training, commonly known as Quality versus Quantity, respectively, is a frequent topic of discussion among swimming coaches and academics. The aim of this study was to explore expert coaches' perceptions of quality and quantity coaching philosophies in competitive swimming and to investigate their current training practices. A purposeful sample of 11 expert swimming coaches was recruited for this study. The study was a mixed methods design and involved each coach participating in 1 semi-structured interview and completing 1 closed-ended questionnaire. The main findings of this study were that coaches felt quality training programmes would lead to short term results for youth swimmers, but were in many cases more appropriate for senior swimmers. The coaches suggested that quantity training programmes built an aerobic base for youth swimmers, promoted technical development through a focus on slower swimming and helped to enhance recovery from training or competition. However, the coaches continuously suggested that quantity training programmes must be performed with good technique and they felt this was a misunderstood element. This study was a critical step towards gaining a richer and broader understanding on the debate over Quality versus Quantity training from an expert swimming coaches' perspective which was not currently available in the research literature.

Quality versus Quantity Debate in Swimming: Perceptions and Training Practices of Expert Swimming Coaches

PubMed Central

Nugent, Frank J; Comyns, Thomas M; Warrington, Giles D

2017-01-01

Abstract The debate over low-volume, high-intensity training versus high-volume, low-intensity training, commonly known as Quality versus Quantity, respectively, is a frequent topic of discussion among swimming coaches and academics. The aim of this study was to explore expert coaches’ perceptions of quality and quantity coaching philosophies in competitive swimming and to investigate their current training practices. A purposeful sample of 11 expert swimming coaches was recruited for this study. The study was a mixed methods design and involved each coach participating in 1 semi-structured interview and completing 1 closed-ended questionnaire. The main findings of this study were that coaches felt quality training programmes would lead to short term results for youth swimmers, but were in many cases more appropriate for senior swimmers. The coaches suggested that quantity training programmes built an aerobic base for youth swimmers, promoted technical development through a focus on slower swimming and helped to enhance recovery from training or competition. However, the coaches continuously suggested that quantity training programmes must be performed with good technique and they felt this was a misunderstood element. This study was a critical step towards gaining a richer and broader understanding on the debate over Quality versus Quantity training from an expert swimming coaches’ perspective which was not currently available in the research literature. PMID:28713467

Influence of Boundary Conditions on Simulated U.S. Air Quality

EPA Science Inventory

One of the key inputs to regional-scale photochemical models frequently used in air quality planning and forecasting applications are chemical boundary conditions representing background pollutant concentrations originating outside the regional modeling domain. A number of studie...

MODIS water quality algorithms for northwest Florida estuaries

EPA Science Inventory

Synoptic and frequent monitoring of water quality parameters from satellite is useful for determining the health of aquatic ecosystems and development of effective management strategies. Northwest Florida estuaries are classified as optically-complex, or waters influenced by chlo...

Data Quality Screening Using Trend Charts. October, 2011 v.2

EPA Pesticide Factsheets

Frequently the quality of results from data collection activities are difficult to assess due to the number of reports one needs to review and digest. These reviews may take place months after data collection is conducted.

Ebola Virus Disease Outbreak in Isiro, Democratic Republic of the Congo, 2012: Signs and Symptoms, Management and Outcomes

PubMed Central

Kratz, Thomas; Roddy, Paul; Tshomba Oloma, Antoine; Jeffs, Benjamin; Pou Ciruelo, Diana; de la Rosa, Olimpia; Borchert, Matthias

2015-01-01

Data collected during the 2012 Ebola virus disease (EVD) epidemic in the Democratic Republic of the Congo were analysed for clinical signs, symptoms and case fatality of EVD caused by Bundibugyo virus (BDBV), establishment of differential diagnoses, description of medical treatment and evaluation of the quality of clinical documentation. In a quantitative observational prospective study, global epidemiological data from 52 patients (34 patients within the community, 18 patients treated in the Ebola Treatment Centre) were entered anonymously into a database, subsequently matched and analysed. Relevant findings include an over-representation of females among community EVD cases (85.3%) and of community EVD cases in the age group of 15-54 years (82.4%). All ETC patients had fever (55.6% of all 18 ETC patients during their hospital stay) or self-reported fever (88.2% upon admission) at some point of time during their illness. Major symptoms of ETC patients during hospital stay included asthenia (82.4%), anorexia (82.4%), myalgia (70.6%), sore throat/difficulty swallowing (70.6%), arthralgia (76.5%) and nausea (70.6%). Gastrointestinal signs and symptoms (nausea, diarrhoea, vomiting) (76.4%) as well as general pain (94.1%) were frequent in ETC patients. The median duration of EVD was 18 days, while the mean incubation period was 11.3 days. Differential diagnosis of EVD included malaria (28.3%), intestinal parasitosis (10.9%), and infectious syndrome (10.9%). There was also an important variation in clinical evolvement. Quality of documentation was adversely affected by the way patient file contents were transferred from inside to outside the high-risk zone, entailing a mean mismatch value of 27.3% between patient file contents inside vs. outside the high-risk zone. This study adds further description of EVD (frequently non-specific signs and symptoms, non frequent bleeding, a long incubation period, long duration of disease) and emphasizes the need for improving clinical monitoring and documentation in EVD outbreak settings. PMID:26107529

Imaging quality of (44)Sc in comparison with five other PET radionuclides using Derenzo phantoms and preclinical PET.

PubMed

Bunka, Maruta; Müller, Cristina; Vermeulen, Christiaan; Haller, Stephanie; Türler, Andreas; Schibli, Roger; van der Meulen, Nicholas P

2016-04-01

PET is the favored nuclear imaging technique because of the high sensitivity and resolution it provides, as well as the possibility for quantification of accumulated radioactivity. (44)Sc (T1/2=3.97h, Eβ(+)=632keV) was recently proposed as a potentially interesting radionuclide for PET. The aim of this study was to investigate the image quality, which can be obtained with (44)Sc, and compare it with five other, frequently employed PET nuclides using Derenzo phantoms and a small-animal PET scanner. The radionuclides were produced at the medical cyclotron at CRS, ETH Zurich ((11)C, (18)F), at the Injector II research cyclotron at CRS, PSI ((64)Cu, (89)Zr, (44)Sc), as well as via a generator system ((68)Ga). Derenzo phantoms, containing solutions of each of these radionuclides, were scanned using a GE Healthcare eXplore VISTA small-animal PET scanner. The image resolution was determined for each nuclide by analysis of the intensity signal using the reconstructed PET data of a hole diameter of 1.3mm. The image quality of (44)Sc was compared to five frequently-used PET radionuclides. In agreement with the positron range, an increasing relative resolution was determined in the sequence of (68)Ga<(44)Sc<(89)Zr<(11)C<(64)Cu<(18)F. The performance of (44)Sc was in agreement with the theoretical expectations based on the energy of the emitted positrons. Copyright © 2016 Elsevier Ltd. All rights reserved.

Psychosocial concerns of cancer patients in Singapore.

PubMed

Mahendran, Rathi; Lim, Haikel A; Chua, Joanne; Lim, Siew Eng; Kua, Ee Heok

2017-04-01

Psychosocial needs are high among cancer patients, and screening for these is recognized as integral to quality cancer care. This study identified the psychosocial needs of cancer patients at their first visit at a hematology-oncology clinic. Fifty-four new consecutive patients completed the Distress Thermometer and the Problem List, the Hospital Anxiety and Depression Scale, and the EuroQol Quality of Life Scale at their first visit to plan for chemotherapy. Data were analyzed with SPSS. Analyses revealed that participants had an average of 2.8 ± 2.3 problems, with 82% having psychosocial needs. Emotional concerns formed the top four psychosocial needs of the cohort (worry 46%, fears 26%, nervousness 26%, sadness 24%), with the fifth being a practical concern (insurance/finance 22%). The former were more frequent among 41- to 50-year-olds and significantly correlated with distress scores. Practical concerns were significantly correlated with depressive symptoms. Family concerns were more significant in women. The overall score on the Problem List correlated with distress, anxious symptomatology and poorer quality of life scores. Distress and psychosocial needs are high in cancer patients even at an early stage prior to chemotherapy. Attention to these needs is crucial as they cause significant distress and affect the patient's quality of life. © 2015 Wiley Publishing Asia Pty Ltd.

Empowering certified nurse's aides to improve quality of work life through a team communication program.

PubMed

Howe, Erin E

2014-01-01

The purpose of this pilot study was to explore the impact of a certified nurse's aide (CNA)-led interdisciplinary teamwork and communication intervention on perceived quality of work environment and six-month job intentions. CNAs are frequently excluded from team communication and decision-making, which often leads to job dissatisfaction with high levels of staff turnover. Using a mixed quantitative and qualitative approach with pre- post-program design, the intervention utilized the strategy of debriefing from the national patient safety initiative, TeamSTEPPS. Inherent in the program design, entitled Long Term Care (LTC) Team Talk, was the involvement of the CNAs in the development of the intervention as an empowering process on two wings of a transitional care unit in a long-term care facility in upstate NY. CNAs' perceptions of work environment quality were measured using a Quality of Work Life (QWL) instrument. Additionally, job turnover intent within six months was assessed. Results indicated improved scores on nearly all QWL subscales anticipated to be impacted, and enhanced perceived empowerment of the CNAs on each wing albeit through somewhat different experiential processes. The program is highly portable and can potentially be implemented in a variety of long-term care settings. Copyright © 2014 Mosby, Inc. All rights reserved.

Effects on work ability, job strain and quality of life of monitoring depression using a self-assessment instrument in recurrent general practitioner consultations: A randomized controlled study.

PubMed

Petersson, E-L; Wikberg, C; Westman, J; Ariai, N; Nejati, S; Björkelund, C

2018-05-01

Depression reduces individuals' function and work ability and is associated with both frequent and long-term sickness absence. Investigate if monitoring of depression course using a self-assessment instrument in recurrent general practitioner (GP) consultations leads to improved work ability, decreased job strain, and quality of life among primary care patients. Primary care patients n = 183, who worked. In addition to regular treatment (control group), intervention patients received evaluation and monitoring and used the MADRS-S depression scale during GP visit at baseline and at visits 4, 8, and 12 weeks. Work ability, quality of life and job strain were outcome measures. Depression symptoms decreased in all patients. Significantly steeper increase of WAI at 3 months in the intervention group. Social support was perceived high in a significantly higher frequency in intervention group compared to control group. Monitoring of depression course using a self-assessment instrument in recurrent GP consultations seems to lead to improved self-assessed work ability and increased high social support, but not to reduced job strain or increased quality of life compared to TAU. Future studies concerning rehabilitative efforts that seek to influence work ability probably also should include more active interventions at the workplace.

Spatial, Temporal, and Density-Dependent Components of Habitat Quality for a Desert Owl

PubMed Central

Flesch, Aaron D.; Hutto, Richard L.; van Leeuwen, Willem J. D.; Hartfield, Kyle; Jacobs, Sky

2015-01-01

Spatial variation in resources is a fundamental driver of habitat quality but the realized value of resources at any point in space may depend on the effects of conspecifics and stochastic factors, such as weather, which vary through time. We evaluated the relative and combined effects of habitat resources, weather, and conspecifics on habitat quality for ferruginous pygmy-owls (Glaucidium brasilianum) in the Sonoran Desert of northwest Mexico by monitoring reproductive output and conspecific abundance over 10 years in and around 107 territory patches. Variation in reproductive output was much greater across space than time, and although habitat resources explained a much greater proportion of that variation (0.70) than weather (0.17) or conspecifics (0.13), evidence for interactions among each of these components of the environment was strong. Relative to habitat that was persistently low in quality, high-quality habitat buffered the negative effects of conspecifics and amplified the benefits of favorable weather, but did not buffer the disadvantages of harsh weather. Moreover, the positive effects of favorable weather at low conspecific densities were offset by intraspecific competition at high densities. Although realized habitat quality declined with increasing conspecific density suggesting interference mechanisms associated with an Ideal Free Distribution, broad spatial heterogeneity in habitat quality persisted. Factors linked to food resources had positive effects on reproductive output but only where nest cavities were sufficiently abundant to mitigate the negative effects of heterospecific enemies. Annual precipitation and brooding-season temperature had strong multiplicative effects on reproductive output, which declined at increasing rates as drought and temperature increased, reflecting conditions predicted to become more frequent with climate change. Because the collective environment influences habitat quality in complex ways, integrated approaches that consider habitat resources, stochastic factors, and conspecifics are necessary to accurately assess habitat quality. PMID:25786257

Spatial, temporal, and density-dependent components of habitat quality for a desert owl.

PubMed

Flesch, Aaron D; Hutto, Richard L; van Leeuwen, Willem J D; Hartfield, Kyle; Jacobs, Sky

2015-01-01

Spatial variation in resources is a fundamental driver of habitat quality but the realized value of resources at any point in space may depend on the effects of conspecifics and stochastic factors, such as weather, which vary through time. We evaluated the relative and combined effects of habitat resources, weather, and conspecifics on habitat quality for ferruginous pygmy-owls (Glaucidium brasilianum) in the Sonoran Desert of northwest Mexico by monitoring reproductive output and conspecific abundance over 10 years in and around 107 territory patches. Variation in reproductive output was much greater across space than time, and although habitat resources explained a much greater proportion of that variation (0.70) than weather (0.17) or conspecifics (0.13), evidence for interactions among each of these components of the environment was strong. Relative to habitat that was persistently low in quality, high-quality habitat buffered the negative effects of conspecifics and amplified the benefits of favorable weather, but did not buffer the disadvantages of harsh weather. Moreover, the positive effects of favorable weather at low conspecific densities were offset by intraspecific competition at high densities. Although realized habitat quality declined with increasing conspecific density suggesting interference mechanisms associated with an Ideal Free Distribution, broad spatial heterogeneity in habitat quality persisted. Factors linked to food resources had positive effects on reproductive output but only where nest cavities were sufficiently abundant to mitigate the negative effects of heterospecific enemies. Annual precipitation and brooding-season temperature had strong multiplicative effects on reproductive output, which declined at increasing rates as drought and temperature increased, reflecting conditions predicted to become more frequent with climate change. Because the collective environment influences habitat quality in complex ways, integrated approaches that consider habitat resources, stochastic factors, and conspecifics are necessary to accurately assess habitat quality.

Perception of front-of-pack labels according to social characteristics, nutritional knowledge and food purchasing habits.

PubMed

Méjean, Caroline; Macouillard, Pauline; Péneau, Sandrine; Hercberg, Serge; Castetbon, Katia

2013-03-01

To identify patterns of perception of front-of-pack (FOP) nutrition labels and to determine social factors, nutritional knowledge and attention to packaging features related to such patterns. Cross-sectional. Perception was measured using indicators of understanding and acceptability of three simple FOP labels (the 'Green Tick', the logo of the French Nutrition and Health Programme (PNNS logo) and 'simple traffic lights' (STL)) and two detailed formats ('multiple traffic lights' (MTL) and the 'colour range' logo (CR)). Associations of perception patterns with individual characteristics were examined using χ2 tests. Data from the French NutriNet-Santé cohort study. A total of 38,763 adults. Four perception patterns emerged. Poorly educated individuals were most often found in groups favouring simple formats. The 'favourable to CR' group had a high rate of men and older persons. Poor nutritional knowledge was more frequent in the 'favourable to STL' group, while individuals with substantial knowledge were proportionally more numerous in the 'favourable to MTL' group. The 'favourable to STL' group more frequently self-reported noting price and marketing characteristics during purchasing, while the 'favourable to MTL' and 'favourable to CR' groups declared more interest in nutritional information. The 'favourable to Green Tick and PNNS logo' group self-reported paying closer attention to claims and quality guarantee labels. The 'favourable to MTL' cluster was most frequently represented in our survey. However, simple FOP formats may be most appropriate for increasing awareness of healthy eating among targeted groups with poor nutritional knowledge and little interest in the nutritional quality of packaged foods.

Pain in IBD Patients: Very Frequent and Frequently Insufficiently Taken into Account

PubMed Central

Ak, Melike; Müller-Mottet, Séverine; Scharl, Sylvie; Biedermann, Luc; Fournier, Nicolas; Frei, Pascal; Pittet, Valerie; Scharl, Michael; Fried, Michael

2016-01-01

Background Pain is a common symptom related to inflammatory bowel disease (IBD). In addition to abdominal pain, pain can also be an extraintestinal manifestation of IBD. Pain treatment is challenging and a substantial part of IBD patients are treated with opioids. Therefore, a better knowledge on pain symptoms is crucial for a better therapeutic approach to this clinical problem. Methods Patients of the Swiss IBD Cohort Study (SIBDCS) (n = 2152) received a questionnaire regarding pain intensity, pain localization and impact of pain on daily life and social activities. Furthermore, the questionnaire investigated the use of pain-specific medication. Results A vast majority of patients (71%) experienced pain during the disease course. For a substantial part of patients (49% in UC and 55% in CD) pain is a longstanding problem (>5 years). Pain in UC was of shorter duration compared to CD (p < 0.01). Abdominal pain (59.5%) and back pain (38.3%) were the main pain localizations. 67% of patients took pain medication; 24% received no pain treatment. The general quality of life was significantly lower in patients suffering of pain compared to those without pain (38 vs. 77; (-100 very bad; 100 very good) p<0.0001). Conclusions Prevalence of pain is high in patients of the SIBDCS. It is a longstanding problem for the majority of the patients affected. Pain was found to be undertreated in the SIBDCS and was significantly associated with health-related quality of life. Thus, an increased awareness is mandatory to address this frequent complication in the course of IBD. PMID:27332879

Sleep quality and health service utilization in Chinese general population: a cross-sectional study in Dongguan, China.

PubMed

Zhang, Hui-Shan; Mai, Yan-Bing; Li, Wei-Da; Xi, Wen-Tao; Wang, Jin-Ming; Lei, Yi-Xiong; Wang, Pei-Xi

The aims of this study were to explore the Pittsburgh Sleep Quality Index (PSQI) and health service utilization in Chinese general population, to investigate the association between PSQI and health service utilization and to identify the independent contributions of social demographic variables, health related factors and PSQI to health service utilization. In a cross-sectional community-based health survey using a multi-instrument questionnaire, 4067 subjects (≥15 years old) were studied. The Chinese version of the PSQI was used to assess sleep quality. Health service utilization was measured by recent two-week physician visit and annual hospitalization rates. Higher PSQI scores were associated with more frequent health service utilization. Higher scores in subjective sleep quality were associated with higher rate of recent two-week physician visit (adjusted OR = 1.24 per SD increase, P = 0.015). Higher scores in habitual sleep efficiency (adjusted OR = 1.24 per SD increase, P = 0.038) and sleep disturbances (adjusted OR = 2.09 per SD increase, P < 0.001) were associated with more frequent annual hospitalization. The independent influence of PSQI on the risk of recent two-week physician visit was 0.7%, and that of annual hospitalization 31.4%. Poorer sleep quality predicted more frequent health service utilization. The independent contribution of PSQI on health service utilization was smaller than social demographic variables. Copyright © 2016. Published by Elsevier B.V.

Prevalence and impact of fibromyalgia on function and quality of life in individuals from the general population: results from a nationwide study in Spain.

PubMed

Mas, A J; Carmona, L; Valverde, M; Ribas, B

2008-01-01

To estimate the prevalence of fibromyalgia (FM) and to compare some descriptive epidemiological and quality of life data between persons with and without FM criteria in a representative sample of the general Spanish population. Cross sectional study of 2,192 Spaniards aged 20 or above, selected by cluster sampling. Subjects were invited to a structured interview carried out by trained rheumatologists to ascertain various musculoskeletal disorders. The visit included screening and examination, validated instruments for measuring function (HAQ) and quality of life (SF-12) and questions about socio-demographic characteristics and musculoskeletal, mental, and other general symptoms. FM was suspected in subjects with widespread pain for more than three months. FM was defined by theAmerican College of Rheumatology classification criteria. All estimates are adjusted to sampling scheme. The prevalence of FM in Spain is 2.4% (95% CI: 1.5-3.2). FM is significantly more frequent in women (4.2%) than in men (0.2%), with an OR for women of 22.5 (95%CI: 7.2- 69.9), mainly in the 40-49 years age interval. It is more frequent in rural (4.1%) than in urban settings (1.7%), with an OR for rural settings of 2.5 (95%CI: 1.03-5.9). FM is associated with a low educational level, to a low social class, and to self-reported depression. The scores in the HAQ and in the SF-12 were significantly lower in FM subjects, despite adjustment by covariates. FM has a high prevalence in the general population. FM is associated to female gender, comorbidities, age between 40 and 59 years, and a rural setting. Persons fulfilling FM criteria show impaired functioning and quality of life.

Sleep and fatigue in multiple sclerosis: A questionnaire-based, cross-sectional, cohort study.

PubMed

Nociti, Viviana; Losavio, Francesco Antonio; Gnoni, Valentina; Losurdo, Anna; Testani, Elisa; Vollono, Catello; Frisullo, Giovanni; Brunetti, Valerio; Mirabella, Massimiliano; Della Marca, Giacomo

2017-01-15

Fatigue and sleep disorders are frequently reported in patients affected by Multiple Sclerosis (MS) but the causes and the relationship are not yet fully understood. This study aimed at evaluating their prevalence, at determining the relationships between clinical findings of MS and the occurrence of sleep disorders and at investigating the relations between sleep disorders and fatigue. One hundred and two MS patients were enrolled in the study. They were analyzed on both their clinical features (type of MS, disease duration, clinical severity, type of treatment, presence of spinal demyelinating lesions) and specific scales scores (Expanded Disability Status Scale, Modified Fatigue Impact Scale - MFIS, Self-Administered Anxiety Scale - SAS, Beck's Depression Inventory - BDI, Pittsburgh Sleep Quality Index - PSQI, Epworth Sleepiness Scale - ESS, and the Berlin's questionnaire for Obstruction Sleep Apnea Syndrome - OSAS). Patients with poor sleep quality are more frequently fatigued (p=0.001), have higher MFIS global scores (p<0.001), higher prevalence of RLS symptoms (p=0.049), and show higher scores at BDI (p=0.017) and SAS (p≤0.001). Conversely patients with fatigue show older age (p=0.005), higher prevalence of sleepiness (p=0.021), higher prevalence of RLS symptoms (p=0.030), higher prevalence of poor sleep quality (p<0.001) with higher PSQI scores (p<0.001), higher scores on the BDI (p<0.001) and SAS (p≤0.001). This study shows that MS is associated with a high prevalence of sleep complaints, including subjectively poor sleep quality, excessive daytime sleepiness, RLS and symptoms of OSAS. Further, it demonstrated a strict relation between fatigue and sleep disorders. Finally, it underlines their relationship with anxiety and depression in MS patients. Copyright © 2016 Elsevier B.V. All rights reserved.

Insomnia in Patients with COPD

PubMed Central

Budhiraja, Rohit; Parthasarathy, Sairam; Budhiraja, Pooja; Habib, Michael P.; Wendel, Christopher; Quan, Stuart F.

2012-01-01

Study Objectives: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality and may frequently be associated with sleep disturbances. However, the correlates of insomnia in COPD patients have not been well characterized. The aim of the current study was to describe the prevalence of insomnia disorder in COPD and to elucidate the demographic and clinical characteristics of COPD patients that are associated with insomnia. Design: Cross-sectional study. Setting: Clinic-based sample from an academic hospital. Participants: Patients with stable COPD. Measurements: An interviewer-conducted survey was administered to 183 participants with COPD. Seventy-two of these participants (30 with and 42 without insomnia) maintained a sleep diary and underwent actigraphy for 7 days. Results: Insomnia (chronic sleep disturbance associated with impaired daytime functioning) was present in 27.3% of participants. Current tobacco users (odds ratio (OR), 2.13) and those with frequent sadness/anxiety (OR, 3.57) had higher odds, but oxygen use was associated with lower odds (OR, 0.35) of insomnia. Patients with insomnia had worse quality of life and a higher prevalence of daytime sleepiness. Actigraphy revealed shorter sleep duration and lower sleep efficiency, and a sleep diary revealed worse self-reported sleep quality in participants with insomnia. Conclusion: Insomnia disorder is highly prevalent in patients with COPD; current tobacco use and sadness/anxiety are associated with a higher prevalence, and oxygen use with a lower prevalence of insomnia; patients with insomnia have poorer quality of life and increased daytime sleepiness; and insomnia is associated with worse objective sleep quality. Citation: Budhiraja R; Parthasarathy S; Budhiraja P; Habib MP; Wendel C; Quan SF. Insomnia in patients with COPD. SLEEP 2012;35(3):369-375. PMID:22379243

Diet quality: associations with health messages included in the Danish Dietary Guidelines 2005, personal attitudes and social factors.

PubMed

Biltoft-Jensen, Anja; Groth, Margit V; Matthiessen, Jeppe; Wachmann, Henrik; Christensen, Tue; Fagt, Sisse

2009-08-01

To study the association between diet quality and the new health messages in the Danish Dietary Guidelines 2005, i.e. 'Eat a varied diet', 'Engage in regular physical activity' and 'Maintain a healthy body weight'. The study was cross-sectional, comprising a random sample of 3151 Danish adults aged 18-75 years. Dietary intake was estimated using a 7 d pre-coded food diary. Information on social background, leisure-time physical activity, height, body weight and intention to eat healthy was obtained by in-person interviews. Logistic regression models were used to explore the independent effects of energy intake, leisure-time physical activity, food variety, BMI, age, gender, education, household income, location of residence and intention to eat healthy on the likelihood to have high diet quality measured by an index based on the intake of dietary fibre and saturated fat. Greater food variety (OR = 1.32 for women, 1.13 for men), high leisure-time physical activity (OR = 2.20 for women, 1.91 for men), frequent intentions to eat healthy (OR = 8.19 for women, 5.40 for men) and low energy intake (OR=0.78 for women, 0.85 for men) were significantly associated with high diet quality. For women education was positively associated with diet quality. The study did not demonstrate any association between BMI and diet quality. The health behaviours 'Eat a varied diet' and 'Engage in regular physical activity' were positively associated with healthy eating. The dietary habits reported were strongly influenced by personal intentions. Thus, the biggest challenge for public health nutritionists will be to reach non-compliers who seldom have intentions to eat healthy.

Assessment of medical care by elderly people: general satisfaction and physician quality.

PubMed Central

Lee, Y; Kasper, J D

1998-01-01

OBJECTIVE: To identify personal characteristics and factors related to health and patterns of healthcare utilization associated with the elderly people's satisfaction with medical care. DATA SOURCES/STUDY SETTING: Data from the 1991 Medicare Current Beneficiary Survey (MCBS) on 8,859 persons age 65 and over living in the community. STUDY DESIGN: Items reflecting general satisfaction with care and views of physician quality are examined and, based on factor analysis, grouped in dimensions of two (global quality, access) and three (technical skills, interpersonal manner, information-giving), respectively. The relationship of high levels of satisfaction in each dimension to personal characteristics of elderly people, and to measures of access and utilization, is assessed using logistic regression. PRINCIPAL FINDINGS: While satisfaction is high, with over 90 percent surveyed expressing some satisfaction, there is substantial variation with less likelihood of high satisfaction among those 80 or older, with less education and income and in poorer health. Longer waiting time at visits and less frequent visits are factors in lower satisfaction as well. A favorable perception of physician quality, especially regarding technical skills, appears to play a significant role in satisfaction with global quality of care. CONCLUSIONS: Studies of patient satisfaction in elderly people are rare. Some factors expected to be related to positive assessment based on earlier studies, were, e.g., better health and shorter waiting time, while others were not, e.g., increasing age. Elderly people appear to place greater importance on physician technical skills, as opposed to interpersonal dimensions, in assessing global quality. These findings suggest the need for a better understanding of how elderly people evaluate care and what they value in interactions with the healthcare system. Images Figure 1 PMID:9460484

The magnitude of variability produced by methods used to estimate annual stormwater contaminant loads for highly urbanised catchments.

PubMed

Beck, H J; Birch, G F

2013-06-01

Stormwater contaminant loading estimates using event mean concentration (EMC), rainfall/runoff relationship calculations and computer modelling (Model of Urban Stormwater Infrastructure Conceptualisation--MUSIC) demonstrated high variability in common methods of water quality assessment. Predictions of metal, nutrient and total suspended solid loadings for three highly urbanised catchments in Sydney estuary, Australia, varied greatly within and amongst methods tested. EMC and rainfall/runoff relationship calculations produced similar estimates (within 1 SD) in a statistically significant number of trials; however, considerable variability within estimates (∼50 and ∼25 % relative standard deviation, respectively) questions the reliability of these methods. Likewise, upper and lower default inputs in a commonly used loading model (MUSIC) produced an extensive range of loading estimates (3.8-8.3 times above and 2.6-4.1 times below typical default inputs, respectively). Default and calibrated MUSIC simulations produced loading estimates that agreed with EMC and rainfall/runoff calculations in some trials (4-10 from 18); however, they were not frequent enough to statistically infer that these methods produced the same results. Great variance within and amongst mean annual loads estimated by common methods of water quality assessment has important ramifications for water quality managers requiring accurate estimates of the quantities and nature of contaminants requiring treatment.

Breast Cancer Screening Programmes across the WHO European Region: Differences among Countries Based on National Income Level.

PubMed

Altobelli, Emma; Rapacchietta, Leonardo; Angeletti, Paolo Matteo; Barbante, Luca; Profeta, Filippo Valerio; Fagnano, Roberto

2017-04-23

Breast cancer (BC) is the most frequent tumour affecting women all over the world. In low- and middle-income countries, where its incidence is expected to rise further, BC seems set to become a public health emergency. The aim of the present study is to provide a systematic review of current BC screening programmes in WHO European Region to identify possible patterns. Multiple correspondence analysis was performed to evaluate the association among: measures of occurrence; GNI level; type of BC screening programme; organization of public information and awareness campaigns regarding primary prevention of modifiable risk factors; type of BC screening services; year of screening institution; screening coverage and data quality. A key difference between High Income (HI) and Low and Middle Income (LMI) States, emerging from the present data, is that in the former screening programmes are well organized, with approved screening centres, the presence of mobile units to increase coverage, the offer of screening tests free of charge; the fairly high quality of occurrence data based on high-quality sources, and the adoption of accurate methods to estimate incidence and mortality. In conclusion, the governments of LMI countries should allocate sufficient resources to increase screening participation and they should improve the accuracy of incidence and mortality rates.

Analysis Of Laryngeal Biomechanics Of Deaf Speakers Utilizing High-Speed Cinematography

NASA Astrophysics Data System (ADS)

Metz, Dale E.; Whitehead, Robert L.

1982-02-01

Since the formalization of the myoelastic-aerodynamic theory of vocal fold vibration, it has been generally accepted that biomechanical and aerodynamic forces determine the nature of vocal fold vibration patterns, speaking fundamental frequency and vocal intensity. The speech of the deaf is frequently characterized by abnormal voice qualities and aberrant frequency and intensity variations suggesting mismanagement of the biomechanical and aerodynamic forces acting on the larynx. Unfortunately, efforts to remediate these abnormal laryngeal activities are frequently ineffective. It is reasonable to suggest that more effective remedial strategies could be developed if we had a better understanding of the underlying nature of the problems deaf persons experience when trying to control laryngeal functioning for speech purposes. Toward this end, we are employing high speed laryngeal filming procedures in conjunction with glottal impedance, respiratory kinematic and acous-tical measurement procedures to assess abnormal laryngeal functioning of deaf speakers. All data are collected simultaneously and are time-locked to facilitate analysis of specific laryngeal events. This unique combination of instrumentation has provided important insights regarding laryngeal functioning of the deaf. For example, we have observed that deaf speakers may assume abnormal glottal configurations during phonation that pro-hibit normal laryngeal functioning and disturb upper airway dynamics. Also, normal vibratory patterns are frequently disturbed. Instrumentation, data collection protocols, analysis procedures and selected findings will be discussed.

Disability in Full-Length Feature Films: Frequency and Quality of Films over an 11 Year Span.

ERIC Educational Resources Information Center

Byrd, E. Keith; Elliot, Timothy R.

1988-01-01

This study assessed the presentation of disabling conditions in feature films and the general quality of these films (as judged by professional film critics' reviews and movie-goer ratings). Psychiatric disorder was the disability most frequently depicted. Films varied in quality with critics markedly more negative in their reviews than movie…

Total Quality Management and the System Safety Secretary

NASA Technical Reports Server (NTRS)

Elliott, Suzan E.

1993-01-01

The system safety secretary is a valuable member of the system safety team. As downsizing occurs to meet economic constraints, the Total Quality Management (TQM) approach is frequently adopted as a formula for success and, in some cases, for survival.

Premenstrual Syndrome in Turkish college students and its effects on life quality.

PubMed

Pinar, Gul; Colak, Meric; Oksuz, Ergun

2011-01-01

The purpose of this research is to analyze the frequency of Premenstrual Syndrome (PMS) in college students, the factors affecting Premenstrual Syndrome and the effect of Premenstrual Syndrome on life quality. The research was performed on 316 students who study at Medical Sciences Faculty of Başkent University and accepted to take part in the research. The data of the research was compiled by using "Questionnaire Form", "PMS Rating Scale" and "Life Quality Scale" developed by the researchers. In the analysis of the data; Percentage distribution, Chi-square test, One Way Anova test, Logistic regression, Multi nominal regression analysis were used. PMS was detected in 72.1% of the students. The most frequent symptoms are mainly low back pain, stress-discomfort, nervous-anger, distention and breast tenderness. PMS was found significantly high in those students who have menstrual irregularity, who have dysmenorrhea, who consume 2 cups of coffee or above per day and who smoke and drink alcohol (p<0.05). When the relation of PMS with life quality was evaluated, it was determined that the life quality decreases as PMS score average increases (p<0.05). PMS rate is high in college students and this adversely affects the life quality. It was revealed that the preventive, instructive and consultancy roles of the medical staff became more of an issue in reducing the effect of the factors causing and/or aggravating these symptoms in order to decrease PMS incidence and to improve the life quality of the students. Copyright © 2010. Published by Elsevier B.V.

Application of microscopy technique and high-performance liquid chromatography for quality assessment of the flower bud of Tussilago farfara L. (Kuandonghua)

PubMed Central

Li, Da; Liang, Li; Zhang, Jing; Kang, Tingguo

2015-01-01

Background: Quality control is one of the bottleneck problems limiting the application and development of traditional Chinese medicine (TCM). In recent years, microscopy and high-performance liquid chromatography (HPLC) techniques have been frequently applied in the quality control of TCM. However, studies combining conventional microscopy and HPLC techniques for the quality control of the flower bud of Tussilago farfara L. (Kuandonghua) have not been reported. Objective: This study was undertaken to evaluate the quality of the flower bud of T. farfara L. and to establish the relationships between the quantity of pollen grains and four main bioactive constituents: tussilagone, chlorogenic acid, rutin and isoquercitrin. Materials and Methods: In this study, microscopic examination was used to quantify microscopic characteristics of the flower bud of T. farfara L., and the chemical components were determined by HPLC. The data were analyzed by Statistical Package for the Social Sciences statistics software. Results: The results of the analysis showed that tussilagone, chlorogenic acid, rutin and isoquercitrin were significantly correlated with the quantity of pollen grains in the flower bud of T. farfara L. There is a positive correlation between them. From these results, it can be deduced that the flower bud of T. farfara L. with a greater quantity of pollen grains should be of better quality. Conclusion: The study showed that the established method can be helpful for evaluating the quality of the flower bud of T. farfara L. based on microscopic characteristic constants and chemical quantitation. PMID:26246737

Impact of persistent, frequent regurgitation on quality of life in heartburn responders treated with acid suppression: a multinational primary care study.

PubMed

Kahrilas, P J; Howden, C W; Wernersson, B; Denison, H; Nuevo, J; Gisbert, J P

2013-05-01

In gastro-oesophageal reflux disease (GERD), heartburn responds well to acid suppression, but regurgitation is a common cause of incomplete treatment response. To assess the prevalence and burden of persistent, frequent regurgitation in primary care patients with GERD treated with acid suppression. We analysed observational data from 134 sites across six European countries in patients diagnosed with GERD. Within 3 months of the index visit, symptoms were assessed using the Reflux Disease Questionnaire, and their impact on sleep and work productivity with the Quality of Life in Reflux and Dyspepsia questionnaire and the Work Productivity and Activity Impairment Questionnaire, respectively. Patients provided information on concomitant over-the-counter (OTC) GERD medication use. Persistent, frequent (3-7 days/week) regurgitation was reported by 13.2% (153/1156) of GERD patients with no heartburn on acid suppression; the prevalence was very similar for patients with up to 2 days/week of ongoing mild heartburn. Among patients without heartburn, sleep disturbance of any type was reported by 50.7-60.1% with persistent, frequent regurgitation, compared with 38.1-51.1% and 14.4-19.2% of those with less frequent or no regurgitation respectively. Persistent, frequent regurgitation was associated with increased use of OTC medication and more hours of work missed, whether mild, infrequent heartburn was present or not. Frequent regurgitation, which persisted in 12-13% of patients with no or infrequent, mild heartburn on acid suppression, negatively affected sleep and work productivity, and increased use of OTC medication. Persistent, frequent regurgitation is problematic for primary care patients with GERD. © 2013 Blackwell Publishing Ltd.

Microbial quality of water in dental unit waterlines.

PubMed

Nikaeen, Mahnaz; Hatamzadeh, Maryam; Sabzevari, Zohre; Zareh, Omolbanin

2009-09-01

Dental unit waterlines (DUWLs) are ideal environment for development of microbial biofilms. Microbial contamination of water in DUWLs is thought to be the result of biofilm formation as it could serves as a haven for pathogens. The aim of this study was to assess microbial quality of water in dental unit waterlines of dental units located at the dental school of Isfahan University of Medical Sciences. Water samples were collected from air/water syringe and high-speed handpiece. Generally, 100-200 ml water samples were collected aseptically in sterile containers with sodium thiosulfate at the beginning of the day after a 2 minute purge. Samples were transferred to the laboratory in insulated box with cooling packs and examined for total viable heterotrophic bacteria and fungi. The heterotrophic plate count levels were significantly exceeded the American Dental Association recommendations for DUWL water quality (< 200 CFU/ml), in both air/water syringe (84%, CFU/ml: 500-20000) and high-speed handpiece (96%, CFU/ml: 710-36800) samples. However, there was no significant difference between the level of contamination in the air/water syringe and high-speed handpiece. Fungi were found in 28% and 36% of air/water syringe and high-speed handpiece samples, respectively; and filamentous fungi were the most frequently isolated fungi. DUWLs should be subjected to routine microbial monitoring and to a decontamination protocol in order to minimize the risk of exposure to potential pathogens from dental units.

Prevalence and impact of respiratory symptoms in a population of patients with COPD in Latin America: The LASSYC observational study.

PubMed

Miravitlles, Marc; Menezes, Ana; López Varela, Maria Victorina; Casas, Alejandro; Ugalde, Luis; Ramirez-Venegas, Alejandra; Mendoza, Laura; López, Ana; Wehrmeister, Fernando C; Surmont, Filip; Montes de Oca, Maria

2018-01-01

To analyse the relationship between symptoms at different times during the 24-hour day and outcomes in COPD. Observational cross-sectional study in a patients from 7 Latin American countries. The frequency of symptoms in the morning, at night and during the day was explored by means of standardised and validated questionnaires, and the relationship between symptoms and exacerbations and quality of life were investigated. 734 patients (59.6% male, mean age 69.5 years, mean FEV 1 50% predicted normal) were recruited. The most frequent symptoms during the day were dyspnea (75% of patients, of which 94% mild-moderate) and cough (72.2%, of which 93.4% mild-moderate). Highly symptomatic patients had a greater impairment in FEV 1 , more exacerbations and worse scores in COPD assessment test (CAT) and Body Mass Index, Obstruction, Dyspnoea and Exacerbations (BODEx) index (all p < 0.001). Morning symptoms were more frequent than night-time symptoms, particularly cough and dyspnoea (morning: 50.1% and 45.7%; night-time: 33.2% and 24.4%, respectively), and mostly rated as mild or moderate. Patients with morning or night-time symptoms presented with worse severity of daytime symptoms. There was a strong correlation between intensity of daytime with morning or night-time symptoms, as well as with CAT score (r = 0.715; p < 0.001), but a weak correlation with FEV 1 (r = -0.205; p < 0.001). Morning symptoms were more frequent than night-time symptoms, and having either morning and/or night-time symptoms was associated with worse severity of daytime symptoms. Increased symptoms were strongly associated with worse quality of life and more frequent exacerbations, but weakly associated with airflow limitation. NCT02789540. Copyright © 2017 Elsevier Ltd. All rights reserved.

Food patterns and dietary quality associated with organic food consumption during pregnancy; data from a large cohort of pregnant women in Norway.

PubMed

Torjusen, Hanne; Lieblein, Geir; Næs, Tormod; Haugen, Margaretha; Meltzer, Helle Margrete; Brantsæter, Anne Lise

2012-08-06

Little is known about the consumption of organic food during pregnancy. The aim of this study was to describe dietary characteristics associated with frequent consumption of organic food among pregnant women participating in the Norwegian Mother and Child Cohort Study (MoBa). The present study includes 63 808 women who during the years 2002-2007 answered two questionnaires, a general health questionnaire at gestational weeks 15 and a food frequency questionnaire at weeks 17-22. The exploration of food patterns by Principal component analyses (PCA) was followed by ANOVA analyses investigating how these food patterns as well as intake of selected food groups were associated with consumption of organic food. The first principal component (PC1) identified by PCA, accounting for 12% of the variation, was interpreted as a 'health and sustainability component', with high positive loadings for vegetables, fruit and berries, cooking oil, whole grain bread and cereal products and negative loadings for meat, including processed meat, white bread, and cakes and sweets. Frequent consumption of organic food, which was reported among 9.1% of participants (n = 5786), was associated with increased scores on the 'health and sustainability component' (p < 0.001). The increase in score represented approximately 1/10 of the total variation and was independent of sociodemographic and lifestyle characteristics. Participants with frequent consumption of organic food had a diet with higher density of fiber and most nutrients such as folate, beta-carotene and vitamin C, and lower density of sodium compared to participants with no or low organic consumption. The present study showed that pregnant Norwegian women reporting frequent consumption of organically produced food had dietary pattern and quality more in line with public advice for healthy and sustainable diets. A methodological implication is that the overall diet needs to be included in future studies of potential health outcomes related to consumption of organic food during pregnancy.

Series: Practical guidance to qualitative research. Part 1: Introduction.

PubMed

Moser, Albine; Korstjens, Irene

2017-12-01

In the course of our supervisory work over the years, we have noticed that qualitative research tends to evoke a lot of questions and worries, so-called Frequently Asked Questions. This journal series of four articles intends to provide novice researchers with practical guidance for conducting high-quality qualitative research in primary care. By 'novice' we mean Master's students and junior researchers, as well as experienced quantitative researchers who are engaging in qualitative research for the first time. This series addresses their questions and provides researchers, readers, reviewers and editors with references to criteria and tools for judging the quality of papers reporting on qualitative research. This first article describes the key features of qualitative research, provides publications for further learning and reading, and gives an outline of the series.

Relationship of sleep quality with coping and life styles in female Moroccan immigrants in Germany.

PubMed

Voss, Ursula; Tuin, Inka

2008-01-01

Epidemiologic studies conducted in Western societies show poorer sleep quality in women compared with men. Socioeconomic and stress-related psychological variables have been shown to influence sleep, but not much is known about sociological and psychological influences on the sleep of women in general and non-Western women in particular. The present study reports on sociodemographic and coping variables in relation to sleep quality in female Moroccan immigrants living in Germany. Participants took part in a structured personal interview on Pittsburg Sleep Quality Inventory (PSQI) sleep quality, coping style preferences, and information related to the degree of identification with Western life style. Sleep quality was poor (PSQI > 6) in 39% of women. Surprisingly, women who had identified with a more Western lifestyle had poorer sleep quality than women who had retained their traditional Moroccan life style. An unusually large proportion of women preferred monitoring (i.e., information-seeking coping style) and adaptive coping (48% and 19%, respectively), regardless of sleep quality. Monitoring was more frequent in women who were less integrated into German culture. Results on sleep quality suggest that for Moroccan immigrant women in Germany, adopting a Western life style may be more stressful than retaining their native life style. The high preference for an information seeking approach in coping may reflect the desire for information rather than actual coping behavior.

Improved model quality assessment using ProQ2.

PubMed

Ray, Arjun; Lindahl, Erik; Wallner, Björn

2012-09-10

Employing methods to assess the quality of modeled protein structures is now standard practice in bioinformatics. In a broad sense, the techniques can be divided into methods relying on consensus prediction on the one hand, and single-model methods on the other. Consensus methods frequently perform very well when there is a clear consensus, but this is not always the case. In particular, they frequently fail in selecting the best possible model in the hard cases (lacking consensus) or in the easy cases where models are very similar. In contrast, single-model methods do not suffer from these drawbacks and could potentially be applied on any protein of interest to assess quality or as a scoring function for sampling-based refinement. Here, we present a new single-model method, ProQ2, based on ideas from its predecessor, ProQ. ProQ2 is a model quality assessment algorithm that uses support vector machines to predict local as well as global quality of protein models. Improved performance is obtained by combining previously used features with updated structural and predicted features. The most important contribution can be attributed to the use of profile weighting of the residue specific features and the use features averaged over the whole model even though the prediction is still local. ProQ2 is significantly better than its predecessors at detecting high quality models, improving the sum of Z-scores for the selected first-ranked models by 20% and 32% compared to the second-best single-model method in CASP8 and CASP9, respectively. The absolute quality assessment of the models at both local and global level is also improved. The Pearson's correlation between the correct and local predicted score is improved from 0.59 to 0.70 on CASP8 and from 0.62 to 0.68 on CASP9; for global score to the correct GDT_TS from 0.75 to 0.80 and from 0.77 to 0.80 again compared to the second-best single methods in CASP8 and CASP9, respectively. ProQ2 is available at http://proq2.wallnerlab.org.

Quality of diabetes care worldwide and feasibility of implementation of the Alphabet Strategy: GAIA project (Global Alphabet Strategy Implementation Audit).

PubMed

Lee, James D; Saravanan, Ponnusamy; Varadhan, Lakshminarayanan; Morrissey, John R; Patel, Vinod

2014-10-11

The Alphabet Strategy (AS) is a diabetes care checklist ensuring "important, simple things are done right all the time." Current audits of diabetes care in developed countries reveal wide variations in quality with performance of care processes frequently sub-optimal. This study had three components:• an audit to assess diabetes care quality worldwide,• a questionnaire study seeking opinions on the merits of the AS,• a pilot study to assess the practicality of implementation of the AS in a low socioeconomic setting. Audit data was collected from 52 centres across 32 countries. Data from 4537 patients were converted to Quality and Outcome Framework (QOF) scores to enable inter-centre comparison. These were compared to each country's Gross Domestic Product (GDP), and Total Health Expenditure percentage per capita (THE%). The opinions of diabetes patients and healthcare professionals from the diabetes care team at each of these centres were sought through a structured questionnaire. A retrospective audit on 100 randomly selected case notes was conducted prior to AS implementation in a diabetes outpatient clinic in India, followed by a prospective audit after four months to assess its impact on care quality. QOF scores showed wide variation across the centres (mean 49.0, range 10.2-90.1). Although there was a positive relationship between GDP and THE% to QOF scores, there were exceptions. 91% of healthcare professionals felt the AS approach was practical. Patients found the checklist to be a useful education tool. Significant improvements in several aspects of care as well as 36% improvement in QOF score were seen following implementation. International centres observed large variations in care quality, with standards frequently sub-optimal. 71% of health care professionals would consider adopting the AS in their daily practice. Implementation in a low resource country resulted in significant improvements in some aspects of diabetes care. The AS checklist for diabetes care is a freely available in the public domain encompassing patient education, care plans, and educational resources for healthcare professionals including summary guidelines. The AS may provide a unique approach in delivering high quality diabetes care in countries with limited resources.

Visible and near-infrared spectral signatures for adulteration assessment of extra virgin olive oil

NASA Astrophysics Data System (ADS)

Mignani, A. G.; Ciaccheri, L.; Ottevaere, H.; Thienpont, H.; Conte, L.; Marega, M.; Cichelli, A.; Attilio, C.; Cimato, A.

2010-04-01

Because of its high price, the extra virgin olive oil is frequently target for adulteration with lower quality oils. This paper presents an innovative optical technique capable of quantifying the adulteration of extra virgin olive oil caused by lowergrade olive oils. It relies on spectral fingerprinting the test liquid by means of diffuse-light absorption spectroscopy carried out by optical fiber technology in the wide 400-1700 nm spectral range. Then, a smart multivariate processing of spectroscopic data is applied for immediate prediction of adulterant concentration.

Factors Influencing Part-time Faculty Engagement With Online Nursing Programs.

PubMed

Reneau, Margaret; Wallace, Cara; Claywell, Lora; Price, Jill; Burdi, Melissa; Trybulski, Joanne

2018-03-28

This research investigated factors that influenced the engagement of part-time faculty teaching in online nursing programs with their institutions. Of the 257 part-time faculty surveyed, the most significant factor was being supported in decisions regarding student issues, followed by institutional commitment to quality online education. Compensation was moderately influential; a negative factor was requiring too frequent meetings. Understanding factors that influence the engagement of part-time faculty teaching in online nursing programs can help leaders of online programs attract and retain experienced, highly skilled faculty.

Treatment of toxicity from amphetamines, related derivatives, and analogues: a systematic clinical review.

PubMed

Richards, John R; Albertson, Timothy E; Derlet, Robert W; Lange, Richard A; Olson, Kent R; Horowitz, B Zane

2015-05-01

Overdose of amphetamine, related derivatives, and analogues (ARDA) continues to be a serious worldwide health problem. Patients frequently present to the hospital and require treatment for agitation, psychosis, and hyperadrenegic symptoms leading to pathologic sequelae and mortality. To review the pharmacologic treatment of agitation, psychosis, and the hyperadrenergic state resulting from ARDA toxicity. MEDLINE, PsycINFO, and the Cochrane Library were searched from inception to September 2014. Articles on pharmacologic treatment of ARDA-induced agitation, psychosis, and hyperadrenergic symptoms were selected. Evidence was graded using Oxford CEBM. Treatment recommendations were compared to current ACCF/AHA guidelines. The search resulted in 6082 articles with 81 eligible treatment involving 835 human subjects. There were 6 high-quality studies supporting the use of antipsychotics and benzodiazepines for control of agitation and psychosis. There were several case reports detailing the successful use of dexmedetomidine for this indication. There were 9 high-quality studies reporting the overall safety and efficacy of β-blockers for control of hypertension and tachycardia associated with ARDA. There were 3 high-quality studies of calcium channel blockers. There were 2 level I studies of α-blockers and a small number of case reports for nitric oxide-mediated vasodilators. High-quality evidence for pharmacologic treatment of overdose from ARDA is limited but can help guide management of acute agitation, psychosis, tachycardia, and hypertension. The use of butyrophenone and later-generation antipsychotics, benzodiazepines, and β-blockers is recommended based on existing evidence. Future randomized prospective trials are needed to evaluate new agents and further define treatment of these patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Assessing the Prevalence of Recurrent Neck and Shoulder Pain in Korean High School Male Students: A Cross-sectional Observational Study.

PubMed

Koh, Min Jung; Park, Sun Young; Woo, Young Sun; Kang, Sung Hyun; Park, Sang Hoon; Chun, Hye Jung; Park, Eun Jung

2012-07-01

Neck and shoulder pain (NSP) is fairly common in adolescents, which is associated with a high prevalence of NSP found during adulthood as well; therefore, its significance during adolescence should not be underestimated. We surveyed the prevalence of recurrent NSP, lifestyle, and risk factors in Korean high school students, and examined the influence of recurrent NSP on the quality of life. Nine hundred thirty one male students (16-19 years old) from two academic high schools in Seoul were included in this study. The survey consisted of a questionnaire to assess the prevalence of recurrent NSP, with questions regarding having an occurrence more than once a week, characteristics of NSP, activity and lifestyle of the students, and the risk factors for recurrent NSP. A 36-item Short Form questionnaire was also examined. We found that 44.3% of the high school students surveyed had recurrent NSP (more than once a week) and the overall prevalence of NSP was 79.1%. The average sitting time was 10.2 ± 2.7 h/day. 59.0% did not sit straight, 14.7% used assisting devices during reading, and 11.9% answered that they stretched regularly. Found from their self assessed health, frequent fatigue and frequent depressed mood presented significant associations with the higher prevalence of recurrent NSP. Korean high school students had a high prevalence of recurrent NSP. Clinical attention is needed for the prevention and resolution of recurrent NSP found in high school students.

Health and condition of endangered young-of-the-year Lost River and Shortnose suckers relative to water quality in Upper Klamath Lake, Oregon, 2014–2015

USGS Publications Warehouse

Burdick, Summer M.; Conway, Carla M.; Elliott, Diane G.; Hoy, Marshal S.; Dolan-Caret, Amari; Ostberg, Carl O.

2017-10-19

Most mortality of endangered Lost River (Deltistes luxatus) and shortnose (Chasmistes brevirostris) suckers in Upper Klamath Lake, Oregon, occurs within the first year of life. Juvenile suckers in Clear Lake Reservoir, California, survive longer and may even recruit to the spawning populations. In a previous (2013–2014) study, the health and condition of juvenile suckers and the dynamics of water quality between Upper Klamath Lake and Clear Lake Reservoir were compared. That study found that apparent signs of stress or exposure to irritants, such as peribiliary cuffing in liver tissue and mild inflammation and necrosis in gill tissues, were present in suckers from both lakes and were unlikely to be clues to the cause of differential mortality between lakes. Seasonal trends in energy storage as glycogen and triglycerides were also similar between lakes, indicating prey limitation was not a likely factor in differential mortality. To better understand the relationship between juvenile sucker health and water quality, we examined suckers collected in 2014–2015 from Upper Klamath Lake, where water quality can be dynamic and, at times, extreme.While there were notable differences in water quality and fish health between years, we were not able to identify any specific water-quality-related causes for differential fish condition. Water quality was generally better in 2014 than in 2015. When considered together afflictions and abnormalities generally indicated healthier suckers in 2014 than 2015. Low dissolved-oxygen events (< 4 milligrams per liter) were less frequent and occurred earlier; high pH events (≥ 9.5) were less frequent and shorter in duration; large diel fluctuations in pH (≥ 1.4) were less frequent; water temperatures were warmer, particularly in July and September; and concentrations of microcystin in both large and small fractions of samples were lower in 2014 than in 2015. Total and therefore also un-ionized ammonia were low in 2014–2015 relative to concentrations known to affect suckers. Petechial hemorrhages of the skin, attached Lernaea spp. and eosinophilic hyaline droplets in the kidney tubules were less prevalent in 2014 than in 2015; however, hyperplastic and hypertrophic gill tissue and trichodinids on the gills were observed more frequently in 2014. There were more suckers with normal liver color and texture in 2014 than in 2015. The prevalence of suckers with liver inflammation was greater in 2014 and only observed in suckers collected after August 5, whereas liver inflammation occurred intermittently in 2015. Liver glycogen among suckers decreased in late-August 2014 and increased from early August to mid-September 2015. Lost River suckers had greater whole-body triglyceride content but a larger proportion with an absence of visceral fat observed in 2014 than in 2015. In contrast, shortnose suckers were similar between years in regard to both whole-body triglyceride and visceral fat. Black-spot-forming parasites (trematode metacercariae) were observed in a higher prevalence on shortnose suckers but not Lost River suckers in 2014 than in 2015. Opercular deformities were less prevalent in both species in 2014 than in 2015.Neither gross nor histological examination revealed a high prevalence of abnormalities in suckers that clearly indicate a primary mechanism for juvenile mortality in Upper Klamath Lake. Histological abnormalities were almost always focal and minimal or mild except where associated with parasites. Mild to severe focal abnormalities associated with Lernaea sp. attachment sites and encysted digenean (trematode) metacercariae are unlikely to be associated with mortality. Severe and diffuse inflammation and hyperplasia of the gills associated with Ichthyobodo sp. on one Lost River sucker, may indicate a potential cause of mortality. High mortality may have primarily occurred outside our study period (for example, in spring or over winter), or was caused by a factor that could not be detected with our methods (for example, predation). Alternatively, abnormalities in a small percentage of passively captured suckers in Upper Klamath Lake may indicate health-related issues that were more prevalent in populations than in our samples. Temporary decreases in liver glycogen stores may also indicate periods of stress, which may eventually lead to mortality of young suckers.

Dyadic coping, quality of life, and psychological distress among chronic obstructive pulmonary disease patients and their partners

PubMed Central

Meier, Caroline; Bodenmann, Guy; Mörgeli, Hanspeter; Jenewein, Josef

2011-01-01

Background Successfully coping with a chronic disease depends significantly on social support, particularly that of a significant other. Thus, it depends on the ways of dealing with stress within a couple (dyadic coping). In this study, the relationship between dyadic coping and well-being was investigated among couples in which one partner suffers from chronic obstructive pulmonary disease (COPD). Methods A total of 43 couples participated. They were mailed questionnaires on anxiety and depression (Hospital Anxiety and Depression Scale), quality of life (World Health Organization Quality of Life Questionnaire-BREF), and dyadic coping (Dyadic Coping Inventory). Results Low scores of positive and high scores of negative dyadic coping were associated with poorer quality of life and higher psychological distress among couples. Delegated coping (assistance with daily tasks) was higher among partners. When estimated by patients, high delegated partner coping (frequent provision of support by partners) and low delegated personal coping (low provision of support by patients) were associated with poorer quality of life for both patient and partner. COPD patients suffering from depression were supported more often and attributed deficits in dyadic coping primarily to themselves, whereas partners with higher scores of depression provided higher estimates of both their own negative coping and the negative coping of their partner. Conclusion The higher the patient perceived the imbalance in delegated dyadic coping, the lower the couple’s quality of life. More negative and less positive dyadic coping were associated with lower quality of life and higher psychological distress. Psychotherapeutic interventions to improve dyadic coping may lead to better quality of life and less psychological distress among COPD patients and their partners. PMID:22135491

Homicides, Public Goods, and Population Health in the Context of High Urban Violence Rates in Cali, Colombia.

PubMed

Martínez, Lina; Prada, Sergio; Estrada, Daniela

2018-06-01

Obesity and frequent mental and physical distress are often associated with major health problems. The characteristics of the urban environment, such as homicide rates and public goods provision, play an important role in influencing participation in physical activity and in overall mental health. This study aimed to determine whether there was a relationship between homicide rates and public goods provision on the health outcomes of the citizens of Cali, Colombia, a city known for its high urban violence rate and low municipal investment in public goods. We used a linear probability model to relate homicide rates and public goods provision (lighted parks, effective public space per inhabitant, and bus stations) at the district level to health outcomes (obesity and frequent mental and physical distress). Individual data were obtained from the 2014 CaliBRANDO survey, and urban context characteristics were obtained from official government statistics. After controlling for individual covariates, results showed that homicide rates were a risk factor in all examined outcomes. An increase in 1.0 m 2 of public space per inhabitant reduced the probability of an individual being obese or overweight by 0.2% (95% confidence interval (CI) = - 0.004 to - 0.001) and the probability of frequent physical distress by 0.1% (95% CI = - 0.002 to - 0.001). On average, the presence of one additional bus station increased the probability of being obese or overweight by 1.1%, the probability of frequent mental distress by 0.3% (95% CI = 0.001-0.004), and the probability of frequent physical distress by 0.02% (95% CI = 0.000-0.003). Living in districts with adequate public space and lighted parks lowers the probability of being obese and high homicide rates, which are correlated with poor health outcomes in Cali, Colombia. Investments in public goods provision and urban safety to reduce obesity rates may contribute to a better quality of life for the population.

An Automated Treatment Plan Quality Control Tool for Intensity-Modulated Radiation Therapy Using a Voxel-Weighting Factor-Based Re-Optimization Algorithm.

PubMed

Song, Ting; Li, Nan; Zarepisheh, Masoud; Li, Yongbao; Gautier, Quentin; Zhou, Linghong; Mell, Loren; Jiang, Steve; Cerviño, Laura

2016-01-01

Intensity-modulated radiation therapy (IMRT) currently plays an important role in radiotherapy, but its treatment plan quality can vary significantly among institutions and planners. Treatment plan quality control (QC) is a necessary component for individual clinics to ensure that patients receive treatments with high therapeutic gain ratios. The voxel-weighting factor-based plan re-optimization mechanism has been proved able to explore a larger Pareto surface (solution domain) and therefore increase the possibility of finding an optimal treatment plan. In this study, we incorporated additional modules into an in-house developed voxel weighting factor-based re-optimization algorithm, which was enhanced as a highly automated and accurate IMRT plan QC tool (TPS-QC tool). After importing an under-assessment plan, the TPS-QC tool was able to generate a QC report within 2 minutes. This QC report contains the plan quality determination as well as information supporting the determination. Finally, the IMRT plan quality can be controlled by approving quality-passed plans and replacing quality-failed plans using the TPS-QC tool. The feasibility and accuracy of the proposed TPS-QC tool were evaluated using 25 clinically approved cervical cancer patient IMRT plans and 5 manually created poor-quality IMRT plans. The results showed high consistency between the QC report quality determinations and the actual plan quality. In the 25 clinically approved cases that the TPS-QC tool identified as passed, a greater difference could be observed for dosimetric endpoints for organs at risk (OAR) than for planning target volume (PTV), implying that better dose sparing could be achieved in OAR than in PTV. In addition, the dose-volume histogram (DVH) curves of the TPS-QC tool re-optimized plans satisfied the dosimetric criteria more frequently than did the under-assessment plans. In addition, the criteria for unsatisfied dosimetric endpoints in the 5 poor-quality plans could typically be satisfied when the TPS-QC tool generated re-optimized plans without sacrificing other dosimetric endpoints. In addition to its feasibility and accuracy, the proposed TPS-QC tool is also user-friendly and easy to operate, both of which are necessary characteristics for clinical use.

SAMOS - A Decade of High-Quality, Underway Meteorological and Oceanographic Data from Research Vessels

NASA Astrophysics Data System (ADS)

Smith, S. R.; Rolph, J.; Briggs, K.; Elya, J. L.; Bourassa, M. A.

2016-02-01

The authors will describe the successes and lessons learned from the Shipboard Automated Meteorological and Oceanographic System (SAMOS) initiative. Over the past decade, SAMOS has acquired, quality controlled, and distributed underway surface meteorological and oceanographic observations from nearly 40 oceanographic research vessels. Research vessels provide underway observations at high-temporal frequency (1-minute sampling interval) that include navigational (position, course, heading, and speed), meteorological (air temperature, humidity, wind, surface pressure, radiation, rainfall), and oceanographic (surface sea temperature and salinity) samples. Vessels recruited to the SAMOS initiative collect a high concentration of data within the U.S. continental shelf, around Hawaii and the islands of the tropical Pacific, and frequently operate well outside routine shipping lanes, capturing observations in extreme ocean environments (Southern, Arctic, South Atlantic, and South Pacific oceans) desired by the air-sea exchange, modeling, and satellite remote sensing communities. The presentation will highlight the data stewardship practices of the SAMOS initiative. Activities include routine automated and visual data quality evaluation, feedback to vessel technicians and operators regarding instrumentation errors, best practices for instrument siting and exposure on research vessels, and professional development activities for research vessel technicians. Best practices for data, metadata, and quality evaluation will be presented. We will discuss ongoing efforts to expand data services to enhance interoperability between marine data centers. Data access and archival protocols will also be presented, including how these data may be referenced and accessed via NCEI.

Is there a relationship between high-quality performance in major teaching hospitals and residents' knowledge of quality and patient safety?

PubMed

Pingleton, Susan K; Horak, Bernard J; Davis, David A; Goldmann, Donald A; Keroack, Mark A; Dickler, Robert M

2009-11-01

The relationship of the quality of teaching hospitals' clinical performance to resident education in quality and patient safety is unclear. The authors studied residents' knowledge of these areas in major teaching hospitals with higher- and lower-quality performance rankings. They assessed the presence of formal and informal quality curricula to determine whether programmatic differences exist. The authors used qualitative research methodology with purposeful sampling. They gathered data from individual structured interviews with residents and key educational and quality leaders in six medical schools and teaching hospitals, which represented a range of quality performance rankings, geographic regions, and public or private status. No relationship emerged between a hospital's quality status, residents' curriculum, and the residents' understanding of quality. Residents' definitions of quality and safety and their knowledge of the practice-based learning and systems-based practice competencies were indistinguishable between hospitals. Residents in all programs had extensive patient safety knowledge acquired through an informal curriculum in the hospital setting. A formal curriculum existed in only two programs, both of them ambulatory settings. Residents' learning about quality and patient safety is extensive, largely through a positive informal curriculum in the teaching hospital and, less frequently, via a formal curriculum. No relationship was found between the quality performance of the teaching hospital and the residents' curriculum or understanding of quality or safety. Residents seem to learn through an informal curriculum provided by hospital initiatives and resources, and thus these data suggest the importance of major teaching hospitals in quality education.

Determinants, Health Problems, and Food Insecurity in Urban Areas of the Largest City in Cape Verde

PubMed Central

Craveiro, Isabel; Alves, Daniela; Amado, Miguel; Santos, Zélia; Fortes, Argentina Tomar; Delgado, António Pedro; Correia, Artur; Gonçalves, Luzia

2016-01-01

Urbanization processes are intertwined with nutritional transition because there is easier access to food of low nutritional quality at reduced prices, changing dietary patterns and leading to an increase of non-communicable chronic diseases. This study aims to understand the perceptions for high blood pressure, obesity, and alcoholism, describing some interactions of these dimensions in the problem of food security in the city of Praia. A qualitative study was carried out under the framework of the research project “UPHI-STAT: Urban Planning and Health Inequalities—moving from macro to micro statistics”. Ten focus groups were conducted in three urban areas with distinct characteristics in the city of Praia, with a total of 48 participants. Participants reported frequent consumption of foods with poor nutritional quality, understanding the potential danger in terms of food security in the city of Praia. Easy access to and high levels of alcohol consumption, and poor quality of traditional drinks were mentioned by participants in the study areas. The impact of the economic situation on the possibility of access to safe and healthy options emerged as a differentiating factor. PMID:27879689

[Antiandrogen gynecomastia: an inescapable harm? Radiotherapy: a simple and efficient solution!].

PubMed

Couke, Philippe A; Jichliski, Patrice; Matzinger, Oscar; Ozsahin, Mahmut; Bulling, Shelley M; Zouhair, Abderrahim

2004-01-01

Anti-androgen induced gynecomastia, resulting from a treatment induced imbalance between oestrogens and androgens, is a frequently encountered side effect in the hormonal treatment of patients with prostatic cancer. One might expect to face an increase in the overall incidence of this side effect in the next-coming years as randomized trials clearly point to the evidence of the therapeutic benefit of anti-androgenic treatment for this prostatic cancer. Gynecomastia is often accompanied by mastodynia and does hamper quality of life. Surgery should be considered for established irreversible gynecomastia characterized by hyalinization and extensive fibrosis. However, radiotherapy is the treatment of choice for gynecomastia at it's early stage, or could eventually be considered as a prophylactic treatment in high risk patients. It is a safe and extremely well tolerated treatment resulting in a high degree of therapeutic success with a demonstrated effect on quality of life as reported in randomized trials. To date no medical treatment is proven effective nor devoid from deleterious effects and licenced for this indication.

Evaluation of a continuous-rotation, high-speed scanning protocol for micro-computed tomography.

PubMed

Kerl, Hans Ulrich; Isaza, Cristina T; Boll, Hanne; Schambach, Sebastian J; Nolte, Ingo S; Groden, Christoph; Brockmann, Marc A

2011-01-01

Micro-computed tomography is used frequently in preclinical in vivo research. Limiting factors are radiation dose and long scan times. The purpose of the study was to compare a standard step-and-shoot to a continuous-rotation, high-speed scanning protocol. Micro-computed tomography of a lead grid phantom and a rat femur was performed using a step-and-shoot and a continuous-rotation protocol. Detail discriminability and image quality were assessed by 3 radiologists. The signal-to-noise ratio and the modulation transfer function were calculated, and volumetric analyses of the femur were performed. The radiation dose of the scan protocols was measured using thermoluminescence dosimeters. The 40-second continuous-rotation protocol allowed a detail discriminability comparable to the step-and-shoot protocol at significantly lower radiation doses. No marked differences in volumetric or qualitative analyses were observed. Continuous-rotation micro-computed tomography significantly reduces scanning time and radiation dose without relevantly reducing image quality compared with a normal step-and-shoot protocol.

Applications of ERTS-A Data Collection System (DCS) in the Arizona Regional Ecological Test Site (ARETS)

NASA Technical Reports Server (NTRS)

Schumann, H. H. (Principal Investigator)

1972-01-01

The author has identified the following significant results. Preliminary analysis of DCS data from the USGS Verde River stream flow measuring site indicates the DCS system is furnishing high quality data more frequently than had been expected. During the 43-day period between Nov. 3, and Dec. 15, 1972, 552 DCS transmissions were received during 193 data passes. The amount of data received far exceeded the single high quality transmission per 12-hour period expected from the DCS system. The digital-parallel ERTS-1 data has furnished sufficient to accurately compute mean daily gage heights. These in turn, are used to compute average daily streamflow rates during periods of stable or slowly changing flow conditions. The digital-parallel data has also furnished useful information during peak flow periods. However, the serial-digital DCS capability, currently under development for transmitting streamflow data, should provide data of greater utility for determining times of flood peaks.

Contribution to applications of EBW in instrument techniques

NASA Astrophysics Data System (ADS)

Hrabovsky, Miroslav

1999-07-01

The electron beam welding belongs to so-called physical methods of welding and it is utilized to welding of most materials, that can be arc welded. It is of use there, where one taxing welding technics and structure technologyableless heavily. As a rule, the quality of weld is better than at most first-rate welds being done by inert gas shielded arc welding (WIG, Argoarc). In plant instrumentation, where the limitation of any welded material distortion is of extraordinary importance, this way of welding is significant at welding of thermal-treated Cu-Be alloys, used in measurement technics, structural members from Ti alloys and stainless steels in branches of biomedicine and cryotechnics. This technology positives, especially high weld purity, narrow and deep root penetration, high welding rate, together with low energy consumption, lead to applications and verification of optimum operating mode at welding of frequent materials. In the contribution the results of this proofs of selected welded materials from viewpoint of weld quality, their physical-mechanic properties and microhardness, are presented.

Variation in Protein Origin and Utilization: Research and Clinical Application.

PubMed

Paddon-Jones, Douglas; Coss-Bu, Jorge A; Morris, Claudia R; Phillips, Stuart M; Wernerman, Jan

2017-04-01

Muscle health can be rapidly compromised in clinical environments. Modifiable strategies to preserve metabolic homeostasis in adult patient populations include physical activity and pharmacologic support; however, optimizing dietary practices, or more specifically protein intake, is a necessary prerequisite for any other treatment strategy to be fully effective. Simply increasing protein intake is a well-intentioned but often unfocused strategy to protect muscle health in an intensive care setting. Protein quality is a frequently overlooked factor with the potential to differentially influence health outcomes. Quality can be assessed by a variety of techniques, with digestible indispensable amino acid score being the current and most comprehensive technique endorsed by the Food and Agriculture Organization. In practical terms, animal-based proteins are consistently scored higher in quality compared with incomplete proteins, regardless of the assessment method. Consequently, choosing parenteral and/or enteral feeding options that contain high-quality proteins, rich in the branched-chain amino acid leucine, may help establish a dietary framework with the potential to support clinical practice and improve health outcomes in critically ill patients.

Complementary Therapies and Medicines and Reproductive Medicine.

PubMed

Smith, Caroline A; Armour, Mike; Ee, Carolyn

2016-03-01

Complementary therapies and medicines are a broad and diverse range of treatments, and are frequently used by women and their partners during the preconception period to assist with infertility, and to address pregnancy-related conditions. Despite frequent use, the evidence examining the efficacy, effectiveness, and safety for many modalities is lacking, with variable study quality. In this article, we provide an overview of research evidence with the aim of examining the evidence to inform clinical practice. During the preconception period, there is mixed evidence for acupuncture to improve ovulation, or increase pregnancy rates. Acupuncture may improve sperm quality, but there is insufficient evidence to determine whether this results in improved pregnancy and live birth rates. Acupuncture can be described as a low-risk intervention. Chinese and Western herbal medicines may increase pregnancy rates; however, study quality is low. The evaluation of efficacy, effectiveness, and safety during the first trimester of pregnancy has most commonly reported on herbs, supplements, and practices such as acupuncture. There is high-quality evidence reporting the benefits of herbal medicines and acupuncture to treat nausea in pregnancy. The benefit from ginger to manage symptoms of nausea in early pregnancy is incorporated in national clinical guidelines, and vitamin B6 is recommended as a first-line treatment for nausea and vomiting in pregnancy. The safety of ginger and vitamin B6 is considered to be well established, and is based on epidemiological studies. Acupuncture has been shown to reduce back pain and improve function for women in early pregnancy. There is little evidence to support the use of cranberries in pregnancy for prevention of urinary tract infections, and chiropractic treatment for back pain. Overall the numbers of studies are small and of low quality, although the modalities appear to be low risk of harm. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effect of auricular acupressure for postpartum insomnia: an uncontrolled clinical trial.

PubMed

Ko, Yi-Li; Lin, Shih-Chi; Lin, Pi-Chu

2016-02-01

This study examined the effects of auricular acupressure therapy on women with postpartum insomnia. Postpartum women generally have poor sleep quality because of frequent night-time breastfeeding during the first month after giving birth. A one-group pretest/post-test quasi-experiment was conducted. A convenience sampling method was used to recruit participants at a postpartum centre (doing-the-month centre) in Northern Taiwan, from January 2014-July 2014. Thirty women with postpartum insomnia received auricular acupressure therapy on one auricular point (Shenmen point pressing) four times a day for 14 days. The Chinese version of the Pittsburgh Sleep Quality Index was used to assess sleep quality before and after the 14-day treatment. After the 14-day auricular acupressure treatment, the Pittsburgh Sleep Quality Index total scores of the women decreased from 8·7 (pretest) to 5·57 (post-test, 36% reduction). Scores on the subscales of the Pittsburgh Sleep Quality Index, including sleep quality, sleep latency, sleep duration and sleep disturbance, also statistically improved (p < 0·05). Hormone changes and frequent breastfeeding were identified as characteristics that may exacerbate poor sleep quality of postpartum women, for whom the auricular acupressure intervention may effectively improve sleep quality. Auricular acupressure can be an alternative complementary therapy to aid postpartum women with insomnia in improving sleep quality. © 2015 John Wiley & Sons Ltd.

Ecological engineering helps maximize function in algal oil production.

PubMed

Jackrel, Sara L; Narwani, Anita; Bentlage, Bastian; Levine, Robert B; Hietala, David C; Savage, Phillip E; Oakley, Todd H; Denef, Vincent J; Cardinale, Bradley J

2018-05-18

Algal biofuels have the potential to curb emissions of greenhouse gases from fossil fuels, but current growing methods fail to produce fuels that meet the multiple standards necessary for economical industrial use. For example, algae grown as monocultures for biofuel production have not simultaneously and economically achieved high yields of the high-quality, lipid-rich biomass desired for the industrial-scale production of bio-oil. Decades of study in the field of ecology have demonstrated that simultaneous increases in multiple functions, such as the quantity and quality of biomass, can occur in natural ecosystems by increasing biological diversity. Here we show that species consortia of algae can improve the production of bio-oil, which benefits from both high biomass yield and high quality of biomass rich in fatty acids. We explain the underlying causes of increased quantity and quality of algal biomass among species consortia by showing that, relative to monocultures, species consortia can differentially regulate lipid metabolism genes while growing to higher levels of biomass, in part due to greater utilization of nutrient resources. We identify multiple genes involved in lipid biosynthesis that are frequently upregulated in bicultures, and further show that these elevated levels of gene expression are highly predictive of the elevated levels in biculture relative to monoculture of multiple quality metrics of algal biomass. These results show that interactions between species can alter the expression of lipid metabolism genes, and further demonstrate that our understanding of diversity-function relationships from natural ecosystems can be harnessed to improve production of bio-oil. Importance section: Algal biofuels are one of the more promising forms of renewable energy. In our study, we investigate whether ecological interactions between species of microalgae regulate two important factors in cultivation - the biomass of the crop produced and quality of the biomass that is produced. We find that species interactions often improved production yields, especially the fatty acid content of the algal biomass, and that differentially expressed genes involved in fatty acid metabolism are predictive of improved quality metrics of bio-oil. Other studies have found that diversity often improves productivity and stability in agricultural and natural ecosystems. Our results provide further evidence that growing multi-species crops of microalgae may improve the production of high-quality biomass for bio-oil. Copyright © 2018 American Society for Microbiology.

Using Claims Data to Generate Clinical Flags Predicting Short-term Risk of Continued Psychiatric Hospitalizations

PubMed Central

Stein, Bradley D.; Pangilinan, Maria; Sorbero, Mark J; Marcus, Sue; Donahue, Sheila; Xu, Yan; Smith, Thomas E; Essock, Susan M

2014-01-01

Objective As health information technology advances, efforts to use administrative data to inform real-time treatment planning for individuals are increasing, despite few empirical studies demonstrating that such administrative data predict subsequent clinical events. Medicaid claims for individuals with frequent psychiatric hospitalizations were examined to test how well patterns of service use predict subsequent high short-term risk of continued psychiatric hospitalizations. Methods Medicaid claims files from New York and Pennsylvania were used to identify Medicaid recipients aged 18-64 with two or more inpatient psychiatric admissions during a target year ending March 31, 2009. Definitions from a quality-improvement initiative were used to identify patterns of inpatient and outpatient service use and prescription fills suggestive of clinical concerns. Generalized estimating equations and Markov models were applied to examine claims through March, 2011, to see what patterns of service use were sufficiently predictive of additional hospitalizations to be clinically useful. Results 11,801 unique individuals in New York and 1,859 in Pennsylvania identified met the cohort definition. In both Pennsylvania and New York, multiple recent hospitalizations, but not failure to use outpatient services or failure to fill medication prescriptions, were significant predictors of high risk of continued frequent hospitalizations, with odds ratios greater than 4.0. Conclusions Administrative data can be used to identify individuals at high risk of continued frequent hospitalizations. Such information could be used by payers and system administrators to authorize special services (e.g., mobile outreach) for such individuals as part of efforts to promote service engagement and prevent rapid rehospitalizations. PMID:25022360

Validating Emergency Department Vital Signs Using a Data Quality Engine for Data Warehouse

PubMed Central

Genes, N; Chandra, D; Ellis, S; Baumlin, K

2013-01-01

Background : Vital signs in our emergency department information system were entered into free-text fields for heart rate, respiratory rate, blood pressure, temperature and oxygen saturation. Objective : We sought to convert these text entries into a more useful form, for research and QA purposes, upon entry into a data warehouse. Methods : We derived a series of rules and assigned quality scores to the transformed values, conforming to physiologic parameters for vital signs across the age range and spectrum of illness seen in the emergency department. Results : Validating these entries revealed that 98% of free-text data had perfect quality scores, conforming to established vital sign parameters. Average vital signs varied as expected by age. Degradations in quality scores were most commonly attributed logging temperature in Fahrenheit instead of Celsius; vital signs with this error could still be transformed for use. Errors occurred more frequently during periods of high triage, though error rates did not correlate with triage volume. Conclusions : In developing a method for importing free-text vital sign data from our emergency department information system, we now have a data warehouse with a broad array of quality-checked vital signs, permitting analysis and correlation with demographics and outcomes. PMID:24403981

Validating emergency department vital signs using a data quality engine for data warehouse.

PubMed

Genes, N; Chandra, D; Ellis, S; Baumlin, K

2013-01-01

Vital signs in our emergency department information system were entered into free-text fields for heart rate, respiratory rate, blood pressure, temperature and oxygen saturation. We sought to convert these text entries into a more useful form, for research and QA purposes, upon entry into a data warehouse. We derived a series of rules and assigned quality scores to the transformed values, conforming to physiologic parameters for vital signs across the age range and spectrum of illness seen in the emergency department. Validating these entries revealed that 98% of free-text data had perfect quality scores, conforming to established vital sign parameters. Average vital signs varied as expected by age. Degradations in quality scores were most commonly attributed logging temperature in Fahrenheit instead of Celsius; vital signs with this error could still be transformed for use. Errors occurred more frequently during periods of high triage, though error rates did not correlate with triage volume. In developing a method for importing free-text vital sign data from our emergency department information system, we now have a data warehouse with a broad array of quality-checked vital signs, permitting analysis and correlation with demographics and outcomes.

The Newick utilities: high-throughput phylogenetic tree processing in the UNIX shell.

PubMed

Junier, Thomas; Zdobnov, Evgeny M

2010-07-01

We present a suite of Unix shell programs for processing any number of phylogenetic trees of any size. They perform frequently-used tree operations without requiring user interaction. They also allow tree drawing as scalable vector graphics (SVG), suitable for high-quality presentations and further editing, and as ASCII graphics for command-line inspection. As an example we include an implementation of bootscanning, a procedure for finding recombination breakpoints in viral genomes. C source code, Python bindings and executables for various platforms are available from http://cegg.unige.ch/newick_utils. The distribution includes a manual and example data. The package is distributed under the BSD License. thomas.junier@unige.ch

Contact Information for EPA's Office of Transportation and Air Quality

EPA Pesticide Factsheets

You will find an EPA employee by name or by topic of interest, also, you will know who to contact if you want to find a specific transportation and air quality document, importing a vehicle to the US, and other frequently asked questions.

Lucid dreaming incidence: A quality effects meta-analysis of 50years of research.

PubMed

Saunders, David T; Roe, Chris A; Smith, Graham; Clegg, Helen

2016-07-01

We report a quality effects meta-analysis on studies from the period 1966-2016 measuring either (a) lucid dreaming prevalence (one or more lucid dreams in a lifetime); (b) frequent lucid dreaming (one or more lucid dreams in a month) or both. A quality effects meta-analysis allows for the minimisation of the influence of study methodological quality on overall model estimates. Following sensitivity analysis, a heterogeneous lucid dreaming prevalence data set of 34 studies yielded a mean estimate of 55%, 95% C. I. [49%, 62%] for which moderator analysis showed no systematic bias for suspected sources of variability. A heterogeneous lucid dreaming frequency data set of 25 studies yielded a mean estimate of 23%, 95% C. I. [20%, 25%], moderator analysis revealed no suspected sources of variability. These findings are consistent with earlier estimates of lucid dreaming prevalence and frequent lucid dreaming in the population but are based on more robust evidence. Copyright © 2016 Elsevier Inc. All rights reserved.

California GAMA program: ground-water quality data in the San Diego drainages hydrogeologic province, California, 2004

USGS Publications Warehouse

Wright, Michael T.; Belitz, Kenneth; Burton, Carmen A.

2005-01-01

Because of concerns over ground-water quality, the California State Water Resources Control Board (SWRCB), in collaboration with the U.S. Geological Survey and Lawrence Livermore National Laboratory, has implemented the Ground-Water Ambient Monitoring and Assessment (GAMA) Program. A primary objective of the program is to provide a current assessment of ground-water quality in areas where public supply wells are an important source of drinking water. The San Diego GAMA study unit was the first region of the state where an assessment of ground-water quality was implemented under the GAMA program. The San Diego GAMA study unit covers the entire San Diego Drainages hydrogeologic province, and is broken down into four distinct hydrogeologic study areas: the Temecula Valley study area, the Warner Valley study area, the Alluvial Basins study area, and the Hard Rock study area. A total of 58 ground-water samples were collected from public supply wells in the San Diego GAMA study unit: 19 wells were sampled in the Temecula Valley study area, 9 in the Warner Valley study area, 17 in the Alluvial Basins study area, and 13 in the Hard Rock study area. Over 350 chemical and microbial constituents and water-quality indicators were analyzed for in this study. However, only select wells were measured for all constituents and water-quality indicators. Results of analyses were calculated as detection frequencies by constituent classification and by individual constituents for the entire San Diego GAMA study unit and for the individual study areas. Additionally, concentrations of constituents that are routinely monitored were compared to maximum contaminant levels (MCL) and secondary maximum contaminant levels (SMCL). Concentrations of constituents classified as 'unregulated chemicals for which monitoring is required' (UCMR) were compared to the 'detection level for the purposes of reporting' (DLR). Eighteen of the 88 volatile organic compounds (VOCs) and gasoline oxygenates analyzed for were detected in ground-water samples. Twenty-eight wells sampled in the San Diego GAMA study had at least a single detection of VOCs or gasoline oxygenates. These constituents were most frequently detected in the Alluvial Basin study area (11 of 17 wells), and least frequently detected in the Warner Valley study area (one of nine wells). Trihalomethanes (THMs) were the most frequently detected class of VOCs (18 of 58 wells). The most frequently detected VOCs were chloroform (18 of 58 wells), bromodichloromethane (8 of 58 wells), and methyl tert-butyl ether (MTBE) (7 of 58 wells). Three VOCs were detected at concentrations greater than their MCLs. Tetrachloroethylene (PCE) and trichloroethylene (TCE) were detected in one well in the Hard Rock study area at concentrations of 9.75 and 7.27 micrograms per liter (?g/L), respectively; the MCL for these compounds is 5 ?g/L. MTBE was detected in one well in the Alluvial Basins study area at a concentration of 28.3 ?g/L; the MCL for MTBE is 13 ?g/L. Twenty-one of the 122 pesticides and pesticide degradates analyzed for were detected in ground-water samples. Pesticide or pesticide degradates were detected in 33 of 58 wells sampled, and were most frequently detected in the Temecula Valley study area wells (9 of 14 wells), and least frequently in the Warner Valley study area wells (3 of 9 wells). Herbicides were the most frequently detected class of pesticides (31 of 58 wells), and simazine was the most frequently detected compound (27 of 58 wells), followed by deethylatrazine (14 of 58 wells), prometon (10 of 58 wells), and atrazine (9 of 58 wells). None of the pesticides detected in ground-water samples had concentrations that exceeded MCLs. Eight waste-water indicator compounds were detected in ground-water samples. Twenty-one of 47 wells sampled for waste-water indicator compounds had at least a single detection. Waste-water indicator compounds were detected most frequently in the Allu

Use of antenatal services and delivery care in Entebbe, Uganda: a community survey.

PubMed

Tann, Carolyn J; Kizza, Moses; Morison, Linda; Mabey, David; Muwanga, Moses; Grosskurth, Heiner; Elliott, Alison M

2007-10-11

Disparities in perinatal health care occur worldwide. If the UN Millennium Development Goals in maternal and child health are to be met, this needs to be addressed. This study was conducted to facilitate our understanding of the changing use of maternity care services in a semi-urban community in Entebbe Uganda and to examine the range of antenatal and delivery services received in health care facilities and at home. We conducted a retrospective community survey among women using structured questionnaires to describe the use of antenatal services and delivery care. In total 413 women reported on their most recent pregnancy. Antenatal care attendance was high with 96% attending once, and 69% the recommended four times. Blood pressure monitoring (95%) and tetanus vaccination (91%) were the services most frequently reported and HIV testing (47%), haematinics (58%) and presumptive treatment for malaria (66%) least frequently. Hospital clinics significantly outperformed public clinics in the quality of antenatal service. A significant improvement in the reported quality of antenatal services received was observed by year (p < 0.001). Improvement in the range and consistency of services at Entebbe Hospital over time was associated with an increase in the numbers who sought care there (p = 0.038). Although 63% delivered their newborn at a local hospital, 11% still delivered at home with no skilled assistance and just under half of these women reported financial/transportation difficulties as the primary reason. Less educated, poorer mothers were more likely to have unskilled/no assistance. Simple newborn care practices were commonly neglected. Only 35% of newborns were breastfed within the first hour and delayed wrapping of newborn infants occurred after 27% of deliveries. Although antenatal services were well utilised, the quality of services varied. Women were able and willing to travel to a facility providing a good service. Access to essential skilled birth attendants remains difficult especially for less educated, poorer women, commonly mediated by financial and transport difficulties and several simple post delivery practices were commonly neglected. These factors need to be addressed to ensure that high quality care reaches the most vulnerable women and infants.

Storm drains are sources of human fecal pollution during dry weather in three urban southern California watersheds.

PubMed

Sercu, Bram; Van De Werfhorst, Laurie C; Murray, Jill; Holden, Patricia A

2009-01-15

Coastal urbanized areas in Southern California experience frequent beach water quality warnings in summer due to high concentrations of fecal indicator bacteria (FIB). Remediation can be difficult, as sources are often unknown. During two summers, we sampled three urbanized watersheds in Santa Barbara, CA at sites with historically high FIB concentrations to determine if human fecal matter was influencing water quality. By quantification of a human-specific Bacteroides marker (HBM), human waste was evidenced throughout both transects, and concentrations were highest in the discharges of several flowing storm drains. The HBM concentrations in storm drain discharges varied by up to 5 orders of magnitude on the same day. While the exact points of entry into the storm drain systems were not definitively determined, further inspection of the drain infrastructure suggested exfiltrating sanitary sewers as possible sources. The HBM and FIB concentrations were not consistently correlated, although the exclusive occurrence of high HBM concentrations with high FIB concentrations warrants the use of FIB analyses for a first tier of sampling. The association of human fecal pollution with dry weather drainage could be a window into a larger problem for other urbanized coastal areas with Mediterranean-type climates.

Automated Quality Assessment of Structural Magnetic Resonance Brain Images Based on a Supervised Machine Learning Algorithm.

PubMed

Pizarro, Ricardo A; Cheng, Xi; Barnett, Alan; Lemaitre, Herve; Verchinski, Beth A; Goldman, Aaron L; Xiao, Ena; Luo, Qian; Berman, Karen F; Callicott, Joseph H; Weinberger, Daniel R; Mattay, Venkata S

2016-01-01

High-resolution three-dimensional magnetic resonance imaging (3D-MRI) is being increasingly used to delineate morphological changes underlying neuropsychiatric disorders. Unfortunately, artifacts frequently compromise the utility of 3D-MRI yielding irreproducible results, from both type I and type II errors. It is therefore critical to screen 3D-MRIs for artifacts before use. Currently, quality assessment involves slice-wise visual inspection of 3D-MRI volumes, a procedure that is both subjective and time consuming. Automating the quality rating of 3D-MRI could improve the efficiency and reproducibility of the procedure. The present study is one of the first efforts to apply a support vector machine (SVM) algorithm in the quality assessment of structural brain images, using global and region of interest (ROI) automated image quality features developed in-house. SVM is a supervised machine-learning algorithm that can predict the category of test datasets based on the knowledge acquired from a learning dataset. The performance (accuracy) of the automated SVM approach was assessed, by comparing the SVM-predicted quality labels to investigator-determined quality labels. The accuracy for classifying 1457 3D-MRI volumes from our database using the SVM approach is around 80%. These results are promising and illustrate the possibility of using SVM as an automated quality assessment tool for 3D-MRI.

Nonpharmacologic Interventions to Prevent Pressure Ulcers in Older Patients: An Overview of Systematic Reviews (The Software ENgine for the Assessment and optimization of drug and non-drug Therapy in Older peRsons [SENATOR] Definition of Optimal Evidence-Based Non-drug Therapies in Older People [ONTOP] Series).

PubMed

Lozano-Montoya, Isabel; Vélez-Díaz-Pallarés, Manuel; Abraha, Iosief; Cherubini, Antonio; Soiza, Roy L; O'Mahony, Denis; Montero-Errasquín, Beatriz; Correa-Pérez, Andrea; Cruz-Jentoft, Alfonso J

2016-04-01

Pressure ulcers (PUs) are frequent in older patients, and the healing process is usually challenging, therefore, prevention should be the first strategic line in PU management. Nonpharmacologic interventions may play a role in the prevention of PUs in older people, but most systematic reviews (SRs) have not addressed this specific population using convincing outcome measures. To summarize and critically appraise the evidence from SRs of the primary studies on nonpharmacologic interventions to prevent PUs in older patients. SR and meta-analysis of comparative studies. PubMed, Cochrane Database of Systematic Reviews, EMBASE, and CINHAL (from inception to October 2013) were searched. A new search for updates in the Cochrane Database was launched in July 2014. SRs that included at least 1 comparative study evaluating any nonpharmacologic intervention to prevent PUs in older patients, in any healthcare setting, were selected. Any primary study with experimental design was then identified and included. From each primary study, quality assessment was undertaken as specified by the Cochrane Collaboration and the Grading of Recommendations Assessment, Development and Evaluation working group. Interventions were identified and compared among different studies to explore the possibility of performing a meta-analysis, using the incidence of new pressure ulcers as the main outcome measure. One hundred ten SRs with 65 primary studies satisfied the inclusion criteria. The most frequent interventions explored in these trials were support surfaces (41 studies), repositioning (8), and nutrition interventions (5). High quality of evidence was not found for any intervention, mainly because of a high risk of bias and imprecision. There is moderate quality evidence to support the use of alternating pressure support mattresses over usual hospital mattresses in medical and surgical inpatients, low quality evidence to support constant low pressure devices and Australian medical sheepskin over usual mattresses, and very low quality evidence to support nutrition interventions in hospital settings. No recommendations on hydration, repositioning, standardized risk assessment, or multicomponent interventions can be done. In older patients at high risk to suffer PUs, high-technology and low- technology support surfaces can significantly reduce the incidence of PUs. Nutrition intervention may also have a role in preventing PUs in hospital settings. More evidence is needed to support other recommendations, which is specially lacking for repositioning. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

[The efficacy of intravenous lacosamide in psychiatric hospital].

PubMed

Vakula, I N; Bojko, E O; Vorona, U A; Storozhuk, J A; Nikiforova, E U; Nikiforova, D I; Glazunova, T I

2016-01-01

To evaluate the efficacy and tolerability of intravenous lacosamide (vimpat) in inpatients with frequent partial-onset seizures and affective and cognitive disorders. Fifteen patients were enrolled including 14 patients diagnosed with «organic personality disorder associated with epilepsy» (cryptogenic or symptomatic epilepsy with frequent partial-onset and/or secondary-generalized seizures (serial seizures in some cases) and 1 patient with a preliminary diagnosis of «organic schizophrenia-like disorder», which was changed for «organic personality disorder associated with epilepsy» after examination. Patients were treated with 2--3 antiepileptic drugs (AEDs), but no one of them received earlier lacosamide. Lacosamide was used intravenously in drops in the dose of 200 or 400 mg daily during 5 days. In 4 patients with marked personality disorders, the frequency of seizures decreased by 75%, no seizures were noted after 2--3 days of treatment in 11 patients. A positive effect of lacosamide on the affective sphere and quality-of-life was observed in 11 (73.4%) patients with epilepsy. Mild and moderate adverse effects were found only in 2 patients. It has been concluded that lacosamide demonstrates the high efficacy in patients with frequent drug-resistant seizures.

Variation in the Reported Management of Canine Prolapsed Nictitans Gland and Feline Herpetic Keratitis.

PubMed

White, Constance N; Jones, Gareth; Baker, Sarah; Dean, Rachel S; Brennan, Marnie L

2018-06-01

Treatment variation in medicine may be driven by evidence gaps, clinician factors, and patient preferences. Although well-documented in human medicine, variation in clinical management is relatively unexplored in veterinary practice. Clinical vignette questionnaires were administered to a cross section of general practitioners (GPs) and veterinarians with postgraduate training in ophthalmology (PGs) to survey recommended management of canine prolapsed nictitans gland ("cherry eye", PNG) and feline herpesvirus (FHV-1) keratitis. The majority of veterinarians (96.2%) suggested surgical replacement of cherry eye, with a pocketing technique being the most frequently nominated procedure. GPs were more likely to suggest gland excision in the event of surgical failure, while PGs more frequently nominated techniques incorporating a periosteal anchor for salvage repair. Most respondents managed FHV-1 keratitis with topical antibiotics (76.4%), with a minority suggesting topical antivirals (32.2%). GPs favoured topical acyclovir whilst PGs more frequently recommended topical trifluorothymidine. A significantly larger proportion of PGs nominated systemic famciclovir and lysine supplement for FHV-1 keratitis. This survey revealed moderate treatment variation for these conditions, both between and within practitioner groups. Additional research is needed to assess the reasons for this variation, particularly for conditions in which high quality evidence is scant.

The commercialization of robotic surgery: unsubstantiated marketing of gynecologic surgery by hospitals.

PubMed

Schiavone, Maria B; Kuo, Eugenia C; Naumann, R Wendel; Burke, William M; Lewin, Sharyn N; Neugut, Alfred I; Hershman, Dawn L; Herzog, Thomas J; Wright, Jason D

2012-09-01

We analyzed the content, quality, and accuracy of information provided on hospital web sites about robotic gynecologic surgery. An analysis of hospitals with more than 200 beds from a selection of states was performed. Hospital web sites were analyzed for the content and quality of data regarding robotic-assisted surgery. Among 432 hospitals, the web sites of 192 (44.4%) contained marketing for robotic gynecologic surgery. Stock images (64.1%) and text (24.0%) derived from the robot manufacturer were frequent. Although most sites reported improved perioperative outcomes, limitations of robotics including cost, complications, and operative time were discussed only 3.7%, 1.6%, and 3.7% of the time, respectively. Only 47.9% of the web sites described a comparison group. Marketing of robotic gynecologic surgery is widespread. Much of the content is not based on high-quality data, fails to present alternative procedures, and relies on stock text and images. Copyright © 2012 Mosby, Inc. All rights reserved.

Standard on microbiological management of fluids for hemodialysis and related therapies by the Japanese Society for Dialysis Therapy 2008.

PubMed

Kawanishi, Hideki; Akiba, Takashi; Masakane, Ikuto; Tomo, Tadashi; Mineshima, Michio; Kawasaki, Tadayuki; Hirakata, Hideki; Akizawa, Tadao

2009-04-01

The Committee of Scientific Academy of the Japanese Society for Dialysis Therapy (JSDT) proposes a new standard on microbiological management of fluids for hemodialysis and related therapies. This standard is within the scope of the International Organization for Standardization (ISO), which is currently under revision. This standard is to be applied to the central dialysis fluid delivery systems (CDDS), which are widely used in Japan. In this standard, microbiological qualities for dialysis water and dialysis fluids are clearly defined by endotoxin level and bacterial count. The qualities of dialysis fluids were classified into three levels: standard, ultrapure, and online prepared substitution fluid. In addition, the therapeutic application of each dialysis fluid is clarified. Since high-performance dialyzers are frequently used in Japan, the standard recommends that ultrapure dialysis fluid be used for all dialysis modalities at all dialysis facilities. It also recommends that the dialysis equipment safety management committee at each facility should validate the microbiological qualities of online prepared substitution fluid.

Biobehavioral pain profile in individuals with chronic spine pain.

PubMed

Matteliano, Deborah; Scherer, Yvonne Krall; Chang, Yu-Ping

2014-03-01

Pain in the spine is the most frequently described pain problem in primary care, afflicting at least 54 million Americans. When spinal pain becomes chronic, the prognosis for recovery is poor, often leading to disability and reduced quality of life. Clinical treatment is inadequate, often focusing on physical pathology alone. To improve treatment outcomes for chronic pain as recommended by current guidelines, the Biobehavioral Pain Profile (BPP), which includes six pain response subscales, was developed to guide cognitive behavioral therapy (CBT). The purpose of this study was to describe the BPP in 100 individuals with chronic spine pain and examine the associations between the BPP and important clinical outcomes, including chronic pain, disability, and quality of life. Participants reported a high level of pain, a low quality of life, and a high level of disability despite receiving treatment with opioids. Scores on BPP subscales including evaluating loss of control, past and current experience, physiologic responsivity, and thoughts of disease progression were elevated, indicating a need for CBT. Five of the six BPP subscales had a significant association with quality of life, chronic pain, and disability with the thought of disease progression being a strong factor for most of the clinical outcome variables. By identifying BPP, clinicians can provide appropriate treatments to improve individuals' quality of life and prevent further disability. Further study using the BPP to guide CBT is needed. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Wildfire effects on source-water quality--Lessons from Fourmile Canyon fire, Colorado, and implications for drinking-water treatment

USGS Publications Warehouse

Writer, Jeffrey H.; Murphy, Sheila F.

2012-01-01

Forested watersheds provide high-quality source water for many communities in the western United States. These watersheds are vulnerable to wildfires, and wildfire size, fire severity, and length of fire season have increased since the middle 1980s (Westerling and others, 2006). Burned watersheds are prone to increased flooding and erosion, which can impair water-supply reservoirs, water quality, and drinking-water treatment processes. Limited information exists on the degree, timing, and duration of the effects of wildfire on water quality, making it difficult for drinking-water providers to evaluate the risk and develop management options. In order to evaluate the effects of wildfire on water quality and downstream ecosystems in the Colorado Front Range, the U.S. Geological Survey initiated a study after the 2010 Fourmile Canyon fire near Boulder, Colorado. Hydrologists frequently sampled Fourmile Creek at monitoring sites upstream and downstream of the burned area to study water-quality changes during hydrologic conditions such as base flow, spring snowmelt, and summer thunderstorms. This fact sheet summarizes principal findings from the first year of research. Stream discharge and nitrate concentrations increased downstream of the burned area during snowmelt runoff, but increases were probably within the treatment capacity of most drinking-water plants, and limited changes were observed in downstream ecosystems. During and after high-intensity thunderstorms, however, turbidity, dissolved organic carbon, nitrate, and some metals increased by 1 to 4 orders of magnitude within and downstream of the burned area. Increases of such magnitude can pose problems for water-supply reservoirs, drinking-water treatment plants, and downstream aquatic ecosystems.

Impacts of savanna trees on forage quality for a large African herbivore

PubMed Central

De Kroon, Hans; Prins, Herbert H. T.

2008-01-01

Recently, cover of large trees in African savannas has rapidly declined due to elephant pressure, frequent fires and charcoal production. The reduction in large trees could have consequences for large herbivores through a change in forage quality. In Tarangire National Park, in Northern Tanzania, we studied the impact of large savanna trees on forage quality for wildebeest by collecting samples of dominant grass species in open grassland and under and around large Acacia tortilis trees. Grasses growing under trees had a much higher forage quality than grasses from the open field indicated by a more favourable leaf/stem ratio and higher protein and lower fibre concentrations. Analysing the grass leaf data with a linear programming model indicated that large savanna trees could be essential for the survival of wildebeest, the dominant herbivore in Tarangire. Due to the high fibre content and low nutrient and protein concentrations of grasses from the open field, maximum fibre intake is reached before nutrient requirements are satisfied. All requirements can only be satisfied by combining forage from open grassland with either forage from under or around tree canopies. Forage quality was also higher around dead trees than in the open field. So forage quality does not reduce immediately after trees die which explains why negative effects of reduced tree numbers probably go initially unnoticed. In conclusion our results suggest that continued destruction of large trees could affect future numbers of large herbivores in African savannas and better protection of large trees is probably necessary to sustain high animal densities in these ecosystems. PMID:18309522

[Surgical assessment of complications after thyroid gland operations].

PubMed

Dralle, H

2015-01-01

The extent, magnitude and technical equipment used for thyroid surgery has changed considerably in Germany during the last decade. The number of thyroidectomies due to benign goiter have decreased while the extent of thyroidectomy, nowadays preferentially total thyroidectomy, has increased. Due to an increased awareness of surgical complications the number of malpractice claims is increasing. In contrast to surgical databases the frequency of complications in malpractice claims reflects the individual impact of complications on the quality of life. In contrast to surgical databases unilateral and bilateral vocal fold palsy are therefore at the forefront of malpractice claims. As guidelines are often not applicable for the individual surgical expert review, the question arises which are the relevant criteria for the professional expert witness assessing the severity of the individual complication. While in surgical databases major complications after thyroidectomy, such as vocal fold palsy, hypoparathyroidism, hemorrhage and infections are equally frequent (1-3 %), in malpractice claims vocal fold palsy is significantly more frequent (50 %) compared to hypoparathyroidism (15 %), hemorrhage and infections (about 5 % each). To avoid bilateral nerve palsy intraoperative nerve monitoring has become of utmost importance for surgical strategy and malpractice suits alike. For surgical expert review documentation of individual risk-oriented indications, the surgical approach and postoperative management are highly important. Guidelines only define the treatment corridors of good clinical practice. Surgical expert reviews in malpractice suits concerning quality of care and causality between surgical management, complications and sequelae of complications are therefore highly dependent on the grounds and documentation of risk-oriented indications for thyroidectomy, intraoperative and postoperative surgical management.

Western US Tropospheric Ozone: An Assessment of Vertical and Seasonal Variations over California and Nevada

NASA Technical Reports Server (NTRS)

Yates, E.; Iraci, Laura T.; Johnson, Matthew; Ryoo, Ju-Mee; Pierce, Bradley R.; Cullis, Patrick; Gore, Warren J. Y.; Ives, Michael; Johnson, Bryan; LeBlanc, Thierry;

Recurrence risk perception and quality of life following treatment of breast cancer.

PubMed

Hawley, Sarah T; Janz, Nancy K; Griffith, Kent A; Jagsi, Reshma; Friese, Christopher R; Kurian, Allison W; Hamilton, Ann S; Ward, Kevin C; Morrow, Monica; Wallner, Lauren P; Katz, Steven J

2017-02-01

Little is known about different ways of assessing risk of distant recurrence following cancer treatment (e.g., numeric or descriptive). We sought to evaluate the association between overestimation of risk of distant recurrence of breast cancer and key patient-reported outcomes, including quality of life and worry. We surveyed a weighted random sample of newly diagnosed patients with early-stage breast cancer identified through SEER registries of Los Angeles County & Georgia (2013-14) ~2 months after surgery (N = 2578, RR = 71%). Actual 10-year risk of distant recurrence after treatment was based on clinical factors for women with DCIS & low-risk invasive cancer (Stg 1A, ER+, HER2-, Gr 1-2). Women reported perceptions of their risk numerically (0-100%), with values ≥10% for DCIS & ≥20% for invasive considered overestimates. Perceptions of "moderate, high or very high" risk were considered descriptive overestimates. In our analytic sample (N = 927), we assessed factors correlated with both types of overestimation and report multivariable associations between overestimation and QoL (PROMIS physical & mental health) and frequent worry. 30.4% of women substantially overestimated their risk of distant recurrence numerically and 14.7% descriptively. Few factors other than family history were significantly associated with either type of overestimation. Both types of overestimation were significantly associated with frequent worry, and lower QoL. Ensuring understanding of systemic recurrence risk, particularly among patients with favorable prognosis, is important. Better risk communication by clinicians may translate to better risk comprehension among patients and to improvements in QoL.

Water-quality assessment of the Kentucky River basin, Kentucky; nutrients, sediments, and pesticides in streams, 1987-90

USGS Publications Warehouse

Haag, K.H.; Porter, S.D.

1995-01-01

The U.S. Geological Survey investigated the water quality of the Kentucky River Basin in Kentucky as part of the National Water Quality Assessment program. Data collected during 1987-90 were used to describe the spatial and temporal variability of nutrients, suspended sediment, and pesticides in streams. Concentrations of phosphorus were signifi- cantly correlated with urban and agricultural land use. The high phosphorus content of Bluegrass Region soils was an important source of phosphorus in streams. At many sites in urban areas, all of the stream nitrogen load was attributable to wastewater- treatment-plant effluent. Tributary streams affected by agricultural sources of nutrients contained higher densities of phytoplankton than streams that drained forested areas. Data indicate that a consid- erable percentage of total nitrogen was transported as algal biomass during periods of low discharge. Average suspended-sediment concentrations for the study period were positively correlated with dis- charge. There was a downward trend in suspended- sediment concentrations downstream in the Kentucky River main stem during the study. Although a large amount of suspended sediment originates in the Eastern Coal Field Region, contributions of suspended sediment from the Red River and other tributary streams of the Knobs Region also are important. The most frequently detected herbicides in water samples were atrazine, 2,4-D, alachlor, metolachlor, and dicamba. Diazinon, malathion, and parathion were the most frequently detected organo- phosphate insecticides in water samples. Detectable concentrations of aldrin, chlordane, DDT, DDE, dieldrin, endrin, endosulfan, heptachlor, heptachlor epoxide, and lindane were found in streambed- sediment samples.

Associations Between Sleep Quality and Migraine Frequency

PubMed Central

Lin, Yu-Kai; Lin, Guan-Yu; Lee, Jiunn-Tay; Lee, Meei-Shyuan; Tsai, Chia-Kuang; Hsu, Yu-Wei; Lin, Yu-Zhen; Tsai, Yi-Chien; Yang, Fu-Chi

2016-01-01

Abstract Migraine has been associated with sleep disturbances. Relationship between sleep quality and migraine frequency is yet to be determined. The present study aimed to investigate sleep disturbances among low-frequency, moderate-frequency, high-frequency, and chronic migraineurs, with and without auras, with well-controlled confounding variables. This cross-sectional controlled study included 357 subjects from an outpatient headache clinic in Taiwan. Standardized questionnaires were utilized to collect demographic, migraine, sleep, depression, anxiety, and restless leg syndrome characteristics in all participants. According to frequency of migraine attacks, patients were divided into 4 groups: with 1 to 4 migraine days per month, 5 to 8 migraine days in a month, 9 to 14 migraine days in a month, and >14 migraine days per month. The Pittsburgh Sleep Quality Index (PSQI) and subgroup items were used to evaluate sleep quality. The association between migraine frequency and sleep quality was investigated using multivariable linear regression and logistic regression. The PSQI total score was highest in patients with high frequent migraine (10.0 ± 3.4) and lowest in controls (7.0 ± 3.4) with a significant trend analysis (P for trend = 0.006). Migraine frequency had an independent effect on the items “Cannot get to sleep within 30 minutes” (P < 0.001), “Wake up in the middle of the night or early morning” (P < 0.001), “Bad dreams” (P = 0.001), “Pain” (P = 0.004), and “Quality of sleep” (P < 0.001). The result showed the effect of migraine frequency in both the aura-present (P for trend = 0.008) and the aura-absent subgroups (P for trend = 0.011). High migraine frequency correlates with poor sleep quality and a higher prevalence of poor sleepers. These associations occur in migraine with aura and without aura. PMID:27124064

Nonsteroidal Anti-inflammatory Drugs for Sciatica: An Updated Cochrane Review.

PubMed

Rasmussen-Barr, Eva; Held, Ulrike; Grooten, Wilhelmus J A; Roelofs, Pepijn D D M; Koes, Bart W; van Tulder, Maurits W; Wertli, Maria M

2017-04-15

Systematic review and meta-analysis. To determine the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) on pain reduction, overall improvement, and reported adverse effects in people with sciatica. NSAIDs are one of the most frequently prescribed drugs for sciatica. We updated a 2008 Cochrane Review through June 2015. Randomized controlled trials that compared NSAIDs with placebo, with other NSAIDs, or with other medication were included. Outcomes included pain using mean difference (MD, 95% confidence intervals [95% CI]). For global improvement and adverse effects risk ratios (RR, 95% CI) were used. We assessed level of evidence using the Grades of Recommendation, Assessment, Development and Evaluation approach. Ten trials were included (N = 1651). Nine out of 10 trials were assessed at high risk of bias. For pain reduction (visual analog scale, 0 to 100) NSAIDs were no more effective than placebo (MD -4.56, 95% CI -11.11 to 1.99, quality of evidence: very low). For global improvement NSAIDs were more effective than placebo (RR 1.14 [95% CI 1.03 to 1.27], low quality of evidence). One trial reported the effect of NSAIDs on disability with very low-quality evidence that NSAIDs are no more effective than placebo. There was low-quality evidence that the risk for adverse effects is higher for NSAID than placebo (RR 1.40, 95% CI 1.02 to 1.93). Our findings show very low-quality evidence that the efficacy of NSAIDs for pain reduction is comparable with that of placebo, low-quality evidence that NSAIDs is better than placebo for global improvement and low-quality evidence for higher risk of adverse effects using NSAIDs compared with placebo. The findings must be interpreted with caution, due to small study samples, inconsistent results, and a high risk of bias in the included trials. 1.

Thirteen ways to say nothing with scientific visualization

NASA Technical Reports Server (NTRS)

Globus, AL; Raible, E.

1992-01-01

Scientific visualization can be used to produce very beautiful images. Frequently, users and others not properly initiated into mysteries of visualization research fail to appreciate the artistic qualities of these images. Scientists will frequently use our work to needlessly understand the data from which it is derived. This paper describes a number of effective techniques to confound such pernicious activity.

Using Quality Tools and Methodologies to Improve a Hospital's Quality Position.

PubMed

Branco, Daniel; Wicks, Angela M; Visich, John K

2017-01-01

The authors identify the quality tools and methodologies most frequently used by quality-positioned hospitals versus nonquality hospitals. Northeastern U.S. hospitals in both groups received a brief, 12-question survey. The authors found that 93.75% of the quality hospitals and 81.25% of the nonquality hospitals used some form of process improvement methodologies. However, there were significant differences between the groups regarding the impact of quality improvement initiatives on patients. The findings indicate that in quality hospitals the use of quality improvement initiatives had a significantly greater positive impact on patient satisfaction and patient outcomes when compared to nonquality hospitals.

Direct benefits of mate choice: a meta-analysis of plumage colour and offspring feeding rates in birds

NASA Astrophysics Data System (ADS)

Hegyi, Gergely; Kötél, Dóra; Laczi, Miklós

2015-10-01

Mate choice is generally costly to the choosy sex, so fitness benefits must counterbalance these costs. Genetic benefits of choice are widely examined and have received overall support. Direct benefits such as high quality parental care by highly ornamented individuals are widely assumed to be important but are less frequently tested, theoretically debated, and their support in the recent literature is unknown. Furthermore, in taxa where both sexes provide care, the preferential investment of the partner in relation to ornamentation may reduce own investment and modify apparent parental care quality. In a phylogenetically controlled meta-analysis, we collated correlative results from birds concerning parental plumage coloration and the nestling feeding rates of the ornament bearer and its partner. Overall evidence was weak for signalling of parental care quality and somewhat stronger for preferential partner investment. Surprisingly, the sex of the signaller and the type of plumage colour seemed to exert weak effects on the signalling of parental care quality. Finally, there was a group of cases with opposite relationships of care and ornamentation in the two parties. We found that this group arose predominately from preferential partner investment in relation to ornamentation, with concomitant, but weaker, reduction of own investment. We conclude that the effect of partner investment on parental care indication seems system-specific and needs further study.

Methodological quality evaluation of systematic reviews or meta-analyses on ERCC1 in non-small cell lung cancer: a systematic review.

PubMed

Tao, Huan; Zhang, Yueyuan; Li, Qian; Chen, Jin

2017-11-01

To assess the methodological quality of systematic reviews (SRs) or meta-analysis concerning the predictive value of ERCC1 in platinum chemotherapy of non-small cell lung cancer. We searched the PubMed, EMbase, Cochrane library, international prospective register of systematic reviews, Chinese BioMedical Literature Database, China National Knowledge Infrastructure, Wan Fang and VIP database for SRs or meta-analysis. The methodological quality of included literatures was evaluated by risk of bias in systematic review (ROBIS) scale. Nineteen eligible SRs/meta-analysis were included. The most frequently searched databases were EMbase (74%), PubMed, Medline and CNKI. Fifteen SRs did additional retrieval manually, but none of them retrieved the registration platform. 47% described the two-reviewers model in the screening for eligible original articles, and seven SRs described the two reviewers to extract data. In methodological quality assessment, inter-rater reliability Kappa was 0.87 between two reviewers. Research question were well related to all SRs in phase 1 and the eligibility criteria was suitable for each SR, and rated as 'low' risk bias. But the 'high' risk bias existed in all the SRs regarding methods used to identify and/or select studies, and data collection and study appraisal. More than two-third of SRs or meta-analysis were finished with high risk of bias in the synthesis, findings and the final phase. The study demonstrated poor methodological quality of SRs/meta-analysis assessing the predictive value of ERCC1 in chemotherapy among the NSCLC patients, especially the high performance bias. Registration or publishing the protocol is recommended in future research.

Quality assessment of pollution indicators in marine water at critical locations of the Gulf of Mannar Biosphere Reserve, Tuticorin.

PubMed

Rajendran, Viji; Nirmaladevi D, Shrinithivihahshini; Srinivasan, Balakrishnan; Rengaraj, Chithradevi; Mariyaselvam, Sheelamary

2018-01-01

The present study focused on the shoreline environment of urban and industrial areas, and the aim of this study was to assess the coastal water quality in the Gulf of Mannar Biosphere Reserve. Water samples were collected from five different coastal sites during the premonsoon and monsoon seasons. The samples were analyzed following the standard methods. The results showed that the levels of microbiological indicators in the samples highly exceeded the regional and national standard seawater permissible limits, and environmental parameters such as the total suspended solid and dissolved oxygen were affected significantly (p<0.05). To identify frequent pollution indicators, their levels should be estimated to determine possible pollution in coastal ecosystems due to human interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Philosophy as news: bioethics, journalism and public policy.

PubMed

Goodman, K W

1999-04-01

News media accounts of issues in bioethics gain significance to the extent that the media influence public policy and inform personal decision making. The increasingly frequent appearance of bioethics in the news thus imposes responsibilities on journalists and their sources. These responsibilities are identified and discussed, as is (i) the concept of "news-worthiness" as applied to bioethics, (ii) the variable quality of bioethics reportage and (iii) journalists' reliance on ethicists to pass judgment. Because of the potential social and other benefits of high quality reporting on ethical issues, it is argued that journalists and their bioethics sources should explore and accommodate more productive relationships. An optimal journalism-ethics relationship will be one characterized by "para-ethics," in which journalistic constraints are noted but also in which issues and arguments are presented without oversimplification and credible disagreement is given appropriate attention.

Relation Between Selected Water-Quality Variables, Climatic Factors, and Lake Levels in Upper Klamath and Agency Lakes, Oregon, 1990-2006

USGS Publications Warehouse

Morace, Jennifer L.

2007-01-01

Growth and decomposition of dense blooms of Aphanizomenon flos-aquae in Upper Klamath Lake frequently cause extreme water-quality conditions that have led to critical fishery concerns for the region, including the listing of two species of endemic suckers as endangered. The Bureau of Reclamation has asked the U.S. Geological Survey (USGS) to examine water-quality data collected by the Klamath Tribes for relations with lake level. This analysis evaluates a 17-year dataset (1990-2006) and updates a previous USGS analysis of a 5-year dataset (1990-94). Both univariate hypothesis testing and multivariable analyses evaluated using an information-theoretic approach revealed the same results-no one overarching factor emerged from the data. No single factor could be relegated from consideration either. The lack of statistically significant, strong correlations between water-quality conditions, lake level, and climatic factors does not necessarily show that these factors do not influence water-quality conditions; it is more likely that these conditions work in conjunction with each other to affect water quality. A few different conclusions could be drawn from the larger dataset than from the smaller dataset examined in 1996, but for the most part, the outcome was the same. Using an observational dataset that may not capture all variation in water-quality conditions (samples were collected on a two-week interval) and that has a limited range of conditions for evaluation (confined to the operation of lake) may have confounded the exploration of explanatory factors. In the end, all years experienced some variation in poor water-quality conditions, either in timing of occurrence of the poor conditions or in their duration. The dataset of 17 years simply provided 17 different patterns of lake level, cumulative degree-days, timing of the bloom onset, and poor water-quality conditions, with no overriding causal factor emerging from the variations. Water-quality conditions were evaluated for their potential to be harmful to the endangered sucker species on the basis of high-stress thresholds-water temperature values greater than 28 degrees Celsius, dissolved-oxygen concentrations less than 4 milligrams per liter, and pH values greater than 9.7. Few water temperatures were greater than 28 degrees Celsius, and dissolved-oxygen concentrations less than 4 milligrams per liter generally were recorded in mid to late summer. In contrast, high pH values were more frequent, occurring earlier in the season and parallel with growth in the algal bloom. The 10 hypotheses relating water-quality variables, lake level, and climatic factors from the earlier USGS study were tested in this analysis for the larger 1990-2006 dataset. These hypotheses proposed relations between lake level and chlorophyll-a, pH, dissolved oxygen, total phosphorus, and water temperature. As in the previous study, no evidence was found in the larger dataset for any of these relations based on a seasonal (May-October) distribution. When analyzing only the June data, the previous 5-year study did find evidence for three hypotheses relating lake level to the onset of the bloom, chlorophyll-a concentrations, and the frequency of high pH values in June. These hypotheses were not supported by the 1990-2006 dataset, but the two hypotheses related to cumulative degree-days from the previous study were: chlorophyll-a concentrations were lower and onset of the algal bloom was delayed when spring air temperatures were cooler. Other relations between water-quality variables and cumulative degree-days were not significant. In an attempt to identify interrelations among variables not detected by univariate analysis, multiple regressions were performed between lakewide measures of low dissolved-oxygen concentrations or high pH values in July and August and six physical and biological variables (peak chlorophyll-a concentrations, degree-days, water temperature, median October-May discharg

Assessment of sound quality perception in cochlear implant users during music listening.

PubMed

Roy, Alexis T; Jiradejvong, Patpong; Carver, Courtney; Limb, Charles J

2012-04-01

Although cochlear implant (CI) users frequently report deterioration of sound quality when listening to music, few methods exist to quantify these subjective claims. 1) To design a novel research method for quantifying sound quality perception in CI users during music listening; 2) To validate this method by assessing one attribute of music perception, bass frequency perception, which is hypothesized to be relevant to overall musical sound quality perception. Limitations in bass frequency perception contribute to CI-mediated sound quality deteriorations. The proposed method will quantify this deterioration by measuring CI users' impaired ability to make sound quality discriminations among musical stimuli with variable amounts of bass frequency removal. A method commonly used in the audio industry (multiple stimulus with hidden reference and anchor [MUSHRA]) was adapted for CI users, referred to as CI-MUSHRA. CI users and normal hearing controls were presented with 7 sound quality versions of a musical segment: 5 high pass filter cutoff versions (200-, 400-, 600-, 800-, 1000-Hz) with decreasing amounts of bass information, an unaltered version ("hidden reference"), and a highly altered version (1,000-1,200 Hz band pass filter; "anchor"). Participants provided sound quality ratings between 0 (very poor) and 100 (excellent) for each version; ratings reflected differences in perceived sound quality among stimuli. CI users had greater difficulty making overall sound quality discriminations as a function of bass frequency loss than normal hearing controls, as demonstrated by a significantly weaker correlation between bass frequency content and sound quality ratings. In particular, CI users could not perceive sound quality difference among stimuli missing up to 400 Hz of bass frequency information. Bass frequency impairments contribute to sound quality deteriorations during music listening for CI users. CI-MUSHRA provided a systematic and quantitative assessment of this reduced sound quality. Although the effects of bass frequency removal were studied here, we advocate CI-MUSHRA as a user-friendly and versatile research tool to measure the effects of a wide range of acoustic manipulations on sound quality perception in CI users.

Video Games, Internet and Social Networks: A Study among French School students

PubMed

Dany, Lionel; Moreau, Laure; Guillet, Clémentine; Franchina, Carmelo

2016-11-25

Aim : Screen-based media use is gradually becoming a public health issue, especially among young people.Method : A local descriptive observational study was conducted in 11 colleges of the Bouches-du-Rhône department. All middle high school students were asked to fill in a questionnaire comprising questions about their demographic characteristics, their screen-based media use (Internet, video games, social networks), any problematic use (video games and social networks), self-esteem and quality of life.Results : A total of 950 college students (mean age : 12.96 years) participated in the research. The results show a high level and a very diverse screen-based media use. Boys more frequently played video games and girls go more frequently used social networks. The levels of problematic use were relatively low for all middle high school students. The level of problematic video game use was significantly higher in boys, and the level of problematic social network use was higher in girls.Conclusion : Differences in the use of video games or social networks raise the general issue of gender differences in society. This study indicates the need for more specific preventive interventions for screen-based media use. The addictive “nature” of certain practices needs to be studied in more detail.

Total Quality Management.

ERIC Educational Resources Information Center

Focus in Change, 1992

1992-01-01

The philosophy known as Total Quality Management (TQM) is frequently presented as a way to change and improve public education. This issue of "Focus in Change" examines Deming's original 14 TQM points and their application to education. Myron Tribus lays out the core philosophy of the movement and discusses its possible application to…

Incorporating green infrastructure into water resources management plans to address water quality impairments

EPA Science Inventory

Managers of urban watersheds with excessive nutrient loads are more frequently turning to green infrastructure (GI) to manage their water quality impairments. The effectiveness of GI is dependent on a number of factors, including (1) the type and placement of GI within the waters...

Impact of Quality Management Systems on Teaching-Learning Processes

ERIC Educational Resources Information Center

Cruz, Francisco José Fernández; Gálvez, Inmaculada Egido; Santaolalla, Rafael Carballo

2016-01-01

Purpose: Quality management systems are being used more frequently in educational institutions, although their application has generated a certain amount of disagreement among education experts, who have at times questioned their suitability and usefulness for improving schools. The purpose of this paper is to contribute to this discussion by…

Southern P indices, water quality data, and modeling results: a comparison

USDA-ARS?s Scientific Manuscript database

Phosphorus (P) indices in the south frequently produce different results for similar conditions. After collecting data from benchmark sites throughout the south (6 Arkansas, 1 Georgia, 2 Mississippi, 4 North Carolina, 4 Oklahoma, and 4 Texas site/treatment water quality and land treatment data sets...

The Human Side of Quality: Employee Care and Empowerment.

ERIC Educational Resources Information Center

Thor, Linda M.

Frequently, educational institutions seeking to implement Total Quality Management (TQM) as a means to improve institutional effectiveness, overemphasize training in the application of TQM tools and fail to fully address human needs and concerns, such as the critical issue of employee empowerment. Four principal barriers exist to adequately…

The National Stream Quality Accounting Network (NASQAN) - Some questions and answers

USGS Publications Warehouse

Ficke, John F.; Hawkinson, Richard O.

1975-01-01

One of the major new efforts of the U.S. Geological Survey is the National Stream Quality Accounting Network (NASQAN). This circular is intended to answer some of the frequently asked questions concerning concepts used in establishing NASQAN, its purposes, design, value, and future plans.

Smoothing and gap-filling of high resolution multi-spectral time series: Example of Landsat data

NASA Astrophysics Data System (ADS)

Vuolo, Francesco; Ng, Wai-Tim; Atzberger, Clement

2017-05-01

This paper introduces a novel methodology for generating 15-day, smoothed and gap-filled time series of high spatial resolution data. The approach is based on templates from high quality observations to fill data gaps that are subsequently filtered. We tested our method for one large contiguous area (Bavaria, Germany) and for nine smaller test sites in different ecoregions of Europe using Landsat data. Overall, our results match the validation dataset to a high degree of accuracy with a mean absolute error (MAE) of 0.01 for visible bands, 0.03 for near-infrared and 0.02 for short-wave-infrared. Occasionally, the reconstructed time series are affected by artefacts due to undetected clouds. Less frequently, larger uncertainties occur as a result of extended periods of missing data. Reliable cloud masks are highly warranted for making full use of time series.

An approach to secure weather and climate models against hardware faults

NASA Astrophysics Data System (ADS)

Düben, Peter D.; Dawson, Andrew

2017-03-01

Enabling Earth System models to run efficiently on future supercomputers is a serious challenge for model development. Many publications study efficient parallelization to allow better scaling of performance on an increasing number of computing cores. However, one of the most alarming threats for weather and climate predictions on future high performance computing architectures is widely ignored: the presence of hardware faults that will frequently hit large applications as we approach exascale supercomputing. Changes in the structure of weather and climate models that would allow them to be resilient against hardware faults are hardly discussed in the model development community. In this paper, we present an approach to secure the dynamical core of weather and climate models against hardware faults using a backup system that stores coarse resolution copies of prognostic variables. Frequent checks of the model fields on the backup grid allow the detection of severe hardware faults, and prognostic variables that are changed by hardware faults on the model grid can be restored from the backup grid to continue model simulations with no significant delay. To justify the approach, we perform model simulations with a C-grid shallow water model in the presence of frequent hardware faults. As long as the backup system is used, simulations do not crash and a high level of model quality can be maintained. The overhead due to the backup system is reasonable and additional storage requirements are small. Runtime is increased by only 13 % for the shallow water model.

An approach to secure weather and climate models against hardware faults

NASA Astrophysics Data System (ADS)

Düben, Peter; Dawson, Andrew

2017-04-01

Enabling Earth System models to run efficiently on future supercomputers is a serious challenge for model development. Many publications study efficient parallelisation to allow better scaling of performance on an increasing number of computing cores. However, one of the most alarming threats for weather and climate predictions on future high performance computing architectures is widely ignored: the presence of hardware faults that will frequently hit large applications as we approach exascale supercomputing. Changes in the structure of weather and climate models that would allow them to be resilient against hardware faults are hardly discussed in the model development community. We present an approach to secure the dynamical core of weather and climate models against hardware faults using a backup system that stores coarse resolution copies of prognostic variables. Frequent checks of the model fields on the backup grid allow the detection of severe hardware faults, and prognostic variables that are changed by hardware faults on the model grid can be restored from the backup grid to continue model simulations with no significant delay. To justify the approach, we perform simulations with a C-grid shallow water model in the presence of frequent hardware faults. As long as the backup system is used, simulations do not crash and a high level of model quality can be maintained. The overhead due to the backup system is reasonable and additional storage requirements are small. Runtime is increased by only 13% for the shallow water model.

Management of Endurance Risk Factors: A Guide for Deep Draft Vessels

DTIC Science & Technology

2001-02-01

Poor diet (frequent fried foods, high fat and sugar content, frequent caffeine consumption) • High workload (high physical and/or mental effort...Appendix A) q 8. Poor diet (menu includes frequent fried foods, high fat and sugar content, frequent caffeine consumption; see Section II-4, and II...into glucose (or sugar ), amino acids, and fatty acids. Cells throughout the body then process these compounds to make energy or ATP

An Architecture for Continuous Data Quality Monitoring in Medical Centers.

PubMed

Endler, Gregor; Schwab, Peter K; Wahl, Andreas M; Tenschert, Johannes; Lenz, Richard

2015-01-01

In the medical domain, data quality is very important. Since requirements and data change frequently, continuous and sustainable monitoring and improvement of data quality is necessary. Working together with managers of medical centers, we developed an architecture for a data quality monitoring system. The architecture enables domain experts to adapt the system during runtime to match their specifications using a built-in rule system. It also allows arbitrarily complex analyses to be integrated into the monitoring cycle. We evaluate our architecture by matching its components to the well-known data quality methodology TDQM.

Synthetic Augmented Suture Anchor Reconstruction for a Complete Traumatic Distal Triceps Tendon Rupture in a Male Professional Bodybuilder with Postoperative Biomechanical Assessment

PubMed Central

Nikolaidou, Maria-Elissavet; Banke, Ingo J.; Laios, Thomas; Petsogiannis, Konstantinos; Mourikis, Anastasios

2014-01-01

Bodybuilding is a high-risk sport for distal triceps tendon ruptures. Management, especially in high-demanding athletes, is operative with suture anchor refixation technique being frequently used. However, the rate of rerupture is high due to underlying poor tendon quality. Thus, additional augmentation could be useful. This case report presents a reconstruction technique for a complete traumatic distal triceps tendon rupture in a bodybuilder with postoperative biomechanical assessment. A 28-year-old male professional bodybuilder was treated with a synthetic augmented suture anchor reconstruction for a complete triceps tendon rupture of his right dominant elbow. Postoperative biomechanical assessment included isokinetic elbow strength and endurance testing by using multiple angular velocities to simulate the “off-season” and “precompetition” phases of training. Eighteen months postoperatively and after full return to training, the biomechanical assessment indicated that the strength and endurance of the operated elbow joint was fully restored with even higher ratings compared to the contralateral healthy arm. The described reconstruction technique can be considered as an advisable option in high-performance athletes with underlying poor tendon quality due to high tensile strength and lack of donor site morbidity, thus enabling them to restore preinjury status and achieve safe return to sports. PMID:24711944

Process stability during fiber laser-arc hybrid welding of thick steel plates

NASA Astrophysics Data System (ADS)

Bunaziv, Ivan; Frostevarg, Jan; Akselsen, Odd M.; Kaplan, Alexander F. H.

2018-03-01

Thick steel plates are frequently used in shipbuilding, pipelines and other related heavy industries, and are usually joined by arc welding. Deep penetration laser-arc hybrid welding could increase productivity but has not been thoroughly investigated, and is therefore usually limited to applications with medium thickness (5-15 mm) sections. A major concern is process stability, especially when using modern welding consumables such as metal-cored wire and advanced welding equipment. High speed imaging allows direct observation of the process so that process behavior and phenomena can be studied. In this paper, 45 mm thick high strength steel was welded (butt joint double-sided) using the fiber laser-MAG hybrid process utilizing a metal-cored wire without pre-heating. Process stability was monitored under a wide range of welding parameters. It was found that the technique can be used successfully to weld thick sections with appropriate quality when the parameters are optimized. When comparing conventional pulsed and the more advanced cold metal transfer pulse (CMT+P) arc modes, it was found that both can provide high quality welds. CMT+P arc mode can provide more stable droplet transfer over a limited range of travel speeds. At higher travel speeds, an unstable metal transfer mechanism was observed. Comparing leading arc and trailing arc arrangements, the leading arc configuration can provide higher quality welds and more stable processing at longer inter-distances between the heat sources.

Effect of alternate day collection on semen quality of Asian elephants (Elephas maximus) with poor initial fresh semen quality.

PubMed

Imrat, P; Mahasawangkul, S; Thitaram, C; Suthanmapinanth, P; Kornkaewrat, K; Sombutputorn, P; Jansittiwate, S; Thongtip, N; Pinyopummin, A; Colenbrander, B; Holt, W V; Stout, T A E

2014-06-30

In captivity, male Asian elephants often yield poor quality semen after transrectal manually assisted semen collection; however, the reasons for the disappointing semen quality are not clear. Here we test the hypothesis that accumulation of senescent spermatozoa is a contributory factor, and that semen quality can therefore be improved by more frequent ejaculation. To this end we investigated the effect of collecting semen five times on alternate days, after a long period of sexual rest, on semen quality in Asian elephants known to deliver poor semen during infrequent single collections. All eight bulls initially displayed a high incidence of detached sperm heads and low percentages of motile (close to 0%) spermatozoa. After semen collection on alternate days, the percentages of detached sperm heads, and head and mid-piece abnormalities, were reduced significantly (p<0.05). In particular, one bull showed markedly improved sperm motility (increased from 0% to 60%) and membrane integrity (increased from 5% to 75%). In addition, advancing age significantly (p<0.01) correlated with lower percentages of sperm with intact membranes and a higher frequency of detached sperm heads. In contrast to sperm accumulation problems in other species, a small ampullary diameter correlated significantly (p<0.05) with reduced semen quality. Copyright © 2014 Elsevier B.V. All rights reserved.

Daily impaired detachment and short-term effects of impaired sleep quality on next-day commuting near-accidents - an ambulatory diary study.

PubMed

Pereira, Diana; Bucher, Sarah; Elfering, Achim

2016-08-01

This study investigated the short-term effects of daily recovery, that is, impaired psychological detachment from work and various actigraphical indicators of sleep quality, on near-accidents when commuting to work the next morning. Furthermore, the mediating effect of actigraphically assessed sleep quality on the relationship between impaired psychological detachment from work and near-accidents when commuting to work was analysed. Fifty-six full-time employees of a Swiss assurance company participated in the one-week study. Multilevel analyses revealed that impaired detachment was highly related to a decrease in sleep duration. Furthermore, impaired daily recovery processes, such as impaired psychological detachment from work and disturbed sleep quality, were related to commuting near-accidents. Impaired sleep quality mediated the effect of impaired psychological detachment from work on these near-accidents. Our results show that occupational safety interventions should address both impaired psychological detachment from work and sleep quality in order to prevent near accidents when commuting to work. Practitioner Summary: Commuting accidents occur frequently and have detrimental effects on employees, organisations and society. This study shows that daily lack of recovery, that is, impaired psychological detachment and impaired sleep quality, is related to near-accidents when commuting to work the next morning. Primary prevention of commuting accidents should therefore address daily lack of recovery.

The eye amputated - consequences of eye amputation with emphasis on clinical aspects, phantom eye syndrome and quality of life.

PubMed

Rasmussen, Marie Louise Roed

2010-12-01

In this thesis the term eye amputation (EA) covers the removing of an eye by: evisceration, enucleation and exenteration. Amputation of an eye is most frequently the end-stage in a complicated disease, or the primary treatment in trauma and neoplasm. In 2010 the literature is extensive due to knowledge about types of surgery, implants and surgical technique. However, not much is known about the time past surgery. To identify the number of EA, the causative diagnosis and the indication for surgical removal of the eye, the chosen surgical technique and to evaluate a possible change in surgical technique in Denmark from 1996 until 2003 (paper I); To describe the phantom eye syndrome and its prevalence of visual hallucinations, phantom pain and phantom sensations (paper II); To characterise the quality of phantom eye pain, including its intensity and frequency among EA patients. We attempted to identify patients with increased risk of developing pain after EA and investigated if preoperative pain is a risk factor for a later development of phantom pain (paper III); In addition we wanted to investigate the health related quality of life, perceived stress, self rated health, job separation due to illness or disability and socio-economic position of the EA in comparison with the general Danish population (paper IV). Records on 431 EA patients, clinical ophthalmological examination and an interview study of 173 EA patients and a questionnaire answered by 120 EA patients. The most frequent indications for EA in Denmark were painful blind eye (37%) and neoplasm (34%). During the study period 1996-2003, the annual number of eye amputations was stable, but an increase in bulbar eviscerations was noticed. Orbital implants were used with an increasing tendency until 2003. The Phantom eye syndrome is frequent among EA patients. Visual hallucinations were described by 42% of the patients. The content were mainly elementary visual hallucinations, with white or colored light as a continuous sharp light or as moving dots. The most frequent triggers were darkness, closing of the eyes, fatigue and psychological stress. Fifty-four percent of the patients had visual hallucinations more than once a week. Ten patients were so visually disturbed that it interfered with their daily life. Approximately 23% of all EA experience phantom pain for several years after the surgery. Phantom pain was reported to be of three different qualities: (i) cutting, penetrating, gnawing or oppressive (n=19); (ii) radiating, zapping or shooting (n=8); (iii) superficial burning or stinging (n=5); or a mixture of these different pain qualities (n=7). The median intensity on a visual analogue scale, ranging from 0 to 100, was 36 [range: 1-89]. One-third of the patients experienced phantom pain every day. Chilliness, windy weather and psychological stress/fatigue were the most commonly reported triggers for pain. Factors associated with phantom pain were: ophthalmic pain before EA, the presence of implant and a patient reported high degree of conjunctival secretion. A common reason for EA is the presence of a painful blind eye. However, one third of these patients continue to have pain after the EA. Phantom sensations were present in 2% of the patients. The impact of an eye amputation is considerable. EA patients have poorer health related quality of life, poorer self-rated health and more perceived stress than does the general population. The largest differences in health related quality of life between the EA patients and the general population were related to role limitations due to emotional problems and mental health. Patients with the indication painful blind eye are having lower scores in all aspects of health related quality of life and perceived stress than patients with the indication neoplasm and trauma. The percentage of eye amputated which is divorced or separated was twice as high as in the general population. Furthermore, 25% retired or changed to part-time jobs due to eye disease and 39.5% stopped participating in leisure activities due to their EAs. © 2010 The Author. Acta Ophthalmologica © 2010 Acta Ophthalmologica Scandinavica Foundation.

Improvement of Skills in Cardiopulmonary Resuscitation of Pediatric Residents by Recorded Video Feedbacks.

PubMed

Anantasit, Nattachai; Vaewpanich, Jarin; Kuptanon, Teeradej; Kamalaporn, Haruitai; Khositseth, Anant

2016-11-01

To evaluate the pediatric residents' cardiopulmonary resuscitation (CPR) skills, and their improvements after recorded video feedbacks. Pediatric residents from a university hospital were enrolled. The authors surveyed the level of pediatric resuscitation skill confidence by a questionnaire. Eight psychomotor skills were evaluated individually, including airway, bag-mask ventilation, pulse check, prompt starting and technique of chest compression, high quality CPR, tracheal intubation, intraosseous, and defibrillation. The mock code skills were also evaluated as a team using a high-fidelity mannequin simulator. All the participants attended a concise Pediatric Advanced Life Support (PALS) lecture, and received video-recorded feedback for one hour. They were re-evaluated 6 wk later in the same manner. Thirty-eight residents were enrolled. All the participants had a moderate to high level of confidence in their CPR skills. Over 50 % of participants had passed psychomotor skills, except the bag-mask ventilation and intraosseous skills. There was poor correlation between their confidence and passing the psychomotor skills test. After course feedback, the percentage of high quality CPR skill in the second course test was significantly improved (46 % to 92 %, p = 0.008). The pediatric resuscitation course should still remain in the pediatric resident curriculum and should be re-evaluated frequently. Video-recorded feedback on the pitfalls during individual CPR skills and mock code case scenarios could improve short-term psychomotor CPR skills and lead to higher quality CPR performance.

What attributions do Australian high-performing general practices make for their success? Applying the clinical microsystems framework: a qualitative study

PubMed Central

Dunham, Annette H; Dunbar, James A; Johnson, Julie K; Fuller, Jeff; Morgan, Mark; Ford, Dale

2018-01-01

Objectives To identify the success attributions of high-performing Australian general practices and the enablers and barriers they envisage for practices wishing to emulate them. Design Qualitative study using semi-structured interviews and content analysis of the data. Responses were recorded, transcribed verbatim and coded according to success characteristics of high-performing clinical microsystems. Setting Primary healthcare with the participating general practices representing all Australian states and territories, and representing metropolitan and rural locations. Participants Twenty-two general practices identified as high performing via a number of success criteria. The 52 participants were 19 general practitioners, 18 practice managers and 15 practice nurses. Results Participants most frequently attributed success to the interdependence of the team members, patient-focused care and leadership of the practice. They most often signalled practice leadership, team interdependence and staff focus as enablers that other organisations would need to emulate their success. They most frequently identified barriers that might be encountered in the form of potential deficits or limitations in practice leadership, staff focus and mesosystem support. Conclusions Practice leaders need to empower their teams to take action through providing inclusive leadership that facilitates team interdependence. Mesosystem support for quality improvement in general practice should focus on enabling this leadership and team building, thereby ensuring improvement efforts are converted into effective healthcare provision. PMID:29643162

Optical design and development of a fiber coupled high-power diode laser system for laser transmission welding of plastics

NASA Astrophysics Data System (ADS)

Rodríguez-Vidal, Eva; Quintana, Iban; Etxarri, Jon; Azkorbebeitia, Urko; Otaduy, Deitze; González, Francisco; Moreno, Fernando

2012-12-01

Laser transmission welding (LTW) of thermoplastics is a direct bonding technique already used in different industrial applications sectors such as automobiles, microfluidics, electronics, and biomedicine. LTW evolves localized heating at the interface of two pieces of plastic to be joined. One of the plastic pieces needs to be optically transparent to the laser radiation whereas the other part has to be absorbent, being that the radiation produced by high power diode lasers is a good alternative for this process. As consequence, a tailored laser system has been designed and developed to obtain high quality weld seams with weld widths between 0.7 and 1.4 mm. The developed laser system consists of two diode laser bars (50 W per bar) coupled into an optical fiber using a nonimaging solution: equalization of the beam parameter product (BPP) in the slow and fast axes by a pair of step-mirrors. The power scaling was carried out by means of a multiplexing polarization technique. The analysis of energy balance and beam quality was performed considering ray tracing simulation (ZEMAX) and experimental validation. The welding experiments were conducted on acrylonitrile/butadiene/styrene (ABS), a thermoplastic frequently used in automotive, electronics and aircraft applications, doped with two different concentrations of carbon nanotubes (0.01% and 0.05% CNTs). Quality of the weld seams on ABS was analyzed in terms of the process parameters (welding speed, laser power and clamping pressure) by visual and optical microscope inspections. Mechanical properties of weld seams were analyzed by mechanical shear tests. High quality weld seams were produced in ABS, revealing the potential of the laser developed in this work for a wide range of plastic welding applications.

Impact of urinary incontinence types on women's quality of life.

PubMed

Saboia, Dayana Maia; Firmiano, Mariana Luisa Veras; Bezerra, Karine de Castro; Vasconcelos, José Ananias; Oriá, Mônica Oliveira Batista; Vasconcelos, Camila Teixeira Moreira

2017-12-21

To identify the most frequent type of urinary incontinence in women assisted in two outpatient clinics of urogynecology, and to compare general and specific quality of life among the different types of incontinence measured through validated questionnaires. Cross-sectional study conducted at the urogynecology outpatient clinic. The following questionnaires were used for quality of life assessment: Medical Outcomes Study 36-item Short-Form Health Survey (SF-36), International Consultation Incontinence Questionnaire Short-Form (ICIQ-SF), King's Health Questionnaire (KHQ), and Pelvic Organ Prolapse Incontinence Sexual Questionnaire (PISQ-12). The study included 556 women. Mixed Urinary Incontinence was the most frequent type (n=348/62.6%), followed by Stress Urinary Incontinence (n=173/31.1%) and Urge Urinary Incontinence (n=35/6.3%). Women with mixed urinary incontinence had greater impact on the general (SF-36) and specific quality of life (KHQ and ICIQ-SF) compared to the others (p<0.05). In the evaluation of sexual function (PISQ-12), there was no difference between groups (p=0.28). All types of urinary incontinence interfere both in the general and specific quality of life, but women with mixed urinary incontinence are the most affected.

Nightmares affect the experience of sleep quality but not sleep architecture: an ambulatory polysomnographic study.

PubMed

Paul, Franc; Schredl, Michael; Alpers, Georg W

2015-01-01

Nightmares and bad dreams are common in people with emotional disturbances. For example, nightmares are a core symptom in posttraumatic stress disorder and about 50% of borderline personality disorder patients suffer from frequent nightmares. Independent of mental disorders, nightmares are often associated with sleep problems such as prolonged sleep latencies, poorer sleep quality, and daytime sleepiness. It has not been well documented whether this is reflected in objectively quantifiable physiological indices of sleep quality. Questionnaires regarding subjective sleep quality and ambulatory polysomnographic recordings of objective sleep parameters were collected during three consecutive nights in 17 individuals with frequent nightmares (NM) and 17 healthy control participants (HC). NM participants reported worse sleep quality, more waking problems and more severe insomnia compared to HC group. However, sleep measures obtained by ambulatory polysomnographic recordings revealed no group differences in (a) overall sleep architecture, (b) sleep cycle duration as well as REM density and REM duration in each cycle and (c) sleep architecture when only nights with nightmares were analyzed. Our findings support the observation that nightmares result in significant impairment which is independent from disturbed sleep architecture. Thus, these specific problems require specific attention and appropriate treatment.

Hypersomnia in children: interface with psychiatric disorders.

PubMed

Kotagal, Suresh

2009-10-01

Patients being evaluated in child psychiatry clinics for behavior and mood disturbances frequently exhibit daytime sleepiness. Conversely, patients being evaluated for hypersomnia by sleep specialists may have depressed mood or hyperactive and aggressive behavior. The etiology of daytime sleepiness in children and adolescents is diverse and includes inadequate sleep hygiene, obstructive sleep apnea, delayed sleep phase syndrome, idiopathic hypersomnia, periodic hypersomnia, narcolepsy, and mood disorders per se. Treatment of a sleep disorder can have a favorable impact on alertness and quality of life. A high index of suspicion for sleep problems should be maintained in children and adolescents with psychiatric disorders.

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

Barton, C.; Vowinkel, E.F.; Nawyn, J.P.

The relation of water quality to hydrogeology and land use was evaluated using analysis of water samples from 71 wells in the northern part of the Potomac-Raritan-Magothy aquifer system in New Jersey. The sampling network was evaluated for variations in hydrogeology. Well depths, pumping rates, and the number of wells in the confined and unconfined parts of the aquifer system did not differ among land-use groups. The influences of hydrogeologic factors on water quality were evaluated without considering land use. Shallow wells had the highest specific conductance and major ion concentrations. Water from wells in the unconfined part of themore » aquifer system had the highest dissolved organic carbon concentration. Dissolved oxygen and nitrate concentrations were lowest, trace metals concentrations were highest, and phenols were detected most frequently in groundwater from undeveloped land. Major ions and trace metals concentrations were lowest, dissolved oxygen and copper concentrations were highest, and pesticides were most frequently detected in groundwater from agricultural land. Nitrate concentrations were highest and orthophosphate, nitrite, and purgeable organics were detected most frequently in groundwater from urban land. These water quality data were compared to data from the same aquifer system in southern New Jersey. Frequencies of detection of purgeable organics among land-use groups were similar in the northern and southern areas. 69 refs., 23 figs., 16 tab.« less

Measuring team-based interprofessional education outcomes in clinical dentistry: psychometric evaluation of a new scale at an Australian dental school.

PubMed

Storrs, Mark J; Alexander, Heather; Sun, Jing; Kroon, Jeroen; Evans, Jane L

2015-03-01

Previous research on interprofessional education (IPE) assessment has shown the need to evaluate the influence of team-based processes on the quality of clinical education. This study aimed to develop a valid and reliable instrument to evaluate the effectiveness of interprofessional team-based treatment planning (TBTP) on the quality of clinical education at the Griffith University School of Dentistry and Oral Health, Queensland, Australia. A scale was developed and evaluated to measure interprofessional student team processes and their effect on the quality of clinical education for dental, oral health therapy, and dental technology students (known more frequently as intraprofessional education). A face validity analysis by IPE experts confirmed that items on the scale reflected the meaning of relevant concepts. After piloting, 158 students (61% response rate) involved with TBTP participated in a survey. An exploratory factor analysis using the principal component method retained 23 items with a total variance of 64.6%, suggesting high content validity. Three subscales accounted for 45.7%, 11.4%, and 7.5% of the variance. Internal consistency of the scale (α=0.943) and subscales 1 (α=0.953), 2 (α=0.897), and 3 (α=0.813) was high. A reliability analysis yielded moderate (rs=0.43) to high correlations (0.81) with the remaining scale items. Confirmatory factor analyses verified convergent validity and confirmed that this structure had a good model fit. This study suggests that the instrument might be useful in evaluating interprofessional or intraprofessional team-based processes and their influence on the quality of clinical education in academic dental institutions.

Wildlife, urban inputs, and landscape configuration are responsible for degraded swimming water quality at an embayed beach

USGS Publications Warehouse

Byappanahalli, Muruleedhara N.; Nevers, Meredith; Whitman, Richard L.; Ge, Zhongfu; Shively, Dawn A.; Spoljaric, Ashley; Przybyla-Kelly, Katarzyna

2015-01-01

Jeorse Park Beach, on southern Lake Michigan, experiences frequent closures due to high Escherichia coli (E. coli) levels since regular monitoring was implemented in 2005. During the summer of 2010, contaminant source tracking techniques, such as the conventional microbial and physical surveys and hydrodynamic models, were used to determine the reasons for poor water quality at Jeorse Park. Fecal indicator bacteria (E. coli, enterococci) were high throughout the season, with densities ranging from 12–2419 (culturable E. coli) and 1–2550 and < 1–5831 (culturable and qPCR enterococci, respectively). Genetic markers for human (Bacteroides HF183) and gull (Catellicoccus marimammalium) fecal contamination were found in 15% and 37% of the samples indicating multiple sources contributing to poor water quality. Nesting colonies of double-crested cormorants (Phalacrocorax auritus) have steadily increased since 2005, coinciding with high E. colilevels. A hydrodynamic model indicated that limited circulation allows bacteria entering the embayed area to be retained in nearshore areas; and bacterial resuspension from sand and stranded beach wrack during storm events compounds the problem. The integration of hydrodynamics, expanded use of chemical and biological markers, as well as more complex statistical multivariate techniques can improve microbial source tracking, informing management actions to improve recreational water quality. Alterations to embayed structures to improve circulation and reduce nuisance algae as well as growing native plants to retain sand to improve beach morphometry are among some of the restoration strategies under consideration in ongoing multi-agency collaborations.

Advantages and Disadvantages of Long-term Proton Pump Inhibitor Use

PubMed Central

Kinoshita, Yoshikazu; Ishimura, Norihisa; Ishihara, Shunji

2018-01-01

Proton pump inhibitors (PPIs) potently inhibit gastric acid secretion and are widely used for treatment of acid-related diseases including gastroesophageal reflux disease and secondary prevention of aspirin/NSAID-induced ulcers. Although clinically important adverse effects of PPIs can occur, just as with other drugs, those are not frequently observed during or after administration. Thus, PPIs are regarded as relatively safe and considered to be clinically beneficial. Recently, PPIs have become frequently administered to patients with functional gastrointestinal diseases or primary prevention of drug-related gastroduodenal damage, even though their beneficial effects for those conditions have not been fully confirmed. PPIs tend to be given for conditions in which the necessity of the drug has not been clarified, thus otherwise rare adverse effects are presented as clinically relevant. Although several PPI-related adverse effects have been reported, their clinical relevance is not yet clear, since the evidence reported in those studies is not at a high enough level, as the majority are based on retrospective observational studies and the reported hazard ratios are low. It is important to administer PPIs only for patients who will gain a substantial clinical benefit and to continue to investigate their adverse effects with high quality prospective studies. PMID:29605975

Increasing physical activity and exercise in lung cancer: reviewing safety, benefits, and application.

PubMed

Bade, Brett C; Thomas, D David; Scott, JoAnn B; Silvestri, Gerard A

2015-06-01

Lung cancer continues to be a difficult disease frequently diagnosed in late stages with a high mortality and symptom burden. In part because of frequent lung comorbidity, even lung cancer survivors often remain symptomatic and functionally limited. Though targeted therapy continues to increase treatment options for advanced-stage disease, symptom burden remains high with few therapeutic options. In the last several decades, exercise and physical activity have arisen as therapeutic options for obstructive lung disease and lung cancer. To date, exercise has been shown to reduce symptoms, increase exercise tolerance, improve quality of life, and potentially reduce length of stay and postoperative complications. Multiple small trials have been performed in perioperative non-small-cell lung cancer patients, although fewer studies are available for patients with advanced-stage disease. Despite the increased interest in this subject over the last few years, a validated exercise regimen has not been established for perioperative or advanced-stage disease. Clinicians underutilize exercise and pulmonary rehabilitation as a therapy, in part because of the lack of evidence-based consensus as to how and when to implement increasing physical activity. This review summarizes the existing evidence on exercise in lung cancer patients.

Advantages and Disadvantages of Long-term Proton Pump Inhibitor Use.

PubMed

Kinoshita, Yoshikazu; Ishimura, Norihisa; Ishihara, Shunji

2018-04-30

Proton pump inhibitors (PPIs) potently inhibit gastric acid secretion and are widely used for treatment of acid-related diseases including gastroesophageal reflux disease and secondary prevention of aspirin/NSAID-induced ulcers. Although clinically important adverse effects of PPIs can occur, just as with other drugs, those are not frequently observed during or after administration. Thus, PPIs are regarded as relatively safe and considered to be clinically beneficial. Recently, PPIs have become frequently administered to patients with functional gastrointestinal diseases or primary prevention of drug-related gastroduodenal damage, even though their beneficial effects for those conditions have not been fully confirmed. PPIs tend to be given for conditions in which the necessity of the drug has not been clarified, thus otherwise rare adverse effects are presented as clinically relevant. Although several PPI-related adverse effects have been reported, their clinical relevance is not yet clear, since the evidence reported in those studies is not at a high enough level, as the majority are based on retrospective observational studies and the reported hazard ratios are low. It is important to administer PPIs only for patients who will gain a substantial clinical benefit and to continue to investigate their adverse effects with high quality prospective studies.

[Retrospective evaluation of 500 endoscopic cholangiopancreatographies performed at the Instituto Nacional de la Nutrición "Salvador Zubiran"].

PubMed

Elizondo, J; Gallo, S; Valdovinos, M A; Paez, R

1989-01-01

We evaluated 500 endoscopic retrograde cholangiopancreatographies (ERCP) performed on 422 patients during a 5-year period in the Gastrointestinal Endoscopy Department, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F. ERCP combines endoscopic and radiologic techniques in order to obtain high quality opacification of pancreatic and biliary ducts. The rate of success for cannulation was 90%; desired duct opacification was possible in 89%. The most frequent indication for ERCP was to establish the differential diagnosis for jaundice; biliary stones in the common bile duct was the most frequent diagnosis, followed by normal biliary ducts. Pancreatography was normal in 74% of patients. ERCP complications were detected in 5.6%; fever and transient pain was the most common complaint in 1.6%. Mortality attributable to the procedure was 0.8%. From histological corroboration of cases by surgery or postmortem studies, diagnostic sensitivity was 92%, specificity 76%, positive predictive value 96% and a prevalence of 89%. We conclude that ERCP is highly sensitive and specific in diagnosing bilio-pancreatic-duodenal disease. Our results are comparable to other's experiences published throughout the world.

[Pulmonary hypoplasia: An analysis of cases over a 20-year period].

PubMed

Delgado-Peña, Yanny Paola; Torrent-Vernetta, Alba; Sacoto, Gabriela; de Mir-Messa, Inés; Rovira-Amigo, Sandra; Gartner, Silvia; Moreno-Galdó, Antonio; Molino-Gahete, José Andrés; Castillo-Salinas, Felíx

2016-08-01

Pulmonary hypoplasia is the most frequent congenital anomaly associated with perinatal mortality. A retrospective and descriptive review was conducted on cases of patients diagnosed with pulmonary hypoplasia between 1995 and 2014 in a tertiary university hospital. An analysis was made of the prenatal imaging, clinical manifestations, post-natal diagnostic tests, treatment and management, long-term follow up, and survival data. A total of 60 cases were identified, all of them with prenatal imaging. Sixteen patients required foetal surgery. Congenital diaphragmatic hernia was the most frequent diagnosis. Main clinical presentation was respiratory distress with severe hypoxemia and high requirements of mechanical ventilation. Mortality rate was 47% within first 60 days of life, and 75% for the first day of life. Pneumonia and recurrent bronchitis episodes were observed during follow-up. They had a lung function obstructive pattern, and their quality of life and exercise tolerance was good. High neonatal mortality and significant long-term morbidity associated with pulmonary hypoplasia requires an early diagnosis and a specialised multidisciplinary team management. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Effects on employees of controlling working hours and working schedules.

PubMed

Kubo, T; Takahashi, M; Togo, F; Liu, X; Shimazu, A; Tanaka, K; Takaya, M

2013-03-01

High levels of control over working time and low variability in working hours have been associated with improved health-related outcomes. The potential mechanisms for this association remain unclear. To examine how work-time control and variability of working times are associated with fatigue recovery, sleep quality, work-life balance, and 'near misses' at work. Manufacturing sector employees completed a questionnaire that assessed work-time control, work-time variability, fatigue recovery, sleep quality, work-life balance and the frequency of near misses in the past 6 months. Mixed model analysis of covariance and multiple logistic regression analysis tested the main effects of work-time control and variability and their interaction, while adjusting for age, sex, work schedules, and overtime work in the past month. Subscales of work-time control were also investigated (control over daily working hours and over days off). One thousand three hundred and seventy-two completed questionnaires were returned, a response rate of 69%. A significantly higher quality of sleep and better work-life balance were found in the 'high control with low variability' reference group than in the other groups. Significantly better recovery of fatigue was also observed in the group having control over days off with low variability. While near misses were more frequent in the group with high control over daily working hours coupled with high variability compared with the reference group this was not significant. High work-time control and low variability were associated with favourable outcomes of health and work-life balance. This combined effect was not observed for the safety outcome addressed here.

Impact of Sleep Quality on Cardiovascular Outcomes in Hemodialysis Patients: Results from the Frequent Hemodialysis Network Study

PubMed Central

Unruh, Mark; Tamura, Manjula Kurella; Larive, Brett; Rastogi, Anjay; James, Sam; Schiller, Brigitte; Gassman, Jennifer; Chan, Christopher; Lockridge, Robert; Kliger, Alan

2011-01-01

Background Poor sleep quality is a common, persistent, and important problem to patients with end-stage renal disease (ESRD). This report examines whether sleep quality is associated with dialysis treatment factors and other modifiable clinical factors in a large group of hemodialysis (HD) patients. Methods Cross-sectional analyses were conducted on baseline data collected from participants in the Frequent Hemodialysis Network trials. Sleep quality was measured using the Medical Outcomes Study Sleep Problems Index II (SPI II), a 9-item measure of sleep quality with higher scores reflecting poorer sleep quality. Results The participants had an age of 51.2 ± 13.6 years, 61% were male, 38% were black, and 42% had diabetes. Higher pre-dialysis serum phosphorus (per 0.5 mg/ml) (OR 0.91; 95% CI 0.85, 0.96) and depression (OR 0.16; 95% CI 0.10, 0.25) were independently associated with decrements in sleep quality. There was also a difference in time to recovery from dialysis for the fourth versus the first SPI II quartile (5.1 h; p < 0.0001). Conclusion These findings underscore the link between sleep and daytime function and suggest that improving sleep may provide an opportunity to improve outcomes in ESRD. Whether sleep problems may be improved by reduction of serum phosphorus or treatment of depression in the HD population merits further investigation. PMID:21474924

High-throughput sequence analysis of Ciona intestinalis SL trans-spliced mRNAs: alternative expression modes and gene function correlates.

PubMed

Matsumoto, Jun; Dewar, Ken; Wasserscheid, Jessica; Wiley, Graham B; Macmil, Simone L; Roe, Bruce A; Zeller, Robert W; Satou, Yutaka; Hastings, Kenneth E M

2010-05-01

Pre-mRNA 5' spliced-leader (SL) trans-splicing occurs in some metazoan groups but not in others. Genome-wide characterization of the trans-spliced mRNA subpopulation has not yet been reported for any metazoan. We carried out a high-throughput analysis of the SL trans-spliced mRNA population of the ascidian tunicate Ciona intestinalis by 454 Life Sciences (Roche) pyrosequencing of SL-PCR-amplified random-primed reverse transcripts of tailbud embryo RNA. We obtained approximately 250,000 high-quality reads corresponding to 8790 genes, approximately 58% of the Ciona total gene number. The great depth of this data revealed new aspects of trans-splicing, including the existence of a significant class of "infrequently trans-spliced" genes, accounting for approximately 28% of represented genes, that generate largely non-trans-spliced mRNAs, but also produce trans-spliced mRNAs, in part through alternative promoter use. Thus, the conventional qualitative dichotomy of trans-spliced versus non-trans-spliced genes should be supplanted by a more accurate quantitative view recognizing frequently and infrequently trans-spliced gene categories. Our data include reads representing approximately 80% of Ciona frequently trans-spliced genes. Our analysis also revealed significant use of closely spaced alternative trans-splice acceptor sites which further underscores the mechanistic similarity of cis- and trans-splicing and indicates that the prevalence of +/-3-nt alternative splicing events at tandem acceptor sites, NAGNAG, is driven by spliceosomal mechanisms, and not nonsense-mediated decay, or selection at the protein level. The breadth of gene representation data enabled us to find new correlations between trans-splicing status and gene function, namely the overrepresentation in the frequently trans-spliced gene class of genes associated with plasma/endomembrane system, Ca(2+) homeostasis, and actin cytoskeleton.

The Newick utilities: high-throughput phylogenetic tree processing in the Unix shell

PubMed Central

Junier, Thomas; Zdobnov, Evgeny M.

2010-01-01

Summary: We present a suite of Unix shell programs for processing any number of phylogenetic trees of any size. They perform frequently-used tree operations without requiring user interaction. They also allow tree drawing as scalable vector graphics (SVG), suitable for high-quality presentations and further editing, and as ASCII graphics for command-line inspection. As an example we include an implementation of bootscanning, a procedure for finding recombination breakpoints in viral genomes. Availability: C source code, Python bindings and executables for various platforms are available from http://cegg.unige.ch/newick_utils. The distribution includes a manual and example data. The package is distributed under the BSD License. Contact: thomas.junier@unige.ch PMID:20472542

Relationship of Religiousness and Religious Coping with Quality of Life among War Trauma Survivors.

PubMed

Fadilpašić, Senadin; Maleč, Daniel; Džubur-Kulenović, Alma

2017-09-01

Long-term posttraumatic outcomes such as quality of life are dependent on a series of factors from the very exposure to traumatic events and stress appraisals, personality traits, posttraumatic growth, symptoms of Posttraumatic stress disorder (PTSD) and different coping strategies to religiousness and religious coping styles. Except of exposure to traumatic events and related stress, all other variables may have indirect mediating effects on long-term posttraumatic outcomes. The main aim of this cross-sectional study is to explore relative independent contribution of these variables in the explanation of quality of life among war trauma survivors, with a special emphasis on the variables of religiousness and religious coping. The research was conducted on 353 subjects who experienced war related traumatic events during the war in Bosnia and Herzegovina (B&H). The data was collected through several self-report measuring instruments: Manchester Short Assessment of Quality of Life, Stressors Check List (SCL); Religiousness Scale, Social Support Resources Scale; Religious Problem-Solving Scale, Brief RCOPE, Posttraumatic Growth Inventory and Mississippi Scale for PTSD. According to the results of the study, experience of loss and frequent exposure to war trauma and high levels on the primary stress appraisals, self-directing coping style and PTSD-symptoms were associated with lower perceived quality of life among the subjects. High levels of extrinsic religious orientation, effect of religiousness on social behavior, positive religious coping and posttraumatic growth were associated with higher perceived quality of life among subjects. These variables showed significant independent contribution to the prediction of the values on quality of life. Results of the study have a scientific significance in understanding the importance and mediating role of religiousness and religious coping for quality of life perception as one of long-term posttraumatic outcomes. Effects of religiousness on social behavior and positive religious coping showed particularly significant contribution across all prediction models for the quality of life.

Addressing basic resource needs to improve primary care quality: a community collaboration programme.

PubMed

Berkowitz, Seth A; Hulberg, A Catherine; Hong, Clemens; Stowell, Brian J; Tirozzi, Karen J; Traore, Carine Y; Atlas, Steven J

2016-03-01

Unmet basic resource needs, such as difficulty affording healthcare, medications, food and housing, may contribute to worse healthcare quality indicators, but interventions are hampered by lack of specific knowledge regarding the distribution of unmet basic resource needs and their association with priority clinical conditions and health service use patterns. Cross-sectional study of primary care patients in two urban academic practices from 1 October 2013 to 30 April 2014. Patients were screened for unmet needs and enrolled in a programme to link them with community resources. Key measures included patient report of unmet basic resource needs, clinical conditions prioritised by quality improvement programmes (hypertension, diabetes and depression), and health service use patterns such as frequent emergency department (ED) visits (>2 in the preceding year) and frequent clinic 'no-shows' (>1 in the preceding year). 416 patients with unmet needs were included, and compared with 2750 patients who did not report needs. The most common types of needs reported were: difficulties affording healthcare (46.5%), food (40.1%) and utilities (36.3%). Patients who reported unmet needs were more likely to have depression (17.8% vs 9.5%, p<0.0001), diabetes (32.7% vs 20.4%, p<0.0001), hypertension (54.3% vs 46.3%, p=0.002), be frequent ED users (11.3% vs 5.4%, p<0.0001), and have frequent 'no-shows' to clinic (21.6% vs 11.9%, p<0.0001). Difficulty affording healthcare and food are particularly common needs among patients with priority conditions. Strategies to identify and address unmet needs as part of routine care may be an important way to improve healthcare quality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Using Formative Student Feedback: A Continuous Quality Improvement Approach for Online Course Development

ERIC Educational Resources Information Center

Bloxham, Kristy Taylor

2010-01-01

The objective of this study was to examine the use of frequent, anonymous student course surveys as a tool in supporting continuous quality improvement (CQI) principles in online instruction. The study used a qualitative, multiple-case design involving four separate online courses. Analysis methods included pattern matching/explanation building,…

Conflict Frequency and Relationship Quality across the Transition to Parenthood

ERIC Educational Resources Information Center

Kluwer, Esther S.; Johnson, Matthew D.

2007-01-01

Longitudinal data from 293 Dutch couples were used to examine the association between conflict frequency and relationship quality across the transition to parenthood, which is known as one of the most challenging events in the early stages of marriage. More frequent conflict during pregnancy was related to lower levels of relationship quality…

Guide to Selected Algorithms, Distributions, and Databases Used in Exposure Models Developed By the Office of Air Quality Planning and Standards

EPA Pesticide Factsheets

In the evaluation of emissions standards, OAQPS frequently uses one or more computer-based models to estimate the number of people who will be exposed to the air pollution levels that are expected to occur under various air quality scenarios.

A Comparison of Growth Percentile and Value-Added Models of Teacher Performance. Working Paper #39

ERIC Educational Resources Information Center

Guarino, Cassandra M.; Reckase, Mark D.; Stacy, Brian W.; Wooldridge, Jeffrey M.

2014-01-01

School districts and state departments of education frequently must choose between a variety of methods to estimating teacher quality. This paper examines under what circumstances the decision between estimators of teacher quality is important. We examine estimates derived from student growth percentile measures and estimates derived from commonly…

Techniques for Developing Health Quality of Life Scales for Point of Service Use

ERIC Educational Resources Information Center

Lee, Young-Sun; Douglas, Jeffrey; Chewning, Betty

2007-01-01

Clinical and health policy research frequently involves health status measurement using generic or disease specific instruments. These instruments are generally developed to arrive at several scales, each measuring a distinct domain of health quality of life (HQOL). Clinical settings are starting to explore how to integrate patient perspectives of…

Harvested rainwater quality before and after treatment in six ...

EPA Pesticide Factsheets

Rainwater harvesting (RWH) is an alternative method of providing water for indoor domestic use, but the water quality after treatment and distribution at individual residences is not well documented. In this study, water quality parameters were measured at the cistern and indoor cold-water taps of six residential RWH systems that use various treatment processes. Potential human pathogens (Mycobacterium avium, Mycobacterium intracellulare, Aspergillus flavus, Aspergillus fumigatus, and Aspergillus niger) were found frequently in cisterns and in treated rainwater delivered at the tap; Legionella pneumophila was not detected as frequently, but it persisted in a system after its first detection. The observed decreases in bacterial concentrations from the cistern to the tap after filtration/ ultraviolet (UV) treatment and distribution were less than expected; this suggests deficiencies in the effectiveness of the filtration/UV processes employed and/or degradation in water quality in the distribution system due to the absence of a disinfectant residual. Determination of the disinfection efficiency occuring in home treatment processes. Molecular analysis of rainwater before and after treatment. First study to include the monitoring of opportunistic fungal pathogens.

Psychological Disturbances and Quality of Life in Obese and Infertile Women and Men

PubMed Central

Kocełak, Piotr; Chudek, Jerzy; Naworska, Beata; Bąk-Sosnowska, Monika; Kotlarz, Barbara; Mazurek, Monika; Madej, Paweł; Skrzypulec-Plinta, Violetta; Skałba, Piotr; Olszanecka-Glinianowicz, Magdalena

2012-01-01

Anovulatory cycles and endometriosis are the main causes of female infertility. The most frequently anovulatory cycles are related to polycystic ovary syndrome (PCOS) commonly associated with obesity and hormonal disturbances in the course of obesity. Recently published studies revealed that infertility affects about one in six couples during their lifetime and is more frequent in obese. Obesity is also associated with male infertility related to erectile dysfunction, hormonal disturbances and lower semen quality. Any of these above mentioned disorder is the important risk factor of psychological disturbances and poor quality of life among women and men in the reproductive age. On the other hand the mood disorders may exacerbate the hormonal disturbances and worsen the effectiveness of infertility management. Infertility, its therapy with accompanying psychological disturbances may also significantly affect the partners relationships. The review summarize the results described in the current literature on the association between obesity and infertility and psychological disturbances as well as their impact on quality of life and sexual functioning in women and men. Moreover, the impact of infertility and psychological disturbances on partners relationships is discussed. PMID:22844280

Geochemical evolution processes and water-quality observations based on results of the National Water-Quality Assessment Program in the San Antonio segment of the Edwards aquifer, 1996-2006

USGS Publications Warehouse

Musgrove, MaryLynn; Fahlquist, Lynne; Houston, Natalie A.; Lindgren, Richard J.; Ging, Patricia B.

2010-01-01

As part of the National Water-Quality Assessment Program, the U.S. Geological Survey collected and analyzed groundwater samples during 1996-2006 from the San Antonio segment of the Edwards aquifer of central Texas, a productive karst aquifer developed in Cretaceous-age carbonate rocks. These National Water-Quality Assessment Program studies provide an extensive dataset of groundwater geochemistry and water quality, consisting of 249 groundwater samples collected from 136 sites (wells and springs), including (1) wells completed in the shallow, unconfined, and urbanized part of the aquifer in the vicinity of San Antonio (shallow/urban unconfined category), (2) wells completed in the unconfined (outcrop area) part of the regional aquifer (unconfined category), and (3) wells completed in and springs discharging from the confined part of the regional aquifer (confined category). This report evaluates these data to assess geochemical evolution processes, including local- and regional-scale processes controlling groundwater geochemistry, and to make water-quality observations pertaining to sources and distribution of natural constituents and anthropogenic contaminants, the relation between geochemistry and hydrologic conditions, and groundwater age tracers and travel time. Implications for monitoring water-quality trends in karst are also discussed. Geochemical and isotopic data are useful tracers of recharge, groundwater flow, fluid mixing, and water-rock interaction processes that affect water quality. Sources of dissolved constituents to Edwards aquifer groundwater include dissolution of and geochemical interaction with overlying soils and calcite and dolomite minerals that compose the aquifer. Geochemical tracers such as magnesium to calcium and strontium to calcium ratios and strontium isotope compositions are used to evaluate and constrain progressive fluid-evolution processes. Molar ratios of magnesium to calcium and strontium to calcium in groundwater typically increase along flow paths; results for samples of Edwards aquifer groundwater show an increase from shallow/urban unconfined, to unconfined, to confined groundwater categories. These differences are consistent with longer residence times and greater extents of water-rock interaction controlling fluid compositions as groundwater evolves from shallow unconfined groundwater to deeper confined groundwater. Results for stable isotopes of hydrogen and oxygen indicate specific geochemical processes affect some groundwater samples, including mixing with downdip saline water, mixing with recent recharge associated with tropical cyclonic storms, or mixing with recharge water than has undergone evaporation. The composition of surface water recharging the aquifer, as well as mixing with downdip water from the Trinity aquifer or the saline zone, also might affect water quality. A time-series record (1938-2006) of discharge at Comal Springs, one of the major aquifer discharge points, indicates an upward trend for nitrate and chloride concentrations, which likely reflects anthropogenic activities. A small number of organic contaminants were routinely or frequently detected in Edwards aquifer groundwater samples. These were the pesticides atrazine, its degradate deethylatrazine, and simazine; the drinking-water disinfection byproduct chloroform; and the solvent tetrachloroethene. Detection of these contaminants was most frequent in samples of the shallow/urban unconfined groundwater category and least frequent in samples of the unconfined groundwater category. Results indicate that the shallow/urban unconfined part of the aquifer is most affected by anthropogenic contaminants and the unconfined part of the aquifer is the least affected. The high frequency of detection for these anthropogenic contaminants aquifer-wide and in samples of deep, confined groundwater indicates that the entire aquifer is susceptible to water-quality changes as a result of anthropogenic activities. L

Poor sleep quality and insufficient sleep of a collegiate student-athlete population.

PubMed

Mah, Cheri D; Kezirian, Eric J; Marcello, Brandon M; Dement, William C

2018-06-01

Poor and inadequate sleep negatively impact cognitive and physical functioning and may also affect sports performance. The study aim is to examine sleep quality, sleep duration, and daytime sleepiness in collegiate student-athletes across a wide range of sports. Questionnaire. University setting. 628 athletes across 29 varsity teams at Stanford University. Athletes completed a questionnaire inquiring about sleep quality via a modified Pittsburgh Sleep Quality Index (PSQI), sleep duration, and daytime sleepiness via Epworth Sleepiness Scale. Sleep quality on campus and while traveling for competition was rated on a 10-point scale. Collegiate athletes were classified as poor sleepers (PSQI 5.38 ± 2.45), and 42.4% of athletes experience poor sleep quality (reporting PSQI global scores >5). Athletes reported lower sleep quality on campus than when traveling for competition (7.1 vs 7.6, P< .001). Inadequate sleep was demonstrated by 39.1% of athletes that regularly obtain <7 hours of sleep on weekdays. Fifty-one percent of athletes reported high levels of daytime sleepiness with Epworth scores ≥10. Teen student-athletes in the first and second year of college reported the highest mean levels of daytime sleepiness. Greater total sleep time was associated with daytime functioning including lower frequency of difficulty waking up for practice or class (P< .001) and lower frequency of trouble staying awake during daily activities (P< .001). Collegiate athletes frequently experience poor sleep quality, regularly obtain insufficient sleep, and commonly exhibit daytime sleepiness. Copyright © 2018 National Sleep Foundation. All rights reserved.

Self-Functionalization Behind a Solution-Processed NiOx Film Used As Hole Transporting Layer for Efficient Perovskite Solar Cells.

PubMed

Ciro, John; Ramírez, Daniel; Mejía Escobar, Mario Alejandro; Montoya, Juan Felipe; Mesa, Santiago; Betancur, Rafael; Jaramillo, Franklin

2017-04-12

Fabrication of solution-processed perovskite solar cells (PSCs) requires the deposition of high quality films from precursor inks. Frequently, buffer layers of PSCs are formed from dispersions of metal oxide nanoparticles (NPs). Therefore, the development of trustable methods for the preparation of stable colloidal NPs dispersions is crucial. In this work, a novel approach to form very compact semiconducting buffer layers with suitable optoelectronic properties is presented through a self-functionalization process of the nanocrystalline particles by their own amorphous phase and without adding any other inorganic or organic functionalization component or surfactant. Such interconnecting amorphous phase composed by residual nitrate, hydroxide, and sodium ions, proved to be fundamental to reach stable colloidal dispersions and contribute to assemble the separate crystalline nickel oxide NPs in the final film, resulting in a very homogeneous and compact layer. A proposed mechanism behind the great stabilization of the nanoparticles is exposed. At the end, the self-functionalized nickel oxide layer exhibited high optoelectronic properties enabling perovskite p-i-n solar cells as efficient as 16.6% demonstrating the pertinence of the presented strategy to obtain high quality buffer layers processed in solution at room temperature.

Personality disorder and treatment outcome in alcohol use disorder.

PubMed

Newton-Howes, Giles; Foulds, James

2018-01-01

As personality disorder impacts the outcome of most major mental disorders, it would be consistent for it to impact negatively on the outcome of alcohol use disorders (AUDs). This update is to provide an up-to-date overview of the recent literature examining the impact of personality disorder and personality traits on the treatment outcome of AUDs. Comorbidity between personality disorder and AUD is significant and approaches 50%. Patients with AUD and comorbid personality disorder are substantially less likely to remain in treatment, drink more per drinking day and drink more frequently. If retained in treatment, comorbidity does not, however, lead to poorer outcomes. Relapse to drinking is more common in patient with high novelty seeking and lower reward dependence and persistence. Reporting from most studies is of moderate-to-poor quality and a single high-quality study may alter these findings. Landmark alcohol studies are notably quiet on the impact of personality on AUD treatment outcome. Both personality disorder and higher novelty seeking impact negatively on the treatment outcome of AUD. As personality disorder is common in this group, clinicians engaged in AUD treatment should screen for personality disturbance, either disorder or high novelty seeking.

“Bad Romance”: Links between Psychological and Physical Aggression and Relationship Functioning in Adolescent Couples

PubMed Central

Seiffge-Krenke, Inge; Burk, William J.

2015-01-01

Assortative mating is an important issue in explaining antisocial, aggressive behavior. It is yet unclear, whether the similarity paradigm fully explains frequent displays of aggression in adolescents’ romantic relationships. In a sample of 194 romantic partner dyads, differences between female and male partners’ reports of aggression (psychological and physical) and different measures of relationship functioning (e.g., jealousy, conflicts, and the affiliative and romantic quality of the relationship) were assessed. A hierarchical cluster analysis identified five distinct subgroups of dyads based on male and female reports of psychological and physical aggression: nonaggressive couples, couples with higher perceived aggressiveness (both physical and psychological) by females, couples with higher aggressiveness perceived by males and mutually aggressive couples. A substantial number of non-aggressive dyads emerged. Of note was the high number of females showing one-sided aggression, which was, however, not countered by their partner. The mutually aggressive couples showed the least adaptive relationship functioning, with a lack of supportive, trusting relationship qualities, high conflict rates and high jealousy. The discussion focuses on the different functions of aggression in these early romantic relations, and the aggravating impact of mutual aggression on relationship functioning and its potential antisocial outcomes. PMID:26067515

Utilization and perceived problems of online medical resources and search tools among different groups of European physicians.

PubMed

Kritz, Marlene; Gschwandtner, Manfred; Stefanov, Veronika; Hanbury, Allan; Samwald, Matthias

2013-06-26

There is a large body of research suggesting that medical professionals have unmet information needs during their daily routines. To investigate which online resources and tools different groups of European physicians use to gather medical information and to identify barriers that prevent the successful retrieval of medical information from the Internet. A detailed Web-based questionnaire was sent out to approximately 15,000 physicians across Europe and disseminated through partner websites. 500 European physicians of different levels of academic qualification and medical specialization were included in the analysis. Self-reported frequency of use of different types of online resources, perceived importance of search tools, and perceived search barriers were measured. Comparisons were made across different levels of qualification (qualified physicians vs physicians in training, medical specialists without professorships vs medical professors) and specialization (general practitioners vs specialists). Most participants were Internet-savvy, came from Austria (43%, 190/440) and Switzerland (31%, 137/440), were above 50 years old (56%, 239/430), stated high levels of medical work experience, had regular patient contact and were employed in nonacademic health care settings (41%, 177/432). All groups reported frequent use of general search engines and cited "restricted accessibility to good quality information" as a dominant barrier to finding medical information on the Internet. Physicians in training reported the most frequent use of Wikipedia (56%, 31/55). Specialists were more likely than general practitioners to use medical research databases (68%, 185/274 vs 27%, 24/88; χ²₂=44.905, P<.001). General practitioners were more likely than specialists to report "lack of time" as a barrier towards finding information on the Internet (59%, 50/85 vs 43%, 111/260; χ²₁=7.231, P=.007) and to restrict their search by language (48%, 43/89 vs 35%, 97/278; χ²₁=5.148, P=.023). They frequently consult general health websites (36%, 31/87 vs 19%, 51/269; χ²₂=12.813, P=.002) and online physician network communities (17%, 15/86, χ²₂=9.841 vs 6%, 17/270, P<.001). The reported inaccessibility of relevant, trustworthy resources on the Internet and frequent reliance on general search engines and social media among physicians require further attention. Possible solutions may be increased governmental support for the development and popularization of user-tailored medical search tools and open access to high-quality content for physicians. The potential role of collaborative tools in providing the psychological support and affirmation normally given by medical colleagues needs further consideration. Tools that speed up quality evaluation and aid selection of relevant search results need to be identified. In order to develop an adequate search tool, a differentiated approach considering the differing needs of physician subgroups may be beneficial.

A threshold model of content knowledge transfer for socioscientific argumentation

NASA Astrophysics Data System (ADS)

Sadler, Troy D.; Fowler, Samantha R.

2006-11-01

This study explores how individuals make use of scientific content knowledge for socioscientific argumentation. More specifically, this mixed-methods study investigates how learners apply genetics content knowledge as they justify claims relative to genetic engineering. Interviews are conducted with 45 participants, representing three distinct groups: high school students with variable genetics knowledge, college nonscience majors with little genetics knowledge, and college science majors with advanced genetics knowledge. During the interviews, participants advance positions concerning three scenarios dealing with gene therapy and cloning. Arguments are assessed in terms of the number of justifications offered as well as justification quality, based on a five-point rubric. Multivariate analysis of variance results indicate that college science majors outperformed the other groups in terms of justification quality and frequency. Argumentation does not differ among nonscience majors or high school students. Follow-up qualitative analyses of interview responses suggest that all three groups tend to focus on similar, sociomoral themes as they negotiate socially complex, genetic engineering issues, but that the science majors frequently reference specific science content knowledge in the justification of their claims. Results support the Threshold Model of Content Knowledge Transfer, which proposes two knowledge thresholds around which argumentation quality can reasonably be expected to increase. Research and educational implications of these findings are discussed.

Pruritus is associated with severely impaired quality of life in patients with primary sclerosing cholangitis.

PubMed

Gotthardt, Daniel Nils; Rupp, Christian; Bruhin, Miriam; Schellberg, Dieter; Weiss, Karl H; Stefan, Reinhard; Donnerstag, Nadine; Stremmel, Wolfgang; Löwe, Bernd; Juenger, Jana; Sauer, Peter

2014-12-01

Quality of life, fundamental to the individual patient, has shown a lack of correlation with severity in research on several diseases. Thus, we aimed to identify factors associated with quality of life in patients with primary sclerosing cholangitis. The Short Form Health Survey and the Patient Health Questionnaire were used to assess quality of life and depression. Complete data sets of 113 patients were analyzed for correlation with sex, age, presence of concomitant inflammatory bowel disease and dominant stenosis, frequency of pruritus, and Mayo Risk Score. Physical functioning decreased with age (P<0.001). Further, women experienced more prominent role limitations because of physical (P<0.03) and emotional (P<0.01) problems. Although patients' quality of life and depression scores were only slightly lower than normal, more frequent pruritus was associated with a considerable reduction in quality of life in terms of physical and social functioning, general and mental health, bodily pain, vitality, and roles (because of physical problems) (P<0.01). It did not differ significantly according to the Mayo Risk Score or the presence of dominant stenoses. Depression scores were only significantly affected in patients with more frequent pruritus. Pruritus severely affects quality of life in patients with primary sclerosing cholangitis and is associated with depression to varying extents, although the most commonly used parameters of disease severity do not correspond to quality of life in these patients. These findings need to be considered with respect to treatment outcomes and indications for liver transplantation.

An Automated Treatment Plan Quality Control Tool for Intensity-Modulated Radiation Therapy Using a Voxel-Weighting Factor-Based Re-Optimization Algorithm

PubMed Central

Song, Ting; Li, Nan; Zarepisheh, Masoud; Li, Yongbao; Gautier, Quentin; Zhou, Linghong; Mell, Loren; Jiang, Steve; Cerviño, Laura

2016-01-01

Intensity-modulated radiation therapy (IMRT) currently plays an important role in radiotherapy, but its treatment plan quality can vary significantly among institutions and planners. Treatment plan quality control (QC) is a necessary component for individual clinics to ensure that patients receive treatments with high therapeutic gain ratios. The voxel-weighting factor-based plan re-optimization mechanism has been proved able to explore a larger Pareto surface (solution domain) and therefore increase the possibility of finding an optimal treatment plan. In this study, we incorporated additional modules into an in-house developed voxel weighting factor-based re-optimization algorithm, which was enhanced as a highly automated and accurate IMRT plan QC tool (TPS-QC tool). After importing an under-assessment plan, the TPS-QC tool was able to generate a QC report within 2 minutes. This QC report contains the plan quality determination as well as information supporting the determination. Finally, the IMRT plan quality can be controlled by approving quality-passed plans and replacing quality-failed plans using the TPS-QC tool. The feasibility and accuracy of the proposed TPS-QC tool were evaluated using 25 clinically approved cervical cancer patient IMRT plans and 5 manually created poor-quality IMRT plans. The results showed high consistency between the QC report quality determinations and the actual plan quality. In the 25 clinically approved cases that the TPS-QC tool identified as passed, a greater difference could be observed for dosimetric endpoints for organs at risk (OAR) than for planning target volume (PTV), implying that better dose sparing could be achieved in OAR than in PTV. In addition, the dose-volume histogram (DVH) curves of the TPS-QC tool re-optimized plans satisfied the dosimetric criteria more frequently than did the under-assessment plans. In addition, the criteria for unsatisfied dosimetric endpoints in the 5 poor-quality plans could typically be satisfied when the TPS-QC tool generated re-optimized plans without sacrificing other dosimetric endpoints. In addition to its feasibility and accuracy, the proposed TPS-QC tool is also user-friendly and easy to operate, both of which are necessary characteristics for clinical use. PMID:26930204

Impact of Providing Compassion on Job Performance and Mental Health: The Moderating Effect of Interpersonal Relationship Quality.

PubMed

Chu, Li-Chuan

2017-07-01

To examine the relationships of providing compassion at work with job performance and mental health, as well as to identify the role of interpersonal relationship quality in moderating these relationships. This study adopted a two-stage survey completed by 235 registered nurses employed by hospitals in Taiwan. All hypotheses were tested using hierarchical regression analyses. The results show that providing compassion is an effective predictor of job performance and mental health, whereas interpersonal relationship quality can moderate the relationships of providing compassion with job performance and mental health. When nurses are frequently willing to listen, understand, and help their suffering colleagues, the enhancement engendered by providing compassion can improve the provider's job performance and mental health. Creating high-quality relationships in the workplace can strengthen the positive benefits of providing compassion. Motivating employees to spontaneously exhibit compassion is crucial to an organization. Hospitals can establish value systems, belief systems, and cultural systems that support a compassionate response to suffering. In addition, nurses can internalize altruistic belief systems into their own personal value systems through a long process of socialization in the workplace. © 2017 Sigma Theta Tau International.

Implications of facultative catadromy in Anguilla anguilla. Does individual migratory behaviour influence eel spawner quality?

NASA Astrophysics Data System (ADS)

Marohn, Lasse; Jakob, Eva; Hanel, Reinhold

2013-03-01

European eel (Anguilla anguilla) recruitment is declining dramatically since the 1980s. Causes for this decline are explained by a combination of environmental changes basically affecting oceanic larval stages and a variety of anthropogenic impacts during the continental phase. Today, evidence is growing that poor silver eel quality has a major impact on reproductive success, implying that habitat quality plays a key role in stock decline. Since eels are frequently moving through a variety of different habitats during their life cycle, a better understanding of the implications of individual diadromous behaviour and habitat choice on spawner quality are crucial for management considerations for a stock recovery. The present study tested whether individual migratory behaviour and habitat choice of European eels affect spawner quality. Therefore, the migratory behaviour of 287 European eels from marine, brackish and freshwater stations in the North Sea, the Baltic Sea and from Northern German inland waters was examined by otolith strontium/calcium analysis. All individuals were classified either as freshwater residents, coastal residents, downstream shifters, upstream shifters or interhabitat shifters. As indicators for eel quality, muscle fat content, infection with the introduced swimbladder nematode Anguillicoloides crassus and body length at onset of spawning migration were assessed. Results indicate that individuals that exclusively inhabited freshwaters had significantly lower muscle fat contents and were more seriously infected with A. crassus than eels that never entered freshwaters. Since high fat contents are considered as prerequisites for a successful transoceanic spawning migration and high A. crassus loads have a negative impact on condition, this study outlines the importance of brackish waters as eel habitats in temperate latitudes. Furthermore, it questions the net benefit of stocking programs for the European eel population, since they include the translocation of eels from coastal waters into freshwaters.

An Experiment with Air Purifiers in Delhi during Winter 2015-2016

PubMed Central

Vyas, Sangita

2016-01-01

Particulate pollution has important consequences for human health, and is an issue of global concern. Outdoor air pollution has become a cause for alarm in India in particular because recent data suggest that ambient pollution levels in Indian cities are some of the highest in the world. We study the number of particles between 0.5μm and 2.5μm indoors while using affordable air purifiers in the highly polluted city of Delhi. Though substantial reductions in indoor number concentrations are observed during air purifier use, indoor air quality while using an air purifier is frequently worse than in cities with moderate pollution, and often worse than levels observed even in polluted cities. When outdoor pollution levels are higher, on average, indoor pollution levels while using an air purifier are also higher. Moreover, the ratio of indoor air quality during air purifier use to two comparison measures of air quality without an air purifier are also positively correlated with outdoor pollution levels, suggesting that as ambient air quality worsens there are diminishing returns to improvements in indoor air quality during air purifier use. The findings of this study indicate that although the most affordable air purifiers currently available are associated with significant improvements in the indoor environment, they are not a replacement for public action in regions like Delhi. Although private solutions may serve as a stopgap, reducing ambient air pollution must be a public health and policy priority in any region where air pollution is as high as Delhi’s during the winter. PMID:27978542

Dealing with Variations over Space and Time in Urban Vegetation-Air Quality Assessment

NASA Astrophysics Data System (ADS)

Tan, P. Y.

2017-12-01

Studies on role of urban vegetation ameliorate poor air quality frequently encountered in urban areas should aim to answer a pertinent question: what is the net impact of urban vegetation in improving public health directly or indirectly through removal of air pollutants? Answers to this question need to consider that role of urban vegetation in air quality improvement is not just dependent on physical and physiological processes mediated by plants, it is also highly dependent on atmospheric processes. The roles of these two components thus need to be separated. This uncertainty is further complicated by heterogeneity of air quality over spatial scales and fluctuations in air quality over time. Singapore is used to illustrate these complexities. Between seasons, the main external source of atmospheric pollutants is aerosols from biomass burning in plantations in surrounding SE Asian countries, and air quality is highly dependent on wind directions dictated by monsoon systems. When air quality does deteriorate from transboundary pollution, there are also spatial differences within the city, as air pollutant levels differ in different regions. Rainfall from monsoons and other rain-bearing weather systems over Singapore also dictate the relative amounts of wet and dry deposition and the persistence of particulate matter deposited on vegetation surfaces. For locally generated air pollutants, diurnal fluctuations of anthropogenic activities, such as vehicular emissions between peak and non-peak hours, should also lead to fluctuations over the day. Not only does air quality vary from region to region, air quality within a vertical transect in the urban canopy layer also differs due to urban morphology and urban elements. A pedestrian along a treed street may experience poorer air quality than one living on highrise building, despite proximity to vegetation. There are thus interactions between climate, weather and urban context, which lead to spatial heterogeneity over multiple scales and temporal variations in air quality. They present challenges in field studies seeking to establish causality between urban vegetation, air quality improvement and public health status. Suggestions on approaches and additional questions that need to be asked will be shared during the panel discussion.

Revealed variations of air quality in industrial development over a remote plateau of Southwest China: an application of atmospheric visibility data

NASA Astrophysics Data System (ADS)

Zhao, Tianliang; Liu, Di; Zheng, Xiaobo; Yang, Lexin; Gu, Xiaoping; Hu, Jun; Shu, Zhuozhi; Chang, Jiacheng; Wu, Xiasheng

2017-12-01

Since the 1980s, an industrial development has bloomed in China including the Yunnan-Guizhou Plateau (YGP), a remote region in Southwest China. To analyze the regional variations in air quality over YGP during the industrial development, we adopt the equivalent visibility by excluding the influence of natural factors on the observed visibility based on the meteorological data observed at 203 sites over YGP from 1980 to 2010 in this study. The YGP air quality exhibits the tremendous spatial differences in a general distribution from western good to eastern poor air quality. A similar pattern shifts seasonally in the spatial distribution with a typical seasonality of air quality over YGP between summertime low air pollution and wintertime high air pollution. The increasing and decreasing trends in visibility are mostly concentrated, respectively, in the YGP regions with high and low visibility, displaying the phenomenon of polarization in air quality change over YGP during 1980-2010. The regional mean visibility of the YGP presents a significant declining trend with change rate of -1.5 km decade-1 for air quality deterioration. The seasonal differences in visibility between summer (33.6 km) and winter (25.2 km) became obscure with the interannual change trends of visibility with stronger declines (-2.29 km decade-1) in summer and weaker decreases (-0.89 km decade-1) in winter over 1980-2010, which lead to a indistinct seasonality of air quality change over YGP. The remote YGP had experienced more frequent haze pollution, especially in the eastern plateau over 31 years. In accompany of increasing energy consumption in the industrial development, population growth is an important factor influencing the interannual change of YGP air quality. The distinct spatial distribution in the YGP terrain exerts an impact on poor air quality in lower flatlands harbored by mountainous topography with good air quality. Declined monsoon winds could meteorologically drive the air quality change with less regional transport of air pollutant over YGP during 1980-2010. Implications of the climate change for atmospheric environment will be having potential utility for sustainable development in China.

The characteristics of patients frequently admitted to academic medical centers in the United States

PubMed Central

Williams, Mark V.; Carrier, Danielle; Hensley, Laurie; Thomas, Stephen; Cerese, Julie

2015-01-01

BACKGROUND The recent intense attention to hospital readmissions and their implications for quality, safety, and reimbursement necessitates understanding specific subsets of readmitted patients. Frequently admitted patients, defined as patients who are admitted 5 or more times within 1 year, may have some distinguishing characteristics that require novel solutions. METHODS A comprehensive administrative database (University HealthSystem Consortium's Clinical Data Base/Resource Manager™) was analyzed to identify demographic, social, and clinical characteristics of frequently admitted patients in 101 US academic medical centers. RESULTS We studied 28,291 frequently admitted patients with 180,185 admissions over a 1‐year period (2011–2012). These patients comprise 1.6% of all patients, but account for 8% of all admissions and 7% of direct costs. Their admissions are driven by multiple chronic conditions; compared to other hospitalized patients, they have significantly more comorbidities (an average of 7.1 vs 2.5), and 84% of their admissions are to medical services. A minority, but significantly more than other patients, have comorbidities of psychosis or substance abuse. Moreover, although they are slightly more likely than other patients to be on Medicaid or to be uninsured (27.6% vs 21.6%), nearly three‐quarters have private or Medicare coverage. CONCLUSIONS Patients who are frequently admitted to US academic medical centers are likely to have multiple complex chronic conditions and may have behavioral comorbidities that mediate their health behaviors, resulting in acute episodes requiring hospitalization. This information can be used to identify solutions for preventing repeat hospitalization for this small group of patients who consume a highly disproportionate share of healthcare resources. Journal of Hospital Medicine 2015;10:563–568. © 2015 The Authors Journal of Hospital Medicine published by Wiley Periodicals, Inc. on behalf of Society of Hospital Medicine PMID:26018340

Emergency Department Frequent Utilization for Non-Emergent Presentments: Results from a Regional Urban Trauma Center Study.

PubMed

Behr, Joshua G; Diaz, Rafael

2016-01-01

First, to test a model of the drivers of frequent emergency department utilization conceptualized as falling within predisposing, enabling, and need dimensions. Second, to extend the model to include social networks and service quality as predictors of frequent utilization. Third, to illustrate the variation in thresholds that define frequent utilization in terms of the number of emergency department encounters by the predictors within the model. Primary data collection over an eight week period within a level-1 trauma urban hospital's emergency department. Representative randomized sample of 1,443 adult patients triaged ESI levels 4-5. Physicians and research staff interviewed patients as they received services. Relationships with the outcome variable, utilization, were tested using logistic regression to establish odds-ratios. 70.6 percent of patients have two or more, 48.3 percent have three or more, 25.3 percent have four or more, and 14.9 percent have five or more emergency department visits within 12 months. Factors associated with frequent utilization include gender, race, poor mental health, mental health drugs, prescription drug abuse, social networks, employment, perceptions of service quality, seriousness of condition, persistence of condition, and previous hospital admittance. Interventions targeting associated factors will change global emergency department encounters, although the mutability varies. Policy interventions to address predisposing factors such as substance abuse or access to mental health treatment as well as interventions that speak to enabling factors such as promoting the resiliency of social networks may result in decreased frequency of emergency department utilization.

Nicotine dependence and sleep quality in young adults.

PubMed

Dugas, E N; Sylvestre, M P; O'Loughlin, E K; Brunet, J; Kakinami, L; Constantin, E; O'Loughlin, J

2017-02-01

More cigarette smokers report poor sleep quality than non-smokers, but the association between nicotine dependence (ND) and sleep quality has not been well-characterized. The objective of this study was to describe the associations among frequency and intensity of cigarette smoking, ND symptoms, and sleep quality in young adults. Data on past-year smoking frequency, number of cigarettes smoked in the past month, five ND indicators (i.e., withdrawal, craving, self-medication symptoms, mFTQ, ICD-10 criteria for tobacco dependence), and sleep quality (measured with the Pittsburgh Sleep Quality Index (PSQI)) were collected in 2011-12 in self-report questionnaires completed by 405 young adult smokers (mean age 24 (0.6) years; 45% male; 45% daily smokers) participating in a longitudinal investigation of the natural course of ND. Associations between indicators of cigarette smoking, ND symptoms, and sleep quality were examined in multivariable logistic regression analyses controlling for age, sex, mother's education, and alcohol use. Thirty-six percent of participants reported poor sleep quality (PSQI>5). Higher cigarette consumption (OR(95% CI), 1.03(1.001-1.05)) but not frequency of past-year smoking, more frequent withdrawal symptoms (1.05(1.004-1.10)), more frequent cravings (1.05(1.004-1.10)), higher mFTQ scores (1.14(1.02-1.27)), and endorsing more ICD-10 criteria for tobacco dependence (1.19(1.04-1.36)) were also associated with poor sleep quality. Cigarette smoking and ND symptoms are associated with poor sleep quality in young adult smokers. Advice from practitioners to cut back on number of cigarettes smoked per day and treatment of ND symptoms may improve sleep quality in young adult smokers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Food patterns and dietary quality associated with organic food consumption during pregnancy; data from a large cohort of pregnant women in Norway

PubMed Central

2012-01-01

Background Little is known about the consumption of organic food during pregnancy. The aim of this study was to describe dietary characteristics associated with frequent consumption of organic food among pregnant women participating in the Norwegian Mother and Child Cohort Study (MoBa). Methods The present study includes 63 808 women who during the years 2002–2007 answered two questionnaires, a general health questionnaire at gestational weeks 15 and a food frequency questionnaire at weeks 17-22. The exploration of food patterns by Principal component analyses (PCA) was followed by ANOVA analyses investigating how these food patterns as well as intake of selected food groups were associated with consumption of organic food. Results The first principal component (PC1) identified by PCA, accounting for 12% of the variation, was interpreted as a ‘health and sustainability component’, with high positive loadings for vegetables, fruit and berries, cooking oil, whole grain bread and cereal products and negative loadings for meat, including processed meat, white bread, and cakes and sweets. Frequent consumption of organic food, which was reported among 9.1% of participants (n = 5786), was associated with increased scores on the ‘health and sustainability component’ (p < 0.001). The increase in score represented approximately 1/10 of the total variation and was independent of sociodemographic and lifestyle characteristics. Participants with frequent consumption of organic food had a diet with higher density of fiber and most nutrients such as folate, beta-carotene and vitamin C, and lower density of sodium compared to participants with no or low organic consumption. Conclusion The present study showed that pregnant Norwegian women reporting frequent consumption of organically produced food had dietary pattern and quality more in line with public advice for healthy and sustainable diets. A methodological implication is that the overall diet needs to be included in future studies of potential health outcomes related to consumption of organic food during pregnancy. PMID:22862737

Analysis of ingredient lists of commercially available gluten-free and gluten-containing food products using the text mining technique.

PubMed

do Nascimento, Amanda Bagolin; Fiates, Giovanna Medeiros Rataichesck; Dos Anjos, Adilson; Teixeira, Evanilda

2013-03-01

Ingredients mentioned on the labels of commercially available packaged gluten-free and similar gluten-containing food products were analyzed and compared, using the text mining technique. A total of 324 products' labels were analyzed for content (162 from gluten-free products), and ingredient diversity in gluten-free products was 28% lower. Raw materials used as ingredients of gluten-free products were limited to five varieties: rice, cassava, corn, soy, and potato. Sugar was the most frequently mentioned ingredient on both types of products' labels. Salt and sodium also were among these ingredients. Presence of hydrocolloids, enzymes or raw materials of high nutritional content such as pseudocereals, suggested by academic studies as alternatives to improve nutritional and sensorial quality of gluten-free food products, was not identified in the present study. Nutritional quality of gluten-free diets and health of celiac patients may be compromised.

Co-Morbidity, Mortality, Quality of Life and the Healthcare/Welfare/Social Costs of Disordered Sleep: A Rapid Review

PubMed Central

Garbarino, Sergio; Lanteri, Paola; Durando, Paolo; Magnavita, Nicola; Sannita, Walter G.

2016-01-01

Sleep disorders are frequent (18%–23%) and constitute a major risk factor for psychiatric, cardiovascular, metabolic or hormonal co-morbidity and mortality. Low social status or income, unemployment, life events such as divorce, negative lifestyle habits, and professional requirements (e.g., shift work) are often associated with sleep problems. Sleep disorders affect the quality of life and impair both professional and non-professional activities. Excessive daytime drowsiness resulting from sleep disorders impairs efficiency and safety at work or on the road, and increases the risk of accidents. Poor sleep (either professional or voluntary) has detrimental effects comparable to those of major sleep disorders, but is often neglected. The high incidence and direct/indirect healthcare and welfare costs of sleep disorders and poor sleep currently constitute a major medical problem. Investigation, monitoring and strategies are needed in order to prevent/reduce the effects of these disorders. PMID:27548196

A matter of motion or an emotional matter? Management of depression in Parkinson's disease.

PubMed

Lagopoulos, Jim; Malhi, Gin S; Ivanovski, Belinda; Cahill, Catherine M; Morris, John G L

2005-11-01

Depression is one of the most frequent comorbidities occurring in Parkinson's disease, affecting up to 50% of patients. Depression is associated with severe negative symptoms and has been shown to contribute to an increased rate of decline of both cognitive and motor function, profoundly impacting on the patient's quality of life. The symptoms of depression overlap with the motor features of Parkinson's disease, making detection difficult. Moreover, the lack of specialized screening tools means that depression remains undiagnosed and untreated in a high percentage of patients. However, depression in Parkinson's disease, when identified early, can be effectively treated with a variety of antidepressant medications, improving quality of life and preserving daily function. The focus of this review is to provide an overview of current knowledge regarding depression in Parkinson's disease, followed by a practical discussion addressing the issues of the detection, diagnosis and treatment.

Dietary choice behavior in Caenorhabditis elegans

PubMed Central

Shtonda, Boris Borisovich; Avery, Leon

2005-01-01

Animals have evolved diverse behaviors that serve the purpose of finding food in the environment. We investigated the food seeking strategy of the soil bacteria-eating nematode Caenorhabditis elegans. C. elegans bacterial food varies in quality: some species are easy to eat and support worm growth well, while others do not. We show that worms exhibit dietary choice: they hunt for high quality food and leave hard-to-eat bacteria. This food seeking behavior is enhanced in animals that have already experienced good food. When hunting for good food, worms alternate between two modes of locomotion, known as dwelling: movement with frequent stops and reversals; and roaming: straight rapid movement. On good food, roaming is very rare, while on bad food it is common. Using laser ablations and mutant analysis, we show that the AIY neurons serve to extend roaming periods, and are essential for efficient food seeking. PMID:16354781

Co-Morbidity, Mortality, Quality of Life and the Healthcare/Welfare/Social Costs of Disordered Sleep: A Rapid Review.

PubMed

Garbarino, Sergio; Lanteri, Paola; Durando, Paolo; Magnavita, Nicola; Sannita, Walter G

2016-08-18

Sleep disorders are frequent (18%-23%) and constitute a major risk factor for psychiatric, cardiovascular, metabolic or hormonal co-morbidity and mortality. Low social status or income, unemployment, life events such as divorce, negative lifestyle habits, and professional requirements (e.g., shift work) are often associated with sleep problems. Sleep disorders affect the quality of life and impair both professional and non-professional activities. Excessive daytime drowsiness resulting from sleep disorders impairs efficiency and safety at work or on the road, and increases the risk of accidents. Poor sleep (either professional or voluntary) has detrimental effects comparable to those of major sleep disorders, but is often neglected. The high incidence and direct/indirect healthcare and welfare costs of sleep disorders and poor sleep currently constitute a major medical problem. Investigation, monitoring and strategies are needed in order to prevent/reduce the effects of these disorders.

Chemical vapor deposition of high T(sub c) superconducting films in a microgravity environment

NASA Technical Reports Server (NTRS)

Levy, Moises; Sarma, Bimal K.

1994-01-01

Since the discovery of the YBaCuO bulk materials in 1987, Metalorganic Chemical Vapor Deposition (MOCVD) has been proposed for preparing HTSC high T(sub c) films. This technique is now capable of producing high-T(sub c) superconducting thin films comparable in quality to those prepared by any other methods. The MOCVD technique has demonstrated its superior advantage in making large area high quality HTSC thin films and will play a major role in the advance of device applications of HTSC thin films. The organometallic precursors used in the MOCVD preparation of HTSC oxide thin films are most frequently metal beta-diketonates. High T(sub c) superconductors are multi-component oxides which require more than one component source, with each source, containing one kind of precursor. Because the volatility and stability of the precursors are strongly dependent on temperature, system pressure, and carrier gas flow rate, it has been difficult to control the gas phase composition, and hence film stoichiometry. In order circumvent these problems we have built and tested a single source MOCVD reactor in which a specially designed vaporizer was employed. This vaporizer can be used to volatilize a stoichiometric mixture of diketonates of yttrium, barium and copper to produce a mixed vapor in a 1:2:3 ratio respectively of the organometellics. This is accomplished even though the three compounds have significantly different volatilities. We have developed a model which provides insight into the process of vaporizing mixed precursors to produce high quality thin films of Y1Ba2Cu3O7. It shows that under steady state conditions the mixed organometallic vapor must have a stoichiometric ratio of the individual organometallics identical to that in the solid mixture.

The role of transboundary air pollution over Galicia and North Portugal area.

PubMed

Borrego, C; Souto, J A; Monteiro, A; Dios, M; Rodríguez, A; Ferreira, J; Saavedra, S; Casares, J J; Miranda, A I

2013-05-01

In summer, high levels of ozone (O3) are frequently measured at both Galicia and Northern Portugal air quality monitoring stations, even exceeding the limit values imposed by legislation. This work aims to investigate the origin of these high O3 concentrations by the application of a chemical transport modelling system over the northwestern area of the Iberian Peninsula. The WRF-CHIMERE modelling system was applied with high resolution to simulate the selected air pollution episodes that occurred simultaneously in Galicia and North Portugal and in order to study both the contribution of local emission sources and the influence of transboundary pollution. Emission inputs have been prepared based on the development of the Portuguese and Galician emission inventories. The obtained results for O3 have been evaluated and validated against observations. Modelling results show possible contribution of the transboundary transport over the border of two neighbour regions/countries, indicating that the O3 episode starts over the urban and industrialised area of North coast of Portugal, reaching the maximum peaks over this region; at the same time, O3 levels increased over Galicia region, where lower concentrations, but still high, were observed. These results pointed out that air quality management should not be driven by political boundaries and highlight the importance of joining efforts between neighbouring countries.

Managing air and water quality in the face of uncertain futures: perspectives, perceptions, reported action, and needs for climate adaptation at the local level

NASA Astrophysics Data System (ADS)

Bedsworth, L. W.; Ekstrom, J.

2017-12-01

As the climate continues to shift, projections show amplified and more frequent extreme events, including coastal and inland flooding, wildfires, prolonged droughts, and heatwaves. Vital public goods, both air quality and water quality, can be critically affected by such extreme events. Climate change will make it increasingly difficult for managers to achieve public health targets for air and water quality. Successfully preparing governance structures developed to maintain and improve air and water quality may benefit from preventative strategies to avoid public health impacts and costs of climate change locally. Perceptions of climate change and its risks, actions taken so far, and perceived barriers to adaptation give insight into the needs of managers for preparing for climate change impacts. This paper compares results of two surveys that looked at local level management of air quality and water quality in California. Air quality managers consistently reported to recognize the risks of climate change on their sector, where water quality managers' perceptions varied between no concern to high concern. We explore the differences in governance, capacity influence the ill-defined responsibility and assumed roles of water and air districts in adaptation to extreme events increasing with climate change. The chain and network of managing air quality is compared with that of water quality - laying out similarities and differences. Then we compare how the survey respondents differed in terms of extreme weather-influenced threats to environmental quality. We end with a discussion of responsibility - where in the chain of managing these life-critical ecosystem services, is the need greatest for adapting to climate change and what does this mean for the other levels in the chain beyond the local management.

Quality of reporting of surveys in critical care journals: a methodologic review.

PubMed

Duffett, Mark; Burns, Karen E; Adhikari, Neill K; Arnold, Donald M; Lauzier, François; Kho, Michelle E; Meade, Maureen O; Hayani, Omar; Koo, Karen; Choong, Karen; Lamontagne, François; Zhou, Qi; Cook, Deborah J

2012-02-01

Adequate reporting is needed to judge methodologic quality and assess the risk of bias of surveys. The objective of this study is to describe the methodology and quality of reporting of surveys published in five critical care journals. All issues (1996-2009) of the American Journal of Respiratory and Critical Care Medicine, Critical Care, Critical Care Medicine, Intensive Care Medicine, and Pediatric Critical Care Medicine. Two reviewers hand-searched all issues in duplicate. We included publications of self-administered questionnaires of health professionals and excluded surveys that were part of a multi-method study or measured the effect of an intervention. Data were abstracted in duplicate. We included 151 surveys. The frequency of survey publication increased at an average rate of 0.38 surveys per 1000 citations per year from 1996-2009 (p for trend = 0.001). The median number of respondents and reported response rates were 217 (interquartile range 90 to 402) and 63.3% (interquartile range 45.0% to 81.0%), respectively. Surveys originated predominantly from North America (United States [40.4%] and Canada [18.5%]). Surveys most frequently examined stated practice (78.8%), attitudes or opinions (60.3%), and less frequently knowledge (9.9%). The frequency of reporting on the survey design and methods were: 1) instrument development: domains (59.1%), item generation (33.1%), item reduction (12.6%); 2) instrument testing: pretesting or pilot testing (36.2%) and assessments of clarity (25.2%) or clinical sensibility (15.7%); and 3) clinimetric properties: qualitative or quantitative description of at least one of face, content, construct validity, intra- or inter-rater reliability, or consistency (28.5%). The reporting of five key elements of survey design and conduct did not significantly change over time. Surveys, primarily conducted in North America and focused on self-reported practice, are increasingly published in highly cited critical care journals. More uniform and comprehensive reporting will facilitate assessment of methodologic quality.

Questioning our Questions: Do frequently asked questions adequately cover the aspects of women's lives most affected by abnormal uterine bleeding? Opinions of women with abnormal uterine bleeding participating in focus group discussions

PubMed Central

Matteson, Kristen A.; Clark, Melissa A.

2010-01-01

Objectives: (1) To explore the effects on women's lives by heavy or irregular menstrual bleeding; (2) To examine whether aspects of women's lives most affected by heavy or irregular menstrual bleeding were adequately addressed by questions that are frequently used in clinical encounters and available questionnaires. Methods: We conducted four focus group sessions with a total of 25 English-speaking women who had reported abnormal uterine bleeding. Discussions included open-ended questions that pertained to bleeding, aspects of life affected by bleeding, and questions frequently used in clinical settings about bleeding and quality of life. Results: We identified five themes that reflected how women's lives were affected by heavy or irregular menstrual bleeding: irritation/inconvenience, bleeding-associated pain, self-consciousness about odor, social embarrassment, and ritual like behavior. Although women responded that the frequently used questions about bleeding and quality of life were important, they felt that the questions failed to go into enough depth to adequately characterize their experiences. Conclusions: Based on the themes identified in our focus group sessions, clinicians and researchers may need to change the questions used to capture “patient experience” with abnormal uterine bleeding more accurately. PMID:20437305

Predictors of mental health and quality of life in male tortured refugees.

PubMed

Carlsson, Jessica M; Mortensen, Erik L; Kastrup, Marianne

2006-01-01

Some of the most frequently reported mental health problems in traumatized refugees are depression, anxiety and post-traumatic stress disorder (PTSD). The aim of this paper is to describe a group of tortured refugees referred to the Rehabilitation and Research Centre for Torture Victims (RCT) and to study the importance of past trauma/torture and post-migratory factors for the present symptoms of PTSD, depression, anxiety and for health-related quality of life. The sample comprises 63 male tortured refugees admitted to a pre-treatment assessment at RCT. Data on personal background, trauma, present situation in Denmark, symptoms of depression, anxiety (Hopkins Symptom Checklist-25, HSCL-25, and Hamilton Depression Scale, HDS), PTSD (Harvard Trauma Questionnaire, HTQ), and on health-related quality of life (WHO Quality of life-Bref, WHOQOL-Bref) were collected through self-administered questionnaires and structured and semi-structured interviews. The scores in the questionnaires measuring emotional distress were high. Previous torture and trauma, lower education, fewer social contacts, no occupation and pain were identified as significant predictors of emotional distress. Few social contacts was a significant predictor of a lower health-related quality of life. Even after many years, past torture is significantly associated with emotional distress. Post-migratory factors are also significantly associated with emotional distress and health-related quality of life, and potentially modifiable factors, such as social relations and occupation, are of special interest.

Occurrence of Legionella in showers at recreational facilities.

PubMed

De Filippis, Patrizia; Mozzetti, Cinzia; Amicosante, Massimo; D'Alò, Gian Loreto; Messina, Alessandra; Varrenti, Donatella; Giammattei, Roberto; Di Giorgio, Floriana; Corradi, Stefania; D'Auria, Alberto; Fraietta, Roberta; Gabrieli, Rosanna

2017-06-01

Critical environments, including water systems in recreational settings, represent an important source of Legionella pneumophila infection in humans. In order to assess the potential risk for legionellosis, we analyzed Legionella contamination of water distribution systems in 36 recreational facilities equipped with swimming pools. One hundred and sixty water samples were analyzed from shower heads or taps located in locker rooms or in bathrooms. By culture method and polymerase chain reaction, 41/160 samples were positive for Legionella from 12/36 recreational centers. Hotels (57.1%) and sports centers (41.2%) were the most contaminated. L. pneumophila serotypes 2-14 (25/41) were more frequently found than serotype 1 (10/41). Samples at temperature ≥30 °C were more frequently positive than samples at temperature <30 °C (n = 39 vs n = 2, p < 0.00001). The presence of L. pneumophila was investigated by comparison with heterotrophic plate count (HPC), an indicator of water quality. The presence of L. pneumophila was associated more frequently with high and intermediate HPC load at 37 °C, therefore should be considered a potential source when HPC at 37 °C is >10 CFU/mL. Maintenance, good hygiene practices, interventions on the hydraulic system and regular controls must be implemented to minimize exposure to L. pneumophila infection risk.

Physical Therapists as Providers of Care: Exercise Prescriptions and Resultant Outcomes in Cardiac and Pulmonary Rehabilitation Programs in New York State

PubMed Central

Scott, Lisa Benz

2008-01-01

Purpose: Physical therapists have engaged in cardiac rehabilitation (CR) and pulmonary rehabilitation (PR) for decades, but the extent of their current involvement in this practice area is unclear. This study surveyed directors of CR and PR programs on a statewide level to ascertain what type of provider is writing the prescription, which methods of exercise formulation are used, which outcome measures are used and their congruency with established guidelines. Methods: A convenience sample of outpatient CR and PR directors (n=31) representing 38 CR and/or PR programs located in New York completed a survey in spring 2005 (29 CR and 9 PR). Results: Results showed that only 2 physical therapists were responsible for writing exercise prescriptions in CR and PR programs. Most program directors were registered nurses (53%), who also wrote the majority of CR exercise prescriptions. Exercise intensity was most frequently determined using formulae and data that were highly patient-specific. Clinical outcomes most frequently included Quality of Life scales and stress tests. Conclusions: Physical therapists are minimally involved in directing programs and writing exercise prescriptions. Exercise prescriptions are individualized to the patient. Outcome measures most frequently used by participating CR and PR program directors are consistent with nationally-recognized best practice. PMID:20467497

Increasing floodplain connectivity through urban stream restoration increases nutrient and sediment retention

USGS Publications Warehouse

McMillan, Sara K.; Noe, Gregory

2017-01-01

Stream restoration practices frequently aim to increase connectivity between the stream channel and its floodplain to improve channel stability and enhance water quality through sediment trapping and nutrient retention. To measure the effectiveness of restoration and to understand the drivers of these functional responses, we monitored five restored urban streams that represent a range of channel morphology and restoration ages. High and low elevation floodplain plots were established in triplicate in each stream to capture variation in floodplain connectivity. We measured ecosystem geomorphic and soil attributes, sediment and nutrient loading, and rates of soil nutrient biogeochemistry processes (denitrification; N and P mineralization) then used boosted regression trees (BRT) to identify controls on sedimentation and nutrient processing. Local channel and floodplain morphology and position within the river network controlled connectivity with increased sedimentation at sites downstream of impaired reaches and at floodplain plots near the stream channel and at low elevations. We observed that nitrogen loading (both dissolved and particulate) was positively correlated with denitrification and N mineralization and dissolved phosphate loading positively influenced P mineralization; however, none of these input rates or transformations differed between floodplain elevation categories. Instead, continuous gradients of connectivity were observed rather than categorical shifts between inset and high floodplains. Organic matter and nutrient content in floodplain soils increased with the time since restoration, which highlights the importance of recovery time after construction that is needed for restored systems to increase ecosystem functions. Our results highlight the importance of restoring floodplains downstream of sources of impairment and building them at lower elevations so they flood frequently, not just during bankfull events. This integrated approach has the greatest potential for increasing trapping of sediment, nutrients, and associated pollutants in restored streams and thereby improving water quality in urban watersheds.

Concomitant treatment of brain metastasis with whole brain radiotherapy [WBRT] and temozolomide [TMZ] is active and improves quality of life.

PubMed

Addeo, Raffaele; Caraglia, Michele; Faiola, Vincenzo; Capasso, Elena; Vincenzi, Bruno; Montella, Liliana; Guarrasi, Rosario; Caserta, Luigi; Del Prete, Salvatore

2007-01-25

Brain metastases (BM) represent one of the most frequent complications related to cancer, and their treatment continues to evolve. We have evaluated the activity, toxicity and the impact on Quality of Life (QoL) of a concomitant treatment with whole brain radiotherapy (WBRT) and Temozolomide (TMZ) in patients with brain metastases from solid tumors in a prospective Simon two stage study. Fifty-nine patients were enrolled and received 30 Gy WBRT with concomitant TMZ (75 mg/m2/day) for ten days, and subsequently TMZ (150 mg/m2/day) for up to six cycles. The primary end points were clinical symptoms and radiologic response. Five patients had a complete response, 21 patients had a partial response, while 18 patients had stable disease. The overall response rate (45%) exceeded the target activity per study design. The median time to progression was 9 months. Median overall survival was 13 months. The most frequent toxicities included grade 3 neutropenia (15%) and anemia (13%), and only one patient developed a grade 4 thrombocytopenia. Age, Karnofsky performance status, presence of extracranial metastases and the recursive partitioning analysis (RPA) were found to be predictive factors for response in patients. Overall survival (OS) and progression-free survival (PFS) were dependent on age and on the RPA class. We conclude that this treatment is well tolerated, with an encouraging objective response rate, and a significant improvement in quality of life (p < 0.0001) demonstrated by FACT-G analysis. All patients answered the questionnaires and described themselves as 'independent' and able to act on their own initiatives. Our study found a high level of satisfaction for QoL, this provides useful information to share with patients in discussions regarding chemotherapy treatment of these lesions.

Model-based economic evaluations in smoking cessation and their transferability to new contexts: a systematic review.

PubMed

Berg, Marrit L; Cheung, Kei Long; Hiligsmann, Mickaël; Evers, Silvia; de Kinderen, Reina J A; Kulchaitanaroaj, Puttarin; Pokhrel, Subhash

2017-06-01

To identify different types of models used in economic evaluations of smoking cessation, analyse the quality of the included models examining their attributes and ascertain their transferability to a new context. A systematic review of the literature on the economic evaluation of smoking cessation interventions published between 1996 and April 2015, identified via Medline, EMBASE, National Health Service (NHS) Economic Evaluation Database (NHS EED), Health Technology Assessment (HTA). The checklist-based quality of the included studies and transferability scores was based on the European Network of Health Economic Evaluation Databases (EURONHEED) criteria. Studies that were not in smoking cessation, not original research, not a model-based economic evaluation, that did not consider adult population and not from a high-income country were excluded. Among the 64 economic evaluations included in the review, the state-transition Markov model was the most frequently used method (n = 30/64), with quality adjusted life years (QALY) being the most frequently used outcome measure in a life-time horizon. A small number of the included studies (13 of 64) were eligible for EURONHEED transferability checklist. The overall transferability scores ranged from 0.50 to 0.97, with an average score of 0.75. The average score per section was 0.69 (range = 0.35-0.92). The relative transferability of the studies could not be established due to a limitation present in the EURONHEED method. All existing economic evaluations in smoking cessation lack in one or more key study attributes necessary to be fully transferable to a new context. © 2017 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

The state of survivorship care in radiation oncology: Results from a nationally distributed survey.

PubMed

Frick, Melissa A; Rosenthal, Seth A; Vapiwala, Neha; Monzon, Brian T; Berman, Abigail T

2018-04-18

Survivorship care has become an increasingly critical component of oncologic care as well as a quality practice and reimbursement metric. To the authors' knowledge, the current climate of survivorship medicine in radiation oncology has not been investigated fully. An institutional review board-approved, Internet-based survey examining practices and preparedness in survivorship care was distributed to radiation oncology practices participating in the American College of Radiology Radiation Oncology Practice Accreditation program between November 2016 and January 2017. A total of 78 surveys were completed. Among these, 2 were nonphysicians, resulting in 76 evaluable responses. Radiation oncologists (ROs) frequently reported that they are the primary provider in the evaluation of late toxicities and the recurrence of primary cancer. Although approximately 68% of ROs frequently discuss plans for future care with survivors, few provide a written survivorship care plan to their patients (18%) or the patients' primary care providers (24%). Patient prognosis, disease site, and reimbursement factors often influence the provision of survivorship care. Although ROs report that several platforms offer training in survivorship medicine, the quality of these resources is variable and extensive instruction is rare. Fewer than one-half of ROs believe they are expertly trained in survivorship care. ROs play an active role within the multidisciplinary team in the cancer-related follow-up care of survivors. Investigation of barriers to the provision of survivorship care and optimization of service delivery should be pursued further. The development of high-quality, easily accessible educational programming is needed so that ROs can participate more effectively in the care of cancer survivors. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

Identification of mitochondrial genome-encoded small RNAs related to egg quality deterioration caused by post-ovulatory aging in rainbow trout

USDA-ARS?s Scientific Manuscript database

Numerous factors have been reported to affect rainbow trout egg quality, among which, post-ovulatory aging is one of the most significant causes as reared rainbow trout do not usually volitionally oviposit the ovulated eggs. Frequent examination of the stock is therefore required in order to reduce...

Curriculum-Based Measurement of Oral Reading: Quality of Progress Monitoring Outcomes

ERIC Educational Resources Information Center

Christ, Theodore J.; Zopluoglu, Cengiz; Long, Jeffery D.; Monaghen, Barbara D.

2012-01-01

Curriculum-based measurement of oral reading (CBM-R) is frequently used to set student goals and monitor student progress. This study examined the quality of growth estimates derived from CBM-R progress monitoring data. The authors used a linear mixed effects regression (LMER) model to simulate progress monitoring data for multiple levels of…

The Effects of Early Childhood Classroom Size and Duration on Development of Children

ERIC Educational Resources Information Center

Canbeldek, Merve; Isikoglu Erdogan, Nesrin

2017-01-01

Purpose: The numbers of early childhood education programs are dramatically increasing throughout Turkey, and the regulations to ensure quality are frequently changing. A very limited number of studies have examined the quality of Turkish ECE programs on children's development. Therefore, the purpose of this study is to identify the effects of…

Developing Professional Early Childhood Educators in England and Hungary: Where Has All the Love Gone?

ERIC Educational Resources Information Center

Campbell-Barr, Verity; Georgeson, Janet; Varga, Anikó Nagy

2015-01-01

European education agendas have emphasized the importance of early childhood education in providing the foundations for lifelong learning. Central to the success of early childhood education is the quality of provision, with the workforce being key. While qualifications levels are frequently cited as important for the quality of provision here we…

Dynamic evaluation of the CMAQv5.0 modeling system: Assessing the model’s ability to simulate ozone changes due to NOx emission reductions

EPA Science Inventory

Regional air quality models are frequently used for regulatory applications to predict changes in air quality due to changes in emissions or changes in meteorology. Dynamic model evaluation is thus an important step in establishing credibility in the model predicted pollutant re...

The Nonprofit Advantage: Producing Quality in Thick and Thin Child Care Markets

ERIC Educational Resources Information Center

Cleveland, Gordon; Krashinsky, Michael

2009-01-01

Nonprofit child care centers are frequently observed to produce child care which is, on average, of higher quality than care provided in commercial child care centers. In part, this nonprofit advantage is due to different input choices made by nonprofit centers--lower child--staff ratios, better-educated staff and directors, higher rates of…

Temperament Styles of Children from the People's Republic of China and the United States

ERIC Educational Resources Information Center

Oakland, Thomas; Lub, Li

2006-01-01

Preferences for four bipolar temperament qualities (i.e. extroversion-introversion, practical-imaginative, thinking-feeling and organized-flexible styles) of 400 Chinese children, ages 9, 11, 13 and 15, first are described and then compared to temperament qualities of 3,539 US children of the same ages. Chinese children more frequently prefer…

Ultra high performance liquid chromatography coupled with triple quadrupole mass spectrometry and chemometric analysis of licorice based on the simultaneous determination of saponins and flavonoids.

PubMed

Jiang, Zhenzuo; Wang, Yuefei; Zheng, Yunfeng; Yang, Jing; Zhang, Lei

2016-08-01

Licorice is among the most popular herbal medicines and frequently used in traditional medicine, food products, and cosmetics. In China, only Glycyrrhiza uralensis Fisch., Glycyrrhiza inflata Bat. and Glycyrrhiza glabra L. are officially used and are usually processed with honey prior to use. To maintain the quality of commercially available herbal products, a simple, rapid, and reliable ultra high performance liquid chromatography with triple quadrupole mass spectrometry was developed to investigate the major active constituents of commercially available licorice products. Nineteen components were accurately determined, including eight triterpenoid saponins, one triterpene, and ten flavonoids. Subsequently, multivariate statistical analysis methods were employed to further explore and interpret the experimental data. The results indicated that liquiritin apioside may be considered as a candidate index for the quality control of licorice as well as 18β-glycyrrhizic acid and liquiritin. In addition, both 18β-glycyrrhizic acid and licorice-saponin G2 can be used for discrimination between crude and honey-processed licorice. Furthermore, using 18β-glycyrrhizic acid and liquiritin as markers, this work revealed that the quality of licorice products may have declined in recent years. This highlights the need for additional effort focused on good agricultural practice during the processing of licorice. In summary, this study provides a valuable reference for the quality assessment of licorice. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Overstory-derived surface fuels mediate plant species diversity in frequently burned longleaf pine forests

Treesearch

Jane E. Dell; Lora A. Richards; Joseph J. O’Brien; E. Louise Loudermilk; Andrew T. Hudak; Scott M. Pokswinski; Benjamin C. Bright; J. Kevin Hiers; Brett W. Williams; Lee A. Dyer

2017-01-01

Frequently burned low-latitude coniferous forests maintain a high-diversity understory. Longleaf pine (Pinus palustris Mill.) forests and woodlands have exceptionally high diversity at fine scales and very frequent fire return intervals (1–3 yr). Furthermore, the positive association between high-frequency, low-intensity surface fires and high species richness in...

The health-related quality-of-life impact of nocturnal awakenings in the middle-aged and older Finnish population.

PubMed

Väätäinen, Saku; Tuomilehto, Henri; Saramies, Jouko; Tuomilehto, Jaakko; Uusitalo, Hannu; Hussi, Esko; Keinänen-Kiukaanniemi, Sirkka; Martikainen, Janne

2013-12-01

The aim of the study is to examine the health-related quality-of-life (HRQOL) impact of the nocturnal awakenings and the duration of the sleep in the Finnish middle-aged and older population. Cross-sectional sample consisted of 823 community-dwelling persons aged 55-75 living in a single municipality in a rural area of Eastern Finland. Frequency of the nocturnal awakenings was dichotomized as reporting "frequent," if the participant reported subjectively awakening "often" or "very often," and "infrequent" if the participant reported awakening "sometimes" or less frequently. HRQOL was measured with a preference-based HRQOL-index instrument, 15D. Analyses were adjusted for gender, BMI, morbidities, depression, employment and marital status, current smoking and drinking, exercise, recommendation to exercise from a health care professional, and subjective opinion about own exercise habits. Frequent nocturnal awakenings had statistically and clinically significant negative impact on HRQOL, the mean (SE) adjusted marginal HRQOL impact being -0.0416 (0.006). More than 10 and less than 6.5 h of daily sleep were associated with higher probability of having low HRQOL, adjusted odd ratios (95 % CI) being 2.65 (1.11-6.33) and 2.65 (1.55-4.52), respectively. However, the changes in daily sleep duration did not have noticeable influence on the significance or magnitude of the negative HRQOL impact of the frequent nocturnal awakenings. Nocturnal awakenings displayed a strong independent association with decreased HRQOL. The findings suggest that both clinicians and researchers should pay closer attention to nocturnal awakenings and other sleep problems in order to find ways to improve the quality of life in individuals with such conditions.

[Qualitative analysis of water quality deterioration and infection by Helicobacter pylori in a community with high risk of stomach cancer (Cauca, Colombia)].

PubMed

Acosta, Claudia Patricia; Benavides, John Alexander; Sierra, Carlos Hernán

2015-12-01

This study looks at aspects of the environmental health of the rural population in Timbío (Cauca, Columbia) in relation to the deterioration of water quality. The information was obtained through participatory research methods exploring the management and use of water, the sources of pollution and the perception of water quality and its relation to Helicobacter pylori infection. The results are part of the qualitative analysis of a first research phase characterizing water and sanitation problems and their relation to emerging infectious diseases as well as possible solutions, which was carried out between November 2013 and August 2014. The results of this research are discussed from an ecosystemic approach to human health, recognizing the complexity of environmental conflicts related to water resources and their impacts on the health of populations. Through the methodology used, it is possible to detect and visualize the most urgent problems as well as frequent causes of contamination of water resources so as to propose solutions within a joint agenda of multiple social actors.

A systematic review of the factors that influence the quality and effectiveness of telesupervision for health professionals.

PubMed

Martin, Priya; Lizarondo, Lucylynn; Kumar, Saravana

2018-05-01

Introduction Whilst telesupervision (clinical supervision undertaken using communication technology) is being used more frequently, there is limited information on what factors influence its effectiveness and quality. We undertook this systematic review to address this gap. Methods Eligible telesupervision studies were identified following targeted search of electronic databases and the grey literature. Data were synthesised thematically, resulting in development of core themes. Results We identified 286 papers for initial relevancy screening by title and abstract. The full text of 36 papers were then retrieved and assessed for further relevance. A total of 11 papers were included in the final analysis. We identified eight themes that contribute to effective and high-quality telesupervision: supervisee characteristics, supervisor characteristics, supervision characteristics, supervisory relationship, communication strategies, prior face-to-face contact, environmental factors and technological considerations. Conclusion From the available evidence, telesupervision can be a feasible and acceptable form of clinical supervision if set up well. Further studies with robust designs are required to strengthen the existing evidence on what makes telesupervision effective, as well as to examine its cost-effectiveness.

Mechanisms affecting water quality in an intermittent piped water supply.

PubMed

Kumpel, Emily; Nelson, Kara L

2014-01-01

Drinking water distribution systems throughout the world supply water intermittently, leaving pipes without pressure between supply cycles. Understanding the multiple mechanisms that affect contamination in these intermittent water supplies (IWS) can be used to develop strategies to improve water quality. To study these effects, we tested water quality in an IWS system with infrequent and short water delivery periods in Hubli-Dharwad, India. We continuously measured pressure and physicochemical parameters and periodically collected grab samples to test for total coliform and E. coli throughout supply cycles at 11 sites. When the supply was first turned on, water with elevated turbidity and high concentrations of indicator bacteria was flushed out of pipes. At low pressures (<10 psi), elevated indicator bacteria were frequently detected even when there was a chlorine residual, suggesting persistent contamination had occurred through intrusion or backflow. At pressures between 10 and 17 psi, evidence of periodic contamination suggested that transient intrusion, backflow, release of particulates, or sloughing of biofilms from pipe walls had occurred. Few total coliform and no E. coli were detected when water was delivered with a chlorine residual and at pressures >17 psi.

Quench-induced degradation of the quality factor in superconducting resonators

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

Checchin, M.; Martinello, M.; Romanenko, A.

Quench of superconducting radio-frequency cavities frequently leads to the lowered quality factor Q 0, which had been attributed to the additional trapped magnetic flux. Here we demonstrate that the origin of this magnetic flux is purely extrinsic to the cavity by showing no extra dissipation (unchanged Q 0) after quenching in zero magnetic field, which allows us to rule out intrinsic mechanisms of flux trapping such as generation of thermal currents or trapping of the rf field. We also show the clear relation of dissipation introduced by quenching to the orientation of the applied magnetic field and the possibility tomore » fully recover the quality factor by requenching in the compensated field. We discover that for larger values of the ambient field, the Q-factor degradation may become irreversible by this technique, likely due to the outward flux migration beyond the normal zone opening during quench. Lastly, our findings are of special practical importance for accelerators based on low- and medium-beta accelerating structures residing close to focusing magnets, as well as for all high-Q cavity-based accelerators.« less

Quench-induced degradation of the quality factor in superconducting resonators

DOE PAGES

Checchin, M.; Martinello, M.; Romanenko, A.; ...

2016-04-28

Quench of superconducting radio-frequency cavities frequently leads to the lowered quality factor Q 0, which had been attributed to the additional trapped magnetic flux. Here we demonstrate that the origin of this magnetic flux is purely extrinsic to the cavity by showing no extra dissipation (unchanged Q 0) after quenching in zero magnetic field, which allows us to rule out intrinsic mechanisms of flux trapping such as generation of thermal currents or trapping of the rf field. We also show the clear relation of dissipation introduced by quenching to the orientation of the applied magnetic field and the possibility tomore » fully recover the quality factor by requenching in the compensated field. We discover that for larger values of the ambient field, the Q-factor degradation may become irreversible by this technique, likely due to the outward flux migration beyond the normal zone opening during quench. Lastly, our findings are of special practical importance for accelerators based on low- and medium-beta accelerating structures residing close to focusing magnets, as well as for all high-Q cavity-based accelerators.« less

Quench-Induced Degradation of the Quality Factor in Superconducting Resonators

NASA Astrophysics Data System (ADS)

Checchin, M.; Martinello, M.; Romanenko, A.; Grassellino, A.; Sergatskov, D. A.; Posen, S.; Melnychuk, O.; Zasadzinski, J. F.

2016-04-01

Quench of superconducting radio-frequency cavities frequently leads to the lowered quality factor Q0 , which had been attributed to the additional trapped magnetic flux. Here we demonstrate that the origin of this magnetic flux is purely extrinsic to the cavity by showing no extra dissipation (unchanged Q0) after quenching in zero magnetic field, which allows us to rule out intrinsic mechanisms of flux trapping such as generation of thermal currents or trapping of the rf field. We also show the clear relation of dissipation introduced by quenching to the orientation of the applied magnetic field and the possibility to fully recover the quality factor by requenching in the compensated field. We discover that for larger values of the ambient field, the Q -factor degradation may become irreversible by this technique, likely due to the outward flux migration beyond the normal zone opening during quench. Our findings are of special practical importance for accelerators based on low- and medium-β accelerating structures residing close to focusing magnets, as well as for all high-Q cavity-based accelerators.

Variation in general practitioners' information-seeking behaviour - a cross-sectional study on the influence of gender, age and practice form.

PubMed

Le, Jette V; Pedersen, Line B; Riisgaard, Helle; Lykkegaard, Jesper; Nexøe, Jørgen; Lemmergaard, Jeanette; Søndergaard, Jens

2016-12-01

To assess general practitioners' (GPs') information-seeking behaviour and perceived importance of sources of scientific medical information and to investigate associations with GP characteristics. A national cross-sectional survey was distributed electronically in December 2013. Danish general practice. A population of 3440 GPs (corresponding to approximately 96% of all Danish GPs). GPs' use and perceived importance of information sources. Multilevel mixed-effects logit models were used to investigate associations with GP characteristics after adjusting for relevant covariates. A total of 1580 GPs (46.4%) responded to the questionnaire. GPs' information-seeking behaviour is associated with gender, age and practice form. Single-handed GPs use their colleagues as an information source significantly less than GPs working in partnership practices and they do not use other sources more frequently. Compared with their younger colleagues, GPs aged above 44 years are less likely to seek information from colleagues, guidelines and websites, but more likely to seek information from medical journals. Male and female GPs seek information equally frequently. However, whereas male GPs are more likely than female GPs to find that pharmaceutical sales representative and non-refundable CME meetings are important, they are less likely to find that colleagues, refundable CME meetings, guidelines and websites are important. Results from this study indicate that GP characteristics should be taken into consideration when disseminating scientific medical information, to ensure that patients receive medically updated, high-quality care. KEY POINTS Research indicates that information-seeking behaviour is associated with GP characteristics. Further insights could provide opportunities for targeting information dissemination strategies. Single-handed GPs seek information from colleagues less frequently than GPs in partnerships and do not use other sources more frequently. GPs aged above 44 years do not seek information as frequently as their younger colleagues and prefer other information sources. Male and female GPs seek information equally frequently, but do not consider information sources equally important in keeping medically updated.

Unravelling associations between unassigned mass spectrometry peaks with frequent itemset mining techniques.

PubMed

Vu, Trung Nghia; Mrzic, Aida; Valkenborg, Dirk; Maes, Evelyne; Lemière, Filip; Goethals, Bart; Laukens, Kris

2014-01-01

Mass spectrometry-based proteomics experiments generate spectra that are rich in information. Often only a fraction of this information is used for peptide/protein identification, whereas a significant proportion of the peaks in a spectrum remain unexplained. In this paper we explore how a specific class of data mining techniques termed "frequent itemset mining" can be employed to discover patterns in the unassigned data, and how such patterns can help us interpret the origin of the unexpected/unexplained peaks. First a model is proposed that describes the origin of the observed peaks in a mass spectrum. For this purpose we use the classical correlative database search algorithm. Peaks that support a positive identification of the spectrum are termed explained peaks. Next, frequent itemset mining techniques are introduced to infer which unexplained peaks are associated in a spectrum. The method is validated on two types of experimental proteomic data. First, peptide mass fingerprint data is analyzed to explain the unassigned peaks in a full scan mass spectrum. Interestingly, a large numbers of experimental spectra reveals several highly frequent unexplained masses, and pattern mining on these frequent masses demonstrates that subsets of these peaks frequently co-occur. Further evaluation shows that several of these co-occurring peaks indeed have a known common origin, and other patterns are promising hypothesis generators for further analysis. Second, the proposed methodology is validated on tandem mass spectrometral data using a public spectral library, where associations within the mass differences of unassigned peaks and peptide modifications are explored. The investigation of the found patterns illustrates that meaningful patterns can be discovered that can be explained by features of the employed technology and found modifications. This simple approach offers opportunities to monitor accumulating unexplained mass spectrometry data for emerging new patterns, with possible applications for the development of mass exclusion lists, for the refinement of quality control strategies and for a further interpretation of unexplained spectral peaks in mass spectrometry and tandem mass spectrometry.

At-Home Versus In-Clinic INR Monitoring: A Cost-Utility Analysis from The Home INR Study (THINRS).

PubMed

Phibbs, Ciaran S; Love, Sean R; Jacobson, Alan K; Edson, Robert; Su, Pon; Uyeda, Lauren; Matchar, David B

2016-09-01

Effective management of patients using warfarin is resource-intensive, requiring frequent in-clinic testing of the international normalized ratio (INR). Patient self-testing (PST) using portable at-home INR monitoring devices has emerged as a convenient alternative. As revealed by The Home INR Study (THINRS), event rates for PST were not significantly different from those for in-clinic high-quality anticoagulation management (HQACM), and a cumulative gain in quality of life was observed for patients undergoing PST. To perform a cost-utility analysis of weekly PST versus monthly HQACM and to examine the sensitivity of these results to testing frequency. In this study, 2922 patients taking warfarin for atrial fibrillation or mechanical heart valve, and who demonstrated PST competence, were randomized to either weekly PST (n = 1465) or monthly in-clinic testing (n = 1457). In a sub-study, 234 additional patients were randomized to PST once every 4 weeks (n = 116) or PST twice weekly (n = 118). The endpoints were quality of life (measured by the Health Utilities Index), health care utilization, and costs over 2 years of follow-up. PST and HQACM participants were similar with regard to gender, age, and CHADS2 score. The total cost per patient over 2 years of follow-up was $32,484 for HQACM and $33,460 for weekly PST, representing a difference of $976. The incremental cost per quality-adjusted life year gained with PST once weekly was $5566 (95 % CI, -$11,490 to $25,142). The incremental cost-effectiveness ratio (ICER) was sensitive to testing frequency: weekly PST dominated PST twice weekly and once every 4 weeks. Compared to HQACM, weekly PST was associated with statistically significant and clinically meaningful improvements in quality of life. The ICER for weekly PST versus HQACM was well within accepted standards for cost-effectiveness, and was preferred over more or less frequent PST. These results were robust to sensitivity analyses of key assumptions. Weekly PST is a cost-effective alternative to monthly HQACM and a preferred testing frequency compared to twice weekly or monthly PST.

Brief alcohol intervention trials conducted by higher prestige authors and published in higher impact factor journals are cited more frequently.

PubMed

Tanner-Smith, Emily E; Polanin, Joshua R

2016-07-01

To examine the relationships between study quality, author prestige, journal impact factors, and citation rates of trials and to examine whether journal impact factors mediated the relationships between study quality and author prestige on citation rates. We used bibliometric data from 128 controlled trials included in a recent meta-analysis on brief alcohol interventions for adolescents and young adults. We obtained the number of citations from ISI Web of Knowledge and Google Scholar; journal impact factors were obtained from ISI Web of Knowledge. Linear regression models were used to examine the direct and indirect effects of interest. The results indicated that studies were published in journals with higher impact factors when first authors had higher h-indices and studies were funded, but this was largely because those studies were of higher quality. Studies were cited more frequently when first authors had higher h-indices and studies were funded, even after adjusting for study quality proxies. The observed associations between study quality and author prestige on citation rates were also partly mediated through journal impact factors. We conclude that studies conducted by more established authors and reported in more prestigious journal outlets are more likely to be cited by other scholars, even after controlling for various proxies of study quality. Copyright © 2016 Elsevier Inc. All rights reserved.

Brief Alcohol Intervention Trials Conducted by Higher Prestige Authors and Published in Higher Impact Factor Journals are Cited More Frequently

PubMed Central

Tanner-Smith, Emily E.; Polanin, Joshua R.

2016-01-01

Objective To examine the relationships between study quality, author prestige, journal impact factors, and citation rates of trials; and to examine whether journal impact factors mediated the relationships between study quality and author prestige on citation rates. Study Design and Setting We used bibliometric data from 128 controlled trials included in a recent meta-analysis on brief alcohol interventions (BAIs) for adolescents and young adults. We obtained the number of citations from ISI Web of Knowledge and Google Scholar; journal impact factors were obtained from ISI Web of Knowledge. Linear regression models were used to examine the direct and indirect effects of interest. Results The results indicated that studies were published in journals with higher impact factors when first authors had higher h-indices and studies were funded, but this was largely because those studies were of higher quality. Studies were cited more frequently when first authors had higher h-indices and studies were funded, even after adjusting for study quality proxies. The observed associations between study quality and author prestige on citation rates were also partly mediated through journal impact factors. Conclusion We conclude that studies conducted by more established authors and reported in more prestigious journal outlets are more likely to be cited by other scholars, even after controlling for various proxies of study quality. PMID:26854420

Discussing Out-of-Pocket Expenses During Clinical Appointments: An Observational Study of Patient-Psychiatrist Interactions.

PubMed

Brown, Gregory D; Hunter, Wynn G; Hesson, Ashley; Davis, J Kelly; Kirby, Christine; Barnett, Jamison A; Byelmac, Dmytro; Ubel, Peter A

2017-06-01

High out-of-pocket expenses for medical treatment have been associated with worse quality of life, decreased treatment adherence, and increased risk of adverse health outcomes. Treatment of depression potentially has high out-of-pocket expenses. Limited data characterize psychiatrist-patient conversations about health care costs. The authors conducted content analysis from 422 outpatient psychiatrist-patient visits for medication management of major depressive disorder in community-based private practices nationwide from 2010 to 2014. Patients' health care expenses were discussed in 38% of clinic visits (95% confidence interval [CI]= 33%-43%). Uninsured patients were significantly more likely to discuss expenses than were patients enrolled in private or public plans (64%, 44%, and 30%, respectively; p<.001). Sixty-nine percent of cost conversations lasted less than one minute (median=36 seconds; interquartile range [IQR]=16-81 seconds). Cost conversations most frequently addressed psychotropic medications (51%). Physicians initiated 50% of cost conversations and brought up costs for psychotropic medications more often than did patients (62% versus 38%, p=.009). Conversely, a greater percentage of patient-initiated cost conversations addressed provider visit costs (27% versus 10%, p=.008). Overall, 45% of cost conversations mentioned cost-reducing strategies (CI=37%-53%). The most frequently discussed cost-reducing strategies were lowering cost by changing the source or timing of an intervention (for example, changing pharmacies), providing free samples, and switching to a lower-cost therapy or diagnostic test. Psychiatrists and patients regularly discuss patients' health care costs in visits for depression. These discussions cover a variety of clinical topics and frequently include strategies to lower patients' costs.

Sleep Duration, Quality of Sleep, and Use of Sleep Medication, by Sex and Family Type, 2013-2014.

PubMed

Nugent, Colleen N; Black, Lindsey I

2016-01-01

Data from the National Health Interview Survey, 2013-2014. Single parents, especially women, were more likely than adults in other types of families to have short sleep duration, frequently have trouble falling asleep and staying asleep, and frequently wake up feeling not well-rested. Within family types, women were more likely than men to frequently have trouble falling asleep and staying asleep, and to frequently wake up feeling not well-rested. Overall, adults in two-parent families were less likely than adults in other types of families to have taken sleep medication four times or more in the past week. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

NetMiner-an ensemble pipeline for building genome-wide and high-quality gene co-expression network using massive-scale RNA-seq samples.

PubMed

Yu, Hua; Jiao, Bingke; Lu, Lu; Wang, Pengfei; Chen, Shuangcheng; Liang, Chengzhi; Liu, Wei

2018-01-01

Accurately reconstructing gene co-expression network is of great importance for uncovering the genetic architecture underlying complex and various phenotypes. The recent availability of high-throughput RNA-seq sequencing has made genome-wide detecting and quantifying of the novel, rare and low-abundance transcripts practical. However, its potential merits in reconstructing gene co-expression network have still not been well explored. Using massive-scale RNA-seq samples, we have designed an ensemble pipeline, called NetMiner, for building genome-scale and high-quality Gene Co-expression Network (GCN) by integrating three frequently used inference algorithms. We constructed a RNA-seq-based GCN in one species of monocot rice. The quality of network obtained by our method was verified and evaluated by the curated gene functional association data sets, which obviously outperformed each single method. In addition, the powerful capability of network for associating genes with functions and agronomic traits was shown by enrichment analysis and case studies. In particular, we demonstrated the potential value of our proposed method to predict the biological roles of unknown protein-coding genes, long non-coding RNA (lncRNA) genes and circular RNA (circRNA) genes. Our results provided a valuable and highly reliable data source to select key candidate genes for subsequent experimental validation. To facilitate identification of novel genes regulating important biological processes and phenotypes in other plants or animals, we have published the source code of NetMiner, making it freely available at https://github.com/czllab/NetMiner.

Cell purification: a new challenge for biobanks.

PubMed

Almeida, Maria; García-Montero, Andres C; Orfao, Alberto

2014-01-01

Performing '-omics' analyses on heterogeneous biological tissue samples, such as blood or bone marrow, can lead to biased or even erroneous results, particularly when the targeted cells and/or molecules are present at relatively low percentages/amounts. In such cases, whole sample analysis will most probably dilute and mask the features of the cell and/or molecules of interest, and this will negatively impact the results and their interpretation. Therefore, frequently it is critically important to have well-characterized and high-quality purified cell populations for the reliable detection of subtle variations in their specific features, such as gene expression profile, protein expression pattern and metabolic status. Biobanks are technological platforms which aim to provide researchers access to a large number of high-quality biological samples and their associated data, particularly to support high-quality scientific and clinical research projects, and such projects will benefit enormously by having access to high-quality purified cell populations or their biological components (e.g. DNA, RNA, proteins). Therefore, a clear opportunity exists for preparative cell sorting techniques in biobanks. Although multiple different cell purification approaches exist or are under development (e.g. cell purification techniques based on cell adherence, density and/or cell size properties, methods based on antibody binding as well as new lab-on-a-chip purification techniques), the choice for a specific technology depends on multiple variables, including cell recovery, purity and yield, among others. In addition, most cell purification approaches are not well suited for high-throughput (HT) purification of multiple cell populations coexisting in a sample. Here we review the most (currently) used cell sorting methods that may be applied for sample preparation in biobanks. For the different approaches, technical considerations about their advantages and limitations are highlighted, and the requirements to be met by a HT cell sorting technology to be used in biobanks are also discussed.

[Mission statements of Dutch mental health institutions; the quality of communication with stakeholders].

PubMed

Krol, D G H; de Kruif, J

2013-01-01

As a result of recent reforms in Dutch health care, healthcare providers are having to operate more and more like commercial organisations and adopt some of the rules prevailing in the profit sector. Because missions statements can be an efficient means of useful communication with internal and external stakeholders they can make a useful contribution to the way healthcare institutions are managed and to their status and reputation. Research shows that in view of this the quality of the messages conveyed via mission statements is important. To ascertain which stakeholders are mentioned in the mission statements of Dutch mental healthcare providers and to quantify the quality of the messages conveyed to them via mission statements. We examined the mission statements of 34 mental health providers to find out which stakeholders were included. The message conveyed to the stakeholders was quantified by means of a validated measuring instrument devised specifically for this purpose. Patients were referred to in all mission statements and the quality of the messages conveyed was of higher quality than the messages conveyed to other stakeholders. Other important stakeholders on whom the institutions depended were referred to much less frequently and the quality of sections of text referring to them was definitely inferior. Mission statements frequently serve as management tool for Dutch mental healthcare providers. The potential benefits that these statements could bestow on the providers are not being fully exploited because the standard of communication with several internal and external stakeholders is of poor quality.

More than 20 years of research into the quality of life of people with HIV and AIDS--a descriptive review of study characteristics and methodological approaches of published empirical studies.

PubMed

Drewes, Jochen; Gusy, Burkhard; Rüden, Ursula von

2013-01-01

The quality of life of people living with HIV and AIDS (PLWHA) is becoming increasingly important--a fact that is also reflected in extensive research efforts. Owing to the almost complete lack of systematic integration of research findings, it is hardly possible to provide an overview of the current status of research, or to derive valid statements about research results. A literature search regarding the quality of life of PLWHA was performed in two international research databases. After checking their relevance, 852 publications appearing in scientific journals and explicitly measuring the quality of life of PLWHA were categorized on the basis of various study characteristics. The number of publications per year in our study pool has been rising steadily since 1989. Well over 40 established instruments were used to determine the quality of life, most frequently the MOS-HIV, followed by the SF-36. The great majority of the studies are correlation studies. CD4 cells, gender, and age are the most common variables for which correlations with quality of life are reported. Our descriptive review stresses both the increasing significance and the challenges of research into quality of life of PLWHA such as the great variety of instruments used. The limits of this review are discussed and we conclude with the formulation of research desiderata concerning comparative review studies on instruments and systematic reviews of frequent research questions.

Urban sprawl leaves its PAH signature

USGS Publications Warehouse

Van Metre, P.C.; Mahler, B.J.; Furlong, E.T.

2000-01-01

The increasing vehicle traffic associated with urban sprawl in the United States is frequently linked to degradation of air quality, but its effect on aquatic sediment is less well-recognized. This study evaluates trends in PAHs, a group of contaminants with multiple urban sources, in sediment cores from 10 reservoirs and lakes in six U.S. metropolitan areas. The watersheds chosen represent a range in degree and age of urbanization. Concentrations of PAHs in all 10 reservoirs and lakes increased during the past 20-40 years. PAH contamination of the most recently deposited sediment at all sites exceeded sediment-quality guidelines established by Environment Canada, in some cases by several orders of magnitude. These results add a new chapter to the story told by previous coring studies that reported decreasing concentrations of PAHs after reaching highs in the 1950s. Concurrent with the increase in concentrations is a change in the assemblage of PAHs that indicates the increasing trends are driven by combustion sources. The increase in PAH concentrations tracks closely with increases in automobile use, even in watersheds that have not undergone substantial changes in urban land-use levels since the 1970s.The increasing vehicle traffic associated with urban sprawl in the United States is frequently linked to degradation of air quality, but its effect on aquatic sediment is less well-recognized. This study evaluates trends in PAHs, a group of contaminants with multiple urban sources, in sediment cores from 10 reservoirs and lakes in six U.S. metropolitan areas. The watersheds chosen represent a range in degree and age of urbanization. Concentrations of PAHs in all 10 reservoirs and lakes increased during the past 20-40 years. PAH contamination of the most recently deposited sediment at all sites exceeded sediment-quality guidelines established by Environment Canada, in some cases by several orders of magnitude. These results add a new chapter to the story told by previous coring studies that reported decreasing concentrations of PAHs after reaching highs in the 1950s. Concurrent with the increase in concentrations is a change in the assemblage of PAHs that indicates the increasing trends are driven by combustion sources. The increase in PAH concentrations tracks closely with increases in automobile use, even in watersheds that have not undergone substantial changes in urban land-use levels since the 1970s.

Clinical profile and quality of life of patients with occupational contact dermatitis from New Delhi, India.

PubMed

Bhatia, Riti; Sharma, Vinod K; Ramam, M; Sethuraman, Gomathy; Yadav, Chander P

2015-09-01

Data regarding occupational contact dermatitis (OCD) and its effect on quality of life (QOL) in India are limited. To evaluate patients with OCD and record the outcome of treatment. All patients with OCD were evaluated for severity of disease (by the use of physician global assessment) and its effect on QOL (by use of the Dermatology Life Quality Index) questionnaire) at the first visit and after 3 months of treatment. Among 117 patients with OCD, hand eczema was present in 81.2%. Positive patch test reactions were found in 76%. The most common allergens were Parthenium hysterophorus and potassium dichromate. The most frequent diagnosis was occupational allergic contact dermatitis (OACD) (57%), caused by farming and construction work, followed by occupational irritant contact dermatitis (OICD) (24%), caused by wet work. Severe psychosocial distress was recorded in 62.5% of patients. After 3 months of treatment, 83% improved significantly, and 54% had improvement in QOL. Farmers were most frequently affected, followed by construction workers and housewives. OACD was found at a higher frequency than OICD. The most frequent allergens were Parthenium hysterophorus in farmers, potassium dichromate in construction workers, and vegetables in housewives. OCD has a significant impact on QOL. Patch testing, in addition to standard treatment, improves the outcome considerably. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Case Studies of Officer and Enlisted Single Parents in the Army: Performance, Retention, and Quality of Life

DTIC Science & Technology

1987-06-01

de- mands unexpected or inordinate amounts of time; (2) the prevalence of child - care problems, especially finding arrangements flexible enough to...associated with frequent relocations, especially the need to reestablish the netwqrk of socia] and child -care supports that enable single parents...most concern to single parents include time pressures, daily child -care arrangements, back-up and emergency supports for children, and frequent

On Open and Collaborative Software Development in the DoD

DTIC Science & Technology

2010-04-30

of this community and the larger F/OSS communities to make changes (and commit those changes) to the artifact base. This churning effect...Succinctly, it is this churning and frequent updates (i.e., "release early, release often") to the artifacts that spark innovation through...the entire project. Artifacts are frequently updated and churned over by the F/OSS community, resulting in better quality and innovation. It is up

What attributions do Australian high-performing general practices make for their success? Applying the clinical microsystems framework: a qualitative study.

PubMed

Dunham, Annette H; Dunbar, James A; Johnson, Julie K; Fuller, Jeff; Morgan, Mark; Ford, Dale

2018-04-10

To identify the success attributions of high-performing Australian general practices and the enablers and barriers they envisage for practices wishing to emulate them. Qualitative study using semi-structured interviews and content analysis of the data. Responses were recorded, transcribed verbatim and coded according to success characteristics of high-performing clinical microsystems. Primary healthcare with the participating general practices representing all Australian states and territories, and representing metropolitan and rural locations. Twenty-two general practices identified as high performing via a number of success criteria. The 52 participants were 19 general practitioners, 18 practice managers and 15 practice nurses. Participants most frequently attributed success to the interdependence of the team members, patient-focused care and leadership of the practice. They most often signalled practice leadership, team interdependence and staff focus as enablers that other organisations would need to emulate their success. They most frequently identified barriers that might be encountered in the form of potential deficits or limitations in practice leadership, staff focus and mesosystem support. Practice leaders need to empower their teams to take action through providing inclusive leadership that facilitates team interdependence. Mesosystem support for quality improvement in general practice should focus on enabling this leadership and team building, thereby ensuring improvement efforts are converted into effective healthcare provision. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Prostate Cancer on the Web-Expedient Tool for Patients' Decision-Making?

PubMed

Borgmann, Hendrik; Wölm, Jan-Henning; Vallo, Stefan; Mager, Rene; Huber, Johannes; Breyer, Johannes; Salem, Johannes; Loeb, Stacy; Haferkamp, Axel; Tsaur, Igor

2017-03-01

Many patients diagnosed with cancer search for health information on the Web. We aimed to assess the quality and reliability of online health information on prostate cancer. Google, Yahoo, and Bing were searched for the term "prostate cancer." After selecting the most frequented websites, quality was measured by DISCERN score, JAMA benchmark criteria, and presence of HONcode certification. Popularity was assessed by Alexa tool, while accessibility, usability, and reliability were investigated by LIDA tool. Readability was analyzed by Flesch-Kincaid Reading Grade Level and Automated Readability Index. All 13 selected websites were rated as being of high quality according to the DISCERN instrument (76.5 ± 2.6 out of 80 points). JAMA benchmark criteria were fulfilled by 87 % of websites, whereas only 37 % were certified by the HONcode. Median Alexa Traffic Rank was 2718 ranging from 7 to 679,038. Websites received 2.3 ± 0.5 daily pageviews per visitor and users spent an average of 2 min 58 s ± 39 sec on the website. Accessibility (92 ± 5 %) and usability (92 ± 3 %) scores were high and reliability (88 ± 8 %) moderate according to the LIDA tool. Flesch-Kincaid Grade Level was 7.9 ± 2.2, and Automated Readability Index was 7.5 ± 2.4, rating the websites as fairly difficult to read. In conclusion, quality, accessibility, and usability of websites on prostate cancer provided a high rating in the current analysis. These findings are encouraging in view of the growing frequency of patients' access of health information online.

A promising new device for the prevention of parastomal hernia.

PubMed

Hoffmann, Henry; Oertli, Daniel; Soysal, Savas; Zingg, Urs; Hahnloser, Dieter; Kirchhoff, Philipp

2015-06-01

Parastomal hernia (PSH) is the most frequent long-term stoma complication with serious negative effects on quality of life. Surgical revision is often required and has a substantial morbidity and recurrence rate. The development of PSH requires revisional surgery with a substantial perioperative morbidity and high failure rate in the long-term follow-up. Prophylactic parastomal mesh insertion during stoma creation has the potential to reduce the rate of PSH, but carries the risk of early and late mesh-related complications such as infection, fibrosis, mesh shrinkage, and/or bowel erosion. We developed a new stomaplasty ring (KORING), which is easy to implant, avoids potential mesh-related complications, and has a high potential of long-term prevention of PSH. Here we describe the technique and the first use. © The Author(s) 2014.

Evaluation of an Integrated Telemonitoring Surveillance System in Patients with Coronary Heart Disease.

PubMed

Ammenwerth, E; Woess, S; Baumgartner, C; Fetz, B; van der Heidt, A; Kastner, P; Modre-Osprian, R; Welte, S; Poelzl, G

2015-01-01

Cardiovascular diseases are the most frequent cause of death in industrialized countries. Non-adherence with prescribed medication and recommended lifestyle changes significantly increases the risk of major cardiovascular events. The telemonitoring programme MyCor (Myokardinfarkt und Koronarstent Programm in Tirol) is a multi-modal intervention programme to improve lifestyle and medication management of patients with coronary heart disease (CHD). It includes patient education, self-monitoring with goal-setting and feedback, and regular clinical visits. We evaluated the MyCor telemonitoring programme regarding technical feasibility, user acceptance, patient adherence, change in health status, and change in quality of life. A 4½-month study was conducted with two telemonitoring phases and one interim phase. The study comprised patient surveys, standardized assessment of quality of life using the MacNew questionnaire at study entry and after 4 and 18 weeks, analysis of adherence to medication and physical activity during the two telemonitoring phases, and analysis of reached goals regarding health conditions during the telemonitoring phases. Twenty-five patients (mean age: 63 years) participated in the study. Patients showed a high acceptance of the MyCor telemonitoring programme. Patients reported feelings of self-control, motivation for lifestyle changes, and improved quality of life. Adherence to daily measurements was high with 86% and 77% in the two telemonitoring phases. Adherence to medication was also high with up to 87% and 80%. Pre-defined goals for physical activity were reached in up to 86% and 73% of days, respectively. Quality of life improved from 5.5 at study entry to 6.3 at the end (p< 0.01; MacNew questionnaire). Reductions in blood pressure and heart rate or an improvement in reaching defined goals could not be observed. The MyCor telemonitoring programme Tirol for CHD patients has a high rate of acceptance among included patients. Critical evaluation revealed subjective benefits regarding quality of life and health status as well as high adherence rates to medication and lifestyle changes. Achieving long-term adherence and verifying clinical outcomes, however, remains an open issue. Our findings will promote further studies, addressing different strategies for an optimal mix of patient education, telemonitoring, feedback, and clinical follow-ups.

Oral health in the elderly patient and its impact on general well-being: a nonsystematic review

PubMed Central

Gil-Montoya, José Antonio; Ferreira de Mello, Ana Lucia; Barrios, Rocío; Gonzalez-Moles, Miguel Angel; Bravo, Manuel

2015-01-01

Data on the oral health of the elderly depict a worrying situation, with an elevated prevalence of caries and moderate periodontal disease, frequent edentulism, and numerous cases of dry mouth and oral cancer. There is wide evidence that periodontitis is a risk factor for certain systemic diseases, and impaired oral health has been associated with mastication and nutritional problems, especially among the elderly, with highly negative effects on their quality of life. In this nonsystematic review, the authors discuss the importance of evaluating the oral health of the geriatric population in a comprehensive manner, beyond simple clinical assessments. PMID:25709420

[Fast food promotes weight gain].

PubMed

Stender, Steen; Dyerberg, Jørn; Astrup, Arne V

2007-05-07

The total amounts of fat in a fast food menu consisting of French fries and fried Chicken Nuggets from McDonald's and KFC, respectively, bought in 35 different countries vary from 41 to 71 gram. In most countries the menu contained unacceptably high amounts of industrially-produced trans fat which contributes to an increased risk of ischaemic heart disease, weight gain, abdominal fat accumulation and type 2 diabetes. The quality of the ingredients in fast food ought to be better and the size of the portions smaller and less energy-dense so that frequent fast food meals do not increase the risk of obesity and diseases among customers.

Predictive risk models for proximal aortic surgery

PubMed Central

Díaz, Rocío; Pascual, Isaac; Álvarez, Rubén; Alperi, Alberto; Rozado, Jose; Morales, Carlos; Silva, Jacobo; Morís, César

2017-01-01

Predictive risk models help improve decision making, information to our patients and quality control comparing results between surgeons and between institutions. The use of these models promotes competitiveness and led to increasingly better results. All these virtues are of utmost importance when the surgical operation entails high-risk. Although proximal aortic surgery is less frequent than other cardiac surgery operations, this procedure itself is more challenging and technically demanding than other common cardiac surgery techniques. The aim of this study is to review the current status of predictive risk models for patients who undergo proximal aortic surgery, which means aortic root replacement, supracoronary ascending aortic replacement or aortic arch surgery. PMID:28616348

Coprocessors for quantum devices

NASA Astrophysics Data System (ADS)

Kay, Alastair

2018-03-01

Quantum devices, from simple fixed-function tools to the ultimate goal of a universal quantum computer, will require high-quality, frequent repetition of a small set of core operations, such as the preparation of entangled states. These tasks are perfectly suited to realization by a coprocessor or supplementary instruction set, as is common practice in modern CPUs. In this paper, we present two quintessentially quantum coprocessor functions: production of a Greenberger-Horne-Zeilinger state and implementation of optimal universal (asymmetric) quantum cloning. Both are based on the evolution of a fixed Hamiltonian. We introduce a technique for deriving the parameters of these Hamiltonians based on the numerical integration of Toda-like flows.

GAGG:ce single crystalline films: New perspective scintillators for electron detection in SEM.

PubMed

Bok, Jan; Lalinský, Ondřej; Hanuš, Martin; Onderišinová, Zuzana; Kelar, Jakub; Kučera, Miroslav

2016-04-01

Single crystal scintillators are frequently used for electron detection in scanning electron microscopy (SEM). We report gadolinium aluminum gallium garnet (GAGG:Ce) single crystalline films as a new perspective scintillators for the SEM. For the first time, the epitaxial garnet films were used in a practical application: the GAGG:Ce scintillator was incorporated into a SEM scintillation electron detector and it showed improved image quality. In order to prove the GAGG:Ce quality accurately, the scintillation properties were examined using electron beam excitation and compared with frequently used scintillators in the SEM. The results demonstrate excellent emission efficiency of the GAGG:Ce single crystalline films together with their very fast scintillation decay useful for demanding SEM applications. Copyright © 2016 Elsevier B.V. All rights reserved.

Shallow Ground-Water Quality in Agricultural Areas of Northern Alabama and Middle Tennessee, 2000-2001

USGS Publications Warehouse

Kingsbury, James A.

2003-01-01

As part of the U.S. Geological Survey National Water-Quality Assessment Program, 32 monitoring wells were installed near cropland in parts of northern Alabama and Middle Tennessee to characterize the effect of row-crop agriculture on shallow ground-water quality. The wells were completed in regolith overlying carbonate bedrock. These geologic units are part of the Mississippian carbonate aquifer, a source of drinking water for domestic and municipal supply in the area. The majority of these wells were sampled in the spring of 2000 for inorganic constituents, nutrients, pesticides, and selected pesticide degradates. Land use and soil characteristics were delineated for a 1,640-foot radius buffer area around each well to relate water quality to environmental factors. A strong association among soil characteristics, land use, and hydrogeology limited the analysis of the effect of these factors on nitrate and pesticide occurrence. Nitrate and pesticide concentrations generally were low, and no samples exceeded established drinking-water maximum contaminant levels. The maximum concentration of nitrate was about 8 milligrams per liter as nitrogen, and the median concentration was 1 milligram per liter. Nitrate concentrations were strongly correlated to dissolved-oxygen concentrations, and ratios of chloride to nitrate indicate nitrate concentrations were affected by denitrification in about a third of the samples. A pesticide or pesticide degradate was detected at concentrations greater than 0.01 microgram per liter in 91 percent of the samples. Pesticides with the highest use typically were detected most frequently and at the highest concentrations; however, glyphosate had the highest estimated use but was not detected in any samples. Fluometuron and atrazine, two high-use pesticides, were detected in 83 and 70 percent, respectively, of the samples from wells where the pesticide was applied in the buffer area. Maximum concentrations of fluometuron and atrazine were 2.13 and 1.83 micrograms per liter, respectively. Detection rates of pesticide degradates were similar to parent pesticides, and concentrations of degradates generally were comparable to or greater than the parent pesticide. Pesticide detections were correlated to dissolved-oxygen concentrations, suggesting that pesticides are most likely to be detected at high concentrations where ground-water residence time is short and the rate of recharge is fast. Nitrate and pesticide data collected in this study were compared to data collected from similar agricultural land-use studies conducted by the National Water-Quality Assessment Program throughout the Nation. Nitrate concentrations generally were lower in this study than in samples from other agricultural areas; however, pesticides were detected more frequently in samples from wells in this study. For example, atrazine and its degradate, deethylatrazine, were detected in 62 and 47 percent, respectively, of water samples in this study but were detected in about 25 percent of the 851 wells sampled for agricultural land-use studies nationwide. In national study areas where atrazine use is greater than in the lower Tennessee River Basin, atrazine was detected in 30 percent of the water samples. Pesticides used on cotton were detected much more frequently in this study, but many of the study areas nationwide have smaller amounts of cotton acreage than the lower Tennessee River Basin. Similarities in nitrate concentrations and the pesticides detected frequently in this agricultural land-use study and a network of drinking-water wells in the same area completed in bedrock in the Mississippian carbonate aquifer (sampled in a previous study) indicate the aquifer is susceptible to contamination from nonpoint sources. Nitrate concentrations were not statistically different for the two well networks and were correlated to total pesticide concentrations in both networks. Although detection frequencies and maximum concentrations

Association Between Echocardiography Laboratory Accreditation and the Quality of Imaging and Reporting for Valvular Heart Disease.

PubMed

Thaden, Jeremy J; Tsang, Michael Y; Ayoub, Chadi; Padang, Ratnasari; Nkomo, Vuyisile T; Tucker, Stephen F; Cassidy, Cynthia S; Bremer, Merri; Kane, Garvan C; Pellikka, Patricia A

2017-08-01

It is presumed that echocardiographic laboratory accreditation leads to improved quality, but there are few data. We sought to compare the quality of echocardiographic examinations performed at accredited versus nonaccredited laboratories for the evaluation of valvular heart disease. We enrolled 335 consecutive valvular heart disease subjects who underwent echocardiography at our institution and an external accredited or nonaccredited institution within 6 months. Completeness and quality of echocardiographic reports and images were assessed by investigators blinded to the external laboratory accreditation status and echocardiographic results. Compared with nonaccredited laboratories, accredited sites more frequently reported patient sex (94% versus 78%; P <0.001), height and weight (96% versus 63%; P <0.001), blood pressure (86% versus 39%; P <0.001), left ventricular size (96% versus 83%; P <0.001), right ventricular size (94% versus 80%; P =0.001), and right ventricular function (87% versus 73%; P =0.006). Accredited laboratories had higher rates of complete and diagnostic color (58% versus 35%; P =0.002) and spectral Doppler imaging (45% versus 21%; P <0.0001). Concordance between external and internal grading of external studies was improved when diagnostic quantification was performed (85% versus 69%; P =0.003), and in patients with mitral regurgitation, reproducibility was improved with higher quality color Doppler imaging. Accredited echocardiographic laboratories had more complete reporting and better image quality, while echocardiographic quantification and color Doppler image quality were associated with improved concordance in grading valvular heart disease. Future quality improvement initiatives should highlight the importance of high-quality color Doppler imaging and echocardiographic quantification to improve the accuracy, reproducibility, and quality of echocardiographic studies for valvular heart disease. © 2017 American Heart Association, Inc.

Do Psychosocial Interventions Improve Quality of Life and Wellbeing in Adults with Neuromuscular Disorders? A Systematic Review and Narrative Synthesis.

PubMed

Walklet, Elaine; Muse, Kate; Meyrick, Jane; Moss, Tim

2016-08-30

Quality of life and well-being are frequently restricted in adults with neuromuscular disorders. As such, identification of appropriate interventions is imperative. The objective of this paper was to systematically review and critically appraise quantitative studies (RCTs, controlled trials and cohort studies) of psychosocial interventions designed to improve quality of life and well-being in adults with neuromuscular disorders. A systematic review of the published and unpublished literature was conducted. Studies meeting inclusion criteria were appraised using a validated quality assessment tool and results presented in a narrative synthesis. Out of 3,136 studies identified, ten studies met criteria for inclusion within the review. Included studies comprised a range of interventions including: cognitive behavioural therapy, dignity therapy, hypnosis, expressive disclosure, gratitude lists, group psychoeducation and psychologically informed rehabilitation. Five of the interventions were for patients with Amyotrophic Lateral Sclerosis (ALS). The remainder were for patients with post-polio syndrome, muscular dystrophies and mixed disorders, such as Charcot-Marie-Tooth disease, myasthenia gravis and myotonic dystrophy. Across varied interventions and neuromuscular disorders, seven studies reported a short-term beneficial effect of intervention on quality of life and well-being. Whilst such findings are encouraging, widespread issues with the methodological quality of these studies significantly compromised the results. There is no strong evidence that psychosocial interventions improve quality of life and well-being in adults with neuromuscular disorders, due to a paucity of high quality research in this field. Multi-site, randomised controlled trials with active controls, standardised outcome measurement and longer term follow-ups are urgently required.

Nutritional status, psychological well-being and the quality of life of AIDS orphans in rural Henan Province, China.

PubMed

He, Zhonghu; Ji, Chengye

2007-10-01

To assess the influence of orphanhood due to AIDS on children's nutritional status, psychological well-being and life quality, and to explore appropriate intervention strategies in China. In 2005, 186 children aged 8-15 years (93 AIDS orphans and 93 non-orphans) from a rural area of Henan Province were surveyed in a cross-sectional and matched pairs study on nutritional status, psychological health and life quality. We found no compelling evidence for poorer nutritional status in orphans. The nutritional status of both orphans and non-orphans was extremely poor according to the prevalence of stunting, underweight, wasting and anaemia. Depression, low self-esteem and lower quality of life were more frequent in orphans. These differences mainly existed in boys' groups. No significant differences were found between paternal, maternal and double orphans, or orphans in orphanages or extended families. Regression analysis revealed that orphanhood leads to low self-esteem and more depression which contributes to lower quality of life and mediates the association between orphanhood and quality of life. The high prevalence of poor nutritional status indicates that basic material needs of children, including AIDS orphans, are not met in rural China. Psychological problems were prominent among orphans and had become the most important contributor of lower life quality. Boys were at least as vulnerable as girls. The living conditions of all children in rural China must be improved; school-based care and support are crucial and would be a cost-effective way to improve the overall life quality of AIDS orphans.

Do Psychosocial Interventions Improve Quality of Life and Wellbeing in Adults with Neuromuscular Disorders? A Systematic Review and Narrative Synthesis

PubMed Central

Walklet, Elaine; Muse, Kate; Meyrick, Jane; Moss, Tim

2016-01-01

Quality of life and well-being are frequently restricted in adults with neuromuscular disorders. As such, identification of appropriate interventions is imperative. The objective of this paper was to systematically review and critically appraise quantitative studies (RCTs, controlled trials and cohort studies) of psychosocial interventions designed to improve quality of life and well-being in adults with neuromuscular disorders. A systematic review of the published and unpublished literature was conducted. Studies meeting inclusion criteria were appraised using a validated quality assessment tool and results presented in a narrative synthesis. Out of 3,136 studies identified, ten studies met criteria for inclusion within the review. Included studies comprised a range of interventions including: cognitive behavioural therapy, dignity therapy, hypnosis, expressive disclosure, gratitude lists, group psychoeducation and psychologically informed rehabilitation. Five of the interventions were for patients with Amyotrophic Lateral Sclerosis (ALS). The remainder were for patients with post-polio syndrome, muscular dystrophies and mixed disorders, such as Charcot-Marie-Tooth disease, myasthenia gravis and myotonic dystrophy. Across varied interventions and neuromuscular disorders, seven studies reported a short-term beneficial effect of intervention on quality of life and well-being. Whilst such findings are encouraging, widespread issues with the methodological quality of these studies significantly compromised the results. There is no strong evidence that psychosocial interventions improve quality of life and well-being in adults with neuromuscular disorders, due to a paucity of high quality research in this field. Multi-site, randomised controlled trials with active controls, standardised outcome measurement and longer term follow-ups are urgently required. PMID:27854227

Confidence Bounds and Power for the Reliability of Observational Measures on the Quality of a Social Setting

ERIC Educational Resources Information Center

Shin, Yongyun; Raudenbush, Stephen W.

2012-01-01

Social scientists are frequently interested in assessing the qualities of social settings such as classrooms, schools, neighborhoods, or day care centers. The most common procedure requires observers to rate social interactions within these settings on multiple items and then to combine the item responses to obtain a summary measure of setting…

Co-Parenting Quality, Parenting Stress, and Feeding Challenges in Families with a Child Diagnosed with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Thullen, Matthew; Bonsall, Aaron

2017-01-01

113 parents of children aged 5-13 with ASD completed online surveys assessing co-parenting quality, parenting stress, and child feeding challenges. Results indicated that food selectivity was both the most frequently reported type of challenging feeding behavior and the most often reported as problematic but was also the only type of challenging…

The Relations of Sleep and Quality of Life to School Performance in Youth with Type 1 Diabetes

ERIC Educational Resources Information Center

Perfect, Michelle M.

2014-01-01

This study examined parent and youth self-reports to test the hypothesis that perceived insufficient sleep duration, inconsistent sleep habits, reduced quality of life, less frequent blood glucose monitoring, and higher hemoglobin A1c would predict poorer school functioning among 50 youth with type 1 diabetes. The data suggested that a delay in…

Quantification of material state using reflectance FTIR spectroscopy

NASA Astrophysics Data System (ADS)

Criner, Amanda K.; Henry, Christine; Imel, Megan; King, Derek

2018-04-01

A common, frequently violated, assumption implicit in many data analysis techniques is that data is of the same quality across observations. The effect of this assumption is discussed and demonstrated in the example of FTIR of CMCs. An alternative analysis, which incorporates the variation in the quality of the data, is presented. A comparison between the analyses is used to demonstrate this difference.

Health-Related Quality of Life and Health-Promoting Behaviors in Black Men

ERIC Educational Resources Information Center

Calvert, Wilma J.; Isaac,, E. Paulette; Johnson, Sharon

2012-01-01

This study examined the health-related quality of life and health-promoting behaviors in a convenience sample of low-income black men. Almost three-fourths reported their overall health as good or better. However, the mean number of recent (that is, past 30 days) mentally unhealthy days was 13.12, and more than half reported frequent (greater than…

Evaluating the data completeness in the Electronic Health Record after the Implementation of an Outpatient Electronic Health Record.

PubMed

Soto, Mauricio; Capurro, Daniel; Catalán, Silvia

2015-01-01

Electronic health records (EHRs) present an opportunity for quality improvement in health organitations, particularly at the primary health level. However, EHR implementation impacts clinical workflows, and physicians frequently prefer to document in a non-structured way, which ultimately hinders the ability to measure quality indicators. We present an assessment of data completeness-a key data quality indicator-during the first 12 months after the implementation of an EHR at a teaching outpatient center in Santiago, Chile.

Emergency Department Frequent Utilization for Non-Emergent Presentments: Results from a Regional Urban Trauma Center Study

PubMed Central

2016-01-01

Objectives First, to test a model of the drivers of frequent emergency department utilization conceptualized as falling within predisposing, enabling, and need dimensions. Second, to extend the model to include social networks and service quality as predictors of frequent utilization. Third, to illustrate the variation in thresholds that define frequent utilization in terms of the number of emergency department encounters by the predictors within the model. Data Source Primary data collection over an eight week period within a level-1 trauma urban hospital’s emergency department. Study Design Representative randomized sample of 1,443 adult patients triaged ESI levels 4–5. Physicians and research staff interviewed patients as they received services. Relationships with the outcome variable, utilization, were tested using logistic regression to establish odds-ratios. Principal Findings 70.6 percent of patients have two or more, 48.3 percent have three or more, 25.3 percent have four or more, and 14.9 percent have five or more emergency department visits within 12 months. Factors associated with frequent utilization include gender, race, poor mental health, mental health drugs, prescription drug abuse, social networks, employment, perceptions of service quality, seriousness of condition, persistence of condition, and previous hospital admittance. Conclusions Interventions targeting associated factors will change global emergency department encounters, although the mutability varies. Policy interventions to address predisposing factors such as substance abuse or access to mental health treatment as well as interventions that speak to enabling factors such as promoting the resiliency of social networks may result in decreased frequency of emergency department utilization. PMID:26784515

A new use of high resolution magnetograms. [solar activity and magnetic flux

NASA Technical Reports Server (NTRS)

Baum, P. J.; Bratenahl, A.

1978-01-01

Ground-based solar magnetograms are frequently in error by as much as twenty percent and contribute to the poor correlation between magnetic changes and solar flares. High resolution measurement of the magnetic field component, which is normal to the photosphere and measured at photospheric height, can be used to construct a magnetic flux partition function F. Therefore, dF/dt is an EMF which drives atmospheric currents in reconnecting solar active regions. With a high quality magnetograph, the solar probe can be used to obtain good estimates of F and dF/dt and thereby the energy stored as induced solar atmospheric currents during quiescent interflare periods. Should a flare occur during a favorable observing period, the present method of analysis should show characteristic signatures in F, DF/dt, and especially, in the stored flux computed from dF/dt.

LED downlights with non-circular spots

NASA Astrophysics Data System (ADS)

Parkyn, William A.; Pelka, David G.

2005-09-01

The ubiquitous downlight inhabits our ceilings by the millions. Hot, inefficient, and electrically wasteful, it is next in line for replacement by the latest high-brightness, high-efficacy white LEDs. The conventional downlight configuration of a large incandescent spotlight in a low-cost, ceiling-recessed metal can, represents the culmination of old technology, fated never to improve significantly. Incandescent downlights add greatly both to direct and indirect electrical consumption, with the lamps requiring relatively frequent replacement. The small size of LED emitters means small optical elements can produce much higher-quality beams than incandescent spotlight-lamps can produce. Herein we introduce compact high-luminosity LED downlights with lenses that deliver uniform illumination to delimited targets such as tables. One version utilizes circular lenses and micro-diffuser films to deliver square outputs. The other uses lenses cut to the target shape. In particular, one of these lenses is the first to offer a semicircular spot suitable for gambling tables.

Tool use by Amazonian capuchin monkeys during predation on caiman nests in a high-productivity forest.

PubMed

Torralvo, Kelly; Rabelo, Rafael M; Andrade, Alfredo; Botero-Arias, Robinson

2017-04-01

Descriptions of new tool-use events are important for understanding how ecological context may drive the evolution of tool use among primate traditions. Here, we report a possible case of the first record of tool use by wild Amazonian capuchin monkeys (Sapajus macrocephalus). The record was made by a camera trap, while we were monitoring caiman nest predation at Mamirauá Reserve in Central Amazonia. An adult individual was registered in a bipedal posture, apparently using a branch as a shovel to dig eggs out of a nest. Caiman eggs are frequently depredated by opportunistic animals, such as the capuchin monkeys. As the Mamirauá Reserve is covered by a high-productivity forest, and caiman eggs are a high-quality food resource seasonally available on the ground, we believe that tool use by capuchins is more likely to be opportunity driven, rather than necessity driven, in our study site.

The socio-economic distribution of health-related occupational stressors among wage-earners in a Post-Fordist labour market

PubMed Central

2010-01-01

Unequal exposure to occupational stressors is a central pathway towards socio-economic health inequalities in working populations. This paper assesses the differential exposure of such stressors within the population of Flemish wage-earners. Our focus is on differences in gender, age, skill levels, occupational and social class positions. Method The analyses are based on the "Flemish Quality of Labour Monitor 2004" (Vlaamse Werkbaarheidsmonitor 2004), a cross-sectional representative sample (N = 11,099) of 16- to 65-year-old wage-earners, living in Flanders. The investigated health-related working conditions are: high quantitative, emotional and physical demands, frequent repetitive movements, atypical work schedules, frequent overtime work and schedule changes, low job autonomy, task variation and superior-support, high job insecurity and exposure to bullying. The distribution of the working conditions is assessed by means of standard logistic regression analyses. Also gender specific analyses are performed. Results At least two clusters of health-related occupational stressors can be identified. On the one hand, high physical demands, atypical schedules, low control over the work environment and high job insecurity are more common in manual, unskilled and subordinate workers. On the other hand, high quantitative and emotional demands, as well as schedule unpredictability are characteristic of higher skilled, professional and managerial employees. Conclusion Since little empirical information on the socio-economic distribution of various health-related occupational stressors is available for Flanders, our results are important for obtaining more insight into the pathways linking occupational health risks to socio-economic health inequalities in the Flemish wage-earning population.

A Survey of Social Media Use and Preferences in Patients with Inflammatory Bowel Disease.

PubMed

Reich, Jason; Guo, Ling; Hall, Julia; Tran, Ashley; Weinberg, Janice; Groshek, Jacob; Rowell, Tanya E; DiPalma, Jack A; Farraye, Francis A

2016-11-01

With the recent increase in the use of social media, patients with chronic illnesses are using the Internet as a resource for disease management. As the peak incidence of inflammatory bowel disease (IBD) occurs in patients between the ages of 15 and 30, IBD is a suitable condition to study social media use. The aim of this study was to assess social media usage and preferences in patients with IBD. We administered a survey to 118 patients with IBD at our outpatient practice at the Boston Medical Center (BMC), Center for Digestive Disorders, and the University of Southern Alabama (USA) between November 1, 2015, and March 9, 2016. The most frequently used IBD-specific social media website was the CCFA (86%). High-frequency social media users were more likely to agree that "social media is useful for managing my IBD," compared with low-frequency social media users (OR 3.23, 0.3-10.1, P = 0.199). Fifty-five percent of respondents were interested in obtaining patient-with-IBD education through social media, or organizations such as the CCFA, whereas 45% did not express interest. Sixty-two percent of patients would be interested in following a social media account established by their gastroenterologist. Privacy and/or confidentiality issues were the primary barriers to social media use. Last, most patients were unsure of the quality of IBD information posted online. The results of this study suggest that patients who frequently use social media are highly interested in using social media in the management of their IBD. Most patients with IBD in our study were interested in receiving IBD information from their gastroenterologist and other patient-related organizations through social media. Most patients are unsure of the quality of IBD information posted on social media. Gastroenterologists should be aware that their patients may use social media to obtain disease education. Future studies should assess the quality of IBD information on social media and the effectiveness of communication through social media as a means to improve patient education and outcomes.

Fast food: unfriendly and unhealthy.

PubMed

Stender, S; Dyerberg, J; Astrup, A

2007-06-01

Although nutrition experts might be able to navigate the menus of fast-food restaurant chains, and based on the nutritional information, compose apparently 'healthy' meals, there are still many reasons why frequent fast-food consumption at most chains is unhealthy and contributes to weight gain, obesity, type 2 diabetes and coronary artery disease. Fast food generally has a high-energy density, which, together with large portion sizes, induces over consumption of calories. In addition, we have found it to be a myth that the typical fast-food meal is the same worldwide. Chemical analyses of 74 samples of fast-food menus consisting of French fries and fried chicken (nuggets/hot wings) bought in McDonalds and KFC outlets in 35 countries in 2005-2006 showed that the total fat content of the same menu varies from 41 to 65 g at McDonalds and from 42 to 74 g at KFC. In addition, fast food from major chains in most countries still contains unacceptably high levels of industrially produced trans-fatty acids (IP-TFA). IP-TFA have powerful biological effects and may contribute to increased weight gain, abdominal obesity, type 2 diabetes and coronary artery disease. The food quality and portion size need to be improved before it is safe to eat frequently at most fast-food chains.

[The contribution of oncology nursing to the Swiss Research Agenda for Nursing - SRAN].

PubMed

Shaha, Maya; Schmid-Büchi, Silvia; Abt, Judith; Mathis-Jäggi, Franziska; Holdener, Eveline; Riederer, Evelyn; Stoll, Hans Ruedi; Fliedner, Monica; Imhof, Lorenz

2008-12-01

Worldwide, cancer remains the second most frequent cause of death in adults and children. A cancer diagnosis often marks the beginning of therapies that may continue over months and years. These therapies frequently consist in surgical interventions in combination with chemotherapy and radiotherapy. For all healthcare professionals involved, cancer also signifies a very complex illness with high demands. It is therefore important to identify research priorities in order to successfully and comprehensively address these demands and to provide high quality patient care. In order to identify research priorities in oncology care in Switzerland, a systematic review of literature was conducted. A total of 30 research priorities emerged from the literature. In accordance with SRAN guidelines, 25 were passed on to the SRAN. The systematic identification of research priorities in oncology nursing has, for the first time, resulted in a list of topics in need of investigation in Switzerland. Completing the list of research priorities for oncology nursing with an updated systematic review of literature and presenting it to a larger and more representative group of oncology nurses, experts, and nurse scientists with oncology nursing experience for assessment and valuation, will be crucial for any future revision of the SRAN. In the future, it will be indispensable to include patients and their families in the process.

Importance of Social Relationships in Patients with Chronic Respiratory Diseases.

PubMed

Kurpas, Donata; Szwamel, Katarzyna; Mroczek, Bozena

2016-01-01

The literature lacks reports on the role of the social relationships domain (SRD) of quality of life (QoL) in shaping care for patients with chronic respiratory diseases in primary care. In this study we examined a group of 582 patients with chronic respiratory diseases and chronic non-respiratory diseases recruited from 199 primary care centers. In the patients with chronic respiratory diseases, higher SRD correlated with more frequent patient visits due to medical issue, fewer district nurse interventions over the past 12 months, less frequent hospitalizations over the past 3 years, and fewer chronic diseases. In these patients, a high SRD was most effectively created by high QoL in the Psychological, Environmental, and Physical domains, and the satisfaction with QoL. Programs for preventing a decline in SRD should include patients with low scores in the Psychological, Environmental, and Physical domains, those who show no improvement in mental or somatic well-being in the past 12 months, those with a low level of positive mental attitudes, unhealthy eating habits, and with low levels of met needs. Such programs should include older widows and widowers without permanent relationships, with only primary education, living far from a primary care center, and those whose visits were not due to a medical issue.

Relationship between health-related quality of life, perceived family support and unmet health needs in adult patients with multimorbidity attending primary care in Portugal: a multicentre cross-sectional study.

PubMed

Prazeres, Filipe; Santiago, Luiz

2016-11-11

Multimorbidity has a high prevalence in the primary care context and it is frequently associated with worse health-related quality of life (HRQoL). Few studies evaluated the variables that could have a potential effect on HRQoL of primary care patients with multimorbidity. The purpose of this study, the first of its kind ever undertaken in Portugal, is to analyse the relationship between multimorbidity, health-related quality of life, perceived family support and unmet health needs in adult patients attending primary care. Multicentre, cross-sectional survey conducted among primary care patients with multimorbidity. It included 521 participants (64.1 % females) who met the inclusion criteria. HRQoL was evaluated using the Portuguese Short Form-12 Health Status Questionnaire. The Portuguese Family APGAR was used to measure the perceived family support. A patients' unmet health needs questionnaire was used. The unmet needs for medical, surgical and dental care; prescription medications; mental healthcare or counselling; and eyeglasses or other technical aid was assessed. Descriptive and multivariate analyses were performed. The sample had an overall average of 4.5 chronic health problems. Increased multimorbidity levels were linked to worse health-related quality of life, particularly the physical health. Some variables were confirmed as playing a role on health-related quality of life. Male patients with high monthly incomes and highly functional families had better physical and mental health. High levels of education and the presence of asthma were also associated with better physical health. Contrariwise, elderly patients with high levels of multimorbidity and with osteoarthritis had lower physical health. The majority of the patients did not have unmet health needs. When health needs were stated they were mostly for generalist medical care, dental care, and eyeglasses/other technical aid. Financial insufficiency was the primary reason for not fulfilling their health needs. To improve the quality of life of multimorbid patients, within primary care practices and health delivery systems, one should take into special account the sex of the patient, the perceived family support and the self-perceived economic status because of their relationship with both physical and mental health. Limitations and recommendations are discussed.

State-Sponsored Public Reporting Programs of Hospital Quality in the United States

PubMed Central

Ross, Joseph S.; Sheth, Sameer D.; Krumholz, Harlan M.

2011-01-01

The prevalence of state public reporting initiatives focused on hospital quality is not known. We systematically reviewed state-sponsored publicly reporting programs focused on clinical aspects of hospital quality and performance for adults, surveying the 50 U.S. states and the District of Columbia. We found that while identifying information about programs was frequently a challenge, programs were present in 25 states (49%) and provided hospital quality information that varied considerably from state to state both by condition and by process and outcome measures reported. We examine the implications of these findings for future state initiatives. PMID:21134936

Reduction of Defects in Germanium-Silicon

NASA Technical Reports Server (NTRS)

Szofran, F. R.; Benz, K. W.; Cobb, S. D.; Croell, A.; Dold, P.; Kaiser, N.; Motakel, S.; Walker, J. S.

2000-01-01

Crystals grown without contact with a container have far superior quality to otherwise similar crystals grown in direct contact with a container. In addition to float-zone processing, detached-Bridgman growth is a promising tool to improve crystal quality, without the limitations of float zoning. Detached growth has been found to occur frequently during microg experiments and considerable improvements of crystal quality have been reported for those cases. However, no thorough understanding of the process or quantitative assessment of the quality improvements exists so far. This project is determining the means to reproducibly grow Ge-Si alloys in the detached mode.

Occurrence of selected pesticides and their metabolites in near-surface aquifers of the midwestern United States

USGS Publications Warehouse

Kolpin, D.W.; Michael, Thurman E.; Goolsby, D.A.

1996-01-01

The occurrence and distribution of selected pesticides and their metabolites were investigated through the collection of 837 water-quality samples from 303 wells across the Midwest. Results of this study showed that five of the six most frequently detected compounds were pesticide metabolites. Thus, it was common for a metabolite to be found more frequently in groundwater than its parent compound. The metabolite alachlor ethanesulfonic acid (alachlor-ESA; 2-[(2,6-diethylphenyl)(methoxymethyl)amino]-2-oxoethanesulfonic acid) was detected almost 10 times as frequently and at much higher concentrations than its parent compound alachlor (2-chloro-2‘,6‘-diethyl-N-(methoxymethyl)acetamide). The median detectable atrazine (2-chloro-4-ethylamino-6- isopropylamino-s-triazine) concentration was almost half that of atrazine residue (atrazine plus the two atrazine metabolites analyzed). Cyanazine amide [2-chloro-4-(1-carbamoyl-1-methylethylamino)-6-ethylamino-s-triazine] was detected almost twice as frequently as cyanazine (2-chloro-4-ethylamino-6-methylpropionitrileamino-s-triazine). Results show that information on pesticide metabolites is necessary to understand the environmental fate of pesticides. Consequently, if pesticide metabolites are not quantified, the effects of chemical use on groundwater quality would be substantially underestimated. Thus, continued research is needed to identify major degradation pathways for all pesticides and to develop analytical methods to determine their concentrations in water and other environmental media.

Challenges and Opportunities of Air Quality Management in Mexico City

NASA Astrophysics Data System (ADS)

Paramo, V.

2013-05-01

The Mexico City Metropolitan Area (MCMA) is located in the central plateau of Mexico and is the capital of the country. Its natural characteristics present favorable conditions for air pollution formation and accumulation: mountains surrounding the city, frequent thermal inversions, high isolation all around the year and weak winds. To these natural conditions, a population of more than 20 million inhabitants, a fleet of 4.5 million vehicles and more than 4 thousands industries, make air quality management a real challenge for governments of the region. Intensive air quality improvement actions and programs began at the end of the 1980's and continued nowadays. Since then criteria air pollutants concentrations have decreased in such a way that currently most of pollutants meet the Mexican air quality standards, except for ozone and particulate matter. Applied measures comprised of fuel quality improvements, fuel replacements, regulations for combustion processes, closing of high polluting refineries and industries, regulations of emissions for new and on road vehicles, mandatory I/M programs for vehicles, circulation restrictions for vehicles (Day without car program), alert program for elevated air pollution episodes, improvement of public transportation, among others. Recent researches (MILAGRO 2006 campaign) found that currently it is necessary to implement emissions reduction actions for Volatile Organic Compounds, particulate matter with a diameter of less than 2.5 micrometers PM2.5 and Nitrogen Oxides, in order to reduce concentrations of ozone and fine particulate matter. Among the new measures to be implemented are: regulations for VOCs emissions in the industry and commercial sectors; regulation of the diesel fleet that includes fleets renewal, filters and particulate traps for in use vehicles and regulation of the cargo fleet; new schemes for reducing the number of vehicles circulating in the city; implementation of non-motorized mobility programs; among others.

Critical appraisal of clinical trials in multiple system atrophy: Toward better quality.

PubMed

Castro Caldas, Ana; Levin, Johannes; Djaldetti, Ruth; Rascol, Olivier; Wenning, Gregor; Ferreira, Joaquim J

2017-10-01

Multiple system atrophy (MSA) is a rare neurodegenerative disease of undetermined cause. Although many clinical trials have been conducted, there is still no treatment that cures the disease or slows its progression. We sought to assess the clinical trials, methodology, and quality of reporting of clinical trails conducted in MSA patients. We conducted a systematic review of all trials with at least 1 MSA patient subject to any pharmacological/nonpharmacological interventions. Two independent reviewers evaluated the methodological characteristics and quality of reporting of trials. A total of 60 clinical trials were identified, including 1375 MSA patients. Of the trials, 51% (n = 31) were single-arm studies. A total of 28% (n = 17) had a parallel design, half of which (n = 13) were placebo controlled. Of the studies, 8 (13.3%) were conducted in a multicenter setting, 3 of which were responsible for 49.3% (n = 678) of the total included MSA patients. The description of primary outcomes was unclear in 60% (n = 40) of trials. Only 10 (16.7%) clinical trials clearly described the randomization process. Blinding of the participants, personnel, and outcome assessments were at high risk of bias in the majority of studies. The number of dropouts/withdrawals was high (n = 326, 23.4% among the included patients). Overall, the design and quality of reporting of the reviewed studies is unsatisfactory. The most frequent clinical trials were small and single centered. Inadequate reporting was related to the information on the randomization process, sequence generation, allocation concealment, blinding of participants, and sample size calculations. Although improved during the recent years, methodological quality and trial design need to be optimized to generate more informative results. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

[Polish adaptation and validation of Health-Related Quality of Life in Childhood Epilepsy Questionnaire].

PubMed

Mathiak, Krystyna A; Karzel, Katarzyna; Mathiak, Klaus; Ostaszewski, Paweł; Luba, Małgorzata; Wolańczyk, Tomasz

2007-01-01

Epilepsy is a frequent chronic disease in children, having a strong impact on a child's psychosocial functioning. Effective therapy must take into account the wide range of physical, psychological and social needs of patients. The importance of assessing patients' quality of life is becoming increasingly acknowledged. In addition to providing better health care, it may reveal how the disease and its psychosocial outcome interact. Quality of life in epilepsy can be assessed most reliably by disease-specific measures. Health-Related Quality of Life in Childhood Epilepsy (QOLCE) is an English parental questionnaire for children aged between 4 and 18 years. It contains 87 questions that fall into five domains: physical function, emotional well-being, cognitive function, social function and behavioural function. The original scale has a well-grounded theoretical background and good psychometric properties. The aim of the study was to create a Polish version of QOLCE and evaluate its psychometric properties. Parents of 87 patients suffering from epilepsy were recruited in neurological clinics in the Warsaw area. Reliability was very high (Cronbach's alpha = 0.97). The construct validity was confirmed by the correlation between subscales of QOLCE and the Child Behaviour Checklist, as well as selected clinical measures of child's health (duration of disease: r=-0.22, p=0.02; duration of treatment: r=-0.20, p=0.04; number of hospitalizations: r=-0.24, p=0.02). All the psychometric properties were similar to those of the original scale. A Polish scale examining the quality of life was created that takes into account a wide range of psychosocial problems. We confirmed very high reliability and good validity, and thus we recommend the inventory for both research on and clinical diagnostics of Polish children with epilepsy.

Telemedicine Use in Rural Native American Communities in the Era of the ACA: a Systematic Literature Review.

PubMed

Kruse, Clemens Scott; Bouffard, Shelby; Dougherty, Michael; Parro, Jenna Stewart

2016-06-01

Native American communities face serious health disparities and, living in rural areas, often lack regular access to healthcare services as compared to other Americans. Since the early 1970's, telecommunication technology has been explored as a means to address the cost and quality of, as well as access to, healthcare on rural reservations. This systematic review seeks to explore the use of telemedicine in rural Native American communities using the framework of cost, quality, and access as promulgated by the Affordable Care Act of 2010 and urge additional legislation to increase its use in this vulnerable population. As a systematic literature review, this study analyzes 15 peer-reviewed articles from four databases using the themes of cost, quality, and access. The theme of access was referenced most frequently in the reviewed literature, indicating that access to healthcare may be the biggest obstacle facing widespread adoption of telemedicine programs on rural Native American reservations. The use of telemedicine mitigates the costs of healthcare, which impede access to high-quality care delivery and, in some cases, deters prospective patients from accessing healthcare at all. Telemedicine offers rural Native American communities a means of accessing healthcare without incurring high costs. With attention to reimbursement policies, educational services, technological infrastructure, and culturally competent care, telemedicine has the potential to decrease costs, increase quality, and increase access to healthcare for rural Native American patients. While challenges facing the implementation of telemedicine programs exist, there is great potential for it to improve healthcare delivery in rural Native American communities. Public policy that increases funding for programs that help to expand access to healthcare for Native Americans will improve outcomes because of the increase in access.

Evaluating YouTube as a Source of Patient Education on the Role of the Hospitalist: A Cross-Sectional Study

PubMed Central

Hudali, Tamer; Bhattarai, Mukul; Deckard, Alan; Hingle, Susan

2017-01-01

Background Hospital medicine is a relatively new specialty field, dedicated to the delivery of comprehensive medical care to hospitalized patients. YouTube is one of the most frequently used websites, offering access to a gamut of videos from self-produced to professionally made. Objective The aim of our study was to determine the adequacy of YouTube as an effective means to define and depict the role of hospitalists. Methods YouTube was searched on November 17, 2014, using the following search words: “hospitalist,” “hospitalist definition,” “what is the role of a hospitalist,” “define hospitalist,” and “who is a hospitalist.” Videos found only in the first 10 pages of each search were included. Non-English, noneducational, and nonrelevant videos were excluded. A novel 7-point scoring tool was created by the authors based on the definition of a hospitalist adopted by the Society of Hospital Medicine. Three independent reviewers evaluated, scored, and classified the videos into high, intermediate, and low quality based on the average score. Results A total of 102 videos out of 855 were identified as relevant and included in the analysis. Videos uploaded by academic institutions had the highest mean score. Only 6 videos were classified as high quality, 53 as intermediate quality, and 42 as low quality, with 82.4% (84/102) of the videos scoring an average of 4 or less. Conclusions Most videos found in the search of a hospitalist definition are inadequate. Leading medical organizations and academic institutions should consider producing and uploading quality videos to YouTube to help patients and their families better understand the roles and definition of the hospitalist. PMID:28073738

Associations between children's diet quality and watching television during meal or snack consumption: A systematic review.

PubMed

Avery, Amanda; Anderson, Catherine; McCullough, Fiona

2017-10-01

Studies have identified an association between watching television (TV) and childhood obesity. This review adds context to existing research by examining the associations between TV viewing, whilst eating, and children's diet quality. Web of Science and PubMed databases were searched from January 2000 to June 2014. Cross-sectional trials of case control or cohort studies, which included baseline data, measuring the associations between eating whilst watching TV and children's food and drink intake. Quality of selected papers was assessed. Thirteen studies, representing 61,674 children aged 1-18 yrs, met inclusion criteria. Of six studies reporting overall food habits, all found a positive association between TV viewing and consumption of pizza, fried foods, sweets, and snacks. Of eight studies looking at fruit and vegetable consumption, seven identified a negative association with eating whilst watching TV (p < .0001). Four out of five studies identified a positive association between watching TV whilst eating and servings of sugar-sweetened beverages (p < .0001). Four studies identified an association between low socioeconomic status and increased likelihood of eating whilst watching TV (p ≤ .01). Family meals did not overcome the adverse impact on diet quality of having the TV on at mealtimes. Eating whilst watching television is associated with poorer diet quality among children, including more frequent consumption of sugar-sweetened beverages and high-fat, high-sugar foods and fewer fruits and vegetables. Although these differences in consumption are small, the cumulative effect may contribute to the positive association between eating whilst watching TV and childhood obesity. © 2017 John Wiley & Sons Ltd.

Popular on YouTube: a critical appraisal of the educational quality of information regarding asthma.

PubMed

Gonzalez-Estrada, Alexei; Cuervo-Pardo, Lyda; Ghosh, Bitan; Smith, Martin; Pazheri, Foussena; Zell, Katrina; Wang, Xiao-Feng; Lang, David M

2015-01-01

Asthma affects >300 million people globally, including 25 million in the United States. Patients with asthma frequently use the Internet as a source of information. YouTube is one of the three most popular Web sites. To determine the educational quality of YouTube videos for asthma. We performed a YouTube search by using the keyword "asthma." The 200 most frequently viewed relevant videos were included in the study. Asthma videos were analyzed for characteristics, source, and content. Source was further classified as asthma health care provider, other health care provider, patient, pharmaceutical company, and professional society and/or media. A scoring system was created to evaluate quality (-10 to 30 points). Negative points were assigned for misleading information. Two hundred videos were analyzed, with a median of 18,073.5 views, 31.5 likes, and 2 dislikes, which spanned a median of 172 seconds. More video presenters were male (60.5%). The most common type of video source was other health care providers (34.5%). The most common video content was alternative treatments (38.0%), including live-fish ingestion; reflexology; acupressure and/or acupuncture; Ayurveda; yoga; raw food, vegan, gluten-free diets; marijuana; Buteyko breathing; and salt therapy. Scores for videos supplied by asthma health care providers were statistically significantly different from other sources (p < 0.001) and had the highest average score (9.91). YouTube videos of asthma were frequently viewed but were a poor source of accurate health care information. Videos by asthma health care providers were rated highest in quality. The allergy/immunology community has a clear opportunity to enhance the value of educational material on YouTube.

Predictive models for fish assemblages in eastern USA streams: implications for assessing biodiversity

USGS Publications Warehouse

Meador, Michael R.; Carlisle, Daren M.

2009-01-01

Management and conservation of aquatic systems require the ability to assess biological conditions and identify changes in biodiversity. Predictive models for fish assemblages were constructed to assess biological condition and changes in biodiversity for streams sampled in the eastern United States as part of the U.S. Geological Survey's National Water Quality Assessment Program. Separate predictive models were developed for northern and southern regions. Reference sites were designated using land cover and local professional judgment. Taxonomic completeness was quantified based on the ratio of the number of observed native fish species expected to occur to the number of expected native fish species. Models for both regions accurately predicted fish species composition at reference sites with relatively high precision and low bias. In general, species that occurred less frequently than expected (decreasers) tended to prefer riffle areas and larger substrates, such as gravel and cobble, whereas increaser species (occurring more frequently than expected) tended to prefer pools, backwater areas, and vegetated and sand substrates. In the north, the percentage of species identified as increasers and the percentage identified as decreasers were equal, whereas in the south nearly two-thirds of the species examined were identified as decreasers. Predictive models of fish species can provide a standardized indicator for consistent assessments of biological condition at varying spatial scales and critical information for an improved understanding of fish species that are potentially at risk of loss with changing water quality conditions.

Electroconvulsive therapy and its relationships with clinical characteristics and quality of life in Chinese psychiatric patients.

PubMed

An, Feng-Rong; Zhang, Ling; Zhang, Qing-E; Ungvari, Gabor S; Ng, Chee H; Chiu, Helen F K; Wu, Ping-Ping; Jin, Xin; Li, Lu; Lok, Grace K I; Xiang, Yu-Tao

2016-12-30

Little is known about the pattern of electroconvulsive therapy (ECT) use in the clinical population in China. This study examined the percentage of ECT use and its association with clinical characteristics and quality of life (QOL) in a psychiatric center in China that caters for a population of 20 million. A total sample of 1364 inpatients was consecutively recruited for the study. Demographic and clinical data including the use of ECT were collected. Psychopathology, activity of daily living and QOL were measured using standardized instruments. The percentage of ECT use was 52.1% in the whole sample; 53.4% in major depression, 57.8% in bipolar disorder, 57.0% in schizophrenia and 32.4% in other diagnoses. There was no significant difference between the ECT and non-ECT groups in any domain of QOL. Multivariate analyses revealed that ECT was independently associated with the diagnoses of major depression, bipolar disorder and schizophrenia, physical restraint, severe aggression, better activity of daily living skills, more frequent use of antipsychotics and less frequent use of benzodiazepines. The percentage of ECT use was much greater in a major psychiatric center in China than those reported from other parts of the world. Use of ECT had no influence on the short-term QOL. Further investigations are warranted to explore the reasons for the high percentage of ECT use. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Virtual reality using games for improving physical functioning in older adults: a systematic review.

PubMed

Molina, Karina Iglesia; Ricci, Natalia Aquaroni; de Moraes, Suzana Albuquerque; Perracini, Monica Rodrigues

2014-11-15

The use of virtual reality through exergames or active video game, i.e. a new form of interactive gaming, as a complementary tool in rehabilitation has been a frequent focus in research and clinical practice in the last few years. However, evidence of their effectiveness is scarce in the older population. This review aim to provide a summary of the effects of exergames in improving physical functioning in older adults. A search for randomized controlled trials was performed in the databases EMBASE, MEDLINE, PsyInfo, Cochrane data base, PEDro and ISI Web of Knowledge. Results from the included studies were analyzed through a critical review and methodological quality by the PEDro scale. Thirteen studies were included in the review. The most common apparatus for exergames intervention was the Nintendo Wii gaming console (8 studies), followed by computers games, Dance video game with pad (two studies each) and only one study with the Balance Rehabilitation Unit. The Timed Up and Go was the most frequently used instrument to assess physical functioning (7 studies). According to the PEDro scale, most of the studies presented methodological problems, with a high proportion of scores below 5 points (8 studies). The exergames protocols and their duration varied widely, and the benefits for physical function in older people remain inconclusive. However, a consensus between studies is the positive motivational aspect that the use of exergames provides. Further studies are needed in order to achieve better methodological quality, external validity and provide stronger scientific evidence.

Research of Sleep Disorders in Patients with Acute Cerebral Infarction.

PubMed

Chen, Xiaofang; Bi, Hongye; Zhang, Meiyun; Liu, Haiyan; Wang, Xueying; Zu, Ruonan

2015-11-01

The purpose of this study is to investigate the incidence of sleep disorders (SD), characteristic of cerebral infarction patients with different parts affected. The research selected 101 patients with a first occurrence of acute cerebral infarction as the experimental group, and 86 patients without cerebral infarction as controls. Polysomnography, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and US National Stroke Scale were assessed. Compared with control group, the incidence of SD was higher in experimental group (P < .05), and the incidence of SD in women was more frequent in experimental group (P < .05). There was no significant difference in the types of SD patients with acute cerebral infarction. In addition, the sleep quality of cerebral infarction patients with different parts affected was different: the sleep quality of left hemisphere infarction patients was poor compared with the right one, and the sleep quality of anterior circulation patients was poor compared with posterior circulation patients. Patients with thalamus infarction had a longer sleep time and a shorter sleep latency and stage 2 of non-rapid eye movement sleep compared with non-thalamus infarction group. The prevalence of SD was relatively high in acute cerebral infarction patients, and the detailed classification of acute cerebral infarction may provide a more effective therapeutic method and therefore relieve patients' pain and supply a better quality of sleep. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Quality of attachment, perinatal risk, and mother-infant interaction in a high-risk premature sample.

PubMed

Udry-Jørgensen, Laura; Pierrehumbert, Blaise; Borghini, Ayala; Habersaat, Stephanie; Forcada-Guex, Margarita; Ansermet, François; Muller-Nix, Carole

2011-05-01

Thirty-three families, each with a premature infant born less than 33 gestational weeks, were observed in a longitudinal exploratory study. Infants were recruited in a neonatal intensive care unit, and follow-up visits took place at 4 months and 12 months of corrected age. The severity of the perinatal problems was evaluated using the Perinatal Risk Inventory (PERI; A.P. Scheiner & M.E. Sexton, 1991). At 4 months, mother-infant play interaction was observed and coded according to the CARE-index (P.M. Crittenden, 2003); at 12 months, the Strange Situation Procedure (SSP; M.D.S. Ainsworth, M.C. Blehar, E. Waters, & S. Wall, 1978) was administered. Results indicate a strong correlation between the severity of perinatal problems and the quality of attachment at 12 months. Based on the PERI, infants with high medical risks more frequently tended to be insecurely attached. There also was a significant correlation between insecure attachment and dyadic play interaction at 4 months (i.e., maternal controlling behavior and infant compulsive compliance). Moreover, specific dyadic interactive patterns could be identified as protective or as risk factors regarding the quality of attachment. Considering that attachment may have long-term influence on child development, these results underline the need for particular attention to risk factors regarding attachment among premature infants. Copyright © 2011 Michigan Association for Infant Mental Health.

The challenges in improving outcome of cataract surgery in low and middle income countries

PubMed Central

Lindfield, Robert; Vishwanath, Kalluru; Ngounou, Faustin; Khanna, Rohit C

2012-01-01

Cataract is the leading cause of blindness globally and surgery is the only known measure to deal with it effectively. Providing high quality cataract surgical services is critical if patients with cataract are to have their sight restored. A key focus of surgery is the outcome of the procedure. In cataract surgery this is measured predominantly, using visual acuity. Population- and hospital-based studies have revealed that the visual outcome of cataract surgery in many low and middle income settings is frequently sub-optimal, often failing to reach the recommended standards set by the World Health Organization (WHO). Another way of measuring outcome of cataract surgery is to ask patients for their views on whether surgery has changed the functioning of their eyes and their quality of life. There are different tools available to capture patient views and now, these patient-reported outcomes are becoming more widely used. This paper discusses the visual outcome of cataract surgery and frames the outcome of surgery within the context of the surgical service, suggesting that the process and outcome of care cannot be separated. It also discusses the components of patient-reported outcome tools and describes some available tools in more detail. Finally, it describes a hierarchy of challenges that need to be addressed before a high quality cataract surgical service can be achieved. PMID:22944761

Measurement properties of disease-specific questionnaires in patients with neck pain: a systematic review.

PubMed

Schellingerhout, Jasper M; Verhagen, Arianne P; Heymans, Martijn W; Koes, Bart W; de Vet, Henrica C; Terwee, Caroline B

2012-05-01

To critically appraise and compare the measurement properties of the original versions of neck-specific questionnaires. Bibliographic databases were searched for articles concerning the development or evaluation of the measurement properties of an original version of a self-reported questionnaire, evaluating pain and/or disability, which was specifically developed or adapted for patients with neck pain. The methodological quality of the selected studies and the results of the measurement properties were critically appraised and rated using a checklist, specifically designed for evaluating studies on measurement properties. The search strategy resulted in a total of 3,641 unique hits, of which 25 articles, evaluating 8 different questionnaires, were included in our study. The Neck Disability Index is the most frequently evaluated questionnaire and shows positive results for internal consistency, content validity, structural validity, hypothesis testing, and responsiveness, but a negative result for reliability. The other questionnaires show positive results, but the evidence for each measurement property is mostly limited, and at least 50% of the information on measurement properties per questionnaire is lacking. Our findings imply that studies of high methodological quality are needed to properly assess the measurement properties of the currently available questionnaires. Until high quality studies are available, we recommend using these questionnaires with caution. There is no need for the development of new neck-specific questionnaires until the current questionnaires have been adequately assessed.

The Relationship between Levels of Physical Activity and Quality of Life among Students of the University of the Third Age.

PubMed

Krzepota, Justyna; Biernat, Elżbieta; Florkiewicz, Beata

2015-12-01

The assessment of quality of life (QoL) among elderly people is of great importance when preparing health care programmes for this social group. Many researchers indicate that poor health is less frequently observed in senior citizens who display levels of physical activity (PA) prescribed by WHO. The aim of the study was to investigate the relationship between the level of PA among students of the University of the Third Age (U3A) and their self-assessment concerning their QoL. The research sample consisted of 131 students from three U3A in West Pomeranian Voivodeship in Poland. PA was assessed with the aid of a short Polish version of the International Physical Activity Questionnaire (IPAQ). The assessment of QoL was conducted with the use of a Polish version of the WHO Quality of Life--BREF instrument (WHOQOL-BREF). The present study has shown that highly active U3A students declare high QoL in the psychological and social domains more often than other respondents. The level of PA recommended by WHO has a positive impact on the perceived QoL. Possible differences are visible mostly in the assessment of different domains of life in relation to the presented levels of PA. Copyright© by the National Institute of Public Health, Prague 2015.

The impact of a good practice manual on professional practice associated with psychotropic PRN in acute mental health wards: an exploratory study.

PubMed

Baker, J A; Lovell, K; Harris, N

2008-10-01

As required or pro re nata (PRN) psychotropic medicines are frequently used in acute mental health wards. PRN is known to contribute to polypharmacy and high doses of antipsychotic medication. Few studies have attempted to improve clinician's use of these potentially harmful drugs. The objectives of the study were to determine the impact and acceptability of a good practice manual on prescribing and administration practices of PRN psychotropic medication in acute mental health wards. The study used a pre-post exploratory design with two acute mental health wards in the NW of England. Over the total trial period of 10 weeks, 28 of 35 patients received 484 doses of PRN. Patients had a mean of 3.6 prescriptions of 14 different PRN medications in 34 different dose combinations prescribed. Medication errors beyond poor quality of prescribing occurred in 23 of the 35 patients (65.7%). Prescription quality improved following the introduction of the intervention but quality of nursing notes reduced. Acceptability of the manual to both nursing and medical staff was high. The introduction of the manual appeared to influence some of the practices associated with the prescribing and administration of PRN psychotropic medications. Further, larger, more robust studies are required in this area. In particular research is required to identify the reasons why professionals continue to rely so heavily on using PRN medication.

Managing Disruptive Behavior by Patients and Physicians: A Responsibility of the Dialysis Facility Medical Director.

PubMed

Jones, Edward R; Goldman, Richard S

2015-08-07

The Centers for Medicare & Medicaid Services' Conditions for Coverage make the medical director of an ESRD facility responsible for all aspects of care, including high-quality health care delivery (e.g., safe, effective, timely, efficient, and patient centered). Because of the high-pressure environment of the dialysis facility, conflicts are common. Conflict frequently occurs when aberrant behaviors disrupt the dialysis facility. Patients, family members, friends, and, less commonly appreciated, nephrology clinicians (i.e., nephrologists and advanced care practitioners) may manifest disruptive behavior. Disruptive behavior in the dialysis facility impairs the ability to deliver high-quality care. Furthermore, disruptive behavior is the leading cause for involuntary discharge (IVD) or involuntary transfer (IVT) of a patient from a facility. IVD usually results in loss of continuity of care, increased emergency department visits, and increased unscheduled, acute dialysis treatments. A sufficient number of IVDs and IVTs also trigger an extensive review of the facility by the regional ESRD Networks, exposing the facility to possible Medicare-imposed sanctions. Medical directors must be equipped to recognize and correct disruptive behavior. Nephrology-based literature and tools exist to help dialysis facility medical directors successfully address and resolve disruptive behavior before medical directors must involuntarily discharge a patient or terminate an attending clinician. Copyright © 2015 by the American Society of Nephrology.

Criteria for assessing problem solving and decision making in complex environments

NASA Technical Reports Server (NTRS)

Orasanu, Judith

1993-01-01

Training crews to cope with unanticipated problems in high-risk, high-stress environments requires models of effective problem solving and decision making. Existing decision theories use the criteria of logical consistency and mathematical optimality to evaluate decision quality. While these approaches are useful under some circumstances, the assumptions underlying these models frequently are not met in dynamic time-pressured operational environments. Also, applying formal decision models is both labor and time intensive, a luxury often lacking in operational environments. Alternate approaches and criteria are needed. Given that operational problem solving and decision making are embedded in ongoing tasks, evaluation criteria must address the relation between those activities and satisfaction of broader task goals. Effectiveness and efficiency become relevant for judging reasoning performance in operational environments. New questions must be addressed: What is the relation between the quality of decisions and overall performance by crews engaged in critical high risk tasks? Are different strategies most effective for different types of decisions? How can various decision types be characterized? A preliminary model of decision types found in air transport environments will be described along with a preliminary performance model based on an analysis of 30 flight crews. The performance analysis examined behaviors that distinguish more and less effective crews (based on performance errors). Implications for training and system design will be discussed.

Enhancing moderate-resolution ocean color products over coastal/inland waters (Conference Presentation)

NASA Astrophysics Data System (ADS)

Pahlevan, Nima; Schott, John R.; Zibordi, Giuseppe

2016-10-01

With the successful launch of Landsat-8 in 2013 followed by a very recent launch of Sentinel-2A, we are entering a new area where frequent moderate resolution water quality products over coastal/inland waters will be available to scientists and operational agencies. Although designed for land observations, the Operational Land Imager (OLI) has proven to provide high-fidelity products in these aquatic systems where coarse-resolution ocean color imagers fail to provide valid observations. High-quality, multi-scale ocean color products can give insights into the biogeochemical/physical processes from the upstream in watersheds, into near-shore regions, and further out in ocean basins. In this research, we describe a robust cross-calibration approach, which facilitates seamless ocean color products at multi scales. The top-of-atmosphere (TOA) OLI imagery is cross-calibrated against near-simultaneous MODIS and VIIRS ocean color observations in high-latitude regions. This allows for not only examining the overall relative performance of OLI but also for characterizing non-uniformity (i.e., banding) across its swath. The uncertainty of this approach is, on average, found to be less than 0.5% in the blue channels. The adjustments made for OLI TOA reflectance products are then validated against in-situ measurements of remote sensing reflectance collected in research cruises or at the AERONET-OC.

Economic Evaluation of Interventions for Prevention of Hospital Acquired Infections: A Systematic Review.

PubMed

Arefian, Habibollah; Vogel, Monique; Kwetkat, Anja; Hartmann, Michael

2016-01-01

This systematic review sought to assess the costs and benefits of interventions preventing hospital-acquired infections and to evaluate methodological and reporting quality. We systematically searched Medline via PubMed and the National Health Service Economic Evaluation Database from 2009 to 2014. We included quasi-experimental and randomized trails published in English or German evaluating the economic impact of interventions preventing the four most frequent hospital-acquired infections (urinary tract infections, surgical wound infections, pneumonia, and primary bloodstream infections). Characteristics and results of the included articles were extracted using a standardized data collection form. Study and reporting quality were evaluated using SIGN and CHEERS checklists. All costs were adjusted to 2013 US$. Savings-to-cost ratios and difference values with interquartile ranges (IQRs) per month were calculated, and the effects of study characteristics on the cost-benefit results were analyzed. Our search returned 2067 articles, of which 27 met the inclusion criteria. The median savings-to-cost ratio across all studies reporting both costs and savings values was US $7.0 (IQR 4.2-30.9), and the median net global saving was US $13,179 (IQR 5,106-65,850) per month. The studies' reporting quality was low. Only 14 articles reported more than half of CHEERS items appropriately. Similarly, an assessment of methodological quality found that only four studies (14.8%) were considered high quality. Prevention programs for hospital acquired infections have very positive cost-benefit ratios. Improved reporting quality in health economics publications is required.

Using Computer-Extracted Data from Electronic Health Records to Measure the Quality of Adolescent Well-Care

PubMed Central

Gardner, William; Morton, Suzanne; Byron, Sepheen C; Tinoco, Aldo; Canan, Benjamin D; Leonhart, Karen; Kong, Vivian; Scholle, Sarah Hudson

2014-01-01

Objective To determine whether quality measures based on computer-extracted EHR data can reproduce findings based on data manually extracted by reviewers. Data Sources We studied 12 measures of care indicated for adolescent well-care visits for 597 patients in three pediatric health systems. Study Design Observational study. Data Collection/Extraction Methods Manual reviewers collected quality data from the EHR. Site personnel programmed their EHR systems to extract the same data from structured fields in the EHR according to national health IT standards. Principal Findings Overall performance measured via computer-extracted data was 21.9 percent, compared with 53.2 percent for manual data. Agreement measures were high for immunizations. Otherwise, agreement between computer extraction and manual review was modest (Kappa = 0.36) because computer-extracted data frequently missed care events (sensitivity = 39.5 percent). Measure validity varied by health care domain and setting. A limitation of our findings is that we studied only three domains and three sites. Conclusions The accuracy of computer-extracted EHR quality reporting depends on the use of structured data fields, with the highest agreement found for measures and in the setting that had the greatest concentration of structured fields. We need to improve documentation of care, data extraction, and adaptation of EHR systems to practice workflow. PMID:24471935

Lidar Monitoring of Mexico City's Atmosphere During High Air Pollution Episodes

NASA Technical Reports Server (NTRS)

Quick, C. R., Jr.; Archuleta, F. L.; Hof, D. E.; Karl, R. R., Jr.; Tiee, J. J., Jr.; Eichinger, W. E.; Holtkamp, D. B.; Tellier, L.

1992-01-01

Over the last two decades, Mexico City, like many large industrial and populous urban areas, has developed a serious air pollution problem, especially during the winter months when there are frequent temperature inversions and weak winds. The deteriorating air quality is the result of several factors. The basin within which Mexico City lies in Mexico's center of political, administrative and economic activity, generating 34 percent of the gross domestic product and 42 percent of the industrial revenue, and supporting a population which is rapidly approaching the 20 million mark. The basin is surrounded by mountains on three sides which end up preventing rapid dispersal of pollutants. Emissions from the transportation fleet (more than 3 million vehicles) are one of the primary pollution sources, and most are uncontrolled. Catalytic converters are just now working their way into the fleet. The Mexico City Air Quality Research Initiative in an international collaboration project between the Los Alamos National Laboratory and the Mexican Petroleum Institute are dedicated to the investigation of the air quality problem in Mexico City. The main objective of the project is to identify and assess the cost and benefits of major options being proposed to improve the air quality. The project is organized into three main activity areas: (1) modeling and simulation; (2) characterization and measurements; and (3) strategic evaluation.

Vocal Tract Discomfort and Voice-Related Quality of Life in Wind Instrumentalists.

PubMed

Cappellaro, Juliane; Beber, Bárbara Costa

2018-05-01

This study aimed to investigate vocal tract discomfort and quality of life in the voice of wind instrumentalists. It is a cross-sectional study. The sample was composed of 37 musicians of the orchestra of Caxias do Sul city, RS, Brazil. The participants answered a nonstandard questionnaire about demographic and professional information, the Voice-Related Quality of Life (V-RQOL), the Vocal Tract Discomfort (VTD) scale, and additional items about fatigue after playing the instrument and pain in the cervical muscles. Correlation analyses were performed using Spearman correlation test. The most frequent symptoms mentioned by musicians in the VTD, for both frequency and intensity of occurrence, were dryness, ache, irritability, and cervical muscle pain, in addition to the frequency of occurrence of fatigue after playing. The musicians showed high scores in the V-RQOL survey. Several symptoms evaluated by the VTD had a negative correlation with the musicians' years of orchestra membership and with V-RQOL scores. Symptoms of vocal tract discomfort are present in wind instrumentalists in low frequency and intensity of occurrence. However, these symptoms affect the musicians' voice-related quality of life, and they occur more in musicians with fewer years of orchestra membership. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Can a two-hour lecture by a pharmacist improve the quality of prescriptions in a pediatric hospital? A retrospective cohort study.

PubMed

Vairy, Stephanie; Corny, Jennifer; Jamoulle, Olivier; Levy, Arielle; Lebel, Denis; Carceller, Ana

2017-12-01

A high rate of prescription errors exists in pediatric teaching hospitals, especially during initial training. To determine the effectiveness of a two-hour lecture by a pharmacist on rates of prescription errors and quality of prescriptions. A two-hour lecture led by a pharmacist was provided to 11 junior pediatric residents (PGY-1) as part of a one-month immersion program. A control group included 15 residents without the intervention. We reviewed charts to analyze the first 50 prescriptions of each resident. Data were collected from 1300 prescriptions involving 451 patients, 550 in the intervention group and 750 in the control group. The rate of prescription errors in the intervention group was 9.6% compared to 11.3% in the control group (p=0.32), affecting 106 patients. Statistically significant differences between both groups were prescriptions with unwritten doses (p=0.01) and errors involving overdosing (p=0.04). We identified many errors as well as issues surrounding quality of prescriptions. We found a 10.6% prescription error rate. This two-hour lecture seems insufficient to reduce prescription errors among junior pediatric residents. This study highlights the most frequent types of errors and prescription quality issues that should be targeted by future educational interventions.

LGBT Caregiving: Frequently Asked Questions

MedlinePlus

... requests should be friendly and followed up by descriptive letters to the persons with whom you speak. ... quality of life for caregivers through education, services, research and advocacy. Through its National Center on Caregiving, ...

Estimating the robustness of contingenet valuation estimates of WTP to survey mode and treatment of protest responses.

Treesearch

John Loomis; Armando Gonzalez-Caban; Joseph Champ

2011-01-01

Over the past four decades teh contingent valuation method (CVM) has become a technique frequently used by economists to estimate willingness-to-pay (WTP) for improvements in environmental quality and prot3tion of natural resources. The CVM was originall applied to estmate recreation use values (Davis, 1963; Hammack and Brown, 1974)and air quality (Brookshire et al....

Factors Contributed by Community Organizations to the Motivation of Teachers in Rural Punjab, Pakistan, and Implications for the Quality of Teaching

ERIC Educational Resources Information Center

Barrs, J.

2005-01-01

The double-edged sword of Jomtien (1990), which emphasized access to education, and of Dakar (2000), which placed additional emphasis on the quality of education, the Holy Grail, provides the context for the expansion of education in developing countries. One of the most frequently espoused ingredients for success is good governance. The…

The Relationship of Maternal Behavior and Acculturation to the Quality of Attachment in Hispanic Infants Living in New York City.

ERIC Educational Resources Information Center

Fracasso, Maria P.; And Others

1994-01-01

Studied the relationship of parenting behavior and acculturation to the quality of attachment in 26 Puerto Rican and Dominican infants. Results revealed equal numbers of secure and insecure infants, although more boys than girls were secure. Mothers of secure infants were more sensitive and engaged in more frequent abrupt-interfering pick-ups. (KS)

The Maintenance of Heating, Ventilating and Air-Conditioning Systems and Indoor Air Quality in Schools: A Guide for School Facility Managers. Technical Bulletin.

ERIC Educational Resources Information Center

Wheeler, Arthur E.

To help maintain good indoor air quality (IAQ) in schools, guidance for the development and implementation of an effective program for maintenance and operation of heating, ventilating, and air-conditioning (HVAC) systems are discussed. Frequently, a building's occupants will complain about IAQ when the temperature or humidity are at uncomfortable…

Pruritus as a leading symptom: clinical characteristics and quality of life in German and Ugandan patients.

PubMed

Weisshaar, E; Apfelbacher, C; Jäger, G; Zimmermann, E; Bruckner, T; Diepgen, T L; Gollnick, H

2006-11-01

Pruritus is the most frequent and distressing symptom associated with dermatoses and various internal and neurological diseases. To investigate two different populations of patients with pruritus, one in Germany and one in Uganda, with a particular focus on clinical characteristics, aetiology and quality of life. We investigated by questionnaire 132 patients (59 men, 73 women, mean age 54.5 years) who were referred to the Department of Dermatology at the University Hospital of Magdeburg, Germany, with the diagnosis of pruritus as a leading symptom. The questionnaire was also applied in 84 patients who consulted the Dermatology Clinic at Mbarara, Uganda for pruritus. The questions referred to personal data and disease history of the individual, history and present occurrence of concomitant diseases, present and past therapy, quality, frequency and triggers of itching and scratching, other disorders and complaints, quality of life and impact on work and disability. Seventy-five (57%) of the German patients had pruritus due to dermatoses, 47 patients (36%) had pruritus due to a systemic disease and in 10 patients (8%) pruritus was of unknown origin. Most had a history of pruritus of several months up to years. Pruritus associated with dermatoses mostly affected the whole body and was permanent with an undulatory character. Affective reactions such as aggression and depression occurred more frequently in dermatological patients compared with those with systemic pruritus. The former group felt that pruritus had a greater impact on their lives. Almost all Ugandan patients had pruritus due to dermatoses except for three patients with pruritus of unknown origin. Eczema and prurigo were the most frequently observed dermatoses in both German and Ugandan patients. Patients with pruritus in both populations showed an impaired quality of life. There was no pronounced difference between the populations with regard to feelings of depression and suicidal thoughts. A great deal of helpful information in this complex group of patients can be obtained using this questionnaire. Pruritus has a major impact on quality of life and especially impairs those patients with pruritus associated with dermatoses and pruritus of unknown origin.

Impacts of Central American Fires on Ozone Air Quality in Texas

NASA Astrophysics Data System (ADS)

Wang, S. C.; Wang, Y.; Lei, R.; Talbot, R. W.

2016-12-01

Background ozone represents the portion of ozone level in one day that cannot be reduced by local emission controls. One of the important factors causing high background ozone events is wildfires. Satellite observations have documented frequent transport of wildfire smoke from Mexico and Central America to the southern US, particularly Texas, causing haze and exceedance of fine particle matters. However, the impact of those fires on background ozone in Texas is poorly understood. In this study, the effects of the Central America fire emissions in spring (Apr-May) from 2000 to 2013 on high background ozone events in Texas are investigated and quantified. We first examine through back trajectory analysis if any high background ozone days in cities of Texas such as Houston can be traced back to fire events in Central America. The GEOS-Chem global chemical transport model and its nested-grid version over North America are used to simulate the periods of the selected cases studies of Central American fires. Long-large transport of gaseous emissions (NOx, VOCs, and CO) from Central American fires are simulated and background ozone concentrations variations in Texas region due to those fire events are also quantified through the difference in model results with and without fire emissions in Central America. Finally, this study connects those fires and high background ozone events, and also quantifies the contribution of fire emissions from Central America on Texas ozone air quality.

Testing the thermal-niche oxygen-squeeze hypothesis for estuarine striped bass

USGS Publications Warehouse

Kraus, Richard T.; Secor, D.H.; Wingate, Rebecca L.

2015-01-01

In many stratified coastal ecosystems, conceptual and bioenergetics models predict seasonal reduction in quality and quantity of fish habitat due to high temperatures and hypoxia. We tested these predictions using acoustic telemetry of 2 to 4 kg striped bass (Morone saxatilis Walbaum) and high-resolution spatial water quality sampling in the Patuxent River, a sub-estuary of the Chesapeake Bay, during 2008 and 2009. Striped bass avoided hypoxic (dissolved oxygen ≤2 mg·l−1) subpycnocline waters, but frequently occupied habitats with high temperatures (>25 °C) in the summer months, as cooler habitats were typically not available. Using traditional concepts of the seasonal thermal-niche oxygen-squeeze, most of the Patuxent estuary would beconsidered unsuitable habitat for adult striped bass during summer. Application of a bioenergetics model revealed that habitats selected by striped bass during summer would support positive growth rates assuming fish could feed at one-half ofmaximum consumption. Occupancy of the estuary during summer by striped bass in this study was likely facilitated by sufficient prey and innate tolerance of high temperatures by sub-adult fish of the size range that we tagged. Our results help extend the thermalniche oxygen-squeeze hypothesis to native populations of striped bass in semi-enclosed coastal systems. Tolerance of for supraoptimal temperatures in our study supports recent suggestions by others that the thermal-niche concept for striped bass should be revised to include warmer temperatures.

Identifying Frequent Users of an Urban Emergency Medical Service Using Descriptive Statistics and Regression Analyses.

PubMed

Norman, Chenelle; Mello, Michael; Choi, Bryan

2016-01-01

This retrospective cohort study provides a descriptive analysis of a population that frequently uses an urban emergency medical service (EMS) and identifies factors that contribute to use among all frequent users. For purposes of this study we divided frequent users into the following groups: low- frequent users (4 EMS transports in 2012), medium-frequent users (5 to 6 EMS transports in 2012), high-frequent users (7 to 10 EMS transports in 2012) and super-frequent users (11 or more EMS transports in 2012). Overall, we identified 539 individuals as frequent users. For all groups of EMS frequent users (i.e. low, medium, high and super) one or more hospital admissions, receiving a referral for follow-up care upon discharge, and having no insurance were found to be statistically significant with frequent EMS use (P<0.05). Within the diagnostic categories, 41.61% of super-frequent users had a diagnosis of "primarily substance abuse/misuse" and among low-frequent users a majority, 53.33%, were identified as having a "reoccurring (medical) diagnosis." Lastly, relative risk ratios for the highest group of users, super-frequent users, were 3.34 (95% CI [1.90-5.87]) for obtaining at least one referral for follow-up care, 13.67 (95% CI [5.60-33.34]) for having four or more hospital admissions and 5.95 (95% CI [1.80-19.63]) for having a diagnoses of primarily substance abuse/misuse. Findings from this study demonstrate that among low- and medium-frequent users a majority of patients are using EMS for reoccurring medical conditions. This could potentially be avoided with better care management. In addition, this study adds to the current literature that illustrates a strong correlation between substance abuse/misuse and high/super-frequent EMS use. For the subgroup analysis among individuals 65 years of age and older, we did not find any of the independent variables included in our model to be statistically significant with frequent EMS use.