Temporal scaling and spatial statistical analyses of groundwater level fluctuations

NASA Astrophysics Data System (ADS)

Sun, H.; Yuan, L., Sr.; Zhang, Y.

2017-12-01

Natural dynamics such as groundwater level fluctuations can exhibit multifractionality and/or multifractality due likely to multi-scale aquifer heterogeneity and controlling factors, whose statistics requires efficient quantification methods. This study explores multifractionality and non-Gaussian properties in groundwater dynamics expressed by time series of daily level fluctuation at three wells located in the lower Mississippi valley, after removing the seasonal cycle in the temporal scaling and spatial statistical analysis. First, using the time-scale multifractional analysis, a systematic statistical method is developed to analyze groundwater level fluctuations quantified by the time-scale local Hurst exponent (TS-LHE). Results show that the TS-LHE does not remain constant, implying the fractal-scaling behavior changing with time and location. Hence, we can distinguish the potentially location-dependent scaling feature, which may characterize the hydrology dynamic system. Second, spatial statistical analysis shows that the increment of groundwater level fluctuations exhibits a heavy tailed, non-Gaussian distribution, which can be better quantified by a Lévy stable distribution. Monte Carlo simulations of the fluctuation process also show that the linear fractional stable motion model can well depict the transient dynamics (i.e., fractal non-Gaussian property) of groundwater level, while fractional Brownian motion is inadequate to describe natural processes with anomalous dynamics. Analysis of temporal scaling and spatial statistics therefore may provide useful information and quantification to understand further the nature of complex dynamics in hydrology.

Factors Influencing Cecal Intubation Time during Retrograde Approach Single-Balloon Enteroscopy

PubMed Central

Chen, Peng-Jen; Shih, Yu-Lueng; Huang, Hsin-Hung; Hsieh, Tsai-Yuan

2014-01-01

Background and Aim. The predisposing factors for prolonged cecal intubation time (CIT) during colonoscopy have been well identified. However, the factors influencing CIT during retrograde SBE have not been addressed. The aim of this study was to determine the factors influencing CIT during retrograde SBE. Methods. We investigated patients who underwent retrograde SBE at a medical center from January 2011 to March 2014. The medical charts and SBE reports were reviewed. The patients' characteristics and procedure-associated data were recorded. These data were analyzed with univariate analysis as well as multivariate logistic regression analysis to identify the possible predisposing factors. Results. We enrolled 66 patients into this study. The median CIT was 17.4 minutes. With univariate analysis, there was no statistical difference in age, sex, BMI, or history of abdominal surgery, except for bowel preparation (P = 0.021). Multivariate logistic regression analysis showed that inadequate bowel preparation (odds ratio 30.2, 95% confidence interval 4.63–196.54; P < 0.001) was the independent predisposing factors for prolonged CIT during retrograde SBE. Conclusions. For experienced endoscopist, inadequate bowel preparation was the independent predisposing factor for prolonged CIT during retrograde SBE. PMID:25505904

Periapical Status and Quality of Root Canal Fillings in a Moroccan Subpopulation

PubMed Central

El Merini, Hafsa; Lamzawaq, Amine; Hamza, Mouna

2017-01-01

Aim The aim of the study was to assess the prevalence of apical periodontitis (AP) and quality of root canal fillings in an adult Moroccan subpopulation. Methods In the study 508 patients were included, attending the Conservative Dentistry Clinic at the Faculty of Dentistry of Casablanca. 508 panoramic and 709 periapical radiographs were observed. The periapical status of all teeth (with the exception of third molars) was examined according to Ørstavik's periapical index. The statistical analysis was performed with the software Epi Info Version 6.04dfr, April 2001. Results A total of 12719 teeth were examined. 45.3% of patients had apical periodontitis. 4.2% of teeth were treated endodontically and 70.4% of these treatments were inadequate. 91,5% with inadequate endodontic treatment presented apical periodontitis, while only 8,2% with adequate endodontic treatment had apical periodontitis. The lower molars and the upper premolars were the most affected teeth. The presence of apical periodontitis was correlated significantly with insufficient root canal fillings (p < 0.05). Conclusions The present study found a high prevalence of apical periodontitis in this Moroccan population. Inadequate root canal fillings were associated with an increased prevalence of apical periodontitis. PMID:28713425

Beyond P Values and Hypothesis Testing: Using the Minimum Bayes Factor to Teach Statistical Inference in Undergraduate Introductory Statistics Courses

ERIC Educational Resources Information Center

Page, Robert; Satake, Eiki

2017-01-01

While interest in Bayesian statistics has been growing in statistics education, the treatment of the topic is still inadequate in both textbooks and the classroom. Because so many fields of study lead to careers that involve a decision-making process requiring an understanding of Bayesian methods, it is becoming increasingly clear that Bayesian…

Knowledge level of effect size statistics, confidence intervals and meta-analysis in Spanish academic psychologists.

PubMed

Badenes-Ribera, Laura; Frias-Navarro, Dolores; Pascual-Soler, Marcos; Monterde-I-Bort, Héctor

2016-11-01

The statistical reform movement and the American Psychological Association (APA) defend the use of estimators of the effect size and its confidence intervals, as well as the interpretation of the clinical significance of the findings. A survey was conducted in which academic psychologists were asked about their behavior in designing and carrying out their studies. The sample was composed of 472 participants (45.8% men). The mean number of years as a university professor was 13.56 years (SD= 9.27). The use of effect-size estimators is becoming generalized, as well as the consideration of meta-analytic studies. However, several inadequate practices still persist. A traditional model of methodological behavior based on statistical significance tests is maintained, based on the predominance of Cohen’s d and the unadjusted R2/η2, which are not immune to outliers or departure from normality and the violations of statistical assumptions, and the under-reporting of confidence intervals of effect-size statistics. The paper concludes with recommendations for improving statistical practice.

Towards Principled Experimental Study of Autonomous Mobile Robots

NASA Technical Reports Server (NTRS)

Gat, Erann

1995-01-01

We review the current state of research in autonomous mobile robots and conclude that there is an inadequate basis for predicting the reliability and behavior of robots operating in unengineered environments. We present a new approach to the study of autonomous mobile robot performance based on formal statistical analysis of independently reproducible experiments conducted on real robots. Simulators serve as models rather than experimental surrogates. We demonstrate three new results: 1) Two commonly used performance metrics (time and distance) are not as well correlated as is often tacitly assumed. 2) The probability distributions of these performance metrics are exponential rather than normal, and 3) a modular, object-oriented simulation accurately predicts the behavior of the real robot in a statistically significant manner.

Are Psychology Students Getting Worse at Math?: Trends in the Math Skills of Psychology Statistics Students across 21 Years

ERIC Educational Resources Information Center

Carpenter, Thomas P.; Kirk, Roger E.

2017-01-01

Statistics is an important subject in psychology and social science education. However, inadequate mathematical skills can pose a barrier to learning statistics. Some educators have suggested that students' math skills are declining. The present research examined trends in the math skills of psychology undergraduates across 21 years. Students…

Addressing Economic Development Goals through Innovative Teaching of University Statistics: A Case Study of Statistical Modelling in Nigeria

ERIC Educational Resources Information Center

Ezepue, Patrick Oseloka; Ojo, Adegbola

2012-01-01

A challenging problem in some developing countries such as Nigeria is inadequate training of students in effective problem solving using the core concepts of their disciplines. Related to this is a disconnection between their learning and socio-economic development agenda of a country. These problems are more vivid in statistical education which…

Should Social Workers Use "Diagnostic and Statistical Manual of Mental Disorders-5?"

ERIC Educational Resources Information Center

Frances, Allen; Jones, K. Dayle

2014-01-01

Up until now, social workers have depended on the "Diagnostic and Statistical Manual of Mental Disorders" ("DSM") as the primary diagnostic classification for mental disorders. However, the "DSM-5" revision includes scientifically unfounded, inadequately tested, and potentially dangerous diagnoses that may lead them…

The effects of vortioxetine on cognitive dysfunction in patients with inadequate response to current antidepressants in major depressive disorder: A short-term, randomized, double-blind, exploratory study versus escitalopram.

PubMed

Vieta, Eduard; Sluth, Lasse B; Olsen, Christina K

2018-02-01

Major Depressive Disorder (MDD) is a heterogeneous disease characterized by emotional, physical and cognitive symptoms. This study explored the effects of vortioxetine versus escitalopram on outcomes of cognition, functioning and mood symptoms in depressed patients with inadequate response to current antidepressant treatment. In this parallel-group, active-comparator study, adult patients (18-65 years, N = 101) with MDD, with inadequate response to current antidepressant monotherapy, were randomized 1:1 to 8 weeks' double-blind treatment with flexible doses (10-20mg/day) of either vortioxetine or escitalopram. Primary and key secondary efficacy measures were the Digit Symbol Substitution Test (DSST), analyzed using a mixed model for repeated measurements, and the University of San Diego Performance-based Skills Assessment - Brief (UPSA-B), analyzed using analysis of covariance (last observation carried forward method). At week 8, DSST and UPSA-B performance had improved in both treatment groups, with no statistically significant treatment differences. Numerical improvements across measures of cognition, functioning and mood symptoms generally favored vortioxetine. Most adverse events were mild or moderate, with nausea being the most common adverse event. This was an exploratory study with small sample sizes implying limited statistical power. Although this explorative study did not meet primary endpoints, the results confirm vortioxetine in doses of 10-20mg/day as an efficacious and well-tolerated antidepressant switch treatment. The overall direction of numerical effect sizes across cognition endpoints support previous findings that vortioxetine specifically benefits cognitive function in MDD. Copyright © 2017 H Lundbeck A/S. Published by Elsevier B.V. All rights reserved.

Good experimental design and statistics can save animals, but how can it be promoted?

PubMed

Festing, Michael F W

2004-06-01

Surveys of published papers show that there are many errors both in the design of the experiments and in the statistical analysis of the resulting data. This must result in a waste of animals and scientific resources, and it is surely unethical. Scientific quality might be improved, to some extent, by journal editors, but they are constrained by lack of statistical referees and inadequate statistical training of those referees that they do use. Other parties, such as welfare regulators, ethical review committees and individual scientists also have an interest in scientific quality, but they do not seem to be well placed to make the required changes. However, those who fund research would have the power to do something if they could be convinced that it is in their best interests to do so. More examples of the way in which better experimental design has led to improved experiments would be helpful in persuading these funding organisations to take further action.

The association between inadequate gestational weight gain and infant mortality among U.S. infants born in 2002.

PubMed

Davis, Regina R; Hofferth, Sandra L

2012-01-01

The purpose of this study was to determine the relative importance of inadequate gestational weight gain as a cause of infant mortality. Birth and infant death certificate data were obtained from a random sample of 100,000 records from the National Center for Health Statistics (NCHS) 2002 Birth Cohort Linked Birth/Infant Death Data File. Descriptive and proportional hazards regression analyses were used to assess the odds of infant mortality associated with inadequate gestational weight gain compared to normal weight gain. Nearly 30% of women experienced inadequate weight gain. Infants born to women with inadequate gestational weight gain had odds of infant death that were 2.23 times the odds for infants born to women with normal weight gain. Increased odds remained after adjustment for gestational age, low birth weight, maternal age, maternal education, and maternal race. Among racial or ethnic subgroups, African American women were 1.3 times as likely as white women to have an infant die, but they were no more likely to have an infant die than white women if they had inadequate weight gain. There is a substantial and significant association between inadequate gestational weight gain and infant death that does not differ by race, ethnic group membership, or maternal age.

The Ontology of Biological and Clinical Statistics (OBCS) for standardized and reproducible statistical analysis.

PubMed

Zheng, Jie; Harris, Marcelline R; Masci, Anna Maria; Lin, Yu; Hero, Alfred; Smith, Barry; He, Yongqun

2016-09-14

Statistics play a critical role in biological and clinical research. However, most reports of scientific results in the published literature make it difficult for the reader to reproduce the statistical analyses performed in achieving those results because they provide inadequate documentation of the statistical tests and algorithms applied. The Ontology of Biological and Clinical Statistics (OBCS) is put forward here as a step towards solving this problem. The terms in OBCS including 'data collection', 'data transformation in statistics', 'data visualization', 'statistical data analysis', and 'drawing a conclusion based on data', cover the major types of statistical processes used in basic biological research and clinical outcome studies. OBCS is aligned with the Basic Formal Ontology (BFO) and extends the Ontology of Biomedical Investigations (OBI), an OBO (Open Biological and Biomedical Ontologies) Foundry ontology supported by over 20 research communities. Currently, OBCS comprehends 878 terms, representing 20 BFO classes, 403 OBI classes, 229 OBCS specific classes, and 122 classes imported from ten other OBO ontologies. We discuss two examples illustrating how the ontology is being applied. In the first (biological) use case, we describe how OBCS was applied to represent the high throughput microarray data analysis of immunological transcriptional profiles in human subjects vaccinated with an influenza vaccine. In the second (clinical outcomes) use case, we applied OBCS to represent the processing of electronic health care data to determine the associations between hospital staffing levels and patient mortality. Our case studies were designed to show how OBCS can be used for the consistent representation of statistical analysis pipelines under two different research paradigms. Other ongoing projects using OBCS for statistical data processing are also discussed. The OBCS source code and documentation are available at: https://github.com/obcs/obcs . The Ontology of Biological and Clinical Statistics (OBCS) is a community-based open source ontology in the domain of biological and clinical statistics. OBCS is a timely ontology that represents statistics-related terms and their relations in a rigorous fashion, facilitates standard data analysis and integration, and supports reproducible biological and clinical research.

Identifying biologically relevant differences between metagenomic communities.

PubMed

Parks, Donovan H; Beiko, Robert G

2010-03-15

Metagenomics is the study of genetic material recovered directly from environmental samples. Taxonomic and functional differences between metagenomic samples can highlight the influence of ecological factors on patterns of microbial life in a wide range of habitats. Statistical hypothesis tests can help us distinguish ecological influences from sampling artifacts, but knowledge of only the P-value from a statistical hypothesis test is insufficient to make inferences about biological relevance. Current reporting practices for pairwise comparative metagenomics are inadequate, and better tools are needed for comparative metagenomic analysis. We have developed a new software package, STAMP, for comparative metagenomics that supports best practices in analysis and reporting. Examination of a pair of iron mine metagenomes demonstrates that deeper biological insights can be gained using statistical techniques available in our software. An analysis of the functional potential of 'Candidatus Accumulibacter phosphatis' in two enhanced biological phosphorus removal metagenomes identified several subsystems that differ between the A.phosphatis stains in these related communities, including phosphate metabolism, secretion and metal transport. Python source code and binaries are freely available from our website at http://kiwi.cs.dal.ca/Software/STAMP CONTACT: beiko@cs.dal.ca Supplementary data are available at Bioinformatics online.

Efficacy and safety of ginger in osteoarthritis patients: a meta-analysis of randomized placebo-controlled trials.

PubMed

Bartels, E M; Folmer, V N; Bliddal, H; Altman, R D; Juhl, C; Tarp, S; Zhang, W; Christensen, R

2015-01-01

The aim of this study was to assess the clinical efficacy and safety of oral ginger for symptomatic treatment of osteoarthritis (OA) by carrying out a systematic literature search followed by meta-analyses on selected studies. Inclusion criteria were randomized controlled trials (RCTs) comparing oral ginger treatment with placebo in OA patients aged >18 years. Outcomes were reduction in pain and reduction in disability. Harm was assessed as withdrawals due to adverse events. The efficacy effect size was estimated using Hedges' standardized mean difference (SMD), and safety by risk ratio (RR). Standard random-effects meta-analysis was used, and inconsistency was evaluated by the I-squared index (I(2)). Out of 122 retrieved references, 117 were discarded, leaving five trials (593 patients) for meta-analyses. The majority reported relevant randomization procedures and blinding, but an inadequate intention-to-treat (ITT) analysis. Following ginger intake, a statistically significant pain reduction SMD = -0.30 ([95% CI: [(-0.50, -0.09)], P = 0.005]) with a low degree of inconsistency among trials (I(2) = 27%), and a statistically significant reduction in disability SMD = -0.22 ([95% CI: ([-0.39, -0.04)]; P = 0.01; I(2) = 0%]) were seen, both in favor of ginger. Patients given ginger were more than twice as likely to discontinue treatment compared to placebo ([RR = 2.33; 95% CI: (1.04, 5.22)]; P = 0.04; I(2) = 0%]). Ginger was modestly efficacious and reasonably safe for treatment of OA. We judged the evidence to be of moderate quality, based on the small number of participants and inadequate ITT populations. Prospero: CRD42011001777. Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

To Evaluate & Compare Retention of Complete Cast Crown in Natural Teeth Using Different Auxiliary Retentive Features with Two Different Crown Heights - An In Vitro Study.

PubMed

Vinaya, Kundapur; Rakshith, Hegde; Prasad D, Krishna; Manoj, Shetty; Sunil, Mankar; Naresh, Shetty

2015-06-01

To evaluate the retention of complete cast crowns in teeth with adequate and inadequate crown height and to evaluate the effects of auxiliary retentive features on retention form complete cast crowns. Sixty freshly extracted human premolars. They were divided into 2 major groups depending upon the height of the teeth after the preparation. Group1 (H1): prepared teeth with constant height of 3.5 mm and Group 2 (H2): prepared teeth with constant height of 2.5 mm. Each group is further subdivided into 3 subgroups, depending upon the retentive features incorporated. First sub group were prepared conventionally, second sub group with proximal grooves and third subgroups with proximal boxes preparation. Castings produced in Nickel chromium alloy were cemented with glass ionomer cement and the cemented castings were subjected to tensional forces required to dislodge each cemented casting from its preparation and used for comparison of retentive quality. The data obtained were statistically analyzed using Oneway ANOVA test. The results showed there was statistically significant difference between adequate (H1) and inadequate (H2) group and increase in retention when there was incorporation of retentive features compared to conventional preparations. Incorporation of retentive grooves was statistically significant compared to retention obtained by boxes. Results also showed there was no statistically significant difference between long conventional and short groove. Complete cast crowns on teeth with adequate crown height exhibited greater retention than with inadequate crown height. Proximal grooves provided greater amount of retention when compared with proximal boxes.

The Statistical Consulting Center for Astronomy (SCCA)

NASA Technical Reports Server (NTRS)

Akritas, Michael

2001-01-01

The process by which raw astronomical data acquisition is transformed into scientifically meaningful results and interpretation typically involves many statistical steps. Traditional astronomy limits itself to a narrow range of old and familiar statistical methods: means and standard deviations; least-squares methods like chi(sup 2) minimization; and simple nonparametric procedures such as the Kolmogorov-Smirnov tests. These tools are often inadequate for the complex problems and datasets under investigations, and recent years have witnessed an increased usage of maximum-likelihood, survival analysis, multivariate analysis, wavelet and advanced time-series methods. The Statistical Consulting Center for Astronomy (SCCA) assisted astronomers with the use of sophisticated tools, and to match these tools with specific problems. The SCCA operated with two professors of statistics and a professor of astronomy working together. Questions were received by e-mail, and were discussed in detail with the questioner. Summaries of those questions and answers leading to new approaches were posted on the Web (www.state.psu.edu/ mga/SCCA). In addition to serving individual astronomers, the SCCA established a Web site for general use that provides hypertext links to selected on-line public-domain statistical software and services. The StatCodes site (www.astro.psu.edu/statcodes) provides over 200 links in the areas of: Bayesian statistics; censored and truncated data; correlation and regression, density estimation and smoothing, general statistics packages and information; image analysis; interactive Web tools; multivariate analysis; multivariate clustering and classification; nonparametric analysis; software written by astronomers; spatial statistics; statistical distributions; time series analysis; and visualization tools. StatCodes has received a remarkable high and constant hit rate of 250 hits/week (over 10,000/year) since its inception in mid-1997. It is of interest to scientists both within and outside of astronomy. The most popular sections are multivariate techniques, image analysis, and time series analysis. Hundreds of copies of the ASURV, SLOPES and CENS-TAU codes developed by SCCA scientists were also downloaded from the StatCodes site. In addition to formal SCCA duties, SCCA scientists continued a variety of related activities in astrostatistics, including refereeing of statistically oriented papers submitted to the Astrophysical Journal, talks in meetings including Feigelson's talk to science journalists entitled "The reemergence of astrostatistics" at the American Association for the Advancement of Science meeting, and published papers of astrostatistical content.

The Hanford Thyroid Disease Study: an alternative view of the findings.

PubMed

Hoffman, F Owen; Ruttenber, A James; Apostoaei, A Iulian; Carroll, Raymond J; Greenland, Sander

2007-02-01

The Hanford Thyroid Disease Study (HTDS) is one of the largest and most complex epidemiologic studies of the relation between environmental exposures to I and thyroid disease. The study detected no dose-response relation using a 0.05 level for statistical significance. The results for thyroid cancer appear inconsistent with those from other studies of populations with similar exposures, and either reflect inadequate statistical power, bias, or unique relations between exposure and disease risk. In this paper, we explore these possibilities, and present evidence that the HTDS statistical power was inadequate due to complex uncertainties associated with the mathematical models and assumptions used to reconstruct individual doses. We conclude that, at the very least, the confidence intervals reported by the HTDS for thyroid cancer and other thyroid diseases are too narrow because they fail to reflect key uncertainties in the measurement-error structure. We recommend that the HTDS results be interpreted as inconclusive rather than as evidence for little or no disease risk from Hanford exposures.

Beyond the Sticker Price: A Closer Look at Canadian University Tuition Fees

ERIC Educational Resources Information Center

Usher, Alex

2006-01-01

At some point every August, Statistics Canada releases its annual tuition fee report. Statistics Canada's numbers are accurate, so far as they go. The weighted provincial and national fee totals accurately reflect the amount of tuition charged by institution. And yet, the tuition report is at the same time a completely inadequate tool for…

Imaging mass spectrometry statistical analysis.

PubMed

Jones, Emrys A; Deininger, Sören-Oliver; Hogendoorn, Pancras C W; Deelder, André M; McDonnell, Liam A

2012-08-30

Imaging mass spectrometry is increasingly used to identify new candidate biomarkers. This clinical application of imaging mass spectrometry is highly multidisciplinary: expertise in mass spectrometry is necessary to acquire high quality data, histology is required to accurately label the origin of each pixel's mass spectrum, disease biology is necessary to understand the potential meaning of the imaging mass spectrometry results, and statistics to assess the confidence of any findings. Imaging mass spectrometry data analysis is further complicated because of the unique nature of the data (within the mass spectrometry field); several of the assumptions implicit in the analysis of LC-MS/profiling datasets are not applicable to imaging. The very large size of imaging datasets and the reporting of many data analysis routines, combined with inadequate training and accessible reviews, have exacerbated this problem. In this paper we provide an accessible review of the nature of imaging data and the different strategies by which the data may be analyzed. Particular attention is paid to the assumptions of the data analysis routines to ensure that the reader is apprised of their correct usage in imaging mass spectrometry research. Copyright © 2012 Elsevier B.V. All rights reserved.

Effects of low income on infant health.

PubMed

Séguin, Louise; Xu, Qian; Potvin, Louise; Zunzunegui, Maria-Victoria; Frohlich, Katherine L

2003-06-10

Few population-based studies have analyzed the link between poverty and infant morbidity. In this study, we wanted to determine whether inadequate income itself has an impact on infant health. We interviewed 2223 mothers of 5-month-old children participating in the 1998 phase of the Quebec Longitudinal Study of Child Development to determine their infant's health and the sociodemographic characteristics of the household (including household income, breast-feeding and the smoking habits of the mother). Data on the health of the infants at birth were taken from medical records. We examined the effects of household income using Statistics Canada definitions of sufficient (above the low-income threshold), moderately inadequate (between 60% and 99% of the low-income threshold) and inadequate (below 60% of the low-income threshold) income on the mother's assessment of her child's overall health, her report of her infant's chronic health problems and her report of the number of times, if any, her child had been admitted to hospital since birth. In the analysis, we controlled for factors known to affect infant health: infant characteristics and neonatal health problems, the mother's level of education, the presence or absence of a partner, the duration of breast-feeding and the mother's smoking status. Compared with infants in households with sufficient incomes, those in households with lower incomes were more likely to be judged by their mothers to be in less than excellent health (moderately inadequate incomes: adjusted odds ratio [OR] 1.5, 95% confidence interval [CI] 1.1-2.1; very inadequate incomes: adjusted OR 1.8, 95% CI 1.3-2.6). Infants in households with moderately inadequate incomes were more likely to have been admitted to hospital (adjusted OR 1.8, 95% CI 1.2-2.6) than those in households with sufficient incomes, but the same was not true of infants in households with very inadequate incomes (adjusted OR 0.7, 95% CI 0.4-1.2). Household income did not significantly affect the likelihood of an infant having chronic health problems. Less than sufficient household incomes are associated with poorer overall health and higher hospital admission rates among infants in the first 5 months of life, even after adjustment for factors known to affect infant health, including the mother's level of education.

Pilot personality and crew coordination - Implications for training and selection

NASA Technical Reports Server (NTRS)

Chidester, Thomas R.; Helmreich, Robert L.; Gregorich, Steven E.; Geis, Craig E.

1991-01-01

It is contended that past failures to find linkages between performance and personality were due to a combination of premature performance evaluation, inadequate statistical modeling, and/or the reliance on data gathered in contrived as opposed to realistic situations. The goal of the research presented is to isolate subgroups of pilots along performance-related personality dimensions and to document limits on the impact of crew coordination training between the groups. Three different profiles were identified through cluster analysis of personality scales that replicated across samples and predicted attitude change following training in crew coordination.

A change in humidification system can eliminate endotracheal tube occlusion.

PubMed

Doyle, Alex; Joshi, Manasi; Frank, Peter; Craven, Thomas; Moondi, Parvez; Young, Peter

2011-12-01

Inadequate airway humidification can result in endotracheal tube occlusion. There is evidence that heat and moisture exchangers (HMEs) are more prone to endotracheal tube occlusion than heated humidifiers (HHs) that contain a heated wire circuit. We aimed to compare the incidence of endotracheal tube occlusion while introducing a new dual-heated wire circuit HH in place of an established hydrophobic HME. This was a prospective observational study. All patients who required intubation were included in our analysis. Univariate statistical analysis was performed using a Fisher exact test. P < .05 was considered statistically significant. There were 158 patients in the HME group and 88 patients in the HH group. The incidence of endotracheal tube occlusion was 5.7% in the HME group and 0% in the HH group. Statistical analysis revealed a significant difference between the 2 groups (P = .02). In light of this finding, we changed our practice to provide humidification exclusively by HH. In the subsequent 18-month period, there were no further episodes of endotracheal tube occlusion. Our study demonstrates that there is a significant increase in the incidence of endotracheal tube occlusion when using a hydrophobic HME compared with an HH and that using a dual-heated wire circuit HH can eliminate endotracheal tube occlusion. Copyright © 2011 Elsevier Inc. All rights reserved.

Statistical Methodology for the Analysis of Repeated Duration Data in Behavioral Studies.

PubMed

Letué, Frédérique; Martinez, Marie-José; Samson, Adeline; Vilain, Anne; Vilain, Coriandre

2018-03-15

Repeated duration data are frequently used in behavioral studies. Classical linear or log-linear mixed models are often inadequate to analyze such data, because they usually consist of nonnegative and skew-distributed variables. Therefore, we recommend use of a statistical methodology specific to duration data. We propose a methodology based on Cox mixed models and written under the R language. This semiparametric model is indeed flexible enough to fit duration data. To compare log-linear and Cox mixed models in terms of goodness-of-fit on real data sets, we also provide a procedure based on simulations and quantile-quantile plots. We present two examples from a data set of speech and gesture interactions, which illustrate the limitations of linear and log-linear mixed models, as compared to Cox models. The linear models are not validated on our data, whereas Cox models are. Moreover, in the second example, the Cox model exhibits a significant effect that the linear model does not. We provide methods to select the best-fitting models for repeated duration data and to compare statistical methodologies. In this study, we show that Cox models are best suited to the analysis of our data set.

Priority of VHS Development Based in Potential Area using Principal Component Analysis

NASA Astrophysics Data System (ADS)

Meirawan, D.; Ana, A.; Saripudin, S.

2018-02-01

The current condition of VHS is still inadequate in quality, quantity and relevance. The purpose of this research is to analyse the development of VHS based on the development of regional potential by using principal component analysis (PCA) in Bandung, Indonesia. This study used descriptive qualitative data analysis using the principle of secondary data reduction component. The method used is Principal Component Analysis (PCA) analysis with Minitab Statistics Software tool. The results of this study indicate the value of the lowest requirement is a priority of the construction of development VHS with a program of majors in accordance with the development of regional potential. Based on the PCA score found that the main priority in the development of VHS in Bandung is in Saguling, which has the lowest PCA value of 416.92 in area 1, Cihampelas with the lowest PCA value in region 2 and Padalarang with the lowest PCA value.

Design and control strategies for CELSS - Integrating mechanistic paradigms and biological complexities

NASA Technical Reports Server (NTRS)

Moore, B., III; Kaufmann, R.; Reinhold, C.

1981-01-01

Systems analysis and control theory consideration are given to simulations of both individual components and total systems, in order to develop a reliable control strategy for a Controlled Ecological Life Support System (CELSS) which includes complex biological components. Because of the numerous nonlinearities and tight coupling within the biological component, classical control theory may be inadequate and the statistical analysis of factorial experiments more useful. The range in control characteristics of particular species may simplify the overall task by providing an appropriate balance of stability and controllability to match species function in the overall design. The ultimate goal of this research is the coordination of biological and mechanical subsystems in order to achieve a self-supporting environment.

Factors associated with an inadequate hypoglycemia in the insulin tolerance test in Japanese patients with suspected or proven hypopituitarism.

PubMed

Takahashi, Kiyohiko; Nakamura, Akinobu; Miyoshi, Hideaki; Nomoto, Hiroshi; Kameda, Hiraku; Cho, Kyu Yong; Nagai, So; Shimizu, Chikara; Taguri, Masataka; Terauchi, Yasuo; Atsumi, Tatsuya

2017-04-29

We attempted to identify the predictors of an inadequate hypoglycemia in insulin tolerance test (ITT), defined as a blood glucose level higher than 2.8 mmol/L after insulin injection, in Japanese patients with suspected or proven hypopituitarism. A total of 78 patients who had undergone ITT were divided into adequate and inadequate hypoglycemia groups. The relationships between the subjects' clinical parameters and inadequate hypoglycemia in ITT were analyzed. Stepwise logistic regression analysis identified high systolic blood pressure (SBP) and high homeostasis model assessment of insulin resistance (HOMA-IR) as being independent factors associated with inadequate hypoglycemia in ITT. Receiver operating characteristic (ROC) curve analysis revealed the cutoff value for inadequate hypoglycemia was 109 mmHg for SBP and 1.4 for HOMA-IR. The areas under ROC curve for SBP and HOMA-IR were 0.72 and 0.86, respectively. We confirmed that high values of SBP and HOMA-IR were associated with inadequate hypoglycemia in ITT, regardless of the degree of reduction of pituitary hormone levels. Furthermore, the strongest predictor of inadequate hypoglycemia was obtained by using the cutoff value of HOMA-IR. Our results suggest that HOMA-IR is a useful pre-screening tool for ITT in these populations.

9 CFR 417.6 - Inadequate HACCP Systems.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Inadequate HACCP Systems. 417.6 Section 417.6 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... ANALYSIS AND CRITICAL CONTROL POINT (HACCP) SYSTEMS § 417.6 Inadequate HACCP Systems. A HACCP system may be...

9 CFR 417.6 - Inadequate HACCP Systems.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Inadequate HACCP Systems. 417.6 Section 417.6 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... ANALYSIS AND CRITICAL CONTROL POINT (HACCP) SYSTEMS § 417.6 Inadequate HACCP Systems. A HACCP system may be...

9 CFR 417.6 - Inadequate HACCP Systems.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Inadequate HACCP Systems. 417.6 Section 417.6 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... ANALYSIS AND CRITICAL CONTROL POINT (HACCP) SYSTEMS § 417.6 Inadequate HACCP Systems. A HACCP system may be...

9 CFR 417.6 - Inadequate HACCP Systems.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Inadequate HACCP Systems. 417.6 Section 417.6 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... ANALYSIS AND CRITICAL CONTROL POINT (HACCP) SYSTEMS § 417.6 Inadequate HACCP Systems. A HACCP system may be...

9 CFR 417.6 - Inadequate HACCP Systems.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Inadequate HACCP Systems. 417.6 Section 417.6 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... ANALYSIS AND CRITICAL CONTROL POINT (HACCP) SYSTEMS § 417.6 Inadequate HACCP Systems. A HACCP system may be...

Quantum probability, choice in large worlds, and the statistical structure of reality.

PubMed

Ross, Don; Ladyman, James

2013-06-01

Classical probability models of incentive response are inadequate in "large worlds," where the dimensions of relative risk and the dimensions of similarity in outcome comparisons typically differ. Quantum probability models for choice in large worlds may be motivated pragmatically - there is no third theory - or metaphysically: statistical processing in the brain adapts to the true scale-relative structure of the universe.

Access to childbirth care by adolescents and young people in the Northeastern region of Brazil

PubMed Central

Furtado, Érida Zoé Lustosa; Gomes, Keila Rejane Oliveira; da Gama, Silvana Granado Nogueira

2016-01-01

ABSTRACT OBJECTIVE To identify the factors that interfere with the access of adolescents and young people to childbirth care for in the Northeast region of Brazil. METHODS Cross-sectional study with 3,014 adolescents and young people admitted to the selected maternity wards to give birth in the Northeast region of Brazil. The sample design was probabilistic, in two stages: the first corresponded to the health establishments and the second to women who had recently given birth and their babies. The data was collected by means of interviews and consulting the hospital records, from pre-tested electronic form. Descriptive statistics were used for the univariate analysis, Pearson’s Chi-square test for the bivariate analysis and multiple logistic regressions for the multivariate analysis. Sociodemographic variables, obstetrical history, and birth care were analyzed. RESULTS Half of the adolescents and young people interviewed had not been given guidance on the location that they should go to when in labor, and among those who had, 23.5% did not give birth in the indicated health service. Furthermore, one third (33.3%) had to travel in search of assisted birth, and the majority (66.7%) of the postpartum women came to maternity by their own means. In the bivariate analysis, the variables marital status, paid work, health insurance, number of previous pregnancies, parity, city location, and type of health establishment showed a significant association (p < 0.20) with inadequate access to childbirth care. The multivariate analysis showed that married adolescents and young people (p < 0.015), with no health insurance (p < 0.002) and from the countryside (p < 0.001) were more likely to have inadequate access to childbirth care. CONCLUSIONS Adolescents and young women, married, without health insurance, and from the countryside are more likely to have inadequate access to birth care. The articulation between outpatient care and birth care can improve this access and, consequently, minimize the maternal and fetal risks that arise from a lack of systematic hospitalization planning. PMID:27253899

Ultrasonic test of resistance spot welds based on wavelet package analysis.

PubMed

Liu, Jing; Xu, Guocheng; Gu, Xiaopeng; Zhou, Guanghao

2015-02-01

In this paper, ultrasonic test of spot welds for stainless steel sheets has been studied. It is indicated that traditional ultrasonic signal analysis in either time domain or frequency domain remains inadequate to evaluate the nugget diameter of spot welds. However, the method based on wavelet package analysis in time-frequency domain can easily distinguish the nugget from the corona bond by extracting high-frequency signals in different positions of spot welds, thereby quantitatively evaluating the nugget diameter. The results of ultrasonic test fit the actual measured value well. Mean value of normal distribution of error statistics is 0.00187, and the standard deviation is 0.1392. Furthermore, the quality of spot welds was evaluated, and it is showed ultrasonic nondestructive test based on wavelet packet analysis can be used to evaluate the quality of spot welds, and it is more reliable than single tensile destructive test. Copyright © 2014 Elsevier B.V. All rights reserved.

Nutritional status and food intake in patients with systemic lupus erythematosus.

PubMed

Borges, Mariane Curado; dos Santos, Fabiana de Miranda Moura; Telles, Rosa Weiss; Lanna, Cristina Costa Duarte; Correia, Maria Isabel T D

2012-01-01

Systemic inflammation, therapy with corticosteroids, and reduced physical activity may increase the predisposition to accumulate body fat in patients with systemic lupus erythematosus (SLE). The aim of this study was to assess the nutritional status and food intake of patients with SLE. One hundred seventy women with SLE were evaluated consecutively in a cross-sectional study. Nutritional status was assessed by subjective global assessment and body mass index. Food intake was assessed by a 24-h recall and a semiquantitative food frequency questionnaire. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS), considering P < 0.05 as significant. The mean ± SD age of the patients was 39.14 ± 9.98 y, and the duration of the disease was 9.94 ± 6.18 y. Approximately 91.8% patients were classified as being well nourished; 6.5% were classified as suspected or moderately malnourished, and 1.8% were classified as severely malnourished. In terms of body mass index, malnutrition was found in 1.2% of the patients, normal weight in 35.9%, overweight in 35.3%, and obesity in 27.7%. Most patients reported food consumption below the estimated needs for energy. Calcium was the nutrient with the most inadequate intake. Low consumption of fruits, vegetables, and dairy products and a high consumption of oils and fats were reported. The results showed that patients with SLE have inadequate nutritional status and food intake. Copyright © 2012 Elsevier Inc. All rights reserved.

Sample size in psychological research over the past 30 years.

PubMed

Marszalek, Jacob M; Barber, Carolyn; Kohlhart, Julie; Holmes, Cooper B

2011-04-01

The American Psychological Association (APA) Task Force on Statistical Inference was formed in 1996 in response to a growing body of research demonstrating methodological issues that threatened the credibility of psychological research, and made recommendations to address them. One issue was the small, even dramatically inadequate, size of samples used in studies published by leading journals. The present study assessed the progress made since the Task Force's final report in 1999. Sample sizes reported in four leading APA journals in 1955, 1977, 1995, and 2006 were compared using nonparametric statistics, while data from the last two waves were fit to a hierarchical generalized linear growth model for more in-depth analysis. Overall, results indicate that the recommendations for increasing sample sizes have not been integrated in core psychological research, although results slightly vary by field. This and other implications are discussed in the context of current methodological critique and practice.

Methotrexate monotherapy and methotrexate combination therapy with traditional and biologic disease modifying antirheumatic drugs for rheumatoid arthritis: abridged Cochrane systematic review and network meta-analysis

PubMed Central

Barnabe, Cheryl; Tomlinson, George; Marshall, Deborah; Devoe, Dan; Bombardier, Claire

2016-01-01

Objective To compare methotrexate based disease modifying antirheumatic drug (DMARD) treatments for rheumatoid arthritis in patients naive to or with an inadequate response to methotrexate. Design Systematic review and Bayesian random effects network meta-analysis of trials assessing methotrexate used alone or in combination with other conventional synthetic DMARDs, biologic drugs, or tofacitinib in adult patients with rheumatoid arthritis. Data sources Trials were identified from Medline, Embase, and Central databases from inception to 19 January 2016; abstracts from two major rheumatology meetings from 2009 to 2015; two trial registers; and hand searches of Cochrane reviews. Study selection criteria Randomized or quasi-randomized trials that compared methotrexate with any other DMARD or combination of DMARDs and contributed to the network of evidence between the treatments of interest. Main outcomes American College of Rheumatology (ACR) 50 response (major clinical improvement), radiographic progression, and withdrawals due to adverse events. A comparison between two treatments was considered statistically significant if its credible interval excluded the null effect, indicating >97.5% probability that one treatment was superior. Results 158 trials were included, with between 10 and 53 trials available for each outcome. In methotrexate naive patients, several treatments were statistically superior to oral methotrexate for ACR50 response: sulfasalazine and hydroxychloroquine (“triple therapy”), several biologics (abatacept, adalimumab, etanercept, infliximab, rituximab, tocilizumab), and tofacitinib. The estimated probability of ACR50 response was similar between these treatments (range 56-67%), compared with 41% with methotrexate. Methotrexate combined with adalimumab, etanercept, certolizumab, or infliximab was statistically superior to oral methotrexate for inhibiting radiographic progression, but the estimated mean change over one year with all treatments was less than the minimal clinically important difference of 5 units on the Sharp-van der Heijde scale. Triple therapy had statistically fewer withdrawals due to adverse events than methotrexate plus infliximab. After an inadequate response to methotrexate, several treatments were statistically superior to oral methotrexate for ACR50 response: triple therapy, methotrexate plus hydroxychloroquine, methotrexate plus leflunomide, methotrexate plus intramuscular gold, methotrexate plus most biologics, and methotrexate plus tofacitinib. The probability of response was 61% with triple therapy and ranged widely (27-70%) with other treatments. No treatment was statistically superior to oral methotrexate for inhibiting radiographic progression. Methotrexate plus abatacept had a statistically lower rate of withdrawals due to adverse events than several treatments. Conclusions Triple therapy (methotrexate plus sulfasalazine plus hydroxychloroquine) and most regimens combining biologic DMARDs with methotrexate were effective in controlling disease activity, and all were generally well tolerated in both methotrexate naive and methotrexate exposed patients. PMID:27102806

Cognitive Correlates of Inadequate Response to Reading Intervention

PubMed Central

Fletcher, Jack M.; Stuebing, Karla K.; Barth, Amy E.; Denton, Carolyn A.; Cirino, Paul T.; Francis, David J.; Vaughn, Sharon

2012-01-01

The cognitive attributes of Grade 1 students who responded adequately and inadequately to a Tier 2 reading intervention were evaluated. The groups included inadequate responders based on decoding and fluency criteria (n = 29), only fluency criteria (n = 75), adequate responders (n = 85), and typically achieving students (n = 69). The cognitive measures included assessments of phonological awareness, rapid letter naming, oral language skills, processing speed, vocabulary, and nonverbal problem solving. Comparisons of all four groups identified phonological awareness as the most significant contributor to group differentiation. Measures of rapid letter naming, syntactic comprehension/working memory, and vocabulary also contributed uniquely to some comparisons of adequate and inadequate responders. In a series of regression analyses designed to evaluate the contributions of responder status to cognitive skills independently of variability in reading skills, only the model for rapid letter naming achieved statistical significance, accounting for a small (1%) increment in explained variance beyond that explained by models based only on reading levels. Altogether, these results do not suggest qualitative differences among the groups, but are consistent with a continuum of severity associated with the level of reading skills across the four groups. PMID:23125475

Effects of Tier 3 Intervention for Students With Persistent Reading Difficulties and Characteristics of Inadequate Responders.

PubMed

Denton, Carolyn A; Tolar, Tammy D; Fletcher, Jack M; Barth, Amy E; Vaughn, Sharon; Francis, David J

2013-08-01

This article describes a randomized controlled trial conducted to evaluate the effects of an intensive, individualized, Tier 3 reading intervention for second grade students who had previously experienced inadequate response to quality first grade classroom reading instruction (Tier 1) and supplemental small-group intervention (Tier 2). Also evaluated were cognitive characteristics of students with inadequate response to intensive Tier 3 intervention. Students were randomized to receive the research intervention ( N = 47) or the instruction and intervention typically provided in their schools ( N = 25). Results indicated that students who received the research intervention made significantly better growth than those who received typical school instruction on measures of word identification, phonemic decoding, and word reading fluency and on a measure of sentence- and paragraph-level reading comprehension. Treatment effects were smaller and not statistically significant on phonemic decoding efficiency, text reading fluency, and reading comprehension in extended text. Effect sizes for all outcomes except oral reading fluency met criteria for substantive importance; however, many of the students in the intervention continued to struggle. An evaluation of cognitive profiles of adequate and inadequate responders was consistent with a continuum of severity (as opposed to qualitative differences), showing greater language and reading impairment prior to the intervention in students who were inadequate responders.

Effects of Tier 3 Intervention for Students With Persistent Reading Difficulties and Characteristics of Inadequate Responders

PubMed Central

Denton, Carolyn A.; Tolar, Tammy D.; Fletcher, Jack M.; Barth, Amy E.; Vaughn, Sharon; Francis, David J.

2013-01-01

This article describes a randomized controlled trial conducted to evaluate the effects of an intensive, individualized, Tier 3 reading intervention for second grade students who had previously experienced inadequate response to quality first grade classroom reading instruction (Tier 1) and supplemental small-group intervention (Tier 2). Also evaluated were cognitive characteristics of students with inadequate response to intensive Tier 3 intervention. Students were randomized to receive the research intervention (N = 47) or the instruction and intervention typically provided in their schools (N = 25). Results indicated that students who received the research intervention made significantly better growth than those who received typical school instruction on measures of word identification, phonemic decoding, and word reading fluency and on a measure of sentence- and paragraph-level reading comprehension. Treatment effects were smaller and not statistically significant on phonemic decoding efficiency, text reading fluency, and reading comprehension in extended text. Effect sizes for all outcomes except oral reading fluency met criteria for substantive importance; however, many of the students in the intervention continued to struggle. An evaluation of cognitive profiles of adequate and inadequate responders was consistent with a continuum of severity (as opposed to qualitative differences), showing greater language and reading impairment prior to the intervention in students who were inadequate responders. PMID:25308995

Low Health Literacy Is Associated with Increased Transitional Care Needs in Hospitalized Patients.

PubMed

Boyle, Joseph; Speroff, Theodore; Worley, Katherine; Cao, Aize; Goggins, Kathryn; Dittus, Robert S; Kripalani, Sunil

2017-11-01

To examine the association of health literacy with the number and type of transitional care needs (TCN) among patients being discharged to home. A cross-sectional analysis of patients admitted to an academic medical center. Nurses administered the Brief Health Literacy Screen and documented TCNs along 10 domains: caregiver support, transportation, healthcare utilization, high-risk medical comorbidities, medication management, medical devices, functional status, mental health comorbidities, communication, and financial resources. Among the 384 patients analyzed, 113 (29%) had inadequate health literacy. Patients with inadequate health literacy had needs in more TCN domains (mean = 5.29 vs 4.36; P < 0 .001). In unadjusted analysis, patients with inadequate health literacy were significantly more likely to have TCNs in 7 out of the 10 domains. In multivariate analyses, inadequate health literacy remained significantly associated with inadequate caregiver support (odds ratio [OR], 2.61; 95% confidence interval [CI], 1.37-4.99) and transportation barriers (OR, 1.69; 95% CI, 1.04-2.76). Among hospitalized patients, inadequate health literacy is prevalent and independently associated with other needs that place patients at a higher risk of adverse outcomes, such as hospital readmission. Screening for inadequate health literacy and associated needs may enable hospitals to address these barriers and improve postdischarge outcomes. © 2017 Society of Hospital Medicine

Nurse Educator Attitudes Toward People With Disabilities.

PubMed

Lyon, Lori; Houser, Rick

As educators strongly influence the attitudes of their students, the purpose of this study was to determine nurse educator attitudes toward people with disabilities. Inadequate education of health professionals is a known barrier to care for people with disability. Continuing calls for improved education of health professionals compel an assessment of nurse educator attitudes. This was a cross-sectional, correlational web-based survey of nurse educators (n = 126). Nurse educator attitudes were analyzed using descriptive statistics, analysis of variance, and multiple regression analysis. Nurse educators held discriminatory attitudes toward people with disabilities, though most preferred a biopsychosocial model of disability. Forty-four percent lacked knowledge of disability-related aims, objectives, or outcomes within the curriculum. To advance equity in health care, nurse educators must confront personal bias and teach competent care of people with disabilities.

Finite Element Analysis of Reverberation Chambers

NASA Technical Reports Server (NTRS)

Bunting, Charles F.; Nguyen, Duc T.

2000-01-01

The primary motivating factor behind the initiation of this work was to provide a deterministic means of establishing the validity of the statistical methods that are recommended for the determination of fields that interact in -an avionics system. The application of finite element analysis to reverberation chambers is the initial step required to establish a reasonable course of inquiry in this particularly data-intensive study. The use of computational electromagnetics provides a high degree of control of the "experimental" parameters that can be utilized in a simulation of reverberating structures. As the work evolved there were four primary focus areas they are: 1. The eigenvalue problem for the source free problem. 2. The development of a complex efficient eigensolver. 3. The application of a source for the TE and TM fields for statistical characterization. 4. The examination of shielding effectiveness in a reverberating environment. One early purpose of this work was to establish the utility of finite element techniques in the development of an extended low frequency statistical model for reverberation phenomena. By employing finite element techniques, structures of arbitrary complexity can be analyzed due to the use of triangular shape functions in the spatial discretization. The effects of both frequency stirring and mechanical stirring are presented. It is suggested that for the low frequency operation the typical tuner size is inadequate to provide a sufficiently random field and that frequency stirring should be used. The results of the finite element analysis of the reverberation chamber illustrate io-W the potential utility of a 2D representation for enhancing the basic statistical characteristics of the chamber when operating in a low frequency regime. The basic field statistics are verified for frequency stirring over a wide range of frequencies. Mechanical stirring is shown to provide an effective frequency deviation.

Associations between Inadequate Parenting Practices and Behavioral Problems in Children and Adolescents with Attention Deficit Hyperactivity Disorder

PubMed Central

Triguero Veloz Teixeira, Maria Cristina; de Freitas Marino, Regina Luisa; Rodrigues Carreiro, Luiz Renato

2015-01-01

Children and adolescents with ADHD present behaviors such as impulsiveness, inattention, and difficulties with personal organization that represent an overload for parents. Moreover, it also increases their level of stress and leads them to resort to inadequate educational strategies. The present study verifies associations between inadequate parenting practices and behavioral profiles of children and adolescents with ADHD. The sample was composed of 22 children with ADHD (age range 6–16 years) and their mothers. Spearman correlation analyses were made with the scores of Parenting Style Inventory (PSI) and Child Behavior Checklist for ages 6–18 (CBCL/6–18). Results indicate statistically significant associations between behavioral problems and the use of punishment practices and negligence. When assessing a child with ADHD, it is important to verify the predominant types of parenting practices that can influence both immediate interventions and the prognosis of the disorder. PMID:26844292

Methods for improved forewarning of critical events across multiple data channels

DOEpatents

Hively, Lee M [Philadelphia, TN

2007-04-24

This disclosed invention concerns improvements in forewarning of critical events via phase-space dissimilarity analysis of data from mechanical devices, electrical devices, biomedical data, and other physical processes. First, a single channel of process-indicative data is selected that can be used in place of multiple data channels without sacrificing consistent forewarning of critical events. Second, the method discards data of inadequate quality via statistical analysis of the raw data, because the analysis of poor quality data always yields inferior results. Third, two separate filtering operations are used in sequence to remove both high-frequency and low-frequency artifacts using a zero-phase quadratic filter. Fourth, the method constructs phase-space dissimilarity measures (PSDM) by combining of multi-channel time-serial data into a multi-channel time-delay phase-space reconstruction. Fifth, the method uses a composite measure of dissimilarity (C.sub.i) to provide a forewarning of failure and an indicator of failure onset.

BETTER STATISTICS FOR BETTER DECISIONS: REJECTING NULL HYPOTHESES STATISTICAL TESTS IN FAVOR OF REPLICATION STATISTICS

PubMed Central

SANABRIA, FEDERICO; KILLEEN, PETER R.

2008-01-01

Despite being under challenge for the past 50 years, null hypothesis significance testing (NHST) remains dominant in the scientific field for want of viable alternatives. NHST, along with its significance level p, is inadequate for most of the uses to which it is put, a flaw that is of particular interest to educational practitioners who too often must use it to sanctify their research. In this article, we review the failure of NHST and propose prep, the probability of replicating an effect, as a more useful statistic for evaluating research and aiding practical decision making. PMID:19122766

Vaccines against leptospirosis.

PubMed

Adler, Ben

2015-01-01

Vaccines against leptospirosis followed within a year of the first isolation of Leptospira, with the first use of a killed whole cell bacterin vaccine in guinea pigs published in 1916. Since then, bacterin vaccines have been used in humans, cattle, swine, and dogs and remain the only vaccines licensed at the present time. The immunity elicited is restricted to serovars with related lipopolysaccharide (LPS) antigen. Likewise, vaccines based on LPS antigens have clearly demonstrated protection in animal models, which is also at best serogroup specific. The advent of leptospiral genome sequences has allowed a reverse vaccinology approach for vaccine development. However, the use of inadequate challenge doses and inappropriate statistical analysis invalidates many of the claims of protection with recombinant proteins.

Performance of the Lot Quality Assurance Sampling Method Compared to Surveillance for Identifying Inadequately-performing Areas in Matlab, Bangladesh

PubMed Central

Hanifi, S.M.A.; Roy, Nikhil; Streatfield, P. Kim

2007-01-01

This paper compared the performance of the lot quality assurance sampling (LQAS) method in identifying inadequately-performing health work-areas with that of using health and demographic surveillance system (HDSS) data and examined the feasibility of applying the method by field-level programme supervisors. The study was carried out in Matlab, the field site of ICDDR,B, where a HDSS has been in place for over 30 years. The LQAS method was applied in 57 work-areas of community health workers in ICDDR,B-served areas in Matlab during July-September 2002. The performance of the LQAS method in identifying work-areas with adequate and inadequate coverage of various health services was compared with those of the HDSS. The health service-coverage indicators included coverage of DPT, measles, BCG vaccination, and contraceptive use. It was observed that the difference in the proportion of work-areas identified to be inadequately performing using the LQAS method with less than 30 respondents, and the HDSS was not statistically significant. The consistency between the LQAS method and the HDSS in identifying work-areas was greater for adequately-performing areas than inadequately-performing areas. It was also observed that the field managers could be trained to apply the LQAS method in monitoring their performance in reaching the target population. PMID:17615902

Performance of the lot quality assurance sampling method compared to surveillance for identifying inadequately-performing areas in Matlab, Bangladesh.

PubMed

Bhuiya, Abbas; Hanifi, S M A; Roy, Nikhil; Streatfield, P Kim

2007-03-01

This paper compared the performance of the lot quality assurance sampling (LQAS) method in identifying inadequately-performing health work-areas with that of using health and demographic surveillance system (HDSS) data and examined the feasibility of applying the method by field-level programme supervisors. The study was carried out in Matlab, the field site of ICDDR,B, where a HDSS has been in place for over 30 years. The LQAS method was applied in 57 work-areas of community health workers in ICDDR,B-served areas in Matlab during July-September 2002. The performance of the LQAS method in identifying work-areas with adequate and inadequate coverage of various health services was compared with those of the HDSS. The health service-coverage indicators included coverage of DPT, measles, BCG vaccination, and contraceptive use. It was observed that the difference in the proportion of work-areas identified to be inadequately performing using the LQAS method with less than 30 respondents, and the HDSS was not statistically significant. The consistency between the LQAS method and the HDSS in identifying work-areas was greater for adequately-performing areas than inadequately-performing areas. It was also observed that the field managers could be trained to apply the LQAS method in monitoring their performance in reaching the target population.

An Outbreak of Norovirus Infections Among Lunch Customers at a Restaurant, Tampere, Finland, 2015.

PubMed

Vo, Thuan Huu; Okasha, Omar; Al-Hello, Haider; Polkowska, Aleksandra; Räsänen, Sirpa; Bojang, Merja; Nuorti, J Pekka; Jalava, Katri

2016-09-01

On January 29, 2015, the city of Tampere environmental health officers were informed of a possible foodborne outbreak among customers who had eaten lunch in restaurant X. Employees of electric companies A and B had a sudden onset of gastrointestinal symptoms. We conducted a retrospective cohort study to identify the vehicle, source, and causative agent of the outbreak. A case was defined as an employee of companies A or B with diarrhea and/or vomiting who ate lunch at Restaurant X on January 26, 2015. All employees of the companies attending the implicated lunch were invited to participate in the cohort study. Environmental investigation was conducted. Twenty-one responders were included in statistical analysis, of which 11 met with the case definition. Of the 15 food items consumed by participants, four food items were associated with gastroenteritis. Of four kitchen staff, three tested positive for norovirus GIP7, the strain was found earlier in the community. No patient samples were obtained. Level of hygiene in the kitchen was inadequate. Infected kitchen staff probably transmitted norovirus by inadequate hygiene practices. No new cases associated with Restaurant X were reported after the hygiene practices were improved.

HIV/AIDS--An Issue in Nurse Education.

ERIC Educational Resources Information Center

Martin, Geoffrey W.

1995-01-01

A survey found that many of British nurses (n=717) had inadequate knowledge and attitudes about people with AIDS. Educational programs should include the following content: attitudes/stereotypes, safer sex and infection control, confidentiality, epidemiology and statistics, and signs, symptoms, and progression of the syndrome. (SK)

Swallowing in children with neurologic disorders: clinical and videofluoroscopic evaluations.

PubMed

Marrara, Jamille Lays; Duca, Ana Paula; Dantas, Roberto Oliveira; Trawitzki, Luciana Vitaliano Voi; Lima, Raquel Aparecida Cardozo de; Pereira, José Carlos

2008-01-01

swallowing in children with neurologic disorders. to relate the data obtained in the clinical and in the videofluoroscopic evaluations of swallowing in children with neurologic disorders. a retrospective analysis of 24 protocols of speech-language evaluation and of medical records of children, of both genders, referred to clinical and videofluoroscopic evaluations of swallowing at the School of Medicine of Ribeirão Preto - University of São Paulo, from January 2001 to June 2005. The following aspects were analyzed in the clinical evaluation: diet consistency, functional aspects of the swallowing mechanism and results of the cervical auscultation. Videofluoroscopic evaluation was performed to determine the dynamic aspects of the oral and pharyngeal phases. during the clinical evaluation of the oral phase, for both liquid and pasty consistencies, a greater occurrence of inadequate bolus control was observed (n = 15 e n = 14, respectively). In the pharyngeal phase, also for both consistencies, an adequate cervical auscultate was more frequently observed before swallowing (n = 16 e n = 13) followed by the inadequate cervical auscultation during swallowing (n = 15 e n = 12). In the videofluoroscopic evaluation, during the oral phase, for both consistencies, the presence of inadequate food propulsion was the most frequent finding (n = 13 e n = 13) and, in the pharyngeal phase, the most frequent finding was the absence of laryngotracheal aspiration (n = 12 e n = 17). There was a statistically significant correlation between the cervical auscultate and the excursion of the hyoid and the larynx, and between the cervical auscultate and laryngotracheal aspiration of liquid and pasty consistencies. both procedures are important and complementary in the diagnosis of dysphagia.

Australian University Libraries: Problems and Prospects for the 1980s.

ERIC Educational Resources Information Center

Steele, Colin

1982-01-01

Inadequate funding for Australian university libraries is criticized. Issues considered include interlibrary loans, staffing needs, the state of cataloging, networks, acquisitions, building and space problems, new technologies, mergers, and governmental priorities. Statistics for individual library holdings and expenditures, and trends in 1976-79…

Indicators of Children's Well-Being.

ERIC Educational Resources Information Center

Hauser, Robert M., Ed.; Brown, Brett V., Ed.; Prosser, William R., Ed.

Social scientists are concerned that many measures of children's physical and emotional health are inadequate, misleading, or outdated, leaving policymakers ill-informed. This book provides an inquiry into current efforts to monitor children from the prenatal period through adolescence. Working with the most up-to-date statistical sources, experts…

Association Between Functional Health Literacy and Postoperative Recovery, Health Care Contacts, and Health-Related Quality of Life Among Patients Undergoing Day Surgery: Secondary Analysis of a Randomized Clinical Trial.

PubMed

Hälleberg Nyman, Maria; Nilsson, Ulrica; Dahlberg, Karuna; Jaensson, Maria

2018-04-25

Day surgery puts demands on the patients to manage their own recovery at home according to given instructions. Low health literacy levels are shown to be associated with poorer health outcomes. To describe functional health literacy levels among patients in Sweden undergoing day surgery and to describe the association between functional health literacy (FHL) and health care contacts, quality of recovery (SwQoR), and health-related quality of life. This observational study was part of a secondary analysis of a randomized clinical trial of patients undergoing day surgery and was performed in multiple centers from October 2015 to July 2016 and included 704 patients. The primary end point was SwQoR in the FHL groups 14 days after surgery. Secondary end points were health care contacts, EuroQol-visual analog scales, and the Short Form (36) Health Survey in the FHL groups. Of 704 patients (418 [59.4%] women; mean [SD] age with inadequate or problematic FHL levels, 47 [16] years and 49 [15.1], respectively), 427 (60.7%) reported sufficient FHL, 223 (31.7%) problematic FHL, and 54 (7.7%) inadequate FHL. The global score of SwQoR indicated poor recovery in both inadequate (37.4) and problematic (22.9) FHL. There was a statistically significant difference in the global score of SwQoR (SD) between inadequate (37.4 [34.7]) and sufficient FHL (17.7 [21.0]) (P < .001). The patients with inadequate or problematic FHL had a lower health-related quality of life than the patients with sufficient FHL in terms of EuroQol-visual analog scale scores (mean [SD], 73 [19.1], 73 [19.1], and 78 [17.4], respectively; P = .008), physical function (mean [SD], 72 [22.7], 75 [23.8], and 81 [21.9], respectively; P < .001), bodily pain (mean [SD], 51 [28.7], 53 [27.4], and 61 [27.0], respectively; P = .001), vitality (mean [SD], 50 [26.7], 56 [23.5], and 62 [25.4], respectively; P < .001), social functioning (mean [SD], 73 [28.2], 81 [21.8], and 84 [23.3], respectively; P = .004), mental health (mean [SD], 65 [25.4], 73 [21.2], and 77 [21.2], respectively; P < .001), and physical component summary (mean [SD], 41 [11.2], 42 [11.3], and 45 [10.1], respectively; P = .004). There were no differences between the FHL groups regarding health care contacts. Inadequate FHL in patients undergoing day surgery was associated with poorer postoperative recovery and a lower health-related quality of life. Health literacy is a relevant factor to consider for optimizing the postoperative recovery in patients undergoing day surgery. clinicaltrials.gov Identifier: NCT02492191.

Prospective analysis of factors associated with inadequate bowel preparation for colonoscopy in actual clinical practice

PubMed Central

Woo, Dae Hyung; Jeong, Da Eun; Nam, Yoon Jeong; Lee, Si Hyung; Jang, Byung Ik; Kim, Tae Nyeun

2018-01-01

Background/Aims Inadequate bowel preparation can result in prolonged procedure time and increased missed lesion and complication rates. This prospective study aimed to evaluate bowel preparation quality and identify the predictive factors for inadequate bowel preparation in actual clinical practice. Methods We included 399 patients who underwent colonoscopy between June 2015 and July 2016. Using the Aronchick bowel preparation scale, we defined a score ≤2 as adequate preparation and a score >2 as inadequate preparation. Results Mean patient age was 58.38±12.97 years; 60.6% were male. Indications for colonoscopy included screening (69.7%) and surveillance after polyp removal (21.3%). A split-dose regimen was prescribed to 55.4% of patients. The inadequate bowel preparation rate was 28.1%. Overall, the median time between the last bowel preparation agent dose and start of colonoscopy was 5.0 hours (range, 1.5–16.0 hours); that of the adequate group was 5.0 hours (range, 1.5–16.0 hours); and that of the inadequate group was 5 hours (range, 2–23 hours). The mean bowel preparation scale score of the ascending colon (1.94±0.25) was significantly higher than that of other colon segments. On multivariate analysis, elderly age, history of cerebrovascular disease, history of gastrectomy or appendectomy, and total preparation solution uptake <2 L were the independent predictors of inadequate bowel preparation. Conclusions The inadequate bowel preparation rate was 28.1%. Risk factors included elderly age and history of cerebrovascular disease or abdominal surgery. Patients with these risk factors require special care and education. PMID:29743843

Health insurance and quality of care: Comparing perceptions of quality between insured and uninsured patients in Ghana's hospitals.

PubMed

Abuosi, Aaron A; Domfeh, Kwame Ameyaw; Abor, Joshua Yindenaba; Nketiah-Amponsah, Edward

2016-05-12

The introduction of health insurance in Ghana in 2003 has resulted in a tremendous increase in utilization of health services. However, concerns are being raised about the quality of patient care. Some of the concerns include long waiting times, verbal abuse of patients by health care providers, inadequate physical examination by doctors and discrimination of insured patients. The study compares perceptions of quality of care between insured and uninsured out-patients in selected hospitals in Ghana to determine whether there is any unequal treatment between insured and uninsured patients in terms of quality of care, as empirical and anecdotal evidence seem to suggest. A cross-sectional survey of 818 out-patients was conducted in 17 general hospitals from three regions of Ghana. These are the Upper East, Brong Ahafo and Central Regions. Convenience sampling was employed to select the patients in exit interviews. Descriptive statistics, including frequency distributions, means and standard deviations, were used to describe socio-economic and demographic characteristics of respondents. Factor analysis was used to determine distinct quality of care constructs; t-test statistic was used to test for differences in quality perceptions between the insured and uninsured patients; and regression analysis was used to test the association between health insurance and quality of care. Overall, there was no significant difference in perceptions of quality between insured and uninsured patients. However, there was a significant difference between insured and uninsured patients in respect of financial access to care. The major quality of care concern affecting all patients was the problem of inadequate resources, especially lack of doctors, lack of drugs and other basic supplies and equipment to work with. It was concluded that generally, insured and uninsured patients are not treated unequally, contrary to prevailing anecdotal and empirical evidence. On the contrary, quality of care is a concern of both insured and uninsured patients.

Oral condition and its relationship to nutritional status in the institutionalized elderly population.

PubMed

Rauen, Michelle Soares; Moreira, Emília Addison Machado; Calvo, Maria Cristina Marino; Lobo, Adriana Soares

2006-07-01

The objective of this study was to identify the relationship between the oral condition and nutritional status of all institutionalized elderly people in Florianópolis, Brazil. Of the population of 232 institutionalized individuals, the sample consisted of 187 elderly people. In the oral evaluation, the criteria used was the number of functional units present in the oral cavity, classifying the participants as those with highly compromised dentition (48%) and those with less-compromised dentition (52%). Diagnosis of nutritional status was carried out according to body mass index, observing a prevalence of 14% thin, 45% eutrophic, 28% overweight, and 13% obese. Statistical analysis of the variables studied was carried out by means of chi(2) association tests. There was a statistically significant association between highly compromised dentition and thinness (P=0.007) and among those who presented less-compromised dentition and the nutritional status of overweight, including obesity (P=0.014). It was concluded that compromising of the teeth could contribute to a tendency toward inadequate nutritional status.

Chronic disease risk factors among hotel workers

PubMed Central

Gawde, Nilesh Chandrakant; Kurlikar, Prashika R.

2016-01-01

Context: Non-communicable diseases have emerged as a global health issue. Role of occupation in pathogenesis of non-communicable diseases has not been explored much especially in the hospitality industry. Aims: Objectives of this study include finding risk factor prevalence among hotel workers and studying relationship between occupational group and chronic disease risk factors chiefly high body mass index. Settings and Design: A cross-sectional study was conducted among non-managerial employees from classified hotels in India. Materials and Methods: The study participants self-administered pre-designed pilot-tested questionnaires. Statistical analysis used: The risk factor prevalence rates were expressed as percentages. Chi-square test was used for bi-variate analysis. Overweight was chosen as ‘outcome’ variable of interest and binary multi-logistic regression analysis was used to identify determinants. Results: The prevalence rates of tobacco use, alcohol use, inadequate physical activity and inadequate intake of fruits and vegetables were 32%, 49%, 24% and 92% respectively among hotel employees. Tobacco use was significantly common among those in food preparation and service, alcohol use among those in food service and security and leisure time physical activity among front office workers. More than two-fifths (42.7%) were overweight. Among the hotel workers, those employed in food preparation and security had higher odds of 1.650 (CI: 1.025 – 2.655) and 3.245 (CI: 1.296 – 8.129) respectively of being overweight. Conclusions: Prevalence of chronic disease risk factors is high among hotel workers. Risk of overweight is significantly high in food preparation and security departments and workplace interventions are necessary to address these risks PMID:27390474

Strongly magnetized classical plasma models

NASA Technical Reports Server (NTRS)

Montgomery, D. C.

1972-01-01

The class of plasma processes for which the so-called Vlasov approximation is inadequate is investigated. Results from the equilibrium statistical mechanics of two-dimensional plasmas are derived. These results are independent of the presence of an external dc magnetic field. The nonequilibrium statistical mechanics of the electrostatic guiding-center plasma, a two-dimensional plasma model, is discussed. This model is then generalized to three dimensions. The guiding-center model is relaxed to include finite Larmor radius effects for a two-dimensional plasma.

A Deterministic Annealing Approach to Clustering AIRS Data

NASA Technical Reports Server (NTRS)

Guillaume, Alexandre; Braverman, Amy; Ruzmaikin, Alexander

2012-01-01

We will examine the validity of means and standard deviations as a basis for climate data products. We will explore the conditions under which these two simple statistics are inadequate summaries of the underlying empirical probability distributions by contrasting them with a nonparametric, method called Deterministic Annealing technique

Delayed Treatment Acceleration in Patients with Rheumatoid Arthritis Who Have Inadequate Response to Initial Tumor Necrosis Factor Inhibitors: Data from the Corrona Registry

PubMed Central

Pappas, Dimitrios A.; Gerber, Robert A.; Litman, Heather J.; Gruben, David; Geier, Jamie; Hua, Winnie D.; Chen, Connie; Li, Youfu; Kremer, Joel M.; Andrews, John S.; Bourret, Jeffrey A.

2018-01-01

Background The implementation of treat-to-target principles in rheumatoid arthritis (RA) has not been fully investigated in patients with inadequate response to tumor necrosis factor (TNF) inhibitor treatment. Objectives To evaluate the prevalence of an inadequate response to initial TNF inhibitor treatment at 6 and 12 months among patients with RA in a real-world patient registry, as well as the delay in therapy adjustment and its impact on disease activity and patient-reported outcome (PRO) measures. Methods This analysis is based on data of patients with moderate or severe disease activity (Clinical Disease Activity Index [CDAI] score >10) who were included in the Consortium of Rheumatology Researchers of North America (Corrona) RA registry, a prospective, observational database. The patients had never received treatment with a biologic disease-modifying antirheumatic drug (DMARD) and had initiated treatment with a TNF inhibitor (adalimumab, certolizumab pegol, etanercept, golimumab, or infliximab) between October 2001 and December 2014. We evaluated treatment response (CDAI score ≤10), select PRO measures, and treatment changes at 6 months. Patients who had an inadequate response to TNF inhibitor therapy at 6 months and continued to use their initial TNF inhibitor were evaluated again at 12 months. Results This retrospective analysis included 2282 patients. At 6 months, 1732 (75.9%) of the patients continued to use their initial TNF inhibitor; of these, 803 (46.4%) patients had an inadequate response to treatment. Of the 803 patients who had an inadequate response at 6 months, 488 (60.8%) continued their initial treatment at 12 months. Of these 488 patients, 315 (64.5%) had an inadequate response at 12 months, and 173 (35.5%) had a response. Numerically greater improvements in all PRO measures were observed for patients who responded to therapy compared with patients with an inadequate response. Conclusions In this real-world analysis of data from the Corrona RA registry, a considerable proportion of patients with RA had an inadequate response to the initial TNF inhibitor therapy at 6 and 12 months. Many patients continued to have moderate or high disease activity, without accelerating treatment (eg, addition or increase in the dose of concurrent conventional synthetic DMARDs or a TNF inhibitor), contrary to treat-to-target principles, thus remaining at risk for accumulating joint damage and disability. PMID:29910846

Modeling Longitudinal Data Containing Non-Normal Within Subject Errors

NASA Technical Reports Server (NTRS)

Feiveson, Alan; Glenn, Nancy L.

2013-01-01

The mission of the National Aeronautics and Space Administration’s (NASA) human research program is to advance safe human spaceflight. This involves conducting experiments, collecting data, and analyzing data. The data are longitudinal and result from a relatively few number of subjects; typically 10 – 20. A longitudinal study refers to an investigation where participant outcomes and possibly treatments are collected at multiple follow-up times. Standard statistical designs such as mean regression with random effects and mixed–effects regression are inadequate for such data because the population is typically not approximately normally distributed. Hence, more advanced data analysis methods are necessary. This research focuses on four such methods for longitudinal data analysis: the recently proposed linear quantile mixed models (lqmm) by Geraci and Bottai (2013), quantile regression, multilevel mixed–effects linear regression, and robust regression. This research also provides computational algorithms for longitudinal data that scientists can directly use for human spaceflight and other longitudinal data applications, then presents statistical evidence that verifies which method is best for specific situations. This advances the study of longitudinal data in a broad range of applications including applications in the sciences, technology, engineering and mathematics fields.

AGREEMENT AND COVERAGE OF INDICATORS OF RESPONSE TO INTERVENTION: A MULTI-METHOD COMPARISON AND SIMULATION

PubMed Central

Fletcher, Jack M.; Stuebing, Karla K.; Barth, Amy E.; Miciak, Jeremy; Francis, David J.; Denton, Carolyn A.

2013-01-01

Purpose Agreement across methods for identifying students as inadequate responders or as learning disabled is often poor. We report (1) an empirical examination of final status (post-intervention benchmarks) and dual-discrepancy growth methods based on growth during the intervention and final status for assessing response to intervention; and (2) a statistical simulation of psychometric issues that may explain low agreement. Methods After a Tier 2 intervention, final status benchmark criteria were used to identify 104 inadequate and 85 adequate responders to intervention, with comparisons of agreement and coverage for these methods and a dual-discrepancy method. Factors affecting agreement were investigated using computer simulation to manipulate reliability, the intercorrelation between measures, cut points, normative samples, and sample size. Results Identification of inadequate responders based on individual measures showed that single measures tended not to identify many members of the pool of 104 inadequate responders. Poor to fair levels of agreement for identifying inadequate responders were apparent between pairs of measures In the simulation, comparisons across two simulated measures generated indices of agreement (kappa) that were generally low because of multiple psychometric issues inherent in any test. Conclusions Expecting excellent agreement between two correlated tests with even small amounts of unreliability may not be realistic. Assessing outcomes based on multiple measures, such as level of CBM performance and short norm-referenced assessments of fluency may improve the reliability of diagnostic decisions. PMID:25364090

Medication literacy status of outpatients in ambulatory care settings in Changsha, China.

PubMed

Zheng, Feng; Ding, Siqing; Luo, Aijing; Zhong, Zhuqing; Duan, Yinglong; Shen, Zhiying

2017-02-01

Objective To assess medication literacy status and to examine risk factors of inadequate medication literacy of outpatients in ambulatory care settings. Methods Study participants were recruited randomly from outpatient departments in four tertiary hospitals (Xiangya Hospital of Central South University, Second Xiangya Hospital of Central South University, Third Xiangya Hospital of Central South University, People's Hospital of Hunan Province) in Changsha, Hunan, China, between October 2014 and January 2015. Medication literacy was assessed using the Medication Literacy Scale, Chinese version. Demographic and clinical data were collected using structured interviews. Multiple logistic regression analysis was used to estimate the independent effects of demographic and clinical factors on medication literacy. Results Of 465 participants, 425 (91.4%) produced valid responses for analysis. The mean medication literacy score was 8.31 (standard deviation = 3.47). Medication literacy was adequate in 131 participants (30.8%), marginally adequate in 248 (58.4%), and inadequate in 46 (10.8%). The risk of inadequate medication literacy was greater for older and unmarried patients but lower for more educated patients. Conclusion Many Chinese outpatients in ambulatory care have inadequate medication literacy. Greater age, low education, and unmarried status are important risk factors of inadequate medication literacy.

Large Area Crop Inventory Experiment (LACIE). YES phase 1 yield feasibility report

NASA Technical Reports Server (NTRS)

1977-01-01

The author has identified the following significant results. Each state model was separately evaluated to determine if a projected performance to the country level would satisfy a 90/90 criterion. All state models, except the North Dakota and Kansas models, satisfied that criterion both for district estimates aggregated to the state level and for state estimates directly from the models. In addition to the tests of the 90/90 criterion, the models were examined for their ability to adequately respond to fluctuations in weather. This portion of the analysis was based on a subjective interpretation of values of certain description statistics. As a result, 10 of the 12 models were judged to respond inadequately to variation in weather-related variables.

The effect of directive tutor guidance on students' conceptual understanding of statistics in problem-based learning.

PubMed

Budé, Luc; van de Wiel, Margaretha W J; Imbos, Tjaart; Berger, Martijn P F

2011-06-01

Education is aimed at students reaching conceptual understanding of the subject matter, because this leads to better performance and application of knowledge. Conceptual understanding depends on coherent and error-free knowledge structures. The construction of such knowledge structures can only be accomplished through active learning and when new knowledge can be integrated into prior knowledge. The intervention in this study was directed at both the activation of students as well as the integration of knowledge. Undergraduate university students from an introductory statistics course, in an authentic problem-based learning (PBL) environment, were randomly assigned to conditions and measurement time points. In the PBL tutorial meetings, half of the tutors guided the discussions of the students in a traditional way. The other half guided the discussions more actively by asking directive and activating questions. To gauge conceptual understanding, the students answered open-ended questions asking them to explain and relate important statistical concepts. Results of the quantitative analysis show that providing directive tutor guidance improved understanding. Qualitative data of students' misconceptions seem to support this finding. Long-term retention of the subject matter seemed to be inadequate. ©2010 The British Psychological Society.

Hydrostratigraphic analysis of the MADE site with full-resolution GPR and direct-push hydraulic profiling

USGS Publications Warehouse

Dogan, M.; Van Dam, R. L.; Bohling, Geoffrey C.; Butler, J.J.; Hyndman, D.W.

2011-01-01

Full-resolution 3D Ground-Penetrating Radar (GPR) data were combined with high-resolution hydraulic conductivity (K) data from vertical Direct-Push (DP) profiles to characterize a portion of the highly heterogeneous MAcro Dispersion Experiment (MADE) site. This is an important first step to better understand the influence of aquifer heterogeneities on observed anomalous transport. Statistical evaluation of DP data indicates non-normal distributions that have much higher similarity within each GPR facies than between facies. The analysis of GPR and DP data provides high-resolution estimates of the 3D geometry of hydrostratigraphic zones, which can then be populated with stochastic K fields. The lack of such estimates has been a significant limitation for testing and parameterizing a range of novel transport theories at sites where the traditional advection-dispersion model has proven inadequate. ?? 2011 by the American Geophysical Union.

Comparative analysis of hydrogen fire and explosion incidents: quarterly report No. 2, December 1, 1977--February 28, 1978

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

Zalosh, R.G.; Short, T.P.

1978-03-01

Additional hydrogen incident reports compiled during this quarter have increased the size of the computerized data base to a current total of 280 incidents. Listings of 165 incidents that have occurred in industrial and transportation operations since 1968 are presented here. Sample case histories in six different cause categories are provided together with a discussion of common safety problems contributing to these incidents. Some of these problems are inadequate detection measures for hydrogen leaks and fires and ineffective purging with inert gas. A preliminary comparison of losses due to natural gas fires/explosions and hydrogen incidents indicates that hydrogen explosions havemore » been, on the average, four-to-six times as damaging as natural gas explosions. Some tentative explanations for this result are presented but await confirmation from a more sophisticated statistical analysis.« less

Application of a faith-based integration tool to assess mental and physical health interventions.

PubMed

Saunders, Donna M; Leak, Jean; Carver, Monique E; Smith, Selina A

2017-01-01

To build on current research involving faith-based interventions (FBIs) for addressing mental and physical health, this study a) reviewed the extent to which relevant publications integrate faith concepts with health and b) initiated analysis of the degree of FBI integration with intervention outcomes. Derived from a systematic search of articles published between 2007 and 2017, 36 studies were assessed with a Faith-Based Integration Assessment Tool (FIAT) to quantify faith-health integration. Basic statistical procedures were employed to determine the association of faith-based integration with intervention outcomes. The assessed studies possessed (on average) moderate, inconsistent integration because of poor use of faith measures, and moderate, inconsistent use of faith practices. Analysis procedures for determining the effect of FBI integration on intervention outcomes were inadequate for formulating practical conclusions. Regardless of integration, interventions were associated with beneficial outcomes. To determine the link between FBI integration and intervention outcomes, additional analyses are needed.

Food Insecurity and Chronic Diseases Among American Indians in Rural Oklahoma: The THRIVE Study

PubMed Central

Wetherill, Marianna S.; Hearod, Jordan; Jacob, Tvli; Salvatore, Alicia L.; Cannady, Tamela; Grammar, Mandy; Standridge, Joy; Fox, Jill; Spiegel, Jennifer; Wiley, AnDina; Noonan, Carolyn; Buchwald, Dedra

2017-01-01

Objectives. To examine food insecurity and cardiovascular disease–related health outcomes among American Indians (AIs) in rural Oklahoma. Methods. We surveyed a cross-sectional sample of 513 AI adults to assess food insecurity domains (i.e., food quality and quantity) and obesity, diabetes, and hypertension. Results. Among AIs surveyed, 56% reported inadequate food quantity and 62% reported inadequate food quality. The unadjusted prevalence of diabetes (28.4% vs 18.4%), obesity (60.0% vs 48.3%), and hypertension (54.1% vs 41.6%) was higher among participants with inadequate food quantity than among those with adequate food quantity. These associations did not reach statistical significance after adjustment for age, gender, study site, education, and income. The unadjusted prevalence of obesity (60.7% vs 45.8%), diabetes (27.3% vs 18.8%), and hypertension (52.5% vs 42.5%) was higher among those with inadequate food quality than among those with adequate food quality, even after adjustment for age, gender, study site, education, and income. Conclusions. Tribal, federal, and state policymakers, as well as businesses and nonprofit organizations, must collaboratively take aggressive action to address food insecurity and its underlying causes, including improving tribal food environments, reducing barriers to healthy foods, and increasing living wages. PMID:28103070

"White Privilege": A Mild Critique

ERIC Educational Resources Information Center

Blum, Lawrence

2008-01-01

White privilege analysis has been influential in philosophy of education. I offer some mild criticisms of this largely salutary direction--its inadequate exploration of its own normative foundations, and failure to distinguish between "spared injustice", "unjust enrichment" and "non-injustice-related" privileges; its inadequate exploration of the…

Intelligent Monitoring? Assessing the ability of the Care Quality Commission's statistical surveillance tool to predict quality and prioritise NHS hospital inspections.

PubMed

Griffiths, Alex; Beaussier, Anne-Laure; Demeritt, David; Rothstein, Henry

2017-02-01

The Care Quality Commission (CQC) is responsible for ensuring the quality of the health and social care delivered by more than 30 000 registered providers in England. With only limited resources for conducting on-site inspections, the CQC has used statistical surveillance tools to help it identify which providers it should prioritise for inspection. In the face of planned funding cuts, the CQC plans to put more reliance on statistical surveillance tools to assess risks to quality and prioritise inspections accordingly. To evaluate the ability of the CQC's latest surveillance tool, Intelligent Monitoring (IM), to predict the quality of care provided by National Health Service (NHS) hospital trusts so that those at greatest risk of providing poor-quality care can be identified and targeted for inspection. The predictive ability of the IM tool is evaluated through regression analyses and χ 2 testing of the relationship between the quantitative risk score generated by the IM tool and the subsequent quality rating awarded following detailed on-site inspection by large expert teams of inspectors. First, the continuous risk scores generated by the CQC's IM statistical surveillance tool cannot predict inspection-based quality ratings of NHS hospital trusts (OR 0.38 (0.14 to 1.05) for Outstanding/Good, OR 0.94 (0.80 to -1.10) for Good/Requires improvement, and OR 0.90 (0.76 to 1.07) for Requires improvement/Inadequate). Second, the risk scores cannot be used more simply to distinguish the trusts performing poorly-those subsequently rated either 'Requires improvement' or 'Inadequate'-from the trusts performing well-those subsequently rated either 'Good' or 'Outstanding' (OR 1.07 (0.91 to 1.26)). Classifying CQC's risk bandings 1-3 as high risk and 4-6 as low risk, 11 of the high risk trusts were performing well and 43 of the low risk trusts were performing poorly, resulting in an overall accuracy rate of 47.6%. Third, the risk scores cannot be used even more simply to distinguish the worst performing trusts-those subsequently rated 'Inadequate'-from the remaining, better performing trusts (OR 1.11 (0.94 to 1.32)). Classifying CQC's risk banding 1 as high risk and 2-6 as low risk, the highest overall accuracy rate of 72.8% was achieved, but still only 6 of the 13 Inadequate trusts were correctly classified as being high risk. Since the IM statistical surveillance tool cannot predict the outcome of NHS hospital trust inspections, it cannot be used for prioritisation. A new approach to inspection planning is therefore required. 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/.

Affirmative Action: The Unrealized Goal. A Decade of "Equal Employment Opportunity."

ERIC Educational Resources Information Center

Willis, Virginia; And Others

More than a decade of affirmative action policy on the part of the federal government has yielded inadequate results. The commonly claimed assumption that blacks are being given unfair and undeserved advantage over whites is examined at length and found unjustified. Bringing together relevant statistics and other data bearing on the effectiveness…

The Use of Radar Imagery in Climatological Research. Resource Paper No. 21.

ERIC Educational Resources Information Center

Williams, Aaron, Jr.

Intended to supplement undergraduate college geography courses, this resource paper investigates the need and use of radar in weather phenomena research. Radar can be used to study weather phenomena over a wide area, thus improving the results of statistical analyses previously limited by inadequate data. Radar techniques are also useful for…

Parental Characteristics and Resiliency in Identification Rates for Special Education

ERIC Educational Resources Information Center

Anderson, Jeffrey A.; Howland, Allison A.; McCoach, D. Betsy

2015-01-01

Even with increased risks, many children demonstrate resiliency and avoid being labeled for special education; however, research on risk and resilience has been problematic because of inadequate statistical models, limitations of available data, and the exclusion of key protective factors. This study used a national sample to examine the influence…

Factors Associated with Medication Refill Adherence in Cardiovascular-related Diseases: A Focus on Health Literacy

PubMed Central

Gazmararian, Julie A; Kripalani, Sunil; Miller, Michael J; Echt, Katharina V; Ren, Junling; Rask, Kimberly

2006-01-01

BACKGROUND The factors influencing medication adherence have not been fully elucidated. Inadequate health literacy skills may impair comprehension of medical care instructions, and thereby reduce medication adherence. OBJECTIVES To examine the relationship between health literacy and medication refill adherence among Medicare managed care enrollees with cardiovascular-related conditions. RESEARCH DESIGN Prospective cohort study. SUBJECTS New Medicare enrollees from 4 managed care plans who completed an in-person survey and were identified through administrative data as having coronary heart disease, hypertension, diabetes mellitus, and/or hyperlipidemia (n=1,549). MEASURES Health literacy was determined using the short form of the Test of Functional Health Literacy in Adults (S-TOFHLA). Prospective administrative data were used to calculate the cumulative medication gap (CMG), a valid measure of medication refill adherence, over a 1-year period. Low adherence was defined as CMG≥20%. RESULTS Overall, 40% of the enrollees had low refill adherence. Bivariate analyses indicated that health literacy, race/ethnicity, education, and regimen complexity were each related to medication refill adherence (P<.05). In unadjusted analysis, those with inadequate health literacy skills had increased odds (odds ratio [OR]=1.37, 95% confidence interval [CI]: 1.08 to 1.74) of low refill adherence compared with those with adequate health literacy skills. However, the OR for inadequate health literacy and low refill adherence was not statistically significant in multivariate analyses (OR=1.23, 95% CI: 0.92 to 1.64). CONCLUSIONS The present study suggests, but did not conclusively demonstrate, that low health literacy predicts poor refill adherence. Given the prevalence of both conditions, future research should continue to examine this important potential association. PMID:17105519

Health literacy and barriers to health information seeking: A nationwide survey in South Korea.

PubMed

Jeong, Seok Hee; Kim, Hyun Kyung

2016-11-01

To identify the level of health literacy and barriers to information seeking and to explore the predictors of health literacy. A cross-sectional descriptive design was used. A total of 1000 Korean adults were recruited through proportional quota sampling. Health literacy, barriers to health information seeking, sociodemographics, and health-related characteristics were surveyed. Descriptive statistics and binary logistic regression were performed for data analysis. About 61% of participants were classified as inadequately health literate. "No health fairs/activities near home" was the most frequently reported barrier. Older age, lower education, living in the capital city, barriers regarding how to get information and access to expensive books and magazines were predictors of inadequate health literacy. Strategies for improving health literacy and reducing barriers to health information seeking should be designed. Education on how to access health-related information with easily accessible sources either free or inexpensive could be a way to help adults with limited health literacy. Health care professionals should assess clients' health literacy levels, particularly amongst those who are older or have less education. They should provide clients with information on how to access credible and readily available sources of health-related information, considering their health literacy level. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Segmentation of fluorescence microscopy images for quantitative analysis of cell nuclear architecture.

PubMed

Russell, Richard A; Adams, Niall M; Stephens, David A; Batty, Elizabeth; Jensen, Kirsten; Freemont, Paul S

2009-04-22

Considerable advances in microscopy, biophysics, and cell biology have provided a wealth of imaging data describing the functional organization of the cell nucleus. Until recently, cell nuclear architecture has largely been assessed by subjective visual inspection of fluorescently labeled components imaged by the optical microscope. This approach is inadequate to fully quantify spatial associations, especially when the patterns are indistinct, irregular, or highly punctate. Accurate image processing techniques as well as statistical and computational tools are thus necessary to interpret this data if meaningful spatial-function relationships are to be established. Here, we have developed a thresholding algorithm, stable count thresholding (SCT), to segment nuclear compartments in confocal laser scanning microscopy image stacks to facilitate objective and quantitative analysis of the three-dimensional organization of these objects using formal statistical methods. We validate the efficacy and performance of the SCT algorithm using real images of immunofluorescently stained nuclear compartments and fluorescent beads as well as simulated images. In all three cases, the SCT algorithm delivers a segmentation that is far better than standard thresholding methods, and more importantly, is comparable to manual thresholding results. By applying the SCT algorithm and statistical analysis, we quantify the spatial configuration of promyelocytic leukemia nuclear bodies with respect to irregular-shaped SC35 domains. We show that the compartments are closer than expected under a null model for their spatial point distribution, and furthermore that their spatial association varies according to cell state. The methods reported are general and can readily be applied to quantify the spatial interactions of other nuclear compartments.

Segmentation of Fluorescence Microscopy Images for Quantitative Analysis of Cell Nuclear Architecture

PubMed Central

Russell, Richard A.; Adams, Niall M.; Stephens, David A.; Batty, Elizabeth; Jensen, Kirsten; Freemont, Paul S.

2009-01-01

Abstract Considerable advances in microscopy, biophysics, and cell biology have provided a wealth of imaging data describing the functional organization of the cell nucleus. Until recently, cell nuclear architecture has largely been assessed by subjective visual inspection of fluorescently labeled components imaged by the optical microscope. This approach is inadequate to fully quantify spatial associations, especially when the patterns are indistinct, irregular, or highly punctate. Accurate image processing techniques as well as statistical and computational tools are thus necessary to interpret this data if meaningful spatial-function relationships are to be established. Here, we have developed a thresholding algorithm, stable count thresholding (SCT), to segment nuclear compartments in confocal laser scanning microscopy image stacks to facilitate objective and quantitative analysis of the three-dimensional organization of these objects using formal statistical methods. We validate the efficacy and performance of the SCT algorithm using real images of immunofluorescently stained nuclear compartments and fluorescent beads as well as simulated images. In all three cases, the SCT algorithm delivers a segmentation that is far better than standard thresholding methods, and more importantly, is comparable to manual thresholding results. By applying the SCT algorithm and statistical analysis, we quantify the spatial configuration of promyelocytic leukemia nuclear bodies with respect to irregular-shaped SC35 domains. We show that the compartments are closer than expected under a null model for their spatial point distribution, and furthermore that their spatial association varies according to cell state. The methods reported are general and can readily be applied to quantify the spatial interactions of other nuclear compartments. PMID:19383481

Health Literacy and Access to Kidney Transplantation

PubMed Central

Grubbs, Vanessa; Gregorich, Steven E.; Perez-Stable, Eliseo J.; Hsu, Chi-yuan

2009-01-01

Background and objectives: Few studies have examined health literacy in patients with end stage kidney disease. We hypothesized that inadequate health literacy in a hemodialysis population is common and is associated with poorer access to kidney transplant wait-lists. Design, setting, participants, & measurements: We enrolled 62 Black and White maintenance hemodialysis patients aged 18 to 75. We measured health literacy using the short form Test of Functional Health Literacy in Adults. Our primary outcomes were (1) time from dialysis start date to referral date for kidney transplant evaluation and (2) time from referral date to date placed on kidney transplant wait-list. We used Cox proportional hazard models to examine the association between health literacy (adequate versus inadequate) and our outcomes after controlling for demographics and co-morbid conditions. Results: Roughly one third (32.3%) of participants had inadequate health literacy. Forty-seven (75.8%) of participants were referred for transplant evaluation. Among those referred, 40 (85.1%) were wait-listed. Participants with inadequate health literacy had 78% lower hazard of referral for transplant evaluation than those with adequate health literacy (adjusted hazard ratio [AHR] 0.22; 95% confidence interval 0.08, 0.60; P = 0.003). The hazard ratio of being wait-listed by health literacy was not statistically different (AHR 0.80, 95% CI, 0.39, 1.61), P = 0.5). Conclusions: Inadequate health literacy is common in our hemodialysis patient population and is associated with a lower hazard of referral for transplant evaluation. Strategies to reduce the impact of health literacy on the kidney transplant process should be explored. PMID:19056617

Nonclassical acoustics

NASA Technical Reports Server (NTRS)

Kentzer, C. P.

1976-01-01

A statistical approach to sound propagation is considered in situations where, due to the presence of large gradients of properties of the medium, the classical (deterministic) treatment of wave motion is inadequate. Mathematical methods for wave motions not restricted to small wavelengths (analogous to known methods of quantum mechanics) are used to formulate a wave theory of sound in nonuniform flows. Nonlinear transport equations for field probabilities are derived for the limiting case of noninteracting sound waves and it is postulated that such transport equations, appropriately generalized, may be used to predict the statistical behavior of sound in arbitrary flows.

Relationship between health services, socioeconomic variables and inadequate weight gain among Brazilian children.

PubMed Central

de Souza, A. C.; Peterson, K. E.; Cufino, E.; Gardner, J.; Craveiro, M. V.; Ascherio, A.

1999-01-01

This ecological analysis assessed the relative contribution of behavioural, health services and socioeconomic variables to inadequate weight gain in infants (0-11 months) and children (12-23 months) in 140 municipalities in the State of Ceara, north-east Brazil. To assess the total effect of selected variables, we fitted three unique sets of multivariate linear regression models to the prevalence of inadequate weight gain in infants and in children. The final predictive models included variables from the three sets. Findings showed that participation in growth monitoring and urbanization were inversely and significantly associated with the prevalence of inadequate weight gain in infants, accounting for 38.3% of the variation. Female illiteracy rate, participation in growth monitoring and degree of urbanization were all positively associated with prevalence of inadequate weight gain in children. Together, these factors explained 25.6% of the variation. Our results suggest that efforts to reduce the average municipality-specific female illiteracy rate, in combination with participation in growth monitoring, may be effective in reducing municipality-level prevalence of inadequate weight gain in infants and children in Ceara. PMID:10612885

Relationship between health services, socioeconomic variables and inadequate weight gain among Brazilian children.

PubMed

de Souza, A C; Peterson, K E; Cufino, E; Gardner, J; Craveiro, M V; Ascherio, A

1999-01-01

This ecological analysis assessed the relative contribution of behavioural, health services and socioeconomic variables to inadequate weight gain in infants (0-11 months) and children (12-23 months) in 140 municipalities in the State of Ceara, north-east Brazil. To assess the total effect of selected variables, we fitted three unique sets of multivariate linear regression models to the prevalence of inadequate weight gain in infants and in children. The final predictive models included variables from the three sets. Findings showed that participation in growth monitoring and urbanization were inversely and significantly associated with the prevalence of inadequate weight gain in infants, accounting for 38.3% of the variation. Female illiteracy rate, participation in growth monitoring and degree of urbanization were all positively associated with prevalence of inadequate weight gain in children. Together, these factors explained 25.6% of the variation. Our results suggest that efforts to reduce the average municipality-specific female illiteracy rate, in combination with participation in growth monitoring, may be effective in reducing municipality-level prevalence of inadequate weight gain in infants and children in Ceara.

Applied statistical training to strengthen analysis and health research capacity in Rwanda.

PubMed

Thomson, Dana R; Semakula, Muhammed; Hirschhorn, Lisa R; Murray, Megan; Ndahindwa, Vedaste; Manzi, Anatole; Mukabutera, Assumpta; Karema, Corine; Condo, Jeanine; Hedt-Gauthier, Bethany

2016-09-29

To guide efficient investment of limited health resources in sub-Saharan Africa, local researchers need to be involved in, and guide, health system and policy research. While extensive survey and census data are available to health researchers and program officers in resource-limited countries, local involvement and leadership in research is limited due to inadequate experience, lack of dedicated research time and weak interagency connections, among other challenges. Many research-strengthening initiatives host prolonged fellowships out-of-country, yet their approaches have not been evaluated for effectiveness in involvement and development of local leadership in research. We developed, implemented and evaluated a multi-month, deliverable-driven, survey analysis training based in Rwanda to strengthen skills of five local research leaders, 15 statisticians, and a PhD candidate. Research leaders applied with a specific research question relevant to country challenges and committed to leading an analysis to publication. Statisticians with prerequisite statistical training and experience with a statistical software applied to participate in class-based trainings and complete an assigned analysis. Both statisticians and research leaders were provided ongoing in-country mentoring for analysis and manuscript writing. Participants reported a high level of skill, knowledge and collaborator development from class-based trainings and out-of-class mentorship that were sustained 1 year later. Five of six manuscripts were authored by multi-institution teams and submitted to international peer-reviewed scientific journals, and three-quarters of the participants mentored others in survey data analysis or conducted an additional survey analysis in the year following the training. Our model was effective in utilizing existing survey data and strengthening skills among full-time working professionals without disrupting ongoing work commitments and using few resources. Critical to our success were a transparent, robust application process and time limited training supplemented by ongoing, in-country mentoring toward manuscript deliverables that were led by Rwanda's health research leaders.

Analysis of North Atlantic tropical cyclone intensify change using data mining

NASA Astrophysics Data System (ADS)

Tang, Jiang

Tropical cyclones (TC), especially when their intensity reaches hurricane scale, can become a costly natural hazard. Accurate prediction of tropical cyclone intensity is very difficult because of inadequate observations on TC structures, poor understanding of physical processes, coarse model resolution and inaccurate initial conditions, etc. This study aims to tackle two factors that account for the underperformance of current TC intensity forecasts: (1) inadequate observations of TC structures, and (2) deficient understanding of the underlying physical processes governing TC intensification. To tackle the problem of inadequate observations of TC structures, efforts have been made to extract vertical and horizontal structural parameters of latent heat release from Tropical Rainfall Measuring Mission (TRMM) Precipitation Radar (PR) data products. A case study of Hurricane Isabel (2003) was conducted first to explore the feasibility of using the 3D TC structure information in predicting TC intensification. Afterwards, several structural parameters were extracted from 53 TRMM PR 2A25 observations on 25 North Atlantic TCs during the period of 1998 to 2003. A new generation of multi-correlation data mining algorithm (Apriori and its variations) was applied to find roles of the latent heat release structure in TC intensification. The results showed that the buildup of TC energy is indicated by the height of the convective tower, and the relative low latent heat release at the core area and around the outer band. Adverse conditions which prevent TC intensification include the following: (1) TC entering a higher latitude area where the underlying sea is relative cold, (2) TC moving too fast to absorb the thermal energy from the underlying sea, or (3) strong energy loss at the outer band. When adverse conditions and amicable conditions reached equilibrium status, tropical cyclone intensity would remain stable. The dataset from Statistical Hurricane Intensity Prediction Scheme (SHIPS) covering the period of 1982-2003 and the Apriori-based association rule mining algorithm were used to study the associations of underlying geophysical characteristics with the intensity change of tropical cyclones. The data have been stratified into 6 TC categories from tropical depression to category 4 hurricanes based on their strength. The result showed that the persistence of intensity change in the past and the strength of vertical shear in the environment are the most prevalent factors for all of the 6 TC categories. Hyper-edge searching had found 3 sets of parameters which showed strong intramural binds. Most of the parameters used in SHIPS model have a consistent "I-W" relation over different TC categories, indicating a consistent function of those parameters in TC development. However, the "I-W" relations of the relative momentum flux and the meridional motion change from tropical storm stage to hurricane stage, indicating a change in the role of those two parameters in TC development. Because rapid intensification (RI) is a major source of errors when predicting hurricane intensity, the association rule mining algorithm was performed on RI versus non-RI tropical cyclone cases using the same SHIPS dataset. The results had been compared with those from the traditional statistical analysis conducted by Kaplan and DeMaria (2003). The rapid intensification rule with 5 RI conditions proposed by the traditional statistical analysis was found by the association rule mining in this study as well. However, further analysis showed that the 5 RI conditions can be replaced by another association rule using fewer conditions but with a higher RI probability (RIP). This means that the rule with all 5 constraints found by Kaplan and DeMaria is not optimal, and the association rule mining technique can find a rule with fewer constraints yet fits more RI cases. The further analysis with the highest RIPs over different numbers of conditions has demonstrated that the interactions among multiple factors are responsible for the RI process of TCs. However, the influence of factors saturates at certain numbers. This study has shown successful data mining examples in studying tropical cyclone intensification using association rules. The higher RI probability with fewer conditions found by association rule technique is significant. This work demonstrated that data mining techniques can be used as an efficient exploration method to generate hypotheses, and that statistical analysis should be performed to confirm the hypotheses, as is generally expected for data mining applications.

A School/Curricular Intervention Martial Arts Program for At-Risk Students.

ERIC Educational Resources Information Center

Glanz, Jeffrey

Statistics clearly demonstrate the need to assist students who may drop out of school or who may graduate with inadequate academic, social, and emotional skills. This paper describes efforts at one elementary school to address some of the needs of at-risk students. The program revolves around a structured martial arts class designed to develop…

Exploring the Impact of Inadequate Funding for English Language Learners in Colorado School Districts

ERIC Educational Resources Information Center

Ramirez, Al; Carpenter, Dick M., II; Breckenridge, Maureen

2014-01-01

This study investigates the relationship between the academic achievement of all students and inadequate funding for English language learners in Colorado school districts. Several stochastic frontier analysis models were used in lieu of traditional production functions in order to achieve clearer estimates. The analyses detected only a few…

Patients with Gout Treated with Conventional Urate-lowering Therapy: Association with Disease Control, Health-related Quality of Life, and Work Productivity.

PubMed

Wood, Robert; Fermer, Steve; Ramachandran, Sulabha; Baumgartner, Scott; Morlock, Robert

2016-10-01

Implications of inadequate gout control were assessed through health-related quality of life (HRQOL) and work productivity of patients with gout adequately controlled while taking conventional urate-lowering therapy (ULT) for ≥ 3 months vs those whose gout was inadequately controlled. Retrospective data were drawn from the Adelphi Disease Specific Programme (DSP), a cross-sectional survey of patients with gout in France, Germany, the United Kingdom, and the United States. Patients completed these questionnaires: EQ-5D (3L), Patient Reported Outcomes Measurement Information System (PROMIS) Health Assessment Questionnaire (HAQ), and Work Productivity and Activity Impairment. Inadequate control was defined as the most recent serum uric acid (SUA) level > 6 mg/dl (> 360 µmol/l) or ≥ 2 flares in the last 12 months; adequate control as SUA level ≤ 6 mg/dl (≤ 360 µmol/l) and 0 flares. Appropriate statistical tests were used to assess differences between groups. There were 836 (69%) inadequately and 368 (31%) adequately controlled gout cases. Mean age was 61 and 63 years and duration of current ULT was 32 and 57 months, respectively. Patients experiencing inadequate control reported significantly worse functioning and HRQOL, as measured by the EQ-5D (0.790 vs 0.877; difference: -0.087; p < 0.001) and PROMIS HAQ (13.21 vs 6.91; difference: 6.30; p < 0.001) scales. Productivity was also more impaired (work time missed: 4.5% vs 1.3%; impairment while working: 19.1% vs 5.2%; overall work impairment: 20.4% vs 5.6%; activity impairment: 20.3% vs 5.3%; all p < 0.001). Less than one-third of patients had gout that was adequately controlled. Those experiencing inadequately controlled gout reported significantly worse functioning, quality of life, and work productivity. Gout treatment strategies to improve disease control may lead to improvements in HRQOL and productivity.

Infant oral health: Knowledge, attitude and practices of parents in Udaipur, India

PubMed Central

Nagarajappa, Ramesh; Kakatkar, Gauri; Sharda, Archana J; Asawa, Kailash; Ramesh, Gayathri; Sandesh, Nagarajappa

2013-01-01

Background: The aim of this study was to assess the infant oral health (IOH) related knowledge, attitudes and practices (KAP) of parents in Udaipur, India. Materials and Methods: A cross-sectional descriptive study was conducted among 470 parents visiting the Department of Pediatrics, Rabindranath Tagore Medical College and Hospital. A 32-item questionnaire covering socio-demographic characteristics and questions pertaining to KAP regarding IOH care was used to collect the data. Descriptive statistics, Student's t-test, one-way analysis of variance, and Scheffe's test were used for the statistical analysis (P ≤ 0.05). Results: Majority of the parents had good knowledge regarding tooth eruption, but had a poor knowledge of cleaning (58.7%) and development of caries (48.5%). Parents in the age group of 25-30 years showed significantly higher mean knowledge (25.90 ± 3.93), attitude (15.71 ± 2.23), and practice (20.09 ± 2.50) scores. Female parents showed a significantly higher mean knowledge (21.45 ± 4.27) and attitude scores (14.97 ± 2.15) than the male parents. Conclusion: Parent's knowledge on IOH care was inadequate. Health professionals, who are the first to come into contact with expectant and new mothers, need to disseminate appropriate and accurate information about oral health-care for infants. PMID:24348626

Infant oral health: Knowledge, attitude and practices of parents in Udaipur, India.

PubMed

Nagarajappa, Ramesh; Kakatkar, Gauri; Sharda, Archana J; Asawa, Kailash; Ramesh, Gayathri; Sandesh, Nagarajappa

2013-09-01

The aim of this study was to assess the infant oral health (IOH) related knowledge, attitudes and practices (KAP) of parents in Udaipur, India. A cross-sectional descriptive study was conducted among 470 parents visiting the Department of Pediatrics, Rabindranath Tagore Medical College and Hospital. A 32-item questionnaire covering socio-demographic characteristics and questions pertaining to KAP regarding IOH care was used to collect the data. Descriptive statistics, Student's t-test, one-way analysis of variance, and Scheffe's test were used for the statistical analysis (P ≤ 0.05). Majority of the parents had good knowledge regarding tooth eruption, but had a poor knowledge of cleaning (58.7%) and development of caries (48.5%). Parents in the age group of 25-30 years showed significantly higher mean knowledge (25.90 ± 3.93), attitude (15.71 ± 2.23), and practice (20.09 ± 2.50) scores. Female parents showed a significantly higher mean knowledge (21.45 ± 4.27) and attitude scores (14.97 ± 2.15) than the male parents. Parent's knowledge on IOH care was inadequate. Health professionals, who are the first to come into contact with expectant and new mothers, need to disseminate appropriate and accurate information about oral health-care for infants.

[Risk factors for infection in total knee artrhoplasty, including previously unreported intraoperative fracture and deep venous thrombosis].

PubMed

de Dios, M; Cordero-Ampuero, J

2015-01-01

To carry out a statistical analysis on the significant risk factors for deep late infection (prosthetic joint infection, PJI) in patients with a knee arthroplasty (TKA). A retrospective observational case-control study was conducted on a case series of 32 consecutive knee infections, using an analysis of all the risk factors reported in the literature. A control series of 100 randomly selected patients operated in the same Department of a University General Hospital during the same period of time, with no sign of deep infection in their knee arthroplasty during follow-up. Statistical comparisons were made using Pearson for qualitative and ANOVA for quantitative variables. The significant (p>0.05) factors found in the series were: Preoperative previous knee surgery, glucocorticoids, immunosuppressants, inflammatory arthritis. prolonged surgical time, inadequate antibiotic prophylaxis, intraoperative fractures. Postoperative secretion of the wound longer than 10 days, deep palpable haematoma, need for a new surgery, and deep venous thrombosis in lower limbs. Distant infections cutaneous, generalized sepsis, urinary tract, pneumonia, abdominal. This is the first report of intraoperative fractures and deep venous thrombosis as significantly more frequent factors in infected TKAs. Other previously described risk factors for TKA PJI are also confirmed. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

Codifference as a practical tool to measure interdependence

NASA Astrophysics Data System (ADS)

Wyłomańska, Agnieszka; Chechkin, Aleksei; Gajda, Janusz; Sokolov, Igor M.

2015-03-01

Correlation and spectral analysis represent the standard tools to study interdependence in statistical data. However, for the stochastic processes with heavy-tailed distributions such that the variance diverges, these tools are inadequate. The heavy-tailed processes are ubiquitous in nature and finance. We here discuss codifference as a convenient measure to study statistical interdependence, and we aim to give a short introductory review of its properties. By taking different known stochastic processes as generic examples, we present explicit formulas for their codifferences. We show that for the Gaussian processes codifference is equivalent to covariance. For processes with finite variance these two measures behave similarly with time. For the processes with infinite variance the covariance does not exist, however, the codifference is relevant. We demonstrate the practical importance of the codifference by extracting this function from simulated as well as real data taken from turbulent plasma of fusion device and financial market. We conclude that the codifference serves as a convenient practical tool to study interdependence for stochastic processes with both infinite and finite variances as well.

The interactive effects of housing and neighbourhood quality on psychological well-being.

PubMed

Jones-Rounds, McKenzie L; Evans, Gary W; Braubach, Matthias

2014-02-01

Many individuals are subject to the physically and mentally detrimental effects of living in substandard housing and inadequate neighbourhoods. We propose that better physical neighbourhood quality can partially offset some of the negative effects of poor housing quality on psychological well-being. Interviews and questionnaires were used to collect data in a cross-sectional study of housing quality, the state of the surrounding environment, and individual health and well-being for 5605 European adults from the Large Analysis and Review of European housing and health Status conducted by WHO in eight European cities. Multilevel random coefficient modelling was used to statistically analyse the main and interactive effects of housing quality and neighbourhood quality on psychological well-being. Socioeconomic status, employment status, gender and marital status were included as statistical controls. Substandard housing quality and poor neighbourhood quality each contribute to lower psychological well-being. Furthermore better neighbourhood quality buffers against the negative effects of poor housing quality on psychological well-being. These results fill a gap in research concerning the ability of neighbourhood quality to amplify or attenuate housing quality impacts on well-being.

Health care research by degrees N Reid Health care research by degrees Blackwell Scientific 162pp £13.99 0632-03466-1 [Formula: see text].

PubMed

1993-03-03

Inadequately understood statistics so often cloud both the argument of the researcher and the judgement of the reader. Norma Reid brings a refreshing clarity to a complex topic; she takes the mystification and mystique out of statistics. Her basic premiss that theory ought to be based on practical utility and relevance shines through her text and helps to make the subject accessible co clinicians who want to understand the underpinnings of their practice. Research methods, particularly qualitative approaches, are sketchily dealt with when compared with the wealth of detail on the mechanics of computing. Also, it is awkward to find methods and analysis not clearly separated in places (eg, Delphi studies), but ample references direct the reader to more expansive sources. Any attempt to steer the uninitiated through the minefields of computing is fraught with difficulties, and some will be disappointed to find one system used exclusively, but, perhaps, it serves as an illustration rather than a course to be slavishly followed.

Commentary on Sommer et al. 'A randomized experiment of the effects of including alternative medicine in the mandatory benefit package of health insurance.

PubMed

Heusser, P

2000-03-01

The study by Sommer et al. recently reported in Complementary Therapies in Medicine has been heavily criticised in Switzerland since its original publication. Its major problems are an inadequate reflection of real practice, an inadequate study design relative to the central research objective, questionable value of the applied instrument and procedure for health assessment, methodological and statistical problems, and failure to consider literature relevant to the topic. For these reasons, this experimental study does not allow an answer to its central questions as to costs and effectiveness of complementary medicine made available within Switzerland's mandatory basic health insurance provisions. We propose more practice-related, non-experimental prospective study designs to realistically answer these questions.

Factors associated with adequate pain control in hospitalized postsurgical patients diagnosed with cancer.

PubMed

Paice, J A; Mahon, S M; Faut-Callahan, M

1991-12-01

The inadequate management of pain continues to be a significant problem for persons with cancer. Experts suggest that contributing factors include discrepancies in pain assessment, inadequate administration of opiate therapy, and insufficient documentation of the patient's pain experience. This study, part of a multidepartmental investigation into the adequacy of pain management in hospitalized patients, describes the pain experience of surgical oncology patients. Its correlational ex post facto design (n = 34) was guided by Loeser's model of pain. Randomly selected surgical oncology patients were interviewed using a structured format. The patient's primary nurse and physician simultaneously completed brief assessments of their perceptions of the patient's pain intensity. Data were analyzed using descriptive and correlational statistics, and implications for nursing practice and future nursing research are discussed.

Efficient Coding and Statistically Optimal Weighting of Covariance among Acoustic Attributes in Novel Sounds

PubMed Central

Stilp, Christian E.; Kluender, Keith R.

2012-01-01

To the extent that sensorineural systems are efficient, redundancy should be extracted to optimize transmission of information, but perceptual evidence for this has been limited. Stilp and colleagues recently reported efficient coding of robust correlation (r = .97) among complex acoustic attributes (attack/decay, spectral shape) in novel sounds. Discrimination of sounds orthogonal to the correlation was initially inferior but later comparable to that of sounds obeying the correlation. These effects were attenuated for less-correlated stimuli (r = .54) for reasons that are unclear. Here, statistical properties of correlation among acoustic attributes essential for perceptual organization are investigated. Overall, simple strength of the principal correlation is inadequate to predict listener performance. Initial superiority of discrimination for statistically consistent sound pairs was relatively insensitive to decreased physical acoustic/psychoacoustic range of evidence supporting the correlation, and to more frequent presentations of the same orthogonal test pairs. However, increased range supporting an orthogonal dimension has substantial effects upon perceptual organization. Connectionist simulations and Eigenvalues from closed-form calculations of principal components analysis (PCA) reveal that perceptual organization is near-optimally weighted to shared versus unshared covariance in experienced sound distributions. Implications of reduced perceptual dimensionality for speech perception and plausible neural substrates are discussed. PMID:22292057

Is psychology suffering from a replication crisis? What does "failure to replicate" really mean?

PubMed

Maxwell, Scott E; Lau, Michael Y; Howard, George S

2015-09-01

Psychology has recently been viewed as facing a replication crisis because efforts to replicate past study findings frequently do not show the same result. Often, the first study showed a statistically significant result but the replication does not. Questions then arise about whether the first study results were false positives, and whether the replication study correctly indicates that there is truly no effect after all. This article suggests these so-called failures to replicate may not be failures at all, but rather are the result of low statistical power in single replication studies, and the result of failure to appreciate the need for multiple replications in order to have enough power to identify true effects. We provide examples of these power problems and suggest some solutions using Bayesian statistics and meta-analysis. Although the need for multiple replication studies may frustrate those who would prefer quick answers to psychology's alleged crisis, the large sample sizes typically needed to provide firm evidence will almost always require concerted efforts from multiple investigators. As a result, it remains to be seen how many of the recently claimed failures to replicate will be supported or instead may turn out to be artifacts of inadequate sample sizes and single study replications. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Mentoring Faculty: A US National Survey of Its Adequacy and Linkage to Culture in Academic Health Centers.

PubMed

Pololi, Linda H; Evans, Arthur T; Civian, Janet T; Vasiliou, Vasilia; Coplit, Lisa D; Gillum, Linda H; Gibbs, Brian K; Brennan, Robert T

2015-01-01

The aims of this study were to (1) describe the quantity and quality of mentoring faculty in US academic health centers (AHCs), (2) measure associations between mentoring and 12 dimensions that reflect the culture of AHCs, and (3) assess whether mentoring predicts seriously contemplating leaving one's institution. During 2007-2009, our National Initiative on Gender, Culture and Leadership in Medicine (C - Change) conducted a cross-sectional study of faculty from 26 representative AHCs in the United States using the 74-item C - Change Faculty Survey to assess relationships of faculty characteristics and various aspects of the institutional culture (52% response rate). Among the 2178 eligible respondents (assistant, associate, and full professors), we classified their mentoring experience as either inadequate, neutral, or positive. In this national sample, 43% of the 2178 respondents had inadequate mentoring; only 30% had a positive assessment of mentoring. There was no statistical difference by sex, minority status, or rank. Inadequate mentoring was most strongly associated with less institutional support, lower self-efficacy in career advancement, and lower scores on the trust/relationship/inclusion scale. The percent of faculty who had seriously considered leaving their institution was highest among those who had inadequate mentoring (58%), compared to those who were neutral (28%) or had positive mentoring (14%) (all paired comparisons, p < .001). In a national survey of faculty of US AHCs, mentoring was frequently inadequate and this was associated with faculty contemplating leaving their institutions. Positive mentoring, although less prevalent, was associated with many other positive dimensions of AHCs. © 2015 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

A Culture in Transition: Poor Reading and Writing Ability among Children in South African Townships.

ERIC Educational Resources Information Center

Pretorius, E.; Naude, H.

2002-01-01

This study examined factors contributing to poor literacy and numeracy development among black South African children ages 5.5 to 7 years. Findings pointed to a conglomerate of factors, namely inadequate visual-motor integration, poor visual analysis and synthesis, poor fine motor development, and inadequate exposure to mediated reading and…

Aboveground tree biomass statistics for Maine: 1982

Treesearch

Eric H. Wharton; Thomas S. Frieswyk; Anne M. Malley

1985-01-01

Traditional measures of volume inadequately describe the total aboveground wood resource. The 1980-82 inventory of Maine included estimates of aboveground tree biomass on timberland. There are nearly 1,504.4 million green tons of wood and bark in all trees above the ground level, or 88.2 green tons per acre of timberland. Most of the biomass is in growing stock, but 49...

Kids Count in Michigan 1999 Data Book: County Profiles of Child and Family Well-Being.

ERIC Educational Resources Information Center

Zehnder-Merrell, Jane; Corey, Michele

This Kids Count data book for 1999 examines statewide and county level trends in the well-being of Michigan's children, featuring available data on young adolescents, ages 10 to 14. The statistical portrait is based on 15 indicators of well-being: (1) child poverty; (2) free and reduced price lunch; (3) inadequate prenatal care; (4) low…

Research and Teaching: Online Collaborative Misconception Mapping Strategy Enhanced Health Science Students' Discussion and Knowledge of Basic Statistical Concepts

ERIC Educational Resources Information Center

Sas, Magdalena; Bendixen, Lisa D.; Crippen, Kent J.; Saddler, Sterling

2017-01-01

Online discussions have become inherent components of both face-to-face and distance education college courses, yet they often fail to provide much benefit to students' learning outcomes. One reason behind this phenomenon is the lack of or inadequate scaffolding or guidance provided to students when participating on asynchronous discussion boards.…

Barriers to oral health care amongst different social classes in India.

PubMed

Garcha, V; Shetiya, S H; Kakodkar, P

2010-09-01

To investigate and compare the influence of social and cultural factors as access barriers to oral health care amongst people from various social classes. A cross sectional survey in Pimpri, was conducted using a pilot tested 15 item-structured, close-ended and self-administered questionnaire. Two hundred and fifty people aged 35-45 years (50 participants each in five social classes as per British Registrar's General classification of occupation) were selected. The chi-square test was applied to check statistical differences between social classes at 5% level of significance. Overall, it was observed that irrespective of the social class difference 88% participants wished to seek only expert/professional advice for the dental treatment. Unavailability of services on Sunday (63%), going to dentist only when in pain (57%), trying self care or home remedy (54%), inadequate government policies (50%), budgetary constraints (40%) were among the major access barriers. Statistically significant difference in the access barriers among the social classes were found related to: Inadequate government policies, budgetary constraints, appointment schedules, far-off located clinics, myths and fear about dental treatment. Social and cultural factors act as access barriers to oral health care and social class differences have a significant influence on the access barriers.

New High-Performance Droplet Freezing Assay (HP-DFA) for the Analysis of Ice Nuclei with Complex Composition

NASA Astrophysics Data System (ADS)

Kunert, Anna Theresa; Scheel, Jan Frederik; Helleis, Frank; Klimach, Thomas; Pöschl, Ulrich; Fröhlich-Nowoisky, Janine

2016-04-01

Freezing of water above homogeneous freezing is catalyzed by ice nucleation active (INA) particles called ice nuclei (IN), which can be of various inorganic or biological origin. The freezing temperatures reach up to -1 °C for some biological samples and are dependent on the chemical composition of the IN. The standard method to analyze IN in solution is the droplet freezing assay (DFA) established by Gabor Vali in 1970. Several modifications and improvements were already made within the last decades, but they are still limited by either small droplet numbers, large droplet volumes or inadequate separation of the single droplets resulting in mutual interferences and therefore improper measurements. The probability that miscellaneous IN are concentrated together in one droplet increases with the volume of the droplet, which can be described by the Poisson distribution. At a given concentration, the partition of a droplet into several smaller droplets leads to finely dispersed IN resulting in better statistics and therefore in a better resolution of the nucleation spectrum. We designed a new customized high-performance droplet freezing assay (HP-DFA), which represents an upgrade of the previously existing DFAs in terms of temperature range and statistics. The necessity of observing freezing events at temperatures lower than homogeneous freezing due to freezing point depression, requires high-performance thermostats combined with an optimal insulation. Furthermore, we developed a cooling setup, which allows both huge and tiny temperature changes within a very short period of time. Besides that, the new DFA provides the analysis of more than 750 droplets per run with a small droplet volume of 5 μL. This enables a fast and more precise analysis of biological samples with complex IN composition as well as better statistics for every sample at the same time.

Impact of Inadequate Empirical Therapy on the Mortality of Patients with Bloodstream Infections: a Propensity Score-Based Analysis

PubMed Central

Retamar, Pilar; Portillo, María M.; López-Prieto, María Dolores; Rodríguez-López, Fernando; de Cueto, Marina; García, María V.; Gómez, María J.; del Arco, Alfonso; Muñoz, Angel; Sánchez-Porto, Antonio; Torres-Tortosa, Manuel; Martín-Aspas, Andrés; Arroyo, Ascensión; García-Figueras, Carolina; Acosta, Federico; Corzo, Juan E.; León-Ruiz, Laura; Escobar-Lara, Trinidad

2012-01-01

The impact of the adequacy of empirical therapy on outcome for patients with bloodstream infections (BSI) is key for determining whether adequate empirical coverage should be prioritized over other, more conservative approaches. Recent systematic reviews outlined the need for new studies in the field, using improved methodologies. We assessed the impact of inadequate empirical treatment on the mortality of patients with BSI in the present-day context, incorporating recent methodological recommendations. A prospective multicenter cohort including all BSI episodes in adult patients was performed in 15 hospitals in Andalucía, Spain, over a 2-month period in 2006 to 2007. The main outcome variables were 14- and 30-day mortality. Adjusted analyses were performed by multivariate analysis and propensity score-based matching. Eight hundred one episodes were included. Inadequate empirical therapy was administered in 199 (24.8%) episodes; mortality at days 14 and 30 was 18.55% and 22.6%, respectively. After controlling for age, Charlson index, Pitt score, neutropenia, source, etiology, and presentation with severe sepsis or shock, inadequate empirical treatment was associated with increased mortality at days 14 and 30 (odds ratios [ORs], 2.12 and 1.56; 95% confidence intervals [95% CI], 1.34 to 3.34 and 1.01 to 2.40, respectively). The adjusted ORs after a propensity score-based matched analysis were 3.03 and 1.70 (95% CI, 1.60 to 5.74 and 0.98 to 2.98, respectively). In conclusion, inadequate empirical therapy is independently associated with increased mortality in patients with BSI. Programs to improve the quality of empirical therapy in patients with suspicion of BSI and optimization of definitive therapy should be implemented. PMID:22005999

Application of a faith-based integration tool to assess mental and physical health interventions

PubMed Central

Saunders, Donna M.; Leak, Jean; Carver, Monique E.; Smith, Selina A.

2017-01-01

Background To build on current research involving faith-based interventions (FBIs) for addressing mental and physical health, this study a) reviewed the extent to which relevant publications integrate faith concepts with health and b) initiated analysis of the degree of FBI integration with intervention outcomes. Methods Derived from a systematic search of articles published between 2007 and 2017, 36 studies were assessed with a Faith-Based Integration Assessment Tool (FIAT) to quantify faith-health integration. Basic statistical procedures were employed to determine the association of faith-based integration with intervention outcomes. Results The assessed studies possessed (on average) moderate, inconsistent integration because of poor use of faith measures, and moderate, inconsistent use of faith practices. Analysis procedures for determining the effect of FBI integration on intervention outcomes were inadequate for formulating practical conclusions. Conclusions Regardless of integration, interventions were associated with beneficial outcomes. To determine the link between FBI integration and intervention outcomes, additional analyses are needed. PMID:29354795

Further dissemination of medical education projects after presentation at a pediatric national meeting (1998-2008).

PubMed

Smith, Sherilyn; Kind, Terry; Beck, Gary; Schiller, Jocelyn; McLauchlan, Heather; Harris, Mitchell; Gigante, Joseph

2014-01-01

Further dissemination of medical education work presented at national meetings is limited. The purpose of this study was to explore dissemination outcomes of scholarly work in pediatric medical education. Council on Medical Student Education in Pediatrics (COMSEP) members who presented at COMSEP national meetings from 1998 to 2008 received a questionnaire about scholarly dissemination outcomes. Descriptive statistics and chi-square analysis explored variables related to dissemination. Qualitative analysis of free text comments explored barriers to dissemination. Outcomes were determined for 81% of presentations (138/171). The dissemination rate was 67% (92/138 presentations), with 47 publications (34%). Dissemination rates did not vary by presentation type (poster vs. oral) or project type. There was no relationship between presentation type, project type, and dissemination method. Barriers included perceived inadequate time, mentorship, and methodological skills for scholarly work. Most projects were further disseminated. Additional resources including mentoring and protected time for scholarly work are needed by educators to optimize dissemination.

Model of urban poverty alleviation through the development of entrepreneurial spirit and business competence

NASA Astrophysics Data System (ADS)

Aryaningsih, NN; Irianto, Kt; Marsa Arsana, Md; Juli Suarbawa, Kt

2018-01-01

The rapid increased of urban population can not be controlled by the city government. This will have an impact on the emergence of new poverty in urban areas, due to inadequate of the job opportunities and skills. Government programs for poverty alleviation can reduce some rural poverty, but have not been able to overcome poverty in urban areas. The diversity of urban issues and needs is greater than in rural areas. Therefore, it is necessary to conduct the research with the aim to build urban poverty reduction model through the development of entrepreneurship spirit and business competence. This research was conducted by investigation method, and questionnaire. Questionnaires are arranged with rating scale measurements. The validity and reliability of the questionnaire were tested by factor analysis. Model construction is constructed from various informant analyzes and descriptive statistical analysis. The results show that poverty alleviation model is very effective done by developing spirit of entrepreneurship and business competence.

Defective support network: a major obstacle to coping for patients with heart failure: a qualitative study

PubMed Central

Shahrbabaki, Parvin Mangolian; Nouhi, Esmat; Kazemi, Majid; Ahmadi, Fazlollah

2016-01-01

Background Heart failure as a chronic disease poses many challenges for a patient in his or her everyday life. Support in various aspects of life positively affects coping strategies and influences the well-being and health outcomes of heart failure patients. Inadequate support may lead to a worsening of symptoms, increased hospital readmissions, psychological disorders, and a reduced quality of life. Objective This study explored obstacles to coping related to support for heart failure patients as viewed by the patients themselves and their family members and caregivers. Design This qualitative study was conducted using content analysis. The 20 Iranian participants included 11 patients with heart failure, three cardiologists, three nurses, and three family members of heart failure patients selected through purposive sampling. Data were collected through semi-structured interviews and analyzed using the Lundman and Graneheim qualitative content analysis method. Results During data analysis, ‘defective support network’ developed as the main theme along with four other categories of ‘inadequate family performance’, ‘inadequate support by the healthcare team’, ‘distorted societal social support’, and ‘inadequate welfare support’. Conclusion The findings of the current study can assist health authorities and planners in identifying the needs of patients with heart failure so as to focus and plan on facilitating their coping as much as possible by obviating the existing obstacles. PMID:27041539

Systematic search for major genes in schizophrenia: Methodological issues and results from chromosome 12

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

Dawson, E.; Powell, J.F.; Sham, P.

1995-10-09

We describe a method of systematically searching for major genes in disorders of unknown mode of inheritance, using linkage analysis. Our method is designed to minimize the probability of missing linkage due to inadequate exploration of data. We illustrate this method with the results of a search for a locus for schizophrenia on chromosome 12 using 22 highly polymorphic markers in 23 high density pedigrees. The markers span approximately 85-90% of the chromosome and are on average 9.35 cM apart. We have analysed the data using the most plausible current genetic models and allowing for the presence of genetic heterogeneity.more » None of the markers was supportive of linkage and the distribution of the heterogeneity statistics was in accordance with the null hypothesis. 53 refs., 2 figs., 4 tabs.« less

Energy Information Needs--Study by the General Accounting Office; Committee on Interior and Insular Affairs, United States Senate, Ninety-Third Congress, Second Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Interior and Insular Affairs.

This publication contains a study by the General Accounting Office which surveys the present inadequate federal system for gathering and analyzing statistics about energy production and use. The magnitude of the federal energy data effort is discussed, problem areas are specified, details of recent executive and legislative activities are…

America's Demography in the New Century: Aging Baby Boomers and New Immigrants as Major Players. Milken Institute Policy Brief.

ERIC Educational Resources Information Center

Frey, William H.; DeVol, Ross C.

America's demography in the new century will be affected by the aging baby boom generation and by new immigrants. Focus on just the national implications of aging baby boomers and the new immigrants is inadequate. This policy brief takes a regional perspective, examining recent trends and population statistics and making the case that aging baby…

Stationary conditions for stochastic differential equations

NASA Technical Reports Server (NTRS)

Adomian, G.; Walker, W. W.

1972-01-01

This is a preliminary study of possible necessary and sufficient conditions to insure stationarity in the solution process for a stochastic differential equation. It indirectly sheds some light on ergodicity properties and shows that the spectral density is generally inadequate as a statistical measure of the solution. Further work is proceeding on a more general theory which gives necessary and sufficient conditions in a form useful for applications.

Iodine nutritional status in Brazil: a meta-analysis of all studies performed in the country pinpoints to an insufficient evaluation and heterogeneity.

PubMed

Campos, Renata de Oliveira; Barreto, Iasmin dos Santos; Maia, Lorena Rejane de Jesus; Rebouças, Sara Cristina Lima; Cerqueira, Taíse Lima de Oliveira; Oliveira, Clotilde Assis; Santos, Carlos Antônio de Souza Teles; Mendes, Carlos Maurício Cardeal; Teixeira, Leonardo Sena Gomes; Ramos, Helton Estrela

2015-02-01

Iodine deficiency disorder (IDD) is the result of an inadequate dietary intake of iodine, which physiological consequences are endemic goiter and thyroid dysfunction. The objective of this study was to a analyze studies that assessed the status of Brazil's population iodine nutrition and IDD prevalence. Systematic review using PRISMA statement. Electronic database: PubMed, Medline, SciELO and Lilacs. Quality of studies: Newcastle-Ottawa Scale. Meta-analysis was carried out with R Core Team Statistical Software, version 3.1.0 (2014). The summary measure (WMD) and its confidence interval (CI) of 95% were calculated. The "Funnel plot" graph assessed publication bias and heterogeneity. Seventeen papers were eligible: pregnant women (2), school children (9), adults/elderly (4) and preschool children/infants (2). Geographic distribution: North (1), Northeast (1), Midwest (2), Southeast (13), South (3). Twenty-three thousand two hundred seventy-two subjects were evaluated between 1997 and 2013 and all have use urinary iodine (UI) measurement. However, only 7 studies could be included in meta-analysis, all from Southeast region. The overall prevalence of IDD in school children in southeast region was 15.3% (95% CI, 13-35%), however this data had an important heterogeneity, expressed by the I2 Statistic of 99.5%. Only few studies have been performed and enrolled populations from south/southeast region of Brazil. The actual IDD prevalence analysis is complex because it was detected bias due influence of individual studies and very high heterogeneity. IDD might still be high in some areas but this remained unknown even after this meta-analysis evaluation. The generation of a national program for analysis of iodine status in all regions is urgently required.

A comparison of the views of extension agents and farmers regarding extension education courses in Dezful, Iran

NASA Astrophysics Data System (ADS)

Nazarzadeh Zare, Mohsen; Dorrani, Kamal; Gholamali Lavasani, Masoud

2012-11-01

Background and purpose : This study examines the views of farmers and extension agents participating in extension education courses in Dezful, Iran, with regard to problems with these courses. It relies upon a descriptive methodology, using a survey as its instrument. Sample : The statistical population consisted of 5060 farmers and 50 extension agents; all extension agents were studied owing to their small population and a sample of 466 farmers was selected based on the stratified ratio sampling method. For the data analysis, statistical procedures including the t-test and factor analysis were used. Results : The results of factor analysis on the views of farmers indicated that these courses have problems such as inadequate use of instructional materials by extension agents, insufficient employment of knowledgeable and experienced extension agents, bad and inconvenient timing of courses for farmers, lack of logical connection between one curriculum and prior ones, negligence in considering the opinions of farmers in arranging the courses, and lack of information about the time of courses. The findings of factor analysis on the views of extension agents indicated that these courses suffer from problems such as use of consistent methods of instruction for teaching curricula, and lack of continuity between courses and their levels and content. Conclusions : Recommendations include: listening to the views of farmers when planning extension courses; providing audiovisual aids, pamphlets and CDs; arranging courses based on convenient timing for farmers; using incentives to encourage participation; and employing extension agents with knowledge of the latest agricultural issues.

Inadequate Dietary Intake in Patients with Thalassemia

PubMed Central

Fung, Ellen B.; Xu, Yan; Trachtenberg, Felicia; Odame, Isaac; Kwiatkowski, Janet L.; Neufeld, Ellis J.; Thompson, Alexis A.; Boudreaux, Jeanne; Quinn, Charles T.; Vichinsky, Elliott P.

2012-01-01

Background Patients with thalassemia have low circulating levels of many nutrients, but the contribution of dietary intake has not been assessed. Objective Assess dietary intake in a large contemporary sample of patients with thalassemia. Design Prospective, longitudinal cohort study using a validated food frequency questionnaire Participants 221 patients (19.7±11.3 yrs, 106 female) categorized into three age groups: young children (3–7.9 y), older children/adolescents (8–18.9 yr), and adult (≥ 19 yr). 78.8% β-thalassemia; 90% chronically transfused. Setting 10 hematology outpatient clinics in the United States and Canada. Main outcome measures Comparison of intake with U.S. Dietary Reference Intakes, and correlation with serum 25-OH vitamin D and total body iron stores. Statistical Analyses Performed Intake was defined as inadequate if less than the estimated average requirement (EAR). Chi-square, Fisher’s exact and Student’s t-test were utilized to compare intake between age categories and logistic regression analysis to test the relationship between intake and outcomes, controlling for age, gender and race. Results Over 30% of patients consumed inadequate levels of vitamin A, D, E, K, folate, calcium, and magnesium. The only nutrients for which >90% of patients consumed adequate amounts were riboflavin, vitamin B12 and selenium. Dietary inadequacy increased with increasing age group (p<0.01) for vitamins A, C, E, B6, folate, thiamin, calcium, magnesium and zinc. Over half the sample took additional supplements of calcium and vitamin D, although circulating levels of 25-OH vitamin D remained insufficient in 61% of patients. Dietary iron intake was not related to total body iron stores. Conclusion Patients with thalassemia have reduced intake of many key nutrients. These preliminary findings of dietary inadequacy is concerning and supports the need for nutritional monitoring to determine which patients are at greatest risk for nutritional deficiency. Future research should focus on the effect of dietary quality and nutritional status on health outcomes in thalassemia. PMID:22551675

Assessing the impact of health literacy on education retention of stroke patients.

PubMed

Sanders, Kalina; Schnepel, Loretta; Smotherman, Carmen; Livingood, William; Dodani, Sunita; Antonios, Nader; Lukens-Bull, Katryne; Balls-Berry, Joyce; Johnson, Yvonne; Miller, Terri; Hodges, Wayne; Falk, Diane; Wood, David; Silliman, Scott

2014-04-10

Inadequate health literacy is a pervasive problem with major implications for reduced health status and health disparities. Despite the role of focused education in both primary and secondary prevention of stroke, the effect of health literacy on stroke education retention has not been reported. We examined the relationship of health literacy to the retention of knowledge after recommended stroke education. This prospective cross-sectional study was conducted at an urban safety-net hospital. Study subjects were patients older than 18 admitted to the hospital stroke unit with a diagnosis of acute ischemic stroke who were able to provide informed consent to participate (N = 100). Health literacy levels were measured by using the short form of Test of Functional Health Literacy in Adults. Patient education was provided to patients at an inpatient stroke unit by using standardized protocols, in compliance with Joint Commission specifications. The education outcomes for poststroke care education, knowledge retention, was assessed for each subject. The effect of health literacy on the Stroke Patient Education Retention scores was assessed by using univariate and multivariate analyses. Of the 100 participating patients, 59% had inadequate to marginal health literacy. Stroke patients who had marginal health literacy (mean score, 7.45; standard deviation [SD], 1.9) or adequate health literacy (mean score, 7.31; SD, 1.76) had statistically higher education outcome scores than those identified as having inadequate health literacy (mean score, 5.58; SD, 2.06). Results from multivariate analysis indicated that adequate health literacy was most predictive of education outcome retention. This study demonstrated a clear relationship between health literacy and stroke education outcomes. Studies are needed to better understand the relationship of health literacy to key educational outcomes for primary or secondary prevention of stroke and to refine stroke education for literacy levels of high-risk populations.

Financial statistics for public health dispensary decisions in Nigeria: insights on standard presentation typologies.

PubMed

Agundu, Prince Umor C

2003-01-01

Public health dispensaries in Nigeria in recent times have demonstrated the poise to boost corporate productivity in the new millennium and to drive the nation closer to concretising the lofty goal of health-for-all. This is very pronounced considering the face-lift giving to the physical environment, increase in the recruitment and development of professionals, and upward review of financial subventions. However, there is little or no emphasis on basic statistical appreciation/application which enhances the decision making ability of corporate executives. This study used the responses from 120 senior public health officials in Nigeria and analyzed them with chi-square statistical technique. The results established low statistical aptitude, inadequate statistical training programmes, little/no emphasis on statistical literacy compared to computer literacy, amongst others. Consequently, it was recommended that these lapses be promptly addressed to enhance official executive performance in the establishments. Basic statistical data presentation typologies have been articulated in this study to serve as first-aid instructions to the target group, as they represent the contributions of eminent scholars in this area of intellectualism.

Ectopic pregnancy in southern Iran: a statistical review of 96 cases.

PubMed

Javey, H

1976-01-01

A review is presented of 96 cases of ectopic pregnacy over a 7-year period. It is noted that in recent years the incidence of this problem has increased. Inadequately diagnosed and treated pelvic inflammatory disease has been found to be the main predisposing factor (40%). The rate of extra-uterine gestation was 1:336 deliveries. In this study, previous fertility was high, and primigravidae constituted only 10.4% of the total. The effect of previous pelvic operations and pelvic infection is discussed; a statistical review of signs and symptoms is tabulated, and the management of the patient and of concomitant problems is presented.

Emergency Department Visits for Homelessness or Inadequate Housing in New York City before and after Hurricane Sandy.

PubMed

Doran, Kelly M; McCormack, Ryan P; Johns, Eileen L; Carr, Brendan G; Smith, Silas W; Goldfrank, Lewis R; Lee, David C

2016-04-01

Hurricane Sandy struck New York City on October 29, 2012, causing not only a large amount of physical damage, but also straining people's health and disrupting health care services throughout the city. In prior research, we determined that emergency department (ED) visits from the most vulnerable hurricane evacuation flood zones in New York City increased after Hurricane Sandy for several medical diagnoses, but also for the diagnosis of homelessness. In the current study, we aimed to further explore this increase in ED visits for homelessness after Hurricane Sandy's landfall. We performed an observational before-and-after study using an all-payer claims database of ED visits in New York City to compare the demographic characteristics, insurance status, geographic distribution, and health conditions of ED patients with a primary or secondary ICD-9 diagnosis of homelessness or inadequate housing in the first week after Hurricane Sandy's landfall versus the baseline weekly average in 2012 prior to Hurricane Sandy. We found statistically significant increases in ED visits for diagnosis codes of homelessness or inadequate housing in the week after Hurricane Sandy's landfall. Those accessing the ED for homelessness or inadequate housing were more often elderly and insured by Medicare after versus before the hurricane. Secondary diagnoses among those with a primary ED diagnosis of homelessness or inadequate housing also differed after versus before Hurricane Sandy. These observed differences in the demographic, insurance, and co-existing diagnosis profiles of those with an ED diagnosis of homelessness or inadequate housing before and after Hurricane Sandy suggest that a new population cohort-potentially including those who had lost their homes as a result of storm damage-was accessing the ED for homelessness or other housing issues after the hurricane. Emergency departments may serve important public health and disaster response roles after a hurricane, particularly for people who are homeless or lack adequate housing. Further, tracking ED visits for homelessness may represent a novel surveillance mechanism to assess post-disaster infrastructure impact and to prepare for future disasters.

Inadequate Health Literacy in Patients with Arterial Vascular Disease.

PubMed

Strijbos, Ruben M; Hinnen, Jan-Willem; van den Haak, Ronald F F; Verhoeven, Bart A N; Koning, Olivier H J

2018-06-08

The aim was to identify the prevalence of inadequate health literacy in patients with arterial vascular disease. This was a cross sectional study. Patients with arterial vascular disease visiting the outpatient clinic between January 5, 2015 and December 28, 2016, were randomly included and screened for inadequate health literacy with the Newest Vital Sign-Dutch (NVS-D), a validated health literacy assessment measure. A score of <4 out of six identified individuals with inadequate health literacy. Age, gender, highest education level, and reason for consultation were also registered. Data analysis was performed using Student's t-test or the Mann-Whitney U test and chi-square test. Logistic regression with backward elimination was applied to identify independent predictors. A total of 202 patients were included. The mean NVS-D score was 1.91 (SD ± 1.948, median 1). The prevalence of inadequate health literacy was 76.7%. A significantly higher prevalence of inadequate health literacy was found in patients ≥65 years (p < .001) and patients with a lower education level (p < .001). No significant difference was found between female/male patients (p = .056), nor between participants with peripheral arterial occlusive disease and abdominal aortic aneurysm (p = .116). Age (OR 1.060; 95% CI 1.017-1.104; p = .005) and education level (OR 0.164; 95% CI 0.078-0.346; p < .001) were identified as independent predictors of inadequate health literacy. This study shows a prevalence of inadequate health literacy of 76.7% in patients with arterial vascular disease, with a significantly higher prevalence in patients ≥ 65 years and patients with a lower education level. The high prevalence of inadequate health literacy should be considered when information is provided, and suggests the need to further investigate the best methods to convey medical information to this group of vulnerable patients. Copyright © 2018 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.

Practice Governance 101, v. 2013.

PubMed

Hayes, David F

2013-03-01

Consensus governance is a principal weakness leading to group malfunction and failure. Inadequate group governance produces inadequate decisions, leading to inconsistent patient care, inadequate responses to marketplace challenges, and disregard for customers and strategic partners. The effectiveness of consensus management is limited by the pervasive incomplete knowledge and personal biases of partners. Additional structural weaknesses of group behavior include information cascade, the wisdom of the crowd, groupthink, pluralistic ignorance, analysis paralysis, peer pressure, and the herding instinct. Usual corporate governance is, by necessity, the governance model of choice. Full accountability of the decider(s) is the defining requirement of all successful governance models. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Biometrical issues in the analysis of adverse events within the benefit assessment of drugs.

PubMed

Bender, Ralf; Beckmann, Lars; Lange, Stefan

2016-07-01

The analysis of adverse events plays an important role in the benefit assessment of drugs. Consequently, results on adverse events are an integral part of reimbursement dossiers submitted by pharmaceutical companies to health policy decision-makers. Methods applied in the analysis of adverse events commonly include simple standard methods for contingency tables. However, the results produced may be misleading if observations are censored at the time of discontinuation due to treatment switching or noncompliance, resulting in unequal follow-up periods. In this paper, we present examples to show that the application of inadequate methods for the analysis of adverse events in the reimbursement dossier can lead to a downgrading of the evidence on a drug's benefit in the subsequent assessment, as greater harm from the drug cannot be excluded with sufficient certainty. Legal regulations on the benefit assessment of drugs in Germany are presented, in particular, with regard to the analysis of adverse events. Differences in safety considerations between the drug approval process and the benefit assessment are discussed. We show that the naive application of simple proportions in reimbursement dossiers frequently leads to uninterpretable results if observations are censored and the average follow-up periods differ between treatment groups. Likewise, the application of incidence rates may be misleading in the case of recurrent events and unequal follow-up periods. To allow for an appropriate benefit assessment of drugs, adequate survival time methods accounting for time dependencies and duration of follow-up are required, not only for time-to-event efficacy endpoints but also for adverse events. © 2016 The Authors. Pharmaceutical Statistics published by John Wiley & Sons Ltd. © 2016 The Authors. Pharmaceutical Statistics published by John Wiley & Sons Ltd.

Monitoring the quality of total hip replacement in a tertiary care department using a cumulative summation statistical method (CUSUM).

PubMed

Biau, D J; Meziane, M; Bhumbra, R S; Dumaine, V; Babinet, A; Anract, P

2011-09-01

The purpose of this study was to define immediate post-operative 'quality' in total hip replacements and to study prospectively the occurrence of failure based on these definitions of quality. The evaluation and assessment of failure were based on ten radiological and clinical criteria. The cumulative summation (CUSUM) test was used to study 200 procedures over a one-year period. Technical criteria defined failure in 17 cases (8.5%), those related to the femoral component in nine (4.5%), the acetabular component in 32 (16%) and those relating to discharge from hospital in five (2.5%). Overall, the procedure was considered to have failed in 57 of the 200 total hip replacements (28.5%). The use of a new design of acetabular component was associated with more failures. For the CUSUM test, the level of adequate performance was set at a rate of failure of 20% and the level of inadequate performance set at a failure rate of 40%; no alarm was raised by the test, indicating that there was no evidence of inadequate performance. The use of a continuous monitoring statistical method is useful to ensure that the quality of total hip replacement is maintained, especially as newer implants are introduced.

A segmentation editing framework based on shape change statistics

NASA Astrophysics Data System (ADS)

Mostapha, Mahmoud; Vicory, Jared; Styner, Martin; Pizer, Stephen

2017-02-01

Segmentation is a key task in medical image analysis because its accuracy significantly affects successive steps. Automatic segmentation methods often produce inadequate segmentations, which require the user to manually edit the produced segmentation slice by slice. Because editing is time-consuming, an editing tool that enables the user to produce accurate segmentations by only drawing a sparse set of contours would be needed. This paper describes such a framework as applied to a single object. Constrained by the additional information enabled by the manually segmented contours, the proposed framework utilizes object shape statistics to transform the failed automatic segmentation to a more accurate version. Instead of modeling the object shape, the proposed framework utilizes shape change statistics that were generated to capture the object deformation from the failed automatic segmentation to its corresponding correct segmentation. An optimization procedure was used to minimize an energy function that consists of two terms, an external contour match term and an internal shape change regularity term. The high accuracy of the proposed segmentation editing approach was confirmed by testing it on a simulated data set based on 10 in-vivo infant magnetic resonance brain data sets using four similarity metrics. Segmentation results indicated that our method can provide efficient and adequately accurate segmentations (Dice segmentation accuracy increase of 10%), with very sparse contours (only 10%), which is promising in greatly decreasing the work expected from the user.

Utilization of Dental Services in Public Health Center: Dental Attendance, Awareness and Felt Needs.

PubMed

Pewa, Preksha; Garla, Bharath K; Dagli, Rushabh; Bhateja, Geetika Arora; Solanki, Jitendra

2015-10-01

In rural India, dental diseases occur due to many factors, which includes inadequate or improper use of fluoride and a lack of knowledge regarding oral health and oral hygiene, which prevent proper screening and dental care of oral diseases. The objective of the study was to evaluate the dental attendance, awareness and utilization of dental services in public health center. A cross-sectional study was conducted among 251 study subjects who were visiting dental outpatient department (OPD) of public health centre (PHC), Guda Bishnoi, and Jodhpur using a pretested proforma from month of July 2014 to October 2014. A pretested questionnaire was used to collect the data regarding socioeconomic status and demographic factors affecting the utilization of dental services. Pearson's Chi-square test and step-wise logistic regression were applied for the analysis. Statistically significant results were found in relation to age, educational status, socioeconomic status and gender with dental attendance, dental awareness and felt needs. p-value <0.05 was kept as statistically significant. The services provided in public health center should be based on the felt need of the population to increase attendance as well as utilization of dental services, thereby increasing the oral health status of the population.

An Assessment of Organizational Health Literacy Practices at an Academic Health Center.

PubMed

Prince, Latrina Y; Schmidtke, Carsten; Beck, Jules K; Hadden, Kristie B

Organizational health literacy is the degree to which an organization considers and promotes the health literacy of patients. Addressing health literacy at an organizational level has the potential to have a greater impact on more health consumers in a health system than individual-level approaches. The purpose of this study was to assess health care practices at an academic health center using the 10 attributes of a health-literate health care organization. Using a survey research design, the Health Literate Healthcare Organization 10-Item Questionnaire was administered online using total population sampling. Employees (N = 10 300) rated the extent that their organization's health care practices consider and promote patients' health literacy. Differences in responses were assessed using factorial analysis of variance. The mean response was 4.7 on a 7-point Likert scale. Employee training and communication about costs received the lowest ratings. Univariate analyses revealed that there were no statistically significant differences (P = .05) by employees' health profession, years of service, or level of patient contact. There were statistically significant differences by highest education obtained with lowest ratings from employees with college degrees. Survey responses indicate a need for improvements in health care practices to better assist patients with inadequate health literacy.

Maladaptively high and low openness: the case for experiential permeability.

PubMed

Piedmont, Ralph L; Sherman, Martin F; Sherman, Nancy C

2012-12-01

The domain of Openness within the Five-Factor Model (FFM) has received inconsistent support as a source for maladaptive personality functioning, at least when the latter is confined to the disorders of personality included within the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR; APA, ). However, an advantage of the FFM relative to the DSM-IV-TR is that the former was developed to provide a reasonably comprehensive description of general personality structure. Rather than suggest that the FFM is inadequate because the DSM-IV-TR lacks much representation of Openness, it might be just as reasonable to suggest that the DSM-IV-TR is inadequate because it lacks an adequate representation of maladaptive variants of both high and low Openness. This article discusses the development and validation of a measure of these maladaptive variants, the Experiential Permeability Inventory. © 2012 The Authors. Journal of Personality © 2012, Wiley Periodicals, Inc.

Health literacy, computer skills and quality of patient-physician communication in Chinese patients with cataract.

PubMed

Lin, Xianchai; Wang, Mei; Zuo, Yajing; Li, Mingge; Lin, Xiaofeng; Zhu, Siping; Zheng, Yongxin; Yu, Minbin; Lamoureux, Ecosse L

2014-01-01

The aim of the study was to assess levels of health literacy and computer skills in Chinese patients with cataract, and their impact on the doctor-patient relationship. We undertook a cross-sectional study of cataract patients scheduled for cataract extraction procedures in Guangdong Province, China. Generic health literacy was assessed using 3 established screening questions. Adequate computer skills was determined if patients had used a computer and routinely used search engines on the Internet. Socio-demographic measures (e.g., age, sex, education) were obtained from a standardized interview. Participants who indicated that they could not understand what their doctors mean were considered to have had poor patient-physician communications. Of the 211 participants, 92 (43.6%) had inadequate health literacy and 204 (96.7%) inadequate computer skills. In multivariate analysis, females were more likely to have inadequate health literacy (odds ratio = 2.5, 95% confidence intervals [CI]: 1.3 to 4.7). People with inadequately health literacy were more likely to have a poor patient-physician communication (odds ratio = 3.5, 95% CIs: 1.3 to 9.0). Similar associations were found for inadequate computer skills. Chinese elderly patients with cataract have inadequate health literacy and very limited computer skills, which place them at high risk of misunderstanding and mismanaging their ocular conditions. Patient education information other than online materials may improve the eye care and outcomes of these patients.

Association between Allergic Rhinitis and Asthma Control in Peruvian School Children: A Cross-Sectional Study

PubMed Central

Uceda, Mónica; Ziegler, Otto; Lindo, Felipe; Herrera-Pérez, Eder

2013-01-01

Background. Asthma and allergic rhinitis are highly prevalent conditions that cause major illness worldwide. This study aimed to assess the association between allergic rhinitis and asthma control in Peruvian school children. Methods. A cross-sectional study was conducted among 256 children with asthma recruited in 5 schools from Lima and Callao cities. The outcome was asthma control assessed by the asthma control test. A score test for trend of odds was used to evaluate the association between allergic rhinitis severity and the prevalence of inadequate asthma control. A generalized linear regression model was used to estimate the adjusted prevalence ratios of inadequate asthma control. Results. Allergic rhinitis was present in 66.4% of the population with asthma. The trend analysis showed a positive association between allergic rhinitis and the probability of inadequate asthma control (P < 0.001). It was associated with an increased prevalence of inadequate asthma control, with adjusted prevalence ratios of 1.53 (95% confidence interval: 1.19−1.98). Conclusion. This study indicates that allergic rhinitis is associated with an inadequate level of asthma control, giving support to the recommendation of evaluating rhinitis to improve asthma control in children. PMID:23984414

Wearable Devices for Classification of Inadequate Posture at Work Using Neural Networks

PubMed Central

Barkallah, Eya; Freulard, Johan; Otis, Martin J. -D.; Ngomo, Suzy; Ayena, Johannes C.; Desrosiers, Christian

2017-01-01

Inadequate postures adopted by an operator at work are among the most important risk factors in Work-related Musculoskeletal Disorders (WMSDs). Although several studies have focused on inadequate posture, there is limited information on its identification in a work context. The aim of this study is to automatically differentiate between adequate and inadequate postures using two wearable devices (helmet and instrumented insole) with an inertial measurement unit (IMU) and force sensors. From the force sensors located inside the insole, the center of pressure (COP) is computed since it is considered an important parameter in the analysis of posture. In a first step, a set of 60 features is computed with a direct approach, and later reduced to eight via a hybrid feature selection. A neural network is then employed to classify the current posture of a worker, yielding a recognition rate of 90%. In a second step, an innovative graphic approach is proposed to extract three additional features for the classification. This approach represents the main contribution of this study. Combining both approaches improves the recognition rate to 95%. Our results suggest that neural network could be applied successfully for the classification of adequate and inadequate posture. PMID:28862665

Risk factors associated with default among tuberculosis patients in Darjeeling district of West Bengal, India

PubMed Central

Roy, Nirmalya; Basu, Mausumi; Das, Sibasis; Mandal, Amitava; Dutt, Debashis; Dasgupta, Samir

2015-01-01

Background: The treatment outcome “default” under Revised National Tuberculosis Control Program (RNTCP) is a patient who after treatment initiation has interrupted treatment consecutively for more than 2 months. Aims: To assess the timing, characteristics and distribution of the reasons for default with relation to some sociodemographic variables among new sputum-positive (NSP) tuberculosis (TB) patients in Darjeeling District, West Bengal. Settings and Design: A case-control study was conducted in three tuberculosis units (TUs) of Darjeeling from August’2011 to December’2011 among NSP TB patients enrolled for treatment in the TB register from 1st Qtr’09 to 2nd Qtr’10. Patients defaulted from treatment were considered as “cases” and those completed treatment as “controls” (79 cases and 79 controls). Materials and Methods: The enrolled cases and controls were interviewed by the health workers using a predesigned structured pro-forma. Statistical Analysis Used: Logistic regression analysis, odds ratios (OR), adjusted odds ratios (AOR). Results: 75% of the default occurred in the intensive phase (IP); 54.24% retrieval action was done within 1 day during IP and 75% within 1 week during continuation phase (CP); cent percent of the documented retrieval actions were undertaken by the contractual TB program staffs. Most commonly cited reasons for default were alcohol consumption (29.11%), adverse effects of drugs (25.32%), and long distance of DOT center (21.52%). In the logistic regression analysis, the factors independently associated were consumption of alcohol, inadequate knowledge about TB, inadequate patient provider interaction, instances of missed doses, adverse reactions of anti-TB drugs, Government Directly Observed Treatment (DOT) provider and smoking. Conclusions: Most defaults occurred in the intensive phase; pre-treatment counseling and initial home visit play very important role in this regard. Proper counseling by health care workers in patient provider meeting is needed. PMID:26288779

Analysis of the national school feeding program in the municipality of Viçosa, state of Minas Gerais

PubMed Central

Rocha, Naruna Pereira; Filgueiras, Mariana De Santis; de Albuquerque, Fernanda Martins; Milagres, Luana Cupertino; Castro, Ana Paula Pereira; Silva, Mariane Alves; da Costa, Glauce Dias; Priore, Silvia Eloiza; de Novaes, Juliana Farias

2018-01-01

ABSTRACT OBJECTIVE To analyze the implementation of the Brazilian National School Feeding Program as a food and nutritional security policy in public schools. METHODS This a cross-sectional study, with a quantitative and qualitative approach, carried out with 268 schoolchildren aged eight to nine years from the public school system of Viçosa, state of Minas Gerais, Brazil, in 2015. Interviews were carried out using semi-structured questionnaires with the children, parents, cooks, nutritionists, trainer of the Technical Assistance and Rural Extension Company, and president of the School Feeding Council. In order to analyze the implementation of the National School Feeding Program in Viçosa, we evaluated the direct weighing of the food served in the schools using mechanical balances with a capacity of up to 10 kg and the perception of the social players involved in the implementation of the National School Feeding Program. The children were questioned about the acceptance of and adherence to the food offered, in addition to the habit of bringing food from home. Parents reported knowledge about the School Feeding Program and Council. The qualitative analysis consisted of content analysis and quantitative analysis using the chi-square test, Fisher’s exact test, and Mann-Whitney test. We adopted the statistical significance of 5% for quantitative analysis. RESULTS Children reported low adherence to the school feeding program and most of them used to bring food from home. Irregularities were identified in the implementation of the National School Feeding Program, such as: inadequate number of nutritionists, suspension of Council meetings, inadequate infrastructure in the areas of preparation and distribution of meals, lack of training of cooks, lack of nutritional adequacy of the food offered, and lack of actions on food and nutritional education. The Program complied with the recommendations for purchasing food from family farms. CONCLUSIONS The National School Feeding Program presented many irregularities in Viçosa. It is important to monitor the problems identified for better reformulation and planning of the Program, in order to guarantee the food and nutritional security of the children served. PMID:29489989

Analysis of the national school feeding program in the municipality of Viçosa, state of Minas Gerais.

PubMed

Rocha, Naruna Pereira; Filgueiras, Mariana De Santis; Albuquerque, Fernanda Martins de; Milagres, Luana Cupertino; Castro, Ana Paula Pereira; Silva, Mariane Alves; Costa, Glauce Dias da; Priore, Silvia Eloiza; Novaes, Juliana Farias de

2018-01-01

OBJECTIVE To analyze the implementation of the Brazilian National School Feeding Program as a food and nutritional security policy in public schools. METHODS This a cross-sectional study, with a quantitative and qualitative approach, carried out with 268 schoolchildren aged eight to nine years from the public school system of Viçosa, state of Minas Gerais, Brazil, in 2015. Interviews were carried out using semi-structured questionnaires with the children, parents, cooks, nutritionists, trainer of the Technical Assistance and Rural Extension Company, and president of the School Feeding Council. In order to analyze the implementation of the National School Feeding Program in Viçosa, we evaluated the direct weighing of the food served in the schools using mechanical balances with a capacity of up to 10 kg and the perception of the social players involved in the implementation of the National School Feeding Program. The children were questioned about the acceptance of and adherence to the food offered, in addition to the habit of bringing food from home. Parents reported knowledge about the School Feeding Program and Council. The qualitative analysis consisted of content analysis and quantitative analysis using the chi-square test, Fisher's exact test, and Mann-Whitney test. We adopted the statistical significance of 5% for quantitative analysis. RESULTS Children reported low adherence to the school feeding program and most of them used to bring food from home. Irregularities were identified in the implementation of the National School Feeding Program, such as: inadequate number of nutritionists, suspension of Council meetings, inadequate infrastructure in the areas of preparation and distribution of meals, lack of training of cooks, lack of nutritional adequacy of the food offered, and lack of actions on food and nutritional education. The Program complied with the recommendations for purchasing food from family farms. CONCLUSIONS The National School Feeding Program presented many irregularities in Viçosa. It is important to monitor the problems identified for better reformulation and planning of the Program, in order to guarantee the food and nutritional security of the children served.

Sexual Knowledge and Attitude among Girls Who are Getting Married Based on the Information from Yas Pre-marriage Counseling Center.

PubMed

Baghersad, Zahra; Fahami, Fariba; Beigi, Marjan; Hasanzadeh, Akbar

2017-01-01

High prevalence of sexual dysfunction results from inadequate knowledge or inappropriate attitude toward the natural phenomenon of sexual desire. This study aimed to define sexual knowledge and attitude among girls who were getting married and referred to Yas pre-marriage counseling center. This research was a descriptive analytical study. The information of 165 girls, who were about to get married, were collected through convenient sampling using a researcher-made questionnaire. Data were analyzed using SPSS version 16 software. Inferential statistical method and Pearson correlation were used for data analysis. Results showed that the mean scores of sexual knowledge and attitude among the participants were 57.42 and 69.02, respectively. There was a significant association between the mean scores of sexual knowledge and sexual attitude ( P < 0.001, r = 0.63). Results showed that the participants had relatively appropriate knowledge and attitude toward sexual relationship.

Electrochemical biosensors for Salmonella: State of the art and challenges in food safety assessment.

PubMed

Silva, Nádia F D; Magalhães, Júlia M C S; Freire, Cristina; Delerue-Matos, Cristina

2018-01-15

According to the recent statistics, Salmonella is still an important public health issue in the whole world. Legislated reference methods, based on counting plate methods, are sensitive enough but are inadequate as an effective emergency response tool, and are far from a rapid device, simple to use out of lab. An overview of the commercially available rapid methods for Salmonella detection is provided along with a critical discussion of their limitations, benefits and potential use in a real context. The distinguished potentialities of electrochemical biosensors for the development of rapid devices are highlighted. The state-of-art and the newest technologic approaches in electrochemical biosensors for Salmonella detection are presented and a critical analysis of the literature is made in an attempt to identify the current challenges towards a complete solution for Salmonella detection in microbial food control based on electrochemical biosensors. Copyright © 2017 Elsevier B.V. All rights reserved.

Student Bedtimes, Academic Performance, and Health in a Residential High School.

PubMed

Wernette, Maliah J; Emory, Jan

2017-08-01

Inadequate sleep among adolescents is considered an epidemic in the United States. Late night bedtimes could be an important factor in academic performance and health with consequences continuing throughout adulthood. The purpose of this study was to explore the relationships between late night bedtimes, academic performance (grade point average [GPA]), and utilization of health care (school nurse visits) in a residential high school. The data were collected from archival records for one academic semester. The statistical analysis employed the nonparametric Pearson's correlation coefficient ( r) with the standard level of significance (α = .05). Positive and inverse linear relationships were found between bedtime and school nurse visits ( p < .00001) and bedtime and GPA ( p = .007). The findings suggest students' late night bedtimes may be related to increased school nurse visits and lower academic performance. Adolescent late night bedtimes may be an important consideration for academic success and maintaining health in residential high schools.

Nasal mask ventilation is better than face mask ventilation in edentulous patients.

PubMed

Kapoor, Mukul Chandra; Rana, Sandeep; Singh, Arvind Kumar; Vishal, Vindhya; Sikdar, Indranil

2016-01-01

Face mask ventilation of the edentulous patient is often difficult as ineffective seating of the standard mask to the face prevents attainment of an adequate air seal. The efficacy of nasal ventilation in edentulous patients has been cited in case reports but has never been investigated. Consecutive edentulous adult patients scheduled for surgery under general anesthesia with endotracheal intubation, during a 17-month period, were prospectively evaluated. After induction of anesthesia and administration of neuromuscular blocker, lungs were ventilated with a standard anatomical face mask of appropriate size, using a volume controlled anesthesia ventilator with tidal volume set at 10 ml/kg. In case of inadequate ventilation, the mask position was adjusted to achieve best-fit. Inspired and expired tidal volumes were measured. Thereafter, the face mask was replaced by a nasal mask and after achieving best-fit, the inspired and expired tidal volumes were recorded. The difference in expired tidal volumes and airway pressures at best-fit with the use of the two masks and number of patients with inadequate ventilation with use of the masks were statistically analyzed. A total of 79 edentulous patients were recruited for the study. The difference in expiratory tidal volumes with the use of the two masks at best-fit was statistically significant (P = 0.0017). Despite the best-fit mask placement, adequacy of ventilation could not be achieved in 24.1% patients during face mask ventilation, and 12.7% patients during nasal mask ventilation and the difference was statistically significant. Nasal mask ventilation is more efficient than standard face mask ventilation in edentulous patients.

Progressive statistics for studies in sports medicine and exercise science.

PubMed

Hopkins, William G; Marshall, Stephen W; Batterham, Alan M; Hanin, Juri

2009-01-01

Statistical guidelines and expert statements are now available to assist in the analysis and reporting of studies in some biomedical disciplines. We present here a more progressive resource for sample-based studies, meta-analyses, and case studies in sports medicine and exercise science. We offer forthright advice on the following controversial or novel issues: using precision of estimation for inferences about population effects in preference to null-hypothesis testing, which is inadequate for assessing clinical or practical importance; justifying sample size via acceptable precision or confidence for clinical decisions rather than via adequate power for statistical significance; showing SD rather than SEM, to better communicate the magnitude of differences in means and nonuniformity of error; avoiding purely nonparametric analyses, which cannot provide inferences about magnitude and are unnecessary; using regression statistics in validity studies, in preference to the impractical and biased limits of agreement; making greater use of qualitative methods to enrich sample-based quantitative projects; and seeking ethics approval for public access to the depersonalized raw data of a study, to address the need for more scrutiny of research and better meta-analyses. Advice on less contentious issues includes the following: using covariates in linear models to adjust for confounders, to account for individual differences, and to identify potential mechanisms of an effect; using log transformation to deal with nonuniformity of effects and error; identifying and deleting outliers; presenting descriptive, effect, and inferential statistics in appropriate formats; and contending with bias arising from problems with sampling, assignment, blinding, measurement error, and researchers' prejudices. This article should advance the field by stimulating debate, promoting innovative approaches, and serving as a useful checklist for authors, reviewers, and editors.

Behavioral risk factors of constipation in palliative care patients.

PubMed

Dzierżanowski, Tomasz; Ciałkowska-Rysz, Aleksandra

2015-06-01

Constipation is frequently encountered in palliative care patients and remains a significant therapeutic problem. The etiology of constipation is multifactorial. Nutritional and behavioral factors are considered common causes of constipation; however, their impact has not yet been assessed precisely. The aim of this study was to assess the correlation between the frequency of bowel movements (FoBM) and risk factors of constipation in palliative care patients. A cohort retrospective study was performed in three palliative care centers, including outpatient, home, and inpatient care cancer patients using questionnaires on bowel dysfunction symptoms, behavioral risk factors, and opioid use. The inclusion criterion was adult patients examined on the day of admission. The exclusion criterion was Karnofsky performance status score ≤20. Spearman's rank correlation coefficient was used to measure the statistical dependence between two variables and frequency analysis was performed using the chi-squared test and Fisher's exact test. Two hundred thirty-seven valid questionnaires were collected. We found the correlation between FoBM and insufficient food and fluid intake (p < 0.0001), as well as for inadequate conditions of privacy (p = 0.0008), dependency on a caregiver (p = 0.0059), and the patient's overall performance status (p = 0.013). We did not manage to prove bed rest as the independent risk factor of constipation. The main risk factors of constipation in palliative care patients appeared to be insufficient fluid and food intake, inadequate conditions of privacy, dependency on a caregiver, as well as poor general performance status.

Systems Theoretic Process Analysis Applied to an Offshore Supply Vessel Dynamic Positioning System

DTIC Science & Technology

2016-06-01

additional safety issues that were either not identified or inadequately mitigated through the use of Fault Tree Analysis and Failure Modes and...Techniques ...................................................................................................... 15 1.3.1. Fault Tree Analysis...49 3.2. Fault Tree Analysis Comparison

Bypass transition to turbulence and research Desiderata

NASA Technical Reports Server (NTRS)

Morkovin, M. V.

1985-01-01

Bypass transitions are seldom mentioned in texts or meetings on instability and transition to wall turbulence. The nature of a number of bypass transitions is illustrated by example. Until this characteristics is truly understood predicting transition on the basis of theory or statistically inadequate correlations (as they all are) entails risks that should be considered in justifying any design involving transition. A historical overview of bypass transition identified on blunt bodies is given.

2,4,6-Trinitrotoluene (TNT) air concentrations, hemoglobin changes, and anemia cases in respirator protected TNT munitions demilitarization workers.

PubMed

Bradley, Melville D

2011-03-01

2,4,6-Trinitrotoluene (TNT) is an explosive used in munitions production that is known to cause both aplastic and hemolytic anemia in exposed workers. Anemia in a TNT worker is considered a sentinel health event (occupational) (SHE(O)) in the United States (US). Deaths have been reported secondary to aplastic anemia. Studies have shown that TNT systemic absorption is significant by both the respiratory and dermal routes. No studies encountered looked at hemoglobin change or anemia cases in respiratory protected workers. It is hypothesized that respiratory protection is insufficient to protect TNT workers from the risk of anemia development and hemoglobin concentration drop. A records review of eight groups of respiratory protected TNT workers' pre-exposure hemoglobin levels were compared with their during-exposure hemoglobin levels for statistically significant (alpha level 0.05) hemoglobin level changes, and anemia cases were recorded. A curve estimation analysis was performed between mean TNT air concentrations and mean hemoglobin change values. Statistically significant hemoglobin level drops and anemia cases were apparent at TNT air concentrations about the REL and PEL in respiratory protected workers. There were no anemia cases or statistically significant hemoglobin level drops at concentrations about the TLV, however. A statistically significant inverse non-linear regression model was found to be the best fit for regressing hemoglobin change on TNT air concentration. Respiratory protection may be inadequate to prevent workers who are at risk for TNT skin absorption from developing anemia. This study contributes evidence that the TLV should be considered for adoption as the new PEL.

Acceptance Probability (P a) Analysis for Process Validation Lifecycle Stages.

PubMed

Alsmeyer, Daniel; Pazhayattil, Ajay; Chen, Shu; Munaretto, Francesco; Hye, Maksuda; Sanghvi, Pradeep

2016-04-01

This paper introduces an innovative statistical approach towards understanding how variation impacts the acceptance criteria of quality attributes. Because of more complex stage-wise acceptance criteria, traditional process capability measures are inadequate for general application in the pharmaceutical industry. The probability of acceptance concept provides a clear measure, derived from specific acceptance criteria for each quality attribute. In line with the 2011 FDA Guidance, this approach systematically evaluates data and scientifically establishes evidence that a process is capable of consistently delivering quality product. The probability of acceptance provides a direct and readily understandable indication of product risk. As with traditional capability indices, the acceptance probability approach assumes that underlying data distributions are normal. The computational solutions for dosage uniformity and dissolution acceptance criteria are readily applicable. For dosage uniformity, the expected AV range may be determined using the s lo and s hi values along with the worst case estimates of the mean. This approach permits a risk-based assessment of future batch performance of the critical quality attributes. The concept is also readily applicable to sterile/non sterile liquid dose products. Quality attributes such as deliverable volume and assay per spray have stage-wise acceptance that can be converted into an acceptance probability. Accepted statistical guidelines indicate processes with C pk > 1.33 as performing well within statistical control and those with C pk < 1.0 as "incapable" (1). A C pk > 1.33 is associated with a centered process that will statistically produce less than 63 defective units per million. This is equivalent to an acceptance probability of >99.99%.

Electricity supply efficiency and organizational growth and profitability in Lagos, Nigeria

NASA Astrophysics Data System (ADS)

Adeleke, Adedeji Tajudeen

A modern and efficient infrastructure is a basic necessity for economic development and integration into the global economy. The specific problem was the inadequate and unreliable supply of electricity to manufacturing corporations in Lagos, Nigeria. The purpose of the current quantitative correlational research study was to examine if there was a correlation between electricity supply efficiency and organizational growth and profitability in manufacturing corporations in Lagos, Nigeria. The population of the current correlational research study involved 28 out of 34 manufacturing corporations from various industrial sectors in Lagos, Nigeria, that are listed and traded on the Nigerian Stock Exchange. Spearman rho correlations were used to assess the relationships between independent variables of electricity supply efficiency levels and the dependent variables of organizational growth and profitability. The result of the correlational analysis of the data revealed that there was a statistically significant, strong positive correlation between the Average Gross Income (1998-2007) and Average Actual Electricity supply efficiency level (1998-2007), rho = 0.57; p = 0.002. A statistically significant, strong positive correlation was found between the Average Balance Sheet Size (1998-2007) and Average Actual Electricity Supply Efficiency Level (1998-2007), rho = 0.54; p = 0.003. A statistically significant, strong positive correlation between the Average Profit After Tax (1998-2007) and Average Actual Electricity Supply Efficiency Level (1998-2007), rho = 0.60; p = 0.001, was found. No statistically significant correlation between the Average Return on Investment (1998-2007) and Average Actual Electricity supply efficiency level (1998-2007), rho = 0.19; p = 0.33, was discovered.

Breast Cancer Knowledge, Perception and Breast Self- Examination Practices among Yemeni Women: an Application of the Health Belief Model.

PubMed

Al-Sakkaf, Khaled Abdulla; Basaleem, Huda Omer

2016-01-01

The incidence of breast cancer is rapidly increasing in Yemen with recent indications of constituting one-third of female cancers. The main problem in Yemen remains very late presentation of breast cancer, most of which should have been easily recognisable. Since stage of disease at diagnosis is the most important prognostic variable, early diagnosis is an important option to be considered for control of breast cancer in low resourced settings like Yemen. In the present study, we aimed at describing breast cancer knowledge, perceptions and breast self-examination (BSE) practices among a sample of Yemeni women. This cross-sectional study covered 400 women attending four reproductive health centres in Aden, Yemen through face-to-face interview using a structured questionnaire during April - July 2014. We collected data on sociodemographic characteristics, knowledge about breast cancer, and screening practices as well as respondents' perceptions based on the five sub scales of the Health Belief Model (HBM): perceived susceptibility; perceived severity; perceived barriers; perceived benefits; and self-efficacy. The response format was a fivepoint Likert scale. Statistical Package for Social Sciences (SPSS 20) was used for statistical analysis. Statistical significance was set at p<0.05. Logistic regression analysis was conducted with BSE as a dependent variable. The mean age of women was 26.5 (S.D=5.6) years. The majority (89.0%) had never ever performed any screening. Two-thirds of respondents had poor knowledge. Perceived BSE benefits and self-efficacy and lower BSE barriers perception were significant independent predictors of BSE practice. Poor knowledge and inadequate BSE practices are prevailing in Yemen. The need for implementing culturally sensitive targeted education measures is mandatory in the effort to improve early detection and reduce the burden of breast cancer.

BIG DATA AND STATISTICS

PubMed Central

Rossell, David

2016-01-01

Big Data brings unprecedented power to address scientific, economic and societal issues, but also amplifies the possibility of certain pitfalls. These include using purely data-driven approaches that disregard understanding the phenomenon under study, aiming at a dynamically moving target, ignoring critical data collection issues, summarizing or preprocessing the data inadequately and mistaking noise for signal. We review some success stories and illustrate how statistical principles can help obtain more reliable information from data. We also touch upon current challenges that require active methodological research, such as strategies for efficient computation, integration of heterogeneous data, extending the underlying theory to increasingly complex questions and, perhaps most importantly, training a new generation of scientists to develop and deploy these strategies. PMID:27722040

Out-of-plane permeability of multilayer 0°/90° non-crimp fabrics

NASA Astrophysics Data System (ADS)

Fang, Liangchao; Wu, Wenyu; Xu, Chunting; Zhang, Hui

2018-03-01

Layer shift is the main source of the variations in permeability values for multilayer fabrics. This phenomenon could change the flow path and cause inadequate infiltration. In this paper, the out-of-plane permeability of multilayer 0°/90° non-crimp fabrics was analyzed statistically. Based on the prediction models of 2-layer fabrics, every two adjacent layers were regarded as porous media with different permeabilities. The out-of-plane permeability of multilayer fabrics was then modeled with the electrical resistance analogy. Analytical results were compared with experiment data. And the effect of number of layer on permeability was thoroughly researched based on the statistical point of view.

Managing Complexity in Evidence Analysis: A Worked Example in Pediatric Weight Management.

PubMed

Parrott, James Scott; Henry, Beverly; Thompson, Kyle L; Ziegler, Jane; Handu, Deepa

2018-05-02

Nutrition interventions are often complex and multicomponent. Typical approaches to meta-analyses that focus on individual causal relationships to provide guideline recommendations are not sufficient to capture this complexity. The objective of this study is to describe the method of meta-analysis used for the Pediatric Weight Management (PWM) Guidelines update and provide a worked example that can be applied in other areas of dietetics practice. The effects of PWM interventions were examined for body mass index (BMI), body mass index z-score (BMIZ), and waist circumference at four different time periods. For intervention-level effects, intervention types were identified empirically using multiple correspondence analysis paired with cluster analysis. Pooled effects of identified types were examined using random effects meta-analysis models. Differences in effects among types were examined using meta-regression. Context-level effects are examined using qualitative comparative analysis. Three distinct types (or families) of PWM interventions were identified: medical nutrition, behavioral, and missing components. Medical nutrition and behavioral types showed statistically significant improvements in BMIZ across all time points. Results were less consistent for BMI and waist circumference, although four distinct patterns of weight status change were identified. These varied by intervention type as well as outcome measure. Meta-regression indicated statistically significant differences between the medical nutrition and behavioral types vs the missing component type for both BMIZ and BMI, although the pattern varied by time period and intervention type. Qualitative comparative analysis identified distinct configurations of context characteristics at each time point that were consistent with positive outcomes among the intervention types. Although analysis of individual causal relationships is invaluable, this approach is inadequate to capture the complexity of dietetics practice. An alternative approach that integrates intervention-level with context-level meta-analyses may provide deeper understanding in the development of practice guidelines. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

The Microbiome in Posttraumatic Stress Disorder and Trauma-Exposed Controls: An Exploratory Study.

PubMed

Hemmings, Sian M J; Malan-Müller, Stefanie; van den Heuvel, Leigh L; Demmitt, Brittany A; Stanislawski, Maggie A; Smith, David G; Bohr, Adam D; Stamper, Christopher E; Hyde, Embriette R; Morton, James T; Marotz, Clarisse A; Siebler, Philip H; Braspenning, Maarten; Van Criekinge, Wim; Hoisington, Andrew J; Brenner, Lisa A; Postolache, Teodor T; McQueen, Matthew B; Krauter, Kenneth S; Knight, Rob; Seedat, Soraya; Lowry, Christopher A

2017-10-01

Inadequate immunoregulation and elevated inflammation may be risk factors for posttraumatic stress disorder (PTSD), and microbial inputs are important determinants of immunoregulation; however, the association between the gut microbiota and PTSD is unknown. This study investigated the gut microbiome in a South African sample of PTSD-affected individuals and trauma-exposed (TE) controls to identify potential differences in microbial diversity or microbial community structure. The Clinician-Administered PTSD Scale for DSM-5 was used to diagnose PTSD according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Microbial DNA was extracted from stool samples obtained from 18 individuals with PTSD and 12 TE control participants. Bacterial 16S ribosomal RNA gene V3/V4 amplicons were generated and sequenced. Microbial community structure, α-diversity, and β-diversity were analyzed; random forest analysis was used to identify associations between bacterial taxa and PTSD. There were no differences between PTSD and TE control groups in α- or β-diversity measures (e.g., α-diversity: Shannon index, t = 0.386, p = .70; β-diversity, on the basis of analysis of similarities: Bray-Curtis test statistic = -0.033, p = .70); however, random forest analysis highlighted three phyla as important to distinguish PTSD status: Actinobacteria, Lentisphaerae, and Verrucomicrobia. Decreased total abundance of these taxa was associated with higher Clinician-Administered PTSD Scale scores (r = -0.387, p = .035). In this exploratory study, measures of overall microbial diversity were similar among individuals with PTSD and TE controls; however, decreased total abundance of Actinobacteria, Lentisphaerae, and Verrucomicrobia was associated with PTSD status.

Nutrient Intake and Anemia Risk in the WHI Observational Study

PubMed Central

Stanaway, Jeffrey; Neuhouser, Marian L.; Snetselaar, Linda G.; Stefanick, Marcia L.; Arendell, Leslie; Chen, Zhao

2011-01-01

Background Nutritional anemia among post-menopausal women is preventable; recent data on prevalence are limited. Objective To investigate the association between nutrient intakes and anemia prevalence, in relation to both incidence and persistence, in a longitudinal sample of post-menopausal women. We hypothesized that anemia prevalence, incidence and persistence would be greater among women reporting lower intake of B12, folate and iron. Design Prospective cohort analysis. Participants/setting Observational Cohort of the Women’s Health Initiative(WHI-OS) including 93,676 postmenopausal women, age 50 to 79 years, were recruited across the United States at 40 clinical study sites. Women were enrolled between 1993 and 1998; data collection for these analyses continued through 2000. Main outcome measures Anemia was defined as a blood hemoglobin concentration of <12.0 mg/dL. Persistent anemia was defined as anemia present at each measurement time point. Diet was assessed by food frequency questionnaire for iron, folate, B12, red meat and cold breakfast cereal; inadequacies were based on dietary reference intakes for women over age 50 years. Statistical analysis Descriptive statistics (mean and standard deviation) were used to characterize the population demographics, anemia rates and diet. Unconditional logistic regression was used to investigate associations between diet and incident and persistent anemia. Associations are presented as odds ratio (OR) and 95% confidence intervals (CI). Results Anemia was identified in 3,979 women or 5.5% of the cohort. Inadequate intakes of multiple anemia-associated nutrients were less frequent in non-Hispanic whites (7.4%) than other race/ethnic groups (inadequacies demonstrated in 14.6 to 16.3% of sample). Age, body mass index and smoking were associated with anemia. Women with anemia reported lower intakes of energy, protein, folate, B12, iron, vitamin C and red meat. Multiple (more than a single nutrient) dietary deficiencies were associated with a 21% greater risk of persistent anemia (OR-1.21, 95% CI: 1.05–1.41) and three deficiencies resulted in a 44% increase in risk for persistent anemia (OR-1.44, 95% CI: 1.20–1.73). Conclusion Inadequate nutrient intake, a modifiable condition, is associated with greater risk for anemia in post-menopausal women participating in the WHI-OS. Efforts to identify and update incidence estimates for anemia-associated nutrient deficiencies in aging women should be undertaken. PMID:21443985

Students' perspectives of undergraduate research methods education at three public medical schools in Uganda.

PubMed

Munabi, Ian Guyton; Buwembo, William; Joseph, Ruberwa; Peter, Kawungezi; Bajunirwe, Francis; Mwaka, Erisa Sabakaki

2016-01-01

In this study we used a model of adult learning to explore undergraduate students' views on how to improve the teaching of research methods and biostatistics. This was a secondary analysis of survey data of 600 undergraduate students from three medical schools in Uganda. The analysis looked at student's responses to an open ended section of a questionnaire on their views on undergraduate teaching of research methods and biostatistics. Qualitative phenomenological data analysis was done with a bias towards principles of adult learning. Students appreciated the importance of learning research methods and biostatistics as a way of understanding research problems; appropriately interpreting statistical concepts during their training and post-qualification practice; and translating the knowledge acquired. Stressful teaching environment and inadequate educational resource materials were identified as impediments to effective learning. Suggestions for improved learning included: early and continuous exposure to the course; more active and practical approach to teaching; and a need for mentorship. The current methods of teaching research methods and biostatistics leave most of the students in the dissonance phase of learning resulting in none or poor student engagement that results in a failure to comprehend and/or appreciate the principles governing the use of different research methods.

An Item Response Theory Analysis of DSM–IV Personality Disorder Criteria Across Younger and Older Age Groups

PubMed Central

Balsis, Steve; Gleason, Marci E. J.; Woods, Carol M.; Oltmanns, Thomas F.

2015-01-01

Many of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM–IV; American Psychiatric Association, 1994) personality disorder (PD) diagnostic criteria focus on a younger social and occupational context. The absence of age-appropriate criteria for older adults forces researchers and clinicians to draw conclusions based on existing criteria, which are likely inadequate. To explore which DSM–IV PD criteria contain age group measurement bias, the authors report 2 analyses of data on nearly 37,000 participants, ages 18–98 years, taken from a public data set that includes 7 of the 10 PDs (antisocial, avoidant, dependent, histrionic, obsessive–compulsive, paranoid, and schizoid). The 1st analysis revealed that older age groups tend to endorse fewer PD criteria than younger age groups. The 2nd analysis revealed that 29% of the criteria contain measurement bias. Although the latent variable structure for each PD was quite similar across younger and older age groups, some individual criteria were differentially endorsed by younger and older adults with equivalent PD pathology. The presence of measurement bias for these criteria raises questions concerning the assessment of PDs in older adults and the interpretation of existing data. PMID:17385993

Inadequate treatment of ventilator-associated pneumonia: risk factors and impact on outcomes.

PubMed

Teixeira, P J Z; Seligman, R; Hertz, F T; Cruz, D B; Fachel, J M G

2007-04-01

Initial antibiotic therapy is an important determinant of clinical outcomes in ventilator-associated pneumonia (VAP). Several studies have investigated this issue, with conflicting results. This study investigated risk factors of inadequate empirical antimicrobial therapy and its impact on outcomes for patients with a clinical diagnosis of VAP. The primary outcome was adequacy of antimicrobial therapy. Secondary outcomes were duration of mechanical ventilation, hospital and intensive care unit (ICU) lengths of stay, and mortality due to VAP. Mean age was 62.9+/-15.2 years, mean APACHE (Acute Physiological Assessment and Chronic Health Evaluation) II score was 20.1+/-8.1 and mean MODS (Multiple Organ Dysfunction Score) was 3.7+/-2.5. Sixty-nine (45.7%) of 151 patients with a clinical diagnosis of VAP received inadequate antimicrobial treatment for VAP initially. There were 100 (66.2%) episodes of VAP caused by multidrug-resistant pathogens, of which 56% were inadequately treated, whereas the rate of inadequate antimicrobial therapy for VAP caused by susceptible-drug pathogens was 25.5% (P<0.001). Multiple logistic regression analysis revealed that the risk of inadequate antimicrobial treatment was more than twice as great for patients with late-onset VAP [odds ratio (OR), 2.93; 95% confidence interval (CI), 1.30-6.64; P=0.01], and more than three times for patients with VAP caused by multidrug-resistant pathogens (OR, 3.07; 95% CI, 1.29-7.30; P=0.01) or with polymicrobial VAP (OR, 3.67; 95% CI, 1.21-11.12; P=0.02). Inadequate antimicrobial treatment was associated with higher mortality for patients with VAP. Two of three independent risk factors for treatment inadequacy were associated with the isolation and identification of micro-organisms.

Inadequate consultation behavior modulates the relationship between type D personality and impaired health status in chronic heart failure.

PubMed

Pelle, Aline J; Schiffer, Angélique A; Smith, Otto R; Widdershoven, Jos W; Denollet, Johan

2010-06-25

Psychological risk factors for impaired health outcomes have been acknowledged in chronic heart failure (CHF), with Type D personality being such a risk factor. Inadequate consultation behavior, a specific aspect of self-management, might be one mechanism in explaining the adverse effect of Type D on health outcomes. In this study we examined the relationship between Type D personality, impaired disease-specific health status, and inadequate consultation behavior. CHF outpatients (n=313) completed the Type D Scale (DS14) at baseline, and the European Heart Failure Self-care Behaviour Scale (EHFScBS) and the Minnesota Living with Heart Failure Questionnaire (MLWHFQ) at 6-month follow-up. Type D personality independently predicted inadequate consultation behavior (OR=1.80, 95%CI [1.03-3.16], p=.04) and impaired health status (OR=3.61, 95%CI [1.93-6.74], p<.001) at 6-month follow-up, adjusting for demographic and clinical variables. Inadequate consultation behavior (OR=1.80, 95%CI [1.11-2.94], p=.02) and NYHA-class (OR=2.83, 95%CI [1.17-4.71], p<.001) were associated with impaired health status, after controlling for demographics, clinical variables, and Type D personality. Post-hoc multivariable analysis pointed out that Type D patients who displayed inadequate consultation behavior were at a 6-fold increased risk of reporting impaired health status, compared to the reference group of non-Type D patients who displayed adequate consultation behavior (OR=6.06, 95%CI [2.53-14.52], p<.001). These findings provide evidence for inadequate behavior as a mechanism that may explain the link between Type D personality and impaired health status. Future studies are warranted to elaborate on these findings. Copyright 2008 Elsevier Ireland Ltd. All rights reserved.

The concept of a composite perioperative quality index in kidney transplantation.

PubMed

Taber, David J; McGillicuddy, John W; Bratton, Charles F; Lin, Angello; Chavin, Kenneth D; Baliga, Prabhakar K

2014-04-01

Public reporting of patient and graft outcomes in a national registry and close Centers for Medicare and Medicaid Services oversight has resulted in transplantation being a highly regulated surgical discipline. Despite this, transplantation surgery lacks comprehensive tracking and reporting of perioperative quality measures. Therefore, the aim of this study was to determine the association between a kidney transplantation centers' perioperative quality benchmarking and graft and patient outcomes. This was an analysis of 2011 aggregate data compiled from 2 national datasets that track outcomes from member hospitals and transplantation centers. The transplantation centers included in this study were composed of accredited US kidney transplantation centers that report data through the national registry and are associate members of the University HealthSystem Consortium. A total of 16,811 kidney transplantations were performed at 236 centers in the United States in 2011, of which 10,241 (61%) from 93 centers were included in the analysis. Of the 6 perioperative quality indicators, 3 benchmarked metrics were significantly associated with a kidney transplantation center's underperformance: mean ICU length of stay (C-statistic 0.731; p = 0.002), 30-day readmissions (C-statistic 0.697; p = 0.012) and in-hospital complications (C-statistic 0.785; p = 0.001). The composite quality index strongly correlated with inadequate center performance (C-statistic 0.854; p < 0.001, R(2) = 0.349). The centers in the lowest quartile of the quality index performed 2,400 kidney transplantations in 2011, which led to 2,640 more hospital days, 4,560 more ICU days, 120 more postoperative complications, and 144 more patients with 30-day readmissions, when compared with centers in the 3 higher-quality quartiles. An objective index of a transplantation center's quality of perioperative care is significantly associated with patient and graft survival. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Prevalence of Inadequate Immunity to Measles, Mumps, Rubella, and Varicella in MLB and NBA Athletes.

PubMed

Conway, Justin J; Toresdahl, Brett G; Ling, Daphne I; Boniquit, Nicole T; Callahan, Lisa R; Kinderknecht, James J

2018-05-01

Multiple outbreaks of vaccine-preventable viral diseases have occurred in professional sports in recent years. Currently, there is no established protocol for vaccination or immunity screening for professional athletes. There are significant differences in the prevalence of inadequate immunity dependent on age, sport, country of birth, and participation in collegiate sports. Cross-sectional cohort study. Level 4. A sample of Major League Baseball (MLB) and National Basketball Association (NBA) players were screened for serologic evidence of immunity to measles, mumps, rubella, and varicella prior to the 2015 and 2016 seasons. The results were designated as adequate (immune) or inadequate (equivocal or nonimmune) based on laboratory criteria. Comparison with an age-matched control group was performed using data from the National Health and Nutrition Examination Survey (NHANES). A total of 98 athletes (62 MLB, 36 NBA) were screened. The prevalence of inadequate immunity for any virus was 35.5% in MLB players and 33.3% in NBA players. There was a significantly greater risk of inadequate immunity to rubella (risk ratio, 6.38; P < 0.01) and varicella (risk ratio, 4.21; P < 0.01) in athletes compared with the age-matched NHANES population. Our analysis did not reveal differences in rates of immunity based on sport, country of birth (US born vs international), or participation in college athletics. There was a lower rate of inadequate immunity to varicella with increasing age (odds ratio, 0.72; P = 0.05). One-third of athletes studied had inadequate immunity to 1 of the 4 viruses tested. Younger players had a significantly greater risk of inadequate immunity to varicella. Birth outside the US and lack of participation in college athletics were not found to influence immunity rates. These results can inform the development of future screening programs to prevent outbreaks of viral infections in professional athletes.

The Efficacy and Safety of Saxagliptin When Added to Metformin Therapy in Patients With Inadequately Controlled Type 2 Diabetes With Metformin Alone

PubMed Central

DeFronzo, Ralph A.; Hissa, Miguel N.; Garber, Alan J.; Luiz Gross, Jorge; Yuyan Duan, Raina; Ravichandran, Shoba; Chen, Roland S.

2009-01-01

OBJECTIVE This 24-week trial assessed the efficacy and safety of saxagliptin as add-on therapy in patients with type 2 diabetes with inadequate glycemic control with metformin alone. RESEARCH DESIGN AND METHODS This was a randomized, double-blind, placebo-controlled study of saxagliptin (2.5, 5, or 10 mg once daily) or placebo plus a stable dose of metformin (1,500–2,500 mg) in 743 patients (A1C ≥7.0 and ≤10.0%). Efficacy analyses were performed using an ANCOVA model using last observation carried forward methodology on primary (A1C) and secondary (fasting plasma glucose [FPG] and postprandial glucose [PPG] area under the curve [AUC]) end points. RESULTS Saxagliptin (2.5, 5, and 10 mg) plus metformin demonstrated statistically significant adjusted mean decreases from baseline to week 24 versus placebo in A1C (−0.59, −0.69, and −0.58 vs. +0.13%; all P < 0.0001), FPG (−14.31, −22.03, and −20.50 vs. +1.24 mg/dl; all P < 0.0001), and PPG AUC (−8,891, −9,586, and −8,137 vs. −3,291 mg · min/dl; all P < 0.0001). More than twice as many patients achieved A1C <7.0% with 2.5, 5, and 10 mg saxagliptin versus placebo (37, 44, and 44 vs. 17%; all P < 0.0001). β-Cell function and postprandial C-peptide, insulin, and glucagon AUCs improved in all saxagliptin treatment groups at week 24. Incidence of hypoglycemic adverse events and weight reductions were similar to those with placebo. CONCLUSIONS Saxagliptin once daily added to metformin therapy was generally well tolerated and led to statistically significant improvements in glycemic indexes versus placebo added to metformin in patients with type 2 diabetes inadequately controlled with metformin alone. PMID:19478198

Creamatocrit analysis of human milk overestimates fat and energy content when compared to a human milk analyzer using mid-infrared spectroscopy.

PubMed

O'Neill, Edward F; Radmacher, Paula G; Sparks, Blake; Adamkin, David H

2013-05-01

Human milk (HM) is the preferred feeding for human infants but may be inadequate to support the rapid growth of the very-low-birth-weight infant. The creamatocrit (CMCT) has been widely used to guide health care professionals as they analyze HM fortification; however, the CMCT method is based on an equation using assumptions for protein and carbohydrate with fat as the only measured variable. The aim of the present study was to test the hypothesis that a human milk analyzer (HMA) would provide more accurate data for fat and energy content than analysis by CMCT. Fifty-one well-mixed samples of previously frozen expressed HM were obtained after thawing. Previously assayed "control" milk samples were thawed and also run with unknowns. All milk samples were prewarmed at 40°C and then analyzed by both CMCT and HMA. CMCT fat results were substituted in the CMCT equation to reach a value for energy (kcal/oz). Fat results from HMA were entered into a computer model to reach a value for energy (kcal/oz). Fat and energy results were compared by paired t test with statistical significance set at P < 0.05. An additional 10 samples were analyzed locally by both methods and then sent to a certified laboratory for quantitative analysis. Results for fat and energy were analyzed by 1-way analysis of variance with statistical significance set at P < 0.05. Mean fat content by CMCT (5.8 ± 1.9 g/dL) was significantly higher than by HMA (3.2 ± 1.1 g/dL, P < 0.001). Mean energy by CMCT (21.8 ± 3.4 kcal/oz) was also significantly higher than by HMA (17.1 ± 2.9, P < 0.001). Comparison of biochemical analysis with HMA of the subset of milk samples showed no statistical difference for fat and energy, whereas CMCT was significantly higher than for both fat (P < 0.001) and energy (P = 0.002). The CMCT method appears to overestimate fat and energy content of HM samples when compared with HMA and biochemical methods.

Knowledge and practice of nurses towards prevention of pressure ulcer and associated factors in Gondar University Hospital, Northwest Ethiopia.

PubMed

Nuru, Nurhusien; Zewdu, Fisseha; Amsalu, Senafikish; Mehretie, Yohannes

2015-01-01

Pressure ulcers are the common conditions among patients hospitalized in acute and chronic care facilities and impose significant burden on patients, their relatives and caregivers. Pressure ulcers have been described as one of the most costly and physically debilitating complications since the 20(th) century. The pain and discomfort due to pressure ulcer prolongs illness, rehabilitation, time of discharge and even contribute to disability and death. This study was aimed to assess knowledge, practice and factors associated with pressure ulcer prevention among nurses in Gondar University Hospital, North-west Ethiopia. An institution-based cross-sectional survey was conducted from March 15 - April 10, 2014 among 248 nurses in Gondar University hospital. A pretested and structured self-administered questionnaire was used for data collection. Data were entered using EPI info version 3.5.3 statistical software and analyzed using SPSS version 20 statistical package. Descriptive statistics was used to describe the study population in relation to relevant variables. Bivariate and multivariate logistic regression was also carried out to see the effect of each independent variable on the dependent variable. Nearly half (54.4 %) of the nurses had good knowledge; similarly 48.4 % of them had good practice on prevention of pressure ulcer. Educational status [Adjusted Odds Ratio (AOR) = 2.4, 95 % CI (1.39-4.15)], work experience [AOR = 4.8, 95 % CI (1.31-10.62)] and having formal training [AOR = 4.1, 95 % CI (1.29-9.92)] were significantly associated with knowledge on prevention of pressure ulcer. While, satisfaction with nursing leadership [AOR = 1.9, 95 % CI (1.04-3.82)], staff shortage [AOR = 0.07, 95 % CI (0.03-0.13)] and inadequate facilities and equipment [AOR = 0.4, 95 % CI (0.19-0.83)] were found to be significantly associated with the practice on prevention of pressure ulcer. Knowledge and practice of the nurses regarding prevention of pressure ulcer was found to be inadequate. Having higher educational status, attending formal training and being experienced were positively associated with knowledge; while shortage of facilities and equipments, dissatisfaction with nursing leadership and inadequate staff number showed negative association with practice of nurse's pressure ulcer prevention. In-service training and upgrading courses are some of the important steps to improve nurses' knowledge and practice on prevention of ulcer pressure.

Psi experiments: do the best parapsychological experiments justify the claims for psi?

PubMed

Hyman, R

1988-04-15

Since the founding of the Society of Psychical Research in 1982, psychical researchers have, in each generation, generated research reports which they believed justified the existence of paranormal phenomena. Throughout this period the scientific establishment has either rejected or ignored such claims. The parapsychologists, with some justification, complained that their claims were being rejected without the benefit of a fair hearing. This paper asks the question of how well the best contemporary evidence for psi--the term used to designate ESP and psychokinetic phenomena--stands up to fair and unbiased appraisal. The results of the scrutiny of the three most widely heralded programs of research--the remote viewing experiments, the psi ganzfeld research, and the work with random number generators--indicates that parapsychological research falls short of the professed standards of the field. In particular, the available reports indicate that randomization is often inadequate, multiple statistical testing without adjustment for significance levels is prevalent, possibilities for sensory leakage are not uniformly prevented, errors in use of statistical tests are much too common, and documentation is typically inadequate. Although the responsible critic cannot argue that these observed departures from optimal experimental procedures have been the sole cause of the reported findings, it is reasonable to demand that the parapsychologists produce consistently significant findings from experiments that are methodologically adequate before their claims are taken seriously.

Prevalence of obesity recorded in Primary Care.

PubMed

Gutiérrez Angulo, María Luisa; Amenabar Azurmendi, Miren Dolores; Cuesta Solé, María Lourdes; Prieto Esteban, Irene; Mancebo Martínez, Sara; Iglesias Alonso, Amparo

2014-11-01

To ascertain the prevalence of obesity and overweight recording in primary care (PC) clinical records. A descriptive, cross-sectional study. The study was conducted in three urban, primary care centers in Gipuzkoa. 620 computerized clinical records randomly selected from a population of 63,820. Patient age older than 14 years was the only inclusion criterion. Recording of the clinical episode referring to obesity and/or overweight. Other variables included age, sex, body mass index (BMI), waist circumference, comorbidity (diabetes, hypertension, heart failure, among others), and variability of the record made by healthcre professionals at each center. Statistical analysis included a Chi-square test or a Fisher's test for low frequencies. A value of P<.05 was considered significant. Analysis was performed using SPSS(®) v.21 software. Prevalence of recorded obesity was 6%, and 78.4% of those with recorded obesity were women. Overweight was recorded in 3% of subjects, of which 33.2% were women. BMI was recorded in 170 cases (27%). At least one comorbidity was found in 241 subjects (39%). Association of BMI with presence of comorbidity was statistically significant (P=.0001). Recording of obesity was associated to presence of comorbidity (P =.0002). This study confirmed that prevalence of obesity is underestimated, mainly because it is inadequately recorded in clinical histories; that prevalence increases in the presence of other risk factors; and that there is a significant variability in data collection between healthcare professionals. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

Internal quality control in an academic cytopathology laboratory for the introduction of a new reporting system for endometrial cytology.

PubMed

Margari, Niki; Pouliakis, Abraham; Aninos, Dionysios; Meristoudis, Christos; Stamataki, Magdalini; Panayiotides, Ioannis; Karakitsos, Petros

2017-10-01

To evaluate reproducibility of a reporting system for endometrial cytology. Cytologic slides from 49 patients, prepared via liquid based cytology, were blindly examined by five cytopathologists of various experience levels, applying a recently introduced reporting system as previously reported. The agreement among cytopathologists was evaluated via Kappa (κ) statistics and the Kendall's Coefficient of Variation (W); cytologic results were compared with the relevant histologic report. Substantial agreement among all five raters was found in the benign, ACE-L and malignant categories, fair agreement in inadequate and ACE-H categories, whereas only slight agreement in ACE-U. For the three more experienced cytopathologists, an almost perfect agreement was found in inadequate, benign, and ACE-L categories, substantial agreement in ACE-H and malignant categories and fair agreement in ACE-U category. Overall agreement for all five cytopathologists and for all categories was moderate, whereas it was very high for the three senior raters. Using the Kendall's test, both five cytopathologists (W = 0.81) and the three senior ones (W = 0.93) had very high agreement. Sensitivity: 83.33-92.59%, specificity: 83.33-94.74%, ROC area: 71.72-90.3%. Application of appropriate statistical tests shows that integration of a new reporting cytologic system is effective with an overall accuracy around 90%. Both statistical tests applied disclosed lower agreement rates among both all five raters and the three most experienced ones in the intermediate categories constituting the gray zone, thus delineating the need for better training of cytopathologists to correctly identify diagnostic criteria for classification of a given case into these categories. © 2017 Wiley Periodicals, Inc.

Nasal mask ventilation is better than face mask ventilation in edentulous patients

PubMed Central

Kapoor, Mukul Chandra; Rana, Sandeep; Singh, Arvind Kumar; Vishal, Vindhya; Sikdar, Indranil

2016-01-01

Background and Aims: Face mask ventilation of the edentulous patient is often difficult as ineffective seating of the standard mask to the face prevents attainment of an adequate air seal. The efficacy of nasal ventilation in edentulous patients has been cited in case reports but has never been investigated. Material and Methods: Consecutive edentulous adult patients scheduled for surgery under general anesthesia with endotracheal intubation, during a 17-month period, were prospectively evaluated. After induction of anesthesia and administration of neuromuscular blocker, lungs were ventilated with a standard anatomical face mask of appropriate size, using a volume controlled anesthesia ventilator with tidal volume set at 10 ml/kg. In case of inadequate ventilation, the mask position was adjusted to achieve best-fit. Inspired and expired tidal volumes were measured. Thereafter, the face mask was replaced by a nasal mask and after achieving best-fit, the inspired and expired tidal volumes were recorded. The difference in expired tidal volumes and airway pressures at best-fit with the use of the two masks and number of patients with inadequate ventilation with use of the masks were statistically analyzed. Results: A total of 79 edentulous patients were recruited for the study. The difference in expiratory tidal volumes with the use of the two masks at best-fit was statistically significant (P = 0.0017). Despite the best-fit mask placement, adequacy of ventilation could not be achieved in 24.1% patients during face mask ventilation, and 12.7% patients during nasal mask ventilation and the difference was statistically significant. Conclusion: Nasal mask ventilation is more efficient than standard face mask ventilation in edentulous patients. PMID:27625477

Pressure ulcers among terminally ill nursing home residents.

PubMed

Kayser-Jones, Jeanie; Kris, Alison E; Lim, Kyung-Choon; Walent, Ronald J; Halifax, Elizabeth; Paul, Steven M

2008-01-01

The purpose of this prospective, anthropological study was to describe and analyze the experiences and care of terminally ill nursing home residents who were admitted with or acquired pressure ulcers (PUs) after admission. Data were collected in two proprietary nursing homes. Participant observation, in-depth interviews, event analysis, and chart review were used to obtain data. A total of 64 (54.7%) of the 117 terminally ill residents in the study had PUs; 52 (81.3%) of whom died with PUs. The findings disclosed that the absence of family advocacy, inability to speak English, and inadequate staffing and lack of supervision, along with other previously reported risk factors, contributed to the development of PUs. Specifically, inadequate staffing and lack of supervision led to inadequate assistance at mealtime, infrequent repositioning, and inadequate continence care, which in turn led to weight loss, unrelieved pressure on bony prominences, and moist, irritated skin. The outcome was a high rate of residents dying with PUs. Knowledge of and attention to these risk factors can guide nurses in the prevention and management of PUs. Copyright 2008, SLACK Incorporated.

Addressing economic development goals through innovative teaching of university statistics: a case study of statistical modelling in Nigeria

NASA Astrophysics Data System (ADS)

Oseloka Ezepue, Patrick; Ojo, Adegbola

2012-12-01

A challenging problem in some developing countries such as Nigeria is inadequate training of students in effective problem solving using the core concepts of their disciplines. Related to this is a disconnection between their learning and socio-economic development agenda of a country. These problems are more vivid in statistical education which is dominated by textbook examples and unbalanced assessment 'for' and 'of' learning within traditional curricula. The problems impede the achievement of socio-economic development objectives such as those stated in the Nigerian Vision 2020 blueprint and United Nations Millennium Development Goals. They also impoverish the ability of (statistics) graduates to creatively use their knowledge in relevant business and industry sectors, thereby exacerbating mass graduate unemployment in Nigeria and similar developing countries. This article uses a case study in statistical modelling to discuss the nature of innovations in statistics education vital to producing new kinds of graduates who can link their learning to national economic development goals, create wealth and alleviate poverty through (self) employment. Wider implications of the innovations for repositioning mathematical sciences education globally are explored in this article.

Nutrition status, bone mass density, and selective serotonin reuptake inhibitors.

PubMed

Kindilien, Shannon; Goldberg, Elle M; Roberts, Melissa H; Gonzales-Pacheco, Diana

2018-05-07

The association between selective serotonin reuptake inhibitor (SSRI) use and bone mass density (BMD) has been debated. Inadequate diet, which may occur in depressed individuals prescribed SSRIs is also associated with decreased BMD. This study seeks to determine if SSRI use in adults is associated with lower than average BMD while controlling for nutrition related variables. Further, it investigates whether there are potential interactions between micronutrients and SSRI use on BMD. Adults, 655 with an SSRI prescription ≥180 days and 12,372 non-users, were identified in the 2005-2014 National Health and Nutrition Examination Survey (NHANES) data. Survey respondents were propensity score matched on propensity to have an SSRI prescription and compared on femoral neck BMD t-scores. A sub-analysis within SSRI users was conducted to calculate the odds ratio (OR) of having a low (osteopenia or osteoporosis) BMD t-score given SSRI exposure and inadequate daily micronutrient intake. Inadequate daily micronutrient intake was common; over half of SSRI users and non-users had inadequate calcium, vitamin d, and potassium. SSRI use was associated with an absolute reduction of 0.11 in BMD t-score. Inadequate daily vitamin D intake was associated with lower BMD t-scores in both SSRI users and non-users. The interaction of SSRI use and inadequate daily intake of zinc was also associated with low BMD (OR: 1.11, 95% CI: 1.01-1.23). Patient health may be improved by nutritional education, referral to a dietician, or by micronutrient monitoring by the prescribing physician. Copyright © 2017. Published by Elsevier Inc.

Alternative dosing of prophylactic enoxaparin in the trauma patient: is more the answer?

PubMed

Kopelman, Tammy R; O'Neill, Patrick J; Pieri, Paola G; Salomone, Jeffrey P; Hall, Scott T; Quan, Asia; Wells, Jordan R; Pressman, Melissa S

2013-12-01

Inadequate anti-factor Xa levels and increased venous thromboembolic events occur in trauma patients receiving standard prophylactic enoxaparin dosing. The aim of this study was to test the hypothesis that higher dosing (40 mg twice daily) would improve peak anti-Xa levels and decrease venous thromboembolism. A retrospective review was performed of trauma patients who received prophylactic enoxaparin and peak anti-Xa levels over 27 months. Patients were divided on the basis of dose: group A received 30 mg twice daily, and group B received 40 mg twice daily. Demographics and rates of venous thromboembolism were compared between dose groups and patients with inadequate or adequate anti-Xa levels. One hundred twenty-four patients were included, 90 in group A and 34 in group B. Demographics were similar, except that patients in group B had a higher mean body weight. Despite this, only 9% of group B patients had inadequate anti-Xa levels, compared with 33% of those in group A (P = .01). Imaging studies were available in 69 patients and revealed 8 venous thromboembolic events (P = NS, group A vs group B) with significantly more venous thromboembolic events occurring in patients with low anti-Xa levels (P = .02). Although higher dosing of enoxaparin led to improved anti-Xa levels, this did not equate to a statistical decrease in venous thromboembolism. Copyright © 2013 Elsevier Inc. All rights reserved.

Urban poverty and infant-health disparities among African Americans and whites in Milwaukee.

PubMed

Sims, Mario; Rainge, Yolanda

2002-06-01

This study examined neighborhood and infant health disparities between African-American and white mothers in Milwaukee, Wisconsin. Census-block data were used for 1990 and Vital Statistics data were used for 1992 through 1994. African-American mothers lived in less desirable, more segregated neighborhoods than white mothers did in 1990. African-American infant and neonatal mortality rates were twice those of whites (2.3 and 2.0, respectively), while African-American postneonatal mortality rates were three times that of whites (3.0). African-American low and very low birth weight rates were more than twice those of whites (2.5 and 2.6, respectively). All African-American mothers were nearly eight times as likely as all white mothers to have inadequate prenatal care, whereas poor African-American mothers were three times as likely to have inadequate prenatal care as were poor white mothers. Public health experts and practitioners may want to consider the communities of minority patients to devise interventions suitable for addressing health disparities.

Rethinking the measurement of energy poverty in Europe: A critical analysis of indicators and data

PubMed Central

Bouzarovski, Stefan; Snell, Carolyn

2017-01-01

Energy poverty – which has also been recognised via terms such as ‘fuel poverty’ and ‘energy vulnerability’ – occurs when a household experiences inadequate levels of energy services in the home. Measuring energy poverty is challenging, as it is a culturally sensitive and private condition, which is temporally and spatially dynamic. This is compounded by the limited availability of appropriate data and indicators, and lack of consensus on how energy poverty should be conceptualised and measured. Statistical indicators of energy poverty are an important and necessary part of the research and policy landscape. They carry great political weight, and are often used to guide the targeting of energy poverty measures – due to their perceived objectivity – with important consequences for both the indoor and built environment of housing. Focussing on the European Union specifically, this paper critically assesses the available statistical options for monitoring energy poverty, whilst also presenting options for improving existing data. This is examined through the lens of vulnerability thinking, by considering the ways in which policies and institutions, the built fabric and everyday practices shape energy use, alongside the manner in which energy poor households experience and address the issue on a day-to-day basis. PMID:28919837

Can purchasing information be used to predict adherence to cardiovascular medications? An analysis of linked retail pharmacy and insurance claims data

PubMed Central

Krumme, Alexis A; Sanfélix-Gimeno, Gabriel; Franklin, Jessica M; Isaman, Danielle L; Mahesri, Mufaddal; Matlin, Olga S; Shrank, William H; Brennan, Troyen A; Brill, Gregory; Choudhry, Niteesh K

2016-01-01

Objective The use of retail purchasing data may improve adherence prediction over approaches using healthcare insurance claims alone. Design Retrospective. Setting and participants A cohort of patients who received prescription medication benefits through CVS Caremark, used a CVS Pharmacy ExtraCare Health Care (ECHC) loyalty card, and initiated a statin medication in 2011. Outcome We evaluated associations between retail purchasing patterns and optimal adherence to statins in the 12 subsequent months. Results Among 11 010 statin initiators, 43% were optimally adherent at 12 months of follow-up. Greater numbers of store visits per month and dollar amount per visit were positively associated with optimal adherence, as was making a purchase on the same day as filling a prescription (p<0.0001 for all). Models to predict adherence using retail purchase variables had low discriminative ability (C-statistic: 0.563), while models with both clinical and retail purchase variables achieved a C-statistic of 0.617. Conclusions While the use of retail purchases may improve the discriminative ability of claims-based approaches, these data alone appear inadequate for adherence prediction, even with the addition of more complex analytical approaches. Nevertheless, associations between retail purchasing behaviours and adherence could inform the development of quality improvement interventions. PMID:28186924

Treatment of missing data in follow-up studies of randomised controlled trials: A systematic review of the literature.

PubMed

Sullivan, Thomas R; Yelland, Lisa N; Lee, Katherine J; Ryan, Philip; Salter, Amy B

2017-08-01

After completion of a randomised controlled trial, an extended follow-up period may be initiated to learn about longer term impacts of the intervention. Since extended follow-up studies often involve additional eligibility restrictions and consent processes for participation, and a longer duration of follow-up entails a greater risk of participant attrition, missing data can be a considerable threat in this setting. As a potential source of bias, it is critical that missing data are appropriately handled in the statistical analysis, yet little is known about the treatment of missing data in extended follow-up studies. The aims of this review were to summarise the extent of missing data in extended follow-up studies and the use of statistical approaches to address this potentially serious problem. We performed a systematic literature search in PubMed to identify extended follow-up studies published from January to June 2015. Studies were eligible for inclusion if the original randomised controlled trial results were also published and if the main objective of extended follow-up was to compare the original randomised groups. We recorded information on the extent of missing data and the approach used to treat missing data in the statistical analysis of the primary outcome of the extended follow-up study. Of the 81 studies included in the review, 36 (44%) reported additional eligibility restrictions and 24 (30%) consent processes for entry into extended follow-up. Data were collected at a median of 7 years after randomisation. Excluding 28 studies with a time to event primary outcome, 51/53 studies (96%) reported missing data on the primary outcome. The median percentage of randomised participants with complete data on the primary outcome was just 66% in these studies. The most common statistical approach to address missing data was complete case analysis (51% of studies), while likelihood-based analyses were also well represented (25%). Sensitivity analyses around the missing data mechanism were rarely performed (25% of studies), and when they were, they often involved unrealistic assumptions about the mechanism. Despite missing data being a serious problem in extended follow-up studies, statistical approaches to addressing missing data were often inadequate. We recommend researchers clearly specify all sources of missing data in follow-up studies and use statistical methods that are valid under a plausible assumption about the missing data mechanism. Sensitivity analyses should also be undertaken to assess the robustness of findings to assumptions about the missing data mechanism.

Meningitis and legal liability: an otolaryngology perspective.

PubMed

Svider, Peter F; Blake, Danielle M; Sahni, Kiren P; Folbe, Adam J; Liu, James K; Baredes, Soly; Eloy, Jean Anderson

2014-01-01

Meningitis is a potential complication in otolaryngologic procedures and conditions. Severe sequelae make understanding factors involved in relevant malpractice litigation critical. We analyze pertinent litigation for awards, outcomes, patient demographic factors, and other alleged causes of malpractice. Pertinent jury verdict and settlement reports were examined using the Westlaw legal database (Thomson Reuters, New York, NY). Twenty-three cases (60.5%) involved non-iatrogenic injuries, including inadequate treatment or failure to diagnose sinusitis or otitis media, while 15 (39.5%) involved iatrogenic cases, mostly rhinologic procedures. 36.8% of cases were resolved for the defendant, 28.9% with juries awarding damages, and 34.2% with settlements. Although not statistically significant, mean damages awarded were higher than settlements ($2.1 vs. 1.5M, p=0.056), and cases involving pediatric patients were more likely to be resolved with payment than those with adult litigants (80.0% vs. 52.2%, p=0.08 respectively). Other frequent alleged factors included permanent deficits (63.2%), requiring additional surgery (41.1%), death (34.2%), cognitive deficits (21.2%), deafness (15.8%), and inadequate informed consent (33.0% of iatrogenic cases). Practitioners facing litigation related to meningitis may wish to consider these findings, notably for cases involving death or permanent functional deficits, as cases with out of court settlements tended to be resolved with lower payments. Cases involving misdiagnosis may be more likely to be resolved with payment compared with iatrogenic cases. By understanding the issues detailed in this analysis and including them in the informed consent process for patients undergoing rhinologic and otologic procedures, otolaryngologists may potentially improve patient safety and decrease liability. © 2014.

Prevalence of apical periodontitis and quality of root canal treatment in an adult Palestinian sub-population

PubMed Central

Mukhaimer, Raed; Hussein, Emad; Orafi, Ibtesam

2012-01-01

Purpose The aim of this study was to determine the prevalence of apical periodontitis and the technical quality of root canal fillings in a Palestinian sub-population. Methods The panoramic radiographs of 258 patients (142 females, 116 males) attending dental clinics in 2010 were examined to identify the presence of apical lesions associated with any remaining teeth, excluding third molars. The technical quality of root canal fillings was also evaluated by assessing apical extension from the radiographic apex. The panoramic radiographs were taken by a well-trained radiology assistant and evaluated by a radiologist and an endodontist. Statistical analysis was performed with the chi-square test with a significant level set at P < 0.05%. Results Of 6482 teeth examined radiographically, 978 (15.1%) had radiographic signs of apical periodontitis (AP). The prevalence of AP was 8.3% in teeth without filled roots and 59.5% (509/855) in root canal-treated teeth. The prevalence of AP and endodontic treatment increased with age and differed significantly (p < 0.05) between males and females. The majority (74.5%) of root canal fillings was performed inadequately, and most (77.2%) inadequate fillings were >2 mm short of the radiographic apex. The presence of AP was correlated significantly with poorly executed root canal fillings (p < 0.05). Conclusions The present study found a high prevalence and incidence of AP in association with root-filled teeth. The technical quality of many root canal treatments was unacceptable. PMID:23960544

Nursing work hours: individual needs versus working conditions.

PubMed

Silva, Amanda Aparecida; Rotenberg, Lúcia; Fischer, Frida Marina

2011-12-01

To assess factors associated with professional and total hours of work (work + home) among nursing staff. Cross-sectional study conducted in a university hospital in the city of São Paulo, southeastern Brazil, between 2004 and 2005. A total of 696 workers (nurses, nurse technicians and aids), mostly women (87.8%) working day and/or night shifts, participated in the study. A self-administered questionnaire was used to collected information on demographic characteristics, and working and life conditions. Translated and adapted into Portuguese versions of the Job Stress Scale, Effort-reward imbalance, Short-Form-Health-related quality of life and the Work Ability Index were also administered. Logistic regression models were used for data analysis. Sole breadwinner, working night shifts and effort-reward imbalance were the variables associated with both professional (OR = 3.38, OR = 10.43, OR = 2.07, respectively) and total hours of work (OR = 1.57, OR = 3.37, OR = 2.75, respectively). There was no significant association between the variables related to hours of work and low Work Ability Index. Inadequate rest at home was statistically associated with professional (OR = 2.47) and total hours of work (OR = 1.48). Inadequate leisure time was significantly associated with professional hours of work (OR = 1.58) and barely associated with total hours of work (OR = 1.43). The sole breadwinner, working night shifts and effort-reward imbalance are variables that need to be further investigated in studies on work hours among nursing staff. These studies should explore workers' income and the relationship between effort and reward, taking into consideration gender issues.

Is small play area in schools associated with overweight among students? A comparative cross-sectional study in Addis Ababa, Ethiopia.

PubMed

Moges, Tsedey; Gebremichael, Bereket; Shiferaw, Solomon; Yirgu, Robel

2018-05-12

Childhood obesity has more than doubled since it was formally recognized as a global epidemic in 1997. With increasingly dwindling space for private schools in Ethiopia, there is unresolved concern among the public on the possible effect of limited play area in schools on overweight/obesity. This study intended to determine and compare the levels of overweight and obesity among adolescents in private schools with and without adequate play area in Addis Ababa. School based comparative cross-sectional study was conducted among 1276 adolescents. 20 private schools were grouped into two based on their size of play area. Data were collected using a pre-tested questionnaire and anthropometric measurements and analyzed using descriptive statistical tests and logistic regression. The magnitude of overweight and obesity was significantly higher in schools without adequate play area than in schools with adequate play area, % (95% CI) = 19.4% (16.4 - 22.7%) and 14.6% (11.9 - 17.5%) respectively. Inadequate play area was also positively associated with overweight/obesity in the multiple logistic regression analysis, OR (95% CI) = 1.62 (1.05-2.51). Using private car transportation to and from school, father's educational status (secondary school and above) and middle wealth quintile were other significantly associated factors with overweight/obesity, OR (95% CI) =2.27 (1.13-4.57), 2.54 (1.14-5.62) and 2.54 (1.50-4.33) respectively. Inadequate play area in schools is an important contributor for overweight and obesity. Sedentary behavior was also significant factor associated with overweight/obesity.

[Knowledge of HIV and sexually-transmitted diseases in Latin American and Maghrebi immigrants in Catalonia (Spain)].

PubMed

Ríos, Erika; Ferrer, Laia; Casabona, Jordi; Caylá, Joan; Avecilla, Angels; Gómez i Prat, Jordi; Edison, Jesús; Pérez, Olga; García, Susana; Torán, Pere; Ruiz, Marta; Gros, Teresa; Rodríguez, Lourdes; Arribas, David; Folch, Cinta; Esteve, Anna

2009-01-01

To describe and compare levels of knowledge about HIV/AIDS and condom use in the immigrant population. We performed a cross-sectional study by means of a semi-structured questionnaire and face-to face interviews in 238 Latin American and Maghrebi users of medical centers in the Barcelona and North Barcelona-Maresme health areas. The questionnaire included sociodemographic variables and questions on sexual behavior and general knowledge about HIV/AIDS, transmission mechanisms, and means of prevention. A logistic regression model was used to identify the determinants of 'inadequate knowledge of HIV/AIDS'. A total of 53.8% of interviewees had inadequate knowledge of HIV/AIDS. Univariate analysis showed inadequate knowledge to be associated with being from the Maghreb, not living in Barcelona, being without work and not having educational qualifications. Multivariate analysis revealed that the only variables significantly associated with inadequate knowledge were being from the Maghreb as opposed to being from Latin America (OR=4.99; 95% CI: 2.74-5.10) and being unemployed as opposed to being employed (OR=2.59; 95% IC: 1.42-4.73). Condoms were seen as an effective prevention method, but 42.1% of interviewees did not use them in occasional relationships. Knowledge of routes of HIV transmission should be improved and mistaken ideas about infection should be eliminated among Latin American and Maghrebi immigrants. The immigrant population is a vulnerable group that ought to be prioritized to promote prevention programs adapted to its linguistic and cultural specificities.

Effect of Pharmacist Counseling Intervention on Health Care Utilization Following Hospital Discharge: A Randomized Control Trial.

PubMed

Bell, Susan P; Schnipper, Jeffrey L; Goggins, Kathryn; Bian, Aihua; Shintani, Ayumi; Roumie, Christianne L; Dalal, Anuj K; Jacobson, Terry A; Rask, Kimberly J; Vaccarino, Viola; Gandhi, Tejal K; Labonville, Stephanie A; Johnson, Daniel; Neal, Erin B; Kripalani, Sunil

2016-05-01

Reduction in 30-day readmission rates following hospitalization for acute coronary syndrome (ACS) and acute decompensated heart failure (ADHF) is a national goal. The aim of this study was to determine the effect of a tailored, pharmacist-delivered, health literacy intervention on unplanned health care utilization, including hospital readmission or emergency room (ER) visit, following discharge. Randomized, controlled trial with concealed allocation and blinded outcome assessors Two tertiary care academic medical centers Adults hospitalized with a diagnosis of ACS and/or ADHF. Pharmacist-assisted medication reconciliation, inpatient pharmacist counseling, low-literacy adherence aids, and individualized telephone follow-up after discharge The primary outcome was time to first unplanned health care event, defined as hospital readmission or an ER visit within 30 days of discharge. Pre-specified analyses were conducted to evaluate the effects of the intervention by academic site, health literacy status (inadequate versus adequate), and cognition (impaired versus not impaired). Adjusted hazard ratios (aHR) and 95% confidence intervals (CI) are reported. A total of 851 participants enrolled in the study at Vanderbilt University Hospital (VUH) and Brigham and Women's Hospital (BWH). The primary analysis showed no statistically significant effect on time to first unplanned hospital readmission or ER visit among patients who received interventions compared to controls (aHR = 1.04, 95% CI 0.78-1.39). There was an interaction of treatment effect by site (p = 0.04 for interaction); VUH aHR = 0.77, 95% CI 0.51-1.15; BWH aHR = 1.44 (95% CI 0.95-2.12). The intervention reduced early unplanned health care utilization among patients with inadequate health literacy (aHR 0.41, 95% CI 0.17-1.00). There was no difference in treatment effect by patient cognition. A tailored, pharmacist-delivered health literacy-sensitive intervention did not reduce post-discharge unplanned health care utilization overall. The intervention was effective among patients with inadequate health literacy, suggesting that targeted practice of pharmacist intervention in this population may be advantageous.

Trends in statistical methods in articles published in Archives of Plastic Surgery between 2012 and 2017.

PubMed

Han, Kyunghwa; Jung, Inkyung

2018-05-01

This review article presents an assessment of trends in statistical methods and an evaluation of their appropriateness in articles published in the Archives of Plastic Surgery (APS) from 2012 to 2017. We reviewed 388 original articles published in APS between 2012 and 2017. We categorized the articles that used statistical methods according to the type of statistical method, the number of statistical methods, and the type of statistical software used. We checked whether there were errors in the description of statistical methods and results. A total of 230 articles (59.3%) published in APS between 2012 and 2017 used one or more statistical method. Within these articles, there were 261 applications of statistical methods with continuous or ordinal outcomes, and 139 applications of statistical methods with categorical outcome. The Pearson chi-square test (17.4%) and the Mann-Whitney U test (14.4%) were the most frequently used methods. Errors in describing statistical methods and results were found in 133 of the 230 articles (57.8%). Inadequate description of P-values was the most common error (39.1%). Among the 230 articles that used statistical methods, 71.7% provided details about the statistical software programs used for the analyses. SPSS was predominantly used in the articles that presented statistical analyses. We found that the use of statistical methods in APS has increased over the last 6 years. It seems that researchers have been paying more attention to the proper use of statistics in recent years. It is expected that these positive trends will continue in APS.

Randomized clinical trials in dentistry: Risks of bias, risks of random errors, reporting quality, and methodologic quality over the years 1955–2013

PubMed Central

Armijo-Olivo, Susan; Cummings, Greta G.; Amin, Maryam; Flores-Mir, Carlos

2017-01-01

Objectives To examine the risks of bias, risks of random errors, reporting quality, and methodological quality of randomized clinical trials of oral health interventions and the development of these aspects over time. Methods We included 540 randomized clinical trials from 64 selected systematic reviews. We extracted, in duplicate, details from each of the selected randomized clinical trials with respect to publication and trial characteristics, reporting and methodologic characteristics, and Cochrane risk of bias domains. We analyzed data using logistic regression and Chi-square statistics. Results Sequence generation was assessed to be inadequate (at unclear or high risk of bias) in 68% (n = 367) of the trials, while allocation concealment was inadequate in the majority of trials (n = 464; 85.9%). Blinding of participants and blinding of the outcome assessment were judged to be inadequate in 28.5% (n = 154) and 40.5% (n = 219) of the trials, respectively. A sample size calculation before the initiation of the study was not performed/reported in 79.1% (n = 427) of the trials, while the sample size was assessed as adequate in only 17.6% (n = 95) of the trials. Two thirds of the trials were not described as double blinded (n = 358; 66.3%), while the method of blinding was appropriate in 53% (n = 286) of the trials. We identified a significant decrease over time (1955–2013) in the proportion of trials assessed as having inadequately addressed methodological quality items (P < 0.05) in 30 out of the 40 quality criteria, or as being inadequate (at high or unclear risk of bias) in five domains of the Cochrane risk of bias tool: sequence generation, allocation concealment, incomplete outcome data, other sources of bias, and overall risk of bias. Conclusions The risks of bias, risks of random errors, reporting quality, and methodological quality of randomized clinical trials of oral health interventions have improved over time; however, further efforts that contribute to the development of more stringent methodology and detailed reporting of trials are still needed. PMID:29272315

Randomized clinical trials in dentistry: Risks of bias, risks of random errors, reporting quality, and methodologic quality over the years 1955-2013.

PubMed

Saltaji, Humam; Armijo-Olivo, Susan; Cummings, Greta G; Amin, Maryam; Flores-Mir, Carlos

2017-01-01

To examine the risks of bias, risks of random errors, reporting quality, and methodological quality of randomized clinical trials of oral health interventions and the development of these aspects over time. We included 540 randomized clinical trials from 64 selected systematic reviews. We extracted, in duplicate, details from each of the selected randomized clinical trials with respect to publication and trial characteristics, reporting and methodologic characteristics, and Cochrane risk of bias domains. We analyzed data using logistic regression and Chi-square statistics. Sequence generation was assessed to be inadequate (at unclear or high risk of bias) in 68% (n = 367) of the trials, while allocation concealment was inadequate in the majority of trials (n = 464; 85.9%). Blinding of participants and blinding of the outcome assessment were judged to be inadequate in 28.5% (n = 154) and 40.5% (n = 219) of the trials, respectively. A sample size calculation before the initiation of the study was not performed/reported in 79.1% (n = 427) of the trials, while the sample size was assessed as adequate in only 17.6% (n = 95) of the trials. Two thirds of the trials were not described as double blinded (n = 358; 66.3%), while the method of blinding was appropriate in 53% (n = 286) of the trials. We identified a significant decrease over time (1955-2013) in the proportion of trials assessed as having inadequately addressed methodological quality items (P < 0.05) in 30 out of the 40 quality criteria, or as being inadequate (at high or unclear risk of bias) in five domains of the Cochrane risk of bias tool: sequence generation, allocation concealment, incomplete outcome data, other sources of bias, and overall risk of bias. The risks of bias, risks of random errors, reporting quality, and methodological quality of randomized clinical trials of oral health interventions have improved over time; however, further efforts that contribute to the development of more stringent methodology and detailed reporting of trials are still needed.

Preparing Master of Public Health Graduates to Work in Local Health Departments.

PubMed

Hemans-Henry, Calaine; Blake, Janice; Parton, Hilary; Koppaka, Ram; Greene, Carolyn M

2016-01-01

To identify key competencies and skills that all master of public health (MPH) graduates should have to be prepared to work in a local health department. In 2011-2012, the New York City Department of Health and Mental Hygiene administered electronic surveys to 2 categories of staff: current staff with an MPH as their highest degree, and current hiring managers. In all, 312 (77%) staff members with an MPH as their highest degree and 170 (57%) hiring managers responded to the survey. Of the respondents with an MPH as their highest degree, 85% stated that their MPH program prepared them for work at the New York City Health Department. Skills for which MPH graduates most often stated they were underprepared included facility in using SAS® statistical software, quantitative data analysis/statistics, personnel management/leadership, and data collection/database management/data cleaning. Among the skills hiring managers identified as required of MPH graduates, the following were most often cited as those for which newly hired MPH graduates were inadequately prepared: quantitative data analysis, researching/conducting literature reviews, scientific writing and publication, management skills, and working with contracts/requests for proposals. These findings suggest that MPH graduates could be better prepared to work in a local health department upon graduation. To be successful, new MPH graduate hires should possess fundamental skills and knowledge related to analysis, communication, management, and leadership. Local health departments and schools of public health must each contribute to the development of the current and future public health workforce through both formal learning opportunities and supplementary employment-based training to reinforce prior coursework and facilitate practical skill development.

Detection of a gravitropism phenotype in glutamate receptor-like 3.3 mutants of Arabidopsis thaliana using machine vision and computation.

PubMed

Miller, Nathan D; Durham Brooks, Tessa L; Assadi, Amir H; Spalding, Edgar P

2010-10-01

Gene disruption frequently produces no phenotype in the model plant Arabidopsis thaliana, complicating studies of gene function. Functional redundancy between gene family members is one common explanation but inadequate detection methods could also be responsible. Here, newly developed methods for automated capture and processing of time series of images, followed by computational analysis employing modified linear discriminant analysis (LDA) and wavelet-based differentiation, were employed in a study of mutants lacking the Glutamate Receptor-Like 3.3 gene. Root gravitropism was selected as the process to study with high spatiotemporal resolution because the ligand-gated Ca(2+)-permeable channel encoded by GLR3.3 may contribute to the ion fluxes associated with gravity signal transduction in roots. Time series of root tip angles were collected from wild type and two different glr3.3 mutants across a grid of seed-size and seedling-age conditions previously found to be important to gravitropism. Statistical tests of average responses detected no significant difference between populations, but LDA separated both mutant alleles from the wild type. After projecting the data onto LDA solution vectors, glr3.3 mutants displayed greater population variance than the wild type in all four conditions. In three conditions the projection means also differed significantly between mutant and wild type. Wavelet analysis of the raw response curves showed that the LDA-detected phenotypes related to an early deceleration and subsequent slower-bending phase in glr3.3 mutants. These statistically significant, heritable, computation-based phenotypes generated insight into functions of GLR3.3 in gravitropism. The methods could be generally applicable to the study of phenotypes and therefore gene function.

Detection of a Gravitropism Phenotype in glutamate receptor-like 3.3 Mutants of Arabidopsis thaliana Using Machine Vision and Computation

PubMed Central

Miller, Nathan D.; Durham Brooks, Tessa L.; Assadi, Amir H.; Spalding, Edgar P.

2010-01-01

Gene disruption frequently produces no phenotype in the model plant Arabidopsis thaliana, complicating studies of gene function. Functional redundancy between gene family members is one common explanation but inadequate detection methods could also be responsible. Here, newly developed methods for automated capture and processing of time series of images, followed by computational analysis employing modified linear discriminant analysis (LDA) and wavelet-based differentiation, were employed in a study of mutants lacking the Glutamate Receptor-Like 3.3 gene. Root gravitropism was selected as the process to study with high spatiotemporal resolution because the ligand-gated Ca2+-permeable channel encoded by GLR3.3 may contribute to the ion fluxes associated with gravity signal transduction in roots. Time series of root tip angles were collected from wild type and two different glr3.3 mutants across a grid of seed-size and seedling-age conditions previously found to be important to gravitropism. Statistical tests of average responses detected no significant difference between populations, but LDA separated both mutant alleles from the wild type. After projecting the data onto LDA solution vectors, glr3.3 mutants displayed greater population variance than the wild type in all four conditions. In three conditions the projection means also differed significantly between mutant and wild type. Wavelet analysis of the raw response curves showed that the LDA-detected phenotypes related to an early deceleration and subsequent slower-bending phase in glr3.3 mutants. These statistically significant, heritable, computation-based phenotypes generated insight into functions of GLR3.3 in gravitropism. The methods could be generally applicable to the study of phenotypes and therefore gene function. PMID:20647506

Associations of health literacy with diabetic foot outcomes: a systematic review and meta-analysis.

PubMed

Chen, P Y; Elmer, S; Callisaya, M; Wills, K; Greenaway, T M; Winzenberg, T M

2018-05-26

People with diabetes have low health literacy, but the role of the latter in diabetic foot disease is unclear. To determine, through a systematic review and meta-analysis, if health literacy is associated with diabetic foot disease, its risk factors, or foot care. We searched PubMed, EMBASE, CINAHL, Web of Science, Scopus and Science Direct. All studies were screened and data extracted by two independent reviewers. Studies in English with valid and reliable measures of health literacy and published tests of association were included. Data were extracted on the associations between the outcomes and health literacy. Meta-analyses were performed using random effects models. Sixteen articles were included in the systematic review, with 11 in the meta-analysis. In people with inadequate health literacy, the odds of having diabetic foot disease were twice those in people with adequate health literacy, but this was not statistically significant [odds ratio 1.99 (95% CI 0.83, 4.78); two studies in 1278 participants]. There was no statistically significant difference in health literacy levels between people with and without peripheral neuropathy [standardized mean difference -0.14 (95% CI -0.47, 0.18); two studies in 399 participants]. There was no association between health literacy and foot care [correlation coefficient 0.01 (95% CI -0.07, 0.10); seven studies in 1033 participants]. There were insufficient data to exclude associations between health literacy and diabetic foot disease and its risk factors, but health literacy appears unlikely to have a role in foot care. The contribution of low health literacy to diabetic foot disease requires definitive assessment through robust longitudinal studies. © 2018 Diabetes UK.

Functional data analysis of sleeping energy expenditure

USDA-ARS?s Scientific Manuscript database

Adequate sleep is crucial during childhood for metabolic health, and physical and cognitive development. Inadequate sleep can disrupt metabolic homeostasis and alter sleeping energy expenditure (SEE). Functional data analysis methods were applied to SEE data to elucidate the population structure of ...

Oral mucosal conditions in preschool children of low socioeconomic status: prevalence and determinant factors.

PubMed

Vieira-Andrade, Raquel Gonçalves; Martins-Júnior, Paulo Antônio; Corrêa-Faria, Patrícia; Stella, Paulo Eduardo Melo; Marinho, Sandra Aparecida; Marques, Leandro Silva; Ramos-Jorge, Maria Letícia

2013-05-01

The aim of the present study was to determine the prevalence of oral mucosal conditions and associated factors among 541 preschoolers of low socioeconomic status. A cross-sectional study was carried out. Sociodemographic data and information on harmful oral habits were gathered with the use of a questionnaire. A clinical exam was performed for the determination of oral mucosal conditions, dental caries and level of oral hygiene. Data analysis involved statistical analysis, the Kruskal-Wallis test, Mann-Whitney test, chi-square test, Fisher's exact test and multivariate regression (p < 0.05, 95 % CI). The prevalence of oral mucosal conditions was 40.7 %. The most prevalent oral mucosal conditions were coated tongue (23.4 %), melanotic macules (14.4 %), oral ulcers (11.8 %), Fordyce's spots (8.1 %), angular cheilitis (3.0 %), geographic tongue (2.8 %), linea alba (1.5 %) and fistula (1.3 %). Children between 3 and 5 years of age had a greater chance of exhibiting coated tongue (OR, 2.55; 95 % CI, 1.6-4.1), melanotic macules (OR, 4.07; 95 % CI, 2.3-7.2) and Fordyce's spots (OR, 12.70; 95 % CI, 7.2-28.6). The female gender had a greater chance of exhibiting melanotic macules (OR, 2.23; 95 % CI, 1.3-1.8). Coated tongue was more prevalent among children from low-income families (OR, 2.35; 95 % CI, 1.3-4.3) and those with inadequate oral hygiene (OR, 4.65; 95 % CI, 2.9-7.4). Caries constituted a predictive factor for oral ulcers (OR, 2.15; 95 % CI, 1.2-3.9) and fistula (OR, 12.00; 95 % CI, 1.4-11.3). Bruxism (teeth clenching/grinding) was a predictive factor for angular cheilitis (OR, 5.55; 95 % CI, 1.9-16.3). The determinant factors for oral mucosal conditions were the female gender, age between 3 and 5 years, inadequate oral hygiene, low household income, residence in rural areas and presence of dental caries and bruxism.

Cancer incidence attributable to inadequate physical activity in Alberta in 2012

PubMed Central

Brenner, Darren R.; Poirier, Abbey E.; Grundy, Anne; Khandwala, Farah; McFadden, Alison; Friedenreich, Christine M.

2017-01-01

Background: Physical inactivity has been consistently associated with increased risk of colorectal, endometrial, breast (in postmenopausal women), prostate, lung and ovarian cancers. The objective of the current analysis was to estimate the proportion and absolute number of site-specific cancer cases attributable to inadequate physical activity in Alberta in 2012. Methods: We used population attributable risks to estimate the proportion of each site-specific cancer attributable to inactivity. Relative risk estimates were obtained from the epidemiological literature, and prevalence estimates were calculated with the use of data from the Canadian Community Health Survey cycle 2.1 (2003). Respondents who acquired 1.5-2.9 kcal/kg per day and less than 1.5 kcal/kg per day of physical activity were classified as moderately active and inactive, respectively, and both levels were considered inadequate for mitigating cancer risks. We obtained age-, sex- and site-specific cancer incidence data from the Alberta Cancer Registry for 2012. Results: About 59%-75% of men and 69%-78% of women did not engage in adequate physical activity. Overall, 13.8% of cancers across all associated cancers were estimated to be attributable to inadequate physical activity, representing 7.2% of all cancers diagnosed in Alberta in 2012. Suboptimal levels of physical activity had a greater impact among women: the proportion of all associated cancers attributable to inadequate physical activity was 18.3% for women and 9.9% for men. Interpretation: A substantial proportion of cancer cases diagnosed in Alberta were estimated to be attributable to inadequate physical activity. With the high prevalence of physical inactivity among adults in the province, developing strategies to increase physical activity levels could have a notable impact on reducing future cancer burden in Alberta. PMID:28468830

Burden of disease from inadequate water, sanitation and hygiene in low- and middle-income settings: a retrospective analysis of data from 145 countries

PubMed Central

Prüss-Ustün, Annette; Bartram, Jamie; Clasen, Thomas; Colford, John M; Cumming, Oliver; Curtis, Valerie; Bonjour, Sophie; Dangour, Alan D; De France, Jennifer; Fewtrell, Lorna; Freeman, Matthew C; Gordon, Bruce; Hunter, Paul R; Johnston, Richard B; Mathers, Colin; Mäusezahl, Daniel; Medlicott, Kate; Neira, Maria; Stocks, Meredith; Wolf, Jennyfer; Cairncross, Sandy

2014-01-01

Objective To estimate the burden of diarrhoeal diseases from exposure to inadequate water, sanitation and hand hygiene in low- and middle-income settings and provide an overview of the impact on other diseases. Methods For estimating the impact of water, sanitation and hygiene on diarrhoea, we selected exposure levels with both sufficient global exposure data and a matching exposure-risk relationship. Global exposure data were estimated for the year 2012, and risk estimates were taken from the most recent systematic analyses. We estimated attributable deaths and disability-adjusted life years (DALYs) by country, age and sex for inadequate water, sanitation and hand hygiene separately, and as a cluster of risk factors. Uncertainty estimates were computed on the basis of uncertainty surrounding exposure estimates and relative risks. Results In 2012, 502 000 diarrhoea deaths were estimated to be caused by inadequate drinking water and 280 000 deaths by inadequate sanitation. The most likely estimate of disease burden from inadequate hand hygiene amounts to 297 000 deaths. In total, 842 000 diarrhoea deaths are estimated to be caused by this cluster of risk factors, which amounts to 1.5% of the total disease burden and 58% of diarrhoeal diseases. In children under 5 years old, 361 000 deaths could be prevented, representing 5.5% of deaths in that age group. Conclusions This estimate confirms the importance of improving water and sanitation in low- and middle-income settings for the prevention of diarrhoeal disease burden. It also underscores the need for better data on exposure and risk reductions that can be achieved with provision of reliable piped water, community sewage with treatment and hand hygiene. PMID:24779548

Burden of disease from inadequate water, sanitation and hygiene in low- and middle-income settings: a retrospective analysis of data from 145 countries.

PubMed

Prüss-Ustün, Annette; Bartram, Jamie; Clasen, Thomas; Colford, John M; Cumming, Oliver; Curtis, Valerie; Bonjour, Sophie; Dangour, Alan D; De France, Jennifer; Fewtrell, Lorna; Freeman, Matthew C; Gordon, Bruce; Hunter, Paul R; Johnston, Richard B; Mathers, Colin; Mäusezahl, Daniel; Medlicott, Kate; Neira, Maria; Stocks, Meredith; Wolf, Jennyfer; Cairncross, Sandy

2014-08-01

To estimate the burden of diarrhoeal diseases from exposure to inadequate water, sanitation and hand hygiene in low- and middle-income settings and provide an overview of the impact on other diseases. For estimating the impact of water, sanitation and hygiene on diarrhoea, we selected exposure levels with both sufficient global exposure data and a matching exposure-risk relationship. Global exposure data were estimated for the year 2012, and risk estimates were taken from the most recent systematic analyses. We estimated attributable deaths and disability-adjusted life years (DALYs) by country, age and sex for inadequate water, sanitation and hand hygiene separately, and as a cluster of risk factors. Uncertainty estimates were computed on the basis of uncertainty surrounding exposure estimates and relative risks. In 2012, 502,000 diarrhoea deaths were estimated to be caused by inadequate drinking water and 280,000 deaths by inadequate sanitation. The most likely estimate of disease burden from inadequate hand hygiene amounts to 297,000 deaths. In total, 842,000 diarrhoea deaths are estimated to be caused by this cluster of risk factors, which amounts to 1.5% of the total disease burden and 58% of diarrhoeal diseases. In children under 5 years old, 361,000 deaths could be prevented, representing 5.5% of deaths in that age group. This estimate confirms the importance of improving water and sanitation in low- and middle-income settings for the prevention of diarrhoeal disease burden. It also underscores the need for better data on exposure and risk reductions that can be achieved with provision of reliable piped water, community sewage with treatment and hand hygiene. © 2014 The Authors. Tropical Medicine and International Health published by John Wiley & Sons Ltd.

Methodological quality and reporting of systematic reviews in hand and wrist pathology.

PubMed

Wasiak, J; Shen, A Y; Ware, R; O'Donohoe, T J; Faggion, C M

2017-10-01

The objective of this study was to assess methodological and reporting quality of systematic reviews in hand and wrist pathology. MEDLINE, EMBASE and Cochrane Library were searched from inception to November 2016 for relevant studies. Reporting quality was evaluated using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and methodological quality using a measurement tool to assess systematic reviews, the Assessment of Multiple Systematic Reviews (AMSTAR). Descriptive statistics and linear regression were used to identify features associated with improved methodological quality. A total of 91 studies were included in the analysis. Most reviews inadequately reported PRISMA items regarding study protocol, search strategy and bias and AMSTAR items regarding protocol, publication bias and funding. Systematic reviews published in a plastics journal, or which included more authors, were associated with higher AMSTAR scores. A large proportion of systematic reviews within hand and wrist pathology literature score poorly with validated methodological assessment tools, which may affect the reliability of their conclusions. I.

Comparison of the pattern, efficacy, and tolerability of self-medicated drugs in primary dysmenorrhea: a questionnaire based survey.

PubMed

Sugumar, Ramya; Krishnaiah, Vasundara; Channaveera, Gokul Shetty; Mruthyunjaya, Shilpa

2013-01-01

To compare the pattern, efficacy, and tolerability of self-medicated drugs and to assess the adequacy of their dose in primary dysmenorrhea (PD). A survey using a self-developed, validated, objective, and structured questionnaire as a tool was conducted among subjects with PD. Statistical analysis was carried out using Chi-square test and ANOVA with post-hoc Tuckey's test. Out of 641 respondents, 42% were self-medicated. The pattern of drugs used was: Dicyclomine, an unknown drug, mefenamic acid, mefenamic acid + dicyclomine, and metamizole by 35%, 29%, 26%, 9%, and 1% of respondents, respectively. Mefenamic acid + dicyclomine, the combination was the most efficacious in comparison to other drugs in moderate to severe dysmenorrhea. There was better tolerability with mefenamic acid + dicyclomine group compared to other drugs. Sub-therapeutic doses were used by 86% of self-medicating respondents. The prevailing self-medication practices were inappropriate in a substantial proportion of women with inadequate knowledge regarding appropriate drug choice, therapeutic doses, and their associated side effects.

Nutrition education: a survey of practices and perceptions in undergraduate dietetics education.

PubMed

Short, Joy E; Chittooran, Mary M

2004-10-01

Electronic mail messages linked to an online survey were sent to 281 directors of didactic and coordinated programs in dietetics to investigate coverage of nutrition education in undergraduate curriculua, perceived importance of topics, and perceived trends. Descriptive statistics and content analysis were performed on responses from 117 programs. Programs addressed nutrition education through a variety of methods and materials. Fifty-three percent (n=62) offered a course dedicated to nutrition education. The most common teaching methods were didactic (88%) and experiential learning (87%). Most of the topics investigated, including those addressed by the Commission on Accreditation for Dietetics Education Accreditation Manual, were viewed as important, very important, or essential. Perceived trends included increased use of technology, theories/models, client-centered education, cultural awareness, and behavior change. Eighty-eight percent of respondents indicated satisfaction with nutrition education curriculum strategies. Dissatisfaction was associated with inadequate time and resources, need for course improvement, and lack of control over experiences. Results may aid in curriculum development.

Structural kinetic modeling of metabolic networks.

PubMed

Steuer, Ralf; Gross, Thilo; Selbig, Joachim; Blasius, Bernd

2006-08-08

To develop and investigate detailed mathematical models of metabolic processes is one of the primary challenges in systems biology. However, despite considerable advance in the topological analysis of metabolic networks, kinetic modeling is still often severely hampered by inadequate knowledge of the enzyme-kinetic rate laws and their associated parameter values. Here we propose a method that aims to give a quantitative account of the dynamical capabilities of a metabolic system, without requiring any explicit information about the functional form of the rate equations. Our approach is based on constructing a local linear model at each point in parameter space, such that each element of the model is either directly experimentally accessible or amenable to a straightforward biochemical interpretation. This ensemble of local linear models, encompassing all possible explicit kinetic models, then allows for a statistical exploration of the comprehensive parameter space. The method is exemplified on two paradigmatic metabolic systems: the glycolytic pathway of yeast and a realistic-scale representation of the photosynthetic Calvin cycle.

Perspectives on African Ozone from Sondes, Dobson and Aircraft Measurements

NASA Technical Reports Server (NTRS)

Thompson, A. M.; Witte, J. C.; Chatfield, R. B.; Diab, R. D.; Thouret, V.; Sauvage, B.

2004-01-01

We have been studying variability in ozone over Africa using data from ozonesondes (vertical profiles from surface to stratosphere), aircraft (the MOZAIC dataset with cruise altitude and landing/takeoff profiles) and the ground (Dobson spectrophotometer total ozone column measurement). The following may give context for ozone investigations during AMMA: 1. Total ozone measurements since 1989 show considerable variability in mean value among the African stations in Algeria, Kenya, Egypt, South Africa, as well as in seasonal cycles and year-to-year. Trends are not evident. 2. The impacts of convection, stratospheric injection, biomass burning and lightning appear in ozone sounding profile data. Time-series analysis and case studies point to periodic influences of long-range interactions with the Atlantic ("ozone paradox," wave-one") and Indian Oceans. 3. Tropospheric ozone variations, observed in tropospheric profiles and integrated column amount, follow general seasonal patterns but short- term variability is so strong that simple averages are inadequate for describing "climatology" and statistical classification approaches may be required.

Dimensionality of the Knee Numeric-Entity Evaluation Score (KNEES-ACL): a condition-specific questionnaire.

PubMed

Comins, J D; Krogsgaard, M R; Kreiner, S; Brodersen, J

2013-10-01

The benefit of anterior cruciate ligament (ACL) reconstruction has been questioned based on patient-reported outcome measures (PROMs). Valid interpretation of such results requires confirmation of the psychometric properties of the PROM. Rasch analysis is the gold standard for validation of PROMs, yet PROMs used for ACL reconstruction have not been validated using Rasch analysis. We used Rasch analysis to investigate the psychometric properties of the Knee Numeric-Entity Evaluation Score (KNEES-ACL), a newly developed PROM for patients treated for ACL deficiency. Two-hundred forty-two patients pre- and post-ACL reconstruction completed the pilot PROM. Rasch models were used to assess the psychometric properties (e.g., unidimensionality, local response dependency, and differential item functioning). Forty-one items distributed across seven unidimensional constructs measuring impairment, functional limitations, and psychosocial consequences were confirmed to fit Rasch models. Fourteen items were removed because of statistical lack of fit and inadequate face validity. Local response dependency and differential item functioning were identified and adjusted. The KNEES-ACL is the first Rasch-validated condition-specific PROM constructed for patients with ACL deficiency and patients with ACL reconstruction. Thus, this instrument can be used for within- and between-group comparisons. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Eastern minds in western cockpits: meta-analysis of human factors in mishaps from three nations.

PubMed

Li, Wen-Chin; Harris, Don; Chen, Aurora

2007-04-01

Aviation accident rates vary in different regions; Asia and Africa have higher rates than Europe and America. There has been a great deal of discussion about the role of culture in aviation mishaps; however, culture is rarely mentioned as a contributory factor in accidents. It is hypothesized that different cultures will show different patterns in the underlying causal factors in aircraft accidents. Using a meta-analysis of previously published results, this research examined statistical differences in the 18 categories of the Human Factors Analysis and Classification System (HFACS) across accidents in the Republic of China (Taiwan), India, and the United States. Seven HFACS categories exhibited significant differences between these three regions. These were mostly concerned with contributory factors at the higher organizational levels. The differences were related to organizational processes, organizational climate, resource management, inadequate supervision, physical/mental limitations, adverse mental states, and decision errors. Overall, the evidence from this research supports the observation that national cultures have an impact on aviation safety and adds further explanatory power with regards to why this should be so. The majority of the cultural issues identified seem to be associated with the style of management of the organizations rather than the operation of the aircraft per se.

Improving the urban environment.

PubMed

Rotibi, A

1992-11-01

An effective environmental sanitation program should encompass key features considered necessary for a primary health care (PHC) program such as availability, accessibility, affordability, acceptability, and practicability. Poor housing conditions give rise to stress, delinquency, and crime, as well as to helminthic and other parasitic infestations. In Africa, urbanization has accelerated since the 1950s because of rural-urban migration. In Nigeria new housing construction has been poor, with inadequate provision of physical facilities and community services in residential areas. Overcrowding is rampant, with occupancy rates of 2-3 persons per room recorded for many cities including Owerri, Abba, Warri and Ontisha. In a survey of rooming-house facilities in Lagos, the average was 5-7 persons per room. 47% of households were living in just one rooms in Sokoto and 80% in the Lagos metropolitan area. An urban household survey by the Federal Office of Statistics found that 45% of households were without electricity. Similarly, 46% of households were found to be without running water, 29% obtained their water from wells, and 14% from streams. The inadequate provision of toilets poses major health risks. Many Nigerian cities lack efficient waste disposal systems: in Ibadan mounds of uncollected rubbish obstruct the roads. According to a Statistics Office survey 48% of refuse is estimated to be dumped illegally, while 23% is simply heaped in family compounds. A recently launched campaign on environmental sanitation is the start of improving the health of urban dwellers which could cut expenditure on curative health measures.

Residential Light and Risk for Depression and Falls: Results from the LARES Study of Eight European Cities

PubMed Central

Brown, Mary Jean; Jacobs, David E.

2011-01-01

Objectives. We examined the relationship between self-reported inadequate residential natural light and risk for depression or falls among adults aged 18 years or older. Methods. Generalized estimating equations were used to calculate the odds of depression or falls in participants with self-reported inadequate natural residential light vs. those reporting adequate light (n=6,017) using data from the World Health Organization's Large Analysis and Review of European Housing and Health Survey, a large cross-sectional study of housing and health in representative populations from eight European cities. Results. Participants reporting inadequate natural light in their dwellings were 1.4 times (95% confidence interval [CI] 1.2,1.7) as likely to report depression and 1.5 times (95% CI 1.2, 1.9) as likely to report a fall compared with those satisfied with their dwelling's light. After adjustment for major confounders, the likelihood of depression changed slightly, while the likelihood of a fall increased to 2.5 (95% CI 1.5, 4.2). Conclusion. Self-reported inadequate light in housing is independently associated with depression and falls. Increasing light in housing, a relatively inexpensive intervention, may improve two distinct health conditions. PMID:21563721

Residential light and risk for depression and falls: results from the LARES study of eight European cities.

PubMed

Brown, Mary Jean; Jacobs, David E

2011-01-01

We examined the relationship between self-reported inadequate residential natural light and risk for depression or falls among adults aged 18 years or older. Generalized estimating equations were used to calculate the odds of depression or falls in participants with self-reported inadequate natural residential light vs. those reporting adequate light (n = 6,017) using data from the World Health Organization's Large Analysis and Review of European Housing and Health Survey, a large cross-sectional study of housing and health in representative populations from eight European cities. Participants reporting inadequate natural light in their dwellings were 1.4 times (95% confidence interval [CI] 1.2,1.7) as likely to report depression and 1.5 times (95% CI 1.2, 1.9) as likely to report a fall compared with those satisfied with their dwelling's light. After adjustment for major confounders, the likelihood of depression changed slightly, while the likelihood of a fall increased to 2.5 (95% CI 1.5, 4.2). Self-reported inadequate light in housing is independently associated with depression and falls. Increasing light in housing, a relatively inexpensive intervention, may improve two distinct health conditions.

Conventional 4-field box radiotherapy technique for cancer cervix: potential for geographic miss without CECT scan-based planning.

PubMed

Nagar, Y S; Singh, S; Kumar, S; Lal, P

2004-01-01

The advantage of 4-field radiation to the pelvis is that the use of lateral portals spares a portion of the small bowel anteriorly and rectum posteriorly. The standard lateral portals defined in textbooks are not always adequate especially in advanced cancer cervix. An analysis was done to determine adequacy of margins of standard lateral pelvic portals with CECT defined tumor volumes. The study included 40 patients of FIGO stage IIB and IIIB treated definitively for cancer cervix between 1998 and 2000. An inadequate margin was defined if the cervical growth and uterus were not encompassed by the 95% isodose. An inadequate posterior margin was common with bulky disease (P = 0.06) and with retroverted uterus (P = 0.08). Menopausal status, FIGO stage, associated myoma, and age were of no apparent prognostic significance. Bulk retained significant on multivariate analysis. An inadequate anterior margin was common in premenopausal (P = 0.01); anteverted uterus (P = 0.02); associated myoma (P = 0.01); and younger patients (P = 0.03). It was not influenced by bulk or stage. Menopausal status and associated myoma retained significant on multivariate analysis. Without the knowledge of precise tumor volume, the 4-field technique with standard portals is potentially risky as it may under dose the tumor through lateral portals and the standard AP/ PA portals are a safer option.

Evaluation of effect of different disposable infection control barriers on light intensity of light-curing unit and microhardness of composite - An in vitro study

PubMed Central

Khode, Rajiv Tarachand; Shenoi, Pratima Ramakrishna; Kubde, Rajesh R.; Makade, Chetana S.; Wadekar, Kanchan D.; Khode, Priyanka Tarachand

2017-01-01

Aims: This study evaluated effect of infection control barriers on light intensity (LI) of light-curing unit (LCU) and microhardness of composite. Materials and Methods: Four different disposable barriers (n = 30) were tested against the control. LI for each barrier was measured with Lux meter. One hundred and fifty Teflon molds were equally divided into five groups of thirty each. Composite was filled in bulk in these molds and cured without and with barrier. Microhardness was evaluated on top and bottom surface of composite specimen with microhardness testing machine and hardness ratio (HR) was derived. Statistical Analysis Used: One-way analysis of variance, Tukey's honestly significant difference test, and paired t-test using SPSS version 18 software. Results: All barriers had significantly reduced the baseline LI of LCU (P < 0.0001), but only Cure Elastic Steri-Shield and latex cut glove pieces (LCGP) significantly reduced the microhardness of the composite (P < 0.05). However, HR determined inadequate curing only with LCGP. Conclusions: Although entire tested barrier significantly reduced the LI; none, except LCGP markedly affected the degree of cure of the composite. PMID:29279622

Bias Characterization in Probabilistic Genotype Data and Improved Signal Detection with Multiple Imputation

PubMed Central

Palmer, Cameron; Pe’er, Itsik

2016-01-01

Missing data are an unavoidable component of modern statistical genetics. Different array or sequencing technologies cover different single nucleotide polymorphisms (SNPs), leading to a complicated mosaic pattern of missingness where both individual genotypes and entire SNPs are sporadically absent. Such missing data patterns cannot be ignored without introducing bias, yet cannot be inferred exclusively from nonmissing data. In genome-wide association studies, the accepted solution to missingness is to impute missing data using external reference haplotypes. The resulting probabilistic genotypes may be analyzed in the place of genotype calls. A general-purpose paradigm, called Multiple Imputation (MI), is known to model uncertainty in many contexts, yet it is not widely used in association studies. Here, we undertake a systematic evaluation of existing imputed data analysis methods and MI. We characterize biases related to uncertainty in association studies, and find that bias is introduced both at the imputation level, when imputation algorithms generate inconsistent genotype probabilities, and at the association level, when analysis methods inadequately model genotype uncertainty. We find that MI performs at least as well as existing methods or in some cases much better, and provides a straightforward paradigm for adapting existing genotype association methods to uncertain data. PMID:27310603

Intravenous theophylline is the most effective intervention to prolong EEG seizure duration in patients undergoing electroconvulsive therapy.

PubMed

Tzabazis, Alexander; Wiernik, Michaela E; Wielopolski, Jan; Sperling, Wolfgang; Ihmsen, Harald; Schmitt, Hubert J; Münster, Tino

2017-08-29

Seizure duration in electroconvulsive therapy (ECT) is positively related with patients' outcome. This study sought to investigate the impact of anesthetic management on seizure duration, and the impact of selected drugs (theophylline, remifentanil, S-ketamine) on seizure duration. Retrospective analysis of all patients undergoing ECT at our institution from January 2011 to April 2012 was performed based on electronic medical chart and review of existing quality improvement data. Patient data (N = 78), including gender, age, height, weight, and administered drugs, energy levels, and electroencephalic seizure duration were analyzed. Statistical analysis was performed using a generalized linear model. A total of 78 patients (male = 39, female = 39, age 51 ± 12 years) were included. Average number of session was 10 ± 6 (1-30). In our patient population, theophylline administration was the only parameter, which significantly prolonged seizure duration, whereas S-ketamine, remifentanil, thiopental, age, sex, session or energy level had no significant effect. Theophylline can be a useful adjunct for patients with inadequate seizure duration. If there is a concomitant beneficial effect on patients' outcome needs to be investigated in further studies.

Impact of PCA Strategies on Pain Intensity and Functional Assessment Measures in Adults with Sickle Cell Disease during Hospitalized Vaso-Occlusive Episodes

PubMed Central

Dampier, Carlton D.; Wager, Carrie G.; Harrison, Ryan; Hsu, Lewis L.; Minniti, Caterina P.; Smith, Wally R.

2012-01-01

Clinical trials of sickle cell disease (SCD) pain treatment usually observe only small decrements in pain intensity during the course of hospitalization. Sub-optimal analgesic management and inadequate pain assessment methods are possible explanations for these findings. In a search for better methods for assessing inpatient SCD pain in adults, we examined several pain intensity and interference measures in both arms of a randomized controlled trial comparing two different opioid PCA therapies. Based upon longitudinal analysis of pain episodes, we found that scores from daily average Visual Analogue Scales (VAS) and several other measures, especially the Brief Pain Inventory (BPI), were sensitive to change in daily improvements in pain intensity associated with resolution of vaso-occlusive pain. In this preliminary trial, the low demand, high basal infusion (LDHI) strategy demonstrated faster, larger improvements in various measures of pain than the high demand, low basal infusion (HDLI) strategy for opioid PCA dosing, however, verification in larger studies is required. The measures and statistical approaches used in this analysis may facilitate design, reduce sample size, and improve analyses of treatment response in future SCD clinical trials of vaso-occlusive episodes. PMID:22886853

Factors Associated With Inadequate Effectiveness of a Multidisciplinary Disease Management Program in Heart Failure Patients Stratified by Galectin 3 Level.

PubMed

Liu, Min-Hui; Wang, Chao-Hung; Chiou, Ai-Fu; Yang, Ning-I; Kuo, Li-Tang

2016-07-21

This study investigated whether multidisciplinary disease management programs (MDPs) exert the same effects in heart failure (HF) patients across risk levels stratified by galectin-3 (Gal-3) level and what factors are associated with inadequate effectiveness of MDP. We used a longitudinal follow-up design based on a previous randomized trial. A total of 355 stabilized hospitalized HF patients were enrolled. The effects of MDP on death and HF-related rehospitalization were analyzed according to Gal-3 levels. During the 4-year follow-up, Gal-3 levels predicted mortality and composite events (p < .001). Multivariable analysis demonstrated the event-lowering effect of MDP (hazard ratio [HR] = 0.49, p = .001 for death and HR = 0.50, p < .001 for composite events). However, the effect of MDP was inadequate for those with high Gal-3 levels (≥17.9 ng/ml), whose 4-year composite event rate was 43% in the MDP arm. Further analysis showed that, in patients with Gal-3 ≥ 17.9 ng/ml, the independent factors associated with a high composite event rate were no MDP, older age, worse New York Heart Association functional class, no angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker use, higher predischarge natriuretic peptide levels, and wider QRS complexes. The effectiveness of MDP for HF patients at high risk was inadequate. Our findings identified the characteristics of these MDP nonresponders. Better integration of advanced care plans based on strategies guided by Gal-3 level is needed to improve care quality. © The Author(s) 2016.

A systems approach to accident causation in mining: an application of the HFACS method.

PubMed

Lenné, Michael G; Salmon, Paul M; Liu, Charles C; Trotter, Margaret

2012-09-01

This project aimed to provide a greater understanding of the systemic factors involved in mining accidents, and to examine those organisational and supervisory failures that are predictive of sub-standard performance at operator level. A sample of 263 significant mining incidents in Australia across 2007-2008 were analysed using the Human Factors Analysis and Classification System (HFACS). Two human factors specialists independently undertook the analysis. Incidents occurred more frequently in operations concerning the use of surface mobile equipment (38%) and working at heights (21%), however injury was more frequently associated with electrical operations and vehicles and machinery. Several HFACS categories appeared frequently: skill-based errors (64%) and violations (57%), issues with the physical environment (56%), and organisational processes (65%). Focussing on the overall system, several factors were found to predict the presence of failures in other parts of the system, including planned inappropriate operations and team resource management; inadequate supervision and team resource management; and organisational climate and inadequate supervision. It is recommended that these associations deserve greater attention in future attempts to develop accident countermeasures, although other significant associations should not be ignored. In accordance with findings from previous HFACS-based analyses of aviation and medical incidents, efforts to reduce the frequency of unsafe acts or operations should be directed to a few critical HFACS categories at the higher levels: organisational climate, planned inadequate operations, and inadequate supervision. While remedial strategies are proposed it is important that future efforts evaluate the utility of the measures proposed in studies of system safety. Copyright © 2011. Published by Elsevier Ltd.

Software Performs Complex Design Analysis

NASA Technical Reports Server (NTRS)

2008-01-01

Designers use computational fluid dynamics (CFD) to gain greater understanding of the fluid flow phenomena involved in components being designed. They also use finite element analysis (FEA) as a tool to help gain greater understanding of the structural response of components to loads, stresses and strains, and the prediction of failure modes. Automated CFD and FEA engineering design has centered on shape optimization, which has been hindered by two major problems: 1) inadequate shape parameterization algorithms, and 2) inadequate algorithms for CFD and FEA grid modification. Working with software engineers at Stennis Space Center, a NASA commercial partner, Optimal Solutions Software LLC, was able to utilize its revolutionary, one-of-a-kind arbitrary shape deformation (ASD) capability-a major advancement in solving these two aforementioned problems-to optimize the shapes of complex pipe components that transport highly sensitive fluids. The ASD technology solves the problem of inadequate shape parameterization algorithms by allowing the CFD designers to freely create their own shape parameters, therefore eliminating the restriction of only being able to use the computer-aided design (CAD) parameters. The problem of inadequate algorithms for CFD grid modification is solved by the fact that the new software performs a smooth volumetric deformation. This eliminates the extremely costly process of having to remesh the grid for every shape change desired. The program can perform a design change in a markedly reduced amount of time, a process that would traditionally involve the designer returning to the CAD model to reshape and then remesh the shapes, something that has been known to take hours, days-even weeks or months-depending upon the size of the model.

Racial and ethnic differences in lymph node examination after colon cancer resection do not completely explain disparities in mortality.

PubMed

Rhoads, Kim F; Cullen, Jennifer; Ngo, Justine V; Wren, Sherry M

2012-01-15

In 1999, a multidisciplinary panel of experts in colorectal cancer reviewed the relevant medical literature and issued a consensus recommendation for a 12-lymph node (LN) minimum examination after resection for colon cancer. Some authors have shown racial/ethnic differences in receipt of this evidence-based care. To date, however, none has investigated the correlation between disparities in LN examination and disparities in outcomes after colon cancer treatment. This retrospective analysis used California Cancer Registry linked to California Office of Statewide Health Planning and Development discharge data (1996-2006). Chi-square analysis, logistic regression, and Cox proportional hazard models predicted disparities in receipt of an adequate examination and the effect of an inadequate exam on mortality and disparities. Patients with stage I and II colon cancers undergoing surgery in California were included; patients with stage III and IV disease were excluded. A total of 37,911 records were analyzed. Adequate staging occurred in fewer than half of cases. An inadequate examination (<12 LNs) was associated with higher mortality rates. Hispanics had the lowest odds of receiving an adequate exam; however, blacks, not Hispanics, had the highest risk of mortality compared with whites. This disparity was not completely explained by inadequate LN examination. Inadequate LN exam occurs often and is associated with increased mortality. There are disparities in receipt of the minimum exam, but this only explains a small part of the observed disparity in mortality. Improving the quality of LN examination alone is unlikely to correct colon cancer disparities. Copyright © 2011 American Cancer Society.

Indonesia Country Analysis Brief

EIA Publications

2015-01-01

Indonesia is reorienting energy production from serving primarily export markets to meeting its growing domestic consumption. Indonesia's energy industry has faced challenges in recent years from regulatory uncertainty and inadequate investment.

Personality disorder in convicted Jamaican murderers.

PubMed

Hickling, F W; Walcott, G

2013-01-01

To establish the aetiology and historical prevalence of personality disorder in violent homicidal men in Jamaica. Examination and analysis of primary data from the psychosocial case study interviews of 36 convicted murderers from the Jamaican Government Barnett Commission of Enquiry in 1976. The disaggregated social and clinical data were analysed using a Chi-square statistical analysis. The mean age at time of arrest for the male convicted murderers was 24.26 ± 8.48 years. Twenty-three (66%) of the subjects had loving relationships with mothers, particularly in those men reared in the rural areas. Twenty-one (59%) cases showed marked paternal rejection and absence of integrated family life. Twenty-four (69%) of the cases experienced severe parental disciplinary methods, and two-thirds were illiterate or barely literate. Twenty-nine (83%) were from very poor socio-economic conditions. Thirty (86%) of all the murder victims were adult males. There were significant differences between the urban reared murderers (URM) and rural reared murderers (RRM). Sixteen (94%) of the victims of the URM ensued from robbery and police confrontation, while 13 (72%) of the victims of the RRM resulted from domestic disputes (p < 0.00). Seventeen (49%) of the men had normal personalities; 18 (51%) were diagnosed as having antisocial and inadequate personalities. Diagnosis of primary data using Diagnostic and Statistical Manual of Mental Disorders fourth edition, text revision (DSM-IV-TR) criteria revealed 23 (66%) men with Antisocial Personality Disorder (APD). There were significantly more APD in the URM than the RRM (p < 0.01). Antisocial personality disorder as an aetiological precursor of homicidal violence represents a major public health problem in contemporary Jamaica.

Two Phase III randomised double-blind studies of fixed-dose TC-5214 (dexmecamylamine) adjunct to ongoing antidepressant therapy in patients with major depressive disorder and an inadequate response to prior antidepressant therapy.

PubMed

Möller, Hans-Jürgen; Demyttenaere, Koen; Olausson, Bengt; Szamosi, Johan; Wilson, Ellis; Hosford, David; Dunbar, Geoffrey; Tummala, Raj; Eriksson, Hans

2015-10-01

To evaluate the neuronal nicotinic channel modulator TC-5214 (dexmecamylamine) as adjunct therapy in patients with major depressive disorder (MDD) and inadequate response to prior antidepressant treatment. Study 004 (D4130C00004) and Study 005 (D4130C00005) comprised an 8-week open-label antidepressant (SSRI/SNRI) treatment period followed by an 8-week randomised, active treatment with twice-daily TC-5214 (0.5, 2 or 4 mg in Study 004; 0.1, 1 or 4 mg in Study 005) or placebo, adjunct to ongoing SSRI/SNRI. Primary efficacy endpoint was change in MADRS total score from randomisation (Week 8) to treatment end (Week 16). Secondary endpoints included MADRS response and remission, and changes in SDS and HAM-D-17-item scores. Safety and tolerability were monitored throughout. Studies 004 and 005 randomised 640 and 696 patients, respectively, to TC-5214 or placebo. No statistically significant improvements in MADRS total score or any secondary endpoints were seen with TC-5214 versus placebo in either study at treatment end. The most commonly reported adverse events (> 10%) with TC-5214 were constipation, dizziness and dry mouth. TC-5214 adjunct to antidepressant was generally well tolerated. However, the studies were not supportive of an antidepressant effect for TC-5214 in patients with MDD and inadequate response to prior antidepressant therapy.

Energy Efficiency Potential in the U.S. Single-Family Housing Stock

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

Wilson, Eric J.; Christensen, Craig B.; Horowitz, Scott G.

Typical approaches for assessing energy efficiency potential in buildings use a limited number of prototypes, and therefore suffer from inadequate resolution when pass-fail cost-effectiveness tests are applied, which can significantly underestimate or overestimate the economic potential of energy efficiency technologies. This analysis applies a new approach to large-scale residential energy analysis, combining the use of large public and private data sources, statistical sampling, detailed building simulations, and high-performance computing to achieve unprecedented granularity - and therefore accuracy - in modeling the diversity of the single-family housing stock. The result is a comprehensive set of maps, tables, and figures showing themore » technical and economic potential of 50 plus residential energy efficiency upgrades and packages for each state. Policymakers, program designers, and manufacturers can use these results to identify upgrades with the highest potential for cost-effective savings in a particular state or region, as well as help identify customer segments for targeted marketing and deployment. The primary finding of this analysis is that there is significant technical and economic potential to save electricity and on-site fuel use in the single-family housing stock. However, the economic potential is very sensitive to the cost-effectiveness criteria used for analysis. Additionally, the savings of particular energy efficiency upgrades is situation-specific within the housing stock (depending on climate, building vintage, heating fuel type, building physical characteristics, etc.).« less

A meta-analysis of the effect of media devices on sleep outcomes

PubMed Central

Carter, Ben; Rees, Philippa; Hale, Lauren; Bhattacharjee, Darsharna; Paradkar, Mandar

2017-01-01

Importance Sleep is vital to children’s bio-psycho-social development. Inadequate sleep quantity and quality is a public health concern with an array of detrimental health outcomes. Portable mobile and media device have become a ubiquitous part of children’s lives and may impact children’s sleep duration and quality. Objective This systematic review was conducted to examine the effect of portable media devices (e.g. mobile phones, and tablet devices) on sleep outcomes Data Sources A search strategy was developed and searches of the published and grey literature were conducted across 12 databases from January 1st 2011 to June 15th, 2015. No language restriction was applied. Study Selection We included randomized controlled trials; cohort; and cross sectional study designs. Of 467 studies identified, 20 cross-sectional studies were assessed for quality Data Extraction and Synthesis Data extraction and quality assessment was independently carried out by two reviewers and disagreements resolved by a third. Data was pooled in a random-effects meta-analysis, and an individual participant meta-analysis was carried out where possible. Main Outcomes and Measures The primary outcomes were: inadequate sleep quantity; poor sleep quality; and excessive daytime sleepiness, carried out following an a priori protocol. Results Twenty studies were included and quality assessed, involving 125,198 children, 50.1% were male. There was a strong and consistent association between bedtime media device use and: inadequate sleep quantity (OR =2.17; 95%CI 1.42-3.32); poor sleep quality (OR=1.46; 95%CI 1.14-1.88); and excessive daytime sleepiness (OR=2.72; 95%CI 1.32-5.61). Additionally, children who had access to (but did not use) media devices at night were more likely to have inadequate: sleep quantity (OR=1.79; 95%CI 1.39-2.31); sleep quality (OR=1.53; 95%CI 1.11-2.10); and daytime sleepiness (OR=2.27; 95%CI 1.54-3.35). Conclusions and relevance This was the first meta-analysis of the effect of access and use of media device on sleep outcomes. Bedtime access and use of media devices was significantly associated with inadequate sleep quantity; poor sleep quality; and excessive daytime sleepiness. An integrated approach between teachers, healthcare providers and parents is needed to minimize device access at bedtime, and future research is needed to evaluate the impact on sleep hygiene and outcomes. PMID:27802500

Prevalence of apical periodontitis and endodontic treatment in a Kosovar adult population.

PubMed

Kamberi, Blerim; Hoxha, Veton; Stavileci, Miranda; Dragusha, Edmond; Kuçi, Astrit; Kqiku, Lumnije

2011-11-29

Despite numerous studies on the prevalence of apical periodontitis (AP) and endodontic treatment in diverse geographical populations, there are currently no data on the prevalence of these conditions in populations of adults native to Kosovo. Therefore, little is known about how widespread these conditions are, and whether there is any correlation between root canal treatment and AP. The purpose of our research was to address this anomaly by investigating AP and endodontic treatment in an adult Kosovar population based on radiographic examination. The sample used for this study consisted of randomly selected individuals referred to the University Dentistry Clinical Center of Kosovo in the years 2006-2007. Orthopantomographs of 193 patients were evaluated. The periapical status of all teeth (with the exception of third molars) was examined according to Ørstavik's Periapical Index. The quality of the root canal filling was rated as 'adequate' or 'inadequate' based on whether all canals were filled, the depth of fill relative to the radiographic apex and the quality of compaction (absence/presence of voids). Data were analyzed statistically using the Chi-square test and calculation of odds ratios. Out of 4131 examined teeth, the prevalence of apical periodontitis (AP) and endodontic treatment was 12.3% and 2.3%, respectively. Of 95 endodontically-treated teeth, 46.3% were associated with AP. The prevalence of AP increased with age. The prevalence in subjects aged over 60 years old (20.2%) was higher than in other age groups. A statistically significant difference was found for the frequency of endodontically-treated teeth associated with AP in the 40-49 year age group (P < 0.001). Of some concern was the discovery that only 30.5% of the endodontically-treated teeth examined met the criteria of an acceptable root canal filling. Inadequately root-filled teeth were associated with an increased AP risk. The prevalence of AP and the frequency of endodontically-treated teeth with AP in this Kosovar population are higher than those found in other countries. Inadequate root canal fillings were associated with an increased prevalence of AP.

A Review of Statistical Disclosure Control Techniques Employed by Web-Based Data Query Systems.

PubMed

Matthews, Gregory J; Harel, Ofer; Aseltine, Robert H

We systematically reviewed the statistical disclosure control techniques employed for releasing aggregate data in Web-based data query systems listed in the National Association for Public Health Statistics and Information Systems (NAPHSIS). Each Web-based data query system was examined to see whether (1) it employed any type of cell suppression, (2) it used secondary cell suppression, and (3) suppressed cell counts could be calculated. No more than 30 minutes was spent on each system. Of the 35 systems reviewed, no suppression was observed in more than half (n = 18); observed counts below the threshold were observed in 2 sites; and suppressed values were recoverable in 9 sites. Six sites effectively suppressed small counts. This inquiry has revealed substantial weaknesses in the protective measures used in data query systems containing sensitive public health data. Many systems utilized no disclosure control whatsoever, and the vast majority of those that did deployed it inconsistently or inadequately.

Radon-222 concentrations in ground water and soil gas on Indian reservations in Wisconsin

USGS Publications Warehouse

DeWild, John F.; Krohelski, James T.

1995-01-01

For sites with wells finished in the sand and gravel aquifer, the coefficient of determination (R2) of the regression of concentration of radon-222 in ground water as a function of well depth is 0.003 and the significance level is 0.32, which indicates that there is not a statistically significant relation between radon-222 concentrations in ground water and well depth. The coefficient of determination of the regression of radon-222 in ground water and soil gas is 0.19 and the root mean square error of the regression line is 271 picocuries per liter. Even though the significance level (0.036) indicates a statistical relation, the root mean square error of the regression is so large that the regression equation would not give reliable predictions. Because of an inadequate number of samples, similar statistical analyses could not be performed for sites with wells finished in the crystalline and sedimentary bedrock aquifers.

Household Food Insecurity Is a Stronger Marker of Adequacy of Nutrient Intakes among Canadian Compared to American Youth and Adults.

PubMed

Kirkpatrick, Sharon I; Dodd, Kevin W; Parsons, Ruth; Ng, Carmina; Garriguet, Didier; Tarasuk, Valerie

2015-07-01

The most recent statistics indicate that the prevalence of food insecurity in the United States is double that in Canada, but the extent to which the nutrition implications of this problem differ between the countries is not known. This study was undertaken to compare adequacy of nutrient intakes in relation to household food insecurity among youth and adults in Canada and the United States. Data from comparable nationally representative surveys, the 2004 Canadian Community Health Survey and the 2003-2006 NHANES, were used to estimate prevalences of inadequate intakes of vitamins A and C, folate, calcium, magnesium, and zinc among youth and adults in food-secure and food-insecure households. Potential differences in the composition of the populations between the 2 countries were addressed by using standardization, and analyses also accounted for participation in food and nutrition assistance programs in the United States. Larger gaps in the prevalences of inadequate intakes between those in food-secure and food-insecure households were observed in Canada than in the United States for calcium and magnesium. For calcium, the prevalences of inadequate intakes among those in food-secure and food-insecure households in Canada were 50% and 66%, respectively, compared with 50% and 51%, respectively, in the United States. For magnesium, the prevalences of inadequate intakes in Canada were 39% and 60% among those in food-secure and food-insecure households, respectively, compared with 60% and 61%, respectively, in the United States. These findings were largely unchanged after we accounted for participation in food and nutrition assistance programs in the United States. This study suggests that household food insecurity is a stronger marker of nutritional vulnerability in Canada than in the United States. The results highlight the need for research to elucidate the effects of domestic policies affecting factors such as food prices and fortification on the nutritional manifestations of food insecurity. © 2015 American Society for Nutrition.

ERICA: intake of macro and micronutrients of Brazilian adolescents

PubMed Central

Souza, Amanda de Moura; Barufaldi, Laura Augusta; Abreu, Gabriela de Azevedo; Giannini, Denise Tavares; de Oliveira, Cecília Lacroix; dos Santos, Marize Melo; Leal, Vanessa Sá; Vasconcelos, Francisco de Assis Guedes

2016-01-01

ABSTRACT OBJECTIVE To describe food and macronutrient intake profile and estimate the prevalence of inadequate micronutrient intake of Brazilian adolescents. METHODS Data from 71,791 adolescents aged from 12 to 17 years were evaluated in the 2013-2014 Brazilian Study of Cardiovascular Risks in Adolescents (ERICA). Food intake was estimated using 24-hour dietary recall (24-HDR). A second 24-HDR was collected in a subsample of the adolescents to estimate within-person variability and calculate the usual individual intake. The prevalence of food/food group intake reported by the adolescents was also estimated. For sodium, the prevalence of inadequate intake was estimated based on the Tolerable Upper Intake Level (UL). The Estimated Average Requirement (EAR) method used as cutoff was applied to estimate the prevalence of inadequate nutrient intake. All the analyses were stratified according to sex, age group and Brazilian macro-regions. All statistical analyses accounted for the sample weight and the complex sampling design. RESULTS Rice, beans and other legume, juice and fruit drinks, breads and meat were the most consumed foods among the adolescents. The average energy intake ranged from 2,036 kcal (girls aged from 12 to 13 years) to 2,582 kcal (boy aged from14 to 17 years). Saturated fat and free sugar intake were above the maximum limit recommended (< 10.0%). Vitamins A and E, and calcium were the micronutrients with the highest prevalence of inadequate intake (> 50.0%). Sodium intake was above the UL for more than 80.0% of the adolescents. CONCLUSIONS The diets of Brazilian adolescents were characterized by the intake of traditional Brazilian food, such as rice and beans, as well as by high intake of sugar through sweetened beverages and processed foods. This food pattern was associated with an excessive intake of sodium, saturated fatty acids and free sugar. PMID:26910551

A randomized clinical trial of the safety and efficacy of sitagliptin in patients with type 2 diabetes mellitus inadequately controlled by acarbose alone.

PubMed

Wang, Weiqing; Ning, Guang; Ma, Jianhua; Liu, Xiaomin; Zheng, Shaoxiong; Wu, Fan; Xu, Lei; O'Neill, Edward A; Fujita, Kenji P; Engel, Samuel S; Kaufman, Keith D; Shankar, R Ravi

2017-04-01

To evaluate the safety and efficacy of sitagliptin when added to the treatment of patients with type 2 diabetes mellitus (T2DM) and inadequate glycemic control on acarbose monotherapy. This was a multicenter, randomized, placebo-controlled, double-blind clinical trial. Patients (N = 381) with T2DM and inadequate glycemic control (glycated hemoglobin [HbA1c] ≥ 7.0% and ≤10.0%) on acarbose monotherapy (at least 50 mg three times daily) were randomized in a 1:1 ratio to receive the addition of sitagliptin 100 mg or matching placebo once daily for 24 weeks. Changes from baseline in HbA1c and fasting plasma glucose (FPG) at Week 24. The mean baseline HbA1c in randomized patients was 8.1%. At Week 24, the placebo-controlled, least squares mean changes from baseline (95% confidence interval) in HbA1c and FPG in the sitagliptin group were -0.62% and -0.8 mmol/L (p < .001), respectively. At Week 24, 37.8% of patients in the sitagliptin group were at HbA1c goal of <7% compared with 17.2% in the placebo group (p < .001). Sitagliptin was generally well tolerated, and there were no significant between-group differences in prespecified safety parameters (symptomatic hypoglycemia, diarrhea, abdominal pain, nausea, vomiting). A higher incidence of serious adverse events was observed in the sitagliptin group (5.2%) relative to placebo (0.5%); all but one, in the sitagliptin group, were not considered related to drug. Sitagliptin was generally well tolerated and provided statistically superior and clinically meaningful improvements in glycemic control after 24 weeks of treatment compared to placebo when added to treatment of patients with inadequate glycemic control on acarbose monotherapy. Clinicaltrials.gov: NCT01177384.

Leadership Analysis in K-12 Case Study: "Divided Loyalties"

ERIC Educational Resources Information Center

Alsubaie, Merfat Ayesh

2016-01-01

This report mainly aims to provide a critical and in-depth analysis of the K-12 Case, "Divided Loyalty" by Holy and Tartar (2004). The case recounts how the manifestation of inadequate leadership skills in a school setting could affect negatively the performance of students.

An evaluation of the state of time synchronization on leadership class supercomputers

DOE PAGES

Jones, Terry; Ostrouchov, George; Koenig, Gregory A.; ...

2017-10-09

We present a detailed examination of time agreement characteristics for nodes within extreme-scale parallel computers. Using a software tool we introduce in this paper, we quantify attributes of clock skew among nodes in three representative high-performance computers sited at three national laboratories. Our measurements detail the statistical properties of time agreement among nodes and how time agreement drifts over typical application execution durations. We discuss the implications of our measurements, why the current state of the field is inadequate, and propose strategies to address observed shortcomings.

An evaluation of the state of time synchronization on leadership class supercomputers

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

Jones, Terry; Ostrouchov, George; Koenig, Gregory A.

We present a detailed examination of time agreement characteristics for nodes within extreme-scale parallel computers. Using a software tool we introduce in this paper, we quantify attributes of clock skew among nodes in three representative high-performance computers sited at three national laboratories. Our measurements detail the statistical properties of time agreement among nodes and how time agreement drifts over typical application execution durations. We discuss the implications of our measurements, why the current state of the field is inadequate, and propose strategies to address observed shortcomings.

Comparative evaluation of free gingival graft and AlloDerm® in enhancing the width of attached gingival: A clinical study

PubMed Central

Agarwal, Chitra; Tarun Kumar, A. B.; Mehta, Dhoom Singh

2015-01-01

Background: The presence of an adequate width of keratinized tissue is important to maintain a healthy dentogingival junction. In case of inadequate width of attached gingiva, the gingival augmentation procedure has been performed classically using the patient's own masticatory mucosa and more recently, using an acellular dermal allograft as the donor material. Aims: The aim of the clinical study was to evaluate and compare the effectiveness of free gingival graft (FGG) and acellular dermal matrix (ADM) allograft in the ability to increase the zone of attached gingiva. Materials and Methods: Fifteen patients with 30 sites showing the inadequate width of attached gingiva (≤1 mm) were enrolled for the split-mouth study. The width of keratinized gingiva and other clinical parameters were recorded at baseline and 12th month postoperatively. Statistical Analysis: The difference in clinical parameters within the group was assessed by Wilcoxon signed rank test. However, Mann–Whitney U-test was used to analyze the differences between test and control groups. Results: The width of attached gingiva increased significantly (P < 0.01) following both the treatments but comparatively lesser gain with ADM allograft (2.13 mm vs. 4.8 mm). ADM site had significantly more shrinkage (76.6%) than FGG site (49.7%). Though FGG was found to be more effective, clinicians can prefer ADM allograft because of its certain advantages over the FGG. Conclusion: ADM allograft has resulted in sufficient increase in width of attached gingiva although lesser than FGG. Considering the disadvantages of FGG, it can be concluded that ADM allograft can be used as an alternative to FGG in increasing width of attached gingival in certain clinical situations. PMID:26681852

Near-peer medical student simulation training.

PubMed

Cash, Thomas; Brand, Eleanor; Wong, Emma; Richardson, Jay; Athorn, Sam; Chowdhury, Faiza

2017-06-01

There is growing concern that medical students are inadequately prepared for life as a junior doctor. A lack of confidence managing acutely unwell patients is often cited as a barrier to good clinical care. With medical schools investing heavily in simulation equipment, we set out to explore if near-peer simulation training is an effective teaching format. Medical students in their third year of study and above were invited to attend a 90-minute simulation teaching session. The sessions were designed and delivered by final-year medical students using clinical scenarios mapped to the Sheffield MBChB curriculum. Candidates were required to assess, investigate and manage an acutely unwell simulated patient. Pre- and post-simulation training Likert scale questionnaires were completed relating to self-reported confidence levels. There is growing concern that medical students are inadequately prepared for life as a junior doctor RESULTS: Questionnaires were completed by 25 students (100% response rate); 52 per cent of students had no prior simulation experience. There were statistically significant improvements in self-reported confidence levels in each of the six areas assessed (p < 0.005). Thematic analysis of free-text comments indicated that candidates enjoyed the practical format of the sessions and found the experience useful. Our results suggest that near-peer medical student simulation training benefits both teacher and learner and that this simplistic model could easily be replicated at other medical schools. As the most junior members of the team, medical students are often confined to observer status. Simulation empowers students to practise independently in a safe and protected environment. Furthermore, it may help to alleviate anxiety about starting work as a junior doctor and improve future patient care. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Patient complaints about hospital services: applying a complaint taxonomy to analyse and respond to complaints.

PubMed

Harrison, Reema; Walton, Merrilyn; Healy, Judith; Smith-Merry, Jennifer; Hobbs, Coletta

2016-04-01

To explore the applicability of a patient complaint taxonomy to data on serious complaint cases. Qualitative descriptive study. Complaints made to the New South Wales (NSW) Health Care Complaints Commission, Australia between 2005 and 2010. All 138 cases of serious complaints by patients about public hospitals and other health facilities investigated in the 5-year period. A thematic analysis of the complaints was conducted to identify particular complaint issues and the Reader et al. (Patient complaints in healthcare systems: a systematic review and coding taxonomy. BMJ Qual Saf 2014;23:678-89.) patient complaint taxonomy was then used to classify these issues into categories and sub-categories. The 138 investigated cases revealed 223 complaint issues. Complaint issues were distributed into the three domains of the patient complaint taxonomy: clinical, management and relationships. Complaint issue most commonly related to delayed diagnosis, misdiagnosis, medication errors, inadequate examinations, inadequate/nil treatment and quality of care including nursing care. The types of complaints from patients about their healthcare investigated by the NSW Commission were similar to those received by other patient complaint entities in Australia and worldwide. The application of a standard taxonomy to large numbers of complaints cases from different sources would enable the creation of aggregated data. Such data would have better statistical capacity to identify common safety and quality healthcare problems and so point to important areas for improvement. Some conceptual challenges in devising and using a taxonomy must be addressed, such as inherent problems in ensuring coding consistency, and giving greater weight to patient concerns about their treatment. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Adherence to Antiretroviral Therapy During and After Pregnancy: Cohort Study on Women Receiving Care in Malawi's Option B+ Program.

PubMed

Haas, Andreas D; Msukwa, Malango T; Egger, Matthias; Tenthani, Lyson; Tweya, Hannock; Jahn, Andreas; Gadabu, Oliver J; Tal, Kali; Salazar-Vizcaya, Luisa; Estill, Janne; Spoerri, Adrian; Phiri, Nozgechi; Chimbwandira, Frank; van Oosterhout, Joep J; Keiser, Olivia

2016-11-01

 Adherence to antiretroviral therapy (ART) is crucial to preventing mother-to-child transmission of human immunodeficiency virus (HIV) and ensuring the long-term effectiveness of ART, yet data are sparse from African routine care programs on maternal adherence to triple ART.  We analyzed data from women who started ART at 13 large health facilities in Malawi between September 2011 and October 2013. We defined adherence as the percentage of days "covered" by pharmacy claims. Adherence of ≥90% was deemed adequate. We calculated inverse probability of censoring weights to adjust adherence estimates for informative censoring. We used descriptive statistics, survival analysis, and pooled logistic regression to compare adherence between pregnant and breastfeeding women eligible for ART under Option B+, and nonpregnant and nonbreastfeeding women who started ART with low CD4 cell counts or World Health Organization clinical stage 3/4 disease.  Adherence was adequate for 73% of the women during pregnancy, for 66% in the first 3 months post partum, and for about 75% during months 4-21 post partum. About 70% of women who started ART during pregnancy and breastfeeding adhered adequately during the first 2 years of ART, but only about 30% of them had maintained adequate adherence at every visit. Risk factors for inadequate adherence included starting ART with an Option B+ indication, at a younger age, or at a district hospital or health center.  One-third of women retained in the Option B+ program adhered inadequately during pregnancy and breastfeeding, especially soon after delivery. Effective interventions to improve adherence among women in this program should be implemented. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.

Association of breast-fed neonatal hyperbilirubinemia with UGT1A1 polymorphisms: 211G>A (G71R) mutation becomes a risk factor under inadequate feeding.

PubMed

Sato, Hiroko; Uchida, Toshihiko; Toyota, Kentaro; Kanno, Miyako; Hashimoto, Taeko; Watanabe, Masashi; Nakamura, Tomohiro; Tamiya, Gen; Aoki, Kuraaki; Hayasaka, Kiyoshi

2013-01-01

Breastfeeding jaundice is a well-known phenomenon, but its pathogenesis is still unclear. Increased production of bilirubin, impaired hepatic uptake and metabolism of bilirubin, and increased enterohepatic circulation of bilirubin account for most cases of pathological neonatal hyperbilirubinemia. We previously reported that 211G>A (G71R) mutation of the UGT1A1 gene is prevalent in East Asians and is associated with the development of neonatal hyperbilirubinemia. Recently, significant association of G71R mutation with hyperbilirubinemia in breast-fed neonates was reported. We enrolled 401 full-term Japanese infants, who were exclusively breast-fed without supplementation of formula before developing hyperbilirubinemia, and classified them into two groups based on the degree of maximal body weight loss during the neonatal period. We analyzed the sex, gestational age, delivery mode, body weight at birth, maximal body weight loss and genotypes of G71R and (TA)(7) polymorphic mutations of UGT1A1. Statistical analysis revealed that maximal body weight loss during the neonatal period is the only independent risk factor for the development of neonatal hyperbilirubinemia. The effect of G71R mutation on neonatal hyperbilirubinemia is significant in neonates with 5% or greater maximal body weight loss and its influence increases in parallel with the degree of maximal body weight loss. Our study indicates that G71R mutation is a risk factor for neonatal hyperbilirubinemia only in infants with inadequate breastfeeding and suggests that adequate breastfeeding may overcome the genetic predisposing factor, G71R mutation, for the development of neonatal hyperbilirubinemia.

Mental Health of Elementary Schoolteachers in Southern Brazil: Working Conditions and Health Consequences.

PubMed

Cezar-Vaz, Marta Regina; Bonow, Clarice Alves; de Almeida, Marlise Capa Verde; Rocha, Laurelize Pereira; Borges, Anelise Miritz

2015-01-01

The mental health of educators is a growing problem in many countries. This study sought to identify self-reported stressful working conditions of elementary schoolteachers and the biopsychosocial consequences of those working conditions and then identify working conditions that promote well-being for teachers in the workplace. Exploratory study was done with 37 teachers. Data collection was performed using a structured interview with a questionnaire. Results show that stressful working conditions are related to inadequate salary, an excessive number of activities, and having to take work home. Biopsychosocial consequences include anxiety, stress, and sleep disorders. There was a statistically significant association between inadequate salary and anxiety (p = 0.01) and between an excessive number of activities and stress (p = 0.01). Teachers reported that a good relationship among colleagues is a working condition that promotes well-being in the workplace. The identification of stressful working conditions for teachers, the biopsychosocial consequences, and working conditions that promote well-being in the workplace are relevant to determining actions that improve the work environment and, consequently, the health of teachers.

The Role of New Removable Complete Dentures in Stimulated Salivary Flow and Taste Perception.

PubMed

Tango, Rubens Nisie; Arata, Anelyse; Borges, Alexandre Luiz Souto; Costa, Anna K F; Pereira, Luciano Jose; Kaminagakura, Estela

2018-04-01

To evaluate the effect of replacement of inadequate complete dentures on salivary flow and taste perception in geriatric patients. Thirty-three patients, 13 males and 20 females, with a mean age of 64.4 years were submitted to stimulated and unstimulated salivary flow rate and salivary pH measurements, and sense of taste evaluation. Tests were performed 3 months before complete denture substitution and 3 weeks after denture insertion. The mean for unstimulated saliva (USS) was 2.1 ml before and 2.7 ml after replacement (p = 0.003). The mean volume of stimulated saliva was 6.3 ml before and 8.2 ml after replacement (p = 0.004). The pH mean of USS was 7.8 ± 0.44 before and 8.02 ± 0.41 after replacement (p = 0.005). No statistically significant difference was determined in the sense of taste before and 3 weeks after complete denture replacement. The replacement of inadequate complete dentures increases saliva flow; however, it does not improve taste perception. © 2016 by the American College of Prosthodontists.

Mental Health of Elementary Schoolteachers in Southern Brazil: Working Conditions and Health Consequences

PubMed Central

Cezar-Vaz, Marta Regina; Bonow, Clarice Alves; de Almeida, Marlise Capa Verde; Rocha, Laurelize Pereira; Borges, Anelise Miritz

2015-01-01

The mental health of educators is a growing problem in many countries. This study sought to identify self-reported stressful working conditions of elementary schoolteachers and the biopsychosocial consequences of those working conditions and then identify working conditions that promote well-being for teachers in the workplace. Exploratory study was done with 37 teachers. Data collection was performed using a structured interview with a questionnaire. Results show that stressful working conditions are related to inadequate salary, an excessive number of activities, and having to take work home. Biopsychosocial consequences include anxiety, stress, and sleep disorders. There was a statistically significant association between inadequate salary and anxiety (p = 0.01) and between an excessive number of activities and stress (p = 0.01). Teachers reported that a good relationship among colleagues is a working condition that promotes well-being in the workplace. The identification of stressful working conditions for teachers, the biopsychosocial consequences, and working conditions that promote well-being in the workplace are relevant to determining actions that improve the work environment and, consequently, the health of teachers. PMID:26366433

Mutation profiles in early-stage lung squamous cell carcinoma with clinical follow-up and correlation with markers of immune function.

PubMed

Choi, M; Kadara, H; Zhang, J; Parra, E R; Rodriguez-Canales, J; Gaffney, S G; Zhao, Z; Behrens, C; Fujimoto, J; Chow, C; Kim, K; Kalhor, N; Moran, C; Rimm, D; Swisher, S; Gibbons, D L; Heymach, J; Kaftan, E; Townsend, J P; Lynch, T J; Schlessinger, J; Lee, J; Lifton, R P; Herbst, R S; Wistuba, I I

2017-01-01

Lung squamous cell carcinoma (LUSC) accounts for 20–30% of non-small cell lung cancers (NSCLCs). There are limited treatment strategies for LUSC in part due to our inadequate understanding of the molecular underpinnings of the disease. We performed whole-exome sequencing (WES) and comprehensive immune profiling of a unique set of clinically annotated early-stage LUSCs to increase our understanding of the pathobiology of this malignancy. Matched pairs of surgically resected stage I-III LUSCs and normal lung tissues (n = 108) were analyzed by WES. Immunohistochemistry and image analysis-based profiling of 10 immune markers were done on a subset of LUSCs (n = 91). Associations among mutations, immune markers and clinicopathological variables were statistically examined using analysis of variance and Fisher’s exact test. Cox proportional hazards regression models were used for statistical analysis of clinical outcome. This early-stage LUSC cohort displayed an average of 209 exonic mutations per tumor. Fourteen genes exhibited significant enrichment for somatic mutation: TP53, MLL2, PIK3CA, NFE2L2, CDH8, KEAP1, PTEN, ADCY8, PTPRT, CALCR, GRM8, FBXW7, RB1 and CDKN2A. Among mutated genes associated with poor recurrence-free survival, MLL2 mutations predicted poor prognosis in both TP53 mutant and wild-type LUSCs. We also found that in treated patients, FBXW7 and KEAP1 mutations were associated with poor response to adjuvant therapy, particularly in TP53-mutant tumors. Analysis of mutations with immune markers revealed that ADCY8 and PIK3CA mutations were associated with markedly decreased tumoral PD-L1 expression, LUSCs with PIK3CA mutations exhibited elevated CD45ro levels and CDKN2A-mutant tumors displayed an up-regulated immune response. Our findings pinpoint mutated genes that may impact clinical outcome as well as personalized strategies for targeted immunotherapies in early-stage LUSC.

Prevalence of third molars and pathological changes related to them in dental medicine.

PubMed

Mikić, Ivana Medvedec; Zore, Irina Filipović; Crcić, Vlatka Fuchs; Matijević, Jurica; Plancak, Dario; Katunarić, Marina; Buković, Dino

2013-09-01

The purpose of this study was to determine the prevalence of third molars in terms of respondents' age. Furthermore it was desired to determine the extent of the manifestation of pathological changes, such as caries, apical lesions, and alveolar bone resorption. This study was based on 500 OPGs of patients from the Faculty of Dentistry, University of Zagreb. Patients were divided into seven age groups. The total number of molars, the number of cavities on remaining molars, the quality of endodontic treatment and the evaluation of their performance and presence of periapical lesions was analyzed. As apart of the periodontal status, the number of inadequate fillings, the number of damaged furcations and bone resorption was analyzed. The statistical analysis was performed by means of STATISTICA 7 statistical package (StatSoft, Tulsa, USA). The correlation between the total number of molars and the age of patients was analyzed by means of Spearman's correlation to the level of significance of 0.05. The number of first, second and third molars significantly decreased in higher age groups. The prevalence of caries in third molars as compared to first and second molars was generally lower, third molars were endodontic treated at least. Assessment of involved furcations showed that the lowest percentage of 8% was found in third molars. The majority of all remaining molars had bone resorption of 1-3 mm.

Compliance with Standard Precautions and Associated Factors among Healthcare Workers in Gondar University Comprehensive Specialized Hospital, Northwest Ethiopia

PubMed Central

Haile, Tariku Gebre

2017-01-01

Background. In many studies, compliance with standard precautions among healthcare workers was reported to be inadequate. Objective. The aim of this study was to assess compliance with standard precautions and associated factors among healthcare workers in northwest Ethiopia. Methods. An institution-based cross-sectional study was conducted from March 01 to April 30, 2014. Simple random sampling technique was used to select participants. Data were entered into Epi info 3.5.1 and were exported to SPSS version 20.0 for statistical analysis. Multivariate logistic regression analyses were computed and adjusted odds ratio with 95% confidence interval was calculated to identify associated factors. Results. The proportion of healthcare workers who always comply with standard precautions was found to be 12%. Being a female healthcare worker (AOR [95% CI] 2.18 [1.12–4.23]), higher infection risk perception (AOR [95% CI] 3.46 [1.67–7.18]), training on standard precautions (AOR [95% CI] 2.90 [1.20–7.02]), accessibility of personal protective equipment (AOR [95% CI] 2.87 [1.41–5.86]), and management support (AOR [95% CI] 2.23 [1.11–4.53]) were found to be statistically significant. Conclusion and Recommendation. Compliance with standard precautions among the healthcare workers is very low. Interventions which include training of healthcare workers on standard precautions and consistent management support are recommended. PMID:28191020

Sexuality: Desire, activity and intimacy in the elderly

PubMed Central

Kalra, Gurvinder; Subramanyam, Alka; Pinto, Charles

2011-01-01

Background: Sexual function and activity in old age have been inadequately studied world over. It is important to know that aging processes are not confined to persons beyond the age of 60 years; many changes in elderly have their antecedents in the middle age. Aims: This study sought to determine the patterns of sexual activity and function in individuals over 50 years of age. It also sought to discuss barriers such as chronic illness that may interfere with sexual function. Materials and Methods: We conducted a study of subjects above the age of 50 years in various outpatient departments (OPDs) of a teaching municipal hospital in Mumbai, by interviewing 60 individuals who attended the OPDs, after taking their informed consent. Socio-demographic and other information on their sexual function and activities were obtained. Data was analyzed using statistical package for social sciences v15. Results: 72% individuals below 60 were sexually active, while only 57% above 60 were active. Others had become completely abstinent at some time in their lives. Statistical analysis revealed significant gender, health and educational status based differences in the sample. Conclusion: Our study showed significant presence of sexual desire, activity and function even after the age of 50 years; a decline by the age of 60 and above was a finding that reflected more in women. Chronic illness did affect sexual function and desire. PMID:22303037

Crying, oral contraceptive use and the menstrual cycle.

PubMed

Romans, Sarah E; Clarkson, Rose F; Einstein, Gillian; Kreindler, David; Laredo, Sheila; Petrovic, Michele J; Stanley, James

2017-01-15

Crying, a complex neurobiological behavior with psychosocial and communication features, has been little studied in relationship to the menstrual cycle. In the Mood and Daily Life study (MiDL), a community sample of Canadian women aged 18-43 years, n=76, recorded crying proneness and crying frequency daily for six months along with menstrual cycle phase information. Crying proneness was most likely during the premenstruum, a little less likely during menses and least likely during the mid-cycle phase, with statistically significant differences although the magnitude of these differences were small. By contrast, actual crying did not differ between the three menstrual cycle phases. Oral contraceptive use did not alter the relationship between menstrual cycle phase and either crying variable. A wide range of menstrual cycle phase - crying proneness patterns were seen with visual inspection of the individual women's line graphs. timing of ovulation was not ascertained. Using a three phase menstrual cycle division precluded separate late follicular and early luteal data analysis. The sample size was inadequate for a robust statistical test of actual crying. reproductive aged women as a group report feeling more like crying premenstrually but may not actually cry more during this menstrual cycle phase. Individual patterns vary substantially. Oral contraceptive use did not affect these relationships. Suggestions for future research are included. Copyright © 2016 Elsevier B.V. All rights reserved.

Using Analysis of Covariance (ANCOVA) with Fallible Covariates

ERIC Educational Resources Information Center

Culpepper, Steven Andrew; Aguinis, Herman

2011-01-01

Analysis of covariance (ANCOVA) is used widely in psychological research implementing nonexperimental designs. However, when covariates are fallible (i.e., measured with error), which is the norm, researchers must choose from among 3 inadequate courses of action: (a) know that the assumption that covariates are perfectly reliable is violated but…

Precision Efficacy Analysis for Regression.

ERIC Educational Resources Information Center

Brooks, Gordon P.

When multiple linear regression is used to develop a prediction model, sample size must be large enough to ensure stable coefficients. If the derivation sample size is inadequate, the model may not predict well for future subjects. The precision efficacy analysis for regression (PEAR) method uses a cross- validity approach to select sample sizes…

Orderedness and Stratificational "and" Nodes.

ERIC Educational Resources Information Center

Herrick, Earl M.

It is possible to apply Lamb's stratificational theory and analysis to English graphonomy, but additional notation devices must be used to explain particular graphemes and their characteristics. The author presents cases where Lamb's notation is inadequate. In those cases, he devises new means for performing the analysis. The result of this…

Quantitative Evaluation of Head and Neck Cancer Treatment-Related Dysphagia in the Development of a Personalized Treatment Deintensification Paradigm.

PubMed

Quon, Harry; Hui, Xuan; Cheng, Zhi; Robertson, Scott; Peng, Luke; Bowers, Michael; Moore, Joseph; Choflet, Amanda; Thompson, Alex; Muse, Mariah; Kiess, Ana; Page, Brandi; Fakhry, Carole; Gourin, Christine; O'Hare, Jolyne; Graham, Peter; Szczesniak, Michal; Maclean, Julia; Cook, Ian; McNutt, Todd

2017-12-01

To test the hypothesis that quantifying swallow function with multiple patient-reported outcome (PRO) instruments is an important strategy to yield insights in the development of personalized deintensified therapies seeking to reduce the risk of head and neck cancer (HNC) treatment-related dysphagia (HNCTD). Irradiated HNC subjects seen in follow-up care (April 2015 to December 2015) who prospectively completed the Sydney Swallow Questionnaire (SSQ) and the MD Anderson Dysphagia Inventory (MDADI) concurrently on the web interface to our Oncospace database were evaluated. A correlation matrix quantified the relationship between the SSQ and MDADI. Machine-learning unsupervised cluster analysis using the elbow criterion and CLUSPLOT analysis to establish its validity was performed. We identified 89 subjects. The MDADI and SSQ scores were moderately but significantly correlated (correlation coefficient -0.69). K-means cluster analysis demonstrated that 3 unique statistical cohorts (elbow criterion) could be identified with CLUSPLOT analysis, confirming that 100% of variances were accounted for. Correlation coefficients between the individual items in the SSQ and the MDADI demonstrated weak to moderate negative correlation, except for SSQ17 (quality of life question). Pilot analysis demonstrates that the MDADI and SSQ are complementary. Three unique clusters of patients can be defined, suggesting that a unique dysphagia signature for HNCTD may be definable. Longitudinal studies relying on only a single PRO, such as MDADI, may be inadequate for classifying HNCTD. Copyright © 2017 Elsevier Inc. All rights reserved.

The experience of adverse childhood experiences and dental care in childhood.

PubMed

Crouch, Elizabeth; Radcliff, Elizabeth; Nelson, Joni; Strompolis, Melissa; Martin, Amy

2018-06-06

Routine preventive dental care is important to overall child health and well-being. However, the experience of adversity in childhood may prevent children from getting adequate preventive care. This study seeks to explore how the prevalence of adverse childhood experiences (ACEs) and the role of a protective adult may be associated with dental care utilization in childhood. Data from the 2016 South Carolina Behavioral Risk Factor Surveillance System (SC BRFSS), which interviews adults eighteen year of age and older, were used in this study. Dental care utilization in childhood was measured as the adult retrospectively reported frequency of dental care in childhood: at least once every 2 years (adequate dental care) or less often than every 2 years (inadequate dental care). ACEs were determined by asking about each of respondent's childhood exposure to eleven childhood experiences, including divorce, parental incarceration, domestic violence, drug and alcohol abuse, mental illness and emotional, physical or sexual abuse. The presence of a protective adult in childhood included respondents who had an adult who made them feel safe and protected during childhood. Descriptive and bivariate statistics explored differences in the adequacy of child dental care by ACE exposure, the presence of a protective adult and selected demographic characteristics. Multivariate regression models were used to examine the impact of counts and types of ACEs and the presence of a protective adult with inadequate childhood dental care. The unweighted study sample included 7079 respondents ageing from 18 to 79 years of age Sampling weights were used for all analyses. Among all respondents, 71.7% reported receiving adequate dental care during childhood; 28.3% responded that they received inadequate dental care. Adjusting for sociodemographic characteristics, respondents who experienced four or more ACEs had a higher likelihood of inadequate dental care than respondents who reported no ACEs (aOR 2.79; 95% CI 2.77-2.82). The odds of reporting inadequate dental care were lower among those grew up with an adult who made them feel safe and protected (aOR 0.38; 95% CI 0.37-0.39). The presence of protective factors may mitigate the effects of ACEs on paediatric dental care. This research contributes to the literature through the further identification of the role of dentists in identifying signs of abuse and neglect. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Comparative efficacy and safety of tocilizumab, rituximab, abatacept and tofacitinib in patients with active rheumatoid arthritis that inadequately responds to tumor necrosis factor inhibitors: a Bayesian network meta-analysis of randomized controlled trials.

PubMed

Lee, Young Ho; Bae, Sang-Cheol

2016-11-01

This study aimed to assess the relative efficacy and safety of biologics and tofacitinib in patients with rheumatoid arthritis (RA) showing an inadequate response to tumor necrosis factor (TNF) inhibitors. We performed a Bayesian network meta-analysis to combine the direct and indirect evidence from randomized controlled trials (RCTs) examining the efficacy and safety of tocilizumab, rituximab, abatacept and tofacitinib in patients with RA that inadequately responds to TNF inhibitors. Four RCTs including 1796 patients met the inclusion criteria. The tocilizumab 8 mg group showed a significantly higher American College of Rheumatology 20% (ACR20) response rate than the abatacept and tofacitinib groups. Ranking probability based on surface under the cumulative ranking curve (SUCRA) indicated that tocilizumab 8 mg had the highest probability of being the best treatment for achieving the ACR20 response rate (SUCRA = 0.9863), followed by rituximab (SUCRA = 0.6623), abatacept (SUCRA = 0.5428), tocilizumab 4 mg (SUCRA = 0.4956), tofacitinib 10 mg (SUCRA = 0.4715), tofacitinib 5 mg (SUCRA = 0.3415) and placebo (SUCRA = 0). In contrast, the safety based on the number of withdrawals due to adverse events did not differ significantly among the treatment options. Tocilizumab 8 mg was the second-line non-TNF biologic with the highest performance regarding an early good response based on ACR20 response rate and acceptable safety profile, followed by rituximab, abatacept and tofacitinib in patients with RA and an inadequate response to anti-TNF therapy, and none of these treatments were associated with a significant risk of withdrawal due to adverse events. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

A Cost-Utility Analysis of Lisdexamfetamine Versus Atomoxetine in the Treatment of Children and Adolescents with Attention-Deficit/Hyperactivity Disorder and Inadequate Response to Methylphenidate.

PubMed

Zimovetz, Evelina A; Beard, Stephen M; Hodgkins, Paul; Bischof, Matthias; Mauskopf, Josephine A; Setyawan, Juliana

2016-10-01

An economic analysis from the perspective of the UK National Health Service (NHS) evaluated the cost effectiveness of lisdexamfetamine dimesylate (LDX) compared with atomoxetine in children and adolescents with attention-deficit/hyperactivity disorder who have had an inadequate response to methylphenidate. A 1-year decision-analytic model was constructed, with the health outcomes "response", "nonresponse", and "unable to tolerate". Clinical data were taken from a head-to-head, randomized controlled trial in inadequate responders to methylphenidate. Response to treatment was defined as a score of 1 (very much improved) or 2 (much improved) on the Clinical Global Impression-Improvement subscale. Tolerability was assessed by discontinuation rates owing to adverse events. Utility weights were identified via a systematic literature review. Healthcare resource use estimates were obtained via a survey of clinicians. Daily drug costs were derived from British National Formulary 2012 costs and mean doses reported in the trial. One-way and probabilistic sensitivity analyses (PSAs) were performed. The comparison of LDX with atomoxetine resulted in an estimate of an incremental cost-effectiveness ratio of £1802 per quality-adjusted life-year (QALY). The result was robust in a wide range of sensitivity analyses; results were most sensitive to changes in drug costs and efficacy. In the PSA, assuming a maximum willingness to pay of £20,000 per QALY, LDX versus atomoxetine had an 86 % probability of being cost effective. In 38 % of PSA runs, LDX was more effective and less costly than atomoxetine. From the perspective of the UK NHS, LDX provides a cost-effective treatment option for children and adolescents who are inadequate responders to methylphenidate.

[Evaluations by hospital-ward physicians of patient care management quality for patients hospitalized after an emergency department admission].

PubMed

Bartiaux, M; Mols, P

2017-01-01

patient management in the acute and sub-acute setting of an Emergency Department is challenging. An assessment of the quality of provided care enables an evaluation of failings. It contributes to the identification of areas for improvement. to obtain an analysis, by hospital-ward physicians, of adult patient care management quality, as well as of the correctness of diagnosis made during emergency admissions. To evaluate the consequences of inadequate patient care management on morbidity, mortality and cost and duration of hospitalization. prospective data analysis obtained between the 1/12/2009 and the 21/12/2009 from physicians using a questionnaire on adult-patient emergency admissions and subsequent hospitalization. questionnaires were completed for 332 patients. Inadequate management of patient care were reported for 73/332 (22 %) cases. Incorrect diagnoses were reported for 20/332 (6 %) cases. 35 cases of inadequate care management (10.5 % overall) were associated with morbidity (34 cases) or mortality (1 case), including 4 cases (1.2 % ) that required emergency intensive-care or surgical interventions. this quality study analyzed the percentage of patient management cases and incorrect diagnoses in the emergency department. The data for serious outcome and wrong diagnosis are comparable with current literature. To improve performance, we consider the process for establishing a diagnosis and therapeutic care.

Views of medical students: what, when and how do they want statistics taught?

PubMed

Fielding, S; Poobalan, A; Prescott, G J; Marais, D; Aucott, L

2015-11-01

A key skill for a practising clinician is being able to do research, understand the statistical analyses and interpret results in the medical literature. Basic statistics has become essential within medical education, but when, what and in which format is uncertain. To inform curriculum design/development we undertook a quantitative survey of fifth year medical students and followed them up with a series of focus groups to obtain their opinions as to what statistics teaching they want, when and how. A total of 145 students undertook the survey and five focus groups were held with between 3 and 9 participants each. Previous statistical training varied and students recognised their knowledge was inadequate and keen to see additional training implemented. Students were aware of the importance of statistics to their future careers, but apprehensive about learning. Face-to-face teaching supported by online resources was popular. Focus groups indicated the need for statistical training early in their degree and highlighted their lack of confidence and inconsistencies in support. The study found that the students see the importance of statistics training in the medical curriculum but that timing and mode of delivery are key. The findings have informed the design of a new course to be implemented in the third undergraduate year. Teaching will be based around published studies aiming to equip students with the basics required with additional resources available through a virtual learning environment. © The Author(s) 2015.

Microwave backscattering theory and active remote sensing of the ocean surface

NASA Technical Reports Server (NTRS)

Brown, G. S.; Miller, L. S.

1977-01-01

The status is reviewed of electromagnetic scattering theory relative to the interpretation of microwave remote sensing data acquired from spaceborne platforms over the ocean surface. Particular emphasis is given to the assumptions which are either implicit or explicit in the theory. The multiple scale scattering theory developed during this investigation is extended to non-Gaussian surface statistics. It is shown that the important statistic for the case is the probability density function of the small scale heights conditioned on the large scale slopes; this dependence may explain the anisotropic scattering measurements recently obtained with the AAFE Radscat. It is noted that present surface measurements are inadequate to verify or reject the existing scattering theories. Surface measurements are recommended for qualifying sensor data from radar altimeters and scatterometers. Additional scattering investigations are suggested for imaging type radars employing synthetically generated apertures.

Testing for periodicity of extinction

NASA Technical Reports Server (NTRS)

Raup, David M.; Sepkoski, J. J., Jr.

1988-01-01

The statistical techniques used by Raup and Sepkoski (1984 and 1986) to identify a 26-Myr periodicity in the biological extinction record for the past 250 Myr are reexamined, responding in detail to the criticisms of Stigler and Wagner (1987). It is argued that evaluation of a much larger set of extinction data using a time scale with 51 sampling intervals supports the finding of periodicity. In a reply by Sigler and Wagner, the preference for a 26-Myr period is attributed to a numerical quirk in the Harland et al. (1982) time scale, in which the subinterval boundaries are not linear interpolations between the stage boundaries but have 25-Myr periodicity. It is stressed that the results of the stringent statistical tests imposed do not disprove periodicity but rather indicate that the evidence and analyses presented so far are inadequate.

Statistical considerations in monitoring birds over large areas

USGS Publications Warehouse

Johnson, D.H.

2000-01-01

The proper design of a monitoring effort depends primarily on the objectives desired, constrained by the resources available to conduct the work. Typically, managers have numerous objectives, such as determining abundance of the species, detecting changes in population size, evaluating responses to management activities, and assessing habitat associations. A design that is optimal for one objective will likely not be optimal for others. Careful consideration of the importance of the competing objectives may lead to a design that adequately addresses the priority concerns, although it may not be optimal for any individual objective. Poor design or inadequate sample sizes may result in such weak conclusions that the effort is wasted. Statistical expertise can be used at several stages, such as estimating power of certain hypothesis tests, but is perhaps most useful in fundamental considerations of describing objectives and designing sampling plans.

On Time Performance Pressure

NASA Technical Reports Server (NTRS)

Connell, Linda; Wichner, David; Jakey, Abegael

2013-01-01

Within many operations, the pressures for on-time performance are high. Each month, on-time statistics are reported to the Department of Transportation and made public. There is a natural tendency for employees under pressure to do their best to meet these objectives. As a result, pressure to get the job done within the allotted time may cause personnel to deviate from procedures and policies. Additionally, inadequate or unavailable resources may drive employees to work around standard processes that are seen as barriers. However, bypassing practices to enable on-time performance may affect more than the statistics. ASRS reports often highlight on-time performance pressures which may result in impact across all workgroups in an attempt to achieve on-time performance. Reporters often provide in-depth insights into their experiences which can be used by industry to identify and focus on the implementation of systemic fixes.

[Candidemias: multicentre analysis in 16 hospitals in Andalusia (Spain)].

PubMed

Rodríguez-Hernández, M Jesús; Ruiz-Pérez de Pipaon, Maite; Márquez-Solero, Manuel; Martín-Rico, Patricia; Castón-Osorio, Juan José; Guerrero-Sánchez, Francisca M; Vidal-Verdú, Elisa; García-Figueras, Carolina; Del Arco-Jiménez, Alfonso; Rodríguez-Baño, Jesús; Martín-Mazuelos, Estrella; Cisneros-Herreros, José Miguel

2011-05-01

Candidemia is a nosocomial infection with high associated mortality. There have been changes in microbiology, epidemiology and treatment over the last few years, which has led us to analyse our own situation. Prospective, multicentre and observational study. All episodes of candidemia in adult patients seen in 17 Andalusian hospitals from 1 October 2005 to 30 September 2006 were included. Were detected 220 cases, the incidence was 0.58 cases/1,000 hospital discharges. Candida albicans was the most frecuent species (53% of cases). The majority of isolates (89%) was susceptibility to fluconazole. Sepsis was the most frequent clinical manifestation (65.7%). The treatment was inadequate in 38.7% of cases. Overall mortality was 40%. On univarite analysis death was found to be significantly associated with: aged > 60 years, unknown candidemia focus, Pitt score ≥ 2, APACHE II, shock at onset, persistents positive second blood cultures, non-removal of the central venous catheter and Candida species different of C. parasilopsis, among others. In the multivariate analysis death was found to be significantly associated with: aged > 60 years, Pitt score ≥ 2, Candida species different of C.parasilopsis and inadequate treatment. The candidemia clinical epidemiology in our region is similar to other areas and receiving inadequate treatment is the only modifiable risk factor associated with higher odds of mortality. Therefore, this modifiable factor needs to be improved to reduce the mortality. Copyright © 2010 Elsevier España, S.L. All rights reserved.

Levels and determinants of complementary feeding based on meal frequency among children of 6 to 23 months in Bangladesh.

PubMed

Chowdhury, Mohammad Rocky Khan; Rahman, Md Shafiur; Khan, Md Mobarak Hossain

2016-09-07

Information concerning complementary feeding (CF) practice during infancy and early childhood is still scarce in Bangladesh. Therefore, this study aimed to estimate the level of CF among children of 6-23 months and identify individual, household and community level determinants in Bangladesh. Secondary data from the Bangladesh Demographic Health Survey (BDHS) 2011 was used. A total of 2,373 children aged 6-23 months were selected. A simplified index called "dimension index" was used to estimate the level of CF. The score of this index was used either as continuous or categorical dependent variables. The highest score based on dimension index is associated to an adequate CF. Statistical analyses and tests were guided by types of variables. Finally, multivariable logistic regression (binary and multinomial) analyses were performed to identify the significant determinants of CF. The overall level of CF among children of 6-23 months was low. More than 90 % of children experienced either no (2.9 %) or inadequate CF (92.7 %). According to bivariable analyses, mean levels of CF as well as percentages of no/inadequate CF were significantly lower among children of the youngest age group, uneducated parents, unemployed/laborer fathers, socio-economically poor families, food insecure families and rural areas. No weekly exposure to mass media (namely watching TV and reading newspapers/magazines) also revealed significant associations with CF. However, only few variables remained significant for adequate CF in the multivariable logistic regression analysis. For example, the likelihood of experiencing adequate CF was significantly lower among children of 6-11 months (OR: 0.22, 95 % CI: 0.10-0.47), children of illiterate fathers (OR: 0.32, 95 % CI: 0.11-0.95) and socio-economically middle-class families (OR: 0.28, 95 % CI: 0.09-0.86) as compared to their reference categories. A high level of inadequate CF leading to malnutrition may cause serious health problems among children of 6-23 months in Bangladesh. Vulnerable groups of children (e.g., the children aged 6 to 11 months and children of illiterate fathers), who received low levels of adequate CF, should be targeted by government and other stakeholders while developing strategies and interventions in order to improve overall situation of CF in Bangladesh.

Lisdexamfetamine dimesylate augmentation for adults with major depressive disorder and inadequate response to antidepressant monotherapy: Results from 2 phase 3, multicenter, randomized, double-blind, placebo-controlled studies.

PubMed

Richards, Cynthia; McIntyre, Roger S; Weisler, Richard; Sambunaris, Angelo; Brawman-Mintzer, Olga; Gao, Joseph; Geibel, Brooke; Dauphin, Matthew; Madhoo, Manisha

2016-12-01

The efficacy, safety, and tolerability of lisdexamfetamine dimesylate (LDX) augmentation of antidepressant monotherapy in adults with major depressive disorder (MDD) from two phase 3 studies are reported. Across study 1 (placebo, n=201; LDX, n=201) and study 2 (placebo, n=213; LDX, n=211), most participants (placebo and LDX) in the safety analysis set were female (study 1: 66.2% and 64.2%; study 2: 67.1% and 66.8%); mean±SD ages were 41.8±12.04 with placebo and 42.2±12.32 with LDX in study 1 and 42.6±11.41 with placebo and 42.0±11.63 with LDX in study 2. Participants (18-65 y) had DSM-IV-TR-diagnosed MDD and lead-in baseline Montgomery-Åsberg Depression Rating Scale (MADRS) total scores ≥24. Eight-week antidepressant lead-in phases prospectively assessed antidepressant response. Then, 8 weeks of randomized (1:1), double-blind treatment with dose-optimized LDX (20-70mg) or placebo in participants exhibiting inadequate antidepressant monotherapy responses (augmentation baseline MADRS total scores ≥18 and <50% MADRS total score reductions from lead-in baseline to augmentation baseline) was initiated. The primary endpoint was MADRS total score change from augmentation baseline to week 16. Safety and tolerability measures included the occurrence of treatment-emergent adverse events (TEAEs). Least squares mean (95% CI) treatment differences (LDX-placebo) for MADRS total score changes from augmentation baseline to week 16 were not statistically significant in study 1 (0.1 [-1.7, 2.0], P=0.883) or study 2 (-0.5 [-2.3, 1.3], P=0.583). The only TEAE reported by >5% of LDX participants at twice the placebo rate in both studies was dry mouth. Limitations include the exclusion of participants with psychiatric comorbidities/active medical disorders, the inability to assess specific MDD symptom domains (eg, anhedonia, cognition) or subtypes, the use of telephone-based depression assessments, and the potential influence of placebo response. Contrary to expectations, LDX augmentation was not superior to placebo in reducing depressive symptoms in individuals with MDD exhibiting inadequate responses to antidepressant monotherapy. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

How Are Kentucky's Children Stacking Up? A County by County Analysis.

ERIC Educational Resources Information Center

Chandler, Betsy

In a county by county analysis, this report assesses the quality of life for Kentucky's children. Researchers developed a child quotient (CQ) based on 18 indicators: per capita income, children in poverty, women receiving inadequate prenatal care, infant deaths, teens giving birth, substandard dwellings, children in foster care, per-pupil…

Meta-Analysis and Inadequate Responders to Intervention: A Reply

ERIC Educational Resources Information Center

Swanson, H. Lee

2012-01-01

A meta-analysis by Tran, Sanchez, Arellano, and Swanson (2011) of the published RTI literature found that the magnitude of effect size (ES) between responders and low responders at posttest was significantly moderated by the pretest ES and the type of dependent measure administered, whereas no significant moderating effects were found in the mixed…

Analysis of Computer Teachers' Online Discussion Forum Messages about Their Occupational Problems

ERIC Educational Resources Information Center

Deryakulu, Deniz; Olkun, Sinan

2007-01-01

This study, using content analysis technique, examined the types of job-related problems that the Turkish computer teachers experienced and the types of social support provided by reciprocal discussions in an online forum. Results indicated that role conflict, inadequate teacher induction policies, lack of required technological infrastructure and…

A Functional Analysis of Moderate-to-Vigorous Physical Activity in Young Children

ERIC Educational Resources Information Center

Larson, Tracy A.; Normand, Matthew P.; Morley, Allison J.; Miller, Bryon G.

2013-01-01

Inadequate physical activity increases the risks related to a number of health problems in children, most notably obesity and the corresponding range of associated health problems. The purpose of the current study was to conduct a functional analysis to investigate the effects of several consequent variables on moderate-to-vigorous physical…

Environmental Pollution Control Policy-Making: An Analysis of Elite Perceptions and Preferences

ERIC Educational Resources Information Center

Althoff, Phillip; Greig, William H.

1974-01-01

This article is based on an analysis of the perceptions and preferences of elite groups concerning environmental pollution control policy making. Results showed that although the groups agreed that present methods were inadequate, they were, nevertheless, unable to agree upon the nature of a future policy-making system. (MA)

The yield of adequate and conclusive fine-needle aspiration results in thyroid nodules is uniform across functional and goiter types.

PubMed

Liel, Y

1999-01-01

Relatively little is known about the cytological characteristics of hyperfunctioning (hot) thyroid nodules. Concern has been expressed that fine-needle aspiration (FNA) identifies hot nodules as follicular tumors or indeterminate, and as a consequence patients could be unnecessarily referred for surgery. Between 1979 and 1996, thyroid FNA was performed on 829 patients. Result of thyroid scan was available in 326; 69 (21%) patients had hot, and 257 (79%) had warm or cold thyroid nodules. Nodules in each of these major groups were divided into 2 subgroups: clinically solitary nodules and dominant nodules in multinodular goiters (MNG). The frequencies of adequate versus inadequate FNA samples, and of conclusive versus indeterminate FNA results were determined separately for each of the groups and subgroups. In addition, patients with hot nodules and overt hyperthyroidism were identified and evaluated separately. Bivariate analyses were performed for the frequency of adequate versus inadequate smears and conclusive versus indeterminate results between hot, toxic, and cold-warm nodules, and between solitary nodules and MNG. The frequency of adequate aspirations and conclusive results in the various groups and subgroups was found to be statistically indistinguishable. In conclusion, the yield of adequate samples and the rate of conclusive results of FNA in thyroid nodules is similar, irrespective of the functional state or of goiter presentation. Hot thyroid nodules do not seem to produce an increase in the rate of inadequate or indeterminate FNA results, and therefore, do not affect the overall performance of thyroid FNA.

Evaluation of health literacy among Spanish-speaking primary care patients along the US--Mexico border.

PubMed

Penaranda, Eribeth; Diaz, Marco; Noriega, Oscar; Shokar, Navkiran

2012-07-01

Health literacy (HL) is a measure of the communication skills that are needed by an individual to effectively navigate the healthcare system. Hispanic adults have lower average levels of HL than any other racial/ethnic group; however, the prevalence of adequate HL among Hispanics along the US-Mexico border is unknown. We performed a cross-sectional survey of 200 adult primary care patients who attended four low-income community clinics along the US-Mexico border. Patients were included in the study if they were self-described Hispanics whose first language was Spanish or bilingual patients who reported that they were primarily Spanish speakers. Adequate HL was defined as having a score of ≥38 on the Short Assessment of Health Literacy for Spanish Adults-50. Three patients (1.5%) had inadequate HL. Because of the high proportion of patients having adequate HL, we found no statistical differences between patients with adequate HL versus inadequate HL by age, sex, educational attainment, health coverage, or self-reported health status; however, all three patients with inadequate HL were found to be 60 years old or older and had less than a high school education. The results of HL assessment varied according to the tool and setting used in measuring Spanish-speaking Hispanics. In certain clinical scenarios, current tools may underestimate the actual prevalence of adequate HL. Further development and assessment of HL tools appropriate for Spanish-speaking Hispanics is needed as a first step in developing interventions to limit disparities in health care among all Americans.

An empirical method to determine inadequacy of dietary water.

PubMed

Armstrong, Lawrence E; Johnson, Evan C; McKenzie, Amy L; Muñoz, Colleen X

2016-01-01

The physiological regulation of total body water and fluid concentrations is complex and dynamic. The human daily water requirement varies because of differences in body size, dietary solute load, exercise, and activities. Although chronically concentrated urine increases the risk of renal diseases, an empirical method to determine inadequate daily water consumption has not been described for any demographic group; instead, statistical analyses are applied to estimate nutritional guidelines (i.e., adequate intake). This investigation describes a novel empirical method to determine the 24-h total fluid intake (TFI; TFI = water + beverages + moisture in food) and 24-h urine volume, which correspond to inadequate 24-h water intake (defined as urine osmolality of 800 mOsm/kg; U800). Healthy young women (mean ± standard deviation; age, 20 ± 2 y, mass, 60.8 ± 11.7 kg; n = 28) were observed for 7 consecutive days. A 24-h urine sample was analyzed for volume and osmolality. Diet records were analyzed to determine 24-h TFI. For these 28 healthy young women, the U800 corresponded to a TFI ≥2.4 L/d (≥39 mL/kg/d) and a urine volume ≥1.3 L/d. The U800 method could be employed to empirically determine 24-h TFI and 24-h urine volumes that correspond to inadequate water intake in diverse demographic groups, residents of specific geographic regions, and individuals who consume specialized diets or experience large daily water turnover. Because laboratory expertise and instrumentation are required, this technique provides greatest value in research and clinical settings. Copyright © 2016 Elsevier Inc. All rights reserved.

Meta-analysis of the effectiveness of nursing discharge planning interventions for older inpatients discharged home.

PubMed

Mabire, Cédric; Dwyer, Andrew; Garnier, Antoine; Pellet, Joanie

2018-04-01

To determine the effectiveness of nursing discharge planning interventions on health-related outcomes for older inpatients discharged home. Inadequate discharge planning for the ageing population poses significant challenges for health services. Effective discharge planning interventions have been examined in several studies, but little information is available on nursing interventions for older people. Despite the research published on the importance of discharge planning, the impact on patient's health outcomes still needs to be evaluated in practice. Systematic review and meta-analysis. A systematic search was undertaken across 13 databases to retrieve published and unpublished studies in English between 2000-2015. Critical appraisal, data extraction and meta-analysis followed the methodology of the Joanna Briggs Institute. Thirteen studies were included in the review, 2 of 13 were pilot studies and one had a pre-post design. Included studies involved 3,964 participants with a median age of 77 years. Nurse discharge planning did not significantly reduce hospital readmission or quality of life, except readmission was lower across studies conducted in the USA. The overall effect score for nurse discharge planning on length of stay was statistically significant and positive. Nursing discharge planning is a complex intervention and difficult to evaluate. Findings suggest that nursing discharge planning for older inpatients discharged home increases the length of stay yet neither reduces readmission rate nor improves quality of life. © 2017 John Wiley & Sons Ltd.

[Death rate by malnutrition in children under the age of five, Colombia].

PubMed

Quiroga, Edwin Fernando

2012-01-01

Much higher mortalities occur in children under five in developing countries with high poverty rates compared with developed countries. Causes of death are related to perinatal conditions, measles, HIV/AIDS, diarrhea, respiratory diseases and others. Throughout the world, malnutrition has been identified as the underlying cause of approximately half of these deaths. Death rate due to malnutrition was described using an adjusted method that takes into account the difficulties of identifying malnutrition as a direct cause of death. A descriptive study included analysis of the International Classification of Diseases (ICD-10) vital statistics from 2003-2007. Death rates were estimated, a method of analysis of multiple causes was applied for infectious diseases, along with calculations of death probabilities. Malnutrition was associated with infectious diseases. The frequency of infectious disease as a direct cause of death was almost seven times higher in cases with the antecedent of malnutrition. When adjusted death rate values were used, the initial value increased nearly five times. The probability of death after the adjustment for inadequate classification increased approximately four times. The Analysis of Multiple Causes Method was established as an effective method in analyzing malnutrition and infectious diesease mortality in Colombia. Malnutrition may be a direct underlying cause of death in one of eight deaths in children <1 year old and one of three deaths in 1-4-year-olds.

Fractographic study of the behavior of different ceramic veneers on full coverage crowns in relation to supporting core materials

PubMed Central

Agustín-Panadero, Rubén; Román-Rodriguez, Juan L.; Solá-Ruíz, María F.; Granell-Ruíz, María; Fons-Font, Antonio

2013-01-01

Objectives: To observe porcelain veneer behavior of zirconia and metal-ceramic full coverage crowns when subjected to compression testing, comparing zirconia cores to metal cores. Study Design: The porcelain fracture surfaces of 120 full coverage crowns (60 with a metal core and 60 with a zirconia core) subjected to static load (compression) testing were analyzed. Image analysis was performed using macroscopic processing with 8x and 12x enlargement. Five samples from each group were prepared and underwent scanning electron microscope (SEM) analysis in order to make a fractographic study of fracture propagation in the contact area and composition analysis in the most significant areas of the specimen. Results: Statistically significant differences in fracture type (cohesive or adhesive) were found between the metal-ceramic and zirconia groups: the incidence of adhesive fracture was seen to be greater in metal-ceramic groups (92%) and cohesive fracture was more frequent in zirconium oxide groups (72%). The fracture propagation pattern was on the periphery of the contact area in the full coverage crown restorations selected for fractographic study. Conclusions: The greater frequency of cohesive fracture in restorations with zirconia cores indicates that their behavior is inadequate compared to metal-ceramic restorations and that further research is needed to improve their clinical performance. Key words:Zirconia, zirconium oxide, fractography, composition, porcelain veneers, fracture, cohesive, adhesive. PMID:24455092

Physiological basis of dietary prevention of perimenopausal disorders in the context of dietary habits associated with the consumption of water and beverages by women aged 45-65

PubMed Central

Remiszewska, Zuzanna

2014-01-01

Introduction This study aimed to evaluate the amount of water and type of beverages consumed by women of perimenopausal age against a background of dietary prevention of perimenopausal disorders. Material and methods This study was conducted in autumn 2012, in Wielkopolska Province (Poland), on 100 women aged from 45 to 65 years, employed as office workers. Information on the diet, beverages consumption and anthropometric data were collected. Results Analysis of the nutritional status of the surveyed women showed that over 50% of them had excess body weight. Analysis of the survey results indicated that the amount of water in the diet of the examined women was appropriate, although the type of drinks consumed was inadequate. The women consumed too much coffee and tea, and simultaneously had a low intake of potable water. More than a half of the surveyed women sweetened coffee and tea. Women with excess body weight did so statistically significantly quite often, and they also used larger amounts of sugar for sweetening. Nearly 60% of the surveyed women added milk, or less frequently cream, to coffee. Milk was statistically significantly more frequently chosen by women with normal body weight, and cream by women with excess body weight. There was a positive correlation between body mass index and the energy value of the consumed fluids. Conclusions The dietary irregularities identified in this study may intensify perimenopausal symptoms and contribute to the development of diet-related chronic diseases. Taking into account the observed irregularities, it seems appropriate to provide perimenopausal women with nutrition education and diet correction, including the amount and type of fluids consumed. PMID:26327836

Critical evaluation of fine needle aspiration cytology as a diagnostic technique in bone tumors and tumor-like lesions.

PubMed

Chakrabarti, Sudipta; Datta, Alok Sobhan; Hira, Michael

2012-01-01

Though open surgical biopsy is the procedure of choice for the diagnosis of bone tumors, many disadvantages are associated with this approach. The present study was undertaken to evaluate the role of fine needle aspiration cytology (FNAC) as a diagnostic tool in cases of bony tumors and tumor-like lesions which may be conducted in centers where facilities for surgical biopsies are inadequate. The study population consisted of 51 cases presenting with a skeletal mass. After clinical evaluation, radiological correlation was done to assess the nature and extent of each lesion. Fine needle aspiration was performed aseptically and smears were prepared. Patients subsequently underwent open surgical biopsy and tissue samples were obtained for histopathological examination. Standard statistical methods were applied for analysis of data. Adequate material was not obtained even after repeated aspiration in seven cases, six of which were benign. Among the remaining 44 cases, diagnosis of malignancy was correctly provided in 28 (93.3%) out of 30 cases and categorical diagnosis in 20 (66.67%). Interpretation of cytology was more difficult in cases of benign and tumor-like lesions, with a categorical opinion only possible in seven (50%) cases. Statistical analysis showed FNAC with malignant tumors to have high sensitivity (93.3%), specificity (92.9%) and positive predictive value of 96.6%, whereas the negative predictive value was 86.7%. FNAC should be included in the diagnostic workup of a skeletal tumor because of its simplicity and reliability. However, a definitive pathologic diagnosis heavily depends on compatible clinical and radiologic features which can only be accomplished by teamwork. The cytological technique applied in this study could detect many bone tumors and tumor-like conditions and appears particularly suitable as a diagnostic technique for rural regions of India as other developing countries.

Inability of Open-Field Autorefraction to Eliminate Accommodation in Preschoolers.

PubMed

Kara, Caner; Petriçli, İkbal Seza

2017-09-01

To evaluate the effectiveness of the Shin-Nippon NVision-K 5001 autorefractometer (Rexxam Co. Ltd., Osaka, Japan) (also branded as the Grand Seiko WR-5100K; Grand Seiko Co. Ltd., Hiroshima, Japan) based on the open-field refractometry principle in refractive measurements of preschool children and to determine its ability to eliminate accommodation adequately. The refractive results of 114 preschool children who presented to the ophthalmology outpatient department for screening were evaluated. The measurements were obtained before and after cycloplegia with the Shin-Nippon NVision-K 5001 autorefractometer and after cycloplegia with retinoscopy, which is the gold standard. The results underwent vectorial transformation to produce the spherical equivalent (M) and two Jackson cross-cylinder (J0 and J45) values. All results were then subjected to statistical analysis. The difference between the measurements was evaluated with repeated measures analysis of variance. Included in the study were 106 preschool children (51 boys and 55 girls). The mean age was 5.3 ± 0.9 years (range: 3 to 6 years). Although statistically significantly more myopic results were obtained with non-cycloplegic measurements using the Shin-Nippon NVision-K 5001 autorefractometer (P < .001), no difference was observed in cylindrical values (P > .05). Cycloplegic J0 measurements were significantly lower (P < .001), but no difference was found between J45 values before and after cycloplegia (P > .05). The Shin-Nippon NVision-K 5001/Grand Seiko WR-5100K open-field autorefractometer seems to be inadequate in eliminating accommodation in childhood. Measurements under cycloplegia continue to be the best method to ensure accurate results. [J Pediatr Ophthalmol Strabismus. 2017;54(5):311-318.]. Copyright 2017, SLACK Incorporated.

Arsenic exposure and bladder cancer: quantitative assessment of studies in human populations to detect risks at low doses.

PubMed

Tsuji, Joyce S; Alexander, Dominik D; Perez, Vanessa; Mink, Pamela J

2014-03-20

While exposures to high levels of arsenic in drinking water are associated with excess cancer risk (e.g., skin, bladder, and lung), exposures at lower levels (e.g., <100-200 µg/L) generally are not. Lack of significant associations may result from methodological issues (e.g., inadequate statistical power, exposure misclassification), or a different dose-response relationship at low exposures, possibly associated with a toxicological mode of action that requires a sufficient dose for increased tumor formation. The extent to which bladder cancer risk for low-level arsenic exposure can be statistically measured by epidemiological studies was examined using an updated meta-analysis of bladder cancer risk with data from two new publications. The summary relative risk estimate (SRRE) for all nine studies was elevated slightly, but not significantly (1.07; 95% confidence interval [CI]: 0.95-1.21, p-Heterogeneity [p-H]=0.543). The SRRE among never smokers was 0.85 (95% CI: 0.66-1.08, p-H=0.915), whereas the SRRE was positive and more heterogeneous among ever smokers (1.18; 95% CI: 0.97-1.44, p-H=0.034). The SRRE was statistically significantly lower than relative risks predicted for never smokers in the United States based on linear extrapolation of risks from higher doses in southwest Taiwan to arsenic water exposures >10 µg/L for more than one-third of a lifetime. By contrast, for all study subjects, relative risks predicted for one-half of lifetime exposure to 50 µg/L were just above the upper 95% CI on the SRRE. Thus, results from low-exposure studies, particularly for never smokers, were statistically inconsistent with predicted risk based on high-dose extrapolation. Additional studies that better characterize tobacco use and stratify analyses of arsenic and bladder cancer by smoking status are necessary to further examine risks of arsenic exposure for smokers. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Admixture analysis of age at onset in first episode bipolar disorder.

PubMed

Nowrouzi, Behdin; McIntyre, Roger S; MacQueen, Glenda; Kennedy, Sidney H; Kennedy, James L; Ravindran, Arun; Yatham, Lakshmi; De Luca, Vincenzo

2016-09-01

Many studies have used the admixture analysis to separate age-at-onset (AAO) subgroups in bipolar disorder, but none of them examined first episode patients. The purpose of this study was to investigate the influence of clinical variables on AAO in first episode bipolar patients. The admixture analysis was applied to identify the model best fitting the observed AAO distribution of a sample of 194 patients with DSM-IV diagnosis of bipolar disorder and the finite mixture model was applied to assess the effect of clinical covariates on AAO. Using the BIC method, the model that was best fitting the observed distribution of AAO was a mixture of three normal distributions. We identified three AAO groups: early age-at-onset (EAO) (µ=18.0, σ=2.88), intermediate-age-at-onset (IAO) (µ=28.7, σ=3.5), and late-age-at-onset (LAO) (µ=47.3, σ=7.8), comprising 69%, 22%, and 9% of the sample respectively. Our first episode sample distribution model was significantly different from most of the other studies that applied the mixture analysis. The main limitation is that our sample may have inadequate statistical power to detect the clinical associations with the AAO subgroups. This study confirms that bipolar disorder can be classified into three groups based on AAO distribution. The data reported in our paper provide more insight into the diagnostic heterogeneity of bipolar disorder across the three AAO subgroups. Copyright © 2016 Elsevier B.V. All rights reserved.

Information sources in science and technology in Finland

NASA Technical Reports Server (NTRS)

Haarala, Arja-Riitta

1994-01-01

Finland poses some problems to be overcome in the field of scientific and technical information: a small user community which makes domestic systems costly; great distances within the country between users and suppliers of information; great distances to international data systems and large libraries abroad; and inadequate collections of scientific and technical information. The national bibliography Fennica includes all books and journals published in Finland. Data base services available in Finland include: reference data bases in science and technology; data banks for decision making such as statistical time series or legal proceedings; national bibliographies; and library catalogs.

On evaluating compliance with air pollution levels 'not to be exceeded more than once per year'

NASA Technical Reports Server (NTRS)

Neustadter, H. E.; Sidik, S. M.

1974-01-01

The point of view taken is that the Environmental Protection Agency (EPA) Air Quality Standards (AQS) represent conditions which must be made to exist in the ambient environment. The statistical techniques developed should serve as tools for measuring the closeness to achieving the desired quality of air. It is shown that the sampling frequency recommended by EPA is inadequate to meet these objectives when the standard is expressed as a level not to be exceeded more than once per year and sampling frequency is once every three days or less frequent.

Health care access and poverty do not explain the higher esophageal cancer mortality in African Americans.

PubMed

Miller, Jordan A G; Rege, Robert V; Ko, Clifford Y; Livingston, Edward H

2004-07-01

Esophageal cancer mortality is increased in African Americans relative to white patients. The reasons for this are unknown but are thought to be related to inadequate access to health care secondary to a higher poverty rate in African American populations. The National Health Interview Survey database for years 1986 to 1994 were combined and linked to the National Death Index. Individuals who died from esophageal carcinoma were assessed in the combined database, thus enabling detailed analysis of their socioeconomic status, race, and health care access. Poverty was 4-fold more frequent in African Americans who died from esophageal carcinoma than whites. Despite poverty, African American patients' access to health care was good and was not statistically related to increased mortality. Although the esophageal carcinoma mortality rate is higher in African Americans than in whites, it is not clearly related to the presence of poverty or to limited health care access. The higher mortality may be related to lifestyle differences, environmental exposure, or difference in disease biology, but it is not related exclusively to socioeconomic factors.

Resin embedded multicycle imaging (REMI): a tool to evaluate protein domains.

PubMed

Busse, B L; Bezrukov, L; Blank, P S; Zimmerberg, J

2016-08-08

Protein complexes associated with cellular processes comprise a significant fraction of all biology, but our understanding of their heterogeneous organization remains inadequate, particularly for physiological densities of multiple protein species. Towards resolving this limitation, we here present a new technique based on resin-embedded multicycle imaging (REMI) of proteins in-situ. By stabilizing protein structure and antigenicity in acrylic resins, affinity labels were repeatedly applied, imaged, removed, and replaced. In principle, an arbitrarily large number of proteins of interest may be imaged on the same specimen with subsequent digital overlay. A series of novel preparative methods were developed to address the problem of imaging multiple protein species in areas of the plasma membrane or volumes of cytoplasm of individual cells. For multiplexed examination of antibody staining we used straightforward computational techniques to align sequential images, and super-resolution microscopy was used to further define membrane protein colocalization. We give one example of a fibroblast membrane with eight multiplexed proteins. A simple statistical analysis of this limited membrane proteomic dataset is sufficient to demonstrate the analytical power contributed by additional imaged proteins when studying membrane protein domains.

Developing an Intelligent System for Diagnosis of Asthma Based on Artificial Neural Network.

PubMed

Alizadeh, Behrouz; Safdari, Reza; Zolnoori, Maryam; Bashiri, Azadeh

2015-08-01

Lack of proper diagnosis and inadequate treatment of asthma, leads to physical and financial complications. This study aimed to use data mining techniques and creating a neural network intelligent system for diagnosis of asthma. The study population is the patients who had visited one of the Lung Clinics in Tehran. Data were analyzed using the SPSS statistical tool and the chi-square Pearson's coefficient was the basis of decision making for data ranking. The considered neural network is trained using back propagation learning technique. According to the analysis performed by means of SPSS to select the top factors, 13 effective factors were selected, in different performances, data was mixed in various forms, so the different modes was made for training the data and testing networks and in all different modes, the network was able to predict correctly 100% of all cases. Using data mining methods before the design structure of system, aimed to reduce the data dimension and the optimum choice of the data, will lead to a more accurate system. So considering the data mining approaches due to the nature of medical data is necessary.

[Knowledge of zoonoses transmission routes and of the species concerned among rural workers].

PubMed

Molineri, Ana I; Signorini, Marcelo L; Tarabla, Héctor D

2014-01-01

The aim of this study was to evaluate the level of awareness of zoonoses among rural workers and their potential associations with socio-demographic factors. A cross-sectional study was performed by holding personal interviews (N=110, n=94) using a structured questionnaire. The statistical analysis included the χ(2) test, the Student's t test and Pearson and Spearman correlations. The highest level of awareness was found for trichinosis, rabies and scabies. Species transmitting brucellosis, tuberculosis and anthrax were well known, but not their modes of transmission. The least known diseases were toxocariasis and hydatidosis, followed by leptospirosis and toxoplasmosis. Significant associations were found (p<0.001) between the knowledge of transmitting species and the modes of transmission. Senior male owners, married, and living in urban areas showed the highest overall knowledge of zoonoses. Awareness of zoonoses among rural workers is inadequate. Veterinarians in conjunction with risk insurers may play a key role in providing information to people at risk. Copyright © 2014 Asociación Argentina de Microbiología. Publicado por Elsevier España. All rights reserved.

Menstrual patterns, fertility and main pregnancy outcomes after allogeneic haematopoietic stem cell transplantation.

PubMed

Chiodi, Sandra; Spinelli, Simonetta; Bruzzi, Paolo; Anserini, Paola; Di Grazia, Carmen; Bacigalupo, Andrea

2016-08-01

Two-hundred and sixty-nine females aged ≤42 and undergoing an allogeneic stem cell transplant were retrospectively studied to assess the effect of age, conditioning regimen and chronic graft-versus-host disease (cGVHD) on resumption of stable menstrual cyclicity. Overall, a stable menstrual cyclicity was observed in 22% of cases. The cumulative probability of menses resumption was significantly age and conditioning regimen related. A statistically significant inverse correlation between cGVHD severity and menses resumption was observed only in univariate analysis. In patients with residual ovarian function, infertility was found in 43% and early menopause in 45%. An increased incidence of prematurity and low birth weight (LBW) was observed among the single spontaneous pregnancies. Follicle-stimulating hormone (FSH) and 17 beta-oestradiol levels were found to be inadequate to detect both early signs of menses resumption and menstrual stability. Our study confirms the crucial role of full dose total body irradiation (TBI) and age on menses recovery and fertility after haematopoietic stem cell transplantation (HSCT). The impact of severe cGVHD remains unclear.

Comparison of the pattern, efficacy, and tolerability of self-medicated drugs in primary dysmenorrhea: A questionnaire based survey

PubMed Central

Sugumar, Ramya; Krishnaiah, Vasundara; Channaveera, Gokul Shetty; Mruthyunjaya, Shilpa

2013-01-01

Objective: To compare the pattern, efficacy, and tolerability of self-medicated drugs and to assess the adequacy of their dose in primary dysmenorrhea (PD). Materials and Methods: A survey using a self-developed, validated, objective, and structured questionnaire as a tool was conducted among subjects with PD. Statistical analysis was carried out using Chi-square test and ANOVA with post-hoc Tuckey's test. Results: Out of 641 respondents, 42% were self-medicated. The pattern of drugs used was: Dicyclomine, an unknown drug, mefenamic acid, mefenamic acid + dicyclomine, and metamizole by 35%, 29%, 26%, 9%, and 1% of respondents, respectively. Mefenamic acid + dicyclomine, the combination was the most efficacious in comparison to other drugs in moderate to severe dysmenorrhea. There was better tolerability with mefenamic acid + dicyclomine group compared to other drugs. Sub-therapeutic doses were used by 86% of self-medicating respondents. Conclusions: The prevailing self-medication practices were inappropriate in a substantial proportion of women with inadequate knowledge regarding appropriate drug choice, therapeutic doses, and their associated side effects. PMID:23716896

Job stress as a risk factor for absences among manual workers: a 12-month follow-up study

PubMed Central

HEO, Yong-Seok; LEEM, Jong-Han; PARK, Shin-Goo; JUNG, Dal-Young; KIM, Hwan-Cheol

2015-01-01

This study was conducted to evaluate the impact of job stress on absence from work caused by illnesses and accidents through a prospective research design. A total of 2,349 manual workers were included in this analysis. In the first survey, job stress was determined using the Korean Occupational Stress Scale-Short Form. In the second survey, information on absence due to accidents or illnesses during the past one year was obtained through a questionnaire. The relationship was analyzed using a logistic regression model with multiple imputation. After adjusting for confounding variables for males, absence due to accidents was statistically associated with high job demand, insufficient job control, inadequate social support, and organizational injustice. In addition, high job demands and organizational injustice were related to increased absence due to illnesses in both genders. A lack of reward was associated with increased absence due to illnesses among female workers. We found that job stress was associated with a higher risk of absence caused by accidents or illnesses of manual workers. PMID:26212413

Job stress as a risk factor for absences among manual workers: a 12-month follow-up study.

PubMed

Heo, Yong-Seok; Leem, Jong-Han; Park, Shin-Goo; Jung, Dal-Young; Kim, Hwan-Cheol

2015-01-01

This study was conducted to evaluate the impact of job stress on absence from work caused by illnesses and accidents through a prospective research design. A total of 2,349 manual workers were included in this analysis. In the first survey, job stress was determined using the Korean Occupational Stress Scale-Short Form. In the second survey, information on absence due to accidents or illnesses during the past one year was obtained through a questionnaire. The relationship was analyzed using a logistic regression model with multiple imputation. After adjusting for confounding variables for males, absence due to accidents was statistically associated with high job demand, insufficient job control, inadequate social support, and organizational injustice. In addition, high job demands and organizational injustice were related to increased absence due to illnesses in both genders. A lack of reward was associated with increased absence due to illnesses among female workers. We found that job stress was associated with a higher risk of absence caused by accidents or illnesses of manual workers.

Status of women in urology: based on a report to the Society of University Urologists.

PubMed

Lightner, Deborah J; Terris, Martha K; Tsao, Alice K; Naughton, Cathy K; Lohse, Christine M

2005-02-01

Written responses from American trained women in urological surgery were obtained to evaluate practice patterns, career choices and workplace satisfaction. A 3-page unblinded questionnaire was mailed in March 2003 to American trained women in urological surgery available through the databases of the Society of Women in Urology with subsequent statistical analysis. The response rate was 60% but inclusive of all women in current academic practice in the United States. A total of 61% reported working 51 or more hours a week whereas 2% have left practice due to retirement or medical infirmity. There were 41% who had completed fellowships including 87% reporting active practice within their subspecialty, whereas 62% of fellowship trained surgeons remained in an academic practice. Among United States women in academic urological practice, academic progression has occurred in a third of this cohort. Threats to successful practice, consistent with other workplace surveys of physicians and professional women including gender based role limitation and inadequate mentoring, were commonly reported. These correctable workplace deficiencies represent an opportunity for American urology to enhance the professional workplace for all urologists regardless of gender.

Systematic review of studies on measurement properties of instruments for adults published in the American Journal of Occupational Therapy, 2009-2013.

PubMed

Yuen, Hon K; Austin, Sarah L

2014-01-01

We describe the methodological quality of recent studies on instrument development and testing published in the American Journal of Occupational Therapy (AJOT). We conducted a systematic review using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist to appraise 48 articles on measurement properties of assessments for adults published in AJOT between 2009 and 2013. Most studies had adequate methodological quality in design and statistical analysis. Common methodological limitations included that methods used to examine internal consistency were not consistently linked to the theoretical constructs underpinning assessments; participants in some test-retest reliability studies were not stable during the interim period; and in several studies of reliability and convergent validity, sample sizes were inadequate. AJOT's dissemination of psychometric research evidence has made important contributions to moving the profession toward the American Occupational Therapy Association's Centennial Vision. This study's results provide a benchmark by which to evaluate future accomplishments. Copyright © 2014 by the American Occupational Therapy Association, Inc.

Resin embedded multicycle imaging (REMI): a tool to evaluate protein domains

PubMed Central

Busse, B. L.; Bezrukov, L.; Blank, P. S.; Zimmerberg, J.

2016-01-01

Protein complexes associated with cellular processes comprise a significant fraction of all biology, but our understanding of their heterogeneous organization remains inadequate, particularly for physiological densities of multiple protein species. Towards resolving this limitation, we here present a new technique based on resin-embedded multicycle imaging (REMI) of proteins in-situ. By stabilizing protein structure and antigenicity in acrylic resins, affinity labels were repeatedly applied, imaged, removed, and replaced. In principle, an arbitrarily large number of proteins of interest may be imaged on the same specimen with subsequent digital overlay. A series of novel preparative methods were developed to address the problem of imaging multiple protein species in areas of the plasma membrane or volumes of cytoplasm of individual cells. For multiplexed examination of antibody staining we used straightforward computational techniques to align sequential images, and super-resolution microscopy was used to further define membrane protein colocalization. We give one example of a fibroblast membrane with eight multiplexed proteins. A simple statistical analysis of this limited membrane proteomic dataset is sufficient to demonstrate the analytical power contributed by additional imaged proteins when studying membrane protein domains. PMID:27499335

Sodium and potassium urinary excretion and their ratio in the elderly: results from the Nutrition UP 65 study

PubMed Central

Moreira, Pedro; Sousa, Ana S.; Guerra, Rita S.; Santos, Alejandro; Borges, Nuno; Afonso, Cláudia; Amaral, Teresa F.; Padrão, Patrícia

2018-01-01

Background We aimed to describe urinary sodium and potassium excretion and their ratio in a representative sample of Portuguese elderly population, according to sociodemographic characteristics and weight status. Methods A cluster sampling approach was used, representing older Portuguese adults (≥65 years) according to age, sex, education level, and regional area within the Nutrition UP 65 study. This cross-sectional evaluation was conducted in 2015 and 2016. From a sample size of 1,500 participants, 1,318 were eligible for the present analysis, 57.3% were women, and 23.5% were aged ≥80 years. Sodium and potassium consumption was evaluated through one 24 h urinary excretion. Inadequate sodium intake was defined as ≥2,000 mg/day, inadequate potassium intake was considered as <3,510 mg/day, and inadequate sodium-to-potassium ratio was defined as >1, according to the World Health Organization cutoffs. Results The proportion of the participants with an inadequate intake was 80.0% in women and 91.5% in men (sodium), 96.2% of women and 79.4% of men (potassium), and 98.4% of women and 99.1% of men (sodium-to-potassium ratio). Higher sodium adequacy was observed among the older elderly, unmarried, with lower household income, and underweight/normal weight. Higher potassium adequacy was observed in the younger elderly, married, and with higher income. Conclusion The majority of the Portuguese elderly population was classified as having inadequate sodium, potassium, and sodium-to-potassium ratio urinary excretion. Therefore, strategies for reducing sodium and increasing potassium intake are priorities in the Portuguese elderly population. PMID:29545733

[Effects of Home Care Services Use by Older Adults on Family Caregiver Distress].

PubMed

Kim, Jiyeon; Kim, Hongsoo

2016-12-01

The purpose of this study was to examine the association between utilization of home care services under the national long-term care insurance system and family caregiver distress. A secondary data analysis was conducted in this study using data collected in 2011 and 2012 from the Korean version of International Resident Assessment Instrument (interRAI) Home Care assessment system. The study sample included 228 clients receiving community based home care and their family caregivers in Korea. Descriptive statistics, χ² test, t-test, and Heckman selection model analysis were conducted using SAS 9.3. Presence of family caregiver distress was significantly associated with days of nurse visits (β=-.89, p=<.001) and home helper visits (β=-.53, p=.014). Level of caregiver distress was also significantly associated with days of nurse visits (β=-.66, p=.028). Other factors which were significantly associated with caregiver distress were depression, cognitive function, inadequate pain control, social support for older adult, and caregiver relationship to the older adult. The results of this study show that visiting nurse service and appropriate support programs for Older Adults and family caregivers experiencing caregiver distress should be developed and provided to families based on the health care needs of older adults and their family caregivers for effective and sustainable home care.

Non-ignorable missingness in logistic regression.

PubMed

Wang, Joanna J J; Bartlett, Mark; Ryan, Louise

2017-08-30

Nonresponses and missing data are common in observational studies. Ignoring or inadequately handling missing data may lead to biased parameter estimation, incorrect standard errors and, as a consequence, incorrect statistical inference and conclusions. We present a strategy for modelling non-ignorable missingness where the probability of nonresponse depends on the outcome. Using a simple case of logistic regression, we quantify the bias in regression estimates and show the observed likelihood is non-identifiable under non-ignorable missing data mechanism. We then adopt a selection model factorisation of the joint distribution as the basis for a sensitivity analysis to study changes in estimated parameters and the robustness of study conclusions against different assumptions. A Bayesian framework for model estimation is used as it provides a flexible approach for incorporating different missing data assumptions and conducting sensitivity analysis. Using simulated data, we explore the performance of the Bayesian selection model in correcting for bias in a logistic regression. We then implement our strategy using survey data from the 45 and Up Study to investigate factors associated with worsening health from the baseline to follow-up survey. Our findings have practical implications for the use of the 45 and Up Study data to answer important research questions relating to health and quality-of-life. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Optimal strategies to consider when peer reviewing a systematic review and meta-analysis.

PubMed

Moher, David

2015-11-02

Systematic reviews are popular. A recent estimate indicates that 11 new systematic reviews are published daily. Nevertheless, evidence indicates that the quality of reporting of systematic reviews is not optimal. One likely reason is that the authors' reports have received inadequate peer review. There are now many different types of systematic reviews and peer reviewing them can be enhanced by using a reporting guideline to supplement whatever template the journal editors have asked you, as a peer reviewer, to use. Additionally, keeping up with the current literature, whether as a content expert or being aware of advances in systematic review methods is likely be make for a more comprehensive and effective peer review. Providing a brief summary of what the systematic review has reported is an important first step in the peer review process (and not performed frequently enough). At its core, it provides the authors with some sense of what the peer reviewer believes was performed (Methods) and found (Results). Importantly, it also provides clarity regarding any potential problems in the methods, including statistical approaches for meta-analysis, results, and interpretation of the systematic review, for which the peer reviewer can seek explanations from the authors; these clarifications are best presented as questions to the authors.

Shengmai injection, a traditional chinese patent medicine, for intradialytic hypotension: a systematic review and meta-analysis.

PubMed

Chen, Chao-Yang; Lu, Ling-Yan; Chen, Peng; Ji, Kang-Ting; Lin, Jia-Feng; Yang, Peng-Lin; Tang, Ji-Fei; Wang, Yan

2013-01-01

Intradialytic hypotension (IDH) is a global public health problem. A rising number of IDH sufferers resort to Chinese patent medicine, Shengmai Injection (SMI) in China. The objectives of present study are to assess the effectiveness and safety of SMI as an adjunct therapy for IDH. A systematic search of 6 medical databases was performed up to December 2011. Randomized trials involving SMI adjuvant therapy versus conventional therapy were identified. RevMan 5.0 was used for data analysis. Ten randomized clinical trials with 437 participants were identified. Methodological quality was considered inadequate in all trials. Compared with conventional therapy, SMI adjunct therapy showed significant effects in improving the clinic effective rate (P < 0.01), decreasing the incidence of IDH episode (P < 0.01), decreasing the frequency of nursing interventions (P < 0.01), and increasing diastolic blood pressure (P < 0.01). There was no statistical significance in the improvement of mean arterial pressure (P = 0.22) and systolic blood pressure (P = 0.08) between two groups. Four studies had mentioned adverse events, but no serious adverse effects were reported in any of the included trials. In conclusion, SMI adjunct therapy appears to be potentially effective in treatment of IDH and is generally safe. However, further rigorous designed trials are needed.

Advanced Methodologies for NASA Science Missions

NASA Astrophysics Data System (ADS)

Hurlburt, N. E.; Feigelson, E.; Mentzel, C.

2017-12-01

Most of NASA's commitment to computational space science involves the organization and processing of Big Data from space-based satellites, and the calculations of advanced physical models based on these datasets. But considerable thought is also needed on what computations are needed. The science questions addressed by space data are so diverse and complex that traditional analysis procedures are often inadequate. The knowledge and skills of the statistician, applied mathematician, and algorithmic computer scientist must be incorporated into programs that currently emphasize engineering and physical science. NASA's culture and administrative mechanisms take full cognizance that major advances in space science are driven by improvements in instrumentation. But it is less well recognized that new instruments and science questions give rise to new challenges in the treatment of satellite data after it is telemetered to the ground. These issues might be divided into two stages: data reduction through software pipelines developed within NASA mission centers; and science analysis that is performed by hundreds of space scientists dispersed through NASA, U.S. universities, and abroad. Both stages benefit from the latest statistical and computational methods; in some cases, the science result is completely inaccessible using traditional procedures. This paper will review the current state of NASA and present example applications using modern methodologies.

Increasing value and reducing waste in research design, conduct, and analysis.

PubMed

Ioannidis, John P A; Greenland, Sander; Hlatky, Mark A; Khoury, Muin J; Macleod, Malcolm R; Moher, David; Schulz, Kenneth F; Tibshirani, Robert

2014-01-11

Correctable weaknesses in the design, conduct, and analysis of biomedical and public health research studies can produce misleading results and waste valuable resources. Small effects can be difficult to distinguish from bias introduced by study design and analyses. An absence of detailed written protocols and poor documentation of research is common. Information obtained might not be useful or important, and statistical precision or power is often too low or used in a misleading way. Insufficient consideration might be given to both previous and continuing studies. Arbitrary choice of analyses and an overemphasis on random extremes might affect the reported findings. Several problems relate to the research workforce, including failure to involve experienced statisticians and methodologists, failure to train clinical researchers and laboratory scientists in research methods and design, and the involvement of stakeholders with conflicts of interest. Inadequate emphasis is placed on recording of research decisions and on reproducibility of research. Finally, reward systems incentivise quantity more than quality, and novelty more than reliability. We propose potential solutions for these problems, including improvements in protocols and documentation, consideration of evidence from studies in progress, standardisation of research efforts, optimisation and training of an experienced and non-conflicted scientific workforce, and reconsideration of scientific reward systems. Copyright © 2014 Elsevier Ltd. All rights reserved.

Energy expenditure in caving.

PubMed

Antoni, Giorgia; Marini, Elisabetta; Curreli, Nicoletta; Tuveri, Valerio; Comandini, Ornella; Cabras, Stefano; Gabba, Silvia; Madeddu, Clelia; Crisafulli, Antonio; Rinaldi, Andrea C

2017-01-01

The aim of this study was to determine the energy expenditure of a group of cavers of both genders and different ages and experience during a 10 hour subterranean exploration, using portable metabolimeters. The impact of caving activity on body composition and hydration were also assessed through bioelectrical impedance, and nutritional habits of cavers surveyed. During cave activity, measured total energy expenditure (TEE) was in the range 225-287 kcal/h for women-men (MET = 4.1), respectively; subjects had an energy intake from food in the range 1000-1200 kcal, thus inadequate to restore lost calories. Bayesian statistical analysis estimated the effect of predictive variables on TEE, revealing that experienced subjects had a 5% lower TEE than the less skilled ones and that women required a comparatively larger energy expenditure than men to perform the same task. BIVA (bioelectrical impedance vector analysis) showed that subjects were within the range of normal hydration before and after cave activity, but bioelectrical changes indicated a reduction of extracellular water in men, which might result in hypo-osmolal dehydration in the case of prolonged underground exercise. All these facts should be considered when planning cave explorations, preparing training programs for subjects practising caving, and optimizing a diet for cavers. Further, information gathered through this study could be of value to reduce accidents in caves related to increase in fatigue.

Methodological issues in current practice may lead to bias in the development of biomarker combinations for predicting acute kidney injury.

PubMed

Meisner, Allison; Kerr, Kathleen F; Thiessen-Philbrook, Heather; Coca, Steven G; Parikh, Chirag R

2016-02-01

Individual biomarkers of renal injury are only modestly predictive of acute kidney injury (AKI). Using multiple biomarkers has the potential to improve predictive capacity. In this systematic review, statistical methods of articles developing biomarker combinations to predict AKI were assessed. We identified and described three potential sources of bias (resubstitution bias, model selection bias, and bias due to center differences) that may compromise the development of biomarker combinations. Fifteen studies reported developing kidney injury biomarker combinations for the prediction of AKI after cardiac surgery (8 articles), in the intensive care unit (4 articles), or other settings (3 articles). All studies were susceptible to at least one source of bias and did not account for or acknowledge the bias. Inadequate reporting often hindered our assessment of the articles. We then evaluated, when possible (7 articles), the performance of published biomarker combinations in the TRIBE-AKI cardiac surgery cohort. Predictive performance was markedly attenuated in six out of seven cases. Thus, deficiencies in analysis and reporting are avoidable, and care should be taken to provide accurate estimates of risk prediction model performance. Hence, rigorous design, analysis, and reporting of biomarker combination studies are essential to realizing the promise of biomarkers in clinical practice.

Evaluation of United States Department of Agriculture-sponsored consumer materials addressing food security.

PubMed

Tolma, Eleni; John, Robert; Garner, Jane

2007-01-01

Food insecurity in the United States is a major public health issue. The main objective of this study was to evaluate the availability and quality of printed materials addressing food security targeted to special populations by the United States Department of Agriculture (USDA). Nutrition education resources addressing food security available from USDA websites were selected for analysis. Not applicable. The review team consisted of project staff (n = 6), two of who were fluent in Spanish. Selection criteria were established to identify the food-security materials, and a group of reviewers assessed the quality of each publication both quantitatively and qualitatively. A consensus meeting among the reviewers was held to make final determinations of the quality of the materials. The quantitative data analysis consisted of basic descriptive statistics. Among the 27 materials initially identified, 20 were either irrelevant or of low relevance to food security. Moreover, very few of them were intended for minority populations. The quality of most of the materials ranged from "average" to "good." Some of the major weaknesses include readability level, lack of cultural relevance, and inadequate coverage of food insecurity. Very few materials on food insecurity are of high quality. In the development of such materials, emphasis should be given to the readability level, content, and cultural relevance.

The Italian Health Literacy Project: Insights from the assessment of health literacy skills in Italy.

PubMed

Palumbo, Rocco; Annarumma, Carmela; Adinolfi, Paola; Musella, Marco; Piscopo, Gabriella

2016-09-01

Inadequate health literacy, namely the problematic individual's ability to navigate the health care system, has been depicted as a silent epidemic affecting a large part of the world population. Inadequate health literacy has been variously found to be a predictor of patient disengagement, inappropriateness of care, increased health care costs, and higher mortality rates. However, to date the evidence on the prevalence of limited health literacy is heterogeneous; moreover, studies dealing with this topic show a pronounced geographical concentration. To contribute in filling these gaps, this paper investigates health literacy skills in Italy. Drawing on the European Health Literacy Survey (HLS-EU), a tool to measure self-perceived levels of health literacy was administered to a representative sample of Italian citizens. A stepwise regression analysis allowed to shed light on the determinants and consequences of limited health literacy. Findings suggested that inadequate health literacy is a prevailing problem in Italy, even though it has been overlooked by both policy makers and health care practitioners. Financial deprivation was found to be a significant predictor of inadequate health literacy. Low health literate patients reported higher hospitalization rates and greater use of health services. As compared with the European Countries, Italy showed some peculiarities in terms of health literacy levels and socio-demographic determinants of health literacy, which provide with intriguing insights for policy making. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Taking Ockham's razor to enzyme dynamics and catalysis.

PubMed

Glowacki, David R; Harvey, Jeremy N; Mulholland, Adrian J

2012-01-29

The role of protein dynamics in enzyme catalysis is a matter of intense current debate. Enzyme-catalysed reactions that involve significant quantum tunnelling can give rise to experimental kinetic isotope effects with complex temperature dependences, and it has been suggested that standard statistical rate theories, such as transition-state theory, are inadequate for their explanation. Here we introduce aspects of transition-state theory relevant to the study of enzyme reactivity, taking cues from chemical kinetics and dynamics studies of small molecules in the gas phase and in solution--where breakdowns of statistical theories have received significant attention and their origins are relatively better understood. We discuss recent theoretical approaches to understanding enzyme activity and then show how experimental observations for a number of enzymes may be reproduced using a transition-state-theory framework with physically reasonable parameters. Essential to this simple model is the inclusion of multiple conformations with different reactivity.

The influence of climate and soil properties on calcium nutrition and vitality of silver fir (Abies alba Mill.).

PubMed

Potocić, Nenad; Cosić, Tomislav; Pilas, Ivan

2005-10-01

As a part of a broader research into the nutrition of silver fir (Abies alba Mill.), the variation of calcium concentrations was investigated in needles and soil in two subsequent, climatologically diverse years. Statistically significant differences between plots were determined in Ca concentrations in soils. Concentrations of Ca in needles were statistically different regarding plot, defoliation class, sampling date within the same year and also between years. Fir trees on acid-rock based soils had lower, often inadequate concentrations of Ca in needles; the opposite was true for trees growing on Ca-rich soils. Trees of lower vitality generally exhibited poor Ca nutrition. Drought in the second year of research caused poor absorption of Ca on all plots and in all defoliation classes, but the combined influence of climate and soil properties affected especially trees of low vitality on acid-rock based soils.

Body checking and eating cognitions in Brazilian outpatients with eating disorders and non psychiatric controls.

PubMed

Kachani, Adriana Trejger; Barroso, Lucia Pereira; Brasiliano, Silvia; Cordás, Táki Athanássios; Hochgraf, Patrícia Brunfentrinker

2015-12-01

Compare inadequate eating behaviors and their relationship to body checking in three groups: patients with anorexia nervosa (AN), patients with bulimia nervosa (BN) and a control group (C). Eighty three outpatients with eating disorders (ED) and 40 controls completed eating attitudes and body checking questionnaires. The overall relationship between the eating attitude and body checking was statistically significant in all three groups. The worse the eating attitude, the greater the body checking behavior. However, when we look at each group individually, the relationship was only statistically significant in the AN group (r=.354, p=0.020). The lower the desired weight and the worse the eating attitude, the more people check themselves, although in the presence of an ED the relationship between body checking and food restrictions is greater. In patients displaying the AN subgroup, body checking is also related to continued dietary control. Copyright © 2015 Elsevier Ltd. All rights reserved.

Analytic score distributions for a spatially continuous tridirectional Monte Carol transport problem

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

Booth, T.E.

1996-01-01

The interpretation of the statistical error estimates produced by Monte Carlo transport codes is still somewhat of an art. Empirically, there are variance reduction techniques whose error estimates are almost always reliable, and there are variance reduction techniques whose error estimates are often unreliable. Unreliable error estimates usually result from inadequate large-score sampling from the score distribution`s tail. Statisticians believe that more accurate confidence interval statements are possible if the general nature of the score distribution can be characterized. Here, the analytic score distribution for the exponential transform applied to a simple, spatially continuous Monte Carlo transport problem is provided.more » Anisotropic scattering and implicit capture are included in the theory. In large part, the analytic score distributions that are derived provide the basis for the ten new statistical quality checks in MCNP.« less

Genetic Epistemology and the Structure of Belief Systems: An Introduction to Piaget for Political Scientists.

ERIC Educational Resources Information Center

Ward, Dana

Suggesting that the concept of structure employed by political scientists in the analysis of belief systems is inadequate and misleading, the paper discusses Jean Piaget's concept of egocentrism as a theoretical alternative to belief systems analysis. The purpose of the paper is to provide political scientists with a short but comprehensive…

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

PubMed

Siddiqui, Faisal Ghani

2013-01-01

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

Determinants of inadequate complementary feeding practices among children aged 6-23 months in Ghana.

PubMed

Issaka, Abukari I; Agho, Kingsley E; Burns, Penelope; Page, Andrew; Dibley, Michael J

2015-03-01

To explore complementary feeding practices and identify potential risk factors associated with inadequate complementary feeding practices in Ghana by using the newly developed WHO infant feeding indicators and data from the nationally representative 2008 Ghana Demographic and Health Survey. The source of data for the analysis was the 2008 Ghana Demographic and Health Survey. Analysis of the factors associated with inadequate complementary feeding, using individual-, household- and community-level determinants, was done by performing multiple logistic regression modelling. Ghana. Children (n 822) aged 6-23 months. The prevalence of the introduction of solid, semi-solid or soft foods among infants aged 6-8 months was 72.6 % (95 % CI 64.6 %, 79.3 %). The proportion of children aged 6-23 months who met the minimum meal frequency and dietary diversity for breast-fed and non-breast-fed children was 46.0 % (95 % CI 42.3 %, 49.9 %) and 51.4 % (95 % CI 47.4 %, 55.3 %) respectively and the prevalence of minimum acceptable diet for breast-fed children was 29.9 % (95 % CI 26.1 %, 34.1 %). Multivariate analysis revealed that children from the other administrative regions were less likely to meet minimum dietary diversity, meal frequency and acceptable diet than those from the Volta region. Household poverty, children whose mothers perceived their size to be smaller than average and children who were delivered at home were significantly less likely to meet the minimum dietary diversity requirement; and children whose mothers did not have any postnatal check-ups were significantly less likely to meet the requirement for minimum acceptable diet. Complementary feeding was significantly lower in infants from illiterate mothers (adjusted OR=3.55; 95 % CI 1.05, 12.02). The prevalence of complementary feeding among children in Ghana is still below the WHO-recommended standard of 90 % coverage. Non-attendance of postnatal check-up by mothers, cultural beliefs and habits, household poverty, home delivery of babies and non-Christian mothers were the most important risk factors for inadequate complementary feeding practices. Therefore, nutrition educational interventions to improve complementary feeding practices should target these factors in order to achieve the fourth Millennium Development Goal.

The Association of Vitamin D Status in Lower Extremity Muscle Strains and Core Muscle Injuries at the National Football League Combine.

PubMed

Rebolledo, Brian J; Bernard, Johnathan A; Werner, Brian C; Finlay, Andrea K; Nwachukwu, Benedict U; Dare, David M; Warren, Russell F; Rodeo, Scott A

2018-04-01

To evaluate the association between serum vitamin D level and the prevalence of lower extremity muscle strains and core muscle injuries in elite level athletes at the National Football League (NFL) combine. During the 2015 NFL combine, all athletes with available serum vitamin D levels were included for study. Baseline data were collected, including age, race, body mass index, position, injury history specific to lower extremity muscle strain or core muscle injury, and Functional Movement Screen scores. Serum 25-hydroxyvitamin D was collected and defined as normal (≥32 ng/mL), insufficient (20-31 ng/mL), and deficient (<20 ng/mL). Univariate regression analysis was used to examine the association of vitamin D level and injury history. Subsequent multivariate regression analysis was used to examine this relation with adjustment for collected baseline data variables. The study population included 214 athletes, including 78% African American athletes and 51% skilled position players. Inadequate vitamin D was present in 59%, including 10% with deficient levels. Lower extremity muscle strain or core muscle injury was present in 50% of athletes, which was associated with lower vitamin D levels (P = .03). Athletes with a positive injury history also showed significantly lower vitamin D levels as compared with uninjured athletes (P = .03). African American/black race (P < .001) and injury history (P < .001) was associated with lower vitamin D. Vitamin D groups showed no differences in age (P = .9), body mass index (P = .9), or Functional Movement Screen testing (P = .2). Univariate analysis of inadequate vitamin D levels showed a 1.86 higher odds of lower extremity strain or core muscle injury (P = .03), and 3.61 higher odds of hamstring injury (P < .001). Multivariate analysis did not reach an independent association of low vitamin D with injury history (P = .07). Inadequate vitamin D levels are a widespread finding in athletes at the NFL combine. Players with a history of lower extremity muscle strain and core muscle injury had a higher prevalence of inadequate vitamin D. Level IV, retrospective study-case series. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Teaching evidence based practice in physical therapy in a developing country: a national survey of Philippine schools

PubMed Central

2013-01-01

Background Early education on the foundations of evidence based practice (EBP) is advocated as a potent intervention toward enhancing EBP uptake among physical therapists. Little is known about the extent to which EBP is integrated in educational curricula in developing countries where the benefits of EBP are more acutely needed. This study sought to describe EBP education in Philippine physical therapy schools, including the challenges encountered by educators in teaching EBP. Methods A national survey of higher education institutions offering an undergraduate degree program in physical therapy was conducted from August 2011 through January 2012. A 35-item questionnaire was developed to gather data on whether or not EBP was taught, specific EBP content covered and courses in which content was covered, teaching and evaluation methods, and challenges in teaching EBP. Data were analyzed descriptively. Results The study had a response rate of 55.7% (34/61). Majority of the participating educational institutions (82%, 28/34) reported teaching EBP by incorporating EBP content in the professional courses. Among those that did not teach EBP, inadequate educator competence was the leading barrier. Courses commonly used to teach EBP were those on research (78.6%, 22/28), therapy planning (71.4%, 20/28), treatment skills (57.1-64.3%, 16-18/28), and undergraduate thesis (60.7%, 17/28). Various EBP contents were covered, with statistical concepts more frequently taught compared with critical EBP content. Lectures and journal reports were the usual teaching methods (96.4%, 27/28 and 89.3%, 25/28, respectively) while written examinations, completion of an undergraduate thesis, and oral reports (82.1%, 23/28, 78.6%, 22/28, and 78.6%, 22/28, respectively) were often used in evaluation. Students’ inadequate knowledge of statistics and lack of curricular structure for EBP were identified as leading challenges to teaching (75%, 21/28 and 50%, 14/28, respectively). Conclusions Many physical therapy faculties across the Philippines are incorporating EBP content in teaching. However, there is arbitrary and fragmented coverage of EBP content and inadequate emphasis on clinically oriented teaching-learning and assessment methods. These findings suggest the need to design appropriate entry-level educational programs on EBP. Effective ‘educating the educators’ strategies are urgently needed and can have far-reaching positive repercussions on EBP uptake in physical therapist practice. PMID:24267512

Teaching evidence based practice in physical therapy in a developing country: a national survey of Philippine schools.

PubMed

Gorgon, Edward James R; Basco, Mark David S; Manuel, Almira T

2013-11-22

Early education on the foundations of evidence based practice (EBP) is advocated as a potent intervention toward enhancing EBP uptake among physical therapists. Little is known about the extent to which EBP is integrated in educational curricula in developing countries where the benefits of EBP are more acutely needed. This study sought to describe EBP education in Philippine physical therapy schools, including the challenges encountered by educators in teaching EBP. A national survey of higher education institutions offering an undergraduate degree program in physical therapy was conducted from August 2011 through January 2012. A 35-item questionnaire was developed to gather data on whether or not EBP was taught, specific EBP content covered and courses in which content was covered, teaching and evaluation methods, and challenges in teaching EBP. Data were analyzed descriptively. The study had a response rate of 55.7% (34/61). Majority of the participating educational institutions (82%, 28/34) reported teaching EBP by incorporating EBP content in the professional courses. Among those that did not teach EBP, inadequate educator competence was the leading barrier. Courses commonly used to teach EBP were those on research (78.6%, 22/28), therapy planning (71.4%, 20/28), treatment skills (57.1-64.3%, 16-18/28), and undergraduate thesis (60.7%, 17/28). Various EBP contents were covered, with statistical concepts more frequently taught compared with critical EBP content. Lectures and journal reports were the usual teaching methods (96.4%, 27/28 and 89.3%, 25/28, respectively) while written examinations, completion of an undergraduate thesis, and oral reports (82.1%, 23/28, 78.6%, 22/28, and 78.6%, 22/28, respectively) were often used in evaluation. Students' inadequate knowledge of statistics and lack of curricular structure for EBP were identified as leading challenges to teaching (75%, 21/28 and 50%, 14/28, respectively). Many physical therapy faculties across the Philippines are incorporating EBP content in teaching. However, there is arbitrary and fragmented coverage of EBP content and inadequate emphasis on clinically oriented teaching-learning and assessment methods. These findings suggest the need to design appropriate entry-level educational programs on EBP. Effective 'educating the educators' strategies are urgently needed and can have far-reaching positive repercussions on EBP uptake in physical therapist practice.

10 CFR 205.375 - Guidelines defining inadequate fuel or energy supply.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Guidelines defining inadequate fuel or energy supply. 205.375 Section 205.375 Energy DEPARTMENT OF ENERGY OIL ADMINISTRATIVE PROCEDURES AND SANCTIONS Electric... Electric Power § 205.375 Guidelines defining inadequate fuel or energy supply. An inadequate utility system...

10 CFR 205.375 - Guidelines defining inadequate fuel or energy supply.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 3 2011-01-01 2011-01-01 false Guidelines defining inadequate fuel or energy supply. 205.375 Section 205.375 Energy DEPARTMENT OF ENERGY OIL ADMINISTRATIVE PROCEDURES AND SANCTIONS Electric... Electric Power § 205.375 Guidelines defining inadequate fuel or energy supply. An inadequate utility system...

10 CFR 205.375 - Guidelines defining inadequate fuel or energy supply.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 3 2014-01-01 2014-01-01 false Guidelines defining inadequate fuel or energy supply. 205.375 Section 205.375 Energy DEPARTMENT OF ENERGY OIL ADMINISTRATIVE PROCEDURES AND SANCTIONS Electric... Electric Power § 205.375 Guidelines defining inadequate fuel or energy supply. An inadequate utility system...

10 CFR 205.375 - Guidelines defining inadequate fuel or energy supply.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 3 2013-01-01 2013-01-01 false Guidelines defining inadequate fuel or energy supply. 205.375 Section 205.375 Energy DEPARTMENT OF ENERGY OIL ADMINISTRATIVE PROCEDURES AND SANCTIONS Electric... Electric Power § 205.375 Guidelines defining inadequate fuel or energy supply. An inadequate utility system...

10 CFR 205.375 - Guidelines defining inadequate fuel or energy supply.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 3 2012-01-01 2012-01-01 false Guidelines defining inadequate fuel or energy supply. 205.375 Section 205.375 Energy DEPARTMENT OF ENERGY OIL ADMINISTRATIVE PROCEDURES AND SANCTIONS Electric... Electric Power § 205.375 Guidelines defining inadequate fuel or energy supply. An inadequate utility system...

[Definite of nutritional status in patients with metabolic syndrome with the use of modern methods of nutrimetabolomica].

PubMed

Viskunova, A A; Kaganov, B S; Sharafetdinov, Kh Kh; Plotnikova, O A; Pogozheva, A V; Vorozhko, I V

2010-01-01

A comprehensive assessment of nutritional status in 73 patients with metabolic syndrome was assessed. The consumption food pattern of the majority of examined patients have had increased energy intake with excessive fat consumption inadequate intake of complex carbohydrates. In patients with type 2 diabetes inadequate compensation of carbohydrate and lipid metabolism was marked. When assessing body composition method bioelectrical impedance analysis increased content of adipose tissue was revealed are positively correlated with insulin and tumor necrosis factor-alpha. According to indirect calorimetry, increase in the level of resting energy expenditure, reducing the rate of oxidation of fat, increase the rate of oxidation of protein and carbohydrates was noted.

Profile of Some Trace Elements in the Liver of Camels, Sheep, and Goats in the Sudan

PubMed Central

Ibrahim, Ibrahim Abdullah; Shamat, Ali Mahmoud; Hussien, Mohammed Osman; El Hussein, Abdel Rahim Mohammed

2013-01-01

One hundred camels (Camelus dromedaries) and fifty sheep and goats being adult, male, and apparently healthy field animals were studied to provide data regarding the normal values of some hepatic trace elements. Liver samples were collected during postmortem examination, digested, and analyzed for Cu, Zn, Fe, Co, and Mn using atomic absorption spectrophotometry. The results showed that the differences in mean liver concentrations of Cu, Zn, Fe, and Co between camels, sheep, and goats were statistically significant (P < 0.05). Hepatic Cu, Fe, and Co concentrations were higher in camels than in sheep and goats. All liver samples were adequate for Fe and Co, whereas only camel liver was adequate for Cu. In camels, hepatic Zn concentration was inadequately lower than that in sheep and goats. No difference in Mn concentration was detected between camels, sheep, and goats. All liver samples were inadequate compared to free-ranging herbivores. In camels, significant correlation (r 2 = −0.207, P value = 0.04) was detected between Zn and Co, whereas in sheep significant correlation (r 2 = −0.444, P value = 0.026) was detected between Zn and Mn. No significant correlation between trace elements was detected in goats. PMID:26464909

Indoor air pollution in old people's homes related to some health problems: a survey study.

PubMed

Coelho, C; Steers, M; Lutzler, P; Schriver-Mazzuoli, L

2005-08-01

The present research reports on a survey of 96 subjects between the ages of 60 and 95 years, living close to Paris in a social collective habitat. The aim was to show, using goodness-of-fit statistical tests (P < 0.1), how old people lifestyles can subject them to generated chemical or bacteriological indoor pollutants. Risk factors due to lifestyles were analyzed in relation to complaints and to health condition. There are many ways that old people are exposed to pollutants: difficulty in maintaining the residence, preference for staying in the kitchens, substantial use of cleaning chemicals. However, the principal risk for health problems is arguably inadequate ventilation (unclean screens, blocked air vents, etc.), which increases the concentration of indoor pollutants. These risks are amplified by ignorance about the hazards of inadequate ventilation. The present investigation suggests that the lifestyle and the behavior of old people could be the cause of an interior air pollution of their housing. Measures realized in representative dwellings selected in relation to results must confirm that these risks would require the installation of an automatic monitoring system of the indoor air near these people.

Physicians' Practice, Attitudes Toward, and Knowledge of Cancer Pain Management in China.

PubMed

Zhang, Qiongwen; Yu, Chunhua; Feng, Shijian; Yao, Wenxiu; Shi, Huashan; Zhao, Yuwei; Wang, Yongsheng

2015-11-01

To evaluate physicians' current practice, attitudes toward, and knowledge of cancer pain management in China. We conducted a face-to-face survey of physicians (oncologists, internists, hematologists) who are responsible for the care of cancer patient of 11 general hospitals in Sichuan, China between December 2011 and December 2013. Statistical analyses were performed using SPSS (SPSS, Chicago, IL) software. A 23-item questionnaire was designed and distributed to 550 physicians in 11 medical facilities in China. Five hundred (90.90%) physicians responded. About one-third (32.6%) of physicians assessed patients' pain rarely, and 85.5% never or occasionally treated patients' cancer pain together with psychologists. More than half of physicians indicated that opioid dose titration in patients with poor pain control and assessment of the cause and severity of pain were urgently needed knowledge for cancer pain management. Inadequate assessment of pain and pain management (63.0%), patients' reluctance to take opioids (62.2%), and inadequate staff knowledge of pain management (61.4%) were the three most frequently cited barriers to physicians' pain management. Physicians' positive attitudes toward cancer pain management need to be encouraged, and active professional analgesic education programs are needed to improve pain management in China. Wiley Periodicals, Inc.

Population changes, racial/ethnic disparities, and birth outcomes in Louisiana after Hurricane Katrina.

PubMed

Harville, Emily W; Tran, Tri; Xiong, Xu; Buekens, Pierre

2010-09-01

To examine how the demographic and other population changes affected birth and obstetric outcomes in Louisiana, and the effect of the hurricane on racial disparities in these outcomes. Vital statistics data were used to compare the incidence of low birth weight (LBW) (<2500 g), preterm birth (PTB) (37 weeks' gestation), cesarean section, and inadequate prenatal care (as measured by the Kotelchuck index), in the 2 years after Katrina compared to the 2 years before, for the state as a whole, region 1 (the area around New Orleans), and Orleans Parish (New Orleans). Logistic models were used to adjust for covariates. After adjustment, rates of LBW rose for the state, but preterm birth did not. In region 1 and Orleans Parish, rates of LBW and PTB remained constant or fell. These patterns were all strongest in African American women. Rates of cesarean section and inadequate prenatal care rose. Racial disparities in birth outcomes remained constant or were reduced. Although risk of LBW/PTB remained higher in African Americans, the storm does not appear to have exacerbated health disparities, nor did population shifts explain the changes in birth and obstetric outcomes.

Effectiveness of touch and feel (TAF) technique on first aid measures for visually challenged.

PubMed

Mary, Helen; Sasikalaz, D; Venkatesan, Latha

2013-01-01

There is a common perception that a blind person cannot even help his own self. In order to challenge that view, a workshop for visually-impaired people to develop the skills to be independent and productive members of society was conceived. An experimental study was conducted at National Institute of Visually Handicapped, Chennai with the objective to assess the effectiveness of Touch and Feel (TAF) technique on first aid measures for the visually challenged. Total 25 visually challenged people were selected by non-probability purposive sampling technique and data was collected using demographic variable and structured knowledge questionnaire. The score obtained was categorised into three levels: inadequate (0-8), moderately adequate (8 - 17), adequate (17 -25). The study revealed that most of the visually challenged (40%) had inadequate knowledge, and 56 percent had moderately adequate and only few (4%) had adequate knowledge in the pre-test, whereas most (68%) of them had adequate knowledge in the post-test which is statistically significant at p < 0.000 with t-value 6.779. This proves that TAF technique was effective for the visually challenged. There was no association between the demographic variables and their level of knowledge regarding first aid.

Reporting and dealing with missing quality of life data in RCTs: has the picture changed in the last decade?

PubMed

Fielding, S; Ogbuagu, A; Sivasubramaniam, S; MacLennan, G; Ramsay, C R

2016-12-01

Missing data are a major problem in the analysis of data from randomised trials affecting power and potentially producing biased treatment effects. Specifically focussing on quality of life outcomes, we aimed to report the amount of missing data, whether imputation was used and what methods and was the missing mechanism discussed from four leading medical journals and compare the picture to our previous review nearly a decade ago. A random selection (50 %) of all RCTS published during 2013-2014 in BMJ, JAMA, Lancet and NEJM was obtained. RCTs reported in research letters, cluster RCTs, non-randomised designs, review articles and meta-analysis were excluded. We included 87 RCTs in the review of which 35 % the amount of missing primary QoL data was unclear, 31 (36 %) used imputation. Only 23 % discussed the missing data mechanism. Nearly half used complete case analysis. Reporting was more unclear for secondary QoL outcomes. Compared to the previous review, multiple imputation was used more prominently but mainly in sensitivity analysis. Inadequate reporting and handling of missing QoL data in RCTs are still an issue. There is a large gap between statistical methods research relating to missing data and the use of the methods in applications. A sensitivity analysis should be undertaken to explore the sensitivity of the main results to different missing data assumptions. Medical journals can help to improve the situation by requiring higher standards of reporting and analytical methods to deal with missing data, and by issuing guidance to authors on expected standard.

Neural networks and traditional time series methods: a synergistic combination in state economic forecasts.

PubMed

Hansen, J V; Nelson, R D

1997-01-01

Ever since the initial planning for the 1997 Utah legislative session, neural-network forecasting techniques have provided valuable insights for analysts forecasting tax revenues. These revenue estimates are critically important since agency budgets, support for education, and improvements to infrastructure all depend on their accuracy. Underforecasting generates windfalls that concern taxpayers, whereas overforecasting produces budget shortfalls that cause inadequately funded commitments. The pattern finding ability of neural networks gives insightful and alternative views of the seasonal and cyclical components commonly found in economic time series data. Two applications of neural networks to revenue forecasting clearly demonstrate how these models complement traditional time series techniques. In the first, preoccupation with a potential downturn in the economy distracts analysis based on traditional time series methods so that it overlooks an emerging new phenomenon in the data. In this case, neural networks identify the new pattern that then allows modification of the time series models and finally gives more accurate forecasts. In the second application, data structure found by traditional statistical tools allows analysts to provide neural networks with important information that the networks then use to create more accurate models. In summary, for the Utah revenue outlook, the insights that result from a portfolio of forecasts that includes neural networks exceeds the understanding generated from strictly statistical forecasting techniques. In this case, the synergy clearly results in the whole of the portfolio of forecasts being more accurate than the sum of the individual parts.

Time-resolved MR angiography of renal artery stenosis in a swine model at 3 Tesla using gadobutrol with digital subtraction angiography correlation.

PubMed

Morelli, John N; Ai, Fei; Runge, Val M; Zhang, Wei; Li, Xiaoming; Schmitt, Peter; McNeal, Gary; Michaely, Henrick J; Schoenberg, Stefan O; Miller, Matthew; Gerdes, Clint M; Sincleair, Spencer T; Spratt, Heidi; Attenberger, Ulrike I

2012-09-01

To establish the minimum dose required for detection of renal artery stenosis using high temporal resolution, contrast enhanced MR angiography (MRA) in a porcine model. Surgically created renal artery stenoses were imaged with 3 Tesla MR and digital subtraction angiography (DSA) in 12 swine in this IACUC approved protocol. Gadobutrol was injected intravenously at doses of 0.5, 1, 2, and 4 mL for time-resolved MRA (1.5 × 1.5 mm(2) spatial resolution). Region of interest analysis was performed together with stenosis assessment and qualitative evaluation by two blinded readers. Mean signal to noise ratio (SNR) and contrast to noise ratio (CNR) values were statistically significantly less with the 0.5-mL protocol (P < 0.001). There were no statistically significant differences among the other evaluated doses. Both readers found 10/12 cases with the 0.5-mL protocol to be of inadequate diagnostic quality (κ = 1.0). All other scans were found to be adequate for diagnosis. Accuracies in distinguishing between mild/insignificant (<50%) and higher grade stenoses (>50%) were comparable among the higher-dose protocols (sensitivities 73-93%, specificities 62-100%). Renal artery stenosis can be assessed with very low doses (~0.025 mmol/kg bodyweight) of a high concentration, high relaxivity gadolinium chelate formulation in a swine model, results which are promising with respect to limiting exposure to gadolinium based contrast agents. Copyright © 2012 Wiley Periodicals, Inc.

Proposal and validation of a clinical trunk control test in individuals with spinal cord injury.

PubMed

Quinzaños, J; Villa, A R; Flores, A A; Pérez, R

2014-06-01

One of the problems that arise in spinal cord injury (SCI) is alteration in trunk control. Despite the need for standardized scales, these do not exist for evaluating trunk control in SCI. To propose and validate a trunk control test in individuals with SCI. National Institute of Rehabilitation, Mexico. The test was developed and later evaluated for reliability and criteria, content, and construct validity. We carried out 531 tests on 177 patients and found high inter- and intra-rater reliability. In terms of criterion validity, analysis of variance demonstrated a statistically significant difference in the test score of patients with adequate or inadequate trunk control according to the assessment of a group of experts. A receiver operating characteristic curve was plotted for optimizing the instrument's cutoff point, which was determined at 13 points, with a sensitivity of 98% and a specificity of 92.2%. With regard to construct validity, the correlation between the proposed test and the spinal cord independence measure (SCIM) was 0.873 (P=0.001) and that with the evolution time was 0.437 (P=0.001). For testing the hypothesis with qualitative variables, the Kruskal-Wallis test was performed, which resulted in a statistically significant difference between the scores in the proposed scale of each group defined by these variables. It was proven experimentally that the proposed trunk control test is valid and reliable. Furthermore, the test can be used for all patients with SCI despite the type and level of injury.

Can purchasing information be used to predict adherence to cardiovascular medications? An analysis of linked retail pharmacy and insurance claims data.

PubMed

Krumme, Alexis A; Sanfélix-Gimeno, Gabriel; Franklin, Jessica M; Isaman, Danielle L; Mahesri, Mufaddal; Matlin, Olga S; Shrank, William H; Brennan, Troyen A; Brill, Gregory; Choudhry, Niteesh K

2016-11-09

The use of retail purchasing data may improve adherence prediction over approaches using healthcare insurance claims alone. Retrospective. A cohort of patients who received prescription medication benefits through CVS Caremark, used a CVS Pharmacy ExtraCare Health Care (ECHC) loyalty card, and initiated a statin medication in 2011. We evaluated associations between retail purchasing patterns and optimal adherence to statins in the 12 subsequent months. Among 11 010 statin initiators, 43% were optimally adherent at 12 months of follow-up. Greater numbers of store visits per month and dollar amount per visit were positively associated with optimal adherence, as was making a purchase on the same day as filling a prescription (p<0.0001 for all). Models to predict adherence using retail purchase variables had low discriminative ability (C-statistic: 0.563), while models with both clinical and retail purchase variables achieved a C-statistic of 0.617. While the use of retail purchases may improve the discriminative ability of claims-based approaches, these data alone appear inadequate for adherence prediction, even with the addition of more complex analytical approaches. Nevertheless, associations between retail purchasing behaviours and adherence could inform the development of quality improvement interventions. 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/.

Data Analysis and Statistical Methods for the Assessment and Interpretation of Geochronologic Data

NASA Astrophysics Data System (ADS)

Reno, B. L.; Brown, M.; Piccoli, P. M.

2007-12-01

Ages are traditionally reported as a weighted mean with an uncertainty based on least squares analysis of analytical error on individual dates. This method does not take into account geological uncertainties, and cannot accommodate asymmetries in the data. In most instances, this method will understate uncertainty on a given age, which may lead to over interpretation of age data. Geologic uncertainty is difficult to quantify, but is typically greater than analytical uncertainty. These factors make traditional statistical approaches inadequate to fully evaluate geochronologic data. We propose a protocol to assess populations within multi-event datasets and to calculate age and uncertainty from each population of dates interpreted to represent a single geologic event using robust and resistant statistical methods. To assess whether populations thought to represent different events are statistically separate exploratory data analysis is undertaken using a box plot, where the range of the data is represented by a 'box' of length given by the interquartile range, divided at the median of the data, with 'whiskers' that extend to the furthest datapoint that lies within 1.5 times the interquartile range beyond the box. If the boxes representing the populations do not overlap, they are interpreted to represent statistically different sets of dates. Ages are calculated from statistically distinct populations using a robust tool such as the tanh method of Kelsey et al. (2003, CMP, 146, 326-340), which is insensitive to any assumptions about the underlying probability distribution from which the data are drawn. Therefore, this method takes into account the full range of data, and is not drastically affected by outliers. The interquartile range of each population of dates (the interquartile range) gives a first pass at expressing uncertainty, which accommodates asymmetry in the dataset; outliers have a minor affect on the uncertainty. To better quantify the uncertainty, a resistant tool that is insensitive to local misbehavior of data is preferred, such as the normalized median absolute deviations proposed by Powell et al. (2002, Chem Geol, 185, 191-204). We illustrate the method using a dataset of 152 monazite dates determined using EPMA chemical data from a single sample from the Neoproterozoic Brasília Belt, Brazil. Results are compared with ages and uncertainties calculated using traditional methods to demonstrate the differences. The dataset was manually culled into three populations representing discrete compositional domains within chemically-zoned monazite grains. The weighted mean ages and least squares uncertainties for these populations are 633±6 (2σ) Ma for a core domain, 614±5 (2σ) Ma for an intermediate domain and 595±6 (2σ) Ma for a rim domain. Probability distribution plots indicate asymmetric distributions of all populations, which cannot be accounted for with traditional statistical tools. These three domains record distinct ages outside the interquartile range for each population of dates, with the core domain lying in the subrange 642-624 Ma, the intermediate domain 617-609 Ma and the rim domain 606-589 Ma. The tanh estimator yields ages of 631±7 (2σ) for the core domain, 616±7 (2σ) for the intermediate domain and 601±8 (2σ) for the rim domain. Whereas the uncertainties derived using a resistant statistical tool are larger than those derived from traditional statistical tools, the method yields more realistic uncertainties that better address the spread in the dataset and account for asymmetry in the data.

Methotrexate Dosage Reduction Upon Adalimumab Initiation: Clinical and Ultrasonographic Outcomes from the Randomized Noninferiority MUSICA Trial.

PubMed

Kaeley, Gurjit S; Evangelisto, Amy M; Nishio, Midori J; Goss, Sandra L; Liu, Shufang; Kalabic, Jasmina; Kupper, Hartmut

2016-08-01

To examine the clinical and ultrasonographic (US) outcomes of reducing methotrexate (MTX) dosage upon initiating adalimumab (ADA) in MTX-inadequate responders with moderately to severely active rheumatoid arthritis (RA). MUSICA (NCT01185288) was a double-blind, randomized, parallel-arm study of 309 patients with RA receiving MTX ≥ 15 mg/week for ≥ 12 weeks before screening. Patients were randomized to high dosage (20 mg/week) or low dosage (7.5 mg/week) MTX; all patients received 40 mg open-label ADA every other week for 24 weeks. The primary endpoint was Week 24 mean 28-joint Disease Activity Score based on C-reactive protein (DAS28-CRP) to test for noninferiority of low-dosage MTX using a 15% margin. US images were scored using a 10-joint semiquantitative system incorporating OMERACT definitions for pathology, assessing synovial hypertrophy, vascularity, and bony erosions. Rapid improvement in clinical indices was observed in both groups after addition of ADA. The difference in mean DAS28-CRP (0.37, 95% CI 0.07-0.66) comparing low-dosage (4.12, 95% CI 3.88-4.34) versus high-dosage MTX (3.75, 95% CI 3.52-3.97) was statistically significant and non-inferiority was not met. Statistically significant differences were not detected for most clinical, functional, and US outcomes. Pharmacokinetic and safety profiles were similar. In MUSICA, Week 24 mean DAS28-CRP, the primary endpoint, did not meet non-inferiority for the low-dosage MTX group. Although the differences between the 2 MTX dosage groups were small, our study findings did not support routine MTX reduction in MTX inadequate responders initiating ADA.

Treatment recommendations for DSM-5-defined mixed features.

PubMed

Rosenblat, Joshua D; McIntyre, Roger S

2017-04-01

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) mixed features specifier provides a less restrictive definition of mixed mood states, compared to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), including mood episodes that manifest with subthreshold symptoms of the opposite mood state. A limited number of studies have assessed the efficacy of treatments specifically for DSM-5-defined mixed features in mood disorders. As such, there is currently an inadequate amount of data to appropriately inform evidence-based treatment guidelines of DSM-5 defined mixed features. However, given the high prevalence and morbidity of mixed features, treatment recommendations based on the currently available evidence along with expert opinion may be of benefit. This article serves to provide these interim treatment recommendations while humbly acknowledging the limited amount of evidence currently available. Second-generation antipsychotics (SGAs) appear to have the greatest promise in the treatment of bipolar disorder (BD) with mixed features. Conventional mood stabilizing agents (ie, lithium and divalproex) may also be of benefit; however, they have been inadequately studied. In the treatment of major depressive disorder (MDD) with mixed features, the comparable efficacy of antidepressants versus other treatments, such as SGAs, remains unknown. As such, antidepressants remain first-line treatment of MDD with or without mixed features; however, there are significant safety concerns associated with antidepressant monotherapy when mixed features are present, which merits increased monitoring. Lurasidone is the only SGA monotherapy that has been shown to be efficacious specifically in the treatment of MDD with mixed features. Further research is needed to accurately determine the efficacy, safety, and tolerability of treatments specifically for mood episodes with mixed features to adequately inform future treatment guidelines.

Is it more dangerous to perform inadequate packing?

PubMed Central

Aydin, Unal; Yazici, Pinar; Zeytunlu, Murat; Coker, Ahmet

2008-01-01

Peri-hepatic packing procedure, which is the basic damage control technique for the treatment of hepatic hemorrhage, is one of the cornerstones of the surgical strategy for abdominal trauma. The purpose of this study was to evaluate the efficacy of the perihepatic packing procedure by comparing the outcomes of appropriately and inappropriately performed interventions. Trauma patients with liver injury were retrospectively evaluated. The patients who had undergone adequate packing were classified as Group A, and the patients who had undergone inappropriate packing, as Group B. Over a five-year period, nineteen patients underwent perihepatic packing. Thirteen of these patients were referred by other hospitals. Of 13 patients, 9 with inappropriate packing procedure due to insertion of intraabdominal drainage catheter (n=4) and underpacking (n=5) were evaluated in Group B, and the others (n=10) with adequate packing were assessed in Group A. Mean 3 units of blood were transfused in Group A and unpacking procedure was performed in the 24th hour. Only 3 (30%) patients required segment resection with homeostasis, and the mortality rate was 20% (2/10 patients). In Group B, 4 patients required repacking in the first 6 hrs. Mean 8 units of blood were transfused until unpacking procedure. The mortality rate was 44% (4/9 patients). The length of intensive care unit stay and requirement of blood transfusion were statistically significantly lower in Group A (p < 0.05). The mortality rate of this group was also lower. However, the difference between the groups for mortality rates was not statistically significant. This study emphasizes that efficacy of the procedure is one of the determinants that affects the results, and inadequate or inappropriate packing may easily result in poor outcome. PMID:18194549

Violence during pregnancy and newborn outcomes: a cohort study in a disadvantaged population in Brazil.

PubMed

Nunes, Maria Angélica Antunes; Camey, Suzi; Ferri, Cleusa P; Manzolli, Patrícia; Manenti, Carlo Nunes; Schmidt, Maria Inês

2011-02-01

Violence against pregnant women is an increasing public health concern. The purpose of this study is to estimate the prevalence of violence during pregnancy, to identify characteristics associated and to assess the impact of violence on newborn outcomes. Prospective cohort study of 652 pregnant women attending primary care clinics in Southern Brazil, from June 2006 to September 2007. Women with gestational age ranging from 16th and 36th were enrolled and their exposure to violence and mental disorder was assessed. After the birth they were contacted by telephone when information on obstetric and neonatal outcomes was obtained. Any violence during current pregnancy was reported by 18.3% [95% confidence interval (CI) 15.3-21.4%] participants, 15.0% (95% CI 12.3-17.8%) psychological violence, 6% (95% CI 4.2-7.8%) physical violence and 3% (0-0.5%) sexual violence. These women were more often of low income, did not work or study and had inadequate prenatal care and pregnancy weight gain. There was a statistically significant crude association between exposure to physical and psychological violence [relative risk (RR) 3.21 (1.51-6.80)]. After adjustment for family income, number of prenatal visits, length of gestation and gestational weight gain, the effect size decreased, but remained statistically significant (RR 2.18; 95% CI 1.16-4.08%). In disadvantaged settings in Brazil, violence in pregnancy is frequent; it is associated with inadequate maternal weight gain during pregnancy and prenatal care, and increases risk of low birth-weight. Thus, violence in pregnancy imposes a challenge to effective prenatal care delivery with potential benefits to the mother and her baby.

Footwear used by older people and a history of hyperkeratotic lesions on the foot

PubMed Central

Palomo-López, Patricia; Becerro-de-Bengoa-Vallejo, Ricardo; Losa-Iglesias, Marta Elena; Rodríguez-Sanz, David; Calvo-Lobo, César; López-López, Daniel

2017-01-01

Abstract Inadequate footwear, painful and hyperkeratotic lesions (HL) are an extremely common problems amongst older people. Such problems increase the risk of falls, hamper mobility, reduction of quality of life, dignity, and ability to remain independent. The etiology of painful and feet conditions is poorly understood. To discover footwear preferences of older people, pain tolerance may favor presence of HL for the use of inadequate footwear in old age. A sample of 100 participants with a mean age of 74.90 ± 7.01 years attended an outpatient clinic where self-reported demographic data, frequency with which they checked their feet were recorded and measurements were taken of foot sensitivity. Additionally, all participants’ shoes were allocated into optimal, adequate, and dangerous categories based on design, structural and safety features, and materials. Only 12% of the sample population checked their feet every day, 37% revealed symptoms of neuropathy, 14% used optimal shoes, and 61% presented HL. In a bivariate analysis, no significant differences were observed. HL are associated with inadequate footwear, loss of sensitivity, and low frequency of foot health checks. PMID:28403112

Fruits and Vegetables Consumption and Associated Factors among In-School Adolescents in Five Southeast Asian Countries

PubMed Central

Peltzer, Karl; Pengpid, Supa

2012-01-01

The aim of the study was to assess the prevalence of fruits and vegetable consumption and associated factors among Southeast Asian in-school adolescents. Data were collected by self-report questionnaire from nationally representative samples (total 16,084) of school children aged 13 to 15 years in five Southeast Asian countries. Overall, 76.3% of the 13 to 15 year-olds had inadequate fruits and vegetables consumptions (less than five servings per day); 28% reported consuming fruits less than once per day and 13.8% indicated consuming vegetables less than once per day. In multivariable analysis, lack of protective factors and being physically inactive were associated with inadequate fruits and vegetable consumption, and sedentary behaviour and being overweight was protective of inadequate fruits and vegetable consumption. The results stress the need for intervention programmes aimed at increased consumption of fruits and vegetables, targeting proximal factors such as the family environment and distal factors by aiming at integrating other risk factors such as physical activity into health promotion among adolescents. PMID:23202763

Fruits and vegetables consumption and associated factors among in-school adolescents in five Southeast Asian countries.

PubMed

Peltzer, Karl; Pengpid, Supa

2012-10-11

The aim of the study was to assess the prevalence of fruits and vegetable consumption and associated factors among Southeast Asian in-school adolescents. Data were collected by self-report questionnaire from nationally representative samples (total 16,084) of school children aged 13 to 15 years in five Southeast Asian countries. Overall, 76.3% of the 13 to 15 year-olds had inadequate fruits and vegetables consumptions (less than five servings per day); 28% reported consuming fruits less than once per day and 13.8% indicated consuming vegetables less than once per day. In multivariable analysis, lack of protective factors and being physically inactive were associated with inadequate fruits and vegetable consumption, and sedentary behaviour and being overweight was protective of inadequate fruits and vegetable consumption. The results stress the need for intervention programmes aimed at increased consumption of fruits and vegetables, targeting proximal factors such as the family environment and distal factors by aiming at integrating other risk factors such as physical activity into health promotion among adolescents.

Planned Educational Change in Search of a Research Tradition

ERIC Educational Resources Information Center

Heathers, Glenn

1974-01-01

Attempts at change in education have been largely unsuccessful, producing only superficial change because of inadequate needs analysis, unsound implementation plans, insufficient training in the use of innovations, and failure to involve practitioners in the decision-making process. (HMD)

Uncertainty-based tradeoff analysis methodology for integrated transportation investment decision-making.

DOT National Transportation Integrated Search

2009-10-28

Transportation agencies strive to maintain their systems in good condition and also to provide : acceptable levels of service to users. However, funding is often inadequate to meet the needs : of system preservation and expansion, and thus performanc...

Incentives for mobility : using market mechanisms to rebuild America's transportation infrastructure

DOT National Transportation Integrated Search

1989-08-01

America's transportation infrastructure is inadequate, but the solution is not simply to spend more public money. A market-oriented analysis reveals that the problem is institutional. The incentives which operate in the public sector under current po...

Converging stepped spillways: Simplified momentum analysis approach

USDA-ARS?s Scientific Manuscript database

Roller compacted concrete (RCC) stepped spillways are growing in popularity for providing overtopping protection for aging watershed dams with inadequate auxiliary spillway capacity and for the construction of new dams. Site conditions, such as limited right-of-way, topography, and geological forma...

Recommendations for shoulder restraint installation in general aviation aircraft.

DOT National Transportation Integrated Search

1966-09-01

The use of inadequate or incomplete body restraint systems is a major factor in the current trend of increasing serious and fatal type injuries reported from general aviation accidents. An analysis of these accident injuries and conditions clearly in...

Efficacy and safety of different doses and retreatment of rituximab: a randomised, placebo-controlled trial in patients who are biological naive with active rheumatoid arthritis and an inadequate response to methotrexate (Study Evaluating Rituximab's Efficacy in MTX iNadequate rEsponders (SERENE)).

PubMed

Emery, P; Deodhar, A; Rigby, W F; Isaacs, J D; Combe, B; Racewicz, A J; Latinis, K; Abud-Mendoza, C; Szczepanski, L J; Roschmann, R A; Chen, A; Armstrong, G K; Douglass, W; Tyrrell, H

2010-09-01

This phase III study evaluated the efficacy and safety of rituximab plus methotrexate (MTX) in patients with active rheumatoid arthritis (RA) who had an inadequate response to MTX and who were naïve to prior biological treatment. Patients with active disease on stable MTX (10-25 mg/week) were randomised to rituximab 2 x 500 mg (n=168), rituximab 2 x 1000 mg (n=172), or placebo (n=172). From week 24, patients not in remission (Disease Activity Score (28 joints) > or =2.6) received a second course of rituximab; patients initially assigned to placebo switched to rituximab 2 x 500 mg. The primary end point was American College of Rheumatology 20 (ACR20) response at week 24. All patients were followed until week 48. At week 24, both doses of rituximab showed statistically superior efficacy (p<0.0001) to placebo (ACR20: 54%, 51% and 23%; rituximab (2 x 500 mg) + MTX, rituximab (2 x 1000 mg) + MTX and placebo + MTX, respectively). Secondary end points were also significantly improved for both rituximab groups compared with placebo. Further improvements in both rituximab arms were observed from week 24 to week 48. Rituximab + MTX was well tolerated, demonstrating comparable safety to placebo + MTX through to week 24, and between rituximab doses through to week 48. Rituximab (at 2 x 500 mg and 2 x 1000 mg) plus MTX significantly improved clinical outcomes at week 24, which were further improved by week 48. No significant differences in either clinical or safety outcomes were apparent between the rituximab doses.

Efficacy and safety of different doses and retreatment of rituximab: a randomised, placebo-controlled trial in patients who are biological naïve with active rheumatoid arthritis and an inadequate response to methotrexate (Study Evaluating Rituximab's Efficacy in MTX iNadequate rEsponders (SERENE))

PubMed Central

Emery, P; Deodhar, A; Rigby, W F; Isaacs, J D; Combe, B; Racewicz, A J; Latinis, K; Abud-Mendoza, C; Szczepański, L J; Roschmann, R A; Chen, A; Armstrong, G K; Douglass, W; Tyrrell, H

2010-01-01

Objectives This phase III study evaluated the efficacy and safety of rituximab plus methotrexate (MTX) in patients with active rheumatoid arthritis (RA) who had an inadequate response to MTX and who were naïve to prior biological treatment. Methods Patients with active disease on stable MTX (10–25 mg/week) were randomised to rituximab 2×500 mg (n=168), rituximab 2×1000 mg (n=172), or placebo (n=172). From week 24, patients not in remission (Disease Activity Score (28 joints) ≥2.6) received a second course of rituximab; patients initially assigned to placebo switched to rituximab 2×500 mg. The primary end point was American College of Rheumatology 20 (ACR20) response at week 24. All patients were followed until week 48. Results At week 24, both doses of rituximab showed statistically superior efficacy (p<0.0001) to placebo (ACR20: 54%, 51% and 23%; rituximab (2×500 mg) + MTX, rituximab (2×1000 mg) + MTX and placebo + MTX, respectively). Secondary end points were also significantly improved for both rituximab groups compared with placebo. Further improvements in both rituximab arms were observed from week 24 to week 48. Rituximab + MTX was well tolerated, demonstrating comparable safety to placebo + MTX through to week 24, and between rituximab doses through to week 48. Conclusions Rituximab (at 2×500 mg and 2×1000 mg) plus MTX significantly improved clinical outcomes at week 24, which were further improved by week 48. No significant differences in either clinical or safety outcomes were apparent between the rituximab doses. PMID:20488885

Barriers to Women's Participation: Experiences of Volunteers and Community Healthcare Authorities.

PubMed

Rezakhani Moghaddam, Hamed; Allahverdipour, Hamid; Matlabi, Hossein

2018-01-01

Along with health development in general terms, women's involvement in health programs can be effective in raising their self-confidence and their health promotion. This study was carried out to unveil the barriers to and challenges of the health volunteers and to present the solutions to its promotion using active women participants' experiences and the authorities of the program. The study was carried out using qualitative method along with content analysis in city of Tabriz East-Azerbaijan province, Iran. Data collection was conducted utilizing semistructured individual interviews and focus group discussions with the participation of 29 health volunteers and responsible authorities. The participants were selected using purposive sampling with maximum variation. Data analysis implemented conventional content analysis using MAXODA. Barriers to and challenges of health volunteers were generally categorized into four main themes including volunteers and trainers' inadequate capabilities, inadequate acceptance of the volunteers, restrictive social norms, and organizational problems. It seems that interaction among health system, people, and health volunteers should be improved. Holding training programs about the activities of health volunteers at the society level leads into the better utilization of society sources in health programs.

D.B.H. and Survival Analysis: A New Methodology for Assessing Forest Inventory Mortality

Treesearch

Christopher W. Woodall; Patricia L. Grambsch; William Thomas

2005-01-01

Tree mortality has typically been assessed in Forest Inventory and Analysis (FIA) studies through summaries of mortality by location, species, and causal agents. Although these methods have historically been used for most of FIA's tree mortality analyses, they are inadequate for robust assessment of mortality trends and dynamics. To offer a new method of analyzing...

A randomized controlled trial of the efficacy and safety of saxagliptin as add-on therapy in patients with type 2 diabetes and inadequate glycaemic control on metformin plus a sulphonylurea.

PubMed

Moses, R G; Kalra, S; Brook, D; Sockler, J; Monyak, J; Visvanathan, J; Montanaro, M; Fisher, S A

2014-05-01

To evaluate the efficacy and safety of saxagliptin as add-on therapy in adults with type 2 diabetes with inadequate glycaemic control on metformin plus a sulphonylurea. In this 24-week, multicentre, randomized, parallel-group, double-blind study, outpatients aged ≥18 years with type 2 diabetes, body mass index ≤40 kg/m(2) and inadequate glycaemic control, received saxagliptin 5 mg or placebo once-daily added to background medication consisting of a stable maximum tolerated dose of metformin plus a sulphonylurea. The primary end point was change in glycated haemoglobin (HbA1c) from baseline to week 24. Safety and tolerability assessments included adverse events (AEs), hypoglycaemia and body weight. A total of 257 patients were randomized, treated and included in the safety analysis (saxagliptin, n = 129; placebo, n = 128); 255 were included in the efficacy analysis (saxagliptin, n = 127; placebo, n = 128). HbA1c reduction was greater with saxagliptin versus placebo [between-group difference in adjusted mean change from baseline, -0.66%; 95% confidence interval (CI), -0.86 to -0.47 (7 mmol/mol, -9.4 to -5.1); p < 0.0001]. The proportion of patients with ≥1 AE was 62.8% with saxagliptin and 71.7% with placebo. In the saxagliptin and placebo groups, rates of reported hypoglycaemia were 10.1 and 6.3%, respectively, and rates of confirmed hypoglycaemia (symptoms + glucose < 2.8 mmol/l) were 1.6 and 0%. Mean change in body weight was 0.2 kg for saxagliptin and -0.6 kg for placebo (p = 0.0272). Addition of saxagliptin 5 mg/day in patients inadequately controlled on metformin and sulphonylurea effectively improved glycaemic control and was well tolerated. © 2013 John Wiley & Sons Ltd.

Association Between Portable Screen-Based Media Device Access or Use and Sleep Outcomes: A Systematic Review and Meta-analysis.

PubMed

Carter, Ben; Rees, Philippa; Hale, Lauren; Bhattacharjee, Darsharna; Paradkar, Mandar S

2016-12-01

Sleep is vital to children's biopsychosocial development. Inadequate sleep quantity and quality is a public health concern with an array of detrimental health outcomes. Portable mobile and media devices have become a ubiquitous part of children's lives and may affect their sleep duration and quality. To conduct a systematic review and meta-analysis to examine whether there is an association between portable screen-based media device (eg, cell phones and tablet devices) access or use in the sleep environment and sleep outcomes. A search strategy consisting of gray literature and 24 Medical Subject Headings was developed in Ovid MEDLINE and adapted for other databases between January 1, 2011, and June 15, 2015. Searches of the published literature were conducted across 12 databases. No language restriction was applied. The analysis included randomized clinical trials, cohort studies, and cross-sectional study designs. Inclusion criteria were studies of school-age children between 6 and 19 years. Exclusion criteria were studies of stationary exposures, such as televisions or desktop or personal computers, or studies investigating electromagnetic radiation. Of 467 studies identified, 20 cross-sectional studies were assessed for methodological quality. Two reviewers independently extracted data. The primary outcomes were inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness, studied according to an a priori protocol. Twenty studies were included, and their quality was assessed. The studies involved 125 198 children (mean [SD] age, 14.5 [2.2] years; 50.1% male). There was a strong and consistent association between bedtime media device use and inadequate sleep quantity (odds ratio [OR], 2.17; 95% CI, 1.42-3.32) (P < .001, I2 = 90%), poor sleep quality (OR, 1.46; 95% CI, 1.14-1.88) (P = .003, I2 = 76%), and excessive daytime sleepiness (OR, 2.72; 95% CI, 1.32-5.61) (P = .007, I2 = 50%). In addition, children who had access to (but did not use) media devices at night were more likely to have inadequate sleep quantity (OR, 1.79; 95% CI, 1.39-2.31) (P < .001, I2 = 64%), poor sleep quality (OR, 1.53; 95% CI, 1.11-2.10) (P = .009, I2 = 74%), and excessive daytime sleepiness (OR, 2.27; 95% CI, 1.54-3.35) (P < .001, I2 = 24%). To date, this study is the first systematic review and meta-analysis of the association of access to and the use of media devices with sleep outcomes. Bedtime access to and use of a media device were significantly associated with the following: inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness. An integrated approach among teachers, health care professionals, and parents is required to minimize device access at bedtime, and future research is needed to evaluate the influence of the devices on sleep hygiene and outcomes.

Global Futures: The Emerging Scenario.

ERIC Educational Resources Information Center

Seth, Satish C.

1983-01-01

Acknowledging global interdependence, especially in economics, may be the most important step toward resolving international conflicts. Describes seven major global dangers and gives scenarios for exploring likely global futures. As "tools of prescription" these global models are inadequate, but as "tools of analysis" they have…

Sex Differences in Impulsivity: A Meta-Analysis

ERIC Educational Resources Information Center

Cross, Catharine P.; Copping, Lee T.; Campbell, Anne

2011-01-01

Men are overrepresented in socially problematic behaviors, such as aggression and criminal behavior, which have been linked to impulsivity. Our review of impulsivity is organized around the tripartite theoretical distinction between reward hypersensitivity, punishment hyposensitivity, and inadequate effortful control. Drawing on evolutionary,…

Diagnosing and treatment planning inadequate tooth display.

PubMed

Spear, F

2016-10-21

Some of the most challenging patients to produce a pleasing smile for are those who present with inadequate tooth display (either due to tooth position, the patient has normal size teeth, but they aren't exposed adequately to fill out the smile) or due to tooth size (the teeth are small, often due to tooth wear). The key to understanding how to manage these patients is to learn to understand the possible aetiologies that could produce the condition, and learn how to diagnose which aetiologies exist for your patient. Potential aetiologies for inadequate tooth display in patients with normal length unworn anterior teeth: excessive lip length; inadequate lip mobility; inadequate vertical eruption of the anterior teeth; inadequate facial prominence of the maxillary anterior teeth; vertical maxillary deficiency; and anterior maxillary deficiency.This article, the first in a British Dental Journal series on the topic of aesthetic dentistry, reviews the clinical findings consistent with diagnosing each of the above etiologies, and then reviews the treatment options available for correcting the inadequate tooth display.

Partial discharge detection and analysis in low pressure environments

NASA Astrophysics Data System (ADS)

Liu, Xin

Typical aerospace vehicles (aircraft and spacecraft) experience a wide range of operating pressures during ascending and returning to earth. Compared to the sea-level atmospheric pressure (760 Torr), the pressure at about 60 km altitude is 2 Torr. The performance of the electric power system components of the aerospace vehicles must remain reliable even under such sub-atmospheric operating conditions. It is well known that the dielectric strength of gaseous insulators, while the electrode arrangement remains unchanged, is pressure dependent. Therefore, characterization of the performance and behavior of the electrical insulation in flight vehicles in low-pressure environments is extremely important. Partial discharge testing is one of the practical methods for evaluating the integrity of electrical insulation in aerospace vehicles. This dissertation describes partial discharge (PD) measurements performed mainly with 60 Hz ac energization in air, argon and helium, for pressures between 2 and 760 Torr. Two main electrode arrangements were used. One was a needle-plane electrode arrangement with a Teflon insulating barrier. The other one was a twisted pair of insulated conductors taken from a standard aircraft wiring harness. The measurement results are presented in terms of typical PD current pulse waveforms and waveform analysis for both main electrode arrangements. The evaluation criteria are the waveform polarity, magnitude, shape, rise time, and phase angle (temporal location) relative to the source voltage. Two-variable histograms and statistical averages of the PD parameters are presented. The PD physical mechanisms are analyzed. For PD pattern recognition, both statistical methods (such as discharge parameter dot pattern representation, discharge parameter phase distribution, statistical operator calculations, and PD fingerprint development) and wavelet transform applications are investigated. The main conclusions of the dissertation include: (1) The PD current pulse waveforms are dependent on the pressure. (2) The rise time of the waveform is another effective PD current pulse characteristic indicator. (3) PD fingerprint patterns that are already available for atmospheric pressure (760 Torr) conditions are inadequate for the evaluation of PD pulses at low pressures. (4) Various wavelet transform techniques can be used effectively for PD pulse signal denoising purposes, and for PD pulse waveform transient feature recognition.

Quantitative characterization of color Doppler images: reproducibility, accuracy, and limitations.

PubMed

Delorme, S; Weisser, G; Zuna, I; Fein, M; Lorenz, A; van Kaick, G

1995-01-01

A computer-based quantitative analysis for color Doppler images of complex vascular formations is presented. The red-green-blue-signal from an Acuson XP10 is frame-grabbed and digitized. By matching each image pixel with the color bar, color pixels are identified and assigned to the corresponding flow velocity (color value). Data analysis consists of delineation of a region of interest and calculation of the relative number of color pixels in this region (color pixel density) as well as the mean color value. The mean color value was compared to flow velocities in a flow phantom. The thyroid and carotid artery in a volunteer were repeatedly examined by a single examiner to assess intra-observer variability. The thyroids in five healthy controls were examined by three experienced physicians to assess the extent of inter-observer variability and observer bias. The correlation between the mean color value and flow velocity ranged from 0.94 to 0.96 for a range of velocities determined by pulse repetition frequency. The average deviation of the mean color value from the flow velocity was 22% to 41%, depending on the selected pulse repetition frequency (range of deviations, -46% to +66%). Flow velocity was underestimated with inadequately low pulse repetition frequency, or inadequately high reject threshold. An overestimation occurred with inadequately high pulse repetition frequency. The highest intra-observer variability was 22% (relative standard deviation) for the color pixel density, and 9.1% for the mean color value. The inter-observer variation was approximately 30% for the color pixel density, and 20% for the mean color value. In conclusion, computer assisted image analysis permits an objective description of color Doppler images. However, the user must be aware that image acquisition under in vivo conditions as well as physical and instrumental factors may considerably influence the results.

On the limitations of standard statistical modeling in biological systems: a full Bayesian approach for biology.

PubMed

Gomez-Ramirez, Jaime; Sanz, Ricardo

2013-09-01

One of the most important scientific challenges today is the quantitative and predictive understanding of biological function. Classical mathematical and computational approaches have been enormously successful in modeling inert matter, but they may be inadequate to address inherent features of biological systems. We address the conceptual and methodological obstacles that lie in the inverse problem in biological systems modeling. We introduce a full Bayesian approach (FBA), a theoretical framework to study biological function, in which probability distributions are conditional on biophysical information that physically resides in the biological system that is studied by the scientist. Copyright © 2013 Elsevier Ltd. All rights reserved.

Disaster-Related Injury Management: High Prevalence of Wound Infection After Super Typhoon Haiyan.

PubMed

Kim, Yong Won; Kim, Seong Yeop; Kim, Hoon; Ahn, Moo Eob; Lee, Kang Hyun; Hong, Eun Seok

2016-02-01

After Super Typhoon Haiyan, a category 5 tropical cyclone, insufficient resources were available for medical management. Many patients in the Philippines were wounded as a result of the disaster. We examined the prevalence, risk factors, and consequences of disaster-related wounds and wound infection in the post-disaster period. We performed a retrospective review of consecutive patients admitted to a Korean Disaster Relief Team clinic at St. Paul's Hospital, Tacloban City, Republic of Philippines, between December 9 and 13, 2013. Traumatic injury patients were included; patients not exhibiting a wound were excluded. Of the 160 patients enrolled in the study, 71 (44.4%) had infected wounds. There were no significant differences in the age, sex, past medical history, wound site, wound depth, injury mechanism, or inducer of injury between the uninfected and infected groups. In the univariate analysis, a foreign-body-contaminated wound, a chronic wound, elapsed time from injury to medical contact, an inadequately cared for wound, and need for subsequent wound management were associated with wound infection (P<0.05). The multivariate analysis revealed that foreign body contamination and having an inadequately cared for wound were associated with wound infection (odds ratio [OR]: 10.12, 95% confidence interval [CI]: 3.59-28.56; OR: 3.51, 95% CI: 1.07-11.51, respectively). In the post-disaster situation, many wound infections required definitive care. Wound infection was associated with inadequately cared for wounds and foreign-body-contaminated wounds.

A systematic review of implant outcomes in treated periodontitis patients.

PubMed

Sousa, Vanessa; Mardas, Nikos; Farias, Bruna; Petrie, Aviva; Needleman, Ian; Spratt, David; Donos, Nikolaos

2016-07-01

To investigate the effect of treated periodontitis on implant outcomes in partially edentulous individuals compared with periodontally healthy patients. Longitudinal studies reporting on implant survival, success, incidence of peri-implantitis, bone loss and periodontal status, and on partially dentate patients with a history of treated periodontitis were included. The search yielded 14,917 citations. Twenty-seven publications met the inclusion criteria for qualitative data synthesis. Implant success and survival were higher in periodontally healthy patients, whilst bone loss and incidence of peri-implantitis was increased in patients with history of treated periodontitis. There was a higher tendency for implant loss and biological complications in patients previously presenting with severe forms of periodontitis. The strength of the evidence was limited by the heterogeneity of the included studies in terms of study design, population, therapy, unit of analysis, inconsistent definition of baselines and outcomes, as well as by the inadequate reporting of statistical analysis and accounting for confounding factors; thus, meta-analysis could not be performed. Implants placed in patients treated for periodontal disease are associated with higher incidence of biological complications and lower success and survival rates than those placed in periodontally healthy patients. Severe forms of periodontal disease are associated with higher rates of implant loss. However, it is critical to develop well-designed, long-term prospective studies to provide further substantive evidence on the association of these outcomes. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Active tectonic deformation along rejuvenated faults in tropical Borneo: Inferences obtained from tectono-geomorphic evaluation

NASA Astrophysics Data System (ADS)

Mathew, Manoj Joseph; Menier, David; Siddiqui, Numair; Kumar, Shashi Gaurav; Authemayou, Christine

2016-08-01

The island of Borneo is enveloped by tropical rainforests and hostile terrain characterized by high denudation rates. Owing to such conditions, studies pertaining to neotectonics and consequent geomorphic expressions with regard to surface processes and landscape evolution are inadequately constrained. Here we demonstrate the first systematic tectono-geomorphic evaluation of north Borneo through quantitative and qualitative morphotectonic analysis at sub-catchment scale, for two large drainage basins located in Sarawak: the Rajang and Baram basins. The extraction of morphometric parameters utilizing digital elevation models arranged within a GIS environment focuses on hypsometric curve analysis, distribution of hypsometric integrals through spatial autocorrelation statistics, relative uplift values, the asymmetry factor and the normalized channel steepness index. Hypsometric analysis suggests a young topography adjusting to changes in tectonic boundary conditions. Autocorrelation statistics show clusters of high values of hypsometric integrals as prominent hotspots that are associated with less eroded, young topography situated in the fold and thrust belts of the Interior Highlands of Borneo. High channel steepness and gradients (> 200 m0.9) are observed in zones corresponding to the hotspots. Relative uplift values reveal the presence of tectonically uplifted blocks together with relatively subsided or lesser uplifted zones along known faults. Sub-catchments of both basins display asymmetry indicating tectonic tilting. Stream longitudinal profiles demonstrate the presence of anomalies in the form of knickzones without apparent lithological controls along their channel reaches. Surfaces represented by cold spots of low HI values and low channel gradients observed in the high elevation headwaters of both basins are linked to isolated erosional planation surfaces that could be remnants of piracy processes. The implication of our results is that Borneo experiences active folding of the Rajang Group fold-thrust belt to present and these events reactivated old major faults and minor related dislocations. From geomorphic analysis associated with sedimentary record, we posit that the terrain could have undergone high uplift rates since 5 Ma or multi-phased uplift with periodic intermittent pulses of high and low uplift rates.

Common System and Software Testing Pitfalls

DTIC Science & Technology

2014-11-03

GEN- TTE -1) Target Platform Difficult to Access (GEN- TTE -2) → Inadequate Test Environments (GEN- TTE -3) Poor Fidelity of Test Environments (GEN- TTE -4...Inadequate Test Environment Quality (GEN- TTE -5) Test Environments Inadequately Tested (GEN- TTE -6) [new pitfall] Inadequate Test Configuration...Management (GEN- TTE -7) 29Common System/SW Testing PitfallsDonald G. Firesmith, 3 November 2014 General Pitfalls – Automated Testing [new pitfall category

Economic burden of inadequate symptom control among US commercially insured patients with irritable bowel syndrome with diarrhea.

PubMed

Buono, Jessica L; Mathur, Kush; Averitt, Amelia J; Andrae, David A

2017-04-01

To assess healthcare resource use and costs among irritable bowel syndrome (IBS) with diarrhea (IBS-D) patients with and without evidence of inadequate symptom control on current prescription therapies and estimate incremental all-cause costs associated with inadequate symptom control. IBS-D patients aged ≥18 years with ≥1 medical claim for IBS (ICD-9-CM 564.1x) and either ≥2 claims for diarrhea (ICD-9-CM 787.91, 564.5x), ≥1 claim for diarrhea plus ≥1 claim for abdominal pain (ICD-9-CM 789.0x), or ≥1 claim for diarrhea plus ≥1 pharmacy claim for a symptom-related prescription within 1 year of an IBS diagnosis were identified from the Truven Health MarketScan database. Inadequate symptom control, resource use, and costs were assessed up to 1 year following the index date. Inadequate symptom control included any of the following: (1) switch or (2) addition of new symptom-related therapy; (3) IBS-D-related inpatient or emergency room (ER) admission; (4) IBS-D-related medical procedure; (5) diagnosis of condition indicating treatment failure; or (6) use of a more aggressive prescription. Generalized linear models assessed incremental costs of inadequate symptom control. Of 20,624 IBS-D patients (mean age = 48.5 years; 77.8% female), 66.4% had evidence of inadequate symptom control. Compared to those without inadequate symptom control, patients with evidence of inadequate symptom control had significantly more hospitalizations (12.0% vs 6.0%), ER visits (37.1% vs 22.6%), use of outpatient services (73.0% vs 60.7%), physician office visits (mean 11.0 vs 8.1), and prescription fills (mean 40.0 vs 26.7) annually (all p < .01). Incremental costs associated with inadequate symptom control were $3,065 (2013 US dollars), and were driven by medical service costs ($2,391; 78%). Study included US commercially insured patients only and inferred IBS-D status and inadequate symptom control from claims. Inadequate symptom control associated with available IBS-D therapies represents a significant economic burden for both payers and IBS-D patients.

Protecting public surface transportation against terrorism and serious crime : an executive overview

DOT National Transportation Integrated Search

2001-10-01

Because terrorist threats are not easily quantifiable, it is difficult to determine the "right" level of security. Using cost-benefit analysis as the sole criterion to determine the level of security is inadequate. The risk of death to any individual...

14 CFR 25.307 - Proof of structure.

Code of Federal Regulations, 2012 CFR

2012-01-01

... load tests may be inadequate. (b)-(c) [Reserved] (d) When static or dynamic tests are used to show... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... condition. Structural analysis may be used only if the structure conforms to that for which experience has...

14 CFR 25.307 - Proof of structure.

Code of Federal Regulations, 2010 CFR

2010-01-01

... load tests may be inadequate. (b)-(c) [Reserved] (d) When static or dynamic tests are used to show... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... condition. Structural analysis may be used only if the structure conforms to that for which experience has...

14 CFR 25.307 - Proof of structure.

Code of Federal Regulations, 2013 CFR

2013-01-01

... load tests may be inadequate. (b)-(c) [Reserved] (d) When static or dynamic tests are used to show... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... condition. Structural analysis may be used only if the structure conforms to that for which experience has...

14 CFR 25.307 - Proof of structure.

Code of Federal Regulations, 2014 CFR

2014-01-01

... load tests may be inadequate. (b)-(c) [Reserved] (d) When static or dynamic tests are used to show... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... condition. Structural analysis may be used only if the structure conforms to that for which experience has...

14 CFR 25.307 - Proof of structure.

Code of Federal Regulations, 2011 CFR

2011-01-01

... load tests may be inadequate. (b)-(c) [Reserved] (d) When static or dynamic tests are used to show... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... condition. Structural analysis may be used only if the structure conforms to that for which experience has...

Risk Factors for premature birth in a hospital 1

PubMed Central

Ahumada-Barrios, Margarita E.; Alvarado, German F.

2016-01-01

Abstract Objective: to determine the risk factors for premature birth. Methods: retrospective case-control study of 600 pregnant women assisted in a hospital, with 298 pregnant women in the case group (who gave birth prematurely <37 weeks) and 302 pregnant women who gave birth to a full-term newborn in the control group. Stata software version 12.2 was used. The Chi-square test was used in bivariate analysis and logistic regression was used in multivariate analysis, from which Odds Ratios (OR) and Confidence Intervals (CI) of 95% were derived. Results: risk factors associated with premature birth were current twin pregnancy (adjusted OR= 2.4; p= 0.02), inadequate prenatal care (< 6 controls) (adjusted OR= 3.2; p <0.001), absent prenatal care (adjusted OR= 3.0; p <0.001), history of premature birth (adjusted OR= 3.7; p <0.001) and preeclampsia (adjusted OR= 1.9; p= 0.005). Conclusion: history of premature birth, preeclampsia, not receiving prenatal care and receiving inadequate prenatal care were risk factors for premature birth. PMID:27463110

Behavioral economics: areas of cooperative research between economics and applied behavioral analysis1

PubMed Central

Kagel, John H.; Winkler, Robin C.

1972-01-01

The current research methods of behavioral economics are characterized by inadequate empirical foundations. Psychologists involved in the experimental analysis of behavior with their research strategies and their experimental technology, particularly that of the Token Economy, can assist in providing empirical foundations for behavioral economics. Cooperative research between economists and psychologists to this end should be immediately fruitful and mutually beneficial. PMID:16795356

Multistage Deployment of the Army Theater Hospital

DTIC Science & Technology

2013-12-01

analysis on the effects warfare tactics, casualty timing, and casualty types had on the medical treatment facility (Cecchine et al., 2001). This proved...the 44-bed mobile portion of the current CSH was potentially inadequate to support approximately four brigades in an asymmetrical warfare scenario...systems and its increased force effectiveness on the fleet. He utilized quantitative analysis with Lanchester and Hughes-Salvo models to show that

The standard treatment protocol for paracetamol poisoning may be inadequate following overdose with modified release formulation: a pharmacokinetic and clinical analysis of 53 cases.

PubMed

Salmonson, Heléne; Sjöberg, Gunilla; Brogren, Jacob

2018-01-01

The use of the standard procedure for managing overdoses with immediate release (IR) paracetamol is questionable when applied to overdoses with modified release (MR) formulations. This study describes the pharmacokinetics of paracetamol and the clinical outcomes following overdoses with a MR formulation. Medical records including laboratory analyses concerning overdoses of MR paracetamol from 2009 to 2015 were collected retrospectively. Inclusion criteria were ingestion of a toxic dose, known time of intake and documented measurements of serum paracetamol and liver function tests. Graphical analysis, descriptive statistics and population pharmacokinetic modelling were used to describe data. Fifty-three cases were identified. Median age was 26 years (range 13-68), median dose was 20 g (range 10-166) and 74% were females. The pharmacokinetic analysis showed a complex, dose dependent serum versus time profile with prolonged absorption and delayed serum peak concentrations with increasing dose. Ten patients had persistently high serum levels for 24 h or more, six of them had a second peak 8-19 h after ingestion. Seven of 34 patients receiving N-acetylcysteine (NAC) within 8 h had alanine aminotransferase (ALT) above reference range. Three of them developed hepatotoxicity (ALT >1000 IU/l). The pharmacokinetic and clinical analysis showed that the standard treatment protocol, including risk assessment and NAC regimen, used for IR paracetamol poisoning not appear suitable for MR formulation. Individual and tailored treatment may be valuable but further studies are warranted to determine optimal regimen of overdoses with MR formulation.

Closing the gap between rocks and clocks using total-evidence dating

PubMed Central

2016-01-01

Total-evidence dating (TED) allows evolutionary biologists to incorporate a wide range of dating information into a unified statistical analysis. One might expect this to improve the agreement between rocks and clocks but this is not necessarily the case. We explore the reasons for such discordance using a mammalian dataset with rich molecular, morphological and fossil information. There is strong conflict in this dataset between morphology and molecules under standard stochastic models. This causes TED to push divergence events back in time when using inadequate models or vague priors, a phenomenon we term ‘deep root attraction’ (DRA). We identify several causes of DRA. Failure to account for diversified sampling results in dramatic DRA, but this can be addressed using existing techniques. Inadequate morphological models also appear to be a major contributor to DRA. The major reason seems to be that current models do not account for dependencies among morphological characters, causing distorted topology and branch length estimates. This is particularly problematic for huge morphological datasets, which may contain large numbers of correlated characters. Finally, diversification and fossil sampling priors that do not incorporate all the available background information can contribute to DRA, but these priors can also be used to compensate for DRA. Specifically, we show that DRA in the mammalian dataset can be addressed by introducing a modest extra penalty for ghost lineages that are unobserved in the fossil record, for instance by assuming rapid diversification, rare extinction or high fossil sampling rate; any of these assumptions produces highly congruent divergence time estimates with a minimal gap between rocks and clocks. Under these conditions, fossils have a stabilizing influence on divergence time estimates and significantly increase the precision of those estimates, which are generally close to the dates suggested by palaeontologists. This article is part of the themed issue ‘Dating species divergences using rocks and clocks’. PMID:27325833

Patient-reported outcomes from a randomised phase III study of baricitinib in patients with rheumatoid arthritis and an inadequate response to biological agents (RA-BEACON)

PubMed Central

Kremer, Joel M; Gaich, Carol L; DeLozier, Amy M; Schlichting, Douglas E; Xie, Li; Stoykov, Ivaylo; Rooney, Terence; Bird, Paul; Sánchez Bursón, Juan Miguel; Genovese, Mark C; Combe, Bernard

2017-01-01

Objectives To assess baricitinib on patient-reported outcomes (PROs) in patients with moderately to severely active rheumatoid arthritis, who had insufficient response or intolerance to ≥1 tumour necrosis factor inhibitors (TNFis) or other biological disease-modifying antirheumatic drugs (bDMARDs). Methods In this double-blind phase III study, patients were randomised to once-daily placebo or baricitinib 2 or 4 mg for 24 weeks. PROs included the Short Form-36, EuroQol 5-D, Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Health Assessment Questionnaire-Disability Index (HAQ-DI), Patient's Global Assessment of Disease Activity (PtGA), patient's assessment of pain, duration of morning joint stiffness (MJS) and Work Productivity and Activity Impairment Questionnaire-Rheumatoid Arthritis. Treatment comparisons were performed with logistic regression for categorical measures or analysis of covariance for continuous variables. Results 527 patients were randomised (placebo, 176; baricitinib 2 mg, 174; baricitinib 4 mg, 177). Both baricitinib-treated groups showed statistically significant improvements versus placebo in most PROs. Improvements were generally more rapid and of greater magnitude for patients receiving baricitinib 4 mg than 2 mg and were maintained to week 24. At week 24, more baricitinib-treated patients versus placebo-treated patients reported normal physical functioning (HAQ-DI <0.5; p≤0.001), reductions in fatigue (FACIT-F ≥3.56; p≤0.05), improvements in PtGA (p≤0.001) and pain (p≤0.001) and reductions in duration of MJS (p<0.01). Conclusions Baricitinib improved most PROs through 24 weeks compared with placebo in this study of treatment-refractory patients with previously inadequate responses to bDMARDs, including at least one TNFi. PRO results aligned with clinical efficacy data for baricitinib. Trial registration number NCT01721044; Results. PMID:27799159

C-reactive protein and its relation to high blood pressure in overweight or obese children and adolescents

PubMed Central

Noronha, Juliana Andreia F.; Medeiros, Carla Campos M.; Cardoso, Anajás da Silva; Gonzaga, Nathalia Costa; Ramos, Alessandra Teixeira; Ramos, André Luiz C.

2013-01-01

OBJECTIVE To investigate the association between C-reactive protein (CRP) and high blood pressure (BP) in overweight or obese children and adolescents. METHODS Cross-sectional study with 184 overweight or obese children and adolescents aged from two to 18 years old, from April, 2009 to April, 2010. The classification of nutritional status used the body mass index (BMI). Based on the Centers for Disease Control and Prevention curve, individuals were classified as: overweight (BMI between the 85th-95th percentiles), obesity (BMI between 95th-97th percentiles) and severe obesity (BMI >97th percentile). Abnormal values were considered for systolic BP (SBP) and/or diastolic (DBP) if ≥90th percentile of the BP curve recommended for children and adolescents in the V Brazilian Guidelines on Hypertension, for waist circumference (WC) if ≥90th percentile of the curve established by the National Cholesterol Education Program, and for high sensitive CRP (hs-CRP) if >3mg/dL. To evaluate the association of inadequate values of CRP and the studied groups, chi-square test and analysis of variance were applied, using the Statistical Package for the Social Sciences version 17.0 and adopting a significance level of 5%. RESULTS Among the evaluated sample, 66.3% were female, 63.5%, non-white, 64.1% had severe obesity, 78.3% had altered WC and 70.6% presented high BP. There was a significant association of CRP high levels with altered WC and BMI ≥97th percentile. In adolescents, high CRP was related to high SBP. CRP mean values were higher in individuals with elevated SBP. CONCLUSIONS Inadequate values of hs-CRP were associated with severe obesity and high SBP in the studied population. These markers can be used to identify children and adolescents at higher risk for developing atherosclerosis. PMID:24142315

Closing the gap between rocks and clocks using total-evidence dating.

PubMed

Ronquist, Fredrik; Lartillot, Nicolas; Phillips, Matthew J

2016-07-19

Total-evidence dating (TED) allows evolutionary biologists to incorporate a wide range of dating information into a unified statistical analysis. One might expect this to improve the agreement between rocks and clocks but this is not necessarily the case. We explore the reasons for such discordance using a mammalian dataset with rich molecular, morphological and fossil information. There is strong conflict in this dataset between morphology and molecules under standard stochastic models. This causes TED to push divergence events back in time when using inadequate models or vague priors, a phenomenon we term 'deep root attraction' (DRA). We identify several causes of DRA. Failure to account for diversified sampling results in dramatic DRA, but this can be addressed using existing techniques. Inadequate morphological models also appear to be a major contributor to DRA. The major reason seems to be that current models do not account for dependencies among morphological characters, causing distorted topology and branch length estimates. This is particularly problematic for huge morphological datasets, which may contain large numbers of correlated characters. Finally, diversification and fossil sampling priors that do not incorporate all the available background information can contribute to DRA, but these priors can also be used to compensate for DRA. Specifically, we show that DRA in the mammalian dataset can be addressed by introducing a modest extra penalty for ghost lineages that are unobserved in the fossil record, for instance by assuming rapid diversification, rare extinction or high fossil sampling rate; any of these assumptions produces highly congruent divergence time estimates with a minimal gap between rocks and clocks. Under these conditions, fossils have a stabilizing influence on divergence time estimates and significantly increase the precision of those estimates, which are generally close to the dates suggested by palaeontologists.This article is part of the themed issue 'Dating species divergences using rocks and clocks'. © 2016 The Authors.

Wind Turbine Dynamics

NASA Technical Reports Server (NTRS)

Thresher, R. W. (Editor)

1981-01-01

Recent progress in the analysis and prediction of the dynamic behavior of wind turbine generators is discussed. The following areas were addressed: (1) the adequacy of state of the art analysis tools for designing the next generation of wind power systems; (2) the use of state of the art analysis tools designers; and (3) verifications of theory which might be lacking or inadequate. Summaries of these informative discussions as well as the questions and answers which followed each paper are documented in the proceedings.

[To inadequate indication of blood transfusion in a reference hospital in Lima, Peru].

PubMed

Flores-Paredes, Wilfredo

2011-12-01

To determine frequency and clinical criteria associated to the inadequate indication of blood products. A cross-sectional study was performed between June and October 2002. Clinical charts and the laboratory tests from patients receiving blood transfusions were examined. A blood transfusion guideline was elaborated based on published consensus, and used to determine whether the indications for blood products transfusion was adequate or inadequate. A total of 311 blood transfusions were evaluated. The global prevalence of inappropriate indication was of 33.8 %. Red blood cells (RBC) were used inappropriately in 25 %, fresh frozen plasma (FFP) in 59 %, platelets in 13 % and cryoprecipitate in 88 %. From surgery related transfusions half of the indications were inadequate. In internal medicine, ICU and emergency related transfusions, approximately one third of the indications were inadequate. The FFP is the worst used blood product. We found a high frequency of inadequate blood transfusion. The identification of the specific clinical criteria used in inadequate indications transfusions will help in designing a better educational strategy towards a more rational use of the blood products.

Moral Education in a Plural Society: A Singapore Case Study.

ERIC Educational Resources Information Center

Gopinathan, S.

1980-01-01

This article examines moral education in the schools of Singapore, a highly complex society with considerable pluralism plus rapid urbanization and industrialization. Analysis of recent government reports indicates an inadequate response to moral education issues--concern for political stability and ethnic sensibilities promote generalizations…

A TIME SERIES ANALYSIS OF AIR POLLUTION AND PRE-TERM BIRTH IN PENNSYLVANIA, 1997-2001

EPA Science Inventory

Background: Preterm delivery can lead to serious infant health outcomes including death and life-long disability. Small increases in preterm delivery risk in relation to air pollution have been reported, but prior investigations may have inadequately controlled for individual fac...

A TIME SERIES ANALYSIS OF AIR POLLUTION AND PRETERM BIRTH IN PENNSYLVANIA, 1997-2001

EPA Science Inventory

Introduction: Small increases in risk for preterm delivery in relation to air pollution have been reported, but prior investigations may have inadequately controlled for individual factors, such as maternal smoking. To eliminate confounding by known and unknown individual risk f...

Knowledge and Self-Perceived Risk for Toxic Shock Syndrome.

ERIC Educational Resources Information Center

Colbry, Sheila Lynds; Boutsen, Frank R.

1993-01-01

Survey investigated female college students' knowledge about toxic shock syndrome (TSS), noting relationships between knowledge, self-perceived risk of developing TSS, and menstrual product use. Data analysis indicated knowledge about TSS was inadequate, particularly among young females. Neither risk perception nor product use were mediated by…

Perspectives on the Validity of the Thinking Styles Inventories

ERIC Educational Resources Information Center

Berding, Florian; Masemann, Maike; Rebmann, Karin; Paechter, Manuela

2016-01-01

The Thinking Styles Inventories (TSI) are questionnaires for assessing individual preferences in constructing knowledge. This paper identifies several problems concerning their validity, which range from an inadequate use of factor analysis, to missing information on the measurement model, to findings indicating a low discrimination between the…

Association among Working Hours, Occupational Stress, and Presenteeism among Wage Workers: Results from the Second Korean Working Conditions Survey.

PubMed

Jeon, Sung-Hwan; Leem, Jong-Han; Park, Shin-Goo; Heo, Yong-Seok; Lee, Bum-Joon; Moon, So-Hyun; Jung, Dal-Young; Kim, Hwan-Cheol

2014-03-24

The purpose of the present study was to identify the association between presenteeism and long working hours, shiftwork, and occupational stress using representative national survey data on Korean workers. We analyzed data from the second Korean Working Conditions Survey (KWCS), which was conducted in 2010, in which a total of 6,220 wage workers were analyzed. The study population included the economically active population aged above 15 years, and living in the Republic of Korea. We used the chi-squared test and multivariate logistic regression to test the statistical association between presenteeism and working hours, shiftwork, and occupational stress. Approximately 19% of the workers experienced presenteeism during the previous 12 months. Women had higher rates of presenteeism than men. We found a statistically significant dose-response relationship between working hours and presenteeism. Shift workers had a slightly higher rate of presenteeism than non-shift workers, but the difference was not statistically significant. Occupational stress, such as high job demand, lack of rewards, and inadequate social support, had a significant association with presenteeism. The present study suggests that long working hours and occupational stress are significantly related to presenteeism.

Association among Working Hours, Occupational Stress, and Presenteeism among Wage Workers: Results from the Second Korean Working Conditions Survey

PubMed Central

2014-01-01

Objectives The purpose of the present study was to identify the association between presenteeism and long working hours, shiftwork, and occupational stress using representative national survey data on Korean workers. Methods We analyzed data from the second Korean Working Conditions Survey (KWCS), which was conducted in 2010, in which a total of 6,220 wage workers were analyzed. The study population included the economically active population aged above 15 years, and living in the Republic of Korea. We used the chi-squared test and multivariate logistic regression to test the statistical association between presenteeism and working hours, shiftwork, and occupational stress. Results Approximately 19% of the workers experienced presenteeism during the previous 12 months. Women had higher rates of presenteeism than men. We found a statistically significant dose–response relationship between working hours and presenteeism. Shift workers had a slightly higher rate of presenteeism than non-shift workers, but the difference was not statistically significant. Occupational stress, such as high job demand, lack of rewards, and inadequate social support, had a significant association with presenteeism. Conclusions The present study suggests that long working hours and occupational stress are significantly related to presenteeism. PMID:24661575

Psychosocial Risk Factors for Low Back Pain and Absenteeism among Slovenian Professional Drivers.

PubMed

Kresal, Friderika; Suklan, Jana; Roblek, Vasja; Jerman, Andrej; Meško, Maja

2017-06-01

The aim of this study was to determine the most common psychosocial risk factors for absenteeism and the extent to which low back pain occurs among Slovenian professional drivers as result of various psychosocial risk factors. The study involved 275 professional drivers, mostly men (mean age 41.6 years). Statistical data analysis was conducted using SPSS package version 21, MS Excel version 2007 and Pajek, version 3. The main method for data processing was regression analysis. The results of the quantitative survey showed that lower back pain is mostly caused by lifting and carrying heavy loads, inadequate working conditions, poor physical fitness, regular nights out, shift work, and stress. Dissatisfaction with work, shift work and unsuitable working conditions significantly affect the incidence of low back pain. Absenteeism is influenced by factors such as dissatisfaction at work, disrespectful attitude of managers, unsuitable working conditions, personal dissatisfaction, lack of understanding of the partner, and enjoying nightlife on a regular basis. The study clarifies the unexplained holistic psychosocial risk factors and treatment effects on health in the population of professional drivers. Such factors can lead to absenteeism. The study also provides initial demonstration research in the Slovenian practice. Furthermore, it provides solutions in a holistic approach to solve the problem of risk factors management. Copyright© by the National Institute of Public Health, Prague 2017

Energy expenditure in caving

PubMed Central

Antoni, Giorgia; Marini, Elisabetta; Curreli, Nicoletta; Tuveri, Valerio; Comandini, Ornella; Cabras, Stefano; Gabba, Silvia; Madeddu, Clelia; Crisafulli, Antonio

2017-01-01

The aim of this study was to determine the energy expenditure of a group of cavers of both genders and different ages and experience during a 10 hour subterranean exploration, using portable metabolimeters. The impact of caving activity on body composition and hydration were also assessed through bioelectrical impedance, and nutritional habits of cavers surveyed. During cave activity, measured total energy expenditure (TEE) was in the range 225–287 kcal/h for women-men (MET = 4.1), respectively; subjects had an energy intake from food in the range 1000–1200 kcal, thus inadequate to restore lost calories. Bayesian statistical analysis estimated the effect of predictive variables on TEE, revealing that experienced subjects had a 5% lower TEE than the less skilled ones and that women required a comparatively larger energy expenditure than men to perform the same task. BIVA (bioelectrical impedance vector analysis) showed that subjects were within the range of normal hydration before and after cave activity, but bioelectrical changes indicated a reduction of extracellular water in men, which might result in hypo-osmolal dehydration in the case of prolonged underground exercise. All these facts should be considered when planning cave explorations, preparing training programs for subjects practising caving, and optimizing a diet for cavers. Further, information gathered through this study could be of value to reduce accidents in caves related to increase in fatigue. PMID:28158208

Current concepts on the effect of environmental factors on cleft lip and palate.

PubMed

Molina-Solana, R; Yáñez-Vico, R M; Iglesias-Linares, A; Mendoza-Mendoza, A; Solano-Reina, E

2013-02-01

The aim of this study was to investigate the effect of environmental factors, such as tobacco, alcohol and folic acid intake, obesity, stressful events, low blood levels of zinc and fever during pregnancy, on the incidence of cleft lip and/or palate (CL±P). An electronic search was performed in the Cochrane Reviews, the ISI Web of Knowledge, PubMed and Scopus, along with a manual search to identify other relevant case-control and cohort studies. Quality assessments and an evaluation of publication bias were undertaken. Statistical heterogeneity was examined, and odds ratios (ORs) and 95% confidence intervals (CI) estimated using the random effects model. Of 372 articles initially retrieved, 28 studies were selected as eligible for meta-analysis. No evidence of publication bias was found using funnel plot analysis and the Egger linear regression method. Many studies were classified as low quality due to inadequate case-control data. On the basis of this research, maternal factors most associated with CL±P were: tobacco (OR 1.48), alcohol (OR 1.28), folic acid intake (OR 0.77), obesity (OR 1.26), stressful events (OR 1.41), low blood zinc levels (OR 1.82), and fever during pregnancy (OR 1.30). Folic acid intake by the mother reduced the risk of CL±P in offspring (OR 0.77). Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Breast Cancer awareness among Saudi females in Jeddah.

PubMed

Radi, Sahar Mahmoud

2013-01-01

Breast cancer is the most frequent malignancy of women worldwide. It is the leading cause of female cancer related disability and mortality. In Saudi Arabia breast cancer ranks first among cancerous diseases in females. In the Gulf region, and especially in Saudi Arabia, few studies have been conducted to address breast cancer awareness. The purpose of the current study was therefore to investigate the level of breast cancer awareness among Saudi females in Jeddah, focusing on knowledge of breast cancer warning signs, risk factors, screening programs and breast self-examination (BSE). The design of this study was an exploratory correlational analysis. The sample comprised 200 Saudi females aged 20 and older living in Jeddah. Data were collected using face-to- face interviews. Breast cancer awareness was measured using a modified Arabic version of the Breast Cancer Awareness Measure (Breast CAM) version 2. Descriptive statistical analysis, Pearson's Product Moment correlation coefficients and ANOVA test were used to answer study questions. Out of 200 participants, 50.5% were aware of breast lump as a warning sign of breast cancer, 57.5% claimed that family history was risk factor, 20.5% had undergone breast screening, 79% heard about BSE, and 47.5% knew how to perform BSE. Findings indicated that Saudi females level of awareness of breast cancer is very inadequate. Public awareness interventions are needed in order to overcome an ever-increasing burden of this disease among Saudi females.

Investigating preferences for mosquito-control technologies in Mozambique with latent class analysis.

PubMed

Smith, Rachel A; Barclay, Victoria C; Findeis, Jill L

2011-07-21

It is common practice to seek the opinions of future end-users during the development of innovations. Thus, the aim of this study is to investigate latent classes of users in Mozambique based on their preferences for mosquito-control technology attributes and covariates of these classes, as well as to explore which current technologies meet these preferences. Surveys were administered in five rural villages in Mozambique. The data were analysed with latent class analysis. This study showed that users' preferences for malaria technologies varied, and people could be categorized into four latent classes based on shared preferences. The largest class, constituting almost half of the respondents, would not avoid a mosquito-control technology because of its cost, heat, odour, potential to make other health issues worse, ease of keeping clean, or inadequate mosquito control. The other three groups are characterized by the attributes which would make them avoid a technology; these groups are labelled as the bites class, by-products class, and multiple-concerns class. Statistically significant covariates included literacy, self-efficacy, willingness to try new technologies, and perceived seriousness of malaria for the household. To become widely diffused, best practices suggest that end-users should be included in product development to ensure that preferred attributes or traits are considered. This study demonstrates that end-user preferences can be very different and that one malaria control technology will not satisfy everyone.

[AIDS, sexuality and attitude of adolescents about protection against HIV].

PubMed

Camargo, Brigido V; Botelho, Lúcio J

2007-02-01

To describe the role of sexual experience based on information and sociocultural contexts for the risk of HIV/AIDS transmission in adolescents. A questionnaire was answered by 1,386 middle school students from the state of Santa Catarina, Southern Brazil, in 2000. The instrument included the following variables: personal characteristics, sexual experience, communication context and knowledge on AIDS, attitudes towards condom use, risk and protective behaviors and feelings. Data analysis comprised statistical description and relational analysis (Chi-square and mean comparison tests). Lack of knowledge about HIV transmission was related to peers as main information source (p<0.05). Steady romantic relationships are the predominant context for sexual relationships with penetration (p<0.001). AIDS protection was associated to three factors: ongoing relationship, number of sexual partners and safe sex (p<0.001). A positive attitude for condom use is favored by talks about sexuality and the intention of condom use (p<0.001). The obstacles to condom use are: having had recent sexual relationships, risk behaviors, inadequate knowledge and dependence of television as an information source (p<0.005). The practice of safe sex is affected by adolescent's level of information, their attitudes about condom use and fear of the epidemic. Reevaluating prevention through multipliers strategy as well as reappraisal of family as mediators and the use of appropriate materials about Aids for teenagers are recommended.

Technologies and decision support systems to aid solid-waste management: a systematic review.

PubMed

Vitorino de Souza Melaré, Angelina; Montenegro González, Sahudy; Faceli, Katti; Casadei, Vitor

2017-01-01

Population growth associated with population migration to urban areas and industrial development have led to a consumption relation that results in environmental, social, and economic problems. With respect to the environment, a critical concern is the lack of control and the inadequate management of the solid waste generated in urban centers. Among the challenges are proper waste-collection management, treatment, and disposal, with an emphasis on sustainable management. This paper presents a systematic review on scientific publications concerning decision support systems applied to Solid Waste Management (SWM) using ICTs and OR in the period of 2010-2013. A statistical analysis of the eighty-seven most relevant publications is presented, encompassing the ICTs and OR methods adopted in SWM, the processes of solid-waste management where they were adopted, and which countries are investigating solutions for the management of solid waste. A detailed discussion on how the ICTs and OR methods have been combined in the solutions was also presented. The analysis and discussion provided aims to help researchers and managers to gather insights on technologies/methods suitable the SWM challenges they have at hand, and on gaps that can be explored regarding technologies/methods that could be useful as well as the processes in SWM that currently do not benefit from using ICTs and OR methods. Copyright © 2016 Elsevier Ltd. All rights reserved.

Choosing treatment and screening options congruent with values: Do decision aids help? Sub-analysis of a systematic review.

PubMed

Munro, Sarah; Stacey, Dawn; Lewis, Krystina B; Bansback, Nick

2016-04-01

To understand how well patients make value congruent decisions with and without patient decision aids (PtDAs) for screening and treatment options, and identify issues with its measurement and evaluation. A sub-analysis of trials included in the 2014 Cochrane Review of Decision Aids. Eligible trials measured value congruence with chosen option. Two reviewers independently screened 115 trials. Among 18 included trials, 8 (44%) measured value congruence using the Multidimensional Measure of Informed Choice (MMIC), 7 (39%) used heterogeneous methods, and 3 (17%) used unclear methods. Pooled results of trials that used heterogeneous measures were statistically non-significant (n=3). Results from trials that used the MMIC suggest patients are 48% more likely to make value congruent decisions when exposed to a PtDA for a screening decision (RR 1.48, 95% CI 1.01 to 2.16, n=8). Patients struggle to make value congruent decisions, but PtDAs may help. While the absolute improvement is relatively small it may be underestimated due to sample size issues, definitions, and heterogeneity of measures. Current approaches are inadequate to support patients making decisions that are consistent with their values. There is some evidence that PtDAs support patients with achieving values congruent decisions for screening choices. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Preparedness for End of Life-a Survey of Jerusalem District Nursing Homes.

PubMed

Shaulov, Adir; Frankel, Meir; Rubinow, Alan; Maaravi, Yoram; Brezis, Mayer

2015-10-01

To evaluate the quality of end-of-life (EOL) care in nursing homes. Survey and semistructured interviews. Jerusalem district nursing homes. Staff members of 28 long-term care and skilled nursing facilities in the Jerusalem area in Israel of various ethnic, religious, and administrative affiliations (N = 207). Qualitative analysis of semistructured interviews and statistical analysis of questionnaires. Most staff members reported that EOL preferences were unknown for more than 90% of residents and that fewer than 10% had a healthcare proxy. Most staff members recalled conducting fewer than five EOL conversations over the past year with residents or family members and could recall fewer than five cases in which a resident was allowed to die in the nursing home. According to staff opinions the prevalence of tube feeding was estimated at greater than 10%, initiated because of aspiration, malnutrition, and understaffing, often against family's preferences. More than 25% of staff members believed that pain management was inadequate. Knowledge about management of chronic pain was poor in half of nurses and nearly one-third of physicians. Most staff would rather not receive the treatments they administered to residents. Nursing homes in Jerusalem lack competency for quality EOL care, and there are multiple psychological, training, and policy challenges to improvement. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Household Response to Inadequate Sewerage and Garbage Collection Services in Abuja, Nigeria

PubMed Central

2017-01-01

Provision of sanitation and garbage collection services is an important and yet challenging issue in the rapidly growing cities of developing countries, with significant human health and environmental sustainability implications. Although a growing number of studies have investigated the consequences of inadequate delivery of basic urban services in developing countries, few studies have examined how households cope with the problems. Using the Exit, Voice, Loyalty, and Neglect (EVLN) model, this article explores how households respond to inadequate sewerage and garbage collection services in Abuja, Nigeria. Based on a qualitative study, data were gathered from in-depth interviews with sixty households, complemented with personal observation. The findings from grounded analysis indicated that majority (62%) and about half (55%) of the respondents have utilized the informal sector for sewerage services and garbage collection, respectively, to supplement the services provided by the city. While 68% of the respondents reported investing their personal resources to improve the delivery of existing sewerage services, half (53%) have collectively complained to the utility agency and few (22%) have neglected the problems. The paper concludes by discussing the public health and environmental sustainability implications of the findings. PMID:28634496

Inadequate ventilation for nosocomial tuberculosis prevention in public hospitals in Central Thailand.

PubMed

Jiamjarasrangsi, W; Bualert, S; Chongthaleong, A; Chaindamporn, A; Udomsantisuk, N; Euasamarnjit, W

2009-04-01

Forty-two community and general hospitals in central Thailand. To examine the adequacy of indoor ventilation for nosocomial tuberculosis (TB) prevention in public hospitals in central Thailand. A cross-sectional survey was conducted among 323 patient care and ancillary areas in the target hospitals. Data on indoor ventilation rate were collected by the tracer gas method and reported as air changes per hour (ACH). The adequacy of the measured ventilation rates were then determined by comparison with the international recommended standard values. Indoor ventilation rates were inadequate in almost half of the studied areas (144/323, 44.6%). The inadequacy was particularly serious in the emergency rooms (ERs) and radiological areas, where 73.8% (31/42 each) of the rooms had ACH below the recommended standards. Detailed analysis showed that most of the rooms with natural ventilation had air exchange rates that exceeded the recommended standards, while the opposite was the case for rooms with air-conditioning, particularly the window or wall-mount type. Indoor ventilation in high-risk nosocomial TB areas in public hospitals in Thailand was inadequate due to the installation of air-conditioning systems in modern buildings.

Cognitive Attributes, Attention, and Self-Efficacy of Adequate and Inadequate Responders in a Fourth Grade Reading Intervention

PubMed Central

Cho, Eunsoo; Roberts, Garrett J.; Capin, Philip; Roberts, Greg; Miciak, Jeremy; Vaughn, Sharon

2015-01-01

We examined cognitive attributes, attention, and self-efficacy of fourth grade struggling readers who were identified as adequate responders (n = 27), inadequate responders with comprehension only deficits (n = 46), and inadequate responders with comprehension and word reading deficits (n = 52) after receiving a multicomponent reading intervention. We also included typical readers (n = 40). These four groups were compared on measures of nonverbal reasoning, working memory, verbal knowledge, listening comprehension, phonological awareness, and rapid naming as well as on teacher ratings of attention problems and self-reported self-efficacy. The two inadequate responder groups demonstrated difficulties primarily with verbal knowledge and listening comprehension compared to typical readers and adequate responders. Phonological awareness and rapid naming differentiated the two inadequate responder groups. In addition, both inadequate responder groups showed more attention problems and low self-efficacy compared to typical readers. PMID:26997755

What's statistical about learning? Insights from modelling statistical learning as a set of memory processes

PubMed Central

2017-01-01

Statistical learning has been studied in a variety of different tasks, including word segmentation, object identification, category learning, artificial grammar learning and serial reaction time tasks (e.g. Saffran et al. 1996 Science 274, 1926–1928; Orban et al. 2008 Proceedings of the National Academy of Sciences 105, 2745–2750; Thiessen & Yee 2010 Child Development 81, 1287–1303; Saffran 2002 Journal of Memory and Language 47, 172–196; Misyak & Christiansen 2012 Language Learning 62, 302–331). The difference among these tasks raises questions about whether they all depend on the same kinds of underlying processes and computations, or whether they are tapping into different underlying mechanisms. Prior theoretical approaches to statistical learning have often tried to explain or model learning in a single task. However, in many cases these approaches appear inadequate to explain performance in multiple tasks. For example, explaining word segmentation via the computation of sequential statistics (such as transitional probability) provides little insight into the nature of sensitivity to regularities among simultaneously presented features. In this article, we will present a formal computational approach that we believe is a good candidate to provide a unifying framework to explore and explain learning in a wide variety of statistical learning tasks. This framework suggests that statistical learning arises from a set of processes that are inherent in memory systems, including activation, interference, integration of information and forgetting (e.g. Perruchet & Vinter 1998 Journal of Memory and Language 39, 246–263; Thiessen et al. 2013 Psychological Bulletin 139, 792–814). From this perspective, statistical learning does not involve explicit computation of statistics, but rather the extraction of elements of the input into memory traces, and subsequent integration across those memory traces that emphasize consistent information (Thiessen and Pavlik 2013 Cognitive Science 37, 310–343). This article is part of the themed issue ‘New frontiers for statistical learning in the cognitive sciences'. PMID:27872374

What's statistical about learning? Insights from modelling statistical learning as a set of memory processes.

PubMed

Thiessen, Erik D

2017-01-05

Statistical learning has been studied in a variety of different tasks, including word segmentation, object identification, category learning, artificial grammar learning and serial reaction time tasks (e.g. Saffran et al. 1996 Science 274: , 1926-1928; Orban et al. 2008 Proceedings of the National Academy of Sciences 105: , 2745-2750; Thiessen & Yee 2010 Child Development 81: , 1287-1303; Saffran 2002 Journal of Memory and Language 47: , 172-196; Misyak & Christiansen 2012 Language Learning 62: , 302-331). The difference among these tasks raises questions about whether they all depend on the same kinds of underlying processes and computations, or whether they are tapping into different underlying mechanisms. Prior theoretical approaches to statistical learning have often tried to explain or model learning in a single task. However, in many cases these approaches appear inadequate to explain performance in multiple tasks. For example, explaining word segmentation via the computation of sequential statistics (such as transitional probability) provides little insight into the nature of sensitivity to regularities among simultaneously presented features. In this article, we will present a formal computational approach that we believe is a good candidate to provide a unifying framework to explore and explain learning in a wide variety of statistical learning tasks. This framework suggests that statistical learning arises from a set of processes that are inherent in memory systems, including activation, interference, integration of information and forgetting (e.g. Perruchet & Vinter 1998 Journal of Memory and Language 39: , 246-263; Thiessen et al. 2013 Psychological Bulletin 139: , 792-814). From this perspective, statistical learning does not involve explicit computation of statistics, but rather the extraction of elements of the input into memory traces, and subsequent integration across those memory traces that emphasize consistent information (Thiessen and Pavlik 2013 Cognitive Science 37: , 310-343).This article is part of the themed issue 'New frontiers for statistical learning in the cognitive sciences'. © 2016 The Author(s).

Effect of a Video-Assisted Teaching Program for Kegel's Exercises on Women's Knowledge About Urinary Incontinence.

PubMed

Seshan, Vidya; Muliira, Joshua Kanaabi

2015-01-01

The aim of this study was to assess community-dwelling women's knowledge about urinary incontinence (UI) and the effectiveness of a Video Assisted Teaching Program for Kegel's Exercises (VATPKE) in increasing their knowledge. A cross-sectional design was used to collect data from 598 community-dwelling women. A pre-/posttest design was then used to assess the effectiveness of the VATPKE in improving knowledge about UI in women with self-reported UI (202) and without UI (396). Data were analyzed using independent and paired t tests. Of the 598 participants, 33.8% self-reported having UI. The majority of women with UI (90%) and without UI (90%) had inadequate knowledge. The mean post-VATPKE knowledge levels of women with and without UI were higher than pre-VATPKE mean scores. Differences in knowledge levels in women with and without UI were statistically significant (P < .001). Most of the women at risk or already affected with UI have inadequate knowledge about the condition. In a resource-poor setting with limited health care human resources to provide one-on-one health education, interventions such as the VATPKE may help improve knowledge about UI among the large numbers of affected and at-risk women.

Ascertainment of risk of serious adverse reactions associated with chemoprophylactic antimalarial drugs.

PubMed Central

Phillips-Howard, P. A.; Bjorkman, A. B.

1990-01-01

Serious adverse reactions during malaria chemoprophylaxis are reviewed. Three drugs considered to have caused serious reactions in recent years are pyrimethamine/sulfadoxine (Fansidar), pyrimethamine/dapsone (Maloprim) and amodiaquine. These reactions are principally independent of dose and cannot be determined during screening for optimal doses. However, host factors may precipitate dose-dependent reactions, some of which could be avoided with improvements in drug licensing. Since serious and life-threatening reactions are relatively rare (between 1:1000 and 1:20,000), Phase I to III trials cannot identify them. Reliance must therefore be placed on Phase IV post-marketing studies, including ongoing reviews of national registers, and specially tailored studies to identify the risk using prescription-event monitoring in high-risk populations. Occasionally, medical-record linkage, case-control and cohort studies may provide supportive data. Although large numbers of travellers must, of necessity, be exposed to a drug before relatively rare reactions are identified, the ascertainment of risk using post-marketing surveillance was prevented by the following five deficiencies: lack of awareness of early alerts, inadequate use of national registers, poor attention to epidemiological and statistical rigour, inadequate verification of denominators, and inadequacy of data records. Recommendations are given for minimizing such errors in the future. PMID:2208562

DIET MICRONUTRIENT ADEQUACY OF WOMEN AFTER 1 YEAR OF GASTRIC BYPASS

PubMed Central

LEIRO, Larissa Silveira; Melendez-ARAÚJO, Mariana Silva

2014-01-01

Background The more effective treatment for severe obesity is bariatric surgery. Gastric bypass is a surgical technique used worldwide; however, as well as other techniques; it has postoperative risks, including nutrient deficiency. Aim To determine the amounts of dietary iron, calcium, vitamin D and vitamin B12 ingested by patients of a public hospital one year after gastric bypass, and compare with the recommendations of the Recommended Dietary Allowances. Methods This was a transverse descriptive study and the sample consisted of 36 women, with at least one year of gastric bypass. Data collected included sociodemographic, anthropometric and diet variables. Dietetic information was collected through a validated food frequency questionnaire. Ingestion of iron, calcium, vitamin D and vitamina B12 was evaluated in comparison with the Recommended Dietary Allowances, as well as correlation of micronutrient ingestion with time of surgery. Results There was inadequate consumption of iron, calcium and vitamin D. The vitamin B12 intake was considered adequate. There was statistically significant positive correlation between the time of surgery and the ingestion of iron, vitamin B12 and vitamin D. Conclusion The intake of iron, calcium and vitamin D of women one year after gastric bypass was inadequate, emphasizing the importance of multiprofessional monitoring postoperatively to prevent nutrient deficiencies. PMID:25409960

Combining nutrient intake from food/beverages and vitamin/mineral supplements.

PubMed

Garriguet, Didier

2010-12-01

To calculate total intake of a nutrient and estimate inadequate intake for a population, the amounts derived from food/beverages and from vitamin/mineral supplements must be combined. The two methods Statistics Canada has suggested present problems of interpretation. Data collected from 34,386 respondents to the 2004 Canadian Community Health Survey-Nutrition were used to compare four methods of combining nutrient intake from food/beverages and vitamin/mineral supplements: adding average intake from supplements to the 24-hour food/beverage recall and estimating the usual distribution in the population (Method 1); estimating usual individual intake from food? beverages and adding intake from supplements (Method 2); and dividing the population into supplement users and non-users and applying Method 1 or Method 2 and combining the estimates based on the percentages of users and non-users (Methods 3 and 4). Interpretation problems arise with Methods 1 and 2; for example, the percentage of the population with inadequate intake of vitamin C and folate equivalents falls outside the expected minimum-maximum range. These interpretation problems are not observed with Methods 3 and 4. Interpretation problems that may arise in combining food and supplement intake of a given nutrient are overcome if the population is divided into supplement users and non-users before Method 1 or Method 2 is applied.

Knowledge, Attitude and Practices (KAP) Survey on Water, Sanitation and Hygiene in Selected Schools in Vhembe District, Limpopo, South Africa

PubMed Central

Sibiya, Jerry E.; Gumbo, Jabulani Ray

2013-01-01

This study assessed the knowledge, attitude and practices (KAP) of learners on issues related to water, sanitation and hygiene in selected schools in Vhembe District, South Africa. The methodology relied on a questionnaire, an inspection of sanitary facilities and discussion with the school authorities. The data was analyzed using the Statistical Package for Social Science. The study revealed that the level of knowledge about waterborne diseases was relatively high (76.7 ± 1.75%), but knowledge on transmission routes was inadequate. The majority of the respondents had no knowledge when it comes to water-based diseases and their prevention (78.4 ± 1.71%).The attitude and practice on hygiene was also found to be high (91.40 ± 1.16%). Some schools from the urban area had proper handwashing facilities, but there was no soap available. The borehole water quality for rural schools appeared clear, but the microbial quality was unknown. The water supply and sanitation facilities were inadequate in rural schools, with no handwashing areas and no sanitary bins for girls. Some schools had toilets with broken doors which did not offer privacy. The only water tap, located at the centre of the school premises, was not enough for the whole school community. PMID:23736657

Working conditions that contribute to absenteeism among nurses in a provincial hospital in the Limpopo Province.

PubMed

Nyathi, M; Jooste, K

2008-03-01

Absenteeism results in an increased workload for nurses who stand in for colleagues and can lead to situations in which a lack of motivation among nurses and a lowering of the quality of patient care may occur. The researcher observed that certain conditions, such as inflexible working schedules, were given as reasons for the absenteeism in units in a provincial hospital. A non-experimental, descriptive, quantitative study was undertaken. The purpose of the article was to describe the working conditions that contribute to absenteeism among the professional and sub-professional nurses at a provincial hospital in the Limpopo province of South Africa. The sample included 107 professional nurses and 163 sub-professional nurses who voluntarily agreed to participate in the study. A questionnaire was used to collect data, which was analysed by using descriptive and inferential statistics. The findings of this study indicated that personal and managerial characteristics, and organisational and working conditions may lead to absenteeism in the workplace. This article focuses on the working conditions that are constraints, namely inadequate group cohesion, inadequate delegation of autonomy, role ambiguity, ineffective routinisation and the effect of the workload in the workplace. Recommendations are made for improving working conditions to combat absenteeism among nurses. The limitations of this study are highlighted.

Environmental cancer risks

NASA Astrophysics Data System (ADS)

Bell, Peter M.

In a long-awaited report (‘Assessment of Technologies for Determining Cancer Risks From the Environment’), the U.S. Office of Technology Assessment (OTA) has evaluated the role of environmental factors in cancer diseases. Environment is interpreted broadly as encompassing anything that interacts with humans, including the natural environment, food, radiation, the workplace, etc. Geologic factors range from geographic location to radiation and specific minerals. The report, however, is based on an inadequate data base in most instances, and its major recommendations are related to the establishment of a national cancer registry to record cancer statistics, as is done for many other diseases. Presently, hard statistics are lacking in the establishment of some association between the cause-effect relationship of most environmental factors and most carcinogens. Of particular interest, but unfortunately based on unreliable data, are the effects of mineral substances such as ‘asbestos.’ USGS mineralogist Malcolm Ross will review asbestos and its effects on human health in the forthcoming Mineralogical Society of America's Short Course on the Amphiboles (Reviews in Mineralogy, 9, in press, 1981).

Modelling of peak temperature during friction stir processing of magnesium alloy AZ91

NASA Astrophysics Data System (ADS)

Vaira Vignesh, R.; Padmanaban, R.

2018-02-01

Friction stir processing (FSP) is a solid state processing technique with potential to modify the properties of the material through microstructural modification. The study of heat transfer in FSP aids in the identification of defects like flash, inadequate heat input, poor material flow and mixing etc. In this paper, transient temperature distribution during FSP of magnesium alloy AZ91 was simulated using finite element modelling. The numerical model results were validated using the experimental results from the published literature. The model was used to predict the peak temperature obtained during FSP for various process parameter combinations. The simulated peak temperature results were used to develop a statistical model. The effect of process parameters namely tool rotation speed, tool traverse speed and shoulder diameter of the tool on the peak temperature was investigated using the developed statistical model. It was found that peak temperature was directly proportional to tool rotation speed and shoulder diameter and inversely proportional to tool traverse speed.

Why Bayesian Psychologists Should Change the Way They Use the Bayes Factor.

PubMed

Hoijtink, Herbert; van Kooten, Pascal; Hulsker, Koenraad

2016-01-01

The discussion following Bem's ( 2011 ) psi research highlights that applications of the Bayes factor in psychological research are not without problems. The first problem is the omission to translate subjective prior knowledge into subjective prior distributions. In the words of Savage ( 1961 ): "they make the Bayesian omelet without breaking the Bayesian egg." The second problem occurs if the Bayesian egg is not broken: the omission to choose default prior distributions such that the ensuing inferences are well calibrated. The third problem is the adherence to inadequate rules for the interpretation of the size of the Bayes factor. The current paper will elaborate these problems and show how to avoid them using the basic hypotheses and statistical model used in the first experiment described in Bem ( 2011 ). It will be argued that a thorough investigation of these problems in the context of more encompassing hypotheses and statistical models is called for if Bayesian psychologists want to add a well-founded Bayes factor to the tool kit of psychological researchers.

Physiological effects of indomethacin and celecobix: an S-transform laser Doppler flowmetry signal analysis

NASA Astrophysics Data System (ADS)

Assous, S.; Humeau, A.; Tartas, M.; Abraham, P.; L'Huillier, J. P.

2005-05-01

Conventional signal processing typically involves frequency selective techniques which are highly inadequate for nonstationary signals. In this paper, we present an approach to perform time-frequency selective processing of laser Doppler flowmetry (LDF) signals using the S-transform. The approach is motivated by the excellent localization, in both time and frequency, afforded by the wavelet basis functions. Suitably chosen Gaussian wavelet functions are used to characterize the subspace of signals that have a given localized time-frequency support, thus enabling a time-frequency partitioning of signals. In this paper, the goal is to study the influence of various pharmacological substances taken by the oral way (celecobix (Celebrex®), indomethacin (Indocid®) and placebo) on the physiological activity behaviour. The results show that no statistical differences are observed in the energy computed from the time-frequency representation of LDF signals, for the myogenic, neurogenic and endothelial related metabolic activities between Celebrex and placebo, and Indocid and placebo. The work therefore proves that these drugs do not affect these physiological activities. For future physiological studies, there will therefore be no need to exclude patients having taken cyclo-oxygenase 1 inhibitions.

Analysis of neurodegenerative Mendelian genes in clinically diagnosed Alzheimer Disease

PubMed Central

Fernández, Maria Victoria; Kim, Jong Hun; Budde, John P.; Black, Kathleen; Medvedeva, Alexandra; Saef, Ben; Del-Aguila, Jorge; Ibañez, Laura; Dube, Umber; Harari, Oscar; Norton, Joanne; Chasse, Rachel; Morris, John C.; Goate, Alison

2017-01-01

Alzheimer disease (AD), Frontotemporal lobar degeneration (FTD), Amyotrophic lateral sclerosis (ALS) and Parkinson disease (PD) have a certain degree of clinical, pathological and molecular overlap. Previous studies indicate that causative mutations in AD and FTD/ALS genes can be found in clinical familial AD. We examined the presence of causative and low frequency coding variants in the AD, FTD, ALS and PD Mendelian genes, in over 450 families with clinical history of AD and over 11,710 sporadic cases and cognitive normal participants from North America. Known pathogenic mutations were found in 1.05% of the sporadic cases, in 0.69% of the cognitively normal participants and in 4.22% of the families. A trend towards enrichment, albeit non-significant, was observed for most AD, FTD and PD genes. Only PSEN1 and PINK1 showed consistent association with AD cases when we used ExAC as the control population. These results suggest that current study designs may contain heterogeneity and contamination of the control population, and that current statistical methods for the discovery of novel genes with real pathogenic variants in complex late onset diseases may be inadequate or underpowered to identify genes carrying pathogenic mutations. PMID:29091718

Research: increasing value, reducing waste 2

PubMed Central

Ioannidis, John P A; Greenland, Sander; Hlatky, Mark A; Khoury, Muin J; Macleod, Malcolm R; Moher, David; Schulz, Kenneth F; Tibshirani, Robert

2015-01-01

Correctable weaknesses in the design, conduct, and analysis of biomedical and public health research studies can produce misleading results and waste valuable resources. Small effects can be difficult to distinguish from bias introduced by study design and analyses. An absence of detailed written protocols and poor documentation of research is common. Information obtained might not be useful or important, and statistical precision or power is often too low or used in a misleading way. Insufficient consideration might be given to both previous and continuing studies. Arbitrary choice of analyses and an overemphasis on random extremes might affect the reported findings. Several problems relate to the research workforce, including failure to involve experienced statisticians and methodologists, failure to train clinical researchers and laboratory scientists in research methods and design, and the involvement of stakeholders with conflicts of interest. Inadequate emphasis is placed on recording of research decisions and on reproducibility of research. Finally, reward systems incentivise quantity more than quality, and novelty more than reliability. We propose potential solutions for these problems, including improvements in protocols and documentation, consideration of evidence from studies in progress, standardisation of research efforts, optimisation and training of an experienced and non-conflicted scientific workforce, and reconsideration of scientific reward systems. PMID:24411645

The future of the New Zealand plastic surgery workforce.

PubMed

Adams, Brandon M; Klaassen, Michael F; Tan, Swee T

2013-04-05

The New Zealand (NZ) plastic and reconstructive surgery (PRS) workforce provides reconstructive plastic surgery (RPS) public services from six centres. There has been little analysis on whether the workforce is adequate to meet the needs of the NZ population currently or in the future. This study analysed the current workforce, its distribution and future requirements. PRS manpower data, workforce activities, population statistics, and population modelling were analysed to determine current needs and predict future needs for the PRS workforce. The NZ PRS workforce is compared with international benchmarks. Regional variation of the workforce was analysed with respect to the population's access to PRS services. Future supply of specialist plastic surgeons is analysed. NZ has a lower number of plastic surgeons per capita than comparable countries. The current NZ PRS workforce is mal-distributed. Areas of current and emerging future need are identified. The current workforce mal-distribution will worsen with future population growth and distribution. Up to 60% of the NZ population will be at risk of inadequate access to PRS services by 2027. Development of PRS services must be coordinated to ensure that equitable and sustainable services are available throughout NZ. Strategies for ensuring satisfactory future workforce are discussed.

Identification of Vehicle Health Assurance Related Trends

NASA Technical Reports Server (NTRS)

Phojanamongkolkij, Nipa; Evans, Joni K.; Barr, Lawrence C.; Leone, Karen M.; Reveley, Mary S.

2014-01-01

Trend analysis in aviation as related to vehicle health management (VHM) was performed by reviewing the most current statistical and prognostics data available from the National Transportation Safety Board (NTSB) accident, the Federal Aviation Administration (FAA) incident, and the NASA Aviation Safety Reporting System (ASRS) incident datasets. In addition, future directions in aviation technology related to VHM research areas were assessed through the Commercial Aviation Safety Team (CAST) Safety Enhancements Reserved for Future Implementations (SERFIs), the National Transportation Safety Board (NTSB) Most-Wanted List and recent open safety recommendations, the National Research Council (NRC) Decadal Survey of Civil Aeronautics, and the Future Aviation Safety Team (FAST) areas of change. Future research direction in the VHM research areas is evidently strong as seen from recent research solicitations from the Naval Air Systems Command (NAVAIR), and VHM-related technologies actively being developed by aviation industry leaders, including GE, Boeing, Airbus, and UTC Aerospace Systems. Given the highly complex VHM systems, modifications can be made in the future so that the Vehicle Systems Safety Technology Project (VSST) technical challenges address inadequate maintenance crew's trainings and skills, and the certification methods of such systems as recommended by the NTSB, NRC, and FAST areas of change.

[Depressive disorder and issues related to DiabetIMSS beneficiaries].

PubMed

Fu-Espinosa, Mario; Trujillo-Olivera, Laura Elena

2013-01-01

Diabetes mellitus type 2 (DM2) is the leading cause of death in people from 15 to 64 years in Mexico, and other regions in the world. For the chronic nature of diabetes and complications caused by inadequate metabolic control, patients may have mood disorders such as depression. Several studies have demonstrated higher prevalence of depression in diabetic patients than in general population. Our objective: is to determine prevalence and factors associated with depressive disorder in patients with type 2 diabetes mellitus enrolled in DiabetIMSS during 2010. Analytical study with random probability sampling. The analysis included prevalence, odds ratios with 95% confidence intervals. The Center Epidemiological Studies Depression Instrument was used. Prevalence of depression was 32.7% at 95% CI = 26.4-38.9%), 67.3% for women, 32.7 % for men; good metabolic control was 51.9%, CI = 95% (45.13-58.66%). We found a higher prevalence of depressive disorders than in the general population, no statistical association with glycemic control, keeping a greater proportion of women as well as the main aspect of depression associated with the perception of emotional support. We discuss DiabetIMSS program effectiveness.

Medication calculation skills of graduating nursing students in Finland.

PubMed

Grandell-Niemi, H; Hupli, M; Leino-Kilpi, H

2001-01-01

The aim of this study was to describe the basic mathematical proficiency and the medication calculation skills of graduating nursing students in Finland. A further concern was with how students experienced the teaching of medication calculation. We wanted to find out whether these experiences were associated with various background factors and the students' medication calculation skills. In spring 1997 the population of graduating nursing students in Finland numbered around 1280; the figure for the whole year was 2640. A convenience sample of 204 students completed a questionnaire specially developed for this study. The instrument included structured questions, statements and a medication calculation test. The response rate was 88%. Data analysis was based on descriptive statistics. The students found it hard to learn mathematics and medication calculation skills. Those who evaluated their mathematical and medication calculation skills as sufficient successfully solved the problems included in the questionnaire. It was felt that the introductory course on medication calculation was uninteresting and poorly organised. Overall the students' mathematical skills were inadequate. One-fifth of the students failed to pass the medication calculation test. A positive correlation was shown between the student's grade in mathematics (Sixth Form College) and her skills in medication calculation.

JOURNAL CLUB: Assessment of Interobserver Variability in the Peer Review Process: Should We Agree to Disagree?

PubMed

Verma, Nupur; Hippe, Daniel S; Robinson, Jeffrey D

2016-12-01

Peer review is an important and necessary part of radiology. There are several options to perform the peer review process. This study examines the reproducibility of peer review by comparing two scoring systems. American Board of Radiology-certified radiologists from various practice environments and subspecialties were recruited to score deidentified examinations on a web-based PACS with two scoring systems, RADPEER and Cleareview. Quantitative analysis of the scores was performed for interrater agreement. Interobserver variability was high for both the RADPEER and Cleareview scoring systems. The interobserver correlations (kappa values) were 0.17-0.23 for RADPEER and 0.10-0.16 for Cleareview. Interrater correlation was not statistically significantly different when comparing the RADPEER and Cleareview systems (p = 0.07-0.27). The kappa values were low for the Cleareview subscores when we evaluated for missed findings (0.26), satisfaction of search (0.17), and inadequate interpretation of findings (0.12). Our study confirms the previous report of low interobserver correlation when using the peer review process. There was low interobserver agreement seen when using both the RADPEER and the Cleareview scoring systems.

Estimating the intensity of ward admission and its effect on emergency department access block.

PubMed

Luo, Wei; Cao, Jiguo; Gallagher, Marcus; Wiles, Janet

2013-07-10

Emergency department access block is an urgent problem faced by many public hospitals today. When access block occurs, patients in need of acute care cannot access inpatient wards within an optimal time frame. A widely held belief is that access block is the end product of a long causal chain, which involves poor discharge planning, insufficient bed capacity, and inadequate admission intensity to the wards. This paper studies the last link of the causal chain-the effect of admission intensity on access block, using data from a metropolitan hospital in Australia. We applied several modern statistical methods to analyze the data. First, we modeled the admission events as a nonhomogeneous Poisson process and estimated time-varying admission intensity with penalized regression splines. Next, we established a functional linear model to investigate the effect of the time-varying admission intensity on emergency department access block. Finally, we used functional principal component analysis to explore the variation in the daily time-varying admission intensities. The analyses suggest that improving admission practice during off-peak hours may have most impact on reducing the number of ED access blocks. Copyright © 2012 John Wiley & Sons, Ltd.

Impact of urban atmospheric environment on hospital admissions in the elderly.

PubMed

Silva, Edelci Nunes da; Ribeiro, Helena

2012-08-01

To analyze the impact of intra-urban atmospheric conditions on circulatory and respiratory diseases in elder adults. Cross-sectional study based on data from 33,212 hospital admissions in adults over 60 years in the city of São Paulo, southeastern Brazil, from 2003 to 2007. The association between atmospheric variables from Congonhas airport and bioclimatic index, Physiological Equivalent Temperature, was analyzed according to the district's socioenvironmental profile. Descriptive statistical analysis and regression models were used. There was an increase in hospital admissions due to circulatory diseases as average and lowest temperatures decreased. The likelihood of being admitted to the hospital increased by 12% with 1ºC decrease in the bioclimatic index and with 1ºC increase in the highest temperatures in the group with lower socioenvironmental conditions. The risk of admission due to respiratory diseases increased with inadequate air quality in districts with higher socioenvironmental conditions. The associations between morbidity and climate variables and the comfort index varied in different groups and diseases. Lower and higher temperatures increased the risk of hospital admission in the elderly. Districts with lower socioenvironmental conditions showed greater adverse health impacts.

Vitamin D status among long-term survivors of testicular cancer.

PubMed

Schepisi, Giuseppe; De Padova, Silvia; Scarpi, Emanuela; Lolli, Cristian; Gurioli, Giorgia; Menna, Cecilia; Burgio, Salvatore L; Rossi, Lorena; Gallà, Valentina; Casadio, Valentina; Salvi, Samanta; Conteduca, Vincenza; De Giorgi, Ugo

2017-05-30

A correlation between disturbances in hormone levels and the onset of metabolic disorders has been reported in long-term survivors of testicular cancer (TC).We evaluated serum vitamin D levels and other biological parameters in a consecutive series of 61 long-term (≥3 years) unilateral TC survivors with a median a follow-up of 4 years and in a cohort of healthy males. Deficient vitamin D levels were observed in 10 (17%) of the 58 long-term unilateral TC survivors but were not reported in healthy males (p=.019, Fisher test). Median vitamin D levels were 18.6 ug/L in 58 assessable TC survivors and 23.6 ug/L in 40 healthy males (p=.031). In univariate logistic regression analysis, TC diagnosis was associated with inadequate levels of vitamin D (p=.047). Vitamin D levels were lower when follow-up was > 10 years, albeit this difference was not statistically significant (p=.074). Long-term (especially > 10 years) TC survivors may have difficulty maintaining optimal vitamin D levels. Larger studies are needed to better characterize vitamin D status and possible correlations with premature hormonal aging reported in long-term TC survivors.

Error-in-variables models in calibration

NASA Astrophysics Data System (ADS)

Lira, I.; Grientschnig, D.

2017-12-01

In many calibration operations, the stimuli applied to the measuring system or instrument under test are derived from measurement standards whose values may be considered to be perfectly known. In that case, it is assumed that calibration uncertainty arises solely from inexact measurement of the responses, from imperfect control of the calibration process and from the possible inaccuracy of the calibration model. However, the premise that the stimuli are completely known is never strictly fulfilled and in some instances it may be grossly inadequate. Then, error-in-variables (EIV) regression models have to be employed. In metrology, these models have been approached mostly from the frequentist perspective. In contrast, not much guidance is available on their Bayesian analysis. In this paper, we first present a brief summary of the conventional statistical techniques that have been developed to deal with EIV models in calibration. We then proceed to discuss the alternative Bayesian framework under some simplifying assumptions. Through a detailed example about the calibration of an instrument for measuring flow rates, we provide advice on how the user of the calibration function should employ the latter framework for inferring the stimulus acting on the calibrated device when, in use, a certain response is measured.

Evaluation of reporting quality for observational studies using routinely collected health data in pharmacovigilance.

PubMed

Nie, Xiaolu; Zhang, Ying; Wu, Zehao; Jia, Lulu; Wang, Xiaoling; Langan, Sinéad M; Benchimol, Eric I; Peng, Xiaoxia

2018-06-01

To appraise the reporting quality of studies which concerned linezolid related thrombocytopenia referring to REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement. Medline, Embase, Cochrane library and clinicaltrial.gov were searched for observational studies concerning linezolid related thrombocytopenia using routinely collected health data from 2000 to 2017. Two reviewers screened potential eligible articles and extracted data independently. Finally, reporting quality assessment was performed by two senior researchers using RECORD statement. Of 25 included studies, 11 (44.0%) mentioned the type of data in the title and/or abstract. In 38 items derived from RECORD statement, the median number of items reported in the included studies was 22 (interquartile range (IQR) 18 to 27). Inadequate reporting issues were discovered in the following aspects: validation studies of the codes or algorithms, study size estimation, quantitative variables, subgroup statistical methods, missing data, follow-up/matching or sampling strategy, sensitivity analysis and cleaning methods, funding and role of funders and accessibility of protocol, raw data. This study provides the evidence that the reporting quality of post-marketing safety evaluation studies conducted using routinely collected health data was often insufficient. Future stakeholders are encouraged to endorse the RECORD guidelines in pharmacovigilance.

Cultural change and traditional ecological knowledge. An empirical analysis from the Tsimane' in the Bolivian Amazon.

PubMed

Reyes-García, Victoria; Paneque-Gálvez, Jaime; Luz, Ana C; Gueze, Maximilien; Macía, Manuel J; Orta-Martínez, Martí; Pino, Joan

2014-01-01

Among the different factors associated to change in traditional ecological knowledge, the study of the relations between cultural change and traditional ecological knowledge has received scan and inadequate scholarly attention. Using data from indigenous peoples of an Amazonian society facing increasing exposure to the mainstream Bolivian society, we analyzed the relation between traditional ecological knowledge, proxied with individual plant use knowledge (n=484), and cultural change, proxied with individual- and village-level (n=47) measures of attachment to traditional beliefs and values. We found that both the individual level of detachment to traditional values and the village level of agreement in detachment to traditional values were associated with individual levels of plant use knowledge, irrespective of other proxy measures for cultural change. Because both the individual- and the village-level variables bear statistically significant associations with plant use knowledge, our results suggest that both the individual- and the supra-individual level processes of cultural change are related to the erosion of plant use knowledge. Results from our work highlight the importance of analyzing processes that happen at intermediary social units -the village in our case study- to explain changes in traditional ecological knowledge.

Effectiveness of a first-aid intervention program applied by undergraduate nursing students to preparatory school children.

PubMed

Wafik, Wagida; Tork, Hanan

2014-03-01

Childhood injuries constitute a major public health problem worldwide. First aid is an effective life-preservation tool at work, school, home, and in public locations. In this study, the effectiveness of a first-aid program delivered by undergraduate nursing students to preparatory school children was examined. This quasi-experimental study was carried out on 100 school children in governmental preparatory schools in Egypt. The researchers designed a program for first-aid training, and this was implemented by trained nursing students. The evaluation involved immediate post-test and follow-up assessment after two months. The results showed generally low levels of satisfactory knowledge and inadequate situational practice among the school students before the intervention. Statistically-significant improvements were shown at the post- and follow-up tests. Multivariate regression analysis identified the intervention and the type of school as the independent predictors of the change in students' knowledge score, while the intervention and the knowledge score were the predictors of the practice score. The study concluded that a first-aid training program delivered by nursing students to preparatory school children is effective in improving their knowledge and practice. © 2013 Wiley Publishing Asia Pty Ltd.

Causative factors of cost overrun in highway projects of Sindh province of Pakistan

NASA Astrophysics Data System (ADS)

Sohu, S.; Halid, A.; Nagapan, S.; Fattah, A.; Latif, I.; Ullah, K.

2017-11-01

Cost overrun is an increase of cost of project from approved budget which was signed by parties at the time of tender. Cost overrun in construction of highway projects is a common problem worldwide and construction industry of Pakistan is also facing this crucial problem of cost overrun in highway projects of Pakistan. The main objective of this research is to identify the causative factors of cost overrun in highway projects of Sindh province of Pakistan. A well designed questionnaire was developed based on 64 common factors of cost overrun from literature review. Developed questionnaire was distributed among selected 30 experts from owner/client, designer/consultant and contractor who have experience more than 20 years’ experience in highway projects. The collected data was statistical analyzed. After analysis results showed that delay process in payment by client, inadequate planning, client interference, poor contract management, delay of decision making, change of scope of project and financial problems faced by client were most causative factors of cost overrun in highway projects. This research will provide alertness to stakeholders of highway projects of Sindh province to avoid cost overrun in projects.

Analysis of neurodegenerative Mendelian genes in clinically diagnosed Alzheimer Disease.

PubMed

Fernández, Maria Victoria; Kim, Jong Hun; Budde, John P; Black, Kathleen; Medvedeva, Alexandra; Saef, Ben; Deming, Yuetiva; Del-Aguila, Jorge; Ibañez, Laura; Dube, Umber; Harari, Oscar; Norton, Joanne; Chasse, Rachel; Morris, John C; Goate, Alison; Cruchaga, Carlos

2017-11-01

Alzheimer disease (AD), Frontotemporal lobar degeneration (FTD), Amyotrophic lateral sclerosis (ALS) and Parkinson disease (PD) have a certain degree of clinical, pathological and molecular overlap. Previous studies indicate that causative mutations in AD and FTD/ALS genes can be found in clinical familial AD. We examined the presence of causative and low frequency coding variants in the AD, FTD, ALS and PD Mendelian genes, in over 450 families with clinical history of AD and over 11,710 sporadic cases and cognitive normal participants from North America. Known pathogenic mutations were found in 1.05% of the sporadic cases, in 0.69% of the cognitively normal participants and in 4.22% of the families. A trend towards enrichment, albeit non-significant, was observed for most AD, FTD and PD genes. Only PSEN1 and PINK1 showed consistent association with AD cases when we used ExAC as the control population. These results suggest that current study designs may contain heterogeneity and contamination of the control population, and that current statistical methods for the discovery of novel genes with real pathogenic variants in complex late onset diseases may be inadequate or underpowered to identify genes carrying pathogenic mutations.

Transforming attitudes and lives: Liberating African-American elementary and middle school students in out-of-school time STEM education

NASA Astrophysics Data System (ADS)

Smith, Charisse F.

Statistically, African-Americans, women, and the disabled are underrepresented in the fields of Science, Technology, Engineering, and Math (STEM). Historically, these underrepresented students, are described as being unrecognized and underdeveloped in the American STEM circuit. Many experience deficient and inadequate educational resources, are not encouraged to pursue STEM education and careers, and are confronted with copious obstructions. In this quantitative study, the researcher collected pretest and posttest survey data from a group of 4th, 5th, and 6th-grade African-American students in Title I funded schools. The reseacher used quantitative analysis to determine any significant differences in the science related attitudes between and within groups who participated in Out of School-Time Science, Technology, Engineering, and Mathematics programs and those who did not. Results revealed no significant differences in the science related attitudes between the groups of the students who participated in the Out of School Time-Science, Technology, Engineering, and Mathematics programs and those who did not. Results also revealed no significant differences in the science related attitudes within the groups of students who participated in the Out of School Time-Science, Technology, Engineering, and Mathematics programs and those who did not.

Barriers for dental treatment of primary teeth in East and West Germany.

PubMed

Splieth, Christian H; Bünger, Bianka; Pine, Cynthia

2009-03-01

In many countries, restorative treatment in primary teeth is suboptimal. Thus, this study tried to detect barriers for dentists to restore primary teeth in kindergarten children (3-6 years). For a representative survey, 320 dentists (184 West, 136 East Germany) were randomly selected from the dental associations' registers and asked to answer a questionnaire on their profile, their view of the National Health System, and possible barriers for restoring primary teeth. The analysis (response rate 57.7%) showed that the parents were no barrier and the dentists felt the need of restoring primary teeth. In addition to the children's anxiety, the inadequate reimbursement for fillings were perceived as clear barrier. The comparison of West and East German dentists detected statistically significantly higher barriers in West Germany, where - in contrast to the German Democratic Republic - no structured training in paediatric dentistry was compulsory before unification. Only 35% of the East German dentists rated restorative treatment in 3- to 6-year-olds as stressful in contrast to 65% in West Germany, where especially male dentists found no time to treat children. This study reveals that dentists can also be a considerable barrier to restorative treatment in small children, especially without adequate training in dental schools.

Analysis of the Possible Persistent Genotoxic Damage in Workers Linked to the Ardystil Syndrome.

PubMed

Montoro, Alegria; Sebastià, Natividad; Hervás, David; Esteban, Valentín; Bonafont, Jose; Barquinero, Joan Francesc; Almonacid, Miguel; Cervera, Jose; Such, Esperanza; Verdú, Gumersindo; Soriano, José Miguel; Villaescusa, Juan Ignacio

2016-02-01

A combination of several factors including a change in the paint application system; a lack of proper hygiene; and inadequate safety measures caused a severe health impact in the workers of some textile painting factories. This outbreak, mainly characterized by respiratory disorders, caused the death of six people and it has been classified as Ardystil syndrome. Fifty-two workers involved in the outbreak and 48 healthy subjects not known to have exposed to the potentially mutagenic agents participated in the study. The program evaluated possible genotoxic damage through the sister chromatid exchange (SCE) cytogenetic biomarker assay. We determined the frequency of SCE, high-frequency cells (HFCs), and a ratio, which can be considered as a new parameter, allowing for the study of the SCE distribution pattern among the chromosomes. There was no statistically significant difference in the SCE frequency and in the mean number of HFCs between the control and the Ardystil-affected groups. However, smoking increased the incidence of all parameters studied in both the case and control groups. This study shows that workers involved in the Ardystil syndrome did not suffer genotoxic damage as measured by SCE and HFCs when compared with the control group.

Cultural change and traditional ecological knowledge. An empirical analysis from the Tsimane’ in the Bolivian Amazon

PubMed Central

Reyes-García, Victoria; Paneque-Gálvez, Jaime; Luz, Ana C.; Gueze, Maximilien; Macía, Manuel J.; Orta-Martínez, Martí; Pino, Joan

2016-01-01

Among the different factors associated to change in traditional ecological knowledge, the study of the relations between cultural change and traditional ecological knowledge has received scan and inadequate scholarly attention. Using data from indigenous peoples of an Amazonian society facing increasing exposure to the mainstream Bolivian society, we analyzed the relation between traditional ecological knowledge, proxied with individual plant use knowledge (n=484), and cultural change, proxied with individual- and village-level (n=47) measures of attachment to traditional beliefs and values. We found that both the individual level of detachment to traditional values and the village level of agreement in detachment to traditional values were associated with individual levels of plant use knowledge, irrespective of other proxy measures for cultural change. Because both the individual- and the village-level variables bear statistically significant associations with plant use knowledge, our results suggest that both the individual- and the supra-individual level processes of cultural change are related to the erosion of plant use knowledge. Results from our work highlight the importance of analyzing processes that happen at intermediary social units -the village in our case study- to explain changes in traditional ecological knowledge. PMID:27642188

Influence of socioeconomic and working status of the parents on the incidence of their children's dental caries.

PubMed

Gokhale, Niraj; Nuvvula, Sivakumar

2016-01-01

In the contemporary scenario of both parents employed, there seems to be limited focus on the dietary habits and dental health of their children. Hence, we attempted to correlate the socioeconomic and working status of the parents to the incidence of their children's dental caries. One thousand school children aged between 3 and 12 years were enrolled in the study. Socioeconomic and working status of their parents was obtained by a pretested questionnaire following which these children were examined for their dental caries status. The data collected were statistically analyzed using logistic regression analysis and calculation of odds ratio. A significant correlation was observed between working status of the parents and dental caries status of their children. Though, the socioeconomic status and dental caries had a weak correlation, the odds ratio was high, indicating that the children of lower socioeconomic status or family with both parents employed were at a higher risk for dental caries. Efforts are needed to implement programs at the school level to enhance the oral and dental health among children, as parental responsibilities toward this maybe inadequate due to economic or time constraints.

An Analysis of the Implementation of the South Carolina Anti-Bullying Legislation in the Middle Schools Involved in the Abbeville, South Carolina, School District Lawsuit

ERIC Educational Resources Information Center

Smith-Canty, Vanessa

2010-01-01

This study presents an analysis of the anti-bullying policies of 24 South Carolina middle schools that were involved in the "Abbeville" lawsuit. These schools sued the state of South Carolina alleging that the school finding system was inadequate. The schools are plagued with numerous problems including being among the lowest performing…

Prolonged fasting with fluid therapy is related to poorer outcomes in medical patients.

PubMed

Kyriakos, Georgios; Calleja-Fernández, Alicia; Ávila-Turcios, Dalia; Cano-Rodríguez, Isidoro; Ballesteros Pomar, María D; Vidal-Casariego, Alfonso

2013-01-01

An inadequate fluid therapy can worsen the outcomes of surgical patients, but there are no data in medical patients. The aim of this study was to determine the adequacy of fluid therapy in hospitalised patients of medical wards, and its influence on outcomes. Cross-sectional study including nil-per-os patients admitted in medical wards of the Complejo Asistencial Universitario de León. The administered fluid therapy was compared with the standardised requirements. Nutritional status was evaluated with Subjective Global Assessment. Fasting was considered inappropriate if it lasted > 7 days in well-nourished, and >5 days in malnourished patients if nutritional support had not been provided. Fluid therapy lasted 4 (IQR = 2) days, and fasting was inadequately maintained in 27% of patients. Fluid requirements were correctly fulfilled, but patients received an excess of sodium (+58.4%) and chloride (+62.2%), and potassium administration was insufficient (-35.1%). Glucose supply was 68.8 (29.2) g/d, and 99% received < 130 g/d. Patients with an inadequate duration of fasting had a longer hospital stay after adjusting for sex, age, nutritional status, infused volume, electrolytes, glucose and diseases. Only malnutrition predicted mortality during hospitalisation (OR 10.5; 95%CI 1.3 to 83.2), when multivariate analysis was performed. Fasting medical patients receive an inadequate supply of glucose and electrolytes. Prolonged fluid therapy and malnutrition may worsen the outcomes of these patients, independently of other conditions like age or diseases. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

Empowerment and use of antenatal care among women in Ghana: a cross-sectional study.

PubMed

Sipsma, Heather; Ofori-Atta, Angela; Canavan, Maureen; Udry, Christopher; Bradley, Elizabeth

2014-11-01

Empowerment among women in the context of a romantic relationship may affect the use of reproductive healthcare services; however, current literature examining this association is limited and inconsistent. We therefore aimed to examine the relationship between several measures of empowerment and use of inadequate antenatal care among women in Ghana. We conducted a cross-sectional study using data from a nationally representative cohort of women in Ghana. Our analytic sample was limited to non-pregnant women who had been pregnant and involved in a relationship within the last 12 months. We used multivariable logistic regression to assess the associations between empowerment and inadequate use of antenatal care and interaction terms to assess moderation by education. Approximately 26% of women received inadequate antenatal care. Multivariable analysis indicated that having experienced physical abuse in the past year was directly associated with inadequate use of antenatal care (OR = 5.12; 95% CI = 1.35, 19.43) after adjusting for socio-demographic characteristics. This effect was particularly pronounced among women with no formal education and was non-significant among women with at least some formal education (P-value for interaction <0.001). Results suggest that improving use of reproductive health care services will require reducing partner abuse and enhancing empowerment among women in Ghana and other low-income countries, particularly among those with no formal education. Furthermore, the involvement of male partners will be critical for improving reproductive health outcomes, and increasing education among girls in these settings is likely a strong approach for improving reproductive health and buffering effects of low empowerment among women.

The economic cost of inadequate sleep.

PubMed

Hillman, David; Mitchell, Scott; Streatfeild, Jared; Burns, Chloe; Bruck, Dorothy; Pezzullo, Lynne

2018-06-04

To estimate the economic cost (financial and nonfinancial) of inadequate sleep in Australia for the 2016-2017 financial year and relate this to likely costs in similar economies. Analysis was undertaken using prevalence, financial, and nonfinancial cost data derived from national surveys and databases. Costs considered included the following: (1) financial costs associated with health care, informal care provided outside healthcare sector, productivity losses, nonmedical work and vehicle accident costs, deadweight loss through inefficiencies relating to lost taxation revenue and welfare payments; and (2) nonfinancial costs of loss of well-being. They were expressed in US dollars ($). The estimated overall cost of inadequate sleep in Australia in 2016-2017 (population: 24.8 million) was $45.21 billion. The financial cost component was $17.88 billion, comprised of as follows: direct health costs of $160 million for sleep disorders and $1.08 billion for associated conditions; productivity losses of $12.19 billion ($5.22 billion reduced employment, $0.61 billion premature death, $1.73 billion absenteeism, and $4.63 billion presenteeism); nonmedical accident costs of $2.48 billion; informal care costs of $0.41 billion; and deadweight loss of $1.56 billion. The nonfinancial cost of reduced well-being was $27.33 billion. The financial and nonfinancial costs associated with inadequate sleep are substantial. The estimated total financial cost of $17.88 billion represents 1.55 per cent of Australian gross domestic product. The estimated nonfinancial cost of $27.33 billion represents 4.6 per cent of the total Australian burden of disease for the year. These costs warrant substantial investment in preventive health measures to address the issue through education and regulation.

Barriers, motivators and facilitators related to prenatal care utilization among inner-city women in Winnipeg, Canada: a case–control study

PubMed Central

2014-01-01

Background The reasons why women do not obtain prenatal care even when it is available and accessible are complex. Despite Canada’s universally funded health care system, use of prenatal care varies widely across neighborhoods in Winnipeg, Manitoba, with the highest rates of inadequate prenatal care found in eight inner-city neighborhoods. The purpose of this study was to identify barriers, motivators and facilitators related to use of prenatal care among women living in these inner-city neighborhoods. Methods We conducted a case–control study with 202 cases (inadequate prenatal care) and 406 controls (adequate prenatal care), frequency matched 1:2 by neighborhood. Women were recruited during their postpartum hospital stay, and were interviewed using a structured questionnaire. Stratified analyses of barriers and motivators associated with inadequate prenatal care were conducted, and the Mantel-Haenszel common odds ratio (OR) was reported when the results were homogeneous across neighborhoods. Chi square analysis was used to test for differences in proportions of cases and controls reporting facilitators that would have helped them get more prenatal care. Results Of the 39 barriers assessed, 35 significantly increased the odds of inadequate prenatal care for inner-city women. Psychosocial issues that increased the likelihood of inadequate prenatal care included being under stress, having family problems, feeling depressed, “not thinking straight”, and being worried that the baby would be apprehended by the child welfare agency. Structural barriers included not knowing where to get prenatal care, having a long wait to get an appointment, and having problems with child care or transportation. Attitudinal barriers included not planning or knowing about the pregnancy, thinking of having an abortion, and believing they did not need prenatal care. Of the 10 motivators assessed, four had a protective effect, such as the desire to learn how to protect one’s health. Receiving incentives and getting help with transportation and child care would have facilitated women’s attendance at prenatal care visits. Conclusions Several psychosocial, attitudinal, economic and structural barriers increased the likelihood of inadequate prenatal care for women living in socioeconomically disadvantaged neighborhoods. Removing barriers to prenatal care and capitalizing on factors that motivate and facilitate women to seek prenatal care despite the challenges of their personal circumstances may help improve use of prenatal care by inner-city women. PMID:25023478

Barriers, motivators and facilitators related to prenatal care utilization among inner-city women in Winnipeg, Canada: a case-control study.

PubMed

Heaman, Maureen I; Moffatt, Michael; Elliott, Lawrence; Sword, Wendy; Helewa, Michael E; Morris, Heather; Gregory, Patricia; Tjaden, Lynda; Cook, Catherine

2014-07-15

The reasons why women do not obtain prenatal care even when it is available and accessible are complex. Despite Canada's universally funded health care system, use of prenatal care varies widely across neighborhoods in Winnipeg, Manitoba, with the highest rates of inadequate prenatal care found in eight inner-city neighborhoods. The purpose of this study was to identify barriers, motivators and facilitators related to use of prenatal care among women living in these inner-city neighborhoods. We conducted a case-control study with 202 cases (inadequate prenatal care) and 406 controls (adequate prenatal care), frequency matched 1:2 by neighborhood. Women were recruited during their postpartum hospital stay, and were interviewed using a structured questionnaire. Stratified analyses of barriers and motivators associated with inadequate prenatal care were conducted, and the Mantel-Haenszel common odds ratio (OR) was reported when the results were homogeneous across neighborhoods. Chi square analysis was used to test for differences in proportions of cases and controls reporting facilitators that would have helped them get more prenatal care. Of the 39 barriers assessed, 35 significantly increased the odds of inadequate prenatal care for inner-city women. Psychosocial issues that increased the likelihood of inadequate prenatal care included being under stress, having family problems, feeling depressed, "not thinking straight", and being worried that the baby would be apprehended by the child welfare agency. Structural barriers included not knowing where to get prenatal care, having a long wait to get an appointment, and having problems with child care or transportation. Attitudinal barriers included not planning or knowing about the pregnancy, thinking of having an abortion, and believing they did not need prenatal care. Of the 10 motivators assessed, four had a protective effect, such as the desire to learn how to protect one's health. Receiving incentives and getting help with transportation and child care would have facilitated women's attendance at prenatal care visits. Several psychosocial, attitudinal, economic and structural barriers increased the likelihood of inadequate prenatal care for women living in socioeconomically disadvantaged neighborhoods. Removing barriers to prenatal care and capitalizing on factors that motivate and facilitate women to seek prenatal care despite the challenges of their personal circumstances may help improve use of prenatal care by inner-city women.

An Analysis of Human Causal Factors in Unmanned Aerial Vehicle (UAV) Accidents

DTIC Science & Technology

2014-12-01

202 • Drugs/over-the-counter medication/supplements (not prescribed) PP 203 • Nutrition/ diet PP 204 • Inadequate rest (self-imposed) PP 205...2008). A survey of unmanned aircraft systems regulation: Status and future perspectives. Paper presented at 16th Mediterranean Conference on Control

The efficacy of wire and glue hair snares in identifying mesocarnivores

Treesearch

William J. Zielinski; Fredrick V. Schlexer; Kristine L. Pilgrim; Michael K. Schwartz

2006-01-01

Track plates and cameras are proven methods for detecting and identifying fishers (Martes pennant) and other mesocarnivores. But these methods are inadequate to achieve demographic and population-monitoring objectives that require identifying sex and individuals. Although noninvasive collection of biological material for genetic analysis (i.e.,...

The Structure and Correlates of Perfectionism in African American Children

ERIC Educational Resources Information Center

McCreary, Beth T.; Joiner, Thomas E.; Schmidt, Norman B.; Ialongo, Nicholas S.

2004-01-01

This study examined the structure and symptom correlates of perfectionism in a sample of 6th-grade, urban, African American children using the Child and Adolescent Perfectionism Scale (CAPS; Flett, Hewitt, Boucher, Davidson, & Munro, 2000). Confirmatory factor analysis showed inadequate fit of the original subscales. Exploratory factor analysis…

Designing Continuous Professional Development Programmes for Teachers: A Literature Review

ERIC Educational Resources Information Center

Luneta, K.

2012-01-01

Continuous professional development is essential for upgrading and updating teachers because the rate of social and educational change makes pre-service training an inadequate basis for long term professional competence. The design of these continuous professional development programmes must be informed by an effective needs analysis that…

An Analysis of a Multidimensional Success: Measure for PSDS Students.

ERIC Educational Resources Information Center

Spuck, Dennis W.

The Program of Special Directed Studies (PSDS) identifies persons with intellectual ability whose academic achievement, as indicated by traditional measures, is inadequate to secure admission to selective colleges. Then, through a program of supervised college courses, special services and individual tutoring, it attempts to prepare these students…

The "Developing" Achievement Gap: Colombian Voucher Reform

ERIC Educational Resources Information Center

Stern, Jonathan M. B.

2014-01-01

The achievement gap in many developing countries is defined in terms of rich/poor and public/private. The prevailing explanation for the "developing" achievement gap is an underfunded, inefficient, and/or inadequately supplied public school sector. Via an analysis of a Colombian voucher experiment, this article examines the extent to…

DESIGN AND ANALYSIS OF AN EXPERIMENT FOR ASSESSING CYANIDE IN GOLD MINING WASTES

EPA Science Inventory

Gold mining wastes treated by heap leaching cyanidization typically contain several metallo-cyanide species. Accurate measurement of total cyanide by the most common methods in such a case may be hampered by the inadequate recoveries that occur for certain cyanide compounds (e.g....

Estimating School Efficiency: A Comparison of Methods Using Simulated Data.

ERIC Educational Resources Information Center

Bifulco, Robert; Bretschneider, Stuart

2001-01-01

Uses simulated data to assess the adequacy of two econometric and linear-programming techniques (data-envelopment analysis and corrected ordinary least squares) for measuring performance-based school reform. In complex data sets (simulated to contain measurement error and endogeneity), these methods are inadequate efficiency measures. (Contains 40…

Analysis of North Atlantic Tropical Cyclone Intensify Change Using Data Mining

ERIC Educational Resources Information Center

Tang, Jiang

2010-01-01

Tropical cyclones (TC), especially when their intensity reaches hurricane scale, can become a costly natural hazard. Accurate prediction of tropical cyclone intensity is very difficult because of inadequate observations on TC structures, poor understanding of physical processes, coarse model resolution and inaccurate initial conditions, etc. This…

Statistics of Storm Updraft Velocities from TWP-ICE Including Verification with Profiling Measurements

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

Collis, Scott; Protat, Alain; May, Peter T.

2013-08-01

Comparisons between direct measurements and modeled values of vertical air motions in precipitating systems are complicated by differences in temporal and spatial scales. On one hand, vertically profiling radars more directly measure the vertical air motion but do not adequately capture full storm dynamics. On the other hand, vertical air motions retrieved from two or more scanning Doppler radars capture the full storm dynamics but require model constraints that may not capture all updraft features because of inadequate sampling, resolution, numerical constraints, and the fact that the storm is evolving as it is scanned by the radars. To investigate themore » veracity of radar-based retrievals, which can be used to verify numerically modeled vertical air motions, this article presents several case studies from storm events around Darwin, Northern Territory, Australia, in which measurements from a dual-frequency radar profiler system and volumetric radar-based wind retrievals are compared. While a direct comparison was not possible because of instrumentation location, an indirect comparison shows promising results, with volume retrievals comparing well to those obtained from the profiling system. This prompted a statistical analysis of an extended period of an active monsoon period during the Tropical Warm Pool International Cloud Experiment (TWP-ICE). Results show less vigorous deep convective cores with maximum updraft velocities occurring at lower heights than some cloudresolving modeling studies suggest. 1. Introduction The regionalization of global climate models has been a driver of demand for more complex convective parameterization schemes. A key readjustment of the modeled atmosphere« less

Online education improves pediatric residents' understanding of atopic dermatitis.

PubMed

Craddock, Megan F; Blondin, Heather M; Youssef, Molly J; Tollefson, Megha M; Hill, Lauren F; Hanson, Janice L; Bruckner, Anna L

2018-01-01

Pediatricians manage skin conditions such as atopic dermatitis (AD) but report that their dermatologic training is inadequate. Online modules may enhance medical education when sufficient didactic or clinical teaching experiences are lacking. We assessed whether an online module about AD improved pediatric residents' knowledge and changed their clinical management of AD. Target and control cohorts of pediatric residents from two institutions were recruited. Target subjects took a 30-question test about AD early in their residency, reviewed the online module, and repeated the test 6 months and 1 year later. The control subjects, who had 1 year of clinical experience but had not reviewed the online module, also took the test. The mean percentage of correct answers was calculated and compared using two-sided, two-sample independent t tests and repeated-measures analysis of variance. For a subset of participants, clinical documentation from AD encounters was reviewed and 13 practice behaviors were compared using the Fisher exact test. Twenty-five subjects in the target cohort and 29 subjects in the control cohort completed the study. The target cohort improved from 18.0 ± 3.2 to 23.4 ± 3.4 correctly answered questions over 1 year (P < .001). This final value was greater than that of the control cohort (20.7 ± 4.5; P = .01). Meaningful differences in practice behaviors were not seen. Pediatric residents who reviewed an online module about AD demonstrated statistically significant improvement in disease-specific knowledge over time and had statistically significantly higher scores than controls. Online dermatology education may effectively supplement traditional clinical teaching. © 2017 Wiley Periodicals, Inc.

Head Lice among Governmental Primary School Students in Southern Jordan: Prevalence and Risk Factors

PubMed Central

Khamaiseh, Abdullah Mousa

2018-01-01

Background: Head lice, a common social and health problem among all age groups, is especially widespread among school-aged children. Aims: This study aimed to assess the prevalence of pediculosis capitis among governmental primary school students in Southern Jordan and its related risk factors. Settings and Design: A sample of 500 primary schools students aged 6–12 from two male and two female public primary schools in four educational directorates were selected randomly in this cross-sectional study. Materials and Methods: Data were collected using a modified questionnaire that was completed by the students with the help of their parents. Students were then asked to return the questionnaire a day ahead of the examination date with a signed consent from the parents. Statistical Analysis: SPSS software was used with Chi-square testing to study the significant relationship between lice infestation prevalence and the independent variables. Statistical significance was set at P < 0.05. Results and Conclusion: The overall prevalence of lice infestation was 20.4% and was significantly higher among girls than boys. The prevalence rate was higher among rural residents, those living in shared rooms, families with a monthly income of <200 Jordanian Dinar, illiterate father and mother, those living in families with more than five members, houses with fewer than three rooms, students with longer hair, those with a history of infestation in the previous year, and students who share home articles with other family members. Female gender, low socioeconomic status, a history of contact, inadequate hygiene practices, and sharing articles were the major risk factors. PMID:29563717

Evaluation of Surface Flux Parameterizations with Long-Term ARM Observations

DOE PAGES

Liu, Gang; Liu, Yangang; Endo, Satoshi

2013-02-01

Surface momentum, sensible heat, and latent heat fluxes are critical for atmospheric processes such as clouds and precipitation, and are parameterized in a variety of models ranging from cloud-resolving models to large-scale weather and climate models. However, direct evaluation of the parameterization schemes for these surface fluxes is rare due to limited observations. This study takes advantage of the long-term observations of surface fluxes collected at the Southern Great Plains site by the Department of Energy Atmospheric Radiation Measurement program to evaluate the six surface flux parameterization schemes commonly used in the Weather Research and Forecasting (WRF) model and threemore » U.S. general circulation models (GCMs). The unprecedented 7-yr-long measurements by the eddy correlation (EC) and energy balance Bowen ratio (EBBR) methods permit statistical evaluation of all six parameterizations under a variety of stability conditions, diurnal cycles, and seasonal variations. The statistical analyses show that the momentum flux parameterization agrees best with the EC observations, followed by latent heat flux, sensible heat flux, and evaporation ratio/Bowen ratio. The overall performance of the parameterizations depends on atmospheric stability, being best under neutral stratification and deteriorating toward both more stable and more unstable conditions. Further diagnostic analysis reveals that in addition to the parameterization schemes themselves, the discrepancies between observed and parameterized sensible and latent heat fluxes may stem from inadequate use of input variables such as surface temperature, moisture availability, and roughness length. The results demonstrate the need for improving the land surface models and measurements of surface properties, which would permit the evaluation of full land surface models.« less

Social network and dominance hierarchy analyses at Chimpanzee Sanctuary Northwest

PubMed Central

Mayhew, Jessica A.; Mulcahy, John B.

2018-01-01

Different aspects of sociality bear considerable weight on the individual- and group-level welfare of captive nonhuman primates. Social Network Analysis (SNA) is a useful tool for gaining a holistic understanding of the dynamic social relationships of captive primate groups. Gaining a greater understanding of captive chimpanzees through investigations of centrality, preferred and avoided relationships, dominance hierarchy, and social network diagrams can be useful in advising current management practices in sanctuaries and other captive settings. In this study, we investigated the dyadic social relationships, group-level social networks, and dominance hierarchy of seven chimpanzees (Pan troglodytes) at Chimpanzee Sanctuary Northwest. We used focal-animal and instantaneous scan sampling to collect 106.75 total hours of associative, affiliative, and agonistic data from June to September 2016. We analyzed our data using SOCPROG to derive dominance hierarchies and network statistics, and we diagrammed the group’s social networks in NetDraw. Three individuals were most central in the grooming network, while two others had little connection. Through agonistic networks, we found that group members reciprocally exhibited agonism, and the group’s dominance hierarchy was statistically non-linear. One chimpanzee emerged as the most dominant through agonism but was least connected to other group members across affiliative networks. Our results indicate that the conventional methods used to calculate individuals’ dominance rank may be inadequate to wholly depict a group’s social relationships in captive sanctuary populations. Our results have an applied component that can aid sanctuary staff in a variety of ways to best ensure the improvement of group welfare. PMID:29444112

Acid base properties of cyanobacterial surfaces I: Influences of growth phase and nitrogen metabolism on cell surface reactivity

NASA Astrophysics Data System (ADS)

Lalonde, S. V.; Smith, D. S.; Owttrim, G. W.; Konhauser, K. O.

2008-03-01

Significant efforts have been made to elucidate the chemical properties of bacterial surfaces for the purposes of refining surface complexation models that can account for their metal sorptive behavior under diverse conditions. However, the influence of culturing conditions on surface chemical parameters that are modeled from the potentiometric titration of bacterial surfaces has received little regard. While culture age and metabolic pathway have been considered as factors potentially influencing cell surface reactivity, statistical treatments have been incomplete and variability has remained unconfirmed. In this study, we employ potentiometric titrations to evaluate variations in bacterial surface ligand distributions using live cells of the sheathless cyanobacterium Anabaena sp. strain PCC 7120, grown under a variety of batch culture conditions. We evaluate the ability for a single set of modeled parameters, describing acid-base surface properties averaged over all culture conditions tested, to accurately account for the ligand distributions modeled for each individual culture condition. In addition to considering growth phase, we assess the role of the various assimilatory nitrogen metabolisms available to this organism as potential determinants of surface reactivity. We observe statistically significant variability in site distribution between the majority of conditions assessed. By employing post hoc Tukey-Kramer analysis for all possible pair-wise condition comparisons, we conclude that the average parameters are inadequate for the accurate chemical description of this cyanobacterial surface. It was determined that for this Gram-negative bacterium in batch culture, ligand distributions were influenced to a greater extent by nitrogen assimilation pathway than by growth phase.

Social network and dominance hierarchy analyses at Chimpanzee Sanctuary Northwest.

PubMed

Funkhouser, Jake A; Mayhew, Jessica A; Mulcahy, John B

2018-01-01

Different aspects of sociality bear considerable weight on the individual- and group-level welfare of captive nonhuman primates. Social Network Analysis (SNA) is a useful tool for gaining a holistic understanding of the dynamic social relationships of captive primate groups. Gaining a greater understanding of captive chimpanzees through investigations of centrality, preferred and avoided relationships, dominance hierarchy, and social network diagrams can be useful in advising current management practices in sanctuaries and other captive settings. In this study, we investigated the dyadic social relationships, group-level social networks, and dominance hierarchy of seven chimpanzees (Pan troglodytes) at Chimpanzee Sanctuary Northwest. We used focal-animal and instantaneous scan sampling to collect 106.75 total hours of associative, affiliative, and agonistic data from June to September 2016. We analyzed our data using SOCPROG to derive dominance hierarchies and network statistics, and we diagrammed the group's social networks in NetDraw. Three individuals were most central in the grooming network, while two others had little connection. Through agonistic networks, we found that group members reciprocally exhibited agonism, and the group's dominance hierarchy was statistically non-linear. One chimpanzee emerged as the most dominant through agonism but was least connected to other group members across affiliative networks. Our results indicate that the conventional methods used to calculate individuals' dominance rank may be inadequate to wholly depict a group's social relationships in captive sanctuary populations. Our results have an applied component that can aid sanctuary staff in a variety of ways to best ensure the improvement of group welfare.

Systematic review of the quality of prognosis studies in systemic lupus erythematosus.

PubMed

Lim, Lily S H; Lee, Senq J; Feldman, Brian M; Gladman, Dafna D; Pullenayegum, Eleanor; Uleryk, Elizabeth; Silverman, Earl D

2014-10-01

Prognosis studies examine outcomes and/or seek to identify predictors or factors associated with outcomes. Many prognostic factors have been identified in systemic lupus erythematosus (SLE), but few have been consistently found across studies. We hypothesized that this is due to a lack of rigor of study designs. This study aimed to systematically assess the methodologic quality of prognosis studies in SLE. A search of prognosis studies in SLE was performed using MEDLINE and Embase, from January 1990 to June 2011. A representative sample of 150 articles was selected using a random number generator and assessed by 2 reviewers. Each study was assessed by a risk of bias tool according to 6 domains: study participation, study attrition, measurement of prognostic factors, measurement of outcomes, measurement/adjustment for confounders, and appropriateness of statistical analysis. Information about missing data was also collected. A cohort design was used in 71% of studies. High risk of bias was found in 65% of studies for confounders, 57% for study participation, 56% for attrition, 36% for statistical analyses, 20% for prognostic factors, and 18% for outcome. Missing covariate or outcome information was present in half of the studies. Only 6 studies discussed reasons for missing data and 2 imputed missing data. Lack of rigorous study design, especially in addressing confounding, study participation and attrition, and inadequately handled missing data, has limited the quality of prognosis studies in SLE. Future prognosis studies should be designed with consideration of these factors to improve methodologic rigor. Copyright © 2014 by the American College of Rheumatology.

COGNITIVE BEHAVIORAL THERAPY AGE EFFECTS IN CHILD AND ADOLESCENT ANXIETY: AN INDIVIDUAL PATIENT DATA METAANALYSIS

PubMed Central

Bennett, Kathryn; Manassis, Katharina; Walter, Stephen D.; Cheung, Amy; Wilansky-Traynor, Pamela; Diaz-Granados, Natalia; Duda, Stephanie; Rice, Maureen; Baer, Susan; Barrett, Paula; Bodden, Denise; Cobham, Vanessa E.; Dadds, Mark R.; Flannery-Schroeder, Ellen; Ginsburg, Golda; Heyne, David; Hudson, Jennifer L.; Kendall, Philip C.; Liber, Juliette; Warner, Carrie Masia; Mendlowitz, Sandra; Nauta, Maaike H.; Rapee, Ronald M.; Silverman, Wendy; Siqueland, Lynne; Spence, Susan H.; Utens, Elisabeth; Wood, Jeffrey J.

2015-01-01

Background Investigations of age effects on youth anxiety outcomes in randomized trials (RCTs) of cognitive behavior therapy (CBT) have failed to yield a clear result due to inadequate statistical power and methodologic weaknesses. We conducted an individual patient data metaanalysis to address this gap. Question Does age moderate CBT effect size, measured by a clinically and statistically significant interaction between age and CBT exposure? Methods All English language RCTs of CBT for anxiety in 6–19 year olds were identified using systematic review methods. Investigators of eligible trials were invited to submit their individual patient data. The anxiety disorder interview schedule (ADIS) primary diagnosis severity score was the primary outcome. Age effects were investigated using multilevel modeling to account for study level data clustering and random effects. Results Data from 17 of 23 eligible trials were obtained (74%); 16 studies and 1,171 (78%) cases were available for the analysis. No interaction between age and CBT exposure was found in a model containing age, sex, ADIS baseline severity score, and comorbid depression diagnosis (power ≥ 80%). Sensitivity analyses, including modeling age as both a categorical and continuous variable, revealed this result was robust. Conclusions Adolescents who receive CBT in efficacy research studies show benefits comparable to younger children. However, CBT protocol modifications routinely carried out by expert trial therapists may explain these findings. Adolescent CBT protocols are needed to facilitate the transportability of efficacy research effects to usual care settings where therapists may have less opportunity for CBT training and expertise development. PMID:23658135

Cost and mortality prediction using polymerase chain reaction pathogen detection in sepsis: evidence from three observational trials

PubMed Central

2010-01-01

Introduction Delays in adequate antimicrobial treatment contribute to high cost and mortality in sepsis. Polymerase chain reaction (PCR) assays are used alongside conventional cultures to accelerate the identification of microorganisms. We analyze the impact on medical outcomes and healthcare costs if improved adequacy of antimicrobial therapy is achieved by providing immediate coverage after positive PCR reports. Methods A mathematical prediction model describes the impact of PCR-based rapid adjustment of antimicrobial treatment. The model is applied to predict cost and medical outcomes for 221 sepsis episodes of 189 post-surgical and intensive care unit (ICU) sepsis patients with available PCR data from a prospective, observational trial of a multiplex PCR assay in five hospitals. While this trial demonstrated reduction of inadequate treatment days, data on outcomes associated with reduced inadequate initial antimicrobial treatment had to be obtained from two other, bigger, studies which involved 1,147 (thereof 316 inadequately treated) medical or surgical ICU patients. Our results are reported with the (5% to 95%) percentile ranges from Monte Carlo simulation in which the input parameters were randomly and independently varied according to their statistical characterization in the three underlying studies. The model allows predictions also for different patient groups or PCR assays. Results A total of 13.1% of PCR tests enabled earlier adequate treatment. We predict that cost for PCR testing (300 €/test) can be fully recovered for patients above 717 € (605 € to 1,710 €) daily treatment cost. A 2.6% (2.0 to 3.2%) absolute reduction of mortality is expected. Cost per incremental survivor calculates to 11,477 € (9,321 € to 14,977 €) and incremental cost-effectiveness ratio to 3,107 € (2,523 € to 4,055 €) per quality-adjusted life-year. Generally, for ICU patients with >25% incidence of inadequate empiric antimicrobial treatment, and at least 15% with a positive blood culture, PCR represents a cost-neutral adjunct method. Conclusions Rapid PCR identification of microorganisms has the potential to become a cost-effective component for managing sepsis. The prediction model tested with data from three observational trials should be utilized as a framework to deepen insights when integrating more complementary data associated with utilization of molecular assays in the management of sepsis. PMID:20950442

Measuring the Autocorrelation Function of Nanoscale Three-Dimensional Density Distribution in Individual Cells Using Scanning Transmission Electron Microscopy, Atomic Force Microscopy, and a New Deconvolution Algorithm.

PubMed

Li, Yue; Zhang, Di; Capoglu, Ilker; Hujsak, Karl A; Damania, Dhwanil; Cherkezyan, Lusik; Roth, Eric; Bleher, Reiner; Wu, Jinsong S; Subramanian, Hariharan; Dravid, Vinayak P; Backman, Vadim

2017-06-01

Essentially all biological processes are highly dependent on the nanoscale architecture of the cellular components where these processes take place. Statistical measures, such as the autocorrelation function (ACF) of the three-dimensional (3D) mass-density distribution, are widely used to characterize cellular nanostructure. However, conventional methods of reconstruction of the deterministic 3D mass-density distribution, from which these statistical measures can be calculated, have been inadequate for thick biological structures, such as whole cells, due to the conflict between the need for nanoscale resolution and its inverse relationship with thickness after conventional tomographic reconstruction. To tackle the problem, we have developed a robust method to calculate the ACF of the 3D mass-density distribution without tomography. Assuming the biological mass distribution is isotropic, our method allows for accurate statistical characterization of the 3D mass-density distribution by ACF with two data sets: a single projection image by scanning transmission electron microscopy and a thickness map by atomic force microscopy. Here we present validation of the ACF reconstruction algorithm, as well as its application to calculate the statistics of the 3D distribution of mass-density in a region containing the nucleus of an entire mammalian cell. This method may provide important insights into architectural changes that accompany cellular processes.

Weighting of the data and analytical approaches may account for differences in overcoming the inadequate representativeness of the respondents to the third wave of a cohort study.

PubMed

Taylor, Anne W; Dal Grande, Eleonora; Grant, Janet; Appleton, Sarah; Gill, Tiffany K; Shi, Zumin; Adams, Robert J

2013-04-01

Attrition in cohort studies can cause the data to be nonreflective of the original population. Although of little concern if intragroup comparisons are being made or cause and effect assessed, the assessment of bias was undertaken in this study so that intergroup or descriptive analyses could be undertaken. The North West Adelaide Health Study is a chronic disease and risk factor cohort study undertaken in Adelaide, South Australia. In the original wave (1999), clinical and self-report data were collected from 4,056 adults. In the third wave (2008-2010), 2,710 adults were still actively involved. Comparisons were made against two other data sources: Australian Bureau of Statistics Estimated Residential Population and a regular conducted chronic disease and risk factor surveillance system. Comparisons of demographics (age, sex, area, education, work status, and income) proved to be statistically significantly different. In addition, smoking status, body mass index, and general health status were statistically significant from the comparison group. No statistically significant differences were found for alcohol risk. Although the third wave of this cohort study is not representative of the broader population on the variables assessed, weighting of the data and analytical approaches can account for differences. Copyright © 2013 Elsevier Inc. All rights reserved.

Measuring the Autocorrelation Function of Nanoscale Three-Dimensional Density Distribution in Individual Cells Using Scanning Transmission Electron Microscopy, Atomic Force Microscopy, and a New Deconvolution Algorithm

PubMed Central

Li, Yue; Zhang, Di; Capoglu, Ilker; Hujsak, Karl A.; Damania, Dhwanil; Cherkezyan, Lusik; Roth, Eric; Bleher, Reiner; Wu, Jinsong S.; Subramanian, Hariharan; Dravid, Vinayak P.; Backman, Vadim

2018-01-01

Essentially all biological processes are highly dependent on the nanoscale architecture of the cellular components where these processes take place. Statistical measures, such as the autocorrelation function (ACF) of the three-dimensional (3D) mass–density distribution, are widely used to characterize cellular nanostructure. However, conventional methods of reconstruction of the deterministic 3D mass–density distribution, from which these statistical measures can be calculated, have been inadequate for thick biological structures, such as whole cells, due to the conflict between the need for nanoscale resolution and its inverse relationship with thickness after conventional tomographic reconstruction. To tackle the problem, we have developed a robust method to calculate the ACF of the 3D mass–density distribution without tomography. Assuming the biological mass distribution is isotropic, our method allows for accurate statistical characterization of the 3D mass–density distribution by ACF with two data sets: a single projection image by scanning transmission electron microscopy and a thickness map by atomic force microscopy. Here we present validation of the ACF reconstruction algorithm, as well as its application to calculate the statistics of the 3D distribution of mass–density in a region containing the nucleus of an entire mammalian cell. This method may provide important insights into architectural changes that accompany cellular processes. PMID:28416035

Hospital inpatient self-administration of medicine programmes: a critical literature review.

PubMed

Wright, Julia; Emerson, Angela; Stephens, Martin; Lennan, Elaine

2006-06-01

The Department of Health, pharmaceutical and nursing bodies have advocated the benefits of self-administration programmes (SAPs), but their implementation within UK hospitals has been limited. Perceived barriers are: anticipated increased workload, insufficient resources and patient safety concerns. This review aims to discover if benefits of SAPs are supported in the literature in relation to risk and resource implications. Electronic databases were searched up to March 2004. Published English language articles that described and evaluated implementation of an SAP were included. Outcomes reported were: compliance measures, errors, knowledge, patient satisfaction, and nursing and pharmacy time. Most of the 51 papers reviewed had methodological flaws. SAPs varied widely in content and structure. Twelve studies (10 controlled) measured compliance by tablet counts. Of 7 studies subjected to statistical analysis, four demonstrated a significant difference in compliance between SAP and controls. Eight studies (5 controlled) measured errors as an outcome. Of the two evaluated statistically, only one demonstrated significantly fewer medication errors in the SAP group than in controls. Seventeen papers (11 controlled) studied the effect of SAPs on patients' medication knowledge. Ten of the 11 statistically analysed studies showed that SAP participants knew significantly more about some aspects of their medication than did controls. Seventeen studies (5 controlled), measured patient satisfaction. Two studies were statistically analysed and these studies suggested that patients were satisfied and preferred SAP. Seven papers studied pharmacy time, three studied nursing time but results were not compared to controls. The paucity of well-designed studies, flawed methodology and inadequate reporting in many papers make conclusions hard to draw. Conclusive evidence that SAPs improve compliance was not provided. Although patients participating in SAPs make errors, small numbers of patients are often responsible for a large number of errors. Whilst most studies suggest that SAPs increase patient's knowledge in part, it is difficult to separate out the effect of the educational component of many SAPs. Most patients who participated in SAPs were satisfied with their care and many would choose to take part in a SAP in the future. No studies measured the total resource requirement of implementing and maintaining a SAP.

Skills in Handling Turbuhaler, Diskus, and Pressurized Metered-Dose Inhaler in Korean Asthmatic Patients

PubMed Central

Lee, Sang Min; Chang, Yoon-Seok; Kim, Cheol-Woo; Kim, Tae-Bum; Kim, Sang-Heon; Kwon, Yong-Eun; Lee, Jong-Myung; Lee, Soo-Keol; Jeong, Jae-Won; Park, Jung-Won; Cho, Sang-Heon; Moon, Hee-Bom

2011-01-01

Purpose The objective of this study was to evaluate skills in handling inhalers and factors associated with these skills among patients with asthma who had undergone treatment at special asthma and allergy clinics in Korea. Methods We enrolled 78 subjects who used Turbuhaler and 145 who used Diskus for asthma control at special clinics in 10 university hospitals and visually assessed their skills in handling these inhalers. We also evaluated skills in 137 subjects who had used pressurized metered-dose inhalers (pMDIs) for symptom relief. Age, sex, duration of asthma and inhaler use, smoking status, monthly income, highest grade completed in school and previous instruction for handling inhalers were also measured to evaluate their association with overall inhaler skills. Results Performance grade was inadequate for 12.8% of participants using Turbuhaler, 6.2% for Diskus, and 23.4% for pMDIs. The success rates for each step in handling the inhalers were relatively high except for the "exhale slowly to residual volume" step, in which success rates ranged from 24.2% to 28.5%. Older age, male sex, lower educational grade, and absence of previous instruction for handling inhalers were associated with inadequate inhaler technique in univariate analysis; however, only older age and absence of previous instruction remained significant independent risk factors in multivariate analysis. Conclusions Among Korean asthmatic patients in special asthma and allergy clinics, skills in handling their inhalers were mostly excellent; meanwhile, older age and absence of previous instruction for handling inhalers were associated with inadequate techniques. PMID:21217925

Working conditions, visual fatigue, and mental health among systems analysts in São Paulo, Brazil

PubMed Central

Rocha, L; Debert-Ribeiro, M

2004-01-01

Aims: To evaluate the association between working conditions and visual fatigue and mental health among systems analysts living in São Paulo, Brazil. Methods: A cross sectional study was carried out by a multidisciplinary team. It included: ergonomic analysis of work, individual and group interviews, and 553 self applied questionnaires in two enterprises. The comparison population numbered 136 workers in different occupations. Results: The study population mainly comprised young males. Among systems analysts, visual fatigue was associated with mental workload, inadequate equipment and workstation, low level of worker participation, being a woman, and subject's attitude of fascination by the computer. Nervousness and intellectual performance were associated with mental workload, inadequate equipment, work environment, and tools. Continuing education and leisure were protective factors. Work interfering in family life was associated with mental workload, difficulties with clients, strict deadlines, subject's attitude of fascination by the computer, and finding solutions of work problems outside work. Family support, satisfaction in life and work, and adequate work environment and tools were protective factors. Work interfering in personal life was associated with subject's attitude of fascination by the computer, strict deadlines, inadequate equipment, and high level of work participation. Satisfaction in life and work and continuing education were protective factors. The comparison population did not share common working factors with the systems analysts in the regression analysis. Conclusions: The main health effects of systems analysts' work were expressed by machine anthropomorphism, being very demanding, mental acceleration, mental absorption, and difficulty in dealing with emotions. PMID:14691269

Results of salvage radiotherapy after inadequate surgery in invasive cervical carcinoma patients: A retrospective analysis

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

Saibishkumar, Elantholi P.; Patel, Firuza D.; Ghoshal, Sushmita

2005-11-01

Purpose: To evaluate the results of salvage radiotherapy (RT) after inadequate surgery in patients with invasive carcinoma of the cervix. Methods and Materials: Between 1996 and 2001, 105 invasive cervical carcinoma patients were treated at our center with external beam RT with or without intracavitary RT after having undergone total/subtotal hysterectomy at outside institutions. Results: The median follow-up was 34 months. The gap between surgery and RT was 23-198 days (median, 80). Clinically visible residual disease was present in 81 patients (77.1%). Total hysterectomy had been done in 82 patients (78%) and subtotal hysterectomy in 23 patients (22%). The 5-yearmore » overall survival, disease-free survival, and pelvic control rates of all patients were 55.2%, 53.3%, and 72.4%, respectively. On univariate analysis, older age, total hysterectomy, hemoglobin level >10 g% before RT, nonsquamous histologic type, use of intracavitary RT, a shorter gap between surgery and RT, and the absence of, or a small volume of, residual disease favorably affected the outcome. The 5-year actuarial rate of late toxicity (Radiation Therapy Oncology Group Criteria) was 19% in the rectum, 4.8% in the bladder, 24.8% in the skin, and 14.3% in the small intestine. Conclusions: Inadequate and inappropriate surgery in invasive cervical cancer with resulting gross residual disease is common in India. Factors such as the use of intracavitary RT, the correction of anemia, and a shorter gap between surgery and RT will enable postoperative RT to achieve acceptable results with minimal morbidity.« less

Environmental gram-positive mastitis treatment: in vitro sensitivity and bacteriologic cure.

PubMed

Cattell, M B; Dinsmore, R P; Belschner, A P; Carmen, J; Goodell, G

2001-09-01

A clinical trial was conducted in a large dairy herd to determine the efficacy of intramammary pirlimycin hydrochloride administration during lactation for bacteriologic clearance of gram-positive environmental clinical and subclinical mastitis infections. Quarters infected with environmental streptococci that received pirlimycin therapy (13/28) were 1.8 times more likely to resolve infection than untreated quarters (5/14). The small numbers of quarters infected with coagulase-negative staphylococci resulted in inadequate power to assess treatment differences in cure rate. Although the association was not statistically significant, quarters from cows with sensitive environmental streptococci isolates from composite samples (8/13) resolved infection with treatment at approximately twice the rate of treated quarters with resistant isolates (3/10).

Embolic Strokes of Unknown Source and Cryptogenic Stroke: Implications in Clinical Practice

PubMed Central

Nouh, Amre; Hussain, Mohammed; Mehta, Tapan; Yaghi, Shadi

2016-01-01

Up to a third of strokes are rendered cryptogenic or of undetermined etiology. This number is specifically higher in younger patients. At times, inadequate diagnostic workups, multiple causes, or an under-recognized etiology contributes to this statistic. Embolic stroke of undetermined source, a new clinical entity particularly refers to patients with embolic stroke for whom the etiology of embolism remains unidentified despite through investigations ruling out established cardiac and vascular sources. In this article, we review current classification and discuss important clinical considerations in these patients; highlighting cardiac arrhythmias and structural abnormalities, patent foramen ovale, paradoxical sources, and potentially under-recognized, vascular, inflammatory, autoimmune, and hematologic sources in relation to clinical practice. PMID:27047443

42 CFR 488.318 - Inadequate survey performance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Inadequate survey performance. 488.318 Section 488... (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES Survey and Certification of Long-Term Care Facilities § 488.318 Inadequate survey performance. (a) CMS considers survey...

42 CFR 488.318 - Inadequate survey performance.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Inadequate survey performance. 488.318 Section 488... (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES Survey and Certification of Long-Term Care Facilities § 488.318 Inadequate survey performance. (a) CMS considers survey...

42 CFR 488.318 - Inadequate survey performance.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Inadequate survey performance. 488.318 Section 488... (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES Survey and Certification of Long-Term Care Facilities § 488.318 Inadequate survey performance. (a) CMS considers survey...

42 CFR 488.318 - Inadequate survey performance.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Inadequate survey performance. 488.318 Section 488... (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES Survey and Certification of Long-Term Care Facilities § 488.318 Inadequate survey performance. (a) CMS considers survey...

42 CFR 488.320 - Sanctions for inadequate survey performance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Sanctions for inadequate survey performance. 488... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES Survey and Certification of Long-Term Care Facilities § 488.320 Sanctions for inadequate survey...

Urban-rural differences in the association between access to healthcare and health outcomes among older adults in China.

PubMed

Zhang, Xufan; Dupre, Matthew E; Qiu, Li; Zhou, Wei; Zhao, Yuan; Gu, Danan

2017-07-19

Studies have shown that inadequate access to healthcare is associated with lower levels of health and well-being in older adults. Studies have also shown significant urban-rural differences in access to healthcare in developing countries such as China. However, there is limited evidence of whether the association between access to healthcare and health outcomes differs by urban-rural residence at older ages in China. Four waves of data (2005, 2008/2009, 2011/2012, and 2014) from the largest national longitudinal survey of adults aged 65 and older in mainland China (n = 26,604) were used for analysis. The association between inadequate access to healthcare (y/n) and multiple health outcomes were examined-including instrumental activities of daily living (IADL) disability, ADL disability, cognitive impairment, and all-cause mortality. A series of multivariate models were used to obtain robust estimates and to account for various covariates associated with access to healthcare and/or health outcomes. All models were stratified by urban-rural residence. Inadequate access to healthcare was significantly higher among older adults in rural areas than in urban areas (9.1% vs. 5.4%; p < 0.01). Results from multivariate models showed that inadequate access to healthcare was associated with significantly higher odds of IADL disability in older adults living in urban areas (odds ratio [OR] = 1.58-1.79) and rural areas (OR = 1.95-2.30) relative to their counterparts with adequate access to healthcare. In terms of ADL disability, we found significant increases in the odds of disability among rural older adults (OR = 1.89-3.05) but not among urban older adults. Inadequate access to healthcare was also associated with substantially higher odds of cognitive impairment in older adults from rural areas (OR = 2.37-3.19) compared with those in rural areas with adequate access to healthcare; however, no significant differences in cognitive impairment were found among older adults in urban areas. Finally, we found that inadequate access to healthcare increased overall mortality risks in older adults by 33-37% in urban areas and 28-29% in rural areas. However, the increased risk of mortality in urban areas was not significant after taking into account health behaviors and baseline health status. Inadequate access to healthcare was significantly associated with higher rates of disability, cognitive impairment, and all-cause mortality among older adults in China. The associations between access to healthcare and health outcomes were generally stronger among older adults in rural areas than in urban areas. Our findings underscore the importance of providing adequate access to healthcare for older adults-particularly for those living in rural areas in developing countries such as China.

Systematic review and network meta-analysis of the efficacy and safety of tumour necrosis factor inhibitor-methotrexate combination therapy versus triple therapy in rheumatoid arthritis.

PubMed

Fleischmann, Roy; Tongbram, Vanita; van Vollenhoven, Ronald; Tang, Derek H; Chung, James; Collier, David; Urs, Shilpa; Ndirangu, Kerigo; Wells, George; Pope, Janet

2017-01-01

Clinical trials have not consistently demonstrated differences between tumour necrosis factor inhibitor (TNFi) plus methotrexate and triple therapy (methotrexate plus hydroxychloroquine plus sulfasalazine) in rheumatoid arthritis (RA). The study objective was to estimate the efficacy, radiographic benefits, safety and patient-reported outcomes of TNFi-methotrexate versus triple therapy in patients with RA. A systematic review and network meta-analysis (NMA) of randomised controlled trials of TNFi-methotrexate or triple therapy as one of the treatment arms in patients with an inadequate response to or who were naive to methotrexate was conducted. American College of Rheumatology 70% response criteria (ACR70) at 6 months was the prespecified primary endpoint to evaluate depth of response. Data from direct and indirect comparisons between TNFi-methotrexate and triple therapy were pooled and quantitatively analysed using fixed-effects and random-effects Bayesian models. We analysed 33 studies in patients with inadequate response to methotrexate and 19 in patients naive to methotrexate. In inadequate responders, triple therapy was associated with lower odds of achieving ACR70 at 6 months compared with TNFi-methotrexate (OR 0.35, 95% credible interval (CrI) 0.19 to 0.64). Most secondary endpoints tended to favour TNFi-methotrexate in terms of OR direction; however, no clear increased likelihood of achieving these endpoints was observed for either therapy. The odds of infection were lower with triple therapy than with TNFi-methotrexate (OR 0.08, 95% CrI 0.00 to 0.57). There were no differences observed between the two regimens in patients naive to methotrexate. In this NMA, triple therapy was associated with 65% lower odds of achieving ACR70 at 6 months compared with TNFi-methotrexate in patients with inadequate response to methotrexate. Although secondary endpoints numerically favoured TNFi-methotrexate, no clear differences were observed. The odds of infection were greater with TNFi-methotrexate. No differences were observed for patients naive to methotrexate. These results may help inform care of patients who fail methotrexate first-line therapy.

Constipation, fiber intake and non-compliance contribute to inadequate colonoscopy bowel preparation: a prospective cohort study.

PubMed

Fang, Jun; Fu, Hong Yu; Ma, Dan; Wang, Dong; Liu, Ya Ping; Wang, Yun Feng; Zhu, Chun Ping; Qian, Wei; Bai, Yu; Li, Zhao Shen

2016-07-01

Adequate bowel preparation is important for colonoscopy. Currently available evidence on the determinants of poor bowel preparation is largely derived from studies in Western countries. We aimed to identify the risk factors for inadequate bowel preparation for colonoscopy in the Chinese population. In this single-center study, patients admitted to the Outpatient Department between March 2013 and December 2015 and had indications for colonoscopy were prospectively enrolled. Questionnaires were administered to the patients. Their characteristics and procedure-related parameters such as procedure time were recorded. Bowel preparation was assessed using Boston bowel preparation scale score. A total of 409 patients with a mean age of 48.8 ± 12.9 years were enrolled in the study, 60.9% of whom were men. On univariate analysis, poor educational level (P = 0.020), chronic constipation (P = 0.001), taking no physical exercise after medication (P < 0.001), a high-fiber diet during the 24-h period immediately preceding the colonoscopy (P < 0.001), incomplete intake of medication (P < 0.001), the passage of yellow or dark stools before colonoscopy (P < 0.001), waiting time (P = 0.001) and stool frequency after medication (P = 0.048) were significantly associated with inadequate bowel preparation. On multivariate analysis, chronic constipation [odds ratio (OR) 2.05, 95% confidence interval (CI) 1.31-3.23, P = 0.002], incomplete intake of the medication (OR 2.77, 95% CI 1.47-5.21, P = 0.002) and a high-fiber diet within 24 h before colonoscopy (OR 2.15, 95% CI 1.40-3.28, P < 0.001) were independent risk factors for inadequate bowel preparation. Chronic constipation, poor compliance with treatment and high-fiber diet were predictors of poor bowel preparation. Patients with these risk factors require more effective strategies for bowel preparation. © 2016 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

Systematic review and network meta-analysis of the efficacy and safety of tumour necrosis factor inhibitor–methotrexate combination therapy versus triple therapy in rheumatoid arthritis

PubMed Central

Fleischmann, Roy; Tongbram, Vanita; van Vollenhoven, Ronald; Tang, Derek H; Chung, James; Collier, David; Urs, Shilpa; Ndirangu, Kerigo; Wells, George; Pope, Janet

2017-01-01

Objective Clinical trials have not consistently demonstrated differences between tumour necrosis factor inhibitor (TNFi) plus methotrexate and triple therapy (methotrexate plus hydroxychloroquine plus sulfasalazine) in rheumatoid arthritis (RA). The study objective was to estimate the efficacy, radiographic benefits, safety and patient-reported outcomes of TNFi–methotrexate versus triple therapy in patients with RA. Methods A systematic review and network meta-analysis (NMA) of randomised controlled trials of TNFi–methotrexate or triple therapy as one of the treatment arms in patients with an inadequate response to or who were naive to methotrexate was conducted. American College of Rheumatology 70% response criteria (ACR70) at 6 months was the prespecified primary endpoint to evaluate depth of response. Data from direct and indirect comparisons between TNFi–methotrexate and triple therapy were pooled and quantitatively analysed using fixed-effects and random-effects Bayesian models. Results We analysed 33 studies in patients with inadequate response to methotrexate and 19 in patients naive to methotrexate. In inadequate responders, triple therapy was associated with lower odds of achieving ACR70 at 6 months compared with TNFi–methotrexate (OR 0.35, 95% credible interval (CrI) 0.19 to 0.64). Most secondary endpoints tended to favour TNFi–methotrexate in terms of OR direction; however, no clear increased likelihood of achieving these endpoints was observed for either therapy. The odds of infection were lower with triple therapy than with TNFi−methotrexate (OR 0.08, 95% CrI 0.00 to 0.57). There were no differences observed between the two regimens in patients naive to methotrexate. Conclusions In this NMA, triple therapy was associated with 65% lower odds of achieving ACR70 at 6 months compared with TNFi–methotrexate in patients with inadequate response to methotrexate. Although secondary endpoints numerically favoured TNFi–methotrexate, no clear differences were observed. The odds of infection were greater with TNFi–methotrexate. No differences were observed for patients naive to methotrexate. These results may help inform care of patients who fail methotrexate first-line therapy. PMID:28123782

The Cost of Inadequate Sleep among On-Call Workers in Australia: A Workplace Perspective

PubMed Central

Ferguson, Sally A.; Jay, Sarah M.

2018-01-01

On-call or stand-by is becoming an increasingly prevalent form of work scheduling. However, on-call arrangements are typically utilised when workloads are low, for example at night, which can result in inadequate sleep. It is a matter of concern that on-call work is associated with an increased risk of workplace injury. This study sought to determine the economic cost of injury due to inadequate sleep in Australian on-call workers. The prevalence of inadequate sleep among on-call workers was determined using an online survey, and economic costs were estimated using a previously validated costing methodology. Two-thirds of the sample (66%) reported obtaining inadequate sleep on weekdays (work days) and over 80% reported inadequate sleep while on-call. The resulting cost of injury is estimated at $2.25 billion per year ($1.71–2.73 billion). This equates to $1222 per person per incident involving a short-term absence from work; $2.53 million per incident classified as full incapacity, and $1.78 million for each fatality. To the best of our knowledge this is the first study to quantify the economic cost of workplace injury due to inadequate sleep in on-call workers. Well-rested employees are critical to safe and productive workplace operations. Therefore, it is in the interest of both employers and governments to prioritise and invest far more into the management of inadequate sleep in industries which utilise on-call work arrangements. PMID:29495371

"Are cognitive interventions effective in Alzheimer's disease? A controlled meta- analysis of the effects of bias": Correction to Oltra-Cucarella et al. (2016).

PubMed

2016-07-01

Reports an error in "Are Cognitive Interventions Effective in Alzheimer's Disease? A Controlled Meta-Analysis of the Effects of Bias" by Javier Oltra-Cucarella, Rubén Pérez-Elvira, Raul Espert and Anita Sohn McCormick (Neuropsychology, Advanced Online Publication, Apr 7, 2016, np). In the article the first sentence of the third paragraph of the Source of bias subsection in the Statistical Analysis subsection of the Correlational Meta-Analysis section should read "For the control condition bias, three comparison groups were differentiated: (a) a structured cognitive intervention, (b) a placebo control condition, and (c) a pharma control condition without cognitive intervention or no treatment at all." (The following abstract of the original article appeared in record 2016-16656-001.) There is limited evidence about the efficacy of cognitive interventions for Alzheimer's disease (AD). However, aside from the methodological quality of the studies analyzed, the methodology used in previous meta-analyses is itself a risk of bias as different types of effect sizes (ESs) were calculated and combined. This study aimed at examining the results of nonpharmacological interventions for AD with an adequate control of statistical methods and to demonstrate a different approach to meta-analysis. ESs were calculated with the independent groups pre/post design. Average ESs for separate outcomes were calculated and moderator analyses were performed so as to offer an overview of the effects of bias. Eighty-seven outcomes from 19 studies (n = 812) were meta-analyzed. ESs were small on average for cognitive and functional outcomes after intervention. Moderator analyses showed no effect of control of bias, although ESs were different from zero only in some circumstances (e.g., memory outcomes in randomized studies). Cognitive interventions showed no more efficacy than placebo interventions, and functional ESs were consistently low across conditions. cognitive interventions delivered may not be effective in AD probably due to the fact that the assumptions behind the cognitive interventions might be inadequate. Future directions include a change in the type of intervention as well as the use of outcomes other than standardized tests. Additional studies with larger sample sizes and different designs are needed to increase the power of both primary studies and meta-analyses. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

A cross-national study of prescription nonadherence due to cost: data from the Joint Canada-United States Survey of Health.

PubMed

Kennedy, Jae; Morgan, Steve

2006-08-01

In Canada and the United States, patients who have difficulty paying for prescribed medications are less likely to obtain them and may experience increased risks for morbidity and mortality and/or increased health care costs due to nonadherence. As prescription drug costs have risen, the ability to pay for medications has emerged as a critical public health issue. The objectives of this study were to estimate the rates of cost-associated nonadherence in Canada and the United States, and to identify factors that predict cost-associated nonadherence in both countries. This original analysis used data from the 2002/2003 Joint Canada-US Survey of Health, a household phone survey jointly conducted by Statistics Canada (Ottawa, Ontario, Canada) and the US National Center for Health Statistics (Hyattsville, Maryland). The sample included 3505 adults in Canada and 5183 adults in the United States. Weighted group comparisons and logistic regression analyses were used to identify population factors predictive of cost-associated prescription nonadherence. Residents of Canada were much less likely than residents of the United States to report cost-associated nonadherence (5.1% vs 9.9%; P < 0.001). Americans without health insurance (28.2%) and Americans and Canadians without prescription-drug coverage (16.2%) were significantly more likely than those with insurance (6.2%) to report cost-associated nonadherence (P < 0.001). In addition to country of residence and insurance coverage, significant risk factors predictive of nonadherence were young age, poor health, chronic pain, and low household income. The results of this analysis suggest that people with low incomes and inadequate insurance, as well as those with poor health and/or chronic symptoms, are more likely to report failing to fill a prescription due to cost. The overall rate of cost-associated nonadherence was significantly higher in the United States than in Canada, even when other person-level factors were controlled for, including health insurance and prescription-drug coverage.

Stoic beliefs and health: development and preliminary validation of the Pathak-Wieten Stoicism Ideology Scale

PubMed Central

Pathak, Elizabeth B; Wieten, Sarah E; Wheldon, Christopher W

2017-01-01

Introduction We developed and validated a new parsimonious scale to measure stoic beliefs. Key domains of stoicism are imperviousness to strong emotions, indifference to death, taciturnity and self-sufficiency. In the context of illness and disease, a personal ideology of stoicism may create an internal resistance to objective needs, which can lead to negative consequences. Stoicism has been linked to help-seeking delays, inadequate pain treatment, caregiver strain and suicide after economic stress. Methods During 2013–2014, 390 adults aged 18+ years completed a brief anonymous paper questionnaire containing the preliminary 24-item Pathak-Wieten Stoicism Ideology Scale (PW-SIS). Confirmatory factor analysis (CFA) was used to test an a priori multidomain theoretical model. Content validity and response distributions were examined. Sociodemographic predictors of strong endorsement of stoicism were explored with logistic regression. Results The final PW-SIS contains four conceptual domains and 12 items. CFA showed very good model fit: root mean square error of approximation (RMSEA)=0.05 (95% CI 0.04 to 0.07), goodness-of-fit index=0.96 and Tucker-Lewis Index=0.93. Cronbach’s alpha was 0.78 and ranged from 0.64 to 0.71 for the subscales. Content validity analysis showed a statistically significant trend, with respondents who reported trying to be a stoic ‘all of the time’ having the highest PW-SIS scores. Men were over two times as likely as women to fall into the top quartile of responses (OR=2.30, 95% CI 1.44 to 3.68, P<0.001). ORs showing stronger endorsement of stoicism by Hispanics, Blacks and biracial persons were not statistically significant. Discussion The PW-SIS is a valid and theoretically coherent scale which is brief and practical for integration into a wide range of health behaviour and outcomes research studies. PMID:29138193

Stoic beliefs and health: development and preliminary validation of the Pathak-Wieten Stoicism Ideology Scale.

PubMed

Pathak, Elizabeth B; Wieten, Sarah E; Wheldon, Christopher W

2017-11-14

We developed and validated a new parsimonious scale to measure stoic beliefs. Key domains of stoicism are imperviousness to strong emotions, indifference to death, taciturnity and self-sufficiency. In the context of illness and disease, a personal ideology of stoicism may create an internal resistance to objective needs, which can lead to negative consequences. Stoicism has been linked to help-seeking delays, inadequate pain treatment, caregiver strain and suicide after economic stress. During 2013-2014, 390 adults aged 18+ years completed a brief anonymous paper questionnaire containing the preliminary 24-item Pathak-Wieten Stoicism Ideology Scale (PW-SIS). Confirmatory factor analysis (CFA) was used to test an a priori multidomain theoretical model. Content validity and response distributions were examined. Sociodemographic predictors of strong endorsement of stoicism were explored with logistic regression. The final PW-SIS contains four conceptual domains and 12 items. CFA showed very good model fit: root mean square error of approximation (RMSEA)=0.05 (95% CI 0.04 to 0.07), goodness-of-fit index=0.96 and Tucker-Lewis Index=0.93. Cronbach's alpha was 0.78 and ranged from 0.64 to 0.71 for the subscales. Content validity analysis showed a statistically significant trend, with respondents who reported trying to be a stoic 'all of the time' having the highest PW-SIS scores. Men were over two times as likely as women to fall into the top quartile of responses (OR=2.30, 95% CI 1.44 to 3.68, P<0.001). ORs showing stronger endorsement of stoicism by Hispanics, Blacks and biracial persons were not statistically significant. The PW-SIS is a valid and theoretically coherent scale which is brief and practical for integration into a wide range of health behaviour and outcomes research studies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Assessing differential expression in two-color microarrays: a resampling-based empirical Bayes approach.

PubMed

Li, Dongmei; Le Pape, Marc A; Parikh, Nisha I; Chen, Will X; Dye, Timothy D

2013-01-01

Microarrays are widely used for examining differential gene expression, identifying single nucleotide polymorphisms, and detecting methylation loci. Multiple testing methods in microarray data analysis aim at controlling both Type I and Type II error rates; however, real microarray data do not always fit their distribution assumptions. Smyth's ubiquitous parametric method, for example, inadequately accommodates violations of normality assumptions, resulting in inflated Type I error rates. The Significance Analysis of Microarrays, another widely used microarray data analysis method, is based on a permutation test and is robust to non-normally distributed data; however, the Significance Analysis of Microarrays method fold change criteria are problematic, and can critically alter the conclusion of a study, as a result of compositional changes of the control data set in the analysis. We propose a novel approach, combining resampling with empirical Bayes methods: the Resampling-based empirical Bayes Methods. This approach not only reduces false discovery rates for non-normally distributed microarray data, but it is also impervious to fold change threshold since no control data set selection is needed. Through simulation studies, sensitivities, specificities, total rejections, and false discovery rates are compared across the Smyth's parametric method, the Significance Analysis of Microarrays, and the Resampling-based empirical Bayes Methods. Differences in false discovery rates controls between each approach are illustrated through a preterm delivery methylation study. The results show that the Resampling-based empirical Bayes Methods offer significantly higher specificity and lower false discovery rates compared to Smyth's parametric method when data are not normally distributed. The Resampling-based empirical Bayes Methods also offers higher statistical power than the Significance Analysis of Microarrays method when the proportion of significantly differentially expressed genes is large for both normally and non-normally distributed data. Finally, the Resampling-based empirical Bayes Methods are generalizable to next generation sequencing RNA-seq data analysis.

Inadequate face mask ventilation--clinical applications.

PubMed

Goranović, Tatjana; Milić, Morena; Holjevac, Jadranka Katancić; Maldini, Branka; Sakić, Katarina

2010-09-01

Face mask ventilation is a life saving technique. This article will review aetiology and patophysiological consequences of inadequate mask ventilation. The main focus will be on circulatory changes during induction of anesthesia, before and in a short period after intubation that could be attributed to inadequate mask ventilation in humans.

Underemployment from a Human Service Perspective. Information Series No. 303.

ERIC Educational Resources Information Center

Meyer, David P.

The issue of underemployment (a condition characterized by inadequate hours, inadequate income, and/or inadequate use of skills) is explored in this monograph. The methodology and vocabulary of underemployment are first examined, including a definition synthesis of hours worked, skill utilization, and compensation. The second section provides…

Inadequate dietary protein intake: When does it occur and what are the consequences?

USDA-ARS?s Scientific Manuscript database

Previous work with country-level data has shown associations between inadequate protein supply and stunting rates. Inadequate protein intake is known to be deleterious in animals. Low dietary protein intake in children is associated with growth faltering. According to World Health Organization (WHO)...

Evaluation of three electronic noses for detecting incipient wood decay

Treesearch

Manuela Baietto; Alphus D. Wilson; Daniele Bassi; Francesco Ferrini

2010-01-01

Tree assessment methodologies, currently used to evaluate the structural stability of individual urban trees, usually involve a visual analysis followed by measurements of the internal soundness of wood using various instruments that are often invasive, expensive, or inadequate for use within the urban environment. Moreover, most conventional instruments do not provide...

The "Incestuous Family" Revisited: A Critical Analysis of Family Therapy Myths.

ERIC Educational Resources Information Center

James, Kerrie; MacKinnon, Laurie

1990-01-01

Critiques family therapy literature concerning incest. Identifies pervasive myths claiming that (1) fathers and mothers are pathologically disturbed or inadequate; (2) incest is caused by separation and loss; (3) family isolation or a rigid external boundary explains incest; and (4) incest serves a function in maintaining family organization.…

Survivors' Narratives of the Impact of Parental Suicide

ERIC Educational Resources Information Center

Ratnarajah, Dorothy; Schofield, Margot J.

2008-01-01

The impact of parental suicide on surviving children and their family system has received inadequate research attention. Using a qualitative narrative methodology with thematic analysis, we explored the short-term and lifelong impact of parental suicide among 10 adults who, as children or adolescents, had lost a parent through suicide. The suicide…

Pathways to a STEMM Profession

ERIC Educational Resources Information Center

Miller, Jon D.; Kimmel, Linda G.

2012-01-01

The inadequate number of American young adults selecting a scientific or engineering profession continues to be a major national concern. Using data from the 23-year record of the Longitudinal Study of American Youth (LSAY) and working within the social learning paradigm, this analysis uses a set of 21 variables to predict young people's…

Analysis of induction and establishment of dwarf bunt of wheat under marginal climatic conditions.

USDA-ARS?s Scientific Manuscript database

Dwarf bunt caused by Tilletia contraversa is a disease of winter wheat that has a limited geographic distribution due to specific winter climate requirements. The pathogen is listed as a quarantine organism by several countries that may have wheat production areas with inadequate or marginal climat...

High School Administrative Staffing in Washington State: Principal Perspectives on Resource Needs and Utilization

ERIC Educational Resources Information Center

Steach, John C.

2011-01-01

This mixed methods study explored how high school principals prioritize their work and utilize available human resources to adjust to inadequate administrative staffing. Analysis of staffing levels across the state of Washington and specifically inside two eastern Washington districts framed interview questions for central office administration…

Mentoring in Cooperative Education and Internships: Preparing Proteges for STEM Professions

ERIC Educational Resources Information Center

Fifolt, Matt; Searby, Linda

2010-01-01

This paper presents the findings of a mixed methods study regarding students' perceptions of mentoring in a cooperative education (co-op) program. Specifically, content analysis of student interviews suggested a lack of understanding of the mentoring process as characterized by unexamined assumptions and inadequate preparation for the co-op…

Rules? Relationships?: A Feminist Analysis of Competition and Fair Play in Physical Education

ERIC Educational Resources Information Center

Singleton, Ellen

2003-01-01

Regardless of recent curriculum revisions, physical educators, faced with reduced time and/or inadequate equipment and facilities, continue to offer competitive team sport activities for a high percentage of their program time. When competition is only experienced as a win-lose situation, possibilities that students will derive any morally…

Proceedings of a Workshop on Community Impact Analysis (Lexington, Kentucky, May 24-26, 1982).

ERIC Educational Resources Information Center

Southern Rural Development Center, Mississippi State, MS.

The Southern Rural Development Center in cooperation with the University of Kentucky sponsored a workshop which brought together extension and research personnel interested in rural economic development concerns (i.e., inadequate water supplies, sewer systems, and schools). The proceedings include "Community Growth Management: The Land-Grant…