21 CFR 210.1 - Status of current good manufacturing practice regulations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Status of current good manufacturing practice... SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PROCESSING, PACKING, OR HOLDING OF DRUGS; GENERAL § 210.1 Status of current good manufacturing practice regulations...

Trends in self-rated health and association with socioeconomic position in Estonia: data from cross-sectional studies in 1996-2014.

PubMed

Põld, Mariliis; Pärna, Kersti; Ringmets, Inge

2016-12-08

Self-rated health (SRH) and socioeconomic position (SEP) as important determinants of health differences are associated with health and economic changes in society. The objectives of this paper were (1) to describe trends in SRH and (2) to analyze associations between SRH and SEP among adults in Estonia in 1996-2014. The study was based on a 25-64-year-old subsample (n = 18757) of postal cross-sectional surveys conducted every second year in Estonia during 1990-2014. SRH was measured using five-point scale and was dichotomized to good and less-than-good. Standardized prevalence of SRH was calculated for each study year. Poisson regression with likelihood ratio test was performed for testing trends of SRH over study years. Age, nationality, marital status, education, work status and income were used to determine SEP. Logistic regression analysis was used to assess association between SRH and SEP. The prevalence of dichotomized good self-rated health increased significantly over the whole study period with slight decrease in 2008-2010. Until 2002, good SRH was slightly more prevalent among men, but after that, among women. Good SRH was significantly associated with younger age, higher education and income and also with employment status among both, men and women. Good SRH was more prevalent among Estonian women and less prevalent among single men. There was a definite increase of good SRH over two decades in Estonia following economic downturn between 2008 and 2010. Good SRH was associated with higher SEP over the study period. Further research is required to study the possible reasons behind increase of good SRH, and it's association with SEP among adults in Estonia.

The Physical Activities Survey of Police Officers in New Jersey. Final Report.

ERIC Educational Resources Information Center

Goldstein, Leo S.

A survey of the physical activities of police officers in New Jersey was conducted to collect information about the kinds of physical activities they perform, their present health status, the measures they take to maintain good physical condition, and their appraisal of the present civil service physical performance test battery. Another purpose…

[Good governance of publicly-produced health services: ideas for moving forward].

PubMed

Freire, José Manuel; Repullo, Jose Ramon

2011-06-01

The good performance of publicly-produced health services is of vital importance, well beyond the health sector. Taking into account the great complexity of the health services in the public sector due both to their public and professional nature, we identify seven Gordian Knots as being responsible for the most frequent problems of publicly produced health services in Spain and Latin America. From the concept of good governance we take its character as a normative and ethical benchmark and its potential to renew and invigorate the government of the public sector. From comparative analysis of publicly-produced health services in the best performing countries, we extract eight characteristics which contribute significantly to good performance. A final reflection is on the relevance of the importance of offsetting the potential hostility to a reformist impulse of the status-quo with alliances that strengthen public trust and the social contract between health professionals and citizens based on the values of public health systems.

13 CFR 120.820 - CDC non-profit status and good standing.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false CDC non-profit status and good... LOANS Development Company Loan Program (504) Requirements for Cdc Certification and Operation § 120.820 CDC non-profit status and good standing. A CDC must be a non-profit corporation, except that for...

13 CFR 120.820 - CDC non-profit status and good standing.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false CDC non-profit status and good... LOANS Development Company Loan Program (504) Requirements for Cdc Certification and Operation § 120.820 CDC non-profit status and good standing. A CDC must be a non-profit corporation, except that for...

13 CFR 120.820 - CDC non-profit status and good standing.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false CDC non-profit status and good... LOANS Development Company Loan Program (504) Requirements for Cdc Certification and Operation § 120.820 CDC non-profit status and good standing. A CDC must be a non-profit corporation, except that for...

13 CFR 120.820 - CDC non-profit status and good standing.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false CDC non-profit status and good... LOANS Development Company Loan Program (504) Requirements for Cdc Certification and Operation § 120.820 CDC non-profit status and good standing. A CDC must be a non-profit corporation, except that for...

13 CFR 120.820 - CDC non-profit status and good standing.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false CDC non-profit status and good... LOANS Development Company Loan Program (504) Requirements for Cdc Certification and Operation § 120.820 CDC non-profit status and good standing. A CDC must be a non-profit corporation, except that for...

Prognostic factors in patients with metastatic spinal cord compression secondary to melanoma: a systematic review.

PubMed

Hadden, Nicholas J; McIntosh, Jerome R D; Jay, Samuel; Whittaker, Paula J

2018-02-01

Melanoma is one of the most common primary tumours associated with metastatic spinal cord compression (MSCC). The aim of this review is to identify prognostic factors specifically for MSCC secondary to melanoma. A systematic search of literature was performed in MEDLINE, Embase and the Cochrane Library to identify studies reporting prognostic factors for patients with MSCC secondary to melanoma. Two studies, involving a total of 39 patients, fulfilled the inclusion criteria. The variables associated with increased survival were receiving postoperative radiotherapy, receiving chemotherapy, perioperative lactate dehydrogenase level less than or equal to 8.0 µkat/l, preoperative haemoglobin level more than 11.5 mg/dl, an interval of 4 or more years between melanoma diagnosis and skeletal metastasis, absence of further skeletal metastases, absence of visceral metastases, Eastern Cooperative Oncology Group Performance Status of 2 or less, two or fewer involved vertebrae, being ambulatory preradiotherapy and an interval of more than 7 days between developing motor deficits and radiotherapy. The variables associated with good functional outcome were slow development of motor dysfunction, good performance status and being ambulatory before radiotherapy. The most important prognostic factors for survival are Eastern Cooperative Oncology Group Performance Status of 2 or less and absence of visceral metastases. There is a lack of studies looking specifically at prognostic factors for patients with MSCC secondary to melanoma, and the number of patients involved in the existing studies is small.

Prehospital antiplatelet use and functional status on admission of patients with non-haemorrhagic moyamoya disease: a nationwide retrospective cohort study (J-ASPECT study)

PubMed Central

Onozuka, Daisuke; Hagihara, Akihito; Nishimura, Kunihiro; Kada, Akiko; Nakagawara, Jyoji; Ogasawara, Kuniaki; Ono, Junichi; Shiokawa, Yoshiaki; Aruga, Toru; Miyachi, Shigeru; Nagata, Izumi; Toyoda, Kazunori; Matsuda, Shinya; Suzuki, Akifumi; Kataoka, Hiroharu; Nakamura, Fumiaki; Kamitani, Satoru; Nishimura, Ataru; Kurogi, Ryota; Sayama, Tetsuro; Iihara, Koji

2016-01-01

Objectives To elucidate the association between antiplatelet use in patients with non-haemorrhagic moyamoya disease before hospital admission and good functional status on admission in Japan. Design Retrospective, multicentre, non-randomised, observational study. Setting Nationwide registry data in Japan. Participants A total of 1925 patients with non-haemorrhagic moyamoya disease admitted between 1 April 2012 and 31 March 2014 in Japan. Main outcome measure We performed propensity score-matched analysis to examine the association between prehospital antiplatelet use and no significant disability on hospital admission, as defined by a modified Rankin Scale score of 0 or 1. Results Propensity-matched patients who received prehospital antiplatelet drugs were associated with a good outcome on hospital admission (OR adjusted for all covariates, 3.82; 95% CI 1.22 to 11.99) compared with those who did not receive antiplatelet drugs prior to hospital admission. Conclusions Prehospital antiplatelet use was significantly associated with good functional status on hospital admission among patients with non-haemorrhagic moyamoya disease in Japan. Our results suggest that prehospital antiplatelet use should be considered when evaluating outcomes of patients with non-haemorrhagic moyamoya disease. PMID:27008684

[Relationship between macronutrient and micronutrient intake and nutritional status of active older adults in Chillán, Chile].

PubMed

Barrón, Verónica; Rodríguez, Alejandra; Cuadra, Ivonne; Flores, Carolina; Sandoval, Paulina

Social participation by older adults is a health-protective element that promotes a normal nutritional status through the intake of appropriate nutrients that favour successful aging. A cross-sectional analytical study was performed on a sample of 118 older adults. Food intake was measured using a 24-h recall questionnaire. The body mass index was used to evaluate the nutritional status. The information was analysed using uni- and bivariate descriptive statistics. Given the abnormal distribution of the responses, the Mann-Whitney and Kolgomorov-Smirnov statistical test were used to compare data at the significance level α=0.05. More than half (55%) of the women and 61% of men had a normal nutritional status. The calories and macronutrient intake were within the recommended ranges and unrelated to the nutritional status (P>.05). The micronutrients showed significant differences in relation to the nutritional status, broken down by gender and age, in the majority of vitamins and minerals. (P>.01). The group between 75-90 years old accomplished the recommended dietary allowance in every case. The active participation in organised community groups, the educational level of the older adults, and higher income, could be key factors to explain the good nutritional status of the group, and appears to be a good indicator of healthy aging. Copyright © 2017 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

The Effect of Testosterone Administration and Digit Ratio (2D:4D) on Implicit Preference for Status Goods in Healthy Males

PubMed Central

Wu, Yin; Zilioli, Samuele; Eisenegger, Christoph; Clark, Luke; Li, Hong

2017-01-01

Testosterone has been linked to social status seeking in humans. The present study investigated the effects of testosterone administration on implicit and explicit preferences for status goods in healthy male participants (n = 64), using a double-blind, placebo-controlled, between-subjects design. We also investigated the interactive effect between second-to-fourth digit ratio (2D:4D; i.e., a proximal index of prenatal testosterone) and testosterone treatment on status preferences. Results showed that testosterone administration has no discernable influence on self-reported willingness-to-pay (i.e., the explicit measure) or implicit attitudes towards status goods. Individuals with lower 2D:4D (i.e., more masculine) had more positive attitudes for high-status goods on an Implicit Association Task, and this association was abolished with testosterone administration. These data suggest interactive effects of acute testosterone administration and prenatal testosterone exposure on human social status seeking, and highlight the utility of implicit methods for measuring status-related behavior. PMID:29085287

Predictors of adolescent compliance with oral hygiene instructions during two-arch multibracket fixed orthodontic treatment.

PubMed

Al-Jewair, Thikriat S; Suri, Sunjay; Tompson, Bryan D

2011-05-01

To determine compliance with oral hygiene instructions (OHI) of adolescents receiving two-arch multibracket fixed appliances and identify its predictive factors. Forty-one patients in a longitudinal study were provided standardized OHI and assessed at baseline: before bonding (T0mo), approximately 30 days after bonding (T1mo), and approximately 150 days (T5mo) after bonding straight-wire appliances simultaneously in the maxillary and mandibular arches. Oral hygiene (OH) performance was measured using plaque and gingival indices. Compliance predictors were identified from questionnaires administered to patients and their parents and from patients' charts. OH performance worsened from T0mo to T1mo but then improved from T1mo to T5mo. At T5mo, 73% of the sample had good OH. Univariate analyses found perceived severity of malocclusion, school performance, and parental marital status to be significant predictors of good OH performance at T5mo. Multiple logistic regressions identified having married parents and good academic performance in school as significant predictors. In the sample studied, after initially worsening, compliance with OHI improved at 5 months after bonding. Adolescents with married parents and those reporting good academic performance in school were found more likely to have complied with OHI provided at baseline and to perform better OH.

RPC PET: Status and perspectives

NASA Astrophysics Data System (ADS)

Couceiro, M.; Blanco, A.; Ferreira, Nuno C.; Ferreira Marques, R.; Fonte, P.; Lopes, L.

2007-10-01

The status of the resistive plate chamber (RPC)-PET technology for small animals is briefly reviewed and its sensitivity performance for human PET studied through Monte-Carlo simulations. The cost-effectiveness of these detectors and their very good timing characteristics open the possibility to build affordable Time of Flight (TOF)-PET systems with very large fields of view. Simulations suggest that the sensitivity of such systems for human whole-body screening, under reasonable assumptions, may exceed the present crystal-based PET technology by a factor up to 20.

Concordance of Barthel Index, ECOG-PS, and Palliative Performance Scale in the assessment of functional status in patients with advanced medical diseases.

PubMed

Hernández-Quiles, C; Bernabeu-Wittel, M; Pérez-Belmonte, L M; Macías-Mir, P; Camacho-González, D; Massa, B; Maiz-Jiménez, M; Ollero-Baturone, M

2017-09-01

Analysing most relevant clinical features and concordance between different functional scales in patients with advanced medical diseases (PAMD). Cross-sectional multicentre study that included PAMD (heart, lung, kidney, liver, and neurological diseases) in hospital settings from February 2009 to October 2010. We analysed clinical, biological and functional features in performing activities of daily living (ADL) by medians of Barthel Index (BI); additionally we assessed their performance status by medians of Eastern Cooperative Oncology Group-Performance Status (ECOG-PS) and Palliative Performance Scale (PPS) scores. We evaluated the concordance of these instruments in assessing functional impairment by κ and intraclass correlation coefficient tests. 1847 patients were included (average age 79 years, 50.1% men). Most common symptoms were dyspnoea (62.31%), asthenia (23%) and delirium (20.14%). Functional assessment showed a high prevalence of severe or total impairment in performing basic ADL by medians of used instruments (BI median=35 (IQR=70), and 52.1% of patients with severe-total impairment; ECOG-PS median=2 (IQR 30), and 44% of patients with severe-total impairment; and PPS median=50 (IQR 30), and 32% of patients with severe-total impairment). Concordance among these instruments was acceptably good ( κ indexes ranging from 0.653 to 0.745 (p<0.0001)). PAMD represent a population with severe functional impairment, which requires a multidisciplinary approach for proper management. Assessment of functional ability in this population by BI, ECOG-PS, and PPS showed good concordance. 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/.

EQ-5D-3L as a health measure of Brazilian adult population.

PubMed

Menezes, Renata de Miranda; Andrade, Mônica Viegas; Noronha, Kenya Valéria Micaela de Souza; Kind, Paul

2015-11-01

This study explores the use of EQ-5D-3L as a measure of population health status in a Brazilian region with significant socioeconomic, demographic, and epidemiological heterogeneity. Data came from a study of 3363 literate individuals aged between 18 and 64 years living in urban areas of the state of Minas Gerais. Descriptive analysis and logistic and OLS regression models were performed to analyze the relationship between EQ-5D-3L (descriptive system and EQ VAS) and other health (self-assessed health status and 8 self-reported diagnosed chronic diseases), socioeconomic (educational level and economic class), and demographic (gender and age) measures. Additionally, a grade of membership (GoM) analysis was performed to identify multidimensional health profiles. A total of 76 health statuses were identified in the Brazilian population. The most prevalent one is full health (44 % of the sample). Elderly people, women, and individuals with poor health and lower socioeconomic conditions generally report more health problems in the EQ-5D-3L dimensions. The GoM analysis demonstrated that health status of older individuals is associated with the socioeconomic condition. Arthritis exhibited the strongest association with the EQ-5D-3L instrument. The results indicate that EQ-5D-3L is a good measure of health status for the Brazilian population. The instrument has a good discriminatory capacity in terms of demographic, socioeconomic, and health measures. The high prevalence of individuals with full health may indicate the presence of ceiling effect. However, this prevalence is smaller than that in other countries.

[Life-style and self-rated health status, and the use of health services by an immigrant population from Paraguay and Bolivia in city of Elche (Alicante, Spain)].

PubMed

Gallegos-Juárez, I G; Ponce-Samaniego, Y Y; Sempere-Selva, M T; Ramos-Rincón, J M

2012-10-01

To study the lifestyle, use of health services, self-perceived health status and health services evaluations of immigrants from Paraguay and Bolivia in the city of Elche, and to establish and/or adapt prevention health services strategies to the needs of this population. A cross-sectional study, using a health questionnaire, was conducted between November 2009 and April 2010, using a convenience sample selected from the Paraguay and Bolivia Citizens Association. A total of 49 Paraguayans and 35 Bolivians over 15 years old were interviewed of whom 42 (50%) were male; 33% of respondents did not perform any physical activity, and 14.3% were smokers (males [23.8%] vs female [4.8%], P=.03). The assessment of health was good or very good in 59.5% (Paraguayans [71.4%] vs Bolivians [42.9%]), P=.02). The use of health services was 85.4% (males [75%] vs women [95.2%], P=02) and 51% went to an emergency department. Consultation with a dentist was reported in 43.9% (Paraguayans [56.2%] vs Bolivians [26.5%], P=.007); 65.9% considered the Spanish public health system as being excellent, very good or good. The lifestyle, the use of private resources and the assessment of health status are different in both groups studied. The assessment of the Spanish public health system was good in both. Strategies are needed to improve lifestyle, counselling for smoking cessation, alcohol use and control of dyslipidaemia. Copyright © 2011 Elsevier España, S.L. y SEMERGEN. All rights reserved.

Seeing Is as Good as Doing

ERIC Educational Resources Information Center

Osman, Magda

2008-01-01

Given the privileged status claimed for active learning in a variety of domains (visuomotor learning, causal induction, problem solving, education, skill learning), the present study examines whether action-based learning is a necessary, or a sufficient, means of acquiring the relevant skills needed to perform a task typically described as…

[Healing status of surgical incisions in human immunodeficiency virus-positive patients with fractures].

PubMed

Li, Xin; Zhang, Qiang; Zhao, Changsong; Sun, Sheng; Cai, Juan

2014-09-09

To observe the healing status of surgical incisions in human immunodeficiency virus (HIV)-positive patients with fractures and explore the factors related with poor wound healing, treatment and preventive measures. Retrospective analyses were performed for the clinical data of 61 HIV-positive patients with fractures. And the influencing factors, treatment and outcomes of poor wound healing were analyzed. Among them, the healing status was good (n = 50) and poor (n = 11). And the outcomes included redness (n = 10), oozing (n = 8), split (n = 3), infection (n = 2), hematoma (n = 1), fat liquefaction (n = 2) and delayed healing (n = 2). All healed well after treatment. There was no infection or death during the follow-up period. Compared with HIV-negative patients, it was not statistically significant in wound infection. However, poor healing rates were significantly different (P < 0.05). The risk factors included advanced age, low body mass index, low albumin, low hemoglobin, low total lymphocyte count, low CD4⁺ T lymphocyte count, high HIV infection clinical stage, long operative duration, emergency surgery and incision contamination. In HIV-positive patients with fractures, the healing of surgical incision is generally good. However few have poor wound healing due to multiple factors. If poor healing is identified early and handled timely and correctly, good healing ensues.

Comparing current definitions of return to work: a measurement approach.

PubMed

Steenstra, I A; Lee, H; de Vroome, E M M; Busse, J W; Hogg-Johnson, S J

2012-09-01

Return-to-work (RTW) status is an often used outcome in work and health research. In low back pain, work is regarded as a normal activity a worker should return to in order to fully recover. Comparing outcomes across studies and even jurisdictions using different definitions of RTW can be challenging for readers in general and when performing a systematic review in particular. In this study, the measurement properties of previously defined RTW outcomes were examined with data from two studies from two countries. Data on RTW in low back pain (LBP) from the Canadian Early Claimant Cohort (ECC); a workers' compensation based study, and the Dutch Amsterdam Sherbrooke Evaluation (ASE) study were analyzed. Correlations between outcomes, differences in predictive validity when using different outcomes and construct validity when comparing outcomes to a functional status outcome were analyzed. In the ECC all definitions were highly correlated and performed similarly in predictive validity. When compared to functional status, RTW definitions in the ECC study performed fair to good on all time points. In the ASE study all definitions were highly correlated and performed similarly in predictive validity. The RTW definitions, however, failed to compare or compared poorly with functional status. Only one definition compared fairly on one time point. Differently defined outcomes are highly correlated, give similar results in prediction, but seem to differ in construct validity when compared to functional status depending on societal context or possibly birth cohort. Comparison of studies using different RTW definitions appears valid as long as RTW status is not considered as a measure of functional status.

STS-114: Discovery Day 13 Mission Status Briefing

NASA Technical Reports Server (NTRS)

2005-01-01

LeRoy Cain, STS-114 Ascent/Entry Flight Director, takes a solo stand with the Press in this briefing. He reports that the vehicle is in good shape, consumable status is excellent, and the shuttle crew is in high spirits and preparing for de-orbit and landing. LeRoy and his team have completed the entry system check up, flight control check up, reactor control system check up, and noted that all are at nominal performance; weather forecast is very good, the Entry team is ready and looking forward to de-orbit and landing at the Kennedy Space Center on Monday, August 8th. Re-entry, personal feelings, Columbia accident, data gathering, consumable situation, back up sites, weather, communication block out, night and day landing, and Commander Collin's piloting skills during night flight are some of the topics covered with the News media.

[The "Short Physical Performance Battery" in the Czech Republic -  the pilot and validation study in older persons].

PubMed

Berková, M; Topinková, E; Mádlová, P; Klán, J; Vlachová, M; Běláček, J

2013-04-01

Population ageing increases number of seniors with decline of physical capabilities and functional deficits. Targeted interventions to maintain or increase physical performance are most effective before the development of full frailty, in so-called "prefrail" period. One of the assessment tools for evaluation of the physical performance and/ or frailty in older persons is the "Short Physical Performance Battery" -  SPPB. The aim of the study was to introduce the assessment battery to clinical practice in the CR and to evaluate its selected psychometric properties. Original English SPPB was translated into Czech language and back translated to ensure linguistic accuracy. SPPB was applied in the selected sample of older persons and validated against other performance tools for cognition, self- care and nutrition status used in CR and selected psychometric properties evaluated. We examined 145 older persons (108 women, i.e. 74.48 % and 37 men, i.e. 25.52 %) mean age 80.38 years (54- 101 years, SD ± 8,47). We found good physical performance in 35 (24.1 %) older persons (SPPB 10- 12 points), 21 (14.5 %) were identified as prefrail (SPPB 7- 9 points) and 89 (61.4 %) as frail in high risk of future disability or already disabled (SPPB 6 points). We found statistically significant correlation of global SPPB score with nutritional status (MNA- Short Form), activities of daily living performance (ADL) and cognitive performance (MMSE) -  (Spearman correlation ρ = 0.51; 0.53 and 0.38 respectively). The Cronbachs a for SPPB variables scored 0.821, which is consistent with good internal consistency of SPPB battery. When evaluating 3 age groups [ 75 years (n = 41), 76- 85 (n = 62) and 86- 101 years (n = 42)] the most significant correlations were found between SPPB and MNA, ADL and MMSE in the young elderly (ρ = 0.74, 0.79 and 0.64 respectively) and they diminished with increasing age. We confirmed significant correlations between SPPB and self care activities, cognitive performance and nutritional status and good internal consistency of the battery. SPPB test is simple, easy to perform, with low time and cost requirements. It could be recommended for clinical practice in both community and hospitalized older patients to evaluate their overall physical performance and identify persons at risk of frailty and disability who may profit from targeted interventions.

Disease resistance is related to inherent swimming performance in Atlantic salmon.

PubMed

Castro, Vicente; Grisdale-Helland, Barbara; Jørgensen, Sven M; Helgerud, Jan; Claireaux, Guy; Farrell, Anthony P; Krasnov, Aleksei; Helland, Ståle J; Takle, Harald

2013-01-21

Like humans, fish can be classified according to their athletic performance. Sustained exercise training of fish can improve growth and physical capacity, and recent results have documented improved disease resistance in exercised Atlantic salmon. In this study we investigated the effects of inherent swimming performance and exercise training on disease resistance in Atlantic salmon.Atlantic salmon were first classified as either poor or good according to their swimming performance in a screening test and then exercise trained for 10 weeks using one of two constant-velocity or two interval-velocity training regimes for comparison against control trained fish (low speed continuously). Disease resistance was assessed by a viral disease challenge test (infectious pancreatic necrosis) and gene expression analyses of the host response in selected organs. An inherently good swimming performance was associated with improved disease resistance, as good swimmers showed significantly better survival compared to poor swimmers in the viral challenge test. Differences in mortalities between poor and good swimmers were correlated with cardiac mRNA expression of virus responsive genes reflecting the infection status. Although not significant, fish trained at constant-velocity showed a trend towards higher survival than fish trained at either short or long intervals. Finally, only constant training at high intensity had a significant positive effect on fish growth compared to control trained fish. This is the first evidence suggesting that inherent swimming performance is associated with disease resistance in fish.

Threshold values and management options for nutrients in a catchment of a temperate estuary with poor ecological status

NASA Astrophysics Data System (ADS)

Hinsby, K.; Markager, S.; Kronvang, B.; Windolf, J.; Sonnenborg, T. O.; Thorling, L.

2012-02-01

Intensive farming has severe impacts on the chemical status of groundwater and streams and consequently on the ecological status of dependent ecosystems. Eutrophication is a widespread problem in lakes and marine waters. Common problems are hypoxia, algal blooms and fish kills, and loss of water clarity, underwater vegetation, biodiversity, and recreational value. In this paper we evaluate the nitrogen (N) and phosphorus (P) chemistry of groundwater and surface water in a coastal catchment, the loadings and sources of N and P and their effect on the ecological status of an estuary. We calculate the necessary reductions in N and P loadings to the estuary for obtaining a good ecological status, which we define based on the number of days with N and P limitation, and the equivalent stream and groundwater threshold values assuming two different management options. The calculations are performed by the combined use of empirical models and a physically based 3-D integrated hydrological model of the whole catchment. The assessment of the ecological status indicates that the N and P loads to the investigated estuary should be reduced by a factor of 0.52 and 0.56, respectively, to restore good ecological status. Model estimates show that threshold total N concentrations should be in the range of 2.9 to 3.1 mg l-1 in inlet freshwater to Horsens Estuary and 6.0 to 9.3 mg l-1 in shallow aerobic groundwater (∼27-41 mg l-1 of nitrate), depending on the management measures implemented in the catchment. The situation for total P is more complex but data indicate that groundwater threshold values are not needed. The inlet freshwater threshold value for total P to Horsens Estuary for the selected management options is 0.084 mg l-1. Regional climate models project increasing winter precipitation and runoff in the investigated region resulting in increasing runoff and nutrient loads to coastal waters if present land use and farming practices continue. Hence, lower threshold values are required in the future to ensure good status of all water bodies and ecosystems.

Threshold values and management options for nutrients in a catchment of a temperate estuary with poor ecological status

NASA Astrophysics Data System (ADS)

Hinsby, K.; Markager, S.; Kronvang, B.; Windolf, J.; Sonnenborg, T. O.; Thorling, L.

2012-08-01

Intensive farming has severe impacts on the chemical status of groundwater and streams and consequently on the ecological status of dependent ecosystems. Eutrophication is a widespread problem in lakes and marine waters. Common problems are hypoxia, algal blooms, fish kills, and loss of water clarity, underwater vegetation, biodiversity and recreational value. In this paper we evaluate the nitrogen (N) and phosphorus (P) concentrations of groundwater and surface water in a coastal catchment, the loadings and sources of N and P, and their effect on the ecological status of an estuary. We calculate the necessary reductions in N and P loadings to the estuary for obtaining a good ecological status, which we define based on the number of days with N and P limitation, and the corresponding stream and groundwater threshold values assuming two different management options. The calculations are performed by the combined use of empirical models and a physically based 3-D integrated hydrological model of the whole catchment. The assessment of the ecological status indicates that the N and P loads to the investigated estuary should be reduced to levels corresponding to 52 and 56% of the current loads, respectively, to restore good ecological status. Model estimates show that threshold total N (TN) concentrations should be in the range of 2.9 to 3.1 mg l-1 in inlet freshwater (streams) to Horsens estuary and 6.0 to 9.3 mg l-1 in shallow aerobic groundwater (∼ 27-41 mg l-1 of nitrate), depending on the management measures implemented in the catchment. The situation for total P (TP) is more complex, but data indicate that groundwater threshold values are not needed. The stream threshold value for TP to Horsens estuary for the selected management options is 0.084 mg l-1. Regional climate models project increasing winter precipitation and runoff in the investigated region resulting in increasing runoff and nutrient loads to the Horsens estuary and many other coastal waters if present land use and farming practices continue. Hence, lower threshold values are required in many coastal catchments in the future to ensure good status of water bodies and ecosystems.

Serum antioxidant levels and nutritional status in early and advanced stage lung cancer patients.

PubMed

Klarod, Kultida; Hongsprabhas, Pranithi; Khampitak, Tueanjit; Wirasorn, Kosin; Kiertiburanakul, Sasisopin; Tangrassameeprasert, Roongpet; Daduang, Jureerut; Yongvanit, Puangrat; Boonsiri, Patcharee

2011-01-01

Malnutrition frequently occurs in lung cancer patients. We aimed to determine nutritional status and antioxidant and mineral levels in Thai patients with lung cancer. A prospective study with matched case-control was conducted. Nutritional status was assessed by body mass index (BMI) and subjective global assessment (SGA). Eastern Cooperative Oncology Group (ECOG) performance status was used to assess the performance. The serum antioxidant and mineral levels were determined. Forty-nine patients with a mean age of 58.8 (range, 35-82) who were first diagnosed with lung cancer were enrolled. They were compared with 60 healthy controls, and levels of retinol, α-tocopherol, β-carotene, lycopene, β-cryptoxanthin, selenium, and zinc were lower (P < 0.05). However, peroxidase activity was higher (P = 0.002) in patients. Selenium levels were higher in early stage compared to advanced stage patients (P = 0.041). Overweight patients had higher selenium levels (0.04 mg/L) than normal BMI patients (β = 0.04, P = 0.035). Patients with SGA class C had lower selenium levels (0.03 mg/L) than those with class A (β = -0.03, P = 0.035). The poorer ECOG performance patients had significantly lower β-carotene (β = -0.192, P = 0.003) and selenium (β = -0.031, P = 0.011) levels compared with those with good ECOG performance status. Significantly lower levels of antioxidants and selenium were found in lung cancer patients compared to healthy controls. Levels of some antioxidants and minerals differed among categories of BMI, SGA categories, or ECOG performance status. These findings may be helpful for further studies, such as the effect of nutritional supplementation on clinical outcomes. Copyright © 2011 Elsevier Inc. All rights reserved.

Development and validation of the Good Outcome Following Attempted Resuscitation (GO-FAR) score to predict neurologically intact survival after in-hospital cardiopulmonary resuscitation.

PubMed

Ebell, Mark H; Jang, Woncheol; Shen, Ye; Geocadin, Romergryko G

2013-11-11

Informing patients and providers of the likelihood of survival after in-hospital cardiac arrest (IHCA), neurologically intact or with minimal deficits, may be useful when discussing do-not-attempt-resuscitation orders. To develop a simple prearrest point score that can identify patients unlikely to survive IHCA, neurologically intact or with minimal deficits. The study included 51,240 inpatients experiencing an index episode of IHCA between January 1, 2007, and December 31, 2009, in 366 hospitals participating in the Get With the Guidelines-Resuscitation registry. Dividing data into training (44.4%), test (22.2%), and validation (33.4%) data sets, we used multivariate methods to select the best independent predictors of good neurologic outcome, created a series of candidate decision models, and used the test data set to select the model that best classified patients as having a very low (<1%), low (1%-3%), average (>3%-15%), or higher than average (>15%) likelihood of survival after in-hospital cardiopulmonary resuscitation for IHCA with good neurologic status. The final model was evaluated using the validation data set. Survival to discharge after in-hospital cardiopulmonary resuscitation for IHCA with good neurologic status (neurologically intact or with minimal deficits) based on a Cerebral Performance Category score of 1. The best performing model was a simple point score based on 13 prearrest variables. The C statistic was 0.78 when applied to the validation set. It identified the likelihood of a good outcome as very low in 9.4% of patients (good outcome in 0.9%), low in 18.9% (good outcome in 1.7%), average in 54.0% (good outcome in 9.4%), and above average in 17.7% (good outcome in 27.5%). Overall, the score can identify more than one-quarter of patients as having a low or very low likelihood of survival to discharge, neurologically intact or with minimal deficits after IHCA (good outcome in 1.4%). The Good Outcome Following Attempted Resuscitation (GO-FAR) scoring system identifies patients who are unlikely to benefit from a resuscitation attempt should they experience IHCA. This information can be used as part of a shared decision regarding do-not-attempt-resuscitation orders.

Estimation of sleep status in sleep apnea patients using a novel head actigraphy technique.

PubMed

Hummel, Richard; Bradley, T Douglas; Fernie, Geoff R; Chang, S J Isaac; Alshaer, Hisham

2015-01-01

Polysomnography is a comprehensive modality for diagnosing sleep apnea (SA), but it is expensive and not widely available. Several technologies have been developed for portable diagnosis of SA in the home, most of which lack the ability to detect sleep status. Wrist actigraphy (accelerometry) has been adopted to cover this limitation. However, head actigraphy has not been systematically evaluated for this purpose. Therefore, the aim of this study was to evaluate the ability of head actigraphy to detect sleep/wake status. We obtained full overnight 3-axis head accelerometry data from 75 sleep apnea patient recordings. These were split into training and validation groups (2:1). Data were preprocessed and 5 features were extracted. Different feature combinations were fed into 3 different classifiers, namely support vector machine, logistic regression, and random forests, each of which was trained and validated on a different subgroup. The random forest algorithm yielded the highest performance, with an area under the receiver operating characteristic (ROC) curve of 0.81 for detection of sleep status. This shows that this technique has a very good performance in detecting sleep status in SA patients despite the specificities in this population, such as respiration related movements.

Analysis of moment structures for assessing relationships among perceived chewing ability, dentition status, muscle strength, and balance in community-dwelling older adults.

PubMed

Moriya, Shingo; Notani, Kenji; Murata, Ayumi; Inoue, Nobuo; Miura, Hiroko

2014-12-01

The aim of this study was to assess relationships among perceived chewing ability, dentition status, muscle strength and balance in community-dwelling older adults using analysis of moment structures (Amos). Physical performance parameters such as muscle strength and balance can predict the future onset of disabilities in activities of daily living among older adults. In this context, elucidation of the relationships among oral conditions and physical performance parameters is necessary. Data on occlusal contact patterns of natural teeth (OPNT), self-assessed masticatory ability (mastication), body mass index (BMI), handgrip strength (HG) and one-leg standing time with eyes open (OLST) were collected from 501 independently living adults aged 65-74 years. The relationships among these parameters were analysed using Spearman's rank correlation coefficients and Amos. Subjects of both genders showed significant correlations among OPNT, mastication, HG and OLST, evaluated using Spearman's rank correlation coefficients. For each Amos model, the goodness-of-fit statistic indicated a good level of fit. In both men and women, OPNT was significantly related to mastication, and mastication was related to HG but not to OLST. OPNT was related to neither HG nor OLST in women and was related to OLST but not HG in men. The findings observed in this study present a possible importance of dental status and perceived chewing ability for the onset of disability by influencing physical performance in community-dwelling older adults. © 2012 The Gerodontology Society and John Wiley & Sons A/S.

Pain, fatigue and hand function closely correlated to work ability and employment status in systemic sclerosis.

PubMed

Sandqvist, Gunnel; Scheja, Agneta; Hesselstrand, Roger

2010-09-01

To identify factors, individual and work related, influencing work ability, and to assess the association between work ability and employment status, activities of daily life (ADLs) and quality of life in patients with SSc. Fifty-seven consecutive patients (53 females/4 males) with SSc (47 lcSSc/10 dcSSc) were included. Median age was 58 [interquartile range (IQR) 47-62] years and disease duration 14 (9-19) years. The patients were assessed for socio-demographic characteristics, disease parameters, symptoms, work ability, empowerment and adaptations in a workplace, social support, ADLs and quality of life. Work ability, assessed with the Work Ability Index (WAI) could be evaluated in 48 of 57 patients. The correlation between employment status and WAI was good (r(s) = 0.79, P < 0.001). Thirteen patients had good or excellent WAI, 15 had less good and 20 had poor WAI. There were no significant differences between subgroups of WAI and socio-demographic characteristics, disease duration or degree of skin and lung involvement. However, patients with good WAI expressed milder perceived symptoms (pain, fatigue and impaired hand function; P < 0.001). Patients with better WAI had better competence (P < 0.001), better possibility of adaptations at work (P < 0.01) and impact at work (P < 0.01) than those with poorer WAI. In SSc, pain, fatigue and impaired hand function have a dominant impact on the WAI. Employment interventions should include support in job adaptations as well as self-management strategies to help patients deal with pain and fatigue and to enhance the confidence to perform their work.

Individual and contextual factors associated with community health workers' performance in Nyanza Province, Kenya: a multilevel analysis.

PubMed

Kawakatsu, Yoshito; Sugishita, Tomohiko; Tsutsui, Junya; Oruenjo, Kennedy; Wakhule, Stephen; Kibosia, Kennedy; Were, Eric; Honda, Sumihisa

2015-10-01

Several African and South Asian countries are currently investing in new cadres of community health workers (CHWs) as a major part of strategies aimed at reaching the Millennium Development Goals. However, one review concluded that community health workers did not consistently provide services likely to have substantial effects on health and that quality was usually poor. The objective of this research was to assess the CHWs' performance in Western Kenya and describe determinants of that performance using a multilevel analysis of the two levels, individual and supervisor/community. This study conducted three surveys between August and September 2011 in Nyanza Province, Kenya. The participants of the three surveys were all 1,788 active CHWs, all their supervisors, and 2,560 randomly selected mothers who had children aged 12 to 23 months. CHW performance was generated by three indicators: reporting rate, health knowledge and household coverage. Multilevel analysis was performed to describe the determinants of that performance. The significant factors associated with the CHWs' performance were their marital status, educational level, the size of their household, their work experience, personal sanitation practice, number of supervisions received and the interaction between their supervisors' better health knowledge and the number of supervisions. A high quality of routine supervisions is one of the key interventions in sustaining a CHW's performance. In addition, decreasing the dropout rate of CHWs is important both for sustaining their performance and for avoiding the additional cost of replacing them. As for the selection criteria of new CHWs, good educational status, availability of supporters for household chores and good sanitation practices are all important in selecting CHWs who can maintain their high performance level.

Associations of health status with subsequent blood donor behavior-An alternative perspective on the Healthy Donor Effect from Donor InSight.

PubMed

van den Hurk, Katja; Zalpuri, Saurabh; Prinsze, Femmeke J; Merz, Eva-Maria; de Kort, Wim L A M

2017-01-01

In donor health research, the 'Healthy Donor Effect' (HDE) often biases study results and hampers their interpretation. This refers to the fact that donors are a selected 'healthier' subset of a population due to both donor selection procedures and self-selection. Donors with long versus short donor careers, or with high versus low donation intensities are often compared to avoid this HDE, but underlying health differences might also cause these differences in behaviour. Our aim was to estimate to what extent a donor´s perceived health status associates with donation cessation and intensity. All active whole blood donors participating in Donor InSight (2007-2009; 11,107 male; 12,616 female) were included in this prospective cohort study. We performed Cox survival and Poisson regression analyses to assess whether self-reported health status, medication use, disease diagnosed by a physician and recently having consulted a general practitioner (GP) or specialist were associated with (time to) donation cessation and donation intensity. At the end of 2013, 44% of the donors in this study had stopped donating. Donors in self-rated good health had a 15% lower risk to stop donating compared to donors in perceived poorer health. Medication use, disease diagnoses and consulting a GP were associated with a 20-40% increased risk to stop donating and a lower donation intensity, when adjusting for age, number of donations and new donor status. Both men and women reporting good health made on average 10% more donations. Donors with a "good" health status were less likely to stop donating blood and tended to donate blood more often than donors with perceived poorer health status. This implies that the HDE is an important source of selection bias in studies on donor health and this includes studies where comparisons within donors are made. This HDE should be adjusted for appropriately when assessing health effects of donation and donors' health status may provide estimates of future donation behavior.

Disease resistance is related to inherent swimming performance in Atlantic salmon

PubMed Central

2013-01-01

Background Like humans, fish can be classified according to their athletic performance. Sustained exercise training of fish can improve growth and physical capacity, and recent results have documented improved disease resistance in exercised Atlantic salmon. In this study we investigated the effects of inherent swimming performance and exercise training on disease resistance in Atlantic salmon. Atlantic salmon were first classified as either poor or good according to their swimming performance in a screening test and then exercise trained for 10 weeks using one of two constant-velocity or two interval-velocity training regimes for comparison against control trained fish (low speed continuously). Disease resistance was assessed by a viral disease challenge test (infectious pancreatic necrosis) and gene expression analyses of the host response in selected organs. Results An inherently good swimming performance was associated with improved disease resistance, as good swimmers showed significantly better survival compared to poor swimmers in the viral challenge test. Differences in mortalities between poor and good swimmers were correlated with cardiac mRNA expression of virus responsive genes reflecting the infection status. Although not significant, fish trained at constant-velocity showed a trend towards higher survival than fish trained at either short or long intervals. Finally, only constant training at high intensity had a significant positive effect on fish growth compared to control trained fish. Conclusions This is the first evidence suggesting that inherent swimming performance is associated with disease resistance in fish. PMID:23336751

The impact of manufacturing complexity drivers on performance-a preliminary study

NASA Astrophysics Data System (ADS)

Huah Leang, Suh; Mahmood, Wan Hasrulnizzam Wan; Rahman, Muhamad Arfauz A.

2018-03-01

Manufacturing systems, in pursuit of cost, time and flexibility optimisation are becoming more and more complex, exhibiting a dynamic and nonlinear behaviour. Unpredictability is a distinct characteristic of such behaviour and effects production planning significantly. Therefore, this study was undertaken to investigate the priority level and current achievement of manufacturing performance in Malaysia’s manufacturing industry and the complexity drivers on manufacturing productivity performance. The results showed that Malaysia’s manufacturing industry prioritised product quality and they managed to achieve a good on time delivery performance. However, for other manufacturing performance, there was a difference where the current achievement of manufacturing performances in Malaysia’s manufacturing industry is slightly lower than the priority given to them. The strong correlation of significant value for priority status was observed between efficient production levelling (finished goods) and finish product management while the strong correlation of significant value for current achievement was minimised the number of workstation and factory transportation system. This indicates that complexity drivers have an impact towards manufacturing performance. Consequently, it is necessary to identify complexity drivers to achieve well manufacturing performance.

Status and performance of the ALICE MRPC-based Time-Of-Flight detector

NASA Astrophysics Data System (ADS)

Alici, A.

2012-10-01

ALICE is the dedicated heavy-ion experiment at the CERN LHC. One of the main detectors devoted to charged hadron identification in the ALICE central barrel is a large Time-Of-Flight (TOF) array; it allows separation among pions, kaons and protons up to a few GeV/c, covering the full azimuthal angle and -0.9 < η < 0.9. The very good performance required for such a system has been achieved by means of the Multigap Resistive Plate Chamber (MRPC) whose intrinsic time resolution is better than 50 ps with an overall efficiency close to 100% and a large operational plateau; the full array consists of 1593 MRPCs covering a cylindrical surface of 141 m2. In this report, the status of the TOF detector and the performance achieved during the 2010 and 2011 data taking periods are reported together with selected physics results obtained with pp and Pb-Pb collisions.

13 CFR 121.404 - When does SBA determine the size status of a business concern?

Code of Federal Regulations, 2013 CFR

2013-01-01

... order. (vi) A Blanket Purchase Agreement (BPA) is not a contract. Goods and services are acquired under a BPA when an order is issued. Thus, a concern's size may not be determined based on its size at the time of a response to a solicitation for a BPA. (4) If during contract performance a subcontractor...

13 CFR 121.404 - When does SBA determine the size status of a business concern?

Code of Federal Regulations, 2012 CFR

2012-01-01

... order. (vi) A Blanket Purchase Agreement (BPA) is not a contract. Goods and services are acquired under a BPA when an order is issued. Thus, a concern's size may not be determined based on its size at the time of a response to a solicitation for a BPA. (4) If during contract performance a subcontractor...

Does fasting during Ramadan trigger non-adherence to oral hormonal therapy in breast cancer patients?

PubMed

Zeeneldin, Ahmed Abdelmabood; Gaber, Ayman Abdelsamee; Taha, Fatma Mohamed

2012-09-01

To estimate the effect of fasting during Ramadan (the ninth lunar month) on adherence to oral hormonal therapies (OHT) among breast cancer (BC) patients. During Ramadan 2010, 139 BC patients were interviewed at the Egyptian National Cancer Institute. They were asked about fasting as well as intake of OHT in Ramadan and in the preceding month. The median age was 50years and most patients were postmenopausal with good performance status and non-metastatic disease. The median number of fasting days was 18% and 93% of patients were fasting 80% or more of Ramadan. Tamoxifen and aromatase inhibitors were used in 64% and 36%, respectively. Adherence to OHT during Ramadan and its preceding month were 94.2% and 95.7%, respectively (p=0.77). In univariate analysis, non-adherence prior to Ramadan and shorter duration of OHT were predictors of non-adherence during Ramadan (P<0.001, 0.003, respectively). Fasting, age, performance status, presence of metastases and type of hormonal therapy were not good predictors of adherence. While most of patients receiving OHT for BC are fasting during Ramadan, this does not negatively impact compliance with treatment. Copyright © 2012. Published by Elsevier B.V.

An Analysis of Integrated Child Development Scheme Performance in Contributing to Alleviation of Malnutrition in Two Economically Resurgent States.

PubMed

Ruia, Aparna; Gupta, Rajul Kumar; Bandyopadhyay, Gargi; Gupta, Rajshree R

2018-01-01

Good economic growth is considered synonymous with good nutrition. In recent past, some states (like Bihar and Gujarat) have seen unprecedented economic growth. Despite this and introducing plethora of programs (including integrated child development scheme [ICDS]) to reduce malnutrition, one state might be performing well in reducing malnutrition whereas other with equally high economic growth rate might lag behind. Is mere economic growth good enough to alleviate malnutrition? The aim of the article is to document a critical comparative analysis of malnutrition with special emphasis on ICDS (with respect to finances, infrastructure, training, performance) in the two economically resurgent states of Gujarat and Bihar. An exploratory study using secondary data sources (for ICDS performance) to critically analyze malnutrition status in Bihar and Gujarat. Gujarat, which was criticized for placing excessive emphasis on economic growth, has shown sharp improvement in combating malnutrition. Undernourished children declined from 73.04% in 2007 to 25.09% in 2013, with just 1.6% being severely malnourished. On the other hand, Bihar too exhibited an impressive economic growth but still languishes at bottom with malnutrition rate of 82%. A high economic growth does not have automatic immediate positive gains on malnutrition alleviation.

24 CFR 1000.244 - If the recipient has made a good-faith effort to negotiate a cooperation agreement and tax-exempt...

Code of Federal Regulations, 2014 CFR

2014-04-01

...-faith effort to negotiate a cooperation agreement and tax-exempt status but has been unsuccessful... recipient has made a good-faith effort to negotiate a cooperation agreement and tax-exempt status but has... recipient's Area ONAP. The request must detail a good faith effort by the recipient, identify the housing...

24 CFR 1000.244 - If the recipient has made a good-faith effort to negotiate a cooperation agreement and tax-exempt...

Code of Federal Regulations, 2013 CFR

2013-04-01

...-faith effort to negotiate a cooperation agreement and tax-exempt status but has been unsuccessful... recipient has made a good-faith effort to negotiate a cooperation agreement and tax-exempt status but has... recipient's Area ONAP. The request must detail a good faith effort by the recipient, identify the housing...

Impaired Patient-Reported Outcomes Predict Poor School Functioning and Daytime Sleepiness: The PROMIS Pediatric Asthma Study.

PubMed

Jones, Conor M; DeWalt, Darren A; Huang, I-Chan

Poor asthma control in children is related to impaired patient-reported outcomes (PROs; eg, fatigue, depressive symptoms, anxiety), but less well studied is the effect of PROs on children's school performance and sleep outcomes. In this study we investigated whether the consistency status of PROs over time affected school functioning and daytime sleepiness in children with asthma. Of the 238 children with asthma enrolled in the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Asthma Study, 169 children who provided survey data for all 4 time points were used in the analysis. The child's PROs, school functioning, and daytime sleepiness were measured 4 times within a 15-month period. PRO domains included asthma impact, pain interference, fatigue, depressive symptoms, anxiety, and mobility. Each child was classified as having poor/fair versus good PROs per meaningful cut points. The consistency status of each domain was classified as consistently poor/fair if poor/fair status was present for at least 3 time points; otherwise, the status was classified as consistently good. Seemingly unrelated regression was performed to test if consistently poor/fair PROs predicted impaired school functioning and daytime sleepiness at the fourth time point. Consistently poor/fair in all PRO domains was significantly associated with impaired school functioning and excessive daytime sleepiness (Ps < .01) after controlling for the influence of the child's age, sex, and race/ethnicity. Children with asthma with consistently poor/fair PROs are at risk of poor school functioning and daytime sleepiness. Developing child-friendly PRO assessment systems to track PROs can inform potential problems in the school setting. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Analytical performance, agreement and user-friendliness of six point-of-care testing urine analysers for urinary tract infection in general practice

PubMed Central

Schot, Marjolein J C; van Delft, Sanne; Kooijman-Buiting, Antoinette M J; de Wit, Niek J; Hopstaken, Rogier M

2015-01-01

Objective Various point-of-care testing (POCT) urine analysers are commercially available for routine urine analysis in general practice. The present study compares analytical performance, agreement and user-friendliness of six different POCT urine analysers for diagnosing urinary tract infection in general practice. Setting All testing procedures were performed at a diagnostic centre for primary care in the Netherlands. Urine samples were collected at four general practices. Primary and secondary outcome measures Analytical performance and agreement of the POCT analysers regarding nitrite, leucocytes and erythrocytes, with the laboratory reference standard, was the primary outcome measure, and analysed by calculating sensitivity, specificity, positive and negative predictive value, and Cohen's κ coefficient for agreement. Secondary outcome measures were the user-friendliness of the POCT analysers, in addition to other characteristics of the analysers. Results The following six POCT analysers were evaluated: Uryxxon Relax (Macherey Nagel), Urisys 1100 (Roche), Clinitek Status (Siemens), Aution 11 (Menarini), Aution Micro (Menarini) and Urilyzer (Analyticon). Analytical performance was good for all analysers. Compared with laboratory reference standards, overall agreement was good, but differed per parameter and per analyser. Concerning the nitrite test, the most important test for clinical practice, all but one showed perfect agreement with the laboratory standard. For leucocytes and erythrocytes specificity was high, but sensitivity was considerably lower. Agreement for leucocytes varied between good to very good, and for the erythrocyte test between fair and good. First-time users indicated that the analysers were easy to use. They expected higher productivity and accuracy when using these analysers in daily practice. Conclusions The overall performance and user-friendliness of all six commercially available POCT urine analysers was sufficient to justify routine use in suspected urinary tract infections in general practice. PMID:25986635

Development and preliminary validation of the EASE: a tool to measure perceived singing voice function.

PubMed

Phyland, Debra J; Pallant, Julie F; Benninger, Michael S; Thibeault, Susan L; Greenwood, Ken M; Smith, Julian A; Vallance, Neil

2013-07-01

Most voice self-rating tools are disease-specific measures and are not suitable for use with healthy voice users. There is a need for a tool that is sensitive to the subtleties of a singer's voice and to perceived physical changes in the singing voice mechanism as a function of load. The aim of this study was to devise and validate a scale to assess singer's perceptions of the current status of their singing voice. Ninety-five vocal health descriptors were collected from focus group interviews of singers. These were reviewed by 25 currently performing music theater (MT) singers. Based on a consensus technique, the number of descriptors was decreased to 42 items. These were administered to a sample of 284 professional MT singers using an online survey to evaluate their perception of current singing voice status. Principal component analysis identified two subsets of items. Rasch analysis was used to evaluate and refine these sets of items to form two 10-item subscales. Both subscales demonstrated good overall fit to the Rasch model, no differential item functioning by sex or age, and good internal consistency reliability. The two subscales were strongly correlated and subsequent Rasch analysis supported their combination to form a single 20-item scale with good psychometric properties. The Evaluation of the Ability to Sing Easily (EASE) is a concise clinical tool to assess singer's perceptions of the current status of their singing voice with good measurement properties. EASE may prove a useful tool to measure changes in the singing voice as indicators of the effect of vocal load. Furthermore, it may offer a valuable means for the prediction or screening of singers "at risk" of developing voice disorders. Copyright © 2013 The Voice Foundation. All rights reserved.

Continuous Amplitude-Integrated Electroencephalographic Monitoring Is a Useful Prognostic Tool for Hypothermia-Treated Cardiac Arrest Patients.

PubMed

Oh, Sang Hoon; Park, Kyu Nam; Shon, Young-Min; Kim, Young-Min; Kim, Han Joon; Youn, Chun Song; Kim, Soo Hyun; Choi, Seung Pill; Kim, Seok Chan

2015-09-22

Modern treatments have improved the survival rate following cardiac arrest, but prognostication remains a challenge. We examined the prognostic value of continuous electroencephalography according to time by performing amplitude-integrated electroencephalography on patients with cardiac arrest receiving therapeutic hypothermia. We prospectively studied 130 comatose patients treated with hypothermia from September 2010 to April 2013. We evaluated the time to normal trace (TTNT) as a neurological outcome predictor and determined the prognostic value of burst suppression and status epilepticus, with a particular focus on their time of occurrence. Fifty-five patients exhibited a cerebral performance category score of 1 to 2. The area under the curve for TTNT was 0.97 (95% confidence interval, 0.92-0.99), and the sensitivity and specificity of TTNT<24 hours after resuscitation as a threshold for predicting good neurological outcome were 94.6% (95% confidence interval, 84.9%-98.9%) and 90.7% (95% confidence interval, 81.7%-96.2%), respectively. The threshold displaying 100% specificity for predicting poor neurological outcome was TTNT>36 hours. Burst suppression and status epilepticus predicted poor neurological outcome (positive predictive value of 98.3% and 96.4%, respectively). The combination of these factors predicted a negative outcome at a median of 6.2 hours after resuscitation (sensitivity and specificity of 92.0% and 96.4%, respectively). A TTNT<24 hours was associated with good neurological outcome. The lack of normal trace development within 36 hours, status epilepticus, and burst suppression were predictors of poor outcome. The combination of these negative predictors may improve their prognostic performance at an earlier stage. © 2015 The Authors.

[Therapeutic strategies against myasthenia gravis].

PubMed

Utsugisawa, Kimiaki; Nagane, Yuriko

2013-05-01

Many patients with myasthenia gravis (MG) still find it difficult to maintain daily activities due to chronic residual fatigability and long-term side effects of oral corticosteroids, since full remission is not common. Our analysis demonstrated that disease severity, oral corticosteroids, and depressive state are the major factors negatively associated with QOL, and that QOL of MM status patients taking < or = 5 mg prednisolne/day is identically good as that seen in CSR and is a target of treatment. In order to achieve early MM or better status with prednisolne < or = 5 mg/day, we advocate the early aggressive treatment strategy that can achieve early improvement by performing an aggressive therapy using combined treatment with plasmapheresis and high-dose intravenous methylprednisolone and then maintain an improved status using low-dose oral corticosteroids and calcineurin inhibitors.

Inventory Control System by Using Vendor Managed Inventory (VMI)

NASA Astrophysics Data System (ADS)

Sabila, Alzena Dona; Mustafid; Suryono

2018-02-01

The inventory control system has a strategic role for the business in managing inventory operations. Management of conventional inventory creates problems in the stock of goods that often runs into vacancies and excess goods at the retail level. This study aims to build inventory control system that can maintain the stability of goods availability at the retail level. The implementation of Vendor Managed Inventory (VMI) method on inventory control system provides transparency of sales data and inventory of goods at retailer level to supplier. Inventory control is performed by calculating safety stock and reorder point of goods based on sales data received by the system. Rule-based reasoning is provided on the system to facilitate the monitoring of inventory status information, thereby helping the process of inventory updates appropriately. Utilization of SMS technology is also considered as a medium of collecting sales data in real-time due to the ease of use. The results of this study indicate that inventory control using VMI ensures the availability of goods ± 70% and can reduce the accumulation of goods ± 30% at the retail level.

The Subjective Well-Being Method of Valuation: An Application to General Health Status.

PubMed

Brown, Timothy T

2015-12-01

To introduce the subjective well-being (SWB) method of valuation and provide an example by valuing health status. The SWB method allows monetary valuations to be performed in the absence of market relationships. Data are from the 1975-2010 General Social Survey. The value of health status is determined via the estimation of an implicit derivative based on a happiness equation. Two-stage least-squares was used to estimate happiness as a function of poor-to-fair health status, annual household income adjusted for household size, age, sex, race, marital status, education, year, and season. Poor-to-fair health status and annual household income are instrumented using a proxy for intelligence, a temporal version of the classic distance instrument, and the average health status of individuals who are demographically similar but geographically separated. Instrument validity is evaluated. Moving from good/excellent health to poor/fair health (1 year of lower health status) is equivalent to the loss of $41,654 of equivalized household income (2010 constant dollars) per annum, which is larger than median equivalized household income. The SWB method may be useful in making monetary valuations where fundamental market relationships are not present. © Health Research and Educational Trust.

A structural equation model of perceived and internalized stigma, depression, and suicidal status among people living with HIV/AIDS.

PubMed

Zeng, Chengbo; Li, Linghua; Hong, Yan Alicia; Zhang, Hanxi; Babbitt, Andrew Walker; Liu, Cong; Li, Lixia; Qiao, Jiaying; Guo, Yan; Cai, Weiping

2018-01-15

Previous studies have shown positive association between HIV-related stigma and depression, suicidal ideation, and suicidal attempt among people living with HIV/AIDS (PLWH). But few studies have examined the mechanisms among HIV-related stigma, depression, and suicidal status (suicidal ideation and/or suicidal attempt) in PLWH. The current study examined the relationships among perceived and internalized stigma (PIS), depression, and suicidal status among PLWH in Guangzhou, China using structural equation modeling. Cross-sectional study by convenience sampling was conducted and 411 PLWH were recruited from the Number Eight People's Hospital from March to June, 2013 in Guangzhou, China. Participants were interviewed on their PIS, depressive symptoms, suicidal status, and socio-demographic characteristics. PLWH who had had suicidal ideation and suicidal attempts since HIV diagnosis were considered to be suicidal. Structural equation model was performed to examine the direct and indirect associations of PIS and suicidal status. Indicators to evaluate goodness of fit of the structural equation model included Chi-square Statistic, Comparative Fit Index (CFI), Root Mean Square Error of Approximation (RMSEA), Standardized Root Mean Square Residual (SRMR), and Weighted Root Mean Square Residual (WRMR). More than one-third (38.4%) of the PLWH had depressive symptoms and 32.4% reported suicidal ideation and/or attempt since HIV diagnosis. The global model showed good model fit (Chi-square value = 34.42, CFI = 0.98, RMSEA = 0.03, WRMR = 0.73). Structural equation model revealed that direct pathway of PIS on suicidal status was significant (standardized pathway coefficient = 0.21), and indirect pathway of PIS on suicidal status via depression was also significant (standardized pathway coefficient = 0.24). There was a partial mediating effect of depression in the association between PIS and suicidal status. Our findings suggest that PIS is associated with increased depression and the likelihood of suicidal status. Depression is in turn positively associated with suicidal status and plays a mediating role between PIS and suicidal status. Therefore, to reduce suicidal ideation and attempt in PLWH, targeted interventions to reduce PIS and improve mental health status of PLWH are warranted.

Do managed care plans' tiered networks lead to inequities in care for minority patients?

PubMed

Brennan, Troyen A; Spettell, Claire M; Fernandes, Joaquim; Downey, Roberta L; Carrara, Lisa M

2008-01-01

This study examined whether specialists designated as meeting efficiency thresholds in an insurance company's performance network were less likely than non-designated specialists to treat minority patients insured by that company. Claims data were used to identify patients treated by specialists. Claimants' race/ethnicity status was self-reported to the insurer at enrollment. In large part, minority patients appeared to be evenly distributed across the performance network, with the exception of Asian/Pacific Islanders, who appeared to be more likely to be treated by nondesignated physicians than by designated "good-performing" specialists.

Effects of individual dietary counseling as part of a comprehensive geriatric assessment (CGA) on nutritional status: a population-based intervention study.

PubMed

Nykänen, I; Rissanen, T H; Sulkava, R; Hartikainen, S

2014-01-01

Nutritional risk is relatively common in community-dwelling older people. To objective of this study was to evaluate the effects of individual dietary counseling as part of a Comprehensive Geriatric Assessment on nutritional status among community-dwelling people aged 75 years or older. Data were obtained from a subpopulation of participants in the population-based Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) intervention study in 2004 to 2007. In the present study, the population consist 173 persons at risk of malnutrition in the year 2005 in an intervention (n=84) and control group (n=89). Nutritional status, body weight, body mass index, serum albumin were performed at the beginning of the study and at a two-year follow-up. The nutritional screening was performed using the Mini Nutritional Assessment (MNA) test. A increase in MNA scores (1.8 95% confidence interval [CI]: 0.7 to 2.0) and in serum albumin (0.8 g/L, 95% CI: 0.2 to 0.9 g/L) were a significant difference between the groups. Nutritional intervention, even dietary counseling without nutritional supplements, may improve nutritional status.

Assessment of biomarkers in Mytilus edulis to determine good environmental status for implementation of MSFD in Ireland.

PubMed

Giltrap, M; Ronan, J; Hardenberg, S; Parkes, G; McHugh, B; McGovern, E; Wilson, J G

2013-06-15

Candidate OSPAR/ICES recommended biomarkers at the level of the individual in Mytilus edulis for determination of good environmental status for MSFD were evaluated against contaminant levels at sites around Ireland. The sites chosen ranged from moderate to low pollution levels, but the actual ranking of the sites varied according to the contaminant levels present. At the most contaminated site, Cork, 4 out of 16 contaminants exceeded the EAC, while at Shannon, no EACs were exceeded. The SOS assay suggested that Cork was the healthiest site with a LT50 of 17.6 days, while SOS for Shannon was 15.6 days. Likewise, condition factors varied among sites and did not always correspond to contaminant-based status. There may be uncertainty in assigning status around the not good:good boundary. This raises potential difficulties not only in the biomarker/contaminant load relationship but also in the reliability of the biomarkers themselves and hence barriers meeting compliance levels. Copyright © 2013 Elsevier Ltd. All rights reserved.

Edentulism and other variables associated with self-reported health status in Mexican adults

PubMed Central

Medina-Solís, Carlo Eduardo; Pontigo-Loyola, América Patricia; Pérez-Campos, Eduardo; Hernández-Cruz, Pedro; Avila-Burgos, Leticia; Mendoza-Rodríguez, Martha; Maupomé, Gerardo

2014-01-01

Background To determine if edentulism, controlling for other known factors, is associated with subjective self-report health status (SRH) in Mexican adults. Material/Methods We examined the SRH of 13 966 individuals 35 years and older, using data from the National Survey of Performance Assessment, a cross-sectional study that is part of the technical collaboration between the Ministry of Health of Mexico and the World Health Organization, which used the survey instrument and sampling strategies developed by WHO for the World Health Survey. Sociodemographic, socioeconomic, medical, and behavioral variables were collected using questionnaires. Self-reported health was our dependent variable. Data on edentulism were available from 20 of the 32 Mexican states. A polynomial logistic regression model adjusted for complex sampling was generated. Results In the SRH, 58.2% reported their health status as very good/good, 33.8% said they had a moderate health status, and 8.0% reported that their health was bad/very bad. The association between edentulism and SRH was modified by age and was significant only for bad/very bad SRH. Higher odds of reporting moderate health or poor/very poor health were found in women, people with lower socio-economic status and with physical disabilities, those who were not physically active, or those who were underweight or obese, those who had any chronic disease, and those who used alcohol. Conclusions The association of edentulism with a self-report of a poor health status (poor/very poor) was higher in young people than in adults. The results suggest socioeconomic inequalities in SRH. Inequality was further confirmed among people who had a general health condition or a disability. PMID:24852266

The science of animal welfare

USDA-ARS?s Scientific Manuscript database

People differ in their culture, education, economic status, and values; thus they may view an animal’s welfare status as good or poor based on their individuality. However, regardless of these human differences in perception the actual state of welfare for the animal does exist in a range from good ...

Reported Child Health Status, Hispanic Ethnicity, and Language of Interview: United States, 2011-2012.

PubMed

Pastor, Patricia N; Reuben, Cynthia A; Duran, Catherine R

2015-09-10

This report has three objectives: a) to describe the reported health status of four subgroups of school-age children: Hispanic children with a Spanish interview (Hispanic–Spanish interview), Hispanic children with an English interview (Hispanic–English interview), non-Hispanic black children, and non-Hispanic white children; b) to describe selected characteristics of children in the four subgroups; and c) to consider whether the characteristics of children account for subgroup variations in reported health status. Data from the 2011–2012 National Survey of Children’s Health were used to describe the health status of children aged 5–17 years using three categories: a) poor or fair, b) good, and c) very good or excellent health. The reported health status of children in the four subgroups was examined using multinomial logistic regression, controlling for the effects of demographic and socioeconomic characteristics and a measure of acculturation. Compared with children in the other subgroups, Hispanic–Spanish interview children were more likely to have reports of poor or fair health (10.6% compared with 1.8%–4.4%) and good health (39.7% compared with 7.7%– 14.4%). Controlling for demographic and socioeconomic characteristics and a measure of acculturation eliminated the subgroup differences in poor or fair health, but not good health. Even after adjustment for confounders, Hispanic–Spanish interview children more often were reported to have good health rather than very good or excellent health compared with children in the other subgroups. Worse reported health status of Hispanic–Spanish interview children, compared with children in other subgroups, could not be explained completely by the confounders in the analysis. Additional research is needed to determine whether the worse reported health status of Hispanic children with Spanish interviews reflects the actual health conditions of these children or difficulties in translating the health status question. 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.

Automated Portable Test System (APTS) - A performance envelope assessment tool

NASA Technical Reports Server (NTRS)

Kennedy, R. S.; Dunlap, W. P.; Jones, M. B.; Wilkes, R. L.; Bittner, A. C., Jr.

1985-01-01

The reliability and stability of microcomputer-based psychological tests are evaluated. The hardware, test programs, and system control of the Automated Portable Test System, which assesses human performance and subjective status, are described. Subjects were administered 11 pen-and-pencil and microcomputer-based tests for 10 sessions. The data reveal that nine of the 10 tests stabilized by the third administration; inertial correlations were high and consistent. It is noted that the microcomputer-based tests display good psychometric properties in terms of differential stability and reliability.

Diet-induced changes in iron and n-3 fatty acid status and associations with cognitive performance in 8-11-year-old Danish children: secondary analyses of the Optimal Well-Being, Development and Health for Danish Children through a Healthy New Nordic Diet School Meal Study.

PubMed

Sørensen, Louise Bergmann; Damsgaard, Camilla Trab; Dalskov, Stine-Mathilde; Petersen, Rikke Agnete; Egelund, Niels; Dyssegaard, Camilla Brørup; Stark, Ken D; Andersen, Rikke; Tetens, Inge; Astrup, Arne; Michaelsen, Kim Fleisher; Lauritzen, Lotte

2015-11-28

Fe and n-3 long-chain PUFA (n-3 LCPUFA) have both been associated with cognition, but evidence remains inconclusive in well-nourished school-aged children. In the Optimal Well-Being, Development and Health for Danish Children through a Healthy New Nordic Diet (OPUS) School Meal Study, the 3-month intervention increased reading performance, inattention, impulsivity and dietary intake of fish and Fe. This study investigated whether the intervention influenced n-3 LCPUFA and Fe status and, if so, explored how these changes correlated with the changes in cognitive performance. The study was a cluster-randomised cross-over trial comparing school meals with packed lunch (control). At baseline and after each treatment, we measured serum ferritin, whole-blood n-3 LCPUFA and Hb, and performance in reading, mathematics and d2-test of attention. Data were analysed using mixed models (n 726) and principal component analysis of test performances (n 644), which showed two main patterns: 'school performance' and 'reading comprehension'. The latter indicated that children with good reading comprehension were also more inattentive and impulsive (i.e. higher d2-test error%). The intervention improved 'school performance' (P=0·015), 'reading comprehension' (P=0·043) and EPA+DHA status 0·21 (95% CI 0·15, 0·27) w/w % (P<0·001), but it did not affect serum ferritin or Hb. At baseline, having small Fe stores was associated with poorer 'school performance' in girls, but with better 'reading comprehension' in both boys and girls. Both baseline EPA+DHA status and the intervention-induced increase in EPA+DHA status was positively associated with 'school performance', suggesting that n-3 LCPUFA could potentially explain approximately 20 % of the intervention effect. These exploratory associations indicate that increased fish intake might explain some of the increase in reading performance and inattention in the study.

Cardiorespiratory endurance in relation to body mass in Polish rural children: Preliminary report.

PubMed

Gajewska, E; Kalińska, K; Bogdański, P; Sobieska, M

2015-06-01

Physical fitness is generally viewed as having morphological, muscular, motor, cardiovascular and metabolic components. Cardiorespiratory fitness describes the capacity of the cardiovascular and respiratory systems to carry out prolonged strenuous exercise. It is often considered as the most important indicator of health status. The place of residence is seen as a factor that may influence the feasibility of physically active lifestyles, and thus shaping cardiorespiratory fitness. The study group consisted of 121 children aged 10-16 years, including 60 girls and 61 boys. All of the children lived in rural areas. The investigated group was divided according to age and sex; body height and weight were measured and body mass index (BMI) calculated. All children performed the Cooper's run test and the Ruffier's test. The analysis of BMI for the nutritional status of children in relation to the entire study group demonstrated that 81 children had normal weight, 20 children were overweight and 11 were obese, while 9 children were underweight. The studied group of children showed on average very good and good performance in the Cooper's test, regardless of body weight, whereas the results of the Ruffier's test showed merely weak or medium cardiorespiratory endurance, which was even worse in overweight or obese children. Copyright © 2015 Elsevier GmbH. All rights reserved.

Status of the NASA-Lewis flat-plate collector tests with a solar simulator

NASA Technical Reports Server (NTRS)

Simon, F. F.

1974-01-01

Simulator test results of 15 collector types are presented. Collectors are given performance ratings according to their use for pool heating, hot water, absorption A/C or heating, and solar Rankine machines. Collectors found to be good performers in the above categories, except for pool heating, were a black nickel coated, 2 glass collector, and a black paint 2 glass collector containing a mylar honeycomb. For pool heating, a black paint, one glass collector was found to be the best performer. Collector performance parameters of 5 collector types were determined to aid in explaining the factors that govern performance. The two factors that had the greatest effect on collector performance were the collector heat loss and the coating absorptivity.

Predictors of work status and quality of life 9-13 years after aneurysmal subarachnoid hemorrahage.

PubMed

Vilkki, Juhani; Juvela, Seppo; Malmivaara, Kirsi; Siironen, Jari; Hernesniemi, Juha

2012-08-01

Aneurysmal subarachnoid hemorrhage (SAH) causes long-term psychosocial impairments even in patients who regain functional independence. Little is known about predictors of these impairments. We studied how early clinical data and neuropsychological results predict work status and health-related quality of life (HRQoL) 9-13 years after SAH. One hundred one patients performed a neuropsychological test battery and returned their self-rating and partner's rating of a psychosocial impairment questionnaire approximately 1 year after SAH. These data were analyzed for association to the patients' work status and self-rated HRQoL approximately 10 years later. Age inversely, lower levels of self-rated impairments, employment and higher levels of education at the first follow-up independently predicted employment at the long-term follow-up. Although most cognitive test results were significantly associated with employment status at the long-term follow-up, they were of limited additional value as predictors of work status. The best predictor combination for long-term high HRQoL was good performance in a face recognition test and lower levels of self-rated impairments at the first follow-up as well as male sex. Problems in usual activities at the long-term follow-up were predicted by poor results in the face recognition and in a word list-learning task. Questionnaire ratings of patients' psychosocial impairments 1 year after SAH give important information for the long-term prediction of their work status and HRQoL. In the long run, patients' unemployment becomes strongly associated with higher age, while their performance of usual activities can be predicted with learning and memory results.

Limited-preparation CT colonography in frail elderly patients: a feasibility study.

PubMed

Keeling, Aoife N; Slattery, Michael M; Leong, Sum; McCarthy, Eoghan; Susanto, Maja; Lee, Michael J; Morrin, Martina M

2010-05-01

Full colonic preparation can be onerous and may be poorly tolerated in frail elderly patients. The purpose of this study was to prospectively assess the image quality and diagnostic yield of limited-preparation CT colonography (CTC) in elderly patients with suspected colorectal cancer who were deemed medically unfit or unsuitable for colonoscopy. A prospective study was performed of 67 elderly patients with reduced functional status referred for CTC. Participants were prescribed a limited bowel preparation consisting of a low-residue diet for 3 days, 1 L of 2% oral diatrizoate meglumine (Gastrografin) 24 hours before CTC, and 1 L of 2% oral Gastrografin over the 2 hours immediately before CTC. No cathartic preparation was administered. All colonic segments were graded from 1 to 5 for image quality (1, unreadable; 2, poor; 3, equivocal; 4, good; 5, excellent) and reader confidence. Clinical and conventional colonoscopy follow-up findings were documented, and all colonic and extracolonic pathologic findings were documented. Overall image quality and reader confidence in the evaluation of the colon was rated good or excellent in 84% of the colonic segments. Colonic abnormalities were identified in 12 patients (18%), including four colonic tumors, two polyps, and seven colonic strictures. Incidental extraintestinal findings were detected in 43 patients (64%), including nine patients with lesions radiologically consistent with malignancy. Limited-preparation low-dose CTC is a feasible and useful minimally invasive technique with which to evaluate the colon and exclude gross pathology (mass lesions and polyps > 1 cm) in elderly patients with diminished performance status, yielding good to excellent image quality.

Rasch analysis and impact factor methods both yield valid and comparable measures of health status in interstitial lung disease.

PubMed

Patel, Amit S; Siegert, Richard J; Bajwah, Sabrina; Brignall, Kate; Gosker, Harry R; Moxham, John; Maher, Toby M; Renzoni, Elisabetta A; Wells, Athol U; Higginson, Irene J; Birring, Surinder S

2015-09-01

Rasch analysis has largely replaced impact factor methodology for developing health status measures. The aim of this study was to develop a health status questionnaire for patients with interstitial lung disease (ILD) using impact factor methodology and to compare its validity with that of another version developed using Rasch analysis. A preliminary 71-item questionnaire was developed and evaluated in 173 patients with ILD. Items were reduced by the impact factor method (King's Brief ILD questionnaire, KBILD-I) and Rasch analysis (KBILD-R). Both questionnaires were validated by assessing their relationship with forced vital capacity (FVC) and St Georges Respiratory Questionnaire (SGRQ) and by evaluating internal reliability, repeatability, and longitudinal responsiveness. The KBILD-R and KBILD-I comprised 15 items each. The content of eight items differed between the KBILD-R and KBILD-I. Internal and test-retest reliability was good for total scores of both questionnaires. There was a good relationship with SGRQ and moderate relationship with FVC for both questionnaires. Effect sizes were comparable. Both questionnaires discriminated patients with differing disease severity. Despite considerable differences in the content of retained items, both KBILD-R and KBILD-I questionnaires demonstrated acceptable measurement properties and performed comparably in a clinical setting. Copyright © 2015 Elsevier Inc. All rights reserved.

Glioblastoma patients in Slovenia from 1997 to 2008

PubMed Central

Smrdel, Uros; Kovac, Viljem; Popovic, Mara; Zwitter, Matjaz

2014-01-01

Background Glioblastoma is the most common primary brain tumour. It has a poor prognosis despite some advances in treatment that have been achieved over the last ten years. In Slovenia, 50 to 60 glioblastoma patients are diagnosed each year. In order to establish whether the current treatment options have any influence on the survival of the Slovenian glioblastoma patients, their data in the period from the beginning of the year 1997 to the end of the year 2008 have been analysed. Patients and methods All patients treated at the Institute of Oncology Ljubljana from 1997 to 2008 were included in the retrospective study. Demographics, treatment details, and survival time after the diagnosis were collected and statistically analysed for the group as a whole and for subgroups. Results From 1997 to 2008, 527 adult patients were diagnosed with glioblastoma and referred to the Institute of Oncology for further treatment. Their median age was 59 years (from 20 to 85) and all but one had the diagnosis confirmed by a pathologist. Gross total resection was reported by surgeons in 261 (49.5%) patients; good functional status (WHO 0 or 1) after surgery was observed in 336 (63.7%) patients, radiotherapy was performed in 422 (80.1%) patients, in 317 (75.1%) of them with radical intent, and 198 (62.5 %) of those received some form of systemic treatment (usually temozolomide). The median survival of all patients amounted to 9.7 months. There was no difference in median survival of all patients or of all treated patients before or after the chemo-radiotherapy era. However, the overall survival of patients treated with radical intent was significantly better (11.4 months; p < 0.05). A better survival was also noticed in radically treated patients who received additional temozolomide therapy (11.4 vs. 13.1 months; p = 0.014). The longer survival was associated with a younger age and a good performance status as well as with a more extensive tumour resection. In patients treated with radical intent, having a good performance status, and receiving radiotherapy and additional temozolomide therapy, the survival was significantly longer, based on multivariate analysis. Conclusions We observed a gradual increase in the survival of glioblastoma patients who were treated with radical intent over the last ten years. Good functional surgery, advances in radiotherapy and addition of temozolomide all contributed to this increase. Though the increased survival seems to be more pronounced in certain subgroups, we have still not been able to exactly define them. Further research, especially in tumour biology and genetics is needed. PMID:24587783

The STIS MAMA status: Current detector performance

NASA Technical Reports Server (NTRS)

Danks, A. C.; Joseph, C.; Bybee, R.; Argebright, V.; Abraham, J.; Kimble, R.; Woodgate, B.

1992-01-01

The STIS (Space Telescope Imaging Spectrograph) is a second generation Hubble instrument scheduled to fly in 1997. Through a variety of modes, the instrument will provide spectral resolutions from R approximately 50 in the objective spectroscopy mode to 100,000 in the high resolution echelle mode in the wavelength region from 115 to 1000 nm. In the UV the instrument employs two MAMA (Multimode Anode Microchannel plate Arrays) 1024 by 1024 pixel detectors, which provide high DQE (Detective Quantum Efficiency), and good dynamic range and resolution. The current progress and performance of these detectors are reported, illustrating that the technology is mature and that the performance is very close to flight requirements.

Income inequality and status seeking: searching for positional goods in unequal U.S. States.

PubMed

Walasek, Lukasz; Brown, Gordon D A

2015-04-01

It is well established that income inequality is associated with lower societal well-being, but the psychosocial causes of this relationship are poorly understood. A social-rank hypothesis predicts that members of unequal societies are likely to devote more of their resources to status-seeking behaviors such as acquiring positional goods. We used Google Correlate to find search terms that correlated with our measure of income inequality, and we controlled for income and other socioeconomic factors. We found that of the 40 search terms used more frequently in states with greater income inequality, more than 70% were classified as referring to status goods (e.g., designer brands, expensive jewelry, and luxury clothing). In contrast, 0% of the 40 search terms used more frequently in states with less income inequality were classified as referring to status goods. Finally, we showed how residual-based analysis offers a new methodology for using Google Correlate to provide insights into societal attitudes and motivations while avoiding confounds and high risks of spurious correlations. © The Author(s) 2015.

Engineering analysis of ERTS data for rice in the Philippines

NASA Technical Reports Server (NTRS)

Mcnair, A. J. (Principal Investigator); Heydt, H. L.

1973-01-01

The author has identified the following significant results. Rice is an important food worldwide. Worthwhile goals, particularly for developing nations, are the capability to recognize from satellite imagery: (1) areas where rice is grown, and (2) growth status (irrigation, vigor, yield). A two-step procedure to achieve this is being investigated. Ground truth, and ERTS-1 imagery (four passes) covering 80% of a rice growth cycle for some Philippine sites, have been analyzed. One-D and three-D signature extraction, and synthesis of an initial site recognition/status algorithm have been performed. Results are encouraging. but additional passes and sites must be analyzed. Good position information for extracted data is a must.

Predictors of functional status at service entry and discharge among young people with first episode psychosis.

PubMed

Cotton, S M; Lambert, M; Schimmelmann, B G; Filia, K; Rayner, V; Hides, L; Foley, D L; Ratheesh, A; Watson, A; Rodger, P; McGorry, P D; Conus, P

2017-05-01

Most patients with first episode psychosis (FEP) are neither studying nor employed (have a poor functional status) when first accessing care. Knowledge of the characteristics of patients with poor functioning and the features influencing functional status over time may pave the way to better treatment. A medical file audit was used to collect data on premorbid, entry, treatment and 18-month outcome characteristics on 661 FEP patients who consecutively attended the Early Psychosis Prevention and Intervention Centre, Melbourne, Australia, between 1998 and 2000. Functional status was ascertained using the modified vocational status index and was rated at baseline (poor or good) and according to its evolution over the treatment period (stable good, stable poor, deteriorating or improved functional status). 52.0% of patients had a poor functional status at service entry. They were more likely to be male with a non-affective psychosis. They also had lower levels of premorbid global functioning and education, and were more likely to have self-reported histories of learning disability, forensic issues, traumatic experiences and substance use. At service entry, they had more severe symptoms and poorer global functioning. 37% of these patients maintained a poor functional status at discharge, and 18% of those with a good functional status at service entry experienced a decline. Although psychosocial interventions might assist a young person with FEP with working towards functional goals, for some, the impact of factors such as ongoing substance use and forensic issues on functional status needs to be addressed.

Real-time eutrophication status evaluation of coastal waters using support vector machine with grid search algorithm.

PubMed

Kong, Xianyu; Sun, Yuyan; Su, Rongguo; Shi, Xiaoyong

2017-06-15

The development of techniques for real-time monitoring of the eutrophication status of coastal waters is of great importance for realizing potential cost savings in coastal monitoring programs and providing timely advice for marine health management. In this study, a GS optimized SVM was proposed to model relationships between 6 easily measured parameters (DO, Chl-a, C1, C2, C3 and C4) and the TRIX index for rapidly assessing marine eutrophication states of coastal waters. The good predictive performance of the developed method was indicated by the R 2 between the measured and predicted values (0.92 for the training dataset and 0.91 for the validation dataset) at a 95% confidence level. The classification accuracy of the eutrophication status was 86.5% for the training dataset and 85.6% for the validation dataset. The results indicated that it is feasible to develop an SVM technique for timely evaluation of the eutrophication status by easily measured parameters. Copyright © 2017. Published by Elsevier Ltd.

Evaluation of diagnostic accuracy in detecting ordered symptom statuses without a gold standard

PubMed Central

Wang, Zheyu; Zhou, Xiao-Hua; Wang, Miqu

2011-01-01

Our research is motivated by 2 methodological problems in assessing diagnostic accuracy of traditional Chinese medicine (TCM) doctors in detecting a particular symptom whose true status has an ordinal scale and is unknown—imperfect gold standard bias and ordinal scale symptom status. In this paper, we proposed a nonparametric maximum likelihood method for estimating and comparing the accuracy of different doctors in detecting a particular symptom without a gold standard when the true symptom status had an ordered multiple class. In addition, we extended the concept of the area under the receiver operating characteristic curve to a hyper-dimensional overall accuracy for diagnostic accuracy and alternative graphs for displaying a visual result. The simulation studies showed that the proposed method had good performance in terms of bias and mean squared error. Finally, we applied our method to our motivating example on assessing the diagnostic abilities of 5 TCM doctors in detecting symptoms related to Chills disease. PMID:21209155

Dental status and self-assessed chewing ability in 70- and 80-year-old subjects in Sweden.

PubMed

Unell, L; Johansson, A; Ekbäck, G; Ordell, S; Carlsson, G E

2015-09-01

The objective was to compare two cohorts of elderly people, 70 and 80 years old, with respect to dental status and self-assessed chewing ability. The hypotheses were as follows: (i) dental status is associated with self-assessed chewing ability; (ii) chewing ability is poorer among the 80- than the 70-year-old subjects. Identical questionnaires were in 2012 sent to all subjects born in 1942 and 1932, living in two Swedish counties. The response rate was 70.1% resulting in samples of 5697 70- and 2922 80-year-old subjects. Answers to questions on self-assessed chewing ability, dental status and some other factors have been analysed. Dental status varied but was in general good; 72% of the 70- and 60% of the 80-year-old subjects reported that they had all or only few missing teeth. Rate of edentulism was 3% and 7%, respectively. Removable partial dentures were reported by 6% and 10%, respectively, implant treatment by 13% in both cohorts. Self-assessed chewing ability was mostly good and correlated with the number of teeth (Spearman rho = 0.46). A majority of the edentulous subjects assessed their chewing ability as very or fairly good. Logistic regression showed that self-assessed chewing ability was significantly associated with a number of dental variables but also with general health. In conclusion, dental status was relatively good at both ages but somewhat poorer in the older cohort. Dental status, some other dental variables and being healthy were in both age groups significantly associated with self-assessed chewing ability. © 2015 John Wiley & Sons Ltd.

Analytical performance, agreement and user-friendliness of six point-of-care testing urine analysers for urinary tract infection in general practice.

PubMed

Schot, Marjolein J C; van Delft, Sanne; Kooijman-Buiting, Antoinette M J; de Wit, Niek J; Hopstaken, Rogier M

2015-05-18

Various point-of-care testing (POCT) urine analysers are commercially available for routine urine analysis in general practice. The present study compares analytical performance, agreement and user-friendliness of six different POCT urine analysers for diagnosing urinary tract infection in general practice. All testing procedures were performed at a diagnostic centre for primary care in the Netherlands. Urine samples were collected at four general practices. Analytical performance and agreement of the POCT analysers regarding nitrite, leucocytes and erythrocytes, with the laboratory reference standard, was the primary outcome measure, and analysed by calculating sensitivity, specificity, positive and negative predictive value, and Cohen's κ coefficient for agreement. Secondary outcome measures were the user-friendliness of the POCT analysers, in addition to other characteristics of the analysers. The following six POCT analysers were evaluated: Uryxxon Relax (Macherey Nagel), Urisys 1100 (Roche), Clinitek Status (Siemens), Aution 11 (Menarini), Aution Micro (Menarini) and Urilyzer (Analyticon). Analytical performance was good for all analysers. Compared with laboratory reference standards, overall agreement was good, but differed per parameter and per analyser. Concerning the nitrite test, the most important test for clinical practice, all but one showed perfect agreement with the laboratory standard. For leucocytes and erythrocytes specificity was high, but sensitivity was considerably lower. Agreement for leucocytes varied between good to very good, and for the erythrocyte test between fair and good. First-time users indicated that the analysers were easy to use. They expected higher productivity and accuracy when using these analysers in daily practice. The overall performance and user-friendliness of all six commercially available POCT urine analysers was sufficient to justify routine use in suspected urinary tract infections in general practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Perceived timeliness of referral to hospice palliative care among bereaved family members in Korea.

PubMed

Jho, Hyun Jung; Chang, Yoon Jung; Song, Hye Young; Choi, Jin Young; Kim, Yeol; Park, Eun Jung; Paek, Soo Jin; Choi, Hee Jae

2015-09-01

We aimed to explore the perceived timeliness of referral to hospice palliative care unit (HPCU) among bereaved family members in Korea and factors associated therewith. Cross-sectional questionnaire survey was performed for bereaved family members of patients who utilized 40 designated HPCUs across Korea. The questionnaire assessed whether admission to the HPCU was "too late" or "appropriate" and the Good Death Inventory (GDI). A total of 383 questionnaires were analyzed. Of participants, 25.8 % replied that admission to HPCU was too late. Patients with hepatobiliary cancer, poor performance status, abnormal consciousness level, and unawareness of terminal status were significantly related with the too late perception. Family members with younger age and being a child of the patient were more frequently noted in the too late group. Ten out of 18 GDI scores were significantly lower in the too late group. Multiple logistic regression analysis revealed patients' unawareness of terminal status, shorter stay in the HPCU, younger age of bereaved family, and lower scores for two GDI items (staying in a favored place, living without concerning death or disease) were significantly associated with the too late group. To promote timely HPCU utilization and better quality of end of life care, patients need to be informed of the terminal status and their preference should be respected.

Self-reported academic performance in relation to health behaviours among Bahria University students.

PubMed

Rehman, Rehana; Zafar, Amara; Mohib, Aleena; Hussain, Mehwish; Ali, Rabiya

2018-02-01

To find an association between self-reported academic performance with different socio-demographic factors, health behaviours and mental health amongst university students. This cross-sectional study was conducted at Bahria University, Karachi, from January 2012 to December 2013, and comprised university students of different disciplines. An anonymous, self-reported questionnaire was distributed among the subjects. Convenient sampling technique was used. Demographic information, including age, gender and field of study, were obtained. Depresion was evaluated via Centre for Epidemiological Studies Depression Scale. SPSS 22 was used to analyse data. Of the 813 respondents, 334(41.1%) were males and 479(58.9%) females. The mean age was 19.9±1.8 years. Overall, 126(15.5%) subjects reported excellent, 242(29.8%) very good, 310(38.1%) good, 100(12.3%) satisfactory and 35(4.3%) not satisfactory academic performance. Residential status of students played a significant role on their academic performance (p=0.011). Breakfast eating behaviour depicted a significant association with the academic performance (p=0.04).The proportion of unsatisfactory academic performances among students having severe sleep disorder was the highest, followed by mild/moderate (p=0.01). The depression scale's item 'troubling in mind' was highly associated with academic performance (p<0.05). A constructive association existed among healthy behaviours and academic performance. .

The association of self-rated health and lifestyle behaviors among foreign-born Chinese, Korean, and Vietnamese Americans.

PubMed

Tran, Thanh V; Nguyen, Duy; Chan, Keith; Nguyen, Thuc-Nhi

2013-03-01

This study employed the 2009 California Health Interview Survey to examine the association of self-rated heath status and lifestyle behavior variables such as smoking at least 100 cigarettes or more in an entire lifetime, alcohol consumption, and physical activity level among foreign-born Chinese, Korean, and Vietnamese Americans aged 18 and older. The total study sample consisted of 3,023 foreign-born adult Chinese (n = 812), Korean (n = 857), and Vietnamese (n = 1,354) Americans. Logistic regression via Stata 12 was employed. Odds ratios (OR) along with confidence intervals (CI) were reported in the results. Results revealed that smoking at least 100 cigarettes or more in an entire lifetime had a negative association with good health status (OR = 0.74, 95 % CI = 0.59, 0.94), while alcohol consumption had a positive association with good health status (OR = 1.20, 95 % CI = 1.00, 1.44). Moderate physical activity (OR = 1.26, 95 % CI = 1.05, 1.50) and vigorous physical activity (OR = 1.68, 95 % CI = 1.31, 2.15) had a similar positive association with good self-rated health status. The results also revealed that the predicted probability of self-rated health status based on ethnicity and lifestyle variables was more favorable for foreign-born Chinese Americans than their Korean and Vietnamese American counterparts. This study's results corroborated the findings reported in previous research on the association of lifestyle behaviors and health status. Regardless of racial or ethnic backgrounds, good lifestyles have an important role in the prevention of poor health status. However, health education and lifestyle intervention programs should take cultural differences among racial and ethnic populations into consideration.

The impact of sport on children with haemophilia.

PubMed

Khair, K; Littley, A; Will, A; von Mackensen, S

2012-11-01

Sport is nowadays perceived as beneficial for children with haemophilia, as good muscle strength supports joints and may reduce bleed frequency; by contrast psychological benefits are less known. This study introduces the impact of sport on health-related quality of life (HRQoL) and physical performance in children with haemophilia. A cross-sectional, multi-site, study of boys aged 6-17 years with haemophilia A or B of any severity, current or past inhibitor, which assessed physical performance, sporting activity and HRQoL using age appropriate questionnaires including KINDL, Haemo-QoL and HEP-Test-Q. Eighty-four haemophilic boys (23 mild, 19 moderate, 42 severe) with a mean age of 11.52 years (SD = 3.4) were enrolled from two haemophilia centres in the United Kingdom. 28.4% were overweight/obese according to their BMI/age and had a good orthopaedic status (M = 1.55, SD = 3.3). Boys watching < 1-2 h of TV/PC/day had fewer days lost (M = 3, SD = 3.2) than those with a more sedentary lifestyle (M = 9.40, SD = 7.1) (P < 0.032). 90.5% participated in regular sporting activity; 79.9% at least twice a week. HRQoL in children was generally good, with highest impairments in boys aged 8-12 years. Boys aged 8-16 years reported good physical performance (M = 80.0, SD = 16.0) with highest impairments in the dimensions 'endurance' and 'mobility'. Boys doing sport had a significant better physical performance and HRQoL than boys not doing sport. Sedentary life styles had a negative impact on the subjective physical performance and number of days lost of children. Encouraging haemophilic boys to participate in sport will have a direct impact on their overall HRQoL. © 2012 Blackwell Publishing Ltd.

Which echocardiographic parameter is a better marker of volume status in hemodialysis patients?

PubMed

Sabaghian, Tahereh; Hajibaratali, Bahareh; Samavat, Shiva

2016-11-01

Bio-impedance analysis (BIA) is a preferred method for estimating the volume status. However, it cannot be utilized in daily practice. Since the assessment of the volume status is important and challenging for hemodialysis (HD) patients, the aim of study was to determine the volume status in chronic HD patients using echocardiographic parameters and assess its correlation with BIA. In this cross-sectional analysis, echocardiography and BIA were performed on 30 chronic HD patients 30 min before and 30 min after dialysis. All the cases of dialysis were performed in the middle of the week. This study also assessed the correlation between echocardiographic parameters and BIA parameters. There were significant differences between ECW, TBW, and TBW% (TBW/W) before and after HD. Significant differences were observed between echocardiographic parameters of IVCD, IVCDi min , IVCDi max before and after the HD. LVEDD, LVESD, LA area, mitral valve inflow, E/E', and IVRT, were improved after dialysis, too. There was a significant correlation between IVCDi min as an index of volume status, ECW% and TBW% before HD and IVCDi min change after dialysis had a significant correlation with %ECW change after dialysis. Comparison between hypertensive and non-hypertensive groups indicated IVCDi min was significantly lower in non-hypertensive group after dialysis. Our results showed a correlation between IVCDi min and BIA parameters before HD. So, it seems that IVCDi min can be a good parameter for determining the volume status of HD patients. However, further studies, with larger sample size and with a prospective study design, are required to confirm these results.

[Prediction of the nutritional status by anthropometrical variables and food safety at homes of pregnant women from Caracas, Venezuela].

PubMed

Pérez Guillén, A; Bernal Rivas, J

2006-01-01

The objective of this research is to analyze the nutritional status and household food security of a sample of healthy pregnant women who attend to external medicine service at Concepcion Palacios Maternity located in Caracas, Venezuela, and identify variables, which could predict the nutritional status of the evaluated group. This cross sectional, descriptive, comparative study evaluates a sample of 89 pregnant women, between 14 and 44 years of age. Economical, social, demographic and alimentary consumption variables and nutritional conditions were studied. On the way, anthropometrics like weight, height, and middle-arm circumference and Household food security scale were obtained. In order to perform the descriptive statistic, bivariate, and multiple linear regression analysis required during the investigation, the software SPSS, version 12, was used. The predictive variables considered for the evaluation of the actual nutritional status in pregnant women were: right middle-arm circumference, household food security level and the supplementation with vitamins and/or minerals. These variables explain 78.2% of the actual nutritional status variation in this sample. Therefore, this investigation highlights the importance of the research on simple variables, as a good prediction of the actual nutritional status in pregnant women, with acceptable precision values and without requiring high-trained personnel to perform it. Under these findings, is very important the study of more predictive variables to evaluate the nutritional and alimentary conditions, with practical and easy mechanisms that can be applied by non-technical personnel. It is recommended to go deep into the study of methods, which evaluate the nutrition in an easy and practical way, applied by non-technical personnel, besides continuing the validation process of the variable combinations determined as predictive of the nutritional status.

[Evaluation on running status of Chinese Polio Laboratories Network in 2008].

PubMed

Zhu, Shuang-li; Yan, Dong-mei; Zhu, Hui

2010-04-01

In order to evaluate the running status and provide the laboratory data for maintaining polio-free status in China, the virology surveillance database of Chinese Polio Laboratories Network (not include Hong Kong, Macao, and Taiwan)in 2008 were analyzed. The case investigation data of Acute Flaccid Paralysis(AFP)cases reported by 31 provinces (municipal, autonomous regions) through EPI surveillance information management system and the database of National Polio Laboratory (NPL) were analyzed, and the indicators of running status of Chinese Polio Laboratories Network were evaluated. 10,116 stool samples were collected from 5116 AFP cases by Chinese Polio Laboratories Network in 2008, and viral isolation and identification of all stool samples were done according to 4th World Health Organization (WHO) Polio Laboratory Manual. The rate of viral isolation and identification performed within 28d was 94.9%. 189 polioviruses (PV) and 597 of non-polio enteroviruses (NPEV) were isolated from AFP cases, the isolatien rates were 3.72% and 11.74% respectively. 251 polio positive isolates were sent to NPL from 31 provincial polio laboratories. There were 318 single serotype PVs were performed VPI sequencing. And no wild polioviruses and Vaccine-derived Polioviruses (VDPVs) were found in 2008. NPL passed the proficiency test and got full accreditation for on-site review by WHO experts in 2008. All 31 provincial Polio laboratories passed the proficiency test with the same panel as NPL, and 13 provincial Polio laboratories joined and passed the on-site review by WHO experts. The running status of Chinese Polio Laboratories Network was good, polio-free status was maintained in China in 2008. The Chinese polio laboratories network running is normaly, the laboratory surveillance system was sensitive and laboratory data were provided for maintaining the polio-free status in China.

Dish concentrators for solar thermal energy - Status and technology development

NASA Technical Reports Server (NTRS)

Jaffe, L. D.

1981-01-01

Comparisons are presented of point-focusing, or 'dish' solar concentrator system features, development status, and performance levels demonstrated to date. In addition to the requirements of good optical efficiency and high geometric concentration ratios, the most important future consideration in solar thermal energy dish concentrator design will be the reduction of installed and lifetime costs, as well as the materials and labor costs of production. It is determined that technology development initiatives are needed in such areas as optical materials, design wind speeds and wind loads, structural configuration and materials resistance to prolonged exposure, and the maintenance of optical surfaces. The testing of complete concentrator systems, with energy-converting receivers and controls, is also necessary. Both reflector and Fresnel lens concentrator systems are considered.

Safety and efficacy of aneurysm treatment with WEB: results of the WEBCAST study.

PubMed

Pierot, Laurent; Costalat, Vincent; Moret, Jacques; Szikora, Istvan; Klisch, Joachim; Herbreteau, Denis; Holtmannspötter, Markus; Weber, Werner; Januel, Anne-Christine; Liebig, Thomas; Sychra, Vojtech; Strasilla, Christoph; Cognard, Christophe; Bonafé, Alain; Molyneux, Andrew; Byrne, James V; Spelle, Laurent

2016-05-01

OBJECT WEB is an innovative intrasaccular treatment for intracranial aneurysms. Preliminary series have shown good safety and efficacy. The WEB Clinical Assessment of Intrasaccular Aneurysm Therapy (WEBCAST) trial is a prospective European trial evaluating the safety and efficacy of WEB in wide-neck bifurcation aneurysms. METHODS Patients with wide-neck bifurcation aneurysms for which WEB treatment was indicated were included in this multicentergood clinical practices study. Clinical data including adverse events and clinical status at 1 and 6 months were collected and independently analyzed by a medical monitor. Six-month follow-up digital subtraction angiography was also performed and independently analyzed by a core laboratory. Success was defined at 6 months as complete occlusion or stable neck remnant, no worsening in angiographic appearance from postprocedure, and no retreatment performed or planned. RESULTS Ten European neurointerventional centers enrolled 51 patients with 51 aneurysms. Treatment with WEB was achieved in 48 of 51 aneurysms (94.1%). Adjunctive implants (coils/stents) were used in 4 of 48 aneurysms (8.3%). Thromboembolic events were observed in 9 of 51 patients (17.6%), resulting in a permanent deficit (modified Rankin Scale [mRS] Score 1) in 1 patient (2.0%). Intraoperative rupture was not observed. Morbidity (mRS score > 2) and mortality were 2.0% (1 of 51 patients, related to rupture status on entry to study) and 0.0% at 1 month, respectively. Success was achieved at 6 months in 85.4% of patients treated with WEB: 23 of 41 patients (56.1%) had complete occlusion, 12 of 41 (29.3%) had a neck remnant, and 6 of 41 (14.6%) had an aneurysm remnant. CONCLUSIONS The WEBCAST study showed good procedural and short-term safety of aneurysm treatment with WEB and good 6-month anatomical results.

Wage differences according to health status in France.

PubMed

Ben Halima, Mohamed Ali; Rococo, Emeline

2014-11-01

Many OECD countries have implemented anti-discrimination laws in recent decades. However, according to the annual report published in 2010 by the French High Authority for the Fight against Discrimination and for Equality, the second most commonly cited factor in discrimination claims since 2005 is a handicap or health status. The aim of this research is to estimate the level of unexplained components in the wage gap that can be attributed to wage discrimination based on health status in France in 2010 utilizing data from the Health, Healthcare and Insurance survey among 1594 individuals. Three health indicators are used: self-perceived health status, activity limitations and long-term chronic illness. To measure the wage gap according to an individual's health status, the analysis considers the endogenous selection of health status and unobserved differences in productivity. The results demonstrate that wage discrimination is experienced by individuals in poor health regardless of the health indicator utilized. The hourly wage rate among individuals with poor self-assessed health status is on average 14.2% lower than among individuals with good self-assessed health status. However, for individuals suffering from a long-term chronic illness or an activity limitation, the gap is 6.3% and 4.5%, respectively. The decomposition performed on wage differences according to health status by correcting for health status selection bias and controlling for unobserved differences in productivity indicates that the 'unexplained component' that can be attributed to wage discrimination is equal to 50%. Copyright © 2014 Elsevier Ltd. All rights reserved.

Changes in nutritional status in nursing home residents and associated factors in nutritional status decline: a secondary data analysis.

PubMed

Bauer, Silvia; Halfens, Ruud J G; Lohrmann, Christa

2017-10-01

The aim of this study was to describe changes in the nutritional status of nursing home residents over a period of 1 year and identify factors associated with a decline in nutritional status. The maintenance of good nutritional status is important for nursing home residents. Therefore, it is essential to identify risk factors that indicate a decline in nutritional status to take early prevention steps. Secondary data analysis of repeated cross-sectional studies. Data collection was performed between 2009-2013 using the International Prevalence Measurement of Care Problems questionnaire. Data from three purposively selected nursing homes that included 157 residents were analysed. The comparison between baseline data and data collected 1 year later showed that the nutritional status declined in 22·8% of the residents and improved in 6·5% of the cases. The body mass index and changes in the body mass index were significantly different between residents with stable/improved and declined nutritional status. The multivariate logistic regression analysis showed that care dependency, length of stay, changes in body mass index and malnutrition risk at baseline were significantly associated with a decline in nutritional status. This study showed that the baseline risk of malnutrition is the most important risk factor indicating a decline in nutritional status. Therefore, healthcare professionals should identify the malnutrition risk and take action as early as possible. © 2017 John Wiley & Sons Ltd.

An approach for estimating item sensitivity to within-person change over time: An illustration using the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog).

PubMed

Dowling, N Maritza; Bolt, Daniel M; Deng, Sien

2016-12-01

When assessments are primarily used to measure change over time, it is important to evaluate items according to their sensitivity to change, specifically. Items that demonstrate good sensitivity to between-person differences at baseline may not show good sensitivity to change over time, and vice versa. In this study, we applied a longitudinal factor model of change to a widely used cognitive test designed to assess global cognitive status in dementia, and contrasted the relative sensitivity of items to change. Statistically nested models were estimated introducing distinct latent factors related to initial status differences between test-takers and within-person latent change across successive time points of measurement. Models were estimated using all available longitudinal item-level data from the Alzheimer's Disease Assessment Scale-Cognitive subscale, including participants representing the full-spectrum of disease status who were enrolled in the multisite Alzheimer's Disease Neuroimaging Initiative. Five of the 13 Alzheimer's Disease Assessment Scale-Cognitive items demonstrated noticeably higher loadings with respect to sensitivity to change. Attending to performance change on only these 5 items yielded a clearer picture of cognitive decline more consistent with theoretical expectations in comparison to the full 13-item scale. Items that show good psychometric properties in cross-sectional studies are not necessarily the best items at measuring change over time, such as cognitive decline. Applications of the methodological approach described and illustrated in this study can advance our understanding regarding the types of items that best detect fine-grained early pathological changes in cognition. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

107: REVIEW OF THE QUALITY HOSPITALS WEBSITES IN KHORASAN RAZAVI PROVINCE

PubMed Central

Dastani, Meisam; Sattari, Masoume

2017-01-01

Background and aims The aim of the present study is to present a clear vision of the quality status of Khorasan Razavi hospitals websites in four dimensions of content, performance, management and usage of the website. Methods This is a survey study. The sample consisted of 49 hospital websites of Khorasan Razavi province. The instrument was used check list including 21 components and four criteria (content, performance, management and how to use the website). Its validity and reliability have proved through previous studies. Also, the data were analyzed using descriptive statistics. Results The findings showed that only %59 of hospitals in Khorasan Razavi, has been active website. The overall Status of website showed that the most popular websites of the situation, too weak (%51), moderate (%26.5) and weak (%16.3), respectively. In relation to criteria content, study, management and how to usage of the website and design, the findings showed that %40.8 of websites had an unfavorable condition. Of the 16 high quality website selected, only three websites Sina Hospital in Mashhad, Javdoll-Aemeh in Mashhad and Razavi were in good condition and the other of the websites had weak condition. Conclusion The results of this study indicate that, yet most websites do not regard minimal medical standards and also, they could not establish good relationships with their audiences. In fact, in Iran, still regard to the quality and performance of websites has not been one of the priorities for improving service quality in hospitals. The findings of this study can be effective in the identification and development of hospital websites quality criteria in terms of design, content, performance and management and how to use.

Informatics in radiology: evaluation of an e-learning platform for teaching medical students competency in ordering radiologic examinations.

PubMed

Marshall, Nina L; Spooner, Muirne; Galvin, P Leo; Ti, Joanna P; McElvaney, N Gerald; Lee, Michael J

2011-01-01

A preliminary audit of orders for computed tomography was performed to evaluate the typical performance of interns ordering radiologic examinations. According to the audit, the interns showed only minimal improvement after 8 months of work experience. The online radiology ordering module (ROM) program included baseline assessment of student performance (part I), online learning with the ROM (part II), and follow-up assessment of performance with simulated ordering with the ROM (part III). A curriculum blueprint determined the content of the ROM program, with an emphasis on practical issues, including provision of logistic information, clinical details, and safety-related information. Appropriate standards were developed by a committee of experts, and detailed scoring systems were devised for assessment. The ROM program was successful in addressing practical issues in a simulated setting. In the part I assessment, the mean score for noting contraindications for contrast media was 24%; this score increased to 59% in the part III assessment (P = .004). Similarly, notification of methicillin-resistant Staphylococcus aureus status and pregnancy status and provision of referring physician contact information improved significantly. The quality of the clinical notes was stable, with good initial scores. Part III testing showed overall improvement, with the mean score increasing from 61% to 76% (P < .0001). In general, medical students lack the core knowledge that is needed for good-quality ordering of radiology services, and the experience typically afforded to interns does not address this lack of knowledge. The ROM program was a successful intervention that resulted in statistically significant improvements in the quality of radiologic examination orders, particularly with regard to logistic and radiation safety issues.

Importance and globalization status of good manufacturing practice (GMP) requirements for pharmaceutical excipients

PubMed Central

Abdellah, Abubaker; Noordin, Mohamed Ibrahim; Wan Ismail, Wan Azman

2013-01-01

Pharmaceutical excipients are no longer inert materials but it is effective and able to improve the characteristics of the products’ quality, stability, functionality, safety, solubility and acceptance of patients. It can interact with the active ingredients and alter the medicament characteristics. The globalization of medicines’ supply enhances the importance of globalized good manufacturing practice (GMP) requirements for pharmaceutical excipients. This review was intended to assess the globalization status of good manufacturing practice (GMP) requirements for pharmaceutical excipients. The review outcomes demonstrate that there is a lack of accurately defined methods to evaluate and measure excipients’ safety. Furthermore good manufacturing practice requirements for excipients are not effectively globalized. PMID:25685037

Integrating long-term water and sediment pollution data, in assessing chemical status within the European Water Framework Directive.

PubMed

Tueros, Itziar; Borja, Angel; Larreta, Joana; Rodríguez, J Germán; Valencia, Victoriano; Millán, Esmeralda

2009-09-01

The European Water Framework Directive (WFD) establishes a framework for the protection and improvement of estuarine (transitional) and coastal waters, attempting to achieve good water status by 2015; this includes, within the assessment, biological and chemical elements. The European Commission has proposed a list of priority dangerous substances (including metals such as Cd, Hg, Ni and Pb), with the corresponding list of environmental quality standards (EQS), to assess chemical status, but only for waters. In this contribution, a long-term (1995-2007) dataset of transitional and coastal water and sediment trace elements concentrations, from the Basque Country (northern Spain), has been used to investigate the response of these systems to water treatment programmes. Moreover, the approach proposed in the WFD, for assessing water chemical status (the 'one out, all out' approach), is compared with the integration of water and sediment data, into a unique assessment. For this exercise, background levels are used as reference conditions, identifying the boundary between high and good chemical status. EQS are used as the boundary between good and moderate chemical status. This contribution reveals that the first approach can lead to misclassification, with the second approach representing the pattern shown by the long-term data trends. Finally, the management implications, using each approach are discussed.

Assessment and physiological state of the Posidonia oceanica meadows in Porto Cristo (Manacor, Spain)

NASA Astrophysics Data System (ADS)

Sureda, Antoni; Box, Antonio; Tejada, Silvia

2015-12-01

In the Mediterranean Sea, Posidonia oceanica is the main seagrass meadow that brings food and shelter to many species. The P. oceanica deterioration is an indicator of its own status, since it is sensitive to many disturbances, such as human impacts or alien species. Lately, oxidative stress has been pointed out as another possible biomarker of the animal and plant status. The aim of this work was to evaluate the physiological status of the P. oceanica meadows in the Porto Cristo bay (Manacor, Mallorca, Balearic Islands, Western Mediterranean), evaluating the possible impact induced by human activity performed in the area. In situ measurements were quantified (shoot density, and the maximum length and width of P. oceanica leaves) by scuba divers. Leaf samples were collected to determine the catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities. The malondialdehyde (MDA) level as marker of lipid peroxidation was also evaluated. Shoot density, and length and width measurements of the leaves in the inner locations of the bay showed inferior structural features than the leaves from the outer areas. CAT, SOD and GPx enzymatic activities and lipid peroxidation were higher in leaves from the internal zones than in the outer placements. In conclusion, the general status of the of P. oceanica meadows on the Porto Cristo Bay according to structural and oxidative biomarkers evidenced a good physiological condition, although the areas nearest to the harbour and the beach reflect signs of human affection. Altogether, it reflects a good physiological condition of the meadows in the external areas of the Porto Cristo Bay.

DNA damage in blood cells in relation to chemotherapy and nutritional status in colorectal cancer patients-A pilot study.

PubMed

Kværner, Ane Sørlie; Minaguchi, Jun; Yamani, Naouale El; Henriksen, Christine; Ræder, Hanna; Paur, Ingvild; Henriksen, Hege Berg; Wiedswang, Gro; Smeland, Sigbjørn; Blomhoff, Rune; Collins, Andrew Richard; Bøhn, Siv Kjølsrud

2018-03-01

DNA damage can be considered as a biomarker for toxicity and response to chemotherapy. It is not known whether the chemotherapy-induced genotoxicity is associated with malnutrition. In this pilot study, we assess genotoxicity by means of DNA damage in patients with lymph-node positive colorectal cancer (CRC) and explore associations with chemotherapy treatment and nutritional status. DNA damage was compared between patients receiving chemotherapy (n = 24) and those not receiving chemotherapy (n = 20). DNA damage was measured in frozen whole blood by the comet assay. Associations between DNA damage and various indicators of malnutrition were also explored, including Patient-Generated Subjective Global Assessment (PG-SGA), bioelectrical impedance analysis (BIA) and anthropometric measurements, using multiple linear regression models. Patients on chemotherapy have higher levels of DNA damage in blood cells than patients not receiving chemotherapy (median of 16.9 and 7.9% tail DNA respectively, p = 0.001). The moderately malnourished patients (PG-SGA category B), representing 41% of the patients, have higher levels of cellular DNA damage than patients with good nutritional status (mean difference of 7.5% tail DNA, p = 0.033). In conclusion, adjuvant chemotherapy and malnutrition are both associated with increased levels of DNA damage in blood cells of CRC patients. Carefully controlled longitudinal studies or randomized controlled trials should be performed to determine whether good nutritional status may protect against chemotherapy-induced genotoxicity and enhance compliance to therapy in CRC patients. Copyright © 2018 Elsevier B.V. All rights reserved.

Effect of iron status on iron absorption in different habitual meals in young south Indian women.

PubMed

Kalasuramath, Suneeta; Kurpad, Anura V; Thankachan, Prashanth

2013-02-01

Iron deficiency (ID) affects a large number of women in India. An inverse relationship exists between iron (Fe) status and Fe absorption. Dietary inhibitory and enhancing factors exert a profound influence on bioavailability of Fe. Although the current recommended dietary allowance (RDA) for Fe is based on 8 per cent bioavailability, it is not clear if this holds good for the usual highly inhibitory Indian diet matrix. This study was aimed to determine Fe absorption from several habitually consumed south Indian food and to evaluate the interaction of Fe status with absorption. Four Fe absorption studies were performed on 60 apparently healthy young women, aged 18-35 years. Based on blood biochemistry, 45 of them were ID and 15 were iron replete (IR). The habitual meals assessed were rice, millet and wheat based meals in the ID subjects and rice based meal alone in the IR subjects. Each subject received the test meal labelled with 3 mg of ⁵⁷Fe and Fe absorption was measured based on erythrocyte incorporation of isotope label 14 days following administration. Mean fractional Fe absorption from the rice, wheat and millet based meals in the ID subjects were 8.3, 11.2 and 4.6 per cent, respectively. Fe absorption from the rice-based meals was 2.5 per cent in IR subjects. Fe absorption is dictated by Fe status from low bioavailability meals. Millet based meals have the lowest bioavailability, while the rice and wheat based meals had moderate to good bioavailability. In millet based meals, it is prudent to consider ways to improve Fe absorption.

Nomogram and Validity of a Model for Predicting Malnutrition in Patients on Liver Transplant Lists.

PubMed

García-Rodríguez, María Teresa; Pértega-Díaz, Sonia; López-Calviño, Beatriz; Piñón-Villar, María Del Carmen; Otero-Ferreiro, Alejandra; Suárez-López, Francisco; Gómez-Gutiérrez, Manuel; Seoane-Pillado, María Teresa; Pita-Fernández, Salvador

2018-04-25

Malnutrition is associated with increased morbimortality in liver transplant patients, and it is important to identify factors related to nutritional status in these patients. Determine variables associated with malnutrition and create a nomogram in liver transplant candidates. Cross-sectional study (n = 110). demographic variables, imbalances due to the disease, transplant aetiology and analytical parameters. Physical examination was performed and degree of hepatic dysfunction calculated. Nutritional status was assessed: Controlling Nutritional Status, Spanish Society of Parenteral and Enteral Nutrition criteria, Nutritional Risk Index, Prognostic Nutritional Index or Onodera Index and The Subjective Global Assessment. Logistic regression analysis was performed. A predictive nomogram (discrimination and calibration analysis) was generated. Malnourishment was defined according to at least 4 or more of the methods studied. Patients with ascites, encephalopathy and portal hypertension presented malnourishment more frequently. Malnutrition was associated with greater liver dysfunction and lower grip strength. Variables independently associated with malnourishment were encephalopathy and lower albumin values. A nomogram was created to predict malnourishment, with good discriminatory power and calibration. A score was developed for evaluating malnutrition risk. This would provide a tool that makes it possible to quickly and easily identify the risk of malnutrition in liver transplant candidates.

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

Changes in the Hippocampal Proteome Associated with Spatial Memory Impairment after Exposure to Low (20 cGy) Doses of 1 GeV/n 56Fe Radiation.

PubMed

Britten, Richard A; Jewell, Jessica S; Davis, Leslie K; Miller, Vania D; Hadley, Melissa M; Semmes, O John; Lonart, György; Dutta, Sucharita M

2017-03-01

Exposure to low (∼20 cGy) doses of high-energy charged (HZE) particles, such as 1 GeV/n 56 Fe, results in impaired hippocampal-dependent learning and memory (e.g., novel object recognition and spatial memory) in rodents. While these findings raise the possibility that astronauts on deep-space missions may develop cognitive deficits, not all rats develop HZE-induced cognitive impairments, even after exposure to high (200 cGy) HZE doses. The reasons for this differential sensitivity in some animals that develop HZE-induced cognitive failure remain speculative. We employed a robust quantitative mass spectrometry-based workflow, which links early-stage discovery to next-stage quantitative verification, to identify differentially active proteins/pathways in rats that developed spatial memory impairment at three months after exposure to 20 cGy of 1 GeV/n 56 Fe (20/impaired), and in those rats that managed to maintain normal cognitive performance (20/functional). Quantitative data were obtained on 665-828 hippocampal proteins in the various cohorts of rats studied, of which 580 were expressed in all groups. A total of 107 proteins were upregulated in the irradiated rats irrespective of their spatial memory performance status, which included proteins involved in oxidative damage response, calcium transport and signaling. Thirty percent (37/107) of these "radiation biomarkers" formed a functional interactome of the proteasome and the COP9 signalosome. These data suggest that there is persistent oxidative stress, ongoing autophagy and altered synaptic plasticity in the irradiated hippocampus, irrespective of the spatial memory performance status, suggesting that the ultimate phenotype may be determined by how well the hippocampal neurons compensate to the ongoing oxidative stress and associated side effects. There were 67 proteins with expression that correlated with impaired spatial memory performance. Several of the "impaired biomarkers" have been implicated in poor spatial memory performance, neurodegeneration, neuronal loss or neuronal susceptibility to apoptosis, or neuronal synaptic or structural plasticity. Therefore, in addition to the baseline oxidative stress and altered adenosine metabolism observed in all irradiated rats, the 20/impaired rats expressed proteins that led to poor spatial memory performance, enhanced neuronal loss and apoptosis, changes in synaptic plasticity and dendritic remodeling. A total of 46 proteins, which were differentially upregulated in the sham-irradiated and 20/functional rat cohorts, can thus be considered as markers of good spatial memory, while another 95 proteins are associated with the maintenance of good spatial memory in the 20/functional rats. The loss or downregulation of these "good spatial memory" proteins would most likely exacerbate the situation in the 20/impaired rats, having a major impact on their neurocognitive status, given that many of those proteins play an important role in neuronal homeostasis and function. Our large-scale comprehensive proteomic analysis has provided some insight into the processes that are altered after exposure, and the collective data suggests that there are multiple problems with the functionality of the neurons and astrocytes in the irradiated hippocampi, which appear to be further exacerbated in the rats that have impaired spatial memory performance or partially compensated for in the rats with good spatial memory.

Relationships between phenylalanine levels, intelligence and socioeconomic status of patients with phenylketonuria.

PubMed

Castro, Isabel Pimenta Spínola; Borges, Juliana Martins; Chagas, Heloísa Alves; Tibúrcio, Jacqueline; Starling, Ana Lúcia Pimenta; Aguiar, Marcos José Burle de

2012-07-01

To assess intelligence and its relationship with blood phenylalanine concentrations and socioeconomic status in patients with phenylketonuria after 6 to 12 years of treatment. Sixty-three children were classified according to phenylalanine levels and socioeconomic status and assessed using the Wechsler Intelligence Scale for Children. The Statistical Package for the Social Sciences (SPSS) was used to analyze phenylalanine; ANOVA was used to analyze intelligence quotients (IQ) and phenylalanine levels; and ordinal logistic regression was used to analyze the likelihood of higher IQ. The overall IQ scores of 90.5% of the children were within a range from borderline intellectual deficiency to very high intelligence; for verbal IQ this proportion was 96.8% and 92.1% had performance IQ scores within this band. The categories from low to upper-medium socioeconomic status contained 98.4% of patients' families. The likelihood of having medium to high IQ was 4.29 times greater for children with good phenylalanine control and 4.03 greater for those from higher socioeconomic strata. Treatment prevented mental retardation in 90.5% of the patients. Control of phenylalanine levels and higher socioeconomic status were associated with higher IQ scores.

Pediatric intramedullary spinal cord lesions: Pathological spectrum and outcome of surgery

PubMed Central

Sahu, Rajni Kant; Das, Kuntal Kanti; Bhaisora, Kamlesh Singh; Singh, Amit Kumar; Mehrotra, Anant; Srivastava, Arun Kumar; Sahu, Rabi Narayan; Jaiswal, Awadhesh Kumar; Behari, Sanjay

2015-01-01

Background: Pediatric intramedullary spinal cord lesions are not only rare but also different from adults in a number of aspects. We aimed to study the incidence and the frequencies of various pediatric intramedullary mass lesions, their outcome to treatment and the factors determining their outcome of treatment. Materials and Methods: Thirty-one consecutive children (aged 1–18 years, mean 11.1 years, male: female = 1.8:1) with pathologically proven intramedullary spinal cord lesions treated at our center were studied. Clinico-radiological, histopathological, operative, and outcome data were reviewed retrospectively. The functional status was assessed using the modified McCormick grading system. Results: Gross total tumor excision was performed in 19 patients (61.3%), subtotal in 9 patients (29%), partial excision was performed in 2 (6.5%) patient, and only biopsy was performed in 1 patient (6.5%). There was one peroperative death, 2 patients died at follow-up. Complications included wound related complications (n = 4), transient deterioration in the motor power, and respiratory complication requiring a tracheostomy. Six patients showed recurrence at a mean follow-up of 16.4 months. Developmental tumors, high-grade ependymomas, and incompletely excised grade 2 ependymomas showed a tendency to recur. Conclusions: Children constituted nearly 1/5th (17.4%) of intramedullary spinal cord tumors. Astrocytomas and ependymomas taken together constituted the most common intramedullary spinal lesions in children; however, developmental tumors predominated in the first decade. Children usually presented in good functional grades preoperatively and maintained good grades after surgery. Functional outcome was dependent on the preoperative neurological status and histopathology of the lesions. PMID:26557160

The Status of Implementation of Good Manufacturing Practices (GMP) Shredded Fish Production in UMKM Az-Zahrah, Makassar

NASA Astrophysics Data System (ADS)

Latif, Rindam; Dirpan, Andi; Indriani, Sylvia

2017-12-01

Good manufacturing practices (GMP) describes the requirements that an industry should follow throughout the production process starting from sorting raw materials to handling final products. The purpose of this research is to disclose each phase of GMP in making shredded fish and to assess the status of the practices implemented by the UMKM Az-zahrah in producing its product. This descriptive study is conducted by doing interview with owner followed by observation and documentation of all activities related to the production process in order to assess the status of GMP applied by the UMKM Az-zahrah. In assessing the status, we referred to Permenperin RI No.75 / M-Ind / Per / 7/2010 and KBPOM regulation no. HK 03.1.23.04.12.22007 Year 2012. The findings indicate some deviation occurred when UMKM Az-zahrah implemented it, those are (1) there is a pet in production room (2) production employees are not yet wearing work uniform (3) production room has directly access to toilet (4) there is no health label about health and nutritional claims. The status of applied GMP in the UMKM Az-zahrah is at D level (less good) with rating IV.

An association of cocoa consumption with improved physical fitness and decreased muscle damage and oxidative stress in athletes.

PubMed

González-Garrido, José A; García-Sánchez, José R; Garrido-Llanos, Silvia; Olivares-Corichi, Ivonne M

2017-04-01

Several studies have demonstrated the protective effects of cocoa consumption, due to its anti-inflammatory and antioxidant properties. Acute exercise induces oxidative stress and causes muscular damage during training. This study was designed to examine the effect of cocoa consumption on the markers of muscle damage, oxidative stress and physical fitness in professional soccer players. Fifteen players (15-18 years old) were included in the study. Biochemical parameters, markers of muscle damage and oxidative stress, and physical performance were evaluated before and after cocoa consumption. Biochemical parameters determined the healthy metabolic status of the study group; biomarkers of muscle and oxidative damage were measured in blood to establish muscle and redox status. However, high levels of biomarkers of muscle damage were detected. Interestingly, cocoa consumption decreased the muscle damage biomarkers of CK and LDH by 39.4% and 23.03%, respectively. The redox status was modified by a decrease in oxidative damage (carbonyl groups, 26.31%; thiol groups, 27.52%; MDA, 32.42%) and an increase in total antioxidant capacity (15.98%) and GSH-Px activity (26.37%). In addition, we observed an increase in physical performance by 4% in the Cooper Test. Our findings suggest that a short period of cocoa consumption could be useful in maintaining a good physical fitness, due to the favourable effects on muscle and redox status in athletes during exhaustive exercise.

Development of battery management system for nickel-metal hydride batteries in electric vehicle applications

NASA Astrophysics Data System (ADS)

Jung, Do Yang; Lee, Baek Haeng; Kim, Sun Wook

Electric vehicle (EV) performance is very dependent on traction batteries. For developing electric vehicles with high performance and good reliability, the traction batteries have to be managed to obtain maximum performance under various operating conditions. Enhancement of battery performance can be accomplished by implementing a battery management system (BMS) that plays an important role in optimizing the control mechanism of charge and discharge of the batteries as well as monitoring the battery status. In this study, a BMS has been developed for maximizing the use of Ni-MH batteries in electric vehicles. This system performs several tasks: the control of charging and discharging, overcharge and over-discharge protection, the calculation and display of state-of-charge (SOC), safety, and thermal management. The BMS is installed in and tested in a DEV5-5 electric vehicle developed by Daewoo Motor Co. and the Institute for Advanced Engineering in Korea. Eighteen modules of a Panasonic nickel-metal hydride (Ni-MH) battery, 12 V, 95 A h, are used in the DEV5-5. High accuracy within a range of 3% and good reliability are obtained. The BMS can also improve the performance and cycle-life of the Ni-MH battery peak, as well as the reliability and the safety of the electric vehicles.

Pornography actresses: an assessment of the damaged goods hypothesis.

PubMed

Griffith, James D; Mitchell, Sharon; Hart, Christian L; Adams, Lea T; Gu, Lucy L

2013-01-01

The damaged goods hypothesis posits that female performers in the adult entertainment industry have higher rates of childhood sexual abuse (CSA), psychological problems, and drug use compared to the typical woman. The present study compared the self-reports of 177 porn actresses to a sample of women matched on age, ethnicity, and marital status. Comparisons were conducted on sexual behaviors and attitudes, self-esteem, quality of life, and drug use. Porn actresses were more likely to identify as bisexual, first had sex at an earlier age, had more sexual partners, were more concerned about contracting a sexually transmitted disease (STD), and enjoyed sex more than the matched sample, although there were no differences in incidence of CSA. In terms of psychological characteristics, porn actresses had higher levels of self-esteem, positive feelings, social support, sexual satisfaction, and spirituality compared to the matched group. Last, female performers were more likely to have ever used 10 different types of drugs compared to the comparison group. A discriminant function analysis was able to correctly classify 83% of the participants concerning whether they were a porn actress or member of the matched sample. These findings did not provide support for the damaged goods hypothesis.

Clinical outcomes and predictive factors related to good outcomes in plasma exchange in severe attack of NMOSD and long extensive transverse myelitis: Case series and review of the literature.

PubMed

Aungsumart, Saharat; Apiwattanakul, Metha

2017-04-01

To investigate the predictive factors associated with good outcomes of plasma exchange in severe attacks through neuromyelitis optica spectrum disorder (NMOSD) and long extensive transverse myelitis (LETM). In addition, to review the literature of predictive factors associated with the good outcomes of plasma exchange in central nervous system inflammatory demyelinating diseases (CNS IDDs). Retrospective study in 27 episodes of severe acute attacks myelitis and optic neuritis in 24 patients, including 20 patients with NMOSD seropositive, 1 patient with NMOSD seronegative and 3 patients with LETM. Plasma exchange was performed, reflecting poor responses to high-dose intravenous methylprednisolone (IVMP) therapy. The outcomes of the present study were the functional outcome improvements at 6 months after plasma exchange. The predictive factors of good outcomes after plasma exchange were determined in this cohort, and additional factors reported in the literature were reviewed. Plasma exchange was performed in 16 spinal cord attacks and 11 attacks of optic neuritis. Twenty patients were female (83%). The median age of the patients at the time of plasma exchange was 41 years old. The median disease duration was 0.6 years. The AQP4-IgG status was positive in 20 patients (83%). Plasma exchange following IVMP therapy led to a significant improvement in 81% of the cases after 6 months of follow up. A baseline Expanded Disability Status Scale (EDSS) score ≤6 before the attack was associated with significant improvement at 6 months (p=0.02, OR 58.33, 95%CI 1.92-1770). In addition, we reviewed the evidence for factors associated with good outcomes of plasma exchange in CNS IDDs, classified according to pre-plasma exchange, post-plasma exchange, and radiological features. Plasma exchange following IVMP therapy is effective as a treatment for patients experiencing a severe attack of NMOSD or LETM. The factors associated with good outcomes after plasma exchange in CNS IDDs are reviewed in the literature. We classified 3 different aspects, including pre-plasma exchange factors, based on minimal disability at baseline, preserved reflexes, early initiation, and short disease duration; post plasma exchange factors, including early improvement or lower disability at last follow up; and radiographic factors, for which the presence of active gadolinium lesions and the absence of spinal cord atrophy seem to be good outcomes for plasmapheresis. Copyright © 2017. Published by Elsevier B.V.

Relationships among sense of coherence, oral health status, nutritional status and care need level of older adults according to path analysis.

PubMed

Dewake, Nanae; Hamasaki, Tomoko; Sakai, Rie; Yamada, Shima; Nima, Yuko; Tomoe, Miki; Kakuta, Satoko; Iwasaki, Masanori; Soh, Inho; Shimazaki, Yoshihiro; Ansai, Toshihiro

2017-11-01

Sense of coherence (SOC) is a measurement of ability of an individual to cope with psychological stress and remain in good health. The aim of the present study was to examine the relationships among SOC score, oral health status, nutritional status and care need level of older adults using path analysis. We enrolled 53 older adults (17 men and 36 women) who were attending a day care service (mean age 80.4 ± 6.5 years). SOC was assessed using a 13-item, seven-scale instrument. Oral health status (number of present teeth, denture use) and nutritional status (assessed with Mini-Nutritional Assessment Short-Form) were also evaluated. Path analysis was used to examine the relationship of SOC with other related factors, including care need level. The mean SOC score was 57.0 ± 13.9. Mini-Nutritional Assessment Short-Form results showed that one participant (1.8%) was malnourished, 26 (49.1%) were at risk of malnutrition and 26 (49.1%) had normal nutritional status. Participants with high SOC scores showed a strong positive attitude, had a relatively large number of teeth, were in good nutritional condition and showed low care need levels. The present results showed that maintaining a high SOC level and good oral health help to reduce care need levels in older adults, and also prevent a worsening of their nutritional condition. Geriatr Gerontol Int 2017; 17: 2083-2088. © 2017 Japan Geriatrics Society.

Determinate factors of mental health status in Chinese medical staff

PubMed Central

Zhou, Chenyu; Shi, Lei; Gao, Lei; Liu, Wenhui; Chen, Zhenkang; Tong, Xinfa; Xu, Wen; Peng, Boshi; Zhao, Yan; Fan, Lihua

2018-01-01

Abstract Numerous previous studies have investigated the mental health status of medical staff in China and explored its associated determinate factors; however, scope and methods associated with these have introduced uncertainty regarding the results. The aim of this study was to perform a comprehensive examination of the mental health status of Chinese medical staff and its relative risk factors based on a cross-sectional survey. We conducted a broad area, cross-sectional, questionnaire-based survey of Chinese medical workers. Participants were randomly selected from 27 hospitals in the Heilongjiang province. The questionnaire that was distributed consisted of 5 parts: the demographic characteristics of the participant; questions related to the relative risk factors of psychological health; the posttraumatic stress disorder (PTSD) Checklist-Civilian Version (PCL-C); the Self-rating Depression Scale (SDS); and the Self-rating Anxiety Scale (SAS). The last 3 components were used to evaluate the mental health status of the target population. Logistic and linear regression were used to analyze the determinate factors of the mental health status of Chinese medical staff. Of the 1679 questionnaires distributed, 1557 medical workers responded (response rate: 92.73%; male: 24.1%; female 75.9%). The results of mental health status self-assessments indicated that 32.3% of participants were considered to have some degree of PTSD (based on the PCL-C). The SDS index was 0.67 and the mean score from SAS was 55.26; a result higher than found in the general population. Multivariate logistic regression analysis revealed that being female, dissatisfaction or average satisfaction with income, and good or very good self-perceived psychological endurance when faced with an emergency were associated with a reduction of PTSD symptoms. A frequency of verbal abuse incidents greater than 4 was associated with an increase in PTSD symptoms. The mental health status of Chinese medical staff is poor. While the determinate factors based on different measurement standards were not completely consistent, the overlapping major risk factors identified that influenced psychological health were the amount of education, the perceived level of respect, and psychological endurance. PMID:29517690

Determinate factors of mental health status in Chinese medical staff: A cross-sectional study.

PubMed

Zhou, Chenyu; Shi, Lei; Gao, Lei; Liu, Wenhui; Chen, Zhenkang; Tong, Xinfa; Xu, Wen; Peng, Boshi; Zhao, Yan; Fan, Lihua

2018-03-01

Numerous previous studies have investigated the mental health status of medical staff in China and explored its associated determinate factors; however, scope and methods associated with these have introduced uncertainty regarding the results. The aim of this study was to perform a comprehensive examination of the mental health status of Chinese medical staff and its relative risk factors based on a cross-sectional survey.We conducted a broad area, cross-sectional, questionnaire-based survey of Chinese medical workers. Participants were randomly selected from 27 hospitals in the Heilongjiang province. The questionnaire that was distributed consisted of 5 parts: the demographic characteristics of the participant; questions related to the relative risk factors of psychological health; the posttraumatic stress disorder (PTSD) Checklist-Civilian Version (PCL-C); the Self-rating Depression Scale (SDS); and the Self-rating Anxiety Scale (SAS). The last 3 components were used to evaluate the mental health status of the target population. Logistic and linear regression were used to analyze the determinate factors of the mental health status of Chinese medical staff.Of the 1679 questionnaires distributed, 1557 medical workers responded (response rate: 92.73%; male: 24.1%; female 75.9%). The results of mental health status self-assessments indicated that 32.3% of participants were considered to have some degree of PTSD (based on the PCL-C). The SDS index was 0.67 and the mean score from SAS was 55.26; a result higher than found in the general population. Multivariate logistic regression analysis revealed that being female, dissatisfaction or average satisfaction with income, and good or very good self-perceived psychological endurance when faced with an emergency were associated with a reduction of PTSD symptoms. A frequency of verbal abuse incidents greater than 4 was associated with an increase in PTSD symptoms.The mental health status of Chinese medical staff is poor. While the determinate factors based on different measurement standards were not completely consistent, the overlapping major risk factors identified that influenced psychological health were the amount of education, the perceived level of respect, and psychological endurance.

Predictors of Good Outcome After Endovascular Therapy for Vertebrobasilar Occlusion Stroke.

PubMed

Bouslama, Mehdi; Haussen, Diogo C; Aghaebrahim, Amin; Grossberg, Jonathan A; Walker, Gregory; Rangaraju, Srikant; Horev, Anat; Frankel, Michael R; Nogueira, Raul G; Jovin, Tudor G; Jadhav, Ashutosh P

2017-12-01

Endovascular therapy is increasingly used in acute ischemic stroke treatment and is now considered the gold standard approach for selected patient populations. Prior studies have demonstrated that eventual patient outcomes depend on both patient-specific factors and procedural considerations. However, these factors remain unclear for acute basilar artery occlusion stroke. We sought to determine prognostic factors of good outcome in acute posterior circulation large vessel occlusion strokes treated with endovascular therapy. We reviewed our prospectively collected endovascular databases at 2 US tertiary care academic institutions for patients with acute posterior circulation strokes from September 2005 to September 2015 who had 3-month modified Rankin Scale documented. Baseline characteristics, procedural data, and outcomes were evaluated. A good outcome was defined as a 90-day modified Rankin Scale score of 0 to 2. The association between clinical and procedural parameters and functional outcome was assessed. A total of 214 patients qualified for the study. Smoking status, creatinine levels, baseline National Institutes of Health Stroke Scale score, anesthesia modality (conscious sedation versus general anesthesia), procedural length, and reperfusion status were significantly associated with good outcomes in the univariate analysis. Multivariate logistic regression indicated that only smoking (odds ratio=2.61; 95% confidence interval, 1.23-5.56; P =0.013), low baseline National Institutes of Health Stroke Scale score (odds ratio=1.09; 95% confidence interval, 1.04-1.13; P <0.0001), and successful reperfusion status (odds ratio=10.80; 95% confidence interval, 1.36-85.96; P =0.025) were associated with good outcome. In our retrospective case series, only smoking, low baseline National Institutes of Health Stroke Scale score, and successful reperfusion status were associated with good outcome in patients with posterior circulation stroke treated with endovascular therapy. © 2017 American Heart Association, Inc.

Double-labelling immunohistochemistry for MGMT and a “cocktail” of non-tumourous elements is a reliable, quick and easy technique for inferring methylation status in glioblastomas and other primary brain tumours

PubMed Central

2013-01-01

Background Our aim was to develop a new protocol for MGMT immunohistochemistry with good agreement between observers and good correlation with molecular genetic tests of tumour methylation. We examined 40 primary brain tumours (30 glioblastomas and 10 oligodendroglial tumours) with our new technique, namely double-labelling immunohistochemistry for MGMT and a "cocktail" of non-tumour antigens (CD34, CD45 and CD68). We compared the results with single-labelling immunohistochemistry for MGMT and methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA, a recognised molecular genetic technique which we applied as the gold-standard for the methylation status). Results Double-labelling immunohistochemistry for MGMT produced a visual separation of tumourous and non-tumourous elements on the same histological slide, making it quick and easy to determine whether tumour cell nuclei were MGMT-positive or MGMT-negative (and thereby infer the methylation status of the tumour). We found good agreement between observers (kappa 0.76) and within observer (kappa 0.84). Furthermore, double-labelling showed good specificity (80%), sensitivity (73.33%), positive predictive value (PPV, 83.33%) and negative predictive value (NPV, 68.75%) compared to MS-MLPA. Double-labelling was quicker and easier to assess than single-labelling and it outperformed quantitative computerised image analysis of MGMT single-labelling in terms of sensitivity, specificity, PPV and NPV. Conclusions Double-labelling immunohistochemistry for MGMT and a cocktail of non-tumourous elements provides a "one look" method for determining whether tumour cell nuclei are MGMT-positive or MGMT-negative. This can be used to infer the methylation status of the tumour. There is good observer agreement and good specificity, sensitivity, PPV and NPV compared to a molecular gold-standard. PMID:24252243

Double-labelling immunohistochemistry for MGMT and a "cocktail" of non-tumourous elements is a reliable, quick and easy technique for inferring methylation status in glioblastomas and other primary brain tumours.

PubMed

Burke, Elinor; Grobler, Mariana; Elderfield, Kay; Bond, Frances; Crocker, Matthew; Taylor, Rohan; Bridges, Leslie R

2013-06-10

Our aim was to develop a new protocol for MGMT immunohistochemistry with good agreement between observers and good correlation with molecular genetic tests of tumour methylation. We examined 40 primary brain tumours (30 glioblastomas and 10 oligodendroglial tumours) with our new technique, namely double-labelling immunohistochemistry for MGMT and a "cocktail" of non-tumour antigens (CD34, CD45 and CD68). We compared the results with single-labelling immunohistochemistry for MGMT and methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA, a recognised molecular genetic technique which we applied as the gold-standard for the methylation status). Double-labelling immunohistochemistry for MGMT produced a visual separation of tumourous and non-tumourous elements on the same histological slide, making it quick and easy to determine whether tumour cell nuclei were MGMT-positive or MGMT-negative (and thereby infer the methylation status of the tumour). We found good agreement between observers (kappa 0.76) and within observer (kappa 0.84). Furthermore, double-labelling showed good specificity (80%), sensitivity (73.33%), positive predictive value (PPV, 83.33%) and negative predictive value (NPV, 68.75%) compared to MS-MLPA. Double-labelling was quicker and easier to assess than single-labelling and it outperformed quantitative computerised image analysis of MGMT single-labelling in terms of sensitivity, specificity, PPV and NPV. Double-labelling immunohistochemistry for MGMT and a cocktail of non-tumourous elements provides a "one look" method for determining whether tumour cell nuclei are MGMT-positive or MGMT-negative. This can be used to infer the methylation status of the tumour. There is good observer agreement and good specificity, sensitivity, PPV and NPV compared to a molecular gold-standard.

[Present status of clinical and fundamental threpsology].

PubMed

Kostiuchenko, L N; Ruchkina, I N; Kuz'mina, T N

2009-01-01

A good nutrition status is one of the impotant prerequisites of good health. Malnutrition in hospital leads to increased complication, morbidity and mortality rates. Whenever the gastrointestinal tract cannot fulfil its function or must be rested (during intestinal desease), parenteral administration of nutrients (or simultative parenteral and enteral alimitation) is necessary. Nowday perspectives of nutrition support in patients whith intestinal deseases, methods of easily diagnosed of malnutrition are the problems of this article.

Happiness and its relation to psychological well-being of adolescents.

PubMed

Heizomi, Haleh; Allahverdipour, Hamid; Asghari Jafarabadi, Mohammad; Safaian, Abdolrasul

2015-08-01

In the present decade, adolescents' mental problems are known as critical problems which have many destructive consequences. This study aimed to measure students' happiness and psychological well-being status in a sample of high school students. The cross sectional study consisted of 403 randomly selected high school students in Tabriz, Iran. Numerous variables including general health status, happiness, self-efficacy, perceived stress, hopefulness and life satisfaction were measured by using self-reported written questionnaires. Significant relation observed between happiness and psychological well-being (r=0.48). Those students with good relationship and those who had reported to enjoy attending social events indicated better mental health status. No causal inferences were investigated due to the non-experimental nature of the study. The findings also revealed that students with higher happiness score have a better school performance. Integration of happiness promotion initiatives into the comprehensive school health programs is recommended to have pleasant environments for a healthy population of adolescents. Copyright © 2015 Elsevier B.V. All rights reserved.

Effectiveness and safety of outpatient pleurodesis in patients with recurrent malignant pleural effusion and low performance status

PubMed Central

Terra, Ricardo Mingarini; Teixeira, Lisete Ribeiro; Bibas, Benoit Jacques; Pego‐Fernandes, Paulo Manuel; Vargas, Francisco Suso; Jatene, Fabio Biscegli

2011-01-01

OBJECTIVES: To evaluate the effectiveness and safety of pleurodesis carried out entirely on an outpatient basis in patients with recurrent malignant pleural effusions and Karnofsky Performance Status scores ≤70. METHODS: This study was a prospective trial comprising patients with symptomatic recurrent malignant pleural effusion and Karnofsky Performance Status scores ≤70 but >30. All selected patients underwent pleural catheter placement (14 Fr) in an outpatient facility. When chest radiography revealed post‐drainage lung expansion of >90%, pleurodesis (3 g of talc) was performed. Catheters were maintained until the daily output was <100 mL/day. The patients were evaluated in the first month and every three months thereafter for fluid recurrence, the need for additional procedures, and complications. RESULTS: During the study period (January 2005 to July 2007), 64 patients (24 men, 40 women), with an average age of 61.4 years, underwent elective chest tube drainage. Primary sites of the underlying malignancy were breast (27), lung (22), and others (15). Sixty‐six pleural catheters were placed (bilaterally in 2 patients), and 52 talc pleurodesis procedures were performed. Fourteen patients had a trapped lung and were excluded from the trial. No complications were observed during catheter placement or pleurodesis. Post‐pleurodesis complications included catheter obstruction (4 patients) and empyema (1). The average drainage time was 9.9 days. The recurrence rate observed in patients that were alive 30 days after pleurodesis was 13.9% (5/36 patients). Six patients required additional procedures after the pleurodesis. The average survival time was 101 days. CONCLUSION: In this study, talc pleurodesis was safely performed in an outpatient setting with good efficacy and a reasonable complication rate, thereby avoiding hospital admission. PMID:21484035

Child and Adolescent Perceptions of Oral Health Over the Life Course

PubMed Central

Maida, Carl A.; Marcus, Marvin; Hays, Ron D.; Coulter, Ian D.; Ramos-Gomez, Francisco; Lee, Steve Y.; McClory, Patricia S.; Van, Laura V.; Wang, Yan; Shen, Jie; Cai, Li; Spolsky, Vladimir W.; Crall, James J.; Liu, Honghu

2016-01-01

Purpose To elicit perceptions of oral health in children and adolescents as an initial step in the in the development of oral health item banks for the Patient-Reported Oral Health Outcomes Measurement Information System project. Methods We conducted focus groups with ethnically, socioeconomically, and geographically diverse youth (8-12, 13-17 years) to identify perceptions of oral health status. We performed content analysis, including a thematic and narrative analysis, to identify important themes. Results We identified three unique themes that the youth associated with their oral health status: 1) understanding the value of maintaining good oral health over the life course, with respect to longevity and quality of life in the adult years; 2) positive association between maintaining good oral health and interpersonal relationships at school, and dating, for older youth; and 3) knowledge of the benefits of orthodontic treatment to appearance and positive self-image, while holding a strong view as to the discomfort associated with braces. Conclusions The results provide valuable information about core domains for the oral health item banks to be developed and generated content for new items to be developed and evaluated with cognitive interviews and in a field test. PMID:26038216

Good Neighbor Forestry Act

THOMAS, 113th Congress

Sen. Barrasso, John [R-WY

2013-02-14

Senate - 09/10/2013 Placed on Senate Legislative Calendar under General Orders. Calendar No. 175. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Risk of Postoperative Performance Status Worsening after Resection of Lesions Involving the Motor Pathway: A Multinomial Logistic Regression Model.

PubMed

Raco, Antonino; Pesce, Alessandro; Fraschetti, Flavia; D'Andrea, Giancarlo; Polli, Filippo Maria; Acqui, Michele; Frati, Alessandro

2018-03-09

 In surgery for gliomas and brain metastases, preservation of neurologic functions is essential to ensure a good quality of life and the eligibility for adjuvant therapies. This article assesses which factors could influence the functional outcome in patients with lesions located in the motor pathways.  A total of 92 patients with gliomas and metastases involving the motor pathways were studied for concerns regarding quality of life (Karnofsky performance status [KPS] and modified Rankin scale [mRS]) before and after surgical treatment supported by intraoperative neuromonitoring. Patient-related, surgery-related, and lesion-related data were recorded to identify the relationships with postoperative performance status. The relationship between lesions and the corticospinal tract were investigated with preoperative magnetic resonance imaging sequences and tractographic reconstructions.  Means of preoperative mRS and KPS were 1.91 ± 1.34 and 80.8 ± 20, and at 30 days postoperatively they were 1.93 ± 1.63 and 79.8 ± 24.4, respectively. The better preoperative performance status was a predictor of better outcome in terms of quality of life. Gender showed a statistical association with ∆KPS ( p  = 0.033) and ∆mRS ( p  = 0.031). A recurrent lesion was a predictor of poor functional outcome ( p = 0.045 for KPS at 30 days).A left-sided lesion showed a statistical association with a lesser improvement with respect to right sided. Complications were associated with a lesser functional improvement (∆mRS, ∆KPS, and clinical improvement: p  = 0.001, p  = 0.006, and p  = 0.003, respectively). Hemorrhagic complications were associated with the worst functional prognosis.  In our experience, factors associated with worse functional prognosis and quality of life were a poor preoperative performance status, female gender, operating on a recurrent lesion, involvement of the left corticospinal tract, and surgical or medical postoperative complications. Georg Thieme Verlag KG Stuttgart · New York.

[Burdens at Admission, Short-term Effects and Predictors of Health Status at Discharge among 1 803 Patients with Fibromyalgia Syndrome].

PubMed

Gerdes, N; Farin, E

2016-10-01

Objective: Taking Fibromyalgia syndrome (FMS) as an example, the article illustrates a problem that to our knowledge has not been addressed in rehabilitation research so far: According to our large dataset, a sizeable proportion of patients had to be sent home with extremely severe burdens (<2 nd percentile in the normal population) at discharge - in spite of good improvements during their stay. Data and methods: Since 2009, patients in the RehaKlinikum Bad Säckingen, an in-patient rehab center for orthopedic-rheumatic diseases, answer the questionnaire "Indicators of Rehabilitation Status" (IRES) at the beginning and the end of their stay. We analysed IRES-data of 1 803 patients with FMS (94% women). In addition to analyses of change, we determined the degrees of severity at admission and discharge on the basis of a comparison with the normative sample of the IRES. In order to predict membership of the high-risk group of patients with still "extremely severe" values at discharge, we performed binary logistic regression analyses. Results: At admission, about 90% of the patients showed either "extreme" (65%<2 nd percentile) or "severe" (27% 2 nd -10 th percentile) values on the IRES summary score as well as on the scores for "psychic status", "pain", "symptoms of orthopedic and cardiovascular diseases", and "functioning in everyday life". In sum, then, FMS-patients have come to rehabilitation with multiple burdens of a severe to extreme degree. At discharge, the mean summary score had improved with a "strong" effect size of SRM=1.07. In spite of these good overall improvements, however, 37.4% of the patients went home with "extreme" burdens remaining, even though almost 60% of them had experienced "strong" (28%) or "relevant" (31%) improvements. The most important predictor of affiliation to this "high-risk group" was - as expected - the IRES summary score at admission. But unexpectedly influential were also some characteristics of social status such as lower household income and lower degrees of education. Conclusion: In rehabilitation research, analyses of change between pre- and post-measurement values should be accompanied by assessments of severity of rehabilitation status at discharge because even good improvements do not necessarily mean that a patient has been rehabilitated successfully. © Georg Thieme Verlag KG Stuttgart · New York.

Periapical and endodontic status scale based on periapical bone lesions and endodontic treatment quality evaluation using cone-beam computed tomography.

PubMed

Venskutonis, Tadas; Plotino, Gianluca; Tocci, Luigi; Gambarini, Gianluca; Maminskas, Julius; Juodzbalys, Gintaras

2015-02-01

The purpose of this study was to present a new periapical and endodontic status scale (PESS) that is based on the complex periapical index (COPI), which was designed for the identification and classification of periapical bone lesions in cases of apical periodontitis, and the endodontically treated tooth index, which was designed for endodontic treatment quality evaluation by means of cone-beam computed tomographic (CBCT) analysis. Periapical and endodontic status parameters were selected from the already known indexes and scientific literature for radiologic evaluation. Radiographic images (CBCT imaging, digital orthopantomography [DOR], and digital periapical radiography) from 55 patients were analyzed. All parameters were evaluated on CBCT, DOR, and digital periapical radiographic images by 2 external observers. The statistical analysis was performed with software SPSS version 19.0 (SPSS Inc, Chicago, IL). Chi-square tests were used to compare frequencies of qualitative variables. The level of significance was set at P ≤ .05. Overall intraobserver and interobserver agreements were very good and good, respectively. CBCT analysis found more lesions and lesions of bigger dimension (P < .001). CBCT imaging was also superior in locating lesions in the apical part on the side compared with DOR and in the diagnosis of cortical bone destruction compared with both methods (P < .001). Through CBCT analysis, more root canals and more canals associated with lesions were found. The most informative and reproducible periapical and endodontic status parameters were selected, and a new PESS was proposed. The classification proposed in the present study seems to be reproducible and objective and adds helpful information with respect to the existing indexes. Future studies need to be conducted to validate PESS. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Association between socioeconomic factors and sleep quality in an urban population-based sample in Germany.

PubMed

Anders, Markus P; Breckenkamp, Jürgen; Blettner, Maria; Schlehofer, Brigitte; Berg-Beckhoff, Gabriele

2014-12-01

Good sleep quality is essential for recovery. The risk factors of sleep disorders have been extensively investigated, but there is sparse information on the association of socioeconomic factors with a person's sleep quality. The aim of the present analysis is to investigate this association, taking particularly the effect of health confounders into consideration. The data were extracted from the cross-sectional QUEBEB Study. In total, the study sample consisted of 3281 participants (1817 women and 1464 men, aged 16-72 years). Here socioeconomic status (SES) was collected from the baseline survey taken in 2004. Sleep quality for the same participants was measured with in-depth personal interviews in 2006 using the Pittsburgh Sleep Quality Index, together with other relevant characteristics (e.g. anxiety, depression and health status). Multiple logistic regression analyses were performed. People living in an urban environment with a high or medium SES have a greater probability of good sleep quality (odds ratio 1.65, 95% confidence interval 1.27-2.14; odds ratio 1.40, 95% confidence interval 1.16-1.69) than persons with a low SES. Anxiety and depression, but also health status, are also associated with sleep quality and can influence in part the socioeconomic levels seen in sleep quality. SES and sleep quality are associated. However, there are important additional determinants that influence the level of association between SES and sleep quality. Several factors, such as anxiety, depression and health status, are associated with poorer sleep quality, but at the same time, these factors occur more often within lower social classes. © The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Survivorship and functional outcomes of patellofemoral arthroplasty: a systematic review.

PubMed

van der List, J P; Chawla, H; Zuiderbaan, H A; Pearle, A D

2017-08-01

Historically poor results of survivorship and functional outcomes of patellofemoral arthroplasty (PFA) have been reported in the setting of isolated patellofemoral osteoarthritis. More recently, however, fairly good results of PFA were reported, but the current status of PFA outcomes is unknown. Therefore, a systematic review was performed to assess overall PFA survivorship and functional outcomes. A search was performed using PubMed, Embase and Cochrane systems, and the registries were searched. Twenty-three cohort studies and one registry reported survivorship using Kaplan-Meier curve, while 51 cohort studies reported functional outcomes of PFA. Twelve studies were level II studies, while 45 studies were level III or IV studies. Heterogeneity was mainly seen in type of prosthesis and year the cohort started. Nine hundred revisions in 9619 PFAs were reported yielding 5-, 10-, 15- and 20-year PFA survivorships of 91.7, 83.3, 74.9 and 66.6 %, respectively, and an annual revision rate of 2.18. Functional outcomes were reported in 2587 PFAs with an overall score of 82.2 % of the maximum score. KSS and Knee Function Score were 87.5 and 81.6 %, respectively. This systematic review showed that fairly good results of PFA survivorship and functional outcomes were reported at short- and midterm follow-up in the setting of isolated patellofemoral osteoarthritis. Heterogeneity existed mainly in prosthesis design and year the cohort started. These results provide a clear overview of the current status of PFA in the setting of isolated patellofemoral osteoarthritis. IV.

Differences in performance and learning proficiency on the Wisconsin Card Sorting Test in schizophrenia: do they reflect distinct neurocognitive subtypes with distinct functional profiles?

PubMed

Kurtz, Matthew M; Wexler, Bruce E

2006-01-31

The aim of this study was two-fold: 1) to determine whether a priori subtyping of patients with schizophrenia based on both overall performance on a measure of executive-function, the Wisconsin Card Sorting Test (WCST), and ability to learn the task with expanded instruction, could be confirmed with other, independent measures of executive-function and learning, and, if so, 2) to determine whether these groups have different neurocognitive profiles and show differences in functional capacity. Fifty-four outpatients with schizophrenia were divided by WCST performance into three groups: intact executive-function (n=28), "good learner" (n=13), and "poor learner" (n=13) groups. These groups were then assessed with a comprehensive neurocognitive test battery and a performance-based measure of functional status, the UCSD Performance-based Skills Assessment (UPSA). The WCST-intact subgroup performed significantly better than other groups on a second measure of executive-function and in working memory, and speeded motor sequencing. Impaired WCST patients who benefited from expanded WCST instruction ("good learners") also showed better performance than patients who did not benefit from instruction ("poor-learners") on a second measure of learning, as well as on a measure of auditory divided attention. The intact WCST subgroup had greater functional capacity than either "strong" or "poor" learners. These subtypes may have implications for response to behavioral treatment interventions.

Outcome following postanoxic status epilepticus in patients with targeted temperature management after cardiac arrest.

PubMed

Dragancea, Irina; Backman, Sofia; Westhall, Erik; Rundgren, Malin; Friberg, Hans; Cronberg, Tobias

2015-08-01

Postanoxic electrographic status epilepticus (ESE) is considered a predictor of poor outcome in resuscitated patients after cardiac arrest (CA). Observational data suggest that a subgroup of patients may have a good outcome. This study aimed to describe the prevalence of ESE and potential clinical and electrographic prognostic markers. In this retrospective single study, we analyzed consecutive patients who suffered from CA, and who received temperature management and were monitored with simplified continuous EEG (cEEG) during a five-year period. The patients' charts and cEEG data were initially screened to identify patients with clinical seizures or ESE. The cEEG diagnosis of ESE was retrospectively reanalyzed according to strict criteria by a neurophysiologist blinded to patient outcome. The EEG background patterns prior to the onset of ESE, duration of ESE, presence of clinical seizures, and use of antiepileptic drugs were analyzed. The results of somatosensory-evoked potentials (SSEPs) and neuron-specific enolase (NSE) at 48 h after CA were described in all patients with ESE. Antiepileptic treatment strategies were not protocolized. Outcome was evaluated using the Cerebral Performance Category (CPC) scale at 6 months, and good outcome was defined as CPC 1-2. Of 127 patients, 41 (32%) developed ESE. Twenty-five patients had a discontinuous EEG background prior to ESE, and all died without regaining consciousness. Sixteen patients developed a continuous EEG background prior to the start of ESE, four of whom survived, three with CPC 1-2 and one with CPC 3 at 6 months. Among survivors, ESE developed at a median of 46 h after CA. All had preserved N20 peaks on SSEP and NSE values of 18-37 μg/l. Electrographic status epilepticus is common among comatose patients after cardiac arrest, with few survivors. A combination of a continuous EEG background prior to ESE, preserved N20 peaks on SSEPs, and low or moderately elevated NSE levels may indicate a good outcome. This article is part of a Special Issue entitled "Status Epilepticus". Copyright © 2015 Elsevier Inc. All rights reserved.

Direct and indirect effects of nutritional status, physical function and cognitive function on activities of daily living in Japanese older adults requiring long-term care.

PubMed

Kamo, Tomohiko; Nishida, Yuusuke

2014-10-01

To identify the direct and indirect effects of nutritional status, physical function, and cognitive function on activities of daily living in Japanese older adults requiring long-term care. In total, 179 participants aged ≥ 65 years who were eligible for long-term care insurance (mean age 85.5 ± 7.8 years) were recruited for this study. Nutritional status (Mini Nutritional Assessment, Short Form) and physical function (Short Physical Performance Battery) were examined. Activities of daily living, cognitive function and frailty were assessed using the Barthel Index, Mini-Mental State Examination and Clinical Frailty Scale, respectively. Path analysis was used to determine relationships between these factors and the activities of daily living. For Japanese older adults requiring long-term care, pathways were modeled for nutritional status, physical function and the activities of daily living. The total effect of nutritional status was 0.516 (P<0.001). The indirect effect of nutritional status through physical function on the activities of daily living was 0.458 (P<0.001). Finally, no significant direct effect of nutritional status on activities of daily living was observed (b=0.058, P=0.258). The present study identified the complex pathway from nutritional status to the activities of daily living through physical function in aged Japanese people requiring long-term care. These findings suggest that maintaining good nutritional status and nutritional support might delay physical function decline, and prolong the activities of daily living. © 2013 Japan Geriatrics Society.

Association of Patient-Reported Health Status with Long-Term Mortality after Transcatheter Aortic Valve Replacement: A Report from the STS/ACC TVT Registry™

PubMed Central

Arnold, Suzanne V.; Spertus, John A.; Vemulapalli, Sreekanth; Dai, Dadi; O’Brien, Sean M.; Baron, Suzanne J.; Kirtane, Ajay J.; Mack, Michael J.; Green, Philip; Reynolds, Matthew R.; Rumsfeld, John S.; Cohen, David J.

2015-01-01

Background Although transcatheter aortic valve replacement (TAVR) is an effective treatment for aortic stenosis, long-term mortality after TAVR remains high and challenging to predict. The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a health status measure, assessed directly from patients, that integrates two clinically relevant factors (symptoms and functional status) that may predict TAVR outcomes. Methods and Results Among 7769 patients from 286 sites in the STS-ACC TVT Registry, we examined the association between pre-procedure (baseline) patient health status, as assessed by the KCCQ, and 1-year mortality after TAVR. The KCCQ Overall Summary Score was categorized as very poor: <25, poor: 25–49, fair: 50–74, or good: ≥75. Prior to TAVR, health status was rated as very poor in 28%, poor in 38%, fair in 24%, and good in 10%. Patients with worse health status were more likely to be female and had more comorbidities and higher STS mortality risk scores. Compared with those with good health status prior to TAVR, and after adjusting for a broad range of baseline covariates, patients with very poor health status had a 2-fold increased hazard of death over the first year after TAVR (adjusted HR 2.00, 95% CI 1.58–2.54), while those with poor and fair health status had intermediate outcomes (adjusted HRs 1.54, 95% CI 1.22–1.95 and 1.20, 95% CI 0.94–1.55, respectively). Conclusions In a national, contemporary practice cohort, worse pre-procedure patient health status, as assessed by the KCCQ, was associated with greater long-term mortality after TAVR. These results support the measurement and integration of the KCCQ into mortality risk assessments for patients considering TAVR. PMID:26643740

Self-assessment of postoperative scars in living liver donors.

PubMed

Imamura, Hajime; Soyama, Akihiko; Takatsuki, Mitsuhisa; Muraoka, Izumi; Hara, Takanobu; Yamaguchi, Izumi; Tanaka, Takayuki; Kinoshita, Ayaka; Kuroki, Tamotsu; Eguchi, Susumu

2013-01-01

The application of less invasive techniques for liver surgery in patients undergoing living donor hepatectomy (LDH) has been reported. The objective of this study was to evaluate physical status according to type of incision in donors. One hundred and forty-seven living liver donors underwent hepatectomy using three types of incisions: (i) Mercedes-Benz incision (M.B.), (ii) right subcostal incision with midline up to xiphoid incision (S.C.), and (iii) short upper midline incision (U.M.). A total of 100 donors answered the questionnaires, and 87 had sufficient data for the analyses. An original questionnaire designed to evaluate the physical status concerning postoperative scars. The questionnaire consisted of three major categories: appearance, sensation, and daily activities. The univariate analysis was performed using the chi-square test. Numbness of the abdominal wall was reported more frequently by the donor with M.B.s and right subcostal incisions up to xiphoid incisions. In terms of appearance, sensation, and daily activities, LDH with a U.M. was found to have a good self-assessment compared with that performed using other types of incisions. LDH with a U.M. is a preferable procedure in terms of physical status and safety. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Good Samaritan Health Professionals Act of 2014

THOMAS, 113th Congress

Sen. Murkowski, Lisa [R-AK

2014-04-01

Senate - 04/01/2014 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Buy Fairly Trade Goods Act of 2012

THOMAS, 112th Congress

Sen. Wyden, Ron [D-OR

2012-09-21

Senate - 09/21/2012 Read twice and referred to the Committee on Homeland Security and Governmental Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Prediction of Recovery from Coma After CPR

MedlinePlus

... to pain. There is good evidence* that myoclonus status epilepticus within the first day after CPR accurately predicts poor recovery from coma. Myoclonus status epilepticus is a constant twitching of muscles, including the ...

Digital Goods and Services Tax Fairness Act of 2013

THOMAS, 113th Congress

Rep. Smith, Lamar [R-TX-21

2013-12-12

House - 01/27/2014 Referred to the Subcommittee on Regulatory Reform, Commercial And Antitrust Law. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

[Thrombotic microangiopathy in pregnancy complicated by acute hemorrhagic-necrotic pancreatitis during early puerperium].

PubMed

Redechová, S; Féderová, L; Hammerová, L; Filkászová, A; Horváthová, D; Redecha, M

2014-06-01

Authors in the article describe a case of a patient with thrombotic thrombocytopenic purpurain 37 weeks gestation complicated by acute severe hemorrhagic-necrotic pancreatitis during the early puerperium. Case report. Ist Department of gynaecology and obstetrics of the Comenius University Bratislava. 33-years-old patient in the 37 weeks gestation was admitted to our department with the signs of HELLP syndrome (hemolysis, elevated liver enzymes, low platelets). Due to the worsening clinical status, we have performed caesarean section. After the transient stabilization of the patient's clinical status, the hemolysis with severe thrombocytopenia reappeared. Based on the clinical signs of abdominal pain and computer tomography, the diagnosis of acute hemorrhagic-necrotic pancreatitis was set. The primary diagnosis was thrombotic thrombocytopenic purpura. Therefore, therapeutic plasma exchange was performed with consequent improvement of the patients clinical state. Normalization of the platelet count was achieved after 4.plasma exchanges. Consequently 5 plasma exchanges were performed. However, one month later, the disease relapsed. Therapeutic plasma exchanges were needed again (4x), with anti CD 20 administration. This therapy had good clinical outcome, without the need for further plasma exchanges. Thrombotic thrombocytopenic purpura is highly lethal disease. Early diagnosis, treatment, and multidisciplinary approach are essential.

A phase I study of gefitinib with concurrent dose-escalated weekly docetaxel and conformal three-dimensional thoracic radiation followed by consolidative docetaxel and maintenance gefitinib for patients with stage III non-small cell lung cancer.

PubMed

Center, Brian; Petty, William Jeffrey; Ayala, Diandra; Hinson, William H; Lovato, James; Capellari, James; Oaks, Timothy; Miller, Antonius A; Blackstock, Arthur William

2010-01-01

Concurrent radiation and chemotherapy is the standard of care for good performance status patients with stage III non-small cell lung cancer. Locoregional control remains a significant factor relating to poor outcome. Preclinical and early clinical data suggest that docetaxel and gefitinib have radiosensitizing activity. This study sought to define the maximum tolerated dose of weekly docetaxel that could be given with daily gefitinib and concurrent thoracic radiation therapy. Patients with histologically confirmed, inoperable stage III non-small cell lung cancer and good performance status (Eastern Cooperative Oncology Group 0-1) were eligible for this study. Patients received three-dimensional conformal thoracic radiation to a dose of 70 Gy concurrently with oral gefitinib at a dose of 250 mg daily and intravenous, weekly docetaxel at escalating doses from 15 to 30 mg/m2 in cohorts of patients. Patients were given a 2-week rest period after the concurrent therapy, during which they received only gefitinib. After the 2-week rest period, patients received consolidation chemotherapy with docetaxel 75 mg/m2 given every 21 days for two cycles. Maintenance gefitinib was continued until disease progression or study completion. Sixteen patients were enrolled on the study between December 2003 and April 2007 with the following characteristics: median age, 64 years (range 43-79 years); M/F: 9/7; and performance status 0/1, 1/15. Dose-limiting pulmonary toxicity and esophagitis were encountered at a weekly docetaxel dose of 25 mg/m2, resulting in a maximum tolerated dose of 20 mg/m2/wk. Overall, grade 3/4 hematologic toxicity was observed in 27% of patients. Grade 3/4 esophageal and pulmonary toxicities were reported in 27% and 20% of patients, respectively. The overall response rate was 46%, and the median survival for all patients was 21 months. Concurrent thoracic radiation with weekly docetaxel and daily gefitinib is feasible but results in moderate toxicity. For further studies, the recommended weekly docetaxel dose for this chemoradiation regimen is 20 mg/m2.

Barriers to calling 911 and learning and performing cardiopulmonary resuscitation for residents of primarily Latino, high-risk neighborhoods in Denver, Colorado.

PubMed

Sasson, Comilla; Haukoos, Jason S; Ben-Youssef, Leila; Ramirez, Lorenzo; Bull, Sheana; Eigel, Brian; Magid, David J; Padilla, Ricardo

2015-05-01

Individuals in neighborhoods composed of minority and lower socioeconomic status populations are more likely to have an out-of-hospital cardiac arrest event, less likely to have bystander cardiopulmonary resuscitation (CPR) performed, and less likely to survive. Latino cardiac arrest victims are 30% less likely than whites to have bystander CPR performed. The goal of this study is to identify barriers and facilitators to calling 911, and learning and performing CPR in 5 low-income, Latino neighborhoods in Denver, CO. Six focus groups and 9 key informant interviews were conducted in Denver during the summer of 2012. Purposeful and snowball sampling, conducted by community liaisons, was used to recruit participants. Two reviewers analyzed the data to identify recurrent and unifying themes. A qualitative content analysis was used with a 5-stage iterative process to analyze each transcript. Six key barriers to calling 911 were identified: fear of becoming involved because of distrust of law enforcement, financial, immigration status, lack of recognition of cardiac arrest event, language, and violence. Seven cultural barriers were identified that may preclude performance of bystander CPR: age, sex, immigration status, language, racism, strangers, and fear of touching someone. Participants suggested that increasing availability of tailored education in Spanish, increasing the number of bilingual 911 dispatchers, and policy-level changes, including CPR as a requirement for graduation and strengthening Good Samaritan laws, may serve as potential facilitators in increasing the provision of bystander CPR. Distrust of law enforcement, language concerns, lack of recognition of cardiac arrest, and financial issues must be addressed when community-based CPR educational programs for Latinos are implemented. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Prognostic factors for survival in 676 consecutive patients with newly diagnosed primary glioblastoma.

PubMed

Filippini, Graziella; Falcone, Chiara; Boiardi, Amerigo; Broggi, Giovanni; Bruzzone, Maria G; Caldiroli, Dario; Farina, Rita; Farinotti, Mariangela; Fariselli, Laura; Finocchiaro, Gaetano; Giombini, Sergio; Pollo, Bianca; Savoiardo, Mario; Solero, Carlo L; Valsecchi, Maria G

2008-02-01

Reliable data on large cohorts of patients with glioblastoma are needed because such studies differ importantly from trials that have a strong bias toward the recruitment of younger patients with a higher performance status. We analyzed the outcome of 676 patients with histologically confirmed newly diagnosed glioblastoma who were treated consecutively at a single institution over a 7-year period (1997-2003) with follow-up to April 30, 2006. Survival probabilities were 57% at 1 year, 16% at 2 years, and 7% at 3 years. Progression-free survival was 15% at 1 year. Prolongation of survival was significantly associated with surgery in patients with a good performance status, whatever the patient's age, with an adjusted hazard ratio of 0.55 (p < 0.001) or a 45% relative decrease in the risk of death. Radiotherapy and chemotherapy improved survival, with adjusted hazard ratios of 0.61 (p = 0.001) and 0.89 (p = 0.04), respectively, regardless of age, performance status, or residual tumor volume. Recurrence occurred in 99% of patients throughout the follow-up. Reoperation was performed in one-fourth of these patients but was not effective, whether performed within 9 months (hazard ratio, 0.86; p = 0.256) or after 9 months (hazard ratio, 0.98; p = 0.860) of initial surgery, whereas second-line chemotherapy with procarbazine, lomustine, and vincristine (PCV) or with temozolomide improved survival (hazard ratio, 0.77; p = 0.008). Surgery followed by radiotherapy and chemotherapy should be considered in all patients with glioblastoma, and these treatments should not be withheld because of increasing age alone. The benefit of second surgery at recurrence is uncertain, and new trials are needed to assess its effectiveness. Chemotherapy with PCV or temozolomide seems to be a reasonable option at tumor recurrence.

Prognostic factors for survival in 676 consecutive patients with newly diagnosed primary glioblastoma

PubMed Central

Filippini, Graziella; Falcone, Chiara; Boiardi, Amerigo; Broggi, Giovanni; Bruzzone, Maria G.; Caldiroli, Dario; Farina, Rita; Farinotti, Mariangela; Fariselli, Laura; Finocchiaro, Gaetano; Giombini, Sergio; Pollo, Bianca; Savoiardo, Mario; Solero, Carlo L.; Valsecchi, Maria G.

2008-01-01

Reliable data on large cohorts of patients with glioblastoma are needed because such studies differ importantly from trials that have a strong bias toward the recruitment of younger patients with a higher performance status. We analyzed the outcome of 676 patients with histologically confirmed newly diagnosed glioblastoma who were treated consecutively at a single institution over a 7-year period (1997 – 2003) with follow-up to April 30, 2006. Survival probabilities were 57% at 1 year, 16% at 2 years, and 7% at 3 years. Progression-free survival was 15% at 1 year. Prolongation of survival was significantly associated with surgery in patients with a good performance status, whatever the patient’s age, with an adjusted hazard ratio of 0.55 (p < 0.001) or a 45% relative decrease in the risk of death. Radiotherapy and chemotherapy improved survival, with adjusted hazard ratios of 0.61 (p = 0.001) and 0.89 (p = 0.04), respectively, regardless of age, performance status, or residual tumor volume. Recurrence occurred in 99% of patients throughout the follow-up. Reoperation was performed in one-fourth of these patients but was not effective, whether performed within 9 months (hazard ratio, 0.86; p = 0.256) or after 9 months (hazard ratio, 0.98; p = 0.860) of initial surgery, whereas second-line chemotherapy with procarbazine, lomustine, and vincristine (PCV) or with temozolomide improved survival (hazard ratio, 0.77; p = 0.008). Surgery followed by radiotherapy and chemotherapy should be considered in all patients with glioblastoma, and these treatments should not be withheld because of increasing age alone. The benefit of second surgery at recurrence is uncertain, and new trials are needed to assess its effectiveness. Chemotherapy with PCV or temozolomide seems to be a reasonable option at tumor recurrence. PMID:17993634

Barriers to Calling 911 and Learning and Performing Cardiopulmonary Resuscitation for Residents of Primarily Latino, High-Risk Neighborhoods in Denver, Colorado

PubMed Central

Sasson, Comilla; Haukoos, Jason S.; Ben-Youssef, Leila; Ramirez, Lorenzo; Bull, Sheana; Eigel, Brian; Magid, David J.; Padilla, Ricardo

2016-01-01

Study objective Individuals in neighborhoods composed of minority and lower socioeconomic status populations are more likely to have an out-of-hospital cardiac arrest event, less likely to have bystander cardiopulmonary resuscitation (CPR) performed, and less likely to survive. Latino cardiac arrest victims are 30% less likely than whites to have bystander CPR performed. The goal of this study is to identify barriers and facilitators to calling 911, and learning and performing CPR in 5 low-income, Latino neighborhoods in Denver, CO. Methods Six focus groups and 9 key informant interviews were conducted in Denver during the summer of 2012. Purposeful and snowball sampling, conducted by community liaisons, was used to recruit participants. Two reviewers analyzed the data to identify recurrent and unifying themes. A qualitative content analysis was used with a 5-stage iterative process to analyze each transcript. Results Six key barriers to calling 911 were identified: fear of becoming involved because of distrust of law enforcement, financial, immigration status, lack of recognition of cardiac arrest event, language, and violence. Seven cultural barriers were identified that may preclude performance of bystander CPR: age, sex, immigration status, language, racism, strangers, and fear of touching someone. Participants suggested that increasing availability of tailored education in Spanish, increasing the number of bilingual 911 dispatchers, and policy-level changes, including CPR as a requirement for graduation and strengthening Good Samaritan laws, may serve as potential facilitators in increasing the provision of bystander CPR. Conclusion Distrust of law enforcement, language concerns, lack of recognition of cardiac arrest, and financial issues must be addressed when community-based CPR educational programs for Latinos are implemented. PMID:25481112

Physical Attractiveness in Preschoolers: Relationships with Power, Status, Aggression and Social Skills

ERIC Educational Resources Information Center

Hawley, Patricia H.; Johnson, Sarah E.; Mize, Jennifer A.; McNamara, Kelly A.

2007-01-01

Several lines of theory and research suggest that power (e.g., social dominance) and status (e.g., social prominence and positive peer regard) are enjoyed by those blessed with good looks. The present work addresses the relations among physical attractiveness, power, status, and aggression from a resource control theoretic perspective that…

[Remote sensing detection of vegetation health status after ecological restoration in soil and water loss region].

PubMed

Hu, Xiu Juan; Xu, Han Qiu; Guo, Yan Bin; Zhang, Bo Bo

2017-01-01

This paper proposed a vegetation health index (VHI) to rapidly monitor and assess vegetation health status in soil and water loss region based on remote sensing techniques and WorldView-2 imagery. VHI was constructed by three factors, i.e., the normalized mountain vegetation index, the nitrogen reflectance index and the reflectance of the yellow band, through the principal component transformation, in order to avoid the deviation induced by subjective method of weighted summation. The Hetian Basin of Changting County in Fujian Province, China, was taken as a test area to assess the vegetation health status in soil and water loss region using VHI. The results showed that the VHI could detect vegetation health status with a total accuracy of 91%. The vegetation of Hetian Basin in good, moderate and poor health status accounted for 10.1%, 49.2% and 40.7%, respectively. The vegetation of the study area was still under an unhealthy status because the soil was poor and the growth of newly planted vegetation was not good in the soil and water loss region.

Collaborative effects of bystander-initiated cardiopulmonary resuscitation and prehospital advanced cardiac life support by physicians on survival of out-of-hospital cardiac arrest: a nationwide population-based observational study.

PubMed

Yasunaga, Hideo; Horiguchi, Hiromasa; Tanabe, Seizan; Akahane, Manabu; Ogawa, Toshio; Koike, Soichi; Imamura, Tomoaki

2010-01-01

There are inconsistent data about the effectiveness of prehospital physician-staffed advanced cardiac life support (ACLS) on the outcomes of out-of-hospital cardiac arrest (OHCA). Furthermore, the relative importance of bystander-initiated cardiopulmonary resuscitation (BCPR) and ACLS and the effectiveness of their combination have not been clearly demonstrated. Using a prospective, nationwide, population-based registry of all OHCA patients in Japan, we enrolled 95,072 patients whose arrests were witnessed by bystanders and 23,127 patients witnessed by emergency medical service providers between 2005 and 2007. We divided the bystander-witnessed arrest patients into Group A (ACLS by emergency life-saving technicians without BCPR), Group B (ACLS by emergency life-saving technicians with BCPR), Group C (ACLS by physicians without BCPR) and Group D (ACLS by physicians with BCPR). The outcome data included 1-month survival and neurological outcomes determined by the cerebral performance category. Among the 95,072 bystander-witnessed arrest patients, 7,722 (8.1%) were alive at 1 month, including 2,754 (2.9%) with good performance and 3,171 (3.3%) with vegetative status or worse. BCPR occurred in 42% of bystander-witnessed arrests. In comparison with Group A, the rates of good-performance survival were significantly higher in Group B (odds ratio (OR), 2.23; 95% confidence interval, 2.05 to 2.42; P < 0.01) and Group D (OR, 2.80; 95% confidence interval, 2.28 to 3.43; P < 0.01), while no significant difference was seen for Group C (OR, 1.18; 95% confidence interval, 0.86 to 1.61; P = 0.32). The occurrence of vegetative status or worse at 1 month was highest in Group C (OR, 1.92; 95% confidence interval, 1.55 to 2.37; P < 0.01). In this registry-based study, BCPR significantly improved the survival of OHCA with good cerebral outcome. The groups with BCPR and ACLS by physicians had the best outcomes. However, receiving ACLS by physicians without preceding BCPR significantly increased the number of patients with neurologically unfavorable outcomes.

Good Samaritan Search and Recovery Act

THOMAS, 113th Congress

Rep. Heck, Joseph J. [R-NV-3

2013-05-23

Senate - 07/30/2014 Committee on Energy and Natural Resources Subcommittee on Public Lands, Forests, and Mining. Hearings held. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

The News Delivery Sequence: Bad News and Good News in Conversational Interaction.

ERIC Educational Resources Information Center

Maynard, Douglas W.

1997-01-01

Explores the conditional nature of good and bad news while focusing on three topics: (1) the status of information as news according the participants in a conversation; (2) the valence of this information with regard to its perception as good or bad; and (3) the effect of news on individuals. Notes that good news is privileged over bad news in…

Factors Affecting Job Motivation among Health Workers: A Study From Iran

PubMed Central

Daneshkohan, Abbas; Zarei, Ehsan; Mansouri, Tahere; Maajani, Khadije; Ghasemi, Mehri Siyahat; Rezaeian, Mohsen

2015-01-01

Objective: Human resources are the most vital resource of any organizations which determine how other resources are used to accomplish organizational goals. This research aimed to identity factors affecting health workers’ motivation in Shahid Beheshti University of Medical Sciences (SBUMS). Method: This is a cross-sectional survey conducted with participation of 212 health workers of Tehran health centers in November and December 2011. The data collection tool was a researcher-developed questionnaire that included 17 motivating factors and 6 demotivating factors and 8 questions to assess the current status of some factors. Validity and reliability of the tool were confirmed. Data were analyzed with descriptive and analytical statistical tests. Results: The main motivating factors for health workers were good management, supervisors and managers’ support and good working relationship with colleagues. On the other hand, unfair treatment, poor management and lack of appreciation were the main demotivating factors. Furthermore, 47.2% of health workers believed that existing schemes for supervision were unhelpful in improving their performance. Conclusion: Strengthening management capacities in health services can increase job motivation and improve health workers’ performance. The findings suggests that special attention should be paid to some aspects such as management competencies, social support in the workplace, treating employees fairly and performance management practices, especially supervision and performance appraisal. PMID:25948438

Factors affecting job motivation among health workers: a study from Iran.

PubMed

Daneshkohan, Abbas; Zarei, Ehsan; Mansouri, Tahere; Maajani, Khadije; Ghasemi, Mehri Siyahat; Rezaeian, Mohsen

2014-11-26

Human resources are the most vital resource of any organizations which determine how other resources are used to accomplish organizational goals. This research aimed to identity factors affecting health workers' motivation in Shahid Beheshti University of Medical Sciences (SBUMS). This is a cross-sectional survey conducted with participation of 212 health workers of Tehran health centers in November and December 2011. The data collection tool was a researcher-developed questionnaire that included 17 motivating factors and 6 demotivating factors and 8 questions to assess the current status of some factors. Validity and reliability of the tool were confirmed. Data were analyzed with descriptive and analytical statistical tests. The main motivating factors for health workers were good management, supervisors and managers' support and good working relationship with colleagues. On the other hand, unfair treatment, poor management and lack of appreciation were the main demotivating factors. Furthermore, 47.2% of health workers believed that existing schemes for supervision were unhelpful in improving their performance. Strengthening management capacities in health services can increase job motivation and improve health workers' performance. The findings suggests that special attention should be paid to some aspects such as management competencies, social support in the workplace, treating employees fairly and performance management practices, especially supervision and performance appraisal.

Socioeconomic Status, Health Behaviors, Obesity and Self-Rated Health among Older Arabs in Israel.

PubMed

Khalaila, R N Rabia

2017-03-01

Socioeconomic inequalities in health are well documented. Recently, researchers have shown interest in exploring the mechanisms by which measures of SES operate through it to impact SRH, such as material, psychosocial and behavioral factors. To examine the relationships between SES indicators and self-rated health (SRH); and to determine whether health behaviors and obesity mediate the association between SES indicators and SRH. A secondary analysis of data previously collected through the third survey of socioeconomic and health status of the Arab population in Israel, in which the SRH of 878 Arab-Israelis age 50 or older were analyzed using logistic regression. The results showed that higher education level and current employment in old age are associated with better SRH. However, neither subjective economic status nor family income was associated with SRH. Greater physical activity was found to be related to good\\very good SRH, while obesity was associated with less than good SRH. Finally, health behaviors (physical activity) and obesity were revealed as mediators between SES indicators (education and employment status) and SRH. The results highlight the importance of high education level and employment status in old age to reduce health inequalities. The findings also show that the relationship between SES and SRH can operate through behavioral mechanisms (i.e., physical activity) and their consequences (i.e., obesity), that can, however, be changed in old age.

Good social skills despite poor theory of mind: exploring compensation in autism spectrum disorder.

PubMed

Livingston, Lucy Anne; Colvert, Emma; Bolton, Patrick; Happé, Francesca

2018-03-26

It is proposed that some individuals with Autism Spectrum Disorder (ASD) can 'compensate' for their underlying difficulties (e.g. in theory of mind; ToM), thus demonstrating relatively few behavioural symptoms, despite continued core cognitive deficits. The mechanisms underpinning compensation are largely unexplored, as is its potential impact on mental health. This study aimed to estimate compensation patterns in ASD, by contrasting overt social behaviour with ToM task performance, in order to compare the characteristics of 'Low' and 'High' Compensators. A total of 136 autistic adolescents, from the ongoing Social Relationships Study, completed a range of cognitive tasks, the Autistic Diagnostic Observation Schedule (ADOS) and a self-report anxiety questionnaire. Participants were assigned compensation group status; High Compensators demonstrated good ADOS scores despite poor ToM performance, while Low Compensators demonstrated similarly poor ToM, accompanied by poor ADOS scores. High Compensators demonstrated better IQ and executive function (EF), but greater self-reported anxiety, compared with Low Compensators. Such differences were not found when comparing individuals who had good versus poor ADOS scores, when ToM performance was good. Other core autistic characteristics (weak central coherence, nonsocial symptoms) did not differentiate the High and Low Compensators. IQ, EF and anxiety appear to be implicated in the processes by which certain autistic young people can compensate for their underlying ToM difficulties. This tendency to compensate does not appear to reflect the severity of 'hit' for ASD per se, suggesting that well-compensated individuals are not experiencing a milder form of ASD. The construct of compensation in ASD has implications for research and clinical practice. © 2018 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

Screening the nutritional status in oncology: a preliminary report on 1,000 outpatients.

PubMed

Bozzetti, Federico

2009-03-01

This study presents the preliminary data of a prospective multi-centre investigation on the screening of the nutritional status of cancer outpatients with the purpose to define: (1) prevalence and rate of weight loss and nutritional risk in this patient population, and (2) to assess the association among some patient-dependent, tumour-dependent and therapy-dependent variables with the nutritional status and the nutritional risk. Seventeen centres were involved to collect demographic data (age and sex), oncologic data (site of primary tumour, stage, Eastern Cooperative Oncology Group Performance State, oncologic therapy) and presence and severity of systemic and digestive/nutritional symptoms (fatigue, anorexia, nausea/vomiting, early satiety, dysgeusia/dysosmia, dysphagia/odynophagia, diarrhoea/constipation). Furthermore, the percentage of the weight loss on the usual body weight and the body mass index were computed. The nutritional risk was assessed according to the Nutrition Risk Screening 2002 questionnaire which scores the risk from 0 to 7. On the first 1,000 screened patients, a significant weight loss (>or=10%) and a nutritional risk score >or=3 were observed in 39.7% and 33.8% of patients, respectively. Weight loss was higher in upper gastrointestinal tumours, in advanced stages of disease and in patients with a poor performance status. Similarly, the nutritional risk was higher in esophageal and pancreatic cancer and in those with a worse performance status. There was a good correlation between the severity of anorexia and the rate of the weight loss The majority of patients with no weight loss or a weight loss <10% were not anorectic; on the contrary, the majority of those with more severe weight loss had some degree of anorexia. Weight loss and nutritional risk are frequent in an unselected series of cancer outpatients. Site of primary tumour, stage and performance state appear to be associated, at a preliminary analysis, with significant weight loss and nutritional risk. Anorexia and weight loss are closely related, and this supports the concept that nutritional depletion can play a major role in the onset of malnutrition-cachexia.

Myxoedema coma presenting in status epilepticus.

PubMed Central

Woods, K. L.; Holmes, G. K.

1977-01-01

A 71-year-old woman with myxoedema coma presenting in status epilepticus is reported. Although this complication of myxoedema coma is considered to be fatal the patient described responded dramatically to treatment and remains in good health. PMID:876913

Perceived health status and daily activity participation of older Malaysians.

PubMed

Ng, Sor Tho; Tengku-Aizan, Hamid; Tey, Nai Peng

2011-07-01

This article investigates the influence of perceived health status on the daily activity participation of older Malaysians. Data from the Survey on Perceptions of Needs and Problems of the Elderly, which was conducted in 1999, were used. The negative binomial regression results show that older persons with good perceived health status reported more varieties of daily activity participation, especially among the uneducated and those with below-average self-esteem. The multinomial logistic regression model suggests that older persons with good perceived health status tended to engage daily in paid work only or with leisure activities, whereas those perceived to have poor health were more likely to engage in leisure activities only or leisure and family role activities. Promotion of a healthy lifestyle at a younger age encourages every person to monitor and take responsibility for their own health, which is a necessary strategy to ensure active participation at an older age, and thus improve their well-being.

High Pressure Electrolyzer System Evaluation

NASA Technical Reports Server (NTRS)

Prokopius, Kevin; Coloza, Anthony

2010-01-01

This report documents the continuing efforts to evaluate the operational state of a high pressure PEM based electrolyzer located at the NASA Glenn Research Center. This electrolyzer is a prototype system built by General Electric and refurbished by Hamilton Standard (now named Hamilton Sunstrand). It is capable of producing hydrogen and oxygen at an output pressure of 3000 psi. The electrolyzer has been in storage for a number of years. Evaluation and testing was performed to determine the state of the electrolyzer and provide an estimate of the cost for refurbishment. Pressure testing was performed using nitrogen gas through the oxygen ports to ascertain the status of the internal membranes and seals. It was determined that the integrity of the electrolyzer stack was good as there were no appreciable leaks in the membranes or seals within the stack. In addition to the integrity testing, an itemized list and part cost estimate was produced for the components of the electrolyzer system. An evaluation of the system s present state and an estimate of the cost to bring it back to operational status was also produced.

Flash memory management system and method utilizing multiple block list windows

NASA Technical Reports Server (NTRS)

Chow, James (Inventor); Gender, Thomas K. (Inventor)

2005-01-01

The present invention provides a flash memory management system and method with increased performance. The flash memory management system provides the ability to efficiently manage and allocate flash memory use in a way that improves reliability and longevity, while maintaining good performance levels. The flash memory management system includes a free block mechanism, a disk maintenance mechanism, and a bad block detection mechanism. The free block mechanism provides efficient sorting of free blocks to facilitate selecting low use blocks for writing. The disk maintenance mechanism provides for the ability to efficiently clean flash memory blocks during processor idle times. The bad block detection mechanism provides the ability to better detect when a block of flash memory is likely to go bad. The flash status mechanism stores information in fast access memory that describes the content and status of the data in the flash disk. The new bank detection mechanism provides the ability to automatically detect when new banks of flash memory are added to the system. Together, these mechanisms provide a flash memory management system that can improve the operational efficiency of systems that utilize flash memory.

Prognostic factors in multiple myeloma: definition of risk groups in 410 previously untreated patients: a Grupo Argentino de Tratamiento de la Leucemia Aguda study.

PubMed

Corrado, C; Santarelli, M T; Pavlovsky, S; Pizzolato, M

1989-12-01

Four hundred ten previously untreated multiple myeloma patients entered onto two consecutive Grupo Argentino de Tratamiento de la Leucemia Aguda (GATLA) protocols were analyzed to identify significant prognostic factors influencing survival. The univariate analysis selected the following variables: performance status, renal function, percentage of bone marrow plasma cells at diagnosis, hemoglobin, and age. A multivariate analysis showed that performance status, renal function, percentage of bone marrow plasma cells, hemoglobin, and age were the best predictive variables for survival. A score was assigned to each patient according to these variables, which led to their classification in three groups: good, intermediate, and poor risk, with a probability of survival of 26% and 10% at 96 months, and 5% at 56 months, and median survival of 60, 37, and 14 months, respectively (P = .0000). In our patient population, this model proved to be superior to the Durie-Salmon staging system in defining prognostic risk groups, and separating patients with significantly different risks within each Durie-Salmon stage.

Differences in change in coping styles between good responders, moderate responders and non-responders to pulmonary rehabilitation.

PubMed

Stoilkova-Hartmann, Ana; Janssen, Daisy J A; Franssen, Frits M E; Wouters, Emiel F M

2015-12-01

Pulmonary rehabilitation (PR) improves exercise tolerance and health status in patients with chronic obstructive pulmonary disease (COPD). Data on the effects of PR on coping styles are limited. Aim of the present study was to compare changes in coping styles between patients who had a good, moderate and no improvement in either exercise tolerance or health status after PR. Coping styles of 439 COPD patients undergoing PR were assessed by the Utrecht Coping List (UCL) at baseline and after PR. Patients' pulmonary function, six-minute walking distance (6MWD), St. George's Respiratory Questionnaire (SGRQ) and Hospital Anxiety and Depression Scale (HADS-A and HADS-D) were recorded. Good, moderate and non-responders were defined on the basis of minimally clinically important difference (MCID) for SGRQ total score and/or 6MWD. Overall, 54.0% of the patients fulfilled the criteria for good responders, while 22.1% were moderate responders. Change in passive reaction pattern coping style differed significantly between good responders and non-responders following PR (p < 0.001). Moreover, within the groups, changes in coping styles after PR occurred among the good responders, whereas the majority of moderate responders' and non-responders' coping styles were not significantly influenced by PR. Good responders decreased their passive reaction pattern coping style in contrast to non-responders after PR. In general, PR did not change the coping among moderate and non-responders. Further research is warranted to determine whether including interventions targeting coping styles may modify coping behaviour of COPD patients, as well as improvement in exercise tolerance or health status after PR. Copyright © 2015 Elsevier Ltd. All rights reserved.

Associations of muscular fitness with psychological positive health, health complaints, and health risk behaviors in Spanish children and adolescents.

PubMed

Padilla-Moledo, Carmen; Ruiz, Jonatan R; Ortega, Francisco B; Mora, Jesús; Castro-Piñero, José

2012-01-01

We examined the association of muscular fitness with psychological positive health, health complaints, and health risk behaviors in 690 (n = 322 girls) Spanish children and adolescents (6-17.9 years old). Lower body muscular strength was assessed with the standing long jump test, and upper-body muscular strength was assessed with the throw basketball test. A muscular fitness index was computed by means of standardized measures of both tests. Psychosocial positive health, health complaints, and health risk behaviors were self-reported using the items of the Health Behavior in School-aged Children questionnaire. Psychological positive health indicators included the following: perceived health status, life satisfaction, quality of family relationships, quality of peer relationships, and academic performance. We computed a health complaints index from 8 registered symptoms: headache, stomach ache, backache, feeling low, irritability or bad temper, feeling nervous, difficulties getting to sleep, and feeling dizzy. The health risk behavior indicators studied included tobacco use, alcohol use, and getting drunk. Children and adolescents with low muscular fitness (below the mean) had a higher odds ratio (OR) of reporting fair (vs. excellent) perceived health status, low life satisfaction (vs. very happy), low quality of family relationships (vs. very good), and low academic performance (vs. very good). Likewise, children and adolescents having low muscular fitness had a significantly higher OR of reporting smoking tobacco sometimes (vs. never), drinking alcohol sometimes (vs. never), and getting drunk sometimes (vs. never). The results of this study suggest a link between muscular fitness and psychological positive health and health risk behavior indicators in children and adolescents.

Extensive validation of the pain disability index in 3 groups of patients with musculoskeletal pain.

PubMed

Soer, Remko; Köke, Albère J A; Vroomen, Patrick C A J; Stegeman, Patrick; Smeets, Rob J E M; Coppes, Maarten H; Reneman, Michiel F

2013-04-20

A cross-sectional study design was performed. To validate the pain disability index (PDI) extensively in 3 groups of patients with musculoskeletal pain. The PDI is a widely used and studied instrument for disability related to various pain syndromes, although there is conflicting evidence concerning factor structure, test-retest reliability, and missing items. Additionally, an official translation of the Dutch language version has never been performed. For reliability, internal consistency, factor structure, test-retest reliability and measurement error were calculated. Validity was tested with hypothesized correlations with pain intensity, kinesiophobia, Rand-36 subscales, Depression, Roland-Morris Disability Questionnaire, Quality of Life, and Work Status. Structural validity was tested with independent backward translation and approval from the original authors. One hundred seventy-eight patients with acute back pain, 425 patients with chronic low back pain and 365 with widespread pain were included. Internal consistency of the PDI was good. One factor was identified with factor analyses. Test-retest reliability was good for the PDI (intraclass correlation coefficient, 0.76). Standard error of measurement was 6.5 points and smallest detectable change was 17.9 points. Little correlations between the PDI were observed with kinesiophobia and depression, fair correlations with pain intensity, work status, and vitality and moderate correlations with the Rand-36 subscales and the Roland-Morris Disability Questionnaire. The PDI-Dutch language version is internally consistent as a 1-factor structure, and test-retest reliable. Missing items seem high in sexual and professional items. Using the PDI as a 2-factor questionnaire has no additional value and is unreliable.

Good Neighbor Forestry Act

THOMAS, 111th Congress

Sen. Barrasso, John [R-WY

2009-05-21

Senate - 10/29/2009 Committee on Energy and Natural Resources Subcommittee on Public Lands and Forests. Hearings held. With printed Hearing: S.Hrg. 111-223. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Good Neighbor Forestry Act

THOMAS, 112th Congress

Sen. Barrasso, John [R-WY

2011-02-17

Senate - 05/25/2011 Committee on Energy and Natural Resources Subcommittee on Public Lands and Forests. Hearings held. With printed Hearing: S.Hrg. 112-131. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Screening of Cognitive Impairment in Schizophrenia: Reliability, Sensitivity, and Specificity of the Repeatable Battery for the Assessment of Neuropsychological Status in a Spanish Sample.

PubMed

De la Torre, Gabriel G; Perez, Maria J; Ramallo, Miguel A; Randolph, Christopher; González-Villegas, Macarena Bernal

2016-04-01

In recent years, a number of studies focusing on the evaluation of neuropsychological deficits in individuals with schizophrenia have shown deficits that include several cognitive functions. Attention deficits as well as memory or executive function deficits are common in this kind of disorder together with sustained attention problems, working memory deficiencies, and problem-solving difficulties, among many others. Currently, the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is gaining special importance in the evaluation of the cognitive deficits associated with schizophrenia. In this article, we describe an RBANS screening in a sample of 88 Spanish patients diagnosed with schizophrenia. We also aimed to check the battery's reliability, sensitivity, and specificity in the studied sample. We performed a comparative study with 88 healthy participants. The results showed a reliability index value of α = .795 and an item value of α = .762. For total test reliability, we obtained an index value of α = .761 and an item value of α = .762. Sensitivity score was 87.5% and specificity 86.4%. RBANS obtained good reliability, sensitivity, and specificity scores and represents a good screening tool in detecting cognitive deficits associated with schizophrenia. © The Author(s) 2015.

Equilibrium Passive Sampling of POP in Lipid-Rich and Lean Fish Tissue: Quality Control Using Performance Reference Compounds.

PubMed

Rusina, Tatsiana P; Carlsson, Pernilla; Vrana, Branislav; Smedes, Foppe

2017-10-03

Passive sampling is widely used to measure levels of contaminants in various environmental matrices, including fish tissue. Equilibrium passive sampling (EPS) of persistent organic pollutants (POP) in fish tissue has been hitherto limited to application in lipid-rich tissue. We tested several exposure methods to extend EPS applicability to lean tissue. Thin-film polydimethylsiloxane (PDMS) passive samplers were exposed statically to intact fillet and fish homogenate and dynamically by rolling with cut fillet cubes. The release of performance reference compounds (PRC) dosed to passive samplers prior to exposure was used to monitor the exchange process. The sampler-tissue exchange was isotropic, and PRC were shown to be good indicators of sampler-tissue equilibration status. The dynamic exposures demonstrated equilibrium attainment in less than 2 days for all three tested fish species, including lean fish containing 1% lipid. Lipid-based concentrations derived from EPS were in good agreement with lipid-normalized concentrations obtained using conventional solvent extraction. The developed in-tissue EPS method is robust and has potential for application in chemical monitoring of biota and bioaccumulation studies.

Classification of Company Performance using Weighted Probabilistic Neural Network

NASA Astrophysics Data System (ADS)

Yasin, Hasbi; Waridi Basyiruddin Arifin, Adi; Warsito, Budi

2018-05-01

Classification of company performance can be judged by looking at its financial status, whether good or bad state. Classification of company performance can be achieved by some approach, either parametric or non-parametric. Neural Network is one of non-parametric methods. One of Artificial Neural Network (ANN) models is Probabilistic Neural Network (PNN). PNN consists of four layers, i.e. input layer, pattern layer, addition layer, and output layer. The distance function used is the euclidean distance and each class share the same values as their weights. In this study used PNN that has been modified on the weighting process between the pattern layer and the addition layer by involving the calculation of the mahalanobis distance. This model is called the Weighted Probabilistic Neural Network (WPNN). The results show that the company's performance modeling with the WPNN model has a very high accuracy that reaches 100%.

Asthma-specific health-related quality of life of people in Great Britain: A national survey.

PubMed

Upton, Jane; Lewis, Carine; Humphreys, Emily; Price, David; Walker, Samantha

2016-11-01

Although the ultimate goal of asthma treatment is to improve asthma-specific Health-Related Quality-Of-Life (HRQOL), in the UK population this is insufficiently studied. National asthma-specific HRQOL data is needed to inform strategies to address this condition. To benchmark asthma-specific HRQOL in a national survey of adults with asthma, and explore differences in this measure within subsections of the population. We analysed answers to the Marks Asthma Quality-of-Life Questionnaire (AQLQ-M) from a representative sample of 658 adults with asthma. Respondents answered asthma-specific questions to assess control, previous hospital admissions, asthma attacks and an indicator of severity. Higher scores indicate poorer HRQOL (maximum = 60). The highest quintile formed a subgroup 'Poor HRQOL'. Data were weighted to correct for any biases caused by differential non-response. Chi-square analyses were used to determine differences between good and poor quality of life and regression analyses performed to determine what factors are associated with poor HRQOL. The response rate was 49%. AQLQ-M median (IQR) scores were 5 (2-13) for the total sample (poor HRQOL = 21, good HRQOL = 3). Significant differences between good and poor HRQOL were observed in smoking status, SES, employment status and co-morbidities, but no differences were found between age groups. Those with poorly controlled asthma were significantly more likely to have poor HRQOL, ≥1 breathing related hospital admission or ≥1 asthma attack. This article provides benchmarking data on asthma-specific HRQOL. Improved strategies are needed to target interventions towards people experiencing poor HRQOL.

Looks good but feels bad: factors that contribute to poor results after total knee arthroplasty.

PubMed

Fisher, David A; Dierckman, Brian; Watts, Melanie R; Davis, Kenneth

2007-09-01

The purpose of this study was to evaluate patient factors that might contribute to a poor result after total knee arthroplasty (TKA). Seventy-one knees (6.9%) of 1024 primary TKAs were identified at 1 year follow-up as having a poor result because of either stiffness or pain. Radiographs demonstrated well-fixed and aligned implants. This group was compared with a matched control group of 148 nonpainful or stiff TKAs, with similar range of motion preoperatively. Logistic regression analysis was performed to compare age, sex, body mass index, comorbidities, previous surgeries, preoperative narcotic use, tobacco or alcohol use, work status, insurance status, and any history of depression. Factors that were significantly associated with a stiff or painful outcome included female sex, higher body mass index, previous knee surgery, patients on disability, diabetes mellitus, pulmonary disease, and depression.

Influence of sleep disturbance, fatigue, vitality on oral health and academic performance in indian dental students

PubMed Central

ASAWA, KAILASH; SEN, NANDINI; BHAT, NAGESH; TAK, MRIDULA; SULTANE, PRATIBHA; MANDAL, ARITRA

2017-01-01

Background Oral health and academic performance are important contributing factors for a student’s professional life. Countless factors affect both, among which sleep, vitality and fatigue are less explored areas that also have a strong impact. Objective The objective of the study was to assess the association of sleep disturbances, fatigue and vitality with self reported oral health status, oral hygiene habits and academic performance of dental students of Udaipur. Methods A descriptive cross-sectional study was conducted among undergraduate and postgraduate dental students of Udaipur. Self-administered structured questionnaire was used to assess the psychological factors, vitality, sleep quality, fatigue, self reported oral health status, habits and academic performance. Analysis of variance and stepwise multiple linear regression were utilized for statistical analysis with 95% confidence level and 5% level of significance. Results Of the 230 participants, 180 (78.3%) were undergraduates and 50 (21.7%) were postgraduates. Among them, females showed higher scores in disturbed sleep index (2.69±2.14) as compared to males (2.45±1.91). Respondents who had “Poor” dental health, scored more in disturbed sleep index (3.15±1.64) and fatigue scale (20.00±4.88). Subjects who flossed “everyday”, were found to have good sleep and more energy (p=0.01) and those who assessed themselves as excellent students scored more in the Vitality Scale (p=0.01) and less in the Sleep index (p=0.01). Conclusion The present study confirms that disturbed sleep, aliveness and fatigue, all are interlinked with each other and are imperative factors having the potential to alter the oral health status, habits and academics of dental students. PMID:28781530

SCI Survey to Determine Pressure Ulcer Vulnerability in the Outpatient Population

DTIC Science & Technology

2013-10-01

of transportation, mobility, caregiver status, bowel and bladder continence, level of education , mental health status or illicit drug use. Key...coded a number of variables. For example, we created a new variable: “Good Nutrition ”, reflecting nutritional status using the recorded albumin and...no difference in age, level of education or marital status and presence of PrUs. Violence as the etiology of SCI was more common among those with ≥ 1

The "one-out, all-out" principle entails the risk of imposing unnecessary restoration costs: a study case in two Mediterranean coastal lakes.

PubMed

Prato, S; La Valle, P; De Luca, E; Lattanzi, L; Migliore, G; Morgana, J G; Munari, C; Nicoletti, L; Izzo, G; Mistri, M

2014-03-15

The Water Framework Directive uses the "one-out, all-out" principle in assessing water bodies (i.e., the worst status of the elements used in the assessment determines the final status of the water body). In this study, we assessed the ecological status of two coastal lakes in Italy. Indices for all biological quality elements used in transitional waters from the Italian legislation and other European countries were employed and compared. Based on our analyses, the two lakes require restoration, despite the lush harbor seagrass beds, articulated macrobenthic communities and rich fish fauna. The "one-out, all-out" principle tends to inflate Type I errors, i.e., concludes that a water body is below the "good" status even if the water body actually has a "good" status. This may cause additional restoration costs where they are not necessarily needed. The results from this study strongly support the need for alternative approaches to the "one-out, all-out" principle. Copyright © 2014 Elsevier Ltd. All rights reserved.

Knowledge, attitude, and practice regarding dengue virus infection among inhabitants of Aceh, Indonesia: a cross-sectional study.

PubMed

Harapan, Harapan; Rajamoorthy, Yogambigai; Anwar, Samsul; Bustamam, Aslam; Radiansyah, Arsil; Angraini, Pradiba; Fasli, Riny; Salwiyadi, Salwiyadi; Bastian, Reza Akbar; Oktiviyari, Ade; Akmal, Imaduddin; Iqbalamin, Muhammad; Adil, Jamalul; Henrizal, Fenni; Darmayanti, Darmayanti; Pratama, Rovy; Setiawan, Abdul Malik; Mudatsir, Mudatsir; Hadisoemarto, Panji Fortuna; Dhimal, Mandira Lamichhane; Kuch, Ulrich; Groneberg, David Alexander; Imrie, Allison; Dhimal, Meghnath; Müller, Ruth

2018-02-27

The Indonesian region of Aceh was the area most severely affected by the earthquake and tsunami of 26 December 2004. Department of Health data reveal an upward trend of dengue cases in Aceh since the events of the tsunami. Despite the increasing incidence of dengue in the region, there is limited understanding of dengue among the general population of Aceh. The aim of this study was to assess the knowledge, attitude, and practice (KAP) regarding dengue among the people of Aceh, Indonesia in order to design intervention strategies for an effective dengue prevention program. A community-based cross-sectional study was conducted in Aceh between November 2014 and March 2015 with a total of 609 participants living in seven regencies and two municipalities. Information on the socio-demographic characteristics of participants and their KAP regarding dengue was collected using a pre-tested structured questionnaire. The KAP status (good vs. poor) of participants with different socio-demographic characteristics was compared using Chi Square-test, ANOVA or Fisher's exact test as appropriate. Logistic regression analysis was used to determine the predictors of each KAP domain. We found that 45% of participants had good knowledge regarding dengue and only 32% had good attitudes and good dengue preventive practices. There was a significant positive correlation between knowledge and attitudes, knowledge and practice, and attitudes and practice. In addition, people who had good knowledge were 2.7 times more likely to have good attitudes, and people who had good attitudes were 2.2 times more likely to have good practices regarding dengue. The level of education, occupation, marital status, monthly income, socioeconomic status (SES) and living in the city were associated with the knowledge level. Occupation, SES, and having experienced dengue fever were associated with attitudes. Education, occupation, SES and type of residence were associated with preventive practices. Our study suggests that dengue prevention programs are required to increase KAP levels regarding dengue in the communities of Aceh.

Brand Name, Store Image, and Country-of-Origin: The Effects on Consumers' Perception of Quality and Price.

ERIC Educational Resources Information Center

King, Margaret C. A.

1993-01-01

A review of literature indicated that, with regard to brand labels, consumers' perception of price, but not of quality, was affected. Consumers expected to pay more for goods bought in a higher status store and rated imported goods as being more expensive than domestically produced goods. Products from developing countries received lower quality…

Study of new anticoincidence systems design

NASA Astrophysics Data System (ADS)

Chabaud, J.; Laurent, P.; Baronick, J.-P.; Oger, R.; Prévôt, G.

2012-12-01

The scientific performances of future hard X-ray missions will necessitate a very low detector background level. This will imply thorough background simulations, and efficient background rejection systems. It necessitates also a very good knowledge of the detectors to be shielded. We got experience on these activities by conceiving and optimizing the active and passive background rejection system of the Simbol-X and IXO/HXI missions. Considering that this work may naturally be extended to other X-ray missions, we have initiated with CNES, in 2010, a R&T project on the study of background rejection systems, whose status will be presented in this paper.

Helmet-Induced Occipital Neuralgia in a Military Aviator.

PubMed

Chalela, Julio A

2018-04-01

Headaches among military personnel are very common and headgear wear is a frequently identified culprit. Helmet wear may cause migrainous headaches, external compression headache, other primary cranial neuralgias, and occipital neuralgia. The clinical features and the response to treatment allow distinction between the different types of headaches. Headaches among aviators are particularly concerning as they may act as distractors while flying and the treatment options are often incompatible with flying status. A 24-yr-old door gunner presented with suboccipital pain associated with the wear of his helmet. He described the pain as a paroxysmal stabbing sensation coming in waves. The physical exam and history supported the diagnosis of primary occipital neuralgia. Systemic pharmacological options were discussed with the soldier, but rejected due to his need to remain in flying status. An occipital nerve block was performed with good clinical results, supporting the diagnosis of occipital neuralgia and allowing him to continue as mission qualified. Occipital neuralgia can be induced by helmet wear in military personnel. Occipital nerve block can be performed in the deployed setting, allowing the service member to remain mission capable and sparing him/her from systemic side effects.Chalela JA. Helmet-induced occipital neuralgia in a military aviator. Aerosp Med Hum Perform. 2018; 89(4):409-410.

Relationship between health literacy, health information access, health behavior, and health status in Japanese people.

PubMed

Suka, Machi; Odajima, Takeshi; Okamoto, Masako; Sumitani, Masahiko; Igarashi, Ataru; Ishikawa, Hirono; Kusama, Makiko; Yamamoto, Michiko; Nakayama, Takeo; Sugimori, Hiroki

2015-05-01

To examine the relationship between health literacy (HL), health information access, health behavior, and health status in Japanese people. A questionnaire survey was conducted at six healthcare facilities in Japan. Eligible respondents aged 20-64 years (n=1218) were included. Path analysis with structural equation modeling was performed to test the hypothesis model linking HL to health information access, health behavior, and health status. The acceptable fitting model indicated that the pathways linking HL to health status consisted of two indirect paths; one intermediated by health information access and another intermediated by health behavior. Those with higher HL as measured by the 14-item Health Literacy Scale (HLS-14) were significantly more likely to get sufficient health information from multiple sources, less likely to have risky habits of smoking, regular drinking, and lack of exercise, and in turn, more likely to report good self-rated health. HL was significantly associated with health information access and health behavior in Japanese people. HL may play a key role in health promotion, even in highly educated countries like Japan. In order to enhance the effects of health promotion interventions, health professionals should aim at raising HL levels of their target population groups. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

An approach to derive groundwater and stream threshold values for total nitrogen and ensure good ecological status of associated aquatic ecosystems - example from a coastal catchment to a vulnerable Danish estuary.

NASA Astrophysics Data System (ADS)

Hinsby, Klaus; Markager, Stiig; Kronvang, Brian; Windolf, Jørgen; Sonnenborg, Torben; Sørensen, Lærke

2015-04-01

Nitrate, which typically makes up the major part (~>90%) of dissolved inorganic nitrogen in groundwater and surface water, is the most frequent pollutant responsible for European groundwater bodies failing to meet the good status objectives of the European Water Framework Directive generally when comparing groundwater monitoring data with the nitrate quality standard of the Groundwater Directive (50 mg/l = the WHO drinking water standard). Still, while more than 50 % of the European surface water bodies do not meet the objective of good ecological status "only" 25 % of groundwater bodies do not meet the objective of good chemical status according to the river basin management plans reported by the EU member states. However, based on a study on interactions between groundwater, streams and a Danish estuary we argue that nitrate threshold values for aerobic groundwater often need to be significantly below the nitrate quality standard to ensure good ecological status of associated surface water bodies, and hence that the chemical status of European groundwater is worse than indicated by the present assessments. Here we suggest a methodology for derivation of groundwater and stream threshold values for total nitrogen ("nitrate") in a coastal catchment based on assessment of maximum acceptable nitrogen loadings (thresholds) to the associated vulnerable estuary. The applied method use existing information on agricultural practices and point source emissions in the catchment, groundwater, stream quantity and quality monitoring data that all feed data to an integrated groundwater and surface water modelling tool enabling us to conduct an assessment of total nitrogen loads and threshold concentrations derived to ensure/restore good ecological status of the investigated estuary. For the catchment to the Horsens estuary in Denmark we estimate the stream and groundwater thresholds for total nitrogen to be about 13 and 27 mg/l (~ 12 and 25 mg/l of nitrate). The shown example of deriving nitrogen threshold concentrations is for groundwater and streams in a coastal catchment discharging to a vulnerable estuary in Denmark, but the principles may be applied to large river basins with sub-catchments in several countries such as e.g. the Danube or the Rhine. In this case the relevant countries need to collaborate on derivation of nitrogen thresholds based on e.g. maximum acceptable nitrogen loadings to the Black Sea / the North Sea, and finally agree on thresholds for different parts of the river basin. Phosphorus is another nutrient which frequently results in or contributes to the eutrophication of surface waters. The transport and retention processes of total phosphorus (TP) is more complex than for nitrate (or alternatively total N), and presently we are able to establish TP thresholds for streams but not for groundwater. Derivation of TP thresholds is covered in an accompanying paper by Kronvang et al.

Finding the Key to a Good Theatre Program: Some Comments on the ETA Survey.

ERIC Educational Resources Information Center

Hobgood, Burnet M.

1991-01-01

Offers some comments on the Educational Theatre Association's survey on the status of theater in U.S. high schools in the same issue of this journal. Discusses finding the key factors responsible for good school theater. (PRA)

Patient Compliance with Surveillance Following Elective Endovascular Aneurysm Repair

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

Godfrey, Anthony D., E-mail: deangodfrey@yahoo.co.uk; Morbi, Abigail H. M., E-mail: a.morbi@soton.ac.uk; Nordon, Ian M., E-mail: ian.nordon@uhs.nhs.uk

PurposeIntegral to maintaining good outcomes post-endovascular aneurysm repair (EVAR) is a robust surveillance protocol. A significant proportion of patients fail to comply with surveillance, exposing themselves to complications. We examine EVAR surveillance in Wessex (UK), exploring factors that may predict poor compliance.MethodsRetrospective analysis of 179 consecutive elective EVAR cases [2008–2013] was performed. 167 patients were male, with the age range of 50–95. Surveillance was conducted centrally (tertiary referral trauma centre) and at four spoke units. Surveillance compliance and predictors of non-compliance including age, gender, co-morbid status, residential location and socioeconomic status were analysed for univariate significance.ResultsFifty patients (27.9 %) were non-compliantmore » with surveillance; 14 (8.1 %) had no imaging post-EVAR. At 1 year, 56.1 % (of 123 patients) were compliant. At years 2 and 3, 41.5 and 41.2 % (of 65 and 34 patients, respectively) were compliant. Four years post-EVAR, only one of eight attended surveillance (12.5 %). There were no statistically significant differences in age (p = 0.77), co-morbid status or gender (p = 0.64). Distance to central unit (p = 0.67) and surveillance site (p = 0.56) was non-significant. While there was a trend towards compliance in upper-middle-class socioeconomic groups (ABC1 vs. C1C2D), correlating with >50 % of non-compliant patients living within <10 mile radius of the central unit, overall predictive value was not significant (p = 0.82).ConclusionsCompliance with surveillance post-EVAR is poor. No independent predictor of non-compliance has been confirmed, but socioeconomic status appears to be relevant. There is a worrying drop-off in attendance beyond the first year. This study highlights a problem that needs to be addressed urgently, if we are to maintain good outcomes post-EVAR.« less

Preoperative Prediction of Node-Negative Disease After Neoadjuvant Chemotherapy in Patients Presenting with Node-Negative or Node-Positive Breast Cancer.

PubMed

Murphy, Brittany L; L Hoskin, Tanya; Heins, Courtney Day N; Habermann, Elizabeth B; Boughey, Judy C

2017-09-01

Axillary node status after neoadjuvant chemotherapy (NAC) influences the axillary surgical staging procedure as well as recommendations regarding reconstruction and radiation. Our aim was to construct a clinical preoperative prediction model to identify the likelihood of patients being node negative after NAC. Using the National Cancer Database (NCDB) from January 2010 to December 2012, we identified cT1-T4c, N0-N3 breast cancer patients treated with NAC. The effects of patient and tumor factors on pathologic node status were assessed by multivariable logistic regression separately for clinically node negative (cN0) and clinically node positive (cN+) disease, and two models were constructed. Model performance was validated in a cohort of NAC patients treated at our institution (January 2013-July 2016), and model discrimination was assessed by estimating the area under the curve (AUC). Of 16,153 NCDB patients, 6659 (41%) were cN0 and 9494 (59%) were cN+. Factors associated with pathologic nodal status and included in the models were patient age, tumor grade, biologic subtype, histology, clinical tumor category, and, in cN+ patients only, clinical nodal category. The validation dataset included 194 cN0 and 180 cN+ patients. The cN0 model demonstrated good discrimination, with an AUC of 0.73 (95% confidence interval [CI] 0.72-0.74) in the NCDB and 0.77 (95% CI 0.68-0.85) in the external validation, while the cN+ patient model AUC was 0.71 (95% CI 0.70-0.72) in the NCDB and 0.74 (95% CI 0.67-0.82) in the external validation. We constructed two models that showed good discrimination for predicting ypN0 status following NAC in cN0 and cN+ patients. These clinically useful models can guide surgical planning after NAC.

A bill to provide for a good faith exemption from suspicious activity reporting requirements, and for other purposes.

THOMAS, 112th Congress

Sen. Paul, Rand [R-KY

2011-05-25

Senate - 05/25/2011 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Do repeated assessments of performance status improve predictions for risk of death among patients with cancer? A population-based cohort study.

PubMed

Su, Jiandong; Barbera, Lisa; Sutradhar, Rinku

2015-06-01

Prior work has utilized longitudinal information on performance status to demonstrate its association with risk of death among cancer patients; however, no study has assessed whether such longitudinal information improves the predictions for risk of death. To examine whether the use of repeated performance status assessments improve predictions for risk of death compared to using only performance status assessment at the time of cancer diagnosis. This was a population-based longitudinal study of adult outpatients who had a cancer diagnosis and had at least one assessment of performance status. To account for each patient's changing performance status over time, we implemented a Cox model with a time-varying covariate for performance status. This model was compared to a Cox model using only a time-fixed (baseline) covariate for performance status. The regression coefficients of each model were derived based on a randomly selected 60% of patients, and then, the predictive ability of each model was assessed via concordance probabilities when applied to the remaining 40% of patients. Our study consisted of 15,487 cancer patients with over 53,000 performance status assessments. The utilization of repeated performance status assessments improved predictions for risk of death compared to using only the performance status assessment taken at diagnosis. When studying the hazard of death among patients with cancer, if available, researchers should incorporate changing information on performance status scores, instead of simply baseline information on performance status. © The Author(s) 2015.

Understanding low temperature oxidation activity of nanoarray-based monolithic catalysts: from performance observation to structural and chemical insights

DOE PAGES

Du, Shoucheng; Tang, Wenxiang; Guo, Yanbing; ...

2016-12-30

Monolithic catalysts have been widely used in automotive, chemical, and energy relevant industries. Nano-array based monolithic catalysts have been developed, demonstrating high catalyst utilization efficiency and good thermal/mechanical robustness. Compared with the conventional wash-coat based monolithic catalysts, they have shown advances in precise and optimum microstructure control and feasibility in correlating materials structure with properties. Recently, the nano-array based monolithic catalysts have been studied for low temperature oxidation of automotive engine exhaust and exhibited interesting and promising catalytic activities. Here, this review focuses on discussing the key catalyst structural parameters that affect the catalytic performance from the following aspects, (1)more » geometric shape and crystal planes, (2) guest atom doping and defects, (3) array size and size-assisted active species loading, and (4) the synergy effect of metal oxide in composite nano-arrays. Prior to the discussion, an overview of the current status of synthesis and development of the nano-array based monolithic catalysts is introduced. The performance of these materials in low temperature simulated engine exhaust oxidation is also demonstrated. Finally, we hope this review will elucidate the science and chemistry behind the good oxidation performance of the nanoarray- based monolithic catalysts, and serve as a timely and useful research guide for rational design and further improvement of the nano-array based monolithic catalysts for automobile emission control.« less

Understanding low temperature oxidation activity of nanoarray-based monolithic catalysts: from performance observation to structural and chemical insights

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

Du, Shoucheng; Tang, Wenxiang; Guo, Yanbing

Monolithic catalysts have been widely used in automotive, chemical, and energy relevant industries. Nano-array based monolithic catalysts have been developed, demonstrating high catalyst utilization efficiency and good thermal/mechanical robustness. Compared with the conventional wash-coat based monolithic catalysts, they have shown advances in precise and optimum microstructure control and feasibility in correlating materials structure with properties. Recently, the nano-array based monolithic catalysts have been studied for low temperature oxidation of automotive engine exhaust and exhibited interesting and promising catalytic activities. Here, this review focuses on discussing the key catalyst structural parameters that affect the catalytic performance from the following aspects, (1)more » geometric shape and crystal planes, (2) guest atom doping and defects, (3) array size and size-assisted active species loading, and (4) the synergy effect of metal oxide in composite nano-arrays. Prior to the discussion, an overview of the current status of synthesis and development of the nano-array based monolithic catalysts is introduced. The performance of these materials in low temperature simulated engine exhaust oxidation is also demonstrated. Finally, we hope this review will elucidate the science and chemistry behind the good oxidation performance of the nanoarray- based monolithic catalysts, and serve as a timely and useful research guide for rational design and further improvement of the nano-array based monolithic catalysts for automobile emission control.« less

Is it worth protecting groundwater from diffuse pollution with agri-environmental schemes? A hydro-economic modeling approach.

PubMed

Hérivaux, Cécile; Orban, Philippe; Brouyère, Serge

2013-10-15

In Europe, 30% of groundwater bodies are considered to be at risk of not achieving the Water Framework Directive (WFD) 'good status' objective by 2015, and 45% are in doubt of doing so. Diffuse agricultural pollution is one of the main pressures affecting groundwater bodies. To tackle this problem, the WFD requires Member States to design and implement cost-effective programs of measures to achieve the 'good status' objective by 2027 at the latest. Hitherto, action plans have mainly consisted of promoting the adoption of Agri-Environmental Schemes (AES). This raises a number of questions concerning the effectiveness of such schemes for improving groundwater status, and the economic implications of their implementation. We propose a hydro-economic model that combines a hydrogeological model to simulate groundwater quality evolution with agronomic and economic components to assess the expected costs, effectiveness, and benefits of AES implementation. This hydro-economic model can be used to identify cost-effective AES combinations at groundwater-body scale and to show the benefits to be expected from the resulting improvement in groundwater quality. The model is applied here to a rural area encompassing the Hesbaye aquifer, a large chalk aquifer which supplies about 230,000 inhabitants in the city of Liege (Belgium) and is severely contaminated by agricultural nitrates. We show that the time frame within which improvements in the Hesbaye groundwater quality can be expected may be much longer than that required by the WFD. Current WFD programs based on AES may be inappropriate for achieving the 'good status' objective in the most productive agricultural areas, in particular because these schemes are insufficiently attractive. Achieving 'good status' by 2027 would demand a substantial change in the design of AES, involving costs that may not be offset by benefits in the case of chalk aquifers with long renewal times. Copyright © 2013 Elsevier Ltd. All rights reserved.

The relationship between seven health practices and oral health status in community-dwelling elderly Thai.

PubMed

Samnieng, Patcharaphol; Ueno, Masayuki; Zaitsu, Takashi; Shinada, Kayoko; Wright, Fredrick A C; Kawaguchi, Yoko

2013-12-01

This study aims to analyse the relationship between seven health practices, oral health behaviors, and oral health status in community dwelling elderly Thai. The subjects were 612 elderly people (mean age = 68.8 ± 5.9 years). Questionnaires survey about sociodemographics, self-reported seven health practices and oral health behaviors were conducted by trained interviewers. Oral examinations investigated the number of teeth present, decayed teeth, periodontal status and functional tooth units (FTUs). Oral malodor was assessed by Organoleptic Test, and unstimulated saliva was collected for 5 min. Five health practices (smoking, drinking, physical activity, breakfast and weight maintenance) were significantly related with oral health behaviors. ancova analysis demonstrated the following significant associations: (i) smoking behavior with number of teeth present, number of FTUs, decayed teeth, periodontal disease, oral malodor and salivary flow rate, (ii) drinking alcohol behavior with number of teeth present, number of FTUs, periodontal disease, oral malodor and salivary flow rate, (iii) eating breakfast behavior with periodontal disease, oral malodor and salivary flow rate, (iv) eating between-meal snack with number of teeth present, number of FTUs, decayed teeth and periodontal disease, (v) maintaining weight with number of teeth present, number of FTUs, periodontal disease and oral malodor, (vi) sleeping with number of teeth present, number of FTUs, periodontal disease, oral malodor and salivary flow rate, (vii) physical activity with periodontal disease and salivary flow rate. Good health practices were related with good oral health behaviors. Moreover, general health practices were associated with the clinical oral health status such as number of teeth present, decayed teeth, FTUs, periodontal disease, oral malodor and salivary flow rate. The elderly with good general health practices were considered to have good oral health status. Improving general health habits are suggested to lead to better oral health for the elderly, and vice versa. © 2012 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

Use of herd information for predicting Salmonella status in pig herds.

PubMed

Baptista, F M; Alban, L; Nielsen, L R; Domingos, I; Pomba, C; Almeida, V

2010-11-01

Salmonella surveillance-and-control programs in pigs are highly resource demanding, so alternative cost-effective approaches are desirable. The aim of this study was to develop and evaluate a tool for predicting the Salmonella test status in pig herds based on herd information collected from 108 industrial farrow-to-finish pig herds in Portugal. A questionnaire including known risk factors for Salmonella was used. A factor analysis model was developed to identify relevant factors that were then tested for association with Salmonella status. Three factors were identified and labelled: general biosecurity (factor 1), herd size (factor 2) and sanitary gap implementation (factor 3). Based on the loadings in factor 1 and factor 3, herds were classified according to their biosecurity practices. In total, 59% of the herds had a good level of biosecurity (interpreted as a loading below zero in factor 1) and 37% of the farms had good biosecurity and implemented sanitary gap (loading below zero in factor 1 and loading above zero in factor 3). This implied that they, among other things, implemented preventive measures for visitors and workers entering the herd, controlled biological vectors, had hygiene procedures in place, water quality assessment, and sanitary gap in the fattening and growing sections. In total, 50 herds were tested for Salmonella. Logistic regression analysis showed that factor 1 was significantly associated with Salmonella test status (P = 0.04). Herds with poor biosecurity had a higher probability of testing Salmonella positive compared with herds with good biosecurity. This study shows the potential for using herd information to classify herds according to their Salmonella status in the absence of good testing options. The method might be used as a potentially cost-effective tool for future development of risk-based approaches to surveillance, targeting interventions to high-risk herds or differentiating sampling strategies in herds with different levels of infection. © 2010 Blackwell Verlag GmbH.

The Effect of Childhood Health Status on Adult Health in China.

PubMed

Wang, Qing; Zhang, Huyang; Rizzo, John A; Fang, Hai

2018-01-26

Childhood health in China was poor in the 1950s and 1960s because of limited nutrition. In the last three decades, China has distinguished itself through its tremendous economic growth and improvements in health and nutrition. However, prior to such growth, access to good nutrition was more variable, with potentially important implications, not only for childhood health, but also for adult health, because of its long-term effects lasting into adulthood. To shed light on these issues, this study examined the long-run association between childhood health and adult health outcomes among a middle-aged Chinese population and addresses the endogeneity of childhood health. A nationwide database from the 2011 China Health and Retirement Longitudinal Study (CHARLS) was employed. Three adult health outcomes variables were used: self-reported health status, cognition, and physical function. The local variation in grain production in the subjects' fetal period and the first 24 months following birth was employed as an instrument for childhood health in order to correct for its endogeneity. Childhood health recalled by the respondents was positively and significantly associated with their adult health outcomes in terms of self-reported health status, cognition, and physical function in single-equation estimates that did not correct for the endogeneity of childhood health. A good childhood health status increased the probabilities of good adult health, good adult cognitive function, and good adult physical function by 16% (95% CI: 13-18%), 13% (95% CI: 10-15%), and 14% (95% CI: 12-17%), respectively. After correcting for endogeneity, the estimated effects of good childhood health were consistent but stronger. We also studied the male and female populations separately, finding that the positive effects of childhood health on adult health were larger for males. In China, childhood health significantly affects adult health. This suggests that early interventions to promote childhood health will have long-term benefits in China and that health-care policies should consider their long-term impacts over the life cycle in addition to their effects on specific age groups.

The Effect of Childhood Health Status on Adult Health in China

PubMed Central

Wang, Qing; Zhang, Huyang; Rizzo, John A.; Fang, Hai

2018-01-01

Childhood health in China was poor in the 1950s and 1960s because of limited nutrition. In the last three decades, China has distinguished itself through its tremendous economic growth and improvements in health and nutrition. However, prior to such growth, access to good nutrition was more variable, with potentially important implications, not only for childhood health, but also for adult health, because of its long-term effects lasting into adulthood. To shed light on these issues, this study examined the long-run association between childhood health and adult health outcomes among a middle-aged Chinese population and addresses the endogeneity of childhood health. A nationwide database from the 2011 China Health and Retirement Longitudinal Study (CHARLS) was employed. Three adult health outcomes variables were used: self-reported health status, cognition, and physical function. The local variation in grain production in the subjects’ fetal period and the first 24 months following birth was employed as an instrument for childhood health in order to correct for its endogeneity. Childhood health recalled by the respondents was positively and significantly associated with their adult health outcomes in terms of self-reported health status, cognition, and physical function in single-equation estimates that did not correct for the endogeneity of childhood health. A good childhood health status increased the probabilities of good adult health, good adult cognitive function, and good adult physical function by 16% (95% CI: 13–18%), 13% (95% CI: 10–15%), and 14% (95% CI: 12–17%), respectively. After correcting for endogeneity, the estimated effects of good childhood health were consistent but stronger. We also studied the male and female populations separately, finding that the positive effects of childhood health on adult health were larger for males. In China, childhood health significantly affects adult health. This suggests that early interventions to promote childhood health will have long-term benefits in China and that health-care policies should consider their long-term impacts over the life cycle in addition to their effects on specific age groups. PMID:29373554

Linking catchment characteristics and water chemistry with the ecological status of Irish rivers.

PubMed

Donohue, Ian; McGarrigle, Martin L; Mills, Paul

2006-01-01

Requirements of the EU Water Framework Directive for the introduction of ecological quality objectives for surface waters and the stipulation that all surface waters in the EU must be of 'good' ecological status by 2015 necessitate a quantitative understanding of the linkages among catchment attributes, water chemistry and the ecological status of aquatic ecosystems. Analysis of lotic ecological status, as indicated by an established biotic index based primarily on benthic macroinvertebrate community structure, of 797 hydrologically independent river sites located throughout Ireland showed highly significant inverse associations between the ecological status of rivers and measures of catchment urbanisation and agricultural intensity, densities of humans and cattle and chemical indicators of water quality. Stepwise logistic regression suggested that urbanisation, arable farming and extent of pasturelands are the principal factors impacting on the ecological status of streams and rivers in Ireland and that the likelihood of a river site complying with the demands of the EU Water Framework Directive, and be of 'good' ecological status, can be predicted with reasonable accuracy using simple models that utilise either widely available landcover data or chemical monitoring data. Non-linear landcover and chemical 'thresholds' derived from these models provide a useful tool in the management of risk in catchments, and suggest strongly that more careful planning of land use in Ireland is essential in order to restore and maintain water quality as required by the Directive.

Land Management, River Restoration and the Water Framework Directive

NASA Astrophysics Data System (ADS)

Smith, Ben; Clifford, Nicholas

2014-05-01

The influence of catchment land-use on river ecosystems is well established, with negative changes in hydrology, sediment supply and pollutants causing widespread degradation in modified catchments across Europe. The strength of relationship found between different land-use types and impacts on river systems varies from study to study as a result of issues around data quality, scale, study design and the interaction of stressors at multiple scales. Analysis of large-scale datasets can provide important information about the way that catchments pressures affect WFD objectives at a national scale. Comparisons of relationships between land-use and WFD status in different types of catchment within the UK allow an assessment of catchment sensitivity and analysis of the catchment characteristics which influence these relationships. The results suggest prioritising catchments at or near land-use thresholds, or targeting waterbodies with limited land-use pressures but which are failing to achieve GES or GEP. This paper uses UK datasets on land cover and WFD waterbody status to examine how catchment land-use impacts on WFD status and to evaluate opportunities to achieve Good Ecological Status or Good Ecological Potential. Agricultural and urban land-use are shown to have different types of relationship with respect to the likelihood of achieving Good Ecological Status, and with clear threshold effects apparent for urban land-use in the catchment. Broad-scale analysis shows the influence of different sized buffer strips in mitigating the negative effects of different types of land-cover, and reinforces the positive effects of riparian woodland on river ecosystems and their potential under the WFD.

Prognostic model of survival for typical bronchial carcinoid tumours: analysis of 1109 patients on behalf of the European Association of Thoracic Surgeons (ESTS) Neuroendocrine Tumours Working Group.

PubMed

Filosso, Pier Luigi; Guerrera, Francesco; Evangelista, Andrea; Welter, Stefan; Thomas, Pascal; Casado, Paula Moreno; Rendina, Erino Angelo; Venuta, Federico; Ampollini, Luca; Brunelli, Alessandro; Stella, Franco; Nosotti, Mario; Raveglia, Federico; Larocca, Valentina; Rena, Ottavio; Margaritora, Stefano; Ardissone, Francesco; Travis, William D; Sarkaria, Inderpal; Sagan, Dariusz

2015-09-01

Typical carcinoids (TCs) are uncommon, slow-growing neoplasms, usually with high 5-year survival rates. As these are rare tumours, their management is still based on small clinical observations and no international guidelines exist. Based on the European Society of Thoracic Surgeon Neuroendocrine Tumours Working Group (NET-WG) Database, we evaluated factors that may influence TCs mortality. Using the NET-WG database, an analysis on TC survival was performed. Overall survival (OS) was calculated starting from the date of intervention. Predictors of OS were investigated using the Cox model with shared frailty (accounting for the within-centre correlation). Candidate predictors were: gender, age, smoking habit, tumour location, previous malignancy, Eastern Cooperative Oncology Group (ECOG) performance status (PS), pT, pN, TNM stage and tumour vascular invasion. The final model included predictors with P ≤ 0.15 after a backward selection. Missing data in the evaluated predictors were multiple-imputed and combined estimates were obtained from five imputed data sets. For 58 of 1167 TC patients vital status was unavailable and analyses were therefore performed on 1109 patients from 17 institutions worldwide. During a median follow-up of 50 months, 87 patients died, with a 5-year OS rate of 93.7% (95% confidence interval: 91.7-95.3). Backward selection resulted in a prediction model for mortality containing age, gender, previous malignancies, peripheral tumour, TNM stage and ECOG PS. The final model showed a good discrimination ability with a C-statistic equal to 0.836 (bootstrap optimism-corrected 0.806). We presented and validated a promising prognostic model for TC survival, showing good calibration and discrimination ability. Further analyses are needed and could be focused on an external validation of this model. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Predictive factors for survival and correlation to toxicity in advanced Stage III non-small cell lung cancer patients with concurrent chemoradiation.

PubMed

Kim, Yong-Hyub; Ahn, Sung-Ja; Kim, Young-Chul; Kim, Kyu-Sik; Oh, In-Jae; Ban, Hee-Jung; Chung, Woong-Ki; Nam, Taek-Keun; Yoon, Mee Sun; Jeong, Jae-Uk; Song, Ju-Young

2016-02-01

Concurrent chemoradiotherapy is the standard treatment for locally advanced Stage III non-small cell lung cancer in patients with a good performance status and minimal weight loss. This study aimed to define subgroups with different survival outcomes and identify correlations with the radiation-related toxicities. We retrospectively reviewed 381 locally advanced Stage III non-small cell lung cancer patients with a good performance status or weight loss of <10% who received concurrent chemoradiotherapy between 2004 and 2011. Three-dimensional conformal radiotherapy was administered once daily, combined with weekly chemotherapy. The Kaplan-Meier method was used for survival comparison and Cox regression for multivariate analysis. Multivariate analysis was performed using all variables with P values <0.1 from the univariate analysis. Median survival of all patients was 24 months. Age > 75 years, the diffusion lung capacity for carbon monoxide ≤80%, gross tumor volume ≥100 cm(3) and subcarinal nodal involvement were the statistically significant predictive factors for poor overall survival both in univariate and multivariate analyses. Patients were classified into four groups according to these four predictive factors. The median survival times were 36, 29, 18 and 14 months in Groups I, II, III and IV, respectively (P < 0.001). Rates of esophageal or lung toxicity ≥Grade 3 were 5.9, 14.1, 12.5 and 22.2%, respectively. The radiotherapy interruption rate differed significantly between the prognostic subgroups; 8.8, 15.4, 22.7 and 30.6%, respectively (P = 0.017). Severe toxicity and interruption of radiotherapy were more frequent in patients with multiple adverse predictive factors. To maintain the survival benefit in patients with concurrent chemoradiotherapy, strategies to reduce treatment-related toxicities need to be deeply considered. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A new method to predict anatomical outcome after idiopathic macular hole surgery.

PubMed

Liu, Peipei; Sun, Yaoyao; Dong, Chongya; Song, Dan; Jiang, Yanrong; Liang, Jianhong; Yin, Hong; Li, Xiaoxin; Zhao, Mingwei

2016-04-01

To investigate whether a new macular hole closure index (MHCI) could predict anatomic outcome of macular hole surgery. A vitrectomy with internal limiting membrane peeling, air-fluid exchange, and gas tamponade were performed on all patients. The postoperative anatomic status of the macular hole was defined by spectral-domain OCT. MHCI was calculated as (M+N)/BASE based on the preoperative OCT status. M and N were the curve lengths of the detached photoreceptor arms, and BASE was the length of the retinal pigment epithelial layer (RPE layer) detaching from the photoreceptors. Postoperative anatomical outcomes were divided into three grades: A (bridge-like closure), B (good closure), and C (poor closure or no closure). Correlation analysis was performed between anatomical outcomes and MHCI. Receiver operating characteristic (ROC) curves were derived for MHCI, indicating good model discrimination. ROC curves were also assessed by the area under the curve, and cut-offs were calculated. Other predictive parameters reported previously, which included the MH minimum, the MH height, the macular hole index (MHI), the diameter hole index (DHI), and the tractional hole index (THI) had been compared as well. MHCI correlated significantly with postoperative anatomical outcomes (r = 0.543, p = 0.000), but other predictive parameters did not. The areas under the curves indicated that MHCI could be used as an effective predictor of anatomical outcome. Cut-off values of 0.7 and 1.0 were obtained for MHCI from ROC curve analysis. MHCI demonstrated a better predictive effect than other parameters, both in the correlation analysis and ROC analysis. MHCI could be an easily measured and accurate predictive index for postoperative anatomical outcomes.

Six-minute-walk test in idiopathic pulmonary fibrosis: test validation and minimal clinically important difference.

PubMed

du Bois, Roland M; Weycker, Derek; Albera, Carlo; Bradford, Williamson Z; Costabel, Ulrich; Kartashov, Alex; Lancaster, Lisa; Noble, Paul W; Sahn, Steven A; Szwarcberg, Javier; Thomeer, Michiel; Valeyre, Dominique; King, Talmadge E

2011-05-01

The 6-minute-walk test (6MWT) is a practical and clinically meaningful measure of exercise tolerance with favorable performance characteristics in various cardiac and pulmonary diseases. Performance characteristics in patients with idiopathic pulmonary fibrosis (IPF) have not been systematically evaluated. To assess the reliability, validity, and responsiveness of the 6MWT and estimate the minimal clinically important difference (MCID) in patients with IPF. The study population included all subjects completing a 6MWT in a clinical trial evaluating interferon gamma-1b (n = 822). Six-minute walk distance (6MWD) and other parameters were measured at baseline and at 24-week intervals using a standardized protocol. Parametric and distribution-independent correlation coefficients were used to assess the strength of the relationships between 6MWD and measures of pulmonary function, dyspnea, and health-related quality of life. Both distribution-based and anchor-based methods were used to estimate the MCID. Comparison of two proximal measures of 6MWD (mean interval, 24 d) demonstrated good reliability (coefficient = 0.83; P < 0.001). 6MWD was weakly correlated with measures of physiologic function and health-related quality of life; however, values were consistently and significantly lower for patients with the poorest functional status, suggesting good construct validity. Importantly, change in 6MWD was highly predictive of mortality; a 24-week decline of greater than 50 m was associated with a fourfold increase in risk of death at 1 year (hazard ratio, 4.27; 95% confidence interval, 2.57- 7.10; P < 0.001). The estimated MCID was 24-45 m. The 6MWT is a reliable, valid, and responsive measure of disease status and a valid endpoint for clinical trials in IPF.

Psychometric validation of the functional assessment of cancer therapy--brain (FACT-Br) for assessing quality of life in patients with brain metastases.

PubMed

Thavarajah, Nemica; Bedard, Gillian; Zhang, Liying; Cella, David; Beaumont, Jennifer L; Tsao, May; Barnes, Elizabeth; Danjoux, Cyril; Sahgal, Arjun; Soliman, Hany; Chow, Edward

2014-04-01

This study aimed to test the reliability, psychometric, and clinical validity of the use of the Functional Assessment of Cancer Therapy--Brain (FACT-Br) in patients with brain metastases. Patients with brain metastases were interviewed using the FACT-Br (including the FACT-general) 1 week prior to treatment. All patients completed a follow-up assessment 1 month post-treatment. Patients with a good performance status and receiving stereotactic radiosurgery completed an additional 1 week follow-up assessment after the initial baseline interview to assess test-retest reliability. Forty patients had complete 1 month follow-up data. Ten of these patients also completed the 1 week follow-up assessment from baseline. The median Karnofsky performance status of patients was 80 and the median age was 64 years. All subscales of the FACT-Br were found to be conceptually related (except for two correlations) using the following subscales: physical well-being (PWB), social/family well-being (SWB), emotional well-being (EWB), functional well-being (FWB), FACT-G total score, brain cancer subscale (BrC), and the FACT-Br total score. All FACT-Br scores demonstrated excellent reliability, except for the SWB scale which revealed good reliability. The FACT-Br scores showed no significant change in the quality of life (QoL) of patients from baseline to 1 month follow-up. The use of the combined FACT-G and FACT-Br Subscale to assess QoL specifically in patients with brain metastases has successfully undergone psychometric validation. Future clinical trials should use the FACT-G and FACT-Br Subscale to assess QoL in this patient population.

Preoperative nutritional status is associated with progression of postoperative cardiac rehabilitation in patients undergoing cardiovascular surgery.

PubMed

Arai, Yasuhiro; Kimura, Toru; Takahashi, Yuki; Hashimoto, Takashi; Arakawa, Mamoru; Okamura, Homare

2018-06-23

Progression of cardiac rehabilitation after cardiovascular surgery can be affected by frailty. The nutritional status of the patient has been proposed as an indicator of frailty. In this study, we aimed to evaluate the influence of preoperative nutritional status on the progress of postoperative cardiac rehabilitation. This study included 146 patients (82 males, 64 females, average age 71.9 ± 12.0 years) who underwent elective cardiovascular surgery. In-hospital mortality cases were excluded to focus on postoperative cardiac rehabilitation. We classified patients with a Geriatric Nutritional Risk Index of 92 or higher as the good nutrition group and those with a Geriatric Nutritional Risk Index less than 92 as the malnutrition group. Preoperative patient characteristics and postoperative cardiac rehabilitation progress were compared between the good nutrition (n = 93) and malnutrition (n = 53) groups. The patients in the good nutrition group had an earlier progression to walking after postoperative rehabilitation (p = 0.002), a shorter postoperative hospital stay (p = 0.004), and a higher rate of discharge home (p = 0.028) than those in the malnutrition group. Multivariable analysis demonstrated preoperative malnutrition to be an independent predictor for the day to 100 m walking (p = 0.010). Preoperative nutritional status was associated with progression of postoperative cardiac rehabilitation.

Nutrition Assessment of B-Vitamins in Highly Active and Sedentary Women.

PubMed

Woolf, Kathleen; Hahn, Nicole L; Christensen, Megan M; Carlson-Phillips, Amanda; Hansen, Christine M

2017-03-26

Female athletes and active women require adequate nutrition for optimal health and performance. Nutrition assessments are needed to identify potential nutrients of concern. Folate, vitamin B6, and vitamin B12 function in important pathways used during physical activity and female athletes may be at risk for poor status of these micronutrients. This cross-sectional study described a comprehensive nutrition assessment of the B-vitamins (folate, vitamin B6, and vitamin B12) using both dietary (food and dietary supplements) and biochemical assessments among highly active and sedentary women. Highly active ( n = 29; age 20 ± 2 years; body mass index (BMI) 23.8 ± 3.5 kg/m²) and sedentary ( n = 29; age 24 ± 3 years; BMI 22.6 ± 3.0 kg/m²) women were recruited for this study. Participants completed 7-day weighed food records and a fasting blood draw. Although the highly active women reported higher intakes of energy ( p < 0.01), folate ( p < 0.01), vitamin B6 ( p < 0.01), and vitamin B12 ( p < 0.01), no significant differences were found between the groups for biomarkers of folate, vitamin B6, and vitamin B12. All of the highly active women had biomarkers within the desired reference ranges, suggesting good status. In general, most participants were able to meet the 1998 Recommended Daily Allowance (RDA) from food alone. For the women that reported using dietary supplements, micronutrient intakes met the 1998 RDA and in some cases, exceeded the Tolerable Upper Intake Level. This nutrition assessment documented good status for folate, vitamin B6, and vitamin B12 in the highly active women. Similar assessment approaches (food, dietary supplements, and biomarkers) should to completed with other nutrients of concern for the female athlete.

Nutrition Assessment of B-Vitamins in Highly Active and Sedentary Women

PubMed Central

Woolf, Kathleen; Hahn, Nicole L.; Christensen, Megan M.; Carlson-Phillips, Amanda; Hansen, Christine M.

2017-01-01

Background: Female athletes and active women require adequate nutrition for optimal health and performance. Nutrition assessments are needed to identify potential nutrients of concern. Folate, vitamin B6, and vitamin B12 function in important pathways used during physical activity and female athletes may be at risk for poor status of these micronutrients. This cross-sectional study described a comprehensive nutrition assessment of the B-vitamins (folate, vitamin B6, and vitamin B12) using both dietary (food and dietary supplements) and biochemical assessments among highly active and sedentary women. Methods: Highly active (n = 29; age 20 ± 2 years; body mass index (BMI) 23.8 ± 3.5 kg/m2) and sedentary (n = 29; age 24 ± 3 years; BMI 22.6 ± 3.0 kg/m2) women were recruited for this study. Participants completed 7-day weighed food records and a fasting blood draw. Results: Although the highly active women reported higher intakes of energy (p < 0.01), folate (p < 0.01), vitamin B6 (p < 0.01), and vitamin B12 (p < 0.01), no significant differences were found between the groups for biomarkers of folate, vitamin B6, and vitamin B12. All of the highly active women had biomarkers within the desired reference ranges, suggesting good status. In general, most participants were able to meet the 1998 Recommended Daily Allowance (RDA) from food alone. For the women that reported using dietary supplements, micronutrient intakes met the 1998 RDA and in some cases, exceeded the Tolerable Upper Intake Level. Conclusion: This nutrition assessment documented good status for folate, vitamin B6, and vitamin B12 in the highly active women. Similar assessment approaches (food, dietary supplements, and biomarkers) should to completed with other nutrients of concern for the female athlete. PMID:28346362

Progress in the Development of CdTe and CdZnTe Semiconductor Radiation Detectors for Astrophysical and Medical Applications

PubMed Central

Sordo, Stefano Del; Abbene, Leonardo; Caroli, Ezio; Mancini, Anna Maria; Zappettini, Andrea; Ubertini, Pietro

2009-01-01

Over the last decade, cadmium telluride (CdTe) and cadmium zinc telluride (CdZnTe) wide band gap semiconductors have attracted increasing interest as X-ray and gamma ray detectors. Among the traditional high performance spectrometers based on silicon (Si) and germanium (Ge), CdTe and CdZnTe detectors show high detection efficiency and good room temperature performance and are well suited for the development of compact and reliable detection systems. In this paper, we review the current status of research in the development of CdTe and CdZnTe detectors by a comprehensive survey on the material properties, the device characteristics, the different techniques for improving the overall detector performance and some major applications. Astrophysical and medical applications are discussed, pointing out the ongoing Italian research activities on the development of these detectors. PMID:22412323

The present status of the high temperature superconducting Maglev vehicle in China

NASA Astrophysics Data System (ADS)

Wang, J. S.; Wang, S. Y.; Zeng, Y. W.; Deng, C. Y.; Ren, Z. Y.; Wang, X. R.; Song, H. H.; Wang, X. Z.; Zheng, J.; Zhao, Y.

2005-02-01

Since the first successful running of the people-carrying high temperature superconducting (HTS) Maglev test vehicle on 31 December 2000, about 27 000 people have taken it, and the accumulated running distance is about 400 km. The levitation force of the onboard HTS equipment is measured periodically, and new experimental results measured on 5 March 2003 show that the performance of the onboard HTS Maglev equipment is almost the same as that of two years ago. Experimental results indicate that the long-term stability of the HTS Maglev vehicle is good. This further proves the feasibility of the HTS Maglev vehicle for practical transportation. It is worth mentioning that all the results are measured at a low speed; however, investigations of the dynamic performance of the HTS Maglev vehicle at high speed are necessary for practical application. Research on the dynamic performance of the HTS Maglev vehicle is ongoing.

Healthcare in Canada's North: Are We Getting Value for Money?

PubMed

Young, T Kue; Chatwood, Susan; Marchildon, Gregory P

2016-08-01

To determine if Canadians are getting value for money in providing health services to our northern residents. Secondary analyses of data from Statistics Canada, the Canadian Institute of Health Information and territorial government agencies on health status, health expenditures and health system performance indicators. Per capita health expenditures in Canada's northern territories are double that of Canada as a whole and are among the highest in the world. The North lags behind the rest of the country in preventable mortality, hospitalization for ambulatory care sensitive conditions and other performance indicators. The higher health expenditure in the North is to be expected from its unique geography and demography. If the North is not performing as well as Canada, it is not due to lack of money, and policy makers should be concerned about whether healthcare can be as good as it could be. Copyright © 2016 Longwoods Publishing.

Preliminary flight-test results of an advanced technology light twin-engine airplane /ATLIT/

NASA Technical Reports Server (NTRS)

Holmes, B. J.; Kohlman, D. L.; Crane, H. L.

1976-01-01

The present status and flight-test results are presented for the ATLIT airplane. The ATLIT is a Piper PA-34 Seneca I modified by the installation of new wings incorporating the GA(W)-1 (Whitcomb) airfoil, reduced wing area, roll-control spoilers, and full-span Fowler flaps. Flight-test results on stall and spoiler roll characteristics show good agreement with wind-tunnel data. Maximum power-off lift coefficients are greater than 3.0 with flaps deflected 37 deg. With flaps down, spoiler deflections can produce roll helix angles in excess of 0.11 rad. Flight testing is planned to document climb and cruise performance, and supercritical propeller performance and noise characteristics. The airplane is scheduled for testing in the NASA-Langley Research Center Full-Scale Tunnel.

Potassium topping cycles for stationary power. [conceptual analysis

NASA Technical Reports Server (NTRS)

Rossbach, R. J.

1975-01-01

A design study was made of the potassium topping cycle powerplant for central station use. Initially, powerplant performance and economics were studied parametrically by using an existing steam plant as the bottom part of the cycle. Two distinct powerplants were identified which had good thermodynamic and economic performance. Conceptual designs were made of these two powerplants in the 1200 MWe size, and capital and operating costs were estimated for these powerplants. A technical evaluation of these plants was made including conservation of fuel resources, environmental impact, technology status, and degree of development risk. It is concluded that the potassium topping cycle could have a significant impact on national goals such as air and water pollution control and conservation of natural resources because of its higher energy conversion efficiency.

Oncologic considerations in the elderly.

PubMed

Kamel, Mohamed K; Port, Jeffrey L

2018-02-01

Elderly patients presenting with thoracic malignancies tend to be largely undertreated because of a presumption that this group will incur a high treatment-associated morbidity and mortality. The current review highlights the current practice and recent updates in the surgical management of thoracic malignancies, mainly lung cancer, in the elderly population. Lung resections appears to be relatively safe in the elderly patients presenting with lung cancer. Whenever possible, a lobectomy should be offered to patients with a good performance status who present with early stage disease. However, a limited resection may offer a valuable comparable alternative in patients with advanced comorbidities and borderline pulmonary functions. The use of minimally invasive approaches, namely video-assisted thoracoscopic surgery and robotic surgery are associated with lower morbidity and improved perioperative outcomes compared with the traditional thoracotomy approach and are ideal for the aged. In elderly patients presenting with advanced staged lung cancer, major lung resections following induction therapy, although feasible, should be discussed in a multispecialty tumor board committee. There is growing evidence from the literature that surgical resection is relatively safe in the elderly population. Age by itself should not preclude patients from having curative resection. Resections can be tailored to performance status of the patient.

Comparing the Performance Status Scale and MD Anderson Dysphagia Inventory as swallowing outcome measures in head and neck cancer: a prospective cohort study.

PubMed

Khan, M K; Patterson, J; Owen, S; Rees, S; Gamberini, L; Paleri, V

2015-08-01

To examine the relationship between the two disease-specific measures currently in use to assess swallowing outcomes following treatment in patients with head and neck cancer: the Performance Status Scale (PSS) and MD Anderson Dysphagia Inventory (MDADI). A prospective cohort study. Four head and neck cancer multidisciplinary clinics in the North of England Cancer Network. 114 patients with cancers of the upper aerodigestive tract. Measures of swallowing function administered prospectively across 4 timepoints Spearman's correlation coefficients were used to measure the relationship between the two scales. There was statistically significant correlation between the two tools at pre-treatment (rs = 0.428, P < 0.000), 3 months post-treatment (rs = 0.454, P < 0.002), 6 months post-treatment (rs = 0.551, P < 0.000) and 12 months post-treatment (rs = 0.680, P < 0.000). This is the first prospective study comparing the MDADI and PSS questionnaires at multiple time points. Our study shows that these different instruments have a good relationship in measuring swallowing function in patients with head and neck cancer in short and medium term after treatment. © 2015 John Wiley & Sons Ltd.

Rapid learning in practice: A lung cancer survival decision support system in routine patient care data

PubMed Central

Dekker, Andre; Vinod, Shalini; Holloway, Lois; Oberije, Cary; George, Armia; Goozee, Gary; Delaney, Geoff P.; Lambin, Philippe; Thwaites, David

2016-01-01

Background and purpose A rapid learning approach has been proposed to extract and apply knowledge from routine care data rather than solely relying on clinical trial evidence. To validate this in practice we deployed a previously developed decision support system (DSS) in a typical, busy clinic for non-small cell lung cancer (NSCLC) patients. Material and methods Gender, age, performance status, lung function, lymph node status, tumor volume and survival were extracted without review from clinical data sources for lung cancer patients. With these data the DSS was tested to predict overall survival. Results 3919 lung cancer patients were identified with 159 eligible for inclusion, due to ineligible histology or stage, non-radical dose, missing tumor volume or survival. The DSS successfully identified a good prognosis group and a medium/poor prognosis group (2 year OS 69% vs. 27/30%, p < 0.001). Stage was less discriminatory (2 year OS 47% for stage I–II vs. 36% for stage IIIA–IIIB, p = 0.12) with most good prognosis patients having higher stage disease. The DSS predicted a large absolute overall survival benefit (~40%) for a radical dose compared to a non-radical dose in patients with a good prognosis, while no survival benefit of radical radiotherapy was predicted for patients with a poor prognosis. Conclusions A rapid learning environment is possible with the quality of clinical data sufficient to validate a DSS. It uses patient and tumor features to identify prognostic groups in whom therapy can be individualized based on predicted outcomes. Especially the survival benefit of a radical versus non-radical dose predicted by the DSS for various prognostic groups has clinical relevance, but needs to be prospectively validated. PMID:25241994

Functional Status Score for the Intensive Care Unit (FSS-ICU): An International Clinimetric Analysis of Validity, Responsiveness, and Minimal Important Difference

PubMed Central

Huang, Minxuan; Chan, Kitty S.; Zanni, Jennifer M.; Parry, Selina M.; Neto, Saint-Clair G. B.; Neto, Jose A. A.; da Silva, Vinicius Z. M.; Kho, Michelle E.; Needham, Dale M.

2017-01-01

Objective To evaluate the internal consistency, validity, responsiveness, and minimal important difference of the Functional Status Score for the Intensive Care Unit (FSS-ICU), a physical function measure designed for the intensive care unit (ICU). Design Clinimetric analysis. Settings Five international data sets from the United States, Australia, and Brazil. Patients 819 ICU patients. Intervention None. Measurements and Main Results Clinimetric analyses were initially conducted separately for each data source and time point to examine generalizability of findings, with pooled analyses performed thereafter to increase power of analyses. The FSS-ICU demonstrated good to excellent internal consistency. There was good convergent and discriminant validity, with significant and positive correlations (r = 0.30 to 0.95) between FSS-ICU and other physical function measures, and generally weaker correlations with non-physical measures (|r| = 0.01 to 0.70). Known group validity was demonstrated by significantly higher FSS-ICU scores among patients without ICU-acquired weakness (Medical Research Council sumscore ≥48 versus <48) and with hospital discharge to home (versus healthcare facility). FSS-ICU at ICU discharge predicted post-ICU hospital length of stay and discharge location. Responsiveness was supported via increased FSS-ICU scores with improvements in muscle strength. Distribution-based methods indicated a minimal important difference of 2.0 to 5.0. Conclusions The FSS-ICU has good internal consistency and is a valid and responsive measure of physical function for ICU patients. The estimated minimal important difference can be used in sample size calculations and in interpreting studies comparing the physical function of groups of ICU patients. PMID:27488220

Psychometric evaluation of the Chinese version of the Child Health Utility 9D (CHU9D-CHN): a school-based study in China.

PubMed

Yang, Peirong; Chen, Gang; Wang, Peng; Zhang, Kejian; Deng, Feng; Yang, Haifeng; Zhuang, Guihua

2018-05-05

The Child Health Utility 9D (CHU9D), a new generic preference-based health-related quality of life (HRQoL) instrument, was developed specifically for the application in cost-effectiveness analyses of treatments and interventions for children and adolescents. The main objective of this study was to examine the psychometric property of the Chinese version of CHU9D (CHU9D-CHN) in a large school-based sample in China. Data were collected using a multi-stage sampling method from third-to-ninth-grade students in Shaanxi Province, China. Participants self-completed a hard-copy questionnaire including the CHU9D-CHN instrument, the Pediatric Quality of Life Inventory™ 4.0 Generic Core Scales (PedsQL), information on socio-demographic characteristics and self-reported health status. The psychometric properties of the CHU9D-CHN, including the internal consistency, 2-week test-retest reliability, convergent and known-groups validity were studied. A total of 1912 students participated in the survey. The CHU9D-CHN internal consistency and test-retest reliability were good to excellent with a Cronbach's alpha of 0.77 and an intra-class correlation coefficient of 0.65, respectively. The CHU9D utility scores moderately correlated with the PedsQL total scores (r = .57, P < .001), demonstrating good convergent validity. Difference of the CHU9D utility scores among the different participants with levels of self-reported general health, health services utilisation and left-behind status demonstrated good construct validity. The findings demonstrated adequate psychometric performance for the CHU9D-CHN. The CHU9D-CHN was a satisfactory, reliable and valid instrument to measure and value HRQoL for children and adolescents in China.

Building Successful Partnerships in Health Literacy

ERIC Educational Resources Information Center

McIntyre, Sue; Dale, Helen; Gabler, Carol

2010-01-01

Health literacy, the ability to obtain and understand information and services to make good health decisions, has received much attention recently. Literacy is a stronger predictor of health status than age, income, race, ethnicity, employment status, or educational level. Inadequate health literacy costs the United States an estimated $100-$236…

Relationship Between the Functional Status Scale and the Pediatric Overall Performance Category and Pediatric Cerebral Performance Category Scales FREE

PubMed Central

Pollack, Murray M.; Holubkov, Richard; Funai, Tomohiko; Clark, Amy; Moler, Frank; Shanley, Thomas; Meert, Kathy; Newth, Christopher J. L.; Carcillo, Joseph; Berger, John T.; Doctor, Allan; Berg, Robert A.; Dalton, Heidi; Wessel, David L.; Harrison, Rick E.; Dean, J. Michael; Jenkins, Tammara L.

2015-01-01

Importance Functional status assessment methods are important as outcome measures for pediatric critical care studies. Objective To investigate the relationships between the 2 functional status assessment methods appropriate for large-sample studies, the Functional Status Scale (FSS) and the Pediatric Overall Performance Category and Pediatric Cerebral Performance Category (POPC/PCPC) scales. Design, Setting, and Participants Prospective cohort study with random patient selection at 7 sites and 8 children’s hospitals with general/medical and cardiac/cardiovascular pediatric intensive care units (PICUs) in the Collaborative Pediatric Critical Care Research Network. Participants included all PICU patients younger than 18 years. Main Outcomes and Measures Functional Status Scale and POPC/PCPC scores determined at PICU admission (baseline) and PICU discharge. We investigated the association between the baseline and PICU discharge POPC/PCPC scores and the baseline and PICU discharge FSS scores, the dispersion of FSS scores within each of the POPC/PCPC ratings, and the relationship between the FSS neurologic components (FSS-CNS) and the PCPC. Results We included 5017 patients. We found a significant (P < .001) difference between FSS scores in each POPC or PCPC interval, with an FSS score increase with each worsening POPC/PCPC rating. The FSS scores for the good and mild disability POPC/PCPC ratings were similar and increased by 2 to 3 points for the POPC/PCPC change from mild to moderate disability, 5 to 6 points for moderate to severe disability, and 8 to 9 points for severe disability to vegetative state or coma. The dispersion of FSS scores within each POPC and PCPC rating was substantial and increased with worsening POPC and PCPC scores. We also found a significant (P < .001) difference between the FSS-CNS scores between each of the PCPC ratings with increases in the FSS-CNS score for each higher PCPC rating. Conclusions and Relevance The FSS and POPC/PCPC system are closely associated. Increases in FSS scores occur with each higher POPC and PCPC rating and with greater magnitudes of change as the dysfunction severity increases. However, the dispersion of the FSS scores indicated a lack of precision in the POPC/PCPC system when compared with the more objective and granular FSS. The relationship between the PCPC and the FSS-CNS paralleled the relationship between the FSS and POPC/PCPC system. PMID:24862461

Validation of the Chinese version of functional assessment of anorexia-cachexia therapy (FAACT) scale for measuring quality of life in cancer patients with cachexia.

PubMed

Zhou, Ting; Yang, Kaixiang; Thapa, Sudip; Fu, Qiang; Jiang, Yongsheng; Yu, Shiying

2017-04-01

The assessment of quality of life (QOL) is an important part of cachexia management for cancer patients. Functional assessment of anorexia-cachexia therapy (FAACT), a specific QOL instrument for cachexia patients, has not been validated in Chinese population. The aim of this study was to validate the FAACT scale in Chinese cancer patients for its future use. Eligible cancer patients were included in our study. Patients' demographic and clinical characteristics were collected from the electronic medical records. Patients were asked to complete the Chinese version of FAACT scale and the MD Anderson symptom inventory (MDASI), and then the reliability and validity were analyzed. A total of 285 patients were enrolled in our study, data of 241 patients were evaluated. Coefficients of Cronbach's alpha, test-retest and split-half analyses were all greater than 0.8, which indicated an excellent reliability for FAACT scale. In item-subscale correlation analysis and factor analysis, good construct validity for FAACT scale was found. The correlation between FAACT and MDASI interference subscale showed reasonable criterion-related validity, and for further clinical validation, the FAACT scale showed excellent discriminative validity for distinguishing patients in different cachexia status and in different performance status. The Chinese version of FAACT scale has good reliability and validity and is suitable for measuring QOL of cachexia patients in Chinese population.

Oxidative status in different settings and with different methodological approaches compared by Receiver Operating Characteristic curve analysis.

PubMed

Cighetti, Giuliana; Bamonti, Fabrizia; Aman, Caroline S; Gregori, Dario; De Giuseppe, Rachele; Novembrino, Cristina; de Liso, Federica; Maiavacca, Rita; Paroni, Rita

2015-01-01

To test the performance of different analytical approaches in highlighting the occurrence of deregulated redox status in various physio-pathological situations. 35 light and 61 heavy smokers, 19 chronic renal failure, 59 kidney transplanted patients, and 87 healthy controls were retrospectively considered for the study. Serum oxidative stress and antioxidant status, assessed by spectrophotometric Reactive Oxygen Metabolites (d-ROMs) and Total Antioxidant Capacity (TAC) tests, respectively, were compared with plasma free (F-MDA) and total (T-MDA) malondialdehyde, both quantified by isotope-dilution-gas chromatography-mass spectrometry (ID-GC-MS). Sensitivity, specificity and cut-off points of T-MDA, F-MDA, d-ROMs and TAC were evaluated by both Receiver Operating Characteristic (ROC) analyses and area under the ROC curve (AUC). Only T-MDA assay showed a clear absence of oxidative stress in controls and significant increase in all patients (AUC 1.00, sensitivity and specificity 100%). Accuracy was good for d-ROMs (AUC 0.87, sensitivity 72.8%, specificity 100%) and F-MDA (AUC 0.82, sensitivity 74.7%, specificity 83.9%), but not high enough for TAC to show in patients impaired antioxidant defense (AUC 0.66, sensitivity 52.0%, specificity 92.9%). This study reveals T-MDA as the best marker to detect oxidative stress, shows the ability of d-ROMs to identify modified oxidative status particularly in the presence of high damages, and evidences the poor TAC performance. d-ROMs and TAC assays could be useful for routine purposes; however, for an accurate clinical data evaluation, their comparison versus a "gold standard method" is required. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Integrating Tenascin-C protein expression and 1q25 copy number status in pediatric intracranial ependymoma prognostication: A new model for risk stratification.

PubMed

Andreiuolo, Felipe; Le Teuff, Gwénaël; Bayar, Mohamed Amine; Kilday, John-Paul; Pietsch, Torsten; von Bueren, André O; Witt, Hendrik; Korshunov, Andrey; Modena, Piergiorgio; Pfister, Stefan M; Pagès, Mélanie; Castel, David; Giangaspero, Felice; Chimelli, Leila; Varlet, Pascale; Rutkowski, Stefan; Frappaz, Didier; Massimino, Maura; Grundy, Richard; Grill, Jacques

2017-01-01

Despite multimodal therapy, prognosis of pediatric intracranial ependymomas remains poor with a 5-year survival rate below 70% and frequent late deaths. This multicentric European study evaluated putative prognostic biomarkers. Tenascin-C (TNC) immunohistochemical expression and copy number status of 1q25 were retained for a pooled analysis of 5 independent cohorts. The prognostic value of TNC and 1q25 on the overall survival (OS) was assessed using a Cox model adjusted to age at diagnosis, tumor location, WHO grade, extent of resection, radiotherapy and stratified by cohort. Stratification on a predictor that did not satisfy the proportional hazards assumption was considered. Model performance was evaluated and an internal-external cross validation was performed. Among complete cases with 5-year median follow-up (n = 470; 131 deaths), TNC and 1q25 gain were significantly associated with age at diagnosis and posterior fossa tumor location. 1q25 status added independent prognostic value for death beyond the classical variables with a hazard ratio (HR) = 2.19 95%CI = [1.29; 3.76] (p = 0.004), while TNC prognostic relation was tumor location-dependent with HR = 2.19 95%CI = [1.29; 3.76] (p = 0.004) in posterior fossa and HR = 0.64 [0.28; 1.48] (p = 0.295) in supratentorial (interaction p value = 0.015). The derived prognostic score identified 3 different robust risk groups. The omission of upfront RT was not associated with OS for good and intermediate prognostic groups while the absence of upfront RT was negatively associated with OS in the poor risk group. Integrated TNC expression and 1q25 status are useful to better stratify patients and to eventually adapt treatment regimens in pediatric intracranial ependymoma.

[Nutritional status of the population over 65 years of age in the city of Badajoz].

PubMed

Suárez-Gómez, A; Sánchez-Vega, J; Suárez-González, F; Peral-Pacheco, D; Dorado-Martin, J J; Suárez-Gómez, M

2017-03-01

Nutritional status is strongly associated with the level of health and quality of life of the population, and is especially relevant in the case of the elderly. The aim was to study the nutritional status in a population of non-institutionalised over 65 year-olds in the city of Badajoz, describing the sociodemographic variables, biochemical parameters, and functional assessment. A descriptive study was performed using a design population, which was randomised and stratified in health centres of the city, with a sample size of 298 patients being obtained. The sociodemographic variables included gender, age, educational level, anthropometric analysis with estimated body mass index, and percentage fat weight. Statistical tests were performed using SPSS v.15 statistical package. The prevalence of overweight and obesity as measured by fat weight was 61.9% (56.1-67.8), with a body mass index of 65.8% (60.2-71.4). It was higher in women, with a fat weight of 67.3% (2.56 to 2.73) and a body mass index of 71.8% (2.64 to 2.78). The nutritional status of the population according to the questionnaire "Know your nutritional health" was rated "good". The most common nutritional problem in the non-institutionalised population over 65 years in the city of Badajoz is obesity, especially in women, and in people with low educational level. This high prevalence suggests that health education on a better lifestyle in this population should be a priority. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Wetlands monitoring - hydrological conditions and water quality in selected transects of Biebrza National Park.

NASA Astrophysics Data System (ADS)

Stelmaszczyk, Mateusz; Okruszko, Tomasz

2010-05-01

Water Framework Directive (WFD) obligates Member States to prevent further deterioration as well as to protect and enhance the status of aquatic ecosystems and wetlands. In order to fulfill one of the WFD objectives - to keep wetlands in good surface water and groundwater status (determined by good ecological, chemical and quantitative status) it is necessary to specify most favourable conditions for them. In that case monitoring of factors responsible for wetlands status in natural areas is a key issue. Further, achieved knowledge of existing relations in ecosystems can be implemented in protection and restoration projects. There are a number of factors influencing diversity of habitats responsible for developing different wetland ecosystems and their sustaining in good ecological status. It's believed that among significant factors such as hydrological conditions, water quality, nutrient availability in the soil, pH value and management (e.g. grazing, mowing) the hydrological conditions are the most important. In presented work authors concentrated on hydrological conditions and water quality and theirs influence on wetland vegetation of Biebrza National Park (BNP). BNP located north-east part of Poland is recognized by many scientist as a unique undisturbed wetland reference area. Five transects located in different basins of BNP were chosen. Transects consist of piezometers in which the water table levels and water quality were measured. Analysis of electroconductivity (EC), alkalinity (HCO3-) and pH were done directly in the field. In the laboratory anions (NO3-, PO43-, Cl-, SO42-) and cations (NH4+, Ca2+, Mg2+, Br+, Li+, Na+, K+) concentration was determined using High Performance Liquid Chromatography (HPLC). D-divers, electronic devices to permanent measurement of groundwater level changes were located in some of the piezometers. Piezometers were located in the sites characterized by different hydrological conditions, from groundwater fed to river fed areas. Studied locations were covered mainly by Magnocaricion vegetation (e.g. Caricetum gracilis and Caricetum elatae), Molinio-Arrhenatheretea vegetation (Molinietum caeruleae), and Scheuchzerio-Caricetea nigrae vegetation (e.g. Caricetum lasiocarpae). In presented work authors show results of water quality measurements and monitoring of hydrological conditions, characterized by changes of groundwater table, period and size of inundation. During six years long monitoring period (2004 - 2009 hydrological years) there were observed high diversification of groundwater and surface water levels among locations. They fluctuate in some places from very low groundwater levels, observed in late summer and in early autumn (over 1 m beneath the ground), to levels reaching surface of the ground or laying nearly below it, occurring in winter and spring. There are also places where quite high inundations in winter and spring are observed. Collected chemical and hydrological data were statistically analyzed using STATISTICA 8 software with a use of one of the multivariate analysis - Principal Component Analysis (PCA) method. Owing to the usage of PCA analysis it was possible to define most important parameters characterizing habitats were occurs selected vegetation. The impact of hydrological conditions (presented as a main factor) on forming particular wetland plant communities can be discussed. Authors determine that some other factors (e.g. management) can be more responsible for occurrence of particular plant communities and their sustaining in good status in specific locations.

A combined hydrochemical - isotopic approach for assessing the regional pollution of an alluvial aquifer in a urbanized environment

NASA Astrophysics Data System (ADS)

Gesels, Julie; Orban, Philippe; Popescu, Cristina; Knöller, Kay; Brouyère, Serge

2014-05-01

The alluvial aquifer of the Meuse River is contaminated at regional scale in the urbanized and industrialized area of Liège in Belgium with different types of contaminants, in particular inorganics such as sulfate, nitrate and ammonium. The sources of those contaminants are numerous: brownfields, urban waste water, subsurface acid mine drainage from former coal mines, atmospheric deposits related to pollutants emissions in the atmosphere... Sulfate, nitrate and ammonium are both typical pollutants of the aquifer and tracers of the possible pollution sources. According to the European legislation on water, groundwater resources should reach a good quality status before 2015. However, an exemption can be obtained if it may be unfeasible or unreasonably expensive to achieve good status. In this case, groundwater quality objectives and management plans can be adapted to these specific conditions. To obtain such an exemption for the Meuse alluvial aquifer, it is required to demonstrate that the poor qualitative status is caused by acid mine drainage, or by widespread historical atmospheric deposition from industries, and not by recent anthropogenic contamination from the urban and industrial context. In this context, a detailed hydrogeochemical characterization of groundwater has been performed, with the aim of determining the origin of the inorganic contaminations and the main processes contributing to poor groundwater quality. A large hydrochemical sampling campaign was performed, based on 71 selected representative sampling locations, to better characterize the different vectors (end-members) of contamination of the alluvial aquifer and their respective contribution to groundwater contamination in the area. Groundwater samples were collected and analyzed for major and minor compounds and metallic trace elements. The analyses also include stable isotopes in water, sulfate, nitrate, ammonium, boron and strontium. Different hydrogeochemical approaches are combined to obtain a global understanding of the hydrogeochemical processes at regional scale. Hydrochemical interpretations are based on classical diagrams (e.g. Piper), spatial distribution maps, geochemical equations, multivariate statistics and isotopic analyses. With this combined approach, the location of the contaminant sources and most contaminated sectors of the alluvial aquifer together with a better understanding of geochemical processes involved are obtained.

Utility of the AD8 as a self-rating tool for cognitive impairment in an Asian population.

PubMed

Chin, Rowena; Ng, Amanda; Narasimhalu, Kaavya; Kandiah, Nagaendran

2013-05-01

AD8 is a brief informant interview used to detect early cognitive change. This study evaluated the diagnostic performance of the participant-rated AD8 (p-AD8) in a predominantly Chinese population. Data on demographics, clinical, and cognitive features were collected from 73 participants with no cognitive impairment (NCI), 27 participants with mild cognitive impairments, and 78 participants with Alzheimer's disease-informant dyads. Agreement and discriminative properties of p-AD8 were assessed. AD8 scores were associated with dementia severity. Participant and informant AD8 scores were moderately correlated within dementia dyads. The p-AD8 showed good diagnostic performance in differentiating between participants with NCI and participants with cognitive impairment (sensitivity = 85.0%, specificity = 74.0%, and area under the curve = 0.80), with a cutoff score of ≥1. Combination of impairment in Mini-Mental State Examination and p-AD8 is more useful in detecting cognitive impairment than using the AD8 alone. Within a transcultural setting, the p-AD8 demonstrated good discriminative validity and can be used to gain a preliminary understanding of an individual's cognitive status.

State of the art and perspectives in the treatment of glioblastoma.

PubMed

Grimm, Sean A; Chamberlain, Marc C

2012-09-01

Glioblastoma is the most common malignant primary brain tumor. Cures are rare and median survival varies from several to 22 months. Standard treatment for good performance patients consists of maximal safe surgical resection followed by radiotherapy with concurrent temozolomide (TMZ) chemotherapy and six cycles of postradiotherapy TMZ. At recurrence, treatment options include repeat surgery (with or without Gliadel wafer placement), reirradiation or systemic therapy. Most patients with good performance status are treated with cytotoxic chemotherapy or targeted biologic therapy following or in lieu of repeat surgery. Cytotoxic chemotherapy options include nitrosoureas, rechallenge with TMZ, platins, phophoramides and topoisomerase inhibitors, although efficacy is limited. Despite the intense effort of developing biologic agents that target angiogenesis and growth and proliferative pathways, bevacizumab is the only agent that has shown efficacy in clinical trials. It was awarded accelerated approval in the USA after demonstrating an impressive radiographic response in two open-label, prospective Phase II studies. Two randomized, Phase III trials of upfront bevacizumab have completed and may demonstrate survival benefit; however, results are pending at this time. Given the limited treatment options at tumor recurrence, consideration for enrollment on a clinical trial is encouraged.

Outfoxing the Hedgehog

ERIC Educational Resources Information Center

Barbieri, Richard

2011-01-01

Jim Collins's "Good to Great" has attained near-scriptural status in organizations, including nonprofits, which Collins says constitute a third of his readers. The pivot point in "Good to Great" is the Hedgehog Concept. The "Hedgehog Concept" (HC), this author claims, is dangerous for schools because it distorts the nature of education. As Collins…

Survival of patients with head and neck cancer. Impact of physical status and comorbidities.

PubMed

Sadat, F; Wienke, A; Dunst, J; Kuhnt, T

2012-01-01

Prognostic factors (e.g., gender, tumor stage, and hypoxia) have an impact on survival in patients with head and neck cancer. Thus, the impact of physical status and comorbidities on treatment decision and survival were evaluated. A total of 169 primary, inoperable patients with squamous cell cancer of the head and neck were retrospectively investigated. Patients were treated with hyperfractionated accelerated radio(chemo)therapy (HARcT) or hypofractionated radio(chemo)therapy (HypoRcT). Depending on the individual patient's situation (Karnofsky Performance Index, KPI), treatment for patients with a KPI of 80-100% was generally radiochemotherapy and for patients with a KPI ≤ 70% treatment was radiotherapy alone. In addition, all comorbidities were evaluated. Uni- and multivariate proportional hazards model were used, and overall survival (OS) was estimated by the Kaplan-Meier method. Treatment consisted of HARcT for 76 patients (45%), HART for 28 patients (17%), HypoRcT for 14 patients(8%), and HypoRT for 51 patients (30%). Of the patients, 107 patients (63%) presented with a KPI of 80-100%. OS (20%) was significantly better for patients with a KPI of 80-100%, while the OS for patients with a KPI ≤ 70% was 8% (p < 0.001). Good KPI, total irradiation dose (> 70 Gy), and chemotherapy were significant prognostic factors for better OS. Our retrospective analysis shows that performance status with dependency on comorbidities was an independent risk factor for OS.

Health status and preventative behaviors of immigrants by gender and origin: a Portuguese cross-sectional study.

PubMed

Dias, Sónia; Gama, Ana; Martins, Maria O

2013-09-01

Migration has been associated with a greater vulnerability in health. Migrants, especially women, go through several experiences during the migration process and in the host countries that ultimately put their health at risk. This study examines self-reported health status and preventive behaviors among female and male immigrants in Portugal, and identifies sociodemographic and behavioral factors underlying gender differences. A sample of 1375 immigrants (51.1% women) was studied. Data were analyzed through logistic regression. Good health status was reported by 66.7% of men and by 56.6% of women (P < 0.001). Gender differences were also found across preventative behaviors. Among women and men, reported good health was associated with younger age, African and Brazilian origin (compared to Eastern European), secondary/higher education, no chronic disease, and concern about eating habits. Among women, good health was also associated with perceived sufficient income, no experience of mental illness, and regular physical exercise. When developing health programs to improve immigrants' health, special attention must be given to existing gender inequalities, and socioeconomic and cultural context, in accordance with their experience of living in the host country over time. © 2013 Wiley Publishing Asia Pty Ltd.

Assessment of the nutritional status of Nigerian rural children and mothers' perceptions of quality of life.

PubMed

Ojofeitimi, E O

1984-01-01

One hundred and fourteen preschool school children and their 30 mothers from three selected villages in Ile-Ife, Nigeria were assessed for nutritional status using selected and sensitive anthropometric techniques. The mothers' dietary patterns, their perceptions as to components of a good quality of life, infants' immunization status and major cause of infant death were also examined. Approximately 56% of the children and 80% of the women were identified to be suffering from mild to moderate malnutrition. The major cause of infant death as reported by the mothers was high fever and convulsion. Practically all the children under 3 years had not received any form of immunization. Ability to have plenty of children, good health and money, were highly perceived as measures of essential components of quality of life by all the mothers, while 20% listed good feeding, housing, clothing, and only 7% listed potable water. The need for effective health services, regular home visits, supplementary feeding programmes for school children and an effective health education campaign on the importance of immunization and nutrition for rural people are discussed. The training of agricultural extension workers in the use of simple anthropometric techniques to identify covert malnutrition is also highlighted.

Comprehensive Geriatric Assessment (CGA) based risk factors for increased caregiver burden among elderly Asian patients with cancer.

PubMed

Rajasekaran, Tanujaa; Tan, Tira; Ong, Whee Sze; Koo, Khai Nee; Chan, Lili; Poon, Donald; Roy Chowdhury, Anupama; Krishna, Lalit; Kanesvaran, Ravindran

2016-05-01

This study aims to identify Comprehensive Geriatric Assessment (CGA) based risk factors to help predict caregiver burden among elderly patients with cancer. The study evaluated 249 patients newly diagnosed with cancer, aged 70years and above, who attended the geriatric oncology clinic at the National Cancer Centre Singapore between 2007 and 2010. Out of 249 patients, 244 patients had information available on family caregiver burden and were analysed. On univariate analysis, ADL dependence, lower IADL scores, ECOG performance status of 3-4, higher fall risk, lower scores in dominant hand grip strength test and mini mental state examination, polypharmacy, higher nutritional risk, haemoglobin <12g/dL and presence of geriatric syndromes were significantly associated with mild to severe caregiver burden. On multivariate analysis, only ECOG performance status of 3-4 (odds ratio [OR], 4.47; 95% confidence interval [CI], 2.27-8.80) and haemoglobin <12g/dL (OR, 2.38; 95% CI, 1.14-4.99) were associated with an increased probability of mild to severe caregiver burden. The model achieved a good fit (Hosmer-Lemeshow's p=0.196) and discrimination (area under the curve [AUC]=0.742; bias-corrected AUC=0.737). Based on this, patients were stratified into 3 risk groups with different proportion of patients with increased caregiver burden (low risk: 3.9% vs intermediate risk: 18.8% vs high risk: 39.6%; p<0.001). ECOG performance status and haemoglobin were associated with increased caregiver burden among elderly patients with cancer. Using these two factors in the clinic may help clinicians identify caregivers at risk and take preventive action to mitigate that. Copyright © 2016 Elsevier Inc. All rights reserved.

Glasgow Prognostic Score is superior to ECOG PS as a prognostic factor in patients with gastric cancer with peritoneal seeding.

PubMed

Yuan, Shu-Qiang; Nie, Run-Cong; Chen, Yong-Ming; Qiu, Hai-Bo; Li, Xiao-Ping; Chen, Xiao-Jiang; Xu, Li-Pu; Yang, Li-Fang; Sun, Xiao-Wei; Li, Yuan-Fang; Zhou, Zhi-Wei; Chen, Shi; Chen, Ying-Bo

2018-04-01

The Glasgow Prognostic Score (GPS) has been shown to be associated with survival rates in patients with advanced cancer. The present study aimed to compare the GPS with the Eastern Cooperative Oncology Group Performance Status (ECOG PS) in patients with gastric cancer with peritoneal seeding. For the investigation, a total of 384 gastric patients with peritoneal metastasis were retrospectively analyzed. Patients with elevated C-reactive protein (CRP; >10 mg/l) and hypoalbuminemia (<35 mg/l) were assigned a score of 2. Patients were assigned a score of 1 if presenting with only one of these abnormalities, and a score of 0 if neither of these abnormalities were present. The clinicopathologic characteristics and clinical outcomes of patients with peritoneal seeding were analyzed. The results showed that the median overall survival (OS) of patients in the GPS 0 group was longer, compared with that in the GPS 1 and GPS 2 groups (15.50, vs. 10.07 and 7.97 months, respectively; P<0.001). No significant difference was found between the median OS of patients with a good performance status (ECOG <2) and those with a poor (ECOG ≥2) performance status (13.67, vs. 11.80 months; P=0.076). In the subgroup analysis, the median OS in the GPS 0 group was significantly longer, compared with that in the GPS 1 and GPS 2 groups, for the patients receiving palliative chemotherapy and patients without palliative chemotherapy. Multivariate survival analysis demonstrated that CA19-9, palliative gastrectomy, first-line chemotherapy and GPS were the prognostic factors predicting OS. In conclusion, the GPS was superior to the subjective assessment of ECOG PS as a prognostic factor in predicting the outcome of gastric cancer with peritoneal seeding.

Pancreatic Reference Set Application: Brian Haab-Van Andel (2012) — EDRN Public Portal

Cancer.gov

New markers are greatly needed for the detection and diagnosis of pancreatic cancer. Patients at high risk for developing pancreatic cancer (for, example because of genetic predisposition or health status) can be screened by endoscopy or a related imaging procedure, but these methods are expensive and burdensome to the patient. Blood-based markers would facilitate regular screening. In addition, patients with known abnormalities of the pancreas (for example, as observed incidentally from an abdominal scan) need to determine whether they have cancer or not. The great majority of patients with pancreatic findings by CT do not have conditions that require treatment, yet nearly all patients undergo invasive and burdensome procedures as a consequence of the CT. Again, a blood-based marker could alleviate this situation and potentially add accuracy to the diagnosis. In preliminary work we showed the potential for highly-accurate discrimination of pancreatic cancer from pancreatitis and healthy control subjects using a panel of protein and glycan markers in the serum. We used an antibody array platform in which we can obtain sensitive, reproducible measurements of protein abundance and glycosylation status in low sample volumes. The detection of the glycosylation status is important for the high accuracy of the test because the glycans attached to the marker proteins are altered in cancer patients. Based on the good performance in these early studies, we now want to validate the performance in rigorously controlled, blinded sample sets. The reference set developed by the EDRN will enable a definitive characterization of our marker performance. In addition, we can make an accurate comparison to other markers that will be applied to the same set and determine whether disparate markers could be used together for added benefit.

Neurocognitive status in patients with newly-diagnosed brain tumors in good neurological condition: The impact of tumor type, volume, and location.

PubMed

Hendrix, Philipp; Hans, Elisa; Griessenauer, Christoph J; Simgen, Andreas; Oertel, Joachim; Karbach, Julia

2017-05-01

Neurocognitive function is of great importance in patients with brain tumors. Even patients in good neurological condition may suffer from neurocognitive dysfunction that affects their daily living. The purpose of the present study was to identify risk factors for neurocognitive dysfunction in patients suffering from common supratentorial brain tumors with minor neurological deficits. A prospective study evaluating neurocognitive dysfunction in patients with a newly-diagnosed brain tumor in good neurological condition was performed at a major German academic institution. Patients underwent extensive neurocognitive testing assessing perceptual speed, executive function, visual-spatial and verbal working memory, short- and long-term memory, verbal fluency, fluid intelligence, anxiety, and depression. For each patient, a healthy control was pair-matched based on age, sex, handedness, and profession. A total of 46 patients and 46 healthy controls underwent neurocognitive testing. Patients suffered from glioblastoma multiforme (10), cerebral metastasis (10), pituitary adenoma (13), or meningioma (13). There was neither any difference in age, educational level, fluid intelligence, neurological deficits, and anxiety nor in any depression scores between tumor subgroups. Overall, neurocognitive performance was significantly worse in patients compared to healthy controls. Larger tumor volume, frontal location, and left/dominant hemisphere were associated with worse executive functioning and verbal fluency. Additionally, larger tumors and left/dominant location correlated with impairments on perceptual speed tasks. Frontal tumor location was related to worse performance in visual-spatial and short- and long-term memory. Tumor type, clinical presentation, and patient self-awareness were not associated with specific neurocognitive impairments. Patients suffering from newly-diagnosed brain tumors presenting in good neurological condition display neurocognitive impairments in various domains. Larger tumor volumes, frontal location, and left/dominant hemisphere are important predictors for potential neurocognitive deficits. Tumor type, clinical presentation, or self-awareness are less significant at the time of diagnosis. Copyright © 2017 Elsevier B.V. All rights reserved.

Unanticipated hospital admission in pediatric patients with congenital heart disease undergoing ambulatory noncardiac surgical procedures.

PubMed

Yuki, Koichi; Koutsogiannaki, Sophia; Lee, Sandra; DiNardo, James A

2018-05-18

An increasing number of surgical and nonsurgical procedures are being performed on an ambulatory basis in children. Analysis of a large group of pediatric patients with congenital heart disease undergoing ambulatory procedures has not been undertaken. The objective of this study was to characterize the profile of children with congenital heart disease who underwent noncardiac procedures on an ambulatory basis at our institution, to determine the incidence of adverse cardiovascular and respiratory adverse events, and to determine the risk factors for unscheduled hospital admission. This is a retrospective study of children with congenital heart disease who underwent noncardiac procedures on an ambulatory basis in a single center. Using the electronic preoperative anesthesia evaluation form, we identified 3010 patients with congenital heart disease who underwent noncardiac procedures of which 1028 (34.1%) were scheduled to occur on an ambulatory basis. Demographic, echocardiographic and functional status data, cardiovascular and respiratory adverse events, and reasons for postprocedure admission were recorded. Univariable analysis was conducted. The unplanned hospital admission was 2.7% and univariable analysis demonstrated that performance of an echocardiogram within 6 mo of the procedure and procedures performed in radiology were associated with postoperative admission. Cardiovascular adverse event incidence was 3.9%. Respiratory adverse event incidence was 1.8%. Ambulatory, noncomplex procedures can be performed in pediatric patients with congenital heart disease and good functional status with a relatively low unanticipated hospital admission rate. © 2018 John Wiley & Sons Ltd.

Professional correlates of insomnia.

PubMed

Léger, Damien; Massuel, Marie-Anne; Metlaine, Arnaud

2006-02-01

Insomnia is a highly prevalent disorder that affects daytime functioning, behavior, and quality of life. Several reports have shown that insomnia impacts on the workforce and is associated with an increased risk of absenteeism. However, few workplace studies have been performed. Our study attempted to evaluate the professional correlates of insomnia by comparing a group of workers with insomnia to a matched group of good sleepers. The main objective measure was absenteeism. Accidents, self-esteem at work, job satisfaction, and efficiency at work were also investigated. Pairs of workers with insomnia (according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition definition) and good sleepers, matched by age, sex, and occupational status, were interviewed by their occupational physician and also answered a self-administered questionnaire on work-related criteria. Objective data on absenteeism (number of days absent from work) were provided by the employers' health resource databases. Paris and the Ile de France region (France). Seven hundred eighty-five subjects completed the questionnaire. We retained 369 pair (ie, 738 subjects) for analysis. Insomniacs missed work twice as often as good sleepers. The difference between insomniacs and good sleepers in terms of absenteeism was particularly high for blue-collar workers (odds ratio = 3.0) and men (odds ratio = 2.31). Insomniacs had also a higher accident rate while driving and, strikingly, a 3-fold greater risk of having 2 or 3 serious road accidents. They also reported poor self-esteem at work, less job satisfaction, and less efficiency at work, compared with good sleepers. Our study found an objective increase in absenteeism in insomniacs compared with good sleepers.

Social status determines how we monitor and evaluate our performance

PubMed Central

Kostermans, Evelien; Milivojevic, Branka; De Cremer, David

2012-01-01

Since people with low status are more likely to experience social evaluative threat and are therefore more inclined to monitor for these threats and inhibit approach behaviour, we expected that low-status subjects would be more engaged in evaluating their own performance, compared with high-status subjects. We created a highly salient social hierarchy based on the performance of a simple time estimation task. Subjects could achieve high, middle or low status while performing this task simultaneously with other two players who were either higher or lower in status. Subjects received feedback on their own performance, as well as on the performance of the other two players simultaneously. Electroencephalography (EEG) was recorded from all three participants. The results showed that medial frontal negativity (an event-related potential reflecting performance evaluation) was significantly enhanced for low-status subjects. Implications for status-related differences in goal-directed behaviour are discussed. PMID:21421733

Differences in the Morale of Older, Rural Widows and Widowers.

ERIC Educational Resources Information Center

Scott, Jean Pearson; Kivett, Vira R.

1985-01-01

Examined effect of sex differences on morale of 257 older rural widows and widowers. Sex of respondent was not found to affect morale; however, perceived financial status and self-rated health had significant direct effects. Widows and widowers reporting higher morale had higher perceived financial status and rated their health as good.…

Predicting Handwriting Difficulties through Spelling Processes

ERIC Educational Resources Information Center

Rodríguez, Cristina; Villarroel, Rebeca

2017-01-01

This study examined whether spelling tasks contribute to the prediction of the handwriting status of children with poor and good handwriting skills in a cross-sectional study with 276 Spanish children from Grades 1 and 3. The main hypothesis was that the spelling tasks would predict the handwriting status of the children, although this influence…

Development of innovative tools for understanding marine biodiversity and assessing good environmental status, within the European Marine Strategy Framework Directive

NASA Astrophysics Data System (ADS)

Borja, Angel; Uyarra, María C.

2014-05-01

Marine natural resources and ecosystem services constitute the natural capital that supports economies, societies and individual well-being. Good governance requires a quantification of the interactions and trade-offs among ecosystem services and understanding of how biodiversity underpins ecosystem functions and services across time, scales and sectors. Marine biodiversity is a key descriptor for the assessment within the Marine Strategy Framework Directive (MSFD), approved in 2008, which comprises a total of 11 descriptors. However, the relationships between pressures from human activities and climatic influences and their effects on marine biological diversity are still only partially understood. Hence, these relationships need to be better understood in order to fully achieve a good environmental status (GEnS), as required by the MSFD. This contribution is based upon the FP7 EU project DEVOTES (DEVelopment Of innovative Tools for understanding marine biodiversity and assessing good Environmental Status), which focus on developing innovative conceptual frameworks, methods and coherent, shared protocols to provide consistent datasets and knowledge at different scales, within four regional seas (Black Sea, Mediterranean, Atlantic and Baltic Sea). This project is developing innovative approaches to valuate biodiversity and ecosystem services and to develop public goods and sustainable economic activities from them. The research will benefit sea users and stakeholders, and will contribute to assess and monitor the environmental status of marine waters. The main objectives are: (i) to improve our understanding of the impact of human activities and variations associated to climate on marine biodiversity, (ii) to test indicators (referred in the Commission Decision on GEnS) and develop new ones for assessment at several ecological levels (species, habitat, ecosystems) and for the characterization and status classification of the marine waters, (iii) to develop, test and validate, on the basis of observations, innovative integrative modelling tools in order to further strengthen our understanding of ecosystem and biodiversity changes in space and time. The resultant models are being developed for implementation as operational tools for managers, decision takers and policy makers. The project is contributing (i) to enable the adaptive development of management (ecosystem-based management approach) strategies and management measures as a result of their implementation taking into account the role of industry and relevant stakeholders, (ii) to provide economic assessment of the consequences of management practices, (iii) to identify the barriers (socio-economic and legislative) that prevent the GES to be achieved (e.g. eutrophication), (iv) to provide a set of policy options for the relevant authorities. In addition the project should propose and demonstrate the utility of innovative monitoring systems capable of providing data on a range of parameters, efficiently and effectively, that may be used as indicators of good environmental status. This contribution presents a summary of most of these aspects.

Determinants of each domain of the Short Physical Performance Battery in COPD.

PubMed

Bernabeu-Mora, Roberto; Giménez-Giménez, Luz M; Montilla-Herrador, Joaquina; García-Guillamón, Gloria; García-Vidal, José Antonio; Medina-Mirapeix, Francesc

2017-01-01

The Short Physical Performance Battery (SPPB) is an assessment tool with good prognostic value in COPD. It includes the following: standing balance, 4 m gait speed test (4MGS), and the timed five-repetition sit-to-stand test (5STS). The specific differences in determinants between these three tasks have not been adequately characterized in COPD patients. We aimed to identify health-related, functional, and psychological determinants of each SPPB test. We conducted a cross-sectional analysis of 137 patients with stable COPD. Patients performed the SPPB, quadriceps muscle strength (QMS), exercise tolerance test (6-min walk test [6MWT]), and pulmonary function; and health-related and psychological factors, physical activity, the COPD assessment test (CAT), body mass index, age, and depression were assessed. Separate multivariable regression models predicting the 4MGS, 5STS, and balance test results described 31%, 39.1%, and 12.1% of the variance for each test, respectively. QMS was negatively associated with all three tests. The 6MWT was negatively associated with the 4MGS and 5STS. Depression and age were positively associated with 4MGS scores, whereas CAT and age were positively associated with 5STS scores. The three SPPB tests did not provide equivalent information regarding a COPD patient's status. The 5STS was associated with health status factors, while the 4MGS was associated with psychological factors.

Determinants of each domain of the Short Physical Performance Battery in COPD

PubMed Central

Bernabeu-Mora, Roberto; Giménez-Giménez, Luz M; Montilla-Herrador, Joaquina; García-Guillamón, Gloria; García-Vidal, José Antonio; Medina-Mirapeix, Francesc

2017-01-01

Background The Short Physical Performance Battery (SPPB) is an assessment tool with good prognostic value in COPD. It includes the following: standing balance, 4 m gait speed test (4MGS), and the timed five-repetition sit-to-stand test (5STS). The specific differences in determinants between these three tasks have not been adequately characterized in COPD patients. We aimed to identify health-related, functional, and psychological determinants of each SPPB test. Methods We conducted a cross-sectional analysis of 137 patients with stable COPD. Patients performed the SPPB, quadriceps muscle strength (QMS), exercise tolerance test (6-min walk test [6MWT]), and pulmonary function; and health-related and psychological factors, physical activity, the COPD assessment test (CAT), body mass index, age, and depression were assessed. Results Separate multivariable regression models predicting the 4MGS, 5STS, and balance test results described 31%, 39.1%, and 12.1% of the variance for each test, respectively. QMS was negatively associated with all three tests. The 6MWT was negatively associated with the 4MGS and 5STS. Depression and age were positively associated with 4MGS scores, whereas CAT and age were positively associated with 5STS scores. Conclusion The three SPPB tests did not provide equivalent information regarding a COPD patient’s status. The 5STS was associated with health status factors, while the 4MGS was associated with psychological factors. PMID:28883721

Development and preliminary testing of a Paediatric Version of the Haemophilia Activities List (pedhal).

PubMed

Groen, W G; van der Net, J; Helders, P J M; Fischer, K

2010-03-01

Worldwide, children with haemophilia suffer from limitations in performing activities of daily living. To measure such limitations in adults a disease-specific instrument, the Haemophilia Activities List (HAL), was created in 2004. The aim of this study was to adapt the HAL for children with haemophilia and to assess its psychometric properties. The structure and the main content were derived from the HAL. Additionally, items of the Childhood Health Assessment Questionnaire and the Activity Scale for Kids were considered for inclusion. This version was evaluated by health professionals (n = 6), patients (n = 4), and parents (n = 3). A pilot test in a sample of 32 Dutch children was performed to assess score distribution, construct validity (Spearman's rho) and reproducibility. Administration of the pedhal was feasible for children from the age of 4 years onwards. The pedhal scores of the Dutch children were in the high end of the scale, reflecting a good functional status. Most subscales showed moderate associations with the joint examination (rho = 0.42-0.63) and moderate-to-good associations with the physical function subscale of the CHQ-50 (rho = 0.48-0.74). No significant associations were found for the pedhal and the subscales mental health and behaviour, except for the subscales leisure and sport and mental health (rho = 0.47). Test-retest agreement was good. The pedhal is a promising tool, but further testing in populations with a higher level of disability is warranted to study the full range of its psychometric properties.

Assessment of the ecological bias of seven aggregate social deprivation indices.

PubMed

Bryere, Josephine; Pornet, Carole; Copin, Nane; Launay, Ludivine; Gusto, Gaëlle; Grosclaude, Pascale; Delpierre, Cyrille; Lang, Thierry; Lantieri, Olivier; Dejardin, Olivier; Launoy, Guy

2017-01-17

In aggregate studies, ecological indices are used to study the influence of socioeconomic status on health. Their main limitation is ecological bias. This study assesses the misclassification of individual socioeconomic status in seven ecological indices. Individual socioeconomic data for a random sample of 10,000 persons came from periodic health examinations conducted in 2006 in 11 French departments. Geographical data came from the 2007 census at the lowest geographical level available in France. The Receiver Operating Characteristics (ROC) curves, the areas under the curves (AUC) for each individual variable, and the distribution of deprived and non-deprived persons in quintiles of each aggregate score were analyzed. The aggregate indices studied are quite good "proxies" for individual deprivation (AUC close to 0.7), and they have similar performance. The indices are more efficient at measuring individual income than education or occupational category and are suitable for measuring of deprivation but not affluence. The study inventoried the aggregate indices available in France and evaluated their assessment of individual SES.

Impact of periodontal status on oral health-related quality of life among police personnel in Virajpet, India.

PubMed

Abhishek, Kanuvanaghatta N; Jain, Jithesh; Shamarao, Supreetha; Khanapure, Sneha C

2016-05-01

The aim of the present study was to determine the association between oral health-related quality of life (OHRQoL) and periodontal status among police personnel in Virajpet, India. Police personnel were randomly selected from the 296 police staff working in Virajpet, India. A self-administered questionnaire was used to collect information on their demographics and dental visit behavior, and to determine their OHRQoL. The community periodontal index (CPI) and loss of attachment were used to assess periodontal status. All 72 invited participants joined this study. The majority (n = 133) had good OHRQoL. For those with a good OHRQoL, 74 had CPI = 0, 25 had CPI = 1, 20 had CPI = 2, and 14 had CPI ≥ 3. For those who had an average or poor OHRQoL (n = 37), 19 had CPI = 0, one had CPI = 1, eight had CPI = 2, and nine had CPI ≥ 3. There was a statistically-significant association between OHRQoL and CPI (P < 0.003). Most participants with good OHRQoL (127/133), but only less than half with an average or poor OHRQoL (22/37), had no loss of periodontal attachment (P < 0.0001). In the present study, there was an association between OHRQoL and periodontal status among police personnel in Virajpet, Coorg. © 2014 Wiley Publishing Asia Pty Ltd.

The impact of cattle access on ecological water quality in streams: Examples from agricultural catchments within Ireland.

PubMed

Conroy, E; Turner, J N; Rymszewicz, A; O'Sullivan, J J; Bruen, M; Lawler, D; Lally, H; Kelly-Quinn, M

2016-03-15

Unrestricted cattle access to rivers and streams represent a potentially significant localised pressure on freshwater systems. However there is no consensus in the literature on the occurrence and extent of impact and limited research has examined the effects on aquatic biota in the humid temperate environment examined in the present study. Furthermore, this is one of the first times that research consider the potential for cattle access impacts in streams of varying water quality in Northern Europe. We investigated the effects of cattle access on macroinvertebrate communities and deposited fine sediment levels, in four rivers of high/good and four rivers of moderate water quality status which drain, low gradient, calcareous grassland catchments in Ireland. We assessed the temporal variability in macroinvertebrates communities across two seasons, spring and autumn. Site specific impacts were evident which appeared to be influenced by water quality status and season. All four high/good water status rivers revealed significant downstream changes in community structure and at least two univariate metrics (total richness and EPT richness together with taxon, E and EPT abundance). Two of the four moderate water status rivers showed significant changes in community structure, abundance and richness metrics and functional feeding groups driven in the main by downstream increases in collectors/gatherers, shredders and burrowing taxa. These two moderate water status rivers had high or prolonged livestock activity. In view of these findings, the potential for some of these sites to achieve at least high/good water quality status, as set out in the EU Water Framework Directive, may be compromised. The results presented highlight the need for additional research to further define the site specific factors and livestock management practices, under different discharge conditions, that increase the risk of impact on aquatic ecology due to these cattle-river interactions. Copyright © 2015 Elsevier B.V. All rights reserved.

Allied-Signal's Mary Good Analyzes New Threats to Chemical Profession.

ERIC Educational Resources Information Center

Chemical and Engineering News, 1986

1986-01-01

Recounts an interview with chemist, educator, and executive Mary Good. Opinions are expressed about the status of basic research in chemistry, the relationship of chemical research to several federal agencies, the value of education in chemistry, and the perceptions of the public regarding the chemical community, particularly the health risks. (TW)

The relationship between social functioning and subjective memory complaints in older persons: a population-based longitudinal cohort study.

PubMed

Kuiper, Jisca S; Oude Voshaar, Richard C; Zuidema, Sytse U; Stolk, Ronald P; Zuidersma, Marij; Smidt, Nynke

2017-10-01

Poor social functioning is associated with cognitive decline in older adults. It is unclear whether social functioning is also associated with subjective memory complaints (SMC). We investigated the association between social functioning and incident SMC and SMC recovery. A population-based sample of 8762 older adults (aged ≥65 years) with good objective cognitive functioning at baseline (MMSE ≥26) from the LifeLines Cohort Study were followed for 1.5 years. Self-reported SMC were measured at baseline and after 1.5 years follow-up. Aspects of social functioning included marital status, household composition, social network size, social activity, quality of social relationships, social support, affection, behavioral confirmation, and status. Thirteen percent (513/3963) developed SMC during follow-up (incident SMC). Multivariate logistic regression analyses (adjusted for age, gender, education level, physical activity, alcohol use, smoking status, depression, arrhythmia, myocardial infarction, heart failure, stroke) showed that participants with better feelings of affection, behavioral confirmation and stable good social support had a lower risk of incident SMC. Thirty-four percent (1632/4799) reported recovery. Participants with good social functioning at baseline on all determinants reported more SMC recovery. People who remained stable in a relationship, stable in good quality of social relationships or increased in quality of social relationships more often report SMC recovery. Good social functioning is associated with less incident SMC and more SMC recovery over a follow-up period of 1.5 years. Albeit future confirmative studies are needed, we argue for targeting also social functioning when designing multidomain interventions to prevent or slow down cognitive decline. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Optimizing associated liver partition and portal vein ligation for staged hepatectomy outcomes: Surgical experience or appropriate patient selection?

PubMed Central

Al Hasan, Ibrahim; Tun-Abraham, Mauro Enrique; Wanis, Kerollos N.; Garcia-Ochoa, Carlos; Levstik, Mark A.; Al-Judaibi, Bandar; Hernandez-Alejandro, Roberto

2017-01-01

Background Early reports of associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) outcomes have been suboptimal. The literature has confirmed that learning curves influence surgical outcomes. We have 54 months of continuous experience performing ALPPS with strict selection criteria. This study aimed to evaluate the impact of the learning curve on ALPPS outcomes. Methods We retrospectively compared patients who underwent ALPPS between April 2012 and March 2016. Patients were grouped into 2 24-month (early and late) periods. All candidates had a high tumour load requiring staged hepatectomy after chemotherapy response, a predicted future liver remnant (FLR) less than 30% and good performance status. Results Thirty-three patients underwent ALPPS during the study period: 16 in the early group (median age 65 yr, mean body mass index [BMI] 27) and 17 in the late group (median age 60 yr, mean BMI 25). Bilobar disease was comparable in both groups (94% v. 88%, p > 0.99). Duration of surgery was not statistically different. Intraoperative blood loss and need for transfusion were significantly lower in the late group (200 ± 109 mL v. 100 ± 43 mL, p < 0.05). The late group had a higher proportion of monosegment ALPPS (4:1). There were no deaths within 90 days in either cohort. Rates of postoperative complications were not statistically significant between groups. The R0 resection rate was similar. The entire 1-year disease-free and overall survival were 52% and 84%, respectively. Conclusion Excellent results can be obtained in innovative complex surgery with careful patient selection and good technical skills. Additionally, the learning curve brought confidence to perform more complex procedures while maintaining good outcomes. PMID:29173259

Application of Machine Learning to Arterial Spin Labeling in Mild Cognitive Impairment and Alzheimer Disease.

PubMed

Collij, Lyduine E; Heeman, Fiona; Kuijer, Joost P A; Ossenkoppele, Rik; Benedictus, Marije R; Möller, Christiane; Verfaillie, Sander C J; Sanz-Arigita, Ernesto J; van Berckel, Bart N M; van der Flier, Wiesje M; Scheltens, Philip; Barkhof, Frederik; Wink, Alle Meije

2016-12-01

Purpose To investigate whether multivariate pattern recognition analysis of arterial spin labeling (ASL) perfusion maps can be used for classification and single-subject prediction of patients with Alzheimer disease (AD) and mild cognitive impairment (MCI) and subjects with subjective cognitive decline (SCD) after using the W score method to remove confounding effects of sex and age. Materials and Methods Pseudocontinuous 3.0-T ASL images were acquired in 100 patients with probable AD; 60 patients with MCI, of whom 12 remained stable, 12 were converted to a diagnosis of AD, and 36 had no follow-up; 100 subjects with SCD; and 26 healthy control subjects. The AD, MCI, and SCD groups were divided into a sex- and age-matched training set (n = 130) and an independent prediction set (n = 130). Standardized perfusion scores adjusted for age and sex (W scores) were computed per voxel for each participant. Training of a support vector machine classifier was performed with diagnostic status and perfusion maps. Discrimination maps were extracted and used for single-subject classification in the prediction set. Prediction performance was assessed with receiver operating characteristic (ROC) analysis to generate an area under the ROC curve (AUC) and sensitivity and specificity distribution. Results Single-subject diagnosis in the prediction set by using the discrimination maps yielded excellent performance for AD versus SCD (AUC, 0.96; P < .01), good performance for AD versus MCI (AUC, 0.89; P < .01), and poor performance for MCI versus SCD (AUC, 0.63; P = .06). Application of the AD versus SCD discrimination map for prediction of MCI subgroups resulted in good performance for patients with MCI diagnosis converted to AD versus subjects with SCD (AUC, 0.84; P < .01) and fair performance for patients with MCI diagnosis converted to AD versus those with stable MCI (AUC, 0.71; P > .05). Conclusion With automated methods, age- and sex-adjusted ASL perfusion maps can be used to classify and predict diagnosis of AD, conversion of MCI to AD, stable MCI, and SCD with good to excellent accuracy and AUC values. © RSNA, 2016.

A 51-Year-Old Woman With an Increasing Chest Wall Mass Years After Resection of an Early Stage Lung Cancer.

PubMed

Dhakal, Ajay; Chen, Hongbin; Dexter, Elisabeth U

2017-12-01

A 51-year-old woman was found to have a new 14 × 6 mm soft tissue mass under the right serratus muscle on a CT scan of the chest performed for routine surveillance due to her history of stage I lung cancer. A follow-up CT scan performed 4 months later showed that the mass had increased in size to 22 × 8 mm. The patient presents to the oncology clinic to discuss the results of the CT scan. She has no pain or swelling on the right lateral chest and no cough, fever, or shortness of breath. She is at her baseline health with good appetite and functional status. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Cooperation and depressive symptoms.

PubMed

Brendan Clark, C; Thorne, Christopher B; Hardy, Sonya; Cropsey, Karen L

2013-09-25

Deficits in pro-social cooperation are common in many individuals with mental illnesses such as depression. For decades, researchers have used economic game paradigms to compare cross-cultural cooperative behavior. However, research using economic games to assess cooperative behavior in clinical populations is in the early stages. We hypothesized that individuals with greater depressive symptoms would struggle to maintain reciprocity in iterative games, but not in single-iteration games measuring personal values. Participants (n=41) played four computer-based economic games (prisoner's dilemma, the public goods game, the ultimatum game, and the trust game) measuring different aspects of cooperation. Participants completed the Depression Anxiety and Stress Scale (DASS) and other measures of personality and demographics. Analyses assessed the relationships between game performance and psychological distress as measured by the DASS. Significant correlations were found between game performance and depressive symptoms, but not symptoms of anxiety or stress. Performance in the prisoner's dilemma and public goods game was significantly related to depression in a linear regression even when known associations with depressive affect such as age, gender, race, education, marital status, and neuroticism were controlled for. Depressive symptoms were associated with an inability to sustain reciprocal cooperation. Participants showed the predicted deficits in cooperation in these economic games. Economic games show the potential for assessing the social deficits associated with depressive symptoms. © 2013 Elsevier B.V. All rights reserved.

Tramadol Extended-Release for the Management of Pain due to Osteoarthritis

PubMed Central

Guetti, Cristiana; Paladini, Antonella; Varrassi, Giustino

2013-01-01

Current knowledge on pathogenesis of osteoarticular pain, as well as the consequent several, especially on the gastrointestinal, renal, and cardiovascular systems, side effects of NSAIDs, makes it difficult to perform an optimal management of this mixed typology of pain. This is especially observable in elderly patients, the most frequently affected by osteoarthritis (OA). Tramadol is an analgesic drug, the action of which has a twofold action. It has a weak affinity to mu opioid receptors and, at the same time, can result in inhibition of the reuptake of noradrenaline and serotonin in nociceptorial descending inhibitory control system. These two mechanisms, “opioidergic” and “nonopioidergic,” are the grounds for contrasting certain types of pain that are generally less responsive to opioids, such as neuropathic pain or mixed OA pain. The extended-release formulation of tramadol has good efficacy and tolerability and acts through a dosing schedule that allows a high level of patients compliance to therapies with a good recovery outcome for the patients' functional status. PMID:27335872

Photometry from space

NASA Technical Reports Server (NTRS)

Nelson, M. J.; Bless, R. C.; Percival, J. W.; White, R. L.

1992-01-01

A brief description of the High Speed Photometer (HSP) of the Hubble Space Telescope is given, in particular the HSP light path, detectors, entrance apertures, and filters. The status of HSP testing to date is reported, and problems encountered with the bright earth and the telescope pointing system are described. The calibration effort for the HSP is well under way. Results of internal (instrument coordinate) aperture locations good to 0.05 arcsec and external (telescope coordinate) locations good to 0.02 arcsec are shown. The effects of spacecraft pointing and jitter on HSP photometry are detailed, and a preliminary measurement of spacecraft jitter with HSP is shown. The aperture calibration effort is verified by accurate pointing of a star to different HSP 1.0 arcsec entrance apertures, and photometric performance of the instrument is shown to be accurate to the 2 percent photon noise of the observations. Future science verification and guaranteed observing time programs are listed. Suggestions are made for future space-based photometers.

Peritoneal dialysis is appropriate for elderly patients.

PubMed

Teitelbaum, Isaac

2006-01-01

The utilization of peritoneal dialysis decreases with age. A number of concerns have been raised regarding the suitability of peritoneal dialysis for elderly patients. The purpose of this review is to determine whether these concerns are medically valid. Literature review and synthesis. Most elderly patients possess the manual and cognitive skills necessary to perform peritoneal dialysis. Elderly patients on peritoneal dialysis exhibit excellent compliance with their treatment regimen and display no increase in the rate of infectious complications though they may have a slight increase in hospital days. They easily achieve adequacy targets, experience good technique survival and their nutritional status is at least as good as that of their hemodialysis counterparts. Patient survival varies around the world but is overall comparable to that of age-matched patients on hemodialysis. Quality of life may be somewhat superior to that of older hemodialysis patients. Elderly patients with end-stage renal disease are appropriate candidates for peritoneal dialysis. It is not medically justifiable to exclude them from consideration for this therapeutic modality.

AMOBH: Adaptive Multiobjective Black Hole Algorithm.

PubMed

Wu, Chong; Wu, Tao; Fu, Kaiyuan; Zhu, Yuan; Li, Yongbo; He, Wangyong; Tang, Shengwen

2017-01-01

This paper proposes a new multiobjective evolutionary algorithm based on the black hole algorithm with a new individual density assessment (cell density), called "adaptive multiobjective black hole algorithm" (AMOBH). Cell density has the characteristics of low computational complexity and maintains a good balance of convergence and diversity of the Pareto front. The framework of AMOBH can be divided into three steps. Firstly, the Pareto front is mapped to a new objective space called parallel cell coordinate system. Then, to adjust the evolutionary strategies adaptively, Shannon entropy is employed to estimate the evolution status. At last, the cell density is combined with a dominance strength assessment called cell dominance to evaluate the fitness of solutions. Compared with the state-of-the-art methods SPEA-II, PESA-II, NSGA-II, and MOEA/D, experimental results show that AMOBH has a good performance in terms of convergence rate, population diversity, population convergence, subpopulation obtention of different Pareto regions, and time complexity to the latter in most cases.

Evaluation of Oral Health Status among 5-15-Year-old School Children in Shimoga City, Karnataka, India: A Cross-sectional Study

PubMed Central

Shashibhushan, Kukkalli Kamalaksharappa; Pradeep, Muttugadur Chandrappa; Babaji, Prashant; Reddy, Vundela Rajashekar

2017-01-01

Introduction Oral health is an integral part of general health. Dental problems can be avoided if identified at an early stage. There is no data on oral health status of school going children in Karnataka state’s Shimoga city. Aim To evaluate oral health status of school going children among 5-15-year-old in Shimoga city. Materials and Methods A cross-sectional study was conducted among 1458 government and private school children aged 5-6, 9-10 and 14-15 years. Dental caries (DMFT and deft Index), oral hygiene status (OHI-S Index) and dental fluorosis (Dean’s Fluorosis Index) according to WHO diagnostic criteria (1997) were assessed. Data was evaluated using ANOVA and t-test by SPSS (IBM statistical software version 21.0.) at a level of 5% significance. Results The deft among 5-6-year-old children was 3.36±3.511, deft and DMFT among 9-10-year-old was 2.55±2.497 and 0.45±0.996 respectively and DMFT among 14-15-year-old was 1.34±1.832. The caries prevalence among 5-6-year-old was 68.8%, 9-10-year-old was 77.2% and 14-15-year-old was 48.9% and overall prevalence of dental caries was 65.3% which was statistically significant. Among 9-10-year-old oral hygiene was good in 85.4%, fair in 13.5% and poor in 1% of school children and among 14-15-year-old oral hygiene was good in 77.4%, fair in 22.2% and poor in 0.4%. Overall 81.7% of children had good oral hygiene. The prevalence of dental fluorosis was 14.5%. Conclusion The children from government school were found to be less caries free than the private school children, but the difference was not significant. Oral hygiene status is found to be good among both the private and government school children. So the dental awareness is required among children of government school. PMID:28893041

Constraints on good child-care practices and nutritional status in urban Dar-es-Salaam, Tanzania.

PubMed

Kulwa, Kissa B M; Kinabo, Joyce L D; Modest, Beata

2006-09-01

Care is increasingly being recognized as a crucial input to child health and nutrition, along with food security, availability of health services, and a healthy environment. Although significant gains have been made in the fight against malnutrition in Tanzania, the nutritional status of preschool children in urban areas is not improving. To assess child-care practices and the nutritional status of infants and young children with the aim of improvingfeeding practices and child nutritional status. A cross-sectional study was undertaken in urban Dar-es-Salaam, Tanzania. The study involved 100 randomly selected mothers of children 6 to 24 months old from households in Ilala Municipality, one of the three municipalities that constitute the Dar-es-Salaam City Council. Data were collected by a structured questionnaire, spot-check observations, and anthropometric measurements. The prevalence rates of stunting, underweight, wasting, and morbidity were 43%, 22%, 3%, and 80%, respectively. The prevalence of exclusive breastfeeding was very low (9%), and most stunted children (88%) were not exclusively breastfed for the first 6 months. The mean age at which complementary foods and fluids were introduced was 3.26 +/- 1.12 months (range, 1 to 5 months). The fluids given were mainly water and thin cereal-based porridge. More than half of the households practiced good hygiene. Most of the psychosocial practices (e.g., caregiver's attention, affection, and involvement in child feeding, hygiene, health care, and training) were performed by mothers, except for cooking and feeding the children and child training, which were done mostly by alternative caregivers. Nearly half of the mothers (44%) worked out of the home. The mean number of working hours per day was long (10.32 +/- 2.13), necessitating the use of alternative caregivers. A negative correlation was found between height-for-age z-scores and the number of hours mothers worked outside the home. The prevalence rates of chronic malnutrition and morbidity are high, and child-feeding practices are inadequate in this urban population. Maternal employment and educational characteristics constrain good child-care practices, and alternative caregivers are taking a more important role in child care as mothers join the work force. We recommend that formative research be conducted to study the actual practices of caregivers in order to form the basis for a child-care education program. There is also a need to strengthen national health system support for improved child feeding.

Use of Wilms Tumor 1 Gene Expression as a Reliable Marker for Prognosis and Minimal Residual Disease Monitoring in Acute Myeloid Leukemia With Normal Karyotype Patients.

PubMed

Marjanovic, Irena; Karan-Djurasevic, Teodora; Ugrin, Milena; Virijevic, Marijana; Vidovic, Ana; Tomin, Dragica; Suvajdzic Vukovic, Nada; Pavlovic, Sonja; Tosic, Natasa

2017-05-01

Acute myeloid leukemia with normal karyotype (AML-NK) represents the largest group of AML patients classified with an intermediate prognosis. A constant need exists to introduce new molecular markers for more precise risk stratification and for minimal residual disease (MRD) monitoring. Quantitative assessment of Wilms tumor 1 (WT1) gene transcripts was performed using real-time polymerase chain reaction. The bone marrow samples were collected at the diagnosis from 104 AML-NK patients and from 34 of these patients during follow-up or disease relapse. We found that overexpression of the WT1 gene (WT1 high status), present in 25.5% of patients, was an independent unfavorable factor for achieving complete remission. WT1 high status was also associated with resistance to therapy and shorter disease-free survival and overall survival. Assessment of the log reduction value of WT1 expression, measured in paired diagnosis/complete remission samples, revealed that patients with a log reduction of < 2 had a tendency toward shorter disease-free survival and overall survival and a greater incidence of disease relapse. Combining WT1 gene expression status with NPM1 and FLT3-ITD mutational status, we found that the tumor behavior of intermediate patients (FLT3-ITD - /NPM1 - double negative) with WT1 high status is almost the same as the tumor behavior of the adverse risk group. WT1 expression status represents a good molecular marker of prognosis, response to treatment, and MRD monitoring. Above all, the usage of the WT1 expression level as an additional marker for more precise risk stratification of AML-NK patients could lead to more adapted, personalized treatment protocols. Copyright © 2017 Elsevier Inc. All rights reserved.

Potential adult Medicaid beneficiaries under the Patient Protection and Affordable Care Act compared with current adult Medicaid beneficiaries.

PubMed

Chang, Tammy; Davis, Matthew

2013-01-01

Under health care reform, states will have the opportunity to expand Medicaid to millions of uninsured US adults. Information regarding this population is vital to physicians as they prepare for more patients with coverage. Our objective was to describe demographic and health characteristics of potentially eligible Medicaid beneficiaries. We performed a cross-sectional study using data from the National Health and Nutrition Examination Survey (2007-2010) to identify and compare adult US citizens potentially eligible for Medicaid under provisions of the Patient Protection and Affordable Care Act (ACA) with current adult Medicaid beneficiaries. We compared demographic characteristics (age, sex, race/ethnicity, education) and health measures (self-reported health status; measured body mass index, hemoglobin A1c level, systolic and diastolic blood pressure, depression screen [9-item Patient Health Questionnaire], tobacco smoking, and alcohol use). Analyses were based on an estimated 13.8 million current adult non-elderly Medicaid beneficiaries and 13.6 million nonelderly adults potentially eligible for Medicaid. Potentially eligible individuals are expected to be more likely male (49.2% potentially eligible vs 33.3% current beneficiaries; P <.001), to be more likely white and less likely black (58.8% white, 20.0% black vs 49.9% white, 25.2% black; P = .02), and to be statistically indistinguishable in terms of educational attainment. Overall, potentially eligible adults are expected to have better health status (34.8% "excellent" or "very good," 40.4% "good") than current beneficiaries (33.5% "excellent" or "very good," 31.6% "good"; P <.001). The proportions obese (34.5% vs 42.9%; P = .008) and with depression (15.5% vs 22.3%; P = .003) among potentially eligible individuals are significantly lower than those for current beneficiaries, while there are no significant differences in the expected prevalence of diabetes or hypertension. Current tobacco smoking (49.2% vs 38.0%; P = .002), and moderate and heavier alcohol use (21.6% vs 16.0% and 16.5% vs 9.8%; P <.001, respectively) are more common among the potentially eligible population than among current beneficiaries. Under the ACA, physicians can anticipate a potentially eligible Medicaid population with equal if not better current health status and lower prevalence of obesity and depression than current Medicaid beneficiaries. Federal Medicaid expenditures for newly covered beneficiaries therefore may not be as high as anticipated in the short term. Given the higher prevalence of tobacco smoking and alcohol use, however, broad enrollment and engagement of this potentially eligible population is needed to address their higher prevalence of modifiable risk factors for future chronic disease.

Perceived fitness protects against stress-based mental health impairments among police officers who report good sleep.

PubMed

Gerber, Markus; Kellmann, Micheal; Elliot, Catherine; Hartmann, Tim; Brand, Serge; Holsboer-Trachsler, Edith; Pühse, Uwe

2014-01-01

This study examined a cognitive stress-moderation model that posits that the harmful effects of chronic stress are decreased in police officers who perceive high levels of physical fitness. It also determined whether the stress-buffering effect of perceived fitness is influenced by officers' self-reported sleep. A total of 460 police officers (n=116 females, n=344 males, mean age: M=40.7; SD=9.7) rated their physical fitness and completed a battery of self-report stress, mental health, and sleep questionnaires. Three-way analyses of covariance were performed to examine whether officers' self-reported mental health status depends on the interaction between stress, perceived fitness and sleep. Highly stressed officers perceived lower mental health and fitness and were overrepresented in the group of poor sleepers. Officers with high fitness self-reports revealed increased mental health and reported good sleep. In contrast, poor sleepers scored lower on the mental health index. High stress was more closely related to low mental health among poor sleepers. Most importantly, perceived fitness revealed a stress-buffering effect, but only among officers who reported good sleep. High perceived fitness and good sleep operate as stress resilience resources among police officers. The findings suggest that multimodal programs including stress management, sleep hygiene and fitness training are essential components of workplace health promotion in the police force.

Effects of family budgeting responsibility on subjective health status: An empirical study of Japanese wives.

PubMed

Niu, Bing; Yoshida, Atsushi

2017-01-01

We examine whether the decision-making power of Japanese wives affects their health status. Looking at cross-sectional data from the Japanese Panel Survey of Consumers (JPSC) conducted with women, we create a new measure for decision-making power based on participation in family budgeting. The data sample covers 1,306 married women aged 25 to 45 years in 2004. We find that Japanese wives are more likely to report good health when they have more responsibility than their husbands for household budgeting. Additionally, having more education or being fully employed increased the probability of reporting "good health" by more than six percentage points.

Workshop 5 (synthesis): water pollution abatement as related to ecosystem protection.

PubMed

Hagebro, C

2004-01-01

Water pollution exerts major stress on water systems and the challenge is to ensure security in river basins for both water-dependent activities and for the aquatic ecosystems. The workshop focused on protection of good ecological status, quality criteria, priorities for action, and on achievement of sustainable improvements. The three keynote speakers presented the concept applied in the EU Water Framework Directive, the need for a multi-stakeholder collaboration in order to reach a good ecological status of waters and a concrete example of interactive planning of water protection measures in a transboundary lake. The additional paper presentations addressed specific pollution problems in catchments, the effect of environmental user fees and ecosystem indicators.

Lack of basic and luxury goods and health-related dysfunction in older persons; Findings from the longitudinal SMILE study

PubMed Central

Groffen, Daniëlle AI; Bosma, Hans; van den Akker, Marjan; Kempen, Gertrudis IJM; van Eijk, Jacques TM

2008-01-01

Background More so than the traditional socioeconomic indicators, such as education and income, wealth reflects the accumulation of resources and makes socioeconomic ranking manifest and explicitly visible to the outside world. While the lack of basic goods, such as a refrigerator, may affect health directly, via biological pathways, the lack of luxury goods, such as an LCD television, may affect health indirectly through psychosocial mechanisms. We set out to examine, firstly, the relevance of both basic and luxury goods in explaining health-related dysfunction in older persons, and, secondly, the extent to which these associations are independent of traditional socioeconomic indicators. Methods Cross-sectional and longitudinal data from 2067 men and women aged 55 years and older who participated in the Study on Medical Information and Lifestyles Eindhoven (SMILE) were gathered. Logistic regression analyses were used to study the relation between a lack of basic and luxury goods and health-related function, assessed with two sub-domains of the SF-36. Results The lack of basic goods was closely related to incident physical (OR = 2.32) and mental (OR = 2.12) dysfunction, even when the traditional measures of socioeconomic status, i.e. education or income, were taken into account. Cross-sectional analyses, in which basic and luxury goods were compared, showed that the lack of basic goods was strongly associated with mental dysfunction. Lack of luxury goods was, however, not related to dysfunction. Conclusion Even in a relatively wealthy country like the Netherlands, the lack of certain basic goods is not uncommon. More importantly, lack of basic goods, as an indicator of wealth, was strongly related to health-related dysfunction also when traditional measures of socioeconomic status were taken into account. In contrast, no effects of luxury goods on physical or mental dysfunction were found. Future longitudinal research is necessary to clarify the precise mechanisms underlying these effects. PMID:18637182

Lack of basic and luxury goods and health-related dysfunction in older persons; findings from the longitudinal SMILE study.

PubMed

Groffen, Daniëlle A I; Bosma, Hans; van den Akker, Marjan; Kempen, Gertrudis I J M; van Eijk, Jacques T M

2008-07-17

More so than the traditional socioeconomic indicators, such as education and income, wealth reflects the accumulation of resources and makes socioeconomic ranking manifest and explicitly visible to the outside world. While the lack of basic goods, such as a refrigerator, may affect health directly, via biological pathways, the lack of luxury goods, such as an LCD television, may affect health indirectly through psychosocial mechanisms. We set out to examine, firstly, the relevance of both basic and luxury goods in explaining health-related dysfunction in older persons, and, secondly, the extent to which these associations are independent of traditional socioeconomic indicators. Cross-sectional and longitudinal data from 2067 men and women aged 55 years and older who participated in the Study on Medical Information and Lifestyles Eindhoven (SMILE) were gathered. Logistic regression analyses were used to study the relation between a lack of basic and luxury goods and health-related function, assessed with two sub-domains of the SF-36. The lack of basic goods was closely related to incident physical (OR = 2.32) and mental (OR = 2.12) dysfunction, even when the traditional measures of socioeconomic status, i.e. education or income, were taken into account. Cross-sectional analyses, in which basic and luxury goods were compared, showed that the lack of basic goods was strongly associated with mental dysfunction. Lack of luxury goods was, however, not related to dysfunction. Even in a relatively wealthy country like the Netherlands, the lack of certain basic goods is not uncommon. More importantly, lack of basic goods, as an indicator of wealth, was strongly related to health-related dysfunction also when traditional measures of socioeconomic status were taken into account. In contrast, no effects of luxury goods on physical or mental dysfunction were found. Future longitudinal research is necessary to clarify the precise mechanisms underlying these effects.

A bill to provide for the award of a gold medal on behalf of Congress to Jack Nicklaus, in recognition of his service to the Nation in promoting excellence, good sportsmanship, and philanthropy.

THOMAS, 112th Congress

Sen. Portman, Rob [R-OH

2012-05-24

Senate - 05/24/2012 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Role Models and the Psychological Characteristics That Buffer Low-Socioeconomic-Status Youth from Cardiovascular Risk

ERIC Educational Resources Information Center

Chen, Edith; Lee, William K.; Cavey, Lisa; Ho, Amanda

2013-01-01

Little is understood about why some youth from low-socioeconomic-status (SES) environments exhibit good health despite adversity. This study tested whether role models and "shift-and-persist" approaches (reframing stressors more benignly while persisting with future optimism) protect low-SES youth from cardiovascular risk. A total of 163…

The Prevalence of Self-Reported Health Problems and Haemoglobin Status of Sudanese Adolescents

ERIC Educational Resources Information Center

Moukhyer, M. E.; de Vries, N. K.; Bosma, H.; van Eijk, J. Th. M.

2006-01-01

In this paper we describe self-reported health problems and haemoglobin status among 1200 Sudanese adolescents (53.2% females, 46.8% males). Many adolescents report their general health as excellent and good (84%). A large number, however, report separate physical and psychological complaints. Report of psychological complaints is equal for both…

[Treatment of refractory status epilepticus with topiramate. Report of three cases].

PubMed

Soler, Bernardita; Godoy, Jaime; Mellado Talesnik, Patricio

2009-07-01

Refractory status epilepticus is a catastrophic illness of the central nervous system, with a mortality rate that reaches 50%. We report three patients admitted with refractory status epilepticus: a 24 year-old male that discontinued antiepileptic medications, a 46 year-old male with a focal epilepsy secondary to an encephalitis that discontinued medications due to gastrointestinal problems and a 59 year-old male with an ischemic encephalopathy AH were treated with topiramate, delivered through a nasogastric tube with a good response.

Legitimacy and status groups in financial markets.

PubMed

Preda, Alex

2005-09-01

Economic sociologists have argued that financial markets should be analysed as uncertainty-processing social networks and intermediary groups. Networks and intermediaries alone cannot confer legitimacy upon financial actors and transactions. Status groups are a solution to this problem. They emphasize reputation, honour and good social behaviour as stabilizers of collective action, as means of social control and as indicators of legitimacy. I examine here the emergence and evolution of status groups of brokers in London, New York and Paris, and show how emphasis on honour was used to legitimize financial transactions. I argue that financial markets should be conceived as networks, intermediary and status groups. In global, automated financial markets status groups like securities analysts are gaining in prominence.

Subjective global assessment of nutritional status in children.

PubMed

Mahdavi, Aida Malek; Ostadrahimi, Alireza; Safaiyan, Abdolrasool

2010-10-01

This study was aimed to compare the subjective and objective nutritional assessments and to analyse the performance of subjective global assessment (SGA) of nutritional status in diagnosing undernutrition in paediatric patients. One hundred and forty children (aged 2-12 years) hospitalized consecutively in Tabriz Paediatric Hospital from June 2008 to August 2008 underwent subjective assessment using the SGA questionnaire and objective assessment, including anthropometric and biochemical measurements. Agreement between two assessment methods was analysed by the kappa (κ) statistic. Statistical indicators including (sensitivity, specificity, predictive values, error rates, accuracy, powers, likelihood ratios and odds ratio) between SGA and objective assessment method were determined. The overall prevalence of undernutrition according to the SGA (70.7%) was higher than that by objective assessment of nutritional status (48.5%). Agreement between the two evaluation methods was only fair to moderate (κ = 0.336, P < 0.001). The sensitivity, specificity, positive and negative predictive value of the SGA method for screening undernutrition in this population were 88.235%, 45.833%, 60.606% and 80.487%, respectively. Accuracy, positive and negative power of the SGA method were 66.428%, 56.074% and 41.25%, respectively. Likelihood ratio positive, likelihood ratio negative and odds ratio of the SGA method were 1.628, 0.256 and 6.359, respectively. Our findings indicated that in assessing nutritional status of children, there is not a good level of agreement between SGA and objective nutritional assessment. In addition, SGA is a highly sensitive tool for assessing nutritional status and could identify children at risk of developing undernutrition. © 2009 Blackwell Publishing Ltd.

Development of pig welfare assessment protocol integrating animal-, environment-, and management-based measures.

PubMed

Renggaman, Anriansyah; Choi, Hong L; Sudiarto, Sartika Ia; Alasaarela, Laura; Nam, Ok S

2015-01-01

Due to increased interest in animal welfare, there is now a need for a comprehensive assessment protocol to be used in intensive pig farming systems. There are two current welfare assessment protocols for pigs: Welfare Quality® Assessment Protocols (applicable in the Europe Union), that mostly focuses on animal-based measures, and the Swine Welfare Assurance Program (applicable in the United States), that mostly focuses on management- and environment-based measures. In certain cases, however, animal-based measures might not be adequate for properly assessing pig welfare status. Similarly, welfare assessment that relies only on environment- and management-based measures might not represent the actual welfare status of pigs. Therefore, the objective of this paper was to develop a new welfare protocol by integrating animal-, environment-, and management-based measures. The background for selection of certain welfare criteria and modification of the scoring systems from existing welfare assessment protocols are described. The developed pig welfare assessment protocol consists of 17 criteria that are related to four main principles of welfare (good feeding, good housing, good health, and appropriate behavior). Good feeding, good housing, and good health were assessed using a 3-point scale: 0 (good welfare), 1 (moderate welfare), and 2 (poor welfare). In certain cases, only a 2-point scale was used: 0 (certain condition is present) or 2 (certain condition is absent). Appropriate behavior was assessed by scan sampling of positive and negative social behaviors based on qualitative behavior assessment and human-animal relationship tests. Modification of the body condition score into a 3-point scale revealed pigs with a moderate body condition (score 1). Moreover, additional criteria such as feed quality confirmed that farms had moderate (score 1) or poor feed quality (score 2), especially those farms located in a high relative humidity region. The developed protocol can be utilized to assess welfare status in an intensive pig farming system. Although further improvements are still needed, this study is a first step in developing a pig welfare assessment protocol that combines animal-, environment-, and management-based measures.

Validation of the King's Sarcoidosis Questionnaire (KSQ) in a Dutch sarcoidosis population.

PubMed

Van Manen, Mirjam J G; Wapenaar, Monique; Strookappe, Bert; Drent, Marjolein; Elfferich, Marjon; de Vries, Jolanda; Gosker, Harry R; Birring, Surinder S; Patel, Amit S; van den Toorn, Leon; van den Blink, Bernt; Boomars, Karin; Hoitsma, Elske; Wijsenbeek, Marlies S

2016-03-29

The King's Sarcoidosis Questionnaire (KSQ) is a brief questionnaire assessing health status using five modules (General Health Status, Lung, Eyes, Skin, Medication) in patients with sarcoidosis. The KSQ was only validated in one English sarcoidosis cohort. The aim of this study was to validate the KSQ in a Dutch sarcoidosis population. The KSQ was translated according to international guidelines and tested in interviews with patients. Consecutive outpatients completed multiple questionnaires twice, two weeks apart. Construct validity, internal consistency and repeatability were determined. Of the 98 patients included 85 had lung, 22 skin and 24 eye disease. There was good construct validity of the KSQ General Health Status module against the World Health Organization Quality of Life-BREF questionnaire. The Medication module correlated weak to moderate with most questionnaires. The correlations with organ-specific questionnaires varied from strong for Eyes (r=0.75), Skin (r=-0.62) to moderate for Lung (r=-0.45 with MRC breathlessness scale). Internal consistency was good for all KSQ modules (Cronbach's α 0.72-0.93). Intraclass correlation coefficients (0.70-0.90) and Bland-Altman plots showed good repeatability of the KSQ. The Dutch KSQ is the first translation of the English KSQ, validated in a Dutch sarcoidosis population.

Lifestyles and mental health status are associated with natural killer cell and lymphokine-activated killer cell activities.

PubMed

Morimoto, K; Takeshita, T; Inoue-Sakurai, C; Maruyama, S

2001-04-10

We investigated the association of lifestyle and mental health status with natural killer (NK) cell and lymphokine-activated killer (LAK) cell activities in healthy males. NK cell activity was determined in 105 male workers and LAK cell activity was determined in 54 male workers. Peripheral blood was obtained from each subject and peripheral blood mononuclear cells (PBMC) were isolated from the blood. These PBMC were used as effector cells. LAK cells were generated by incubation of PBMC with interleukin-2 for 72 h. NK cell activity against NK-sensitive K562 cells and LAK cell activity against NK-resistant Raji cells were examined by 51Cr release assay. Overall lifestyles were evaluated according to the answers on a questionnaire regarding eight health practices (cigarette smoking, alcohol consumption, eating breakfast, hours of sleep, hours of work, physical exercise, nutritional balance, mental stress). Subjects with a good overall lifestyle showed significantly higher NK cell (P < 0.05) and LAK cell (P < 0.05) activities than those with a poor overall lifestyles. Among eight lifestyle factors, cigarette smoking has relatively strong effects on NK cell and LAK cell activities. Subjects who complained of unstable mental status had significantly lower NK cell activity than those who reported stable mental status. When subjects were divided into four groups by lifestyle and mental health status, subjects who had poor or moderate lifestyle and reported unstable mental status showed the lowest NK cell activity and subjects who had good lifestyle and reported stable mental status showed the highest NK cell activity among four groups.

Brazilian version of the Functional Status Score for the ICU: translation and cross-cultural adaptation

PubMed Central

da Silva, Vinicius Zacarias Maldaner; de Araújo Neto, Jose Aires; Cipriano Jr., Gerson; Pinedo, Mariela; Needham, Dale M.; Zanni, Jennifer M.; Guimarães, Fernando Silva

2017-01-01

Objective The aim of the present study was to translate and cross-culturally adapt the Functional Status Score for the intensive care unit (FSS-ICU) into Brazilian Portuguese. Methods This study consisted of the following steps: translation (performed by two independent translators), synthesis of the initial translation, back-translation (by two independent translators who were unaware of the original FSS-ICU), and testing to evaluate the target audience's understanding. An Expert Committee supervised all steps and was responsible for the modifications made throughout the process and the final translated version. Results The testing phase included two experienced physiotherapists who assessed a total of 30 critical care patients (mean FSS-ICU score = 25 ± 6). As the physiotherapists did not report any uncertainties or problems with interpretation affecting their performance, no additional adjustments were made to the Brazilian Portuguese version after the testing phase. Good interobserver reliability between the two assessors was obtained for each of the 5 FSS-ICU tasks and for the total FSS-ICU score (intraclass correlation coefficients ranged from 0.88 to 0.91). Conclusion The adapted version of the FSS-ICU in Brazilian Portuguese was easy to understand and apply in an intensive care unit environment. PMID:28444070

Central venous device-related thrombosis as imaged with MDCT in oncologic patients: prevalence and findings.

PubMed

Catalano, Orlando; de Lutio di Castelguidone, Elisabetta; Sandomenico, Claudia; Petrillo, Mario; Aprea, Pasquale; Granata, Vincenza; D'Errico, Adolfo Gallipoli

2011-03-01

Venous thrombosis is a common occurrence in cancer patients, developing spontaneously or in combination with indwelling central venous devices (CVD). To analyze the multidetector CT (MDCT) prevalence, appearance, and significance of catheter-related thoracic venous thrombosis in oncologic patients and to determine the percentage of thrombi identified in the original reports. Five hundred consecutive patients were considered. Inclusion criteria were: presence of a CVD; availability of a contrast-enhanced MDCT; and cancer history. Exclusion criteria were: direct tumor compression/infiltration of the veins; poor image quality; device tip not in the scanned volume; and missing clinical data. Seventeen (3.5%) out of the final 481 patients had a diagnosis of venous thrombosis. Factors showing the highest correlation with thrombosis included peripherally-inserted CVD, right brachiocephalic vein tip location, patient performance status 3, metastatic stage disease, ongoing chemotherapy, and longstanding CVD. The highest prevalence was in patients with lymphoma, lung carcinoma, melanoma, and gynecologic malignancies. Eleven out of 17 cases had not been identified in the original report. CVD-related thrombosis is not uncommon in cancer patients and can also be observed in outpatients with a good performance status and a non-metastatic disease. Thrombi can be very tiny. Radiologists should be aware of the possibility to identify (or overlook) small thrombi.

Nutritional Status of Rural Older Adults is Linked to Physical and Emotional Health

PubMed Central

Jung, Seung Eun; Bishop, Alex J; Kim, Minjung; Hermann, Janice; Kim, Giyeon; Lawrence, Jeannine

2017-01-01

Background Although nutritional status is influenced by multi-dimensional aspects encompassing physical and emotional well-being, there is limited research on this complex relationship. Objective The purpose of this study was to examine the interplay between indicators of physical health (perceived health status and self-care capacity) and emotional well-being (depressive affect and loneliness) on rural older adults’ nutritional status. Design The cross-sectional study was conducted from June 1, 2007 to June 1, 2008. Participants/setting A total of 171 community-dwelling older adults, 65 years and older, who resided within non-metro rural communities in the U.S. participated in this study. Main outcome measures Participants completed validated instruments measuring self-care capacity, perceived health status, loneliness, depressive affect, and nutritional status. Statistical analyses performed Structural equation modeling (SEM) was employed to investigate the complex interplay of physical and emotional health status with nutritional status among rural older adults, Chi-square statistic, CFI, RMSEA and SRMR were used to assess model fit. Results Chi-square statistic and the other model fit indices showed the hypothesized SEM model provided a good fit to the data (χ2 (2)=2.15, p=0.34; CFI=1.00; RMSEA=0.02; SRMR=0.03). Self-care capacity was significantly related with depressive affect (γ = −0.11, p=0.03) whereas self-care capacity was not significantly related with loneliness. Perceived health status had a significant negative relationship with both loneliness (γ = −0.16, p=0.03) and depressive affect (γ = −0.22, p=0.03). Although loneliness showed no significant direct relationship with nutritional status, it showed a significant direct relationship with depressive affect (β = 0.46, p<0.01). Finally, the results demonstrated that depressive affect had a significant negative relationship with nutritional status (β = −0.30, p<0.01). The results indicated physical health and emotional indicators have significant multi-dimensional associations with nutritional status among rural older adults. Conclusions The present study provides insights into the importance of addressing both physical and emotional well-being together to reduce potential effects of poor emotional well-being on nutritional status, particularly among rural older adults with impaired physical health and self-care capacity. PMID:28274787

Hierarchy stability moderates the effect of status on stress and performance in humans

PubMed Central

Knight, Erik L.; Mehta, Pranjal H.

2017-01-01

High social status reduces stress responses in numerous species, but the stress-buffering effect of status may dissipate or even reverse during times of hierarchical instability. In an experimental test of this hypothesis, 118 participants (57.3% female) were randomly assigned to a high- or low-status position in a stable or unstable hierarchy and were then exposed to a social-evaluative stressor (a mock job interview). High status in a stable hierarchy buffered stress responses and improved interview performance, but high status in an unstable hierarchy boosted stress responses and did not lead to better performance. This general pattern of effects was observed across endocrine (cortisol and testosterone), psychological (feeling in control), and behavioral (competence, dominance, and warmth) responses to the stressor. The joint influence of status and hierarchy stability on interview performance was explained by feelings of control and testosterone reactivity. Greater feelings of control predicted enhanced interview performance, whereas increased testosterone reactivity predicted worse performance. These results provide direct causal evidence that high status confers adaptive benefits for stress reduction and performance only when the social hierarchy is stable. When the hierarchy is unstable, high status actually exacerbates stress responses. PMID:27994160

Hierarchy stability moderates the effect of status on stress and performance in humans.

PubMed

Knight, Erik L; Mehta, Pranjal H

2017-01-03

High social status reduces stress responses in numerous species, but the stress-buffering effect of status may dissipate or even reverse during times of hierarchical instability. In an experimental test of this hypothesis, 118 participants (57.3% female) were randomly assigned to a high- or low-status position in a stable or unstable hierarchy and were then exposed to a social-evaluative stressor (a mock job interview). High status in a stable hierarchy buffered stress responses and improved interview performance, but high status in an unstable hierarchy boosted stress responses and did not lead to better performance. This general pattern of effects was observed across endocrine (cortisol and testosterone), psychological (feeling in control), and behavioral (competence, dominance, and warmth) responses to the stressor. The joint influence of status and hierarchy stability on interview performance was explained by feelings of control and testosterone reactivity. Greater feelings of control predicted enhanced interview performance, whereas increased testosterone reactivity predicted worse performance. These results provide direct causal evidence that high status confers adaptive benefits for stress reduction and performance only when the social hierarchy is stable. When the hierarchy is unstable, high status actually exacerbates stress responses.

Effects of TCMC on Transformation of Good Health Status to Suboptimal Health Status: A Nested Case-Control Study

PubMed Central

Wang, Tian; Chen, Jieyu; Sun, Xiaomin; Xiang, Lei; Zhou, Lin; Li, Fei; Lin, Changsong; Jiang, Pingping; Wu, Shengwei; Xiao, Ya; Cheng, Jingru; Luo, Ren; Liu, Yanyan; Zhao, Xiaoshan

2015-01-01

To explore the effects of traditional Chinese medicine constitution (TCMC) on transformation of good health status to suboptimal health status (SHS), we conducted a nested case-control study among college students in China. During the 18-month mean follow-up time, 543 cases of SHS (42.7%) occurred in 1273 healthy students. There was a significant (P = 0.000) and marked reduction in SHMS V1.0 total score in the case group at the 18-month follow-up (69.32 ± 5.45) compared with baseline (78.60 ± 4.70), but there was no significant change in the control group. Conditional logistic regression analysis showed that respondents reporting Yin-deficiency and Qi-deficiency were, respectively, 2.247 and 2.198 times more likely to develop SHS, while tendency to Yin-deficiency and tendency to Damp-heat were, respectively, 1.642 and 1.506 times more likely to develop SHS. However, the Balanced Constitution was a significant protective factor (OR 0.649; P < 0.05). Altogether, these findings demonstrate that Yin-deficiency, Qi-deficiency, tendency to Yin-deficiency, and tendency to Damp-heat appeared to induce a change in health status to SHS, while the Balanced Constitution seemed to restrain this change. We conclude that regulating the unbalanced TCMC (such as Yin-deficiency and Qi-deficiency) may prevent a healthy status developing into SHS or lead to the regression of SHS. PMID:26346320

Fail or flourish? Cognitive appraisal moderates the effect of solo status on performance.

PubMed

White, Judith B

2008-09-01

When everyone in a group shares a common social identity except one individual, the one who is different from the majority has solo status. Solo status increases one's visibility and performance pressure, which may result in stress. Stress has divergent effects on performance, and individuals' response to stressful situations is predicted by their cognitive appraisal (challenge or threat) of the situation. Two experiments test the hypothesis that cognitive appraisal moderates the effect of solo status on performance. Experiment 1 finds that at relatively high appraisal levels (resources exceed demands), solo status improves men's and women's performance; at relatively low appraisal levels, solo status hurts performance. Experiment 2 replicates this effect for solo status based on minimal group assignment. Results suggest that for individuals who feel challenged and not threatened by their work, it may help to be a solo.

Boys' and girls' weight status and math performance from kindergarten entry through fifth grade: a mediated analysis.

PubMed

Gable, Sara; Krull, Jennifer L; Chang, Yiting

2012-01-01

This study tests a mediated model of boys' and girls' weight status and math performance with 6,250 children from the Early Childhood Longitudinal Study. Five data points spanning kindergarten entry (mean age=68.46 months) through fifth grade (mean age=134.60 months) were analyzed. Three weight status groups were identified: persistent obesity, later onset obesity, and never obese. Multilevel models tested relations between weight status and math performance, weight status and interpersonal skills and internalizing behaviors, and interpersonal skills and internalizing behaviors and math performance. Interpersonal skills mediated the association between weight status and math performance for girls, and internalizing behaviors mediated the association between weight status and math performance for both sexes, with effects varying by group and time. © 2012 The Authors. Child Development © 2012 Society for Research in Child Development, Inc.

Clinician-Reported Outcome Assessments of Treatment Benefit: Report of the ISPOR Clinical Outcome Assessment Emerging Good Practices Task Force

PubMed Central

Powers, John H.; Patrick, Donald L.; Walton, Marc K.; Marquis, Patrick; Cano, Stefan; Hobart, Jeremy; Isaac, Maria; Vamvakas, Spiros; Slagle, Ashley; Molsen, Elizabeth; Burke, Laurie B.

2017-01-01

A clinician-reported outcome (ClinRO) assessment is a type of clinical outcome assessment (COA). ClinRO assessments, like all COAs (patient-reported, observer-reported, or performance outcome assessments), are used to 1) measure patients’ health status and 2) define end points that can be interpreted as treatment benefits of medical interventions on how patients feel, function, or survive in clinical trials. Like other COAs, ClinRO assessments can be influenced by human choices, judgment, or motivation. A ClinRO assessment is conducted and reported by a trained health care professional and requires specialized professional training to evaluate the patient’s health status. This is the second of two reports by the ISPOR Clinical Outcomes Assessment—Emerging Good Practices for Outcomes Research Task Force. The first report provided an overview of COAs including definitions important for an understanding of COA measurement practices. This report focuses specifically on issues related to ClinRO assessments. In this report, we define three types of ClinRO assessments (readings, ratings, and clinician global assessments) and describe emerging good measurement practices in their development and evaluation. The good measurement practices include 1) defining the context of use; 2) identifying the concept of interest measured; 3) defining the intended treatment benefit on how patients feel, function, or survive reflected by the ClinRO assessment and evaluating the relationship between that intended treatment benefit and the concept of interest; 4) documenting content validity; 5) evaluating other measurement properties once content validity is established (including intra- and inter-rater reliability); 6) defining study objectives and end point(s) objectives, and defining study end points and placing study end points within the hierarchy of end points; 7) establishing interpretability in trial results; and 8) evaluating operational considerations for the implementation of ClinRO assessments used as end points in clinical trials. Applying good measurement practices to ClinRO assessment development and evaluation will lead to more efficient and accurate measurement of treatment effects. This is important beyond regulatory approval in that it provides evidence for the uptake of new interventions into clinical practice and provides justification to payers for reimbursement on the basis of the clearly demonstrated added value of the new intervention. PMID:28212963

Clinician-Reported Outcome Assessments of Treatment Benefit: Report of the ISPOR Clinical Outcome Assessment Emerging Good Practices Task Force.

PubMed

Powers, John H; Patrick, Donald L; Walton, Marc K; Marquis, Patrick; Cano, Stefan; Hobart, Jeremy; Isaac, Maria; Vamvakas, Spiros; Slagle, Ashley; Molsen, Elizabeth; Burke, Laurie B

2017-01-01

A clinician-reported outcome (ClinRO) assessment is a type of clinical outcome assessment (COA). ClinRO assessments, like all COAs (patient-reported, observer-reported, or performance outcome assessments), are used to 1) measure patients' health status and 2) define end points that can be interpreted as treatment benefits of medical interventions on how patients feel, function, or survive in clinical trials. Like other COAs, ClinRO assessments can be influenced by human choices, judgment, or motivation. A ClinRO assessment is conducted and reported by a trained health care professional and requires specialized professional training to evaluate the patient's health status. This is the second of two reports by the ISPOR Clinical Outcomes Assessment-Emerging Good Practices for Outcomes Research Task Force. The first report provided an overview of COAs including definitions important for an understanding of COA measurement practices. This report focuses specifically on issues related to ClinRO assessments. In this report, we define three types of ClinRO assessments (readings, ratings, and clinician global assessments) and describe emerging good measurement practices in their development and evaluation. The good measurement practices include 1) defining the context of use; 2) identifying the concept of interest measured; 3) defining the intended treatment benefit on how patients feel, function, or survive reflected by the ClinRO assessment and evaluating the relationship between that intended treatment benefit and the concept of interest; 4) documenting content validity; 5) evaluating other measurement properties once content validity is established (including intra- and inter-rater reliability); 6) defining study objectives and end point(s) objectives, and defining study end points and placing study end points within the hierarchy of end points; 7) establishing interpretability in trial results; and 8) evaluating operational considerations for the implementation of ClinRO assessments used as end points in clinical trials. Applying good measurement practices to ClinRO assessment development and evaluation will lead to more efficient and accurate measurement of treatment effects. This is important beyond regulatory approval in that it provides evidence for the uptake of new interventions into clinical practice and provides justification to payers for reimbursement on the basis of the clearly demonstrated added value of the new intervention. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

The German version of the Anorectic Behavior Observation Scale (ABOS).

PubMed

Salbach-Andrae, Harriet; Klinkowski, Nora; Holzhausen, Martin; Frieler, Katja; Bohnekamp, Inga; Thiels, Cornelia; Bender, Caroline; Vandereycken, Walter

2009-05-01

To assess the performance of the German version of the Anorectic Behavior Observation Scale (ABOS) as a parent-report screening instrument for eating disorders (ED) in their children. Parents of 101 ED female patients (80 with Anorexia Nervosa; 21 with Bulimia Nervosa) and of 121 age- and socioeconomic status (SES)-matched female controls completed the ABOS. Confirmatory factor analysis supported the original three-factor structure model of the ABOS. Cronbach's alpha coefficients indicated good internal consistency for the three factors and the total score in the total sample. The best cut-off point (100% sensitivity and specificity) in the German version was >or=23. The ABOS may be a useful additional instrument for assessing ED.

[Inactivity, obesity and mental health in the Spanish population from 4 to 15 years of age].

PubMed

Rodríguez-Hernández, Arturo; Cruz-Sánchez, Ernesto de la; Feu, Sebastián; Martínez-Santos, Raúl

2011-08-01

An active lifestyle and a good weight status are two major health determinants from a public health perspective. To evaluate the degree of association between physical activity, weight status and the emotional and mental health of Spanish schoolchildren. Mental health status was assessed through the Strengths and Difficulties Questionnaire (SDQ), also leisure time physical activity and body mass index (BMI) in a total of 6 803 children from 4 to 15 years participating in the Spanish National Health Survey 2006. The degree of association between. these variables was estimated by a multinomial logistic regression analysis. Among sedentary schoolchildren are more common mental health problems (OR 2.10), emotional problems (OR 1.84), conduct problems (OR 1.53), problems with peers (OR 2.35) and social relationship difficulties (OR 1.36). Obesity is associated with poor general mental health (OR 1.58), and obese schoolchildren show more often emotional problems (OR 1.52) and problems with peers (OR 2.43). In the Spanish schoolchildren, a healthy BMI is associated with increased mental well-being, although an active lifestyle is the best indicator of a good mental health status.

Further validation of the peripheral artery questionnaire: results from a peripheral vascular surgery survey in the Netherlands.

PubMed

Smolderen, K G; Hoeks, S E; Aquarius, A E; Scholte op Reimer, W J; Spertus, J A; van Urk, H; Denollet, J; Poldermans, D

2008-11-01

Peripheral arterial disease (PAD) is associated with adverse cardiovascular events and can significantly impair patients' health status. Recently, marked methodological improvements in the measurement of PAD patients' health status have been made. The Peripheral Artery Questionnaire (PAQ) was specifically developed for this purpose. We validated a Dutch version of the PAQ in a large sample of PAD patients. Cross-sectional study. The Dutch PAQ was completed by 465 PAD patients (70% men, mean age 65+/-10 years) participating in the Euro Heart Survey Programme. Principal components analysis and reliability analyses were performed. Convergent validity was documented by comparing the PAQ with EQ-5D scales. Three factors were discerned; Physical Function, Perceived Disability, and Treatment Satisfaction (factor loadings between 0.50 and 0.90). Cronbach's alpha values were excellent (mean alpha=0.94). Shared variance of the PAQ domains with EQ-5D scales ranged from 3 to 50%. The Dutch PAQ proved to have good measurement qualities; assessment of Physical Function, Perceived Disability, and Treatment Satisfaction facilitates the monitoring of patients' perceived health in clinical research and practice. Measuring disease-specific health status in a reliable way becomes essential in times were a wide array of treatment options are available for PAD patients.

Characterization of 193-nm resists for optical mask manufacturing

NASA Astrophysics Data System (ADS)

Fosshaug, Hans; Paulsson, Adisa; Berzinsh, Uldis; Magnusson, Helena

2004-12-01

The push for smaller linewidths and tighter critical dimension (CD) budgets forced manufacturers of optical pattern generators to move from traditional i-line to deep ultraviolet (DUV) resist processing. Entering the DUV area was not without pain. The process conditions, especially exposure times of a few hours, put very tough demands on the resist material itself. However, today 248nm laser writers are fully operating using a resist process that exhibits the requested resolution, CD uniformity and environmental stability. The continuous demands of CD performance made Micronic to investigate suitable resist candidate materials for the next generation optical writer using 193nm excimer laser exposure. This paper reports on resist benchmarking of one commercial as well as several newly developed resists. The resists were investigated using a wafer scanner. The data obtained illustrate the current performance of 193nm photoresists, and further demonstrate that despite good progress in resist formulation optimization, the status is still a bit from the required lithographic performance.

Spinal epidural hematomas: personal experience and literature review of more than 1000 cases.

PubMed

Domenicucci, Maurizio; Mancarella, Cristina; Santoro, Giorgio; Dugoni, Demo Eugenio; Ramieri, Alessandro; Arezzo, Maria Felice; Missori, Paolo

2017-08-01

OBJECTIVE The goal of this study was to identify factors that contribute to the formation of acute spinal epidural hematoma (SEH) by correlating etiology, age, site, clinical status, and treatment with immediate results and long-term outcomes. METHODS The authors reviewed their series of 15 patients who had been treated for SEH between 1996 and 2012. In addition, the authors reviewed the relevant international literature from 1869 (when SEH was first described) to 2012, collecting a total of 1010 cases. Statistical analysis was performed in 959 (95%) cases that were considered valid for assessing the incidence of age, sex, site, and clinical status at admission, correlating each of these parameters with the treatment results. Statistical analysis was also performed in 720 (71.3%) cases to study the incidence of etiological factors that favor SEH formation: coagulopathy, trauma, spinal puncture, pregnancy, and multifactorial disorders. The clinical status at admission and long-term outcome were studied for each group. Clinical status was assessed using the Neuro-Grade (NG) scale. RESULTS The mean patient age was 47.97 years (range 0-91 years), and a significant proportion of patients were male (60%, p < 0.001). A bimodal distribution has been reported for age at onset with peaks in the 2nd and 6th decades of life. The cause of the SEH was not reported in 42% of cases. The etiology concerned mainly iatrogenic factors (18%), such as coagulopathy or spinal puncture, rather than noniatrogenic factors (29%), such as genetic or metabolic coagulopathy, trauma, and pregnancy. The etiology was multifactorial in 11.1% of cases. The most common sites for SEH were C-6 (n = 293, 31%) and T-12 (n = 208, 22%), with maximum extension of 6 vertebral bodies in 720 cases (75%). At admission, 806 (84%) cases had moderate neurological impairment (NG 2 or 3), and only lumbar hematoma was associated with a good initial clinical neurological status (NG 0 or 1). Surgery was performed in 767 (80%) cases. Mortality was greater in patients older than 40 years of age (9%; p < 0.01). Sex did not influence any of these data (p > 0.05). CONCLUSIONS Factors that contribute to the formation of acute SEH are iatrogenic, not iatrogenic, or multifactorial. The treatment of choice is surgery, and the results of treatment are influenced by the patient's clinical and neurological status at admission, age, and the craniocaudal site.

Validation of a web-based questionnaire for pregnant women to assess utilization of internet: survey among an Italian sample.

PubMed

Siliquini, R; Saulle, R; Rabacchi, G; Bert, F; Massimi, A; Bulzomì, V; Boccia, A; La Torre, G

2012-01-01

Objective of this pilot study was to evaluate the reliability and validity of the web-based questionnaire in pregnant women as a tool to examine prevalence, knowledge and attitudes about internet utilization for health-related purposes, in a sample of Italian pregnant women. The questionnaire was composed by 9 sections for a total of 73 items. Reliability analysis was tested and content validity was evaluated using Cronbach's alpha to check internal consistency. Statistical analysis was performed through SPSS 13.0. Questionnaire was administered to 56 pregnant women. The higher value of Cronbach's alpha resulted on 61 items: alpha = 0.786 (n. 73 items: alpha = 0.579). High rate of pregnant women generally utilized internet (87.5%) and the 92.1% confirmed to use internet with the focus to acquire information about pregnancy (p < 0.0001). The questionnaire showed a good reliability property in the pilot study. In terms of internal consistency and validity appeared to have a good performance. Given the high prevalence of pregnant women that use internet to search information about their pregnancy status, professional healthcare workers should give advice regarding official websites where they could retrieve safe information and learn knowledge based on scientific evidence.

Development and Validation of a HPTLC Method for Simultaneous Estimation of L-Glutamic Acid and γ-Aminobutyric Acid in Mice Brain

PubMed Central

Sancheti, J. S.; Shaikh, M. F.; Khatwani, P. F.; Kulkarni, Savita R.; Sathaye, Sadhana

2013-01-01

A new robust, simple and economic high performance thin layer chromatographic method was developed for simultaneous estimation of L-glutamic acid and γ-amino butyric acid in brain homogenate. The high performance thin layer chromatographic separation of these amino acid was achieved using n-butanol:glacial acetic acid:water (22:3:5 v/v/v) as mobile phase and ninhydrin as a derivatising agent. Quantitation of the method was achieved by densitometric method at 550 nm over the concentration range of 10-100 ng/spot. This method showed good separation of amino acids in the brain homogenate with Rf value of L-glutamic acid and γ-amino butyric acid as 21.67±0.58 and 33.67±0.58, respectively. The limit of detection and limit of quantification for L-glutamic acid was found to be 10 and 20 ng and for γ-amino butyric acid it was 4 and 10 ng, respectively. The method was also validated in terms of accuracy, precision and repeatability. The developed method was found to be precise and accurate with good reproducibility and shows promising applicability for studying pathological status of disease and therapeutic significance of drug treatment. PMID:24591747

Development and Validation of a HPTLC Method for Simultaneous Estimation of L-Glutamic Acid and γ-Aminobutyric Acid in Mice Brain.

PubMed

Sancheti, J S; Shaikh, M F; Khatwani, P F; Kulkarni, Savita R; Sathaye, Sadhana

2013-11-01

A new robust, simple and economic high performance thin layer chromatographic method was developed for simultaneous estimation of L-glutamic acid and γ-amino butyric acid in brain homogenate. The high performance thin layer chromatographic separation of these amino acid was achieved using n-butanol:glacial acetic acid:water (22:3:5 v/v/v) as mobile phase and ninhydrin as a derivatising agent. Quantitation of the method was achieved by densitometric method at 550 nm over the concentration range of 10-100 ng/spot. This method showed good separation of amino acids in the brain homogenate with Rf value of L-glutamic acid and γ-amino butyric acid as 21.67±0.58 and 33.67±0.58, respectively. The limit of detection and limit of quantification for L-glutamic acid was found to be 10 and 20 ng and for γ-amino butyric acid it was 4 and 10 ng, respectively. The method was also validated in terms of accuracy, precision and repeatability. The developed method was found to be precise and accurate with good reproducibility and shows promising applicability for studying pathological status of disease and therapeutic significance of drug treatment.

Sub-classification of Advanced-Stage Hepatocellular Carcinoma: A Cohort Study Including 612 Patients Treated with Sorafenib.

PubMed

Yoo, Jeong-Ju; Chung, Goh Eun; Lee, Jeong-Hoon; Nam, Joon Yeul; Chang, Young; Lee, Jeong Min; Lee, Dong Ho; Kim, Hwi Young; Cho, Eun Ju; Yu, Su Jong; Kim, Yoon Jun; Yoon, Jung-Hwan

2018-04-01

Advanced hepatocellular carcinoma (HCC) is associated with various clinical conditions including major vessel invasion, metastasis, and poor performance status. The aim of this study was to establish a prognostic scoring system and to propose a sub-classification of the Barcelona-Clinic Liver Cancer (BCLC) stage C. This retrospective study included consecutive patientswho received sorafenib for BCLC stage C HCC at a single tertiary hospital in Korea. A Cox proportional hazard model was used to develop a scoring system, and internal validationwas performed by a 5-fold cross-validation. The performance of the model in predicting risk was assessed by the area under the curve and the Hosmer-Lemeshow test. A total of 612 BCLC stage C HCC patients were sub- classified into strata depending on their performance status. Five independent prognostic factors (Child-Pugh score, α-fetoprotein, tumor type, extrahepatic metastasis, and portal vein invasion) were identified and used in the prognostic scoring system. This scoring system showed good discrimination (area under the receiver operating characteristic curve, 0.734 to 0.818) and calibration functions (both p < 0.05 by the Hosmer-Lemeshow test at 1 month and 12 months, respectively). The differences in survival among the different risk groups classified by the total score were significant (p < 0.001 by the log-rank test in both the Eastern Cooperative Oncology Group 0 and 1 strata). The heterogeneity of patientswith BCLC stage C HCC requires sub-classification of advanced HCC. A prognostic scoring system with five independent factors is useful in predicting the survival of patients with BCLC stage C HCC.

How good is "very good"? Translation effect in the racial/ethnic variation in self-rated health status.

PubMed

Seo, Sukyong; Chung, Sukyung; Shumway, Martha

2014-03-01

To examine the influence of translation when measuring and comparing self-rated health (SRH) measured with five response categories (excellent, very good, good, fair, and poor), across racial/ethnic groups. Using data from the California Health Interview Survey, which were administered in five languages, we analyzed variations in the five-category SRH across five racial/ethnic groups: non-Hispanic white, Latino, Chinese, Vietnamese, and Korean. Logistic regression was used to estimate independent effects of race/ethnicity, culture, and translation on SRH, after controlling for risk factors and other measures of health status. Latinos, Chinese, Vietnamese, and Koreans were less likely than non-Hispanic whites to rate their health as excellent or very good and more likely to rate it as good, fair, or poor. This racial/ethnic difference diminished when adjusting for acculturation. Independently of race/ethnicity, respondents using non-English surveys were less likely to answer excellent (OR = 0.24-0.55) and very good (OR = 0.30-0.34) and were more likely to answer fair (OR = 2.48-4.10) or poor (OR = 2.87-3.51), even after controlling for other measures of SRH. Responses to the five-category SRH question depend on interview language. When responding in Spanish, Chinese, Korean, or Vietnamese, respondents are more likely to choose a lower level SRH category, "fair" in particular. If each SRH category measured in different languages is treated as equivalent, racial/ethnic disparities in SRH among Latinos and Asian subgroups, as compared to non-Hispanic whites, may be exaggerated.

Embedding ecosystem services into the Marine Strategy Framework Directive: Illustrated by eutrophication in the North Sea

NASA Astrophysics Data System (ADS)

O'Higgins, T. G.; Gilbert, A. J.

2014-03-01

The introduction of the Marine Strategy Framework Directive (MSFD) with its focus on an Ecosystem Approach places an emphasis on the human dimensions of environmental problems. Human activities may be the source of marine degradation, but may also be adversely affected should degradation compromise the provision of ecosystem services. The MSFD marks a shift away from management aiming to restore past, undegraded states toward management for Good Environmental Status (GEnS) based on delivery of marine goods and services. An example relating ecosystem services to criteria for Good Environmental Status is presented for eutrophication, a long recognised problem in many parts of Europe's seas and specifically targeted by descriptors for GEnS. Taking the North Sea as a case study the relationships between the eutrophication criteria of the MSFD and final and intermediate marine ecosystem services are examined. Ecosystem services are valued, where possible in monetary terms, in order to illustrate how eutrophication affects human welfare (economic externalities) through its multiple effects on ecosystem services.

Treatment of premenstrual syndrome with a phytopharmaceutical formulation containing Vitex agnus castus.

PubMed

Loch, E G; Selle, H; Boblitz, N

2000-04-01

A multicentric noninterventional trial (open study without control) to investigate the efficacy and tolerance of a drug in a large number of patients under routine medical conditions was performed for a new solid preparation from an extract of the fruit of Vitex agnus castus (VAC, Vitex, chaste tree, Chasteberry) in 1634 patients suffering from premenstrual syndrome (PMS). A specific questionnaire was developed for determining the effect of Vitex on psychic and somatic complaints, on the four characteristic PMS symptom complexes depression, anxiety, craving, and hyperhydration (DACH), and on single groups of symptoms. After a treatment period of three menstrual cycles 93% of patients reported a decrease in the number of symptoms or even cessation of PMS complaints. To a certain extent, this effect was observed within all symptom complexes and correlated with the global assessment of therapeutic efficacy. Whereas 85% of physicians rated it as good or very good, 81% of patients assessed their status after treatment as very much or much better. Analysis of frequency and severity of mastodynia as the predominant symptom revealed that complaints still present after 3 months of therapy were mostly less severe. Ninety-four percent of patients assessed the tolerance of Vitex treatment as good or very good. Adverse drug reactions were suspected by physicians in 1.2% of patients, but there were no serious adverse drug reactions. Hence, the risk/benefit ratio of the new Vitex preparation can be rated as very good, with significant efficacy for all aspects of the multifaceted and inhomogeneous clinical picture of PMS, with a safety profile comparable to other Vitex preparations.

Ecological quality status evaluation of a monsoonal tropical estuary using benthic indices: comparison via a seasonal approach.

PubMed

Dias, Heidy Q; Sukumaran, Soniya; Srinivas, Tatiparthi; Mulik, Jyoti

2018-05-30

The use of biotic indices has garnered attention during the last decade due to its extensive application in evaluating ecological quality status (EcoQS) of marine waters and estuaries. Three seasonal surveys were conducted in the Kundalika estuary, India to evaluate the ecostatus using five benthic indices and comparing their effectiveness considering the estuarine salinity gradient and seasonality. All indices gave divergent results displaying a wide range of classes (good to bad) across salinity zones and seasons. Comparatively, M-AMBI discriminated the EcoQS suitably than other indices. Hence, a seasonally averaged approach for M-AMBI was proposed to obtain a final mean EcoQS which assigned moderate status to the euhaline and poly-mesohaline zones and poor status to the oligohaline zone. Considering the high degree of spatial heterogeneity and seasonality in the estuary, the monsoon data was found to lower the EcoQS due to natural stress in some cases; the exclusion of the monsoon season resulted in a more valid ecostatus. Therefore, this approach which combines information from the non-monsoon seasons stands out in providing a useful basis for ecological management by scrutinizing responses of macrobenthos. Also, we suggest salinity zone-wise evaluation for more effective classification chiefly in tropical monsoonal estuaries. An effort to establish a final EcoQS was performed; however, future in-depth studies are necessary to ascertain the reliability of the successful biotic index (M-AMBI) in estuaries with different stressors.

Professors' Pay Raises Beat Inflation; So Much for the Good News

ERIC Educational Resources Information Center

June, Audrey Williams

2009-01-01

Faculty pay has been battered by the deepening national recession, but one cannot tell that from the American Association of University Professors' new annual report on the economic status of the profession. The average salary of a full-time faculty member rose 3.4% in 2008-2009, it says, a rate well above inflation. That would be good news, but…

Use of a macroinvertebrate based biotic index to estimate critical metal concentrations for good ecological water quality.

PubMed

Van Ael, Evy; De Cooman, Ward; Blust, Ronny; Bervoets, Lieven

2015-01-01

Large datasets from total and dissolved metal concentrations in Flemish (Belgium) fresh water systems and the associated macroinvertebrate-based biotic index MMIF (Multimetric Macroinvertebrate Index Flanders) were used to estimate critical metal concentrations for good ecological water quality, as imposed by the European Water Framework Directive (2000). The contribution of different stressors (metals and water characteristics) to the MMIF were studied by constructing generalized linear mixed effect models. Comparison between estimated critical concentrations and the European and Flemish EQS, shows that the EQS for As, Cd, Cu and Zn seem to be sufficient to reach a good ecological quality status as expressed by the invertebrate-based biotic index. In contrast, the EQS for Cr, Hg and Pb are higher than the estimated critical concentrations, which suggests that when environmental concentrations are at the same level as the EQS a good quality status might not be reached. The construction of mixed models that included metal concentrations in their structure did not lead to a significant outcome. However, mixed models showed the primary importance of water characteristics (oxygen level, temperature, ammonium concentration and conductivity) for the MMIF. Copyright © 2014 Elsevier Ltd. All rights reserved.

Prediction of wastewater treatment plants performance based on artificial fish school neural network

NASA Astrophysics Data System (ADS)

Zhang, Ruicheng; Li, Chong

2011-10-01

A reliable model for wastewater treatment plant is essential in providing a tool for predicting its performance and to form a basis for controlling the operation of the process. This would minimize the operation costs and assess the stability of environmental balance. For the multi-variable, uncertainty, non-linear characteristics of the wastewater treatment system, an artificial fish school neural network prediction model is established standing on actual operation data in the wastewater treatment system. The model overcomes several disadvantages of the conventional BP neural network. The results of model calculation show that the predicted value can better match measured value, played an effect on simulating and predicting and be able to optimize the operation status. The establishment of the predicting model provides a simple and practical way for the operation and management in wastewater treatment plant, and has good research and engineering practical value.

Research on flight stability performance of rotor aircraft based on visual servo control method

NASA Astrophysics Data System (ADS)

Yu, Yanan; Chen, Jing

2016-11-01

control method based on visual servo feedback is proposed, which is used to improve the attitude of a quad-rotor aircraft and to enhance its flight stability. Ground target images are obtained by a visual platform fixed on aircraft. Scale invariant feature transform (SIFT) algorism is used to extract image feature information. According to the image characteristic analysis, fast motion estimation is completed and used as an input signal of PID flight control system to realize real-time status adjustment in flight process. Imaging tests and simulation results show that the method proposed acts good performance in terms of flight stability compensation and attitude adjustment. The response speed and control precision meets the requirements of actual use, which is able to reduce or even eliminate the influence of environmental disturbance. So the method proposed has certain research value to solve the problem of aircraft's anti-disturbance.

PREDICTING INDIVIDUAL WELL-BEING THROUGH THE LANGUAGE OF SOCIAL MEDIA.

PubMed

Schwartz, H Andrew; Sap, Maarten; Kern, Margaret L; Eichstaedt, Johannes C; Kapelner, Adam; Agrawal, Megha; Blanco, Eduardo; Dziurzynski, Lukasz; Park, Gregory; Stillwell, David; Kosinski, Michal; Seligman, Martin E P; Ungar, Lyle H

2016-01-01

We present the task of predicting individual well-being, as measured by a life satisfaction scale, through the language people use on social media. Well-being, which encompasses much more than emotion and mood, is linked with good mental and physical health. The ability to quickly and accurately assess it can supplement multi-million dollar national surveys as well as promote whole body health. Through crowd-sourced ratings of tweets and Facebook status updates, we create message-level predictive models for multiple components of well-being. However, well-being is ultimately attributed to people, so we perform an additional evaluation at the user-level, finding that a multi-level cascaded model, using both message-level predictions and userlevel features, performs best and outperforms popular lexicon-based happiness models. Finally, we suggest that analyses of language go beyond prediction by identifying the language that characterizes well-being.

Investigation of High-alpha Lateral-directional Control Power Requirements for High-performance Aircraft

NASA Technical Reports Server (NTRS)

Foster, John V.; Ross, Holly M.; Ashley, Patrick A.

1993-01-01

Designers of the next-generation fighter and attack airplanes are faced with the requirements of good high-angle-of-attack maneuverability as well as efficient high speed cruise capability with low radar cross section (RCS) characteristics. As a result, they are challenged with the task of making critical design trades to achieve the desired levels of maneuverability and performance. This task has highlighted the need for comprehensive, flight-validated lateral-directional control power design guidelines for high angles of attack. A joint NASA/U.S. Navy study has been initiated to address this need and to investigate the complex flight dynamics characteristics and controls requirements for high-angle-of-attack lateral-directional maneuvering. A multi-year research program is underway which includes ground-based piloted simulation and flight validation. This paper will give a status update of this program that will include a program overview, description of test methodology and preliminary results.

Investigation of high-alpha lateral-directional control power requirements for high-performance aircraft

NASA Technical Reports Server (NTRS)

Foster, John V.; Ross, Holly M.; Ashley, Patrick A.

1993-01-01

Designers of the next-generation fighter and attack airplanes are faced with the requirements of good high angle-of-attack maneuverability as well as efficient high speed cruise capability with low radar cross section (RCS) characteristics. As a result, they are challenged with the task of making critical design trades to achieve the desired levels of maneuverability and performance. This task has highlighted the need for comprehensive, flight-validated lateral-directional control power design guidelines for high angles of attack. A joint NASA/U.S. Navy study has been initiated to address this need and to investigate the complex flight dynamics characteristics and controls requirements for high angle-of-attack lateral-directional maneuvering. A multi-year research program is underway which includes groundbased piloted simulation and flight validation. This paper will give a status update of this program that will include a program overview, description of test methodology and preliminary results.

Literacy and cancer anxiety as predictors of health status: an exploratory study.

PubMed

Hoffman-Goetz, L; Meissner, H I; Thomson, M D

2009-01-01

Socioeconomic status is a strong correlate of health status. Low literacy is associated with barriers to health information and anxiety about disease. Using 2003 Health Information National Trends Survey data, the relationship between self-reported health status and proxy measures of literacy (Hispanic ethnicity, education, and media variables), cancer anxiety, and cancer information seeking were assessed. Low literacy, measured by proxy variables, was associated with a greater likelihood of reporting fair-poor health status. Reporting excellent-good health status was less likely for people reporting frustration finding cancer information (odds ratio [OR] 0.68, 95% confidence interval [CI] 0.52-0.89), worry about cancer (OR 0.56, 95% CI 0.35-0.89), and increased chance of getting cancer (OR 3.5, 95% CI 0.24-0.51). Proxy variables for literacy suggest a possible contribution to health status disparities.

[Performance of LED fluorescence microscopy for the detection of acid-fast bacilli from respiratory samples in peripheral laboratories in Argentina].

PubMed

Imaz, María; Allassia, Sonia; Aranibar, Mónica; Gunia, Alba; Poggi, Susana; Togneri, Ana; Wolff, Lidia; Of Fluorescence, Group Of Implementation

2017-06-01

Light-emitting diode fluorescence microscopy (LED-FM) has been endorsed by the World Health Organization (WHO) for tuberculosis diagnosis, but its accuracy in HIV-infected patients remains controversial, and only some few studies have explored procedural factors that may affect its performance. To evaluate the performance of LED-FM for tuberculosis diagnosis in patients with and without HIV infection using a newer, less expensive LED lamp. We compared the performance of LED-FM and Ziehl-Neelsen (ZN) microscopy on respiratory specimen smears from tuberculosis (TB) suspects and patients on treatment examined by different technicians blinded for HIV-status and for the result of the comparative test. We analyzed the effect of concentrating specimens prior to microscopy using different examination schemes and user-appraisal of the LED device. Of the 6,968 diagnostic specimens collected, 869 (12.5%) had positive Mycobacterium tuberculosis cultures. LED-FM was 11.4% more sensitive than ZN (p;0.01). Among HIV-positive TB patients, sensitivity differences between LED-FM and ZN (20.6%) doubled the figure obtained in HIVnegative patients or in those with unknown HIV status (9.3%). After stratifying by direct and concentrated slides, the superiority of LED-FM remained. High specificity values were obtained both with LED-FM(99.9%) and ZN (99.9%).The second reading of a sample of slides showed a significantly higher positive detection yield using 200x magnification (49.4 %) than 400x magnification (33.8%) (p;0.05). The LEDdevice had a very good acceptance among the technicians. LED-FM better performance compared with ZN in HIV-infected patients and user-appraisal support the rapid roll-out of LED-FM. Screening at 200x magnification was essential to achieve LEDFM increased sensitivity.

Association between psychological and self-assessed health status and smartphone overuse among Korean college students.

PubMed

Kim, Hyun-Jin; Min, Jin-Young; Kim, Hye-Jin; Min, Kyoung-Bok

2017-09-04

Several studies suggest that subjective health status is closely related to various behavioral addictions, but there are few studies on smartphone overuse. This study investigated the associations between psychological and subjective health conditions and smartphone overuse in Korean college students. A total of 608 college students participated in this study. We investigated the perceived psychological factors, such as stress, depression symptoms and suicidal ideation. Overall health status was evaluated with self-assessed items, including usual health condition and EuroQol-visual analog scales (EQ-VAS) score. Smartphone overuse was evaluated as the Korean Smartphone Addiction Proneness Scale. Students with psychotic anxiety (i.e. stress, depression and suicidal ideation) showed significant associations with smartphone overuse, indicating an approximately twofold increased risk compared to those without psychological anxiety (all p < 0.05). Students who reported feeling that their usual health is not good were more likely to overuse smartphones than those who are in good health (OR = 1.98; 95% CI = 1.22-3.21). The EQ-VAS score, which indicates current self-assessed health status, also showed a similar result with general health status (OR = 2.14; 95% CI = 1.14-4.02). Negative conditions in self-perceived emotional or overall health condition are associated with the increased likelihood of smartphone overuse in Korean college students.

Social Support and Thriving Health: A New Approach to Understanding the Health of Indigenous Canadians

PubMed Central

Richmond, Chantelle A.M.; Ross, Nancy A.; Egeland, Grace M.

2007-01-01

Objectives. We examined the importance of social support in promoting thriving health among indigenous Canadians, a disadvantaged population. Methods. We categorized the self-reported health status of 31625 adult indigenous Canadians as thriving (excellent, very good) or nonthriving (good, fair, poor). We measured social support with indices of positive interaction, emotional support, tangible support, and affection and intimacy. We used multivariable logistic regression analyses to estimate odds of reporting thriving health, using social support as the key independent variable, and we controlled for educational attainment and labor force status. Results. Compared with women reporting low levels of social support, those reporting high levels of positive interaction (odds ratio [OR]=1.4; 95% confidence interval [CI]=1.2, 1.6), emotional support (OR=2.1; 95% CI=1.8, 2.4), and tangible support (OR = 1.4; 95% CI = 1.2, 1.5) were significantly more likely to report thriving health. Among men, only emotional support was significantly related to thriving health (OR=1.7; 95% CI=1.5, 1.9). Thriving health status was also significantly mediated by age, aboriginal status (First Nations, Métis, or Inuit), educational attainment, and labor force status. Conclusions. Social support is a strong determinant of thriving health, particularly among women. Research that emphasizes thriving represents a positive and necessary turn in the indigenous health discourse. PMID:17761564

Predicting survival of de novo metastatic breast cancer in Asian women: systematic review and validation study.

PubMed

Miao, Hui; Hartman, Mikael; Bhoo-Pathy, Nirmala; Lee, Soo-Chin; Taib, Nur Aishah; Tan, Ern-Yu; Chan, Patrick; Moons, Karel G M; Wong, Hoong-Seam; Goh, Jeremy; Rahim, Siti Mastura; Yip, Cheng-Har; Verkooijen, Helena M

2014-01-01

In Asia, up to 25% of breast cancer patients present with distant metastases at diagnosis. Given the heterogeneous survival probabilities of de novo metastatic breast cancer, individual outcome prediction is challenging. The aim of the study is to identify existing prognostic models for patients with de novo metastatic breast cancer and validate them in Asia. We performed a systematic review to identify prediction models for metastatic breast cancer. Models were validated in 642 women with de novo metastatic breast cancer registered between 2000 and 2010 in the Singapore Malaysia Hospital Based Breast Cancer Registry. Survival curves for low, intermediate and high-risk groups according to each prognostic score were compared by log-rank test and discrimination of the models was assessed by concordance statistic (C-statistic). We identified 16 prediction models, seven of which were for patients with brain metastases only. Performance status, estrogen receptor status, metastatic site(s) and disease-free interval were the most common predictors. We were able to validate nine prediction models. The capacity of the models to discriminate between poor and good survivors varied from poor to fair with C-statistics ranging from 0.50 (95% CI, 0.48-0.53) to 0.63 (95% CI, 0.60-0.66). The discriminatory performance of existing prediction models for de novo metastatic breast cancer in Asia is modest. Development of an Asian-specific prediction model is needed to improve prognostication and guide decision making.

Could cash and good parenting affect child cognitive development? A cross-sectional study in South Africa and Malawi.

PubMed

Sherr, Lorraine; Macedo, Ana; Tomlinson, Mark; Skeen, Sarah; Cluver, Lucie Dale

2017-05-12

Social protection interventions, including cash grants and care provision have been shown to effectively reduce some negative impacts of the HIV epidemic on adolescents and families. Less is known about the role of social protection on younger HIV affected populations. This study explored the impact of cash grants on children's cognitive development. Additionally, we examined whether combined cash and care (operationalised as good parenting) was associated with improved cognitive outcomes. The sample included 854 children, aged 5 - 15, participating in community-based organisation (CBO) programmes for children affected by HIV in South Africa and Malawi. Data on child cognitive functioning were gathered by a combination of caregiver report and observer administered tests. Primary caregivers also reported on the economic situation of the family, cash receipt into the home, child and household HIV status. Parenting was measured on a 10 item scale with good parenting defined as a score of 8 or above. About half of families received cash (55%, n = 473), only 6% (n = 51) reported good parenting above the cut-off point but no cash, 18% (n = 151) received combined cash support and reported good parenting, and 21% (n = 179) had neither. Findings show that cash receipt was associated with enhanced child cognitive outcomes in a number of domains including verbal working memory, general cognitive functioning, and learning. Furthermore, cash plus good parenting provided an additive effect. Child HIV status had a moderating effect on the association between cash or/plus good parenting and cognitive outcomes. The association between cash and good parenting and child cognitive outcomes remained significant among both HIV positive and negative children, but overall the HIV negative group benefited more. This study shows the importance of cash transfers and good parenting on cognitive development of young children living in HIV affected environments. Our data clearly indicate that combined provision (cash plus good parenting) have added value.

Metastatic Pancreatic Carcinoma and Experience with FOLFIRINOX - a Cross Sectional Analysis From a Developing Country.

PubMed

Zahir, Muhammad Nauman; Jabbar, Adnan Abdul

2015-01-01

Pancreatic cancer is the fourth leading cause of cancer related death with median survival ranging from 3 to 6 months for metastatic disease. Palliative chemotherapy has been the backbone of treatment in advanced stage and has evolved over time. Data pertaining to the disease are scarce from our part of the world where treatment poses a significant challenge due to lack of resources. A retrospective chart review was performed for all patients presenting with stage IV pancreatic carcinoma at a tertiary care hospital in Karachi, Pakistan between January 2008 and December 2012. Data were collected using a pre-designed, coded questionnaire looking at patient characteristics, treatment given and outcome. 101 patients were found to be eligible. Mean age was 56.7 ± 12.8 years, the male to female ratio was 2:1 and most patients had a good performance status. More than half of the tumors were located in the head (57%, n=58) and almost all were adenocarcinomas (95%, n=96). Some 58% (n=59) received first line chemotherapy of which 49% (n=29) received gemcitabine-based regimens and 39% (n=23) received FOLFIRINOX. The median progression free survival for gemcitabine based treatment was 2.9 months (IQR=1.6-5.6) as opposed to 7.3 months (IQR=4.5-9.2) for FOLFIRINOX (P=0.02). Median overall survival was 4.9 months (IQR=2.3-9.5) for first line gemcitabine based treatment and 10.5 months (IQR=7.0-13.2) for first line FOLFIRINOX therapy (P=0.002). Patients on FOLFIRINOX had better survival across all subgroups. Inpatient admissions and dose reductions were more frequent with FOLFIRINOX but the difference between the two regimens was not statistically significant. FOLFIRINOX could be successfully administered as outpatient therapy to a number of patients. FOLFIRINOX remains a suitable first line option in patients with metastatic pancreatic cancer with good performance status even in a resource-poor country where diagnostic and supportive care facilities may be less than optimal and cost is a limitation.

Screening for Vulnerability in Older Cancer Patients: The ONCODAGE Prospective Multicenter Cohort Study

PubMed Central

Soubeyran, Pierre; Bellera, Carine; Goyard, Jean; Heitz, Damien; Curé, Hervé; Rousselot, Hubert; Albrand, Gilles; Servent, Véronique; Jean, Olivier Saint; van Praagh, Isabelle; Kurtz, Jean-Emmanuel; Périn, Stéphane; Verhaeghe, Jean-Luc; Terret, Catherine; Desauw, Christophe; Girre, Véronique; Mertens, Cécile; Mathoulin-Pélissier, Simone; Rainfray, Muriel

2014-01-01

Background Geriatric Assessment is an appropriate method for identifying older cancer patients at risk of life-threatening events during therapy. Yet, it is underused in practice, mainly because it is time- and resource-consuming. This study aims to identify the best screening tool to identify older cancer patients requiring geriatric assessment by comparing the performance of two short assessment tools the G8 and the Vulnerable Elders Survey (VES-13). Patients and Methods The diagnostic accuracy of the G8 and the (VES-13) were evaluated in a prospective cohort study of 1674 cancer patients accrued before treatment in 23 health care facilities. 1435 were eligible and evaluable. Outcome measures were multidimensional geriatric assessment (MGA), sensitivity (primary), specificity, negative and positive predictive values and likelihood ratios of the G8 and VES-13, and predictive factors of 1-year survival rate. Results Patient median age was 78.2 years (70-98) with a majority of females (69.8%), various types of cancer including 53.9% breast, and 75.8% Performance Status 0-1. Impaired MGA, G8, and VES-13 were 80.2%, 68.4%, and 60.2%, respectively. Mean time to complete G8 or VES-13 was about five minutes. Reproducibility of the two questionnaires was good. G8 appeared more sensitive (76.5% versus 68.7%, P =  0.0046) whereas VES-13 was more specific (74.3% versus 64.4%, P<0.0001). Abnormal G8 score (HR = 2.72), advanced stage (HR = 3.30), male sex (HR = 2.69) and poor Performance Status (HR = 3.28) were independent prognostic factors of 1-year survival. Conclusion With good sensitivity and independent prognostic value on 1-year survival, the G8 questionnaire is currently one of the best screening tools available to identify older cancer patients requiring geriatric assessment, and we believe it should be implemented broadly in daily practice. Continuous research efforts should be pursued to refine the selection process of older cancer patients before potentially life-threatening therapy. PMID:25503576

Effects of nutritional and psychological status of the patients with advanced stomach cancer on physical performance status.

PubMed

Tian, Jun; Chen, Zhen-chun; Hang, Li-Fang

2009-10-01

The aim of this study was to assess the associations between coping mode, nutritional status, and psychological status and performance status of the patients with advanced stomach cancer. An epidemiological survey was conducted among 233 patients with advanced stomach cancer in Fujian, China. In-person interviews were performed for the participants with respect to information of psychological status prior to chemotherapy, nutritional status during chemotherapy, and physical performance status after chemotherapy. Multivariate logistic regression analyses showed that the level of hemoglobin (HB), level of daily calorie intake, score of Depression Status Inventory (DSI), and score of confrontation subscale of Medical Coping Modes Questionnaire had a significant influence on performance status (P < 0.05). The relative risks (95% confidence interval) were 2.06 (1.12-3.79) for low level of hemoglobin versus normal level of hemoglobin, 1.16 (1.02-1.32) for low level of daily calorie intake versus normal level of daily calorie intake, 5.89 (2.00-17.31) for DSI score > or =40 versus DSI score <40, and 3.17 (1.73-5.78) for low score of confrontation versus high score of confrontation, respectively. Depression, low score of "Confrontation", low levels of HB, and low level of daily calorie intake may be the risk factors of poor performance status of the patients with advanced stomach cancer.

Temporal change to self-rated health in the Swiss population from 1997 to 2012: the roles of age, gender, and education.

PubMed

Volken, T; Wieber, F; Rüesch, P; Huber, M; Crawford, R J

2017-09-01

Our study aimed to describe the temporal changes in self-rated health status (SRH) from 1997 to 2012 in adults aged 25 to 84 residing in Switzerland, with a view to identifying groups at risk for declining health. Secondary analysis of population-based cross-sectional health surveys. Data were collected from the cross-sectional, population-based, five-year Swiss Health Survey, from 1997, 2002, 2007 and 2012. A total of 63,861 individuals' data were included. Multilevel mixed-effect logistic regression analysis was employed to estimate the probability of very good and good health within the framework of a hierarchical cross-classified age-period-cohort model (HAPC), adjusting for education level, gender, civil status, smoking status and body mass index. Individuals with higher education were substantially more likely than those with primary education to report good SRH (OR = 2.12; 95% CI = 1.93-2.33 for secondary education and OR = 3.79; 95% CI = 3.39-4.23 for tertiary education). The education effect depended on birth cohort and age: higher proportions of good SRH were reported by secondary (8%-17%) and tertiary (10%-22%) compared with primary educated individuals from the 1940 birth cohort onward; the proportion of secondary/tertiary (compared to primary) educated people reporting good SRH increased with age (by 10/11% at 45-50 years and 25/36% at 80-84 years). Gender health equality was achieved by the 1955 (primary educated) and 1960 (secondary educated) birth cohorts, while these women overtook men in reporting good SRH from the 1975 birth cohort onward. Tertiary educated younger women were significantly less likely to report good SRH than men but parity was achieved at around pension age. Similarly, gender inequality in those with primary and secondary education reduced in the younger ages to not be significant at around age 55, with women overtaking men from age 65. Younger birth cohorts with lower education levels appear most vulnerable in terms of their SRH. The education effect cumulatively increases when attaining incrementally higher education levels. While women report lower health than men, gender inequality in SRH has declined and even reversed over time and is substantially linked to differences in educational status. Swiss public health strategies should particularly target the younger adults with only primary school education of both genders; for women, to combat health burdens in their early life, and men, to mitigate issues in their later life. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Materialism, status consumption, and consumer independence.

PubMed

Goldsmith, Ronald Earl; Clark, Ronald A

2012-01-01

Materialism influences many people. We focus on two aspects of this influence: reactions to prestige products and to the influence of others. A study of 187 U.S. student consumers shows that materialism is positively related to buying products that confer status. In contrast, materialism is negatively related to consumer independence, an enduring tendency to pay minimal attention to the prescribed norms of other consumers and to make product and brand decisions according to personal preferences. Consuming products for status is also negatively related to consumer independence. Moreover, the association between materialism and consumer independence is completely mediated by consuming for status. Materialism urges consumers to be status conscious so that they follow social norms in purchasing, but seeking status through goods is avoided by less materialistic, independent consumers. A second study (n = 258) also using student consumers confirmed these results.

A Two-Domain Self-Report Measure of Periodontal Disease Has Good Accuracy for Periodontitis Screening in Dental School Outpatients.

PubMed

Chatzopoulos, Georgios S; Tsalikis, Lazaros; Konstantinidis, Antonios; Kotsakis, Georgios A

2016-10-01

The assessment of periodontitis and treatment needs is primarily based on clinical and radiographic examinations. Albeit effective in predicting treatment needs, these examinations are costly, time-consuming, and impractical for assessing population-level needs. The purpose of the present study is to evaluate a two-domain self-report questionnaire for rapid periodontitis screening. Six hundred white adult individuals, dentate or partially dentate and seeking dental therapy at a university clinic, underwent oral examination utilizing the full-mouth Community Periodontal Index of Treatment Needs (CPITN). To assess predictive value of self-reported periodontal measures (SRPMs) for periodontitis screening, four questions were formulated. Two questions aimed to assess "dentist-diagnosed periodontal disease" and two inquired about "self-assessed periodontitis." Multiple logistic regression models were used to construct receiver-operating characteristic curves, and predictor selection was performed via a forward stepwise selection process. Five hundred thirty-five volunteers with a mean age of 50.1 years elected to respond to SRPMs via telephone interview. After oral examination, 17.8% of participants were assessed as having CPITN = 4, representing compromised periodontal status. Sensitivity and specificity for correctly classifying compromised periodontal status ranged from 5.3% to 72.6%, and 87.8% to 99.5% for individual SRPMs. Sensitivity and specificity were increased when combining a measure of self-assessed periodontal disease and a measure of dentist-diagnosed disease as predictors. Addition of age and sex maximized sensitivity/specificity at 82.1%/82.2%. Diabetic status, smoking, and body mass index did not enhance the prediction. A two-domain self-report measure combining two self-report items with age and sex has good sensitivity and specificity for periodontitis screening in a white, university-based population. The proposed self-report measure can be valuable for periodontitis screening in resource-limited settings where gold standard clinical examination may not be pragmatic. Further validation studies are required to assess whether findings from this study are context-specific.

Reliability and validity of 12-item Short-Form health survey (SF-12) for the health status of Chinese community elderly population in Xujiahui district of Shanghai.

PubMed

Shou, Juan; Ren, Limin; Wang, Haitang; Yan, Fei; Cao, Xiaoyun; Wang, Hui; Wang, Zhiliang; Zhu, Shanzhu; Liu, Yao

2016-04-01

The 12-item Short-Form Health Survey (SF-12) is the abridged practical version of SF-36. This cross-sectional study was aimed to assess the reliability and validity of SF-12 for the health status of Chinese community elderly population. The Chinese community elderly people in Xujiahui district of Shanghai were investigated. The internal consistency reliability was assessed using Cronbach's alpha and split-half reliability coefficients. Construct validity was analyzed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Spearman's correlation coefficient (ρ) was used for the evaluation of criterion, convergent, and discriminant validity with Spearman's ρ ≥ 0.4 as satisfactory. Comparisons of the SF-12 summary scores among populations that differed in demographics were performed for discriminant validity. Total 1343 individuals aged ≥60 and <85 years old (response rate: 91.3 %) were analyzed. The Cronbach's α value (0.910) and the split-half reliability coefficient (0.812) reflected satisfactory internal consistency reliability of SF-12. EFA extracted a two-factor model (physical and mental health). About 60.7 % of the total variance was explained by the two factors. CFA showed that the two-factor solution provided a good fit to the data. Good convergent validity and discriminant validity of SF-12 were proved by the correction analyses (Spearman's ρ > 0.4) and the comparisons of the SF-12 summary scores among populations (P < 0.05). SF-12 summary scores were significantly correlated with the SF-36 summary scores (Spearman's ρ > 0.4, P < 0.05). In conclusion, SF-12 had satisfactory reliability and validity in measuring health status of Chinese community elderly population in Xujiahui district of Shanghai.

To provide for the award of a gold medal on behalf of Congress to Jack Nicklaus in recognition of his service to the Nation in promoting excellence and good sportsmanship in golf.

THOMAS, 112th Congress

Rep. Baca, Joe [D-CA-43

2012-02-15

Senate - 04/17/2012 Received in the Senate and Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

[Analysis on the reasons of mastery of medicine in literati].

PubMed

Huang, Zhirong; Hou, Guohong

2002-01-01

In the history of traditional Chinese medicine, some literati mastered medicine. By analyzing several typical representatives. It can be seen that the reasons for such phenomenon are: 1) the theories of medicine and literature are interlinked on the basis of literature; 2) a good doctor and good prime ministers have the same social status and reputation; 3) morally good doctors fulfill the duty of loyalty, filial piety and comfort much more than good prime ministers on ethics; 4) healthy care and health preserving are action aspiring for fundamentality of life. Thus, this is the result from literati's crudition and edification of traditional Chinese culture.

Patient-reported outcomes in type 2 diabetes mellitus: patients' and primary care physicians' perspectives in the Spanish health care system.

PubMed

Franch-Nadal, Josep; Labrador Barba, Elena; Gómez-García, M Carmen; Buil-Cosiales, Pilar; Millaruelo, José Manuel; Peña, María Luisa Orera

2015-01-01

Understanding patients' and physicians' perceptions of type 2 diabetes mellitus (T2DM) management and treatment has important implications for diabetes care, allowing the identification of clinical practice issues that could be improved, leading to patients' better understanding of the illness and, consequently, healthier self-management behaviors. The objective of this study was to identify differences between physicians' and T2DM patients' perceptions related to health status, patient-reported outcomes assessments, and T2DM management and treatment, in routine clinical practice in Spain. This was an observational, cross-sectional study including 1,012 T2DM patients and 974 physicians from 47 and 52 Spanish provinces, respectively. An electronic structured self-administered questionnaire containing 17 questions was designed aiming to address both physicians' and patient's perceptions on overall T2DM health status and patient-reported outcomes. T2DM patients perceived a worse health status (40% reported having a "good" and 38% a "neither good nor bad" health status) compared with physicians' perceptions (77% thought patients had a "good" health status). Most patients answered being "satisfied" or "neither satisfied nor unsatisfied" with the given information, while physicians considered that patients were "satisfied" or "very satisfied" with the information for self-monitoring blood glucose and treatment administration. Fifty-seven percent of patients reported that medical recommendations were "important", while 58% of physicians considered it as "very important". Fifty-three percent of patients perceived that their current T2DM treatment suited their preferences "quite a lot", and this was lower than the proportion of physicians (69%) that believed this for their patients. Additionally, a lower percentage of patients (53%) than physicians (79%) believed that their treatment improved their health-related quality of life "quite a lot". All differences between patients and physicians were statistically significant (P<0.001). Patients and physicians demonstrate different views concerning all questions related to T2DM health status and diabetes management and treatment (information, recommendations, satisfaction, and preferences).

Hyperspectral-based predictive modelling of grapevine water status in the Portuguese Douro wine region

NASA Astrophysics Data System (ADS)

Pôças, Isabel; Gonçalves, João; Costa, Patrícia Malva; Gonçalves, Igor; Pereira, Luís S.; Cunha, Mario

2017-06-01

In this study, hyperspectral reflectance (HySR) data derived from a handheld spectroradiometer were used to assess the water status of three grapevine cultivars in two sub-regions of Douro wine region during two consecutive years. A large set of potential predictors derived from the HySR data were considered for modelling/predicting the predawn leaf water potential (Ψpd) through different statistical and machine learning techniques. Three HySR vegetation indices were selected as final predictors for the computation of the models and the in-season time trend was removed from data by using a time predictor. The vegetation indices selected were the Normalized Reflectance Index for the wavelengths 554 nm and 561 nm (NRI554;561), the water index (WI) for the wavelengths 900 nm and 970 nm, and the D1 index which is associated with the rate of reflectance increase in the wavelengths of 706 nm and 730 nm. These vegetation indices covered the green, red edge and the near infrared domains of the electromagnetic spectrum. A large set of state-of-the-art analysis and statistical and machine-learning modelling techniques were tested. Predictive modelling techniques based on generalized boosted model (GBM), bagged multivariate adaptive regression splines (B-MARS), generalized additive model (GAM), and Bayesian regularized neural networks (BRNN) showed the best performance for predicting Ψpd, with an average determination coefficient (R2) ranging between 0.78 and 0.80 and RMSE varying between 0.11 and 0.12 MPa. When cultivar Touriga Nacional was used for training the models and the cultivars Touriga Franca and Tinta Barroca for testing (independent validation), the models performance was good, particularly for GBM (R2 = 0.85; RMSE = 0.09 MPa). Additionally, the comparison of Ψpd observed and predicted showed an equitable dispersion of data from the various cultivars. The results achieved show a good potential of these predictive models based on vegetation indices to support irrigation scheduling in vineyard.

Protocol for the CONVERT trial-Concurrent ONce-daily VErsus twice-daily RadioTherapy: an international 2-arm randomised controlled trial of concurrent chemoradiotherapy comparing twice-daily and once-daily radiotherapy schedules in patients with limited stage small cell lung cancer (LS-SCLC) and good performance status.

PubMed

Faivre-Finn, Corinne; Falk, Sally; Ashcroft, Linda; Bewley, Michelle; Lorigan, Paul; Wilson, Elena; Groom, Nicki; Snee, Michael; Fournel, Pierre; Cardenal, Felipe; Bezjak, Andrea; Blackhall, Fiona

2016-01-20

Concurrent ONce-daily VErsus twice-daily RadioTherapy (CONVERT) is the only multicentre, international, randomised, phase III trial open in Europe and Canada looking at optimisation of chemoradiotherapy (RT) in limited stage small cell lung cancer (LS-SCLC). Following on from the Turrisi trial of once-daily versus twice-daily (BD) concurrent chemoradiotherapy, there is a real need for a new phase III trial using modern conformal RT techniques and investigating higher once-daily radiation dose. This trial has the potential to define a new standard chemo-RT regimen for patients with LS-SCLC and good performance status. 447 patients with histologically or cytologically proven diagnosis of SCLC were recruited from 74 centres in eight countries between 2008 and 2013. Patients were randomised to receive either concurrent twice-daily RT(45 Gy in 30 twice-daily fractions over 3 weeks) or concurrent once-daily RT(66 Gy in 33 once-daily fractions over 6.5 weeks) both starting on day 22 of cycle 1. Patients are followed up until death. The primary end point of the study is overall survival and secondary end points include local progression-free survival, metastasis-free survival, acute and late toxicity based on the Common Terminology Criteria for Adverse Events V.3.0, chemotherapy and RTdose intensity. The trial received ethical approval from NRES Committee North West-Greater Manchester Central (07/H1008/229). There is a trial steering committee, including independent members and an independent data monitoring committee. Results will be published in a peer-reviewed journal and presented at international conferences. ISRCTN91927162; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Revised Hammersmith Scale for spinal muscular atrophy: A SMA specific clinical outcome assessment tool.

PubMed

Ramsey, Danielle; Scoto, Mariacristina; Mayhew, Anna; Main, Marion; Mazzone, Elena S; Montes, Jacqueline; de Sanctis, Roberto; Dunaway Young, Sally; Salazar, Rachel; Glanzman, Allan M; Pasternak, Amy; Quigley, Janet; Mirek, Elizabeth; Duong, Tina; Gee, Richard; Civitello, Matthew; Tennekoon, Gihan; Pane, Marika; Pera, Maria Carmela; Bushby, Kate; Day, John; Darras, Basil T; De Vivo, Darryl; Finkel, Richard; Mercuri, Eugenio; Muntoni, Francesco

2017-01-01

Recent translational research developments in Spinal Muscular Atrophy (SMA), outcome measure design and demands from regulatory authorities require that clinical outcome assessments are 'fit for purpose'. An international collaboration (SMA REACH UK, Italian SMA Network and PNCRN USA) undertook an iterative process to address discontinuity in the recorded performance of the Hammersmith Functional Motor Scale Expanded and developed a revised functional scale using Rasch analysis, traditional psychometric techniques and the application of clinical sensibility via expert panels. Specifically, we intended to develop a psychometrically and clinically robust functional clinician rated outcome measure to assess physical abilities in weak SMA type 2 through to strong ambulant SMA type 3 patients. The final scale, the Revised Hammersmith Scale (RHS) for SMA, consisting of 36 items and two timed tests, was piloted in 138 patients with type 2 and 3 SMA in an observational cross-sectional multi-centre study across the three national networks. Rasch analysis demonstrated very good fit of all 36 items to the construct of motor performance, good reliability with a high Person Separation Index PSI 0.98, logical and hierarchical scoring in 27/36 items and excellent targeting with minimal ceiling. The RHS differentiated between clinically different groups: SMA type, World Health Organisation (WHO) categories, ambulatory status, and SMA type combined with ambulatory status (all p < 0.001). Construct and concurrent validity was also confirmed with a strong significant positive correlation with the WHO motor milestones rs = 0.860, p < 0.001. We conclude that the RHS is a psychometrically sound and versatile clinical outcome assessment to test the broad range of physical abilities of patients with type 2 and 3 SMA. Further longitudinal testing of the scale with regards change in scores over 6 and 12 months are required prior to its adoption in clinical trials.

Simultaneous Prediction of New Morbidity, Mortality, and Survival without New Morbidity from Pediatric Intensive Care: A New Paradigm for Outcomes Assessment

PubMed Central

Pollack, Murray M.; Holubkov, Richard; Funai, Tomohiko; Berger, John T.; Clark, Amy E.; Meert, Kathleen; Berg, Robert A.; Carcillo, Joseph; Wessel, David L.; Moler, Frank; Dalton, Heidi; Newth, Christopher J. L.; Shanley, Thomas; Harrison, Rick E.; Doctor, Allan; Jenkins, Tammara L.; Tamburro, Robert; Dean, J. Michael

2015-01-01

Objective Assessments of care including quality assessments adjusted for physiological status should include the development of new morbidities as well as mortalities. We hypothesized that morbidity, like mortality, is associated with physiological dysfunction and could be predicted simultaneously with mortality. Design Prospective cohort study from December 4, 2011 to April 7, 2013. Setting and Patients General and cardiac/cardiovascular pediatric intensive care units at 7 sites. Measurements and Main Results Among 10,078 admissions, the unadjusted morbidity rates (measured with the Functional Status Scale (FSS), and defined as an increase of ≥ 3 from pre-illness to hospital discharge) were 4.6% (site range 2.6% to 7.7%) and unadjusted mortality rates were 2.7% (site range 1.3% – 5.0%). Morbidity and mortality were significantly (p<0.001) associated with physiological instability (measured with the PRISM III score) in dichotomous (survival, death) and trichotomous (survival without new morbidity, survival with new morbidity, death) models without covariate adjustments. Morbidity risk increased with increasing PRISM III scores and then decreased at the highest PRISM III values as potential morbidities became mortalities. The trichotomous model with covariate adjustments included age, admission source, diagnostic factors, baseline FSS and the PRISM III score. The three-level goodness of fit test indicated satisfactory performance for the derivation and validation sets (p>0.20). Predictive ability assessed with the volume under the surface (VUS) was 0.50 ± 0.019 (derivation) and 0.50 ± 0.034 (validation) (versus chance performance = 0.17). Site-level standardized morbidity ratios were more variable than standardized mortality ratios. Conclusions New morbidities were associated with physiological status and can be modeled simultaneously with mortality. Trichotomous outcome models including both morbidity and mortality based on physiological status are suitable for research studies, and quality and other outcome assessments. This approach may be applicable to other assessments presently based only on mortality. PMID:25985385

Reduced intensity conditioned allograft yields favorable survival for older adults with B-cell acute lymphoblastic leukemia.

PubMed

Rosko, Ashley; Wang, Hai-Lin; de Lima, Marcos; Sandmaier, Brenda; Khoury, H Jean; Artz, Andrew; Brammer, Johnathan; Bredeson, Christopher; Farag, Sherif; Kharfan-Dabaja, Mohamed; Lazarus, Hillard M; Marks, David I; Bufarull, Rodrigo Martino; McGuirk, Joseph; Mohty, Mohamed; Nishihori, Taiga; Nivison-Smith, Ian; Rashidi, Armin; Ringden, Olle; Seftel, Matthew; Weisdorf, Daniel; Bachanova, Veronika; Saber, Wael

2017-01-01

Older adults with B-cell acute lymphoblastic leukemia (B-ALL) have poor survival. We examined the effectiveness of reduced intensity conditioning (RIC) hematopoietic cell transplant (HCT) in adults with B-ALL age 55 years and older and explored prognostic factors associated with long-term outcomes. Using CIBMTR registry data, we evaluated 273 patients (median age 61, range 55-72) with B-ALL with disease status in CR1 (71%), >CR2 (17%) and Primary Induction Failure (PIF)/Relapse (11%), who underwent RIC HCT between 2001 and 2012 using mostly unrelated donor (59%) or HLA-matched sibling (32%). Among patients with available cytogenetic data, the Philadelphia chromosome (Ph+) was present in 50%. The 3-year cumulative incidences of nonrelapse mortality (NRM) and relapse were 25% (95% confidence intervals (CI): 20-31%) and 47% (95% CI: 41-53%), respectively. Three-year overall survival (OS) was 38% (95% CI: 33-44%). Relapse remained the leading cause of death accounting for 49% of all deaths. In univariate analysis, 3 year risk of NRM was significantly higher with reduced Karnofsky performance status (KPS <90: 34% (95% CI: 25-43%) versus KPS ≥90 (18%; 95% CI: 12-24%, P = 0.006). Mortality was increased in older adults (66+ vs. 55-60: Relative Risk [RR] 1.51 95% CI: 1.00-2.29, P = 0.05) and those with advanced disease (RR 2.13; 95% CI: 1.36-3.34, P = 0.001). Survival of patients in CR1 yields 45% (95% CI: 38-52%) at 3 years and no relapse occurred after 2 years. We report promising OS and acceptable NRM using RIC HCT in older patients with B-ALL. Disease status in CR1 and good performance status are associated with improved outcomes. Am. J. Hematol. 92:42-49, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

[Effects of Feiji decoction for soothing the liver combined with psychotherapy on quality of life in primary lung cancer patients].

PubMed

Yao, Yilin

2012-01-01

Primary lung cancer is one of the most common malignant tumors. It causes great pain and mood disorders to patients, and significantly reduces their quality of life. The aim of the current study is to evaluate the effect of Feiji Decoction for soothing the liver combined with psychotherapy on quality of life (QoL) and physical status of patients with primary lung cancer. A total of 118 patients with primary non-small cell lung cancer were randomly divided into two groups. The 57 patients in the combined therapy group were treated with Feiji Decoction for soothing the liver and psychotherapy combined with chemotherapy, whereas the 61 patients in the control group were treated with chemotherapy only. Both groups were observed for the two treatment courses. The European Organization for Research and Treatment of Cancer QoL Questionnaire LC-43 (EORTC QLQ-LC43) was used to assess the QoL of every patient in both groups before and after treatment scales. At the same time, physical status was assessed using the Karnofsky performance status (KPS) and East Cooperative Oncology Group performance status (ECOG). The scores of physiology function, role function, emotion function, cognize function, society function, and general health in the therapy group were higher than that of the control group. The therapy group also showed better QoL results than the contol group. Significant differences were observed between the two groups (P<0.01). Meanwhile, the scores of fatigue, vomit, pain, polypnea, insomnia, anorexia, constipation, and specific manifestation of lung cancer in the therapy group were obviously lower than that of the control group; more patients were observed to be relieved. Significant differences between the two groups were observed (P<0.01). The KPS and ECOG scores of the patients were observed to have improved and stabilized in the therapy group than that of the control group; the differences were statistically significant (P<0.01). Feiji Decoction for soothing the liver combined with psychotherapy can alleviate the clinical symptoms, elevate the physical status, and improve the QOL of patients with primary lung cancer. Thus, this therapy has a good clinical therapeutic effect.

Simultaneous Prediction of New Morbidity, Mortality, and Survival Without New Morbidity From Pediatric Intensive Care: A New Paradigm for Outcomes Assessment.

PubMed

Pollack, Murray M; Holubkov, Richard; Funai, Tomohiko; Berger, John T; Clark, Amy E; Meert, Kathleen; Berg, Robert A; Carcillo, Joseph; Wessel, David L; Moler, Frank; Dalton, Heidi; Newth, Christopher J L; Shanley, Thomas; Harrison, Rick E; Doctor, Allan; Jenkins, Tammara L; Tamburro, Robert; Dean, J Michael

2015-08-01

Assessments of care including quality assessments adjusted for physiological status should include the development of new morbidities as well as mortalities. We hypothesized that morbidity, like mortality, is associated with physiological dysfunction and could be predicted simultaneously with mortality. Prospective cohort study from December 4, 2011, to April 7, 2013. General and cardiac/cardiovascular PICUs at seven sites. Randomly selected PICU patients from their first PICU admission. None. Among 10,078 admissions, the unadjusted morbidity rates (measured with the Functional Status Scale and defined as an increase of ≥ 3 from preillness to hospital discharge) were 4.6% (site range, 2.6-7.7%) and unadjusted mortality rates were 2.7% (site range, 1.3-5.0%). Morbidity and mortality were significantly (p < 0.001) associated with physiological instability (measured with the Pediatric Risk of Mortality III score) in dichotomous (survival and death) and trichotomous (survival without new morbidity, survival with new morbidity, and death) models without covariate adjustments. Morbidity risk increased with increasing Pediatric Risk of Mortality III scores and then decreased at the highest Pediatric Risk of Mortality III values as potential morbidities became mortalities. The trichotomous model with covariate adjustments included age, admission source, diagnostic factors, baseline Functional Status Scale, and the Pediatric Risk of Mortality III score. The three-level goodness-of-fit test indicated satisfactory performance for the derivation and validation sets (p > 0.20). Predictive ability assessed with the volume under the surface was 0.50 ± 0.019 (derivation) and 0.50 ± 0.034 (validation) (vs chance performance = 0.17). Site-level standardized morbidity ratios were more variable than standardized mortality ratios. New morbidities were associated with physiological status and can be modeled simultaneously with mortality. Trichotomous outcome models including both morbidity and mortality based on physiological status are suitable for research studies and quality and other outcome assessments. This approach may be applicable to other assessments presently based only on mortality.

Cosmetic Outcomes and Quality of Life in Thai Women Post Breast Conserving Therapy for Breast Cancer.

PubMed

Thanarpan, Peerawong; Somrit, Mahattanobon; Rungarun, Jiratrachu; Paytai, Rordlamool; Duangjai, Sangtawan; Chanon, Kongkamol; Puttisak, Puttawibul

2015-01-01

To evaluate the correlation between cosmetic outcome (CO), body image, and quality of life in post breast-conserving therapy (BCT) women. This cross-sectional study concerned one-year post-completed BCT Thai women. The data included subjective and objective CO with a questionnaire covering demographic and clinical data, anti-hormonal treatment status, Eastern Cooperative Oncology Group (ECOG) performance status, Self-Reported Cosmetic Outcomes (SRCO), Self-Reported Breast Symmetry (SRBS), Body Image Scale (BIS), and the Functional Assessment of Cancer Therapy with Breast Cancer subscale (FACT-B). Participants had breast photographs taken for the evaluation of objective cosmetic outcome (OCO) after breast cancer conservation treatment. The relationship between CO and FACT-B was tested using Spearman's rank correlation Results: A total 127 participants volunteered for the study. The participant characteristics were age 52(±9), Buddhist 87%, married 65%, body mass index 25.0(±4.6), breast cup size A-C 91%, college educated 60%, employed 66%, ECOG 0-1 95%, tumor size less than or equal to 2 cm 55%, no lymph node metastasis 98%, and taking tamoxifen 57%. Two percent of the participants regretted their decision to undergo BCT. The SRCO was excellent in 2%, good in 68%, fair in 30%, and poor in 0%. For SRBS, rates were 17%, 58%, 24% and 1% for excellent, good, fair and poor cosmetic outcomes, respectively. The BCCT scores were excellent 24%, good 39%, fair 32%, and poor 6%. The median total QOL score of the participants was 130 (93-144). There was no significant correlation between CO and FACT-B scores. The significance of CO for FACT-B in Thai women with breast cancer could not be assessed in detail because of a very low level of correlation. The results may be due to the effects of cultural background.

Long-term outcome after adjacent two-level anterior cervical discectomy and fusion using stand-alone plasmaphore-covered titanium cages.

PubMed

Marbacher, Serge; Hidalgo-Staub, Teresa; Kienzler, Jenny; Wüergler-Hauri, Carola; Landolt, Hans; Fandino, Javier

2015-05-01

Reports on long-term outcome of stand-alone contiguous two-level anterior cervical discectomy and fusion (ACDF) using stand-alone Plasmaphore-coated titanium cages (PCTCs) are rare, and data on follow-ups > 3 years are missing. To evaluate the long-term outcome of adjacent two-level microsurgical ACDF using stand-alone PCTC. A total of 33 consecutive patients presented with cervical degenerative disc disease (DDD) underwent contiguous two-level ACDF. Clinical long-term evaluation (mean: 61 ± 14 months) included documentation of neurologic deficits (motor deficits, sensory deficits, reflex status, and gait disturbance), neck pain, and radicular pain. Functional outcome was measured using the Odom criteria, patient-perceived outcome, and evaluation of work status. Radiographs were evaluated to assess intervertebral disc height, subsidence, level of fusion, sagittal balance, and implant position. Surgery was performed at levels C5-C6 and C6-C7 in 30 patients and at C4-C5 and C5-C6 in 3 (mean age: 50.1 ± 7.7 years). Symptoms and neurologic deficits improved as follows: neurologic deficits (pre: 100%; post: 36%), radicular pain (pre: 85%; post: 15%), and neck pain (pre: 94%; post: 33%). Excellent and good functional and subjective outcome was noted in 75%. Cage subsidence was found to be more prominent in the lower (52%) than the upper (36%) mobile cervical segment. Two-level fusion was documented in most patients (n = 29 [88%]). Kyphotic deformity occurred in two cases (n = 2 [6%]). Stand-alone contiguous two-level ACDF using PCPT proved to be effective, yielding good long-term clinical and functional outcomes. The relatively high rate of subsidence did not affect the good clinical and functional long-term outcome. Georg Thieme Verlag KG Stuttgart · New York.

The relationship of plasma miR-503 and coronary collateral circulation in patients with coronary artery disease.

PubMed

Fei, Yu; Hou, Jianhua; Xuan, Wei; Zhang, Chenghua; Meng, Xiuping

2018-06-02

Although angiogenesis plays an important role in coronary collateral circulation (CCC) formation and there are many determinants of coronary angiogenesis, they cannot fully explain the mechanism of CCC formation or as potent biomarker for CCC status. Therefore, there is of great clinical significance to identify the novel molecules associated with CCC. Previously, miR-503 exerts anti-angiogenesis effect via inhibition of VEGF-A and its expression is associated with many angiogenesis-related factors. Thus, we aimed to investigate the relationship of plasma miR-503 with CCC formation as well as its predictive power for CCC status in patients with coronary artery disease. Among patients who underwent coronary angiography with coronary artery disease and a stenosis of ≥90% were included in our study. Collateral degree was graded according to Rentrop Cohen classification. The patients were divided to good CCC group (grade 2 or 3) and poor CCC group (grade 0 or 1) according to Rentrop grade. We investigated the plasma levels of miR-503 and VEGF-A by ELISA or q RT-PCR, respectively. In addition, we assayed the correlations of plasma miR-503 with VEGF-A or Rentrop grade using the spearman correlation test and its predictive power by receiver operating characteristic (ROC) and binary logistical regression analysis. Our data showed that plasma VEGF-A was significantly higher in good CCC group than that in poor group. Plasma miR-503 was lower in CAD patients with good CCC or poor CCC compared with control subjects and lowest in good CCC group. In addition, miR-503 negatively correlated with VEGF-A and Rentrop grade, respectively. Moreover, miR-503 displayed more potent predictive power for CCC status than VEGF-A, but its sensitivity and specificity for CCC status were only 72.4 or 60.9%, respectively. Lower plasma miR-503 level was related to better CCC formation, accompanied by up-regulation of VEGF-A. In addition, miR-503 displayed potent predictive power for CCC status, but its sensitivity and specificity were not high enough, indicating that miR-503 might be as an additional prognosis biomarker for CCC. Copyright © 2017. Published by Elsevier Inc.

California Wellness Study: American Indians and Obesity

PubMed Central

Hodge, Felicia Schanche; Kotkin-Jaszi, Suzanne T.

2011-01-01

This paper identifies the prevalence and predictors of obesity among California’s American Indian adults. A cross-sectional study was conducted at 13 rural sites. Indian healthcare clinics served as the sampling frame and were selected because of their proximity and access to the target population. Four-hundred and fifty adult American Indians participated; 74 percent were female and 26 percent were male. The average age was 40, ranging from 18–74. Measures included socio-demographics, general health, BMI, type 2 diabetes, exercise and dietary habits. Eighty-two percent were overweight, obese or morbidly obese. Chi-square tests revealed three variables significantly associated with BMI categories: having type 2 diabetes, female gender and poor general health status. A logistic regression model for obese/morbidly obese (BMI > 30) versus overweight/normal (BMI < 30) persons found gender and diabetes status as significant predictors, while general health status showed trend. Females had 1.59 greater odds of being obese than males (p=0.04). Those that do not have diabetes are less likely to be obese (p=0.02). Those that do not have good general health were 2.5 times more likely to be obese than those that have good general health (p=0.06). Overall goodness of fit was significant (p=0.0009). It is important to identify individuals and population who are normal/overweight, obese/morbidly obese so support and interventions can be planned and implemented. PMID:21625381

The social determinants of health of the child-adolescent immigration and its influence on the nutritional status: systematic review.

PubMed

Cheikh Moussa, Kamila; Sanz-Valero, Javier; Wanden-Berghe, Carmina

2014-11-01

to review the social determinants of health more characteristic of the child and adolescents of immigrants, by reviewing the literature and assess its effect on nutritional status. a systematic review was performed using Medical Subject Headings (MeSH) in PubMed (Medline) and The Cochrane Library, in order to identify undetected studies; articles bibliographic lists were examined. The final election was done according to inclusion and exclusion criteria. No restrictions on sex and ethnicity of the participants. STROBE checkpoints were used for an information and methodological quality control. As Social Determinants of Health (SDH); social, demographic and economic conditions were considered for the study of their effect on the nutritional status. from 31 identified articles 18 are included in this study, 17 (94.4%) had a good or excellent quality. Hispanic and African were the most studied ethnicities; birth place and parent's residence period were used for generational classification. Alimentary culture and linguistic isolation of the first generation have a protective effect preventing from overweight and obesity risk while it decrease in second and third generation due to the experienced acculturation process equalizing their weight gain to natives; which prevalence is higher among Hispanics. No relation was found for nutritional status differences between sexes neither alimentary aids protective effect hypothesis was confirmed. the SDH with greater influence on child-adolescent immigrants were the socio-demographic conditions; among them: residence period distinguish the three identified generations while linguistic barrier and ethnic background are truly influential on the biological response to the experimented change caused by the acculturation process, establishing differences in the nutritional status. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Functional health status of adults with tetralogy of Fallot: matched comparison with healthy siblings.

PubMed

Knowles, Rachel; Veldtman, Gruschen; Hickey, Edward J; Bradley, Timothy; Gengsakul, Aungkana; Webb, Gary D; Williams, William G; McCrindle, Brian W

2012-07-01

Survival prospects for adults with repaired tetralogy of Fallot (TOF) are now excellent. Attention should therefore shift to assessing and improving functional health status and quality of life. We aimed to assess late functional health status of adults surviving TOF repair by matched comparison to their healthy siblings. All 1,693 TOF repairs performed at our institution between 1946 and 1990 were reviewed. A matched comparison was undertaken whereby presumed survivors and their healthy sibling were contacted and asked to complete the Ontario Health Survey 1990 and the 36-Item Short Form Health Survey (SF-36) questionnaire. Both questionnaires were completed by 224 adult survivors and their sibling closest in age. Adults with repaired TOF had lower scores for self-perceived general health status (p < 0.001), were less likely to rate their health as good or excellent (p < 0.001), and had lower SF-36 scores for physical functioning and general health (p = 0.001) than their siblings. However, patients reported similar satisfaction with their lives, similar levels of social participation and support, and were as likely to be in long-term partnerships. Worse physical and mental health scores were associated with older age at surgery and at time of questionnaire completion and recent requirement for noncardiac medication. Although reporting lower functional health status then their siblings, quality of life and life satisfaction for adults who underwent surgery for TOF during childhood is comparable to that of their siblings without heart defects. Follow-up of younger adults is required to understand current health outcomes attributable to improvements in the management of TOF. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

How well does a single question about health predict the financial health of Medicare managed care plans?

PubMed

Bierman, A S; Bubolz, T A; Fisher, E S; Wasson, J H

1999-01-01

Responses to simple questions that predict subsequent health care utilization are of interest to both capitated health plans and the payer. To determine how responses to a single question about general health status predict subsequent health care expenditures. Participants in the 1992 Medicare Current Beneficiary Survey were asked the following question: "In general, compared to other people your age, would you say your health is: excellent, very good, good, fair or poor?" To obtain each participant's total Medicare expenditures and number of hospitalizations in the ensuing year, we linked the responses to this question with data from the 1993 Medicare Continuous History Survey. Nationally representative sample of 8775 noninstitutionalized Medicare beneficiaries 65 years of age and older. Annual age- and sex-adjusted Medicare expenditures and hospitalization rates. Eighteen percent of the beneficiaries rated their health as excellent, 56% rated it as very good or good, 17% rated it as fair, and 7% rated it as poor. Medicare expenditures had a marked inverse relation to self-assessed health ratings. In the year after assessment, age- and sex-adjusted annual expenditures varied fivefold, from $8743 for beneficiaries rating their health as poor to $1656 for beneficiaries rating their health as excellent. Hospitalization rates followed the same pattern: Respondents who rated their health as poor had 675 hospitalizations per 1000 beneficiaries per year compared with 136 per 1000 for those rating their health as excellent. The response to a single question about general health status strongly predicts subsequent health care utilization. Self-reports of fair or poor health identify a group of high-risk patients who may benefit from targeted interventions. Because the current Medicare capitation formula does not account for health status, health plans can maximize profits by disproportionately enrolling beneficiaries who judge their health to be good. However, they are at a competitive disadvantage if they enroll beneficiaries who view themselves as sick.

Good Health Is Not the Same as a Good Life: Survey Results from Brandon, Manitoba

ERIC Educational Resources Information Center

Michalos, Alex C.; Ramsey, Douglas; Eberts, Derrek; Kahlke, P. Maurine

2012-01-01

The aim of this investigation was to obtain some baseline self-reported data on the health status and overall quality of life of a sample of residents of the city of Brandon, Manitoba aged 18 years or older, and to measure the impact of a set of designated health determinants, comparison standards and satisfaction with diverse domains of life on…

First birth interval, an indicator of energetic status, is a predictor of lifetime reproductive strategy.

PubMed

Nenko, Ilona; Jasienska, Grazyna

2013-01-01

Women should differ in their reproductive strategies according to their nutritional status. We tested a hypothesis that women who have a good nutritional status early in life, as indicated by a shorter waiting time to the first birth (first birth interval, FBI), are able to afford higher costs of reproduction than women who have worse nutritional condition. We collected data on 377 women who got married between the years 1782 and 1882 in a natural fertility population in rural Poland. The study group was divided into tertiles based on the length of FBI. Women with the shortest FBI had a higher number of children (P = 0.005), higher number of sons (P = 0.01), and shorter mean interbirth intervals (P = 0.06). Women who had ever given birth to twins had shorter FBI than women of singletons (20.1 and 26.1 months, respectively; P = 0.049). Furthermore, women with a shorter FBI, despite having higher costs of reproduction, did not have a different lifespan than women with a longer FBI. Our results suggest that women who were in better energetic condition (shorter length of FBI), achieved higher reproductive success without reduction in lifespan. FBI reflects interindividual variation, which may result from variation in nutritional status early in life and thus may be a good predictor of subsequent reproductive strategy. We propose to use FBI as an indicator of women's nutritional status in studies of historical populations, especially when information about social status is not available. Copyright © 2012 Wiley Periodicals, Inc.

Validity of Montreal Cognitive Assessment in non-english speaking patients with Parkinson's disease.

PubMed

Krishnan, Syam; Justus, Sunitha; Meluveettil, Radhamani; Menon, Ramshekhar N; Sarma, Sankara P; Kishore, Asha

2015-01-01

The Montreal Cognitive Assessment is a brief and easy screening tool for accurately testing cognitive dysfunction in Parkinson's disease. We tested its validity for use in non-English (Malayalam) speaking patients with Parkinson's disease. We developed a Malayalam (a south-Indian language) version of Montreal Cognitive Assessment and applied to 70 patients with Parkinson's disease and 60 age- and education-matched healthy controls. Metric properties were assessed, and the scores were compared with the performance in validated Malayalam versions of Mini Mental Status Examination and Addenbrooke's Cognitive Examination. The Montreal Cognitive Assessment-Malayalam showed good internal consistency and test-retest reliability and its scores correlated with Mini Mental Status Examination (patients: R = 0.70; P < 0.001; healthy controls: R = 0.26; P = 0.04) and Addenbrooke's Cognitive Examination (patients: R = 0.8; P < 0.001; healthy controls: R = 0.52; P < 0.001) scores. This study establishes the reliability of cross-cultural adaptation of Montreal Cognitive Assessment for assessing cognition in Malayalam-speaking Parkinson's disease patients for early screening and potential future interventions for cognitive dysfunction.

Remodeling of alveolar bone crest after molar intrusion with skeletal anchorage system in dogs.

PubMed

Kanzaki, Reiko; Daimaruya, Takayoshi; Takahashi, Ichiro; Mitani, Hideo; Sugawara, Junji

2007-03-01

The aim of this study was to clarify the influence of supra-alveolar fibers on alveolar bone crest remodeling when several teeth are intruded simultaneously. The skeletal anchorage system was used to bilaterally intrude the second and third premolars of 10 beagles; supracrestal fiberotomies were performed on 1 side only. The amount of intrusion was greater and the amount of alveolar bone resorption was smaller in the fiberotomy group compared with the nonfiberotomy group. The health status (pocket depth <3 mm) of the dentogingival unit was maintained in the nonfiberotomy group during the experimental period. In the fiberotomy group, the number of osteoclasts on the marginal alveolar crest was less than in the nonfiberotomy group. The dense fiber bundles connecting the second and third premolars and the gingival attachments were maintained in the nonfiberotomy group. Pressure from the supra-alveolar fibers generated by segmental molar intrusion with the skeletal anchorage system induced alveolar bone crest resorption and remodeling, and, as a result, it prevented deepening of the gingival pocket. Periodontal status was good during tooth intrusion.

Current status of laparoscopic and robotic ventral mesh rectopexy for external and internal rectal prolapse.

PubMed

van Iersel, Jan J; Paulides, Tim J C; Verheijen, Paul M; Lumley, John W; Broeders, Ivo A M J; Consten, Esther C J

2016-06-07

External and internal rectal prolapse with their affiliated rectocele and enterocele, are associated with debilitating symptoms such as obstructed defecation, pelvic pain and faecal incontinence. Since perineal procedures are associated with a higher recurrence rate, an abdominal approach is commonly preferred. Despite the description of greater than three hundred different procedures, thus far no clear superiority of one surgical technique has been demonstrated. Ventral mesh rectopexy (VMR) is a relatively new and promising technique to correct rectal prolapse. In contrast to the abdominal procedures of past decades, VMR avoids posterolateral rectal mobilisation and thereby minimizes the risk of postoperative constipation. Because of a perceived acceptable recurrence rate, good functional results and low mesh-related morbidity in the short to medium term, VMR has been popularized in the past decade. Laparoscopic or robotic-assisted VMR is now being progressively performed internationally and several articles and guidelines propose the procedure as the treatment of choice for rectal prolapse. In this article, an outline of the current status of laparoscopic and robotic ventral mesh rectopexy for the treatment of internal and external rectal prolapse is presented.

Status of HgCdTe Barrier Infrared Detectors Grown by MOCVD in Military University of Technology

NASA Astrophysics Data System (ADS)

Kopytko, M.; Jóźwikowski, K.; Martyniuk, P.; Gawron, W.; Madejczyk, P.; Kowalewski, A.; Markowska, O.; Rogalski, A.; Rutkowski, J.

2016-09-01

In this paper we present the status of HgCdTe barrier detectors with an emphasis on technological progress in metalorganic chemical vapor deposition (MOCVD) growth achieved recently at the Institute of Applied Physics, Military University of Technology. It is shown that MOCVD technology is an excellent tool for HgCdTe barrier architecture growth with a wide range of composition, donor /acceptor doping, and without post-grown annealing. The device concept of a specific barrier bandgap architecture integrated with Auger-suppression is as a good solution for high-operating temperature infrared detectors. Analyzed devices show a high performance comparable with the state-of-the-art of HgCdTe photodiodes. Dark current densities are close to the values given by "Rule 07" and detectivities of non-immersed detectors are close to the value marked for HgCdTe photodiodes. Experimental data of long-wavelength infrared detector structures were confirmed by numerical simulations obtained by a commercially available software APSYS platform. A detailed analysis applied to explain dark current plots was made, taking into account Shockley-Read-Hall, Auger, and tunneling currents.

Quality of life after Brooke ileostomy and ileal pouch-anal anastomosis. Comparison of performance status.

PubMed Central

Pemberton, J H; Phillips, S F; Ready, R R; Zinsmeister, A R; Beahrs, O H

1989-01-01

Although the clinical results of Brooke ileostomy are good, patients are permanently incontinent of stool and gas. Alternative operations designed to restore enteric continence, such as ileal pouch-anal anastomosis, must not only be as safe and effective as Brooke ileostomy, but should provide an improved quality of life in order to establish long-term acceptability. Ileal pouch-anal anastomosis has been performed safely and good functional results have been reported. The quality of life after ileal pouch-anal anastomosis, however, has not been documented. Two hundred ninety-eight ileal pouch patients and 406 Brooke ileostomy patients who had the operations performed for chronic ulcerative colitis or familial adenomatous polyposis formed the basis of the study. After adjusting for age, diagnosis, and reoperation rate, logistic regression analysis of performance scores in seven different categories was used to discriminate between operations. Median follow-up was longer in Brooke ileostomy patients than in ileal pouch patients (104 months vs. 47 months, respectively), and Brooke ileostomy patients were slightly older (38 years vs. 32 years). A great majority of patients in each group were satisfied (93% Brooke ileostomy; 95% ileal pouch-anal anastomosis). Thirty-nine per cent of Brooke ileostomy patients, however, desired a change in the type of ileostomy they had. At 47 months, ileal pouch patients had a median of 5 stools per day and 1 at night, 77% did not experience any daytime incontinence, while 22% reported occasional spotting. In each performance category, the performance score discriminated between operations, with the probability of having had an ileal pouch-anal anastomosis operation increasing with improvement in performance scores (p less than 0.05). We concluded that after ileal pouch-anal anastomosis, patients experienced significant advantages in performing daily activities compared to patients with Brooke ileostomy and thus may experience a better quality of life. These results help further to establish ileal pouch-anal anastomosis as a safe, attractive, and valid alternative to Brooke ileostomy. PMID:2539790

Good soldiers and good actors: prosocial and impression management motives as interactive predictors of affiliative citizenship behaviors.

PubMed

Grant, Adam M; Mayer, David M

2009-07-01

Researchers have discovered inconsistent relationships between prosocial motives and citizenship behaviors. We draw on impression management theory to propose that impression management motives strengthen the association between prosocial motives and affiliative citizenship by encouraging employees to express citizenship in ways that both "do good" and "look good." We report 2 studies that examine the interactions of prosocial and impression management motives as predictors of affiliative citizenship using multisource data from 2 different field samples. Across the 2 studies, we find positive interactions between prosocial and impression management motives as predictors of affiliative citizenship behaviors directed toward other people (helping and courtesy) and the organization (initiative). Study 2 also shows that only prosocial motives predict voice-a challenging citizenship behavior. Our results suggest that employees who are both good soldiers and good actors are most likely to emerge as good citizens in promoting the status quo.

The Great Observatories Origins Deep Survey (GOODS): Overview and Status

NASA Astrophysics Data System (ADS)

Hook, R. N.; GOODS Team

2002-12-01

GOODS is a very large project to gather deep imaging data and spectroscopic followup of two fields, the Hubble Deep Field North (HDF-N) and the Chandra Deep Field South (CDF-S), with both space and ground-based instruments to create an extensive multiwavelength public data set for community research on the distant Universe. GOODS includes a SIRTF Legacy Program (PI: Mark Dickinson) and a Hubble Treasury Program of ACS imaging (PI: Mauro Giavalisco). The ACS imaging was also optimized for the detection of high-z supernovae which are being followed up by a further target of opportunity Hubble GO Program (PI: Adam Riess). The bulk of the CDF-S ground-based data presently available comes from an ESO Large Programme (PI: Catherine Cesarsky) which includes both deep imaging and multi-object followup spectroscopy. This is currently complemented in the South by additional CTIO imaging. Currently available HDF-N ground-based data forming part of GOODS includes NOAO imaging. Although the SIRTF part of the survey will not begin until later in the year the ACS imaging is well advanced and there is also a huge body of complementary ground-based imaging and some follow-up spectroscopy which is already publicly available. We summarize the current status of GOODS and give an overview of the data products currently available and present the timescales for the future. Many early science results from the survey are presented in other GOODS papers at this meeting. Support for the HST GOODS program presented here and in companion abstracts was provided by NASA thorugh grant number GO-9425 from the Space Telescope Science Institute, which is operated by the Association of Universities for Research in Astronomy, Incorporated, under NASA contract NAS5-26555.

Sorafenib for the Treatment of Advanced Hepatocellular Cancer - a UK Audit.

PubMed

King, J; Palmer, D H; Johnson, P; Ross, P; Hubner, R A; Sumpter, K; Darby, S; Braconi, C; Iwuji, C; Swinson, D; Collins, P; Patel, K; Nobes, J; Muazzam, I; Blesing, C; Kirkwood, A; Nash, S; Meyer, T

2017-04-01

Sorafenib is the current standard treatment for advanced hepatocellular carcinoma. We carried out a national audit of UK patients treated with sorafenib as standard-of-care and those treated with systemic therapy in first-line trials. Sorafenib-treated and trial-treated patients were identified via the Cancer Drugs Fund and local databases. Data were collected retrospectively from medical records according to a standard case report form. The primary outcome measure was overall survival, estimated by the Kaplan-Meier method. Data were obtained for 448 sorafenib-treated patients from 15 hospitals. The median age was 68 years (range 17-89) and 75% had performance status ≤ 1. At baseline, 77% were Child-Pugh A and 16.1% Child-Pugh B; 38% were albumin-bilirubin grade 1 (ALBI-1) and 48% ALBI-2; 23% were Barcelona Clinic Liver Classification B (BCLC-B) and 72% BCLC-C. The median time on sorafenib was 3.6 months, with a mean daily dose of 590 mg. The median overall survival for 448 evaluable sorafenib-treated patients was 8.5 months. There were significant differences in overall survival comparing Child-Pugh A versus Child-Pugh B (9.5 versus 4.6 months), ALBI-1 versus ALBI-2 (12.9 versus 5.9 months) and BCLC-B versus BCLC-C (13.0 versus 8.3 months). For trial-treated patients (n=109), the median overall survival was 8.1 months and this was not significantly different from the sorafenib-treated patients. For Child-Pugh A patients with good performance status, survival outcomes were similar to those reported in global randomised controlled trials. Patients with ALBI grade > 1, Child-Pugh B or poor performance status seem to derive limited benefit from sorafenib treatment. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Current status of percutaneous endoscopic gastrostomy (PEG) in a general hospital in Japan: a cross-sectional study

PubMed Central

Kusano, Chika; Yamada, Nobuo; Kikuchi, Kenji; Hashimoto, Masaji; Gotoda, Takuji

2016-01-01

Background: There has been debate over the indications for percutaneous endoscopic gastrostomy (PEG) in recent years in Japan. In addition, the level of satisfaction of patients and patient’s family after PEG remains unclear. The aim of this study was to investigate the current status of PEG and the level of satisfaction of patients and patients’ families after PEG in Japan. Methods: We reviewed the existing data of all patients who underwent PEG tube insertion at Yuri Kumiai General Hospital (Akita, Japan) between February 2000 and December 2010. We examined the following points: underlying diseases requiring PEG, levels of consciousness, and performance status. We also sent a questionnaire to the patients and patient’s families to ask about their satisfaction with and thoughts about PEG. Results: The data of 545 patients who underwent PEG were reviewed. There were 295 men and 250 women, with a mean age of 77.2 ± 11.4 years. PEG was indicated most frequently for cerebrovascular disorders (48.2%, 239/545). There were 515 (94.4%, 515/545) patients showing consciousness disturbance and 444 (81.5%, 444/545) bedridden patients. The questionnaire was answered by one patient himself and 316 patients’ families. When asked, “Was performing PEG a good decision?”, 57.5% (182/316) of the patients’ families answered yes. Meanwhile, when patients’ family members were asked if they would wish to undergo PEG if they were in the same condition as the patient, 28.4% (90/316) answered yes, whereas 55.3% (175/316) answered no. Conclusions: Few patients were able to make their own decision about PEG tube placement because of consciousness disturbance. As a result, many family members of the patients did not want to experience PEG for themselves. Future studies should be performed to clarify the quality of life and ethical aspects associated with PEG. PMID:27313796

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

Russo, Andrea L.; Adams, Judith A.; Weyman, Elizabeth A.

Purpose: Squamous cell carcinoma (SCC) is the most common sinonasal cancer and is associated with one of the poor outcomes. Proton therapy allows excellent target coverage with maximal sparing of adjacent normal tissues. We evaluated the long-term outcomes in patients with sinonasal SCC treated with proton therapy. Methods and Materials: Between 1991 and 2008, 54 patients with Stage III and IV SCC of the nasal cavity and paranasal sinus received proton beam therapy at our institution to a median dose of 72.8 Gy(RBE). Sixty-nine percent underwent prior surgical resection, and 74% received elective nodal radiation. Locoregional control and survival probabilities weremore » estimated with the Kaplan-Meier method. Multivariate analyses were performed using the Cox proportional-hazards model. Treatment toxicity was scored using the Common Terminology Criteria for Adverse Events version 4.0. Results: With a median follow-up time of 82 months in surviving patients, there were 10 local, 7 regional, and 11 distant failures. The 2-year and 5-year actuarial local control rate was 80%. The 2-year and 5-year rates of overall survival were 67% and 47%, respectively. Only smoking status was predictive for worse locoregional control, with current smokers having a 5-year rate of 23% compared with 83% for noncurrent smokers (P=.004). Karnofsky performance status ≤80 was the most significant factor predictive for worse overall survival in multivariate analysis (adjusted hazard ratio 4.5, 95% confidence interval 1.6-12.5, P=.004). There were nine grade 3 and six grade 4 toxicities, and no grade 5 toxicity. Wound adverse events constituted the most common grade 3-4 toxicity. Conclusions: Our long-term results show that proton radiation therapy is well tolerated and yields good locoregional control for SCC of the nasal cavity and paranasal sinus. Current smokers and patients with poor performance status had inferior outcomes. Prospective study is necessary to compare IMRT with proton therapy in the treatment of sinonasal malignancy.« less

Chemotherapy-induced (febrile) neutropenia prophylaxis with biosimilar filgrastim in elderly versus non-elderly cancer patients: Patterns, outcomes, and determinants (MONITOR-GCSF study).

PubMed

Aapro, Matti; Bokemeyer, Carsten; Ludwig, Heinz; Gascón, Pere; Boccadoro, Mario; Denhaerynck, Kris; Gorray, Michael; Krendyukov, Andriy; MacDonald, Karen; Abraham, Ivo

2017-03-01

Myelotoxic chemotherapy is associated with chemotherapy-induced (febrile) neutropenia (CIN/FN). The MONITOR-GCSF study evaluated biosimilar filgrastim (Zarzio®) prophylaxis patterns, associated outcomes, and determinants. We performed stratified analyses comparing elderly and non-elderly patients. Comparative (elderly/non-elderly) analysis of demographics and clinical status, prophylaxis, associated CIN/FN outcomes (CIN grade 4 [CIN4], FN, CIN/FN-related hospitalizations and chemodisturbances, composite), and, per hierarchical modeling, determinants thereof evaluated at the patient- and cycle-level. There were no significant differences between both cohorts in prophylaxis initiation/duration and associated outcomes, but proportionately more elderly patients were correctly-prophylacted and fewer over-prophylacted. Common determinants of poor CIN/FN outcomes included concomitant antibiotic prophylaxis, impaired performance status, and any grade CIN in a previous cycle, whereas common determinants of good outcomes included over-prophylaxis and prophylaxis initiation within 24-72h. In the elderly, female gender, liver/renal/cardiovascular disease, secondary prophylaxis, and under-prophylaxis were associated with poorer outcomes. In the non-elderly, CIN4 at baseline or in a prior cycle was associated with poorer CIN/FN outcomes, and higher biosimilar filgrastim dose and, perhaps counter-intuitively, under-prophylaxis with better outcomes. Adequate GCSF support is essential for all patients, but especially for elderly patients with serious chronic disease, certainly, if concomitant antibiotic prophylaxis is indicated and if a CIN4 episode occurred in a prior cycle. The potential impact of impaired performance status, especially ECOG≥2 at chemotherapy start or a worsening to such during chemotherapy; under-prophylaxis, including inadequate secondary prophylaxis, should be considered in elderly patients. Timely GCSF initiation and over-prophylaxis is associated with lower rates of adverse CIN/FN events in elderly and non-elderly patients, and should be further evaluated in prospective randomized trials. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Effects of a supplemented hypoproteic diet in chronic kidney disease.

PubMed

Mircescu, Gabriel; Gârneaţă, Liliana; Stancu, Simona Hildegard; Căpuşă, Cristina

2007-05-01

We assessed the effect of a severe hypoproteic diet supplemented with ketoanalogues (SVLPD) for 48 weeks on certain metabolic disorders of chronic kidney disease (CKD). We performed a prospective, open-label, parallel, randomized, controlled trial. The study took place in the Nephrology Department at the Dr Carol Davila Teaching Hospital of Nephrology, Bucharest, Romania. A total of 53 nondiabetic patients with CKD with an estimated glomerular filtration rate less than 30 mL/min/1.73 m(2) (Modification of Diet in Renal Disease formula), proteinuria less than 1 g/g urinary creatinine, good nutritional status, and anticipated good compliance with the diet were randomly assigned to two groups. Group I (n = 27) received the SVLPD (0.3 g/kg/d of vegetable proteins and ketoanalogues, 1 capsule for every 5 kg of ideal body weight per day). Group II (n = 26) continued a conventional low mixed protein diet (0.6 g/kg/d). Nitrogen waste products retention and calcium-phosphorus and acid-base disturbances were primary efficacy parameters, and "death" of the kidney or the patient and the estimated glomerular filtration rate were secondary efficacy parameters. The nutritional status and compliance with the diet were predefined as safety variables. There were no differences between groups in any parameter at baseline. In the SVLPD group, serum urea significantly decreased (56 +/- 7.9 mmol/L vs. 43.2 +/- 10 mmol/L), and significant improvements in serum bicarbonate (23.4 +/- 2.1 mmol/L vs. 18.1 +/- 1.5 mmol/L), serum calcium (1.10 +/- 0.17 mmol/L vs. 1.00 +/- 0.15 mmol/L at baseline), serum phosphates (1.45 +/- 0.66 mmol/L vs. 1.91 +/- 0.68 mmol/L), and calcium-phosphorus product (1.59 +/- 0.11 mmol(2)/L(2) vs. 1.91 +/- 0.10 mmol(2)/L(2)) were noted after 48 weeks. No death was registered in any group. Significantly lower percentages of patients in group I required renal replacement therapy initiation (4% vs. 27%). After 48 weeks, estimated glomerular filtration rate did not significantly change in patients receiving SVLPD (0.26 +/- 0.08 mL/s vs. 0.31 +/- 0.08 mL/s at baseline), but significantly decreased in controls (0.22 +/- 0.09 mL/s vs. 0.30 +/- 0.07 mL/s). The compliance with the keto-diet was good in enrolled patients. No significant changes in any of the parameters of the nutritional status and no adverse reactions were noted. SVLPD seems to ameliorate the nitrogen waste products retention and acid-base and calcium-phosphorus metabolism disturbances and to postpone the renal replacement therapy initiation, preserving the nutritional status in patients with CKD.

Determining team cognition from delay analysis using cross recurrence plot.

PubMed

Hajari, Nasim; Cheng, Irene; Bin Zheng; Basu, Anup

2016-08-01

Team cognition is an important factor in evaluating and determining team performance. Forming a team with good shared cognition is even more crucial for laparoscopic surgery applications. In this study, we analyzed the eye tracking data of two surgeons during a laparoscopic simulation operation, then performed Cross Recurrence Analysis (CRA) on the recorded data to study the delay behaviour for good performer and poor performer teams. Dual eye tracking data for twenty two dyad teams were recorded during a laparoscopic task and then the teams were divided into good performer and poor performer teams based on the task times. Eventually we studied the delay between two team members for good and poor performer teams. The results indicated that the good performer teams show a smaller delay comparing to poor performer teams. This study is compatible with gaze overlap analysis between team members and therefore it is a good evidence of shared cognition between team members.

A resolution recognizing the threats to freedom of the press and expression around the world and reaffirming freedom of the press as a priority in the efforts of the United States Government to promote democracy and good governance.

THOMAS, 113th Congress

Sen. Casey, Robert P., Jr. [D-PA

2014-05-15

Senate - 07/08/2014 Resolution agreed to in Senate with an amendment and an amended preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Agreed to in SenateHere are the steps for Status of Legislation:

Status-Relevant Experiences and Conspicuous Consumption - the Moderating Role of Prenatal Androgen Exposure.

PubMed

Cornelissen, Gert; Palacios-Fenech, Javier

2016-09-20

In this paper we study consumers' interest in acquiring and displaying expensive luxury products. Based on recent insights in consumer psychology, which build on developments in evolutionary biology, we consider luxury products as "costly signals": wasteful and costly goods, whose purpose is to communicate one's biological fitness, and social status, to others. In line with previous research, we show that experiences that trigger mate attraction goals (Study 1: Exposure to others in bathing outfit) or status display goals (Study 2: Experiencing a vicarious victory of one's favorite sports team) can increase people's interest in luxury products. However, we demonstrate that some individuals are predictably more responsive to those experiences than others. We used a physiological measure (the proportion of the length of the index finger and ring finger of the right hand, 2D:4D) as a proxy for individual differences in exposure to prenatal androgens (i.e., testosterone). This measure has been related to dominant and competitive behavior later in life. We predict and find that individuals with a low 2D:4D (i.e., high exposure to prenatal androgens) were more responsive to the status-relevant experiences: they became more interested in luxury goods after these experiences. This was not the case for high 2D:4D individuals.

Predictors of Outcome of Convulsive Status Epilepticus Among an Egyptian Pediatric Tertiary Hospital.

PubMed

Halawa, Eman F; Draz, Iman; Ahmed, Dalia; Shaheen, Hala A

2015-11-01

Convulsive status epilepticus is a common neurologic emergency in pediatrics. We aimed to study the etiology, clinical features, and prognostic factors among pediatric patients with convulsive status epilepticus. Seventy patients were included in this cohort study from pediatric emergency department of the specialized Children Hospital of Cairo University. The outcome was evaluated using the Glasgow Outcome Score. Acute symptomatic etiology was the most common cause of convulsive status epilepticus. Refractory convulsive status epilepticus was observed more significantly in cases caused by acute symptomatic etiologies. The outcome was mortality in 26 (37.1%) patients, severe disability in 15 (21.4%), moderate disability in 17 (24.3%), and good recovery in 12 (17.1%) patients. The significant predictor of mortality was lower modified Glasgow Coma Scale score on admission, whereas lower modified Glasgow Coma Scale score on admission and refractory convulsive status epilepticus were the significant predictors for disability and mortality. © The Author(s) 2015.

An unusual case of isolated, serial metastases of gallbladder carcinoma involving the chest wall, axilla, breast and lung parenchyma

PubMed Central

Jeyaraj, Pamela; Sio, Terence T.; Iott, Matthew J.

2013-01-01

In the English literature, only 9 cases of adenocarcinoma of the gallbladder with cutaneous metastasis have been reported so far. One case of multiple cutaneous metastases along with deposits in the breast tissue has been reported. We present a case of incidental metastatic gallbladder carcinoma with no intra-abdominal disease presenting as a series of four isolated cutaneous right chest wall, axillary nodal, breast, and pulmonary metastases following resection and adjuvant chemoradiation for her primary tumor. In spite of the metastatic disease coupled with the aggressive nature of the cancer, this patient reported that her energy level had returned to baseline with a good appetite and a stable weight indicating a good performance status and now is alive at 25 months since diagnosis. Her serially-presented, oligometastatic diseases were well-controlled by concurrent chemoradiotherapy and stereotactic radiation therapy. We report this case study because of its rarity and for the purpose of complementing current literature with an additional example of cutaneous metastasis from adenocarcinoma of the gallbladder. PMID:23772306

[Surgery for thoracic tuberculosis].

PubMed

Kilani, T; Boudaya, M S; Zribi, H; Ouerghi, S; Marghli, A; Mestiri, T; Mezni, F

2015-01-01

Tuberculosis is mainly a medical disease. Surgery has been the unique therapeutic tool for a long time before the advent of specific antituberculous drugs, and the role of surgery was then confined to the treatment of the sequelae of tuberculosis and their complications. The resurgence of tuberculosis and the emergence of multidrug-resistant TB combined to immunosuppressed patients represent a new challenge for tuberculosis surgery. Surgery may be indicated for a diagnostic purpose in patients with pulmonary, pleural, mediastinal or thoracic wall involvement, or with a therapeutic purpose (drainage, resection, residual cavity obliteration). Modern imaging techniques and the advent of video-assisted thoracic surgery allowed a new approach of this pathology; the majority of diagnostic interventions and selected cases requiring lung resection can be performed through a mini-invasive approach. Patients proposed for aggressive surgery may be treated with the best results thanks to a good evaluation of the thoracic lesions, of the patients' nutritional, infectious and general status combined with a good coordination between the specialized medical team for an optimal preparation to surgery. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Heterogeneity and frequency of BRAF mutations in primary melanoma: Comparison between molecular methods and immunohistochemistry

PubMed Central

Bruno, William; Martinuzzi, Claudia; Andreotti, Virginia; Pastorino, Lorenza; Spagnolo, Francesco; Dalmasso, Bruna; Cabiddu, Francesco; Gualco, Marina; Ballestrero, Alberto; Bianchi-Scarrà, Giovanna; Queirolo, Paola

2017-01-01

Finding the best technique to identify BRAF mutations with a high sensitivity and specificity is mandatory for accurate patient selection for target therapy. BRAF mutation frequency ranges from 40 to 60% depending on melanoma clinical characteristics and detection technique used. Intertumoral heterogeneity could lead to misinterpretation of BRAF mutational status; this is especially important if testing is performed on primary specimens, when metastatic lesions are unavailable. Aim of this study was to identify the best combination of methods for detecting BRAF mutations (among peptide nucleic acid – PNA-clamping real-time PCR, immunohistochemistry and capillary sequencing) and investigate BRAF mutation heterogeneity in a series of 100 primary melanomas and a subset of 25 matched metastatic samples. Overall, we obtained a BRAF mutation frequency of 62%, based on the combination of at least two techniques. Concordance between mutation status in primary and metastatic tumor was good but not complete (67%), when agreement of at least two techniques were considered. Next generation sequencing was used to quantify the threshold of detected mutant alleles in discordant samples. Combining different methods excludes that the observed heterogeneity is technique-based. We propose an algorithm for BRAF mutation testing based on agreement between immunohistochemistry and PNA; a third molecular method could be added in case of discordance of the results. Testing the primary tumor when the metastatic sample is unavailable is a good option if at least two methods of detection are used, however the presence of intertumoral heterogeneity or the occurrence of additional primaries should be carefully considered. PMID:28039443

Validation of the geriatric anxiety inventory in a duloxetine clinical trial for elderly adults with generalized anxiety disorder.

PubMed

Ball, Susan G; Lipsius, Sarah; Escobar, Rodrigo

2015-09-01

The Generalized Anxiety Inventory (GAI) has been developed for use in the assessment of anxiety symptoms in older adults (≥ 65 years), but previous validation work has not examined the psychometric qualities of the instrument in relation to treatment. The objective of this study was to examine the performance of the GAI for its internal reliability, convergent and divergent validity, and its sensitivity to treatment. Elderly patients with generalized anxiety disorder (GAD) participated in a 10-week double-blind study of duloxetine treatment for patients with GAD. Anxiety symptoms were assessed with the Hamilton Anxiety Rating Scale (HAMA), the Hospital Anxiety and Depression Scale (HADS) anxiety and depression subscales, and the GAI. Internal reliability of the GAI was assessed with Cronbach's α. Correlations among the HAMA, HADS, and GAI scores were analyzed to determine convergent and divergent validity. Patients were also compared on remission status using recommended cut-off scores for the GAI. Patients with GAD, who were at least 65 years of age, were randomly assigned to double-blind treatment with either duloxetine (N = 151) or placebo (N = 140) for 10 weeks acute therapy. The mean change on the GAI was significantly greater with duloxetine compared with placebo treatment (-8.36 vs. -4.96, respectively, p ≤ 0.001). The GAI demonstrated good internal consistency, good convergent and divergent validity, but suggested cut-off values for caseness with the GAI did not correspond to remission status as measured by the HAMA. Within an elderly patient population with GAD, the GAI demonstrated sound psychometric qualities and sensitivity to change with treatment.

Active smoking may negatively affect response rate, progression-free survival, and overall survival of patients with metastatic renal cell carcinoma treated with sunitinib.

PubMed

Keizman, Daniel; Gottfried, Maya; Ish-Shalom, Maya; Maimon, Natalie; Peer, Avivit; Neumann, Avivit; Hammers, Hans; Eisenberger, Mario A; Sinibaldi, Victoria; Pili, Roberto; Hayat, Henry; Kovel, Svetlana; Sella, Avishay; Boursi, Ben; Weitzen, Rony; Mermershtain, Wilmosh; Rouvinov, Keren; Berger, Raanan; Carducci, Michael A

2014-01-01

Obesity, smoking, hypertension, and diabetes are risk factors for renal cell carcinoma development. Their presence has been associated with a worse outcome in various cancers. We sought to determine their association with outcome of sunitinib treatment in metastatic renal cell carcinoma (mRCC). An international multicenter retrospective study of sunitinib-treated mRCC patients was performed. Multivariate analyses were performed to determine the association between outcome and the pretreatment status of smoking, body mass index, hypertension, diabetes, and other known prognostic factors. Between 2004 and 2013, 278 mRCC patients were treated with sunitinib: 59 were active smokers, 67 were obese, 73 were diabetic, and 165 had pretreatment hypertension. Median progression-free survival (PFS) was 9 months, and overall survival (OS) was 22 months. Factors associated with PFS were smoking status (past and active smokers: hazard ratio [HR]: 1.17, p = .39; never smokers: HR: 2.94, p < .0001), non-clear cell histology (HR: 1.62, p = .011), pretreatment neutrophil-to-lymphocyte ratio >3 (HR: 3.51, p < .0001), use of angiotensin system inhibitors (HR: 0.63, p = .01), sunitinib dose reduction or treatment interruption (HR: 0.72, p = .045), and Heng risk (good and intermediate risk: HR: 1.07, p = .77; poor risk: HR: 1.87, p = .046). Factors associated with OS were smoking status (past and active smokers: HR: 1.25, p = .29; never smokers: HR: 2.7, p < .0001), pretreatment neutrophil-to-lymphocyte ratio >3 (HR: 2.95, p < .0001), and sunitinib-induced hypertension (HR: 0.57, p = .002). Active smoking may negatively affect the PFS and OS of sunitinib-treated mRCC. Clinicians should consider advising patients to quit smoking at initiation of sunitinib treatment for mRCC.

The behavior of Turkish cancer patients in fasting during the holy month of Ramadan.

PubMed

Tas, Faruk; Karabulut, Senem; Ciftci, Rumeysa; Yildiz, Ibrahim; Keskin, Serkan; Kilic, Leyla; Disci, Rian

2014-08-01

Fasting during the holy month of Ramadan is one of the major obligations for all adult Muslims. We performed a survey of Turkish Muslim cancer patients to examine the extent of their fasting status and to compare various clinical characteristics of fasting and non-fasting cancer patients during the month of Ramadan. This study was conducted on 701 adult cancer patients who attended ambulatory patient care units answered the questionnaires. The population comprised 445 women (63.5%), and the median age was 54 years. Before diagnosis of cancer, 93.1% of the patients used fast consists of completely (78.3%) and partial (14.8%). However, 15% of cases were fasting on the day of interview, either partially (7.4%) or completely (7.6%) with equal distributions. Patients who were females, those with good performance status, those without any comorbid disease, who had non-metastatic disease, those with history of surgery, those treated with radiotherapy and those being treated with oral chemotherapeutic agents were more likely to be fasting than others. The fasting ones had more prevalent among patients with lymphoma, urogenital cancer and breast cancer; conversely, the rate of fasting status among patients with lung and gastrointestinal cancer was quite low. Only 20.8% of all patients asked their physician whether it was alright for them to fast and physicians generally had a negative attitude towards fasting (83.2%). Majority of cancer patients are not fasting during the month of Ramadan, and a small part of patients consult this situation to their physician. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Is the Functional Threshold Power (FTP) a Valid Surrogate of the Lactate Threshold?

PubMed

Valenzuela, Pedro L; Morales, Javier S; Foster, Carl; Lucia, Alejandro; de la Villa, Pedro

2018-05-10

This study aimed to analyze the relationship between the Functional Threshold Power (FTP) and the Lactate Threshold (LT). 20 male cyclists performed an incremental test in which the LT was determined. At least 48 h later, they performed a 20-minute time trial and 95% of the mean power output (P20) was defined as FTP. Participants were divided into recreational (Peak Power Output [PPO] < 4.5 W∙kg -1 , n=11) or trained cyclists (PPO > 4.5 W∙kg -1 , n=9) according to their fitness status. The FTP (240 ± 35 W) was overall not significantly different (effect size[ES]=0.20, limits of agreement [LoA]=-2.4 ± 11.5%) from the LT (246 ± 24 W), and both markers were strongly correlated (r=0.95, p<0.0001). Accounting for the participants' fitness status, no significant differences were found between FTP and LT ([ES]=0.22; LoA=2.1 ± 7.8%) in TC, but FTP was significantly lower than the LT (p=0.0004, ES=0.81; LoA=-6.5 ± 8.3%) in RC. A significant relationship was found between relative PPO and the bias between FTP and the LT markers (r=0.77, p<0.0001). The FTP is a valid field test-based marker for the assessment of endurance fitness. However, caution should be taken when using the FTP interchangeably with the LT as the bias between markers seems to depend on the athletes' fitness status. Whereas the FTP provides a good estimate of the LT in trained cyclists, in recreational cyclists FTP may underestimate LT.

Chair rise capacity and associated factors in older home-care clients.

PubMed

Tiihonen, Miia; Hartikainen, Sirpa; Nykänen, Irma

2017-07-01

The aim of this study was to investigate the ability of older home-care clients to perform the five times chair rise test and associated personal characteristics, nutritional status and functioning. The study sample included 267 home-care clients aged ≥75 years living in Eastern and Central Finland. The home-care clients were interviewed at home by home-care nurses, nutritionists and pharmacists. The collected data contained sociodemographic factors, functional ability (Barthel Index, IADL), cognitive functioning (MMSE), nutritional status (MNA), depressive symptoms (GDS-15), medical diagnoses and drug use. The primary outcome was the ability to perform the five times chair rise test. Fifty-one per cent ( n=135) of the home-care clients were unable to complete the five times chair rise test. Twenty-three per cent ( n=64) of the home-care clients had good chair rise capacity (≤17 seconds). In a multivariate logistic regression analysis, fewer years of education (odds ratio [OR] = 1.11, 95% confidence interval [CI] 1.04-1.18), lower ADL (OR = 1.54, 95% CI 1.34-1.78) and low MNA scores (OR = 1.12, 95% CI 1.04-1.20) and a higher number of co-morbidities (OR = 1.21, 95% CI 1.02-1.43) were associated with inability to complete the five times chair rise test. Poor functional mobility, which was associated with less education, a high number of co-morbidities and poor nutritional status, was common among older home-care clients. To maintain and to prevent further decline in functional mobility, physical training and nutritional services are needed. (NutOrMed, ClinicalTrials.gov Identifier: NCT02214758).

Assessing the socio-economic and demographic impact on health-related quality of life: evidence from Greece.

PubMed

Pappa, Evelina; Kontodimopoulos, Nick; Papadopoulos, Angelos A; Niakas, Dimitris

2009-01-01

The impact of socioeconomic status on health has been extensively studied and studies have shown that low socio-economic status is related to lower values of various health and quality-of-health measures. The aim of this study was to assess the influence of demographic and socio-economic factors on health- related quality of life (HRQoL). A cross-sectional study was carried out in 2003 using a representative sample of a Greek general population (n = 1007, 18+ years old), living in Athens area. Multivariate stepwise linear regression analyses were performed to investigate the influence of socio-demographic and economic variables on HRQoL, measured by eight scales of the SF-36. Interaction effects between socioeconomic status (SES) and demographic variables were also performed. Females and elderly people were associated with impaired HRQoL in all SF-36 scales. Disadvantaged SES i. e. primary education and low total household income was related to important decline in HRQoL and a similar relation was identified among men and women. Only the interaction effects between age and SES was statistically significant for some SF-36 scales. Multiple regression analyses produced models explaining significant portions of the variance in SF-36 scales, especially physical functioning. The analysis presented here gives evidence of a relationship existing between SES and HRQoL similar to what has been found elsewhere. In order to protect people from the damaging effects of poverty in health it is important to formulate health promotion educational programs or to direct policies to empower the disposable income etc. Helping people in disadvantaged SES to achieve the good health that people in more advantaged SES attained would help to prevent the widening of health inequalities.

Speaker recognition with temporal cues in acoustic and electric hearing

NASA Astrophysics Data System (ADS)

Vongphoe, Michael; Zeng, Fan-Gang

2005-08-01

Natural spoken language processing includes not only speech recognition but also identification of the speaker's gender, age, emotional, and social status. Our purpose in this study is to evaluate whether temporal cues are sufficient to support both speech and speaker recognition. Ten cochlear-implant and six normal-hearing subjects were presented with vowel tokens spoken by three men, three women, two boys, and two girls. In one condition, the subject was asked to recognize the vowel. In the other condition, the subject was asked to identify the speaker. Extensive training was provided for the speaker recognition task. Normal-hearing subjects achieved nearly perfect performance in both tasks. Cochlear-implant subjects achieved good performance in vowel recognition but poor performance in speaker recognition. The level of the cochlear implant performance was functionally equivalent to normal performance with eight spectral bands for vowel recognition but only to one band for speaker recognition. These results show a disassociation between speech and speaker recognition with primarily temporal cues, highlighting the limitation of current speech processing strategies in cochlear implants. Several methods, including explicit encoding of fundamental frequency and frequency modulation, are proposed to improve speaker recognition for current cochlear implant users.

The effects of individual status and group performance on network ties among teammates in the National Basketball Association

PubMed Central

Aven, Brandy

2018-01-01

For individuals, status is derived both from their personal attributes and the groups with whom they are affiliated. Depending on the performance of their groups, the status of individuals may benefit or suffer from identifying closely with the group. When the group excels, high-status members potentially receive much of the credit and increased status. Conversely, high-status members of underperforming groups potentially suffer disproportionate declines in their status relative to the low-status group members. We therefore predict an interaction between group performance and individual status on the willingness to associate with the group and its members. We test our prediction by examining social media ties among teammates in the National Basketball Association. Specifically, we investigate the “following” ties of teammates on Twitter at the end of the 2014–2015 season. Elections to All-Star games are used to measure the status of players, and team performance is measured by recent success in the postseason playoffs. The results show that compared to high-status players on successful teams, high-status players on underperforming teams are less likely to follow their teammates. This result aligns with research on status inconsistency, suggesting that individuals deemphasize their group affiliation when it jeopardizes their individual status. An additional contribution is the advancement of the probit Social Relations Model for the analysis of binary ties in social networks. PMID:29708984

The effects of individual status and group performance on network ties among teammates in the National Basketball Association.

PubMed

Koster, Jeremy; Aven, Brandy

2018-01-01

For individuals, status is derived both from their personal attributes and the groups with whom they are affiliated. Depending on the performance of their groups, the status of individuals may benefit or suffer from identifying closely with the group. When the group excels, high-status members potentially receive much of the credit and increased status. Conversely, high-status members of underperforming groups potentially suffer disproportionate declines in their status relative to the low-status group members. We therefore predict an interaction between group performance and individual status on the willingness to associate with the group and its members. We test our prediction by examining social media ties among teammates in the National Basketball Association. Specifically, we investigate the "following" ties of teammates on Twitter at the end of the 2014-2015 season. Elections to All-Star games are used to measure the status of players, and team performance is measured by recent success in the postseason playoffs. The results show that compared to high-status players on successful teams, high-status players on underperforming teams are less likely to follow their teammates. This result aligns with research on status inconsistency, suggesting that individuals deemphasize their group affiliation when it jeopardizes their individual status. An additional contribution is the advancement of the probit Social Relations Model for the analysis of binary ties in social networks.

Dogs and Monsters: Moral Status Claims in the Fiction of Dean Koontz.

PubMed

Smith, Stephen W

2016-03-01

This article explores conceptions of moral status in the work of American thriller author Dean Koontz. It begins by examining some of the general theories of moral status used by philosophers to determine whether particular entities have moral status. This includes both uni-criterial theories and multi-criterial theories of moral status. After this examination, the article argues for exploring bioethics conceptions in popular fiction. Popular fiction is considered a rich source for analysis because it provides not only a good approximation of the beliefs of ordinary members of the moral community, but also explores important issues in a context where ordinary individuals are likely to encounter them. Following on from this, the article then explores theories of moral status in the context of Koontz's novels. In particular, the article focuses on the novel Watchers and Koontz's Frankenstein series. Through these works, Koontz indicates that entities have moral status for a variety of reasons and thus presumably, he is a proponent of multi-criterial theories of moral status. The article concludes with an examination of what this might mean for our understanding of moral status claims generally.

Fighting Status Inequalities: Non-domination vs Non-interference

PubMed Central

Nielsen, Morten Ebbe Juul

2016-01-01

Status inequalities seem to play a fairly big role in creating inequalities in health. This article assumes that there can be good reasons to fight status inequalities in order to reduce inequalities in health. It examines whether the neorepublican ideal of non-dominance does a better job as a theoretical foil for this as compared to a liberal notion of non-interference. The article concludes that there is a prima facie case for incorporating non-dominance into our thinking about public health, but that it needs to go hand in hand with a more traditional liberal ideal of non-interference. PMID:27551298

Fighting Status Inequalities: Non-domination vs Non-interference.

PubMed

Nielsen, Morten Ebbe Juul; Landes, Xavier

2016-07-01

Status inequalities seem to play a fairly big role in creating inequalities in health. This article assumes that there can be good reasons to fight status inequalities in order to reduce inequalities in health. It examines whether the neorepublican ideal of non-dominance does a better job as a theoretical foil for this as compared to a liberal notion of non-interference. The article concludes that there is a prima facie case for incorporating non-dominance into our thinking about public health, but that it needs to go hand in hand with a more traditional liberal ideal of non-interference.

Pre-hospital physical activity status affects in-hospital course of elderly patients with acute myocardial infarction.

PubMed

Miyamoto, Takamichi; Obayashi, Tohru; Hattori, Eijirou; Yamauchi, Yasuteru; Niwa, Akihiro; Isobe, Mitsuaki

2010-03-01

The clinical course of elderly patients with acute myocardial infarction (AMI) can sometimes unexpectedly result in an adverse outcome even when therapy appears to be successful. We suspect that specific factors may characterize this worsening of status during hospitalization. This study examines whether the pre-hospital physical activity status of the elderly treated with percutaneous coronary intervention (PCI) for AMI affects their in-hospital course. We studied 110 consecutive patients, aged 80 or older, who had undergone emergent PCI for AMI. Patients were divided into two groups based on clinical presentation: Better Killip class (Killip classes I and II) and Worse Killip class (Killip classes III and IV). Patients were also divided into two groups based on pre-hospital physical activity status, determined retrospectively by review of medical records: Good physical activity (n=57) comprising those able to go out alone independently and Poor physical activity comprising those mainly confined to home (n=53). The overall in-hospital mortality rate was 9.1% for the study population. The Worse Killip class group had a higher in-hospital mortality rate than the Better Killip class group (27.8% vs 5.4%, respectively; p=0.0102). In addition, the Poor physical activity group had a higher in-hospital mortality rate than the Good physical activity group (15.1% vs. 3.5%, respectively; p=0.047). These data suggest that pre-hospital physical activity status in elderly patients with AMI may affect in-hospital mortality as well as Killip class.

Study of Predictors of Suicidal Behaviour in Bundeswehr Soldiers Receiving Inpatient Care

DTIC Science & Technology

2011-04-01

i.e. external restrictions (regarding alcohol and drug consumption ) and a good resource situation (solid employment, good physical condition...self-poisoning by medication/ drugs ), X70-79 (cuts, hanging, firearm discharge), X80-84 (jumping from a high place/intentional crashing of motor...for the following potential regressors are analysed based on the established group differences:  sex  diagnosis  drug abuse  status

The status of pediatric cardiology at a tertiary center in Lebanon.

PubMed

Arabi, Mariam; Majdalani, Marianne; El Hajj, Maria Atoui; Nemer, Georges; Sawaya, Fadi; Obeid, Mounir; Bitar, Fadi F

2011-01-01

Cardiac disease, both congenital and acquired, contributes significantly to morbidity and mortality in children. This article describes the status of pediatric cardiology at the Children's Heart Center in the American University of Beirut Medical Center. It addresses the available clinical services as well as the research and educational activities that are present at a tertiary center in Lebanon, a developing country with a population of 4 million. Lebanon has witnessed major developments in the field of pediatric cardiology over the past few years. About 650 babies are born with heart disease every year, with more than 425 needing treatment. Nearly all types of interventional catheterization procedures are currently being performed. About 300 open and closed pediatric cardiac surgeries are performed per year in Lebanon. In 2008, the in-hospital surgical mortality rate at our center was 2.6%, reflecting the good level of care in the treatment of children with congenital heart disease (CHD) in Lebanon. Basic research in the field of pediatric cardiology is emerging at our center. Our team has been studying the effect of chronic hypoxemia on the neonatal myocardium in an animal model of chronic hypoxia, as well as the study of molecular basis of CHD. Appropriate identification of cardiac disease, its epidemiology, and outcome is of utmost importance in guiding adequate care. Centralization of facilities is important to improve results and level of care.

Primary Care, Self-rated Health, and Reductions in Social Disparities in Health

PubMed Central

Shi, Leiyu; Starfield, Barbara; Politzer, Robert; Regan, Jerri

2002-01-01

Objective To examine the extent to which good primary-care experience attenuates the adverse association of income inequality with self-reported health. Data Sources Data for the study were drawn from the Robert Wood Johnson Foundation sponsored 1996–1997 Community Tracking Study (CTS) Household Survey and state indicators of income inequality and primary care. Study Design Cross-sectional, mixed-level analysis on individuals with a primary-care physician as their usual source of care. The analyses were weighted to represent the civilian noninstitutionalized population of the continental United States. Data Collection/Extraction Methods Principal component factor analysis was used to explore the structure of the primary-care indicators and examine their construct validity. Income inequality for the state in which the community is located was measured by the Gini coefficient, calculated using income distribution data from the 1996 current population survey. Stratified analyses compared proportion of individuals reporting bad health and feeling depressed with those with good and bad primary-care experiences for each of the four income-inequality strata. A set of logistic regressions were performed to examine the relation between primary-care experience, income inequality, and self-rated health. Principal Findings Good primary-care experience, in particular enhanced accessibility and continuity, was associated with better self-reported health both generally and mentally. Good primary-care experience was able to reduce the adverse association of income inequality with general health although not with mental health, and was especially beneficial in areas with highest income inequality. Socioeconomic status attenuated, but did not eliminate, the effect of primary-care experience on health. In conclusion, good primary-care experience is associated not only with improved self-rated overall and mental health but also with reductions in disparities between more- and less-disadvantaged communities in ratings of overall health. PMID:12132594

Equity in access to health care among asylum seekers in Germany: evidence from an exploratory population-based cross-sectional study.

PubMed

Bozorgmehr, Kayvan; Schneider, Christine; Joos, Stefanie

2015-11-09

Research on inequities in access to health care among asylum-seekers has focused on disparities between asylum-seekers and resident populations, but little attention has been paid to potential inequities in access to care within the group of asylum-seekers. We aimed to analyse the principles of horizontal equity (i.e., equal access for equal need irrespective of socioeconomic status, SES) and vertical equity (higher allocation of resources to those with higher need) among asylum-seekers in Germany. We performed a secondary exploratory analysis on cross-sectional data obtained from a population-based questionnaire survey among all asylum-seekers (aged 18 or above) registered in three administrative districts in Germany during the three-month study period (N = 1017). Data were collected on health care access (health care utilisation of four types of services and unmet medical need), health care need (approximated by sex, age and self-rated health status), and SES (highest educational attainment and subjective social status, SSS). We calculated odds ratios and 95% confidence intervals (CI) in multiple logistic regression models to analyse associations between SES indicators and access to health care under control of need. We contacted 60.4% (614) of the total asylum-seekers population, of which 25.4% (N = 156) participated in the study. Educational attainment showed no significant effect on health care access in crude models, but was positively associated with utilisation of psychotherapists and hospital admissions in adjusted models. Higher SSS was positively associated with health care utilisation of all types of services. The odds of hospitals admissions for asylum-seekers in the medium and highest SSS category were 3.18 times [1.06, 9.59] and 1.6 times [0.49, 5.23] the odds of those in the lowest SSS category. After controlling for need variables none of the SES indicators were significantly associated with measures of access to care, but a positive association remained, indicating higher utilisation of health care among asylum-seekers with higher SES. Age, sex or general health status were the only significant predictors of health care utilisation in fully adjusted models. The adjusted odds of reporting unmet medical needs among asylum-seekers with "fair/bad/very bad" health status were 2.16 times [0.84, 5.59] the odds of those with "good/very good" health status. Our findings revealed that utilisation of health services among asylum-seekers is associated with higher need (vertical equity met). Horizontal equity was met with respect to educational attainment for most outcomes, but a social gradient in health care utilisation was observed across SSS. Further confirmatory research is needed, especially on potential inequities in unmet medical need and on measurements of SES among asylum-seekers.

Derivation and Validation of a Renal Risk Score for People With Type 2 Diabetes

PubMed Central

Elley, C. Raina; Robinson, Tom; Moyes, Simon A.; Kenealy, Tim; Collins, John; Robinson, Elizabeth; Orr-Walker, Brandon; Drury, Paul L.

2013-01-01

OBJECTIVE Diabetes has become the leading cause of end-stage renal disease (ESRD). Renal risk stratification could assist in earlier identification and targeted prevention. This study aimed to derive risk models to predict ESRD events in type 2 diabetes in primary care. RESEARCH DESIGN AND METHODS The nationwide derivation cohort included adults with type 2 diabetes from the New Zealand Diabetes Cohort Study initially assessed during 2000–2006 and followed until December 2010, excluding those with pre-existing ESRD. The outcome was fatal or nonfatal ESRD event (peritoneal dialysis or hemodialysis for ESRD, renal transplantation, or death from ESRD). Risk models were developed using Cox proportional hazards models, and their performance was assessed in a separate validation cohort. RESULTS The derivation cohort included 25,736 individuals followed for up to 11 years (180,497 person-years; 86% followed for ≥5 years). At baseline, mean age was 62 years, median diabetes duration 5 years, and median HbA1c 7.2% (55 mmol/mol); 37% had albuminuria; and median estimated glomerular filtration rate (eGFR) was 77 mL/min/1.73 m2. There were 637 ESRD events (2.5%) during follow-up. Models that included sex, ethnicity, age, diabetes duration, albuminuria, serum creatinine, systolic blood pressure, HbA1c, smoking status, and previous cardiovascular disease status performed well with good discrimination and calibration in the derivation cohort and the validation cohort (n = 5,877) (C-statistics 0.89–0.92), improving predictive performance compared with previous models. CONCLUSIONS These 5-year renal risk models performed very well in two large primary care populations with type 2 diabetes. More accurate risk stratification could facilitate earlier intervention than using eGFR and/or albuminuria alone. PMID:23801726

Can Locoregional Treatment of the Primary Tumor Improve Outcomes for Women With Stage IV Breast Cancer at Diagnosis?

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

Nguyen, David H.A., E-mail: dhanguyen@yahoo.com; Departement de Radio-Oncologie, Hopital Maisonneuve-Rosemont, Montreal, Quebec; Truong, Pauline T.

2012-09-01

Purpose: To examine the effect of locoregional treatment (LRT) of the primary tumor on survival in patients with Stage IV breast cancer at diagnosis. Methods and Materials: The study cohort comprised 733 women referred to the British Columbia Cancer Agency between 1996 and 2005 with newly diagnosed clinical or pathologic M1 breast cancer. Tumor and treatment characteristics, overall survival (OS), and locoregional progression-free survival were compared between patients treated with (n = 378) and without (n = 355) LRT of the primary disease. Multivariable analysis was performed with Cox regression modeling. Results: The median follow-up time was 1.9 years. LRTmore » consisted of surgery alone in 67% of patients, radiotherapy alone in 22%, and both in 11%. LRT was used more commonly in women with age <50 years, Eastern Cooperative Oncology Group (ECOG) performance status 0-1, Stage T1-2 tumors, N0-1 disease, limited M1 burden, and asymptomatic M1 disease (all p < 0.05). Systemic therapy was used in 92% of patients who underwent LRT and 85% of patients who did not. In patients treated with LRT compared with those without LRT, the 5-year OS rates were 21% vs. 14% (p < 0.001), and the rates of locoregional progression-free survival were 72% vs. 46% (p < 0.001). Among 378 patients treated with LRT, the rates of 5-year OS were higher in patients with age <50, ECOG performance status 0-1, estrogen receptor-positive disease, clear surgical margins, single subsite, bone-only metastasis, and one to four metastatic lesions (all p < 0.003). On multivariable analysis, LRT was associated with improved OS (hazard ratio, 0.78; 95% confidence interval, 0.64-0.94, p = 0.009). Conclusion: Locoregional treatment of the primary disease is associated with improved survival in some women with Stage IV breast cancer at diagnosis. Among those treated with LRT, the most favorable rates of survival were observed in subsets with young age, good performance status, estrogen receptor-positive disease, clear margins, and distant disease limited to one subsite, bone-only involvement, or fewer than five metastatic lesions.« less

"Top Performing" US Hospitals and the Health Status of Counties they Serve.

PubMed

Maraccini, Amber M; Yang, Wei; Slonim, Anthony D

2018-06-01

This study (a) examined the relationships between "top performing" US hospitals and the health status of counties they serve and (b) compared the health status of "top performing" US hospital counties versus that of remaining US counties. Statistical analyses considered US News and World Report Honor Roll ranking data, as a measure of hospital performance, and County Health Rankings (CHR) data, as a measure of county health status. "Top performing" hospital Honor Roll scores were correlated with measures of Clinical Care (p < 0.001). Counties with "top performing" US hospitals presented greater health status with regard to All Health Outcomes (p < 0.001), Length of Life (p < 0.001), Quality of Life (p < 0.001), All Health Factors (p < 0.001), Health Behaviors (p < 0.001), and Clinical Care (p < 0.001), than compared to remaining US counties. Hospital impact on county health status remains primarily recognized in clinical care and not in overall health. Also, counties that contain a "top performing" US hospital tend to present lower health risks to their citizens than compared to other US counties.

Hemadsorption with Adult CytoSorb® in a Low Weight Pediatric Case

PubMed Central

Barascu, Ileana; Mc Kenzie Stancu, Samantha

2017-01-01

Cytokine adsorber (CytoSorb) has been used successfully as adjunctive treatment for adult patients with elevated cytokine levels in the setting with severe sepsis and septic shock and to reduce blood myoglobin, unconjugated bilirubin, and conjugated bilirubin. In this article we present the case of a nine-month-old male infant who was admitted to the NICU due to sepsis after cardiac surgery, Fallot tetralogy, and multisystem organ failure (MSOF) including liver failure and renal failure which was successfully treated by a combination of continuous hemodiafiltration (HDF) and hemadsorption with CytoSorb. HDF was safe and effective from the first day for urea removal, but the patient's bilirubin levels kept increasing gradually, culminating on the 9th day with a maximum value of 54 mg/dL of total bilirubin and 31.67 mg/dL of direct bilirubin when we performed hemadsorption with CytoSorb. Over the 49-hour period of hemadsorption, the total bilirubin value decreased from 54 to 14 mg/dL, and the patient's general status improved considerably accompanied by a rapid drop of aminotransferases. Hemodynamic status has been improved as well and inotropes dropped rapidly. The patient's ventilation settings improved during CytoSorb treatment permitting weaning the patient from mechanical ventilation after five days of hemadsorption. The patient was discharged home after 34 days of hospitalization, in a good general status. PMID:28127473

Hemadsorption with Adult CytoSorb® in a Low Weight Pediatric Case.

PubMed

Cirstoveanu, Catalin Gabriel; Barascu, Ileana; Mc Kenzie Stancu, Samantha

2017-01-01

Cytokine adsorber (CytoSorb) has been used successfully as adjunctive treatment for adult patients with elevated cytokine levels in the setting with severe sepsis and septic shock and to reduce blood myoglobin, unconjugated bilirubin, and conjugated bilirubin. In this article we present the case of a nine-month-old male infant who was admitted to the NICU due to sepsis after cardiac surgery, Fallot tetralogy, and multisystem organ failure (MSOF) including liver failure and renal failure which was successfully treated by a combination of continuous hemodiafiltration (HDF) and hemadsorption with CytoSorb. HDF was safe and effective from the first day for urea removal, but the patient's bilirubin levels kept increasing gradually, culminating on the 9th day with a maximum value of 54 mg/dL of total bilirubin and 31.67 mg/dL of direct bilirubin when we performed hemadsorption with CytoSorb. Over the 49-hour period of hemadsorption, the total bilirubin value decreased from 54 to 14 mg/dL, and the patient's general status improved considerably accompanied by a rapid drop of aminotransferases. Hemodynamic status has been improved as well and inotropes dropped rapidly. The patient's ventilation settings improved during CytoSorb treatment permitting weaning the patient from mechanical ventilation after five days of hemadsorption. The patient was discharged home after 34 days of hospitalization, in a good general status.

Sociodemographic and Clinical Characteristics of Centenarians in Mexico City.

PubMed

Pedro, Valdés-Corchado; Arturo, Ruiz-Hernández; Alejandro, Pérez-Moreno; Oscar, Rosas-Carrasco

2017-01-01

There is little evidence about the demography and health status of adults aged 100 years and over in Latin America and there are no studies in Mexico. To describe the demographic characteristics and health status of centenarians residing in Mexico City. This is a cross-sectional study using a population base of 393 community-dwelling centenarians in Mexico City. A comprehensive geriatric assessment was performed, including demographic information and health status. The mean age of centenarians was 101.82 ± 2.02 years, of whom 44 (9.1%) were semisupercentenarians (105-109 years old) and 5 (0.2%) were supercentenarians (≥110 years old). The female/male ratio was 3.2 : 1. Twelve (4.5%) reside in nursing homes. Women versus men have unfavorable conditions given their criteria: being without a partner, dependence in 1 or more basic activities, dependence in 1 or more instrumental activities, hypertension, cancer, and Parkinson's disease. Nevertheless, as compared to other populations, Mexican centenarians report having good self-perception of health (78.9%), polypharmacy (17.8%), low rate of pain (11.4%), diabetes (4.8%), and dyslipidemia (1.8%). This is the first study in Latin America that describes the social and clinical characteristics of centenarians in Mexico City. This population has a high percentage of malnutrition and osteoarthrosis, a high self-perception of health, low frequency of diabetes, dyslipidemia, cardiovascular disease, and a high frequency of "escapers" (24%).

Prevalence of apical periodontitis and quality of root canal treatment in an adult Saudi population

PubMed Central

Al-Nazhan, Saad A.; Alsaeed, Suliman A.; Al-Attas, Hussan A.; Dohaithem, Abdullah J.; Al-Serhan, Mohamed S.; Al-Maflehi, Nassr S.

2017-01-01

Objectives: To determine the health status of periradicular tissue and the quality of root canal fillings in an adult Saudi population attending dental clinics for the first time. Methods: This cross sectional study was conducted in the dental clinics at King Saud University, Riyadh and other dental centers (Jeddah, Najran, and Albaha City), Kingdom of Saudi Arabia between year 2010 and 2012. Good-quality panoramic radiographs of 926 Saudi subjects (540 males and 386 females)were analyzed based on the gender, age, health status, smoking habits, periapical status of the endodontically treated teeth, technical quality of the root canal fillings, and the presence or absence of coronal restoration. Data were calibrated and statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA) version 17. Results: Of the 25,028 teeth examined, 1,556 teeth (6.2%) had apical periodontitis (AP). Male subjects aged over 55 years and females between 36 and 45 years had higher AP. A total of 36 diabetic and 87 smokers subjects had AP. The AP was more common in male diabetics than female (p=0.383), and in female smokers more than male (p=0.44). Only 42.2% of male and 57.7% of female teeth had adequate root canal treatment. Conclusions: Apical periodontitis was significantly related to diabetes, smoking, and inadequate endodontic treatment. PMID:28397949

A bill to direct the Secretary of the Interior and Secretary of Agriculture to expedite access to certain Federal lands under the administrative jurisdiction of each Secretary for good Samaritan search-and-recovery missions, and for other purposes.

THOMAS, 113th Congress

Sen. Heller, Dean [R-NV

2013-05-23

Senate - 07/30/2014 Committee on Energy and Natural Resources Senate Subcommittee on Public Lands, Forests, and Mining. Hearings held. With printed Hearing: S.Hrg. 113-433. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Trace element distribution in the rat cerebellum

NASA Astrophysics Data System (ADS)

Kwiatek, W. M.; Long, G. J.; Pounds, J. G.; Reuhl, K. R.; Hanson, A. L.; Jones, K. W.

1990-04-01

Spatial distributions and concentrations of trace elements (TE) in the brain are important because TE perform catalytic and structural functions in enzymes which regulate brain function and development. We have investigated the distributions of TE in rat cerebellum. Structures were sectioned and analyzed by the Synchrotron Radiation Induced X-ray Emission (SRIXE) method using the NSLS X-26 white-light microprobe facility. Advantages important for TE analysis of biological specimens with X-ray microscopy include short time of measurement, high brightness and flux, good spatial resolution, multielemental detection, good sensitivity, and nondestructive irradiation. Trace elements were measured in thin rat brain sections of 20 μm thickness. The analyses were performed on sample volumes as small as 0.2 nl with Minimum Detectable Limits (MDL) of 50 ppb wet weight for Fe, 100 ppb wet weight for Cu, and Zn, and 1 ppm wet weight for Pb. The distribution of TE in the molecular cell layer, granule cell layer and fiber tract of rat cerebella was investigated. Both point analyses and two-dimensional semiquantitative mapping of the TE distribution in a section were used. All analyzed elements were observed in each structure of the cerebellum except mercury which was not observed in granule cell layer or fiber tract. This approach permits an exacting correlation of the TE distribution in complex structure with the diet, toxic elements, and functional status of the animal.

Changes in Children's Oral Health Status and Receipt of Preventive Dental Visits, United States, 2003-2011/2012.

PubMed

Mandal, Mahua; Edelstein, Burton L; Ma, Sai; Minkovitz, Cynthia S

2015-12-01

Oral health represents the largest unmet health care need for children, and geographic variations in children's receipt of oral health services have been noted. However, children's oral health outcomes have not been systematically evaluated over time and across states. This study examined changes in parent-reported children's oral health status and receipt of preventive dental visits in 50 states and the District of Columbia. We used data from the 2003 and the 2011/2012 National Survey of Children's Health. National and state-level estimates of the adjusted prevalence of oral health status and preventive dental visits were calculated and changes over time examined. Multivariable logistic regression was used to compare outcomes across all states and the District of Columbia for each survey year. The percentage of parents who reported that their children had excellent or very good oral health increased from 67.7% in 2003 to 71.9% in 2011/2012. Parents who reported that their children had preventive dental visits increased from 71.5% in 2003 to 77.0% in 2011/2012. The prevalence of children with excellent or very good oral health status increased in 26 states, and the prevalence of children who received at least 1 preventive care dental visit increased in 45 states. In both years, there was more variation among states for preventive dental visits than for oral health status. State variation in oral health status and receipt of preventive dental services remained after adjusting for demographic characteristics. Understanding these differences is critical to addressing the most common chronic disease of childhood and achieving the oral health objectives of Healthy People 2020.

Changes in children's oral health status and receipt of preventive dental visits, United States, 2003-2011/2012.

PubMed

Mandal, Mahua; Edelstein, Burton L; Ma, Sai; Minkovitz, Cynthia S

2013-12-05

Oral health represents the largest unmet health care need for children, and geographic variations in children's receipt of oral health services have been noted. However, children's oral health outcomes have not been systematically evaluated over time and across states. This study examined changes in parent-reported children's oral health status and receipt of preventive dental visits in 50 states and the District of Columbia. We used data from the 2003 and the 2011/2012 National Survey of Children's Health. National and state-level estimates of the adjusted prevalence of oral health status and preventive dental visits were calculated and changes over time examined. Multivariable logistic regression was used to compare outcomes across all states and the District of Columbia for each survey year. The percentage of parents who reported that their children had excellent or very good oral health increased from 67.7% in 2003 to 71.9% in 2011/2012. Parents who reported that their children had preventive dental visits increased from 71.5% in 2003 to 77.0% in 2011/2012. The prevalence of children with excellent or very good oral health status increased in 26 states, and the prevalence of children who received at least 1 preventive care dental visit increased in 45 states. In both years, there was more variation among states for preventive dental visits than for oral health status. State variation in oral health status and receipt of preventive dental services remained after adjusting for demographic characteristics. Understanding these differences is critical to addressing the most common chronic disease of childhood and achieving the oral health objectives of Healthy People 2020.

Effect of oil source and peroxidation status on broiler performance and oxidative stress

USDA-ARS?s Scientific Manuscript database

Oil source has been shown to affect broiler performance and oxidative status. Lipid peroxidation may also affect animal performance and oxidative status through the generation and degradation of peroxidation compounds which differ according to oil source and temperature and length of heating. The ob...

The Parent Perspective: “Being a Good Parent” When Making Critical Decisions in the PICU

PubMed Central

October, Tessie W.; Fisher, Kiondra R.; Feudtner, Chris; Hinds, Pamela S.

2015-01-01

Objective To identify factors important to parents making decisions for their critically ill child. Design Prospective cross-sectional study. Setting Single center, tertiary care PICU. Subjects Parents making critical treatment decisions for their child. Intervention One-on-one interviews that used the Good Parent Tool-2 open-ended question that asks parents to describe factors important for parenting their ill child and how clinicians could help them achieve their definition of “being a good parent” to their child. Parent responses were analyzed thematically. Parents also ranked themes in order of importance to them using the Good Parent Ranking Exercise. Measurement and Main Results Of 53 eligible parents, 43 (81%) participated. We identified nine themes through content analysis of the parent’s narrative statements from the Good Parent Tool. Most commonly (60% of quotes) components of being a good parent described by parents included focusing on their child’s quality of life, advocating for their child with the medical team, and putting their child’s needs above their own. Themes key to parental decision making were similar regardless of parent race and socioeconomic status or child’s clinical status. We identified nine clinician strategies identified by parents as helping them fulfill their parenting role, most commonly, parents wanted to be kept informed (32% of quotes). Using the Good Parent Ranking Exercise, fathers ranked making informed medical decisions as most important, whereas mothers ranked focusing on the child’s health and putting their child’s needs above their own as most important. However, mothers who were not part of a couple ranked making informed medical decisions as most important. Conclusion These findings suggest a range of themes important for parents to “be a good parent” to their child while making critical decisions. Further studies need to explore whether clinician’s knowledge of the parent’s most valued factor can improve family-centered care. PMID:24583502

Nutrition screening tools: does one size fit all? A systematic review of screening tools for the hospital setting.

PubMed

van Bokhorst-de van der Schueren, Marian A E; Guaitoli, Patrícia Realino; Jansma, Elise P; de Vet, Henrica C W

2014-02-01

Numerous nutrition screening tools for the hospital setting have been developed. The aim of this systematic review is to study construct or criterion validity and predictive validity of nutrition screening tools for the general hospital setting. A systematic review of English, French, German, Spanish, Portuguese and Dutch articles identified via MEDLINE, Cinahl and EMBASE (from inception to the 2nd of February 2012). Additional studies were identified by checking reference lists of identified manuscripts. Search terms included key words for malnutrition, screening or assessment instruments, and terms for hospital setting and adults. Data were extracted independently by 2 authors. Only studies expressing the (construct, criterion or predictive) validity of a tool were included. 83 studies (32 screening tools) were identified: 42 studies on construct or criterion validity versus a reference method and 51 studies on predictive validity on outcome (i.e. length of stay, mortality or complications). None of the tools performed consistently well to establish the patients' nutritional status. For the elderly, MNA performed fair to good, for the adults MUST performed fair to good. SGA, NRS-2002 and MUST performed well in predicting outcome in approximately half of the studies reviewed in adults, but not in older patients. Not one single screening or assessment tool is capable of adequate nutrition screening as well as predicting poor nutrition related outcome. Development of new tools seems redundant and will most probably not lead to new insights. New studies comparing different tools within one patient population are required. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Review on analog/radio frequency performance of advanced silicon MOSFETs

NASA Astrophysics Data System (ADS)

Passi, Vikram; Raskin, Jean-Pierre

2017-12-01

Aggressive gate-length downscaling of the metal-oxide-semiconductor field-effect transistor (MOSFET) has been the main stimulus for the growth of the integrated circuit industry. This downscaling, which has proved beneficial to digital circuits, is primarily the result of the need for improved circuit performance and cost reduction and has resulted in tremendous reduction of the carrier transit time across the channel, thereby resulting in very high cut-off frequencies. It is only in recent decades that complementary metal-oxide-semiconductor (CMOS) field-effect transistor (FET) has been considered as the radio frequency (RF) technology of choice. In this review, the status of the digital, analog and RF figures of merit (FoM) of silicon-based FETs is presented. State-of-the-art devices with very good performance showing low values of drain-induced barrier lowering, sub-threshold swing, high values of gate transconductance, Early voltage, cut-off frequencies, and low minimum noise figure, and good low-frequency noise characteristic values are reported. The dependence of these FoM on the device gate length is also shown, helping the readers to understand the trends and challenges faced by shorter CMOS nodes. Device performance boosters including silicon-on-insulator substrates, multiple-gate architectures, strain engineering, ultra-thin body and buried-oxide and also III-V and 2D materials are discussed, highlighting the transistor characteristics that are influenced by these boosters. A brief comparison of the two main contenders in continuing Moore’s law, ultra-thin body buried-oxide and fin field-effect transistors are also presented. The authors would like to mention that despite extensive research carried out in the semiconductor industry, silicon-based MOSFET will continue to be the driving force in the foreseeable future.

Predicting Survival of De Novo Metastatic Breast Cancer in Asian Women: Systematic Review and Validation Study

PubMed Central

Miao, Hui; Hartman, Mikael; Bhoo-Pathy, Nirmala; Lee, Soo-Chin; Taib, Nur Aishah; Tan, Ern-Yu; Chan, Patrick; Moons, Karel G. M.; Wong, Hoong-Seam; Goh, Jeremy; Rahim, Siti Mastura; Yip, Cheng-Har; Verkooijen, Helena M.

2014-01-01

Background In Asia, up to 25% of breast cancer patients present with distant metastases at diagnosis. Given the heterogeneous survival probabilities of de novo metastatic breast cancer, individual outcome prediction is challenging. The aim of the study is to identify existing prognostic models for patients with de novo metastatic breast cancer and validate them in Asia. Materials and Methods We performed a systematic review to identify prediction models for metastatic breast cancer. Models were validated in 642 women with de novo metastatic breast cancer registered between 2000 and 2010 in the Singapore Malaysia Hospital Based Breast Cancer Registry. Survival curves for low, intermediate and high-risk groups according to each prognostic score were compared by log-rank test and discrimination of the models was assessed by concordance statistic (C-statistic). Results We identified 16 prediction models, seven of which were for patients with brain metastases only. Performance status, estrogen receptor status, metastatic site(s) and disease-free interval were the most common predictors. We were able to validate nine prediction models. The capacity of the models to discriminate between poor and good survivors varied from poor to fair with C-statistics ranging from 0.50 (95% CI, 0.48–0.53) to 0.63 (95% CI, 0.60–0.66). Conclusion The discriminatory performance of existing prediction models for de novo metastatic breast cancer in Asia is modest. Development of an Asian-specific prediction model is needed to improve prognostication and guide decision making. PMID:24695692

The MICROSCOPE inertial sensor: qualification status

NASA Astrophysics Data System (ADS)

Santos Rodrigues, Manuel; Touboul, Pierre; Liorzou, Francoise; Bodoville, Guillaume

The payload of the MICROSCOPE space mission embarks two pairs of test-masses, made of Platinum Rhodium alloy and Titanium alloy, that are used to perform the test of the Uni-versality of free fall, i.e. of the Equivalence Principle (EP). These cylindrical test-masses are at the core of the inertial sensors used to perform the full drag-free and attitude control of the satellite. Based on electrostatic space accelerometers developed in ONERA, the payload has been designed with challenging technologies for the electronics and for the sensor core. Following a very specific development plan, the payload is currently in the qualification phase, by being integrated after a long period of challenging accurate production and metrology. The results obtained for the driving components of the expected performance will be addressed. In particular, the micrometric metrology of the instrument core, made in gold coated silica, will be presented: the specific ultra-sonic machining processes, optimized for this production, indeed exhibit a few micrometers accuracy. Similar accuracy is obtained for the geometry of the test-masses, produced and controlled in collaboration with the PTB, Physikalisch-Technische Bundesanstalt. This accurate geometry and the specific selected shape is mandatory to balance the mass moment of inertia for gravity gradient rejection and to highly decouple the instru-ment measurement axes. The first results of the flight model electronics will be also presented demonstrating micro-volt low noise and weak thermal sensitivity in good agreement with the requirements. At last, the development status of the payload will be mentioned insisting on the coming milestones.

Influence of transactive memory on perceived performance, job satisfaction and identification in anaesthesia teams.

PubMed

Michinov, E; Olivier-Chiron, E; Rusch, E; Chiron, B

2008-03-01

There is an increasing awareness in the medical community that human factors are involved in effectiveness of anaesthesia teams. Communication and coordination between physicians and nurses seems to play a crucial role in maintaining a good level of performance under time pressure, particularly for anaesthesia teams, who are confronted with uncertainty, rapid changes in the environment, and multi-tasking. The aim of this study was to examine the relationship between a specific form of implicit coordination--the transactive memory system--and perceptions of team effectiveness and work attitudes such as job satisfaction and team identification. A cross-sectional study was conducted among 193 nurse and physician anaesthetists from eight French public hospitals. The questionnaire included some measures of transactive memory system (coordination, specialization, and credibility components), perception of team effectiveness, and work attitudes (Minnesota Job Satisfaction Questionnaire, team identification scale). The questionnaire was designed to be filled anonymously, asking only biographical data relating to sex, age, status, and tenure. Hierarchical multiple regression analyses revealed as predicted that transactive memory system predicted members' perceptions of team effectiveness, and also affective outcomes such as job satisfaction and team identification. Moreover, the results demonstrated that transactive memory processes, and especially the coordination component, were a better predictor of teamwork perceptions than socio-demographic (i.e. gender or status) or contextual variables (i.e. tenure and size of team). These findings provided empirical evidence of the existence of a transactive memory system among real anaesthesia teams, and highlight the need to investigate whether transactive memory is actually linked with objective measures of performance.

38 CFR 21.3305 - “Interrupted” status.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) VOCATIONAL REHABILITATION AND EDUCATION Survivors' and Dependents' Educational Assistance Under 38 U.S.C... her physical condition or other good reason, it would not be to his or her best interest to pursue...

Iron nutrition and premenopausal women: effects of poor iron status on physical and neuropsychological performance.

PubMed

McClung, James P; Murray-Kolb, Laura E

2013-01-01

Iron is a nutritionally essential trace element that functions through incorporation into proteins and enzymes, many of which contribute to physical and neuropsychological performance. Poor iron status, including iron deficiency (ID; diminished iron stores) and iron deficiency anemia (IDA; poor iron stores and diminished hemoglobin), affects billions of people worldwide. This review focuses on physical and neuropsychological outcomes associated with ID and IDA in premenopausal women, as the prevalence of ID and IDA is often greater in premenopausal women than other population demographics. Recent studies addressing the physiological effects of poor iron status on physical performance, including work productivity, voluntary activity, and athletic performance, are addressed. Similarly, the effects of iron status on neurological performance, including cognition, affect, and behavior, are summarized. Nutritional countermeasures for the prevention of poor iron status and the restoration of decrements in performance outcomes are described.

Motor expertise and performance in spatial tasks: A meta-analysis.

PubMed

Voyer, Daniel; Jansen, Petra

2017-08-01

The present study aimed to provide a summary of findings relevant to the influence of motor expertise on performance in spatial tasks and to examine potential moderators of this effect. Studies of relevance were those in which individuals involved in activities presumed to require motor expertise were compared to non-experts in such activities. A final set of 62 effect sizes from 33 samples was included in a multilevel meta-analysis. The results showed an overall advantage in favor of motor experts in spatial tasks (d=0.38). However, the magnitude of that effect was moderated by expert type (athlete, open skills/ball sports, runner/cyclist, gymnast/dancers, musicians), stimulus type (2D, blocks, bodies, others), test category (mental rotation, spatial perception, spatial visualization), specific test (Mental Rotations Test, generic mental rotation, disembedding, rod-and-frame test, other), and publication status. These findings are discussed in the context of embodied cognition and the potential role of activities requiring motor expertise in promoting good spatial performance. Copyright © 2017 Elsevier B.V. All rights reserved.

Suitability of ultra-high performance liquid chromatography for the determination of fat-soluble nutritional status (vitamins A, E, D, and individual carotenoids).

PubMed

Granado-Lorencio, F; Herrero-Barbudo, C; Blanco-Navarro, I; Pérez-Sacristán, B

2010-06-01

Our aim was to assess the suitability of ultra-high performance liquid chromatography (UHPLC) for the simultaneous determination of biomarkers of vitamins A (retinol, retinyl esters), E (alpha- and gamma-tocopherol), D (25-OH-vitamin D), and the major carotenoids in human serum to be used in clinical practice. UHPLC analysis was performed on HSS T3 column (2.1 x 100 mm; 1.8 microm) using gradient elution and UV-VIS detection. The system allows the simultaneous determination of retinol, retinyl palmitate, 25-OH-vitamin D, alpha- and gamma-tocopherol, lutein plus zeaxanthin, alpha-carotene, beta-carotene, alpha- and beta-cryptoxanthin and lycopene. The method showed a good linearity over the physiological range with an adequate accuracy in samples from quality control programs. Suitability of the method in clinical practice was tested by analyzing samples (n = 286) from patients. In conclusion, UHPLC constitutes a reliable approach for nutrient/biomarker profiling allowing the rapid, simultaneous and low-cost determination of vitamins A, E, and D (including vitamers and ester forms) and the major carotenoids in clinical practice.

Assisting people with disabilities in actively performing physical activities by controlling the preferred environmental stimulation with a gyration air mouse.

PubMed

Shih, Ching-Tien; Shih, Ching-Hsiang; Luo, Ching-Hsing

2013-12-01

The latest researchers have employed software technology to turn gyration air mice into a high performance limb detector to detect specific limb movement, and to further collaborate using the preferred environmental stimulation to help people with disabilities to suppress unwanted behaviors or habits and to reward good behaviors. This study extended the functionality of a gyration air mouse, and used the mouse as a precise physical activity detector integrated with the preferred environmental stimulation to assess if this integrated set can be used to help two disabled people who are overweight and lacking in exercise to actively perform physical activities. The study was conducted based on an A-B-A-B design. The results showed that both participants increased significantly the time duration required for them to maintain their physical activity status so that they could obtain their favorite environmental stimulation during the intervention phases. Both the practical and developmental implications of the findings are then discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

Agency as a mediator in the pathway from transactional sex to HIV among pregnant women in Swaziland: a multigroup path analysis.

PubMed

Fielding-Miller, Rebecca; Dunkle, Kristin L; Hadley, Craig; Cooper, Hannah Lf; Windle, Michael

2017-07-18

Transactional sex is a structural driver of HIV for women and girls in sub-Saharan Africa. In transactional relationships, sexual and economic obligations intertwine and may have positive and negative effects on women's financial standing and social status. We conducted a clinic-based survey with pregnant women in Swaziland using a locally validated transactional sex scale to measure the association between subjective social status, transactional sex, and HIV status, and to assess whether this association differed according to a woman's agency within her relationship. We recruited a convenience sample of 406 pregnant women at one rural and one urban public antenatal clinic in Swaziland and administered a behavioural survey that was linked to participant HIV status using clinic records. We then conducted a multigroup path analysis to test three hypotheses: (1) that more engagement in transactional sex is associated with decreased condom use and increased subjective social status; (2) that subjective social status mediates the relationship between transactional sex and HIV status; and (3) that these relationships are different across groups according to whether or not a woman reported any indicator of constrained agency within her relationship. The amount and value of material goods received from a sexual partner was significantly and positively associated with higher subjective social status among all participants. As the amount of material goods received from a partner increased, women who reported no indicators of constrained agency were less likely to use condoms. Conversely, there was no relationship between transactional sex and condom use among women who reported any indicator of constrained relationship agency. Among women who reported any indicator of constrained agency, HIV was significantly associated with lower subjective social status. Relationship agency likely plays a key role in determining which mechanisms create HIV risk for women in transactional relationships. Interventions to mitigate these risks must address social forces that penalize women who engage in sexual relationships as well as structural drivers of gendered economic disparity that reduce women's agency within their sexual and romantic relationships.

Omnidirectional Internal Fixation by Double Approaches for Treating Rüedi-Allgöwer Type III Pilon Fractures.

PubMed

Dai, Chong-Hua; Sun, Jun; Chen, Kun-Quan; Zhang, Hui-Bo

In the present study, we explored the effectiveness and complications of omnidirectional internal fixation using a double approach for treating Rüedi-Allgöwer type III pilon fractures. A retrospective analysis was performed of 19 cases of Rüedi-Allgöwer type III unilateral closed pilon fracture. With preoperative preparation and correct surgical timing, the reduction was performed using anteromedial and posterolateral approaches, and the fracture fragments were fixed by omnidirectional internal fixation. Imaging evaluation was performed using the Burwell-Charnley scoring system. The Johner-Wruhs scoring system was used to assess the functional status of the patients. A comprehensive evaluation of efficacy was performed using a 5-point Likert score. The complications were also recorded and analyzed. All patients were followed up for an average of 16.2 months. The operative incisions of 15 cases healed by primary intent and with delayed healing in 4. All patients had achieved bony union at an average of 16 weeks postoperatively. No deep infection, broken nail or withdrawn nail, exposed plate, or skin flap necrosis occurred. The Burwell-Charnley imaging evaluation showed that 14 patients had anatomic reduction of the articular surface and 5 had acceptable reduction. Using the Johner-Wruhs scoring system, the results were excellent for 8, good for 7, fair for 2, and poor for 2 patients; the combined rate of excellent and good results was 78.9%. The Likert score of efficacy self-reported by the patients was 3 to 4 points for 12 patients, 2 points for 4 patients, and 0 to 1 point for 3 patients. The Likert score of therapeutic efficacy reported by the physicians was 3 to 4 points for 10 patients, 2 points for 5 patients, and 0 to 1 point for 4 patients. Omnidirectional internal fixation using double approaches was an effective method to treat Rüedi-Allgöwer type III pilon fractures with satisfactory reduction and rigid fixation, good joint function recovery, and few complications. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

The Effects of Solo Status on Women's and Men's Success: The Moderating Role of the Performance Context

ERIC Educational Resources Information Center

Viallon, Marie-Laure; Martinot, Delphine

2009-01-01

A considerable body of research has shown that being the only representative of one's gender group (solo status) when performing an activity affects women more than men. The aim of our two experiments was to show that the performance context can moderate the effects of numerical status (majority vs. solo) on performance and that men can also be…

[Surgery in portal hypertension. Which patient and which operation?].

PubMed

Mercado, M A; Takahashi, T; Rojas, G; Prado, E; Hernández, J; Tielve, M; Orozco, H

1993-01-01

A prospective trial of a cohort of patients (N = 94) with portal hypertension and history of bleeding was selected for surgery based on strict clinical and laboratory criteria. All of them were treated with portal blood flow preserving procedures. The following selection criteria were used: good cardiopulmonary function without pulmonary hypertension and good liver function (Child-Pugh A). All patients were operated in an elective fashion and the operations performed were: selective shunts (N = 38) (distal splenorenal and splenocaval), low diameter mesocaval shunts (N = 13) and the esophagogastric devascularization with esophageal transection (Sugiura-Futagawa) (N = 43). Patients were selected for each operation according to their anatomical conditions. Sixty-one of the patients were cirrhotics. Operative mortality was 8% and rebleeding was observed in 5% of the cases. Postoperative encephalopathy was seen in seven patients (three selective shunts, two low diameter mesocaval shunts and two devascularizations). In 13 of 62 patients postoperatively evaluated by means of angiography, portal vein thrombosis was shown (seven selective shunts, two low diameter shunts and four devascularizations). Twenty-two patients with preoperative portal vein thrombosis (and treated with a Sugiura-Futagawa operation) were excluded from postoperative angiographic evaluation. Survival (Kaplan-Meier) was 85% at 60 months. Portal blood flow preserving procedures are the treatment of choice for patients with hemorrhagic portal hypertension and good liver function. The kind of operation is selected according to the individual anatomical status of the patient.

Relationship between time management in construction industry and project management performance

NASA Astrophysics Data System (ADS)

Nasir, Najuwa; Nawi, Mohd Nasrun Mohd; Radzuan, Kamaruddin

2016-08-01

Nowadays, construction industry particularly in Malaysia struggle in achieving status of eminent time management for construction project. Project managers have a great responsibility to keep the project success under time of project completion. However, studies shows that delays especially in Malaysian construction industry still unresolved due to weakness in managing the project. In addition, quality of time management on construction projects is generally poor. Due to the progressively extended delays issue, time performance becomes an important subject to be explored to investigate delay factors. The method of this study is review of literature towards issues in construction industry which affecting time performance of project in general by focusing towards process involved for project management. Based on study, it was found that knowledge, commitment, cooperation are the main criteria as an overall to manage the project into a smooth process during project execution until completion. It can be concluded that, the strength between project manager and team members in these main criteria while conducting the project towards good time performance is highly needed. However, there is lack of establishment towards factors of poor time performance which strongly related with project management. Hence, this study has been conducted to establish factors of poor time performance and its relations with project management.

Incidentally diagnosed melorheostosis of upper limb: case report.

PubMed

Vyskocil, Vaclav; Koudela, Karel; Pavelka, Tomas; Stajdlova, Kristyna; Suchy, David

2015-01-31

Melorheostosis is quite a rare bone disease with still unclear ethiology. Although multifocal affection is highly debilitating with unfavorable prognosis, there is no clear consensus about therapeutical approach. There is still insufficient evidence in the literature for almost a century after the first description. Affected bone has a typical appearance of melting wax. Diagnosis is usually incidental with pain as a leading symptom. Diagnosis itself is relatively easy, routine X-ray examination is sufficient. Even though it could be easily overlooked and mistaken with other diseases. Melorheostosis is incurable, the therapy is mostly focused on maintaining patient quality of life. Presented case is unique in terms of extent of the affection (index finger, metacarp shaft, carpal bones, forearm, humerus and whole scapula) in combination with osteopoikilotic islands in other 3 regions (vertebrae, manubrium sterni and left collar bone). Currently there is only one such a case published in the literature (Campbell), but without osteopoikilotic islands. Melorheostosis was diagnosed in 26-year old female after injury as an incidental finding. This was quite surprising as the patient already suffered by limited movement in the upper limb and pain before the injury. Detailed examination were performed to confirm the diagnosis, no family history was found. Pharmacotherapy with bisphosphonates, non-steroidal antirheumatics and vasodilatans/rheologic drugs seemed to be effective to maintain the relatively good quality of patient life and good performance in daily routine. Questionable is further development of patient performance status and sustainability of conservative treatment in the long term follow up. Conservative treatment with bisphopshonates and COX-2 inhibitors in combination with naftidrofuryl can delay surgery solution.

Impact of poor oral health on children's school attendance and performance.

PubMed

Jackson, Stephanie L; Vann, William F; Kotch, Jonathan B; Pahel, Bhavna T; Lee, Jessica Y

2011-10-01

We examined school days missed for routine dental care versus dental pain or infection to determine the relationship between children's oral health status and school attendance and performance. We used 2008 data from the North Carolina Child Health Assessment and Monitoring Program. The study sample, weighted to reflect the state's population, included 2183 schoolchildren. Variables assessed included school absences and performance, oral health status, parental education, health insurance coverage, race, and gender. Children with poor oral health status were nearly 3 times more likely (odds ratio = 3.89; 95% confidence interval = 1.96, 7.75) than were their counterparts to miss school as a result of dental pain. Absences caused by pain were associated with poorer school performance (P < .05), but absences for routine care were not. Mediation analyses revealed that oral health status was associated with performance independent of absence for pain. Children with poorer oral health status were more likely to experience dental pain, miss school, and perform poorly in school. These findings suggest that improving children's oral health status may be a vehicle to enhancing their educational experience.

Dramatic response to alectinib in a patient of ALK-rearranged lung cancer with poor performance status.

PubMed

Tanaka, Hisashi; Taima, Kageaki; Morimoto, Takeshi; Nakamura, Kunihiko; Tanaka, Yoshihito; Itoga, Masamichi; Takanashi, Shingo; Okumura, Ken

2016-03-17

Lung cancers with anaplastic lymphoma kinase rearrangements are highly sensitive to anaplastic lymphoma kinase tyrosine kinase inhibition, underscoring the notion that such cancers are addicted to anaplastic lymphoma kinase activity. Several anaplastic lymphoma kinase inhibitors have been identified and are being evaluated in clinical trials. However patients with poor performance status (3 or 4) were not involved in these clinical trials, it has been unclear to use anaplastic lymphoma kinase-tyrosine kinase inhibitors for these patients. Here, we report an anaplastic lymphoma kinase-positive non small cell lung cancer patient with performance status 4, who was successfully treated with alectinib. We report on a 52-year-old patient diagnosed as non small cell lung cancer harboring echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase fusion gene. His performance status was 4 because of severe respiratory failure. We treated this patient with alectinib as the first line therapy. Dramatic response was obtained and his performance status improved from 4 to 1 without severe adverse events. Alectinib is a therapeutic option for the anaplastic lymphoma kinase positive patients with poor performance status.

Impact of Poor Oral Health on Children's School Attendance and Performance

PubMed Central

Vann, William F.; Kotch, Jonathan B.; Pahel, Bhavna T.; Lee, Jessica Y.

2011-01-01

Objectives. We examined school days missed for routine dental care versus dental pain or infection to determine the relationship between children's oral health status and school attendance and performance. Methods. We used 2008 data from the North Carolina Child Health Assessment and Monitoring Program. The study sample, weighted to reflect the state's population, included 2183 schoolchildren. Variables assessed included school absences and performance, oral health status, parental education, health insurance coverage, race, and gender. Results. Children with poor oral health status were nearly 3 times more likely (odds ratio = 3.89; 95% confidence interval = 1.96, 7.75) than were their counterparts to miss school as a result of dental pain. Absences caused by pain were associated with poorer school performance (P < .05), but absences for routine care were not. Mediation analyses revealed that oral health status was associated with performance independent of absence for pain. Conclusions. Children with poorer oral health status were more likely to experience dental pain, miss school, and perform poorly in school. These findings suggest that improving children's oral health status may be a vehicle to enhancing their educational experience. PMID:21330579

The influence of re-employment on quality of life and self-rated health, a longitudinal study among unemployed persons in the Netherlands

PubMed Central

2013-01-01

Background Unemployed persons have a poorer health compared with employed persons and unemployment may cause ill health. The aim of this study was to investigate the effect of re-employment on quality of life and health among unemployed persons on social benefits. Methods A prospective study with 18 months follow-up was conducted among unemployed persons (n=4,308) in the Netherlands, receiving either unemployment benefits or social security benefits. Quality of life, self-rated health, and employment status were measured at baseline and every 6 months of follow up with questionnaires. Generalized estimating equations (GEE) modeling was performed to study the influence of re-employment on change in self-rated health and quality of life over time. Results In the study population 29% had a less than good quality of life and 17% had a poor self-rated health. Persons who started with paid employment during the follow-up period were more likely to improve towards a good quality of life (OR 1.76) and a good self-rated health (OR 2.88) compared with those persons who remained unemployed. Up to 6 months after re-employment, every month with paid employment, the likelihood of a good quality of life increased (OR 1.12). Conclusions Starting with paid employment improves quality of life and self-rated health. This suggests that labour force participation should be considered as an important measure to improve health of unemployed persons. Improving possibilities for unemployed persons to find paid employment will reduce socioeconomic inequalities in health. PMID:23706106

Cancer and heart attack survivors' expectations of employment status: results from the English Longitudinal Study of Ageing.

PubMed

Duijts, Saskia F A; van der Beek, Allard J; Bleiker, Eveline M A; Smith, Lee; Wardle, Jane

2017-08-07

Sociodemographic, health- and work-related factors have been found to influence return to work in cancer survivors. It is feasible though that behavioural factors, such as expectation of being at work, could also affect work-related outcomes. Therefore, the effect of earlier identified factors and expectation of being at work on future employment status in cancer survivors was explored. To assess the degree to which these factors specifically concern cancer survivors, a comparison with heart attack survivors was made. Data from the English Longitudinal Study of Ageing were used. Cancer and heart attack survivors of working age in the UK were included and followed up for 2 years. Baseline characteristics of both cancer and heart attack survivors were compared regarding employment status. Univariate and multivariate regression analyses were performed in survivors at work, and the interaction between independent variables and diagnose group was assessed. In cancer survivors at work (N = 159), alcohol consumption, participating in moderate or vigorous sport activities, general health and participation were univariate associated with employment status at two-year follow-up. Only fair general health (compared to very good general health) remained statistically significant in the multivariate model (OR 0.31; 95% CI 0.13-0.76; p = 0.010). In heart attack survivors at work (N = 78), gender, general health and expectation of being at work were univariate associated with employment status at follow-up. Female gender (OR 0.03; 95% CI 0.00-0.57; p = 0.018) and high expectation of being at work (OR 10.68; 95% CI 1.23-93.92; p = 0.033) remained significant in the multivariate model. The influence of gender (p = 0.066) and general health (p = 0.020) regarding employment status was found to differ significantly between cancer and heart attack survivors. When predicting future employment status in cancer survivors in the UK, general health is the most relevant factor to consider. While expectation of being at work did not show any significant influence in cancer survivors, in heart attack survivors, it should not be disregarded though, when developing interventions to affect their employment status. Future research should focus on more specific measures for expectation, and additional behavioural factors, such as self-efficacy, and their effect on employment status.

Humans as Sensors: Assessing the Information Value of Qualitative Farmer's Crop Condition Surveys for Crop Yield Monitoring and Forecasting

NASA Astrophysics Data System (ADS)

Beguería, S.

2017-12-01

While large efforts are devoted to developing crop status monitoring and yield forecasting systems trough the use of Earth observation data (mostly remotely sensed satellite imagery) and observational and modeled weather data, here we focus on the information value of qualitative data on crop status from direct observations made by humans. This kind of data has a high value as it reflects the expert opinion of individuals directly involved in the development of the crop. However, they have issues that prevent their direct use in crop monitoring and yield forecasting systems, such as their non-spatially explicit nature, or most importantly their qualitative nature. Indeed, while the human brain is good at categorizing the status of physical systems in terms of qualitative scales (`very good', `good', `fair', etcetera), it has difficulties in quantifying it in physical units. This has prevented the incorporation of this kind of data into systems that make extensive use of numerical information. Here we show an example of using qualitative crop condition data to estimate yields of the most important crops in the US early in the season. We use USDA weekly crop condition reports, which are based on a sample of thousands of reporters including mostly farmers and people in direct contact with them. These reporters provide subjective evaluations of crop conditions, in a scale including five levels ranging from `very poor' to `excellent'. The USDA report indicates, for each state, the proportion of reporters fort each condition level. We show how is it possible to model the underlying non-observed quantitative variable that reflects the crop status on each state, and how this model is consistent across states and years. Furthermore, we show how this information can be used to monitor the status of the crops and to produce yield forecasts early in the season. Finally, we discuss approaches for blending this information source with other, more classical earth data sources such as remote sensing or weather data, in the context of hierarchical regression models.

A bill to provide for the award of a gold medal on behalf of Congress to Jack Nicklaus, in recognition of his service to the Nation in promoting excellence, good sportsmanship, and philanthropy.

THOMAS, 113th Congress

Sen. Portman, Rob [R-OH

2013-05-23

Senate - 05/23/2013 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Notes: For further action, see H.R.2203, which became Public Law 113-210 on 12/16/2014. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

A bill to provide for the award of a gold medal on behalf of Congress to Arnold Palmer in recognition of his service to the Nation in promoting excellence and good sportsmanship in golf.

THOMAS, 111th Congress

Sen. Martinez, Mel [R-FL

2009-07-07

Senate - 07/07/2009 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Notes: For further action, see H.R.1243, which became Public Law 111-65 on 9/30/2009. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Research status of multi - robot systems task allocation and uncertainty treatment

NASA Astrophysics Data System (ADS)

Li, Dahui; Fan, Qi; Dai, Xuefeng

2017-08-01

The multi-robot coordination algorithm has become a hot research topic in the field of robotics in recent years. It has a wide range of applications and good application prospects. This paper analyzes and summarizes the current research status of multi-robot coordination algorithms at home and abroad. From task allocation and dealing with uncertainty, this paper discusses the multi-robot coordination algorithm and presents the advantages and disadvantages of each method commonly used.

A resolution recognizing the threats to press freedom and expression around the world and reaffirming press freedom as a priority in the efforts of the United States to promote democracy and good governance, on the occasion of World Press Freedom Day on May 3, 2009.

THOMAS, 111th Congress

Sen. Feingold, Russell D. [D-WI

2009-04-30

Senate - 04/30/2009 Submitted in the Senate, considered, and agreed to without amendment and with a preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Agreed to in SenateHere are the steps for Status of Legislation:

Lessons learned from the ATLAS performance studies of the Iberian Cloud for the first LHC running period

NASA Astrophysics Data System (ADS)

Sánchez-Martínez, V.; Borges, G.; Borrego, C.; del Peso, J.; Delfino, M.; Gomes, J.; González de la Hoz, S.; Pacheco Pages, A.; Salt, J.; Sedov, A.; Villaplana, M.; Wolters, H.

2014-06-01

In this contribution we describe the performance of the Iberian (Spain and Portugal) ATLAS cloud during the first LHC running period (March 2010-January 2013) in the context of the GRID Computing and Data Distribution Model. The evolution of the resources for CPU, disk and tape in the Iberian Tier-1 and Tier-2s is summarized. The data distribution over all ATLAS destinations is shown, focusing on the number of files transferred and the size of the data. The status and distribution of simulation and analysis jobs within the cloud are discussed. The Distributed Analysis tools used to perform physics analysis are explained as well. Cloud performance in terms of the availability and reliability of its sites is discussed. The effect of the changes in the ATLAS Computing Model on the cloud is analyzed. Finally, the readiness of the Iberian Cloud towards the first Long Shutdown (LS1) is evaluated and an outline of the foreseen actions to take in the coming years is given. The shutdown will be a good opportunity to improve and evolve the ATLAS Distributed Computing system to prepare for the future challenges of the LHC operation.

Outcome Evaluation of HER2 Breast Cancer Patients with Limited Brain Metastasis.

PubMed

Pessina, Federico; Navarria, Pierina; Cozzi, Luca; Franceschini, Davide; Tomatis, Stefano; Clerici, Elena; Ascolese, Anna Maria; DE Rose, Fiorenza; Bello, Lorenzo; Masci, Giovanna; Santoro, Armando; Scorsetti, Marta

2017-12-01

To appraise the outcome of limited brain metastasis (BMs) from HER2 breast cancer. The study cohort included sixty-six patients Treatments consisted of surgery followed by radiotherapy (RT), or radiosurgery (SRS/HSRS) or whole brain radiotherapy (WBRT). Surgery followed by RT was performed in 25.8% of patients, SRS/HSRS alone in 48.5%, and WBRT alone in 25.7%. The median follow-up time was 23.4 months and 32.5 months for alive patients. Local recurrence occurred in 16 (24.2%) patients. The median, 1-, 2-, 3-year local control were (median not reached=nr), 87.5%, 71.2%, and 63.0%. The median 1-, 2-, 3-year overall survival were 30.7 months (95%CI: 18.9-42.6 months), 78.5%, 57.4%, 43.3%. Karnofsky Performance Scale (KPS), number of BMs, local treatment performed, the presence of extracranial (EC) metastases at the time of BMs diagnosis, and the administration of trastuzumab affected survival. HER2BC patients with good performance status, controlled EC disease and single BM had better outcome. In this long-term survivor patients, local BMs treatment can affect survival. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

The Link Between Everyday Discrimination, Healthcare Utilization, and Health Status Among a National Sample of Women.

PubMed

Fazeli Dehkordy, Soudabeh; Hall, Kelli S; Dalton, Vanessa K; Carlos, Ruth C

2016-10-01

Research has not adequately examined the potential negative effects of perceiving routine discrimination on general healthcare utilization or health status, especially among reproductive-aged women. We sought to evaluate the association between everyday discrimination, health service use, and perceived health among a national sample of women in the United States. Data were drawn from the Women's Healthcare Experiences and Preferences survey, a randomly selected, national probability sample of 1078 U.S. women aged 18-55 years. We examined associations between everyday discrimination (via a standardized scale) on frequency of health service utilization and perceived general health status using chi-square and multivariable logistic regression modeling. Compared with women who reported healthcare visits every 3 years or less (reference group), each one-point increase in discrimination score was associated with higher odds of having healthcare visits annually or more often (odds ratio [OR] = 1.36, confidence interval [95% CI] = 1.01-1.83). Additionally, each one-point increase in discrimination score was significantly associated with lower odds of having excellent/very good perceived health (OR = 0.65; 95% CI = 0.54-0.80). Perceived discrimination was associated with increased exposure to the healthcare setting among this national sample of women. Perceived discrimination was also inversely associated with excellent/very good perceived health status.

[Tobacco smoking and self-assessment of health status among students from High School of Country Economy in Kutno--preliminary study].

PubMed

Adamek, Renata; Kurzepa-Hasan, Edyta; Pietrzak, Anna; Zysnarska, Monika; Jagielska, Joanna

2008-01-01

Tobacco smoking is still actual and common problem, which affects both students' high schools and their professors. In this study results are presented among students from one private schools in Poland, when students are educated in the following directions: geodesy, Europe science, pedagogy, computer science and nursing. The aim of the study was to assess prevalence of tobacco smoking among students and the awareness of health consequences. It is also decided to check which variables determinate self-assessment of health status of students and what motives of tobacco smoking are. Tobacco smoking was declared by 39% of students, 81.9% of them smoked regular and 18.1% - occasional. The biggest group of tobacco smoking students was noticed in geodesy - 35.4% students and nursing - 29%. Nearly 44% had opinion that tobacco smoking become addicted (22.9% students from nursing, 31.4% from geodesy, 8.6% from Europe science and 143% from pedagogy). Almost 36% students, in their opinion, become addicted to nicotine, over 32% students smoked because of relaxing effects of smoking, 129% smoked for company, The biggest group of surveyed group assess their health status as a good (56.3%) and very good (42%), one person as a very bad - 125%. There are statistical significant dependence between health status and gender, age, study, year of study and place of residence.

[Assessment of comprehensive nutritional status and eating behavior among 311 middle aged and aged women with osteoporosis in Chengdu].

PubMed

Zhao, R P; Wang, W Z; Cheng, G P; Zhang, H J; Zhou, F M; Li, Y Y; Wu, C; Yang, L Q; Zeng, G

2017-06-06

Objective: To investigate the comprehensive nutritional status and diet behavior of middle aged and elderly women with osteoporosis, and thereby to explore the relationship between diet behavior and comprehensive nutritional status. Methods: 311 middle-aged and elderly women with osteoporosis in Chengdu were included in this study. Mini Nutritional Assessment (MNA) was applied to assess their comprehensive nutritional status. Information of social-demographic characteristics and diet behavior (about meals, snacks and water drinking, etc.) of the subjects was collected by questionnaire. Chi square test was used to assess the differences in nutritional status among patients who have different eating behaviors. Logistic regression analysis was performed to evaluate the relationship between diet behaviors and comprehensive nutritional status. Results: The mean MNA score of subjects was 25.8±2.5. 20.3% (63/311) of the subjets were at risk of potential malnutrition, but there was no malnourished subjects found. 46.9% (46/311) of the subjects were in good appetite. 95.2% (296/311) of them had a fixed food intake each meal. 65.8% (198/311) of them had snacks every day, and the most common choice was fruit (86.4% (248/287)). 54.8% (165/311) of them had initiative drinking water habits, and the most common choice was plain boiled water (79.9%, 246/308). 76.5% (238/311) of them had daily portable water less than 1 500 ml. After adjusting the effects of age, occupation and education level, bad appetite ( OR= 3.50, 95% CI: 1.18-10.62), unfixed food intake ( OR= 7.27, 95% CI: 1.40-35.83), and seldom or never intake of snack ( OR= 3.71, 95% CI: 1.42-9.72) were risk factors for malnutrition risk, while tea drinking was protective factor( OR= 0.31, 95% CI: 0.11-0.93). Conclusion: Risk of potential malnutrition and unhealthy diet behavior among the middle aged and elderly women with osteoporosis should be paid more attention. Unhealtghy diet behavior has a negative effect on their comprehensive nutritional status.

Self-reported health and functional limitations among older people in the Kassena-Nankana District, Ghana.

PubMed

Debpuur, Cornelius; Welaga, Paul; Wak, George; Hodgson, Abraham

2010-09-27

Ghana is experiencing significant increases in its ageing population, yet research on the health and quality of life of older people is limited. Lack of data on the health and well-being of older people in the country makes it difficult to monitor trends in the health status of adults and the impact of social policies on their health and welfare. Research on ageing is urgently required to provide essential data for policy formulation and programme implementation. To describe the health status and identify factors associated with self-rated health (SRH) among older adults in a rural community in northern Ghana. The data come from a survey on Adult Health and Ageing in the Kassena-Nankana District involving 4,584 people aged 50 and over. Survey participants answered questions pertaining to their health status, including self-rated overall health, perceptions of well-being and quality of life, and self-reported assessment of functioning on a range of different health domains. Socio-demographic information such as age, sex, marital status and education were obtained from a demographic surveillance database. The majority of older people rated their health status as good, with the oldest old reporting poorer health. Multivariate regression analysis showed that functional ability and sex are significant factors in SRH status. Adults with higher levels of functional limitations were much more likely to rate their health as being poorer compared with those having lower disabilities. Household wealth was significantly associated with SRH, with wealthier adults more likely to rate their health as good. The depreciation in health and daily functioning with increasing age is likely to increase people's demand for health care and other services as they grow older. There is a need for regular monitoring of the health status of older people to provide public health agencies with the data they need to assess, protect and promote the health and well-being of older people.

Self-reported health and functional limitations among older people in the Kassena-Nankana District, Ghana

PubMed Central

Debpuur, Cornelius; Welaga, Paul; Wak, George; Hodgson, Abraham

2010-01-01

Background Ghana is experiencing significant increases in its ageing population, yet research on the health and quality of life of older people is limited. Lack of data on the health and well-being of older people in the country makes it difficult to monitor trends in the health status of adults and the impact of social policies on their health and welfare. Research on ageing is urgently required to provide essential data for policy formulation and programme implementation. Objective To describe the health status and identify factors associated with self-rated health (SRH) among older adults in a rural community in northern Ghana. Methods The data come from a survey on Adult Health and Ageing in the Kassena-Nankana District involving 4,584 people aged 50 and over. Survey participants answered questions pertaining to their health status, including self-rated overall health, perceptions of well-being and quality of life, and self-reported assessment of functioning on a range of different health domains. Socio-demographic information such as age, sex, marital status and education were obtained from a demographic surveillance database. Results The majority of older people rated their health status as good, with the oldest old reporting poorer health. Multivariate regression analysis showed that functional ability and sex are significant factors in SRH status. Adults with higher levels of functional limitations were much more likely to rate their health as being poorer compared with those having lower disabilities. Household wealth was significantly associated with SRH, with wealthier adults more likely to rate their health as good. Conclusion The depreciation in health and daily functioning with increasing age is likely to increase people's demand for health care and other services as they grow older. There is a need for regular monitoring of the health status of older people to provide public health agencies with the data they need to assess, protect and promote the health and well-being of older people. PMID:20963186

SUBJECTIVE SOCIOECONOMIC STATUS AND HEALTH: RELATIONSHIPS RECONSIDERED

PubMed Central

Nobles, Jenna; Ritterman Weintraub, Miranda; Adler, Nancy

2013-01-01

Subjective status, an individual’s perception of her socioeconomic standing, is a robust predictor of physical health in many societies. To date, competing interpretations of this correlation remain unresolved. Using longitudinal data on 8,430 older adults from the 2000 and 2007 waves of the Indonesia Family Life Survey, we test these oft-cited links. As in other settings, perceived status is a robust predictor of self-rated health, and also of physical functioning and nurse-assessed general health. These relationships persist in the presence of controls for unobserved traits, such as difficult-to-measure aspects of family background and persistent aspects of personality. However, we find evidence that these links likely represent bi-directional effects. Declines in health that accompany aging are robust predictors of declines in perceived socioeconomic status, net of observed changes to the economic profile of respondents. The results thus underscore the social value afforded good health status. PMID:23453318

HSR Aerodynamic Performance Status and Challenges

NASA Technical Reports Server (NTRS)

Gilbert, William P.; Antani, Tony; Ball, Doug; Calloway, Robert L.; Snyder, Phil

1999-01-01

This paper describes HSR (High Speed Research) Aerodynamic Performance Status and Challenges. The topics include: 1) Aero impact on HSR; 2) Goals and Targets; 3) Progress and Status; and 4) Remaining Challenges. This paper is presented in viewgraph form.

Direct and indirect relationships of physical fitness, weight status, and learning duration to academic performance in Japanese schoolchildren.

PubMed

Ishihara, Toru; Morita, Noriteru; Nakajima, Toshihiro; Okita, Koichi; Yamatsu, Koji; Sagawa, Masato

2018-03-01

The purpose of this study was to determine, using structural equation modelling (SEM), the direct and indirect influence of daily behaviours (i.e. exercise/learning durations), weight status, and physical fitness on academic performance among seventh-grade schoolchildren, after controlling for socioeconomic status. We analysed cross-sectional data from 274 schoolchildren (159 males and 115 females; 12-13 years old). Academic performance was assessed using the total grade points in eight academic subjects. Physical fitness was evaluated using the total score of eight physical fitness tests and weight status using body mass index. The daily behaviours and socioeconomic status were assessed by the questionnaire. The SEM showed an adequate fit to the data (χ 2  = 0.684, p = .710, RMSEA = .000). Physical fitness and learning durations had direct effects on academic performance (β = .301, p < .001; β = .132, p = .037, respectively) after controlling for confounders. Healthy weight status and exercise habits positively indirectly influenced academic performance via physical fitness. These findings suggest that, independent of socioeconomic status and learning durations, exercise habits and maintaining healthy weight status may indirectly contribute to academic success via better physical fitness in children.

Midazolam fails to prevent neurological damage in children with convulsive refractory febrile status epilepticus.

PubMed

Nagase, Hiroaki; Nishiyama, Masahiro; Nakagawa, Taku; Fujita, Kyoko; Saji, Yohsuke; Maruyama, Azusa

2014-07-01

We conducted a retrospective study to compare the outcome of intravenous midazolam infusion without electroencephalography or targeted temperature management and barbiturate coma therapy with electroencephalography and targeted temperature management for treating convulsive refractory febrile status epilepticus. Of 49 consecutive convulsive refractory febrile status epilepticus patients admitted to the pediatric intensive care unit of our hospital, 29 were excluded because they received other treatments or because of various underlying illnesses. Thus, eight patients were treated with midazolam and 10 with barbiturate coma therapy using thiamylal. Midazolam-treated patients were intubated only when necessary, whereas barbiturate coma therapy patients were routinely intubated. Continuous electroencephalography monitoring was utilized only for the barbiturate coma group. The titration goal for anesthesia was clinical termination of status epilepticus in the midazolam group and suppression or burst-suppression patterns on electroencephalography in the barbiturate coma group. Normothermia was maintained using blankets and neuromuscular blockade in the barbiturate coma group and using antipyretics in the midazolam group. Prognoses were measured at 1 month after onset; children were classified into poor and good outcome groups. Good outcome was achieved in all the barbiturate coma group patients and 50% of the midazolam group patients (P = 0.02, Fisher's exact test). Although the sample size was small and our study could not determine which protocol element is essential for the neurological outcome, the findings suggest that clinical seizure control using midazolam without continuous electroencephalography monitoring or targeted temperature management is insufficient in preventing neurological damage in children with convulsive refractory febrile status epilepticus. Copyright © 2014 Elsevier Inc. All rights reserved.

The effect of perceived health status on patient satisfaction.

PubMed

Xiao, Hong; Barber, Janet P

2008-01-01

To examine the effect of perceived health status on three components of patient satisfaction. The Household Component of the 1999 Medical Expenditure Panel Survey for people 35-64 years of age was used to examine the effect of perceived health status on patient satisfaction measured in terms of access to care, provider quality and quality of care. Descriptive statistics and multivariate regression were used to describe the subjects and to examine the relationship between patient satisfaction and perceived health status controlling for patient demographic factors, health factors and provider characteristics. All analyses used STATA 8.0 which is designed to analyze weighted data. A total of 4,417 patients (71% women) met the inclusion criteria for the study. Patients who rated their health excellent or good scored higher on the three dimensions of patient satisfaction. Higher scores on one or more components of patient satisfaction were associated with being older, married, better educated and having higher income, health insurance and good mental health. Seeing the health-care provider for an old problem resulted in lower levels of patient satisfaction. Provider characteristics significantly related to patient satisfaction were listening to the patient, being a specialist, seeing patients in an office setting and being located in the South. This study has shown that patient satisfaction is influenced by a person's self-perceived health status and other personal characteristics that are external to the delivery of health care. These findings suggest that patient satisfaction data should be used judiciously because a significant portion of the variation may be attributed to factors endogenous to the patient and therefore are not amenable to provider intervention.

Assessment of voice related quality of life and its correlation with socioeconomic status after total laryngectomy.

PubMed

Agarwal, Sangeet Kumar; Gogia, Shweta; Agarwal, Alok; Agarwal, Rajiv; Mathur, Ajay Swaroop

2015-10-01

After total laryngectomy for laryngeal cancer, the major determinants of QOL is the patient's voice related quality of life (V-RQOL). The primary aim of this study was to assess the V-RQOL and impact of socioeconomic status over it in Indian population by using two validated scales [voice handicap index (VHI) and V-RQOL questionnaires]. Total 104 patients underwent total laryngectomy but 71 were eligible for study. Patients filled the VHI and V-RQOL questionnaires after completion of 1 year of usage of the TEP voice. The socioeconomic status of the patients was calculated according to various domains related to their life and were divided into lower and higher status. A total of 76.1% patients had VHI score between 0 to 30 (minimal voice handicap), 19.7% had score between 31 to 60 (moderate voice handicap) and only 4.2% patients had VHI score more than 61 (serious voice handicap). On V-RQOL scores, 16.9% patients had score between 10 to 15 (excellent), 40.8% patients, between 16 to 20 (very good), 22.5% patients, between 21 and 25 (good voice), 15.5% patients, between 26 and 30 (fair) and only 4.2% patients scored more than 30 with poor quality of voice. Patients with lower socioeconomic group had better V-RQOL than with high socioeconomic group. VHI and V-RQOL scores in our series were superior to other studies due to major population with lower socioeconomic status and better social support which exists in our society.

Monthly fluctuations of insomnia symptoms in a population-based sample.

PubMed

Morin, Charles M; Leblanc, M; Ivers, H; Bélanger, L; Mérette, Chantal; Savard, Josée; Jarrin, Denise C

2014-02-01

To document the monthly changes in sleep/insomnia status over a 12-month period; to determine the optimal time intervals to reliably capture new incident cases and recurrent episodes of insomnia and the likelihood of its persistence over time. Participants were 100 adults (mean age = 49.9 years; 66% women) randomly selected from a larger population-based sample enrolled in a longitudinal study of the natural history of insomnia. They completed 12 monthly telephone interviews assessing insomnia, use of sleep aids, stressful life events, and physical and mental health problems in the previous month. A total of 1,125 interviews of a potential 1,200 were completed. Based on data collected at each assessment, participants were classified into one of three subgroups: good sleepers, insomnia symptoms, and insomnia syndrome. At baseline, 42 participants were classified as good sleepers, 34 met criteria for insomnia symptoms, and 24 for an insomnia syndrome. There were significant fluctuations of insomnia over time, with 66% of the participants changing sleep status at least once over the 12 monthly assessments (51.5% for good sleepers, 59.5% for insomnia syndrome, and 93.4% for insomnia symptoms). Changes of status were more frequent among individuals with insomnia symptoms at baseline (mean = 3.46, SD = 2.36) than among those initially classified as good sleepers (mean = 2.12, SD = 2.70). Among the subgroup with insomnia symptoms at baseline, 88.3% reported improved sleep (i.e., became good sleepers) at least once over the 12 monthly assessments compared to 27.7% whose sleep worsened (i.e., met criteria for an insomnia syndrome) during the same period. Among individuals classified as good sleepers at baseline, risks of developing insomnia symptoms and syndrome over the subsequent months were, respectively, 48.6% and 14.5%. Monthly assessment over an interval of 6 months was found most reliable to estimate incidence rates, while an interval of 3 months proved the most reliable for defining chronic insomnia. Monthly assessment of insomnia and sleep patterns revealed significant variability over the course of a 12-month period. These findings highlight the importance for future epidemiological studies of conducting repeated assessment at shorter than the typical yearly interval in order to reliably capture the natural course of insomnia over time.

Changes in activities performed in leisure time after open heart surgery.

PubMed

Bunzel, B; Eckersberger, F

1989-06-01

To assess any changes made in the leisure activities performed after open heart surgery, 94 patients (48 with aortocoronary bypass operation, 46 with valve replacements) were asked exactly one year postoperatively whether activities, collected in a list of 21 items, had increased, decreased or remained equal since their operation. In spite of the fact that most leisure activities seemed to have remained unchanged, after operation patients seem to undertake activities quite contrary to their motivations for undergoing surgery in the first place: active participation (such as involvement in some kind of sport, going out to cinema, theatre, restaurants,...) decreases, whereas passive activities (such as watching sports on television, listening to music,...) increases significantly. Although 90% of the patients stated their physical, and 67% their emotional status, as being clearly improved compared to preoperative values, the experience of body limitations as well as of fear and anxiety seems to be so durable that the patients, now in good condition, become passive onlookers and cease to participate in social life.

Why do kids eat healthful food? Perceived benefits of and barriers to healthful eating and physical activity among children and adolescents.

PubMed

O'dea, Jennifer A

2003-04-01

The goal was to have children and adolescents identify and rank the major perceived benefits of and barriers to healthful eating and physical activity and to suggest strategies for overcoming barriers. Semistructured, in-depth focus groups were undertaken using standardized questions and prompts. Students in grades 2 through 11(ages 7 through 17; N=213) from 34 randomly selected schools participated in 38 focus groups. Major benefits of healthful eating included improvements to cognitive and physical performance, fitness, endurance, psychological benefits, physical sensation (feeling good physically), and production of energy. Barriers included convenience, taste, and social factors. Benefits of physical activity included social benefits, enhancement of psychological status, physical sensation, and sports performance. Barriers included a preference for indoor activities, lack of energy and motivation, time constraints, and social factors. Suggested strategies for overcoming barriers included support from parents and school staff, better planning, time management, self-motivation, education, restructuring the physical environment, and greater variety of physical activities.

The Ignition Physics Campaign on NIF: Status and Progress

NASA Astrophysics Data System (ADS)

Edwards, M. J.; Ignition Team

2016-03-01

We have made significant progress in ICF implosion performance on NIF since the 2011 IFSA. Employing a 3-shock, high adiabat CH (“High-Foot”) design, total neutron yields have increased 10-fold to 6.3 x1015 (a yield of ∼ 17 kJ, which is greater than the energy invested in the DT fuel ∼ 12kJ). At that level, the yield from alpha self-heating is essentially equivalent to the compression yield, indicating that we are close to the alpha self-heating regime. Low adiabat, 4-shock High Density Carbon (HDC) capsules have been imploded in conventional gas-filled hohlraums, and employing a 6 ns, 2-shock pulse, HDC capsules were imploded in near-vacuum hohlraums with overall coupling ∼ 98%. Both the 4- and 2-shock HDC capsules had very low mix and high yield over simulated performance. Rugby holraums have demonstrated uniform x-ray drive with minimal Cross Beam Energy Transfer (CBET), and we have made good progress in measuring and modelling growth of ablation front hydro instabilities.

Oral nutritional supplements intake and nutritional status among inpatients admitted in a tertiary hospital.

PubMed

Lammel Ricardi, Juliana; Marcadenti, Aline; Perocchin de Souza, Simone; Siviero Ribeiro, Anelise

2013-01-01

Malnutrition is very common in hospitals and inpatients with prescription of oral nutritional supplementation have improvement of the nutritional status. To detect the total acceptance rate and a possible association between oral nutritional supplements intake and nutritional status. A cross-sectional study was carried out among 398 inpatients. Fifteen types of supplements were analyzed and nutritional status was detected by Subjective Global Assessment (SGA). Rest-ingestion index (RI) was obtained and Modified Poisson's regression was used to detect associations between nutritional status and intake of nutritional supplements. The prevalence of malnutrition was 43.7% and overall acceptance of supplements was around 75%. Industrialized supplements have better acceptance among well-nourished inpatients and patients who ate less than 80% of the supplement offered (industrialized or homemade) had higher risk for malnutrition (48%). There was an association between oral nutritional supplements intake and nutritional status, despite the good acceptance rate. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

Held in contempt: the psychological, interpersonal, and performance consequences of contempt in a work context.

PubMed

Melwani, Shimul; Barsade, Sigal G

2011-09-01

Guided by a social function of emotions perspective, the authors examined a model of the psychological, interpersonal, and performance consequences of contempt in a series of 3 experiments that tested the outcomes of being a recipient of contempt in the work domain. In these experiments, participants engaged in a business strategy simulation with a virtual partner-a computer programmed to give contemptuous and other types of feedback. In Study 1, which examined the task performance and interpersonal outcomes of contempt, recipients of contempt had significantly better task performance but also significantly more interpersonal aggressiveness toward their virtual partners compared with recipients of failure, angry, or neutral feedback. Study 2 examined 3 psychological outcomes mediating the contempt-task performance/aggression relationship: self-esteem, returned feelings of contempt, and activation levels. Lowered levels of implicit self-esteem and greater levels of activation significantly mediated the relationship between receiving contempt and task performance, whereas the contempt-aggression relationship was mediated by lowered implicit self-esteem and increased feelings of returned contempt. Study 3 examined status as a moderator of these relationships. Low-status recipients had significantly better task performance than did equal-status recipients, who performed significantly better than did the high-status recipients of contempt. In addition, low-status recipients displayed significantly lower levels of aggression in response to contempt than did equal-status and high-status recipients. PsycINFO Database Record (c) 2011 APA, all rights reserved.

A national cohort study of parental socioeconomic status and non-fatal suicidal behaviour-the mediating role of school performance

PubMed Central

2012-01-01

Background A link between low parental socioeconomic status and mental health problems in offspring is well established in previous research. The mechanisms that explain this link are largely unknown. The present study investigated whether school performance was a mediating and/or moderating factor in the path between parental socioeconomic status and the risk of hospital admission for non-fatal suicidal behaviour. Methods A national cohort of 447 929 children born during 1973-1977 was followed prospectively in the National Patient Discharge Register from the end of their ninth and final year of compulsory school until 2001. Multivariate Cox proportional hazards and linear regression analyses were performed to test whether the association between parental socioeconomic status and non-fatal suicidal behaviour was mediated or moderated by school performance. Results The results of a series of multiple regression analyses, adjusted for demographic variables, revealed that school performance was as an important mediator in the relationship between parental socioeconomic status and risk of non-fatal suicidal behaviour, accounting for 60% of the variance. The hypothesized moderation of parental socioeconomic status-non-fatal suicidal behaviour relationship by school performance was not supported. Conclusions School performance is an important mediator through which parental socioeconomic status translates into a risk for non-fatal suicidal behaviour. Prevention efforts aimed to reduce socioeconomic inequalities in non-fatal suicidal behaviour among young people will need to consider socioeconomic inequalities in school performance. PMID:22230577

[Factors influencing antiretroviral therapy adherence among HIV-infected people on antiretroviral therapy in Ili Kazakh Autonomous Prefecture].

PubMed

Wang, W; Liu, W; Chen, T; Liu, N P; Zheng, Y J; Ye, S D; Zhang, Y; Wang, X M; Wang, G Z; Zhang, H B

2017-02-06

Objective: To analyze factors influencing antiretroviral therapy (ART) adherence among human immunodeficiency virus (HIV) patients receiving ART at the town level in Ili Kazakh Autonomous Prefecture (Ili) in May 2015 and to document enhanced ART for acquired immunodeficiency syndrome (AIDS) cases. Methods: A cross-sectional survey was conducted using one-on-one interviews and data collection from the system of AIDS follow-up management in three ART services centers at the town level of Ili. The subjects were HIV-infected individuals, aged 18 years or older, who were receiving ART during the survey. The surveys collected demographic characteristics, information related to ART and status of engaging ART, smoking and drinking behavior, depression, and quality of life. Results: A total of 412 participants completed the survey. The age was (41.1±8.0) years (range, 19-67 years). Approximately 60.9% (251) were male and 39.1% (161) were female. The survey showed that 75.0% (309) of participants were in good adherence and the P (50) ( P (25), P (75)) of quality of life was 56.31 (50.55, 59.42). Females demonstrated better adherence to ART (82.6% ( n= 133)) than males (70.1% ( n= 76)) (χ(2)=8.16, P= 0.005). The compliance rate of participants (78.0% ( n= 54)) with depression was higher than non-depressed participants (63.5% ( n= 255)) (χ(2)=7.52, P= 0.008). Multivariate logistic regression analyses showed that the probability of good adherence to ART increased with increasing quality of life ( OR= 1.06, 95% CI: 1.02-1.09). Moreover, participants who consumed alcohol or disclosed their HIV infection status to families were less likely to have good adherence to ART ( OR= 0.26, 95% CI: 0.13-0.53 and OR= 0.31, 95% CI: 0.13-0.72, respectively). Additionally, employed participants were also less likely to have good adherence to ART compared with unemployed participants ( OR= 0.45, 95% CI: 0.21-0.97). Conclusion: HIV/AIDS patients primarily showed good adherence to ART. Factors related to ART adherence included alcohol consumption, informing family of infection, work status, and quality of life.

How Past Loss of Control Accidents May Inform Safety Cases for Advanced Control Systems on Commercial Aircraft

NASA Technical Reports Server (NTRS)

Holloway, C. M.; Johnson, C. W.

2008-01-01

This paper describes five loss of control accidents involving commercial aircraft, and derives from those accidents three principles to consider when developing a potential safety case for an advanced flight control system for commercial aircraft. One, among the foundational evidence needed to support a safety case is the availability to the control system of accurate and timely information about the status and health of relevant systems and components. Two, an essential argument to be sustained in the safety case is that pilots are provided with adequate information about the control system to enable them to understand the capabilities that it provides. Three, another essential argument is that the advanced control system will not perform less safely than a good pilot.

Prediction of ball and roller bearing thermal and kinematic performance by computer analysis

NASA Technical Reports Server (NTRS)

Pirvics, J.; Kleckner, R. J.

1983-01-01

Characteristics of good computerized analysis software are suggested. These general remarks and an overview of representative software precede a more detailed discussion of load support system analysis program structure. Particular attention is directed at a recent cylindrical roller bearing analysis as an example of the available design tools. Selected software modules are then examined to reveal the detail inherent in contemporary analysis. This leads to a brief section on current design computation which seeks to suggest when and why computerized analysis is warranted. An example concludes the argument offered for such design methodology. Finally, remarks are made concerning needs for model development to address effects which are now considered to be secondary but are anticipated to emerge to primary status in the near future.

[Advances in the treatment of chronic lymphocytic leukaemia].

PubMed

Mozas, Pablo; Delgado, Julio

2016-11-18

Chronic lymphocytic leukemia (CLL), a proliferation of mature B cells, is one of the most prevalent haematological malignancies. Progress has been made in its treatment during the last few decades, and chemoimmunotherapy based on fludarabine, cyclophosphamide and rituximab is considered the treatment of choice for patients with standard-risk CLL and good performance status. However, due to the characterization of high-risk biological subgroups and its presentation in elderly patients and/or with comorbidities, targeted therapies, such as B-cell receptor inhibitors, have been developed and approved during the last few years. The current review examines traditional therapeutic strategies and focuses on new small molecules that already represent promising elements of the CLL treatment landscape. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Five-Year Analysis of Treatment Efficacy and Cosmesis by the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial in Patients Treated With Accelerated Partial Breast Irradiation

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

Vicini, Frank, E-mail: fvicini@beaumont.ed; Beitsch, Peter; Quiet, Coral

2011-03-01

Purpose: To present 5-year data on treatment efficacy, cosmetic results, and toxicities for patients enrolled on the American Society of Breast Surgeons MammoSite breast brachytherapy registry trial. Methods and Materials: A total of 1440 patients (1449 cases) with early-stage breast cancer receiving breast-conserving therapy were treated with the MammoSite device to deliver accelerated partial-breast irradiation (APBI) (34 Gy in 3.4-Gy fractions). Of 1449 cases, 1255 (87%) had invasive breast cancer (IBC) (median size, 10 mm) and 194 (13%) had ductal carcinoma in situ (DCIS) (median size, 8 mm). Median follow-up was 54 months. Results: Thirty-seven cases (2.6%) developed an ipsilateralmore » breast tumor recurrence (IBTR), for a 5-year actuarial rate of 3.80% (3.86% for IBC and 3.39% for DCIS). Negative estrogen receptor status (p = 0.0011) was the only clinical, pathologic, or treatment-related variable associated with IBTR for patients with IBC and young age (<50 years; p = 0.0096) and positive margin status (p = 0.0126) in those with DCIS. The percentage of breasts with good/excellent cosmetic results at 60 months (n = 371) was 90.6%. Symptomatic breast seromas were reported in 13.0% of cases, and 2.3% developed fat necrosis. A subset analysis of the first 400 consecutive cases enrolled was performed (352 with IBC, 48 DCIS). With a median follow-up of 60.5 months, the 5-year actuarial rate of IBTR was 3.04%. Conclusion: Treatment efficacy, cosmesis, and toxicity 5 years after treatment with APBI using the MammoSite device are good and similar to those reported with other forms of APBI with similar follow-up.« less

The experience of demanding work environments in younger workers.

PubMed

Winding, T N; Labriola, M; Nohr, E A; Andersen, J H

2015-06-01

Investigating whether certain individual or background characteristics are associated with an increased risk of experiencing an excessively demanding work environment in younger workers may help to reduce future inequality in health and maximize their labour market participation. To describe the work environment of Danish 20- to 21-year olds and to investigate the influence of family socioeconomic background and individual characteristics at age 14-15 on later experience of physical and psychosocial work environments. We obtained information on subjects' school performance, vulnerability, health and parental socioeconomic status from registers and a questionnaire completed in 2004. A questionnaire concerning eight measures of subjects' psychosocial and physical work environment in 2010 was used to determine the outcomes of interest. The study population consisted of 679 younger workers aged 20-21. The psychosocial work environment was in general good but younger workers experienced more demanding physical work than the general working population. Overall, individual as well as family factors had a limited impact on their assessment of the work environment. Low self-esteem at age 14-15 was associated with experiencing high demands and lack of trust and fairness at work, whereas low parental socioeconomic status was associated with a demanding physical work environment. This study showed a social gradient in experiencing a demanding physical work environment at age 20-21. The psychosocial work environment experienced by younger workers was generally good, but vulnerable young people may need special attention to protect them from or prepare them for psychosocially demanding jobs later in life. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Purpose and status of the multimodal commodity and passenger flow surveys

DOT National Transportation Integrated Search

1993-05-28

Because transportation exists to move people and goods, information on the quantity and characteristics of commodity and passenger movements between and within regions is essential to the development of informed transportation decisions. Information ...

Developing Markets for Zero-Emission Vehicles in Goods Movement

DOT National Transportation Integrated Search

2018-03-01

This report evaluates the market status and potential freight market penetration of zero emission vehicles (ZEVs) and near ZEVs in the medium and heavy duty class within the California market. It evaluates alternative technologies, primarily battery ...

The Role of Baked Egg and Milk in the Diets of Allergic Children.

PubMed

Robinson, Melissa L; Lanser, Bruce J

2018-02-01

Baked egg and baked milk are tolerated by most children who are allergic to hen's egg and cow's milk. Incorporating baked goods into the diets of allergic children may help them outgrow their primary allergy more quickly, with changes observed akin to immunotherapy. Benefits may also include increased quality of life and improved nutritional status. The search for a reliable biomarker to predict tolerance to baked goods is ongoing. Most children with a milk or egg allergy who are not previously tolerating egg or milk in baked goods should be offered an observed oral food challenge. Copyright © 2017 Elsevier Inc. All rights reserved.

Using biological effects tools to define Good Environmental Status under the European Union Marine Strategy Framework Directive.

PubMed

Lyons, B P; Thain, J E; Stentiford, G D; Hylland, K; Davies, I M; Vethaak, A D

2010-10-01

The use of biological effects tools offer enormous potential to meet the challenges outlined by the European Union Marine Strategy Framework Directive (MSFD) whereby Member States are required to develop a robust set of tools for defining 11 qualitative descriptors of Good Environmental Status (GES), such as demonstrating that "Concentrations of contaminants are at levels not giving rise to pollution effects" (GES Descriptor 8). This paper discusses the combined approach of monitoring chemical contaminant levels, along side biological effect measurements relating to the effect of pollutants, for undertaking assessments of GES across European marine regions. We outline the minimum standards that biological effects tools should meet if they are to be used for defining GES in relation to Descriptor 8 and describe the current international initiatives underway to develop assessment criteria for these biological effects techniques. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

The application status of Good Food Production Method (GFPM) production of corn crackers in SME Mawar Merah Luwu Utara

NASA Astrophysics Data System (ADS)

Latief, R.; Dirpan, A.; Tahir, M. M.; Albanjar, F. V.

2018-05-01

Good Food Production Method (GFPM) requires several requirements that must be fulfilled by all industries involved in the whole production chain from raw materials to the fonal product. This study aims to identify the application of GFPM in the production of corn chips, and assess the status of GFPM implementation which was conducted through observations, interwiews, and documentation of all activities related to the production process. The assessment used a reference adapted from the Decree of Indonesian Minister of Industry Affairs (Permenperin) number 75/M-Ind/Per/7/2010 and the regulation of Head of National Drug and Food Control Agency (KBPOM) number HK.03.1.23.04.12.22007 in 2012. The result showed several inappropriate conditios including: (1) absence of continuing maintanace of the wall and ceiling of the production room: (2) unstandardized ventilation in the production room; (3) absence of net weight and production labels on the packages; and (4) the absence of health label informing health claims and nutrition claims. The status of GFPM implementation in UKM Mawar Merah is at D (poor) level with a rate of IV.

Asian American women in science, engineering, and mathematics: Background contextual and college environment influences on self-efficacy and academic achievement

NASA Astrophysics Data System (ADS)

Vogt, Kristen E.

2005-07-01

The purpose of this research study was to examine, for undergraduate women of various Asian American ethnic backgrounds, the influence of background contextual and college environment factors on their sense of academic self-efficacy and achievement in science, technology, engineering, and mathematics (STEM) majors. Social cognitive career theory and its critiques provided a theoretical foundation for relationships from past performance, socioeconomic status, acculturation, and college environment variables (compositional diversity, racial climate, gendered climate, academic peer support), to academic self-efficacy and achievement. Data were collected through an online survey. Instrumentation included the scales of Language, Identity, and Behavioral Acculturation; Gender Discrimination; Faculty and Classroom Behavior; Interactions with Peers; and Academic Milestones Self-efficacy. The participants were 228 Asian American undergraduate women in STEM at a large public, doctoral research extensive university on the east coast; the response rate was 51%. In three MANOVAs for nine social cognitive career variables, four ethnic groups (East, South, Southeast, and Multi-ethnic Asian American) significantly differed only on socioeconomic status. In path analysis, the initial model was not a good fit and was rejected. The model was respecified through statistical and theoretical evaluation, tested in exploratory analysis, and considered a good fit. The respecified model explained 36% of semester GPA (achievement) and 28% of academic self-efficacy. The academic achievement of Asian American women in STEM was related to past performance, background contextual factors, academic self-efficacy, academic peer support, and gendered climate. The strongest direct influence on achievement was academic self-efficacy followed by past performance. The total effect of Asian acculturation on achievement was negative and the total effect of American acculturation on achievement was not significant; academic self-efficacy mediated these complex relationships. The total effects of racial and gendered compositional diversity and racial climate on both academic self-efficacy and achievement were not significant. Students in majors with more female peers reported less academic peer support. In this study, when culturally specific variables embellished social cognitive career theory, the theory exhibited cultural validity for undergraduate Asian American women in STEM. The nature of the relationships among culturally specific variables and college environment variables, however, requires further study.

Low vitamin D status is associated with reduced muscle mass and impaired physical performance in frail elderly people.

PubMed

Tieland, M; Brouwer-Brolsma, E M; Nienaber-Rousseau, C; van Loon, L J C; De Groot, L C P G M

2013-10-01

Serum 25-hydroxyvitamin D (25(OH)D) status has been associated with muscle mass, strength and physical performance in healthy elderly people. Yet, in pre-frail and frail elderly people this association has not been studied. The objective of this study was to explore the association between vitamin D intake and serum 25(OH)D status with muscle mass, strength and physical performance in a pre-frail and frail elderly population. This cross-sectional study included 127 pre-frail and frail elderly people in The Netherlands. Whole body and appendicular lean mass (ALM) (dual energy X-ray absorptiometry), leg strength (one repetition maximum), handgrip strength and physical performance (short physical performance battery) were measured, and blood samples were collected for the assessment of serum 25(OH)D status (liquid chromatography-tandem mass spectrometry). In addition, habitual dietary intake (3-day food records) and physical activity data (accelerometers) were collected. In total, 53% of the participants had a serum 25(OH)D level below 50  nmol/l. After adjustment for confounding factors, 25(OH)D status was associated with ALM (β=0.012, P=0.05) and with physical performance (β=0.020, P<0.05). Vitamin D intake was associated with physical performance (β=0.18, P<0.05) but not with ALM (P>0.05). In this frail elderly population, 25(OH)D status is low and suggests a modest association with reduced ALM and impaired physical performance. In addition, vitamin D intake tended to be associated with impaired physical performance. Our findings highlight the need for well-designed intervention trials to assess the impact of vitamin D supplementation on 25(OH)D status, muscle mass and physical performance in pre-frail and frail elderly people.

Defining a Good Death (Successful Dying): Literature Review and a Call for Research and Public Dialogue

PubMed Central

Meier, Emily A.; Gallegos, Jarred V.; Montross-Thomas, Lori P.; Depp, Colin A.; Irwin, Scott A.; Jeste, Dilip V.

2016-01-01

There is little agreement about what constitutes good death or successful dying. The authors conducted a literature search for published, English-language, peer-reviewed reports of qualitative and quantitative studies that provided a definition of a good death. Stakeholders in these articles included patients, prebereaved and bereaved family members, and healthcare providers (HCPs). Definitions found were categorized into core themes and subthemes, and the frequency of each theme was determined by stakeholder (patients, family, HCPs) perspectives. Thirty-six studies met eligibility criteria, with 50% of patient perspective articles including individuals over age 60 years. We identified 11 core themes of good death: preferences for a specific dying process, pain-free status, religiosity/spiritualty, emotional well-being, life completion, treatment preferences, dignity, family, quality of life, relationship with HCP, and other. The top three themes across all stakeholder groups were preferences for dying process (94% of reports), pain-free status (81%), and emotional well-being (64%). However, some discrepancies among the respondent groups were noted in the core themes: Family perspectives included life completion (80%), quality of life (70%), dignity (70%), and presence of family (70%) more frequently than did patient perspectives regarding those items (35%–55% each). In contrast, religiosity/spirituality was reported somewhat more often in patient perspectives (65%) than in family perspectives (50%). Taking into account the limitations of the literature, further research is needed on the impact of divergent perspectives on end-of-life care. Dialogues among the stakeholders for each individual must occur to ensure a good death from the most critical viewpoint—the patient’s. PMID:26976293

Qualification Status of Non-Asbestos Internal Insulation in the Reusable Solid Rocket Motor Program

NASA Technical Reports Server (NTRS)

Clayton, Louie

2011-01-01

This paper provides a status of the qualification efforts associated with NASA's RSRMV non-asbestos internal insulation program. For many years, NASA has been actively engaged in removal of asbestos from the shuttle RSRM motors due to occupation health concerns where technicians are working with an EPA banned material. Careful laboratory and subscale testing has lead to the downselect of a organic fiber known as Polybenzimidazol to replace the asbestos fiber filler in the existing synthetic rubber copolymer Nitrile Butadiene - now named PBI/NBR. Manufacturing, processing, and layup of the new material has been a challenge due to the differences in the baseline shuttle RSRM internal insulator properties and PBI/NBR material properties. For this study, data gathering and reduction procedures for thermal and chemical property characterization for the new candidate material are discussed. Difficulties with test procedures, implementation of properties into the Charring Material Ablator (CMA) codes, and results correlation with static motor fire data are provided. After two successful five segment motor firings using the PBI/NBR insulator, performance results for the new material look good and the material should eventually be qualified for man rated use in large solid rocket motor applications.

Predictive role of repair enzymes in the efficacy of Cisplatin combinations in pancreatic and lung cancer.

PubMed

Peters, Godefridus J; Avan, Abolfazl; Ruiz, Marielle Gallegos; Orsini, Vanessa; Avan, Amir; Giovannetti, Elisa; Smit, Egbert F

2014-01-01

Platinum combinations are the mainstay of treatment for non-small cell lung cancer (NSCLC), while for pancreatic cancer platinum combinations are being given to good-performance status patients. These platinum combinations consist of cis- or carboplatin with gemcitabine, while, for non-squamous NSCLC and mesothelioma, of pemetrexed. The combination of gemcitabine and cisplatin is based on gemcitabine-induced increased formation and retention of DNA-platinum adducts, which can be explained by a decrease of excision repair cross-complementing group-1 (ERCC1)-mediated DNA repair. In these patients, survival and response is prolonged when ERCC1 has a low protein or mRNA expression. A low expression of ribonucleotide reductase (RR) is related to a better treatment outcome after both gemcitabine and gemcitabine-platinum combinations. For pemetrexed combinations, ERCC1 expression was not related to survival. For both NSCLC and pancreatic cancer, polymorphisms in ERCC1 (C118T) and Xeroderma pigmentosum group D (XPD) (A751C) were related to survival. In currently ongoing and future prospective studies, patients should be selected based on their DNA repair status, but it still has to be determined whether this should be by immunohistochemistry, mRNA expression, or a polymorphism.

Health-related quality of life of Spanish children with cystic fibrosis.

PubMed

Groeneveld, Iris F; Sosa, Elena S; Pérez, Margarita; Fiuza-Luces, Carmen; Gonzalez-Saiz, Laura; Gallardo, Cristian; López-Mojares, Luis M; Ruiz, Jonatan R; Lucia, Alejandro

2012-12-01

To investigate (1) the contributions of sex, age, nutritional status- and physical-fitness-related variables on health-related quality of life (HRQOL) in Spanish children with cystic fibrosis, and (2) the agreement on HRQOL between children and their parents. In 28 children aged 6-17 years, body mass index percentile, percentage body fat, physical activity, pulmonary function, cardiorespiratory fitness, functional mobility, and dynamic muscle strength were determined using objective measures. HRQOL was measured using the revised version of the cystic fibrosis questionnaire. Simple and multiple linear regression analyses were performed to determine the variables associated with HRQOL. To assess the agreement on HRQOL between children and parents, intra-class correlation coefficients (ICCs) were calculated. Girls reported worse emotional functioning, a higher treatment burden, and more respiratory problems than boys. Greater functional mobility appeared associated with a less favourable body image and more eating disturbances. Agreement on HRQOL between children and parents was good to excellent, except for the domain of treatment burden. Sex and age were stronger predictors of HRQOL than nutritional status- or physical-fitness-related variables. Children reported a lower treatment burden than their parents perceived them to have.

Examining the Cervical Screening Behaviour of Women Aged 50 or above and Its Predicting Factors: A Population-Based Survey.

PubMed

Chan, Carmen W H; Choi, Kai Chow; Wong, Rosa S; Chow, Ka Ming; So, Winnie K W; Leung, Doris Y P; Lam, Wendy W T; Goggins, William

2016-12-02

Under-screening may increase the risk of cervical cancer in middle-aged women. This study aimed to investigate cervical cancer screening behaviour and its predictors among women aged 50 years or above. A population-based sample of 959 women was recruited by telephone from domestic households in Hong Kong, using random methods, and a structured questionnaire developed to survey participants. Multivariable logistic regressions were performed to examine the factors independently associated with cervical screening behaviour. Nearly half the sample (48%) had never had a cervical smear test. Multivariable analyses showed that age, educational level, marital status, family history of cancer, smoking status, use of complementary therapy, recommendation from health professionals, and believing that regular visits to a doctor or a Chinese herbalist were good for their health were predictors of cervical screening behaviour. Misconceptions concerned with menopause may reduce women's perceived susceptibility to cervical cancer, especially if they are 50 or above, and exert a negative effect on their screening behaviour. Healthcare professionals should actively approach these high-risk groups-older unmarried women, smokers, those less educated and who are generally not much concerned with their health.

Current status of laparoscopic and robotic ventral mesh rectopexy for external and internal rectal prolapse

PubMed Central

van Iersel, Jan J; Paulides, Tim J C; Verheijen, Paul M; Lumley, John W; Broeders, Ivo A M J; Consten, Esther C J

2016-01-01

External and internal rectal prolapse with their affiliated rectocele and enterocele, are associated with debilitating symptoms such as obstructed defecation, pelvic pain and faecal incontinence. Since perineal procedures are associated with a higher recurrence rate, an abdominal approach is commonly preferred. Despite the description of greater than three hundred different procedures, thus far no clear superiority of one surgical technique has been demonstrated. Ventral mesh rectopexy (VMR) is a relatively new and promising technique to correct rectal prolapse. In contrast to the abdominal procedures of past decades, VMR avoids posterolateral rectal mobilisation and thereby minimizes the risk of postoperative constipation. Because of a perceived acceptable recurrence rate, good functional results and low mesh-related morbidity in the short to medium term, VMR has been popularized in the past decade. Laparoscopic or robotic-assisted VMR is now being progressively performed internationally and several articles and guidelines propose the procedure as the treatment of choice for rectal prolapse. In this article, an outline of the current status of laparoscopic and robotic ventral mesh rectopexy for the treatment of internal and external rectal prolapse is presented. PMID:27275090

The status of Chinese permanent magnet industry and R&D activities

NASA Astrophysics Data System (ADS)

Dong, Shengzhi; Li, Wei; Chen, Hongsheng; Han, Rui

2017-05-01

It has been 15 years since China dominated the rare earth permanent magnet market in 2001. The annual output of sintered Nd-Fe-B magnets in China reached a new record of 126,300 tonnages in 2015 while the output in 2001 is only 6,500 tonnages. The average growth rate from 2001 to 2015 is about 23.5% though the output in 2012 suffers a deep drop due to the well known rare earth crisis in 2011. Currently, the RE magnet production capability in China seems to be over developed compared to actual requirements. Needless to say the oversupply situation implies a hard time for RE magnet manufacturers due to the fierce competition but maybe a good time for the whole industry. The motivation for a company to develop new technology and more competitive products with better performance and/or lower costs is greatly enhanced. The objective of this paper is to give a general picture of Chinese REPM industry and market including the output capability, the status of competition, the development of magnet application and the market trend. Some new research hot points potentially being applied, for example the Cerium magnet, will be introduced as well.

Does activity limitation predict discharge destination for postacute care patients?

PubMed

Chang, Feng-Hang; Ni, Pengsheng; Jette, Alan M

2014-09-01

This study aimed to examine the ability of different domains of activity limitation to predict discharge destination (home vs. nonhome settings) 1 mo after hospital discharge for postacute rehabilitation patients. A secondary analysis was conducted using a data set of 518 adults with neurologic, lower extremity orthopedic, and complex medical conditions followed after discharge from a hospital into postacute care. Variables collected at baseline include activity limitations (basic mobility, daily activity, and applied cognitive function, measured by the Activity Measure for Post-Acute Care), demographics, diagnosis, and cognitive status. The discharge destination was recorded at 1 mo after being discharged from the hospital. Correlational analyses revealed that the 1-mo discharge destination was correlated with two domains of activity (basic mobility and daily activity) and cognitive status. However, multiple logistic regression and receiver operating characteristic curve analyses showed that basic mobility functioning performed the best in discriminating home vs. nonhome living. This study supported the evidence that basic mobility functioning is a critical determinant of discharge home for postacute rehabilitation patients. The Activity Measure for Post-Acute Care-basic mobility showed good usability in discriminating home vs. nonhome living. The findings shed light on the importance of basic mobility functioning in the discharge planning process.

Making women's voices heard: technological change and women's employment in Malaysia.

PubMed

Ng Choon Sim, C

1999-01-01

This paper examines the 1994-96 UN University Institute for New Technologies policy research project on technological change and women's employment in Asia. The project was conducted to provide a voice for nongovernmental organizations (NGOs) representing women workers. It focuses on the Malaysian experience in terms of the impact of technology on women's work and employment in the telecommunications and electronic industry. The results of the NGO research project revealed that the shift to a more intensive production has no uniform impact on women. Although new jobs were created, women employment status remains vulnerable. Meaning, female workers are afraid of the technological redundancy, casualization of labor, as well as health and safety hazards associated with new technology. A good example of the effect of industrialization to women¿s rights is the situation in Malaysia. Although cutting edge technology, combined with restructuring, has yielded some benefits in terms of a vastly expanded network and services, better performances and economies of scale, employment situation of the majority of women still remained in the low-skilled or semi-skilled categories. In order to upgrade women employment status along with the technological advancement, open communication and cooperation of all types is needed to ensure a successful outcome.

Influence of educational status on executive function and functional balance in individuals with Parkinson disease.

PubMed

Souza, Carolina de Oliveira; Voos, Mariana Callil; Francato, Débora Valente; Chien, Hsin Fen; Barbosa, Egberto Reis

2013-03-01

This study investigated whether educational status influenced how people with Parkinson disease (PD) performed on Parts A, B, and DELTA of the Trail Making Test (TMT) and on the Berg Balance Scale (BBS). Recent studies have shown that educational status may influence cognitive and motor test performance. We gave the TMT and the BBS to assess executive function and functional balance in 28 people with PD (Hoehn and Yahr score between 2 and 3) and 30 healthy elderly people. Participants reported their number of years of formal education. We divided each group of participants by educational status: low (4 to 10 years of education) or high (≥11 years). In both the PD (P=0.018) and control (P=0.003) groups, participants with low educational status performed worse on the TMT Part B than did those with high educational status. Within the PD group, the less-educated participants scored worse on the BBS than did the more educated (P<0.001); this difference was not significant between the more- and less-educated controls (P=0.976). Whether or not they had PD, less-educated people performed worse than more-educated people on the TMT Part B. Educational status affected executive function, but PD status did not. Among individuals with PD, educational status influenced functional balance.

The Reliability and Validity of the Thoracolumbar Injury Classification System in Pediatric Spine Trauma.

PubMed

Savage, Jason W; Moore, Timothy A; Arnold, Paul M; Thakur, Nikhil; Hsu, Wellington K; Patel, Alpesh A; McCarthy, Kathryn; Schroeder, Gregory D; Vaccaro, Alexander R; Dimar, John R; Anderson, Paul A

2015-09-15

The thoracolumbar injury classification system (TLICS) was evaluated in 20 consecutive pediatric spine trauma cases. The purpose of this study was to determine the reliability and validity of the TLICS in pediatric spine trauma. The TLICS was developed to improve the categorization and management of thoracolumbar trauma. TLICS has been shown to have good reliability and validity in the adult population. The clinical and radiographical findings of 20 pediatric thoracolumbar fractures were prospectively presented to 20 surgeons with disparate levels of training and experience with spinal trauma. These injuries were consecutively scored using the TLICS. Cohen unweighted κ coefficients and Spearman rank order correlation values were calculated for the key parameters (injury morphology, status of posterior ligamentous complex, neurological status, TLICS total score, and proposed management) to assess the inter-rater reliabilities. Five surgeons scored the same cases 3 months later to assess the intra-rater reliability. The actual management of each case was then compared with the treatment recommended by the TLICS algorithm to assess validity. The inter-rater κ statistics of all subgroups (injury morphology, status of the posterior ligamentous complex, neurological status, TLICS total score, and proposed treatment) were within the range of moderate to substantial reproducibility (0.524-0.958). All subgroups had excellent intra-rater reliability (0.748-1.000). The various indices for validity were calculated (80.3% correct, 0.836 sensitivity, 0.785 specificity, 0.676 positive predictive value, 0.899 negative predictive value). Overall, TLICS demonstrated good validity. The TLICS has good reliability and validity when used in the pediatric population. The inter-rater reliability of predicting management and indices for validity are lower than those in adults with thoracolumbar fractures, which is likely due to differences in the way children are treated for certain types of injuries. TLICS can be used to reliably categorize thoracolumbar injuries in the pediatric population; however, modifications may be needed to better guide treatment in this specific patient population. 4.

Impact of collaterals on the efficacy and safety of endovascular treatment in acute ischaemic stroke: a systematic review and meta-analysis.

PubMed

Leng, Xinyi; Fang, Hui; Leung, Thomas W H; Mao, Chen; Miao, Zhongrong; Liu, Liping; Wong, Ka Sing; Liebeskind, David S

2016-05-01

We aimed to investigate the role of pretreatment collateral status in predicting the efficacy and safety of endovascular treatment (EVT) in acute ischaemic stroke due to cervical and/or cerebral arterial occlusions. Relevant full-text articles published since 1 January 2000, investigating correlations between collateral status and any efficacy or safety outcome in patients undergoing EVT in cohort or case-control studies, or randomised clinical trials, were retrieved by PubMed and manual search. Two authors extracted data from eligible studies and assessed study quality. Risk ratios (RR) were pooled for good versus poor collaterals for outcomes based on a random-effects model. Sensitivity and subgroup analyses were conducted. In total, 35 (3542 participants) and 23 (2652 participants) studies were included in qualitative review and quantitative meta-analysis, respectively. Overall, good pretreatment collaterals increased the rate of favourable functional outcome at 3 months (RR=1.98, 95% CI 1.64 to 2.38; p<0.001), and reduced the risks of periprocedural symptomatic intracranial haemorrhage (RR=0.59, 95% CI 0.43 to 0.81; p=0.001) and 3-month mortality (RR=0.49, 95% CI 0.38 to 0.63; p<0.001), as compared with poor collaterals, in patients with acute ischaemic stroke under EVT. No individual study could alter the estimate of overall effect of collateral status, but there were moderate to significant heterogeneities between subgroups of studies with different modes of EVT, different arterial occlusions and different collateral grading methods. Good pretreatment collateral status is associated with higher rates of favourable functional outcome, and lower rates of symptomatic intracranial haemorrhage and mortality, in patients with acute ischaemic stroke receiving endovascular therapies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

A resolution recognizing the threats to freedom of the press and expression around the world and reaffirming freedom of the press as a priority in the efforts of the United States Government to promote democracy and good governance on the occasion of World Press Freedom Day on May 3, 2013.

THOMAS, 113th Congress

Sen. Menendez, Robert [D-NJ

2013-05-16

Senate - 06/18/2013 Resolution agreed to in Senate without amendment and with a preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Agreed to in SenateHere are the steps for Status of Legislation:

Menopausal status and physical performance in middle aged women: a cross-sectional community-based study in Northeast Brazil.

PubMed

da Câmara, Saionara M A; Zunzunegui, Maria Victoria; Pirkle, Catherine; Moreira, Mayle A; Maciel, Álvaro C C

2015-01-01

To examine associations between menopausal status and physical performance in middle-aged women from the Northeast region of Brazil. Cross-sectional study of women between 40 to 65 years old living in Parnamirim. Women were recruited by advertisements in primary care neighborhood centers across the city. Physical performance was assessed by grip strength, gait speed and chair stands. Menopausal status was determined using the Stages of Reproductive Aging Workshop classification and women were classified in: premenopausal, perimenopausal or postmenopausal. Multiple linear regression analyses were performed to model the effect of menopausal status on each physical performance measure, adjusting for covariates (age, family income, education, body mass index, parity and age at first birth). The premenopausal women were significantly stronger and performed better in chair stands than perimenopausal and postmenopausal women. Gait speed did not vary significantly by menopausal status. In multivariate analyses, menopausal status remained statistically significant only for grip strength. In fully adjusted analyses, premenopausal women had grip strength mean of 2.226 Kgf (95% CI: 0.361 - 4.091) higher than the postmenopausal group. This study provides further evidence for the associations between menopause and physical performance in middle-aged women, since grip strength is weaker in peri and postmenopausal women compared to premenopausal, even adjusted for age and other covariates.

[Directions for use of corticosteroids and calcineurin inhibitors against generalized myasthenia gravis: therapeutic strategies that can lead to early improvements and veer away from high-dose oral corticosteroids].

PubMed

Utsugisawa, Kimiaki; Nagane, Yuriko; Suzuki, Shigeaki; Suzuki, Norihiro

2012-01-01

The advent of effective immune treatment has meant that myasthenia gravis (MG) is most often not lethal. However, many MG patients still find it difficult to maintain daily activities due to chronic residual fatigability and long-term side effects of medication, since full remission without immune treatment is not common. Our analysis demonstrated that disease severity, dose of oral corticosteroids, and depressive state are the major independent factors negatively associated with self-reported QOL (MG-QOL15-J score). It is noteworthy that oral corticosteroid, the first-line agent for MG, is negatively associated with patients' QOL. When the analysis took into account MGFA postintervention status and dose of oral prednisolne (PSL), the MG-QOL15-J score of MM status patients taking ≤ 5 mg PSL per day is identically low (i.e., just as good QOL) as that seen in CSR and is a target of treatment. In order to veer away from high-dose oral corticosteroids and to achieve early MM or better status with PSL ≤ 5 mg/day, we advocate the early aggressive treatment strategy that can achieve early improvement by performing an aggressive therapy using combined treatment with plasmapheresis and high-dose intravenous methylprednisolone and then maintain an improved clinical status using low-dose oral corticosteroids and calcineurin inhibitors (cyclosporine microemulsion and tacrolimus). The early stages of MG are susceptible to treatment with calcineurin inhibitors. When using cyclosporine microemulsion for MG, blood concentrations 2 h after administration (C2) correlate with clinical improvement and immediately before administration (C0) with side effects (increased serum creatinine and/or hypertension). Monitoring of C2 and C0 levels is useful to estimate efficacy and safety of the drug.

Evaluation of potential salivary acetaldehyde production from ethanol in oral cancer patients and healthy subjects.

PubMed

Kocaelli, H; Apaydin, A; Aydil, B; Ayhan, M; Karadeniz, A; Ozel, S; Yılmaz, E; Akgün, B; Eren, B

2014-01-01

Acetaldehyde has been implicated as a major factor in oral carcinogenesis associated with alcohol consumption. In this study, saliva samples from oral cancer patients and healthy individuals were incubated in vitro with ethanol in order to investigate factors which can influence salivary acetaldehyde production. A total of 66 individuals (40 males and 26 females, mean age 52 years) participated in the study. Participants were classified into three groups: Group 1 (oral cancer patients [n = 20]); Group 2 (poor dental health status [n = 25]) and Group 3 (good dental health status [n=21]). Every patient chewed a 1g piece of paraffin chewing gum for 1 minute then saliva samples were collected from all individuals. After in vitro incubation of the samples with ethanol, the levels of salivary acetaldehyde production was measured by head space gas chromatography. Kruskal-Wallis and Mann-Whitney tests and Spearman's Correlations analysis were performed for statistical analyses. The salivary acetaldehyde production was significantly higher (p <0.0001) in both group 1 and group 2 when compared to group 3. However, there was no significant difference between group 1 and group 2. Poor dental health status, infrequent oral hygiene habits and dental visits, smoking and presence of a dental prosthesis were significant parameters for increased levels of salivary acetaldehyde production from alcohol. The evaluation of salivary acetaldehyde production after in vitro incubation with ethanol may be useful for early detection of oral cancer. According to the results of this study, the significantly higher levels of salivary acetaldehyde production in oral cancer patients and individuals with poor dental health status may suggest a possible link between increased salivary acetaldehyde production and oral cancer. Improved oral hygiene can effectively decrease the level of salivary acetaldehyde production in oral cavity. Hippokratia 2014; 18 (3): 269-274.

Treatment of Lung Cancer in Medically Compromised Patients.

PubMed

Crawford, Jeffrey; Wheatley-Price, Paul; Feliciano, Josephine Louella

2016-01-01

Outcomes for patients with lung cancer have been improved substantially through the integration of surgery, radiation, and systemic therapy for patients with early-stage disease. Meanwhile, advances in our understanding of molecular mechanisms have substantially advanced our treatment of patients with advanced lung cancer through the introduction of targeted therapies, immune approaches, improvements in chemotherapy, and better supportive care. However, the majority of these advances have occurred among patients with good functional status, normal organ function, and with the social and economic support systems to be able to benefit most from these treatments. The aim of this article is to bring greater attention to management of lung cancer in patients who are medically compromised, which remains a major barrier to care delivery. Impaired performance status is associated with poor outcomes and correlates with the high prevalence of cachexia among patients with advanced lung cancer. CT imaging is emerging as a research tool to quantify muscle loss in patients with cancer, and new therapeutics are on the horizon that may provide important adjunctive therapy in the future. The benefits of cancer therapy for patients with organ failure are poorly understood because of their exclusion from clinical trials. The availability of targeted therapy and immunotherapy may provide alternatives that may be easier to deliver in this population, but clinical trials of these new agents in this population are vital. Patients with lower socioeconomic status are disproportionately affected by lung cancer because of higher rates of tobacco addiction and the impact of socioeconomic status on delay in diagnosis, treatment, and outcomes. For all patients who are medically compromised with lung cancer, multidisciplinary approaches are particularly needed to evaluate these patients and to incorporate rapidly changing therapeutics to improve outcomes.

Individual-level factors related to better mental health outcomes following child maltreatment among adolescents.

PubMed

Cheung, Kristene; Taillieu, Tamara; Turner, Sarah; Fortier, Janique; Sareen, Jitender; MacMillan, Harriet L; Boyle, Michael H; Afifi, Tracie O

2018-05-01

Research on factors associated with good mental health following child maltreatment is often based on unrepresentative adult samples. To address these limitations, the current study investigated the relationship between individual-level factors and overall mental health status among adolescents with and without a history of maltreatment in a representative sample. The objectives of the present study were to: 1) compute the prevalence of mental health indicators by child maltreatment types, 2) estimate the prevalence of overall good, moderate, and poor mental health by child maltreatment types; and 3) examine the relationship between individual-level factors and overall mental health status of adolescents with and without a history of maltreatment. Data were from the National Comorbidity Survey of Adolescents (NCS-A; n = 10,123; data collection 2001-2004); a large, cross-sectional, nationally representative sample of adolescents aged 13-17 years from the United States. All types of child maltreatment were significantly associated with increased odds of having poor mental health (adjusted odds ratios ranged from 3.2 to 9.5). The individual-level factors significantly associated with increased odds of good mental health status included: being physically active in the winter; utilizing positive coping strategies; having positive self-esteem; and internal locus of control (adjusted odds ratios ranged from 1.7 to 38.2). Interventions targeted to adolescents with a history of child maltreatment may want to test for the efficacy of the factors identified above. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Reliability and Responsiveness of NutriQoL® Questionnaire.

PubMed

Cuerda, Maria Cristina; Apezetxea, Antonio; Carrillo, Lourdes; Casanueva, Felipe; Cuesta, Federico; Irles, Jose Antonio; Virgili, Maria Nuria; Layola, Miquel; Lizán, Luis

2016-10-01

NutriQoL ® (Nestlé Health Science, Vevay, Switzerland) is a questionnaire developed to assess the health-related quality-of-life (HRQoL) of patients with home enteral nutrition (HEN) irrespective of their underlying condition and route of administration. The aim of this work is assessing the questionnaire's reliability and responsiveness to change. Two cohorts of patients with HEN and their primary caregivers were enrolled to assess reliability and responsiveness, respectively. All participants had to be 18 years of age or older, without mental deterioration (≤3 or 4 errors in the Pfeiffer's test) and with sufficient functional status (>40 points on Karnovsky's performance status scale). When the patients' ability to respond to the questionnaire was impaired due to underlying disease, their caregivers answered on their behalf. NutriQoL was administered in two and three visits to reliability and responsiveness cohorts, respectively. Test-retest reliability and internal consistency were assessed by the intra-class correlation coefficient (ICC) and the Cronbach's α, respectively. Responsiveness was evaluated by standardized effect size and standardized response mean between basal visit and third visit. Finally, the minimal clinically important difference (MCID) was estimated. A total of 54 and 86 participants were recruited to the reliability and responsiveness cohort, respectively. Thirty-five caregivers were selected to assess the inter-observer reliability. ICC values confirmed the good reproducibility level (ICC >0.75) of the questionnaire in both "physical functioning and activities of daily living" and "social life" domains and total score. The assessment of internal consistency in both domains of the questionnaire showed good internal consistency in visit 2. ICC showed the excellent agreement level between caregiver and patient in the global NutriQoL score. Finally, patients classified as having a minimal change in their health reported a mean (standard deviation) MCID in NutriQoL score of 0.63 (11.51). NutriQoL is a reliable and unique instrument to measure the HRQoL in HEN patients. NutriQoL detects changes in the health status of the patient. Nevertheless, further research is needed to determine the full extent of the questionnaire responsiveness.

Canopy Vegetation Indices from In situ Hyperspectral Data to Assess Plant Water Status of Winter Wheat under Powdery Mildew Stress

PubMed Central

Feng, Wei; Qi, Shuangli; Heng, Yarong; Zhou, Yi; Wu, Yapeng; Liu, Wandai; He, Li; Li, Xiao

2017-01-01

Plant disease and pests influence the physiological state and restricts the healthy growth of crops. Physiological measurements are considered the most accurate way of assessing plant health status. In this paper, we researched the use of an in situ hyperspectral remote sensor to detect plant water status in winter wheat infected with powdery mildew. Using a diseased nursery field and artificially inoculated open field experiments, we detected the canopy spectra of wheat at different developmental stages and under different degrees of disease severity. At the same time, destructive sampling was carried out for physical tests to investigate the change of physiological parameters under the condition of disease. Selected vegetation indices (VIs) were mostly comprised of green bands, and correlation coefficients between these common VIs and plant water content (PWC) were generally 0.784–0.902 (p < 0.001), indicating the green waveband may have great potential in the evaluation of water content of winter wheat under powdery mildew stress. The Photochemical Reflectance Index (PRI) was sensitive to physiological response influenced by powdery mildew, and the relationships of PRI with chlorophyll content, the maximum quantum efficiency of PSII photochemistry (Fv/Fm), and the potential activity of PSII photochemistry (Fv/Fo) were good with R2 = 0.639, 0.833, 0.808, respectively. Linear regressions showed PRI demonstrated a steady relationship with PWC across different growth conditions, with R2 = 0.817 and RMSE = 2.17. The acquired PRI model of wheat under the powdery mildew stress has a good compatibility to different experimental fields from booting stage to filling stage compared with the traditional water signal vegetation indices, WBI, FWBI1, and FWBI2. The verification results with independent data showed that PRI still performed better with R2 = 0.819 between measured and predicted, and corresponding RE = 8.26%. Thus, PRI is recommended as a potentially reliable indicator of PWC in winter wheat with powdery mildew stress. The results will help to understand the physical state of the plant, and provide technical support for disease control using remote sensing during wheat production. PMID:28751904

Canopy Vegetation Indices from In situ Hyperspectral Data to Assess Plant Water Status of Winter Wheat under Powdery Mildew Stress.

PubMed

Feng, Wei; Qi, Shuangli; Heng, Yarong; Zhou, Yi; Wu, Yapeng; Liu, Wandai; He, Li; Li, Xiao

2017-01-01

Plant disease and pests influence the physiological state and restricts the healthy growth of crops. Physiological measurements are considered the most accurate way of assessing plant health status. In this paper, we researched the use of an in situ hyperspectral remote sensor to detect plant water status in winter wheat infected with powdery mildew. Using a diseased nursery field and artificially inoculated open field experiments, we detected the canopy spectra of wheat at different developmental stages and under different degrees of disease severity. At the same time, destructive sampling was carried out for physical tests to investigate the change of physiological parameters under the condition of disease. Selected vegetation indices (VIs) were mostly comprised of green bands, and correlation coefficients between these common VIs and plant water content (PWC) were generally 0.784-0.902 ( p < 0.001), indicating the green waveband may have great potential in the evaluation of water content of winter wheat under powdery mildew stress. The Photochemical Reflectance Index (PRI) was sensitive to physiological response influenced by powdery mildew, and the relationships of PRI with chlorophyll content, the maximum quantum efficiency of PSII photochemistry (Fv/Fm), and the potential activity of PSII photochemistry (Fv/Fo) were good with R 2 = 0.639, 0.833, 0.808, respectively. Linear regressions showed PRI demonstrated a steady relationship with PWC across different growth conditions, with R 2 = 0.817 and RMSE = 2.17. The acquired PRI model of wheat under the powdery mildew stress has a good compatibility to different experimental fields from booting stage to filling stage compared with the traditional water signal vegetation indices, WBI, FWBI 1 , and FWBI 2 . The verification results with independent data showed that PRI still performed better with R 2 = 0.819 between measured and predicted, and corresponding RE = 8.26%. Thus, PRI is recommended as a potentially reliable indicator of PWC in winter wheat with powdery mildew stress. The results will help to understand the physical state of the plant, and provide technical support for disease control using remote sensing during wheat production.

The Influence of Chronic and Situational Social Status on Stereotype Susceptibility

PubMed Central

Pillaud, Vincent; Rigaud, David; Clémence, Alain

2015-01-01

We tested whether stereotypical situations would affect low-status group members' performance more strongly than high-status group members'. Experiment 1 and 2 tested this hypothesis using gender as a proxy of chronic social status and a gender-neutral task that has been randomly presented to favor boys (men superiority condition), favor girls (women superiority condition), or show no gender preference (control condition). Both experiments found that women’s (Experiment 1) and girls’ performance (Experiment 2) suffered more from the evoked stereotypes than did men's and boys’ ones. This result was replicated in Experiment 3, indicating that short men (low-status group) were more affected compared to tall men (high-status group). Additionally, men were more affected compared to women when they perceived height as a threat. Hence, individuals are more or less vulnerable to identity threats as a function of the chronic social status at play; enjoying a high status provides protection and endorsing a low one weakens individual performance in stereotypical situations. PMID:26645829

The Influence of Chronic and Situational Social Status on Stereotype Susceptibility.

PubMed

Pillaud, Vincent; Rigaud, David; Clémence, Alain

2015-01-01

We tested whether stereotypical situations would affect low-status group members' performance more strongly than high-status group members'. Experiment 1 and 2 tested this hypothesis using gender as a proxy of chronic social status and a gender-neutral task that has been randomly presented to favor boys (men superiority condition), favor girls (women superiority condition), or show no gender preference (control condition). Both experiments found that women's (Experiment 1) and girls' performance (Experiment 2) suffered more from the evoked stereotypes than did men's and boys' ones. This result was replicated in Experiment 3, indicating that short men (low-status group) were more affected compared to tall men (high-status group). Additionally, men were more affected compared to women when they perceived height as a threat. Hence, individuals are more or less vulnerable to identity threats as a function of the chronic social status at play; enjoying a high status provides protection and endorsing a low one weakens individual performance in stereotypical situations.

[SCREENING OF NUTRITIONAL STATUS AMONG ELDERLY PEOPLE AT FAMILY MEDICINE].

PubMed

Račić, M; Ivković, N; Kusmuk, S

2015-11-01

The prevalence of malnutrition in elderly is high. Malnutrition or risk of malnutrition can be detected by use of nutritional screening or assessment tools. This systematic review aimed to identify tools that would be reliable, valid, sensitive and specific for nutritional status screening in patients older than 65 at family medicine. The review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies were retrieved using MEDLINE (via Ovid), PubMed and Cochrane Library electronic databases and by manual searching of relevant articles listed in reference list of key publications. The electronic databases were searched using defined key words adapted to each database and using MESH terms. Manual revision of reviews and original articles was performed using Electronic Journals Library. Included studies involved development and validation of screening tools in the community-dwelling elderly population. The tools, subjected to validity and reliability testing for use in the community-dwelling elderly population were Mini Nutritional Assessment (MNA), Mini Nutritional Assessment-Short Form (MNA-SF), Nutrition Screening Initiative (NSI), which includes DETERMINE list, Level I and II Screen, Seniors in the Community: Risk Evaluation for Eating, and Nutrition (SCREEN I and SCREEN II), Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), and Malaysian and South African tool. MNA and MNA-SF appear to have highest reliability and validity for screening of community-dwelling elderly, while the reliability and validity of SCREEN II are good. The authors conclude that whilst several tools have been developed, most have not undergone extensive testing to demonstrate their ability to identify nutritional risk. MNA and MNA-SF have the highest reliability and validity for screening of nutritional status in the community-dwelling elderly, and the reliability and validity of SCREEN II are satisfactory. These instruments also contain all three nutritional status indicators and are practical for use in family medicine. However, the gold standard for screening cannot be set because testing of reliability and continuous validation in the study with a higher level of evidence need to be conducted in family medicine.

Short-term evaluation of the impact of a fortified food aid program on the micronutrient nutritional status of Argentinian pregnant women.

PubMed

Malpeli, Agustina; Ferrari, María Guillermina; Varea, Ana; Falivene, Mariana; Etchegoyen, Graciela; Vojkovic, María; Carmuega, Estéban; Disalvo, Liliana; Apezteguía, María; Pereyras, Silvia; Tournier, Andrea; Vogliolo, Daniel; Gonzalez, Horacio F

2013-11-01

We studied the impact of a food supplementation program (Plan Más Vida (PMV)) on the micronutrient nutritional condition of pregnant women from low-income families 1 year after its implementation. The food program provided supplementary diet (wheat and maize--fortified flour, rice or sugar, and fortified soup). We performed a prospective, nonexperimental, cross-sectional study in the province of Buenos Aires, Argentina, evaluating pregnant women at baseline (n = 164) and 1 year after PMV implementation (n = 108). Biochemical tests (hemogram, ferritin, vitamin A, zinc, and folic acid), anthropometric assessments (weight and height), and dietary surveys (24 h recall) were performed at the two study points. One year after PMV implementation, no significant changes in anthropometric values were observed. Folic acid deficiency and the risk of vitamin A deficiency (retinol, 20-30 μg/dl) decreased significantly (35.8 to 6.1 % and 64 to 41 %, respectively; p < 0.000). Anemia and prevalence of iron and zinc deficiency values did not change. Diet survey results showed that although nutrient intake increased significantly, it was still below recommendations. Implementation of the PMV and of the government nutritional strategies had a high impact on the prevalence of folic acid deficiency. We also observed a decrease in the risk of vitamin A deficiency, and no impact on iron and zinc nutritional status. Adherence to the specific fortified food (soup) was not good and intra-family dilution and distribution of food was high.

Brain metastases as site of first and isolated recurrence of breast cancer: the role of systemic therapy after local treatment.

PubMed

Niwińska, Anna

2016-10-01

The role of systemic treatment was assessed after local therapy for breast cancer patients who developed central nervous system (CNS) metastases as a first and isolated recurrence. Subjects were 128 breast cancer patients with brain metastases as the first and isolated site of recurrence that were selected from 673 consecutive breast cancer patients with brain metastases treated at the same institution. Median survival from brain metastases in patients with and without systemic treatment after local therapy was respectively 15 and 4 months (p < 0.001). In patients with a Karnofsky Performance Status ≥70 and those <70, survival was respectively 16 and 5.5 months (p < 0.001). The median survival from brain metastasis in patients with solitary brain metastasis, with and without systemic treatment after local therapy, was respectively 22 and 7 months (p = 0.003). Cox multivariate analysis demonstrated that good performance status, solitary brain metastasis and systemic therapy undertaken after local treatment were factors which prolonged survival. However patient survival was adversely affected by those having leptomeningeal metastasis associated with brain parenchymal lesions. Systemic therapy, undertaken after local treatment improved survival in those patients with breast cancer and brain metastases as the site of first and isolated recurrence. Further study is required in order to fully establish the role of systemic treatment for this patient group.

The status of water demand management in selected cities of southern Africa

NASA Astrophysics Data System (ADS)

Gumbo, Bekithemba

As a result of the rapid rate of urbanisation throughout Africa, many African cities face mounting challenges of providing their increasing populations with adequate and sustainable water services. Water demand management (WDM) offers a sustainable solution to water woes experienced in most cities in the southern Africa region. The region is characterised by frequent droughts, floods and erratic, unevenly distributed rainfall. Meanwhile nearly half of the southern Africa’s 200 million inhabitants do not have access to safe water and sanitation. This paper makes an assessment of the status of WDM in eight cities in the region based on published data and reports. It provides a basis of benchmarking the progress and success in WDM programmes by using selected key performance indicators. Gross unaccounted-for-water (UAW) is used as a crude measure of WDM good practice. From the eight selected case studies, Windhoek, Bulawayo and Hermanus have achieved considerable success in water use efficiency, implementing WDM programmes and recording UAW values of less than 20%, whilst Johannesburg; Maputo; Maseru; Lusaka and Mutare cannot account for about 40-60% of the water introduced into the distribution system. WDM projects require some key performance indicators which need to be recorded systematically by water supply agencies to enable a consistent monitoring and evaluation of programme. Finally for WDM to succeed, a new breed of professionals with multi-disciplinary skills is required as well as training of operatives, i.e. technicians, plumbers and meter readers.

Impact of Having a Mentally Disabled Child in the Family on the Oral Health of the Healthy Sibling: A Comparative Study.

PubMed

Chauhan, Astha; Nagarajappa, Sandesh; Dasar, Pralhad L; Mishra, Prashant

To determine and compare oral health status, knowledge and attitude among siblings of mentally disabled with siblings of normal healthy children. 240 study subjects consisting of 120 each of siblings of mentally disabled and normal, healthy children (control group) matched for age and gender were selected by convenience sampling. Oral health was assessed using the WHO-1997 proforma. A pretested questionnaire (30 items) was used for oral health knowledge and attitude assessment. Statistical analysis was performed using the chi-squared and Mann-Whitney tests. Caries prevalence among the siblings of mentally disabled and control group was 82% (mean DMFT 1.68 ± 1.18) and 45% (mean DMFT 0.58 ± 0.72), respectively (p < 0.05). The siblings of mentally disabled children also showed good oral health knowledge (mean 7.1 ± 1.4) and a positive attitude (p < 0.05). Siblings of mentally disabled children showed higher caries experience. Knowledge and attitude towards oral health was comparatively good among siblings of mentally disabled children. They exhibited favourable attitudes and involvement in helping their sibling to maintain oral health.

Adult Supratentorial Low-Grade Glioma: Long-Term Experience at a Single Institution

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

Bauman, Glenn, E-mail: glenn.bauman@lhsc.on.c; Fisher, Barbara; Watling, Christopher

2009-12-01

Purpose: To report the long-term follow-up of a cohort of adult patients with supratentorial low-grade glioma treated at a single institution. Methods and Materials: A cohort of 145 adult patients treated at the London Regional Cancer Program between 1979 and 1995 was reviewed. Results: With a median follow-up of 105 months, the median progression-free survival was 61 months (95% confidence interval, 53-77), and the median overall survival was 118 months (95% confidence interval, 93-129). The 10- and 20-year progression-free and overall survival rate was 18% and 0% and 48% and 22%, respectively. Cox regression analysis confirmed the importance of age,more » histologic type, presence of seizures, Karnofsky performance status, and initial extent of surgery as prognostic variables for overall and cause-specific survival. Function among long-term survivors without tumor progression was good to excellent for most patients. Conclusion: Low-grade glioma is a chronic disease, with most patients dying of their disease. However, long-term survival with good function is possible. Survival is determined primarily by the disease factors with selection and timing of adjuvant treatments having less influence on outcome.« less

LANDSCAPE SCALE INDICATORS OF MINING ACTIVITY

EPA Science Inventory

Ecological indicators of stress are used by the Environmental Monitoring and Assessment Program (EMAP) to quantify the status, trends and changes of ecological goods and services. The purpose of developing landscape indicators of stress is to identify environmental and ecological...

Space life sciences: A status report

NASA Technical Reports Server (NTRS)

1990-01-01

The scientific research and supporting technology development conducted in the Space Life Sciences Program is described. Accomplishments of the past year are highlighted. Plans for future activities are outlined. Some specific areas of study include the following: Crew health and safety; What happens to humans in space; Gravity, life, and space; Sustenance in space; Life and planet Earth; Life in the Universe; Promoting good science and good will; Building a future for the space life sciences; and Benefits of space life sciences research.

Mapping groundwater quality distinguishing geogenic and anthropogenic contribution using NBL

NASA Astrophysics Data System (ADS)

Preziosi, Elisabetta; Ducci, Daniela; Condesso de Melo, Maria Teresa; Parrone, Daniele; Sellerino, Mariangela; Ghergo, Stefano; Oliveira, Joana; Ribeiro, Luis

2015-04-01

Groundwaters are threatened by anthropic activities and pollution is interesting a large number of aquifers worldwide. Qualitative and quantitative monitoring is required to assess the status and track its evolution in time and space especially where anthropic pressures are stronger. Up to now, groundwater quality mapping has been performed separately from the assessment of its natural status, i.e. the definition of the natural background level of a particular element in a particular area or groundwater body. The natural background level (NBL) of a substance or element allows to distinguish anthropogenic pollution from contamination of natural origin in a population of groundwater samples. NBLs are the result of different atmospheric, geological, chemical and biological interaction processes during groundwater infiltration and circulation. There is an increasing need for the water managers to have sound indications on good quality groundwater exploitation. Indeed the extension of a groundwater body is often very large, in the order of tens or hundreds of square km. How to select a proper location for good quality groundwater abstraction is often limited to a question of facility for drilling (access, roads, authorizations, etc.) or at the most related to quantitative aspects driven by geophysical exploration (the most promising from a transmissibility point of view). So how to give indications to the administrators and water managers about the exploitation of good quality drinking water? In the case of anthropic contamination, how to define which area is to be restored and to which threshold (e.g. background level) should the concentration be lowered through the restoration measures? In the framework of a common project between research institutions in Italy (funded by CNR) and Portugal (funded by FCT), our objective is to establish a methodology aiming at merging together 1) the evaluation of NBL and 2) the need to take into account the drinking water standards with a spatial analysis. We compare diverse case studies using geochemical maps built by kriging in which we interpolate the conditional probability of exceeding the reference value (i.e. the drinking water standard) OR the local natural background level. The resulting maps provide a useful reference for management purposes.

The Pluripotent Stem-Cell Marker Alkaline Phosphatase is Highly Expressed in Refractory Glioblastoma with DNA Hypomethylation.

PubMed

Iwadate, Yasuo; Suganami, Akiko; Tamura, Yutaka; Matsutani, Tomoo; Hirono, Seiichiro; Shinozaki, Natsuki; Hiwasa, Takaki; Takiguchi, Masaki; Saeki, Naokatsu

2017-02-01

Hypomethylation of genomic DNA induces stem-cell properties in cancer cells and contributes to the treatment resistance of various malignancies. To examine the correlation between the methylation status of stem-cell-related genes and the treatment outcomes in patients with glioblastoma (GBM). The genome-wide DNA methylation status was determined using HumanMethylation450 BeadChips, and the methylation status was compared between a group of patients with good prognosis (survival > 4 yr) and a group with poor prognosis (survival < 1 yr). Immunohistochemistry for proteins translated from hypomethylated genes, including alkaline phosphatase (ALPL), CD133, and CD44, was performed in 70 GBMs and 60 oligodendroglial tumors. The genomic DNA in refractory GBM was more hypomethylated than in GBM from patients with relatively long survival (P = .0111). Stem-cell-related genes including ALPL, CD133, and CD44 were also significantly hypomethylated. A validation study using immunohistochemistry showed that DNA hypomethylation was strongly correlated with high protein expression of ALPL, CD133, and CD44. GBM patients with short survival showed high expression of these stem-cell markers. Multivariate analysis confirmed that co-expression of ALPL + CD133 or ALPL + CD44 was a strong predictor of short survival. Anaplastic oligodendroglial tumors without isocitrate dehydrogenase 1 mutation were significantly correlated with high ALPL expression and poor survival. Accumulation of stem-cell properties due to aberrant DNA hypomethylation is associated with the refractory nature of GBM. Copyright © 2017 by the Congress of Neurological Surgeons

Evaluation of Dietary Intakes, Body Composition, and Cardiometabolic Parameters in Adolescent Team Sports Elite Athletes: A Cross-sectional Study.

PubMed

Hosseinzadeh, Javad; Maghsoudi, Zahra; Abbasi, Behnood; Daneshvar, Pooya; Hojjati, Atefeh; Ghiasvand, Reza

2017-01-01

Nutritional intake is an important issue in adolescent athletes. Proper athletes' performance is a multifactorial outcome of good training, body composition, and nutritional status. The aim of the present study was to assess nutritional status, body composition, and cardiometabolic factors in adolescent elite athlete's province of Isfahan, Iran. In this cross-sectional study, 100 adolescent elite athletes from volleyball, basketball, and soccer teams were selected for the study. Demographic, anthropometric, and cardiometabolic parameters were assessed. Nutritional intakes of participants were recorded using three 24-h recall questioners. Thirty-four female athletes and 66 male athletes participated in this study. Body mass index had not significantly different between the sexes. Energy, protein, carbohydrate, iron, and fat intakes were significantly higher in male athletes ( P = 0.02), but calcium and folic acid intakes were not significantly different between the sexes, and Vitamin D intake was significantly higher in females ( P = 0.01). Systolic and diastolic blood pressure was significantly higher in males ( P = 0.04) and heart rate had not significantly different between the sexes ( P = 0.09). Heart murmurs and heart sounds in the majority of participants were normal. All the evaluated anthropometric and cardiometabolic parameters were in normal range in the majority of participants. The results showed that dietary intake in these athletes is approximately normal but micronutrients intake status in these athletes needs to be investigated further and longer.

Analytical validation and reference intervals for freezing point depression osmometer measurements of urine osmolality in dogs.

PubMed

Guerrero, Samantha; Pastor, Josep; Tvarijonaviciute, Asta; Cerón, José Joaquín; Balestra, Graziano; Caldin, Marco

2017-11-01

Urine osmolality (UOsm) is considered the most accurate measure of urine concentration and is used to assess body fluid homeostasis and renal function. We performed analytical validation of freezing point depression measurement of canine UOsm, to establish reference intervals (RIs) and to determine the effect of age, sex, and reproductive status on UOsm in dogs. Clinically healthy dogs ( n = 1,991) were retrospectively selected and stratified in groups by age (young [0-12 mo], adults [13-84 mo], and seniors [>84 mo]), sex (females and males), and reproductive status (intact and neutered). RIs were calculated for each age group. Intra- and inter-assay coefficients of variation were <1% in all cases. Good linearity ( r 2 = 1, p < 0.001) and recovery (89-98%) were observed. The limit of detection and limit of quantification were zero. Urine specific gravity and UOsm had a highly significant positive correlation ( r = 0.96, p < 0.001) but had inconsistent agreement. The 95% RI for canine UOsm was 369-2,416 mOsm/kg in young and adult dogs, and 366-2,178 mOsm/kg in seniors. Senior dogs had a significantly lower UOsm than young and adult dogs ( p < 0.000). Neutered females had a significantly lower UOsm than intact female dogs ( p < 0.002). These results indicate that the method evaluated is adequate for UOsm measurement and that RIs based on age and reproductive status should be used in dogs.

Evaluation of Dietary Intakes, Body Composition, and Cardiometabolic Parameters in Adolescent Team Sports Elite Athletes: A Cross-sectional Study

PubMed Central

Hosseinzadeh, Javad; Maghsoudi, Zahra; Abbasi, Behnood; Daneshvar, Pooya; Hojjati, Atefeh; Ghiasvand, Reza

2017-01-01

Background: Nutritional intake is an important issue in adolescent athletes. Proper athletes’ performance is a multifactorial outcome of good training, body composition, and nutritional status. The aim of the present study was to assess nutritional status, body composition, and cardiometabolic factors in adolescent elite athlete's province of Isfahan, Iran. Materials and Methods: In this cross-sectional study, 100 adolescent elite athletes from volleyball, basketball, and soccer teams were selected for the study. Demographic, anthropometric, and cardiometabolic parameters were assessed. Nutritional intakes of participants were recorded using three 24-h recall questioners. Results: Thirty-four female athletes and 66 male athletes participated in this study. Body mass index had not significantly different between the sexes. Energy, protein, carbohydrate, iron, and fat intakes were significantly higher in male athletes (P = 0.02), but calcium and folic acid intakes were not significantly different between the sexes, and Vitamin D intake was significantly higher in females (P = 0.01). Systolic and diastolic blood pressure was significantly higher in males (P = 0.04) and heart rate had not significantly different between the sexes (P = 0.09). Heart murmurs and heart sounds in the majority of participants were normal. Conclusion: All the evaluated anthropometric and cardiometabolic parameters were in normal range in the majority of participants. The results showed that dietary intake in these athletes is approximately normal but micronutrients intake status in these athletes needs to be investigated further and longer. PMID:28904935

Sociodemographic and Clinical Characteristics of Centenarians in Mexico City

PubMed Central

Pedro, Valdés-Corchado; Arturo, Ruiz-Hernández; Alejandro, Pérez-Moreno

2017-01-01

Background There is little evidence about the demography and health status of adults aged 100 years and over in Latin America and there are no studies in Mexico. Objectives To describe the demographic characteristics and health status of centenarians residing in Mexico City. Methods This is a cross-sectional study using a population base of 393 community-dwelling centenarians in Mexico City. A comprehensive geriatric assessment was performed, including demographic information and health status. Results The mean age of centenarians was 101.82 ± 2.02 years, of whom 44 (9.1%) were semisupercentenarians (105–109 years old) and 5 (0.2%) were supercentenarians (≥110 years old). The female/male ratio was 3.2 : 1. Twelve (4.5%) reside in nursing homes. Women versus men have unfavorable conditions given their criteria: being without a partner, dependence in 1 or more basic activities, dependence in 1 or more instrumental activities, hypertension, cancer, and Parkinson's disease. Nevertheless, as compared to other populations, Mexican centenarians report having good self-perception of health (78.9%), polypharmacy (17.8%), low rate of pain (11.4%), diabetes (4.8%), and dyslipidemia (1.8%). Conclusions This is the first study in Latin America that describes the social and clinical characteristics of centenarians in Mexico City. This population has a high percentage of malnutrition and osteoarthrosis, a high self-perception of health, low frequency of diabetes, dyslipidemia, cardiovascular disease, and a high frequency of “escapers” (24%). PMID:28904969

The Quadratic Relationship between Socioeconomic Status and Learning Performance in China by Multilevel Analysis: Implications for Policies to Foster Education Equity

ERIC Educational Resources Information Center

Zhao, Ningning; Valcke, Martin; Desoete, Annemie; Verhaeghe, JeanPierre

2012-01-01

The purpose of the present study is to explore the relationship between family socioeconomic status and mathematics performance on the base of a multi-level analysis involving a large sample of Chinese primary school students. A weak relationship is found between socioeconomic status and performance in the Chinese context. The relationship does…

Outcomes in Children Treated with Pentobarbital Infusion for Refractory and Super-Refractory Status Epilepticus.

PubMed

Erklauer, Jennifer; Graf, Jeanine; McPherson, Mona; Anderson, Anne; Wilfong, Angus; Minard, Charles G; Loftis, Laura

2018-03-26

Functional neurologic outcome for children with refractory and super-refractory status epilepticus has not been well defined. Retrospective chart review including children age 0-17 years who received pentobarbital infusion from 2003 to 2016 for status epilepticus. Outcomes were defined in terms of mortality, need for new medical technology assistance at hospital discharge and functional neurologic outcome determined by pediatric cerebral performance category score (PCPC). Potential patient characteristics associated with functional neurologic outcome including age, sex, ethnicity, etiology of the status epilepticus, and duration of pentobarbital infusion were evaluated. Forty children met inclusion criteria. In-hospital mortality was 30% (12/40). Of survivors, 21% (6/28) returned to baseline PCPC while half (14/28) declined in function ≥ 2 PCPC categories at hospital discharge. 25% (7/28) of survivors required tracheostomy and 27% (7/26) required new gastrostomy. Seizures persisted at discharge for most patients with new onset status epilepticus while the majority of patients with known epilepsy returned to baseline seizure frequency. Etiology (p = 0.015), PCPC at admission (p = 0.0006), new tracheostomy (p = 0.012), and new gastrostomy tube (p = 0.012) were associated with increase in PCPC score ≥ 2 categories in univariable analysis. Duration of pentobarbital infusion (p = 0.005) and length of hospital stay (p = 0.056) were longer in patients who demonstrated significant decline in neurologic function. None of these variables maintained statistical significance when multiple logistic regression model adjusting for PCPC score at admission was applied. At long-term follow-up, 36% (8/22) of children demonstrated improvement in PCPC compared to discharge and 23% (5/22) showed deterioration including three additional deaths. Mortality in this population was high. The majority of children experienced some degree of disability at discharge. Despite prolonged pentobarbital infusion, there were cases of survival with good neurologic outcome.

Outcome of acute myeloid leukemia and high-risk myelodysplastic syndrome according to health insurance status.

PubMed

Al-Ameri, Ali; Anand, Ankit; Abdelfatah, Mohamed; Kanaan, Zeyad; Hammonds, Tracy; Haller, Nairmeen; Cherry, Mohamad

2014-12-01

Age, cytogenetic status, and molecular features are the most important prognostic factors in acute myeloid leukemia (AML). This study aimed to analyze the outcomes of patients with AML or high-risk myelodysplastic syndrome (MDS) according to insurance status. A retrospective chart review was performed, covering all patients with AML and high-risk MDS evaluated and treated at Akron General Medical Center between 2002 and 2012. A Cox regression model was analyzed to account for survival over time, adjusted for insurance type, while controlling for patient age at diagnosis and patient risk of mortality. A total of 130 adult patients (age ≥ 18 years) were identified. Insurance information was available for 97 patients enrolled in the study; 3 were excluded because of self-pay status. Cox regression analysis with insurance type as the predictor found that overall survival declines over time and that the rate of decline may be influenced by insurance type (χ(2)(2) = 6.4; P = .044). The likelihood of survival in patients with Medicaid or Medicare without supplemental insurance was .552 (95% CI, .338-.903; P = .018) times the likelihood in patients who had Medicare with supplemental insurance. To explain the difference, variables of age, gender, and risk of mortality were added to the model. Age and risk of mortality were found to be significant predictors of survival. The addition of insurance type to the model did not significantly contribute (χ(2)(3) = 3.83; P = .147). No significant difference in overall survival was observed when patients with AML or high-risk MDS were analyzed according to their health insurance status. The overall survival was low in this study compared with the national average. Early referral to a specialized center or possible clinical trial enrollment may be a good alternative to improve outcome. Copyright © 2014 Elsevier Inc. All rights reserved.

Outcomes of reirradiation in the treatment of patients with multiple brain metastases of solid tumors: a retrospective analysis

PubMed Central

Koc, Mehmet; Kanyilmaz, Gul; Tezcan, Yilmaz

2015-01-01

Background Patients with multiple brain metastases are often treated with whole brain radiation therapy (WBRT). Second course of WBRT is an important treatment option for patients with clinical or radiological intracranial disease progression. This study examines the outcomes in patients with multiple brain metastases who underwent reirradiation. Methods We examined the medical records of 34 patients with multiple brain metastases who were treated WBRT. The median dose for the first course of WBRT was 30 Gy (range, 25–30 Gy) and for the second course 25 Gy (range, 20–30 Gy). Statistical analyses were performed with using Cox regression analyses, log-rank test and Kaplan-Meier method. Results The median Karnofsky performance status (KPS) was 80 (range, 50–100) before reirradiation. Patients with KPS of >70 had a median survival of 11.4 months, compared to 2.2 months with KPS of ≤70 (P=0.012) and patients who have severe symptoms at the time of reirradiation with median survival 2.2 months while those with mild symptoms had a median of 4.8 months survival (P=0.08). The median overall survival for all patients after diagnosis of metastases was 24.7 months, after the re-irradiation WBRT (re-WBRT) it was 5.3 months (95% CI, 4.08–6.62) and from the diagnosis of primary tumor was 27.1 months (95% CI, 17.75–37.04). Conclusions In select patients who have good performance status and who do not have severe symptoms might benefit from re-WBRT and re-WBRT seems to be associated with minimal toxicity in patients treated with lower palliation doses. PMID:26734635

Outcomes of reirradiation in the treatment of patients with multiple brain metastases of solid tumors: a retrospective analysis.

PubMed

Aktan, Meryem; Koc, Mehmet; Kanyilmaz, Gul; Tezcan, Yilmaz

2015-12-01

Patients with multiple brain metastases are often treated with whole brain radiation therapy (WBRT). Second course of WBRT is an important treatment option for patients with clinical or radiological intracranial disease progression. This study examines the outcomes in patients with multiple brain metastases who underwent reirradiation. We examined the medical records of 34 patients with multiple brain metastases who were treated WBRT. The median dose for the first course of WBRT was 30 Gy (range, 25-30 Gy) and for the second course 25 Gy (range, 20-30 Gy). Statistical analyses were performed with using Cox regression analyses, log-rank test and Kaplan-Meier method. The median Karnofsky performance status (KPS) was 80 (range, 50-100) before reirradiation. Patients with KPS of >70 had a median survival of 11.4 months, compared to 2.2 months with KPS of ≤70 (P=0.012) and patients who have severe symptoms at the time of reirradiation with median survival 2.2 months while those with mild symptoms had a median of 4.8 months survival (P=0.08). The median overall survival for all patients after diagnosis of metastases was 24.7 months, after the re-irradiation WBRT (re-WBRT) it was 5.3 months (95% CI, 4.08-6.62) and from the diagnosis of primary tumor was 27.1 months (95% CI, 17.75-37.04). In select patients who have good performance status and who do not have severe symptoms might benefit from re-WBRT and re-WBRT seems to be associated with minimal toxicity in patients treated with lower palliation doses.

Outcomes of Australian patients receiving non-funded anti-PD-1 immune checkpoint inhibitors for non-melanoma cancers.

PubMed

Tiu, Crescens; Wong, Annie; Herschtal, Alan; Mileshkin, Linda

2018-03-01

To characterize the outcomes of patients with nonmelanoma solid tumors receiving anti-PD-1 immunotherapy not funded by the Australian Pharmaceutical Benefits Scheme. Medical records of patients with metastatic nonmelanoma tumor diagnoses treated with anti-PD-1 (self-funded pembrolizumab or nivolumab through an access program) from January 1, 2014, to December 31, 2016, at Peter MacCallum Cancer Centre, were retrospectively reviewed. Events after December 31, 2016, were censored. Of 47 patients identified, 27 (57%) had lung cancer. Twenty-six had compassionate access to nivolumab (24 lung, one renal, one gastroesophageal with possible new lung primary). Median overall survival was 5.7 months. Eleven (23%) achieved a partial response; none had complete response. Twenty (43%) had disease progression on first imaging; 16 (48%) of these continued treatment beyond radiological progression, with three achieving subsequent partial responses. Ten (21%) were not re-staged mostly due to rapid deterioration or death. At 6 and 12 months, nine (20%) and two (4%) remained on treatment, respectively. Five (12%) discontinued treatment due to immune-related toxicities. Of 34 patients who died, 71% received treatment within the last month of life; 38% died in an acute hospital. None of 25 patients with poor Eastern Cooperative Oncology Group performance scores of 2-4 responded. The response rates and overall survival of patients with NSCLC, renal carcinoma and triple negative breast cancer of good performance status receiving anti-PD-1 therapy outside of a clinical trial are consistent with clinical trial data. However, patients with poor ECOG performance status are unlikely to respond. Careful patient selection and counseling about the potential outcomes of self-funding treatment in this setting is needed. © 2018 John Wiley & Sons Australia, Ltd.

Distance from public transportation and physical activity in Japanese older adults: The moderating role of driving status.

PubMed

Harada, Kazuhiro; Lee, Sangyoon; Lee, Sungchul; Bae, Seongryu; Anan, Yuya; Harada, Kenji; Shimada, Hiroyuki

2018-04-01

Although previous studies have shown that good access to public transportation is positively related with physical activity, the moderators of this relationship have not been explored sufficiently in older adults. It is possible that driving status could moderate this relationship. The present study examined whether the objectively measured distance between public transportation and the home was associated with physical activity levels, and whether this association was moderated by driving status among Japanese older adults. In this cross-sectional study, participants (n = 2,878) completed questionnaires and wore accelerometers for at least 7 days, to measure their average daily step counts and minutes spent engaging in moderate-to-vigorous physical activity. Road network distances between the home and the nearest bus stop or train station were measured using geographic information systems. Driving status was assessed using questionnaires. Multiple regression analyses stratified by driving status revealed that, among nondrivers, living further away from public transportation was associated with higher step counts (β = 0.08, p < .001) and moderate-to-vigorous physical activity (β = 0.06, p = .029). Among drivers, living closer to public transportation was significantly associated with higher moderate-to-vigorous physical activity levels (β = -0.05, p = .042). Despite the small effect sizes, the direction of the association between distance from public transportation and physical activity was different for current drivers and nondrivers. These findings imply that good access to public transportation does not positively relate with greater engagement in physical activity among nondriving older adults. Shorter distances to public transportation might reduce opportunities for engaging in physical activity for them. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The use of biotopes in assessing the environmental quality of tidal estuaries in Europe

NASA Astrophysics Data System (ADS)

Ducrotoy, Jean-Paul

2010-02-01

In Europe, the Water Framework Directive (WFD) (European Commission 2000) - and the recently proposed EU Marine Strategy Directive - have established a framework for the protection of groundwater, inland surface waters, estuarine (transitional) waters and coastal waters. TheWFD has several objectives: to prevent water ecosystem deterioration, to protect and to enhance the status of water resources but the most important aspect is to achieve a 'Good Ecological Status' (GES) for all waters, by 2015. In essence, the WFD requires a water body to be compared against a reference condition and then its ecological status designated - if the water body does not meet good or high ecological status, i.e. it is in moderate, poor or bad ecological status, then remedial measures have to be taken (e.g. pollution has to be removed). Many indices were developed from benthic work and are often thought fit for purpose. Based on the successional model proposed by Pearson and Rosenberg (1978), most of these indices were effectively established for soft sediment benthos. However, those developed in the framework of the WFD were derived from work on the subtidal. They are difficult to use in the intertidal and in transitional waters. As they were derived from work on organic pollution, there is no or little evident link with chemical and physical pollution. Ecomorphology brings together a biological approach and a sedimentological approach to estuarine ecology. It considers the use of the biotope and related concepts (biocenosis, bio-facies, ecotone, habitat…) as a basis to a novel approach to environmental quality assessment. It addresses the problem of the estuarine quality paradox in recognising the role of nutrients and organic matter in biogeochemical cycles. The discussion shows the complementarity of biotopes with the Sato-Umi and the ecohydrolgy approaches.

The German Version of the Dutch Eating Behavior Questionnaire: Psychometric Properties, Measurement Invariance, and Population-Based Norms

PubMed Central

Hilbert, Anja; de Zwaan, Martina; Braehler, Elmar; Kersting, Anette

2016-01-01

The Dutch Eating Behavior Questionnaire is an internationally widely used instrument assessing different eating styles that may contribute to weight gain and overweight: emotional eating, external eating, and restraint. This study aimed to evaluate the psychometric properties of the 30-item German version of the DEBQ including its measurement invariance across gender, age, and BMI-status in a representative German population sample. Furthermore, we examined the distribution of eating styles in the general population and provide population-based norms for DEBQ scales. A representative sample of the German general population (N = 2513, age ≥ 14 years) was assessed with the German version of the DEBQ along with information on sociodemographic characteristics and body weight and height. The German version of the DEQB demonstrates good item characteristics and reliability (restraint: α = .92, emotional eating: α = .94, external eating: α = .89). The 3-factor structure of the DEBQ could be replicated in exploratory and confirmatory factor analyses and results of multi-group confirmatory factor analyses supported its metric and scalar measurement invariance across gender, age, and BMI-status. External eating was the most prevalent eating style in the German general population. Women scored higher on emotional and restrained eating scales than men, and overweight individuals scored higher in all three eating styles compared to normal weight individuals. Small differences across age were found for external eating. Norms were provided according to gender, age, and BMI-status. Our findings suggest that the German version of the DEBQ has good reliability and construct validity, and is suitable to reliably measure eating styles across age, gender, and BMI-status. Furthermore, the results demonstrate a considerable variation of eating styles across gender and BMI-status. PMID:27656879

The antioxidant status of coenzyme Q10 and vitamin E in children with type 1 diabetes.

PubMed

Alkholy, Usama M; Abdalmonem, Nermin; Zaki, Ahmed; Elkoumi, Mohamed A; Hashim, Mustafa I Abu; Basset, Maha A A; Salah, Hossam E

2018-02-07

The purpose of this study was to evaluate the antioxidant status of plasma vitamin E and plasma and intracellular coenzyme Q10 in children with type 1 diabetes. This case-control study was conducted on 72 children with type 1 diabetes and compared to 48 healthy children, who were age, sex, and ethnicity-matched. The diabetic children were divided according to their glycosylated hemoglobin (A1c %) into two groups: poor and good glycemic control groups. All children underwent full history taking, clinical examination, and laboratory measurement of complete blood count, A1c %, plasma cholesterol, triglycerides, and vitamin E levels and coenzyme Q10 levels in plasma, erythrocytes, and platelets. Children with poor glycemic control showed significantly higher plasma vitamin E, coenzyme Q10, triglycerides, low-density lipoproteins, waist circumference/height ratio, cholesterol levels, and lower high-density lipoproteins and platelet coenzyme Q10 redox status in comparison to those with good glycemic control and the control group (p<0.05). Plasma coenzyme Q10 showed a positive correlation with the duration of type 1 diabetes, triglycerides, cholesterol, vitamin E, and A1c %, and negative correlation with the age of the diabetic group (p<0.05). The platelet redox status showed a negative correlation with the A1c % levels (r=-0.31; p=0.022) and the duration of type 1 diabetes (r=-0.35, p=0.012). Patients with type 1 diabetes, especially poorly controlled, had elevation of plasma vitamin E and coenzyme Q10 levels and decreased platelet redox status of coenzyme Q10, which may be an indicator of increased oxidative stress. Copyright © 2018 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Impact of Sense of Coherence on Oral Health among Bus Drivers: A Cross-Sectional Study

PubMed Central

Ahmed, Shaik Ijaz; Sudhir, Kudlur Maheswarappa; Reddy, V. Chandra Sekhara; Kumar, R. V. S. Krishna; Srinivasulu, G.; Deepthi, Athuluru

2018-01-01

Aim and Objectives: To assess the sense of coherence (SOC) and the impact of SOC on oral hygiene behaviors and oral health status among bus drivers in Nellore district, Andhra Pradesh. Materials and Methods: A descriptive cross-sectional study was conducted during August–September 2017. Cluster random sampling methodology was used for the selection of drivers. Five depots were randomly selected from the list of various Andhra Pradesh State Road Transport Corporation depots in Nellore district. The estimated sample size was proportionately divided among these five depots of Nellore district (n = 120). The SOC-related data were obtained using short version of Antonovsky's SOC scale. Every item was scored on a Likert scale ranging from 1 to 7. The sum of the scores for SOC was 13–91. A high score indicates a strong SOC. Clinical examination was done for recording oral health status using Oral Hygiene Index-simplified (OHI-S), dental caries, periodontal status, and oral mucosal lesions were recorded according to the WHO criteria 1997. Data were entered and analyzed using SPSS ver. 22 (SPSS Inc., Chicago, IL, USA). Results: Majority of the bus drivers who participated in the study had a low SOC (60%). A significant (P < 0.05) positive correlation was observed with age (r = 0.1420), socioeconomic status (r = 0.1467), and visit to dentist (r = 0.1912). A nonsignificant negative correlation was observed with habits (r = −0.0681), OHI-S (r = −0.0772), dental caries (r = −0.0874), Community Periodontal Index (r = −0.0642), loss of attachment (r = −0.0650), and oral mucosal lesions (r = −0.0542). Conclusion: Strong SOC was associated with increase in age, better socioeconomic status, good habits, increased frequency of dental visits, and a good oral health.

The German Version of the Dutch Eating Behavior Questionnaire: Psychometric Properties, Measurement Invariance, and Population-Based Norms.

PubMed

Nagl, Michaela; Hilbert, Anja; de Zwaan, Martina; Braehler, Elmar; Kersting, Anette

The Dutch Eating Behavior Questionnaire is an internationally widely used instrument assessing different eating styles that may contribute to weight gain and overweight: emotional eating, external eating, and restraint. This study aimed to evaluate the psychometric properties of the 30-item German version of the DEBQ including its measurement invariance across gender, age, and BMI-status in a representative German population sample. Furthermore, we examined the distribution of eating styles in the general population and provide population-based norms for DEBQ scales. A representative sample of the German general population (N = 2513, age ≥ 14 years) was assessed with the German version of the DEBQ along with information on sociodemographic characteristics and body weight and height. The German version of the DEQB demonstrates good item characteristics and reliability (restraint: α = .92, emotional eating: α = .94, external eating: α = .89). The 3-factor structure of the DEBQ could be replicated in exploratory and confirmatory factor analyses and results of multi-group confirmatory factor analyses supported its metric and scalar measurement invariance across gender, age, and BMI-status. External eating was the most prevalent eating style in the German general population. Women scored higher on emotional and restrained eating scales than men, and overweight individuals scored higher in all three eating styles compared to normal weight individuals. Small differences across age were found for external eating. Norms were provided according to gender, age, and BMI-status. Our findings suggest that the German version of the DEBQ has good reliability and construct validity, and is suitable to reliably measure eating styles across age, gender, and BMI-status. Furthermore, the results demonstrate a considerable variation of eating styles across gender and BMI-status.

Floodplain Condition and Water Framework Directive River Classification in England: Evidence of a Disconnect.

NASA Astrophysics Data System (ADS)

Bentley, S.

2017-12-01

The European Union Water Framework Directive came into force in October 2000 committing European Union member states to achieve Good Ecological Status for all water bodies. By 2015 29% of rivers across England had achieved this level suggesting that these watercourse units are now functioning well. This study utilises recently published land cover data for England clipped to the floodplain boundary as defined by the 100 year return period discharge to examine the state of valley bottom vegetation and function for these Good Status rivers. Agricultural use of floodplain areas is high with cereal and horticulture covering an average of 24% and pasture accounting for some 37% of the area. Maximum values increase to 77% and 92% respectively. In all cases wetland accounts for less than 2% of the floodplain and rough grassland averages 7%. Such significant and widespread alteration to floodplain vegetation character suggests that the ecological functioning of this component of the fluvial system has been severely negatively impacted calling into question the Water Framework Directive status level. This is a fault of the Water Framework Directive process which only explicitly evaluates the hydromorphological component of the fluvial system for high status rivers preferring to infer functioning from biological indicators that are focused on in-channel assessments. The fundamental omission of floodplain condition in the Water Framework Directive process will result in only partial achievement of the original goals of the Directive with the majority of Europe's floodplains remaining in a highly degraded, non-functional state.

Perceived oral health status and treatment needs of dental auxiliaries.

PubMed

Azodo, Clement C; Ehizele, Adebola O; Umoh, Agnes; Ojehanon, Patrick I; Akhionbare, Osagie; Okechukwu, Robinson; Igbinosa, Lawrence

2010-03-15

To determine the perceived oral health status and treatment needs of Nigerian dental therapists in training and dental technology students. A descriptive cross-sectional study of students from Federal School of Dental Therapy and Technology Enugu, Nigeria was conducted using self-administered questionnaire to obtain information on demography, self-reported oral health status, knowledge of impact of oral health on daily life activity, dental attendance and perceived dental need. The perception of oral health status and treatment need of the two groups of dental auxiliaries was the same. Fewer respondents (27.3%) rated their oral health as excellent, while 50.4% rated their oral health as good. Majority (95.5%) agreed that oral health is a part of general health and 94.6% agreed that oral health has a role in daily life. Out of 81.4% that had previous dental treatment, scaling and polishing accounted for 66.1%. Presently, 48.8% think they need dental treatment ranging from scaling and polishing (33.9%), tooth restoration (10.3%), to extraction (1.2%). This survey revealed that most of the students are aware that oral health is a component of general health and that it has an impact on an individual's daily life. More than half of the students perceived their oral health as good, but only a few knew that there is a need for a preventive approach to oral health as evident by the percentage that perceived scaling and polishing as a treatment need.

28 CFR 523.10 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-07-01

... TRANSFER COMPUTATION OF SENTENCE Extra Good Time § 523.10 Purpose and scope. (a) The Bureau of Prisons awards extra good time credit for performing exceptionally meritorious service, or for performing duties... of extra good time award at a time (e.g., an inmate earning industrial or camp good time is not...

28 CFR 523.10 - Purpose and scope.

Code of Federal Regulations, 2014 CFR

2014-07-01

... TRANSFER COMPUTATION OF SENTENCE Extra Good Time § 523.10 Purpose and scope. (a) The Bureau of Prisons awards extra good time credit for performing exceptionally meritorious service, or for performing duties... of extra good time award at a time (e.g., an inmate earning industrial or camp good time is not...

28 CFR 523.10 - Purpose and scope.

Code of Federal Regulations, 2011 CFR

2011-07-01

... TRANSFER COMPUTATION OF SENTENCE Extra Good Time § 523.10 Purpose and scope. (a) The Bureau of Prisons awards extra good time credit for performing exceptionally meritorious service, or for performing duties... of extra good time award at a time (e.g., an inmate earning industrial or camp good time is not...