Mental Health of Parents as Caregivers of Children with Disabilities: Based on Japanese Nationwide Survey

PubMed Central

Yamaoka, Yui; Tamiya, Nanako; Moriyama, Yoko; Sandoval Garrido, Felipe Alfonso; Sumazaki, Ryo; Noguchi, Haruko

2015-01-01

The number of children with disability is increasing gradually in Japan. Previous researches in other countries have reported that parents as caregivers (CGs) of children with disability have mental health problems, but the actual situation has not been examined nationwide in Japan so far. The aim of this study was to evaluate the association between mental health of CGs who had children with disability and characteristics of children, CGs, and household based on the nation-wide survey. This study utilized data from 2010 Comprehensive Survey of the Living Conditions, and defined children with disability aged 6 to 17. Individual data of children and CGs were linked, and 549 pairs of them were extracted. The Japanese version of Kessler 6 (K6) was used to assess mental health status of caregiver, scored 5 and over represented to general psychological distress. Logistic regression was used to evaluate the associations of interest. The almost half (44.4%) of CGs had psychological distress (k6 score; 5 +) in nationwide, and 8.9% of CGs might have serious mental illness (K6 score; 13+). After adjusting covariates of child, CG, and household factors, CG having a current symptom (OR, 95% CI: 3.26, 1.97–5.39), CG's activity restriction (OR, 95% CI: 2.95, 1.38–6.32), low social support (OR, 95%CI: 9.31, 1.85–46.8), three generation family (OR, 95% CI: 0.49, 0.26–0.92), and lower 25% tile group of monthly household expenditure (OR, 95% CI:1.92, 1.05–3.54), were significantly associated with psychological distress of CGs. This study encourages health care providers to pay more attentions toward parent's mental health, especially for in case of having low social support, and lower income family. Further research should examine the detailed information of child's disease and disability, medical service use, and quality and quantity of social support in nationwide to straighten the system for supporting services of both children with disabilities and their CGs. PMID:26692344

Nation-Wide Korean Breast Cancer Data from 2008 Using the Breast Cancer Registration Program

PubMed Central

Na, Kuk Young; Kim, Ku Sang; Ahn, Sei-Hyun; Lee, Soo-Joong; Park, Heung Kyu; Cho, Young Up

2011-01-01

Purpose Since 1996, the Korean Breast Cancer Society has collected nation-wide breast cancer data and analyzed the data using their online registration program biannually. The purpose of this study was to evaluate the characteristics of Korean breast cancer from 2008 and examine chronological based patterns. Methods Data were collected from 38 medical schools (67 hospitals), 20 general hospitals, and 10 private clinics. The data on the total number, gender, and age distribution were collected through a questionnaire as well as other detailed data analyzed via the online registration program. Results In 2008, there were 13,908 patients who were newly diagnosed with breast cancer. The crude incidence rate of female breast cancer was 57.3 among 100,000 and the median age was 49 years. The age distribution had not changed since the initial survey; however the proportion of postmenopausal patients had increased and median age was older than the past. In staging distribution, the proportion of early breast cancer (stage 0, I) was 47.2% with, breast-conserving surgery performed in 58% and mastectomy in 39.5%. Conclusion Compared to past data, the incidence of breast cancer in Korea continues to rise. Furthermore, the proportion of those detected by screening and breast conservation surgery has increased remarkably. To understand the patterns of Korean breast cancer, the nation-wide data should continuously investigated. PMID:22031806

URBAN STORMWATER INVESTIGATIONS BY THE U. S. GEOLOGICAL SURVEY.

USGS Publications Warehouse

Jennings, Marshall E.

1985-01-01

Urban stormwater hydrology studies in the U. S. Geological Survey are currently focused on compilation of national data bases containing flood-peak and short time-interval rainfall, discharge and water-quality information for urban watersheds. Current data bases, updated annually, are nationwide in scope. Supplementing the national data files are published reports of interpretative analyses, a map report and research products including improved instrumentation and deterministic modeling capabilities. New directions of Survey investigations include gaging programs for very small catchments and for stormwater detention facilities.

Trimethoprim use in early pregnancy and the risk of miscarriage: a register-based nationwide cohort study.

PubMed

Andersen, J T; Petersen, M; Jimenez-Solem, E; Broedbaek, K; Andersen, E W; Andersen, N L; Afzal, S; Torp-Pedersen, C; Keiding, N; Poulsen, H E

2013-08-01

The antibiotic trimethoprim acts as a folate antagonist. Since trophoblasts are very sensitive to drugs that interfere with the folic acid cycle and thereby inhibit DNA synthesis, use of trimethoprim during the first trimester could be associated with miscarriage. A nationwide cohort study including all women in Denmark with a registered pregnancy between 1997 and 2005 was conducted. We used nationwide registers to identify all women giving birth, having a record of miscarriage or induced abortion. Data on exposure to trimethoprim were obtained from the National Prescription Register. Cox proportional hazard regression analysis with exposure to trimethoprim as a time-dependent variable was used to estimate the risk of miscarriage. The adjusted hazard ratio of having a miscarriage after exposure to trimethoprim in the first trimester compared to non-exposure was 2∙04 (95% confidence interval 1∙43-2∙91). Our results indicate that trimethoprim exposure in the first trimester is associated with a doubling of the hazard of miscarriage.

Comparing field- and model-based standing dead tree carbon stock estimates across forests of the US

Treesearch

Chistopher W. Woodall; Grant M. Domke; David W. MacFarlane; Christopher M. Oswalt

2012-01-01

As signatories to the United Nation Framework Convention on Climate Change, the US has been estimating standing dead tree (SDT) carbon (C) stocks using a model based on live tree attributes. The USDA Forest Service began sampling SDTs nationwide in 1999. With comprehensive field data now available, the objective of this study was to compare field- and model-based...

Nationwide population-based study of cause-specific death rates in patients with psoriasis.

PubMed

Salahadeen, E; Torp-Pedersen, C; Gislason, G; Hansen, P R; Ahlehoff, O

2015-05-01

Psoriasis is a common chronic disease, mediated by type 1 and 17 helper T cell-driven inflammation. Epidemiological studies have demonstrated a wide range of comorbidities and increased mortality rates. However, the current evidence on psoriasis-related mortality is limited and nationwide data have not been presented previously. In a nationwide population-based cohort we evaluated all-cause and cause-specific death rates in patients with psoriasis as compared to the general population. The entire Danish population aged 18 and above, corresponding to a total of 5,458,627 individuals (50.7% female, 40.9 years ± 19.7), including 94,069 with mild psoriasis (53% female, 42.0 ± 17.0 years) and 28,253 with severe psoriasis (53.4% female, 43.0 ± 16.5 years), was included. A total of 884,661 deaths were recorded, including 10 916 in patients with mild psoriasis and 3699 in patients with severe psoriasis. The age at time of death varied by psoriasis status, i.e. 76.5 ± 14.0, 74.4 ± 12.8 and 72.0 ± 13.4 years, for the general population, mild psoriasis and severe psoriasis respectively. In general, the highest death rates were observed in patients with severe psoriasis. Overall death rates per 1000 patient years were 13.8 [confidence interval (CI) 13.8-13.8], 17.0 (CI 16.7-17.3) and 25.4 (CI 24.6-26.3) for the general population, patients with mild psoriasis and patients with severe psoriasis respectively. This nationwide population-based study of cause-specific death rates in patients with psoriasis demonstrated reduced lifespan and increased rates of all examined specific causes of death in patients with psoriasis compared to the general population. © 2014 European Academy of Dermatology and Venereology.

Cancer registries in Japan: National Clinical Database and site-specific cancer registries.

PubMed

Anazawa, Takayuki; Miyata, Hiroaki; Gotoh, Mitsukazu

2015-02-01

The cancer registry is an essential part of any rational program of evidence-based cancer control. The cancer control program is required to strategize in a systematic and impartial manner and efficiently utilize limited resources. In Japan, the National Clinical Database (NCD) was launched in 2010. It is a nationwide prospective registry linked to various types of board certification systems regarding surgery. The NCD is a nationally validated database using web-based data collection software; it is risk adjusted and outcome based to improve the quality of surgical care. The NCD generalizes site-specific cancer registries by taking advantage of their excellent organizing ability. Some site-specific cancer registries, including pancreatic, breast, and liver cancer registries have already been combined with the NCD. Cooperation between the NCD and site-specific cancer registries can establish a valuable platform to develop a cancer care plan in Japan. Furthermore, the prognosis information of cancer patients arranged using population-based and hospital-based cancer registries can help in efficient data accumulation on the NCD. International collaboration between Japan and the USA has recently started and is expected to provide global benchmarking and to allow a valuable comparison of cancer treatment practices between countries using nationwide cancer registries in the future. Clinical research and evidence-based policy recommendation based on accurate data from the nationwide database may positively impact the public.

Occupational risk factors for systemic lupus erythematosus: a nationwide study based on hospitalizations in Sweden.

PubMed

Li, Xinjun; Sundquist, Jan; Sundquist, Kristina; Zöller, Bengt

2012-04-01

To investigate possible associations between occupation and hospitalization for systemic lupus erythematosus (SLE) in a nationwide study. A nationwide database was constructed in Sweden by linking the Swedish Census to the Hospital Discharge Register to obtain data on all first hospitalizations with a primary or secondary diagnosis of SLE in adults during the study period (1970 to 2008). Standardized incidence ratios (SIR) and 95% CI were calculated for different occupations. Two cohorts were defined based on occupational titles recorded in Swedish census data in 1970 and 1980. A total of 8921 male and 42290 female hospitalizations for SLE were retrieved in individuals aged over 15 years. High education (> 12 yrs) was associated with a lower risk of hospitalization for SLE among both women (SIR = 0.73) and men (SIR = 0.72). Among men with the same occupation in 2 consecutive censuses, increased risks (SIR) > 2.0 were present among artistic workers (2.52); shop managers and assistants (3.63); miners and quarry workers (6.04); shoe and leather workers (6.93); plumbers (2.21); other construction workers (2.08); glass, ceramic and tile workers (4.43); chimney sweeps (4.54); and military personnel (3.01). Among women with the same occupation in 2 consecutive censuses, no occupation was associated with SIR > 2.0. Occupation may carry significantly increased risk of hospital admission for SLE. Especially among men, several occupations were associated with increased risks for SLE.

Time Trends over 16 Years in Incidence-Rates of Autism Spectrum Disorders across the Lifespan Based on Nationwide Danish Register Data

ERIC Educational Resources Information Center

Jensen, Christina Mohr; Steinhausen, Hans-Christoph; Lauritsen, Marlene Briciet

2014-01-01

This study investigated time trends and associated factors of incidence rates of diagnosed autism spectrum disorders (ASD) across the lifespan from 1995 to 2010, using data from the Danish Psychiatric Central Research Registry. First time diagnosis of childhood autism, atypical autism, Asperger's syndrome, or pervasive developmental…

Synthesis of Available Research and Databases on the Migrant Education Program. Volume II: the Migrant Student Record Transfer System.

ERIC Educational Resources Information Center

Eckels, Elaine; Vorek, Robert

The Migrant Student Record Transfer System (MSRTS) is a nationwide computer-based communications network originally designed to transfer the health and educational records of migrant workers' children. This report assesses MSRTS data from September 1984 through June 1986 to determine the potential utility of such data for national studies of the…

The need for obtaining accurate nationwide estimates of diabetes prevalence in India - Rationale for a national study on diabetes

PubMed Central

Anjana, R.M.; Ali, M.K.; Pradeepa, R.; Deepa, M.; Datta, M.; Unnikrishnan, R.; Rema, M.; Mohan, V.

2011-01-01

According to the World Diabetes Atlas, India is projected to have around 51 million people with diabetes. However, these data are based on small sporadic studies done in some parts of the country. Even a few multi-centre studies that have been done, have several limitations. Also, marked heterogeneity between States limits the generalizability of results. Other studies done at various time periods also lack uniform methodology, do not take into consideration ethnic differences and have inadequate coverage. Thus, till date there has been no national study on the prevalence of diabetes which are truly representative of India as a whole. Moreover, the data on diabetes complications is even more scarce. Therefore, there is an urgent need for a large well-planned national study, which could provide reliable nationwide data, not only on prevalence of diabetes, but also on pre-diabetes, and the complications of diabetes in India. A study of this nature will have enormous public health impact and help policy makers to take action against diabetes in India. PMID:21537089

1977 Nationwide Personal Transportation Study : urban/rural split of travel

DOT National Transportation Integrated Search

1982-06-01

This report is part of a series that provides findings from the 1977 Nationwide Personal Transportation Study (NPTS). Data related to the urban/rural split of travel are analyzed for all trips and vehicle miles of travel made in a private motor vehic...

1977 Nationwide Personal Transportation Study : a life cycle of travel by the American family

DOT National Transportation Integrated Search

1981-07-01

This report provides information about family trips and travel from the point of view of the family life cycle, using data from the 1977 Nationwide Personal Transportation Study. Daily travel characteristics of families in stages of four life cycles ...

Mass Communication and Journalism Faculty's Perceptions of the Effectiveness of Email Communication with College Students: A Nationwide Study

ERIC Educational Resources Information Center

Yates, Bradford L.; Adams, Jennifer Wood; Brunner, Brigitta R.

2009-01-01

Nearly 700 US journalism and mass communication faculty (all teaching personnel) reported their perceptions of student email use via a web-based survey. This nationwide study focused on the content of email sent by faculty to students, email's effectiveness, and email's effect on student learning. Comparisons were made based on faculty gender,…

Nationwide disturbance attribution on NASA’s earth exchange: experiences in a high-end computing environment

Treesearch

J. Chris Toney; Karen G. Schleeweis; Jennifer Dungan; Andrew Michaelis; Todd Schroeder; Gretchen G. Moisen

2015-01-01

The North American Forest Dynamics (NAFD) project’s Attribution Team is completing nationwide processing of historic Landsat data to provide a comprehensive annual, wall-to-wall analysis of US disturbance history, with attribution, over the last 25+ years. Per-pixel time series analysis based on a new nonparametric curve fitting algorithm yields several metrics useful...

An Overview of Classes Taken and Credits Earned by Beginning Postsecondary Students. WEB Tables. NCES 2013-151rev

ERIC Educational Resources Information Center

Radford, Alexandria Walton; Horn, Laura

2012-01-01

These Web Tables provide an overview of classes taken and credits earned by a nationwide sample of first-time beginning postsecondary students based on data from the Postsecondary Education Transcript Study (PETS) of the 2004/09 Beginning Postsecondary Students Longitudinal Study. PETS collected transcripts from all the postsecondary institutions…

Incidence of Hospitalization Due to Child Maltreatment in Taiwan, 1996-2007: A Nationwide Population-Based Study

ERIC Educational Resources Information Center

Chiang, Wan-Lin; Huang, Yu-Tung; Feng, Jui-Ying; Lu, Tsung-Hsueh

2012-01-01

Objectives: Little is known regarding the epidemiology of child maltreatment in Asian countries. This study aimed to examine the incidence of hospitalization coded as due to child maltreatment in Taiwan. Methods: We used inpatient claims data of the National Health Insurance for the years 1996 through 2007 for estimation. Hospitalization of…

Health examination utilization in the visually disabled population in Taiwan: a nationwide population-based study

PubMed Central

2013-01-01

Background People with visual disabilities have increased health needs but face worse inequity to preventive health examinations. To date, only a few nationwide studies have analyzed the utilization of preventive adult health examinations by the visually disabled population. The aim of this study was to investigate the utilization of health examinations by the visually disabled population, and analyze the factors associated with the utilization. Methods Visual disability was certified by ophthalmologists and authenticated by the Ministry of the Interior (MOI), Taiwan. We linked data from three different nationwide datasets (from the MOI, Bureau of Health Promotion, and National Health Research Institutes) between 2006 and 2008 as the data sources. Independent variables included demographic characteristics, income status, health status, and severity of disability; health examination utilization status was the dependent variable. The chi-square test was used to check statistical differences between variables, and a multivariate logistic regression model was used to examine the associated factors with health examination utilization. Results In total, 47,812 visually disabled subjects aged 40 years and over were included in this study, only 16.6% of whom received a health examination. Lower utilization was more likely in male subjects, in those aged 65 years and above, insured dependents and those with a top-ranked premium-based salary, catastrophic illness/injury, chronic diseases of the genitourinary system, and severe or very severe disabilities. Conclusion The overall health examination utilization in the visually disabled population was very low. Lower utilization occurred mainly in males, the elderly, and those with severe disabilities. PMID:24313981

Dissemination of Evidence-Based Practice to Directors of Nursing by an Outreach Campaign in Taiwan.

PubMed

Weng, Yi-Hao; Chen, Chiehfeng; Chen, Kee-Hsin; Kuo, Ken N; Yang, Chun-Yuh; Chiu, Ya-Wen

2016-04-01

Directors of nursing (DONs) have an important influence in the dissemination of evidence-based practice (EBP) in hospital settings. The current study examined how the knowledge, skills, and behaviors of DONs changed when EBP was implemented during a 5-year, nationwide promotional campaign providing EBP-related information resources and promotional activities in regional hospitals in Taiwan. Cross-sectional questionnaire surveys for a nationwide representative sample of DONs were conducted in 2007, 2009, and 2011 to examine views related to EBP, including changes in beliefs, attitudes, knowledge, skills, behaviors, and barriers. This study enrolled 267 DONs in 2007, 257 in 2009, and 287 in 2011. During the study period, DONs' EBP knowledge and skills increased, but their beliefs and attitudes did not significantly change. Furthermore, the use of Internet-based resources, including web portals, electronic textbooks, electronic journals, and evidence-based online databases, increased. Most barriers significantly declined after the intervention. DONs' knowledge, skills, and behaviors regarding EBP increased after the multifaceted intervention. The data suggest this outreach program is useful in disseminating EBP implementation to DONs. Copyright 2016, SLACK Incorporated.

Epilepsy in Individuals with a History of Asperger's Syndrome: A Danish Nationwide Register-Based Cohort Study

ERIC Educational Resources Information Center

Mouridsen, Svend Erik; Rich, Bente; Isager, Torben

2013-01-01

We performed a nationwide, register-based retrospective follow-up study of epilepsy in all people who were born between January 1, 1980 and June 29, 2006 and registered in the Danish Psychiatric Central Register with Asperger's syndrome on February 7, 2011. All 4,180 identified cases with AS (3,431 males and 749 females) were screened through the…

Risk model of thoracic aortic surgery in 4707 cases from a nationwide single-race population through a web-based data entry system: the first report of 30-day and 30-day operative outcome risk models for thoracic aortic surgery.

PubMed

Motomura, Noboru; Miyata, Hiroaki; Tsukihara, Hiroyuki; Takamoto, Shinichi

2008-09-30

The objective of this study was to collect integrated data from nationwide hospitals using a web-based national database system to build up our own risk model for the outcome from thoracic aortic surgery. The Japan Adult Cardiovascular Surgery Database was used; this involved approximately 180 hospitals throughout Japan through a web-based data entry system. Variables and definitions are almost identical to the STS National Database. After data cleanup, 4707 records were analyzed from 97 hospitals (between January 1, 2000, and December 31, 2005). Mean age was 66.5 years. Preoperatively, the incidence of chronic lung disease was 11%, renal failure was 9%, and rupture or malperfusion was 10%. The incidence of the location along the aorta requiring replacement surgery (including overlapping areas) was: aortic root, 10%; ascending aorta, 47%; aortic arch, 44%; distal arch, 21%; descending aorta, 27%; and thoracoabdominal aorta, 8%. Raw 30-day and 30-day operative mortality rates were 6.7% and 8.6%, respectively. Postoperative incidence of permanent stroke was 6.1%, and renal failure requiring dialysis was 6.7%. OR for 30-day operative mortality was as follows: emergency or salvage, 3.7; creatinine >3.0 mg/dL, 3.0; and unexpected coronary artery bypass graft, 2.6. As a performance metric of the risk model, C-index of 30-day and 30-day operative mortality was 0.79 and 0.78, respectively. This is the first report of risk stratification on thoracic aortic surgery using a nationwide surgical database. Although condition of these patients undergoing thoracic aortic surgery was much more serious than other procedures, the result of this series was excellent.

Chronotype correlates with developmental index, intelligence and academic achievement: A study based on nationwide indicators.

PubMed

Randler, Christoph

2017-01-01

Chronotype or morningness-eveningness (M/E) is an individual trait with a biological basis. In this study, I analysed the relationship between M/E and nationwide available data, such as economic variables, school achievement, intelligence and conscientiousness, which is a personality trait. These variables have been chosen because, first, they are linked on the individual level with circadian preference, and, second these associations have been found based on meta-analyses, which gives these findings a high plausibility. In addition, economic status has also been proposed to be related to M/E. Higher developed countries showed a lower morningness, based on both, the ranking of countries as well as on the HDI value. Similarly, GNI was related to morningness, while higher intelligence and performance in PISA were related to eveningness. Conscientiousness was related to morningness, although the results failed the significance level marginally. When using IQ as a control variable in partial correlations, the relationship between GNI and morningness disappeared, as did the correlation between eveningness and PISA results.

Incidence and mortality of herpes simplex encephalitis in Denmark: A nationwide registry-based cohort study.

PubMed

Jørgensen, Laura Krogh; Dalgaard, Lars Skov; Østergaard, Lars Jørgen; Nørgaard, Mette; Mogensen, Trine Hyrup

2017-01-01

We aimed to investigate the incidence and mortality of herpes simplex encephalitis (HSE) in a nationwide cohort. From the Danish National Patient Registry, we identified all adults hospitalised with a first-time diagnosis of HSE in Denmark during 2004-2014. The HSE diagnoses were verified using medical records and microbiological data. Patients were followed for mortality through the Danish Civil Registry System. We estimated age-standardised incidence rates of HSE and 30-day, 60-day, and 1-year cumulative mortality. Furthermore, we assessed whether calendar year, age, gender, level of comorbidity, virus type, and department type was associated with HSE mortality. We identified a total of 230 cases of HSE. Median age was 60.7 years (interquartile range: 49.3-71.6). The overall incidence rate was 4.64 cases per million population per year (95% confidence interval: 4.06-5.28). The cumulative mortality within 30 days, 60 days, and 1 year of the HSE admission was 8.3%, 11.3%, and 18.6%, respectively. Advanced age and presence of comorbidity were associated with increased 60-day and 1-year mortality. This nationwide study of verified HSE found a higher incidence than reported in previous nationwide studies. Presence of comorbidity was identified as a novel adverse prognostic factor. Mortality rates following HSE remain high. Copyright © 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

The Humanities and Sciences in Two-Year Colleges.

ERIC Educational Resources Information Center

Brawer, Florence B., Ed.

Based on research conducted by the Center for the Study of Community Colleges between 1975 and 1980, this monograph presents 11 articles on the role of humanities and sciences at two-year colleges. In the first three articles, Miriam Beckwith compares data on humanities faculty in Washington State with nationwide information; Joseph Marks…

The Supervision of Information Technology Classrooms in Turkey: A Nationwide Survey

ERIC Educational Resources Information Center

Memisoglu, Salih Pasa

2007-01-01

The purpose of this study was to identify how primary school supervisors carry out their roles concerning information and communications technology (ICT) based classrooms in public primary schools in Turkey. Data were collected via a questionnaire from 583 primary school supervisors working in 17 different provinces. Statistical programs were used…

Forensic Psychiatric Perspective on Criminality Associated with Intellectual Disability: A Nationwide Register-Based Study

ERIC Educational Resources Information Center

Mannynsalo, L.; Putkonen, H.; Lindberg, N.; Kotilainen, I.

2009-01-01

Background: Contrasting views exist over the association of intellectual disability (ID) and criminal offending. This nationwide study attempts to shed further light to expand understanding to substantiate the relation between socio-demographic characteristics, psychiatric co-morbidity and criminal behaviour among the Finnish forensic population…

Differences in Household Registration and College Student Employment--An Empirical Study Based on an Employment Survey of College Graduates

ERIC Educational Resources Information Center

Yujie, Wang; Yali, Liu; Zebing, Li; Chunbing, Xing; Xiaoyong, Cui; Cheng, Jiang

2017-01-01

This article uses 2011 sampling survey data on the nationwide state of employment of college graduates to investigate differences in the following three areas: starting salary, industry entry, and entry to state-owned work units between college students with urban and rural household registrations. The study finds that college students with rural…

Food Hygiene Education in UK Secondary Schools: A Nationwide Survey of Teachers' Views

ERIC Educational Resources Information Center

Egan, M. B.; Bielby, G.; Eves, A.; Lumbers, M. L.; Raats, M. M.; Adams, M. R.

2008-01-01

Objective: A nationwide survey of teachers investigated the teaching of food hygiene in UK secondary schools. Previous studies have focused on effective strategies in consumer food hygiene training but there is little research focusing on school-based education. Design: The questionnaire was developed based on the results of in-depth interviews…

Measles resurgence following a nationwide measles vaccination campaign in Nigeria, 2005-2008.

PubMed

Weldegebriel, Goitom G; Gasasira, Alex; Harvey, Pauline; Masresha, Balcha; Goodson, James L; Pate, Muhammad A; Abanida, Emmanuel; Chevez, Ana

2011-07-01

From 1990 through 2008, routine immunization coverage of measles vaccine in Nigeria ranged from 35% to 70%. Nigeria conducted a nationwide measles vaccination campaign in 2 phases during 2005-2006 that targeted children aged 9 months to 14 years; in 2008, a nationwide follow-up campaign that targeted children aged 9 months to 4 years was conducted in 2 phases. Despite these efforts, measles cases continued to occur. This is a descriptive study that reviewed the measles immunization coverage data from administrative, World Health Organization, United Nations Children's Fund, survey, and supplemental immunization activities data. Measles surveillance data were analyzed from case-based surveillance reports. Confirmed measles cases increased from 383 in 2006 to 2542 in 2007 and to 9510 in 2008. Of the confirmed cases in 2008, 717 (30%) occurred in children <2 years of age, 1145 (48%) in children 2-4 years of age, and 354 (14%) were in children 5-14 years of age. In 2008, the measles case fatality rate was 1.2%. Suboptimal routine coverage and the wide interval between the catch-up and follow-up campaigns likely led to an accumulation of children susceptible to measles. © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.

Population-based prevalence, incidence, and disease burden of autoimmune hepatitis in South Korea

PubMed Central

Ki, Moran; Kim, Kyung-Ah; Jang, Eun Sun; Jeong, Sook-Hyang

2017-01-01

Background and aim Little is known about population-based epidemiology and disease burden of autoimmune hepatitis (AIH). The aim of this study was to investigate the prevalence, incidence, comorbidity and direct medical cost of AIH in South Korea. Methods The data was from the nationwide, population-based National Health Insurance Service claims database and the Rare Intractable Disease registration program. Age and gender-specific prevalence rates were calculated, and data on comorbidity, diagnostic tests, prescribed drugs, and medical costs were retrieved for patients registered under the disease code K75.4 (AIH) from 2009 to 2013. Results A total of 4,085 patients with AIH were identified between 2009 and 2013 with a female-to-male ratio of 6.4. The age-adjusted prevalence rate was 4.82/100,000 persons and gender adjusted prevalence rates were 8.35 in females and 1.30 in males. The age-adjusted calculated incidence rate was 1.07/100,000 persons (gender-adjusted 1.83 in females and 0.31 in males). Ascites, variceal bleeding, and hepatocellular carcinoma were found in 1.4%, 1.3%, and 2.2% of the patients, respectively. Forty-six patients (1.1%) underwent liver transplantation during the study period. Case-fatality was 2.18%. Corticosteroid and azathioprine were prescribed in 44.1% and 38.0% of prevalent patients with AIH in 2013, respectively. The nationwide total direct medical cost was less than 4.0 million USD, and the average cost for each patient was 1,174 USD in 2013. Conclusion This is the first report on the nationwide epidemiology of AIH in Korea, and it showed a lower prevalence than that of Western countries with considerable disease burden. PMID:28771543

Benchmarking the quality of breast cancer care in a nationwide voluntary system: the first five-year results (2003–2007) from Germany as a proof of concept

PubMed Central

Brucker, Sara Y; Schumacher, Claudia; Sohn, Christoph; Rezai, Mahdi; Bamberg, Michael; Wallwiener, Diethelm

2008-01-01

Background The main study objectives were: to establish a nationwide voluntary collaborative network of breast centres with independent data analysis; to define suitable quality indicators (QIs) for benchmarking the quality of breast cancer (BC) care; to demonstrate existing differences in BC care quality; and to show that BC care quality improved with benchmarking from 2003 to 2007. Methods BC centres participated voluntarily in a scientific benchmarking procedure. A generic XML-based data set was developed and used for data collection. Nine guideline-based quality targets serving as rate-based QIs were initially defined, reviewed annually and modified or expanded accordingly. QI changes over time were analysed descriptively. Results During 2003–2007, respective increases in participating breast centres and postoperatively confirmed BCs were from 59 to 220 and from 5,994 to 31,656 (> 60% of new BCs/year in Germany). Starting from 9 process QIs, 12 QIs were developed by 2007 as surrogates for long-term outcome. Results for most QIs increased. From 2003 to 2007, the most notable increases seen were for preoperative histological confirmation of diagnosis (58% (in 2003) to 88% (in 2007)), appropriate endocrine therapy in hormone receptor-positive patients (27 to 93%), appropriate radiotherapy after breast-conserving therapy (20 to 79%) and appropriate radiotherapy after mastectomy (8 to 65%). Conclusion Nationwide external benchmarking of BC care is feasible and successful. The benchmarking system described allows both comparisons among participating institutions as well as the tracking of changes in average quality of care over time for the network as a whole. Marked QI increases indicate improved quality of BC care. PMID:19055735

Benchmarking the quality of breast cancer care in a nationwide voluntary system: the first five-year results (2003-2007) from Germany as a proof of concept.

PubMed

Brucker, Sara Y; Schumacher, Claudia; Sohn, Christoph; Rezai, Mahdi; Bamberg, Michael; Wallwiener, Diethelm

2008-12-02

The main study objectives were: to establish a nationwide voluntary collaborative network of breast centres with independent data analysis; to define suitable quality indicators (QIs) for benchmarking the quality of breast cancer (BC) care; to demonstrate existing differences in BC care quality; and to show that BC care quality improved with benchmarking from 2003 to 2007. BC centres participated voluntarily in a scientific benchmarking procedure. A generic XML-based data set was developed and used for data collection. Nine guideline-based quality targets serving as rate-based QIs were initially defined, reviewed annually and modified or expanded accordingly. QI changes over time were analysed descriptively. During 2003-2007, respective increases in participating breast centres and postoperatively confirmed BCs were from 59 to 220 and from 5,994 to 31,656 (> 60% of new BCs/year in Germany). Starting from 9 process QIs, 12 QIs were developed by 2007 as surrogates for long-term outcome. Results for most QIs increased. From 2003 to 2007, the most notable increases seen were for preoperative histological confirmation of diagnosis (58% (in 2003) to 88% (in 2007)), appropriate endocrine therapy in hormone receptor-positive patients (27 to 93%), appropriate radiotherapy after breast-conserving therapy (20 to 79%) and appropriate radiotherapy after mastectomy (8 to 65%). Nationwide external benchmarking of BC care is feasible and successful. The benchmarking system described allows both comparisons among participating institutions as well as the tracking of changes in average quality of care over time for the network as a whole. Marked QI increases indicate improved quality of BC care.

Determinants of Taxpayers' Adoption of Electronic Filing Methods in Taiwan: An Exploratory Study

ERIC Educational Resources Information Center

Fu, Jen-Ruei; Chao, Wen-Pin; Farn, Cheng-Kiang

2004-01-01

Using the personal income tax filing as an example of e-governmental services, this paper seeks to develop an understanding of the factors that influence citizens' adoption of electronic tax-filing services based on empirical data gathered from a large-scale nationwide survey. The taxpayers' satisfaction and usage intention regarding the use of…

Investigating Gender Differences on Homework in Middle School Mathematics

ERIC Educational Resources Information Center

Feng, Mingyu; Roschelle, Jeremy; Mason, Craig; Bhanot, Ruchi

2016-01-01

Recent studies [10, 23] using US nationwide databases showed high school boys spent significantly less time doing homework than girls, based on their responses to questionnaires and surveys. To investigate gender differences in homework in middle school, in this paper, we analyzed computer log data and standardized test scores of more than 1,000…

Welfare to Wages: Strategies To Assist the Private Sector To Employ Welfare Recipients. Companion Case Studies, Focus Groups & Data Analysis.

ERIC Educational Resources Information Center

Roberts, Brandon; Padden, Jeffrey D.

This report, which is directed toward policymakers at the local, state, and national levels, is based on an extensive nationwide study of welfare-to-work initiatives. It identifies strategies to assist the private sector in employing welfare recipients. The document begins with an executive summary that discusses the following: the research study…

Effects of Familial Risk Factors and Place of Birth on the Risk of Autism: A Nationwide Register-Based Study

ERIC Educational Resources Information Center

Lauritsen, Marlene Briciet; Pedersen, Carsten Bocker; Mortensen, Preben Bo

2005-01-01

Background: The etiology of autism is unknown. A strong genetic component has been detected but non-genetic factors may also be involved in the etiology. Methods: We used data from the Danish Psychiatric Central Register and the Danish Civil Registration System to study some risk factors of autism, including place of birth, parental place of…

[2-year results of leg amputation in Hungary based on a nationwide data base].

PubMed

Kullmann, L; Belicza, E; László, G

1997-09-14

Authors review nation-wide hospital data of amputees over two years in order to make comparison with similar data gathered about 20 years ago. Data were provided by the National Medical Records Centre and processed by own developed programmes. The quality level of data validity is slightly criticised. The cause of amputation was most often vascular disease, amputees were elderly and large majority of amputation surgery was carried out on the lower limb. The rate of below-knee amputation has gone up favourably over the 20 years, but there are large regional differences within the country. Mortality parameters remarkably exceed those of foreign countries. Regarding compromised data accuracy, still there are ways of exploiting data in favour of quality improvement of care, e.g. improve below-knee amputation rate, reduce mortality. Publication of data can be of bench-marking importance for hospitals by enabling them to compare own results with those of other hospitals, as well as develop and improve performance.

[Quality management in oncology supported by clinical cancer registries].

PubMed

Klinkhammer-Schalke, Monika; Gerken, Michael; Barlag, Hagen; Tillack, Anett

2015-01-01

Efforts in nationwide quality management for oncology have so far failed to comprehensively document all levels of care. New organizational structures such as population-based clinical cancer registries or certified organ cancer centers were supposed to solve this problem more sufficiently, but they have to be accompanied by valid trans-sectoral documentation and evaluation of clinical data. To measure feasibility and qualitative effectiveness of guideline implementation we approached this problem with a nationwide investigation from 2000 to 2011. The rate of neoadjuvant radio/chemotherapy in stage UICC II/III rectum cancer, cut-off point 80% for separating good from insufficient quality, was used as a quality indicator. The nationwide analysis indicates an increase from 45% to 70%, but only with the implementation strategy of CME. The combination of new structures, evidence-based quality indicators, organ cancer center and clinical cancer registries has shown good feasibility and seems promising. Copyright © 2015. Published by Elsevier GmbH.

Early Predictors of Alcohol Abuse: A Study of the Relationships Between Interests, Values and Personality Variables From the 1960 TALENT Data Base and Alcohol Abuse in Later Life. Final Report.

ERIC Educational Resources Information Center

Bond, Richard A.

In 1960, Project TALENT gathered demographic, cognitive, and socio-pyschological data from a nationwide sample of high school students. In addition, responses from a saturation sample of 16,000 cases in Knox County, Tennessee were collected. The relationships between attitudes, personality traits, and subsequent alcohol abuse (as shown by Knox…

Mass Communication and Journalism Faculty and Their Electronic Communication with College Students: A Nationwide Examination

ERIC Educational Resources Information Center

Brunner, Brigitta R.; Yates, Bradford L.; Adams, Jennifer Wood

2008-01-01

Nearly 700 U.S. journalism and mass communication faculty reported their perceptions of student e-mail use via a Web-based survey. This nationwide study focused on content of e-mail received by faculty and made comparisons based on faculty gender. Nearly half of the respondents reported that they occasionally receive e-mails from students before a…

Nationwide cross-sectional survey of schistosomiasis and soil-transmitted helminthiasis in Sudan: study protocol.

PubMed

Cha, Seungman; Hong, Sung-Tae; Lee, Young-Ha; Lee, Keon Hoon; Cho, Dae Seong; Lee, Jinmoo; Chai, Jong-Yil; Elhag, Mousab Siddig; Khaled, Soheir Gabralla Ahmad; Elnimeiri, Mustafa Khidir Mustafa; Siddig, Nahid Abdelgadeir Ali; Abdelrazig, Hana; Awadelkareem, Sarah; Elshafie, Azza Tag Eldin; Ismail, Hassan Ahmed Hassan Ahmed; Amin, Mutamad

2017-09-12

Schistosomiasis and soil-transmitted helminthiasis (STHs) are target neglected tropical diseases (NTDs) of preventive chemotherapy, but the control and elimination of these diseases have been impeded due to resource constraints. Few reports have described study protocol to draw on when conducting a nationwide survey. We present a detailed methodological description of the integrated mapping of schistosomiasis and STHs on the basis of our experiences, hoping that this protocol can be applied to future surveys in similar settings. In addition to determining the ecological zones requiring mass drug administration interventions, we aim to provide precise estimates of the prevalence of these diseases. A school-based cross-sectional design will be applied for the nationwide survey across Sudan. The survey is designed to cover all districts in every state. We have divided each district into 3 different ecological zones depending on proximity to bodies of water. We will employ a probability-proportional-to-size sampling method for schools and systematic sampling for student selection to provide adequate data regarding the prevalence for schistosomiasis and STHs in Sudan at the state level. A total of 108,660 students will be selected from 1811 schools across Sudan. After the survey is completed, 391 ecological zones will be mapped out. To carry out the survey, 655 staff members were recruited. The feces and urine samples are microscopically examined by the Kato-Katz method and the sediment smears for helminth eggs respectively. For quality control, a minimum of 10% of the slides will be rechecked by the federal supervisors in each state and also 5% of the smears are validated again within one day by independent supervisors. This nationwide mapping is expected to generate important epidemiological information and indicators about schistosomiasis and STHs that will be useful for monitoring and evaluating the control program. The mapping data will also be used for overviewing the status and policy formulation and updates to the control strategies. This paper, which describes a feasible and practical study protocol, is to be shared with the global health community, especially those who are planning to perform nationwide mapping of NTDs by feces or urine sampling.

No evidence of a causal relationship between hypothyroidism and glaucoma: A Danish nationwide register-based cohort study.

PubMed

Thvilum, Marianne; Brandt, Frans; Brix, Thomas Heiberg; Hegedüs, Laszlo

2018-01-01

An interrelationship between hypothyroidism and glaucoma, due to a shared autoimmune background or based on deposition of mucopolysaccharides in the trabecular meshwork in the eye, has been suggested but is at present unsubstantiated. Therefore, our objective was to investigate, at a nationwide and population-based level, whether there is such an association. Observational cohort study using record-linkage data from nationwide Danish health registers. 121,799 individuals diagnosed with a first episode of hypothyroidism were identified and were matched with 4 non-hypothyroid controls according to age and sex. Prevalence of glaucoma was recorded and cases and controls were followed over a mean of 7.1 years (range 0-17). Logistic and Cox regression models were used to assess the risk of glaucoma before and after the diagnosis of hypothyroidism, respectively. Overall, we found a higher prevalence of glaucoma in subjects with hypothyroidism as compared to controls (4.6% vs. 4.3%, p < 0.001). Prior to the diagnosis of hypothyroidism, the odds ratio (OR) was significantly increased for glaucoma [1.09; 95% confidence interval (CI): 1.04-1.13]. Based on the Cox regression model, there was no increased risk of glaucoma after the diagnosis of hypothyroidism [hazard ratio (HR) 1.00; 95% CI: 0.96-1.06], and the HR decreased further after adjusting for pre-existing co-morbidity (0.88; 95% CI: 0.84-0.93). There was an increased risk of glaucoma before but not after the diagnosis of hypothyroidism, suggesting that screening for glaucoma in hypothyroid individuals is unwarranted.

School Choice and the Achievement Gap

ERIC Educational Resources Information Center

Jeynes, William H.

2014-01-01

The possibility is examined that school choice programs could be a means to reducing the achievement gap. Data based on meta-analytic research and the examination of nationwide data sets suggest that school choice programs that include private schools could reduce the achievement gap by 25%. The propounding of this possibility is based on research…

Variation in primary site resection practices for advanced colon cancer: a study using the National Cancer Data Base.

PubMed

Healy, Mark A; Pradarelli, Jason C; Krell, Robert W; Regenbogen, Scott E; Suwanabol, Pasithorn A

2016-10-01

Treatment of metastatic colon cancer may be driven as much by practice patterns as by features of disease. To optimize management, there is a need to better understand what is determining primary site resection use. We evaluated all patients with stage IV cancers in the National Cancer Data Base from 2002 to 2012 (50,791 patients, 1,230 hospitals). We first identified patient characteristics associated with primary tumor resection. Then, we assessed nationwide variation in hospital resection rates. Overall, 27,387 (53.9%) patients underwent primary site resection. Factors associated with resection included younger age, having less than 2 major comorbidities, and white race (P < .001). Nationwide, hospital-adjusted primary tumor resection rates ranged from 26.0% to 87.8% with broad differences across geographical areas and hospital accreditation types. There is statistically significant variation in hospital rates of primary site resection. This demonstrates inconsistent adherence to guidelines in the presence of conflicting evidence regarding resection benefit. Copyright © 2016 Elsevier Inc. All rights reserved.

The clinical efficacy of a clarithromycin-based regimen for Mycobacterium avium complex disease: A nationwide post-marketing study.

PubMed

Kadota, Jun-Ichi; Kurashima, Atsuyuki; Suzuki, Katsuhiro

2017-05-01

The revised 2007 American Thoracic Society/Infectious Diseases Society of America statement recommend clarithromycin-based combination therapy for treatment of Mycobacterium avium complex lung disease and stipulates approximately 1 year of continuous treatment after bacilli negative conversion. However, supporting data are insufficient. Our objective was to obtain data on the clinical outcome of clarithromycin-based daily regimens by conducting a nationwide retrospective post-marketing study of M. avium complex lung disease. In accordance with the Japanese guidelines, patients were enrolled in this survey according to their chest radiographic findings and microbiologic test results. They were treated with a multidrug regimen including clarithromycin, rifampicin, and ethambutol (clarithromycin-based regimen) until bacilli negative conversion, and the treatment was continued for approximately 1 year after the initial conversion. Data were collected before administration, at the time of bacilli negative conversion, at the end of treatment, and at 6 months after the end of treatment. Of the 466 subjects enrolled in the study, 271 patients who received clarithromycin at 800 mg/day underwent evaluation for M. avium complex disease. The final bacilli negative conversion rate in those patients was 94.7%. The bacteriological relapse rate was 5.0% (5/100 patients). Bacteriological relapse was noted in patients treated for less than 15 months after conversion. No life-threatening or serious adverse drug reactions were observed. This study demonstrated that a clarithromycin-based daily regimen can yield a high bacteriological conversion rate in M. avium complex disease. After conversion, treatment for less than 15 months might be insufficient to prevent bacteriological relapse. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

[Diagnosis and treatment of thyroid storm].

PubMed

Akamizu, Takashi

2012-11-01

Thyrotoxic storm is a life-threatening condition requiring emergency treatment. Neither its epidemiological data nor diagnostic criteria have been fully established. We clarified the clinical and epidemiological characteristics of thyroid storm using nationwide surveys and then formulate diagnostic criteria for thyroid storm. To perform the nationwide survey on thyroid storm, we first developed tentative diagnostic criteria for thyroid storm, mainly based upon the literature (the first edition). We analyzed the relationship of the major features of thyroid storm to mortality and to certain other features. Finally, based upon the findings of these surveys, we revised the diagnostic criteria. Thyrotoxic storm is still a life-threatening disorder with over 10% mortality in Japan.

Projecting the impact of a nationwide school plain water access intervention on childhood obesity: a cost-benefit analysis.

PubMed

An, R; Xue, H; Wang, L; Wang, Y

2017-09-22

This study aimed to project the societal cost and benefit of an expansion of a water access intervention that promotes lunchtime plain water consumption by placing water dispensers in New York school cafeterias to all schools nationwide. A decision model was constructed to simulate two events under Markov chain processes - placing water dispensers at lunchtimes in school cafeterias nationwide vs. no action. The incremental cost pertained to water dispenser purchase and maintenance, whereas the incremental benefit was resulted from cases of childhood overweight/obesity prevented and corresponding lifetime direct (medical) and indirect costs saved. Based on the decision model, the estimated incremental cost of the school-based water access intervention is $18 per student, and the corresponding incremental benefit is $192, resulting in a net benefit of $174 per student. Subgroup analysis estimates the net benefit per student to be $199 and $149 among boys and girls, respectively. Nationwide adoption of the intervention would prevent 0.57 million cases of childhood overweight, resulting in a lifetime cost saving totalling $13.1 billion. The estimated total cost saved per dollar spent was $14.5. The New York school-based water access intervention, if adopted nationwide, may have a considerably favourable benefit-cost portfolio. © 2017 World Obesity Federation.

Prognostic scoring systems for myelodysplastic syndromes (MDS) in a population-based setting: a report from the Swedish MDS register.

PubMed

Moreno Berggren, Daniel; Folkvaljon, Yasin; Engvall, Marie; Sundberg, Johan; Lambe, Mats; Antunovic, Petar; Garelius, Hege; Lorenz, Fryderyk; Nilsson, Lars; Rasmussen, Bengt; Lehmann, Sören; Hellström-Lindberg, Eva; Jädersten, Martin; Ejerblad, Elisabeth

2018-06-01

The myelodysplastic syndromes (MDS) have highly variable outcomes and prognostic scoring systems are important tools for risk assessment and to guide therapeutic decisions. However, few population-based studies have compared the value of the different scoring systems. With data from the nationwide Swedish population-based MDS register we validated the International Prognostic Scoring System (IPSS), revised IPSS (IPSS-R) and the World Health Organization (WHO) Classification-based Prognostic Scoring System (WPSS). We also present population-based data on incidence, clinical characteristics including detailed cytogenetics and outcome from the register. The study encompassed 1329 patients reported to the register between 2009 and 2013, 14% of these had therapy-related MDS (t-MDS). Based on the MDS register, the yearly crude incidence of MDS in Sweden was 2·9 per 100 000 inhabitants. IPSS-R had a significantly better prognostic power than IPSS (P < 0·001). There was a trend for better prognostic power of IPSS-R compared to WPSS (P = 0·05) and for WPSS compared to IPSS (P = 0·07). IPSS-R was superior to both IPSS and WPSS for patients aged ≤70 years. Patients with t-MDS had a worse outcome compared to de novo MDS (d-MDS), however, the validity of the prognostic scoring systems was comparable for d-MDS and t-MDS. In conclusion, population-based studies are important to validate prognostic scores in a 'real-world' setting. In our nationwide cohort, the IPSS-R showed the best predictive power. © 2018 John Wiley & Sons Ltd.

Multiple sclerosis in India: An institutional study.

PubMed

Singhal, Ankit; Bhatia, Rohit; Srivastava, M V Padma; Prasad, Kameshwar; Singh, Mamta Bhushan

2015-05-01

Few population based studies on multiple sclerosis have been published from India. There is an increasing demand to establish a nationwide MS registry in India especially in view of the percieved increased incidence and prevalence. To create a registry data base for all MS patients presenting at our institute and understand the disease characteristics in our population and compare them with the published reports from the west. MS was diagnosed on the basis of clinical and imaging features (Revised McDonald׳s criteria 2010). Demographics, clinical data, treatment details and disease behavior were recorded over a follow up of one year. Descriptive analyses was performed. 101 patients (61 females) were recruited in the study period from June 2011 to December 2012. Mean age of the patients at the time of presentation was 33.3±9.2 years and mean duration of illness was 5.98±4.95. 68.4% patients had RRMS, 16.8% had SPMS whereas 14.8% patients had PPMS. Site(s) involved in first relapse was spinal cord in 43.7% patients followed by brainstem 25.3% and optic nerve in 24.1% patients. Mean number of relapses were 3.26±2.026. Mean EDSS at the time of presentation was 3.20±2.11. Overall, 55.44% patients took DMT at some point during their course of disease. No significant differences were observed between our patient characteristics when compared to publications from west. Demographic data in the present study are comparable to those reported in population-based epidemiological studies from west. A nationwide registry network will help establish stronger data on incidence, prevalence and disease profile of MS in India. Copyright © 2015 Elsevier B.V. All rights reserved.

Autism spectrum disorder in individuals with anorexia nervosa and in their first- and second-degree relatives: Danish nationwide register-based cohort-study.

PubMed

Koch, Susanne V; Larsen, Janne T; Mouridsen, Svend E; Bentz, Mette; Petersen, Liselotte; Bulik, Cynthia; Mortensen, Preben B; Plessen, Kerstin J

2015-05-01

Clinical and population-based studies report increased prevalence of autism spectrum disorders (ASD) in individuals with anorexia nervosa and in their relatives. No nationwide study has yet been published on co-occurrence of these disorders. To investigate comorbidity of ASD in individuals with anorexia nervosa, and aggregation of ASD and anorexia nervosa in their relatives. In Danish registers we identified all individuals born in 1981-2008, their parents, and full and half siblings, and linked them to data on hospital admissions for psychiatric disorders. Risk of comorbidity of ASD in probands with anorexia nervosa and aggregation of ASD in families of anorexia nervosa probands were increased. However, the risk of comorbid and familial ASD did not differ significantly from comorbid and familial major depression or any psychiatric disorder in anorexia nervosa probands. We confirm aggregation of ASD in probands with anorexia nervosa and in their relatives; however, the relationship between anorexia nervosa and ASD appears to be non-specific. © The Royal College of Psychiatrists 2015.

Discrepancy in term calculation from second trimester ultrasound scan versus last menstrual period in women with type 1 diabetes.

PubMed

Eidem, Ingvild; Vangen, Siri; Henriksen, Tore; Vollset, Stein E; Hanssen, Kristian F; Joner, Geir; Stene, Lars C

2014-08-01

To study differences in ultrasound-based compared to menstrual-based term estimation in women with type 1 diabetes. Nationwide register study. Norway. Deliveries in Norway 1999-2004 by women registered in the Norwegian Childhood Diabetes Registry (n = 342) and the background population (n = 307 248), with data on both ultrasound-based and menstrual-based gestational age notified in the Birth Registry of Norway. Births with major malformations were excluded. Linkage of two nationwide registries, the Medical Birth Registry of Norway and the Norwegian Childhood Diabetes Registry. Estimated gestational age at delivery based on routine second trimester ultrasound measurements and last menstrual period. In women with type 1 diabetes, the distribution of gestational age at delivery was shifted considerably towards a lower gestational age when using second trimester ultrasound data for estimation, compared with last menstrual period data. The difference between the two estimation methods was larger among women with type 1 diabetes, although also evident in the general population. One in four women with diabetes and a certain last menstrual period date had their ultrasound-calculated term postponed 1 week or more, while one in 10 had it postponed 2 weeks or more. Corresponding numbers in the background population were one in five and one in 20. We found a systematic postponement of ultrasound-based compared with menstrual-based term estimation in women with type 1 diabetes. Relying solely on routine ultrasound-based term calculation for delivery decision may imply a risk of going beyond an optimal pregnancy length. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

Weigh-in-motion (WIM) data for site-specific LRFR bridge load rating.

DOT National Transportation Integrated Search

2011-08-12

The live load factors in the Load and Resistant Factor Rating (LRFR) Manual are based on load data from Ontario : thought to be representative of traffic volumes nationwide. However, in accordance with the methodology for : developing site-specific l...

A nationwide register study of the characteristics, incidence and validity of diagnosed Tourette syndrome and other tic disorders.

PubMed

Leivonen, Susanna; Voutilainen, Arja; Hinkka-Yli-Salomäki, Susanna; Timonen-Soivio, Laura; Chudal, Roshan; Gissler, Mika; Huttunen, Jukka; Sourander, Andre

2014-09-01

The aim of this study was to describe the characteristics and incidence rates of diagnosed tic disorders in the Finnish Hospital Discharge Register, including changing incidence rates between 1991 and 2010. We also aimed to validate the diagnoses of Tourette's syndrome recorded in the register. Children born between January 1, 1991 and December 31, 2010, who were diagnosed with tic disorders, were identified from the Finnish Hospital Discharge Register (n = 3003). We studied the validity of the Tourette's syndrome diagnoses by reviewing the medical charts of 88 children born since 1997 and carrying out telephone interviews with 55 of their guardians. The incidence rates of all diagnosed tic disorders increased during the study period. A comorbid diagnosis of hyperkinetic disorder diagnosis was recorded in 28.2% of the children with Tourette's syndrome, and the validity of the register-based Tourette's syndrome diagnosis was approximately 95%. This is the first nationwide study to demonstrate the increasing incidence of all register-based tic disorder diagnoses. The validity of the Tourette's syndrome diagnoses in the Finnish Hospital Discharge Register was good, and the data provided are suitable for use in further register-based studies of tic disorders. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

[Benchmarking of university trauma centers in Germany. Research and teaching].

PubMed

Gebhard, F; Raschke, M; Ruchholtz, S; Meffert, R; Marzi, I; Pohlemann, T; Südkamp, N; Josten, C; Zwipp, H

2011-07-01

Benchmarking is a very popular business process and meanwhile is used in research as well. The aim of the present study is to elucidate key numbers of German university trauma departments regarding research and teaching. The data set is based upon the monthly reports given by the administration in each university. As a result the study shows that only well-known parameters such as fund-raising and impact factors can be used to benchmark university-based trauma centers. The German federal system does not allow a nationwide benchmarking.

Trends in health-care costs and utilization for inflammatory bowel disease from 2010 to 2014 in Korea: A nationwide population-based study.

PubMed

Kim, Jung-Wook; Lee, Chang Kyun; Rhee, Sang Youl; Oh, Chi Hyuck; Shim, Jae-Jun; Kim, Hyo Jong

2018-04-01

Data regarding health-care costs and utilization for inflammatory bowel disease (IBD) at the population level are limited in Asia. We aimed to investigate the nationwide prevalence and health-care cost and utilization of IBD in Korea. We tracked the IBD-attributable health-care costs and utilization from 2010 to 2014 using the public dataset obtained from Korean National Health Insurance Service claims. We estimated the nationwide prevalence of IBD using population census data from Statistics Korea during the same period. In total, 236 106 IBD patients were analyzed. The estimated IBD prevalence significantly increased from 85.1/100 000 in 2010 to 106/100 000 in 2014. The overall annual health-care costs for IBD increased from $23.2 million (US dollars) in 2010 to $49.7 million in 2014 (P < 0.001). During the same period, the health-care cost per capita also increased from $572.3 to $983.7 (P < 0.001). The outpatient to total cost ratio increased from 45.5% in 2010 to 66.6% in 2014. Regarding health-care utilization, the outpatient to total days of service use ratio increased from 73.1% in 2010 to 76.9% in 2014. Of the total days of service used, the proportions of tertiary, general, and community hospitals increased significantly with a concomitant decrease in that of primary clinics (all P values < 0.001). This population-based study confirmed the steadily rising rate of prevalence of IBD in Korea. It also demonstrated that the shifting to outpatient care and advanced care settings are drivers for the dramatic increase in IBD-related health-care costs in Korea. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Hysterectomy in Germany: a DRG-based nationwide analysis, 2005-2006.

PubMed

Stang, Andreas; Merrill, Ray M; Kuss, Oliver

2011-07-01

Hysterectomy is among the more common surgical procedures in gynecology. The aim of this study was to calculate population-wide rates of hysterectomy across Germany and to obtain information on the different modalities of hysterectomy currently performed in German hospitals. This was done on the basis of nationwide DRG statistics (DRG = diagnosis-related groups) covering the years 2005-2006. We analyzed the nationwide DRG statistics for 2005 and 2006, in which we found 305 015 hysterectomies. Based on these data we calculated hysterectomy rates for the female population. We determined the indications for each hysterectomy with an algorithm based on the ICD-10 codes, and we categorized the operations on the basis of their OPS codes (OPS = Operationen- und Prozedurenschlüssel [Classification of Operations and Procedures]). The overall rate of hysterectomy in Germany was 362 per 100 000 person-years. 55% of hysterectomies for benign diseases of the female genital tract were performed transvaginally. Bilateral ovariectomy was performed concomitantly in 23% of all hysterectomies, while 4% of all hysterectomies were subtotal. Hysterectomy rates varied considerably across federal states: the rate for benign disease was lowest in Hamburg (213.8 per 100 000 women per year) and highest in Mecklenburg-West Pomerania (361.9 per 100 000 women per year). Hysterectomy rates vary markedly from one region to another. Moreover, even though recent studies have shown that bilateral ovariectomy is harmful to women under 50 who undergo hysterectomy for benign disease, it is still performed in 4% of all hysterectomies for benign indications in Germany.

Development of a Web-Based Nationwide Korean Pediatric Dental Sedation Registry.

PubMed

Choi, Sung Chul; Yang, Yeonmi; Yoo, Seunghoon; Kim, Jiyeon; Jeong, Taesung; Shin, Teo Jeon

Finding a balance between sedation efficacy and safety remains an ongoing challenge. In children, the risk of sedation-related complications is relatively high. It is of utmost importance to determine the factors related to improved overall sedation outcomes. However, most previous reports have been based on small samples at single institutions. The Korean Academy of Pediatric Dentistry (KAPD) developed a Korean Pediatric Dental Sedation Registry using a web-based platform. Specialists in pediatric dental sedation selected the itemized list included within the registry through an extensive literature review. The web-based registry was built into the KAPD homepage to facilitate easy access to the sedation data. All teaching and university hospitals agreed to participate in the Korean Pediatric Dental Sedation Registry. This is the first attempt to collect sedation data on a nationwide scale in the field of pediatric dentistry. The sedation database established with the registry may facilitate standardizing and improving pediatric dental sedation clinical practices.

Improving Assessment of Lifetime Solar Ultraviolet Radiation Exposure in Epidemiologic Studies: Comparison of Ultraviolet Exposure Assessment Methods in a Nationwide United States Occupational Cohort.

PubMed

Little, Mark P; Tatalovich, Zaria; Linet, Martha S; Fang, Michelle; Kendall, Gerald M; Kimlin, Michael G

2018-06-13

Solar ultraviolet radiation is the primary risk factor for skin cancers and sun-related eye disorders. Estimates of individual ambient ultraviolet irradiance derived from ground-based solar measurements and from satellite measurements have rarely been compared. Using self-reported residential history from 67,189 persons in a nationwide occupational US radiologic technologists cohort, we estimated ambient solar irradiance using data from ground-based meters and noontime satellite measurements. The mean distance-moved from city of longest residence in childhood increased from 137.6 km at ages 13-19 to 870.3 km at ages ≥65, with corresponding increases in absolute latitude-difference moved. At ages 20/40/60/80, the Pearson/Spearman correlation coefficients of ground-based and satellite-derived solar potential ultraviolet exposure, using irradiance and cumulative radiant-exposure metrics, were high (=0.87-0.92). There was also moderate correlation (Pearson/Spearman correlation coefficients=0.51-0.60) between irradiance at birth and at last-known address, for ground-based and satellite data. Satellite-based lifetime estimates of ultraviolet radiation were generally 14-15% lower than ground-based estimates, albeit with substantial uncertainties, possibly because ground-based estimates incorporate fluctuations in cloud and ozone, which are incompletely incorporated in the single noontime satellite-overpass ultraviolet value. If confirmed elsewhere, the findings suggest that ground-based estimates may improve exposure-assessment accuracy and potentially provide new insights into ultraviolet-radiation-disease relationships in epidemiologic studies. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

A security framework for nationwide health information exchange based on telehealth strategy.

PubMed

Zaidan, B B; Haiqi, Ahmed; Zaidan, A A; Abdulnabi, Mohamed; Kiah, M L Mat; Muzamel, Hussaen

2015-05-01

This study focuses on the situation of health information exchange (HIE) in the context of a nationwide network. It aims to create a security framework that can be implemented to ensure the safe transmission of health information across the boundaries of care providers in Malaysia and other countries. First, a critique of the major elements of nationwide health information networks is presented from the perspective of security, along with such topics as the importance of HIE, issues, and main approaches. Second, a systematic evaluation is conducted on the security solutions that can be utilized in the proposed nationwide network. Finally, a secure framework for health information transmission is proposed within a central cloud-based model, which is compatible with the Malaysian telehealth strategy. The outcome of this analysis indicates that a complete security framework for a global structure of HIE is yet to be defined and implemented. Our proposed framework represents such an endeavor and suggests specific techniques to achieve this goal.

No evidence of a causal relationship between hypothyroidism and glaucoma: A Danish nationwide register-based cohort study

PubMed Central

2018-01-01

Background An interrelationship between hypothyroidism and glaucoma, due to a shared autoimmune background or based on deposition of mucopolysaccharides in the trabecular meshwork in the eye, has been suggested but is at present unsubstantiated. Therefore, our objective was to investigate, at a nationwide and population-based level, whether there is such an association. Subjects and methods Observational cohort study using record-linkage data from nationwide Danish health registers. 121,799 individuals diagnosed with a first episode of hypothyroidism were identified and were matched with 4 non-hypothyroid controls according to age and sex. Prevalence of glaucoma was recorded and cases and controls were followed over a mean of 7.1 years (range 0–17). Logistic and Cox regression models were used to assess the risk of glaucoma before and after the diagnosis of hypothyroidism, respectively. Results Overall, we found a higher prevalence of glaucoma in subjects with hypothyroidism as compared to controls (4.6% vs. 4.3%, p < 0.001). Prior to the diagnosis of hypothyroidism, the odds ratio (OR) was significantly increased for glaucoma [1.09; 95% confidence interval (CI): 1.04–1.13]. Based on the Cox regression model, there was no increased risk of glaucoma after the diagnosis of hypothyroidism [hazard ratio (HR) 1.00; 95% CI: 0.96–1.06], and the HR decreased further after adjusting for pre-existing co-morbidity (0.88; 95% CI: 0.84–0.93). Conclusions There was an increased risk of glaucoma before but not after the diagnosis of hypothyroidism, suggesting that screening for glaucoma in hypothyroid individuals is unwarranted. PMID:29444121

An Assessment of Turkish Young Pupils' Environmental Literacy: A Nationwide Survey

ERIC Educational Resources Information Center

Erdogan, Mehmet; Ok, Ahmet

2011-01-01

The purpose of this nationwide survey was to assess young Turkish pupils' environmental literacy (EL) level by considering six EL components. The sample of the study comprised of 2,412 fifth graders selected from 78 elementary schools (26 private and 52 public) in 26 provinces of Turkey. Data were obtained through the use of an elementary school…

Use of sediment-trace element geochemical models for the identification of local fluvial baseline concentrations

USGS Publications Warehouse

Horowitz, A.J.; Elrick, K.A.; Demas, C.R.; Demcheck, D.K.

1991-01-01

Studies have demonstrated the utility of fluvial bed sediment chemical data in assesing local water-quality conditions. However, establishing local background trace element levels can be difficult. Reference to published average concentrations or the use of dated cores are often of little use in small areas of diverse local petrology, geology, land use, or hydrology. An alternative approach entails the construction of a series of sediment-trace element predictive models based on data from environmentally diverse but unaffected areas. Predicted values could provide a measure of local background concentrations and comparison with actual measured concentrations could identify elevated trace elements and affected sites. Such a model set was developed from surface bed sediments collected nationwide in the United States. Tests of the models in a small Louisiana basin indicated that they could be used to establish local trace element background levels, but required recalibration to account for local geochemical conditions outside the range of samples used to generate the nationwide models.

Simulating Nationwide Pandemics: Applying the Multi-scale Epidemiologic Simulation and Analysis System to Human Infectious Diseases

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

Dombroski, M; Melius, C; Edmunds, T

2008-09-24

This study uses the Multi-scale Epidemiologic Simulation and Analysis (MESA) system developed for foreign animal diseases to assess consequences of nationwide human infectious disease outbreaks. A literature review identified the state of the art in both small-scale regional models and large-scale nationwide models and characterized key aspects of a nationwide epidemiological model. The MESA system offers computational advantages over existing epidemiological models and enables a broader array of stochastic analyses of model runs to be conducted because of those computational advantages. However, it has only been demonstrated on foreign animal diseases. This paper applied the MESA modeling methodology to humanmore » epidemiology. The methodology divided 2000 US Census data at the census tract level into school-bound children, work-bound workers, elderly, and stay at home individuals. The model simulated mixing among these groups by incorporating schools, workplaces, households, and long-distance travel via airports. A baseline scenario with fixed input parameters was run for a nationwide influenza outbreak using relatively simple social distancing countermeasures. Analysis from the baseline scenario showed one of three possible results: (1) the outbreak burned itself out before it had a chance to spread regionally, (2) the outbreak spread regionally and lasted a relatively long time, although constrained geography enabled it to eventually be contained without affecting a disproportionately large number of people, or (3) the outbreak spread through air travel and lasted a long time with unconstrained geography, becoming a nationwide pandemic. These results are consistent with empirical influenza outbreak data. The results showed that simply scaling up a regional small-scale model is unlikely to account for all the complex variables and their interactions involved in a nationwide outbreak. There are several limitations of the methodology that should be explored in future work including validating the model against reliable historical disease data, improving contact rates, spread methods, and disease parameters through discussions with epidemiological experts, and incorporating realistic behavioral assumptions.« less

Case-spouse control design in practice: an experience in estimating smoking and chronic obstructive pulmonary disease deaths in Chinese adults.

PubMed

Jiang, Jingmei; Liu, Boqi; Sitas, Freddy; Zeng, Xianjia; Chen, Junshi; Han, Wei; Zou, Xiaonong; Wu, Yanping; Zhao, Ping; Li, Junyao

2010-05-01

We assessed the effect of smoking on death from chronic obstructive pulmonary disease (COPD) in China by employing a large population-based, case-spouse control study design using data from a nationwide survey of mortality. During 1989-1991, a nationwide retrospective survey of mortality was conducted in China. For approximately 1,000,000 adults dying from all causes during 1986-1988, their surviving spouses or other informants provided detailed information about their own as well as the deceased person's smoking history. For this study, 183,393 individuals who died of COPD at age > or = 40 years were taken as cases, while 272,984 sex-matched surviving spouses of subjects who died from any cause were taken as controls. COPD death rates for smokers were more than twice as high as those of non-smokers, with a dose-response risk pattern, despite the fact that COPD death rates varied widely by region and age. Tobacco accounted for 41.4% of COPD deaths in men, but only 13.5% of those in women, who had a lower rate of smoking. A case-spouse control study, as an alternative design, is valid and feasible in utilizing information from population-based, retrospective mortality survey data for an analytical epidemiological study of disease etiology. Copyright 2010 Formosan Medical Association & Elsevier. Published by Elsevier B.V. All rights reserved.

Nationwide singleton birth weight percentiles by gestational age in Taiwan, 1998-2002.

PubMed

Hsieh, Wu-Shiun; Wu, Hui-Chen; Jeng, Suh-Fang; Liao, Hua-Fang; Su, Yi-Ning; Lin, Shio-Jean; Hsieh, Chia-Jung; Chen, Pau-Chung

2006-01-01

There are limited nationwide population-based data about birth weight percentiles by gestational age in Taiwan. The purpose of this study was to develop updated intrauterine growth charts that are population based and contain the information of birth weight percentiles by gestational age for singleton newborns in Taiwan. We abstracted and analyzed the birth registration database from the Ministry of the Interior in Taiwan during the period of 1998-2002 that consisted of over one million singleton births. Percentiles of birth weight for each increment of gestational week from 21 to 44 weeks were estimated using smoothed means and standard deviations. The analyses revealed that birth weight rose with advancing gestational age, with greater slopes during the third trimester and then leveled off beyond 40 weeks of gestational age. The male to female ratio ranged from 1.088 to 1.096. The mean birth weights during the period of 1998-2002 were higher than those previously reported for the period of 1945-1967; while the birth weight distribution and percentile during the period of 1998-2002 were similar to those reported for the period of 1979-1989. The 10th, 50th, and 90th percentiles of birth weigh at 40th gestational age among the male newborns were 2914, 3374, and 3890 g respectively; and for the female newborns 2816, 3250, and 3747 g. At the gestational age of 37 weeks, the 10th, 50th, and 90th percentiles of birth weigh among the male newborns were 2499, 2941, and 3433 g respectively; and for the female newborns 2391, 2832, and 3334 g. From 1998 to 2002, there was a gradual increase in the prevalence of low birth weight and preterm birth together with the percentage of infants born to foreign-born mothers. This study provides the first nationwide singleton intrauterine growth charts in Taiwan that are population-based and gender-specific. The normative data are particularly useful for the investigation of predictors and outcomes of altered fetal growth.

Chinese Herbal Medicine as an Adjunctive Therapy Ameliorated the Incidence of Chronic Hepatitis in Patients with Breast Cancer: A Nationwide Population-Based Cohort Study.

PubMed

Huang, Kuo-Chin; Yen, Hung-Rong; Chiang, Jen-Huai; Su, Yuan-Chih; Sun, Mao-Feng; Chang, Hen-Hong; Huang, Sheng-Teng

2017-01-01

We conducted a National Health Insurance Research Database-based Taiwanese nationwide population-based cohort study to evaluate whether Chinese herbal medicine (CHM) treatment decreased the incidence of chronic hepatitis in breast cancer patients receiving chemotherapy and/or radiotherapy. A total of 81171 patients were diagnosed with breast cancer within the defined study period. After randomly equal matching, data from 13856 patients were analyzed. Hazard ratios of incidence rate of chronic hepatitis were used to determine the influence and therapeutic potential of CHM in patients with breast cancer. The patients with breast cancer receiving CHM treatment exhibited a significantly decreased incidence rate of chronic hepatitis even across the stratification of age, CCI score, and treatments. The cumulative incidence of chronic hepatitis for a period of seven years after initial breast cancer diagnosis was also reduced in the patients receiving CHM treatment. The ten most commonly used single herbs and formulas were effective in protecting liver function in patients with breast cancer, where Hedyotis diffusa and Jia-Wei-Xiao-Yao-San were the most commonly used herbal agents. In conclusion, our study provided information that western medicine therapy combined with CHM as an adjuvant modality may have a significant impact on liver protection in patients with breast cancer.

Evaluation of Thyroid Hormone Levels and Urinary Iodine Concentrations in Koreans Based on the Data from Korea National Health and Nutrition Examination Survey VI (2013 to 2015).

PubMed

Chung, Jae Hoon

2018-06-01

No nationwide data have been published about thyroid hormone levels and urinary iodine concentrations (UICs) in Korea. The Korea Centers for Disease Control and Prevention and the Korean Thyroid Association established a project to evaluate the nationwide thyroid hormone profile and UICs in healthy Koreans as part of the Korea National Health and Nutrition Examination Survey (KNHANES) VI (2013 to 2015), a nationwide, cross-sectional survey of the Korean population that enrolled 7,061 individuals who were weighted to represent the entire Korean population. Based on the KNHANES VI, the geometric mean value of serum thyroid stimulating hormone was 2.16 mIU/L, and its reference interval was 0.59 to 7.03 mIU/L. The mean value of serum free thyroxine was 1.25 ng/dL, and its reference interval was 0.92 to 1.60 ng/dL. The median UIC in the Korean population was reported to be 294 μg/L, corresponding to 'above requirements' iodine intake according to the World Health Organization recommendations. A U-shaped relationship of UIC with age was found. The prevalence of overt hyperthyroidism and overt hypothyroidism in the Korean population based on the KNHANES VI was 0.54% and 0.73%, respectively. Copyright © 2018 Korean Endocrine Society.

Design and implementation of the first nationwide, web-based Chinese Renal Data System (CNRDS)

PubMed Central

2012-01-01

Background In April 2010, with an endorsement from the Ministry of Health of the People's Republic of China, the Chinese Society of Nephrology launched the first nationwide, web-based prospective renal data registration platform, the Chinese Renal Data System (CNRDS), to collect structured demographic, clinical, and laboratory data for dialysis cases, as well as to establish a kidney disease database for researchers and policy makers. Methods The CNRDS program uses information technology to facilitate healthcare professionals to create a blood purification registry and to deliver an evidence-based care and education protocol tailored to chronic kidney disease, as well as online forum for communication between nephrologists. The online portal https://www.cnrds.net is implemented as a Java web application using an Apache Tomcat web server and a MySQL database. All data are stored in a central databank to establish a Chinese renal database for research and publication purposes. Results Currently, over 270,000 clinical cases, including general patient information, diagnostics, therapies, medications, and laboratory tests, have been registered in CNRDS by 3,669 healthcare institutions qualified for hemodialysis therapy. At the 2011 annual blood purification forum of the Chinese Society of Nephrology, the CNRDS 2010 annual report was reviewed and accepted by the society members and government representatives. Conclusions CNRDS is the first national, web-based application for collecting and managing electronic medical records of patients with dialysis in China. It provides both an easily accessible platform for nephrologists to store and organize their patient data and acts as a communication platform among participating doctors. Moreover, it is the largest database for treatment and patient care of end-stage renal disease (ESRD) patients in China, which will be beneficial for scientific research and epidemiological investigations aimed at improving the quality of life of such patients. Furthermore, it is a model nationwide disease registry, which could potentially be used for other diseases. PMID:22369692

Design and implementation of the first nationwide, web-based Chinese Renal Data System (CNRDS).

PubMed

Xie, Fengbo; Zhang, Dong; Wu, Jinzhao; Zhang, Yunfeng; Yang, Qing; Sun, Xuefeng; Cheng, Jing; Chen, Xiangmei

2012-02-28

In April 2010, with an endorsement from the Ministry of Health of the People's Republic of China, the Chinese Society of Nephrology launched the first nationwide, web-based prospective renal data registration platform, the Chinese Renal Data System (CNRDS), to collect structured demographic, clinical, and laboratory data for dialysis cases, as well as to establish a kidney disease database for researchers and policy makers. The CNRDS program uses information technology to facilitate healthcare professionals to create a blood purification registry and to deliver an evidence-based care and education protocol tailored to chronic kidney disease, as well as online forum for communication between nephrologists. The online portal https://www.cnrds.net is implemented as a Java web application using an Apache Tomcat web server and a MySQL database. All data are stored in a central databank to establish a Chinese renal database for research and publication purposes. Currently, over 270,000 clinical cases, including general patient information, diagnostics, therapies, medications, and laboratory tests, have been registered in CNRDS by 3,669 healthcare institutions qualified for hemodialysis therapy. At the 2011 annual blood purification forum of the Chinese Society of Nephrology, the CNRDS 2010 annual report was reviewed and accepted by the society members and government representatives. CNRDS is the first national, web-based application for collecting and managing electronic medical records of patients with dialysis in China. It provides both an easily accessible platform for nephrologists to store and organize their patient data and acts as a communication platform among participating doctors. Moreover, it is the largest database for treatment and patient care of end-stage renal disease (ESRD) patients in China, which will be beneficial for scientific research and epidemiological investigations aimed at improving the quality of life of such patients. Furthermore, it is a model nationwide disease registry, which could potentially be used for other diseases.

Going to Scale: A Nonrandomized Nationwide Trial of the KiVa Antibullying Program for Grades 1-9

ERIC Educational Resources Information Center

Karna, Antti; Voeten, Marinus; Little, Todd D.; Poskiparta, Elisa; Alanen, Erkki; Salmivalli, Christina

2011-01-01

Objective: The effects of school-based antibullying programs have typically been examined on small samples, with number of schools ranging from 1 to 78 (Farrington & Ttofi, 2009). This study investigated the effectiveness of the KiVa antibullying program in the beginning of its nationwide implementation in Finland. Method: At each time point,…

Information governance in NHS's NPfIT: a case for policy specification.

PubMed

Becker, Moritz Y

2007-01-01

The National Health Service's (NHS's) National Programme for Information Technology (NPfIT) in the UK with its proposed nation-wide online health record service poses serious technical challenges, especially with regard to access control and patient confidentiality. The complexity of the confidentiality requirements and their constantly evolving nature (due to changes in law, guidelines and ethical consensus) make traditional technologies such as role-based access control (RBAC) unsuitable. Furthermore, a more formal approach is also needed for debating about and communicating on information governance, as natural-language descriptions of security policies are inherently ambiguous and incomplete. Our main goal is to convince the reader of the strong benefits of employing formal policy specification in nation-wide electronic health record (EHR) projects. Many difficulties could be alleviated by specifying the requirements in a formal authorisation policy language such as Cassandra. The language is unambiguous, declarative and machine-enforceable, and is based on distributed constrained Datalog. Cassandra is interpreted within a distributed Trust Management environment, where digital credentials are used for establishing mutual trust between strangers. To demonstrate how policy specification can be applied to NPfIT, we translate a fragment of natural-language NHS specification into formal Cassandra rules. In particular, we present policy rules pertaining to the management of Clinician Sealed Envelopes, the mechanism by which clinical patient data can be concealed in the nation-wide EHR service. Our case study exposes ambiguities and incompletenesses in the informal NHS documents. We strongly recommend the use of trust management and policy specification technology for the implementation of nation-wide EHR infrastructures. Formal policies can be used for automatically enforcing confidentiality requirements, but also for specification and communication purposes. Formalising the requirements also reveals ambiguities and missing details in the currently used informal specification documents.

Therapeutic inertia and intensified treatment in diabetes mellitus prescription patterns: A nationwide population-based study in Taiwan.

PubMed

Huang, Li-Ying; Yeh, Hseng-Long; Yang, Ming-Chin; Shau, Wen-Yi; Su, Syi; Lai, Mei-Shu

2016-12-01

Objective To measure therapeutic inertia by characterizing prescription patterns using secondary data obtained from the nationwide diabetes mellitus pay-for-performance (DM-P4P) programme in Taiwan. Methods Using reimbursement claims from Taiwan's National Health Insurance Research Database, a nationwide retrospective cohort study was undertaken of patients with diabetes mellitus who participated in the DM-P4P programme from 2006-2008. Glycosylated haemoglobin results were used to evaluate modifications in therapy in response to poor diabetes control. Prescription patterns were used to assign patients to either a therapeutic inertia group or an intensified treatment group. Therapeutic inertia was defined as the failure to act on a known problem. Results The research sample comprised of 168 876 patients with diabetes mellitus who had undergone 899 135 tests. Of these, 37.4% (336 615 visits) of prescriptions were for a combination of two types of drug and 27.7% (248 788 visits) were for a combination of three types of drug. The proportion of patients in the intensified therapy group who were prescribed more than two types of drug was considerably higher than that in the therapeutic inertia group. Conclusion In many cases in the therapeutic inertia group only a single type of hypoglycaemic drug was prescribed or the dosage remained unchanged.

DEVELOPMENT OF A DIETARY EXPOSURE POTENTIAL MODEL FOR EVALUATING DIETARY EXPOSURE TO CHEMICAL RESIDUES IN FOOD

EPA Science Inventory

The Dietary Exposure Potential Model (DEPM) is a computer-based model developed for estimating dietary exposure to chemical residues in food. The DEPM is based on food consumption data from the 1987-1988 Nationwide Food Consumption Survey (NFCS) administered by the United States ...

Disability and Hospital Care Expenses among National Health Insurance Beneficiaries: Analyses of Population-Based Data in Taiwan

ERIC Educational Resources Information Center

Lin, Lan-Ping; Lee, Jiunn-Tay; Lin, Fu-Gong; Lin, Pei-Ying; Tang, Chi-Chieh; Chu, Cordia M.; Wu, Chia-Ling; Lin, Jin-Ding

2011-01-01

Nationwide data were collected concerning inpatient care use and medical expenditure of people with disabilities (N = 937,944) among national health insurance beneficiaries in Taiwan. Data included gender, age, hospitalization frequency and expenditure, healthcare setting and service department, discharge diagnose disease according to the ICD-9-CM…

Improved Survival With Integration of Chinese Herbal Medicine Therapy in Patients With Acute Myeloid Leukemia: A Nationwide Population-Based Cohort Study.

PubMed

Fleischer, Tom; Chang, Tung-Ti; Chiang, Jen-Huai; Sun, Mao-Feng; Yen, Hung-Rong

2017-06-01

Acute myeloid leukemia (AML) is the most deadly subtype of leukemia, and many patients with this disease seek other complementary therapies, one of which is Chinese medicine. We set out to provide reliable data regarding the benefit of Chinese herbal medicine (CHM) for AML patients, using mortality as the main outcome measure. We also characterized the herbal prescriptions of patients. Using the Taiwanese National Health Insurance Research Database, we performed a nationwide population-based cohort study among AML patients from 1997 to 2010. The Cox regression model was used to adjust for comorbidities and other variables, and the hazard ratios (HRs) of CHM users and non-CHM users were compared. After 1:1 matching, 498 patients were included into the study. The HR of the CHM group was 0.41 (95% CI = 0.26-0.65; P = .0001) compared with the non-CHM group. This decrease in HR was also shown to be dose dependent ( P < .001). The 3 single-herbs most commonly prescribed were Salvia miltiorrhiza (Dan Shen), Astragalus membranaceus (Huang Qi), and Spatholobus suberectus (Ji Xue Teng). The 3 mutli-herb products most commonly prescribed were Jia Wei Xiao Yao San, Gui Pi Tang, and Qi Ju Di Huang Wan. Prospective controlled clinical data is still needed, however, this study provides real-world data regarding the benefit AML patients may have from CHM. This study suggests that all AML patients, regardless of age or other prognostic factors, may achieve longer survival times when receiving CHM in addition to standard therapy.

Cost and cost-effectiveness of a school-based education program to reduce salt intake in children and their families in China

PubMed Central

Li, Xian; Jan, Stephen; Yan, Lijing L.; Hayes, Alison; Chu, Yunbo; Wang, Haijun; Feng, Xiangxian; Niu, Wenyi; He, Feng J.; Ma, Jun; Han, Yanbo; MacGregor, Graham A.; Wu, Yangfeng

2017-01-01

Objective The School-based Education Program to Reduce Salt Intake in Children and Their Families study was a cluster randomized control trial among grade five students in 28 primary schools and their families in Changzhi, China. It achieved a significant effect in lowering systolic blood pressure (SBP) in all family adults by 2.3 mmHg and in elderlies (aged > = 60 years) by 9.5 mmHg. The aim of this study was to assess the cost-effectiveness of this salt reduction program. Methods Costs of the intervention were assessed using an ingredients approach to identify resource use. A trial-based incremental cost-effectiveness ratio (ICER) was estimated based on the observed effectiveness in lowering SBP. A Markov model was used to estimate the long-term cost-effectiveness of the intervention, and then based on population data, extrapolated to a scenario where the program is scaled up nationwide. Findings were presented in terms of an incremental cost per quality-adjusted life year (QALY). The perspective was that of the health sector. Results The intervention cost Int$19.04 per family and yielded an ICER of Int$2.74 (90% CI: 1.17–12.30) per mmHg reduction of SBP in all participants (combining children and adult participants together) compared with control group. If scaled up nationwide for 10 years and assumed deterioration in treatment effect of 50% over this period, it would reach 165 million families and estimated to avert 42,720 acute myocardial infarction deaths and 107,512 stroke deaths in China. This would represent a gain of 635,816 QALYs over 10-year time frame, translating into Int$1,358 per QALY gained. Conclusion Based on WHO-CHOICE criteria, our analysis demonstrated that the proposed salt reduction strategy is highly cost-effective, and if scaled up nationwide, the benefits could be substantial. Trial registration ClinicalTrials.gov NCT01821144 PMID:28902880

Information Literacy: Instrument Development to Measure Competencies and Knowledge Among Nursing Educators, Nursing Administrators, and Nursing Clinicians: A Pilot Study

PubMed Central

Pierce, Susan; Pravikoff, Diane; Tanner, Annelle

2003-01-01

This poster describes a pilot study conducted to establish validity and reliability of an instrument that will be used in a nationwide needs assessment, implemented to identify gaps in Information Literacy skills, competencies, and knowledge among key nursing groups nationally. Data and information gathered using the tool will guide the profession in developing appropriate education and continuing education programs to close identified gaps and enhance nurses’ readiness for Evidence-Based Practice (EBP). PMID:14728475

Use of hand hygiene agents as a surrogate marker of compliance in Hungarian long-term care facilities: first nationwide survey.

PubMed

Szabó, Rita; Morvai, Júlia; Bellissimo-Rodrigues, Fernando; Pittet, Didier

2015-01-01

Hand hygiene practice is an important measure for preventing infections in long-term care facilities (LTCFs). However, low compliance with hand hygiene has been reported in a number of studies. The purpose of this study was to provide an overview of the first reference data collected on alcohol-based handrub (ABHR) and antiseptic soap consumption, as surrogate markers for hand hygiene compliance by healthcare workers (HCWs) in Hungarian LTCFs. The objective was to inform stakeholders on the need of hand hygiene improvement in these settings. Between 5 May and 30 September 2014, we conducted a nationwide, cross-sectional survey using a standardized self-administered questionnaire; all Hungarian LTCFs were eligible. The Statistical Package for Social Sciences (SPSS) version 20.0 was used for data analysis. The questionnaire was completed by 354 LTCFs, representing 24 % of all Hungarian LTCFs. In total, the median consumption of ABHR and antimicrobial soap was 15.5 L (IQR, 0-800 L) and 60 L (IQR, 0-1,680 L) per LTCFs, and 2.2 mL (IQR, 0.4-9.1 mL) and 12.1 mL (IQR, 0.7-32.8 mL) per HCWs in 2013, respectively. The estimated number of hand hygiene actions was 0.6 hygienic handrub/HCW per day (IQR, 0-12.8/HCWs) and 2.4 hygienic handwashing/HCW per day (IQR, 0-21.9/HCWs; P = .001), respectively. This study suggests that non-compliance with hand hygiene is a significant problem in Hungarian LTCFs. Based on our results, there is an urgent need for a nationwide multimodal hand hygiene promotion strategy including education and performance monitoring and feedback in all LTCFs. Furthermore, monitoring of ABHR consumption constitute an additional component of the existing National Nosocomial Surveillance system.

Shunt Intervention for Possible Idiopathic Normal Pressure Hydrocephalus Improves Patient Outcomes: A Nationwide Hospital-Based Survey in Japan.

PubMed

Nakajima, Madoka; Miyajima, Masakazu; Ogino, Ikuko; Akiba, Chihiro; Kawamura, Kaito; Kurosawa, Michiko; Kuriyama, Nagato; Watanabe, Yoshiyuki; Fukushima, Wakaba; Mori, Etsuro; Kato, Takeo; Sugano, Hidenori; Karagiozov, Kostadin; Arai, Hajime

2018-01-01

Background and Purpose: This study aimed to investigate the efficacy of cerebrospinal fluid shunt intervention for idiopathic normal pressure hydrocephalus (iNPH) using data from a nationwide epidemiological survey in Japan. Methods: We conducted a cross-sectional study using data from a nationwide epidemiological survey performed in Japan. Propensity score matching was used to select 874 patients from 1,423 patients aged ≥60 years, who were diagnosed with iNPH based on clinical guidelines following a hospital visit in 2012. Patients who experienced an improvement of at least 1 modified Rankin Scale (mRS) grade after the intervention were classified as "improved," while the remaining patients were classified as "non-improved." In the shunt intervention ( n = 437) and non-shunt intervention ( n = 437) groups, the differences in mRS grade improvement were analyzed using the Mann-Whitney U -test. Finally, we examined subjects in the shunt intervention group ( n = 974) to compare the outcomes and complications of ventriculoperitoneal (VP) shunt (n = 417) with lumboperitoneal (LP) shunt ( n = 540). Results: We examined subjects with iNPH to compare the non-shunt intervention group to the shunt intervention group following adjustment for age and mRS grade at baseline by propensity score matching (0.31-0.901). The mRS grade (mean [SD]) was found to improve with non-shunt intervention (2.46 [0.88]) and shunt intervention (1.93 [0.93]) ( p < 0.001) in iNPH patients. The mRS outcome score and complications comparison between the VP and LP shunt groups did not show significant difference. Conclusions: In this study, analysis of the efficacy of shunts for possible iNPH conducted in Japan indicated a significant improvement in the mRS grade between baseline and outcome within 1 year, regardless of the surgical technique, and shunt intervention was found to be effective.

Seasonal variation in home blood pressure: findings from nationwide web-based monitoring in Japan

PubMed Central

Miura, Katsuyuki; Obayashi, Keiichi; Ohkubo, Takayoshi; Nakajima, Hiroshi; Shiga, Toshikazu; Ueshima, Hirotsugu

2018-01-01

Objectives Our aim was to assess seasonal variation in home blood pressure (BP) among free-living nationwide participants using home BP values accumulated from a web-based healthcare platform established in Japan. Settings An observational study. OMRON Healthcare Co., Ltd. has been developing web-based personal healthcare record systems in Japan since November 2010; over two million voluntary participants had joined this platform in September 2015. Nationwide home BP measurements made by oscillometric-type electronic sphygmomanometers from over 110 000 voluntary participants have been transmitted to the system from devices. Participants Seasonal variation in home BP was evaluated among 64 536 (51 335 men, 13 201 women; mean age 52.9 years) free-living nationwide users for whom data were automatically and simultaneously transmitted to the system from devices. Primary outcome measures Mean monthly and weekly home BP. Results In multiple regression analysis, the relationship between BP and temperature was a significant inverse association, independent of age, gender and geological locations. Highest and lowest BP was observed in December and July, respectively. Substantial seasonal differences in the mean values of morning and evening home systolic BP between summer and winter were 6.2 mmHg and 5.5 mmHg in men, and 7.3 mmHg and 6.5 mmHg in women. Seasonal variation was a little greater in older (7.3 mmHg in men, 8.7 mmHg in women) than in younger individuals (5.8 mmHg in men, 6.5 mmHg in women). BP from February to July was approximately 1.5 mmHg lower than the value from August to December. Conclusions A web-based healthcare platform has enabled easier monitoring of population-wide BP. Tighter BP control is necessary in winter than in summer, and especially in a colder climate toward winter than toward summer. New technologies using web-based self-monitoring systems for health-related indexes are expected to initiate a new phase of cardiovascular disease prevention and public health promotion. PMID:29306878

America's Children: Key National Indicators of Well-Being, 1999.

ERIC Educational Resources Information Center

Federal Interagency Forum on Child and Family Statistics, Washington, DC.

This report presents nationwide data on the well-being of America's children. The statistical report is based on indicators of child well-being such as family income and mortality rates. The first part of the report, "Population and Family Characteristics," presents data that illustrate the changes that have taken place during the past…

America's Children: Key National Indicators of Well-Being, 2003.

ERIC Educational Resources Information Center

Benson, Carole, Ed.

This report is the seventh to present nation-wide data on the well-being of U.S. children. The statistical portrait is based on indicators of child well-being and on contextual measures describing the changing population and family context. Part 1 of the report, "Population and Family Characteristics," presents data that illustrate the…

The federal health record gateway.

PubMed

Porter, Dennis

2010-01-01

The federal government can make federally held health data available to every American through a single, secure, recurring instance based portal on the emerging Nationwide Health Information Network (NHIN). The Federal Health Record Gateway (FHR Gateway) supports the President's initiatives for patient-centered health by enhancing transparency of government-held clinical and health claims data.

Big Data in Organ Transplantation: Registries and Administrative Claims

PubMed Central

Massie, Allan B.; Kucirka, Lauren; Segev, Dorry L.

2015-01-01

The field of organ transplantation benefits from large, comprehensive, transplant-specific national datasets available to researchers. In addition to the widely-used OPTN-based registries (the UNOS and SRTR datasets) and USRDS datasets, there are other publicly available national datasets, not specific to transplantation, which have historically been underutilized in the field of transplantation. Of particular interest are the Nationwide Inpatient Sample (NIS) and State Inpatient Databases (SID), produced by the Agency for Healthcare Research and Quality (AHRQ). The United States Renal Data System (USRDS) database provides extensive data relevant to studies of kidney transplantation. Linkage of publicly available datasets to external data sources such as private claims or pharmacy data provides further resources for registry-based research. Although these resources can transcend some limitations of OPTN-based registry data, they come with their own limitations, which must be understood to avoid biased inference. This review discusses different registry-based data sources available in the United States, as well as the proper design and conduct of registry-based research. PMID:25040084

Risk of erectile dysfunction in transfusion-naive thalassemia men: a nationwide population-based retrospective cohort study.

PubMed

Chen, Yu-Guang; Lin, Te-Yu; Lin, Cheng-Li; Dai, Ming-Shen; Ho, Ching-Liang; Kao, Chia-Hung

2015-04-01

Based on the mechanism of pathophysiology, thalassemia major or transfusion-dependent thalassemia patients may have an increased risk of developing organic erectile dysfunction resulting from hypogonadism. However, there have been few studies investigating the association between erectile dysfunction and transfusion-naive thalassemia populations. We constructed a population-based cohort study to elucidate the association between transfusion-naive thalassemia populations and organic erectile dysfunction. This nationwide population-based cohort study involved analyzing data from 1998 to 2010 obtained from the Taiwanese National Health Insurance Research Database, with a follow-up period extending to the end of 2011. We identified men with transfusion-naive thalassemia and selected a comparison cohort that was frequency-matched with these according to age, and year of diagnosis thalassemia at a ratio of 1 thalassemia man to 4 control men. We analyzed the risks for transfusion-naive thalassemia men and organic erectile dysfunction by using Cox proportional hazards regression models. In this study, 588 transfusion-naive thalassemia men and 2337 controls were included. Total 12 patients were identified within the thalassaemia group and 10 within the control group. The overall risks for developing organic erectile dysfunction were 4.56-fold in patients with transfusion-naive thalassemia men compared with the comparison cohort after we adjusted for age and comorbidities. Our long-term cohort study results showed that in transfusion-naive thalassemia men, there was a higher risk for the development of organic erectile dysfunction, particularly in those patients with comorbidities.

Nitrogen and phosphorus losses from agricultural systems in China: a meta-analysis.

PubMed

Cao, Di; Cao, Wenzhi; Fang, Jing; Cai, Longyan

2014-08-30

Studies worldwide have indicated that agricultural pollution is the main source of nitrogen and phosphorus (N and P) in surface waters. A systematic understanding of N and P sources and sinks in agricultural systems is important for selecting the appropriate remedial strategies to control nutrient losses and water pollution. Based on nationwide data and a long-term monitoring program in Southeast China, the nationwide spatial and temporal patterns of N and P losses and the relationships between such losses and N and P inputs and rainfall were analyzed. The results showed that the annual nutrient losses from agricultural systems in China strongly varied, and the N/P values ranged from 0.01 to 51.0, with a majority at approximately 0-20, and an arithmetic mean of 9.73; these values mostly overlap the suitable range of N/P (6-15) for red bloom algae. Copyright © 2014 Elsevier Ltd. All rights reserved.

Brief Report: Databases in the Asia-Pacific Region: The Potential for a Distributed Network Approach.

PubMed

Lai, Edward Chia-Cheng; Man, Kenneth K C; Chaiyakunapruk, Nathorn; Cheng, Ching-Lan; Chien, Hsu-Chih; Chui, Celine S L; Dilokthornsakul, Piyameth; Hardy, N Chantelle; Hsieh, Cheng-Yang; Hsu, Chung Y; Kubota, Kiyoshi; Lin, Tzu-Chieh; Liu, Yanfang; Park, Byung Joo; Pratt, Nicole; Roughead, Elizabeth E; Shin, Ju-Young; Watcharathanakij, Sawaeng; Wen, Jin; Wong, Ian C K; Yang, Yea-Huei Kao; Zhang, Yinghong; Setoguchi, Soko

2015-11-01

This study describes the availability and characteristics of databases in Asian-Pacific countries and assesses the feasibility of a distributed network approach in the region. A web-based survey was conducted among investigators using healthcare databases in the Asia-Pacific countries. Potential survey participants were identified through the Asian Pharmacoepidemiology Network. Investigators from a total of 11 databases participated in the survey. Database sources included four nationwide claims databases from Japan, South Korea, and Taiwan; two nationwide electronic health records from Hong Kong and Singapore; a regional electronic health record from western China; two electronic health records from Thailand; and cancer and stroke registries from Taiwan. We identified 11 databases with capabilities for distributed network approaches. Many country-specific coding systems and terminologies have been already converted to international coding systems. The harmonization of health expenditure data is a major obstacle for future investigations attempting to evaluate issues related to medical costs.

Variations in data collection methods between national databases affect study results: a comparison of the nationwide inpatient sample and national surgical quality improvement program databases for lumbar spine fusion procedures.

PubMed

Bohl, Daniel D; Russo, Glenn S; Basques, Bryce A; Golinvaux, Nicholas S; Fu, Michael C; Long, William D; Grauer, Jonathan N

2014-12-03

There has been an increasing use of national databases to conduct orthopaedic research. Questions regarding the validity and consistency of these studies have not been fully addressed. The purpose of this study was to test for similarity in reported measures between two national databases commonly used for orthopaedic research. A retrospective cohort study of patients undergoing lumbar spinal fusion procedures during 2009 to 2011 was performed in two national databases: the Nationwide Inpatient Sample and the National Surgical Quality Improvement Program. Demographic characteristics, comorbidities, and inpatient adverse events were directly compared between databases. The total numbers of patients included were 144,098 from the Nationwide Inpatient Sample and 8434 from the National Surgical Quality Improvement Program. There were only small differences in demographic characteristics between the two databases. There were large differences between databases in the rates at which specific comorbidities were documented. Non-morbid obesity was documented at rates of 9.33% in the Nationwide Inpatient Sample and 36.93% in the National Surgical Quality Improvement Program (relative risk, 0.25; p < 0.05). Peripheral vascular disease was documented at rates of 2.35% in the Nationwide Inpatient Sample and 0.60% in the National Surgical Quality Improvement Program (relative risk, 3.89; p < 0.05). Similarly, there were large differences between databases in the rates at which specific inpatient adverse events were documented. Sepsis was documented at rates of 0.38% in the Nationwide Inpatient Sample and 0.81% in the National Surgical Quality Improvement Program (relative risk, 0.47; p < 0.05). Acute kidney injury was documented at rates of 1.79% in the Nationwide Inpatient Sample and 0.21% in the National Surgical Quality Improvement Program (relative risk, 8.54; p < 0.05). As database studies become more prevalent in orthopaedic surgery, authors, reviewers, and readers should view these studies with caution. This study shows that two commonly used databases can identify demographically similar patients undergoing a common orthopaedic procedure; however, the databases document markedly different rates of comorbidities and inpatient adverse events. The differences are likely the result of the very different mechanisms through which the databases collect their comorbidity and adverse event data. Findings highlight concerns regarding the validity of orthopaedic database research. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Regression models for explaining and predicting concentrations of organochlorine pesticides in fish from streams in the United States

USGS Publications Warehouse

Nowell, Lisa H.; Crawford, Charles G.; Gilliom, Robert J.; Nakagaki, Naomi; Stone, Wesley W.; Thelin, Gail; Wolock, David M.

2009-01-01

Empirical regression models were developed for estimating concentrations of dieldrin, total chlordane, and total DDT in whole fish from U.S. streams. Models were based on pesticide concentrations measured in whole fish at 648 stream sites nationwide (1992-2001) as part of the U.S. Geological Survey's National Water Quality Assessment Program. Explanatory variables included fish lipid content, estimates (or surrogates) representing historical agricultural and urban sources, watershed characteristics, and geographic location. Models were developed using Tobit regression methods appropriate for data with censoring. Typically, the models explain approximately 50 to 70% of the variability in pesticide concentrations measured in whole fish. The models were used to predict pesticide concentrations in whole fish for streams nationwide using the U.S. Environmental Protection Agency's River Reach File 1 and to estimate the probability that whole-fish concentrations exceed benchmarks for protection of fish-eating wildlife. Predicted concentrations were highest for dieldrin in the Corn Belt, Texas, and scattered urban areas; for total chlordane in the Corn Belt, Texas, the Southeast, and urbanized Northeast; and for total DDT in the Southeast, Texas, California, and urban areas nationwide. The probability of exceeding wildlife benchmarks for dieldrin and chlordane was predicted to be low for most U.S. streams. The probability of exceeding wildlife benchmarks for total DDT is higher but varies depending on the fish taxon and on the benchmark used. Because the models in the present study are based on fish data collected during the 1990s and organochlorine pesticide residues in the environment continue to decline decades after their uses were discontinued, these models may overestimate present-day pesticide concentrations in fish. ?? 2009 SETAC.

Incidence and Clinical Outcomes of Inflammatory Bowel Disease in South Korea, 2011-2014: A Nationwide Population-Based Study.

PubMed

Jung, Yoon Suk; Han, Minkyung; Kim, Won Ho; Park, Sohee; Cheon, Jae Hee

2017-08-01

The incidence of inflammatory bowel disease (IBD) is increasing in East Asia; however, population-based data from this region are lacking. We conducted a nationwide, population-based study to examine the incidence and disease course of IBD in South Korea. Using the National Health Insurance claims data, we collected data on patients diagnosed with IBD [10,049 with ulcerative colitis (UC) and 5595 with Crohn's disease (CD)] from 2011 to 2014. During the study period, the average annual incidence of UC was 5.0 per 10 5 , while that of CD was 2.8 per 10 5 . Among patients with UC, the cumulative rates of surgery 1 and 4 years after diagnosis were 1.0 and 2.0%; those among patients with CD were 9.0 and 13.9%, respectively. The 1- and 4-year cumulative rates of moderate- to high-dose corticosteroid use were, respectively, 26.6 and 45.2% among patients with UC, and 29.9 and 50.8% among those with CD. Similarly, the 1- and 4-year cumulative rates of immunomodulator use were 14.1 and 26.4% among patients with UC, and 58.3 and 76.1% among those with CD, respectively. With regard to biologic use, the 1- and 4-year cumulative rates were 3.0 and 9.0% among patients with UC, and 11.1 and 31.7% among those with CD, respectively. The recent incidence of IBD in South Korea has been the highest in East Asia. Patients who had been diagnosed recently with IBD showed lower rates of surgery and higher rates of immunomodulator and biologic use compared to those reported ever in South Korea.

The psychosocial work environment among physicians employed at Danish oncology departments in 2009. A nationwide cross-sectional study.

PubMed

Andreassen, Christian Nicolaj; Eriksen, Jesper Grau

2013-01-01

Working as a physician at an oncology department has some distinctive characteristics that may lead to a stressful work environment. The present study was conducted to provide a nationwide description of the work conditions of all oncologists in Denmark. By comparing the results of the present study with those of a similar study carried out in 2006, the aim was furthermore to elucidate changes in the psychosocial work environment over time. From May to September 2009, 330 physicians employed at six oncology centres and seven community based oncology departments were invited to participate in a survey based on the short version of the COPSOQ II questionnaire. The results were compared with data from a representative section of Danish employees and with data from the 2006 survey. Two hundred and twenty of the 330 invited physicians returned the questionnaire (response rate 67%). Concerning the aspects quantitative demands, work pace, emotional demands, influence, burnout and stress, the oncologists reported worse work conditions than the average Danish employee. However, with regard to possibilities for development, meaning of work and commitment to workplace, the oncologists reported better work conditions. Between 2006 and 2009, substantial improvement was seen concerning several of the assessed work environment aspects within the group of young physicians at the oncology centres. Though substantial improvement of the work conditions has been achieved between 2006 and 2009, certain aspects of the psychosocial work environment at Danish oncology departments still require attention.

Does marital status predict the odds of suicidal death in taiwan? A seven-year population-based study.

PubMed

Yeh, Jui-Yuan; Xirasagar, Sudha; Liu, Tsai-Ching; Li, Chong-Yi; Lin, Herng-Ching

2008-06-01

Using nationwide, 7-year population-based data for 1997-2003, we examined marital status to see if it predicted suicide among the ethnic Chinese population of Taiwan. Using cause of death data, with a case-control design, two groups-total adult suicide deaths, n = 17,850, the study group, and adult deaths other than suicide, n = 71,400 (randomly selected from age, sex, and geographic region matched controls, four per suicide)-were studied. Using multiple logistic regression analysis including age-marital status interaction, adjusted estimates show divorced status to be the most detrimental for suicide propensity, with males showing stronger effect size. Females never married, aged below 35 and 65-plus, and widowed 65-plus had lower suicide odds.

Chinese Herbal Medicine as an Adjunctive Therapy Ameliorated the Incidence of Chronic Hepatitis in Patients with Breast Cancer: A Nationwide Population-Based Cohort Study

PubMed Central

Chiang, Jen-Huai; Su, Yuan-Chih; Chang, Hen-Hong

2017-01-01

We conducted a National Health Insurance Research Database-based Taiwanese nationwide population-based cohort study to evaluate whether Chinese herbal medicine (CHM) treatment decreased the incidence of chronic hepatitis in breast cancer patients receiving chemotherapy and/or radiotherapy. A total of 81171 patients were diagnosed with breast cancer within the defined study period. After randomly equal matching, data from 13856 patients were analyzed. Hazard ratios of incidence rate of chronic hepatitis were used to determine the influence and therapeutic potential of CHM in patients with breast cancer. The patients with breast cancer receiving CHM treatment exhibited a significantly decreased incidence rate of chronic hepatitis even across the stratification of age, CCI score, and treatments. The cumulative incidence of chronic hepatitis for a period of seven years after initial breast cancer diagnosis was also reduced in the patients receiving CHM treatment. The ten most commonly used single herbs and formulas were effective in protecting liver function in patients with breast cancer, where Hedyotis diffusa and Jia-Wei-Xiao-Yao-San were the most commonly used herbal agents. In conclusion, our study provided information that western medicine therapy combined with CHM as an adjuvant modality may have a significant impact on liver protection in patients with breast cancer. PMID:29234362

Spatial Econometric Research on the Relationship between Highway Construction and Regional Economic Growth in China: Evidence from the Nationwide Panel Data

NASA Astrophysics Data System (ADS)

Ye, N. J.; Li, W. J.; Li, Y.; Bai, Y. F.

2017-12-01

Based on spatial panel data from 2010 to 2016 in China, this paper makes an empirical analysis on the relationship between highway construction and regional economic growth by means of spatial econometric model. The results show that there is positive spatial correlation on regional economic growth in China, and strong spatial dependences between some provinces and cities appear, specifically, Hebei, Beijing, Tianjin, Shanghai, Zhejiang and other eastern coastal areas show high-high agglomeration trend, the Pearl River Delta region presents high-low agglomeration trend; In terms of nationwide provinces and municipalities, a province’s highway construction investment for their own province and the neighboring provinces has pulling effect on economic growth to a certain extent, and the direct effect is more obvious.

Differences in prescription rates and odds ratios of antidepressant drugs in relation to individual hormonal contraceptives: a nationwide population-based study with age-specific analyses.

PubMed

Lindberg, Malou; Foldemo, Anniqa; Josefsson, Ann; Wiréhn, Ann-Britt

2012-04-01

To examine, among young women, the association of individual hormonal contraceptives, within two broad groupings, with antidepressant therapy. In a nationwide register-based study, we examined the prescription rates of antidepressant drugs in relation to individual combined hormonal and progestin-only contraceptives among Swedish women aged 16-31 years (N = 917,993). Drug data were obtained from the Swedish Prescribed Drug Register for the period 1 July 2005-30 June 2008. Data on the total population of women aged 16-31 in 2008 were obtained from the Total Population Register of Statistics Sweden. The proportion of women using both hormonal contraception and antidepressants, and odds ratios (ORs) for antidepressant use for hormonal contraceptive users versus non-users, were calculated, the latter by logistic regression, for each formulation. The highest antidepressant OR in all age groups, particularly in the 16-19 years age group, related to medroxyprogesterone-only, followed by etonogestrel-only, levonorgestrel-only and ethinylestradiol/norelgestromin formulations. Oral contraceptives containing ethinylestradiol combined with lynestrenol or drospirenone had considerably higher ORs than other pills. ORs significantly lower than 1 were observed when ethinylestradiol was combined with norethisterone, levonorgestrel or desogestrel. The association between use of hormonal contraceptives and antidepressant drugs varies considerably within both the combined hormonal contraceptive and the progestin-only groups.

Therapeutic inertia and intensified treatment in diabetes mellitus prescription patterns: A nationwide population-based study in Taiwan

PubMed Central

Huang, Li-Ying; Yeh, Hseng-Long; Yang, Ming-Chin; Shau, Wen-Yi; Su, Syi

2016-01-01

Objective To measure therapeutic inertia by characterizing prescription patterns using secondary data obtained from the nationwide diabetes mellitus pay-for-performance (DM-P4P) programme in Taiwan. Methods Using reimbursement claims from Taiwan’s National Health Insurance Research Database, a nationwide retrospective cohort study was undertaken of patients with diabetes mellitus who participated in the DM-P4P programme from 2006–2008. Glycosylated haemoglobin results were used to evaluate modifications in therapy in response to poor diabetes control. Prescription patterns were used to assign patients to either a therapeutic inertia group or an intensified treatment group. Therapeutic inertia was defined as the failure to act on a known problem. Results The research sample comprised of 168 876 patients with diabetes mellitus who had undergone 899 135 tests. Of these, 37.4% (336 615 visits) of prescriptions were for a combination of two types of drug and 27.7% (248 788 visits) were for a combination of three types of drug. The proportion of patients in the intensified therapy group who were prescribed more than two types of drug was considerably higher than that in the therapeutic inertia group. Conclusion In many cases in the therapeutic inertia group only a single type of hypoglycaemic drug was prescribed or the dosage remained unchanged. PMID:28322095

The association between scabies and myasthenia gravis: A nationwide population-based cohort study.

PubMed

Hsu, Ren-Jun; Lin, Chien-Yu; Chang, Fung-Wei; Huang, Chun-Fa; Chuang, Heng-Chang; Liu, Jui-Ming

2017-11-01

Scabies is an infectious inflammatory pruritic skin disease. Cytokine-mediated inflammatory processes contribute to the pathologic mechanism in scabies. Myasthenia gravis (MG) is also an autoimmune disease that is mediated by cytokines. The study aimed to investigate the association between scabies and myasthenia gravis. We conducted a nationwide population-based cohort study utilized data from the National Health Insurance Research Database (NHIRD) of Taiwan. Patients with scabies (n=5429) and control subjects without scabies (n=20,176) were enrolled. We tracked the subjects in both groups for a 7-year period to identify new onset MG. Cox regression analysis was performed to calculate the hazard ratio (HR) for MG. A total of 25,605 patients were enrolled in the study, including 5429 patients in the scabies group and 20,176 in the control group. There were 40 (0.7%) patients from the scabies group and 84 (0.4%) subjects from the control group who were newly diagnosed with MG during the 7-year follow-up period. The scabies patients had a significantly increased risk of MG, with an adjusted HR of 1.27 (95% confidence interval [CI] 1.01-1.89). As such, prompt diagnosis and treatment of scabies may decrease the risk of subsequent MG. Copyright © 2017 Elsevier Ltd. All rights reserved.

Gender ratios of administrative prevalence and incidence of attention-deficit/hyperactivity disorder (ADHD) across the lifespan: A nationwide population-based study in Taiwan.

PubMed

Huang, Charles Lung-Cheng; Weng, Shih-Feng; Ho, Chung-Han

2016-10-30

To verify the hypothesis that there is different gender ratio of attention-deficit/hyperactivity disorder (ADHD) among adults compared to children and adolescents in the clinical setting among Asian population. The nationwide population-based database containing data on enrollees in the National Health Insurance program in Taiwan during 2000-2007 was used in this study, and we investigated the lifetime gender ratios of administrative prevalence and incidence in healthcare-seeking ADHD patients (n=228,029). The male-to-female ratios of diagnosed incidence and prevalence of child/adolescent ADHD (age <20 years) ranged from 3.39 to 4.07 and 3.87-4.31, respectively. The male-to-female ratios of diagnosed incidence and prevalence of ADHD in the adult group (age 20-65 years) ranged from 0.24 to 0.76 and 0.35-0.98, respectively. In conclusion, there was substantially increased female-to-male ratio in adults ADHD compared to children and adolescents in the clinical setting. Further researches on the management and mechanism are needed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

America's Children: Key National Indicators of Well-Being, 1998.

ERIC Educational Resources Information Center

Federal Interagency Forum on Child and Family Statistics, Washington, DC.

This report presents nationwide data on the well-being of U.S. children. The statistical report is based on indicators of child well-being such as family income and mortality rates. The first part of the report, "Population and Family Characteristics," presents data that illustrate the changes that have taken place during the past few…

Strengthening Teachers' Abilities to Implement a Vision Health Program in Taiwanese Schools

ERIC Educational Resources Information Center

Chang, L. C.; Liao, L. L.; Chen, M. I.; Niu, Y. Z.; Hsieh, P. L.

2017-01-01

We designed a school-based, nationwide program called the "New Era in Eye Health" to strengthen teacher training and to examine whether the existence of a government vision care policy influenced teachers' vision care knowledge and students' behavior. Baseline data and 3-month follow-up data were compared. A random sample of teachers (n…

Ecoenzymatic Stoichiometry of Stream Sediments with Comparison to Terrestrial Soils

EPA Science Inventory

In this study, we extend the development of ecoenzymatic stoichiometry to the surface sediments of stream ecosystems using data collected in a nationwide survey. The data set is larger and more comprehensive than those used in our previous studies. The data include the first broa...

Development and implementation of a geographical area categorisation method with targeted performance indicators for nationwide EMS in Finland.

PubMed

Pappinen, Jukka; Laukkanen-Nevala, Päivi; Mäntyselkä, Pekka; Kurola, Jouni

2018-05-15

In Finland, hospital districts (HD) are required by law to determine the level and availability of Emergency Medical Services (EMS) for each 1-km 2 sized area (cell) within their administrative area. The cells are currently categorised into five risk categories based on the predicted number of missions. Methodological defects and insufficient instructions have led to incomparability between EMS services. The aim of this study was to describe a new, nationwide method for categorising the cells, analyse EMS response time data and describe possible differences in mission profiles between the new risk category areas. National databases of EMS missions, population and buildings were combined with an existing nationwide 1-km 2 hexagon-shaped cell grid. The cells were categorised into four groups, based on the Finnish Environment Institute's (FEI) national definition of urban and rural areas, population and historical EMS mission density within each cell. The EMS mission profiles of the cell categories were compared using risk ratios with confidence intervals in 12 mission groups. In total, 87.3% of the population lives and 87.5% of missions took place in core or other urban areas, which covered only 4.7% of the HDs' surface area. Trauma mission incidence per 1000 inhabitants was higher in core urban areas (42.2) than in other urban (24.2) or dispersed settlement areas (24.6). The results were similar for non-trauma missions (134.8, 93.2 and 92.2, respectively). Each cell category had a characteristic mission profile. High-energy trauma missions and cardiac problems were more common in rural and uninhabited cells, while violence, intoxication and non-specific problems dominated in urban areas. The proposed area categories and grid-based data collection appear to be a useful method for evaluating EMS demand and availability in different parts of the country for statistical purposes. Due to a similar rural/urban area definition, the method might also be usable for comparison between the Nordic countries.

Psoriatic patients with chronic viral hepatitis do not have an increased risk of liver cirrhosis despite long-term methotrexate use: real-world data from a nationwide cohort study in Taiwan.

PubMed

Tang, Kuo-Tung; Chen, Yi-Ming; Chang, Shih-Ni; Lin, Ching-Heng; Chen, Der-Yuan

2018-05-09

Methotrexate (MTX) is commonly used in the treatment of patients with moderate to severe psoriasis. We conducted a nationwide population-based cohort study to investigate the impact of long-term MTX use on the risk of chronic viral hepatitis-related cirrhosis among psoriatic patients in Taiwan. This study obtained data from the National Health Insurance Research Database in Taiwan. We identified 2417 psoriatic patients with chronic hepatitis B (CHB) (370 MTX users and 2047 MTX non-users) and 1127 psoriatic patients with chronic hepatitis C (CHC) (174 MTX users and 953 MTX non-users) from January 1, 2000 to December 31, 2010. After a mean follow-up of more than 9 years since the diagnosis of chronic viral hepatitis, a total of 125 (5%) CHB patients and 120 (11%) CHC patients developed liver cirrhosis. A comparable proportion of MTX users and MTX non-users developed liver cirrhosis (4% vs. 5% in CHB patients and 11% and vs. 11% in CHC patients, both p < 0.05). There is possibly selection bias and medication nonadherence. Our real-world data show that long-term MTX use may not be associated with an increased risk of liver cirrhosis among psoriatic patients with chronic viral hepatitis. Copyright © 2018. Published by Elsevier Inc.

Nationwide Risk-Based PCB Remediation Waste Disposal Approvals under Title 40 of the Code of Federal Regulations (CFR) Section 761.61(c)

EPA Pesticide Factsheets

This page contains information about Nationwide Risk-Based Polychlorinated Biphenyls (PCBs) Remediation Waste Disposal Approvals under Title 40 of the Code of Federal Regulations (CFR) Section 761.61(c)

The first private sector health insurance company in Ghana.

PubMed

Huff-Rousselle, M; Akuamoah-Boateng, J

1998-01-01

This article analyses the development of Ghana's first private sector health insurance company, the Nationwide Medical Insurance Company. Taking both policy and practical considerations into account (stakeholders' perspectives, economic viability, equity and efficiency), it is structured around key questions which help to define the position and roles of stakeholders--the insurance agency itself, contributors, beneficiaries, and providers--and how they relate to one another and the insurance scheme. These relationships will to a large extent determine Nationwide's long-term success or failure. By creating a unique alliance between physician providers and private sector companies, Nationwide has used employers' interest in cost containment and physicians' interest in expanding their client base as an entrée into the virgin territory of health insurance, and created a hybrid variety of private sector insurance with some of the attributes of a health maintenance organization or managed care. The case study is unusual in that, while public sector programs are often open to academic scrutiny, researchers have rarely had access to detailed data on the establishment of a single private sector insurance company in a developing country. Given that Ghana is planning to launch a national health insurance plan, the article concludes by considering what the experience of this private sector initiative might have to offer public sector planners.

Methodology of a nationwide cross-sectional survey of prevalence and epidemiological patterns of hepatitis A, B and C infection in Brazil.

PubMed

Ximenes, Ricardo Arraes de Alencar; Pereira, Leila Maria Beltrão; Martelli, Celina Maria Turchi; Merchán-Hamann, Edgar; Stein, Airton Tetelbom; Figueiredo, Gerusa Maria; Braga, Maria Cynthia; Montarroyos, Ulisses Ramos; Brasil, Leila Melo; Turchi, Marília Dalva; Fonseca, José Carlos Ferraz da; Lima, Maria Luiza Carvalho de; Alencar, Luis Cláudio Arraes de; Costa, Marcelo; Coral, Gabriela; Moreira, Regina Celia; Cardoso, Maria Regina Alves

2010-09-01

A population-based survey to provide information on the prevalence of hepatitis viral infection and the pattern of risk factors was carried out in the urban population of all Brazilian state capitals and the Federal District, between 2005 and 2009. This paper describes the design and methodology of the study which involved a population aged 5 to 19 for hepatitis A and 10 to 69 for hepatitis B and C. Interviews and blood samples were obtained through household visits. The sample was selected using stratified multi-stage cluster sampling and was drawn with equal probability from each domain of study (region and age-group). Nationwide, 19,280 households and ~31,000 residents were selected. The study is large enough to detect prevalence of viral infection around 0.1% and risk factor assessments within each region. The methodology seems to be a viable way of differentiating between distinct epidemiological patterns of hepatitis A, B and C. These data will be of value for the evaluation of vaccination policies and for the design of control program strategies.

47 CFR 90.769 - Construction and implementation of Phase II nationwide licenses.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... (a) A nationwide licensee must construct a sufficient number of base stations (i.e., base stations... their authorized channels at all of their base stations or fixed stations. [69 FR 75173, Dec. 15, 2004] ... will not be converted to individual, site-by-site authorizations for already constructed stations. (d...

Prevalence and Associated Factors of Depression in General Population of Korea: Results from the Korea National Health and Nutrition Examination Survey, 2014

PubMed Central

2017-01-01

Depressive disorder is a common mental illness and remains a major cause of morbidity worldwide. The present study, a cross-sectional, nationwide, population-based survey assessed the prevalence of depression in the general population of Korea through a random sampling of the non-institutionalized population for the Korea National Health and Nutrition Examination Survey (KNHANES) VI. The Patient Health Questionnaire (PHQ)-9 was first introduced into the KNHANES to detect depression. The point prevalence of depression (PHQ score of 10 or higher) was 6.7% (95% confidence interval [CI], 5.7–7.6) in 4,949 subjects. Based on the analysis using the diagnostic algorithm of the PHQ-9, the prevalence of major depressive disorder was 2.7% (95% CI, 2.2–3.3). Multiple logistic regression analysis, after adjusting the sociodemographic variables, also showed that the factors associated with depression were perceived stress and health status. This study reported for the first time that the point prevalence of depression screened using the PHQ-9 in this nationwide survey of the Korean population was similar to that of the western countries. As the KNHANES to detect depression is conducted biennially, further studies on the accumulated data are expected in the future. PMID:28960042

The Clinical Profile of Patients with Psoriasis in Korea: A Nationwide Cross-Sectional Study (EPI-PSODE).

PubMed

Song, Hae Jun; Park, Chul Jong; Kim, Tae Yoon; Choe, Yong Beom; Lee, Seok-Jong; Kim, Nack In; Cho, Jae We; Jeon, Jie Hyun; Jang, Min Soo; Youn, Jai Il; Kim, Myung Hwa; Park, Joonsoo; Kim, Ki Ho; Kim, Byung Soo; Youn, Sang Woong; Lee, Joo-Heung; Lee, Min-Geol; Ahn, Sung Ku; Won, Young Ho; Yun, Seok Kweon; Shin, Bong Seok; Seo, Seong Jun; Lee, Ji Yeoun; Kim, Kwang Joong; Ro, Young Suck; Kim, Youngdoe; Yu, Dae Young; Choi, Jee-Ho

2017-08-01

Psoriasis is an immune-mediated, chronic inflammatory disease affecting multiple aspects of patients' lives. Its epidemiology varies regionally; however, nationwide epidemiologic data on psoriasis depicting profile of Korean patients has not been available to date. To understand nationwide epidemiologic characteristics and clinical features of adult patients with psoriasis visited university hospitals in Korea. This multicenter, non-interventional, cross-sectional study recruited 1,278 adult patients with psoriasis across 25 centers in Korea in 2013. Various clinical data including PASI, BSA, DLQI, SF-36 and PASE were collected. A total of 1,260 patients completed the study (male:female=1.47:1). The mean age was 47.0 years with a distribution mostly in the 50s (24.9%). Early onset (<40 years) of psoriasis accounted for 53.9% of patients. The mean disease duration was 109.2 months; mean body mass index was 23.9 kg/m 2 ; and 12.7% of patients had a family history of psoriasis. Plaque and guttate types of psoriasis accounted for 85.8% and 8.4%, respectively. Patients with PASI ≥10 accounted for 24.9%; patients with body surface area ≥10 were 45.9%. Patients with DLQI ≥6 accounted for 78.8%. Between PASI <10 and PASI ≥10 groups, significant difference was noted in age at diagnosis, disease duration, blood pressure, waist circumference of female, and treatment experiences with phototherapy, systemic agents, and biologics. This was the first nationwide epidemiologic study of patients with psoriasis in Korea and provides an overview of the epidemiologic characteristics and clinical profiles of this patient population.

A Research Report of Small/Rural School Districts in New Mexico Compared to School Districts of Similiar Size Nationwide.

ERIC Educational Resources Information Center

Barker, Bruce O.; Muse, Ivan D.

A 1982-83 survey produced data used to compare 17 small/rural K-12 New Mexico school districts (900 students or fewer) with 642 similar districts nationwide. Of New Mexico's 88 school districts, 43 were identified as qualifying (48.9%, enrolling 16,648 students), for comparison to 4,125 similar districts nationwide. A questionnaire mailed to…

Associations among Child Care, Family, and Behavior Outcomes in a Nation-Wide Sample of Preschool-Aged Children

ERIC Educational Resources Information Center

Romano, Elisa; Kohen, Dafna; Findlay, Leanne C.

2010-01-01

Canadian data based on maternal reports for a nationally representative sample of 4,521 4-5-year-olds were used to examine associations among child care, family factors, and behaviors in preschool-aged children. Linear regressions testing for direct and moderated associations indicated that regulated home-based care was associated with less…

Primary Sjogren's syndrome and the risk of acute pancreatitis: a nationwide cohort study.

PubMed

Chang, Chi-Ching; Chang, Yu-Sheng; Wang, Shu-Hung; Lin, Shyr-Yi; Chen, Yi-Hsuan; Chen, Jin Hua

2017-08-11

Studies on the risk of acute pancreatitis in patients with primary Sjogren's syndrome (pSS) are limited. We evaluated the effects of pSS on the risk of acute pancreatitis in a nationwide, population-based cohort in Taiwan. Population-based retrospective cohort study. We studied the claims data of the >97% Taiwan population from 2002 to 2012. We identified 9468 patients with pSS by using the catastrophic illness registry of the National Health Insurance Database in Taiwan. We also selected 37 872 controls that were randomly frequency matched by age (in 5 year bands), sex and index year from the general population. We analysed the risk of acute pancreatitis by using Cox proportional hazards regression models including sex, age and comorbidities. From 23.74 million people in the cohort, 9468 patients with pSS (87% women, mean age=55.6 years) and 37 872 controls were followed-up for 4.64 and 4.74 years, respectively. A total of 44 cases of acute pancreatitis were identified in the pSS cohort versus 105 cases in the non-pSS cohort. Multivariate Cox regression analysis indicated that the incidence rate of acute pancreatitis was significantly higher in the pSS cohort than in the non-pSS cohort (adjusted HR (aHR) 1.48, 95% CI 1.03 to 2.12). Cyclophosphamide use increased the risk of acute pancreatitis (aHR 5.27, 95% CI 1.16 to 23.86). By contrast, hydroxychloroquine reduced the risk of acute pancreatitis (aHR 0.23, 95% CI 0.09 to 0.55). This nationwide, retrospective cohort study demonstrated that the risk of acute pancreatitis was significantly higher in patients with pSS than in the general population. © 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.

Genetic erosion in maize's center of origin.

PubMed

Dyer, George A; López-Feldman, Alejandro; Yúnez-Naude, Antonio; Taylor, J Edward

2014-09-30

Crop genetic diversity is an indispensable resource for farmers and professional breeders responding to changing climate, pests, and diseases. Anecdotal appraisals in centers of crop origin have suggested serious threats to this diversity for over half a century. However, a nationwide inventory recently found all maize races previously described for Mexico, including some formerly considered nearly extinct. A flurry of social studies seems to confirm that farmers maintain considerable diversity. Here, we compare estimates of maize diversity from case studies over the past 15 y with nationally and regionally representative matched longitudinal data from farmers across rural Mexico. Our findings reveal an increasing bias in inferences based on case study results and widespread loss of diversity. Cross-sectional, case study data suggest that farm-level richness has increased by 0.04 y(-1) nationwide; however, direct estimates using matched longitudinal data reveal that richness dropped -0.04 y(-1) between 2002 and 2007, from 1.43 to 1.22 varieties per farm. Varietal losses occurred across regions and altitudinal zones, and regardless of farm turnover within the sector. Extinction of local maize populations may not have resulted in an immediate loss of alleles, but low varietal richness and changes in maize's metapopulation dynamics may prevent farmers from accessing germplasm suitable to a rapidly changing climate. Declining yields could then lead farmers to leave the sector and result in a further loss of diversity. Similarities in research approaches across crops suggest that methodological biases could conceal a loss of diversity at other centers of crop origin.

Twenty years of measurement of polycyclic aromatic hydrocarbons (PAHs) in UK ambient air by nationwide air quality networks.

PubMed

Brown, Andrew S; Brown, Richard J C; Coleman, Peter J; Conolly, Christopher; Sweetman, Andrew J; Jones, Kevin C; Butterfield, David M; Sarantaridis, Dimitris; Donovan, Brian J; Roberts, Ian

2013-06-01

The impact of human activities on the health of the population and of the wider environment has prompted action to monitor the presence of toxic compounds in the atmosphere. Toxic organic micropollutants (TOMPs) are some of the most insidious and persistent of these pollutants. Since 1991 the United Kingdom has operated nationwide air quality networks to assess the presence of TOMPs, including polycyclic aromatic hydrocarbons (PAHs), in ambient air. The data produced in 2010 marked 20 years of nationwide PAH monitoring. This paper marks this milestone by providing a novel and critical review of the data produced since nationwide monitoring began up to the end of 2011 (the latest year for which published data is available), discussing how the networks performing this monitoring has evolved, and elucidating trends in the concentrations of the PAHs measured. The current challenges in the area and a forward look to the future of air quality monitoring for PAHs are also discussed briefly.

Risk of cancer in patients with irritable bowel syndrome: a nationwide population-based study.

PubMed

Hu, Li-Yu; Ku, Fan-Chen; Lu, Ti; Shen, Cheng-Che; Hu, Yu-Wen; Yeh, Chiu-Mei; Tzeng, Cheng-Hwai; Chen, Tzeng-Ji; Chen, Pan-Ming; Liu, Chia-Jen

2015-12-01

The aim of our study was to evaluate the overall cancer risk among patients with the irritable bowel syndrome (IBS) by using a nationwide population-based data set. We obtained data on newly diagnosed IBS patients (age ≥ 20 years) without antecedent cancer from the Taiwan National Health Insurance Research Database for the period between 2000 and 2010. Standardized incidence ratios (SIRs) were calculated for various types of cancer in the IBS patients. A total of 1,043 people among the 29,838 IBS patients had developed cancer, and the follow-up was 139,185 person-years (median, 4.56 years), leading to a significantly increased SIR (1.18; 95% confidence interval [CI]) = 1.11-1.26) among all cancer types. However, after excluding cancer that developed within the first year after IBS diagnosis, the increased SIR of overall cancer was nonsignificant. In particular, the IBS patients exhibited an increased risk of cancers of the colon and rectum (SIR = 1.51; 95% CI = 1.31-1.73), liver and biliary tract (SIR = 1.40; 95% CI = 1.21-1.62), pancreas (SIR = 1.56; 95% CI = 1.02-2.28), and kidney (SIR = 1.56; 95% CI = 1.10-2.15). An increased SIR in IBS patients was observed only within the first year of IBS diagnosis. The findings of this study might have resulted from detection bias, localized symptoms, or paraneoplastic syndromes associated with IBS-like symptoms. Additional prospective studies are necessary to confirm these findings. Copyright © 2015 Elsevier Inc. All rights reserved.

Risk of depression in patients with chronic rhinosinusitis: A nationwide population-based retrospective cohort study.

PubMed

Hsu, Che-Lun; Wang, Tang-Chuan; Shen, Te-Chun; Huang, Yu-Jhen; Lin, Cheng-Li; Sung, Fung-Chang

2016-12-01

Depression is prevalent in patients with chronic rhinosinusitis (CRS). However, no population-based study has ever investigated this relationship. We used nationwide population insurance data to conduct a retrospective cohort study to evaluate the subsequent risk of depression among patients with CRS. We used the National Health Insurance Research Database (NHIRD) of Taiwan identified 15,371 CRS patients diagnosed during 2000-2010. The non-CRS group consisted of 61,484 individuals without CRS frequency matched by sex, age, and the year of diagnosis. The occurrence of depression was monitored until the end of 2011. The hazard ratios (HRs) of depression were estimated using the Cox proportional hazards model after adjusting for demographic characteristics and comorbidities. The overall incidence of depression was 77% higher in the CRS group than in the non-CRS group (8.25 vs. 4.66/1000 person-years, p<0.001), with an adjusted HR of 1.56 (95% confidence interval=1.43-1.70). Further data analyses revealed that the adjusted HRs of depression in the CRS group compared with the non-CRS group by sex, age, urbanization level, monthly income, occupation category, and comorbidity were all significant. However, there was no difference in incidences of depression between CRS patients with and without surgical treatment (8.31 vs. 8.24/1000 person-years). The present study suggests that patients with CRS are at an increased risk of depression, compared with those without CRS. Therefore, we should pay attention to the psychiatric status of these patients and provide adequate support for them. Copyright © 2016 Elsevier B.V. All rights reserved.

Advertising down, but marketing spending climbs; survey says focus is on targeting, not overviews.

PubMed

Burns, J

1992-02-03

Hard economic times forced hospitals nationwide to cut their advertising budgets in 1991. But marketing expenditures hit an all-time high, as hospitals shifted the emphasis to high-technology marketing efforts that employ computer data bases and market research to seek and find potential business.

America's Children: Key National Indicators of Well-Being, 2001.

ERIC Educational Resources Information Center

Benson, Carole, Ed.

This report is the fifth to present nationwide data on the well-being of America's children. The statistical portrait is based on indicators of child well-being and on contextual measures describing the changing population and family context. Part 1 of the report, "Population and Family Characteristics," presents information illustrating…

Student Engagement in High-Stakes Accountability Systems

ERIC Educational Resources Information Center

Cavendish, Wendy; Márquez, Adrián; Roberts, Mary; Suarez, Kristen; Lima, Wesley

2017-01-01

In a nationwide effort to create standardized performance criteria, there has been an emphasis on testing data as the strict measurement of teacher and student success or failure (Volante & Sonia, 2010). These testing accountability systems, developed under No Child Left Behind (2001), were based on assumptions that high-stakes assessments…

Copenhagen Airport Cohort: air pollution, manual baggage handling and health

PubMed Central

Møller, Karina Lauenborg; Brauer, Charlotte; Mikkelsen, Sigurd; Loft, Steffen; Simonsen, Erik B; Koblauch, Henrik; Bern, Stine Hvid; Alkjær, Tine; Hertel, Ole; Becker, Thomas; Larsen, Karin Helweg; Bonde, Jens Peter; Thygesen, Lau Caspar

2017-01-01

Purpose Copenhagen Airport Cohort 1990–2012 presents a unique data source for studies of health effects of occupational exposure to air pollution (ultrafine particles) and manual baggage handling among airport employees. We describe the extent of information in the cohort and in the follow-up based on data linkage to the comprehensive Danish nationwide health registers. In the cohort, all information is linked to the personal identification number that also is used in Denmark Statistics demographic and socioeconomic databases and in the nationwide health registers. Participants The cohort covers 69 175 men in unskilled positions. The exposed cohort includes men in unskilled jobs employed at Copenhagen Airport in the period 1990–2012 either as baggage handlers or in other outdoor work. The reference cohort includes men in unskilled jobs working in the greater Copenhagen area. Findings to date The cohort includes environmental Global Positioning System (GPS) measurements in Copenhagen Airport, information on job function/task for each calendar year of employment between 1990 and 2012, exposure to air pollution at residence, average weight of baggage lifted per day and lifestyle. By linkage to registers, we retrieved socioeconomic and demographic data and data on healthcare contacts, drug subscriptions, incident cancer and mortality. Future plans The size of the cohort and the completeness of the register-based follow-up allow a more accurate assessment of the possible health risks of occupational exposure to ultrafine particles and manual baggage handling at airports than in previous studies. We plan to follow the cohort for the incidence of ischaemic heart diseases, cerebrovascular disease, lung and bladder cancer, asthma and chronic obstructive pulmonary disease, and further for associations between heavy manual baggage handling and musculoskeletal disorders. Trial registration number 2012–41–0199. PMID:28478397

Extraction of land cover change information from ENVISAT-ASAR data in Chengdu Plain

NASA Astrophysics Data System (ADS)

Xu, Wenbo; Fan, Jinlong; Huang, Jianxi; Tian, Yichen; Zhang, Yong

2006-10-01

Land cover data are essential to most global change research objectives, including the assessment of current environmental conditions and the simulation of future environmental scenarios that ultimately lead to public policy development. Chinese Academy of Sciences generated a nationwide land cover database in order to carry out the quantification and spatial characterization of land use/cover changes (LUCC) in 1990s. In order to improve the reliability of the database, we will update the database anytime. But it is difficult to obtain remote sensing data to extract land cover change information in large-scale. It is hard to acquire optical remote sensing data in Chengdu plain, so the objective of this research was to evaluate multitemporal ENVISAT advanced synthetic aperture radar (ASAR) data for extracting land cover change information. Based on the fieldwork and the nationwide 1:100000 land cover database, the paper assesses several land cover changes in Chengdu plain, for example: crop to buildings, forest to buildings, and forest to bare land. The results show that ENVISAT ASAR data have great potential for the applications of extracting land cover change information.

The effect of amiodarone on warfarin anticoagulation: a register-based nationwide cohort study involving the Swedish population.

PubMed

Holm, J; Lindh, J D; Andersson, M L; Mannheimer, B

2017-03-01

Essentials Data on the effect of introducing amiodarone in patients already using warfarin regime are scarce. Information on 754 patients was extracted from three nationwide registers in Sweden. With amiodaron, 37% of patients had an international normalized ratio (INR) over 3.0 To avoid bleeding, the initiation of amiodarone should be accompanied by closer INR monitoring. Background Data indicate that the interaction between warfarin and amiodarone results in an increased warfarin effect. There are several large, well-performed studies using genetic and clinical factors such as co-medication to predict an adequate starting dose of warfarin. However, longitudinal data on the effect of introducing amiodarone in patients on an ongoing warfarin regime are more scarce. Objectives An investigation of how initiation of amiodarone affects the anticoagulant effect and dosing of warfarin, using data from three nationwide registries. Patients/Methods In a retrospective cohort study including 754 patients, warfarin doses were compared between two 4-week periods, before and 18-21 weeks after initiating co-treatment with amiodarone. In addition, warfarin doses and international normalized ratio (INR) values were calculated week-by-week after the initiation of amiodarone. Results The initiation of amiodarone increased the mean INR from 2.6 to 3.1. The proportion of patients with a supratherapeutic INR over 3.0 and 4.0 increased from 12% to 37% and 0.9% to 5.5%, respectively. The subsequent mean decrease in warfarin dose was 24.6% (95% confidence interval [CI], 23.5, 25.6). The frequency of INR monitoring within 1 and 2 weeks after initiation of amiodarone was 67% and 90%. Conclusions Although warfarin doses in most patients were within the therapeutic range, more than one in three patients initiating co-treatment with amiodarone were exposed to a supratherapeutic anticoagulative effect within 3 weeks. In order to further avoid severe unnecessary bleeding, the initiation of amiodarone should be accompanied by closer INR monitoring, anticipating an average dose reduction of 25%. © 2017 International Society on Thrombosis and Haemostasis.

Increased subsequent risk of inflammatory bowel disease association in patients with chronic pancreatitis: a nationwide population-based cohort study.

PubMed

Chen, Yu-Long; Hsu, Chin-Wang; Cheng, Cheng-Chung; Yiang, Giou-Teng; Lin, Chin-Sheng; Lin, Cheng-Li; Sung, Fung-Chang; Liang, Ji-An

2017-06-01

To investigate the relationship between chronic pancreatitis (CP) and inflammatory bowel disease (IBD) in a large population-based cohort study. Data was obtained from the Taiwan National Health Insurance Research Database. The cohort study comprised 17,796 patients newly diagnosed with CP between 2000 and 2010 and 71,164 matched controls. A Cox proportional hazards model was used for evaluating the risk of IBD in the CP and comparison cohorts. When examined with a mean follow-up period of 4.87 and 6.04 years for the CP and comparison cohorts, respectively, the overall incidence of IBD was 10.3 times higher in the CP cohort than in the comparison cohort (5.75 vs. 0.56 per 10,000 person-years). Compared with the comparison cohort, the CP cohort exhibited a higher risk of IBD, irrespective of age, sex, and presence or absence of comorbidities. Moreover, the CP cohort was associated with a significantly higher risk of Crohn's disease (adjusted hazard ratio [aHR] = 12.9, 95% confidence interval [CI] = 5.15-32.5) and ulcerative colitis (aHR = 2.80, 95% CI = 1.00-7.86). This nationwide population-based cohort study revealed a significantly higher risk of IBD in patients with CP compared with control group. Clinicians should notice this association to avoid delayed diagnosis of IBD in patients with CP.

Incidence, management and outcome of women requiring massive transfusion after childbirth in the Netherlands: secondary analysis of a nationwide cohort study between 2004 and 2006.

PubMed

Ramler, Paul I; van den Akker, Thomas; Henriquez, Dacia D C A; Zwart, Joost J; van Roosmalen, Jos

2017-06-19

Postpartum hemorrhage remains the leading cause of maternal morbidity and mortality worldwide. Few population-based studies have examined the epidemiology of massive transfusion for postpartum hemorrhage. The aim of this study was to determine the incidence, management, and outcomes of women with postpartum hemorrhage who required massive transfusion in the Netherlands between 2004 and 2006. Data for all women from a gestational age of 20 weeks onwards who had postpartum hemorrhage requiring eight or more red blood cell concentrates were obtained from a nationwide population-based cohort study including all 98 hospitals with a maternity unit in the Netherlands. Three hundred twenty-seven women who had postpartum hemorrhage requiring massive transfusion were identified (massive transfusion rate 91 per 100,000 deliveries (95% confidence interval: 81-101)). The median blood loss was 4500 mL (interquartile range 3250-6000 mL) and the median number of red blood cell concentrates transfused was 11 units (interquartile range 9-16 units). Among women receiving massive transfusion, the most common cause of hemorrhage was uterine atony. Eighty-three women (25%) underwent hysterectomy, 227 (69%) were admitted to an intensive care unit, and three women died (case fatality rate 0,9%). The number of women in the Netherlands who had postpartum hemorrhage treated with massive transfusion was relatively high compared to other comparable settings. Evidence-based uniform management guidelines are necessary.

Prayer beliefs and change in life satisfaction over time.

PubMed

Krause, Neal; Hayward, R David

2013-06-01

A considerable number of studies have focused on the relationship between prayer, health, and well-being. But the influence of some types of prayer (e.g., petitionary prayer) has received more attention than others. The purpose of this study is to examine an overlooked aspect of prayer: trust-based prayer beliefs. People with this orientation believe that God knows that best way to answer a prayer and He selects the best time to provide an answer. Three main findings emerge from data that were provided by a nationwide longitudinal survey of older people reveals. First, the results reveal that Conservative Protestants are more likely to endorse trust-based prayer beliefs. Second, the findings suggest that these prayer beliefs tend to be reinforced through prayer groups and informal support from fellow church members. Third, the data indicate that stronger trust-based prayer beliefs are associated with a greater sense of life satisfaction over time.

Prayer Beliefs and Change in Life Satisfaction over Time

PubMed Central

Krause, Neal; Hayward, R. David

2012-01-01

A considerable number of studies have focused on the relationship between prayer, health, and well-being. But the influence of some types of prayer (e.g., petitionary prayer) has received more attention than others. The purpose of this study is to examine an overlooked aspect of prayer: trust-based prayer beliefs. People with this orientation believe that God knows that best way to answer a prayer and He selects the best time to provide an answer. Three main findings emerge from data that were provided by a nationwide longitudinal survey of older people reveals. First, the results reveal that Conservative Protestants are more likely to endorse trust-based prayer beliefs. Second, the findings suggest that these prayer beliefs tend to be reinforced through prayer groups and informal support from fellow church members. Third, the data indicate that stronger trust-based prayer beliefs are associated with a greater sense of life satisfaction over time. PMID:23117927

Phase 1 AGTC survey : data collected .

DOT National Transportation Integrated Search

1972-05-01

As part of a nationwide airport ground traffic control requirements study, a survey of nine airports has been made to gather data. At each airport, pre-planned interviews were conducted with the airport management and with FAA control tower personnel...

Multidimensional poverty and health: evidence from a nationwide survey in Japan.

PubMed

Oshio, Takashi; Kan, Mari

2014-12-19

It is well known that lower income is associated with poorer health, but poverty has several dimensions other than income. In the current study, we investigated the associations between multidimensional poverty and health variables. Using micro data obtained from a nationwide population survey in Japan (N = 24,905), we focused on four dimensions of poverty (income, education, social protection, and housing conditions) and three health variables (self-rated health (SRH), psychological distress, and current smoking). We examined how health variables were associated with multidimensional poverty measures, based on descriptive and multivariable logistic regression analyses. Unions as composite measures of multiple poverty dimensions were more useful for identifying individuals in poor SRH or psychological distress than a single dimension such as income. In comparison, intersections of poverty dimensions reduced the coverage of individuals considered to be in poverty and tend to be difficult to justify without any explicit policy objective. Meanwhile, education as a unidimensional poverty indicator could be useful for predicting current smoking. Results obtained from the current study confirmed the practical relevance of multidimensional poverty for health.

Cost and cost-effectiveness of nationwide school-based helminth control in Uganda

PubMed Central

BROOKER, SIMON; KABATEREINE, NARCIS B; FLEMING, FIONA; DEVLIN, NANCY

2009-01-01

Estimates of cost and cost-effectiveness are typically based on a limited number of small-scale studies with no investigation of the existence of economies to scale or intra-country variation in cost and cost-effectiveness. This information gap hinders the efficient allocation of health care resources and the ability to generalize estimates to other settings. The current study investigates the intra-country variation in the cost and cost-effectiveness of nationwide school-based treatment of helminth (worm) infection in Uganda. Programme cost data were collected through semi-structured interviews with districts officials and from accounting records in six of the 23 intervention districts. Both financial and economic costs were assessed. Costs were estimated on the basis of cost in US$ per schoolchild treated and an incremental cost effectiveness ratio (cost in US$ per case of anaemia averted) was used to evaluate programme cost-effectiveness. Sensitivity analysis was performed to assess the effect of discount rate and drug price. The overall economic cost per child treated in the six districts was US$ 0.54 and the cost-effectiveness was US$ 3.19 per case of anaemia averted. Analysis indicated that estimates of both cost and cost-effectiveness differ markedly with the total number of children which received treatment, indicating economies of scale. There was also substantial variation between districts in the cost per individual treated (US$ 0.41-0.91) and cost per anaemia case averted (US$ 1.70-9.51). Independent variables were shown to be statistically associated with both sets of estimates. This study highlights the potential bias in transferring data across settings without understanding the nature of observed variations. PMID:18024966

Epidemiology of upper urinary tract stone disease in a Taiwanese population: a nationwide, population based study.

PubMed

Huang, Wei-Yi; Chen, Yu-Fen; Carter, Stacey; Chang, Hong-Chiang; Lan, Chung-Fu; Huang, Kuo-How

2013-06-01

We investigated the epidemiology of upper urinary tract stone disease in Taiwan using a nationwide, population based database. This study was based on the National Health Insurance Research Database of Taiwan, which contains data on all medical beneficiary claims from 22.72 million enrollees, accounting for almost 99% of the Taiwanese population. The Longitudinal Health Insurance Database 2005, a subset of the National Health Insurance Research Database, contains data on all medical benefit claims from 1997 through 2010 for a subset of 1 million beneficiaries randomly sampled from the 2005 enrollment file. For epidemiological analysis we selected subjects whose claims records included the diagnosis of upper urinary tract urolithiasis. The age adjusted rate of medical care visits for upper urinary tract urolithiasis decreased by 6.5% from 1,367/100,000 subjects in 1998 to 1,278/100,000 in 2010. There was a significantly decreasing trend during the 13-year period in visits from female and all subjects (r(2) = 0.86, p = 0.001 and r(2) = 0.52, p = 0.005, respectively). In contrast, an increasing trend was noted for male subjects (r(2) = 0.45, p = 0.012). The age adjusted prevalence in 2010 was 9.01%, 5.79% and 7.38% in male, female and all subjects, respectively. The overall recurrence rate at 1 and 5 years was 6.12% and 34.71%, respectively. Male subjects had a higher recurrence rate than female subjects. Our study provides important information on the epidemiology of upper urinary tract stone disease in Taiwan, helping to quantify the burden of urolithiasis and establish strategies to decrease the risk of urolithiasis. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Nationwide population-based study reveals increased malignancy risk in taiwanese liver transplant recipients.

PubMed

Tsai, Yung Fong; Chen, Hsiu Pin; Liu, Fu Chao; Liu, Shih Hao; Chen, Chun Yu; Cheng, Chih Wen; Lin, Jr-Rung

2016-12-13

Post-transplant malignancy is a major cause of late mortality for liver transplant recipients (LTRs). This nationwide population-based cohort study investigated the cancer type, incidence, and risk factors associated with post-transplant malignancies in 2938 Taiwanese LTRs who underwent transplantation between 1998 and 2012. Data from the National Health Insurance Research Database were extracted on the basis of the International Classification of Disease, Ninth Revision, Clinical Modification codes. Among these patients, 284 post-transplant malignancies were diagnosed. These included 99 de novo malignancies among 98 patients, yielding a standardized incidence ratio of 2.17 (95% CI, 1.76 to 2.64) compared to the general population. The most common malignancies were infection related liver cancer (19.39%), oropharyngeal cancer (19.39%), non-Hodgkin's lymphoma (9.18%), and esophageal cancer (5.10%), as well as non-infection-related prostate cancer (6.12%). Patients with recurrent malignancies had the highest mortality. Furthermore, 186 recurrent malignancies relapsed, and the commonly affected organs were the liver (83.33%), lung (4.84%), bone and bone marrow (4.30%), and intrahepatic bile ducts (2.69%). Old age, the male sex, liver cirrhosis, hepatitis B, peptic ulcer, diabetes mellitus, and pre-existing cancer were all risk factors associated with post-transplant malignancies. Recipients with biliary atresia or urea cycle metabolism disorders were protected from post-transplant malignancies. Our data revealed a significantly increased risk of malignancies in Taiwanese LTRs and suggest implementation of a careful malignancy-surveillance program and immunosuppression-minimizing strategy for high-risk patients.

Suicides in Visually Impaired Persons: A Nation-Wide Register-Linked Study from Finland Based on Thirty Years of Data

PubMed Central

Meyer-Rochow, Victor Benno; Hakko, Helinä; Ojamo, Matti; Uusitalo, Hannu; Timonen, Markku

2015-01-01

Focusing on seasonality, gender, age, and suicide methods a Finnish nation-wide cohort-based study was carried out to compare suicide data between sighted, visually-impaired (WHO impairment level I-II, i.e., visual acuity >0.05, but <0.3) and blind (WHO impairment level III-V, i.e., visual acuity <0.05) victims. Standardized mortality ratios (SMR) of age- and gender-matched populations from official 1982–2011 national registers were used. Group differences in categorical variables were assessed with Pearson's Chi-square or Fisher's Exact test and in continuous variables with Mann-Whitney U-test. Seasonality was assessed by Chi-square for multinomials; ratio of observed to expected number of suicides was calculated with 95% confidence level. Hanging, poisoning, drowning, but rarely shooting or jumping from high places, were preferred suicide methods of the blind. Mortality was significantly increased in the visually impaired (SMR = 1.3; 95% CI 1.07–1.61), but in gender-stratified analyses the increase only affected males (1.34; 95% CI = 1.06–1.70) and not females (1.24; 95% CI 0.82–1.88). Age-stratified analyses identified blind males of working age rather than older men (as in the general population) as a high risk group that requires particular attention. The statistically significant spring suicide peak in blind subjects mirrors that of sighted victims and its possible cause in the blind is discussed. PMID:26509899

Suicides in Visually Impaired Persons: A Nation-Wide Register-Linked Study from Finland Based on Thirty Years of Data.

PubMed

Meyer-Rochow, Victor Benno; Hakko, Helinä; Ojamo, Matti; Uusitalo, Hannu; Timonen, Markku

2015-01-01

Focusing on seasonality, gender, age, and suicide methods a Finnish nation-wide cohort-based study was carried out to compare suicide data between sighted, visually-impaired (WHO impairment level I-II, i.e., visual acuity >0.05, but <0.3) and blind (WHO impairment level III-V, i.e., visual acuity <0.05) victims. Standardized mortality ratios (SMR) of age- and gender-matched populations from official 1982-2011 national registers were used. Group differences in categorical variables were assessed with Pearson's Chi-square or Fisher's Exact test and in continuous variables with Mann-Whitney U-test. Seasonality was assessed by Chi-square for multinomials; ratio of observed to expected number of suicides was calculated with 95% confidence level. Hanging, poisoning, drowning, but rarely shooting or jumping from high places, were preferred suicide methods of the blind. Mortality was significantly increased in the visually impaired (SMR = 1.3; 95% CI 1.07-1.61), but in gender-stratified analyses the increase only affected males (1.34; 95% CI = 1.06-1.70) and not females (1.24; 95% CI 0.82-1.88). Age-stratified analyses identified blind males of working age rather than older men (as in the general population) as a high risk group that requires particular attention. The statistically significant spring suicide peak in blind subjects mirrors that of sighted victims and its possible cause in the blind is discussed.

A Retrospective Population-Based Data Analyses of Inpatient Care Use and Medical Expenditure in People with Intellectual Disability Co-Occurring Schizophrenia

ERIC Educational Resources Information Center

Lai, Chia-Im; Hung, Wen-Jiu; Lin, Lan-Ping; Chien, Wu-Chien; Lin, Jin-Ding

2011-01-01

The paper aims to analyze the hospital inpatient care use and medical fee of people with ID co-occurring with schizophrenia in Taiwan. A nationwide data were collected concerning hospital admission and medical expenditure of people with ID (n = 2565) among national health insurance beneficiaries in Taiwan. Multiple regression analyses were…

Associations between arsenic in drinking water and occurrence of end-stage renal disease with modifications by comorbidities: A nationwide population-based study in Taiwan.

PubMed

Cheng, Ya-Yun; Chang, Yu-Tzu; Cheng, Hong-Lin; Shen, Kun-Hung; Sung, Junne-Ming; Guo, How-Ran

2018-06-01

Arsenic may affect the function of proximal convoluted tubules and glomeruli, but epidemiological data on the association between arsenic ingestion and end-stage renal disease (ESRD) are limited. Therefore, we conducted a nationwide population-based study in Taiwan, where the incidence of ESRD is the highest in the world, to study the potential association. Using the National Health Insurance Database in Taiwan, we constructed a cohort of 362,505 members with age≥40years in 1998. We identified patients of ESRD newly diagnosed between January 1, 1998 and December 31, 2010 and performed Cox proportional hazard regressions to identify risk factors for ESRD and evaluate their effects. Arsenic levels in drinking water were assessed on the basis of a nationwide census survey conducted by the government, of which measurement reports were available for 311 townships. We identified 5442 new patient of ESRD during the study period and found that residents of areas with arsenic levels≥50μg/L in the drinking water had a hazard ratio (HR) of 1.14 (95% confidence interval [CI]: 1.08-1.21) for ESRD. After adjusting for sex, age, income, and comorbidities, we found an adjusted HR of 1.12 (95% CI: 1.06-1.19), which was still statistically significant. Furthermore, the effect was modified by comorbidities, with more prominent effects on patients with less than three comorbidities (adjusted HR=1.51; 95% CI: 1.22-1.86 for low comorbidity score). In conclusion, a high arsenic level in drinking water was a risk factor for ESRD, independent of other documented risk factors. Reducing high-risk comorbidities in patients with early-stage renal dysfunction is important for slowing the progression of the disease to ESRD, even in the endemic area of arsenic exposure. Copyright © 2018 Elsevier B.V. All rights reserved.

Examining related influential factors for dental calculus scaling utilization among people with disabilities in Taiwan, a nationwide population-based study.

PubMed

Lai, Hsien-Tang; Kung, Pei-Tseng; Su, Hsun-Pi; Tsai, Wen-Chen

2014-09-01

Limited studies with large samples have been conducted on the utilization of dental calculus scaling among people with physical or mental disabilities. This study aimed to investigate the utilization of dental calculus scaling among the national disabled population. This study analyzed the utilization of dental calculus scaling among the disabled people, using the nationwide data between 2006 and 2008. Descriptive analysis and logistic regression were performed to analyze related influential factors for dental calculus scaling utilization. The dental calculus scaling utilization rate among people with physical or mental disabilities was 16.39%, and the annual utilization frequency was 0.2 times. Utilization rate was higher among the female and non-aboriginal samples. Utilization rate decreased with increased age and disability severity while utilization rate increased with income, education level, urbanization of residential area and number of chronic illnesses. Related influential factors for dental calculus scaling utilization rate were gender, age, ethnicity (aboriginal or non-aboriginal), education level, urbanization of residence area, income, catastrophic illnesses, chronic illnesses, disability types, and disability severity significantly influenced the dental calculus scaling utilization rate. Copyright © 2014 Elsevier Ltd. All rights reserved.

Institutional racism in public health contracting: Findings of a nationwide survey from New Zealand.

PubMed

Came, H; Doole, C; McKenna, B; McCreanor, T

2018-02-01

Public institutions within New Zealand have long been accused of mono-culturalism and institutional racism. This study sought to identify inconsistencies and bias by comparing government funded contracting processes for Māori public health providers (n = 60) with those of generic providers (n = 90). Qualitative and quantitative data were collected (November 2014-May 2015), through a nationwide telephone survey of public health providers, achieving a 75% response rate. Descriptive statistical analyses were applied to quantitative responses and an inductive approach was taken to analyse data from open-ended responses in the survey domains of relationships with portfolio contract managers, contracting and funding. The quantitative data showed four sites of statistically significant variation: length of contracts, intensity of monitoring, compliance costs and frequency of auditing. Non-significant data involved access to discretionary funding and cost of living adjustments, the frequency of monitoring, access to Crown (government) funders and representation on advisory groups. The qualitative material showed disparate provider experiences, dependent on individual portfolio managers, with nuanced differences between generic and Māori providers' experiences. This study showed that monitoring government performance through a nationwide survey was an innovative way to identify sites of institutional racism. In a policy context where health equity is a key directive to the health sector, this study suggests there is scope for New Zealand health funders to improve their contracting practices. Copyright © 2017 Elsevier Ltd. All rights reserved.

47 CFR 90.769 - Construction and implementation of Phase II nationwide licenses.

Code of Federal Regulations, 2014 CFR

2014-10-01

.... (a) A nationwide licensee must construct a sufficient number of base stations (i.e., base stations... square kilometers or 37.5 percent of the United States population within five years of the issuance of... United States population within ten years of the issuance of its initial license. Licensees may, in the...

47 CFR 90.769 - Construction and implementation of Phase II nationwide licenses.

Code of Federal Regulations, 2013 CFR

2013-10-01

.... (a) A nationwide licensee must construct a sufficient number of base stations (i.e., base stations... square kilometers or 37.5 percent of the United States population within five years of the issuance of... United States population within ten years of the issuance of its initial license. Licensees may, in the...

47 CFR 90.769 - Construction and implementation of Phase II nationwide licenses.

Code of Federal Regulations, 2012 CFR

2012-10-01

.... (a) A nationwide licensee must construct a sufficient number of base stations (i.e., base stations... square kilometers or 37.5 percent of the United States population within five years of the issuance of... United States population within ten years of the issuance of its initial license. Licensees may, in the...

Developing and Refining the Taiwan Birth Cohort Study (TBCS): Five Years of Experience

ERIC Educational Resources Information Center

Lung, For-Wey; Chiang, Tung-Liang; Lin, Shio-Jean; Shu, Bih-Ching; Lee, Meng-Chih

2011-01-01

The Taiwan Birth Cohort Study (TBCS) is the first nationwide birth cohort database in Asia designed to establish national norms of children's development. Several challenges during database development and data analysis were identified. Challenges include sampling methods, instrument development and statistical approach to missing data. The…

Hypothyroidism incidence in and around pregnancy: a Danish nationwide study.

PubMed

Andersen, S L; Carlé, A; Olsen, J; Laurberg, P

2016-11-01

Immunological changes in and after a pregnancy may influence the onset of autoimmune diseases. An increased incidence of hyperthyroidism has been observed both in early pregnancy and postpartum, but it remains to be studied if the incidence of hypothyroidism varies in a similar way. Population-based cohort study using Danish nationwide registers. All women who gave birth to a singleton live-born child in Denmark from 1999 to 2008 (n = 403 958) were identified, and data on hospital diagnosis of hypothyroidism and redeemed prescriptions of thyroid hormone were extracted. The overall incidence rate (IR) of hypothyroidism during 1997-2010 and the IR in three-month intervals before, during and after the woman's first pregnancy in the study period were calculated and compared with the IR of hyperthyroidism. Altogether 5220 women were identified with onset of hypothyroidism from 1997 to 2010 (overall IR 92.3/100 000/year) and 1572 women developed hypothyroidism in the period from 2 years before to 2 years after birth of the first child in the study period. The incidence of hypothyroidism decreased during the pregnancy (incidence rate ratio (IRR) vs overall IR in the rest of the study period: first trimester: 0.89 (95% CI: 0.66-1.19), second trimester: 0.71 (0.52-0.97), third trimester: 0.29 (0.19-0.45)) and increased after birth with the highest level at 4-6 months postpartum (IRR 3.62 (2.85-4.60)). These are the first population-based data on the incidence of hypothyroidism in and around pregnancy. The incidence declined during pregnancy followed by a sharp increase postpartum. Notably, hypothyroidism as opposed to hyperthyroidism showed no early pregnancy increase. © 2016 European Society of Endocrinology.

Nationwide telecare for diabetics: a pilot implementation of the HOLON architecture.

PubMed Central

Jones, P. C.; Silverman, B. G.; Athanasoulis, M.; Drucker, D.; Goldberg, H.; Marsh, J.; Nguyen, C.; Ravichandar, D.; Reis, L.; Rind, D.; Safran, C.

1998-01-01

This paper presents results from a demonstration project of nationwide exchange of health data for the home care of diabetic patients. A consortium of industry, academic, and health care partners has developed reusable middleware components integrated using the HOLON architecture. Engineering approaches for multi-organization systems development, lessons learned in developing layered object-oriented systems, security and confidentiality considerations, and functionality for nationwide telemedicine applications are discussed. PMID:9929239

Systems Architecture for a Nationwide Healthcare System.

PubMed

Abin, Jorge; Nemeth, Horacio; Friedmann, Ignacio

2015-01-01

From a national level to give Internet technology support, the Nationwide Integrated Healthcare System in Uruguay requires a model of Information Systems Architecture. This system has multiple healthcare providers (public and private), and a strong component of supplementary services. Thus, the data processing system should have an architecture that considers this fact, while integrating the central services provided by the Ministry of Public Health. The national electronic health record, as well as other related data processing systems, should be based on this architecture. The architecture model described here conceptualizes a federated framework of electronic health record systems, according to the IHE affinity model, HL7 standards, local standards on interoperability and security, as well as technical advice provided by AGESIC. It is the outcome of the research done by AGESIC and Systems Integration Laboratory (LINS) on the development and use of the e-Government Platform since 2008, as well as the research done by the team Salud.uy since 2013.

The Clinical Profile of Patients with Psoriasis in Korea: A Nationwide Cross-Sectional Study (EPI-PSODE)

PubMed Central

Song, Hae Jun; Park, Chul Jong; Kim, Tae Yoon; Choe, Yong Beom; Lee, Seok-Jong; Kim, Nack In; Cho, Jae We; Jeon, Jie Hyun; Jang, Min Soo; Youn, Jai Il; Kim, Myung Hwa; Park, Joonsoo; Kim, Ki Ho; Kim, Byung Soo; Youn, Sang Woong; Lee, Joo-Heung; Lee, Min-Geol; Ahn, Sung Ku; Won, Young Ho; Yun, Seok Kweon; Shin, Bong Seok; Seo, Seong Jun; Lee, Ji Yeoun; Kim, Kwang Joong; Ro, Young Suck; Kim, Youngdoe; Yu, Dae Young

2017-01-01

Background Psoriasis is an immune-mediated, chronic inflammatory disease affecting multiple aspects of patients' lives. Its epidemiology varies regionally; however, nationwide epidemiologic data on psoriasis depicting profile of Korean patients has not been available to date. Objective To understand nationwide epidemiologic characteristics and clinical features of adult patients with psoriasis visited university hospitals in Korea. Methods This multicenter, non-interventional, cross-sectional study recruited 1,278 adult patients with psoriasis across 25 centers in Korea in 2013. Various clinical data including PASI, BSA, DLQI, SF-36 and PASE were collected. Results A total of 1,260 patients completed the study (male:female=1.47:1). The mean age was 47.0 years with a distribution mostly in the 50s (24.9%). Early onset (<40 years) of psoriasis accounted for 53.9% of patients. The mean disease duration was 109.2 months; mean body mass index was 23.9 kg/m2; and 12.7% of patients had a family history of psoriasis. Plaque and guttate types of psoriasis accounted for 85.8% and 8.4%, respectively. Patients with PASI ≥10 accounted for 24.9%; patients with body surface area ≥10 were 45.9%. Patients with DLQI ≥6 accounted for 78.8%. Between PASI <10 and PASI ≥10 groups, significant difference was noted in age at diagnosis, disease duration, blood pressure, waist circumference of female, and treatment experiences with phototherapy, systemic agents, and biologics. Conclusion This was the first nationwide epidemiologic study of patients with psoriasis in Korea and provides an overview of the epidemiologic characteristics and clinical profiles of this patient population. PMID:28761295

Addition of immunosuppressive treatment to hemoperfusion is associated with improved survival after paraquat poisoning: a nationwide study.

PubMed

Wu, Wen-Pyng; Lai, Ming-Nan; Lin, Ching-Heng; Li, Yu-Fen; Lin, Ching-Yuang; Wu, Ming-Ju

2014-01-01

Paraquat poisoning associates very high mortality rate. Early treatment with hemoperfusion is strongly suggested by animal and human studies. Although the survival benefit of additional immunosuppressive treatment (IST) in combination with hemoperfusion is also reported since 1971, the large-scale randomized control trials to confirm the effects of IST is difficult to be executed. Therefore, we designed this nationwide large-scale population-based retrospective cohort study to investigate the outcome of paraquat poisoning with hemoperfusion and the additional effects of IST combined with hemoperfusion. This nationwide retrospective cohort study utilized data retrieved from the National Health Insurance Research Database (NHIRD) of Taiwan. A total of 1811 hospitalized patients with a diagnosis of paraquat poisoning who received hemoperfusion between 1997 and 2009 were enrolled. The mean age of all 1811 study subjects was 47.3 years. 70% was male. The overall survival rate was only 26.4%. Respiratory failure and renal failure were diagnosed in 56.2% and 36% patients. The average frequency of hemoperfusion was twice. IST was added in 42.2% patients. IST significantly increases survival rate (from 24.3% to 29.3%, P<0.001). The combined IST with methylprednisolone, cyclophosphamide and dexamethasone associates with the highest survival rate (48%, P<0.001). Moreover, patients younger than 45 years of age in the IST group had the best survival (41.0% vs. 33.7%, p<0.001). Our results support the use of IST with hemoperfusion for paraquat-poisoned patients. The best survival effect of IST is the combination of methylprednisolone, cyclophosphamide and daily dexamethasone, especially in patients with younger age.

Addition of Immunosuppressive Treatment to Hemoperfusion Is Associated with Improved Survival after Paraquat Poisoning: A Nationwide Study

PubMed Central

Wu, Wen-Pyng; Lai, Ming-Nan; Lin, Ching-Heng; Li, Yu-Fen

2014-01-01

Paraquat poisoning associates very high mortality rate. Early treatment with hemoperfusion is strongly suggested by animal and human studies. Although the survival benefit of additional immunosuppressive treatment (IST) in combination with hemoperfusion is also reported since 1971, the large-scale randomized control trials to confirm the effects of IST is difficult to be executed. Therefore, we designed this nationwide large-scale population-based retrospective cohort study to investigate the outcome of paraquat poisoning with hemoperfusion and the additional effects of IST combined with hemoperfusion. This nationwide retrospective cohort study utilized data retrieved from the National Health Insurance Research Database (NHIRD) of Taiwan. A total of 1811 hospitalized patients with a diagnosis of paraquat poisoning who received hemoperfusion between 1997 and 2009 were enrolled. The mean age of all 1811 study subjects was 47.3 years. 70% was male. The overall survival rate was only 26.4%. Respiratory failure and renal failure were diagnosed in 56.2% and 36% patients. The average frequency of hemoperfusion was twice. IST was added in 42.2% patients. IST significantly increases survival rate (from 24.3% to 29.3%, P<0.001). The combined IST with methylprednisolone, cyclophosphamide and dexamethasone associates with the highest survival rate (48%, P<0.001). Moreover, patients younger than 45 years of age in the IST group had the best survival (41.0% vs. 33.7%, p<0.001). Our results support the use of IST with hemoperfusion for paraquat-poisoned patients. The best survival effect of IST is the combination of methylprednisolone, cyclophosphamide and daily dexamethasone, especially in patients with younger age. PMID:24475310

The Dutch Pancreas Biobank Within the Parelsnoer Institute: A Nationwide Biobank of Pancreatic and Periampullary Diseases.

PubMed

Strijker, Marin; Gerritsen, Arja; van Hilst, Jony; Bijlsma, Maarten F; Bonsing, Bert A; Brosens, Lodewijk A; Bruno, Marco J; van Dam, Ronald M; Dijk, Frederike; van Eijck, Casper H; Farina Sarasqueta, Arantza; Fockens, Paul; Gerhards, Michael F; Groot Koerkamp, Bas; van der Harst, Erwin; de Hingh, Ignace H; van Hooft, Jeanin E; Huysentruyt, Clément J; Kazemier, Geert; Klaase, Joost M; van Laarhoven, Cornelis J; van Laarhoven, Hanneke W; Liem, Mike S; de Meijer, Vincent E; van Rijssen, L Bengt; van Santvoort, Hjalmar C; Suker, Mustafa; Verhagen, Judith H; Verheij, Joanne; Verspaget, Hein W; Wennink, Roos A; Wilmink, Johanna W; Molenaar, I Quintus; Boermeester, Marja A; Busch, Olivier R; Besselink, Marc G

2018-04-01

Large biobanks with uniform collection of biomaterials and associated clinical data are essential for translational research. The Netherlands has traditionally been well organized in multicenter clinical research on pancreatic diseases, including the nationwide multidisciplinary Dutch Pancreatic Cancer Group and Dutch Pancreatitis Study Group. To enable high-quality translational research on pancreatic and periampullary diseases, these groups established the Dutch Pancreas Biobank. The Dutch Pancreas Biobank is part of the Parelsnoer Institute and involves all 8 Dutch university medical centers and 5 nonacademic hospitals. Adult patients undergoing pancreatic surgery (all indications) are eligible for inclusion. Preoperative blood samples, tumor tissue from resected specimens, pancreatic cyst fluid, and follow-up blood samples are collected. Clinical parameters are collected in conjunction with the mandatory Dutch Pancreatic Cancer Audit. Between January 2015 and May 2017, 488 patients were included in the first 5 participating centers: 4 university medical centers and 1 nonacademic hospital. Over 2500 samples were collected: 1308 preoperative blood samples, 864 tissue samples, and 366 follow-up blood samples. Prospective collection of biomaterials and associated clinical data has started in the Dutch Pancreas Biobank. Subsequent translational research will aim to improve treatment decisions based on disease characteristics.

Steps toward a CONUS-wide reanalysis with archived NEXRAD data using National Mosaic and Multisensor Quantitative Precipitation Estimation (NMQ/Q2) algorithms

NASA Astrophysics Data System (ADS)

Stevens, S. E.; Nelson, B. R.; Langston, C.; Qi, Y.

2012-12-01

The National Mosaic and Multisensor QPE (NMQ/Q2) software suite, developed at NOAA's National Severe Storms Laboratory (NSSL) in Norman, OK, addresses a large deficiency in the resolution of currently archived precipitation datasets. Current standards, both radar- and satellite-based, provide for nationwide precipitation data with a spatial resolution of up to 4-5 km, with a temporal resolution as fine as one hour. Efforts are ongoing to process archived NEXRAD data for the period of record (1996 - present), producing a continuous dataset providing precipitation data at a spatial resolution of 1 km, on a timescale of only five minutes. In addition, radar-derived precipitation data are adjusted hourly using a wide variety of automated gauge networks spanning the United States. Applications for such a product range widely, from emergency management and flash flood guidance, to hydrological studies and drought monitoring. Results are presented from a subset of the NEXRAD dataset, providing basic statistics on the distribution of rainrates, relative frequency of precipitation types, and several other variables which demonstrate the variety of output provided by the software. Precipitation data from select case studies are also presented to highlight the increased resolution provided by this reanalysis and the possibilities that arise from the availability of data on such fine scales. A previously completed pilot project and steps toward a nationwide implementation are presented along with proposed strategies for managing and processing such a large dataset. Reprocessing efforts span several institutions in both North Carolina and Oklahoma, and data/software coordination are key in producing a homogeneous record of precipitation to be archived alongside NOAA's other Climate Data Records. Methods are presented for utilizing supercomputing capability in expediting processing, to allow for the iterative nature of a reanalysis effort.

Selective serotonin reuptake inhibitors and risk of major congenital anomalies for pregnancies in Japan: A nationwide birth cohort study of the Japan Environment and Children's Study.

PubMed

Nishigori, Hidekazu; Obara, Taku; Nishigori, Toshie; Mizuno, Satoshi; Metoki, Hirohito; Hoshiai, Tetsuro; Watanabe, Zen; Sakurai, Kasumi; Ishikuro, Mami; Tatsuta, Nozomi; Nishijima, Ichiko; Fujiwara, Ikuma; Kuriyama, Shinichi; Arima, Takahiro; Nakai, Kunihiko; Yaegashi, Nobuo

2017-05-01

We analyzed data from the Japan Environment and Children's Study (JECS), on the association between selective serotonin reuptake inhibitors (SSRI) use during pregnancy and the risk of developing of major congenital anomalies in Japan. JECS is an ongoing nationwide birth cohort study. The study includes 95 994 single pregnant women and their offspring. Among them, 172 used any SSRI up to the 12 th gestational week. Crude analyses show a significantly increased incidence of upper limb, abdominal, and urogenital abnormalities. In particular, the incidence of microcephaly, hydrencephalus, esophageal atresia, small intestinal atresia, and achondroplasia was significantly higher with than without exposure to these substances. On multivariate analyses, urogenital abnormality was significant (odds ratio 3.227; 95% confidence interval: 1.460-7.134). This Japanese nationwide birth cohort survey clarified that the use of any SSRI until the 12 th gestational week was associated with urogenital abnormality in children. The survey for association with minor classification abnormality needs further examination in Japan. © 2016 Japanese Teratology Society.

Relationship between arsenic-containing drinking water and skin cancers in the arseniasis endemic areas in Taiwan.

PubMed

Cheng, Pai-Shan; Weng, Shih-Feng; Chiang, Chi-Hsuan; Lai, Feng-Jie

2016-02-01

Artesian well-water had high concentrations of arsenic that led to the well-known black foot disease in Taiwan around the 1950s, and the associated cancers including skin cancer, bladder cancers and lung cancers. We sought to estimate the standardized morbidity ratio (SMR) and age-standardized incidence rate (ASIR) of cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) in the black foot disease endemic areas (BFDEA) in Taiwan. A nationwide retrospective population-based survey was done with the data from the National Taiwan Cancer Registry Center between 1979 and 2007. Among the 29-year period, there were 11 191 cases with SCC and 13 684 cases with BCC diagnosed pathologically. The incidence rates were 4-6-fold higher for SCC and 3-4-fold higher for BCC in the BFDEA compared with the rest of Taiwan. The SMR decreased after stopping arsenic-containing well-water drinking in the 1970s. The arsenic level in the drinking water, amount of contaminated water intake, occupation and sun-exposure time were not documented. This is the first nationwide, population-based study that shows the relationship between arsenic intoxication and non-melanoma skin cancers (SCC and BCC) through comparing the data in people living in the BFDEA and non-BFDEA in Taiwan. © 2015 Japanese Dermatological Association.

Excess cause-specific mortality in in-patient-treated individuals with personality disorder: 25-year nationwide population-based study.

PubMed

Björkenstam, Emma; Björkenstam, Charlotte; Holm, Herman; Gerdin, Bengt; Ekselius, Lisa

2015-10-01

Although personality disorders are associated with increased overall mortality, less is known about cause of death and personality type. To determine causes of mortality in ICD personality disorders. Based on data from Swedish nationwide registers, individuals admitted to hospital with a primary diagnosis of personality disorder between 1987 and 2011 were followed with respect to mortality until 31 December 2011. Standardised mortality ratios (SMRs) with 95% confidence intervals and underlying causes of death were calculated. All-cause SMRs were increased, overall and in all clusters, for natural as well as unnatural causes of death. The overall SMR was 6.1 in women and 5.0 in men, as high as previously reported for anorexia nervosa, with higher rates in cluster B and mixed/other personality disorders. The SMR for suicide was 34.5 in women and 16.0 in men for cluster B disorders. Somatic and psychiatric comorbidity increased SMRs. The SMR was substantially increased for all personality disorder clusters. Thus, there was an increased premature mortality risk for all personality disorders, irrespective of category. © The Royal College of Psychiatrists 2015.

[Evaluating the effectiveness of a disease management program diabetes in the German Statutory Health Insurance: first results and methodological considerations].

PubMed

Drabik, Anna; Graf, Christian; Büscher, Guido; Stock, Stephanie

2012-01-01

Disease management programs (DMPs) were implemented in the German Statutory Health Insurance (SHI) in a nationwide rollout in 2002. The explicit goal of the programs is to improve coordination and quality of care for the chronically ill (Sect. 137f, SGB V). To reach this goal extensive quality assurance measures in the programs are mandatory, enrolment and coordination of care rests with the primary care or DMP physician, treatment is based on evidence-based care guidelines, and patients are offered diabetes education classes to support self-management. The present study evaluates the DMP diabetes mellitus type II, a nationwide program offered by the BARMER, a German health insurance company. To minimize selection bias we formed a control group of administrative data using a propensity score matching approach. In comparison to the control group DMP participants have a significantly lower mortality rate, and their average drug and hospital costs are reduced. Enrolled patients also had a lower mean number of hospital stays and shorter hospital stays. These results indicate that the programs meet the initial goal of improving the quality of care for the chronically ill. Copyright © 2011. Published by Elsevier GmbH.

Church-Based Social Support, Functional Disability, and Change in Personal Control over Time

PubMed Central

Krause, Neal; Hayward, R. David

2013-01-01

The purpose of this study is to see if measures of church-based and secular social support offset the effects of functional disability on change in feelings of personal control over time. Survey data were obtained from Wave 2 and Wave 3 of a nationwide sample of older adults (N = 583). The findings suggest that spiritual support from fellow church members offsets the effects of functional disability on change in feelings of personal control over time. In contrast, neither emotional support from fellow church members nor emotional support from secular social network members exerted a similar effect. PMID:23553003

Pedagogical Staff in Children's Day Care Centres in Germany--Links between Working Conditions, Job Satisfaction, Commitment and Work-Related Stress

ERIC Educational Resources Information Center

Schreyer, Inge; Krause, Martin

2016-01-01

This article investigates links between staff working conditions in children's day care centres ("Kindertageseinrichtungen"--known as "Kitas" in Germany), job satisfaction, commitment and perceived stress at work. Data are based on the nationwide, representative questionnaire survey AQUA ("Arbeitsplatz und Qualität in…

Cyanotoxins in Inland Lakes of the United States: Occurrence and Potential Recreational Health Risks in the EPA National Lakes Assessment 2007

EPA Science Inventory

A large nation-wide survey or cyanotoxlns (1161 lakes)in the United States (U.S.) was conducted dunng the EPA National Lakes Assessment 2007. Cyanotoxin data were compared with cyanobacteria abundance- and chlorophyll-based World Health Organization (WHO) thresholds and mouse to...

An Exploration of Pennsylvania Corrective Action Plans, 2006-2007

ERIC Educational Resources Information Center

Morgan-Davis, Carrie Lynn

2013-01-01

With the "No Child Left Behind Act of 2001" ("NCLB"), signed into law on January 8, 2002, schools nationwide have been challenged to improve student achievement. Several middle and junior high schools in the Commonwealth of Pennsylvania were identified as being in need of Corrective Action in 2006 based upon data from the…

America's Children: Key National Indicators of Well-Being, 2000.

ERIC Educational Resources Information Center

Benson, Carole, Ed.

This report is the fourth to present nationwide data on the well-being of America's children. The statistical portrait is based on indicators of child well-being such as family income and mortality rates. Part 1 of the report, "Population and Family Characteristics," presents information illustrating the changes that have occurred during…

America's Children: Key National Indicators of Well-Being, 2002.

ERIC Educational Resources Information Center

Benson, Carole, Ed.

This report is the sixth to present nationwide data on the well-being of U.S. children. The statistical portrait is based on indicators of child well-being and on contextual measures describing the changing population and family context. Part 1 of the report, "Population and Family Characteristics," presents information illustrating…

Performance and Cost Efficiency of KRAS Mutation Testing for Metastatic Colorectal Cancer in Routine Diagnosis: The MOKAECM Study, a Nationwide Experience

PubMed Central

Chatellier, Gilles; Côté, Jean-François; Pages, Jean-Christophe; de Fraipont, Florence; Boyer, Jean-Christophe; Merlio, Jean Philippe; Morel, Alain; Gorisse, Marie-Claude; de Cremoux, Patricia; Leroy, Karen; Milano, Gérard; Ouafik, L’Houcine; Merlin, Jean-Louis; Le Corre, Delphine; Aucouturier, Pascaline; Sabourin, Jean-Christophe; Nowak, Frédérique; Frebourg, Thierry; Emile, Jean-François; Durand-Zaleski, Isabelle; Laurent-Puig, Pierre

2013-01-01

Purpose Rapid advances in the understanding of cancer biology have transformed drug development thus leading to the approval of targeted therapies and to the development of molecular tests to select patients that will respond to treatments. KRAS status has emerged as a negative predictor of clinical benefit from anti-EGFR antibodies in colorectal cancer, and anti-EGFR antibodies use was limited to KRAS wild type tumors. In order to ensure wide access to tumor molecular profiling, the French National Cancer Institute (INCa) has set up a national network of 28 regional molecular genetics centers. Concurrently, a nationwide external quality assessment for KRAS testing (MOKAECM) was granted to analyze reproducibility and costs. Methods 96 cell-line DNAs and 24 DNA samples from paraffin embedded tumor tissues were sent to 40 French laboratories. A total of 5448 KRAS results were collected and analyzed and a micro-costing study was performed on sites for 5 common methods by an independent team of health economists. Results This work provided a baseline picture of the accuracy and reliability of KRAS analysis in routine testing conditions at a nationwide level. Inter-laboratory Kappa values were >0.8 for KRAS results despite differences detection methods and the use of in-house technologies. Specificity was excellent with only one false positive in 1128 FFPE data, and sensitivity was higher for targeted techniques as compared to Sanger sequencing based methods that were dependent upon local expertise. Estimated reagent costs per patient ranged from €5.5 to €19.0. Conclusion The INCa has set-up a network of public laboratories dedicated to molecular oncology tests. Our results showed almost perfect agreements in KRAS testing at a nationwide level despite different testing methods ensuring a cost-effective equal access to personalized colorectal cancer treatment. PMID:23935912

Performance and cost efficiency of KRAS mutation testing for metastatic colorectal cancer in routine diagnosis: the MOKAECM study, a nationwide experience.

PubMed

Blons, Hélène; Rouleau, Etienne; Charrier, Nathanaël; Chatellier, Gilles; Côté, Jean-François; Pages, Jean-Christophe; de Fraipont, Florence; Boyer, Jean-Christophe; Merlio, Jean Philippe; Morel, Alain; Gorisse, Marie-Claude; de Cremoux, Patricia; Leroy, Karen; Milano, Gérard; Ouafik, L'houcine; Merlin, Jean-Louis; Le Corre, Delphine; Aucouturier, Pascaline; Sabourin, Jean-Christophe; Nowak, Frédérique; Frebourg, Thierry; Emile, Jean-François; Durand-Zaleski, Isabelle; Laurent-Puig, Pierre

2013-01-01

Rapid advances in the understanding of cancer biology have transformed drug development thus leading to the approval of targeted therapies and to the development of molecular tests to select patients that will respond to treatments. KRAS status has emerged as a negative predictor of clinical benefit from anti-EGFR antibodies in colorectal cancer, and anti-EGFR antibodies use was limited to KRAS wild type tumors. In order to ensure wide access to tumor molecular profiling, the French National Cancer Institute (INCa) has set up a national network of 28 regional molecular genetics centers. Concurrently, a nationwide external quality assessment for KRAS testing (MOKAECM) was granted to analyze reproducibility and costs. 96 cell-line DNAs and 24 DNA samples from paraffin embedded tumor tissues were sent to 40 French laboratories. A total of 5448 KRAS results were collected and analyzed and a micro-costing study was performed on sites for 5 common methods by an independent team of health economists. This work provided a baseline picture of the accuracy and reliability of KRAS analysis in routine testing conditions at a nationwide level. Inter-laboratory Kappa values were >0.8 for KRAS results despite differences detection methods and the use of in-house technologies. Specificity was excellent with only one false positive in 1128 FFPE data, and sensitivity was higher for targeted techniques as compared to Sanger sequencing based methods that were dependent upon local expertise. Estimated reagent costs per patient ranged from €5.5 to €19.0. The INCa has set-up a network of public laboratories dedicated to molecular oncology tests. Our results showed almost perfect agreements in KRAS testing at a nationwide level despite different testing methods ensuring a cost-effective equal access to personalized colorectal cancer treatment.

Nationwide incidence of blindness in South Korea: a 12-year study from 2002 to 2013.

PubMed

Rim, Tyler Hyungtaek; Kim, Dong Wook; Chung, Eun Jee; Kim, Sung Soo

2017-11-01

Blindness is an important public health issue. The background of the study is to determine the incidence of blindness in South Korea. Nationwide population-based retrospective study. All individuals from South Korea (n = 47 516 098). Patients confirmed with legal blindness based on the worse-seeing and better-seeing eyes between 1 January 2002 and 31 December 2013 were included. The Korean National Health Insurance Service (KNHIS) database was used. Using the World Health Organization definition, blindness was defined as best-corrected visual acuity in the worse-seeing and better-seeing eyes of <20/400. The mean incidence of blindness during the 12-year period was estimated. The population of South Korea was estimated using census data in 2005 and 2010. The total number of legal blindness cases in the KNHIS database. We identified 195 004 and 20 492 cases of newly developed legal blindness based on the worse-seeing and better-seeing eyes, respectively, and the mean incidences of blindness were 34.2 and 3.6 cases/100 000 person-years, respectively. The prevalence of blindness based on the worse-seeing and better-seeing eyes was 425.3 and 57.7 cases/100 000 persons, respectively. The incidence of blindness based on the worse-seeing eye was higher in men than in women overall. Additionally, the incidence increased with age and showed a decreasing trend from 2002 to 2013. The prevalence of blindness showed an increasing trend from 2002 to 2013. The findings of our study will help in the assessment of the blindness-related socio-economic burden and in healthcare planning. © 2017 Royal Australian and New Zealand College of Ophthalmologists.

Evaluation of techniques for handling missing cost-to-charge ratios in the USA Nationwide Inpatient Sample: a simulation study.

PubMed

Yu, Tzy-Chyi; Zhou, Huanxue

2015-09-01

Evaluate performance of techniques used to handle missing cost-to-charge ratio (CCR) data in the USA Healthcare Cost and Utilization Project's Nationwide Inpatient Sample. Four techniques to replace missing CCR data were evaluated: deleting discharges with missing CCRs (complete case analysis), reweighting as recommended by Healthcare Cost and Utilization Project, reweighting by adjustment cells and hot deck imputation by adjustment cells. Bias and root mean squared error of these techniques on hospital cost were evaluated in five disease cohorts. Similar mean cost estimates would be obtained with any of the four techniques when the percentage of missing data is low (<10%). When total cost is the outcome of interest, a reweighting technique to avoid underestimation from dropping observations with missing data should be adopted.

Identification and prevalence of adverse drug events caused by potentially inappropriate medication in homebound elderly patients: a retrospective study using a nationwide survey in Japan

PubMed Central

Onda, Mitsuko; Imai, Hirohisa; Takada, Yurina; Fujii, Shingo; Shono, Takako; Nanaumi, Yoko

2015-01-01

Objectives A nationwide large-scale survey was conducted to identify the prevalence and causal medications of adverse drug events (ADEs) that are caused by potentially inappropriate medications (PIMs) given to homebound elderly patients, factors associated with ADEs, and measures taken by pharmacists to manage ADEs and their effects on ADEs. Settings A questionnaire was mailed to 3321 pharmacies nationwide. It asked about the details of PIMs and ADEs of up to 5 patients for whom home visits were provided by a pharmacist. Questionnaire forms were filled in by pharmacists who visited the patients. Design and participants Between 23 January and 13 February 2013, comprehensive assessment forms were sent to 3321 pharmacies. Data collected from 1890 pharmacies including data of 4815 patients were analysed and 28 patients of unknown sex were excluded. Their average age was 82.7 years. PIMs were identified based on the 2003 Beers Criteria Japan. Results There were 600 patients who did not provide valid answers regarding the medications. In the remaining 4243 patients, one or more medications that were considered to be PIMs had been prescribed to 48.4% of patients. PIM-induced ADEs were found in 8% of these patients by pharmacists during home visits. The top ADE-inducing medications were strong anticholinergic antihistamines, benzodiazepines, sulpiride and digoxin. The most common ADEs associated with benzodiazepines were frequent lightheadedness, somnolence and sleepiness, which increase the risk of falls and subsequent fractures in elderly patients. The following factors associated with ADEs were identified: sex, pharmacist awareness of prescription issues, frequency of visits and time spent at patients’ homes, and the frequency of detailed checks for patient adverse reactions by pharmacists. Conclusions The PIM prevalence associated with home healthcare in Japan was relatively high, as reported in previous studies. The present study suggests that pharmacists could reduce the incidence of PIMs and consequent ADEs. PMID:26260347

The Association of Ursodeoxycholic Acid Use With Colorectal Cancer Risk

PubMed Central

Huang, Wen-Kuan; Hsu, Hung-Chih; Liu, Jia-Rou; Yang, Tsai-Sheng; Chen, Jen-Shi; Chang, John Wen-Cheng; Lin, Yung-Chang; Yu, Kuang-Hui; Kuo, Chang-Fu; See, Lai-Chu

2016-01-01

Abstract Data from preclinical studies suggest that ursodeoxycholic acid (UDCA) has a chemopreventive effect on colorectal cancer (CRC) development, but no large observational study has examined this possibility. The aim of this study was to investigate the association of UDCA use with CRC risk in a nationwide population-based cohort. This nationwide population-based cohort study used data from the Taiwan National Health Insurance Research Database for the period from 2000 through 2010. This study included data from 7119 Taiwanese adults who received ≥28 cumulative defined daily doses (cDDDs) of UDCA and 14,238 patients who did not receive UDCA (<28 cDDDs). UDCA nonusers were matched 1:2 for age, sex, enrollment date, and presence of chronic liver disease, viral hepatitis, cholelithiasis, and alcoholic liver disease. The 2 cohorts were followed until December 31, 2010 or occurrence of CRC. Cox proportional hazards regression with robust Sandwich variance estimator, which can cooperate with matching design, was used to examine the association between UDCA use and CRC risk. During 109,312 person-years of follow-up (median, 5 years), 121 patients had newly diagnosed CRC: 28 UDCA users (76.7 per 100,000 person-years) and 93 nonusers (127.7 per 100,000 person-years) (log-rank test, P = 0.0169). After multivariate adjustment for age, UDCA use was associated with a reduced risk of CRC (hazard ratio, 0.60; 95% confidence interval [CI], 0.39–0.92). The adjusted hazard ratios were 0.55 (95% CI, 0.35–0.89), 0.89 (95% CI, 0.36–2.20), and 0.63 (95% CI, 0.16–2.53) for patients with 28 to 180, 181 to 365, and >365 cDDDs, respectively, relative to nonusers. UDCA use was associated with reduced risk of CRC in a cohort mainly comprising patients with chronic liver diseases. However, further studies are needed to determine the optimal dosage of UDCA. PMID:26986110

"Invisible" Bilingualism--"Invisible" Language Ideologies: Greek Teachers' Attitudes Towards Immigrant Pupils' Heritage Languages

ERIC Educational Resources Information Center

Gkaintartzi, Anastasia; Kiliari, Angeliki; Tsokalidou, Roula

2015-01-01

This paper presents data from two studies--a nationwide quantitative research and an ethnographic study--on Greek schoolteachers' attitudes towards immigrant pupils' bilingualism. The quantitative data come from a large-scale questionnaire survey, which aimed at the investigation of the needs and requirements for the implementation of a pilot…

Introducing laparoscopic total gastrectomy for gastric cancer in general practice: a retrospective cohort study based on a nationwide registry database in Japan.

PubMed

Kodera, Yasuhiro; Yoshida, Kazuhiro; Kumamaru, Hiraku; Kakeji, Yoshihiro; Hiki, Naoki; Etoh, Tsuyoshi; Honda, Michitaka; Miyata, Hiroaki; Yamashita, Yuichi; Seto, Yasuyuki; Kitano, Seigo; Konno, Hiroyuki

2018-02-09

Although laparoscopic total gastrectomy (LTG) is considered a technically demanding procedure with safety issues, it has been performed in several hospitals in Japan. Data from a nationwide web-based data entry system for surgical procedures (NCD) that started enrollment in 2011 are now available for analysis. A retrospective cohort study was conducted using data from 32,144 patients who underwent total gastrectomy and were registered in the NCD database between January 2012 and December 2013. Mortality and morbidities were compared between patients who received LTG and those who underwent open total gastrectomy (OTG) in the propensity score-matched Stage I cohort and Stage II-IV cohort. There was no significant difference in mortality rate between LTG and OTG in both cohorts. Operating time was significantly longer in LTG while the blood loss was smaller. In the Stage I cohort, LTG, performed in 33.6% of the patients, was associated with significantly shorter hospital stay but significantly higher incidence of readmission, reoperation, and anastomotic leakage (5.4% vs. 3.6%, p < 0.01). In the Stage II-IV cohort, LTG was performed in only 8.8% of the patients and was associated with significantly higher incidence of leakage (5.7% vs. 3.6%, p < 0.02) although the hospital stay was shorter (15 days vs. 17 days, p < 0.001). LTG was more discreetly introduced than distal gastrectomy, but remained a technically demanding procedure as of 2013. This procedure should be performed only among the well-trained and informed laparoscopic team.

Major sources of benzene exposure.

PubMed Central

Wallace, L A

1989-01-01

Data from EPA's TEAM Study allow us to identify the major sources of exposure to benzene for much of the U.S. population. These sources turn out to be quite different from what had previously been considered the important sources. The most important source of exposure for 50 million smokers is the mainstream smoke from their cigarettes, which accounts for about half of the total population burden of exposure to benzene. Another 20% of nationwide exposure is contributed by various personal activities, such as driving and using attached garages. (Emissions from consumer products, building materials, paints, and adhesives may also be important, although data are largely lacking.) The traditional sources of atmospheric emissions (auto exhaust and industrial emissions) account for only about 20% of total exposure. Environmental tobacco smoke is an important source, accounting for about 5% of total nationwide exposure. A number of sources sometimes considered important, such as petroleum refining operations, petrochemical manufacturing, oil storage tanks, urban-industrial areas, service stations, certain foods, groundwater contamination, and underground gasoline leaks, appear to be unimportant on a nationwide basis. PMID:2477239

Thyroid Storm: A Japanese Perspective.

PubMed

Akamizu, Takashi

2018-01-01

Thyroid storm (TS) is life threatening. In the mid-2000s, its incidence was poorly defined, peer-reviewed diagnostic criteria were not available, and management and treatment did not seem to be verified based upon evidence and latest advances in medicine. First, diagnostic criteria were developed based on 99 patients in the literature and seven patients in this study. Then, initial and follow-up surveys were conducted from 2004 through 2008, targeting all hospitals in Japan to obtain and verify information on patients who met diagnostic criteria for TS. Based on these data, the diagnostic criteria were revised, and management and treatment guidelines were created. The incidence of TS in hospitalized patients in Japan was estimated to be 0.20 per 100,000 per year and 0.22% of all thyrotoxic patients. The mortality rate was 10.7%. Multiple organ failure was the most common cause of death, followed by congestive heart failure, respiratory failure, and arrhythmia. In the final diagnostic criteria for TS, the definition of jaundice as serum bilirubin concentration >3 mg/dL was added. Based upon nationwide surveys and the latest information, guidelines for the management and treatment for TS were extensively revised and algorithms were developed. TS remains a life-threatening disorder, with >10% mortality in Japan. New peer-reviewed diagnostic criteria for TS are presented and its clinical features, prognosis, and incidence are clarified based on nationwide surveys. Furthermore, this information helped to establish detailed guidelines for the management and treatment of TS. A prospective prognostic study to validate the guidelines is eagerly anticipated.

Thyroid Storm: A Japanese Perspective

PubMed Central

2018-01-01

Background: Thyroid storm (TS) is life threatening. In the mid-2000s, its incidence was poorly defined, peer-reviewed diagnostic criteria were not available, and management and treatment did not seem to be verified based upon evidence and latest advances in medicine. Methods: First, diagnostic criteria were developed based on 99 patients in the literature and seven patients in this study. Then, initial and follow-up surveys were conducted from 2004 through 2008, targeting all hospitals in Japan to obtain and verify information on patients who met diagnostic criteria for TS. Based on these data, the diagnostic criteria were revised, and management and treatment guidelines were created. Results: The incidence of TS in hospitalized patients in Japan was estimated to be 0.20 per 100,000 per year and 0.22% of all thyrotoxic patients. The mortality rate was 10.7%. Multiple organ failure was the most common cause of death, followed by congestive heart failure, respiratory failure, and arrhythmia. In the final diagnostic criteria for TS, the definition of jaundice as serum bilirubin concentration >3 mg/dL was added. Based upon nationwide surveys and the latest information, guidelines for the management and treatment for TS were extensively revised and algorithms were developed. Conclusions: TS remains a life-threatening disorder, with >10% mortality in Japan. New peer-reviewed diagnostic criteria for TS are presented and its clinical features, prognosis, and incidence are clarified based on nationwide surveys. Furthermore, this information helped to establish detailed guidelines for the management and treatment of TS. A prospective prognostic study to validate the guidelines is eagerly anticipated. PMID:28899229

Genetic erosion in maize’s center of origin

PubMed Central

Dyer, George A.; López-Feldman, Alejandro; Yúnez-Naude, Antonio; Taylor, J. Edward

2014-01-01

Crop genetic diversity is an indispensable resource for farmers and professional breeders responding to changing climate, pests, and diseases. Anecdotal appraisals in centers of crop origin have suggested serious threats to this diversity for over half a century. However, a nationwide inventory recently found all maize races previously described for Mexico, including some formerly considered nearly extinct. A flurry of social studies seems to confirm that farmers maintain considerable diversity. Here, we compare estimates of maize diversity from case studies over the past 15 y with nationally and regionally representative matched longitudinal data from farmers across rural Mexico. Our findings reveal an increasing bias in inferences based on case study results and widespread loss of diversity. Cross-sectional, case study data suggest that farm-level richness has increased by 0.04 y−1 nationwide; however, direct estimates using matched longitudinal data reveal that richness dropped −0.04 y−1 between 2002 and 2007, from 1.43 to 1.22 varieties per farm. Varietal losses occurred across regions and altitudinal zones, and regardless of farm turnover within the sector. Extinction of local maize populations may not have resulted in an immediate loss of alleles, but low varietal richness and changes in maize’s metapopulation dynamics may prevent farmers from accessing germplasm suitable to a rapidly changing climate. Declining yields could then lead farmers to leave the sector and result in a further loss of diversity. Similarities in research approaches across crops suggest that methodological biases could conceal a loss of diversity at other centers of crop origin. PMID:25197088

Selenium, Chromium, and Vitamin D: What Dietitians Need to Know Regarding Dietary Supplements

USDA-ARS?s Scientific Manuscript database

Accurate nutrient data for dietary supplement composition are essential for determining supplements’ contribution to total dietary intake. To plan a nationwide adult multivitamin/mineral (MVM) study, the USDA Nutrient Data Laboratory (NDL) obtained prevalence information for the most common labeled...

Breast Cancer Incidence and Predictors of Surgical Outcome: a Nationwide Longitudinal Study in Taiwan.

PubMed

Chang, Hong-Tai; Shi, Hon-Yi; Wang, Being-Whey; Yeh, Shu-Chuan Jennifer

2017-06-01

Despite the huge and growing global burden of patients who require breast cancer surgery, high-quality population-based studies of breast cancer trends and outcomes are scarce. The purpose of this study was to explore the incidence of breast cancer and predictors of hospital resource utilisation, mortality and recurrence in a nationwide population of patients who have received surgery. This retrospective study analysed trends and outcomes in a Taiwan population of 77 971 patients after breast cancer surgery during 1996-2010. The Cox proportional hazards model was used for multivariate assessment of both mortality and recurrence predictors. The data analysis indicated that, during this period, the estimated mean hospital treatment cost and mean length of stay increased by 16.3% and 53.4%, respectively. The estimated mean overall survival time was 138.9 months (standard deviation 0.3 months) and the overall 1, 3, 5 and 10 year survival rates were 97.3, 89.2, 82.2 and 70.1%, respectively. The estimated mean overall recurrence time was 10.8 months (standard deviation 0.2 months) and the overall 1, 3, 5 and 10 year recurrence rates were 0.1, 18.8, 26.6 and 36.0%, respectively. Outcomes were significantly associated with age, Deyo-Charlson comorbidity index score, surgeon seniority, hospital volume, surgeon volume, surgery type, hospital level and baseline comorbidities (P<0.001). Analyses of these population-based data revealed simultaneous increases in the standard incidence of breast cancer surgery and its associated medical resource utilisation. Notably, healthcare providers and patients should recognise that both patient attributes and hospital attributes may affect breast cancer surgery outcomes. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Sick-leave measures, socio-demographic factors and health care as risk indicators for suicidal behavior in patients with depressive disorders--a nationwide prospective cohort study in Sweden.

PubMed

Wang, Mo; Alexanderson, Kristina; Runeson, Bo; Mittendorfer-Rutz, Ellenor

2015-03-01

Studies based on large data sets investigating a wide range of risk indicators on suicidal behavior in patients with depressive disorders are sparse. This study aimed to examine the association of sick-leave measured in different ways on one hand and socio-demographics, medication, and health care on the other hand with suicide attempt and suicide among patients with depressive disorders. This is a population-based prospective cohort study using nationwide register data. All individuals who lived in Sweden 31.12.2004, then aged 16-64 years, and had psychiatric in- or out-patient care due to depressive disorders in 2005 were included (N = 21,096). Univariate and multivariate hazard ratios (HR) and 95% Confidence Intervals (CI) with regard to suicide attempt and suicide during 2006-2010 were estimated by Cox regression. Those with new sick-leave spells, full-time spells, spells due to mental diagnoses and exceeding one year and those having ≥ 1 sick-leave spells had a higher risk of suicide attempt. Female sex, young age, lower education, living alone, prescription of antidepressants and anxiolytics, inpatient health care, and suicide attempts resulted in higher HRs of suicide attempt in the multivariate analyses (range of HRs 1.17-3.28). Male sex, combined antidepressant and anxiolytic prescription, mental inpatient health care, and suicide attempts predicted subsequent suicide (range of HRs 1.84-3.33). Focus on specialized health care limited generalization. Sickness absence, social-demographics, and medical determinants were associated with suicidal behavior. These risk indicators should be considered when monitoring individuals with depressive disorders and assessing suicide risk. Copyright © 2014 Elsevier B.V. All rights reserved.

Long-term mortality of acetaminophen poisoning: a nationwide population-based cohort study with 10-year follow-up in Taiwan.

PubMed

Huang, Hung-Sheng; Ho, Chung-Han; Weng, Shih-Feng; Hsu, Chien-Chin; Wang, Jhi-Joung; Su, Shih-Bin; Lin, Hung-Jung; Huang, Chien-Cheng

2018-01-08

The long-term mortality of acetaminophen (APAP) poisoning has not yet been well studied; hence, we conducted this study to gain understanding of this issue. We conducted a nationwide population-based cohort study by identifying 3235 participants with APAP poisoning and 9705 participants without APAP poisoning in Taiwan between 2003 and 2012 in the Nationwide Poisoning Database and Longitudinal Health Insurance Database 2000. Participants with APAP poisoning and control subjects were compared for the risk of all-cause mortality by follow-up until 2013. Two hundred forty-one participants with APAP poisoning (7.5%) and ninety-four control subjects (1.0%) died during the follow-up. Participants with APAP poisoning had a higher risk of all-cause mortality than the control subjects (incidence rate ratio [IRR], 8.1; 95% confidence interval [CI], 6.3-10.2), especially in the subgroup aged 20 years and younger (IRR, 27.3; 95% CI, 3.5-215.5) and in the first 12 months after poisoning (IRR, 16.0; 95% CI, 9.9-25.7). The increased risk of all-cause mortality was found even up to 2 years after the index poisoning. APAP poisoning was associated with increased long-term mortality. Early referral for intensive aftercare and associated interventions are suggested; however, further studies of the method are needed for clarification.

Lithium in drinking water and the incidence of bipolar disorder: A nation-wide population-based study.

PubMed

Kessing, Lars V; Gerds, Thomas A; Knudsen, Nikoline N; Jørgensen, Lisbeth F; Kristiansen, Søren M; Voutchkova, Denitza; Ernstsen, Vibeke; Schullehner, Jörg; Hansen, Birgitte; Andersen, Per K; Ersbøll, Annette K

2017-11-01

Animal data suggest that subtherapeutic doses, including micro doses, of lithium may influence mood, and lithium levels in drinking water have been found to correlate with the rate of suicide. It has never been investigated whether consumption of lithium may prevent the development of bipolar disorder (primary prophylaxis). In a nation-wide population-based study, we investigated whether long-term exposure to micro levels of lithium in drinking water correlates with the incidence of bipolar disorder in the general population, hypothesizing an inverse association in which higher long-term lithium exposure is associated with lower incidences of bipolar disorder. We included longitudinal individual geographical data on municipality of residence, data from drinking water lithium measurements and time-specific data from all cases with a hospital contact with a diagnosis of mania/bipolar disorder from 1995 to 2013 (N=14 820) and 10 age- and gender-matched controls from the Danish population (N= 140 311). Average drinking water lithium exposure was estimated for all study individuals. The median of the average lithium exposure did not differ between cases with a diagnosis of mania/bipolar disorder (12.7 μg/L; interquartile range [IQR]: 7.9-15.5 μg/L) and controls (12.5 μg/L; IQR: 7.6-15.7 μg/L; P=.2). Further, the incidence rate ratio of mania/bipolar disorder did not decrease with higher long-term lithium exposure, overall, or within age categories (0-40, 41-60 and 61-100 years of age). Higher long-term lithium exposure from drinking water was not associated with a lower incidence of bipolar disorder. The association should be investigated in areas with higher lithium levels than in Denmark. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Towards shared patient records: an architecture for using routine data for nationwide research.

PubMed

Knaup, Petra; Garde, Sebastian; Merzweiler, Angela; Graf, Norbert; Schilling, Freimut; Weber, Ralf; Haux, Reinhold

2006-01-01

Ubiquitous information is currently one of the most challenging slogans in medical informatics research. An adequate architecture for shared electronic patient records is needed which can use data for multiple purposes and which is extensible for new research questions. We introduce eardap as architecture for using routine data for nationwide clinical research in a multihospital environment. eardap can be characterized as terminology-based. Main advantage of our approach is the extensibility by new items and new research questions. Once the definition of items for a research question is finished, a consistent, corresponding database can be created without any informatics skills. Our experiences in pediatric oncology in Germany have shown the applicability of eardap. The functions of our core system were in routine clinical use in several hospitals. We validated the terminology management system (TMS) and the module generation tool with the basic data set of pediatric oncology. The multiple usability depends mainly on the quality of item planning in the TMS. High quality harmonization will lead to a higher amount of multiply used data. When using eardap, special emphasis is to be placed on interfaces to local hospital information systems and data security issues.

A cross-sectional investigation of acceptance of health information technology: A nationwide survey of community pharmacists in Turkey.

PubMed

Sezgin, Emre; Özkan-Yıldırım, Sevgi

Health information technologies have become vital to health care services. In that regard, successful use of information technologies in pharmaceutical services is important to manage, control and maintain pharmaceutical transactions, which increase the quality of health care delivery. This study aimed to identify influencing factors on pharmacists' acceptance of pharmaceutical service systems. A cross-sectional study was conducted employing a research model based on technology acceptance theories. A parsimonious model was developed, and a self-reported questionnaire was distributed online. Community pharmacists participated voluntarily via the website of Turkish Pharmacists' Association. The data was analyzed employing Structural Equation Modeling. From 77 out of 81 cities of Turkey, 2169 community pharmacists participated to the survey with 43% response rate. Perceived usefulness, perceived ease of use, system factors and perceived behavioral control explained 47% of total variance in pharmacists' intention to use the pharmaceutical technology. The findings of the research provided insight about relations of influencing factors and practical implications regarding perceived behaviors and system use. Future researchers would benefit from the study design and findings. The study is also valuable for being the first nationwide study conducted on pharmacists about user attitudes toward a technology. Copyright © 2015 Elsevier Inc. All rights reserved.

[What potential do geographic information systems have for population-wide health monitoring in Germany? : Perspectives and challenges for the health monitoring of the Robert Koch Institute].

PubMed

Thißen, Martin; Niemann, Hildegard; Varnaccia, Gianni; Rommel, Alexander; Teti, Andrea; Butschalowsky, Hans; Manz, Kristin; Finger, Jonas David; Kroll, Lars Eric; Ziese, Thomas

2017-12-01

Geographic information systems (GISs) are computer-based systems with which geographical data can be recorded, stored, managed, analyzed, visualized and provided. In recent years, they have become an integral part of public health research. They offer a broad range of analysis tools, which enable innovative solutions for health-related research questions. An analysis of nationwide studies that applied geographic information systems underlines the potential this instrument bears for health monitoring in Germany. Geographic information systems provide up-to-date mapping and visualization options to be used for national health monitoring at the Robert Koch Institute (RKI). Furthermore, objective information on the residential environment as an influencing factor on population health and on health behavior can be gathered and linked to RKI survey data at different geographic scales. Besides using physical information, such as climate, vegetation or land use, as well as information on the built environment, the instrument can link socioeconomic and sociodemographic data as well as information on health care and environmental stress to the survey data and integrate them into concepts for analyses. Therefore, geographic information systems expand the potential of the RKI to present nationwide, representative and meaningful health-monitoring results. In doing so, data protection regulations must always be followed. To conclude, the development of a national spatial data infrastructure and the identification of important data sources can prospectively improve access to high quality data sets that are relevant for the health monitoring.

A multicenter prospective study of surgical audit systems.

PubMed

Haga, Yoshio; Ikejiri, Koji; Wada, Yasuo; Takahashi, Tadateru; Ikenaga, Masakazu; Akiyama, Noriyoshi; Koike, Shoichiro; Koseki, Masato; Saitoh, Toshihiro

2011-01-01

This study was undertaken to evaluate a modified form of Estimation of Physiologic Ability and Surgical Stress (E-PASS) for surgical audit comparing with other existing models. Although several scoring systems have been devised for surgical audit, no nation-wide survey has been performed yet. We modified our previous E-PASS surgical audit system by computing the weights of 41 procedures, using data from 4925 patients who underwent elective digestive surgery, designated it as mE-PASS. Subsequently, a prospective cohort study was conducted in 43 national hospitals in Japan from April 1, 2005, to April 8, 2007. Variables for the E-PASS and American Society of Anesthesiologists (ASA) status-based model were collected for 5272 surgically treated patients. Of the 5272 patients, we also collected data for the Portsmouth modification of Physiologic and Operative Severity Score for the enUmeration of Mortality and morbidity (P-POSSUM) in 3128 patients. The area under the receiver operative characteristic curve (AUC) was used to evaluate discrimination performance to detect in-hospital mortality. The ratio of observed to estimated in-hospital mortality rates (OE ratio) was defined as a measure of quality. The numbers of variables required were 10 for E-PASS, 7 for mE-PASS, 20 for P-POSSUM, and 4 for the ASA status-based model. The AUC (95% confidence interval) values were 0.86 (0.79-0.93) for E-PASS, 0.86 (0.79-0.92) for mE-PASS, 0.81 (0.75-0.88) for P-POSSUM, and 0.73 (0.63-0.83) for the ASA status-based model. The OE ratios for mE-PASS among large-volume hospitals significantly correlated with those for E-PASS (R = 0.93, N = 9, P = 0.00026), P-POSSUM (R = 0.96, N = 6, P = 0.0021), and ASA status-based model (R = 0.83, N = 9, P = 0.0051). Because of its features of easy use, accuracy, and generalizability, mE-PASS is a candidate for a nation-wide survey.

America's Children: Key National Indicators of Well-Being, 1997.

ERIC Educational Resources Information Center

Miller, Felicia, Ed.

This report of the Interagency Forum on Child and Family Statistics presents nationwide data on the well-being of America's children. The statistical report is based on 25 indicators of child well being: (1) child poverty; (2) food security; (3) housing problems; (4) secure parental employment; (5) health insurance; (6) summary health status; (7)…

Risk of impaired condition of watersheds containing National Forest lands

Treesearch

Thomas C Brown; Pamela Froemke

2010-01-01

We assessed the risk of impaired condition of the nearly 3700 5th-level watersheds in the contiguous 48 states containing the national forests and grasslands that make up the U.S. Forest Service's National Forest System (NFS). The assessment was based on readily available, relatively consistent nationwide data sets for a series of indicators representing watershed...

On the Integration of Wind and Solar Energy to Provide a Total Energy Supply in the U.S

NASA Astrophysics Data System (ADS)

Liebig, E. C.; Rhoades, A.; Sloggy, M.; Mills, D.; Archer, C. L.

2009-12-01

This study examines the feasibility of using renewable energy - mostly wind and solar radiation - as the primary sources of energy in the U.S., under the assumption that a nationwide electric transmission grid is in place. Previous studies have shown that solar output from California and Texas using energy storage is well correlated with the state energy load on an hour by hour basis throughout the year and with the US national load on a monthly basis. Other studies have shown that solar or wind alone can power the present US grid on average. This study explores scenarios for use of wind and solar energy together at the national scale on an hour by hour basis to determine if such a combination is a better match to national seasonal load scenarios than either of the two alone on an hour-by-hour basis. Actual hour by hour national load data from a particular year will be used as a basis, with some scenarios incorporating vehicle sector electrification and building heating and cooling using electric heat pumps. Hydro and geothermal generation can provide additional controllable output, when needed, to fulfill the hourly electricity and/or energy needs. Hourly wind speed data were calculated at the hub height of 80 m above the ground for the year 2006 at over 150 windy locations in the continental US using an extrapolation technique based on 10-m wind speed measurements and vertical sounding profiles. Using a 1.5 MW wind turbine as benchmark, the hourly wind power production nationwide was determined at all locations. Similarly, the hourly output from solar plants, with and without thermal storage, was calculated based on Ausra’s model assuming that the solar production would occur in the Southwest, the area with the greatest solar radiation density in the U.S. Hourly electricity demand for the year 2006 was obtained nationwide from a variety of sources, including the Federal Energy Regulation Commission. Hourly residential heating and cooking, industrial heat processing, and future electrified transportation loads were calculated from monthly energy consumption data from the Energy Information Administration. Using different scenarios of wind power penetration (10%, 20%, 30%, 50%, 80%, 100% of the average national electricity and/or energy demand), the remaining hourly electricity and/or energy load was covered by various combinations of solar, hydro, and geothermal generation. Statistics of the reliability of the various scenarios, as well as details on the area covered by wind and solar farms per each scenario, will be analyzed and presented.

[Infant mortality according to color or race based on the 2010 Population Census and national health information systems in Brazil].

PubMed

Caldas, Aline Diniz Rodrigues; Santos, Ricardo Ventura; Borges, Gabriel Mendes; Valente, Joaquim Gonçalves; Portela, Margareth Crisóstomo; Marinho, Gerson Luiz

2017-08-07

The aim of this study was to investigate infant mortality data according to color or race in Brazil with a focus on indigenous individuals, based on data from the 2010 Population Census and the Brazilian Mortality Information System (SIM) and Brazilian Information System on Live Births (SINASC). In both sources, the infant mortality rate (IMR) for indigenous individuals was the highest of all the various population segments. Although the census data indicate inequalities by color or race, the infant mortality rates for indigenous and black individuals were lower than those based on data from SIM/SINASC. Methodological specificities in the data collection in the two sources should be considered. The reduction in IMR in Brazil in recent decades is largely attributed to the priority of infant health on the policy agenda. The study's findings indicate that the impact of public policies failed to reach indigenous peoples on the same scale as in the rest of the population. New sources of nationwide data on deaths in households, as in the case of the 2010 Census, can contribute to a better understanding of inequalities by color or race in Brazil.

VetCompass Australia: A National Big Data Collection System for Veterinary Science.

PubMed

McGreevy, Paul; Thomson, Peter; Dhand, Navneet K; Raubenheimer, David; Masters, Sophie; Mansfield, Caroline S; Baldwin, Timothy; Soares Magalhaes, Ricardo J; Rand, Jacquie; Hill, Peter; Peaston, Anne; Gilkerson, James; Combs, Martin; Raidal, Shane; Irwin, Peter; Irons, Peter; Squires, Richard; Brodbelt, David; Hammond, Jeremy

2017-09-26

VetCompass Australia is veterinary medical records-based research coordinated with the global VetCompass endeavor to maximize its quality and effectiveness for Australian companion animals (cats, dogs, and horses). Bringing together all seven Australian veterinary schools, it is the first nationwide surveillance system collating clinical records on companion-animal diseases and treatments. VetCompass data service collects and aggregates real-time, clinical records for researchers to interrogate, delivering sustainable and cost-effective access to data from hundreds of veterinary practitioners nationwide. Analysis of these clinical records will reveal geographical and temporal trends in the prevalence of inherited and acquired diseases, identify frequently prescribed treatments, revolutionize clinical auditing, help the veterinary profession to rank research priorities, and assure evidence-based companion-animal curricula in veterinary schools. VetCompass Australia will progress in three phases: (1) roll-out of the VetCompass platform to harvest Australian veterinary clinical record data; (2) development and enrichment of the coding (data-presentation) platform; and (3) creation of a world-first, real-time surveillance interface with natural language processing (NLP) technology. The first of these three phases is described in the current article. Advances in the collection and sharing of records from numerous practices will enable veterinary professionals to deliver a vastly improved level of care for companion animals that will improve their quality of life.

National Study of School Psychologists' Use of Evidence-Based Assessment in Autism Spectrum Disorder

ERIC Educational Resources Information Center

Aiello, Rachel; Ruble, Lisa; Esler, Amy

2017-01-01

This study aimed to better understand predictors of evidence-based assessment practices for autism spectrum disorder (ASD). Nationwide, 402 school psychologists were surveyed for their knowledge of and training and experience with ASD on assessment practices, including reported areas of training needs. The majority of school psychologists reported…

The 5-minute Apgar score as a predictor of childhood cancer: a population-based cohort study in five million children.

PubMed

Li, Jiong; Cnattingus, Sven; Gissler, Mika; Vestergaard, Mogens; Obel, Carsten; Ahrensberg, Jette; Olsen, Jørn

2012-01-01

The aetiology of childhood cancer remains largely unknown but recent research indicates that uterine environment plays an important role. We aimed to examine the association between the Apgar score at 5 min after birth and the risk of childhood cancer. Nationwide population-based cohort study. Nationwide register data in Denmark and Sweden. All live-born singletons born in Denmark from 1978 to 2006 (N=1 771 615) and in Sweden from 1973 to 2006 (N=3 319 573). Children were followed up from birth to 14 years of age. Rates and HRs for all childhood cancers and for specific childhood cancers. A total of 8087 children received a cancer diagnosis (1.6 per 1000). Compared to children with a 5-min Apgar score of 9-10, children with a score of 0-5 had a 46% higher risk of cancer (adjusted HR 1.46, 95% CI 1.15 to 1.89). The potential effect of low Apgar score on overall cancer risk was mostly confined to children diagnosed before 6 months of age. Children with an Apgar score of 0-5 had higher risks for several specific childhood cancers including Wilms' tumour (HR 4.33, 95% CI 2.42 to 7.73). A low 5 min Apgar score was associated with a higher risk of childhood cancers diagnosed shortly after birth. Our data suggest that environmental factors operating before or during delivery may play a role on the development of several specific childhood cancers.

Risk factors of coercion among psychiatric inpatients: a nationwide register-based cohort study.

PubMed

Thomsen, Christoffer; Starkopf, Liis; Hastrup, Lene Halling; Andersen, Per Kragh; Nordentoft, Merete; Benros, Michael Eriksen

2017-08-01

Reducing the use of coercion among patients with mental disorders has long been a political priority. However, risk factors for coercive measures have primarily been investigated in smaller studies. To reduce the use of coercion, it is crucial to identify people at risk which we aim to do in this first large-scale study. A cohort study was conducted among all psychiatric inpatients in Denmark, following 112,233 individuals during 1999-2014. Data from Danish registers were analysed using logistic regression for repeated measures. 24,594 inpatients were exposed to a coercive measure (21.9%). Clinical characteristics were the foremost predictors of coercion and patients with organic mental disorder had the highest increased risk of being subjected to a coercive measure (OR = 5.56; 95% CI = 5.04, 6.14). The risk of coercion was the highest in the first admission and decreased with the number of admissions (all p < 0.001). The following socioeconomic variables were associated with an increased risk of coercion: male sex, unemployment, lower social class and immigrants from low and middle income countries (all p < 0.001). Early retirement and social relations, such as being married and having children, reduced the risk of being subjected to coercive measure (all p < 0.05). From our nationwide data, we identified a broad range of risk factors associated with coercive measures. Our findings can assist researchers in identifying patients at risk of coercion and thereby help targeting new coercion reduction programs.

Developing a stroke severity index based on administrative data was feasible using data mining techniques.

PubMed

Sung, Sheng-Feng; Hsieh, Cheng-Yang; Kao Yang, Yea-Huei; Lin, Huey-Juan; Chen, Chih-Hung; Chen, Yu-Wei; Hu, Ya-Han

2015-11-01

Case-mix adjustment is difficult for stroke outcome studies using administrative data. However, relevant prescription, laboratory, procedure, and service claims might be surrogates for stroke severity. This study proposes a method for developing a stroke severity index (SSI) by using administrative data. We identified 3,577 patients with acute ischemic stroke from a hospital-based registry and analyzed claims data with plenty of features. Stroke severity was measured using the National Institutes of Health Stroke Scale (NIHSS). We used two data mining methods and conventional multiple linear regression (MLR) to develop prediction models, comparing the model performance according to the Pearson correlation coefficient between the SSI and the NIHSS. We validated these models in four independent cohorts by using hospital-based registry data linked to a nationwide administrative database. We identified seven predictive features and developed three models. The k-nearest neighbor model (correlation coefficient, 0.743; 95% confidence interval: 0.737, 0.749) performed slightly better than the MLR model (0.742; 0.736, 0.747), followed by the regression tree model (0.737; 0.731, 0.742). In the validation cohorts, the correlation coefficients were between 0.677 and 0.725 for all three models. The claims-based SSI enables adjusting for disease severity in stroke studies using administrative data. Copyright © 2015 Elsevier Inc. All rights reserved.

Endoscopic management and outcomes of pregnant women hospitalized for nonvariceal upper GI bleeding: a nationwide analysis.

PubMed

Nguyen, Geoffrey C; Dinani, Amreen M; Pivovarov, Kevin

2010-11-01

Upper GI endoscopy has an important diagnostic and therapeutic role in the management of nonvariceal upper GI bleeding (NVUGB). To characterize nationwide patterns of utilization of upper GI endoscopy in pregnant women with NVUGB and to assess health outcomes. Retrospective cohort study. Participating hospitals from the Nationwide Inpatient Sample, 1998-2007. Pregnant and age-matched nonpregnant women admitted for NVUGB. The study population was classified as pregnant women with NVUGB (n = 1210) and nonpregnant women with NVUGB (n = 6050). Rate of upper GI endoscopy, maternal mortality, fetal death/complications, and premature delivery. Pregnant women were less likely than nonpregnant women to undergo upper GI endoscopy (26% vs 69%; P < .0001) even after adjustment for comorbidities, transfusion requirement, and the presence of hypovolemic shock (adjusted odds ratio, 0.19; 95% confidence interval, 0.16-0.22). Among those who underwent endoscopy, pregnant women were less likely to undergo the procedure within 24 hours of admission (50% vs 57%; P = .02). Mortality was lower among pregnant women compared with nonpregnant women (0% vs 0.6%; P = .006). In comparing outcomes between those who did and did not undergo endoscopy, there was no difference in fetal loss (0.2% vs 0.6%), fetal distress/complications (2.7% vs 2.6%), or premature delivery (7.3% vs 6.4%). The study was based on administrative data. A conservative nonendoscopic approach is common in the management of pregnant women with NVUGB and is not associated with worse maternal or fetal outcomes. Upper GI endoscopy is, however, safe when judiciously implemented in the actively bleeding patient. Copyright © 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

Comprehensive analysis of mutations in the hepatitis delta virus genome based on full-length sequencing in a nationwide cohort study and evolutionary pattern during disease progression.

PubMed

Shirvani-Dastgerdi, E; Amini-Bavil-Olyaee, S; Alavian, S Moayed; Trautwein, C; Tacke, F

2015-05-01

Delta hepatitis, caused by co-infection or super-infection of hepatitis D virus (HDV) in hepatitis B virus (HBV) -infected patients, is the most severe form of chronic hepatitis, often progressing to liver cirrhosis and liver failure. Although 15 million individuals are affected worldwide, molecular data on the HDV genome and its proteins, small and large delta antigen (S-/L-HDAg), are limited. We therefore conducted a nationwide study in HBV-HDV-infected patients from Iran and successfully amplified 38 HDV full genomes and 44 L-HDAg sequences from 34 individuals. Phylogenetic analyses of full-length HDV and L-HDAg isolates revealed that all strains clustered with genotype 1 and showed high genotypic distances to HDV genotypes 2 to 8, with a maximal distance to genotype 3. Longitudinal analyses in individual patients indicated a reverse evolutionary trend, especially in L-HDAg amino acid composition, over time. Besides multiple sequence variations in the hypervariable region of HDV, nucleotide substitutions preferentially occurred in the stabilizing P4 domain of the HDV ribozyme. A high rate of single amino acid changes was detected in structural parts of L-HDAg, whereas its post-translational modification sites were highly conserved. Interestingly, several non-synonymous mutations were positively selected that affected immunogenic epitopes of L-HDAg towards CD8 T-cell- and B-cell-driven immune responses. Hence, our comprehensive molecular analysis comprising a nationwide cohort revealed phylogenetic relationships and provided insight into viral evolution within individual hosts. Moreover, preferential areas of frequent mutations in the HDV ribozyme and antigen protein were determined in this study. Copyright © 2014 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Risk Factors for Fatal Hyperglycaemia Confirmed by Forensic Postmortem Examination - A Nationwide Cohort in Sweden.

PubMed

Walz, Lotta; Jönsson, Anna K; Zilg, Brita; Östgren, Carl Johan; Druid, Henrik

2016-01-01

The aim of this study was to identify risk factors associated with confirmed fatal hyperglycaemia, which could predispose potentially preventable deaths in individuals on glucose lowering drugs. A retrospective register-based case-control study conducted on a nationwide cohort with individuals who died due to hyperglycaemia as determined by forensic postmortem examination, in Sweden August 2006 to December 2012. Vitreous glucose was used to diagnose hyperglycaemia postmortem. The forensic findings stored in the National Forensic Medicine Database were linked to nationwide registers. Cases that died due to confirmed hyperglycemia with dispensed glucose lowering drugs were identified and living controls with dispensed glucose lowering drugs were randomly selected in the Swedish prescribed drug register and matched on age and sex. Information on comorbidities, dispensed pharmaceuticals, clinical data and socioeconomic factors were obtained for cases and controls. Adjusted multiple logistic regression models were used to identify risk factors associated with fatal hyperglycaemia. During the study period 322 individuals, mostly males (79%) with the mean age of 53.9 years (SD.± 14) died due to confirmed hyperglycaemia. Risk factors for fatal hyperglycaemia included; insulin treatment (OR = 4.40; 95%CI,1.96, 9.85), poor glycaemic control (OR = 2.00 95%CI,1.23, 3.27), inadequate refill-adherence before death (OR = 3.87; 95%CI,1.99, 7.53), microvascular disease (OR = 3.26; 95% CI, 1.84, 5.79), psychiatric illness (OR = 2.30; 95% CI,1.32, 4.01), substance abuse (OR = 8.85; 95%CI,2.34, 35.0) and/or living alone (OR = 2.25; 95%CI,1.21, 4.18). Our results demonstrate the importance of clinical attention to poor glycaemic control in subjects with psychosocial problems since it may indicate serious non-adherence, which consequently could lead to fatal hyperglycaemia.

Is individual educational level related to end-of-life care use? Results from a nationwide retrospective cohort study in Belgium.

PubMed

Bossuyt, Nathalie; Van den Block, Lieve; Cohen, Joachim; Meeussen, Koen; Bilsen, Johan; Echteld, Michael; Deliens, Luc; Van Casteren, Viviane

2011-10-01

Educational level has repeatedly been identified as an important determinant of access to health care, but little is known about its influence on end-of-life care use. To examine the relationship between individual educational attainment and end-of-life care use and to assess the importance of individual educational attainment in explaining differential end-of-life care use. A retrospective cohort study via a nationwide sentinel network of general practitioners (GPs; SENTI-MELC Study) provided data on end-of-life care utilization. Multilevel analysis was used to model the association between educational level and health care use, adjusting for individual and contextual confounders based upon Andersen's behavioral model of health services use. A Belgian nationwide representative sample of people who died not suddenly in 2005-2007. In comparison to their less educated counterparts, higher educated people equally often had a palliative treatment goal but more often used multidisciplinary palliative care services (odds ratios [OR] for lower secondary education 1.28 [1.04-1.59] and for higher [secondary] education: 1.31 [1.02-1.68]), moved between care settings more frequently (OR: 1.68 [1.13-2.48] for lower secondary education and 1.51 [0.93-2.48] for higher [secondary] education) and had more contacts with the GP in the final 3 months of life. Less well-educated people appear to be disadvantaged in terms of access to specialist palliative care services, and GP contacts at the end of life, suggesting a need for empowerment of less well-educated terminally ill people regarding specialist palliative and general end-of-life care use.

Time trends in lifetime incidence rates of first-time diagnosed anorexia nervosa and bulimia nervosa across 16 years in a Danish nationwide psychiatric registry study.

PubMed

Steinhausen, Hans-Christoph; Jensen, Christina Mohr

2015-11-01

To study recent time trends in the incidence of diagnosed anorexia nervosa (AN) and bulimia nervosa (BN) based on nationwide psychiatric register data. The Danish Psychiatric Central Research Registry was used to identify the incidence of diagnosed cases with AN and BN at the ages of 4-65 years from 1995 to 2010. Age- and sex-adjusted incidence rates per 100,000 person-years were calculated and were adjusted for time trends in the total number of people diagnosed in psychiatry. Time trends were analyzed using JoinPoint regression analysis. A total of N = 5,902 persons had a first-time incidence of AN, and a total of N = 5,113 had first-time incidence of BN. Incidence rates increased for AN from 6.4 to 12.6 per 100,000 person-years, and for BN from 6.3 to 7.2 per 100,000 person-years. In 2010, the male-to-female ratio was 1:8 for AN, and 1:20 for BN. There was an earlier onset for AN than for BN, and age at incidence decreased during the observation period for AN but not for BN. A sizeable part of the increasing incidence rates for AN and in particular, the younger AN age groups, could be attributed to an increase in the total number of N = 249,607 persons with first-time diagnoses in psychiatry. Incidence rates had increased slightly for AN, but were stable for BN across 16 years in this nationwide study and to a large extent were reflective of a general increase in diagnosed mental disorders. © 2015 Wiley Periodicals, Inc.

Proton pump inhibitor use and risk of adverse cardiovascular events in aspirin treated patients with first time myocardial infarction: nationwide propensity score matched study

PubMed Central

Grove, Erik L; Hansen, Peter Riis; Olesen, Jonas B; Ahlehoff, Ole; Selmer, Christian; Lindhardsen, Jesper; Madsen, Jan Kyst; Køber, Lars; Torp-Pedersen, Christian; Gislason, Gunnar H

2011-01-01

Objective To examine the effect of proton pump inhibitors on adverse cardiovascular events in aspirin treated patients with first time myocardial infarction. Design Retrospective nationwide propensity score matched study based on administrative data. Setting All hospitals in Denmark. Participants All aspirin treated patients surviving 30 days after a first myocardial infarction from 1997 to 2006, with follow-up for one year. Patients treated with clopidogrel were excluded. Main outcome measures The risk of the combined end point of cardiovascular death, myocardial infarction, or stroke associated with use of proton pump inhibitors was analysed using Kaplan-Meier analysis, Cox proportional hazard models, and propensity score matched Cox proportional hazard models. Results 3366 of 19 925 (16.9%) aspirin treated patients experienced recurrent myocardial infarction, stroke, or cardiovascular death. The hazard ratio for the combined end point in patients receiving proton pump inhibitors based on the time dependent Cox proportional hazard model was 1.46 (1.33 to 1.61; P<0.001) and for the propensity score matched model based on 8318 patients it was 1.61 (1.45 to 1.79; P<0.001). A sensitivity analysis showed no increase in risk related to use of H2 receptor blockers (1.04, 0.79 to 1.38; P=0.78). Conclusion In aspirin treated patients with first time myocardial infarction, treatment with proton pump inhibitors was associated with an increased risk of adverse cardiovascular events. PMID:21562004

Is It the Music or Is It Selection Bias? A Nationwide Analysis of Music and Non-Music Students' SAT Scores

ERIC Educational Resources Information Center

Elpus, Kenneth

2013-01-01

This study examined the college entrance examination scores of music and non-music students in the United States, drawing data from the restricted-use data set of the Education Longitudinal Study of 2002 (ELS), a nationally representative education study ("N" = 15,630) conducted by the National Center for Education Statistics. Analyses…

Heritage Language Maintenance and Education in the Greek Sociolinguistic Context: Albanian Immigrant Parents' Views

ERIC Educational Resources Information Center

Gkaintartzi, Anastasia; Kiliari, Angeliki; Tsokalidou, Roula

2016-01-01

This paper presents data from two studies--a nationwide quantitative research and an ethnographic study--on immigrant parents' perspectives about heritage language maintenance and education in Greek state schools. The quantitative data come from a large-scale questionnaire survey, which aimed at the investigation of the needs and requirements for…

Food Intakes: Individuals in 48 States, Year 1977-78. Nationwide Food Consumption Survey 1977-78. Report No. I-1.

ERIC Educational Resources Information Center

Human Nutrition Information Service (USDA), Hyattsville, MD.

This report presents 3-day food intake data for about 36,l00 individuals in the 48 conterminous States. The information was collected from April 1977 through March 1978 in the Nationwide Food Consumption Survey conducted by the U.S. Department of Agriculture. Data on food intakes and characteristics of the sample are presented in 510 tables.…

Field methods in medical record abstraction: assessing the properties of comparative effectiveness estimates.

PubMed

Cook, Elizabeth A; Schneider, Kathleen M; Robinson, Jennifer; Wilwert, June; Chrischilles, Elizabeth; Pendergast, Jane; Brooks, John

2014-09-15

Comparative effectiveness studies using Medicare claims data are vulnerable to treatment selection biases and supplemental data from a sample of patients has been recommended for examining the magnitude of this bias. Previous research using nationwide Medicare claims data has typically relied on the Medicare Current Beneficiary Survey (MCBS) for supplemental data. Because many important clinical variables for our specific research question are not available in the MCBS, we collected medical record data from a subsample of patients to assess the validity of assumptions and to aid in the interpretation of our estimates. This paper seeks to describe and document the process used to collect and validate this supplemental information. Medicare claims data files for all patients with fee-for-service Medicare benefits who had an acute myocardial infarction (AMI) in 2007 or 2008 were obtained. Medical records were obtained and abstracted for a stratified subsample of 1,601 of these patients, using strata defined by claims-based measures of physician prescribing practices and drug treatment combinations. The abstraction tool was developed collaboratively by study clinicians and researchers, leveraging important elements from previously validated tools. Records for 2,707 AMI patients were requested from the admitting hospitals and 1,751 were received for an overall response rate of 65%; 1,601 cases were abstracted by trained personnel at a contracted firm. Data were collected with overall 96% inter-abstractor agreement across all variables. Some non-response bias was detected at the patient and facility level. Although Medicare claims data are a potentially powerful resource for conducting comparative effectiveness analyses, observational databases are vulnerable to treatment selection biases. This study demonstrates that it is feasible to abstract medical records for Medicare patients nationwide and collect high quality data, to design the sampling purposively to address specific research questions, and to more thoroughly evaluate the appropriateness of care delivered to AMI patients.

The Deaf Acculturation Scale (DAS): Development and Validation of a 58-Item Measure

PubMed Central

Maxwell-McCaw, Deborah; Zea, Maria Cecilia

2011-01-01

This study involved the development and validation of the Deaf Acculturation Scale (DAS), a new measure of cultural identity for Deaf and hard-of-hearing (hh) populations. Data for this study were collected online and involved a nation-wide sample of 3,070 deaf/hh individuals. Results indicated strong internal reliabilities for all the subscales, and construct validity was established by demonstrating that the DAS could discriminate groups based on parental hearing status, school background, and use of self-labels. Construct validity was further demonstrated through factorial analyses, and findings resulted in a final 58-item measure. Directions for future research are discussed. PMID:21263041

Near hybrid passenger vehicle development program, phase 1. Appendices A and B. Mission analysis and performance specification studies report, volume 1

NASA Technical Reports Server (NTRS)

1979-01-01

The three most promising vehicle use patterns (missions) for the near term electric hybrid vehicle were found to be all-purpose city driving, commuting, and family and civic business. The mission selection process was based principally on an analysis of the travel patterns found in the Nationwide Transportation Survey and on the Los Angeles and Washington, D.C. origin-destination studies data. Travel patterns in turn were converted to fuel requirements for 1985 conventional and hybrid cars. By this means, the potential fuel savings for each mission were estimated, and preliminary design requirements for hybrid vehicles were derived.

77 FR 77015 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-31

... operation of a nationwide PSBN, based on a single, national network architecture. The Act also charges NTIA... infrastructure, equipment, and other architecture associated with the nationwide PSBN to satisfy the wireless...: Business or other for-profit organizations. Frequency: Annually and quarterly. Respondent's Obligation: OMB...

Doctor Shopping Behavior for Zolpidem Among Insomnia Patients in Taiwan: A Nationwide Population-Based Study

PubMed Central

Lu, Tzu-Hsuan; Lee, Yen-Ying; Lee, Hsin-Chien; Lin, You-Meei

2015-01-01

Objectives: Although zolpidem is listed as a controlled drug in Taiwan, patients' behavior has not been restricted and has led to the problem of doctor shopping behavior (DSB), leading to overutilization of medical resources and excess spending. The National Health Insurance Administration in Taiwan has instituted a new policy to regulate physicians' prescribing behavior and decrease DSB. This retrospective study aimed to analyze the DSB for zolpidem by insomnia patients and assess related factors. Design and Participants: Data were extracted from the Longitudinal Health Insurance Database in Taiwan. Individuals with a diagnosis of insomnia who received more than one prescription of zolpidem in 2008 were followed for 24 mo. Doctor shopping was defined as ≥ 2 prescriptions by different doctors within ≥ 1 day overlapping in the duration of therapy. The percentage of zolpidem obtained through doctor shopping was used as an indicator of the DSB of each patient. Results: Among the 6,947 insomnia patients who were prescribed zolpidem, 1,652 exhibited DSB (23.78%). The average dose of zolpidem dispensed for each patient during 24 mo was 244.21 daily defined doses. The doctor shopping indicator (DSI) was 0.20 (standard deviation, 0.23) among patients with DSB. Younger age, chronic diseases, high number of diseases, higher premium status, high socioeconomic status, and fewer people served per practicing physicians were all factors significantly related to doctor shopping behavior. Conclusion: Doctor shopping for zolpidem appears to be an important issue in Taiwan. Implementing a proper referral system with efficient data exchange by physician or pharmacist-led medication reconciliation process might reduce DSB. Citation: Lu TH, Lee YY, Lee HC, Lin YM. Doctor shopping behavior for zolpidem among insomnia patients in Taiwan: a nationwide population-based study. SLEEP 2015;38(7):1039–1044. PMID:25761979

Use of Proton Pump Inhibitors and the Risk of Listeriosis: A Nationwide Registry-based Case-Control Study.

PubMed

Kvistholm Jensen, Anne; Simonsen, Jacob; Ethelberg, Steen

2017-04-01

Recent studies suggest that proton pump inhibitors (PPIs) may increase the risk for listeriosis. We investigated a potential association in cases of nonpregnancy-associated listeriosis using registry data. We conducted a population-based, case-control study using Danish health registries. Cases (n = 721) were defined as patients aged ≥45 years notified with listeriosis from July 1994 to December 2012. We selected 34800 controls using risk-set sampling. Controls were individually matched for age, sex, and municipality. Data on use of PPIs and other drugs and hospitalization diagnoses over a 5-year period were extracted from nationwide health registries. A comorbidity index (CMI) was constructed. We calculated the association between use of PPIs and related drugs within 30 days (current use) and other time windows before the index date. Using conditional logistic regression, matched odds ratios (ORs) adjusted for CMI and confounders were estimated. The adjusted OR for current use of PPIs and development of listeriosis was 2.81 (95% confidence interval [CI], 2.14-3.69). PPI usage up to 90 days before the index date remained statistically significant. Subgroup analyses revealed increasing ORs with decreasing age and level of comorbidity and an increased OR for concurrent glucocorticoid treatment (OR, 4.61; 95% CI, 3.01-7.06). No significant association was found for current use of histamine-2-receptor antagonists (adjusted OR, 1.82; 95% CI, 0.89-3.71). Prescribed PPIs were associated with increased risk of listeriosis. The risk waned with time since last prescription redemption. PPIs may have unwanted side effects in vulnerable populations. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Comparisons of musculoskeletal disorders among ten different medical professions in Taiwan: a nationwide, population-based study.

PubMed

Wang, Shu Yi; Liu, Liang Chun; Lu, Ming Chi; Koo, Malcolm

2015-01-01

Medical personnel are at risk of musculoskeletal disorders but little is known whether the risk of musculoskeletal disorders were different among various medical professions. Therefore, this study compared the risk of musculoskeletal disorders among personnel of 10 different medical professions in Taiwan using a nationwide health claims database. Data from the 2000-2010 Taiwan National Health Insurance Research Database were used to identify personnel of 10 different medical professions. Diagnoses based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) were used to identify eight different musculoskeletal disorders that occurred after the license issuance date. Cox proportional hazards model was used to compare the risk of eight musculoskeletal disorders among the 10 different medical professions using dentists as the reference category. A total of 7,820 medical personnel were included in the analysis. Using dentists as the reference category, physical therapists showed a significantly higher risk of all eight musculoskeletal disorders (ranging from 1.59 [p = 0.032] in sprains and strains of other and unspecified parts of back to 2.93 [p < 0.001] in spondylosis and allied disorders). Compared with dentists, a profession that already known to suffer from high rates of work-related musculoskeletal disorders, physical therapists, registered nurses, and doctors of Chinese medicine showed an even higher risk of musculoskeletal disorders.

Quality of life, use of topical medications and socio-economic data in hand eczema: a Swedish nationwide survey.

PubMed

Bingefors, Kerstin; Lindberg, Magnus; Isacson, Dag

2011-06-01

Hand eczema is common and has an adverse impact on the lives of patients. There is a need for population-based surveys on the pharmacoepidemiological aspects, quality of life and impact of socioeconomic factors in hand eczema. The aim of this cross-sectional study was to investigate these factors. A questionnaire-based nationwide survey of health was performed, including questions on hand eczema, use of pharmaceuticals and socioeconomic factors. Quality of life was estimated with the generic instrument Short Form 36 (SF-36). The questionnaire was sent to 7,985 persons (age range 18-84 years), response rate 61.1% (n = 4,875). The 1-year prevalence of hand eczema in the study population was 7.5%. In this group, quality of life was lower. All dimensions of SF-36 were affected, most markedly general health and those dimensions reporting on mental health. In the group with self-reported hand eczema, 51% reported using topical pharmaceuticals. Hand eczema was more common among women (9.1%, n = 2,630) than among men (5.6%, n = 2,245) and in the age group below 65 years (8.5%, n = 3,274) compared with those aged 65 years and over (4.3%, n = 1,151). This survey clearly demonstrates the impact of hand eczema on several dimensions of life and also highlights age, gender and socioeconomic differences.

18 CFR Appendix C to Part 2 - Nationwide Proceeding Computation of Federal Income Tax Allowance Independent Producers, Pipeline...

Code of Federal Regulations, 2011 CFR

2011-04-01

... Continental U.S.-1972 Data (Docket No. R-478) C Appendix C to Part 2 Conservation of Power and Water Resources... INTERPRETATIONS Pt. 2, App. C Appendix C to Part 2—Nationwide Proceeding Computation of Federal Income Tax...

18 CFR Appendix C to Part 2 - Nationwide Proceeding Computation of Federal Income Tax Allowance Independent Producers, Pipeline...

Code of Federal Regulations, 2010 CFR

2010-04-01

... Continental U.S.-1972 Data (Docket No. R-478) C Appendix C to Part 2 Conservation of Power and Water Resources... INTERPRETATIONS Pt. 2, App. C Appendix C to Part 2—Nationwide Proceeding Computation of Federal Income Tax...

The Proposal of the Model for Developing Dispatch System for Nationwide One-Day Integrative Planning

NASA Astrophysics Data System (ADS)

Kim, Hyun Soo; Choi, Hyung Rim; Park, Byung Kwon; Jung, Jae Un; Lee, Jin Wook

The problems of dispatch planning for container truck are classified as the pickup and delivery problems, which are highly complex issues that consider various constraints in the real world. However, in case of the current situation, it is developed by the control system so that it requires the automated planning system under the view of nationwide integrative planning. Therefore, the purpose of this study is to suggest model to develop the automated dispatch system through the constraint satisfaction problem and meta-heuristic technique-based algorithm. In the further study, the practical system is developed and evaluation is performed in aspect of various results. This study suggests model to undergo the study which promoted the complexity of the problems by considering the various constraints which were not considered in the early study. However, it is suggested that it is necessary to add the study which includes the real-time monitoring function for vehicles and cargos based on the information technology.

Quantifying fat, oil, and grease deposit formation kinetics

USDA-ARS?s Scientific Manuscript database

Fat, oil, and grease (FOG) deposits formed in sanitary sewers are calcium-based saponified solids that are responsible for a significant number of nationwide sanitary sewer overflows (SSOs) across United States. In the current study, the kinetics of lab-based saponified solids were determined to un...

Decrease in seroprevalence of hepatitis A after the implementation of nationwide disposable tableware use in Taiwan.

PubMed

Su, Shih-Bin; Lin, Ching-Yih; Sheu, Ming-Jen; Kan, Wei-Chih; Wang, Hsien-Yi; Guo, How-Ran

2010-11-23

Taiwan is an endemic area of viral hepatitis, including hepatitis A, which is transmitted mainly from the fecal-oral route. In order to reduce the transmission through food intake, the government implemented a policy of nationwide disposal tableware use in public eating places in 1982. We conducted a study to estimate the seroprevalence of Hepatitis A in a group of workers in Taiwan in 2005, determine the risk factors, and compare seroprevalence to published estimates in Taiwan to evaluate changes in the seroprevalence after the implementation of the nationwide disposal tableware use. We recruited workers of an industrial park during their annual health examinations in 2005 and measured their anti-hepatitis A virus IgG titer using microparticle enzyme immunoassay. We compared the seroprevalence across different birth cohorts within the study population and also analyzed data from previous studies. The overall sero-positive rate was 22.0% in the 11,777 participants. The rate was much lower among those who were covered by the program since birth (born after 1982) in comparison with those who were not (2.7% vs. 25.3%, p < 0.001). From the analyses of data from previous studies, we found the age-specific rates were similar in cohorts born in or after 1982 across studies conducted in different time periods but decreased with the calendar year in cohorts born before 1982. In particular, the age-specific seroprevalence dropped to less than one third in a three-year period among those who were born around 1982. Data from both the current and previous studies in different time periods supported the effectiveness of disposal tableware in preventing the transmission of hepatitis A.

Decrease in seroprevalence of Hepatitis A after the implementation of nationwide disposable tableware use in Taiwan

PubMed Central

2010-01-01

Background Taiwan is an endemic area of viral hepatitis, including hepatitis A, which is transmitted mainly from the fecal-oral route. In order to reduce the transmission through food intake, the government implemented a policy of nationwide disposal tableware use in public eating places in 1982. We conducted a study to estimate the seroprevalence of Hepatitis A in a group of workers in Taiwan in 2005, determine the risk factors, and compare seroprevalence to published estimates in Taiwan to evaluate changes in the seroprevalence after the implementation of the nationwide disposal tableware use. Methods We recruited workers of an industrial park during their annual health examinations in 2005 and measured their anti-hepatitis A virus IgG titer using microparticle enzyme immunoassay. We compared the seroprevalence across different birth cohorts within the study population and also analyzed data from previous studies. Results The overall sero-positive rate was 22.0% in the 11,777 participants. The rate was much lower among those who were covered by the program since birth (born after 1982) in comparison with those who were not (2.7% vs. 25.3%, p < 0.001). From the analyses of data from pervious studies, we found the age-specific rates were similar in cohorts born in or after 1982 across studies conducted in different time periods but decreased with the calendar year in cohorts born before 1982. In particular, the age-specific seroprevalence dropped to less than one third in a three-year period among those who were born around 1982. Conclusions Data from both the current and previous studies in different time periods supported the effectiveness of disposal tableware in preventing the transmission of hepatitis A. PMID:21092247

Status and Future Perspectives of Utilizing Big Data in Neurosurgical and Stroke Research

PubMed Central

NISHIMURA, Ataru; NISHIMURA, Kunihiro; KADA, Akiko; IIHARA, Koji

2016-01-01

The management, analysis, and integration of Big Data have received increasing attention in healthcare research as well as in medical bioinformatics. The J-ASPECT study is the first nationwide survey in Japan on the real-world setting of stroke care using data obtained from the diagnosis procedure combination-based payment system. The J-ASPECT study demonstrated a significant association between comprehensive stroke care (CSC) capacity and the hospital volume of stroke interventions in Japan; further, it showed that CSC capabilities were associated with reduced in-hospital mortality rates. Our study aims to create new evidence and insight from ‘real world’ neurosurgical practice and stroke care in Japan using Big Data. The final aim of this study is to develop effective methods to bridge the evidence-practice gap in acute stroke healthcare. In this study, the authors describe the status and future perspectives of the development of a new method of stroke registry as a powerful tool for acute stroke care research. PMID:27680330

The effect of the introduction of a nationwide DUR system where local DUR systems are operating--The Korean experience.

PubMed

Yang, Ju-Hyun; Kim, Mira; Park, Young-Taek; Lee, Eui-Kyung; Jung, Chai Young; Kim, Sukil

2015-11-01

Outpatient clinics in Korea usually have local DUR (drug utilisation review) systems, which are integrated with EMRs or health insurance claims submission systems. Whenever, the government announces a list of drug contraindications, each local DUR system loads the list and applies it in practice. In December 2010, a nationwide DUR system was introduced. This study is to investigate the impact of the nationwide DUR system on prescribing practices where local DUR systems are already operating. Between January 2009 and December 2012 the monthly number of drugs per prescription was retrieved from the health insurance claims data warehouse at the Health Insurance Review and Assessment (HIRA). The monthly proportions of 3 DDI (drug-drug interaction) pairs, 6 drug-age contraindications, and 3 drug-pregnancy contraindications from January 2007 to December 2012, at the outpatient clinic level, were also retrieved. An interrupted time series analysis was used for controlling government announcements of drug contraindications. There was no difference in the number of drugs per prescription before and after the introduction of the nationwide DUR system. Most proportions of the 3 DDI pairs, 6 drug-age contraindications, and 3 drug-pregnancy contraindications, were significantly reduced following the government announcement of drug contraindications in the short term and/or long term. The number of drugs per prescription was not related to the nationwide DUR introduction in places where local DUR systems are operating. The introduction of duplicate guidelines, in locations where the guidelines were already well followed, is considered to be the main reason for this. Furthermore, the Doctor's ignorance of alerts, and their continued substitution of regulated drugs, for non-regulated drugs, likely played a role in nullifying the effectiveness of the nationwide DUR system. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Information for decision making from imperfect national data: tracking major changes in health care use in Kenya using geostatistics.

PubMed

Gething, Peter W; Noor, Abdisalan M; Goodman, Catherine A; Gikandi, Priscilla W; Hay, Simon I; Sharif, Shahnaaz K; Atkinson, Peter M; Snow, Robert W

2007-12-11

Most Ministries of Health across Africa invest substantial resources in some form of health management information system (HMIS) to coordinate the routine acquisition and compilation of monthly treatment and attendance records from health facilities nationwide. Despite the expense of these systems, poor data coverage means they are rarely, if ever, used to generate reliable evidence for decision makers. One critical weakness across Africa is the current lack of capacity to effectively monitor patterns of service use through time so that the impacts of changes in policy or service delivery can be evaluated. Here, we present a new approach that, for the first time, allows national changes in health service use during a time of major health policy change to be tracked reliably using imperfect data from a national HMIS. Monthly attendance records were obtained from the Kenyan HMIS for 1 271 government-run and 402 faith-based outpatient facilities nationwide between 1996 and 2004. A space-time geostatistical model was used to compensate for the large proportion of missing records caused by non-reporting health facilities, allowing robust estimation of monthly and annual use of services by outpatients during this period. We were able to reconstruct robust time series of mean levels of outpatient utilisation of health facilities at the national level and for all six major provinces in Kenya. These plots revealed reliably for the first time a period of steady nationwide decline in the use of health facilities in Kenya between 1996 and 2002, followed by a dramatic increase from 2003. This pattern was consistent across different causes of attendance and was observed independently in each province. The methodological approach presented can compensate for missing records in health information systems to provide robust estimates of national patterns of outpatient service use. This represents the first such use of HMIS data and contributes to the resurrection of these hugely expensive but underused systems as national monitoring tools. Applying this approach to Kenya has yielded output with immediate potential to enhance the capacity of decision makers in monitoring nationwide patterns of service use and assessing the impact of changes in health policy and service delivery.

Paid expenditures and productivity costs associated with permanent disability pensions in patients with spinal disorders: Nationwide Finnish Register-based Study, 1990-2010.

PubMed

Asklöf, Tom; Martikainen, Janne; Kautiainen, Hannu; Haanpää, Maija; Kiviranta, Ilkka; Pohjolainen, Timo

2016-01-01

The objective of this study is to present the paid expenditures and productivity costs of disability pensions (DP) due to spinal disorders (SD) in Finland during 1990-2010. This study is a register-based national study. All new cases aged 20-64 that were granted a DP due to SD were identified from the nationwide register maintained by the Finnish Centre of Pensions. The data included sex, age group, year of the DP decision, main cause of incapacity (diagnosis) leading to permanent DP and yearly paid expenditures for DPs. Annual productivity costs were estimated based on labour force participation rate and the employment rate adjusted gross domestic product. A total of 39,107 individuals (18,072 females, 21,035 males) received DPs during the study period. SDs generated 9,372 million euros extra cost during this period due to DP (females 3.5 billion, males 5.9 billion). The total DP expenditures paid increased during the first half of 1990s but decreased during the second half of 1990s (-44.8 %). For degenerative SD cases, the DP expenditure was 5.1 billion €, disc disease 3.5 billion € and for other SDs 0.7 billion €. Males, compared to females, were expected to have a rate 1.22 times greater costs due to DPs. The estimated total annual productivity costs due to SDs have been over six times higher than expenditures paid for DPs per year. The costs of DPs are different compared to occurrence rates due to salary and early retirement age differences between genders. Despite a significant decrease in DP-associated expenditures due to SDs after 1993, the annual expenditures have stayed on a high level in Finland.

Forest-Based Biomass Supply Curves for the United States

Treesearch

Kenneth Skog; Jamie Barbour; Marilyn Buford; Dennis Drykstra; Patti Lebow; Pat Miles; Bob Perlack; Bryce Stokes

2013-01-01

Nationwide, county-level supply curves have been estimated for forest-based biomass to evaluate their potential contributions to producing biofuels. This study builds on the estimates of potential supply in the Billion Ton Supply study prepared by the U.S. Department of Agriculture and the U.S. Department of Energy. Forest biomass sources include logging...

Development of a Mixed Methods Investigation of Process and Outcomes of Community-Based Participatory Research

ERIC Educational Resources Information Center

Lucero, Julie; Wallerstein, Nina; Duran, Bonnie; Alegria, Margarita; Greene-Moton, Ella; Israel, Barbara; Kastelic, Sarah; Magarati, Maya; Oetzel, John; Pearson, Cynthia; Schulz, Amy; Villegas, Malia; White Hat, Emily R.

2018-01-01

This article describes a mixed methods study of community-based participatory research (CBPR) partnership practices and the links between these practices and changes in health status and disparities outcomes. Directed by a CBPR conceptual model and grounded in indigenous-transformative theory, our nation-wide, cross-site study showcases the value…

College Student Attitudes Towards "Smart" Guns: Results from a Nationwide Survey.

PubMed

Wallace, Lacey N; Dunn, Kaylin C

2018-02-01

Existing studies focusing on "smart" guns, weapons that can only be fired by an authorized user, have focused largely on overall views towards the topic. Little is known about how views differ within key demographics or why Americans feel positively or negatively towards smart guns. This study used data from a nationwide web survey of 520 college students to address these concerns. Multinomial regression was used to identify patterns of smart gun preference in quantitative data. Respondents' open-ended reasoning for their views was examined through common themes and descriptive statistics. About half of the sample preferred smart guns over traditional firearms, with support more likely among females and liberals. Those with more advanced academic standing were more likely to have a traditional gun preference. The sample did not rank cost as a significant concern. Child protection was a much less prominent theme than concerns over (un)authorized users.

Effects of a german asthma disease management program using sickness fund claims data.

PubMed

Windt, Roland; Glaeske, Gerd

2010-08-01

The purpose of this study was to assess outcomes of a nationwide asthma disease management (DM) program in Germany. A retrospective observational study with propensity-score matching was performed using claims data of sickness funds exclusively. Effects were analyzed on the basis of a match of 317 program participants and nonparticipants with similar propensity score and age. Hospitalization or oral corticosteroid user rates were comparable in both groups, whereas there are significantly more subjects in the DM group with a prescription of an inhaled corticosteroid and fewer with a prescription of a cromolyn/reproterol combination. There are also less "doctor hoppers" in the DM group, defined as subjects with antiasthmatic drug prescriptions of at least three physicians. The results suggest that the impact of a nationwide disease management program for asthma is weak in respect of clinically relevant endpoints, but there are indications that medication in a DM program approximates asthma guidelines more closely.

A national study of the streamflow data-collection program

USGS Publications Warehouse

Benson, Manuel A.; Carter, Rolland William

1973-01-01

The streamflow data program of the U.S. Geological Survey was evaluated in a nationwide study during 1970. The principal elements of the study were (1) establishing the objectives and goals of the program, (2) analyzing all available data to determine which of the goals have already been met, (3) considering alternate means of meeting the remaining goals, and (4) identifying the elements which should be included in the future program.

Surveillance of antimicrobial resistance in Lebanese hospitals: retrospective nationwide compiled data.

PubMed

Chamoun, Kamal; Farah, Maya; Araj, Georges; Daoud, Ziad; Moghnieh, Rima; Salameh, Pascale; Saade, Danielle; Mokhbat, Jacques; Abboud, Emme; Hamze, Monzer; Abboud, Edmond; Jisr, Tamima; Haddad, Antoine; Feghali, Rita; Azar, Nadim; El-Zaatari, Mohammad; Chedid, Marwan; Haddad, Christian; Zouain Dib Nehme, Mireille; Barakat, Angelique; Husni, Rola

2016-05-01

Antimicrobial resistance is closely linked to antimicrobial use and is a growing concern worldwide. Antimicrobial resistance increases healthcare costs substantially in many countries, including Lebanon. National data from Lebanon have, in the most part, been limited to a few academic hospitals. The Lebanese Society of Infectious Diseases conducted a retrospective study to better describe the antimicrobial susceptibility patterns of bacterial isolates in Lebanon. Data were based on records retrieved from the bacteriology laboratories of 16 different Lebanese hospitals between January 2011 and December 2013. The susceptibility results of a total 20684 Gram-positive and 55594 Gram-negative bacteria were analyzed. The prevalence rate of methicillin-resistant Staphylococcus aureus was 27.6% and of vancomycin-resistant Enterococcus spp was 1%. Streptococcus pneumoniae had susceptibilities of 46% to oxacillin, 63% to erythromycin, and 98% to levofloxacin. Streptococcus pyogenes had susceptibilities of 94% to erythromycin and 95% to clindamycin. The mean ampicillin susceptibility of Haemophilus influenzae, Salmonella spp, and Shigella spp isolates was 79%, 81.3%, and 62.2%, respectively. The extended-spectrum beta-lactamase production rate for Escherichia coli was 32.3% and for Klebsiella spp was 29.2%. Acinetobacter spp showed high resistance to most antimicrobials, with low resistance to colistin (17.1%). Pseudomonas spp susceptibilities to piperacillin-tazobactam and imipenem were lower than 80% (79.7% and 72.8%, respectively). This study provides population-specific data that are valuable in guiding antimicrobial use in Lebanon and neighbouring countries and will help in the establishment of a surveillance system for antimicrobial resistance following the implementation of a nationwide standardization of laboratory methods and data entry. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Comparison of outcomes after use of biphasic or monophasic defibrillators among out-of-hospital cardiac arrest patients: a nationwide population-based observational study.

PubMed

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

2012-09-01

The use and popularity of the biphasic waveform defibrillator as a replacement for the monophasic waveform defibrillator are increasing, but it is unclear whether this can improve the rate of survival among out-of-hospital cardiac arrest patients. This study aimed to verify the hypothesis that the outcome of out-of-hospital cardiac arrest patients who received defibrillation shock with the biphasic waveform defibrillator was better than that of patients who received defibrillation shock with the monophasic defibrillator. This prospective, nationwide, population-based, observational study included 21 172 out-of-hospital cardiac arrest patients with initial ventricular fibrillation or pulseless ventricular tachycardia from January 1, 2005, through December 31, 2007. Defibrillation shock was performed by monophasic defibrillator on 8224 (39%) patients and by biphasic defibrillator on 12 948 (61%) patients. The rate of survival at 1 month with minimal neurological impairment was 11.6% (951/8192) in the monophasic defibrillator group and 12.8% (1653/12 928) in the biphasic defibrillator group. Hierarchical logistic regression analysis using a generalized estimation equation showed no significant difference between the biphasic and monophasic groups in 1-month survival with minimal neurological impairment (adjusted odds ratio, 1.07; 95% confidence interval, 0.91-1.26; P=0.42). Confirmatory propensity score analyses showed similar results. Although monophasic defibrillators are being replaced by biphasic defibrillators, our nationwide population-based observational study failed to demonstrate a statistically significant association between defibrillation waveform and 1-month survival rate with minimal neurological impairment.

Community Policing: A Preliminary Assessment of Environmental Impact with Panel Data on Program Implementation in U.S. Cities

ERIC Educational Resources Information Center

He, Ni; Zhao, Jihong; Lovrich, Nicholas P.

2005-01-01

This article examines the environmental impact on the programmatic implementation of community-oriented policing (COP) in large municipal police agencies during the 1990s. Three waves of nationwide surveys (1993, 1996, and 2000) based on a random sample of 281 municipalities and the corresponding police agencies were used for our analysis. Based…

Youth Risk Behavior Surveillance--United States, 2013. Morbidity and Mortality Weekly Report (MMWR). Surveillance Summaries. Volume 63, Number SS-4

ERIC Educational Resources Information Center

Kann, Laura; Kinchen, Steve; Shanklin, Shari L.; Flint, Katherine H.; Hawkins, Joseph; Harris, William A.; Lowry, Richard; Olsen, Emily O'Malley; McManus, Tim; Chyen, David; Whittle, Lisa; Taylor, Eboni; Demissie, Zewditu; Brener, Nancy; Thornton, Jemekia; Moore, John; Zaza, Stephanie

2014-01-01

Problem: Priority health-risk behaviors contribute to the leading causes of morbidity and mortality among youth and adults. Population-based data on these behaviors at the national, state, and local levels can help monitor the effectiveness of public health interventions designed to protect and promote the health of youth nationwide. Reporting…

Youth Risk Behavior Surveillance--United States, 2015. Morbidity and Mortality Weekly Report. Surveillance Summaries. Volume 65, Number 6

ERIC Educational Resources Information Center

Kann, Laura; McManus, Tim; Harris, William A.; Shanklin, Shari L.; Flint, Katherine H.; Hawkins, Joseph; Queen, Barbara; Lowry, Richard; Olsen, Emily O'Malley; Chyen, David; Whittle, Lisa; Thornton, Jemekia; Lim, Connie; Yamakawa, Yoshimi; Brener, Nancy; Zaza, Stephanie

2016-01-01

Problem: Priority health-risk behaviors contribute to the leading causes of morbidity and mortality among youth and adults. Population-based data on these behaviors at the national, state, and local levels can help monitor the effectiveness of public health interventions designed to protect and promote the health of youth nationwide. Reporting…

Economic Conditions May Contribute to Increased Violence toward Children: A Nationwide Population-Based Analysis of Pediatric Injuries in Taiwanese Emergency Departments.

PubMed

Liu, Yueh-Ping; Hsu, Ren-Jun; Wu, Mei-Hwan; Peng, Chun-Chih; Chang, Shu-Ting; Lei, Wei-Te; Yeh, Tzu-Lin; Liu, Jui-Ming; Lin, Chien-Yu

2018-01-23

Childhood injuries are unfortunately common. Analysis procedures may assist professionals who work with children with developing preventive measures for protecting children's wellness. This study explores the causes of pediatric injuries presenting to an emergency department in Taiwan. This nationwide, population-based study was conducted using data from the National Health Insurance Research Database of Taiwan (NHIRD). Patients aged <18 years were identified from approximately one million individuals listed in the NHIRD. We followed up with these patients for nine years and analyzed the causes of injuries requiring presentation to an emergency department. Variables of interest were age, sex, injury mechanisms, and temporal trends. A total of 274,028 children were identified in our study. Between 2001 and 2009, the leading causes of pediatric injuries treated in emergency departments were motor vehicle injuries, falls, and homicide. The overall incidence of injuries declined over the course of the study because of reductions in motor vehicle accidents and falls. The incidence of homicide increased during the study period, particularly between 2007 and 2009. A moderately inverse correlation between homicide rate and economic growth was observed (correlation coefficient: -0.613, p = 0.041). There was a general decline in pediatric injuries between 2001 and 2009. Public policy changes, including motorcycle helmet laws and increases in alcohol taxes, may have contributed to this decline. Unfortunately, the incidence of homicide increased over the course of the study. Ongoing financial crises may have contributed to this increase. Multidisciplinary efforts are required to reduce homicide and reinforce the importance of measures that protect children against violence.

A Dutch Nationwide Bariatric Quality Registry: DATO.

PubMed

Poelemeijer, Youri Q M; Liem, Ronald S L; Nienhuijs, Simon W

2017-12-22

In the Netherlands, the number of bariatric procedures increased exponentially in the 90s. To ensure and improve the quality of bariatric surgery, the nationwide Dutch Audit for Treatment of Obesity (DATO) was established in 2014. The audit was coordinated by the Dutch Institute for Clinical Auditing (DICA). This article provides a review of the aforementioned process in establishing a nationwide registry in the Netherlands. In collaboration with the DATO's scientific committee and other stakeholders, an annual list of several external quality indicators was formulated. This list consists of volume, process, and outcome indicators. In addition to the annual external indicators, the database permits individual hospitals to analyze their own data. The dashboard provides several standardized reports and detailed quality indicators, which are updated on a weekly base. Since the start, all 18 Dutch bariatric centers participated in the nationwide audit. A total of 21,941 cases were registered between 2015 and 2016. By 2016, the required variables were registered in 94.3% of all cases. A severe complicated course was seen in 2.87%, and mortality in 0.05% in 2016. The first-year follow-up shows a > 20% TWL in 86.1% of the registered cases. The DATO has become rapidly a mature registry. The well-organized structure of the national audit institution DICA and governmental funding were essential. However, most important were the bariatric teams themselves. The authors believe reporting the results from the registry has already contributed to more knowledge and acceptance by other health care providers.

Gender differences in homicide offenders' criminal career, substance abuse and mental health care. A nationwide register-based study of Finnish homicide offenders 1995-2004.

PubMed

Putkonen, Hanna; Weizmann-Henelius, Ghitta; Lindberg, Nina; Rovamo, Tuija; Häkkänen-nyholm, Helinä

2011-02-01

It is generally considered that women who kill are more likely to have a psychiatric disorder than their male counterparts, but as a relatively small group, women are much less often studied than men in this context. To explore gender differences in the psychosocial history of homicide offenders. In this nationwide register-based study, data were extracted from the forensic psychiatric examination and crime reports of all 91 women prosecuted for homicide in Finland between 1995 and 2004 and from those of the next adjacent man convicted of a separate homicide (n = 91). Both female and male homicide offenders had a troubled childhood, but more women had witnessed or experienced family violence; more women had failed to complete their primary education. Men, however, were more likely to have had an offending history. Although there were no differences between the men and women in the frequencies of psychiatric diagnoses or of substance abuse, the women had more often received prior mental health treatment. The women were also more likely to have had a history of suicidal behaviour. Both female and male homicide offenders are a troubled group of people, with slightly different criminal careers. Many use mental health services and therefore prevention could be improved. The suggestion of a special sub-group of women characterised by early educational and behavioural difficulties needs replication, as it may have implications for service development. Copyright © 2010 John Wiley & Sons, Ltd.

The Utilization of Rehabilitation in Patients with Hemophilia A in Taiwan: A Nationwide Population-Based Study

PubMed Central

Yang, Yao-Hsu; Chang, Chia-Hao; Chen, Chih-Cheng; Chen, Pau-Chung

2016-01-01

Introduction Rehabilitation plays an important role in the physical health of patients with hemophilia. However, comprehensive information regarding the utilization of rehabilitation for such patients remains scarce. Aim This population-based study aimed to examine the characteristics, trends, and most important factors affecting rehabilitation usage in patients with hemophilia A using a nationwide database in Taiwan. Methods Data from 777 patients with hemophilia A who were registered in the National Health Insurance Research Database between 1998 and 2008 were analyzed using SAS 9.0. Results Musculoskeletal or nervous system-related surgical procedures and clotting factor VIII concentrate costs were identified as factors affecting rehabilitation usage; musculoskeletal or nervous system-related surgical procedures (odds ratio = 3.788; P < 0.001) were the most important predictor of whether a patient with hemophilia A would use rehabilitation services. Joint disorders, arthropathies, bone and cartilage disorders, intracranial hemorrhage, and brain trauma were common diagnoses during rehabilitation use. The costs of physical therapy (physiotherapy) comprised the majority (71.2%) of rehabilitation therapy categories. Increasingly, rehabilitation therapy was performed at physician clinics. The total rehabilitation costs were <0.1% of the total annual medical costs. Conclusion Musculoskeletal or nervous system-related surgical procedures and increased use of clotting factor VIII concentrate affect the rehabilitation utilization of patients with hemophilia A the most. The findings in this study could help clinicians comprehensively understand the rehabilitation utilization of patients with hemophilia A. PMID:27690229

Establishing Baseline Data: Using Institutional Data to Learn More about Completion Factors at One New Zealand University

ERIC Educational Resources Information Center

Clark, Austina; van der Meer, Jacques; van Koten, Chikako

2008-01-01

This paper discusses demographic and study-related factors that contribute to completion of degrees in one university in New Zealand. Although much can be learned from nationwide and cross-institutional studies, it is important that each institution comes to an understanding of its own particular student population and the factors that impact on…

Implementing a nationwide criteria-based emergency medical dispatch system: A register-based follow-up study

PubMed Central

2013-01-01

Background A criteria-based nationwide Emergency Medical Dispatch (EMD) system was recently implemented in Denmark. We described the system and studied its ability to triage patients according to the severity of their condition by analysing hospital admission and case-fatality risks. Methods This was a register-based follow-up study of all 1-1-2 calls in a 6-month period that were triaged according to the Danish Index – the new criteria-based dispatch protocol. Danish Index data were linked with hospital and vital status data from national registries. Confidence intervals (95%) for proportions with binomial data were computed using exact methods. To test for trend the Wald test was used. Results Information on level of emergency according to the Danish Index rating was available for 67,135 patients who received ambulance service. Emergency level A (urgent cases) accounted for 51.4% (n = 34,489) of patients, emergency level B for 46.3% (n = 31,116), emergency level C for 2.1% (n = 1,391) and emergency level D for 0.2% (n = 139). For emergency level A, the median time from call receipt to ambulance dispatch was 2 min 1 s, and the median time to arrival was 6 min 11 s. Data concerning admission and case fatality was available for 55,270 patients. The hospital admission risk for emergency level A patients was 64.4% (95% CI = 63.8-64.9). There was a significant trend (p < 0.001) towards lower admission risks for patients with lower levels of emergency. The case fatality risk for emergency level A patients on the same day as the 1-1-2 call was 4.4% (95% CI = 4.1-4.6). The relative case-fatality risk among emergency level A patients compared to emergency level B–D patients was 14.3 (95% CI: 11.5-18.0). Conclusion The majority of patients were assessed as Danish Index emergency level A or B. Case fatality and hospital admission risks were substantially higher for emergency level A patients than for emergency level B–D patients. Thus, the newly implemented Danish criteria-based dispatch system seems to triage patients with high risk of admission and death to the highest level of emergency. Further studies are needed to determine the degree of over- and undertriage and prognostic factors. PMID:23835246

Parental occupation and risk of small-for-gestational-age births: a nationwide epidemiological study in Sweden

PubMed Central

Li, X.; Sundquist, J.; Sundquist, K.

2010-01-01

BACKGROUND Although evidence suggests that some occupations may be a risk factor for small-for-gestational age (SGA) birth, associations between a wide range of maternal and paternal occupations and risk of SGA births remain unclear. Our objective was to analyze the risk of SGA births by parental occupation, including the entire Swedish population of mothers (≥20 years) and fathers. METHODS We linked nationwide data (1990–2004) on singletons born to employed mothers to nationwide data on maternal and paternal occupation and other individual-level variables. Information on parental occupations was obtained from the 1990 census. Approximately 95% of SGA births (calculated using normative data) were defined on the basis of ultrasound. Odds ratios of SGA birth were calculated with 95% confidence intervals. Women and men were analyzed separately. RESULTS There were 816 310 first singleton live births during the study period, of which 29 603 were SGA events. Families with low incomes had an increased risk of SGA births. After accounting for maternal age at the infant's birth, period of birth, family income, region of residence, marital status and smoking habits, several maternal occupational groups (including ‘mechanics and iron and metalware workers’ and ‘packers, loaders and warehouse workers’) had a significantly higher risk of SGA birth than the reference group (all women in the study population). Among paternal occupational groups, only waiters had an increased risk of SGA birth. CONCLUSIONS This large-scale follow-up study shows that maternal occupation affects risk of SGA birth, whereas paternal occupation does not seem to have an impact on SGA birth. Further studies are required to examine the specific agents in those maternal occupations that are associated with an increased risk of SGA birth. PMID:20133322

77 FR 60680 - Development of the Nationwide Interoperable Public Safety Broadband Network

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-04

... public comment on the conceptual network architecture presentation made at the FirstNet Board of... business plan considerations. NTIA also seeks comment on the general concept of how to develop applications... network based on a single, nationwide network architecture called for under the Middle Class Tax Relief...

Disaster Vulnerability of Hospitals: A Nationwide Surveillance in Japan.

PubMed

Ochi, Sae; Kato, Shigeaki; Kobayashi, Kenichi; Kanatani, Yasuhiro

2015-12-01

Hospital preparedness against disasters is key to achieving disaster mitigation for health. To gain a holistic view of hospitals in Japan, one of the most disaster-prone countries, a nationwide surveillance of hospital preparedness was conducted. A cross-sectional, paper-based interview was conducted that targeted all of the 8701 registered hospitals in Japan. Preparedness was assessed with regard to local hazards, compliance to building code, and preparation of resources such as electricity, water, communication tools, and transportation tools. Answers were obtained from 6122 hospitals (response rate: 70.3%), among which 20.5% were public (national or city-run) hospitals and others were private. Eight percent were the hospitals assigned as disaster-base hospitals and the others were non-disaster-base hospitals. Overall compliance to building code, power generators, water tanks, emergency communication tools, and helicopter platforms was 90%, 84%, 95%, 43%, and 22%, respectively. Major vulnerabilities in logistics in mega-cities and stockpiles required for chronic care emerged from the results of this nationwide surveillance of hospitals in Japan. To conduct further intensive surveillance to meet community health needs, appropriate sampling methods should be established on the basis of this preliminary study. Holistic vulnerability analysis of community hospitals will lead to more robust disaster mitigation at the local level.

Copenhagen Airport Cohort: air pollution, manual baggage handling and health.

PubMed

Møller, Karina Lauenborg; Brauer, Charlotte; Mikkelsen, Sigurd; Loft, Steffen; Simonsen, Erik B; Koblauch, Henrik; Bern, Stine Hvid; Alkjær, Tine; Hertel, Ole; Becker, Thomas; Larsen, Karin Helweg; Bonde, Jens Peter; Thygesen, Lau Caspar

2017-05-06

Copenhagen Airport Cohort 1990-2012 presents a unique data source for studies of health effects of occupational exposure to air pollution (ultrafine particles) and manual baggage handling among airport employees. We describe the extent of information in the cohort and in the follow-up based on data linkage to the comprehensive Danish nationwide health registers. In the cohort, all information is linked to the personal identification number that also is used in Denmark Statistics demographic and socioeconomic databases and in the nationwide health registers. The cohort covers 69 175 men in unskilled positions. The exposed cohort includes men in unskilled jobs employed at Copenhagen Airport in the period 1990-2012 either as baggage handlers or in other outdoor work. The reference cohort includes men in unskilled jobs working in the greater Copenhagen area. The cohort includes environmental Global Positioning System (GPS) measurements in Copenhagen Airport, information on job function/task for each calendar year of employment between 1990 and 2012, exposure to air pollution at residence, average weight of baggage lifted per day and lifestyle. By linkage to registers, we retrieved socioeconomic and demographic data and data on healthcare contacts, drug subscriptions, incident cancer and mortality. The size of the cohort and the completeness of the register-based follow-up allow a more accurate assessment of the possible health risks of occupational exposure to ultrafine particles and manual baggage handling at airports than in previous studies. We plan to follow the cohort for the incidence of ischaemic heart diseases, cerebrovascular disease, lung and bladder cancer, asthma and chronic obstructive pulmonary disease, and further for associations between heavy manual baggage handling and musculoskeletal disorders. number 2012-41-0199. 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/.

Differences between homicide and filicide offenders; results of a nationwide register-based case-control study

PubMed Central

Putkonen, Hanna; Weizmann-Henelius, Ghitta; Lindberg, Nina; Eronen, Markku; Häkkänen, Helinä

2009-01-01

Background Filicide, the killing of one's child, is an extraordinary form of homicide. It has commonly been associated with suicide and parental psychiatric illness. In the research on filicide, nationwide studies with comparison groups, specific perpetrator subgroups, and assessment of possible risk factors have been called for. The purpose of the current study was to provide all that. Methods In this nationwide register-based case-control study all filicide offenders who were in a forensic psychiatric examination in Finland 1995–2004 were examined and compared with an age- and gender matched control group of homicide offenders. The assessed variables were psychosocial history, index offence, and psychiatric variables as well as psychopathy using the PCL-R. Results Filicide offenders were not significantly more often diagnosed with psychotic disorders than the controls but they had attempted suicide at the crime scene significantly more often. Filicide offenders had alcohol abuse/dependence and antisocial personality less often than the controls. Filicide offenders scored significantly lower on psychopathy than the controls. Within the group of filicide offenders, the psychopathy items with relatively higher scores were lack of remorse or guilt, shallow affect, callous/lack of empathy, poor behavioral controls, and failure to accept responsibility. Conclusion Since filicide offenders did not seem significantly more mentally disordered than the other homicide offenders, psychiatry alone cannot be held responsible for the prevention of filicide. Extensive international studies are needed to replicate our findings and provide more specific knowledge in order to enhance prevention. PMID:19480648

Nationwide prevalence of human papillomavirus infection and viral genotype distribution in 37 cities in China.

PubMed

Wang, Rong; Guo, Xiao-Lei; Wisman, G Bea A; Schuuring, Ed; Wang, Wen-Feng; Zeng, Zheng-Yu; Zhu, Hong; Wu, Shang-Wei

2015-07-04

Type-specific high-risk HPV (hrHPV) infection is related to cervical carcinogenesis. The prevalence of hrHPV infection varies geographically, which might reflect the epidemiological characteristics of cervical cancer among different populations. To establish a foundation for HPV-based screening and vaccination programs in China, we investigated the most recent HPV prevalence and genotypic distributions in different female age groups and geographical regions in China. In 2012, a total of 120,772 liquid-based cytological samples from women enrolled for population- or employee-based cervical screening in 37 Chinese cities were obtained by the Laboratory of Molecular Infectious Diseases of Guangzhou KingMed. A total of 111,131 samples were tested by Hybrid Capture II and the other 9,641 were genotyped using the Tellgenplex™ HPV DNA Assay. The total positive rate for hrHPV was 21.07 %, which ranged from 18.42 % (Nanchang) to 31.94 % (Haikou) and varied by region. The regions of Nanchang, Changsha, Hangzhou, Chengdu, Fuzhou, Guangdong, and Guiyang could be considered the low prevalence regions. Age-specific prevalence showed a "two-peak" pattern, with the youngest age group (15-19 years) presenting the highest hrHPV infection rate (30.55 %), followed by a second peak for the 50-60-year-old group. Overall, the most prevalent genotypes were HPV16 (4.82 %) and HPV52 (4.52 %), followed by HPV58 (2.74 %). Two genotypes HPV6 (4.01 %) and HPV11 (2.29 %) were predominant in the low-risk HPV (lrHPV) type, while the mixed genotypes HPV16 + 52 and HPV52 + 58 were most common in women with multiple infections. This study shows that HPV infection in China has increased to the level of an "HPV-heavy-burden" zone in certain regions, with prevalence varying significantly among different ages and regions. Data from this study represent the most current survey of the nationwide prevalence of HPV infection in China, and can serve as valuable reference to guide nationwide cervical cancer screening and HPV vaccination programs.

Estimates of associated outdoor particulate matter health risk and costs reductions from alternative building, ventilation and filtration scenarios.

PubMed

Sultan, Zuraimi M

2007-05-01

Although many studies have reported calculations of outdoor particulate matter (PM) associated externalities using ambient data, there is little information on the role buildings, their ventilation and filtration play. This study provides the framework to evaluate the health risk and cost reduction of building, ventilation and filtration strategies from outdoor PM pollution on a nationwide level and applied it to a case study in Singapore. Combining Indoor Air Quality (IAQ) and time weighted exposure models, with established concentration-response functions and monetary valuation methods, mortality and morbidity effects of outdoor PM on the population of Singapore under different building, ventilation and filtration strategies were estimated. Different interventions were made to compare the effects from the current building conditions. The findings demonstrate that building protection effect reduced approximately half the attributable health cases amounting to US$17.7 billion due to PM pollution when compared to levels computed using outdoor data alone. For residential buildings, nationwide adoption of natural ventilation from current state is associated with 28% higher cases of mortality and 13 to 38% higher cases for different morbidities, amounting to US$6.7 billion. The incurred cost is negligible compared to energy costs of air-conditioning. However, nationwide adoption of closed residence and air-conditioning are associated with outcomes including fewer mortality (10 and 6% respectively), fewer morbidities (8 and 4% respectively) and economic savings of US$1.5 and 0.9 billion respectively. The related savings were about a factor of 9 the energy cost for air-conditioning. Nationwide adoption of mechanical ventilation and filtration from current natural ventilation in schools is associated with fewer asthma hospital admissions and exacerbations; although the economic impact is not substantial. Enhanced workplace filtration reduces the mortality and morbidity cases by 14 and 13% respectively amounting to savings of up to US$2.4 billion. The huge costs savings are comparable to the average worker salary and insignificant to energy, installation and rental cost. Despite uncertainty about accurate benefits, this study shows that health and economic gain via different building, ventilation and filtration designs in minimizing ingress of outdoor PM applied to a nationwide scale can be very large. Importantly, the results suggest that PM associated externalities and legislative efforts should not only focus on ambient PM reduction policies but also include building-informed decisions.

Associations between Beliefs about Medicines and Medicines Education: A Survey among Finnish Comprehensive School Teachers

ERIC Educational Resources Information Center

Siitonen, Piia; Vainio, Kirsti; Keinonen, Tuula; Kiviniemi, Vesa; Hämeen-Anttila, Katri

2015-01-01

Objective: To describe the association between teachers' beliefs about medicines and teaching about illnesses and medicines-related topics by Finnish comprehensive school teachers. Design: A nationwide postal survey. Setting: Finnish primary and lower secondary school teachers. Method: Data were collected using a nationwide postal survey from a…

Where Are We Now? Statistics on Capstone Courses Nationwide

ERIC Educational Resources Information Center

Howe, Susannah

2010-01-01

Capstone design courses are an increasingly common component of engineering curricula nationwide, but how much do we really know about the current practices? How do capstone courses differ across departments and institutions? How have capstone courses changed in the past 10 years? This paper highlights data from a survey of engineering capstone…

The State of Teacher Professional Learning: Results from a Nationwide Survey

ERIC Educational Resources Information Center

Learning Forward, 2017

2017-01-01

Effective teacher learning is vital to student success. Teachers who continually improve their practice by using data to inform instructional decisions see improved results for their students. In the tradition of supporting effective professional learning, in 2016 Corwin launched a nationwide survey in partnership with Learning Forward and the…

The Impact of Competency-Based Teacher Education and Certification Programs in Utah.

ERIC Educational Resources Information Center

Mouritsen, Roger C.

Utah is a member of a nine-state consortium to study competency-based teacher education and certification programs. This paper presents an overview of the nationwide movement for competency-based teacher education, followed by a description of the situation in Utah. The State Board of Education is making an effort through the Teacher Education and…

Emerging Personnel Requirements in Academic Libraries as Reflected in Recent Position Announcements.

ERIC Educational Resources Information Center

Block, David

This study of the personnel requirements and hiring patterns of academic libraries draws on data collected from academic library position announcements issued nationwide during the fourth quarter of 1980. Data on 224 announcements were analyzed using the Statistical Package for the Social Sciences, and the resulting statistics are interpreted as a…

Tracking the Transfers: State Policy and Practice.

ERIC Educational Resources Information Center

Cohen, Arthur M.

1992-01-01

In an effort to standardize the definition of the two-year college student transfer rate and to collect national transfer data, the Center for the Study of Community Colleges (CSCC) has solicited data annually since 1989 from a sample of 240 public and private two-year colleges nationwide. The CSCC has standardized the definition of "transfer…

Risk of anxiety and depressive disorders in patients with myocardial infarction: A nationwide population-based cohort study.

PubMed

Feng, Hsin-Pei; Chien, Wu-Chien; Cheng, Wei-Tung; Chung, Chi-Hsiang; Cheng, Shu-Meng; Tzeng, Wen-Chii

2016-08-01

Anxiety and depressive symptoms are associated with adverse cardiovascular events after an acute myocardial infarction (MI). However, most studies focusing on anxiety or depression have used rating scales or self-report methods rather than clinical diagnosis. This study aimed to investigate the association between psychiatrist-diagnosed psychiatric disorders and cardiovascular prognosis.We sampled data from the National Health Insurance Research Database; 1396 patients with MI were recruited as the study cohort and 13,960 patients without MI were recruited as the comparison cohort. Cox proportional hazard regression models were used to examine the effect of MI on the risk of anxiety and depressive disorders.During the first 2 years of follow-up, patients with MI exhibited a significantly higher risk of anxiety disorders (adjusted hazard ratio [HR] = 5.06, 95% confidence interval [CI]: 4.61-5.54) and depressive disorders (adjusted HR = 7.23, 95% CI: 4.88-10.88) than those without MI did. Greater risk for anxiety and depressive disorders was observed among women and patients aged 45 to 64 years following an acute MI. Patients with post-MI anxiety had a 9.37-fold (95% CI: 4.45-19.70) higher risk of recurrent MI than those without MI did after adjustment for age, sex, socioeconomic status, and comorbidities.This nationwide population-based cohort study provides evidence that MI increases the risk of anxiety and depressive disorders during the first 2 years post-MI, and post-MI anxiety disorders are associated with a higher risk of recurrent MI.

After the MV Estonia ferry disaster A Swedish nationwide survey of the relatives of the MV Estonia victims

PubMed Central

Brandänge, Kristina; Gustavsson, J. Petter

2000-01-01

Just after midnight on the 28th of September 1994, the Estonian-flagged ro-ro passenger ferry MV Estonia was shipwrecked on its route between Tallinn and Stockholm. Out of about 1000 persons on board only 137 survived. This paper describes the work that the Psychiatric Clinic at Ersta Hospital performed with the relatives of the MV Estonia victims after the disaster, in addition, we present data from seven consecutive Swedish nationwide surveys based on a questionnaire, which started as a correspondence between the hospital and the relatives of the Estonia victims. Findings concerning the care relatives received and issues regarding their collaboration with the decisionmaking authorities are presented. The importance of inviting the relatives to participate in discussions concerning the Estonia victims is stressed. PMID:22034392

Objectives and Design of the Russian Acute Coronary Syndrome Registry (RusACSR).

PubMed

Gridnev, Vladimir I; Kiselev, Anton R; Posnenkova, Olga M; Popova, Yulia V; Dmitriev, Viktor A; Prokhorov, Mikhail D; Dovgalevsky, Pavel Ya; Oschepkova, Elena V

2016-01-01

The Russian Acute Coronary Syndrome Registry (RusACSR) is a retrospective, continuous, nationwide, Web-based registry of patients with acute coronary syndromes (ACS). The RusACSR is a database that uses a secure Web-based interface for data entry by individual users. Participation in the RusACSR is voluntary. Any clinical center that provides health care to ACS patients can take part in the RusACSR. The RusACSR enrolls ACS patients who have undergone care in Russian hospitals from February 2008 to the present. Key data elements and methods of data analysis in the RusACSR are presented in this article. Up to 2015, 213 clinical centers from 36 regions of Russia had participated in the RusACSR. Currently, the database contains data on more than 250 000 ACS patients who underwent care from 2008 to 2015. Some current problems are highlighted in this article. The RusACSR is a perspective project for different epidemiologic studies in Russian ACS patients. © 2015 Wiley Periodicals, Inc.

Concepts for a standard based cross-organisational information security management system in the context of a nationwide EHR.

PubMed

Mense, Alexander; Hoheiser-Pförtner, Franz; Schmid, Martin; Wahl, Harald

2013-01-01

Working with health related data necessitates appropriate levels of security and privacy. Information security, meaning ensuring confidentiality, integrity, and availability, is more organizational, than technical in nature. It includes many organizational and management measures, is based on well-defined security roles, processes, and documents, and needs permanent adaption of security policies, continuously monitoring, and measures assessment. This big challenge for any organization leads to implementation of an information security management system (ISMS). In the context of establishing a regional or national electronic health record for integrated care (ICEHR), the situation is worse. Changing the medical information exchange from on-demand peer-to-peer connections to health information networks requires all organizations participating in the EHR system to have consistent security levels and to follow the same security guidelines and rules. Also, the implementation must be monitored and audited, establishing cross-organizational information security management systems (ISMS) based on international standards. This paper evaluates requirements and defines basic concepts for an ISO 27000 series-based cross-organizational ISMS in the healthcare domain and especially for the implementation of the nationwide electronic health record in Austria (ELGA).

A Follow-up of a National Cohort of Breast Disease Factors Affecting the Development of Breast Cancer.

DTIC Science & Technology

1996-09-01

The study is based on a twelve-year follow-up of the cohort of 3500 women histologically diagnosed nationwide for benign and malignant breast lesions...between US whites and Africans. This study offers a unique opportunity to evaluate the progression of benign and malignant breast disease on a whole community base population.

Transfer of the nationwide Czech soil survey data to a foreign soil classification - generating input parameters for a process-based soil erosion modelling approach

NASA Astrophysics Data System (ADS)

Beitlerová, Hana; Hieke, Falk; Žížala, Daniel; Kapička, Jiří; Keiser, Andreas; Schmidt, Jürgen; Schindewolf, Marcus

2017-04-01

Process-based erosion modelling is a developing and adequate tool to assess, simulate and understand the complex mechanisms of soil loss due to surface runoff. While the current state of available models includes powerful approaches, a major drawback is given by complex parametrization. A major input parameter for the physically based soil loss and deposition model EROSION 3D is represented by soil texture. However, as the model has been developed in Germany it is dependent on the German soil classification. To exploit data generated during a massive nationwide soil survey campaign taking place in the 1960s across the entire Czech Republic, a transfer from the Czech to the German or at least international (e.g. WRB) system is mandatory. During the survey the internal differentiation of grain sizes was realized in a two fractions approach, separating texture into solely above and below 0.01 mm rather than into clayey, silty and sandy textures. Consequently, the Czech system applies a classification of seven different textures based on the respective percentage of large and small particles, while in Germany 31 groups are essential. The followed approach of matching Czech soil survey data to the German system focusses on semi-logarithmic interpolation of the cumulative soil texture curve additionally on a regression equation based on a recent database of 128 soil pits. Furthermore, for each of the seven Czech texture classes a group of typically suitable classes of the German system was derived. A GIS-based spatial analysis to test approaches of interpolation the soil texture was carried out. First results show promising matches and pave the way to a Czech model application of EROSION 3D.

26 CFR 1.263A-4 - Rules for property produced in a farming business.

Code of Federal Regulations, 2013 CFR

2013-04-01

... period of plants grown in commercial quantities in the United States is based on the nationwide weighted... plants grown in commercial quantities in the United States, the nationwide weighted average preproductive... crop or yield. The plants are grown in commercial quantities in the United States. Farmer A acquires 1...

26 CFR 1.263A-4 - Rules for property produced in a farming business.

Code of Federal Regulations, 2010 CFR

2010-04-01

... period of plants grown in commercial quantities in the United States is based on the nationwide weighted... plants grown in commercial quantities in the United States, the nationwide weighted average preproductive... crop or yield. The plants are grown in commercial quantities in the United States. Farmer A acquires 1...

26 CFR 1.263A-4 - Rules for property produced in a farming business.

Code of Federal Regulations, 2012 CFR

2012-04-01

... period of plants grown in commercial quantities in the United States is based on the nationwide weighted... plants grown in commercial quantities in the United States, the nationwide weighted average preproductive... crop or yield. The plants are grown in commercial quantities in the United States. Farmer A acquires 1...

26 CFR 1.263A-4 - Rules for property produced in a farming business.

Code of Federal Regulations, 2014 CFR

2014-04-01

... period of plants grown in commercial quantities in the United States is based on the nationwide weighted... plants grown in commercial quantities in the United States, the nationwide weighted average preproductive... crop or yield. The plants are grown in commercial quantities in the United States. Farmer A acquires 1...

26 CFR 1.263A-4 - Rules for property produced in a farming business.

Code of Federal Regulations, 2011 CFR

2011-04-01

... period of plants grown in commercial quantities in the United States is based on the nationwide weighted... plants grown in commercial quantities in the United States, the nationwide weighted average preproductive... crop or yield. The plants are grown in commercial quantities in the United States. Farmer A acquires 1...

Effect of Maternal Age at Childbirth on Obesity in Postmenopausal Women: A Nationwide Population-Based Study in Korea.

PubMed

We, Ji-Sun; Han, Kyungdo; Kwon, Hyuk-Sang; Kil, Kicheol

2016-05-01

The object of this study was to assess the obesity in postmenopausal women, according to age at childbirth.We analyzed the association between age at first childbirth, age at last childbirth, parity, and subject obesity status (general obesity; BMI >25 kg/m, nongeneral obesity; BMI ≤25 kg/m, abdominal obesity; waist circumference >85 cm, nonabdominal obesity; waist circumference ≤85 cm), using data from a nationwide population-based survey, the 2010 to 2012 Korean National Health and Nutrition Examination Survey. Data from a total of 4382 postmenopausal women were analyzed using multivariate regression analysis with complex survey design sampling. And, the subjects were subdivided into groups according to obesity or not. Age, smoking, alcohol consumption, exercise, education, income level, number of pregnancies, oral contraceptive uses, breast feeding experience were adjusted as the confounders.The prevalence of general obesity among Korean postmenopausal women was 37.08%. Women with general obesity and abdominal obesity were significantly younger at first childbirth compared with women with nongeneral obesity and no abdominal obesity (23.89 ± 0.1 vs. 23.22 ± 0.1, P <0.001). Age at first childbirth was inversely associated with obesity, while age at last childbirth was not associated with obesity or abdominal obesity. Women with a higher number of pregnancies were also more likely to have obesity and abdominal obesity. Age at first childbirth remained significantly associated with obesity, after adjusting for confounding factors.Obesity in postmenopausal women is associated with first childbirth at a young age, and higher parity. Further research is needed to clarify the association between obesity and reproductive characteristics.

Morbidity and mortality from a propensity score-matched, prospective cohort study of laparoscopic versus open total gastrectomy for gastric cancer: data from a nationwide web-based database.

PubMed

Etoh, Tsuyoshi; Honda, Michitaka; Kumamaru, Hiraku; Miyata, Hiroaki; Yoshida, Kazuhiro; Kodera, Yasuhiro; Kakeji, Yoshihiro; Inomata, Masafumi; Konno, Hiroyuki; Seto, Yasuyuki; Kitano, Seigo; Hiki, Naoki

2018-06-01

Controversy persists regarding the technical feasibility of laparoscopic total gastrectomy (LTG), and to our knowledge, no prospective study with a sample size sufficient to investigate its safety has been reported. We aimed to compare the postoperative morbidity and mortality rates in patients undergoing LTG and open total gastrectomy (OTG) for gastric cancer in prospectively enrolled cohort using nationwide web-based registry. From August 2014 to July 2015, consecutive patients undergoing LTG or OTG (925 and 1569 patients, respectively) at the participating institutions were enrolled prospectively into the National Clinical Database registration system. We constructed propensity score (PS) models separately in four facility yearly case-volume groups, and evaluated the postoperative morbidity and mortality in PS-matched 1024 patients undergoing LTG or OTG. The incidence of overall morbidity were 84 (16.4%) in the OTG and 54 (10.3%) in the LTG groups (p = 0.01).The incidence of anastomotic leakage and pancreatic fistula grade B or above were not significantly different between the two groups (LTG 5.3% vs. OTG 6.1%, p = 0.59, LTG 2.7% vs. OTG 3.7%, p = 0.38, respectively). There were also no significant differences in the 30-day and in-hospital mortality rates between the two groups (LTG 0.2% vs. OTG 0.4%, p = 0.56; LTG 0.4% vs. OTG 0.4%, p = 1.00, respectively). The results from our nationally representative data analysis showed that LTG could be a safe procedure to treat gastric cancer compared to OTG. The indication for LTG should be considered carefully in a clinical setting.

Four sexually transmitted infections (STIs) in Belgian general practice: first results (2013-2014) of a nationwide continuing surveillance study.

PubMed

Boffin, N; Moreels, S; Deblonde, J; Van Casteren, V

2017-01-27

To describe and explore data from the surveillance of chlamydia, syphilis, gonorrhoea and genital warts by the Belgian Network of Sentinel General Practices (SGP) over the first 2 years (2013 and 2014) and to estimate the incidence of these 4 sexually transmitted infections (STIs). A special focus is put on data quality. Retrospective observational study. General practices from the nationwide representative SGP network. Agreement between data distributions by year, agreement between SGP-based incidence and incidence based on mandatory notification, missingness of patient age or gender and incompleteness of sexual risk history of patients. 306 new STI episodes were reported from 298 patients, corresponding with an episode-based incidence of 91.9/100 000 (95% CI 81.9 to 102.8) general practice patients, with almost half of it due to chlamydia. The incidence of chlamydia in men was significantly higher in 2014 than in 2013. Population characteristics were similarly distributed in 2013 and 2014. The SGP-based incidence of gonorrhoea and syphilis in Flanders were in agreement with the incidence based on mandatory notification of cases. Patient age or gender was missing from 35 episodes (11.4%). Independent determinants of missingness of patient age or gender were the Flemish region (OR 3.46; 95% CI 1.02 to 11.73) and genital warts infection (OR 2.23; 95% CI 1.07 to 4.63). An incomplete sexual risk history was reported for 54.6% STI episodes. The odds for an incomplete sexual history were higher for older patients (OR 1.72; 95% CI 1.06 to 2.76) and for patients infected with syphilis, gonorrhoea or co-infection(s) (OR 1.71; 95% CI 1.03 to 2.83). Incompleteness of reports about patients with STI sexual risk histories is important from the perspective of quality of data and of quality of care. Together with the low rates of both HIV testing and discussion of partner notification, this suggests that a general practice guideline is needed. 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/.

General anesthesia exposure in early life reduces the risk of allergic diseases: A nationwide population-based cohort study.

PubMed

Kuo, Ho-Chang; Yang, Ya-Ling; Ho, Shu-Chen; Guo, Mindy Ming-Huey; Jiang, Jyun-Hong; Huang, Ying-Hsien

2016-07-01

General anesthesia (GA) has been used for second line treatment strategy for status asthmaticus in pediatric patients. The association between GA in children and risk of followed-up allergic diseases is unclear. This study aims to assess the risk of allergic diseases after GA in children.We did a nationwide retrospective cohort study by analyzing data from the National Health Insurance Research Database (NHIRD) in Taiwan. The subsequent risks for allergic diseases, including asthma (ICD-9: 493.X), allergic rhinitis (AR; ICD-9 CM code 477.X), and atopic dermatitis (AD; ICD-9-CM code 691.X), were compared between exposure to GA and none before 1 year of age throughout the follow-up period using the Cox proportional hazards model.Insurance claims data for 32,742 children younger than 1 year old from all insured children in the NHIRD. Of those, 2358 subjects were exposed to GA; 414 and 1944 children exposed to mask and intubation ventilation, respectively, served as the study cohort, whereas the remaining 30,384 children made up the comparison cohort. Children in the GA group were at a lower risk of developing asthma, AR and AD, with adjusted hazard ratios of 0.67 (0.62-0.72, 95%CI), 0.72 (0.68-0.77, 95%CI), 0.60 (0.56-0.64, 95%CI), respectively.Children who were exposed to GA in early life before 1 year of age had reduced risk of subsequently developing allergic diseases such as asthma, AD, and AR, when compared with general population.

The effect of implementation of an early detection team: A nationwide register-based study of characteristics and help-seeking behavior in first-episode schizophrenia in Denmark.

PubMed

Hastrup, Lene Halling; Haahr, Ulrik Helt; Nordgaard, Julie; Simonsen, Erik

2018-04-26

In an effort to make people with signs of psychosis seek help as early as possible, Region Zealand launched in 2012 an early detection team project as the first and only in Denmark. The project consisted of a combination of easy access and an information campaign targeting the public. This nation-wide study examined characteristics and help-seeking behavior of patients with first-episode schizophrenia (FES) in the early detection region in comparison with other Danish regions. Data from the Danish National Schizophrenia register on all Danish patients diagnosed with first-episode schizophrenia during 2012 to 2015 were linked to demographic and health care data drawn from official national registers. Binary logistic regression analyses examined the difference between the early detection region and other regions controlling for demographic characteristics and utilization of mental health care services and contacts to general practitioner (GP). Patients in the early detection region were younger (OR = 0.51; CI: 0.42-0.62; p < 0.000) than in regions without early detection teams. Furthermore, they were more likely to be of Danish origin, and less likely to have contact with mental health services and GPs prior to FES. The study suggests that implementing an early detection team in combination with an information campaign contributed to detecting patients with first-episode schizophrenia earlier than in regions without the early detection team. The study gives an indication of different pathways among patients in the early detection region. Copyright © 2018. Published by Elsevier B.V.

1983-1984 nationwide personal transportation study : survey data tabulations

DOT National Transportation Integrated Search

1985-11-01

This report is part of a series that presents findings from the 1 983-1984 : Nat ionwide Personal Transportat ion S tudy (NPTS ) . This report contains : tabulat ions which relat e 1983-1984 t ravel to various demographic characterist ics.

Undergraduate Music Program Alumni's Career Path, Retrospective Institutional Satisfaction, and Financial Status

ERIC Educational Resources Information Center

Miksza, Peter; Hime, Lauren

2015-01-01

The purpose of this study was to examine undergraduate music education and performance alumni's career path, retrospective institutional satisfaction, and financial status. Data for this study were drawn from respondents from the 2010 administration of the nationwide, multi-institutional survey conducted by the Strategic National Arts Alumni…

76 FR 31943 - Notice of Proposed Information Collection Requests

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-02

..., Evaluation and Policy Development Type of Review: New. Title of Collection: Analysis of State Bullying Laws... bullying laws and policies. The field data collection portion of the study will involve case studies conducted in 24 school sites nationwide to document state and local implementation of anti-bullying laws and...

Neighborhood walkability and particulate air pollution in a nationwide cohort of women.

PubMed

James, Peter; Hart, Jaime E; Laden, Francine

2015-10-01

Features of neighborhoods associated with walkability (i.e., connectivity, accessibility, and density) may also be correlated with levels of ambient air pollution, which would attenuate the health benefits of walkability. We examined the relationship between neighborhood walkability and ambient air pollution in a cross-sectional analysis of a cohort study spanning the entire United States using residence-level exposure assessment for ambient air pollution and the built environment. Using data from the Nurses' Health Study, we used linear regression to estimate the association between a neighborhood walkability index, combining neighborhood intersection count, business count, and population density (defined from Census data, infoUSA business data, and StreetMap USA data), and air pollution, defined from a GIS-based spatiotemporal PM2.5 model. After adjustment for Census tract median income, median home value, and percent with no high school education, the highest tertile of walkability index, intersection count, business count, and population density was associated with a with 1.58 (95% CI 1.54, 1.62), 1.20 (95% CI 1.16, 1.24), 1.31 (95% CI 1.27, 1.35), and 1.84 (95% CI 1.80, 1.88) µg/m(3) higher level of PM2.5 respectively, compared to the lowest tertile. Results varied somewhat by neighborhood socioeconomic status and greatly by region. This nationwide analysis showed a positive relationship between neighborhood walkability and modeled air pollution levels, which were consistent after adjustment for neighborhood-level socioeconomic status. Regional differences in the air pollution-walkability relationship demonstrate that there are factors that vary from region to region that allow for walkable neighborhoods with low levels of air pollution. Copyright © 2015 Elsevier Inc. All rights reserved.

Exposures to Walkability and Particulate Air Pollution in a Nationwide Cohort of Women

PubMed Central

James, Peter; Hart, Jaime E.; Laden, Francine

2015-01-01

Background Features of neighborhoods associated with walkability (i.e., connectivity, accessibility, and density) may also be correlated with levels of ambient air pollution, which would attenuate the health benefits of walkability. Objectives We examined the relationship between neighborhood walkability and ambient air pollution in a cross-sectional analysis of a cohort study spanning the entire United States using residence-level exposure assessment for ambient air pollution and the built environment. Methods Using data from the Nurses’ Health Study, we used linear regression to estimate the association between a neighborhood walkability index, combining neighborhood intersection count, business count, and population density (defined from Census data, infoUSA business data, and StreetMap USA data), and air pollution, defined from a GIS-based spatiotemporal PM2.5 model. Results After adjustment for Census tract median income, median home value, and percent with no high school education, the highest tertile of walkability index, intersection count, business count, and population density was associated with a with 1.58 (95% CI 1.54, 1.62), 1.20 (95% CI 1.16, 1.24), 1.31 (95% CI 1.27, 1.35), and 1.84 (95% CI 1.80, 1.88) μg/m3 higher level of PM2.5 respectively, compared to the lowest tertile. Results varied somewhat by neighborhood socioeconomic status and greatly by region. Conclusions This nationwide analysis showed a positive relationship between neighborhood walkability and modeled air pollution levels, which were consistent after adjustment for neighborhood-level socioeconomic status. Regional differences in the air pollution-walkability relationship demonstrate that there are factors that vary across region that allow for walkable neighborhoods with low levels of air pollution. PMID:26397775

Alcohol Education Provided to Opioid Treatment Program Patients: Results of a Nationwide Survey

ERIC Educational Resources Information Center

Strauss, Shiela M.; Harris, Gavin; Katigbak, Carina; Rindskopf, David M.; Singh, Sheena; Greenblum, Ilana; Brown, Lawrence S.; Kipnis, Steven; Kritz, Steven A.; Parrino, Mark W.

2010-01-01

Alcohol-related problems are especially common among opioid treatment program (OTP) patients, suggesting that educating OTP patients about alcohol and its harmful effects needs to be a priority in OTPs. Using data collected in interviews with a nationwide U.S. sample of OTP directors (N = 200) in 25 states, we identified factors that differentiate…

Attributing causal agents to nationwide maps of forest disturbance

Treesearch

Gretchen G. Moisen; Todd A. Schroeder; Karen Schleeweis; Chris Toney; Warren B. Cohen; Samuel N. Goward

2012-01-01

Currently in its third phase, the North American Forest Dynamics (NAFD) project has launched nationwide processing of historic Landsat data to provide a comprehensive annual, wall-to-wall analysis of U.S. disturbance history over the last 30+ years. Because understanding the cause of disturbance is important to quantifying carbon dynamics, work is underway to attribute...

Schoolwide Social-Behavioral Climate, Student Problem Behavior, and Related Administrative Decisions: Empirical Patterns from 1,510 Schools Nationwide

ERIC Educational Resources Information Center

Spaulding, Scott A.; Irvin, Larry K.; Horner, Robert H.; May, Seth L.; Emeldi, Monica; Tobin, Tary J.; Sugai, George

2010-01-01

Office discipline referral (ODR) data provide useful information about problem behavior and consequence patterns, social-behavioral climates, and effects of social-behavioral interventions in schools. The authors report patterns of ODRs and subsequent administrative decisions from 1,510 schools nationwide that used the School-Wide Information…

A nationwide population-based study of depression in Brazil.

PubMed

Munhoz, Tiago N; Nunes, Bruno P; Wehrmeister, Fernando C; Santos, Iná S; Matijasevich, Alicia

2016-03-01

The state of mental health of the population is considered to be an important and essential component of public health. Depression is the mental disorder with greatest prevalence in several countries around the world. This was a nationwide Brazilian survey with household-based interviews. The sampling process was at random and cluster-based, and performed in three stages: census tracts, households and individuals. One inhabitant aged ≥18 years was selected per household. Individuals at greater risk of depression were identified through the Patient Health Questionnaire-9 (PHQ-9) algorithm, which uses internationally accepted diagnostic criteria. All analyses took into account sample weights. A total of 60,202 individuals were evaluated and the prevalence of positive screening for depression was 4.1% (95% CI: 3.8-4.4%). After adjustments for potential confounding factors, depression was found to be greater among women, individuals aged either 40-59 years or 80 years or over, individuals living in urban areas, those with lower educational level, smokers, and among individuals with arterial hypertension, diabetes and heart disorders. Skin colour, marital status and alcohol abuse were not associated with depression. Characteristics of respondents and non-respondents in the sample could not be compared because data about non-respondents was not available. The prevalence of positive screening for depression in Brazil was similar to other studies conducted worldwide. In Brazil, this proportion reflects a considerable absolute number of people with greater risk of depression (≈5.5 million) that may require adequate management through the health system and services. Copyright © 2015 Elsevier B.V. All rights reserved.

Association between a history of periodontitis and the risk of rheumatoid arthritis: a nationwide, population-based, case-control study.

PubMed

Chen, Hsin-Hua; Huang, Nicole; Chen, Yi-Ming; Chen, Tzeng-Ji; Chou, Pesus; Lee, Ya-Ling; Chou, Yiing-Jenq; Lan, Joung-Liang; Lai, Kuo-Lung; Lin, Ching-Heng; Chen, Der-Yuan

2013-07-01

To investigate the association between the risk of rheumatoid arthritis (RA) and a history of periodontitis. This nationwide, population-based, case-control study used administrative data to identify 13 779 newly diagnosed patients with RA (age ≥16 years) as the study group and 137 790 non-patients with RA matched for age, sex, and initial diagnosis date (index date) as controls. Using conditional logistic regression analysis after adjustment for potential confounders, including geographical region and a history of diabetes and Sjögren's syndrome, ORs with 95% CI were calculated to quantify the association between RA and periodontitis. To evaluate the effects of periodontitis severity and the lag time since the last periodontitis visit on RA development, ORs were calculated for subgroups of patients with periodontitis according to the number of visits, cumulative cost, periodontal surgery and time interval between the last periodontitis-related visit and the index date. An association was found between a history of periodontitis and newly diagnosed RA (OR=1.16; 95% CI 1.13 to 1.21). The strength of this association remained statistically significant after adjustment for potential confounders (OR=1.16; 95% CI 1.12 to 1.20), and after variation of periodontitis definitions. The association was dose- and time-dependent and was strongest when the interval between the last periodontitis-related visit and the index date was <3 months (OR=1.64; 95% CI 1.49 to 1.79). This study demonstrates an association between periodontitis and incident RA. This association is weak and limited to lack of individual smoking status.

The design, rationale, and baseline characteristics of a nationwide cohort registry in China: blood pressure and clinical outcome in TIA or ischemic stroke.

PubMed

Xu, Jie; Liu, Yi; Tao, Yongli; Xie, Xuewei; Gu, Hongqiu; Pan, Yuesong; Zhao, Xingquan; Wang, Yongjun; Yan, Aoshuang; Wang, Yilong

2016-01-01

The relationship between poststroke blood pressure (BP) and clinical outcomes in ischemic stroke (IS) is still controversial. However, there is no large BP database for IS or transient ischemic attack (TIA) in China. This study aims to describe the rationale, study design, and baseline characteristics of a nationwide BP database in IS or TIA patients in China. The BOSS (blood pressure and clinical outcome in TIA or ischemic stroke) study was a hospital-based, prospective cohort study aiming to assess BP parameters and clinical outcome in IS/TIA patients. BP parameters were based on office BP, ambulatory BP, and home BP. Clinical outcomes included stroke recurrence, combined vascular events, and disability. Electronic case-report forms were used to record baseline and follow-up data. The patients were followed up for clinical outcomes at 3 months through face-to-face interview and at 12 months by telephone. Between October 2012 and February 2014, the BOSS registry recruited 2,608 patients from 61 hospitals, with a mean age of 62.5 years, 32.4% of whom were female, 88.9% with an entry diagnosis of IS, and 86% diagnosed with hypertension. The rates of patients lost-to-follow-up were 3.1% at 3 months and 5.1% at 1 year; 93% of patients completed ambulatory BP monitoring during hospitalization and 94.7% finished a 3-month BP diary. The BOSS registry will provide important evidence about BP management in the acute phase and secondary prevention for IS/TIA patients.

The Cost and Effectiveness of School-Based Preventive Dental Care.

ERIC Educational Resources Information Center

Klein, Stephen P.; And Others

1985-01-01

The cost and effectiveness of various types and combinations of school-based preventive dental care procedures were assessed in the National Preventive Dentistry Demonstration Program, a four-year study involving more than 20,000 students, from ten schools nationwide. Communal water fluoridation was reaffirmed as the most cost-effective means of…

The radiologic technologists' health study in South Korea: study design and baseline results.

PubMed

Lee, Won Jin; Ha, Mina; Hwang, Seung-sik; Lee, Kyoung-Mu; Jin, Young-Woo; Jeong, Meeseon; Jun, Jae Kwan; Cha, Eun Shil; Ko, Yousun; Choi, Kyung-Hwa; Lee, Jung-Eun

2015-08-01

To describe the study design, methods, and baseline results of a prospective cohort of radiologic technologists which we have initiated in South Korea. The cohort participants were enrolled through a self-administered questionnaire survey administered from April 2012 to May 2013. Survey data were linked with radiation dosimetry, a cancer registry, and health insurance data by personal identification numbers. A nationwide representative survey was also conducted using a stratified random sampling design with face-to-face interviews. A total of 12,387 radiologic technologists were enrolled, which accounted for approximately 63% of all diagnostic radiologic technologists working in South Korea. For nationwide survey, 585 workers were interviewed using the detailed questionnaire, and buccal cells were also collected by scraping the inside of the cheek. The majority of study subjects were under 50-year-old and male workers. The average annual effective dose of radiation declined both men (from 2.75 to 1.43 mSv) and women (from 1.34 to 0.95 mSv) over the period of 1996-2011. A total of 99 cancers (66 cancers in men and 33 in women) were reported from 1992 to 2010. The standardized incidence ratio of all cancer combined was significantly lower in men (SIR = 0.75, 95% CI 0.58-0.96) than general population, but the ratios for thyroid cancer were significantly higher than expected among both men and women. This cohort provides comprehensive information on work activities and health status of diagnostic radiologic technologists. In addition, the nationwide representative sample provides unique opportunities compared with previous radiologic technologist studies.

Clinic characteristics of psoriasis in China: a nationwide survey in over 12000 patients.

PubMed

Chen, Kun; Wang, Gang; Jin, Hongzhong; Xu, Jinhua; Zhu, Xuejun; Zheng, Min; Gu, Heng

2017-07-11

Psoriasis is a worldwide chronic inflammatory disease, involving both skin and joints. In order to characterize psoriasis in Han Chinese population, we conducted this nationwide prospective and hospital based survey, in which 56 hospitals with departments of dermatology participated, located in 33 cities across China. A total of 12,031 outpatients with psoriasis were registered during 2009 to 2010, which the data was collected by standard questionnaires. The main data acquisition included demographics, family history, disease status and other comorbidities. Physical and dermatological examination, including body surface area (BSA) and psoriasis area severity index (PASI) were applied to evaluate the disease severity. Descriptive statistics, 2 tailed t-test and chi-square test were used appropriately for the statistical analysis. From the study, we found that the male and female ratio of the patients was 1.49:1. Mean age of onset was 30.2 ± 14.5 years for males and 27.1 ± 15.6 years for females (P < 0.05). Scalp was the most common onset site (52.8%), The mean PASI was 18.70 ± 10.01, indicating that most patients presenting at the hospitals had moderate-to-severe psoriasis and the majority was psoriasis vulgaris (96.5%). Among 12,031 patients, 23.1% had a family history of psoriasis,16.1% had comorbidities, and 29.9% had nail changes. The most important aggravation factor was season change (60.2%), followed by psychological stress (34.5%), and there significant differences between genders on trigger factors. In conclusion, this study characterizing psoriasis in Han Chinese population, could be used as basic data for future study.

Opportunistic diseases among HIV-infected patients: a multicenter-nationwide Korean HIV/AIDS cohort study, 2006 to 2013

PubMed Central

Kim, Youn Jeong; Woo, Jun Hee; Kim, Min Ja; Park, Dae Won; Song, Joon-Young; Kim, Shin Woo; Choi, Jun Yong; Kim, June Myung; Han, Sang Hoon; Lee, Jin-Soo; Choi, Bo Youl; Lee, Joo Shil; Kim, Sung-Soon; Kee, Mee-Kyung; Kang, Moon Won; Kim, Sang Il

2016-01-01

Background/Aims: The frequencies of opportunistic diseases (ODs) vary across countries based on genetic, environmental, and social differences. The Korean HIV/AIDS cohort study was initiated in 2006 to promote research on human immunodeficiency virus (HIV) infection in Korea, and to provide a logistical network to support multicenter projects on epidemiological, clinical, and laboratory aspects of HIV infection. This study evaluated the prevalence of ODs among HIV-infected patients in the era of highly active antiretroviral therapy, and the risk factors associated with ODs. Methods: The study enrolled 1,086 HIV-infected patients from 19 hospitals. This study examined the baseline data of the HIV/AIDS Korean cohort study at the time of enrollment from December 2006 to July 2013. Results: Candidiasis was the most prevalent opportunistic infection (n = 176, 16.2%), followed by Mycobacterium tuberculosis infection (n = 120, 10.9%), Pneumocystis jirovecii pneumonia (n = 121, 11.0%), cytomegalovirus infection (n = 52, 4.7%), and herpes zoster (n = 44, 4.0%). The prevalence rates of Kaposi’s sarcoma (n = 8, 0.7%) and toxoplasmosis (n = 4, 0.4%) were very low compared with other countries. The risk factors for ODs were a low CD4 T cell count at the time of HIV diagnosis (odds ratio [OR], 1.01; p < 0.01), current smoking (OR, 2.27; p = 0.01), current alcohol use (OR, 2.57; p = 0.04), and a history of tuberculosis (OR, 5.23; p < 0.01). Conclusions: Using recent Korean nationwide data, this study demonstrated that an important predictor of ODs was a low CD4 T cell count at the time of HIV diagnosis. Tuberculosis remains one of the most important ODs in HIV-infected patients in Korea. PMID:27117317

Removing user fees for basic health services: a pilot study and national roll-out in Afghanistan

PubMed Central

Steinhardt, Laura C; Aman, Iqbal; Pakzad, Iqbalshah; Kumar, Binay; Singh, Lakhwinder P; Peters, David H

2011-01-01

Background User fees for primary care tend to suppress utilization, and many countries are experimenting with fee removal. Studies show that additional inputs are needed after removing fees, although well-documented experiences are lacking. This study presents data on the effects of fee removal on facility quality and utilization in Afghanistan, based on a pilot experiment and subsequent nationwide ban on fees. Methods Data on utilization and observed structural and perceived overall quality of health care were compared from before-and-after facility assessments, patient exit interviews and catchment area household surveys from eight facilities where fees were removed and 14 facilities where fee levels remained constant, as part of a larger health financing pilot study from 2005 to 2007. After a national user fee ban was instituted in 2008, health facility administrative data were analysed to assess subsequent changes in utilization and quality. Results The pilot study analysis indicated that observed and perceived quality increased across facilities but did not differ by fee removal status. Difference-in-difference analysis showed that utilization at facilities previously charging both service and drug fees increased by 400% more after fee removal, prompting additional inputs from service providers, compared with facilities that previously only charged service fees or had no change in fees (P = 0.001). Following the national fee ban, visits for curative care increased significantly (P < 0.001), but institutional deliveries did not. Services typically free before the ban—immunization and antenatal care—had immediate increases in utilization but these were not sustained. Conclusion Both pilot and nationwide data indicated that curative care utilization increased following fee removal, without differential changes in quality. Concerns raised by non-governmental organizations, health workers and community leaders over the effects of lost revenue and increased utilization require continued effort to raise revenues, monitor health worker and patient perceptions, and carefully manage health facility performance. PMID:22027924

Current and Projected Burden of Disease From High Ambient Temperature in Korea.

PubMed

Chung, Soo Eun; Cheong, Hae-Kwan; Park, Jae-Hyun; Kim, Jong-Hun; Han, Hyunjin

2017-10-01

The objective of the present study was to estimate the current and projected burden of disease from high ambient temperature using population-based data sources of nationwide mortality and morbidity in Korea. Disability-adjusted life years (DALY) were estimated using noninjury-related deaths, and cerebrovascular and cardiovascular diseases from recently released nationwide health and mortality databases. Years of life lost and years lost due to disability were measured based on the point prevalence and number of deaths during the study period. Future DALY attributable to heat waves were estimated from projected populations, and temperature predictions for the years 2030 and 2050 were under Representative Concentration Pathways (RCP) 4.5 and 8.5 with summertime temperatures above threshold. Relative risks (RR) of total mortality and of cardiovascular disease were 1.02 (95% CI, 1.01, 1.02) and 1.08 (95% CI, 1.06, 1.09) for each 1°C increase in temperature above threshold, respectively. The morbidity of heat-related disease was RR 1.67 (95% CI, 1.64, 1.68) for each 1°C increase in temperature above threshold. DALY for all-cause death were 0.49 DALY/1000 in 2011, 0.71 (0.71) DALY/1000 in 2030 and 0.77 (1.72) DALY/1000 in 2050 based on RCP 4.5 (RCP 8.5). DALY for cardio- and cerebrovascular diseases were 1.24 DALY/1000 in 2011, 1.63 (1.82) DALY/1000 in 2030, and 1.76 (3.66) DALY/1000 in 2050 based on RCP 4.5 (RCP 8.5). Future excess mortality due to high ambient temperature is expected to be profound in Korea. Efforts to mitigate climate change can provide substantial health benefits via reducing heat-related mortality.

A Comparison between the Second Korean Working Conditions Survey (KWCS) and the First KWCS.

PubMed

Kim, Young Sun; Park, Jungsun; Rhee, Kyung Yong; Kim, Hye Min

2015-06-01

The study was designed to assess the changes in working conditions through a comparative analysis of the characteristics of working conditions in 2006 and 2010. We performed a comparative analysis of the data related to the first Korean Working Conditions Survey (KWCS) and the second KWCS in the categories of demographic characteristics, quality of labor, exposure to hazards, and health problems. From our analysis of the demographic characteristics, we saw an increase in labor force participation rate of women and elderly people. As a result of the investigation with regards to working hours, the ratio of employees who worked for ≥ 49 hours per week was decreased and the ratio of employees who worked for ≥ 40 h/wk increased. As for exposure to hazards, exposure to tobacco smoke notably decreased in 2010 compared with 2006. With regards to health problems, there was a sharp increase in the number of people who complained of muscle pain in their arms and legs. KWCS data included many aspects of working conditions as a nationwide sample. In addition, because this is a periodic nationwide survey, the labor force, working hours, harmful factor exposure, and the change in health problems characteristics according to the flow of time could be investigated. The information comparing the main results of the first survey conducted in 2006 and the second survey conducted in 2010 obtained through this study can be used as an important base material for the establishment of the national policy.

Professional Development: A Six-Year Data Evaluation of HIDTA Law Enforcement Task Force Training Programs

ERIC Educational Resources Information Center

Burnett, Larry D.

2012-01-01

This is a nationwide six-year data study of law enforcement training and professional development in relationship to workplace productivity. Why do we care about law enforcement training and professional development? Because the law enforcement environment is not standing still. Unlawful activity, and in particular drug trafficking strategies,…

A method for explaining trends in river recreation demand

Treesearch

George L. Peterson; David W. Lime; Dorothy H. Anderson

1980-01-01

Data being collected by The National River Recreation Study (NRRS) (U.S. Forest Service, St. Paul) includes origin-destination information for recreational visits to a variety of rivers nationwide. Such data are being collected over several years during a time of rapidly changing energy costs, economic conditions and consumer attitudes. This presents an opportunity to...

Mesh versus bathtub - effects of flood models on exposure analysis in Switzerland

NASA Astrophysics Data System (ADS)

Röthlisberger, Veronika; Zischg, Andreas; Keiler, Margreth

2016-04-01

In Switzerland, mainly two types of maps that indicate potential flood zones are available for flood exposure analyses: 1) Aquaprotect, a nationwide overview provided by the Federal Office for the Environment and 2) communal flood hazard maps available from the 26 cantons. The model used to produce Aquaprotect can be described as a bathtub approach or linear superposition method with three main parameters, namely the horizontal and vertical distance of a point to water features and the size of the river sub-basin. Whereas the determination of flood zones in Aquaprotect is based on a uniform, nationwide model, the communal flood hazard maps are less homogenous, as they have been elaborated either at communal or cantonal levels. Yet their basic content (i.e. indication of potential flood zones for three recurrence periods, with differentiation of at least three inundation depths) is described in national directives and the vast majority of communal flood hazard maps are based on 2D inundation simulations using meshes. Apart from the methodical differences between Aquaprotect and the communal flood hazard maps (and among different communal flood hazard maps), all of these maps include a layer with a similar recurrence period (i.e. Aquaprotect 250 years, flood hazard maps 300 years) beyond the intended protection level of installed structural systems. In our study, we compare the resulting exposure by overlaying the two types of flood maps with a complete, harmonized, and nationwide dataset of building polygons. We assess the different exposure at the national level, and also consider differences among the 26 cantons and the six biogeographically unique regions, respectively. It was observed that while the nationwide exposure rates for both types of flood maps are similar, the differences within certain cantons and biogeographical regions are remarkable. We conclude that flood maps based on bathtub models are appropriate for assessments at national levels, while maps based on 2D simulations are preferable at sub-national levels.

Current status of nutritional support for hospitalized children: a nationwide hospital-based survey in South Korea.

PubMed

Kim, Seung; Lee, Eun Hye; Yang, Hye Ran

2018-06-01

The prevalence of malnutrition among hospitalized children ranges between 12% and 24%. Although the consequences of hospital malnutrition are enormous, it is often unrecognized and untreated. The aim of this study was to identify the current status of in-hospital nutrition support for children in South Korea by carrying out a nationwide hospital-based survey. Out of 345 general and tertiary hospitals in South Korea, a total of 53 institutes with pediatric gastroenterologists and more than 10 pediatric inpatients were selected. A questionnaire was developed by the nutrition committee of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition. The questionnaires were sent to pediatric gastroenterologists in each hospital. Survey was performed by e-mails. Forty hospitals (75.5%) responded to the survey; 23 of them were tertiary hospitals, and 17 of them were general hospitals. Only 21 hospitals (52.5%) had all the required nutritional support personnel (including pediatrician, nutritionist, pharmacist, and nurse) assigned to pediatric patients. Routine nutritional screening was performed in 22 (55.0%) hospitals on admission, which was lower than that in adult patients (65.8%). Nutritional screening tools varied among hospitals; 33 of 40 (82.5%) hospitals used their own screening tools. The most frequently used nutritional assessment parameters were weight, height, hemoglobin, and serum albumin levels. In our nationwide hospital-based survey, the most frequently reported main barriers of nutritional support in hospitals were lack of manpower and excessive workload, followed by insufficient knowledge and experience. Although this nationwide hospital-based survey targeted general and tertiary hospitals with pediatric gastroenterologists, manpower and medical resources for nutritional support were still insufficient for hospitalized children, and nutritional screening was not routinely performed in many hospitals. More attention to hospital malnutrition and additional national policies for nutritional support in hospitals are required to ensure appropriate nutritional management of hospitalized pediatric patients.

On the integration of wind and solar energy to provide a total energy supply in the USA

NASA Astrophysics Data System (ADS)

Archer, Cristina; Mills, David; Cheng, Weili; Sloggy, Matthew; Liebig, Edwin; Rhoades, Alan

2010-05-01

This study examines the feasibility of using renewable energy - mostly wind and solar radiation - as the primary source of energy in the USA, under the assumption that a nationwide electric transmission grid is in place. Previous studies have shown that solar or wind alone can power the present U.S. grid on average. Other studies have shown that solar output from California and Texas using energy storage is well correlated with the state energy load on an hour by hour basis throughout the year and with the U.S. national load on a monthly basis. This study explores scenarios for use of wind and solar energy together at the national scale on an hour by hour basis to determine if such a combination is a better match to national seasonal load scenarios than either of the two alone on an hour-by-hour basis. Actual hour by hour national load data from the year 2006 are used as a basis, with some scenarios incorporating vehicle sector electrification and building heating and cooling using electric heat pumps. Hourly wind speed data were calculated at the hub height of 80 m above the ground for the year 2006 at over 150 windy locations in the continental U.S. using an extrapolation technique based on 10-m wind speed measurements and vertical sounding profiles. Using a 1.5 MW wind turbine as benchmark, the hourly wind power production nationwide was determined at all suitable locations. Similarly, the hourly output from solar plants, with and without thermal storage, was calculated based on Ausra's model assuming that the solar production would occur in the Southwest, the area with the greatest solar radiation density in the U.S. Hourly electricity demand for the year 2006 was obtained nationwide from a variety of sources, including the Federal Energy Regulation Commission. Hourly residential heating and cooking, industrial heat processing, and future electrified transportation loads were calculated from monthly and yearly energy consumption data from the Energy Information Administration. Using different scenarios of wind power penetration (between 10% and 120% of the average national electricity and/or energy demand), the remaining hourly electricity and/or energy load was covered by solar thermal electricity produced via the Ausra's innovative linear reflective system, with various amounts of storage. With a 20% redundancy (i.e., an average production of 120% of the demand), a match of ~98% for electric load and ~96% for total energy load were found for the 60%wind-60%solar combination and with 12-hr storage. Work is continuing on improving that match through more sophisticated storage usage strategies and by looking at other options for the few days in the year for which wind and solar might be insufficient.

Cost-benefit analysis of childhood asthma management through school-based clinic programs.

PubMed

Tai, Teresa; Bame, Sherry I

2011-04-01

Asthma is a leading chronic illness among American children. School-based health clinics (SBHCs) reduced expensive ER visits and hospitalizations through better healthcare access and monitoring in select case studies. The purpose of this study was to examine the cost-benefit of SBHC programs in managing childhood asthma nationwide for reduction in medical costs of ER, hospital and outpatient physician care and savings in opportunity social costs of lowing absenteeism and work loss and of future earnings due to premature deaths. Eight public data sources were used to compare costs of delivering primary and preventive care for childhood asthma in the US via SBHC programs, including direct medical and indirect opportunity costs for children and their parents. The costs of nurse staffing for a nationwide SBHC program were estimated at $4.55 billion compared to the estimated medical savings of $1.69 billion, including ER, hospital, and outpatient care. In contrast, estimated total savings for opportunity costs of work loss and premature death were $23.13 billion. Medical savings alone would not offset the expense of implementing a SBHC program for prevention and monitoring childhood asthma. However, even modest estimates of reducing opportunity costs of parents' work loss would be far greater than the expense of this program. Although SBHC programs would not be expected to affect the increasing prevalence of childhood asthma, these programs would be designed to reduce the severity of asthma condition with ongoing monitoring, disease prevention and patient compliance.

A study of demographic, situational, and motivational factors affecting restraint usage in automobiles

DOT National Transportation Integrated Search

1983-02-01

Data were obtained from a nationwide telephone survey, extensive face-to-face interviews, and observations to assess the impact of demographic, situational, and motivational variables on seat belt use. The results revealed that almost one-third of th...

Occupational Therapy in the Context of Head Start: A Preliminary Survey Study

ERIC Educational Resources Information Center

Bowyer, Patricia; Moore, Cary C.; Thom, Carly

2016-01-01

This preliminary, descriptive study yields information on the utilization of occupational therapy services within Head Start programs. Participants completed an Internet-based survey of 25 questions pertaining to the understanding, scope, and utilization of occupational therapy services. Surveys were completed by 35 respondents nationwide. A total…

The Impact of the West Africa Ebola Outbreak on Obstetric Health Care in Sierra Leone.

PubMed

Brolin Ribacke, Kim J; van Duinen, Alex J; Nordenstedt, Helena; Höijer, Jonas; Molnes, Ragnhild; Froseth, Torunn Wigum; Koroma, A P; Darj, Elisabeth; Bolkan, Håkon Angel; Ekström, AnnaMia

2016-01-01

As Sierra Leone celebrates the end of the Ebola Virus Disease (EVD) outbreak, we can begin to fully grasp its impact on already weak health systems. The EVD outbreak in West Africa forced many hospitals to close down or reduce their activity, either to prevent nosocomial transmission or because of staff shortages. The aim of this study is to assess the potential impact of EVD on nationwide access to obstetric care in Sierra Leone. Community health officers collected weekly data between January 2014-May 2015 on in-hospital deliveries and caesarean sections (C-sections) from all open facilities (public, private for-profit and private non-profit sectors) offering emergency obstetrics in Sierra Leone. This was compared to official data of EVD cases per district. Logistic and Poisson regression analyses were used to compute risk and rate estimates. Nationwide, the number of in-hospital deliveries and C-sections decreased by over 20% during the EVD outbreak. The decline occurred early on in the EVD outbreak and was mainly attributable to the closing of private not-for-profit hospitals rather than government facilities. Due to difficulties in collecting data in the midst of an epidemic, limitations of this study include some missing data points. Both the number of in-hospital deliveries and C-sections substantially declined shortly after the onset of the EVD outbreak. Since access to emergency obstetric care, like C-sections, is associated with decreased maternal mortality, many women are likely to have died due to the reduced access to appropriate care during childbirth. Future research on indirect health effects of health system breakdown should ideally be nationwide and continue also into the recovery phase. It is also important to understand the mechanisms behind the deterioration so that important health services can be reestablished.

Bridging the Gap between Science and Practice: The Effective Nationwide Transport of MST Programs in Norway

ERIC Educational Resources Information Center

Ogden, Terje; Christensen, Bernadette; Sheidow, Ashli J.; Holth, Per

2008-01-01

The successful nationwide transport and evaluation of Multisystemic Therapy (MST) programs in Norway is described. This description is provided within the context of the nation's movement towards the adoption of evidence-based practices (EBPs) during the past decade, the conduct of a multisite randomized clinical trial to examine the effectiveness…

A decision analysis framework for estimating the potential hazards for drinking water resources of chemicals used in hydraulic fracturing fluids.

PubMed

Yost, Erin E; Stanek, John; Burgoon, Lyle D

2017-01-01

Despite growing concerns over the potential for hydraulic fracturing to impact drinking water resources, there are limited data available to identify chemicals used in hydraulic fracturing fluids that may pose public health concerns. In an effort to explore these potential hazards, a multi-criteria decision analysis (MCDA) framework was employed to analyze and rank selected subsets of these chemicals by integrating data on toxicity, frequency of use, and physicochemical properties that describe transport in water. Data used in this analysis were obtained from publicly available databases compiled by the United States Environmental Protection Agency (EPA) as part of a larger study on the potential impacts of hydraulic fracturing on drinking water. Starting with nationwide hydraulic fracturing chemical usage data from EPA's analysis of the FracFocus Chemical Disclosure Registry 1.0, MCDAs were performed on chemicals that had either noncancer toxicity values (n=37) or cancer-specific toxicity values (n=10). The noncancer MCDA was then repeated for subsets of chemicals reported in three representative states (Texas, n=31; Pennsylvania, n=18; and North Dakota, n=20). Within each MCDA, chemicals received scores based on relative toxicity, relative frequency of use, and physicochemical properties (mobility in water, volatility, persistence). Results show a relative ranking of these chemicals based on hazard potential, and provide preliminary insight into chemicals that may be more likely than others to impact drinking water resources. Comparison of nationwide versus state-specific analyses indicates regional differences in the chemicals that may be of more concern to drinking water resources, although many chemicals were commonly used and received similar overall hazard rankings. Several chemicals highlighted by these MCDAs have been reported in groundwater near areas of hydraulic fracturing activity. This approach is intended as a preliminary analysis, and represents one possible method for integrating data to explore potential public health impacts. Published by Elsevier B.V.

Mentoring in Schools: An Impact Study of Big Brothers Big Sisters School-Based Mentoring

ERIC Educational Resources Information Center

Herrera, Carla; Grossman, Jean Baldwin; Kauh, Tina J.; McMaken, Jennifer

2011-01-01

This random assignment impact study of Big Brothers Big Sisters School-Based Mentoring involved 1,139 9- to 16-year-old students in 10 cities nationwide. Youth were randomly assigned to either a treatment group (receiving mentoring) or a control group (receiving no mentoring) and were followed for 1.5 school years. At the end of the first school…

Tree biomass in the Swiss landscape: nationwide modelling for improved accounting for forest and non-forest trees.

PubMed

Price, B; Gomez, A; Mathys, L; Gardi, O; Schellenberger, A; Ginzler, C; Thürig, E

2017-03-01

Trees outside forest (TOF) can perform a variety of social, economic and ecological functions including carbon sequestration. However, detailed quantification of tree biomass is usually limited to forest areas. Taking advantage of structural information available from stereo aerial imagery and airborne laser scanning (ALS), this research models tree biomass using national forest inventory data and linear least-square regression and applies the model both inside and outside of forest to create a nationwide model for tree biomass (above ground and below ground). Validation of the tree biomass model against TOF data within settlement areas shows relatively low model performance (R 2 of 0.44) but still a considerable improvement on current biomass estimates used for greenhouse gas inventory and carbon accounting. We demonstrate an efficient and easily implementable approach to modelling tree biomass across a large heterogeneous nationwide area. The model offers significant opportunity for improved estimates on land use combination categories (CC) where tree biomass has either not been included or only roughly estimated until now. The ALS biomass model also offers the advantage of providing greater spatial resolution and greater within CC spatial variability compared to the current nationwide estimates.

Association of UV radiation with Parkinson disease incidence: A nationwide French ecologic study

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

Kravietz, Adam

Background: Vitamin D is thought to contribute to brain health, but it is unclear whether low vitamin D levels are associated with increased incidence of Parkinson's disease (PD). Using ultraviolet B (UV-B) as a surrogate for vitamin D levels, we conducted a nationwide ecologic study in France in order to examine the association of UV-B with PD incidence. Methods: We used French national drug claims databases to identify PD cases using a validated algorithm. UV-B data from the solar radiation database were derived from satellite images. We estimated PD incidence (2010–2012) at the canton level (small administrative French unit) andmore » used multilevel Poisson regression to examine its association with UV-B (2005 annual average), after adjustment for age, sex, deprivation index, density of neurologists, smoking, proportion of agricultural land, and vitamin D supplementation. Results: Analyses are based on 69,010 incident PD patients. The association between UV-B and PD incidence was quadratic (P<0.001) and modified by age (P<0.001). Below 70y, incidence was higher in the bottom quintile (relative risk, RR{sub Q1:45-49y}=1.18, 95% CI=1.08–1.29) compared with the middle UV-B quintile, and lower in the top quintile (RR{sub Q5:45-49y}=0.85 [0.77–0.94]). An opposite pattern was observed in older subjects (RR{sub Q1:85-89y}=0.92 [0.89–0.96]; RR{sub Q5:85-89y}=1.06 [1.02–1.11]). Analysis based on continuous UV-B yielded similar conclusions. Conclusions: In this nationwide study, there was an age-dependent quadratic association between UV-B and PD incidence. This study suggests that reasonable UV-B exposure is associated with lower PD risk in younger persons and that future studies should examine dose-response relations and take age into account. - Highlights: • There is an age-dependent quadratic association between UV-B and PD incidence. • Reasonable UV-B exposure is beneficial in younger persons for the risk of PD. • Our findings are consistent with a role of vitamin D in PD, especially at younger ages. • Future studies should examine dose-effect relations and take age into account.« less

Traumatic Injuries in Developing Countries: Report from a Nationwide Cross-Sectional Survey of Sierra Leone

PubMed Central

Stewart, Kerry-Ann; Groen, Reinou S.; Kamara, Thaim B.; Farahzard, Mina; Samai, Mohamed; Yambasu, Sahr E.; Cassidy, Laura D.; Kushner, Adam L.; Wren, Sherry M.

2014-01-01

Objective Despite the tremendous disability and mortality caused by traumatic injuries worldwide, there is a relative dearth of information on the burden of injuries in developing countries. In an effort to document the surgical burden of disease in Sierra Leone, a nationwide survey was conducted utilizing the Surgeons OverSeas Assessment of Surgical Need (SOSAS) tool. Here, we report the injury data from this study with the aim to (1) provide an estimate of injury prevalence, (2) determine the mechanisms of injury, and (3) evaluate the degree of injury related deaths. Methods A population-based household survey was conducted in Sierra Leone in 2012. Participants were selected using a two-stage random sampling method, which generated a target population of 3750 participants across the 14 districts of Sierra Leone. Frequency distributions of mechanisms of injury based on age, sex, and urban versus rural residence were computed, and bivariate logistic regression models used to determine associations between sociodemographic factors and injury patterns. Results Data was analyzed from 1,843 households and 3,645 respondents, representing a response rate of 98.3%. Four hundred and fifty-two respondents (12.4%) reported at least one traumatic injury in the preceding year. Falls were the most common cause of non-fatal injuries, accounting for over 40% of injuries. The extremities were most commonly injured (55% of injuries) regardless of age or sex. Although motor vehicle related injuries were the 4th most common cause of injury overall, they were the leading cause of injury related deaths, accounting for almost 6% of fatal injuries. Conclusion This study provides baseline data on the burden of traumatic injuries in one of the world's poorest nations. In addition to injury prevention measures, immediate strategies to address current healthcare deficits are urgently needed in these resource poor areas. This report is an Original Article with Level I evidence. PMID:23325317

Best Fed Beginnings: A Nationwide Quality Improvement Initiative to Increase Breastfeeding.

PubMed

Feldman-Winter, Lori; Ustianov, Jennifer; Anastasio, Julius; Butts-Dion, Sue; Heinrich, Patricia; Merewood, Anne; Bugg, Kimarie; Donohue-Rolfe, Sarah; Homer, Charles J

2017-07-01

In response to a low number of Baby-Friendly-designated hospitals in the United States, the Centers for Disease Control and Prevention funded the National Institute for Children's Health Quality to conduct a national quality improvement initiative between 2011 and 2015. The initiative was entitled Best Fed Beginnings and enrolled 90 hospitals in a nationwide initiative to increase breastfeeding and achieve Baby-Friendly designation. The intervention period lasted from July 2012 to August 2014. During that period, data on process indicators aligned with the Ten Steps to Successful Breastfeeding and outcome measures (overall and exclusively related to breastfeeding) were collected. In addition, data on the Baby-Friendly designation were collected after the end of the intervention through April 2016. Hospitals assembled multidisciplinary teams that included parent partners and community representatives. Three in-person learning sessions were interspersed with remote learning and tests of change, and a Web-based platform housed resources and data for widespread sharing. By April 2016, a total of 72 (80%) of the 90 hospitals received the Baby-Friendly designation, nearly doubling the number of designated hospitals in the United States. Participation in the Best Fed Beginnings initiative had significantly high correlation with designation compared with hospital applicants not in the program (Pearson's r [235]: 0.80; P < .01). Overall breastfeeding increased from 79% to 83% ( t = 1.93; P = .057), and exclusive breastfeeding increased from 39% to 61% ( t = 9.72; P < .001). A nationwide initiative of maternity care hospitals accomplished rapid transformative changes to achieve Baby-Friendly designation. These changes were accompanied by a significant increase in exclusive breastfeeding. Copyright © 2017 by the American Academy of Pediatrics.

Identifying effective actions to guide volunteer-based and nationwide conservation efforts for a ground-nesting farmland bird.

PubMed

Santangeli, Andrea; Arroyo, Beatriz; Millon, Alexandre; Bretagnolle, Vincent

2015-08-01

1. Modern farming practices threaten wildlife in different ways, and failure to identify the complexity of multiple threats acting in synergy may result in ineffective management. To protect ground-nesting birds in farmland, monitoring and mitigating impacts of mechanical harvesting is crucial. 2. Here, we use 6 years of data from a nationwide volunteer-based monitoring scheme of the Montagu's harrier, a ground-nesting raptor, in French farmlands. We assess the effectiveness of alternative nest protection measures and map their potential benefit to the species. 3. We show that unprotected nests in cultivated land are strongly negatively affected by harvesting and thus require active management. Further, we show that protection from harvesting alone (e.g. by leaving a small unharvested buffer around the nest) is impaired by post-harvest predation at nests that become highly conspicuous after harvest. Measures that simultaneously protect from harvesting and predation (by adding a fence around the nest) significantly enhance nest productivity. 4. The map of expected gain from nest protection in relation to available volunteers' workforce pinpoints large areas of high expected gain from nest protection that are not matched by equally high workforce availability. This mismatch suggests that the impact of nest protection can be further improved by increasing volunteer efforts in key areas where they are low relative to the expected gain they could have. 5. Synthesis and applications . This study shows that synergistic interplay of multiple factors (e.g. mechanical harvesting and predation) may completely undermine the success of well-intentioned conservation efforts. However, identifying areas where the greatest expected gains can be achieved relative to effort expended can minimize the risk of wasted volunteer actions. Overall, this study underscores the importance of citizen science for collecting large-scale data useful for producing science and ultimately informs large-scale evidence-based conservation actions within an adaptive management framework.

An exploration of facilitators and challenges in the scale-up of a national, public sector community health worker cadre in Zambia: a qualitative study.

PubMed

Phiri, Sydney Chauwa; Prust, Margaret Lippitt; Chibawe, Caroline Phiri; Misapa, Ronald; van den Broek, Jan Willem; Wilmink, Nikhil

2017-06-24

In 2010 a public sector cadre of community health workers called Community Health Assistants (CHAs) was created in Zambia through the National Community Health Worker Strategy to expand access to health services. This cadre continues to be scaled up to meet the growing demands of Zambia's rural population. We summarize factors that have facilitated the scale-up of the CHA program into a nationwide CHW cadre and the challenges of introducing and institutionalizing the cadre within the Zambian health system. Semi-structured, individual interviews were held across 5 districts with 16 CHAs and 6 CHA supervisors, and 10 focus group discussions were held with 93 community members. Audio recordings of interviews and focus group discussions were transcribed and thematically coded using Dedoose web-based software. The study showed that the CHAs play a critical role in providing a wide range of services at the community level, as described by supervisors and community members. Some challenges still remain, that may inhibit the CHAs ability to provide health services effectively. In particular, the respondents highlighted infrequent supervision, lack of medical and non-medical supplies for outreach services, and challenges with the mobile data reporting system. The study shows that in order to optimize the impact of CHAs or other community health workers, key health-system support structures need to be functioning effectively, such as supervision, community surveillance systems, supplies, and reporting. The Ministry of Health with support from partners are currently addressing these challenges through nationwide supervisor and community data trainings, as well as advocating for adding primary health care as a specific focus area in the new National Health Strategy Plan 2017-2021. This study contributes to the evidence base on the introduction of formalized community health worker cadres in developing countries.

Incidence of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Nationwide Population-Based Study Using National Health Insurance Database in Korea.

PubMed

Yang, Min-Suk; Lee, Jin Yong; Kim, Jayeun; Kim, Gun-Woo; Kim, Byung-Keun; Kim, Ju-Young; Park, Heung-Woo; Cho, Sang-Heon; Min, Kyung-Up; Kang, Hye-Ryun

2016-01-01

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening diseases; however, it is hard to estimate their incidence due to the rarity of these diseases. We evaluated the incidence of SJS and TEN using a nationwide administrative database. We used a national medical insurance review system (Health Insurance Review and Assessment) database which contained the claim data of the entire nation from 2009 to 2013 to estimate the accurate incidence of SJS and TEN in Korea. The diagnostic codes of L511 (SJS) or L512 (TEN) from the International Classification of Diseases-10th revision were used to define the target study population. We also retrospectively followed up a 2011 SJS and TEN cohort for 24 months in order to assess the in-hospital mortality, related complications and total claims cost due to SJS and TEN. A total of 1,167 (938 SJS and 229 TEN) cases were newly diagnosed from 2010 to 2013. The age- and sex-standardized annual incidences estimated in this study were 3.96 to 5.03 in SJS and 0.94 to 1.45 in TEN per million. There was no significant change in annual incidence throughout the study periods. When analyzed by 10-year age groups, the annual incidence was the lowest in group 20-29 years and the highest in group 70 for both SJS and TEN. Based on the 2011 cohort analysis, the in-hospital mortality were 5.7 and 15.1% for SJS and TEN, respectively. The mortality increased with age, particularly, after 40 years of age. Among the complications related with SJS or TEN, ocular sequelae was the most common (43.1 and 43.4% of SJS and TEN patients, respectively) followed by urethral sequelae (5.7 and 9.4% of SJS and TEN patients, respectively). Overall, our data suggest that SJS, and TEN are infrequent but constantly arise throughout the years.

An Empirical Study on the Job Satisfaction of College Graduates in China

ERIC Educational Resources Information Center

Changjun, Yue

2014-01-01

This study used nationwide, randomly sampled data from the Peking University Institute of Economics of Education 2011 survey of college graduates to conduct an empirical analysis of their job satisfaction. The results indicate that work-related factors have a significant effect on the job satisfaction of college graduates, while nonwork factors…

RDA: Training and Continuing Education Needs in Academic Libraries

ERIC Educational Resources Information Center

Tosaka, Yugi; Park, Jung-ran

2014-01-01

This study aims at gaining a better understanding of the current state and needs of RDA training among cataloging and metadata practitioners. Using nationwide survey data focusing on the academic library sector, this study finds that while training activities since RDA's release in 2010 show a positive correlation with catalogers' levels of RDA…

Undergraduate Physical Activity and Depressive Symptoms: A National Study

ERIC Educational Resources Information Center

Elliot, Catherine A.; Kennedy, Catherine; Morgan, George; Anderson, Sharon K.; Morris, Debra

2012-01-01

Objective: To study the effects of college students' physical activity and gender on depressive and suicidal symptoms. Method: The National College Health Assessment survey was administered to college students nationwide. Data were analyzed with 4x2 ANOVAs and Games-Howell post hoc tests when appropriate. Results: More frequent physical activity…

The Girl Child and the Family: An Action Research Study.

ERIC Educational Resources Information Center

Anandalakshmy, S., Comp.

This report describes a nationwide study of female children and the family in rural India. The objectives of the study were to generate data on the situation of female children; to identify the major problems related to their status; to start a series of programs to help remedy those shortcomings; and to assist communities, and women in…

With long hours of work, might depression then lurk? A nationwide prospective follow-up study among Danish senior medical consultants.

PubMed

Varma, Anshu; Marott, Jacob Louis; Stoltenberg, Christian Ditlev Gabriel; Wieclaw, Joanna; Kolstad, Henrik Albert; Bonde, Jens Peter Ellekilde

2012-09-01

The aim of this study was to examine depression as a potential negative health effect of long work hours, anticipating an exposure-response relationship. A nationwide prospective cohort study of 2790 Danish senior medical consultants was conducted (61.7% response rate). With the consent of Danish Data Protection Agency, data from a questionnaire survey was linked with data from a Medical Products Agency Register. Long work hours were defined based on a self-reported average of weekly work hours >40, while redemption of anti-depressive (AD) drug prescriptions defined depression. Proportional hazards Cox regression analyses were conducted adjusting for gender, age, marital status, medical specialty, decision authority at work, work social support, quantitative work demands, and AD drugs prescribed before baseline. Long weekly work hours did not increase the risk of redeeming AD drug prescriptions at all times during follow-up compared to the reference of 37-40 work hours [41-44 hours: hazard ratio (HR) 0.95, 95% confidence interval (95% CI) 0.5-1.8; 45-49 hours: HR 0.88, 95% CI 0.4-1.8; 50-54 hours: HR 0.83, 95% CI 0.3-2.1; 55-59 hours: HR 0.67, 95% CI 0.2-2.9; ≥ 60 hours: HR 0.48, 95% CI 0.1-3.7]. The same result emerged when work hours was applied in a continuous form (from 25-36 hours to 37-40 hours to 41-44 hours and so on) (HR 0.93, 95% CI 0.76-1.13) and when robust analyses were conducted (data not shown). This study does not support the anticipation that long work hours increase the risk of depression. If anything, long work hours vaguely appear to decrease the risk of redeeming AD drug prescriptions.

Are prehospital airway management resources compatible with difficult airway algorithms? A nationwide cross-sectional study of helicopter emergency medical services in Japan.

PubMed

Ono, Yuko; Shinohara, Kazuaki; Goto, Aya; Yano, Tetsuhiro; Sato, Lubna; Miyazaki, Hiroyuki; Shimada, Jiro; Tase, Choichiro

2016-04-01

Immediate access to the equipment required for difficult airway management (DAM) is vital. However, in Japan, data are scarce regarding the availability of DAM resources in prehospital settings. The purpose of this study was to determine whether Japanese helicopter emergency medical services (HEMS) are adequately equipped to comply with the DAM algorithms of Japanese and American professional anesthesiology societies. This nationwide cross-sectional study was conducted in May 2015. Base hospitals of HEMS were mailed a questionnaire about their airway management equipment and back-up personnel. Outcome measures were (1) call for help, (2) supraglottic airway device (SGA) insertion, (3) verification of tube placement using capnometry, and (4) the establishment of surgical airways, all of which have been endorsed in various airway management guidelines. The criteria defining feasibility were the availability of (1) more than one physician, (2) SGA, (3) capnometry, and (4) a surgical airway device in the prehospital setting. Of the 45 HEMS base hospitals questioned, 42 (93.3 %) returned completed questionnaires. A surgical airway was practicable by all HEMS. However, in the prehospital setting, back-up assistance was available in 14.3 %, SGA in 16.7 %, and capnometry in 66.7 %. No HEMS was capable of all four steps. In Japan, compliance with standard airway management algorithms in prehospital settings remains difficult because of the limited availability of alternative ventilation equipment and back-up personnel. Prehospital health care providers need to consider the risks and benefits of performing endotracheal intubation in environments not conducive to the success of this procedure.

Increase the risk of intellectual disability in children with scabies: A nationwide population-based cohort study.

PubMed

Liu, Jui-Ming; Hsu, Ren-Jun; Chang, Fung-Wei; Yeh, Chia-Lun; Huang, Chun-Fa; Chang, Shu-Ting; Chiu, Nan-Chang; Chang, Hung-Yang; Chi, Hsin; Lin, Chien-Yu

2017-06-01

Scabies is a common and distressing disease caused by the mite Sarcoptes scabiei var. hominis. Psychiatric disorder in childhood is an important disease and easily neglected. There are several similarities in scabies and psychiatric disorders in childhood (PDC). Both of them may present with pruritus. They are relatively common in patients with lower socioeconomic status and crowded environment. Furthermore, immune-mediated inflammatory processes play a role in the pathophysiology in both diseases. An association between scabies and psychiatric disorders may exist. This nationwide population-based cohort study utilized data from the National Health Insurance Research Database to investigate the relationship between scabies and PDC. A total of 2137 children with scabies were identified as the study group and 8548 age- and sex-matched children were selected as the control group. A total of 607 (5.68%) children developed PDC during the 7-year follow-up period. The overall incidences of PDC are similar but patients with scabies had a higher risk of developing intellectual disability (ID) (scabies group vs control group: 1.3% vs 0.6%, adjusted hazard ratio: 2.04 and 95% confidence interval: 1.25-3.32). The immune-mediated inflammatory processes of both diseases were reviewed and may contribute to the 104% increased risk of interleukin in patients with scabies. We suggest a more comprehensive management in treating patients with scabies or ID. Early and comprehensive treatment of scabies and other risk factors may decrease the risk of subsequent ID. When we approach patients with ID, concurrent evaluation of scabies and other risk factors may contribute to successful management.

Home and Community Based Services (HCBS) Waivers: A Nationwide Study of the States

ERIC Educational Resources Information Center

Rizzolo, Mary C.; Friedman, Carli; Lulinski-Norris, Amie; Braddock, David

2013-01-01

In fiscal year (FY) 2009, the Medicaid program funded over 75% of all publicly funded long-term supports and services (LTSS) for individuals with intellectual and developmental disabilities (IDD) in the United States (Braddock et al., 2011). The majority of spending was attributed to the Home and Community Based Services (HCBS) Waiver program. In…

A Nationwide Overview of Sight-Singing Requirements of Large-Group Choral Festivals

ERIC Educational Resources Information Center

Norris, Charles E.

2004-01-01

The purpose of this study was to examine sight-singing requirements at junior and senior high school large-group ratings-based choral festivals throughout the United States. Responses to the following questions were sought from each state: (1) Are there ratings-based large-group choral festivals? (2) Is sight-singing a requirement? (3) Are there…

School-Based Drug Prevention Program: Quantitative Assessment of Life Skills Training Elementary School Program

ERIC Educational Resources Information Center

Kindle, Silverlene J.

2013-01-01

Since the 1960s long-term studies have documented nation-wide patterns of adolescent smoking, drinking and illicit drug use. The federal government responded by passing the Safe and Drug Free Schools and Communities Act, which funded school-based prevention programs. The problem for school counselors in a Georgia Public School District was…

From nationwide standardized testing to school-based alternative embedded assessment in Israel: Students' performance in the matriculation 2000 project

NASA Astrophysics Data System (ADS)

Dori, Yehudit J.

2003-01-01

Matriculation 2000 was a 5-year project aimed at moving from the nationwide traditional examination system in Israel to a school-based alternative embedded assessment. Encompassing 22 high schools from various communities in the country, the Project aimed at fostering deep understanding, higher-order thinking skills, and students' engagement in learning through alternative teaching and embedded assessment methods. This article describes research conducted during the fifth year of the Project at 2 experimental and 2 control schools. The research objective was to investigate students' learning outcomes in chemistry and biology in the Matriculation 2000 Project. The assumption was that alternative embedded assessment has some effect on students' performance. The experimental students scored significantly higher than their control group peers on low-level assignments and more so on assignments that required higher-order thinking skills. The findings indicate that given adequate support and teachers' consent and collaboration, schools can transfer from nationwide or statewide standardized testing to school-based alter-native embedded assessment.

In Preparation of the Nationwide Dissemination of the School-Based Obesity Prevention Program DOiT: Stepwise Development Applying the Intervention Mapping Protocol

ERIC Educational Resources Information Center

van Nassau, Femke; Singh, Amika S.; van Mechelen, Willem; Brug, Johannes; Chin A. Paw, Mai J. M.

2014-01-01

Background: The school-based Dutch Obesity Intervention in Teenagers (DOiT) program is an evidence-based obesity prevention program. In preparation for dissemination throughout the Netherlands, this study aimed to adapt the initial program and to develop an implementation strategy and materials. Methods: We revisited the Intervention Mapping (IM)…

Compiling a national resistivity atlas of Denmark based on airborne and ground-based transient electromagnetic data

NASA Astrophysics Data System (ADS)

Barfod, Adrian A. S.; Møller, Ingelise; Christiansen, Anders V.

2016-11-01

We present a large-scale study of the petrophysical relationship of resistivities obtained from densely sampled ground-based and airborne transient electromagnetic surveys and lithological information from boreholes. The overriding aim of this study is to develop a framework for examining the resistivity-lithology relationship in a statistical manner and apply this framework to gain a better description of the large-scale resistivity structures of the subsurface. In Denmark very large and extensive datasets are available through the national geophysical and borehole databases, GERDA and JUPITER respectively. In a 10 by 10 km grid, these data are compiled into histograms of resistivity versus lithology. To do this, the geophysical data are interpolated to the position of the boreholes, which allows for a lithological categorization of the interpolated resistivity values, yielding different histograms for a set of desired lithological categories. By applying the proposed algorithm to all available boreholes and airborne and ground-based transient electromagnetic data we build nation-wide maps of the resistivity-lithology relationships in Denmark. The presented Resistivity Atlas reveals varying patterns in the large-scale resistivity-lithology relations, reflecting geological details such as available source material for tills. The resistivity maps also reveal a clear ambiguity in the resistivity values for different lithologies. The Resistivity Atlas is highly useful when geophysical data are to be used for geological or hydrological modeling.

A Nationwide Survey of Nonspeech Oral Motor Exercise Use: Implications for Evidence-Based Practice

ERIC Educational Resources Information Center

Lof, Gregory L.; Watson, Maggie M.

2008-01-01

Purpose: A nationwide survey was conducted to determine if speech-language pathologists (SLPs) use nonspeech oral motor exercises (NSOMEs) to address children's speech sound problems. For those SLPs who used NSOMEs, the survey also identified (a) the types of NSOMEs used by the SLPs, (b) the SLPs' underlying beliefs about why they use NSOMEs, (c)…

Maternal thyroid disorder in pregnancy and risk of cerebral palsy in the child: a population-based cohort study.

PubMed

Petersen, Tanja Gram; Andersen, Anne-Marie Nybo; Uldall, Peter; Paneth, Nigel; Feldt-Rasmussen, Ulla; Tollånes, Mette Christophersen; Strandberg-Larsen, Katrine

2018-05-31

Cerebral palsy is the most frequent motor disability in childhood, but little is known about its etiology. It has been suggested that cerebral palsy risk may be increased by prenatal thyroid hormone disturbances. The objective of this study was to investigate whether maternal thyroid disorder is associated with increased risk of cerebral palsy. A population-based cohort study using two study populations. 1) 1,270,079 children born in Denmark 1979-2007 identified in nationwide registers, and 2) 192,918 children born 1996-2009 recruited into the Danish National Birth Cohort and The Norwegian Mother and Child Cohort study, combined in the MOthers and BAbies in Norway and Denmark (MOBAND) collaboration cohort. Register-based and self-reported information on maternal thyroid disorder was studied in relation to risk of cerebral palsy and its unilateral and bilateral spastic subtypes using multiple logistic regression. Children were followed from the age of 1 year to the age of 6 years, and cerebral palsy was identified in nationwide registers with verified diagnoses. In register data, hypothyroidism was recognized in 12,929 (1.0%), hyperthyroidism in 9943 (0.8%), and unclassifiable thyroid disorder in 753 (< 0.1%) of the mothers. The odds ratio for an association between maternal thyroid disorder and bilateral spastic cerebral palsy was 1.0 (95% CI: 0.7-1.5). Maternal thyroid disorder identified during pregnancy was associated with elevated risk of unilateral spastic cerebral palsy (odds ratio 3.1 (95% CI: 1.2-8.4)). In MOBAND, 3042 (1.6%) of the mothers reported a thyroid disorder in pregnancy, which was not associated with cerebral palsy overall (odds ratio 1.2 (95% CI: 0.6-2.4)). Maternal thyroid disorder overall was not related to bilateral spastic cerebral palsy, but maternal thyroid disorder identified in pregnancy was associated with increased risk of unilateral spastic cerebral palsy. These findings should be replicated in studies making use of maternal blood samples.

Prevalence and Annual Incidence of Thyroid Disease in Korea from 2006 to 2015: A Nationwide Population-Based Cohort Study.

PubMed

Kwon, Hyemi; Jung, Jin Hyung; Han, Kyung Do; Park, Yong Gyu; Cho, Jung Hwan; Lee, Da Young; Han, Ji Min; Park, Se Eun; Rhee, Eun Jung; Lee, Won Young

2018-06-01

The incidence of thyroid nodules has increased worldwide in recent years. Thyroid dysfunction is a potential risk factor for hypercholesterolemia, cardiovascular disease, osteoporosis, arrhythmia, and neuropsychiatric disease. This study investigated the prevalence and annual incidence of thyroid nodules, hypothyroidism, and hyperthyroidism in Koreans. In this nationwide population-based cohort study, 51,834,660 subjects were included using the National Health Information database from 2006 to 2015, after the exclusion of subjects with thyroid cancer. The prevalence in Korea in 2015 of thyroid nodules, hypothyroidism in patients taking thyroid hormone, and hyperthyroidism in patients undergoing treatment was 15.82/1,000 population, 15.94/1,000 population, and 2.76/1,000 population, respectively. All these diseases were more prevalent among women than among men. The number of incident cases of these three thyroid diseases steadily increased from 2006 to 2012, and then decreased through 2015. The incidence of thyroid nodules, hypothyroidism treated with thyroid hormone, and treated hyperthyroidism was 6.79/1,000 population, 1.76/1,000 population, and 0.55/1,000 population, respectively, in Korea in 2015. The use of methimazole continuously increased, from 33% of total antithyroid drug prescriptions in 2006 to 74.4% in 2015, and it became the most frequently prescribed antithyroid drug in Korea. In contrast, the use of propylthiouracil continuously decreased. This was the first nationwide study of the prevalence and annual incidence of thyroid nodules, hypothyroidism, and hyperthyroidism to take into account recent changes and to include the current status of patients receiving treatment. Copyright © 2018 Korean Endocrine Society.

[Retired physicians in Hungary - nationwide, representative study].

PubMed

Győrffy, Zsuzsa; Szél, Zsuzsanna; Girasek, Edmond

2016-10-01

The aging population and the aging physician society is an important challenge of the New Millenium. Despite this, very few publications are dealing with the older generations' physical and mental well-being, quality of life and working conditions. The aim of this study was to describe the retired physicians populations' (n = 2112) demographic data, work status, income and health status. Data of this representative, cross-sectional epidemiological study was obtained from online and paper-based questionnaires completed by 2112 retired physicians. The retired physicians' average age is 72 years, nearly two-thirds of the respondents retired after 35-45 years of service. Currently, nearly 60% are working, almost a quarter of them more than 40 hours per week. 35% of the respondents' income is below HUF 150,000. On this issue, significant differences emerge between female doctors and their male colleagues. The employment data of the results is consistent with the international trend, but the gender perspectives has unique significance in the international literature. Orv. Hetil., 2016, 157(43), 1729-1736.

Talent management best practices: how exemplary health care organizations create value in a down economy.

PubMed

Groves, Kevin S

2011-01-01

: Difficult economic conditions and powerful workforce trends pose significant challenges to managing talent in health care organizations. Although robust research evidence supports the many benefits of maintaining a strong commitment to talent management practices despite these challenges, many organizations compound the problem by resorting to workforce reductions and limiting or eliminating investments in talent management. : This study examines how nationwide health care systems address these challenges through best practice talent management systems. Addressing important gaps in talent management theory and practice, this study develops a best practice model of talent management that is grounded in the contextual challenges facing health care practitioners. : Utilizing a qualitative case study that examined 15 nationwide health care systems, data were collected through semistructured interviews with 30 executives and document analysis of talent management program materials submitted by each organization. : Exemplary health care organizations employ a multiphased talent management system composed of six sequential phases and associated success factors that drive effective implementation. Based on these findings, a model of talent management best practices in health care organizations is presented. : Health care practitioners may utilize the best practice model to assess and enhance their respective talent management systems by establishing the business case for talent management, defining, identifying, and developing high-potential leaders, carefully communicating high-potential designations, and evaluating talent management outcomes.

The need for a juvenile fire setting database.

PubMed

Klein, Julianne J; Mondozzi, Mary A; Andrews, David A

2008-01-01

A juvenile fire setter can be classified as any youth setting a fire regardless of the reason. Many communities have programs to deal with this problem, most based on models developed by the United States Fire Administration. We reviewed our programs data to compare it with that published nationally. Currently there is not a nationwide database to compare fire setter data. A single institution, retrospective chart review of all fire setters between the years of January 1, 2003 and December 31, 2005 was completed. There were 133 participants ages 3 to 17. Information obtained included age, location, ignition source, court order and recidivism. Analysis from our data set found 26% of the peak ages for fire involvement to be 12 and 14. Location, ignition source, and court ordered participants were divided into two age groups: 3 to 10 (N = 58) and 11 to 17 (N = 75). Bedrooms ranked first for the younger population and schools for the latter. Fifty-four percentage of the 133 participants used lighters over matches. Twelve percentage of the 3- to 10-year-olds were court mandated, compared with 52% of the 11- to 17-year-olds. Recidivism rates were 4 to 10% with a 33 to 38% survey return rate. Currently there is no state or nationwide, time honored data base to compare facts from which conclusions can be drawn. Starting small with a statewide database could educe a stimulus for a national database. This could also enhance the information provided by the United States Fire Administration, National Fire Data Center beginning one juvenile firesetter program and State Fire Marshal's office at a time.

Risk Factors for Fatal Hyperglycaemia Confirmed by Forensic Postmortem Examination - A Nationwide Cohort in Sweden

PubMed Central

Walz, Lotta; Jönsson, Anna K.; Zilg, Brita; Östgren, Carl Johan; Druid, Henrik

2016-01-01

Aims/Hypothesis The aim of this study was to identify risk factors associated with confirmed fatal hyperglycaemia, which could predispose potentially preventable deaths in individuals on glucose lowering drugs. Methods A retrospective register-based case-control study conducted on a nationwide cohort with individuals who died due to hyperglycaemia as determined by forensic postmortem examination, in Sweden August 2006 to December 2012. Vitreous glucose was used to diagnose hyperglycaemia postmortem. The forensic findings stored in the National Forensic Medicine Database were linked to nationwide registers. Cases that died due to confirmed hyperglycemia with dispensed glucose lowering drugs were identified and living controls with dispensed glucose lowering drugs were randomly selected in the Swedish prescribed drug register and matched on age and sex. Information on comorbidities, dispensed pharmaceuticals, clinical data and socioeconomic factors were obtained for cases and controls. Adjusted multiple logistic regression models were used to identify risk factors associated with fatal hyperglycaemia. Results During the study period 322 individuals, mostly males (79%) with the mean age of 53.9 years (SD.± 14) died due to confirmed hyperglycaemia. Risk factors for fatal hyperglycaemia included; insulin treatment (OR = 4.40; 95%CI,1.96, 9.85), poor glycaemic control (OR = 2.00 95%CI,1.23, 3.27), inadequate refill-adherence before death (OR = 3.87; 95%CI,1.99, 7.53), microvascular disease (OR = 3.26; 95% CI, 1.84, 5.79), psychiatric illness (OR = 2.30; 95% CI,1.32, 4.01), substance abuse (OR = 8.85; 95%CI,2.34, 35.0) and/or living alone (OR = 2.25; 95%CI,1.21, 4.18). Conclusions/Interpretation Our results demonstrate the importance of clinical attention to poor glycaemic control in subjects with psychosocial problems since it may indicate serious non-adherence, which consequently could lead to fatal hyperglycaemia. PMID:27768720

The prevalence of clinically diagnosed ankylosing spondylitis and its clinical manifestations: a nationwide register study.

PubMed

Exarchou, Sofia; Lindström, Ulf; Askling, Johan; Eriksson, Jonas K; Forsblad-d'Elia, Helena; Neovius, Martin; Turesson, Carl; Kristensen, Lars Erik; Jacobsson, Lennart T H

2015-05-09

Prevalence estimates of ankylosing spondylitis vary considerably, and there are few nationwide estimates. The present study aimed to describe the national prevalence of clinically diagnosed ankylosing spondylitis in Sweden, stratified according to age, sex, geographical, and socio-economic factors, and according to subgroups with ankylosing spondylitis-related clinical manifestations and pharmacological treatment. All individuals diagnosed with ankylosing spondylitis according to the World Health Organization International Classification of Disease codes, between 1967 and 2009, were identified from the National Patient Register. Data regarding disease manifestations, patient demographics, level of education, pharmacological treatment, and geographical region were retrieved from the National Patient Register and other national registers. A total of 11,030 cases with an ankylosing spondylitis diagnosis (alive, living in Sweden, and 16 to 64 years old in December 2009) were identified in the National Patient Register, giving a point prevalence of 0.18% in 2009. The prevalence was higher in northern Sweden, and lower in those with a higher level of education. Men had a higher prevalence of ankylosing spondylitis (0.23% versus 0.14%, P < 0.001), a higher frequency of anterior uveitis (25.5% versus 20.0%, P < 0.001) and were more likely to receive tumor necrosis factor inhibitors than women (15.6% versus 11.8% in 2009, P < 0.001). Women were more likely than men to have peripheral arthritis (21.7% versus 15.3%, P < 0.001), psoriasis (8.0% versus 6.9%, P = 0.03), and treatment with oral corticosteroids (14.0% versus 10.4% in 2009, P < 0.001). This nationwide, register-based study demonstrated a prevalence of clinically diagnosed ankylosing spondylitis of 0.18%. It revealed phenotypical and treatment differences between the sexes, as well as geographical and socio-economic differences in disease prevalence.

Mortality, cancer, and comorbidities associated with chronic pancreatitis: a Danish nationwide matched-cohort study.

PubMed

Bang, Ulrich Christian; Benfield, Thomas; Hyldstrup, Lars; Bendtsen, Flemming; Beck Jensen, Jens-Erik

2014-04-01

We aimed to assess the risk of death, cancer, and comorbidities among patients with alcoholic and nonalcoholic chronic pancreatitis (CP). We performed a nationwide retrospective cohort study, collecting data from Danish registries from 1995 through 2010. We evaluated the prevalences and incidences of death, cancers, and comorbidities among subjects with CP (cases) compared with age- and sex-matched individuals (controls). In total, 11,972 cases (71,814 person-years) and 119,720 controls (917,436 person-years) were included in the analysis. Hazard ratios (HR) were estimated by Cox proportional hazards regression. Forty-six percent of the cases died during the follow-up period, compared with 13.0% of controls (mean age, 63.7 vs 72.1 y; P < .0001), corresponding to a HR of 5.0 for CP (95% confidence interval [CI], 4.8-5.2). Cancer was a frequent cause of death among cases (10.2%) and controls (3.3%). Cancer (particularly pancreatic cancer) was a frequent cause of death among cases; the HR was 6.9 (95% CI, 7.5-11.8). Alcoholic CP did not produce a higher risk for cancer or death than nonalcoholic CP. Cerebrovascular disease (HR, 1.3; 95% CI, 1.2-1.4), chronic pulmonary disease (HR, 1.9; 95% CI, 1.8-2.1), ulcer disease (HR, 3.6; 95% CI, 3.3-3.9), diabetes (HR, 5.2; 95% CI, 5.0-5.6), and chronic renal disease (HR, 1.7; 95% CI, 1.5-1.9) occurred more frequently among patients with CP, but myocardial infarction did not (HR, 0.9; 95% CI, 0.8-1.0). Based on a Danish nationwide cohort study, individuals with CP are at higher risk for death from cancer (particularly pancreatic cancer) and have a higher incidence of comorbidities than people without CP. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

Increasing Marriage Will Dramatically Reduce Child Poverty. A Report of the Heritage Center for Data Analysis.

ERIC Educational Resources Information Center

Rector, Robert E.; Johnson, Kirk A.; Fagan, Patrick F.; Noyes, Lauren R.

This report uses data from the Fragile Families and Child Well-Being Study (a nationwide survey that collects data on married and non-married parents at the time of the child's birth) to determine how much marriage could reduce poverty among couples who are not married at the time of birth. To determine the impact of marriage on children's and…

Nationwide tsunami hazard assessment project in Japan

NASA Astrophysics Data System (ADS)

Hirata, K.; Fujiwara, H.; Nakamura, H.; Osada, M.; Ohsumi, T.; Morikawa, N.; Kawai, S.; Aoi, S.; Yamamoto, N.; Matsuyama, H.; Toyama, N.; Kito, T.; Murashima, Y.; Murata, Y.; Inoue, T.; Saito, R.; Akiyama, S.; Korenaga, M.; Abe, Y.; Hashimoto, N.

2014-12-01

In 2012, we began a project of nationwide Probabilistic Tsunami Hazard Assessment (PTHA) in Japan to support various measures (Fujiwara et al., 2013, JpGU; Hirata et al., 2014, AOGS). The most important strategy in the nationwide PTHA is predominance of aleatory uncertainty in the assessment but use of epistemic uncertainty is limited to the minimum, because the number of all possible combinations among epistemic uncertainties diverges quickly when the number of epistemic uncertainties in the assessment increases ; we consider only a type of earthquake occurrence probability distribution as epistemic uncertainty. We briefly show outlines of the nationwide PTHA as follows; (i) we consider all possible earthquakes in the future, including those that the Headquarters for Earthquake Research Promotion (HERP) of Japanese Government, already assessed. (ii) We construct a set of simplified earthquake fault models, called "Characterized Earthquake Fault Models (CEFMs)", for all of the earthquakes by following prescribed rules (Toyama et al., 2014, JpGU; Korenaga et al., 2014, JpGU). (iii) For all of initial water surface distributions caused by a number of the CEFMs, we calculate tsunamis by solving a nonlinear long wave equation, using FDM, including runup calculation, over a nesting grid system with a minimum grid size of 50 meters. (iv) Finally, we integrate information about the tsunamis calculated from the numerous CEFMs to get nationwide tsunami hazard assessments. One of the most popular representations of the integrated information is a tsunami hazard curve for coastal tsunami heights, incorporating uncertainties inherent in tsunami simulation and earthquake fault slip heterogeneity (Abe et al., 2014, JpGU). We will show a　PTHA along the eastern coast of Honshu, Japan, based on approximately 1,800 tsunami sources located within the subduction zone along the Japan Trench, as a prototype of the nationwide PTHA. This study is supported by part of the research project on research on evaluation of hazard and risk of natural disasters, under the direction of the HERP of Japanese Government.

Food Consumption: Households in the Northeast, Spring 1977. Nationwide Food Consumption Survey 1977-78. Report No. H-2.

ERIC Educational Resources Information Center

Department of Agriculture, Washington, DC.

This report presents data for spring 1977 from the household portion of the Nationwide Food Consumption survey in the Northeast conducted by the U.S. Department of Agriculture during April 1977 through March 1978. Statistics are presented on food consumption by consumers with incomes ranging from under $5,000 through $20,000 and over. Information…

Sampling intensity and normalizations: Exploring cost-driving factors in nationwide mapping of tree canopy cover

Treesearch

John Tipton; Gretchen Moisen; Paul Patterson; Thomas A. Jackson; John Coulston

2012-01-01

There are many factors that will determine the final cost of modeling and mapping tree canopy cover nationwide. For example, applying a normalization process to Landsat data used in the models is important in standardizing reflectance values among scenes and eliminating visual seams in the final map product. However, normalization at the national scale is expensive and...

1977 Nationwide Personal Transportation Study : household travel

DOT National Transportation Integrated Search

1982-07-01

This report is one of a series prepared from the findings of the 1977 Nationwide Personal Transportation Study (NPTS). The report examines the relationship between household travel patterns and characteristics of the household. Vehicle trips and vehi...

Exploring Anti-Semitism in the Classroom: A Case Study among Norwegian Adolescents from Minority Backgrounds

ERIC Educational Resources Information Center

Thomas, Paul

2016-01-01

This study explores high school students' views of Jews in one minority-dominated school in Oslo, Norway. Employing a qualitative approach, semistructured interview guides and classroom-based discussions teased out attitudes toward Jews drawing on questions from a nationwide research conducted by The Center for Studies of the Holocaust and…

Comorbidity of Allergic and Autoimmune Diseases in Patients with Autism Spectrum Disorder: A Nationwide Population-Based Study

ERIC Educational Resources Information Center

Chen, Mu-Hong; Su, Tung-Ping; Chen, Ying-Sheue; Hsu, Ju-Wei; Huang, Kai-Lin; Chang, Wen-Han; Chen, Tzeng-Ji; Bai, Ya-Mei

2013-01-01

Previous clinical and genetic studies have suggested autism spectrum disorders (ASDs) is associated with immunological abnormalities involving cytokines, immunoglobulins, inflammation, and cellular immunity, but epidemiological reports are still limited. Patients with ASDs were identified in the National Health Insurance Database from 1996 to…

Fostering Science Literacy, Environmental Stewardship, and Collaboration: Assessing a Garden-Based Approach to Teaching Life Science

ERIC Educational Resources Information Center

Fisher-Maltese, Carley B.

2013-01-01

Recently, schools nationwide have expressed a renewed interest in school gardens (California School Garden Network, 2010), viewing them as innovative educational tools. Most of the scant studies on these settings investigate the health/nutritional impacts, environmental attitudes, or emotional dispositions of students. However, few studies examine…

Methodology of the National School-based Health Survey in Malaysia, 2012.

PubMed

Yusoff, Fadhli; Saari, Riyanti; Naidu, Balkish M; Ahmad, Noor Ani; Omar, Azahadi; Aris, Tahir

2014-09-01

The National School-Based Health Survey 2012 was a nationwide school health survey of students in Standard 4 to Form 5 (10-17 years of age), who were schooling in government schools in Malaysia during the period of data collection. The survey comprised 3 subsurveys: the Global School Health Survey (GSHS), the Mental Health Survey, and the National School-Based Nutrition Survey. The aim of the survey was to provide data on the health status of adolescents in Malaysia toward strengthening the adolescent health program in the country. The design of the survey was created to fulfill the requirements of the 3 subsurveys. A 2-stage stratified sampling method was adopted in the sampling. The methods for data collection were via questionnaire and physical examination. The National School-Based Health Survey 2012 adopted an appropriate methodology for a school-based survey to ensure valid and reliable findings. © 2014 APJPH.

Data mining analysis of factors influencing children's blood pressure in a nation-wide health survey

NASA Astrophysics Data System (ADS)

Wasiewicz, Piotr; Kulaga, Zbigniew; Litwin, Mieczyslaw

2009-06-01

Blood pressure in childhood and adolescents is important indicator of good health and strong predictor of BP in adulthood. Genetic susceptibility, environmental and socioeconomic factors are related both with life style, obesity and cardiovascular risk including elevated BP. Increased body mass index is strictly correlated with BP, and obesity and overweight is main intermediate phenotype of childhood hypertension. However, despite current obesity epidemic available data do not fully support the hypothesis that it has resulted in increase of BP in children. We analysed data obtained from 7591 children participating in nation-wide health survey using data mining methodology. Results reveal relationships of obesity and high blood pressure with school environment characteristics.

hydropower biological evaluation tools

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

This software is a set of analytical tools to evaluate the physical and biological performance of existing, refurbished, or newly installed conventional hydro-turbines nationwide where fish passage is a regulatory concern. The current version is based on information collected by the Sensor Fish. Future version will include other technologies. The tool set includes data acquisition, data processing, and biological response tools with applications to various turbine designs and other passage alternatives. The associated database is centralized, and can be accessed remotely. We have demonstrated its use for various applications including both turbines and spillways

Microcomputers on Campus.

ERIC Educational Resources Information Center

Schimizzi, Ned V.; Dudley, Donald

The study reports on a nationwide survey that investigated the specific planning steps and procedures used by colleges and universities in implementing microcomputer instruction into their teacher education curriculum. The findings presented are based on 101 usable responses to a 55-item questionnaire mailed to five major college and university…

Exploring the scientific underpinnings of ecosystem services in the Willamette Valley, Oregon, USA - a place-based study

EPA Science Inventory

The US Environmental Protection Agency has undertaken a national research effort (Ecological Research Program) involving approximately 200 scientists, nation-wide to develop the science breadth and depth required to incorporate ecosystem services into environmental policy decisio...

Invasive Group A Streptococcal Infections in Children: A Nationwide Survey in Finland.

PubMed

Tapiainen, Terhi; Launonen, Saana; Renko, Marjo; Saxen, Harri; Salo, Eeva; Korppi, Matti; Kainulainen, Leena; Heiskanen-Kosma, Tarja; Lindholm, Laura; Vuopio, Jaana; Huotari, Tiina; Rusanen, Jarmo; Uhari, Matti

2016-02-01

The incidence of invasive group A streptococcus (iGAS) infections varies in time and geographically for unknown reasons. We performed a nationwide survey to assess the population-based incidence rates and outcomes of children with iGAS infections. We collected data on patients from hospital discharge registries and the electronic databases of microbiological laboratories in Finland for the period 1996-2010. We then recorded the emm types or serotypes of the strains. The study physician visited all university clinics and collected the clinical data using the same data entry sheet. We identified 151 children with iGAS infection. Varicella preceded iGAS infection in 20% of cases and fasciitis infection in 83% of cases. The annual incidence rate of iGAS infection was 0.93 per 100,000 in 1996-2000, 1.80 in 2001-2005 and 2.50 in 2006-2010. The proportion of emm 1.0 or T1M1 strains peaked in 1996-2000 and again in 2006-2010, to 44% and 37% of all typed isolates. The main clinical diagnoses of the patients were severe soft-tissue infection (46%), sepsis (28%), empyema (10%), osteoarticular infection (9%) and primary peritonitis (5%). Severe pain was the most typical symptom for soft-tissue infections. More than half of the patients underwent surgery and received clindamycin. The readmission rate was 7%, and the case fatality rate was 2%. The incidence rate of pediatric iGAS infections tripled during our study. The increase was not, however, the result of a change in the strain types causing iGAS. Varicella immunization would likely have prevented a significant number of the cases.

Nation-Wide, Web-Based, Geographic Information System for the Integrated Surveillance and Control of Dengue Fever in Mexico

PubMed Central

Hernández-Ávila, Juan Eugenio; Rodríguez, Mario-Henry; Santos-Luna, René; Sánchez-Castañeda, Veronica; Román-Pérez, Susana; Ríos-Salgado, Víctor Hugo; Salas-Sarmiento, Jesús Alberto

2013-01-01

Dengue fever incidence and its geographical distribution are increasing throughout the world. Quality and timely information is essential for its prevention and control. A web based, geographically enabled, dengue integral surveillance system (Dengue-GIS) was developed for the nation-wide collection, integration, analysis and reporting of geo-referenced epidemiologic, entomologic, and control interventions data. Consensus in the design and practical operation of the system was a key factor for its acceptance. Working with information systems already implemented as a starting point facilitated its acceptance by officials and operative personnel. Dengue-GIS provides the geographical detail needed to plan, asses and evaluate the impact of control activities. The system is beginning to be adopted as a knowledge base by vector control programs. It is used to generate evidence on impact and cost-effectiveness of control activities, promoting the use of information for decision making at all levels of the vector control program. Dengue-GIS has also been used as a hypothesis generator for the academic community. This GIS-based model system for dengue surveillance and the experience gathered during its development and implementation could be useful in other dengue endemic countries and extended to other infectious or chronic diseases. PMID:23936394

Do parental education and income matter? A nationwide register-based study on HPV vaccine uptake in the school-based immunisation programme in Norway

PubMed Central

Feiring, Berit; Laake, Ida; Molden, Tor; Cappelen, Inger; Håberg, Siri E; Magnus, Per; Steingrímsdóttir, Ólöf Anna; Strand, Bjørn Heine; Stålcrantz, Jeanette; Trogstad, Lill

2015-01-01

Objective Vaccine against human papillomavirus (HPV) has been offered free of charge to all 12-year-old girls in Norway since 2009. Nevertheless, the uptake of HPV vaccine is lower than for other childhood vaccines. The aim of this study was to examine whether parental education and income are associated with initiation and completion of HPV vaccination. Design Nationwide register-based study. Setting Publicly funded childhood immunisation programme in Norway. Participants 91 405 girls born between 1997 and 1999 and registered in the Norwegian Central Population Registry were offered HPV vaccine during the first 3 programme years. Of these, 84 139 had complete information on all variables and were included in the study. Measurements Information on HPV-vaccination status was obtained from the Norwegian Immunisation Registry. Data on socioeconomic factors were extracted from Statistics Norway. Risk differences (RDs) and CIs were estimated with Poisson regression. Results In the study sample, 78.3% received at least one dose of HPV vaccine and 73.6% received all three doses. High maternal education was significantly associated with lower probability of initiating HPV vaccination (multivariable RD=−5.5% (95% CI −7.0% to −4.0%) for highest compared with lowest education level). In contrast, high maternal income was significantly associated with higher probability of initiating vaccination (multivariable RD=10.1% (95% CI 9.0% to 11.3%) for highest compared with lowest quintile). Paternal education and income showed similar, but weaker, associations. The negative association between education and initiation was only seen for incomes below the median value. Conclusions In spite of the presumably equal access to HPV vaccine in Norway, we found socioeconomic disparities in vaccine uptake. More studies are needed to explain the underlying factors responsible for the observed socioeconomic differences. Insight into these factors is necessary to target information and increase vaccination coverage to ultimately reduce HPV-related disease across socioeconomic barriers. PMID:25991445

Comparison of hospital variation in acute myocardial infarction care and outcome between Sweden and United Kingdom: population based cohort study using nationwide clinical registries.

PubMed

Chung, Sheng-Chia; Sundström, Johan; Gale, Chris P; James, Stefan; Deanfield, John; Wallentin, Lars; Timmis, Adam; Jernberg, Tomas; Hemingway, Harry

2015-08-07

To assess the between hospital variation in use of guideline recommended treatments and clinical outcomes for acute myocardial infarction in Sweden and the United Kingdom. Population based longitudinal cohort study using nationwide clinical registries. Nationwide registry data comprising all hospitals providing acute myocardial infarction care in Sweden (SWEDEHEART/RIKS-HIA, n=87; 119,786 patients) and the UK (NICOR/MINAP, n=242; 391,077 patients), 2004-10. Between hospital variation in 30 day mortality of patients admitted with acute myocardial infarction. Case mix standardised 30 day mortality from acute myocardial infarction was lower in Swedish hospitals (8.4%) than in UK hospitals (9.7%), with less variation between hospitals (interquartile range 2.6% v 3.5%). In both countries, hospital level variation and 30 day mortality were inversely associated with provision of guideline recommended care. Compared with the highest quarter, hospitals in the lowest quarter for use of primary percutaneous coronary intervention had higher volume weighted 30 day mortality for ST elevation myocardial infarction (10.7% v 6.6% in Sweden; 12.7% v 5.8% in the UK). The adjusted odds ratio comparing the highest with the lowest quarters for hospitals' use of primary percutaneous coronary intervention was 0.70 (95% confidence interval 0.62 to 0.79) in Sweden and 0.68 (0.60 to 0.76) in the UK. Differences in risk between hospital quarters of treatment for non-ST elevation myocardial infarction and secondary prevention drugs for all discharged acute myocardial infarction patients were smaller than for reperfusion treatment in both countries. Between hospital variation in 30 day mortality for acute myocardial infarction was greater in the UK than in Sweden. This was associated with, and may be partly accounted for by, the higher practice variation in acute myocardial infarction guideline recommended treatment in the UK hospitals. High quality healthcare across all hospitals, especially in the UK, with better use of guideline recommended treatment, may not only reduce unacceptable practice variation but also deliver improved clinical outcomes for patients with acute myocardial infarction. Clinical trials registration Clinical trials NCT01359033. © Chung et al 2015.

Second Malignant Neoplasms and Cause of Death in Patients With Germ Cell Cancer: A Danish Nationwide Cohort Study.

PubMed

Kier, Maria G; Hansen, Merete K; Lauritsen, Jakob; Mortensen, Mette S; Bandak, Mikkel; Agerbaek, Mads; Holm, Niels V; Dalton, Susanne O; Andersen, Klaus K; Johansen, Christoffer; Daugaard, Gedske

2016-12-01

Patients given systemic treatment for testicular germ cell cancer (GCC) are at increased risk for a second malignant neoplasm (SMN). Previous studies on SMN and causes of death lacked information on the exact treatment applied or were based on patients receiving former treatment options. To evaluate the treatment-specific risks for SMN and death in a nationwide population-based cohort of patients with GCC treated with current standard regimens. This study examined a Danish nationwide cohort of 5190 men with GCC who entered the Danish Testicular Cancer database between January 1, 1984, and December 31, 2007. Treatment results were compared with a randomly sampled, age-stratified, population-based control group. Cases of gonadal and extragonadal primary were included in the nationwide cohort. The treatments were surveillance only; retroperitoneal radiotherapy (RT); bleomycin, etoposide, and cisplatin (BEP); or more than 1 line of treatment (MTOL). Cumulative incidence and hazard ratios (HRs) for SMN and death calculated by the Cox proportional hazards model were compared with those of age-matched controls. The study population comprised 2804 patients with seminoma and 2386 with nonseminoma. The median follow-up was 14.4 years (interquartile range, 8.6-20.5 years). The 20-year cumulative incidence of SMN with death as a competing risk was 7.8% (surveillance), 7.6% (BEP), 13.5% (RT), 9.2% (MTOL), and 7.0% (controls). We found no increased risk for SMN after surveillance, while the HRs were 1.7 (95% CI, 1.4-2.0), 1.8 (95% CI, 1.5-2.3), and 3.7 (95% CI, 2.5-5.5), respectively, after BEP, RT, and MTOL. Mortality owing to non-GCC causes was decreased after surveillance, but increased by 1.3 times after BEP and RT and by 2.6 times after MTOL. Excess mortality due to SMN was found after BEP (HR, 1.6; 95% CI, 1.2-2.2), RT (HR, 2.1; 95% CI, 1.5-2.9), and MTOL (HR, 5.8; 95% CI, 3.6-9.6). We found no increased risk for SMN or death among patients undergoing surveillance only. The risks for SMN and death due to SMN were increased after BEP alone, RT alone, and MTOL. Approaches to define patients who might benefit from less intensive treatment are needed.

Lower reoperation rate for recurrence after mesh versus sutured elective repair in small umbilical and epigastric hernias. A nationwide register study.

PubMed

Christoffersen, M W; Helgstrand, F; Rosenberg, J; Kehlet, H; Bisgaard, T

2013-11-01

Repair for a small (≤ 2 cm) umbilical and epigastric hernia is a minor surgical procedure. The most common surgical repair techniques are a sutured repair or a repair with mesh reinforcement. However, the optimal repair technique with regard to risk of reoperation for recurrence is not well documented. The aim of the present study was in a nationwide setup to investigate the reoperation rate for recurrence after small open umbilical and epigastric hernia repairs using either sutured or mesh repair. This was a prospective cohort study based on intraoperative registrations from the Danish Ventral Hernia Database (DVHD) of patients undergoing elective open mesh and sutured repair for small (≤ 2 cm) umbilical and epigastric hernias. Patients were included during a 4-year study period. A complete follow-up was obtained by combining intraoperative data from the DVHD with data from the Danish National Patient Register. The cumulative reoperation rates were obtained using cumulative incidence plot and compared with the log rank test. In total, 4,786 small (≤ 2 cm) elective open umbilical and epigastric hernia repairs were included. Age was median 48 years (range 18-95 years). Follow-up was 21 months (range 0-47 months). The cumulated reoperation rates for recurrence were 2.2 % for mesh reinforcement and 5.6 % for sutured repair (P = 0.001). The overall cumulated reoperation rate for sutured and mesh repairs was 4.8 %. In conclusion, reoperation rate for recurrence for small umbilical and epigastric hernias was significantly lower after mesh repair compared with sutured repair. Mesh reinforcement should be routine in even small umbilical or epigastric hernias to lower the risk of reoperation for recurrence avoid recurrence.

H. Pylori as a predictor of marginal ulceration: A nationwide analysis.

PubMed

Schulman, Allison R; Abougergi, Marwan S; Thompson, Christopher C

2017-03-01

Helicobacter pylori has been implicated as a risk factor for development of marginal ulceration following gastric bypass, although studies have been small and yielded conflicting results. This study sought to determine the relationship between H. pylori infection and development of marginal ulceration following bariatric surgery in a nationwide analysis. This was a retrospective cohort study using the 2012 Nationwide Inpatient Sample (NIS) database. Discharges with ICD-9-CM code indicating marginal ulceration and a secondary ICD-9-CM code for bariatric surgery were included. Primary outcome was incidence of marginal ulceration. A stepwise forward selection model was used to build the multivariate logistic regression model based on known risk factors. A P value of 0.05 was considered significant. There were 253,765 patients who met inclusion criteria. Prevalence of marginal ulceration was 3.90%. Of those patients found to have marginal ulceration, 31.20% of patients were H. pylori-positive. Final multivariate regression analysis revealed that H. pylori was the strongest independent predictor of marginal ulceration. H. pylori is an independent predictor of marginal ulceration using a large national database. Preoperative testing for and eradication of H. pylori prior to bariatric surgery may be an important preventive measure to reduce the incidence of ulcer development. © 2017 The Obesity Society.

Sex discrepancies in COPD patients and burden of the disease in females: a nationwide study in Greece (Greek Obstructive Lung Disease Epidemiology and health ecoNomics: GOLDEN study)

PubMed Central

Papaioannou, Andriana I; Bania, Eleni; Alexopoulos, Evangelos C; Mitsiki, Eirini; Malli, Foteini; Gourgoulianis, Konstantinos I

2014-01-01

Background The prevalence of chronic obstructive pulmonary disease (COPD) in females appears to be increasing. Recent studies have revealed that the percentage of women with COPD in Greece is approximately 12.5%. Aims To evaluate the burden of COPD among males and females in Greece through a nationwide cross-sectional survey and to explore sex differences regarding functional characteristics and exacerbation frequency. Methods Data collection was completed in a 6-month period. The present study followed a nationwide sampling approach of respiratory medicine physicians. The sampling approach included three steps: 1) estimation of expected incidence and prevalence of COPD cases in each prefecture of Greece and in total; 2) estimation of expected incidence of COPD cases per physician in each prefecture; and 3) creation of a frame of three different sampling zones. Following this sampling, data were provided by 199 respiratory physicians. Results The participating physicians provided data from 6,125 COPD patients. Female patients represented 28.7% of the study participants. Female COPD patients were, on average, 5 years younger than male COPD patients. Never smokers accounted for 9.4% within female patients, compared to 2.7% of males (P<0.001). Female patients were characterized by milder forms of the disease. Comorbidities were more prevalent in men, with the exception of gastroesophageal reflux (14.6% versus 17.1% for men and women, respectively, P=0.013). Female COPD patients had a higher expected number of outpatient visits per year (by 8.9%) than males (P<0.001), although hospital admissions did not differ significantly between sexes (P=0.116). Females had fewer absences from work due to COPD per year, by 19.0% (P<0.001), compared to males. Conclusion The differences observed between male and female COPD patients provide valuable information which could aid the prevention and management of COPD in Greece. PMID:24600217

1977 Nationwide Personal Transportation Study : vehicle occupancy

DOT National Transportation Integrated Search

1981-04-01

This report is part of a series that presents findings from the 1977 Nationwide Personal Transportation Study (NPTS). This report contains average vehicle occupancy rates by trip characteristics (trip purpose, trip length, time of day and day of the ...

1977 Nationwide Personal Transportation Study : household vehicle utilization

DOT National Transportation Integrated Search

1981-04-01

This report is part of a series that presents findings from the 1977 Nationwide Personal Transportation Study (NPTS). This report describes patterns of utilization of private vehicles (annual miles driven) in 1977. Utilization is keyed to estimates p...

The effects of climate factors on scabies. A 14-year population-based study in Taiwan

PubMed Central

Liu, Jui-Ming; Wang, Hsiao-Wei; Chang, Fung-Wei; Liu, Yueh-Ping; Chiu, Feng-Hsiang; Lin, Yi-Chun; Cheng, Kuan-Chen; Hsu, Ren-Jun

2016-01-01

Scabies is a common infectious disease and can cause severe outbreaks if not controlled quickly. Besides personal contact history, environmental factors are also important. This study analyzed the effects of environmental climate factors on the incidence of scabies in Taiwan. We conducted a 14-year nationwide population-based study: a total of 14,883 patients with scabies infestation were enrolled. Monthly climate data were collected from Taiwan’s Central Weather Bureau, including data on temperature, relative humidity, total rainfall, total rain days, and total sunshine hours. The linear relationships between these climate factors and scabies infestations or other risk factors were examined by Pearson’s correlation analysis. Overall, the incidence of scabies was negatively correlated with temperature (γ = −0.152, p < 0.001), while being positively correlated with humidity (γ = 0.192, p < 0.001). This useful information may provide evidence for lowering humidity at nursing facilities, hospitals, and military camps with scabies infestations, which may help to reduce its spread and prevent outbreaks. PMID:27905271

The effects of climate factors on scabies. A 14-year population-based study in Taiwan.

PubMed

Liu, Jui-Ming; Wang, Hsiao-Wei; Chang, Fung-Wei; Liu, Yueh-Ping; Chiu, Feng-Hsiang; Lin, Yi-Chun; Cheng, Kuan-Chen; Hsu, Ren-Jun

2016-01-01

Scabies is a common infectious disease and can cause severe outbreaks if not controlled quickly. Besides personal contact history, environmental factors are also important. This study analyzed the effects of environmental climate factors on the incidence of scabies in Taiwan. We conducted a 14-year nationwide population-based study: a total of 14,883 patients with scabies infestation were enrolled. Monthly climate data were collected from Taiwan's Central Weather Bureau, including data on temperature, relative humidity, total rainfall, total rain days, and total sunshine hours. The linear relationships between these climate factors and scabies infestations or other risk factors were examined by Pearson's correlation analysis. Overall, the incidence of scabies was negatively correlated with temperature (γ = -0.152, p < 0.001), while being positively correlated with humidity (γ = 0.192, p < 0.001). This useful information may provide evidence for lowering humidity at nursing facilities, hospitals, and military camps with scabies infestations, which may help to reduce its spread and prevent outbreaks. © J.-M. Liu et al., published by EDP Sciences, 2016.

Future Critical Issues and Problems Facing Technology and Engineering Education in the Commonwealth of Virginia

ERIC Educational Resources Information Center

Katsioloudis, Petros; Moye, Johnny J.

2012-01-01

The purpose of this research was to determine the future critical issues and problems facing the K-12 technology and engineering education profession in the Commonwealth of Virginia. This study was based on the Wicklein nationwide studies (1993a, 2005). Even though this study did not exactly replicate the Wicklein studies--since it was limited to…

Prospective, Multicentre, Nationwide Clinical Data from 600 Cases of Acute Pancreatitis

PubMed Central

Párniczky, Andrea; Kui, Balázs; Szentesi, Andrea; Balázs, Anita; Szűcs, Ákos; Mosztbacher, Dóra; Czimmer, József; Sarlós, Patrícia; Bajor, Judit; Gódi, Szilárd; Vincze, Áron; Illés, Anita; Szabó, Imre; Pár, Gabriella; Takács, Tamás; Czakó, László; Szepes, Zoltán; Rakonczay, Zoltán; Izbéki, Ferenc; Gervain, Judit; Halász, Adrienn; Novák, János; Crai, Stefan; Hritz, István; Góg, Csaba; Sümegi, János; Golovics, Petra; Varga, Márta; Bod, Barnabás; Hamvas, József; Varga-Müller, Mónika; Papp, Zsuzsanna; Sahin-Tóth, Miklós; Hegyi, Péter

2016-01-01

Objective The aim of this study was to analyse the clinical characteristics of acute pancreatitis (AP) in a prospectively collected, large, multicentre cohort and to validate the major recommendations in the IAP/APA evidence-based guidelines for the management of AP. Design Eighty-six different clinical parameters were collected using an electronic clinical research form designed by the Hungarian Pancreatic Study Group. Patients 600 adult patients diagnosed with AP were prospectively enrolled from 17 Hungarian centres over a two-year period from 1 January 2013. Main Results With respect to aetiology, biliary and alcoholic pancreatitis represented the two most common forms of AP. The prevalence of biliary AP was higher in women, whereas alcoholic AP was more common in men. Hyperlipidaemia was a risk factor for severity, lack of serum enzyme elevation posed a risk for severe AP, and lack of abdominal pain at admission demonstrated a risk for mortality. Abdominal tenderness developed in all the patients with severe AP, while lack of abdominal tenderness was a favourable sign for mortality. Importantly, lung injury at admission was associated with mortality. With regard to laboratory parameters, white blood cell count and CRP were the two most sensitive indicators for severe AP. The most common local complication was peripancreatic fluid, whereas the most common distant organ failure in severe AP was lung injury. Deviation from the recommendations in the IAP/APA evidence-based guidelines on fluid replacement, enteral nutrition and timing of interventions increased severity and mortality. Conclusions Analysis of a large, nationwide, prospective cohort of AP cases allowed for the identification of important determinants of severity and mortality. Evidence-based guidelines should be observed rigorously to improve outcomes in AP. PMID:27798670

Association of rheumatoid arthritis with allergic diseases: A nationwide population-based cohort study.

PubMed

Lai, Ning-Sheng; Tsai, Tzung-Yi; Koo, Malcolm; Lu, Ming-Chi

2015-01-01

Low-grade inflammation conditions, e.g., type 2 diabetes, have been shown to be associated with an increased risk of rheumatoid arthritis (RA). However, the association between other chronic inflammatory conditions, e.g., asthma, allergic rhinitis, and atopic dermatitis, is still unclear. To investigate the risk of RA in patients with allergic diseases, including asthma, allergic rhinitis, and atopic dermatitis, by using a nationwide health claims database. The Taiwan National Health Insurance Research Database was used to assemble a cohort of 170,570 patients ages 20 years old and older diagnosed with allergic diseases, including asthma, allergic rhinitis, or atopic dermatitis. A comparison cohort of 170,238 patients was constructed from the same data base, with frequency matching for sex, 10-year age group, and year of insurance enrollment. Cox proportional hazards regression analyses were conducted to assess the association between the allergic diseases and incident RA. Asthma (adjusted hazard ratio [AHR] 1.67, [95% confidence interval {CI}], 1.32-2.62) and allergic rhinitis (AHR 1.62 [95% CI, 1.33-1.98]) were significantly associated with the incident RA. These associations remained significant even after excluding patients who had concurrent diagnoses of asthma and allergic rhinitis. Patients with more than one allergic disease had an increased risk of developing RA (AHR 1.98 [95% CI, 1.50-2.62]). Subgroup analysis further indicated that middle-aged and elderly female patients with more than one allergic disease exhibited a high risk of developing RA. Significant associations between common allergic diseases and incident RA was found in this population-based cohort study. Our findings provided support to the hypothesis that allergic diseases and RA might share a similar underlying etiologic pathway related to chronic inflammatory responses.

More Becomes Less: Management Strategy Has Definitely Changed over the Past Decade of Splenic Injury—A Nationwide Population-Based Study

PubMed Central

Soo, Kwan-Ming; Lin, Tsung-Ying; Chen, Chao-Wen; Kuo, Liang-Chi; Wang, Jaw-Yuan; Lee, Wei-Che; Lin, Hsing-Lin

2015-01-01

Background. Blunt spleen injury is generally taken as major trauma which is potentially lethal. However, the management strategy has progressively changed to noninvasive treatment over the decade. This study aimed to (1) find out the incidence and trend of strategy change; (2) investigate the effect of change on the mortality rate over the study period; and (3) evaluate the risk factors of mortality. Materials and Methods. We utilized nationwide population-based data to explore the incidence of BSI during a 12-year study period. The demographic characteristics, including gender, age, surgical intervention, blood transfusion, availability of CT scans, and numbers of coexisting injuries, were collected for analysis. Mortality, hospital length of stay, and cost were as outcome variables. Results. 578 splenic injuries were recorded with an estimated incidence of 48 per million per year. The average 12-year overall mortality rate during hospital stay was 5.28% (29/549). There is a trend of decreasing operative management in patients (X 2, P = 0.004). The risk factors for mortality in BSI from a multivariate logistic regression analysis were amount of transfusion (OR 1.033, P < 0.001, CI 1.017–1.049), with or without CT obtained (OR 0.347, P = 0.026, CI 0.158–0.889), and numbers of coexisting injuries (OR 1.346, P = 0.043, CI 1.010–1.842). Conclusion. Although uncommon of BSI, management strategy is obviously changed to nonoperative treatment without increasing mortality and blood transfusion under the increase of CT utilization. Patients with more coexisting injuries and more blood transfusion had higher mortality. PMID:25629032

Epidemiology and outcomes of out-of-hospital cardiac arrest in Qatar: A nationwide observational study.

PubMed

Irfan, Furqan B; Bhutta, Zain Ali; Castren, Maaret; Straney, Lahn; Djarv, Therese; Tariq, Tooba; Thomas, Stephen Hodges; Alinier, Guillaume; Al Shaikh, Loua; Owen, Robert Campbell; Al Suwaidi, Jassim; Shuaib, Ashfaq; Singh, Rajvir; Cameron, Peter Alistair

2016-11-15

Out-of-hospital cardiac arrest (OHCA) studies from the Middle East and Asian region are limited. This study describes the epidemiology, emergency health services, and outcomes of OHCA in Qatar. This was a prospective nationwide population-based observational study on OHCA patients in Qatar according to Utstein style guidelines, from June 2012 to May 2013. Data was collected from various sources; the national emergency medical service, 4 emergency departments, and 8 public hospitals. The annual crude incidence of presumed cardiac OHCA attended by EMS was 23.5 per 100,000. The age-sex standardized incidence was 87.8 per 100,000 population. Of the 447 OHCA patients included in the final analysis, most were male (n=360, 80.5%) with median age of 51years (IQR=39-66). Frequently observed nationalities were Qatari (n=89, 19.9%), Indian (n=74, 16.6%) and Nepalese (n=52, 11.6%). Bystander cardiopulmonary resuscitation (CPR) was carried out in 92 (20.6%) OHCA patients. Survival rate was 8.1% (n=36) and multivariable logistic regression indicated that initial shockable rhythm (OR 13.4, 95% CI 5.4-33.3, p=0.001) was associated with higher odds of survival while male gender (OR 0.27, 95% CI 0.1-0.8, p=0.01) and advanced cardiac life support (ACLS) (OR 0.15, 95% CI 0.04-0.5, p=0.02) were associated with lower odds of survival. Standardized incidence and survival rates were comparable to Western countries. Although expatriates comprise more than 80% of the population, Qataris contributed 20% of the total cardiac arrests observed. There are significant opportunities to improve outcomes, including community-based CPR and defibrillation training. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Associations between serum uric acid levels and the incidence of nonfatal stroke: a nationwide community-based cohort study.

PubMed

Kamei, Keita; Konta, Tsuneo; Hirayama, Atsushi; Ichikawa, Kazunobu; Kubota, Isao; Fujimoto, Shouichi; Iseki, Kunitoshi; Moriyama, Toshiki; Yamagata, Kunihiro; Tsuruya, Kazuhiko; Narita, Ichiei; Kondo, Masahide; Shibagaki, Yugo; Kasahara, Masato; Asahi, Koichi; Watanabe, Tsuyoshi

2017-06-01

Hyperuricemia is an established risk factor for cardiovascular events and mortality. This study investigated the association between serum uric acid and the incidence of nonfatal stroke in a Japanese community-based population. We used a nationwide database of 155,322 subjects (aged 40-73, male 39 %) who participated in the annual "Specific Health Check and Guidance in Japan" checkup from 2008 to 2010. We examined the relationship between the quintiles of serum uric acid levels at baseline and the incidence of nonfatal stroke during a 2-year study period using self-reported data. The crude incidence of nonfatal stroke was significantly associated with serum uric acid levels at baseline, showing the lowest values in subjects with the 3rd quintile (Q3: men, 5.0-5.6; women, 3.8-4.3) of uric acid levels (mg/dL) and the highest values in subjects with the highest quintile (Q5: men ≥7.1, women ≥5.5) both in men and women (P < 0.05). In multivariate-adjusted logistic regression analysis, the odds ratio (OR) of the Q5 group was significantly higher than for the Q3 group in both men and women [men: OR 1.26, 95 % confidence interval (CI) 1.04-1.54, women: OR 1.24, 95 % CI 1.00-1.48]. In the subgroup analysis, the OR of the Q5 group of uric acid levels for incident stroke was high, irrespective of characteristics such as age, sex, and renal function. This study has shown that serum uric acid is independently associated with the incidence of nonfatal stroke in the general Japanese population.

[Prevention of neonatal group B streptococcal sepsis in Hungary in 2012. Preliminary data of a nation-wide survey].

PubMed

Sziller, István; Szabó, Miklós; Valek, Andrea; Rigó, Barbara; Ács, Nándor

2014-07-20

At present, there is no obligatory guideline for the prevention of early-onset neonatal group B streptococcal disease in Hungary. The aim of the present study was to gain insight into the spontaneously developed preventive strategy of the domestic obstetric divisions and departments in Hungary. Standardized questionnaire was sent out to each of the 71 obstetric divisions and departments in Hungary. Overall, 20 (27.4%) of the chairpersons replied, and thus, 39.9% of the total number of live births in Hungary were included in the study. Despite missing public health guidelines, each of the divisions and departments developed their own strategy to prevent neonatal group B streptococcal disease. In 95% of cases, bacterial culture of the lower vagina was the method of identifying pregnant women at risk. In 5% of the cases intrapartum antibiotic prophylaxis was based on risk assessment only. Of the departments using culture-based prophylaxis, 58% departments sampled women after completion of 36th gestational weeks. Antibiotic of choice was penicillin or ampicillin in 100% of cases. Of the study participants, 80% reported on multiple administration of colonized pregnant women after onset of labor or rupture of the membranes. The authors concluded that the rate of participation in the study was low. However, prevention of early-onset neonatal group B streptococcal infection is a priority of obstetric care in Hungary. Lack of a nation-wide public health policy did not prevent obstetric institutions in this country to develop their own prevention strategy. In the majority of cases and institutions, the policy is consistent with the widely accepted international standards.

Treatment of Intra-abdominal Abscesses in Crohn’s Disease – A Nationwide Analysis of Patterns and Outcomes of Care

PubMed Central

Ananthakrishnan, Ashwin N; McGinley, Emily L

2013-01-01

Background Abdominal abscesses are a common complication in Crohn’s disease (CD). Percutaneous drainage of such abscesses has become increasingly popular and may deliver outcomes comparable to surgical treatment; however, such comparative data are limited from single center studies. There have been no nationally representative studies comparing different treatment modalities for abdominal abscesses. Methods We identified all adult CD-related non-elective hospitalizations from the Nationwide Inpatient Sample 2007 that were complicated by an intra-abdominal abscess. Treatment modality was categorized into 3 strata – medical treatment alone, percutaneous drainage, and surgery. We analyzed the nationwide patterns in the treatment and outcomes of each treatment modality and examined for patient demographic, disease, or hospital-related disparities in treatment and outcome. Results There were an estimated 3,296 hospitalizations for abdominal abscesses in patients with CD. Approximately 39% were treated by medical treatment alone, 29% with percutaneous drainage, and 32% with surgery with a significant increase in the use of percutaneous drainage since 1998 (7%). Co-morbidity burden, admission to a teaching hospital, and complicated Crohn’s disease (fistulae, stricture) were associated with non-medical treatment. Use of percutaneous drainage was more common in teaching hospitals. Mean time to percutaneous drainage and surgical treatment were 4.6 and 3.3 days respectively and early intervention was associated with significantly shorter hospitalization. Conclusions We describe the nationwide pattern in the treatment of abdominal abscesses and demonstrate an increase in the use of percutaneous drainage for the treatment of this subgroup. Early treatment intervention was predictive of shorter hospitalization. PMID:23392744

Diabetes mellitus and cardiovascular clinical characteristics of Spanish women with stable ischaemic heart disease: Data from the SIRENA study.

PubMed

Gámez, José M; Masmiquel, Luis; Ripoll, Tomás; Barrios, Vivencio; Anguita, Manuel

2017-01-01

The relationship between diabetes and the cardiovascular clinical characteristics of Spanish women with stable ischaemic heart disease was studied in a nationwide cross-sectional study. Diabetes was related to a higher burden of risk factors, comorbidity, multivessel disease and coronary surgery. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Effectiveness of the 10-Valent Pneumococcal Conjugate Vaccine (PCV-10) in Children in Chile: A Nested Case-Control Study Using Nationwide Pneumonia Morbidity and Mortality Surveillance Data

PubMed Central

Toscano, Cristiana M.; Alencar, Gizelton P.; Alvarez, Andrés; Valenzuela, Maria T.; Andrus, Jon; del Aguila, Roberto; Hormazábal, Juan C.; Araya, Pamela; Pidal, Paola; Matus, Cuauhtemoc R.; de Oliveira, Lucia H.

2016-01-01

Background The ten-valent pneumococcal conjugate vaccine (PCV10) was introduced into the Chilean National Immunization Program (NIP) in January 2011 with a 3+1 schedule (2, 4, 6 and 12 months) without catch-up vaccination. We evaluated the effectiveness of PCV10 on pneumonia morbidity and mortality among infants during the first two years after vaccine introduction. Methods This is a population-based nested case-control study using four merged nationwide case-based electronic health data registries: live birth, vaccination, hospitalization and mortality. Children born in 2010 and 2011 were followed from two moths of age for a period of two years. Using four different case definitions of pneumonia hospitalization and/or mortality (all-cause and pneumonia related deaths), all cases and four randomly selected matched controls per case were selected. Controls were matched to cases on analysis time. Vaccination status was then assessed. Vaccine effectiveness (VE) was estimated using conditional logistic regression. Results There were a total of 497,996 children in the 2010 and 2011 Chilean live-birth cohorts. PCV10 VE was 11.2% (95%CI 8.5–13.6) when all pneumonia hospitalizations and deaths were used to define cases. VE increased to 20.7 (95%CI 17.3–23.8) when ICD10 codes used to denote viral pneumonia were excluded from the case definition. VE estimates on pneumonia deaths and all-cause deaths were 71.5 (95%CI 9.0–91.8) and 34.8 (95% CI 23.7–44.4), respectively. Conclusion PCV10 vaccination substantially reduced the number of hospitalizations due to pneumonia and deaths due to pneumonia and to all-causes over this study period. Our findings also reinforce the importance of having quality health information systems for measuring VE. PMID:27058873

Mortality among men with locally advanced prostate cancer managed with noncurative intent: a nationwide study in PCBaSe Sweden.

PubMed

Akre, Olof; Garmo, Hans; Adolfsson, Jan; Lambe, Mats; Bratt, Ola; Stattin, Pär

2011-09-01

There are limited prognostic data for locally advanced prostate cancer PCa to guide in the choice of treatment. To assess mortality in different prognostic categories among men with locally advanced PCa managed with noncurative intent. We conducted a register-based nationwide cohort study within the Prostate Cancer DataBase Sweden. The entire cohort of locally advanced PCa included 14 908 men. After the exclusion of 2724 (18%) men treated with curative intent, 12 184 men with locally advanced PCa either with local clinical stage T3 or T4 or with T2 with serum levels of prostate-specific antigen (PSA) between 50 and 99 ng/ml and without signs of metastases remained for analysis. We followed up the patient cohort in the Cause of Death Register for ≤ 11 yr and assessed cumulative incidence of PCa -specific death stratified by age and clinical characteristics. The PCa -specific mortality at 8 yr of follow-up was 28% (95% confidence interval [CI], 25-32%) for Gleason score (GS) 2-6, 41% (95% CI, 38-44%) for GS 7, 52% (95% CI, 47-57%) for GS 8, and 64% (95% CI, 59-69%) for GS 9-10. Even for men aged >85 yr at diagnosis with GS 8-10, PCa was a major cause of death: 42% (95% CI, 37-47%). Men with locally advanced disease and a PSA<4 ng/ml at diagnosis were at particularly increased risk of dying from PCa. One important limitation is the lack of bone scans in 42% of the patient cohort, but results remained after exclusion of patients with unknown metastasis status. The PCa-specific mortality within 8 yr of diagnosis is high in locally advanced PCa, suggesting undertreatment, particularly among men in older age groups. Our results underscore the need for more studies of treatment with curative intent for locally advanced tumors. Copyright © 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved.

High School Physics Courses & Enrollments: Results from the 2012-13 Nationwide Survey of High School Physics Teachers. Focus On

ERIC Educational Resources Information Center

White, Susan; Tesfaye, Casey Langer

2014-01-01

This report examines enrollments in high school physics during the 2012-13 school year. Based on data from the most recent survey (which includes both public and private high schools in the U.S.), it is estimated that 39% of the class of 2013 took high school physics before graduating. During the 2012-13 school year, 1.38 million students were…

Determinants of Demand for Private Supplementary Tutoring in China: Findings from a National Survey

ERIC Educational Resources Information Center

Liu, Junyan; Bray, Mark

2017-01-01

Private tutoring has expanded and intensified in China. However, no government statistical data or other empirical studies fully capture its extent and characteristics. This paper analyses private tutoring received by students in Grades 1-12 as indicated by a nationwide representative survey entitled China Family Panel Studies. The paper employs a…

Girls and Boys Gambling with Health and Well-Being in Finland

ERIC Educational Resources Information Center

Räsänen, Tiina; Lintonen, Tomi; Joronen, Katja; Konu, Anne

2015-01-01

Background: The aim of this study was to examine the associations among gambling frequency, health status, health risk behavior, and sexual risk-taking among eighth and ninth grade boys and girls (N?=?101,167). Methods: Data were obtained from the nationwide School Health Promotion Study conducted in Finland 2010 and 2011. Outcome measures were…

A Nationwide Assessment of the Scope and Impact of Agricultural Leadership Education

ERIC Educational Resources Information Center

Velez, Jonathan J.; McKim, Aaron J.; Moore, Lori L.; Stephens, Carrie A.

2015-01-01

Agricultural leadership education is an important component of agricultural education programs across the country; yet, a national study of the scope and types of programs offered has not been conducted since 2003. The purpose of the current study was to provide national and timely data regarding the scope and type of opportunities offered in…

Legal Rights, Local Wrongs: When Community Control Collides with Educational Equity. SUNY Series, Restructuring and School Change.

ERIC Educational Resources Information Center

Welner, Kevin G.

This book challenges fundamental assumptions about the opportunities for equity-minded educational reform, using data from case studies of districts nationwide and their experiences with court-ordered detracking. The case studies show how white, upper middle class parents exercised a disproportionate amount of power in local school policy making…

Student Language Production, Second Language Tasks, and Instructional Scaffolding in an English-Based Curriculum in Vietnam: Realities and Hopes

ERIC Educational Resources Information Center

Pham, Thuong T. M.

2017-01-01

This dissertation investigates L2 student language production, task-based instruction, and teachers' scaffolding strategies in two special EFL classes in a Vietnamese university. Two English teachers and 73 students were studied as they participated in a nationwide educational project known as the Advanced Curriculum (AC), an initiative launched…

Hospital implementation of resuscitation guidelines and review of CPR training programmes: a nationwide study.

PubMed

Schmidt, Anders S; Lauridsen, Kasper G; Adelborg, Kasper; Løfgren, Bo

2016-06-01

This study aimed to investigate cardiopulmonary resuscitation (CPR) guideline implementation and CPR training in hospitals. This nationwide study included mandatory resuscitation protocols from each Danish hospital. Protocols were systematically reviewed for adherence to the European Resuscitation Council (ERC) 2010 guidelines and CPR training in each hospital. Data were included from 45 of 47 hospitals. Adherence to the ERC basic life support (BLS) algorithm was 49%, whereas 63 and 58% of hospitals adhered to the recommended chest compression depth and rate. Adherence to the ERC advanced life support (ALS) algorithm was 81%. Hospital BLS course duration was [median (interquartile range)] 2.3 (1.5-2.5) h, whereas ALS course duration was 4.0 (2.5-8.0) h. Implementation of ERC 2010 guidelines on BLS is limited in Danish hospitals 2 years after guideline publication, whereas the majority of hospitals adhere to the ALS algorithm. CPR training differs among hospitals.

Consumer Feedback to Steer the Future of Assistive Technology Research and Development: A Pilot Study

PubMed Central

Kelleher, Annmarie; Dicianno, Brad E.; Eckstein, Stacy; Schein, Richard; Pearlman, Jonathan

2017-01-01

Objective: The overall objective of this project was to identify consumers' opinions of their needs and wants related to assistive technology (AT) in a systematic and quantitative manner via a questionnaire that can be used to validate existing and establish new research priorities. Methods: This pilot study describes questionnaire development, online implementation, and revisions considered to the questionnaire in preparation for conducting a nationwide survey. Data from a sample (N = 112) are presented. The pilot study was critical to refine the questions and ensure that meaningful information was being collected. Results: It was identified that revisions were warranted to provide more structure and allow for consumers to prioritize AT research efforts. Conclusion: The questionnaire results, although positively in favor of many of the technologies presented, are inconclusive to identify generalizable research priorities, thus expansion to a nationwide population is warranted. PMID:29339885

The ten-ecosystem study investigation plan

NASA Technical Reports Server (NTRS)

Kan, E. P.

1976-01-01

With the continental United States divided into ten forest and grassland ecosystems, the Ten Ecosystem Study (TES) is designed to investigate the feasibility and applicability of state-of-the-art automatic data processing remote sensing technology to inventory forest, grassland, and water resources by using Land Satellite data. The study will serve as a prelude to a possible future nationwide remote sensing application to inventory forest and rangeland renewable resources. This plan describes project design and phases, the ten ecosystem, data utilization and output, personnel organization, resource requirements, and schedules and milestones.

Epidemiological considerations for the use of databases in transfusion research: a Scandinavian perspective.

PubMed

Edgren, Gustaf; Hjalgrim, Henrik

2010-11-01

At current safety levels, with adverse events from transfusions being relatively rare, further progress in risk reductions will require large-scale investigations. Thus, truly prospective studies may prove unfeasible and other alternatives deserve consideration. In this review, we will try to give an overview of recent and historical developments in the use of blood donation and transfusion databases in research. In addition, we will go over important methodological issues. There are at least three nationwide or near-nationwide donation/transfusion databases with the possibility for long-term follow-up of donors and recipients. During the past few years, a large number of reports have been published utilizing such data sources to investigate transfusion-associated risks. In addition, numerous clinics systematically collect and use such data on a smaller scale. Combining systematically recorded donation and transfusion data with long-term health follow-up opens up exciting opportunities for transfusion medicine research. However, the correct analysis of such data requires close attention to methodological issues, especially including the indication for transfusion and reverse causality.

Examining the Relationship Between Perceived Quality of Care and Actual Quality of Care as Measured by 30-Day Readmission Rates.

PubMed

Salinas, Stanley R

To test the relationship between patient experience, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), and actual quality of care, as measured by 30-day readmission rates. Both HCAHPS data and outcome data reported to the Centers of Medicare & Medicaid Services (CMS). This secondary, nationwide (N = 4060), hospital-level study focused only on acute care hospitals. HCAHPS question 22 "Would you recommend this hospital to your friends and family?" was used to determine level of overall satisfaction, and 30-day readmission rates, as reported to the CMS, was used as a proxy for actual quality of care. A statistically significant relationship was found between patient experience and actual quality outcomes. The results of this study reinforce the inclusion of patient experience in Medicare's Value Based Purchasing program as a matter of good public policy.

Technology Use in the Classroom: Preferences of Management Faculty Members

ERIC Educational Resources Information Center

Peluchette, Joy V.; Rust, Kathleen A.

2005-01-01

In this study, the authors investigated faculty members' preferences regarding the use of technologies as instructional tools in management courses. They mailed surveys to 500 management faculty members nationwide; 124 were returned with usable data. Respondents indicated that course subject and classroom environmental factors did not affect their…

Maternal Infection Requiring Hospitalization during Pregnancy and Autism Spectrum Disorders

ERIC Educational Resources Information Center

Atladottir, Hjordis O.; Thorsen, Poul; Ostergaard, Lars; Schendel, Diana E.; Lemcke, Sanne; Abdallah, Morsi; Parner, Erik T.

2010-01-01

Exposure to prenatal infection has been suggested to cause deficiencies in fetal neurodevelopment. In this study we included all children born in Denmark from 1980, through 2005. Diagnoses of autism spectrum disorders (ASDs) and maternal infection were obtained through nationwide registers. Data was analyzed using Cox proportional hazards…

Available Equipment in School Foodservice.

ERIC Educational Resources Information Center

Meyer, Mary Kay

This report provides data on the National Food Service Management Institute's multi-year research project that identified type, style, age, and condition of available food service equipment in K-12 schools nationwide. The study found that smaller schools, serving less than 400 lunches per day, had kitchens equipped with ranges, small…

Economic Consequences of Horizontal Stratification in Postsecondary Education: Evidence from Urban China

ERIC Educational Resources Information Center

Hu, Anning; Vargas, Nicholas

2015-01-01

Drawing on nationwide representative data, we study the patterns of horizontal stratification of higher education in contemporary urban Chinese society, examining how college major, location, and ranking affect college graduates' occupational income and the likelihood of assuming a managerial position. The results suggest that (1) college major…

Compiling the space shuttle wind tunnel data base: An exercise in technical and managerial innovators

NASA Technical Reports Server (NTRS)

Kemp, N. D.

1983-01-01

Engineers evaluating Space Shuttle flight data and performance results are using a massive data base of wind tunnel test data. A wind tunnel test data base of the magnitude attained is a major accomplishment. The Apollo program spawned an automated wind tunnel data analysis system called SADSAC developed by the Chrysler Space Division. An improved version of this system renamed DATAMAN was used by Chrysler to document analyzed wind tunnel data and data bank the test data in standardized formats. These analysis documents, associated computer graphics and standard formatted data were disseminated nationwide to the Shuttle technical community. These outputs became the basis for substantiating and certifying the flight worthiness of the Space Shuttle and for improving future designs. As an aid to future programs this paper documents the lessons learned in compiling the massive wind tunnel test data base for developing the Space Shuttle. In particular, innovative managerial and technical concepts evolved in the course of conceiving and developing this successful DATAMAN system and the methods and organization for applying the system are presented.

Cost-Effectiveness of Nationwide Hepatitis B Catch-up Vaccination Among Children and Adolescents in China

PubMed Central

Hutton, David W.; So, Samuel K.; Brandeau, Margaret L.

2011-01-01

Liver disease and liver cancer associated with childhood-acquired chronic hepatitis B are leading causes of death among adults in China. Despite expanded newborn hepatitis B vaccination programs, approximately 20% of children under age 5 years and 40% of children aged 5-19 years remain unprotected from hepatitis B. Although immunizing them will be beneficial, no studies have examined the cost-effectiveness of hepatitis B catch-up vaccination in an endemic country like China. We examined the cost-effectiveness of a hypothetical nationwide free hepatitis B catch-up vaccination program in China for unvaccinated children and adolescents aged 1 to 19 years. We used a Markov model for disease progression and infections. Cost variables were based on data published by the Chinese Ministry of Health, peer-reviewed Chinese and English publications, and the GAVI Alliance. We measured costs (2008 U.S. dollars and Chinese renminbi), quality-adjusted life years (QALYs), and incremental cost-effectiveness from a societal perspective. Our results show that hepatitis B catch-up vaccination for children and adolescents in China is cost-saving across a range of parameters, even for adolescents aged 15-19 years old. We estimate that if all 150 million susceptible children under 19 were vaccinated, more than 8 million infections and 65,000 deaths due to hepatitis B would be prevented. Conclusion The adoption of a nationwide free catch-up hepatitis B vaccination program for unvaccinated children and adolescents in China, in addition to ongoing efforts to improve birth dose and newborn vaccination coverage, will be cost-saving and can generate significant population-wide health benefits. The success of such a program in China could serve as a model for other endemic countries. PMID:19839061

Reducing under-five mortality through Hôpital Albert Schweitzer's integrated system in Haiti.

PubMed

Perry, Henry; Cayemittes, Michel; Philippe, Francois; Dowell, Duane; Dortonne, Jean Richard; Menager, Henri; Bottex, Erve; Berggren, Warren; Berggren, Gretchen

2006-05-01

The degree to which local health systems contribute to reductions in under-five mortality in severely impoverished settings has not been well documented. The current study compares the under-five mortality in the Hôpital Albert Schweitzer (HAS) Primary Health Care Service Area with that for Haiti in general. HAS provides an integrated system of community-based primary health care services, hospital care and community development. A sample of 10% of the women of reproductive age in the HAS service area was interviewed, and 2390 live births and 149 child deaths were documented for the period 1995-99. Under-five mortality rates were computed and compared with rates for Haiti. In addition, available data regarding inputs, processes and outputs for the HAS service area and for Haiti were assembled and compared. Under-five mortality was 58% less in the HAS service area, and mortality for children 12-59 months of age was 76% less. These results were achieved with an input of fewer physicians and hospital beds per capita than is available for Haiti nationwide, but with twice as many graduate nurses and auxiliary nurses per capita than are available nationwide, and with three cadres of health workers that do not exist nationwide: Physician Extenders, Health Agents and Community Health Volunteers. The population coverage of targeted child survival services was generally 1.5-2 times higher in the HAS service area than in rural Haiti. These findings support the conclusion that a well-developed system of primary health care, with outreach services to the household level, integrated with hospital referral care and community development programmes, can make a strong contribution to reducing infant and child mortality in severely impoverished settings.

Perspectives of nursing professionals and older adults differ on aspects of care for older people after a nationwide improvement program.

PubMed

Verweij, Lisanne Marlieke; Wehrens, Rik; Oldenhof, Lieke; Bal, Roland; Francke, Anneke L

2018-05-02

The perspectives of nursing professionals might differ from those of older adults when it comes to care for older people. This cross-sectional study compares the views of older adults with the views of nursing professionals on the quality of care after a nationwide improvement program for care for older people was implemented (2008-2016) in the Netherlands. Questionnaire data were used from 385 nursing professionals (response rate 51%) that were part of the Nursing Staff Panel, a nationwide representative group of nursing staff, and working in home care, hospitals or general practices. Additionally, questionnaire data were used from 73 older adults (response rate 81%) who were involved in regional networks to discuss project proposals and to represent the voice of older adults in the nationwide improvement program. Participants were asked to evaluate care for older people with regard to collaboration between healthcare organizations and with regard to the tailored service, accessibility, and quality of care within their organizations and in the region in which they lived. A majority of older adults (54%) and nursing professionals (61%) felt that collaboration with others had improved over the last few years. Approximately one third of the older adults stated that care for older people was tailored to fit individual needs and was accessible most of the time or always, as opposed to approximately two thirds of the professionals. Moreover, 17% older adults thought that the quality of care was good, compared with 54% of the nursing professionals. 77% of the nursing professionals and 94% of the older adults thought that improvements were still needed in care for older people, for example better integration of the different aspects of care and a more patient-centered approach. Older adults who were involved in networks of the improvement program generally gave a less positive evaluation of aspects of care for older people and its development than nursing professionals. Considering differences in the perspectives of key stakeholders is relevant for the development and evaluation of nationwide improvement programs, for a correct interpretation of findings, and for making appropriate recommendations.

VetCompass Australia: A National Big Data Collection System for Veterinary Science

PubMed Central

McGreevy, Paul; Thomson, Peter; Dhand, Navneet K.; Raubenheimer, David; Masters, Sophie; Mansfield, Caroline S.; Baldwin, Timothy; Soares Magalhaes, Ricardo J.; Rand, Jacquie; Hill, Peter; Gilkerson, James; Combs, Martin; Raidal, Shane; Irwin, Peter; Irons, Peter; Squires, Richard; Brodbelt, David; Hammond, Jeremy

2017-01-01

Simple Summary The VetCompass Australia program collects real-time clinical records from veterinary practices and aggregates them for researchers to interrogate. It delivers Australian researchers sustainable and cost-effective access to authoritative data from hundreds of veterinary practitioners, across Australia and opens up major international collaborative opportunities with related projects in the United Kingdom and elsewhere. Abstract VetCompass Australia is veterinary medical records-based research coordinated with the global VetCompass endeavor to maximize its quality and effectiveness for Australian companion animals (cats, dogs, and horses). Bringing together all seven Australian veterinary schools, it is the first nationwide surveillance system collating clinical records on companion-animal diseases and treatments. VetCompass data service collects and aggregates real-time, clinical records for researchers to interrogate, delivering sustainable and cost-effective access to data from hundreds of veterinary practitioners nationwide. Analysis of these clinical records will reveal geographical and temporal trends in the prevalence of inherited and acquired diseases, identify frequently prescribed treatments, revolutionize clinical auditing, help the veterinary profession to rank research priorities, and assure evidence-based companion-animal curricula in veterinary schools. VetCompass Australia will progress in three phases: (1) roll-out of the VetCompass platform to harvest Australian veterinary clinical record data; (2) development and enrichment of the coding (data-presentation) platform; and (3) creation of a world-first, real-time surveillance interface with natural language processing (NLP) technology. The first of these three phases is described in the current article. Advances in the collection and sharing of records from numerous practices will enable veterinary professionals to deliver a vastly improved level of care for companion animals that will improve their quality of life. PMID:28954419

Clinical characteristics of patients with treated epilepsy in Korea: a nationwide epidemiologic study.

PubMed

Kim, Dong Wook; Lee, Seo-Young; Chung, Soo-Eun; Cheong, Hae-Kwan; Jung, Ki-Young

2014-01-01

Although a number of epidemiologic studies have been conducted on the prevalence and incidence of epilepsy around the world, only a few studies have investigated the clinical characteristics of patients with epilepsy in a population-based sample. The purpose of the present study was to describe the clinical characteristics of treated patients with epilepsy in Korea via a nationwide medical records survey. The study population was obtained through a nationwide database registered to the Health Insurance Review and Assessment service. Patients were recruited from clinics and hospitals in each cluster according to region and referral level by random selection from a preallocated sample of patients. All patients were being treated with antiepileptic drug medication with or without a diagnosis code for epilepsy or seizure between January 2009 and December 2009. Among the 6,436 selected patients, 2,150 met the diagnostic criteria for epilepsy and were included in our survey on the clinical characteristics of patients who were with treated epilepsy. The proportion of male patients with epilepsy in this study was higher (1,226; 57.0%) than that of female patients. In addition, 10.6% of patients were first diagnosed with epilepsy in 2009, and 53.6% of patients experienced at least one seizure over the course of 2009; 78.1% were classified as having localization-related epilepsy, whereas 7.3% were considered to have generalized epilepsy. Thirty-five percent of patients were thus classified as idiopathic or cryptogenic cases. The most common cause of symptomatic epilepsy was trauma (10.0%), followed by stroke (9.6%), central nervous system (CNS) infection (5.7%), and hippocampal sclerosis (4.9%). This is the first nationwide study of the clinical characteristics of treated epilepsy in Korea using a national database validated by medical records survey. The etiologies of epilepsy and epilepsy syndrome classifications were comparable to those previously reported in other developed countries. Wiley Periodicals, Inc. © 2013 International League Against Epilepsy.

Fatal cervical spine injuries: a Finnish nationwide register-based epidemiologic study on data from 1987 to 2010.

PubMed

Thesleff, Tuomo; Niskakangas, Tero; Luoto, Teemu M; Öhman, Juha; Ronkainen, Antti

2016-08-01

The number of cervical spine injuries (CSIs) is increasing. Cervical spine injuries are associated with high morbidity and mortality. Identifying those who are at risk for CSI-related death can help develop national and international interventions and policies to reduce mortality. This study aimed to determine the trends in the incidence and the characteristics of fatal CSIs in Finland over a 24-year study period from 1987 to 2010. A large nationwide, retrospective, register-based study was carried out. The population-based sample was collected from death certificates issued in Finland between 1987 and 2010. The death certificates were obtained from the official Cause-of-Death Register, coordinated by Statistics Finland, which covers all deaths occurring in Finland. Sociodemographics and injury- and death-related data were used for outcome measures. All death certificates issued in Finland (1987-2010) containing a CSI as the cause of death were carefully reviewed. A total of 2,041 fatal CSIs were identified. These constituted 0.17% of all deaths in Finland within the study period. The average annual incidence of fatal CSIs was 16.5 per million (range: 12.5-21.2). The majority of the victims were male (72.9%) and had concurrent spinal cord injury (83.0%). Traffic accidents (40.1%) and falls (45.0%) were the most common injury mechanisms. Almost one-third (29.8%) of the deaths were alcohol-related. Among the young victims (<60 years) with upper CSI (C0-C2), the majority (91.8%) died within 24 hours post-injury. One-third of elderly victims' (≥60 years) CSI-related deaths occurred after 1 week post-injury and were mostly (74.2%) caused by respiratory and circulatory system diseases. Within the 24-year period, the incidence of fatal CSIs (+2/million), as well as the average age of sustaining a fatal CSI (+13.5 years), increased markedly. Fall-induced accidents among elderly males were the most prominently increasing subpopulation of fatal CSI victims. In recent decades, fatal CSI incidence (death certificate-based) has increased, being 18.6 per million in Finland in 2010. Victims of fatal CSIs tend to be older than in the past, and for a substantial number of males, low-energy falls lead to cervical trauma and death. Copyright © 2015 Elsevier Inc. All rights reserved.

How Over 500 Firms Manage the Maintenance Force: Summary Report of a Survey of Maintenance Administrative Ratios.

ERIC Educational Resources Information Center

Ramond (Albert) and Associates, Inc., Chicago, IL. Research Planning Div.

A survey questionnaire, directed to determining maintenance administrative ratios, was mailed to 3,685 nation-wide companies. Of the 509 responses, 502 were sufficiently complete to use in the study. The survey data are presented in the form of charts and tables, grouping the companies by the type of manufacturing reported. Each data table is…

How Over 600 Firms Manage the Maintenance Force: Summary Report of a Second Survey of Maintenance Administrative Ratios.

ERIC Educational Resources Information Center

Ramond (Albert) and Associates, Inc., Chicago, IL. Research Planning Div.

A survey questionnaire, directed to determining the management of the maintenance force, was mailed to 4,104 nation-wide companies. Of the 669 responses, 623 were sufficiently complete to use in the study. The survey data are presented in the form of charts and tables, grouping the companies by the type of manufacturing reported. Each data table…

Examining the Relationships among Mathematics Coaches and Specialists, Student Achievement, and Disability Status: A Multilevel Analysis Using National Assessment of Educational Progress Data

ERIC Educational Resources Information Center

Harbour, Kristin E.; Adelson, Jill L.; Pittard, Caroline M.; Karp, Karen S.

2018-01-01

Using restricted-use data from the 2011 National Assessment of Educational Progress mathematics assessment, the current study examined the relationship between the presence of elementary mathematics coaches and specialists (MCSs) and the mathematics achievement of more than 190,000 fourth-grade students in more than 7,400 schools nationwide. In…

Nationwide implementation of integrated community case management of childhood illness in Rwanda

PubMed Central

Mugeni, Catherine; Levine, Adam C; Munyaneza, Richard M; Mulindahabi, Epiphanie; Cockrell, Hannah C; Glavis-Bloom, Justin; Nutt, Cameron T; Wagner, Claire M; Gaju, Erick; Rukundo, Alphonse; Habimana, Jean Pierre; Karema, Corine; Ngabo, Fidele; Binagwaho, Agnes

2014-01-01

ABSTRACT Background: Between 2008 and 2011, Rwanda introduced integrated community case management (iCCM) of childhood illness nationwide. Community health workers in each of Rwanda's nearly 15,000 villages were trained in iCCM and equipped for empirical diagnosis and treatment of pneumonia, diarrhea, and malaria; for malnutrition surveillance; and for comprehensive reporting and referral services. Methods: We used data from the Rwanda health management information system (HMIS) to calculate monthly all-cause under-5 mortality rates, health facility use rates, and community-based treatment rates for childhood illness in each district. We then compared a 3-month baseline period prior to iCCM implementation with a seasonally matched comparison period 1 year after iCCM implementation. Finally, we compared the actual changes in all-cause child mortality and health facility use over this time period with the changes that would have been expected based on baseline trends in Rwanda. Results: The number of children receiving community-based treatment for diarrhea and pneumonia increased significantly in the 1-year period after iCCM implementation, from 0.83 cases/1,000 child-months to 3.80 cases/1,000 child-months (P = .01) and 0.25 cases/1,000 child-months to 5.28 cases/1,000 child-months (P<.001), respectively. On average, total under-5 mortality rates declined significantly by 38% (P<.001), and health facility use declined significantly by 15% (P = .006). These decreases were significantly greater than would have been expected based on baseline trends. Conclusions: This is the first study to demonstrate decreases in both child mortality and health facility use after implementing iCCM of childhood illness at a national level. While our study design does not allow for direct attribution of these changes to implementation of iCCM, these results are in line with those of prior studies conducted at the sub-national level in other low-income countries. PMID:25276592

Comparing population and incident data for optimal air ambulance base locations in Norway.

PubMed

Røislien, Jo; van den Berg, Pieter L; Lindner, Thomas; Zakariassen, Erik; Uleberg, Oddvar; Aardal, Karen; van Essen, J Theresia

2018-05-24

Helicopter emergency medical services are important in many health care systems. Norway has a nationwide physician manned air ambulance service servicing a country with large geographical variations in population density and incident frequencies. The aim of the study was to compare optimal air ambulance base locations using both population and incident data. We used municipality population and incident data for Norway from 2015. The 428 municipalities had a median (5-95 percentile) of 4675 (940-36,264) inhabitants and 10 (2-38) incidents. Optimal helicopter base locations were estimated using the Maximal Covering Location Problem (MCLP) optimization model, exploring the number and location of bases needed to cover various fractions of the population for time thresholds 30 and 45 min, in green field scenarios and conditioned on the existing base structure. The existing bases covered 96.90% of the population and 91.86% of the incidents for time threshold 45 min. Correlation between municipality population and incident frequencies was -0.0027, and optimal base locations varied markedly between the two data types, particularly when lowering the target time. The optimal solution using population density data put focus on the greater Oslo area, where one third of Norwegians live, while using incident data put focus on low population high incident areas, such as northern Norway and winter sport resorts. Using population density data as a proxy for incident frequency is not recommended, as the two data types lead to different optimal base locations. Lowering the target time increases the sensitivity to choice of data.

Sentinel-1 Constellation for nationwide deformation mapping with InSAR -- From science to operations

NASA Astrophysics Data System (ADS)

Dehls, John; Larsen, Yngvar; Marinkovic, Petar

2016-04-01

For more than a decade, InSAR has been used in Norway study landslides and subsidence. Initial studies concentrated on understanding and validating the technique in various settings. During the last five years, however, we have moved towards using InSAR in operational settings. Of all the challenges we have faced, the largest has been regular access to SAR imagery. The Sentinel-1 constellation will bring a paradigm shift to the field with its operational characteristics: mission configuration, acquisition planning, and data distribution policy. For the first time, we will have nationwide acquisitions with an unprecedented temporal spacing. By the end of this year, we will have a sufficiently long time series of data to produce an initial version of a national deformation map. Within the ESA SEOM InSARap project, we have developed the necessary updates of interferometric processing tools necessary to handle the novel TOPS mode, and successfully demonstrated the performance of S1 InSAR in a number of scientific applications. However, to fully exploit the key advantages of the Sentinel-1 mission, we still face a number of scientific and operational challenges, due to the new and unique characteristics of the mission. Specifically, the large coverage and dense temporal sampling results in very large data sets with a vastly increased information content, which still needs new algorithmic development to extract. In the context of national mapping, optimal harmonization of deformation maps based on overlapping individual S1 stacks is the most prominent challenge. Urban areas in Norway face much the same problems as many other cities throughout the world; subsidence due to soil compaction and groundwater changes or excavation, and resulting damage to infrastructure. More unique to Norway is the threat to lives caused by large unstable rock slopes along the steep fjords. In the 20th century alone, catastrophic rock slope failures leading to tsunamis in fjords and large lakes, caused the deaths of nearly 200 people. Each of these failures was preceded by years of slow deformation. Through systematic mapping, including the use of InSAR, we have now identified more than 70 unstable rock slopes that are deforming and have the potential to collapse. In order to meet the needs of the local communities living under the threat of these landslides, as well as the urban areas dealing with subsidence problems, we are developing an automatically updated, nationwide InSAR service based upon the Sentinel-1 constellation. The proposed map product will be periodically updated and will be of a different resolution for urban and non-urban areas. Deformation data will be fed directly into the decision-support tools of various local, regional and national authorities via appropriate web GIS protocols. The data will also be made available to the public via a web map interface with simple tools to query and visualize the information.

Low Vocational Outcome Among People Diagnosed With Borderline Personality Disorder During First Admission to Mental Health Services in Denmark: A Nationwide 9-Year Register-Based Study.

PubMed

Hastrup, Lene Halling; Kongerslev, Mickey T; Simonsen, Erik

2018-03-05

Earlier studies report that although people with borderline personality disorder (BPD) experience symptom reduction in the long term, they continue to have difficulties in work recovery. This nationwide 9-year register-based study (N = 67,075) investigated the long-term labor-market attachment of all individuals diagnosed with BPD during first admission to Danish mental health services in comparison with other psychiatric disorders. Controlling for baseline characteristics and co-occurring secondary psychiatric diagnoses, the BPD group had 32% lower odds (OR = 0.68; 95% CI [0.61, 0.76]) of being in work/under education after 9 years. Individuals diagnosed with BPD also showed more impairment in long-term vocational outcome than other personality disorders, and lower labor-market attachment than other psychiatric disorders except for schizophrenia, schizotypal and delusional disorders, and mental and behavioral disorders due to psychoactive substance use. Intervention programs addressing social psychiatric aspects of BPD in terms of work functioning is henceforth an important area for future research.

A Nationwide Population-Based Approach to Study Health-Related and Psychosocial Aspects of Neurofibromatosis Type 1

DTIC Science & Technology

2015-07-01

Neurofibromatosis Type 1 PRINCIPAL INVESTIGATOR: Dr. Jeanette Falck Winther CONTRACTING ORGANIZATION: Danish Cancer Society Research Center Copenhagen, Denmark...Study Health-Related and Psychosocial Aspects of Neurofibromatosis Type 1 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...Clinics in Denmark and a clinical geneticist with expertise in ethical aspects. 15. SUBJECT TERMS Neurofibromatosis type 1, population-based, nation

Requirements and design aspects of a data model for a data dictionary in paediatric oncology.

PubMed

Merzweiler, A; Knaup, P; Creutzig, U; Ehlerding, H; Haux, R; Mludek, V; Schilling, F H; Weber, R; Wiedemann, T

2000-01-01

German children suffering from cancer are mostly treated within the framework of multicentre clinical trials. An important task of conducting these trials is an extensive information and knowledge exchange, which has to be based on a standardised documentation. To support this effort, it is the aim of a nationwide project to define a standardised terminology that should be used by clinical trials for therapy documentation. In order to support terminology maintenance we are currently developing a data dictionary. In this paper we describe requirements and design aspects of the data model used for the data dictionary as first results of our research. We compare it with other terminology systems.

Get Your Degree from an Educational ATM: An Empirical Study in Online Education

ERIC Educational Resources Information Center

Lee, Y.; Nguyen, H.

2007-01-01

This article studies the modern trend of online education in the United States. Based on a wide range of statistics, the number of cyberspace courses offered by four-year institutions and universities nationwide has rapidly increased over the past one and a half decades. Under a case study, colleges of business from ranked universities and…

Catch-Up Growth and Neurobehavioral Development among Full-Term, Small-for-Gestational-Age Children: A Nationwide Japanese Population-Based Study.

PubMed

Takeuchi, Akihito; Yorifuji, Takashi; Nakamura, Kazue; Tamai, Kei; Mori, Shigehiro; Nakamura, Makoto; Kageyama, Misao; Kubo, Toshihide; Ogino, Tatsuya; Kobayashi, Katsuhiro; Doi, Hiroyuki

2018-01-01

To examine the relationship between catch-up growth of full-term, small for gestational age (SGA) children and their neurobehavioral development. Data were obtained from a population-based nationwide Japanese longitudinal survey that started in 2001. Study participants were full-term children with information on height at 2 years of age (n = 32 533). Catch-up growth for SGA infants was defined as achieving a height at 2 years of age of more than -2.0 standard deviations for chronological age. Logistic regression analyses were used to estimate ORs and 95% CIs for the associations of SGA and catch-up growth status with neurobehavioral development at 2.5 and 8 years of age, adjusting for potential infant- and parent-related confounding factors. Fifteen percent of term SGA infants failed to catch up in height. At 2.5 years of age, SGA children without catch-up growth were more likely to be unable to climb stairs (OR, 10.42; 95% CI, 5.55-19.56) and unable to compose a 2-word sentence (OR, 3.58; 95% CI, 1.81-7.08) compared with children with normal growth at birth. Furthermore, SGA children without catch-up growth were at increased risk for aggressive behaviors (OR, 3.85; 95% CI, 1.19-12.47) at 8 years of age. Continuous follow-up for full-term SGA infants with failure of catch-up growth or poor postnatal growth may be beneficial for early detection and intervention for behavioral problems. Copyright © 2017 Elsevier Inc. All rights reserved.

Trends and outcome predictors after traumatic brain injury surgery: a nationwide population-based study in Taiwan.

PubMed

Shi, Hon-Yi; Hwang, Shiuh-Lin; Lee, I-Chen; Chen, I-Te; Lee, King-Teh; Lin, Chih-Lung

2014-12-01

The authors sought to analyze trends in hospital resource utilization and mortality rates in a population of patients who had received traumatic brain injury (TBI) surgery. This nationwide population-based cohort study retrospectively analyzed 18,286 patients who had received surgical treatment for TBI between 1998 and 2010. The multiple linear regression model and Cox proportional hazards model were used for multivariate assessment of outcome predictors. The prevalence rate of surgical treatment for patients with TBI gradually but significantly (p < 0.001) increased by 47.6% from 5.0 per 100,000 persons in 1998 to 7.4 per 100,000 persons in 2010. Age, sex, Deyo-Charlson comorbidity index score, hospital volume, and surgeon volume were significantly associated with TBI surgery outcomes (p < 0.05). Over the 12-year period analyzed, the estimated mean hospital treatment cost increased 19.06%, whereas the in-hospital mortality rate decreased 10.9%. The estimated mean time of overall survival after TBI surgery (± SD) was 83.0 ± 4.2 months, and the overall in-hospital and 1-, 3-, and 5-year survival rates were 74.5%, 67.3%, 61.1%, and 57.8%, respectively. These data reveal an increased prevalence of TBI, especially in older patients, and an increased hospital treatment cost but a decreased in-hospital mortality rate. Health care providers and patients should recognize that attributes of the patient and of the hospital may affect hospital resource utilization and the mortality rate. These results are relevant not only to other countries with similar population sizes but also to countries with larger populations.

Sickness absence and disability pension due to otoaudiological diagnoses: risk of premature death--a nationwide prospective cohort study.

PubMed

Friberg, Emilie; Rosenhall, Ulf; Alexanderson, Kristina

2014-02-08

It is estimated that hearing difficulties will be one of the top ten leading burdens of disease by 2030. Knowledge of mortality among individuals on sick leave or disability pension due to hearing diagnoses is virtually non-existent. We aimed prospectively to examine the associations of diagnosis-specific sick leave and disability pension due to different otoaudiological diagnoses with risks of all-cause and cause-specific mortality. A cohort, based on Swedish registry data, including all 5,248,672 individuals living in Sweden in 2005, aged 20-64, and not on old-age pension, was followed through 2010. Otoaudiological diagnoses were placed in the following categories: otological, hearing, vertigo, and tinnitus. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazard models; individuals on sick leave or disability pension due to different otoaudiological diagnoses during 2005 were compared with those not on sick leave or disability pension. In multivariable models, individuals with sickness absence due to otoaudiological diagnoses showed a lower risk of mortality, while individuals on disability pension due to otoaudiological diagnoses showed a 14% (95% CI 1-29%) increased risk of mortality, compared with individuals not on sick leave or disability pension. The risk increase among individuals on disability pension was largely attributable to otological (HR 1.56; 95% CI = 1.04-2.33) and hearing diagnoses (HR 1.20; 95% CI = 1.00-1.43). This large nationwide population-based cohort study suggests an increased risk of mortality among individuals on disability pension due to otoaudiological diagnoses.

Nationwide Natural Resource Inventory of the Philippines Using Lidar: Strategies, Progress, and Challenges

NASA Astrophysics Data System (ADS)

Blanco, A. C.; Tamondong, A.; Perez, A. M.; Ang, M. R. C.; Paringit, E.; Alberto, R.; Alibuyog, N.; Aquino, D.; Ballado, A.; Garcia, P.; Japitana, M.; Ignacio, M. T.; Macandog, D.; Novero, A.; Otadoy, R. E.; Regis, E.; Rodriguez, M.; Silapan, J.; Villar, R.

2016-06-01

The Philippines has embarked on a detailed nationwide natural resource inventory using LiDAR through the Phil-LiDAR 2 Program. This 3-year program has developed and has been implementing mapping methodologies and protocols to produce high-resolution maps of agricultural, forest, coastal marine, hydrological features, and renewable energy resources. The Program has adopted strategies on system and process development, capacity building and enhancement, and expanding the network of collaborations. These strategies include training programs (on point cloud and image processing, GIS, and field surveys), workshops, forums, and colloquiums (program-wide, cluster-based, and project-based), and collaboration with partner national government agencies and other organizations. In place is a cycle of training, implementation, and feedback in order to continually improve the system and processes. To date, the Program has achieved progress in the development of workflows and in rolling out products such as resource maps and GIS data layers, which are indispensable in planning and decision-making. Challenges remains in speeding up output production (including quality checks) and in ensuring sustainability considering the short duration of the program. Enhancements in the workflows and protocols have been incorporated to address data quality and data availability issues. More trainings have been conducted for project staff hired to address human resource gaps. Collaborative arrangements with more partners are being established. To attain sustainability, the Program is developing and instituting a system of training, data updating and sharing, information utilization, and feedback. This requires collaboration and cooperation of the government agencies, LGUs, universities, other organizations, and the communities.

[Topics on Which Relatives of Persons with Dementia Seek Counseling Over Telephone or Email: Current Results of a Nationwide Counseling Service of the German Alzheimer Society].

PubMed

Pendergrass, Anna; Weiß, Saskia; Gräßel, Elmar

2018-04-19

Since 15 years, the Alzheimer 's Telephone of the German Alzheimer Society (Deutsche Alzheimer Gesellschaft e.V.; DAlzG), a nationwide psychosocial counseling service, has been offering support for people with dementia (PwD) and their families. The aim of this study was to evaluate: a) why informal PwD caregivers seek telephone counseling, b) whether these telephone calls are one-time counseling or long-term support, and c) whether the telephone inquiries differ from the email-based inquiries with regard to the addressed issues. The data are based on the inquiries of 3,744 informal caregivers, which consulted the DAlzG in 2015. Sociodemographic data on the informal caregivers and the PwD, the characteristics of the telephone call, and the topics addressed in the email inquiries were collected. 70.3% of the callers were female. Most of them (59.9%) were the children (in-law) of and half of them (49.7%) lived with PwD. More than two-thirds of the callers (70%) were seeking help in dealing with the person with dementia (e. g. challenging behavior) and 36.5% of the relatives needed recommendations for further local help and assistance. In the third place, the calls were related to financial and legal topics (23.5%). 92.2% of the calls were one-time consultations. The addressed issues in the email inquiries did not significantly differ from the topics discussed over the telephone. On many topics there is a need for further "on site" consultation. Doctors and other health professionals should therefore be actively involved in counseling relatives of PwD. © Georg Thieme Verlag KG Stuttgart · New York.

Factors associated with free adult preventive health care utilization among physically disabled people in Taiwan: nationwide population-based study.

PubMed

Yen, Suh-May; Kung, Pei-Tseng; Tsai, Wen-Chen

2014-12-05

Few previous studies have specifically addressed the health care utilization situation of the physically disabled. This study aimed to investigate the utilization of free adult preventive health care for physically disabled people and its' affecting factors. The data was obtained from three nationwide databases from 2006 to 2008. This study comprised 329,264 physically disabled people in Taiwan above the age of 40 who had eligible health checks during 2008. We employed descriptive statistics to analyze the use and rate of free preventive health care use by physically disabled adults. Logistic regression analysis was used to explore the factors that affect physically disabled adults' use of free adult preventive health care. 16.37% of the physically disabled adults used free adult preventive health care. Women (17.66%), married (17.16%), a junior high education level (17.89%), and mildly disabled adults (18.77%) had the highest use rate among various participant subgroups. The variables that significantly influenced the use of free adult preventive health care by the physically disabled included gender, age, education, marital status, urbanization of the residence areas, monthly payroll, aboriginal status, catastrophic illnesses status, relevant chronic diseases, and severity of disability. Physically disabled using preventive health care tend to be low. Governments should use the media to reinforce propagation and education of these services to specific, low-utilization groups, and encourage doctors to actively provide preventive health care to communities.

Urinary calculi increase the risk for adverse pregnancy outcomes: a nationwide study.

PubMed

Chung, Shiu-Dong; Chen, Yi-Hua; Keller, Jospeh J; Lin, Ching-Chun; Lin, Herng-Ching

2013-01-01

Using two large-scale nationwide population-based data sets, this study aimed to assess the risk of adverse pregnancy outcomes between mothers with and without urinary calculi. Cross-sectional study. Taiwan. This study included 3694 women who had live singleton births and received a diagnosis of urinary calculi (UC) in the year prior to their delivery, as well as 18 470 matched women without UC, who were used as a comparison group. Conditional logistic regression analyses were performed. Low birthweight, preterm birth, small for gestational age, cesarean section, lower Apgar score and pre-eclampsia/eclampsia. Women with UC had a higher prevalence of low-birthweight neonates (7.4 vs. 6.0%, p = 0.003), preterm births (9.5 vs. 7.3%, p < 0.001) and cesarean sections (43.1 vs. 35.4%, p < 0.001) than women without UC. After adjusting for potential confounding factors, women with UC were more likely than women without UC to have low-birthweight neonates (odds ratio 1.21, 95% confidence interval 1.05-1.39), preterm birth (odds ratio 1.28, 95% confidence interval 1.13-1.43) and cesarean sections (odds ratio 1.37, 95% confidence interval 1.28-1.48). There were increased risks for having low-birthweight, preterm infants and for experiencing cesarean section among women with UC in comparison to women without UC. © 2012 The Authors © 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

The past, present and future use of epidemiological intelligence to plan malaria vector control and parasite prevention in Uganda.

PubMed

Talisuna, Ambrose O; Noor, Abdisalan M; Okui, Albert P; Snow, Robert W

2015-04-15

An important prelude to developing strategies to control infectious diseases is a detailed epidemiological evidence platform to target cost-effective interventions and define resource needs. A review of published and un-published reports of malaria vector control and parasite prevention in Uganda was conducted for the period 1900-2013. The objective was to provide a perspective as to how epidemiological intelligence was used to design malaria control before and during the global malaria eradication programme (GMEP) and to contrast this with the evidence generated in support of the Roll Back Malaria (RBM) initiative from 1998 to date. During the GMEP era, comprehensive investigations were undertaken on the effectiveness of vector and parasite control such as indoor residual house-spraying (IRS) and mass drug administration (MDA) at different sites in Uganda. Nationwide malariometric surveys were undertaken between 1964 and 1967 to provide a profile of risk, epidemiology and seasonality leading to an evidence-based national cartography of risk to characterize the diversity of malaria transmission in Uganda. At the launch of the RBM initiative in the late 1990s, an equivalent level of evidence was lacking. There was no contemporary national evidence-base for the likely impact of insecticide-treated nets (ITN), no new malariometric data, no new national cartography of malaria risk or any evidence of tailored intervention delivery based on variations in the ecology of malaria risk in Uganda. Despite millions of dollars of overseas development assistance over the last ten years in ITN, and more recently the resurrection of the use of IRS, the epidemiological impact of vector control remains uncertain due to an absence of nationwide basic parasite and vector-based field studies. Readily available epidemiological data should become the future business model to maximize malaria funding from 2015. Over the next five to ten years, accountability, impact analysis, financial business cases supported by a culture of data use should become the new paradigm by which malaria programmes, governments and their development partners operate.

A Nationwide Population-Based Approach to Study Health-Related and Psychosocial Aspects of Neurofibromatosis Type 1

DTIC Science & Technology

2016-07-31

the relatively narrow focus on Wechsler’s IQ test (WAIS-IV) – a test chosen primarily due to budget constraints. Thus, to meet the requests from the...consultants allows us to re-allocate financial resources to address the limitations of our study 7 raised by the reviewers. Jens Richardt Møllegaard

A Garden-Based Approach to Teaching Life Science Produces Shifts in Students' Attitudes toward the Environment

ERIC Educational Resources Information Center

Fisher-Maltese, Carley; Zimmerman, Timothy D.

2015-01-01

Recently, schools nationwide have expressed a renewed interest in school gardens, viewing them as innovative educational tools. Most of the scant studies on these settings investigate the health/nutritional impacts, science learning potential, or emotional dispositions of students. However, few studies examine the shifts in attitudes that occur…

Drug adherence and multidisciplinary care in patients with multiple sclerosis: protocol of a prospective, web-based, patient-centred, nation-wide, Dutch cohort study in glatiramer acetate treated patients (CAIR study).

PubMed

Jongen, Peter J; Hengstman, Gerald; Hupperts, Raymond; Schrijver, Hans; Gilhuis, Job; Vliegen, Joseph H; Hoogervorst, Erwin; van Huizen, Marc; van Munster, Eric; Samijn, Johnny; de Schryver, Els; Siepman, Theodora; Tonk, Martijn; Zandbergen, Eveline; ten Holter, Jacques; van der Kruijk, Ruud; Borm, George

2011-03-30

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system, for which no definitive treatment is available. Most patients start with a relapsing-remitting course (RRMS). Disease-modifying drugs (DMDs) reduce relapses and disability progression. First line DMDs include glatiramer acetate (GA), interferon-beta (INFb)-1a and INFb-1b, which are all administered via injections. Effectiveness of DMD treatment depends on adequate adherence, meaning year-long continuation of injections with a minimum of missed doses. In real-life practice DMD-treated patients miss 30% of doses. The 6-month discontinuation rate is up to 27% and most patients who discontinue do so in the first 12 months.Treatment adherence is influenced by the socio-economic situation, health care and caregivers, disease, treatment and patient characteristics. Only a few studies have dealt with adherence-related factors in DMD-treated patients. Self-efficacy expectations were found to be related to GA adherence. Patient education and optimal support improve adherence in general. Knowledge of the aspects of care that significantly relate to adherence could lead to adherence-improving measures. Moreover, identification of patients at risk of inadequate adherence could lead to more efficient care.In the near future new drugs will become available for RRMS. Detailed knowledge on factors prognostic of adherence and on care aspects that are associated with adequate adherence will improve the chances of these drugs becoming effective treatments. We investigate in RRMS patients the relationship between drug adherence and multidisciplinary care, as well as factors associated with adherence. Given the differences in the frequency of administration and in the side effects between the DMDs we decided to study patients treated with the same DMD, GA. The Correlative analyses of Adherence In Relapsing remitting MS (CAIR) study is an investigator-initiated, prospective, web-based, patient-centred, nation-wide cohort study in the Netherlands.The primary objective is to investigate whether GA adherence is associated with specific disciplines of care or quantities of specific care. The secondary objective is to investigate whether GA adherence is associated with specific aspects of the socio-economic situation, health care and caregivers, disease, treatment or patient characteristics.All data are acquired on-line via a study website. All RRMS patients in the Netherlands starting GA treatment are eligible. Patients are informed by neurologists, nurses, and websites from national MS patient organisations. All data, except on disability, are obtained by patient self-reports on pre-defined and random time points. The number of missed doses and the number of patients having discontinued GA treatment at 6 and 12 months are measures of adherence. Per care discipline the number of sessions and the total duration of care are measures of received care. The full spectrum of non-experimental care that is available in the Netherlands is assessed. Care includes 'physical' contacts, contacts by telephone or internet, health-promoting activities and community care activities. Care received over the preceding 14 days is assessed by patients at baseline and every other week thereafter up to month 12. Every 3 months neurologists and nurses record care disciplines to which patients have been referred.The Dutch Adherence Questionnaire-90 (DAQ-90) is a 90-item questionnaire based on the World Health Organisation (WHO) 2003 report on adherence and comprehensively assesses five domains of evidence-based determinants of adherence: socio-economic, health care and caregivers, disease, treatment, and patient-related factors. In addition, self-efficacy is assessed by the MS Self-Efficacy Scale (MSSES), and mood and health-related quality of life (HRQoL) by the Multiple Sclerosis Quality of Life-54 questionnaire (MSQoL-54). Relapses and adverse events probably or definitively related to GA are also reported. In this study data is mainly acquired by patients' self-reporting via the internet. On-line data acquisition by patients does not require study visits to the hospital and can easily be integrated into daily life. The web-based nature of the study is believed to prevent missing data and study drop-outs. Moreover, the automated process of filling in questionnaires ensures completeness and consistency, thus improving data quality. The combination of patient-reported outcomes, fully web-based data capture and nation-wide information to all eligible patients are distinguishing features of the study and contribute to its scientific potential. Netherlands Trial Register (NTR): NTR2432.

The use of Chinese herbal medicine as an adjuvant therapy to reduce incidence of chronic hepatitis in colon cancer patients: A Taiwanese population-based cohort study.

PubMed

Lin, Tsai-Hui; Yen, Hung-Rong; Chiang, Jen-Huai; Sun, Mao-Feng; Chang, Hen-Hong; Huang, Sheng-Teng

2017-04-18

There is a decided lack of in-depth studies to evaluate the effectiveness of Chinese Herbal Medicine (CHM) as an adjuvant therapy on the incidence of chronic hepatitis in patients with colon cancer. The aim of this study is to assess whether CHM treatment decreased the incidence of chronic hepatitis in colon cancer patients who received conventional Western medical treatment. A Taiwanese nationwide population-based study of colon cancer patients receiving Western medicine treatment in conjunction with CHM treatment, using data provided by the National Health Insurance (NHI) Research Database, was conducted. A total of 61676 patients were diagnosed with colon cancer in Taiwan within the defined study period, from 1997 to 2010. After randomly equal matching for age, sex, excluding patients younger than 18 years of age, chronic hepatitis before colon cancer diagnosis date, receiving acupuncture and/or moxibustion and taking CHM for less than 30 days, data from 155 patients were analyzed. Hazard ratios of incidence rate of chronic hepatitis were used to determine the influence of CHM and the therapeutic potential of herbal products in treating patients with colon cancer. CHM used for patients with colon cancer exhibited significantly decreased incidence rates of chronic hepatitis [hazard ratio (HR)=0.53; 95% confidence interval (CI):0.38-0.74], with multivariate adjustment, compared to those without CHM use. The protective effect of CHM treatment with statistical significance across the stratification of age, gender, co-morbidity and treatment modality was noted. The cumulative incidence of chronic hepatitis was also reduced in patients with colon cancer receiving CHM treatment during a five-year period. In this study, we provide the ten most used single herbs and herbal formulas that were prescribed for patients with colon cancer; moreover, we identify the eight single herbs and five formulas used in CHM treatment which significantly decreased incidence of chronic hepatitis among colon cancer patients. This nationwide retrospective cohort study determined that therapy using CHM as an adjuvant modality may have a significant impact on liver protection in patients with colon cancer. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Ancient flood records from historical documents in Korea

NASA Astrophysics Data System (ADS)

Kim, H. J.; Noh, S. J.; Jang, C. H.

2009-04-01

This paper is designed to comprehensively study a myriad of floods that have been witnessed on the Korean Peninsula for the past two millennia, by reviewing historical documents. The floods between the era of Three Kingdoms and the age of the Choson Dynasty were listed in the Chronicles of Three Kingdoms on the Korean Peninsula, the History of the Goreyo Dynasty, and the Annals of the Choson Dynasty and the Encyclopedic Annals of the Korean History & Culture (Dongguk Munheon Bigo). In particular, the Annals of the Choson Dynasty provided an ample store of flood records. Based on the data, Korea is judged to have continuously experienced nationwide floods in the 17th century.

Using secure web services to visualize poison center data for nationwide biosurveillance: a case study.

PubMed

Savel, Thomas G; Bronstein, Alvin; Duck, William; Rhodes, M Barry; Lee, Brian; Stinn, John; Worthen, Katherine

2010-01-01

Real-time surveillance systems are valuable for timely response to public health emergencies. It has been challenging to leverage existing surveillance systems in state and local communities, and, using a centralized architecture, add new data sources and analytical capacity. Because this centralized model has proven to be difficult to maintain and enhance, the US Centers for Disease Control and Prevention (CDC) has been examining the ability to use a federated model based on secure web services architecture, with data stewardship remaining with the data provider. As a case study for this approach, the American Association of Poison Control Centers and the CDC extended an existing data warehouse via a secure web service, and shared aggregate clinical effects and case counts data by geographic region and time period. To visualize these data, CDC developed a web browser-based interface, Quicksilver, which leveraged the Google Maps API and Flot, a javascript plotting library. Two iterations of the NPDS web service were completed in 12 weeks. The visualization client, Quicksilver, was developed in four months. This implementation of web services combined with a visualization client represents incremental positive progress in transitioning national data sources like BioSense and NPDS to a federated data exchange model. Quicksilver effectively demonstrates how the use of secure web services in conjunction with a lightweight, rapidly deployed visualization client can easily integrate isolated data sources for biosurveillance.

The Role of the United States Book Exchange in the Nationwide Library and Information Services Network. National Program for Libraries and Information Services Related Paper No. 27.

ERIC Educational Resources Information Center

Ball, Alice Dulany

The National Commission on Libraries and Information Science's (NCLIS) nationwide information program is based in part on the sharing of resources. The United States Book Exchange (USBE) and its existing services may have a role in this program, since the USBE's major function is the preservation and maximum utilization of publications through…

Church-Based Social Relationships and Change in Self-Esteem Over Time

PubMed Central

2010-01-01

This study had two goals. The first goal was to see if church-based social relationships are associated with change in self-esteem. Emotional support from fellow church members and having a close personal relationship with God served as measures of church-based social ties. The second goal was to see whether emotional support from fellow church members is more strongly associated with self-esteem than emotional support from secular social network members. The data came from an ongoing nationwide survey of older adults. The findings revealed that having a close personal relationship with God is associated with a stronger sense of self-esteem at the baseline and follow-up interviews. In contrast, emotional support from fellow church members was not associated with self-esteem at either point in time. However, emotional support from secular social network members was related to self-esteem at the baseline but not the follow-up interview. PMID:20300481

Adult sepsis - A nationwide study of trends and outcomes in a population of 23 million people.

PubMed

Lee, Chien-Chang; Yo, Chia-Hung; Lee, Meng-Tse Gabriel; Tsai, Kuang-Chau; Lee, Shih-Hao; Chen, Yueh-Sheng; Lee, Wan-Chien; Hsu, Tzu-Chun; Lee, Sie-Hue; Chang, Shy-Shin

2017-11-01

To determine the trend of incidence and outcome of sepsis based on a nationwide administrative database. We analyzed the incidence and mortality of both emergency department treated and hospital treated sepsis from 2002 through 2012 using the entire health insurance claims data of Taiwan. The national health insurance covers 99% of residents in Taiwan. Sepsis patients were identified using a set of validated ICD-9CM codes conforming to the sepsis-3 definition. The 30-day all-cause mortality was verified by linked death certificate database. During the 11-year study period, a total of 1,259,578 episodes of sepsis was identified. The mean incidence rate was 639 per 100,000 person-years, increasing from 637.8/100,000 persons in 2002 to 772.1/100,000 persons in 2012 (annual increase: 1.9%). The mortality rate, however, has decreased from 27.8% in 2002 to 22.8% in 2012 (annual decrease: 0.45%). The trend of incidence and mortality did not change after standardization by age and gender using 2002 as the reference standard. We showed that the incidence of sepsis has increased while the mortality has decreased in Taiwan. Despite the decreasing trend in sepsis mortality, the total number of sepsis mortality remains increasing due to the rapid increase in sepsis incidence. Copyright © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

[Deep brain stimulation - expectations and doubts. A nationwide questionnaire study of patients with Parkinson's disease and their family members].

PubMed

Südmeyer, M; Volkmann, J; Wojtecki, L; Deuschl, G; Schnitzler, A; Möller, B

2012-04-01

The aim of this questionnaire-based study was to determine the decision-making motives from Parkinson's patients and their family members for deep brain stimulation (DBS), which are crucial for the attitude towards this therapy and which should be considered during the clinical interview. The questionnaire was sent out nationwide to members of the German Parkinson Association. Patient and family specific data as well as information sources, doubts and expectations with respect to DBS were assessed. A total of 582 patients and 476 family members answered the questionnaire, revealing that 96% of the patients and 91% of the family members already possessed information regarding DBS. While a large proportion of interviewees had specific expectations concerning DBS, more than two thirds expressed concerns regarding DBS; the most frequent with respect to intraoperative complications and stimulation-induced worsening of symptoms. The quantity of realistic patients and family expectations significantly correlated with a positive evaluation of DBS and doubts as well as unrealistic expectations of family members correlated with a negative attitude towards the operation. The findings suggest that patients and their relatives organized in support groups indeed possess detailed information regarding DBS. However, for the acceptance of the treatment a timely elucidation about DBS as well as responding to the individual concerns by the consulting physician is essential.

Surgical Treatment in Childhood-onset Inflammatory Bowel Disease-A Nationwide Register-based Study of 4695 Incident Patients in Sweden 2002-2014.

PubMed

Nordenvall, Caroline; Rosvall, Oda; Bottai, Matteo; Everhov, Åsa H; Malmborg, Petter; Smedby, Karin E; Ekbom, Anders; Askling, Johan; Ludvigsson, Jonas F; Myrelid, Pär; Olén, Ola

2018-01-24

The incidence of childhood-onset [< 18 years] inflammatory bowel disease [IBD] is increasing worldwide, and some studies suggest that it represents a more severe disease phenotype. Few nationwide, population-based studies have evaluated the surgical burden in patients with childhood-onset IBD, and whether the improved medical treatment has influenced the need for gastrointestinal surgery. The aim was to examine whether the surgical treatment at any age of patients with childhood-onset IBD has changed over time. In a nationwide cohort study we identified 4695 children [< 18 years] diagnosed with incident IBD in 2002-2014 through the Swedish Patient Register [ulcerative colitis: n = 2295; Crohn's disease: n = 2174; inflammatory bowel disease-unclassified: n = 226]. Abdominal [intestinal resections and colectomies] and perianal surgeries were identified through the Swedish Patient Register. The cumulative incidences of surgeries were calculated using the Kaplan-Meier method. In the cohort, 44% were females and 56% males. The median age at inflammatory bowel disease diagnosis was 15 years and the maximum age at end of follow-up was 31 years. The 3-year cumulative incidence of intestinal surgery was 5% in patients with ulcerative colitis and 7% in patients with Crohn's disease, and lower in children aged < 6 years at inflammatory bowel disease diagnosis [3%] than in those aged 15-17 years at diagnosis [7%]. Calendar period of inflammatory bowel disease diagnosis was not associated with risk of surgery. Over the past 13 years, the risk of surgery in childhood-onset inflammatory bowel disease has remained unchanged. Copyright © 2017 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com

Educational achievements of children of parents with multiple sclerosis: A nationwide register-based cohort study.

PubMed

Moberg, J Y; Magyari, M; Koch-Henriksen, N; Thygesen, L C; Laursen, B; Soelberg Sørensen, P

2016-11-01

Little is known about the impact of parental multiple sclerosis (MS) on offspring's educational attainment. The objective of the study was to examine educational achievements in offspring of parents with MS compared with matched children of parents without MS in a nationwide register-based cohort study. Children of all Danish-born residents with onset between 1950 and 1986 were identified by linking the Danish Multiple Sclerosis Registry with the Civil Registration System. Twins, children with MS, and emigrated persons were excluded. The reference cohort consisted of randomly drawn individuals from the Civil Registration System without parental MS matched 8:1 to the MS offspring by sex and year of birth. Information about education was linked to the cohorts from nationwide educational registries. We included 4177 children of MS parents and 33,416 reference persons. Children of MS parents achieved statistically significant higher average grades than the reference cohort in their final exam of basic school with a mean grade difference of 0.46 (95 % CI 0.22-0.69; p = 0.0002). We found no difference in achievement of educational level above basic school (OR 1.04; 95 % CI 0.98-1.10; p = 0.20). There was a trend toward more MS offspring attaining health-related educations (OR 1.10; 95 % CI 1.00-1.21; p = 0.06). In conclusion, children of MS parents showed a small advantage in grade point average in final examinations in basic school, and they more often tended toward health-related educations. This study revealed no negative consequences of parental MS on grades and highest educational level achieved.

Low cost satellite land mobile service for nationwide applications

NASA Technical Reports Server (NTRS)

Weiss, J. A.

1978-01-01

A satellite land mobile system using mobile radios in the UHF band, and Ku-band Communications Routing Terminals (earth stations) for a nationwide connection from any mobile location to any fixed or mobile location, and from any fixed location to any mobile location is proposed. The proposed nationwide satellite land mobile service provides: telephone network quality (1 out of 100 blockage) service, complete privacy for all the users, operation similar to the telephone network, alternatives for data services up to 32 Kbps data rates, and a cost effective and practical mobile radio compatible with system sizes ranging from 10,000 to 1,000,000 users. Seven satellite alternatives (ranging from 30 ft diameter dual beam antenna to 210 ft diameter 77 beam antenna) along with mobile radios having a sensitivity figure of merit (G/T) of -15 dB/deg K are considered. Optimized mobile radio user costs are presented as a function of the number of users with the satellite and mobile radio alternatives as system parameters.

Housing characteristics 1993

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

NONE

1995-06-01

This report, Housing Characteristics 1993, presents statistics about the energy-related characteristics of US households. These data were collected in the 1993 Residential Energy Consumption Survey (RECS) -- the ninth in a series of nationwide energy consumption surveys conducted since 1978 by the Energy Information Administration of the US Department of Energy. Over 7 thousand households were surveyed, representing 97 million households nationwide. A second report, to be released in late 1995, will present statistics on residential energy consumption and expenditures.

Patients push for price data. Lawsuits, regulations could cause consumers nationwide to start seeking more transparency from hospitals on outpatient fees.

PubMed

Becker, Cinda

2006-11-20

Lawsuits over hospital outpatient fees, including a case at Virginia Mason Medical Center, could prompt consumers nationwide to seek more information about their bills. The issue highlights the turf battle between physician- or corporate-owned clinics and competing hospital facilities, and how they're marketed. "We absolutely agree that patients need full information", says Virginia Mason's Sarah Patterson, left.

1977 Nationwide Personal Transportation Study : home-to-work trips and travel

DOT National Transportation Integrated Search

1980-12-01

This report is part of a series that presents findings from the 1977 Nationwide Personal Transportation Study (NPTS). This report describes home-to-work trips and trave l in 1977. The home-to-work trip purpose is explored relative to location, househ...

The National Water Data Exchange (NAWDEX)

USGS Publications Warehouse

Edwards, Melvin D.

1977-01-01

The National Water Data Exchange (NAWDEX) was established in 1976 to assist users of water data to identify, locate, and acquire needed data. NAWDEX is a confederation of water-oriented organizations working together to provide more timely and convenient access to their data. A directory of sources of water data and a nationwide index of available water data are maintained for the storage and dissemination of information on available water data. Assistance services are provided through a nationwide network of Local Assistance Centers. This network consists of 51 Centers located in 45 states and Puerto Rico. The Centers provide convenient access to NAWDEX services as well as making local-area expertise available in the identification and location of needed data. Additional Centers will be added to the network, as needed, to meet demands. NAWDEX is centrally managed by a Program Office located within the U.S. Geological Survey 's Water Resources Division in Reston, Virginia. (Woodard-USGS)

Public Experience with Psychoactive Substances: A Nationwide Study Among Adults and Youth. Part 1, Main Findings.

ERIC Educational Resources Information Center

Abelson, Herbert I.; Atkinson, Ronald B.

This is a study of beliefs, attitudes, and behavior with regard to a wide range of legal and illegal drugs. Included are data about coffee, tea, tobacco, and illicit drugs such as marihuana and heroin. The report covers the current situation and highlights trends from two prior studies on drug abuse conducted for the National Commission on…

Time-trends on incidence and survival in a nationwide and unselected cohort of patients with skeletal osteosarcoma

PubMed Central

Johannesen, Tom B⊘rge; Berner, Aasmund; Haugland, Hans Kristian; Bjerkehagen, Bodil; B⊘hler, Per J.; Bruland, Øyvind S.

2015-01-01

Abstract Background This study describes time-trends on epidemiology, subtypes and histopathological entities of osteosarcoma (OS) in a nationwide and unselected cohort of OS patients in Norway between 1975 and 2009. Few nationwide studies are published, and we still have particularly limited knowledge regarding patients not included in clinical trials comprising about half of the OS population. Method Histologically verified skeletal OS for all subgroups were included, resulting in 473 eligible cases from a total of 702 evaluated patients. To ensure completeness, the present cohort was based on all cases reported to the Norwegian Cancer Registry, complemented with data from all Norwegian hospitals involved in sarcoma management. Survival analyses were performed with overall and sarcoma-specific survival as endpoints. Results Mean annual age-standard incidence amounted to about 3.8 per million in male and 2.8 per million in female with no clear time-trends. The male to female ratio was 1.4. Peak incidence was observed in the second decade for both genders. Conventional OS comprised 71.2% of all cases, while low grade OS represented 10.4% and telangiectatic OS only 1.3%. The most common primary site of OS was femur and tibia, respectively. The axial to appendicular ratio increased with the age. The overall 10-year survival did increase from about 30% during the late 1970s to around 50% 20 years later, with no subsequent improvement during the last two decades. Axial tumours, age above 40 years and overt metastatic disease at time of diagnosis were all negative prognostic factors. Conclusion No improvement in the overall survival for OS since the 1990s was documented. The survival rates are still poor for elderly people, patients with axial disease and in the primary metastatic setting. The average incidence rate of skeletal OS in Norway was in line with international figures. PMID:24957555

Time-trends on incidence and survival in a nationwide and unselected cohort of patients with skeletal osteosarcoma.

PubMed

Berner, Kjetil; Johannesen, Tom Børge; Berner, Aasmund; Haugland, Hans Kristian; Bjerkehagen, Bodil; Bøhler, Per J; Bruland, Øyvind S

2015-01-01

This study describes time-trends on epidemiology, subtypes and histopathological entities of osteosarcoma (OS) in a nationwide and unselected cohort of OS patients in Norway between 1975 and 2009. Few nationwide studies are published, and we still have particularly limited knowledge regarding patients not included in clinical trials comprising about half of the OS population. Histologically verified skeletal OS for all subgroups were included, resulting in 473 eligible cases from a total of 702 evaluated patients. To ensure completeness, the present cohort was based on all cases reported to the Norwegian Cancer Registry, complemented with data from all Norwegian hospitals involved in sarcoma management. Survival analyses were performed with overall and sarcoma-specific survival as endpoints. Mean annual age-standard incidence amounted to about 3.8 per million in male and 2.8 per million in female with no clear time-trends. The male to female ratio was 1.4. Peak incidence was observed in the second decade for both genders. Conventional OS comprised 71.2% of all cases, while low grade OS represented 10.4% and telangiectatic OS only 1.3%. The most common primary site of OS was femur and tibia, respectively. The axial to appendicular ratio increased with the age. The overall 10-year survival did increase from about 30% during the late 1970s to around 50% 20 years later, with no subsequent improvement during the last two decades. Axial tumours, age above 40 years and overt metastatic disease at time of diagnosis were all negative prognostic factors. No improvement in the overall survival for OS since the 1990s was documented. The survival rates are still poor for elderly people, patients with axial disease and in the primary metastatic setting. The average incidence rate of skeletal OS in Norway was in line with international figures.

Risk of Periodontal Diseases in Patients With Chronic Obstructive Pulmonary Disease: A Nationwide Population-based Cohort Study.

PubMed

Shen, Te-Chun; Chang, Pei-Ying; Lin, Cheng-Li; Chen, Chia-Hung; Tu, Chih-Yen; Hsia, Te-Chun; Shih, Chuen-Ming; Hsu, Wu-Huei; Sung, Fung-Chang; Kao, Chia-Hung

2015-11-01

Several studies have reported an association between chronic obstructive pulmonary disease (COPD) and periodontal diseases. However, a large-scale population-based cohort study was previously absent from the literature. Therefore, we evaluated the risk of periodontal diseases in patients with COPD in a nationwide population.From the National Health Insurance claims data of Taiwan, we identified 22,332 patients with COPD who were newly diagnosed during 2000 to 2010. For each case, two individuals without COPD were randomly selected and frequency matched by age, sex, and diagnosis year. Both groups were followed up till the end of 2011.The overall incidence of periodontal diseases was 1.19-fold greater in the COPD group than in the comparison group (32.2 vs 26.4 per 1000 person-years; 95% confidence interval [CI] 1.15-1.24). Compared with non-COPD patients, the adjusted hazard ratios of patients with COPD increased with the number of emergency room visits (from 1.14 [95% CI 1.10-1.19] to 5.09 [95% CI 4.53-5.72]) and admissions (from 1.15 [95% CI 1.10-1.20] to 3.17 [95% CI 2.81-3.57]). In addition, the adjusted hazard ratios of patients with COPD treated with inhaled corticosteroids (1.22, 95% CI 1.11-1.34) and systemic corticosteroids (1.15, 95% CI 1.07-1.23) were significantly higher than those of patients not treated with corticosteroids.Patient with COPD are at a higher risk of developing periodontal diseases than the general population. Our results also support that the risk of periodontal diseases is proportional to COPD control. In addition, patients who receive corticosteroid treatment are at a higher risk of developing periodontal diseases.

Clozapine use in childhood and adolescent schizophrenia: A nationwide population-based study.

PubMed

Schneider, Carolina; Papachristou, Efstathios; Wimberley, Theresa; Gasse, Christiane; Dima, Danai; MacCabe, James H; Mortensen, Preben Bo; Frangou, Sophia

2015-06-01

Early onset schizophrenia (EOS) begins in childhood or adolescence. EOS is associated with poor treatment response and may benefit from timely use of clozapine. This study aimed to identify the predictors of clozapine use in EOS and characterize the clinical profile and outcome of clozapine-treated youths with schizophrenia. We conducted a nationwide population-based study using linked data from Danish medical registries. We examined all incident cases of EOS (i.e., cases diagnosed prior to their 18th birthday) between December 31st 1994 and December 31st 2006 and characterized their demographic, clinical and treatment profiles. We then used multivariable cox proportional hazard models to identify predictors of clozapine treatment in this patient population. We identified 662 EOS cases (1.9% of all schizophrenia cases), of whom 108 (17.6%) had commenced clozapine by December 31st 2008. Patients had on average 3 antipsychotic trials prior to clozapine initiation. The mean interval between first antipsychotic treatment and clozapine initiation was 3.2 (2.9) years. Older age at diagnosis of schizophrenia [HR=1.2, 95% CI (1.05-1.4), p=0.01], family history of schizophrenia [HR=2.1, 95% CI (1.1-3.04), p=0.02] and attempted suicide [HR=1.8, 95% CI (1.1-3.04), p=0.02] emerged as significant predictors of clozapine use. The majority of patients (n=96, 88.8%) prescribed clozapine appeared to have a favorable clinical response as indicated by continued prescription redemption and improved occupational outcomes. Our findings support current recommendations for the timely use of clozapine in EOS. Copyright © 2015 Elsevier B.V. and ECNP. All rights reserved.

Association between diverticular disease and Ehlers-Danlos syndrome: a 13-year nationwide population-based cohort study.

PubMed

Leganger, Julie; Søborg, Marie-Louise Kulas; Mortensen, Laura Quitzau; Gregersen, Rasmus; Rosenberg, Jacob; Burcharth, Jakob

2016-12-01

The aim of this study was to examine occurrence and consequences of diverticular disease in patients with Ehlers-Danlos syndrome (EDS) compared with a matched cohort. This nationwide population-based cohort study was conducted using data from medical registers in Denmark from year 2000 to 2012. The EDS cohort was identified using the specific diagnosis code for EDS and was randomly matched in a ratio of 1:20 by sex and date of birth (±1 year) with persons from the Danish general population. The occurrence of diverticular disease and the clinical characteristics of the initial diverticular event were compared between the EDS cohort and the comparison cohort. The first admission with diverticulitis was identified, and severity of diverticulitis, treatment, colonoscopies, length of stay, and 30-day mortality were investigated. We identified 1336 patients with EDS and matched a control cohort of 26,720 patients. The occurrence of diverticular disease in the EDS cohort (2.0 %) and the comparison cohort (0.68 %) differed significantly (p < 0.001). At the first diverticular event, the majority of patients were women (85 % for EDS and 87 % for the comparison cohort). Mean age, localization, and type of contact did not differ significantly. Admission with diverticulitis (1.0 % for EDS and 0.34 % for the comparison cohort) differed significantly (p < 0.001). We found no significant difference in severity of diverticulitis, treatment, length of stay, or 30-day mortality between the EDS and the comparison cohorts. Patients with EDS had an increased occurrence of overall diverticular events and admissions with diverticulitis compared with the general population.

The timber resources of Pennsylvania. A report on the forest survey made by the U.S. Forest Service

Treesearch

Roland H. Ferguson; Roland H. Ferguson

This is a report on the timber resources of Pennsylvania. It is based on the findings of a survey made by the Forest Service, U.S. Department of Agriculture as part of a nationwide forest appraisal. The survey data show--as of January 1955--the area and condition of the forest land and the volume and quality of the standing timber. They also include, for the year 1954...

Contact with the Dead, Religion, and Death Anxiety among Older Mexican Americans

ERIC Educational Resources Information Center

Krause, Neal; Bastida, Elena

2012-01-01

The purpose of this study is to see if contact with the dead is associated with lower death anxiety among older Mexican Americans. The data come from a nationwide survey of older Mexican Americans (N = 1,005). The study model specifies that (a) older Mexican Americans who have experienced contact with the dead are more likely to see the…

College Student Entrepreneurship in China: Results from a National Survey of Directors of Career Services in Chinese Higher Education Institutions

ERIC Educational Resources Information Center

You, You; Zhu, Feifei; Ding, Xiaohao

2017-01-01

As the number of college graduates increases dramatically in recent years in China, the Chinese Central government encourages college graduates to partake in entrepreneurial activities. The current study uses data from a nationwide institutional survey of directors of career services of 840 Chinese colleges and universities to study the current…

The Deaf Acculturation Scale (DAS): Development and Validation of a 58-Item Measure

ERIC Educational Resources Information Center

Maxwell-McCaw, Deborah; Zea, Maria Cecilia

2011-01-01

This study involved the development and validation of the Deaf Acculturation Scale (DAS), a new measure of cultural identity for Deaf and hard-of-hearing (hh) populations. Data for this study were collected online and involved a nation-wide sample of 3,070 deaf/hh individuals. Results indicated strong internal reliabilities for all the subscales,…

Comparative study of control selection in a national population-based case-control study: Estimating risk of smoking on cancer deaths in Chinese men.

PubMed

Jiang, Jingmei; Liu, Boqi; Nasca, Philip C; Han, Wei; Zou, Xiaonong; Zeng, Xianjia; Tian, Xiaobing; Wu, Yanping; Zhao, Ping; Li, Junyao

2009-10-28

To assess the validation of a novel control selection design by comparing the consistency between the new design and a routine design in a large case-control study that was incorporated into a nationwide mortality survey in China. A nationwide mortality study was conducted during 1989-1991. Surviving spouses or other relatives of all adults who died during 1986-1988 provided detailed information about their own as well as the deceased person's smoking history. In this study, 130,079 males who died of various smoking-related cancers at age 35 or over were taken as cases, while 103,248 male surviving spouses (same age range with cases) of women who died during the same period and 49,331 males who died from causes other than those related to smoking were used as control group 1 and control group 2, respectively. Consistency in the results when comparing cases with each of the control groups was assessed. Consistency in the results was observed in the analyses using different control groups although cancer deaths varied with region and age. Equivalence could be ascertained using a 15% criterion in most cancer deaths which had high death rates in urban areas, but they were uncertain for most cancers in rural areas irrespective of whether the hypothesis testing showed significant differences or not. Sex-matched living spouse control design as an alternative control selection for a case-control study is valid and feasible, and the basic principles of the equivalence study are also supported by epidemiological survey data.

EpiHosp: A web-based visualization tool enabling the exploratory analysis of complications of implantable medical devices from a nationwide hospital database.

PubMed

Ficheur, Grégoire; Ferreira Careira, Lionel; Beuscart, Régis; Chazard, Emmanuel

2015-01-01

Administrative data can be used for the surveillance of the outcomes of implantable medical devices (IMDs). The objective of this work is to build a web-based tool allowing for an exploratory analysis of time-dependent events that may occur after the implementation of an IMD. This tool should enable a pharmacoepidemiologist to explore on the fly the relationship between a given IMD and a potential outcome. This tool mine the French nationwide database of inpatient stays from 2008 to 2013. The data are preprocessed in order to optimize the queries. A web tool is developed in PHP, MySQL and Javascript. The user selects one or a group of IMD from a tree, and can filter the results using years and hospital names. Four result pages describe the selected inpatient stays: (1) temporal and demographic description, (2) a description of the geographical location of the hospital, (3) a description of the geographical place of residence of the patient and (4) a table showing the rehospitalization reasons by decreasing order of frequency. Then, the user can select one readmission reason and display dynamically the probability of readmission by mean of a Kaplan-Meier curve with confidence intervals. This tool enables to dynamically monitor the occurrence of time-dependent complications of IMD.

Traffic-related air pollution increased the risk of Parkinson's disease in Taiwan: A nationwide study.

PubMed

Lee, Pei-Chen; Liu, Li-Ling; Sun, Yu; Chen, Yu-An; Liu, Chih-Ching; Li, Chung-Yi; Yu, Hwa-Lung; Ritz, Beate

2016-11-01

Ambient air pollution has been associated with many health conditions, but little is known about its effects on neurodegenerative diseases, such as Parkinson's disease (PD). In this study, we investigated the influence of ambient air pollution on PD in a nationwide population-based case-control study in Taiwan. We identified 11,117 incident PD patients between 2007 and 2009 from the Taiwanese National Health Insurance Research Database and selected 44,468 age- and gender-matched population controls from the longitudinal health insurance database. The average ambient pollutant exposure concentrations from 1998 through the onset of PD were estimated using quantile-based Bayesian Maximum Entropy models. Basing from logistic regression models, we estimated the odds ratios (ORs) and 95% confidence intervals (CIs) of ambient pollutant exposures and PD risk. We observed positive associations between NO x , CO exposures, and PD. In multi-pollutant models, for NO x and CO above the 75th percentile exposure compared with the lowest percentile, the ORs of PD were 1.37 (95% CI=1.23-1.52) and 1.17 (95% CI=1.07-1.27), respectively. This study suggests that ambient air pollution exposure, especially from traffic-related pollutants such as NO x and CO, increases PD risk in the Taiwanese population. Copyright © 2016 Elsevier Ltd. All rights reserved.

CSDC: a nationwide screening platform for stroke control and prevention in China.

PubMed

Jinghui Yu; Huajian Mao; Mei Li; Dan Ye; Dongsheng Zhao

2016-08-01

As a leading cause of severe disability and death, stroke places an enormous burden on Chinese society. A nationwide stroke screening platform called CSDC (China Stoke Data Center) has been built to support the national stroke prevention program and stroke clinical research since 2011. This platform is composed of a data integration system and a big data analysis system. The data integration system is used to collect information on risk factors, diagnosis history, treatment, and sociodemographic characteristics and stroke patients' EMR. The big data analysis system support decision making of stroke control and prevention, clinical evaluation and research. In this paper, the design and implementation of CSDC are illustrated, and some application results are presented. This platform is expected to provide rich data and powerful tool support for stroke control and prevention in China.

Monophasic versus biphasic defibrillation for pediatric out-of-hospital cardiac arrest patients: a nationwide population-based study in Japan

PubMed Central

2012-01-01

Introduction Conventional monophasic defibrillators for out-of-hospital cardiac-arrest patients have been replaced with biphasic defibrillators. However, the advantage of biphasic over monophasic defibrillation for pediatric out-of-hospital cardiac-arrest patients remains unknown. This study aimed to compare the survival outcomes of pediatric out-of-hospital cardiac-arrest patients who underwent monophasic defibrillation with those who underwent biphasic defibrillation. Methods This prospective, nationwide, population-based observational study included pediatric out-of-hospital cardiac-arrest patients from January 1, 2005, to December 31, 2009. The primary outcome measure was survival at 1 month with minimal neurologic impairment. The secondary outcome measures were survival at 1 month and the return of spontaneous circulation before hospital arrival. Multivariable logistic regression analysis was performed to identify the independent association between defibrillator type (monophasic or biphasic) and outcomes. Results Among 5,628 pediatric out-of-hospital cardiac-arrest patients (1 through 17 years old), 430 who received defibrillation shock with monophasic or biphasic defibrillator were analyzed. The number of patients who received defibrillation shock with monophasic defibrillator was 127 (30%), and 303 (70%) received defibrillation shock with biphasic defibrillator. The survival rates at 1 month with minimal neurologic impairment were 17.5% and 24.4%, the survival rates at 1 month were 32.3% and 35.6%, and the rates of return of spontaneous circulation before hospital arrival were 24.4% and 27.4% in the monophasic and biphasic defibrillator groups, respectively. Hierarchic logistic regression analyses by using generalized estimation equations found no significant difference between the two groups in terms of 1-month survival with minimal neurologic impairment (odds ratio (OR), 1.57; 95% confidence interval (CI), 0.87 to 2.83; P = 0.14) and 1-month survival (OR, 1.38; 95% CI, 0.87 to 2.18; P = 0.17). Conclusions The present nationwide population-based observational study could not confirm an advantage of biphasic over monophasic defibrillators for pediatric OHCA patients. PMID:23148767

Background and Data Configuration Process of a Nationwide Population-Based Study Using the Korean National Health Insurance System

PubMed Central

Song, Sun Ok; Jung, Chang Hee; Song, Young Duk; Park, Cheol-Young; Kwon, Hyuk-Sang; Cha, Bong Soo; Park, Joong-Yeol; Lee, Ki-Up

2014-01-01

Background The National Health Insurance Service (NHIS) recently signed an agreement to provide limited open access to the databases within the Korean Diabetes Association for the benefit of Korean subjects with diabetes. Here, we present the history, structure, contents, and way to use data procurement in the Korean National Health Insurance (NHI) system for the benefit of Korean researchers. Methods The NHIS in Korea is a single-payer program and is mandatory for all residents in Korea. The three main healthcare programs of the NHI, Medical Aid, and long-term care insurance (LTCI) provide 100% coverage for the Korean population. The NHIS in Korea has adopted a fee-for-service system to pay health providers. Researchers can obtain health information from the four databases of the insured that contain data on health insurance claims, health check-ups and LTCI. Results Metabolic disease as chronic disease is increasing with aging society. NHIS data is based on mandatory, serial population data, so, this might show the time course of disease and predict some disease progress, and also be used in primary and secondary prevention of disease after data mining. Conclusion The NHIS database represents the entire Korean population and can be used as a population-based database. The integrated information technology of the NHIS database makes it a world-leading population-based epidemiology and disease research platform. PMID:25349827

Background and data configuration process of a nationwide population-based study using the korean national health insurance system.

PubMed

Song, Sun Ok; Jung, Chang Hee; Song, Young Duk; Park, Cheol-Young; Kwon, Hyuk-Sang; Cha, Bong Soo; Park, Joong-Yeol; Lee, Ki-Up; Ko, Kyung Soo; Lee, Byung-Wan

2014-10-01

The National Health Insurance Service (NHIS) recently signed an agreement to provide limited open access to the databases within the Korean Diabetes Association for the benefit of Korean subjects with diabetes. Here, we present the history, structure, contents, and way to use data procurement in the Korean National Health Insurance (NHI) system for the benefit of Korean researchers. The NHIS in Korea is a single-payer program and is mandatory for all residents in Korea. The three main healthcare programs of the NHI, Medical Aid, and long-term care insurance (LTCI) provide 100% coverage for the Korean population. The NHIS in Korea has adopted a fee-for-service system to pay health providers. Researchers can obtain health information from the four databases of the insured that contain data on health insurance claims, health check-ups and LTCI. Metabolic disease as chronic disease is increasing with aging society. NHIS data is based on mandatory, serial population data, so, this might show the time course of disease and predict some disease progress, and also be used in primary and secondary prevention of disease after data mining. The NHIS database represents the entire Korean population and can be used as a population-based database. The integrated information technology of the NHIS database makes it a world-leading population-based epidemiology and disease research platform.

Reducing Teacher Turnover by Utilizing a National List of Reasons for Teacher Dissatisfaction or How to Keep Teachers from Declaring "Dear Folks, I Quit"

ERIC Educational Resources Information Center

Lopez, Angela J.

2010-01-01

Background: Teacher turnover is a national problem and has been investigated on the national level since the 1920's. This study compares the reasons teachers give for leaving teaching positions from data collected nationwide with local data. Purpose: To examine whether the same problems that arise on the local level have been identified in the…

A Nationwide Survey of Disability Support Personnel Regarding Transition, Documentation, and Services for Postsecondary Students with Invisible Disabilities

ERIC Educational Resources Information Center

Wadlington, Charles

2012-01-01

The purpose of this exploratory study was to analyze the perceptions (through survey data) of Disability Support Services (DSS) personnel regarding the transition process, documentation requirements to receive services, and services for students with invisible disabilities (Autism Spectrum Disorder [ASD], Attention-Deficit Hyperactivity Disorder…

Curricular Comprehensiveness in Small Rural Community Colleges. "Horizons Issues" Monograph Series.

ERIC Educational Resources Information Center

Atwell, Charles A.; Sullins, W. Robert

A nationwide study was conducted to assess the degree of curricular comprehensiveness in small rural community colleges and to identify funding mechanisms and strategies that affect comprehensiveness. Data were collected on transfer and occupational-technical offerings from 160 public two-year colleges that enrolled fewer than 2,500 headcount…

Staff downsizing on the decline for organizations trying to cut overall health care costs.

PubMed

1998-04-01

Data Benchmarks: Don't look to downsizing as a major cost-cutting strategy this year. This industry study identifies staffing strategies at hospitals nationwide, plus other important human resource issues for 1998. Not surprisingly, controlling organization-wide costs is a top priority. Here are the details.

Critical Pedagogy, Rituals of Distinction, and True Professionalism

ERIC Educational Resources Information Center

Nodoushan, Mohammad Ali Salmani; Pashapour, Arezou

2016-01-01

The current study sought to critically address the practice of rituals of distinction in nation-wide educational milieus to see if such practices can produce generations of underdeveloped and deprived learners. Data were collected over a course of two years from North Korea, Pakistan, Zimbabwe, Venezuela, and Somalia. A total of 419 teachers,…

Patient Safety Outcomes in Small Urban and Small Rural Hospitals

ERIC Educational Resources Information Center

Vartak, Smruti; Ward, Marcia M.; Vaughn, Thomas E.

2010-01-01

Purpose: To assess patient safety outcomes in small urban and small rural hospitals and to examine the relationship of hospital and patient factors to patient safety outcomes. Methods: The Nationwide Inpatient Sample and American Hospital Association annual survey data were used for analyses. To increase comparability, the study sample was…

Perceived constraints to art museum attendance

Treesearch

Jinhee Jun; Gerard Kyle; Joseph T. O' Leary

2007-01-01

We explored selected socio-demographic factors that influence the perception of constraints to art museum attendance among a sample of interested individuals who were currently not enjoying art museum visitation. Data from the Survey of Public Participation in the Arts (SPPA), a nationwide survey were used for this study. Using multivariate analysis of variance, we...

Alcohol-Specific Socialization Practices and Alcohol Use in Dutch Early Adolescents

ERIC Educational Resources Information Center

Koning, Ina M.; Engels, Rutger C. M. E.; Verdurmen, Jacqueline E. E.; Vollebergh, Wilma A. M.

2010-01-01

The present study examined the associations of alcohol-specific socialization practices and heavy parental drinking with alcohol use in early adolescents. Cross-sectional nationwide survey data from 2599 parent-adolescent (mean age = 12.16) dyads were used to conduct logistic regression analyses. Onset of alcohol use as well as infrequent and…

Staffing Trends of Disability Care Institutions in Taiwan during the Period 2002-2007

ERIC Educational Resources Information Center

Fang, Wen-Hui; Yen, Chia-Feng; Wu, Jia-Ling; Lin, Lan-Ping; Kuo, Fang-Yu; Chou, Yu-Ching; Lin, Jin-Ding

2009-01-01

The objectives of this study were to examine trends related to the staffing of disability welfare institutions caring for people with disabilities in Taiwan. Nationwide data from the 2002 to 2007 "Service Manpower in Disability Welfare Institutions" report, which are derived mainly from the Department of Statistics, Ministry of the…

Availability of Special Education Teachers: Trends and Tests.

ERIC Educational Resources Information Center

Katsiyannis, Antonis; Zhang, Dalun; Conroy, Maureen A.

2003-01-01

A study examined trends in teacher availability in special education by analyzing data from annual reports to Congress from 1988-1989 to 1998- 1999. Findings indicate a nationwide shortage of teacher qualified to teach across all disabilities and a dramatic decrease in the teacher shortage rate beginning in the 1993-1994 year. (Contains…

Development of bankfull hydraulic geometry relationships for the physiographic divisions of the United States

USDA-ARS?s Scientific Manuscript database

Bankfull hydraulic geometry relationships are used to estimate channel dimensions for stream flow simulation models, which require channel geometry data as input parameters. Often, one nationwide curve is used across the entire U.S. (e.g. in SWAT), even though studies have shown that the use of reg...

A Study of the College of Pharmacy Library Concerning Facilities, Services and User Satisfaction.

ERIC Educational Resources Information Center

Parkin, Derral

This report examines the college of pharmacy library in relation to its historical development, present facilities, services, and user satisfaction, and makes a statistical comparison between the University of Houston College of Pharmacy Library and other accredited pharmacy libraries nationwide. Data were gathered through 28 completed library…

Craft Artist Membership Organizations 1978. Report No. 13.

ERIC Educational Resources Information Center

National Endowment for the Arts, Washington, DC. Research Div.

To describe what has been learned about craft membership organizations is the goal of this research report, which utilizes data collected in a nationwide survey of craft organizations. Specific purposes of the study were aimed at developing a better understanding of U.S. craft artists and organizations. Findings indicated that a typical craft…

The effect of blurred plot coordinates on interpolating forest biomass: a case study

Treesearch

J. W. Coulston

2004-01-01

Interpolated surfaces of forest attributes are important analytical tools and have been used in risk assessments, forest inventories, and forest health assessments. The USDA Forest Service Forest Inventory and Analysis program (FIA) annually collects information on forest attributes in a consistent fashion nation-wide. Users of these data typically perform...

West Nile Virus Seroprevalence in the Greek Population in 2013: A Nationwide Cross-Sectional Survey

PubMed Central

Hadjichristodoulou, Christos; Pournaras, Spyros; Mavrouli, Maria; Marka, Andriani; Tserkezou, Persefoni; Baka, Agoritsa; Billinis, Charalambos; Katsioulis, Antonios; Psaroulaki, Anna; Papa, Anna; Papadopoulos, Nikos; Mamuris, Zissis; Tsakris, Athanasios; Kremastinou, Jenny

2015-01-01

Cases of West Nile Virus (WNV) disease were recorded for three consecutive years in Greece following the year 2010 outbreak. A cross-sectional serologic survey was conducted to estimate the WNV seroprevalence and assess the ratio of infection to neuroinvasive disease. A stratified left-over sampling methodology was used including age and residence strata. A total of 3,962 serum samples was collected and tested for WNV Immunoglobulin G (IgG) antibodies by Enzyme–Linked Immunosorbent Assay (ELISA). All positive samples were further tested by Plaque Reduction Neutralization Test (PRNT) and WNV Immunoglobulin M (IgM) antibodies. WNV IgG antibodies were detected in 82 samples and 61 were also positive in PRNT representing a weighted seroprevalence of 2.1% (95% C.I.: 1.7–2.6) and 1.5% (95% C.I.: 1.2–2.0), respectively. Multivariable analysis showed that seroprevalence was associated with age and residence. The overall ratio of neuroinvasive disease to infected persons was estimated at 1:376 (95% C.I.: 1:421–1:338), while the elderly people had the highest ratio. This nationwide study provided valuable data regarding the epidemiology of WNV in Greece based on the fact that elderly people have higher risk of being both infected and having severe disease. PMID:26605539

Analysis of risk factors for schizophrenia with two different case definitions: a nationwide register-based external validation study.

PubMed

Sørensen, Holger J; Larsen, Janne T; Mors, Ole; Nordentoft, Merete; Mortensen, Preben B; Petersen, Liselotte

2015-03-01

Different case definitions of schizophrenia have been used in register based research. However, no previous study has externally validated two different case definitions of schizophrenia against a wide range of risk factors for schizophrenia. We investigated hazard ratios (HRs) for a wide range of risk factors for ICD-10 DCR schizophrenia using a nationwide Danish sample of 2,772,144 residents born in 1955-1997. We compared one contact only (OCO) (the case definition of schizophrenia used in Danish register based studies) with two or more contacts (TMC) (a case definition of at least 2 inpatient contacts with schizophrenia). During the follow-up, the OCO definition included 15,074 and the TMC 7562 cases; i.e. half as many. The TMC case definition appeared to select for a worse illness course. A wide range of risk factors were uniformly associated with both case definitions and only slightly higher risk estimates were found for the TMC definition. Choosing at least 2 inpatient contacts with schizophrenia (TMC) instead of the currently used case definition would result in almost similar risk estimates for many well-established risk factors. However, this would also introduce selection and include considerably fewer cases and reduce power of e.g. genetic studies based on register-diagnosed cases only. Copyright © 2015 Elsevier B.V. All rights reserved.

Sustaining Fidelity Following the Nationwide PMTO™ Implementation in Norway

PubMed Central

Forgatch, Marion S.; DeGarmo, David S.

2011-01-01

This report describes three studies from the nationwide Norwegian implementation of Parent Management Training – Oregon Model (PMTO™), an empirically supported treatment for families of children with behavior problems (Forgatch and Patterson 2010). Separate stages of the implementation were evaluated using a fidelity measure based on direct observation of intervention sessions. Study 1 assessed growth in fidelity observed early, mid, and late in the training of a group of practitioners. We hypothesized increased fidelity and decreased variability in practice. Study 2 evaluated method fidelity over the course of three generations of practitioners trained in PMTO. Generation 1 (G1) was trained by the PMTO developer/purveyors; Generation 2 (G2) was trained by selected G1 Norwegian trainers; and Generation 3 (G3) was trained by G1 and G2 trainers. We hypothesized decrease in fidelity with each generation. Study 3 tested the predictive validity of fidelity in a cross-cultural replication, hypothesizing that higher fidelity scores would correlate with improved parenting practices observed in parent-child interactions before and after treatment. In Study 1, trainees' performance improved and became more homogeneous as predicted. In Study 2, a small decline in fidelity followed the transfer from the purveyor trainers to Norwegian trainers in G2, but G3 scores were equivalent to those attained by G1. Thus, the hypothesis was not fully supported. Finally, the FIMP validity model replicated; PMTO fidelity significantly contributed to improvements in parenting practices from pre- to post-treatment. The data indicate that PMTO was transferred successfully to Norwegian implementation with sustained fidelity and cross-cultural generalization. PMID:21671090

Church-Based Social Relationships, Belonging, and Health Among Older Mexican Americans

PubMed Central

Krause, Neal; Bastida, Elena

2011-01-01

The purpose of this study is to explain how church-based emotional support influences the health of older Mexican Americans. This issue is evaluated with a theoretical model that contains the following core linkages: (1) older Mexican Americans who go to church more often will be more likely to receive emotional support from fellow church members; (2) older Mexican Americans who receive more support from their fellow church members will be more likely to feel they belong in their congregation; (3) older Mexican Americans who feel they belong in their congregation are likely to have a stronger sense of personal control; and (4) older Mexican Americans who have a stronger sense of personal control are likely to enjoy better health. Data from a recent nationwide survey of older Mexican Americans provide support for each of these relationships. PMID:21687808

Heart Failure and Mortality of Adult Survivors from Acute Myocarditis Requiring Intensive Care Treatment - A Nationwide Cohort Study

PubMed Central

Chang, Jung-Jung; Lin, Ming-Shyan; Chen, Tien-Hsing; Chen, Dong-Yi; Chen, Shao-Wei; Hsu, Jen-Te; Wang, Po-Chang; Lin, Yu-Sheng

2017-01-01

Background The correlation between severity and long-term outcomes of pediatric myocarditis have been reported, however this correlation in adults has rarely been studied. Materials and Methods This nationwide population-based cohort study used data from the National Health Insurance Research Database in Taiwan. Patients aged < 75 and > 18 years admitted to an intensive care unit due to acute myocarditis were enrolled and divided into three groups according to mechanical circulatory support (MCS) after excluding major comorbidities. All-cause mortality, cardiovascular death, and heart failure hospitalization were evaluated from January 1, 2001 to December 31, 2011. Results There were 1145 patients with acute myocarditis (mean age 40.2 years, SD: 14.8 years), of which 851 did not require MCS, 99 underwent intra-aortic balloon pump (IABP) support, and 195 extracorporeal membrane oxygenation (ECMO) support. There was no significant difference in heart failure hospitalization between the three groups after index admission. The incidence of cardiovascular death after discharge ranged from 10 % to 22%, which was highest in the ECMO group, and was also significantly different between the three groups within 3 months (p<0.001) but it disappeared after 3 months (p=0.458). The trend was also noted in incidence of all-cause mortality. Conclusions The severity of acute myocarditis did not affect long-term outcomes, however, it was associated with cardiovascular/all-cause death within 3 months after discharge. PMID:29104480

The risk of stroke after bilateral salpingo-oophorectomy at hysterectomy for benign diseases: A nationwide cohort study.

PubMed

Lai, Jerry Cheng-Yen; Chou, Yiing-Jenq; Huang, Nicole; Chen, Hung-Hui; Wang, Kung-Liahng; Wang, Chien-Wei; Shen, I-Hsuan; Chang, Hung-Chang

2018-08-01

To assess the risk of stroke (and subtypes of stroke) in women after elective bilateral salpingo-oophorectomy at hysterectomy for benign diseases. We conducted a nationwide population-based, retrospective cohort study using claims data from Taiwan's National Health Insurance program between 1997 and 2013. Women aged 20 years or more who underwent bilateral salpingo-oophorectomy at hysterectomy for benign diseases (n = 1083) were compared with women who did not undergo bilateral salpingo-oophorectomy at hysterectomy for benign diseases (n = 3903). The follow-up period ranged from 10 to 16 years. Age-adjusted (or unadjusted) and multivariate Cox proportional hazards regression models were used to estimate the risk of stroke between the two groups. A diagnosis of stroke (and subtypes of stroke). We did not find a significant association between bilateral salpingo-oophorectomy and the risk of incident stroke (or subtypes of stroke) over an average follow-up of 13 years. Among women aged 50 years or more who used estrogen therapy, the risk of developing stroke was 64% lower in those who had undergone bilateral salpingo-oophorectomy (hazard ratio, 0.36; 95% confidence interval, 0.16-0.79) than in those who had undergone hysterectomy only. This study suggests that the use of estrogen after bilateral salpingo-oophorectomy at hysterectomy for benign diseases reduces the risk of stroke in women aged 50 years or more. Copyright © 2018 Elsevier B.V. All rights reserved.

Comparison of outcome and cost among open, laparoscopic, and robotic surgical treatments for rectal cancer: A propensity score matched analysis of nationwide inpatient sample data.

PubMed

Chen, Szu-Ta; Wu, Meng-Che; Hsu, Tzu-Chun; Yen, Debra W; Chang, Chia-Na; Hsu, Wan-Ting; Wang, Chia-Chun; Lee, Matthew; Liu, Shing-Hwa; Lee, Chien-Chang

2018-03-01

Population-based studies evaluating outcomes of different approaches for rectal cancer are scarce. We conducted a retrospective cohort study using the Nationwide Inpatient Sample database between 2008 and 2012. We compared the outcomes and costs among rectal cancer patients undergoing robotic, laparoscopic, or open surgeries using propensity scores for adjusted and matched analysis. We identified 194 957 rectal cancer patients. Over the 5-year period, the annual admission number decreased by 13.9%, the in-hospital mortality rate decreased by 32.2%, while the total hospitalization cost increased by 13.6%. Compared with laparoscopic surgery, robotic surgery had significantly lower length of stay (LOS) (OR 0.69, 95%CI 0.57-0.84), comparable wound complications (OR 1.08, 95%CI 0.70-1.65) and higher cost (OR 1.42, 95%CI 1.13-1.79), while open surgery had significantly longer LOS (OR 1.38, 95%CI 1.19-1.59), more wound complications (OR 1.49, 95%CI 1.08-1.79), and comparable cost (OR 0.92, 95%CI 0.79-1.07). There were no difference in in-hospital mortality among three approaches. Laparoscopic surgery was associated with better outcomes than open surgery. Robotic surgery was associated with higher cost, but no advantage over laparoscopic surgery in terms of mortality and complications. Studies on cost-effectiveness of robotic surgery may be warranted. © 2017 Wiley Periodicals, Inc.

Use of acid-suppressive therapy before anti-reflux surgery in 2922 patients: a nationwide register-based study in Denmark.

PubMed

Lødrup, A; Pottegård, A; Hallas, J; Bytzer, P

2015-07-01

Guidelines recommend that patients with gastro-oesophageal reflux disease are adequately treated with acid-suppressive therapy before undergoing anti-reflux surgery. Little is known of the use of acid-suppressive drugs before anti-reflux surgery. To determine the use of proton pump inhibitors and H2 -receptor antagonists in the year before anti-reflux surgery. A nationwide retrospective study of all patients aged ≥18 undergoing first-time anti-reflux surgery in Denmark during 2000-2012 using data from three different sources: the Danish National Register of Patients, the Danish National Prescription Register, and the Danish Person Register. The study population thus included 2922 patients (median age: 48 years, 55.7% male). The annual proportion of patients redeeming ≥180 DDD of acid-suppressive therapy increased from 17.0% 5 years before anti-reflux surgery to 64.9% 1 year before. The probability for inadequate dosing 1 year before surgery (<180 DDD) was significantly increased for younger patients, patients operated in the period 2000-2003, patients who had not undergone pre-surgical manometry, pH- or impedance monitoring, and patients who had not redeemed prescriptions on NSAID or anti-platelet drugs. Compliance with medical therapy should be evaluated thoroughly before planning anti-reflux surgery, as a high proportion of patients receive inadequate dosing of acid-suppressive therapy prior to the operation. © 2015 John Wiley & Sons Ltd.

Improving the delivery of preventive care services.

PubMed

Hung, Dorothy Y

2007-05-01

Performance of preventive services is an important indicator of high-quality health care, but many recommended services are not regularly offered in primary care practices. Health risk assessments, counseling, and referral to community-based programs help address risk behaviors, many of which are leading causes of preventable death and disability in the United States. This study examined various influences on the delivery of preventive services designed to address smoking, excessive consumption of alcohol, unhealthy diets, and sedentary lifestyles. More than 300 health care providers in 52 practices nationwide have contributed data to this study. Staff participation in quality improvement enhanced work relationships and also diminished the effect of practice size on the performance of preventive care. The use of nurse practitioners, allied health professionals, clinician reminders, and patient registries were positively associated with care delivery.

Timing of two versus three doses of quadrivalent HPV vaccine and associated effectiveness against condyloma in Sweden: a nationwide cohort study

PubMed Central

F, Lamb; E, Herweijer; A, Ploner; I, Uhnoo; K, Sundström; P, Sparén; L, Arnheim-Dahlström

2017-01-01

Objective To assess incidence of condyloma after two doses of quadrivalent human papillomavirus (qHPV) vaccine, by time since first vaccine dose, in girls and women initiating vaccination before age 20 years. Design Register-based nationwide open cohort study. Setting Sweden. Participants Girls and women initiating qHPV vaccination before age 20 years between 2006 and 2012. The study cohort included 264 498 girls, of whom 72 042 had received two doses of qHPV vaccine and 185 456 had received all three doses. Main outcome measure Incidence rate ratios (IRRs) of condyloma estimated by time between first and second doses of qHPV in months (m) and age at vaccination, adjusted for attained age. Results For girls first vaccinated with two doses before the age of 17 years, the IRR of condyloma for 0–3 months between the first and second doses was 1.96 (95% CI 1.43 to 2.68) as compared with the standard three-dose schedule. The IRRs were 1.27 (95% CI 0.63 to 2.58) and 4.36 (95% CI 2.05 to 9.28) after receipt of two doses with 4–7 months and 8+ months between doses, respectively. For women first vaccinated after the age of 17 years, vaccination with two doses of qHPV vaccine and 0–3 months between doses was associated with an IRR of 2.12 (95% CI 1.62 to 2.77). For an interval of 4–7 months between doses, the IRR did not statistically significantly differ to the standard three-dose schedule (IRR=0.81, 95% CI 0.36 to 1.84). For women with 8+ months between dose 1 and dose 2 the IRR was 3.16 (95% CI 1.40 to 7.14). Conclusion A two-dose schedule for qHPV vaccine with 4–7 months between the first and second doses may be as effective against condyloma in girls and women initiating vaccination under 20 years as a three-dose schedule. Results from this nationwide study support immunogenicity data from clinical trials. PMID:28600369

Comparative Effectiveness of Intravenous Immunoglobulin for Children with Kawasaki Disease: A Nationwide Cohort Study

PubMed Central

Lin, Ming-Chih; Fu, Yun-Ching; Jan, Sheng-Ling; Lai, Mei-Shu

2013-01-01

Introduction Different immunoglobulin manufacturing processes may influence its effectiveness for Kawasaki disease. However, nationwide studies with longitudinal follow-up are still lacking. The aim of this study was to evaluate the comparative effectiveness of immunoglobulin preparations from a nationwide perspective. Materials and Methods This is a nationwide retrospective cohort study with a new user design. Data came from the National Health Insurance Research Database of Taiwan. From 1997 to 2008, children under 2 years old who received immunoglobulin therapy for the first time under the main diagnosis of Kawasaki disease were enrolled. The manufacturing processes were divided into β-propiolactonation, acidification and those containing IgA. The endpoints were immunoglobulin non-responsiveness, acute aneurysm, prolonged use of anti-platelets or anti-coagulants, and recurrence. Results In total, 3830 children were enrolled. β-propiolactonation had a relative risk of 1.45 (95% CI 1.08∼1.94) of immunoglobulin non-responsiveness, however, the relative risks for acidification and containing IgA were non-significant. For acute aneurysms, acidification had a relative risk of 1.49 (95% CI 1.17∼1.90), however the relative risks for β-propiolactonation and containing IgA were non-significant. For prolonged use of anti-platelets or anti-coagulants, β-propiolactonation had a relative risk of 1.44 (95% CI 1.18∼1.76), and acidification protected against them both with a relative risk of 0.82 (95% CI 0.69∼0.97), whereas the relative risk for containing IgA was non-significant. For recurrence, all three factors were non-significant. Conclusions The effectiveness of immunoglobulin may differ among different manufacturing processes. β-propiolactonation had a higher risk of treatment failure and prolonged use of anti-platelets or anti-coagulants. Acidification may increase the risk of acute coronary aneurysms. PMID:23650564

Hospitalizations for Suicide-Related Drug Poisonings and Co-Occurring Alcohol Overdoses in Adolescents (Ages 12-17) and Young Adults (Ages 18-24) in the United States, 1999-2008: Results from the Nationwide Inpatient Sample

ERIC Educational Resources Information Center

White, Aaron M.; MacInnes, Erin; Hingson, Ralph W.; Pan, I-Jen

2013-01-01

Drug poisoning is the leading method of suicide-related deaths among females and third among males in the United States. Alcohol can increase the severity of drug poisonings, yet the prevalence of alcohol overdoses in suicide-related drug poisonings (SRDP) remains unclear. Data from the Nationwide Inpatient Sample was examined to determine rates…

Seropositivity of Lyme Borreliosis and Associated Risk Factors: A Population-Based Study in Children and Adolescents in Germany (KiGGS)

PubMed Central

Dehnert, Manuel; Fingerle, Volker; Klier, Christiane; Talaska, Thomas; Schlaud, Martin; Krause, Gérard; Wilking, Hendrik; Poggensee, Gabriele

2012-01-01

Background Lyme borreliosis (LB) caused by spirochetes of the Borrelia burgdorferi sensu lato complex is the most common tick-borne disease in the northern hemisphere. Data on the distribution and on risk factors in Germany are sketchy. Methodology/Principal Findings Blood samples of a nationwide population-based cross-sectional study from 2003–2006 in children and adolescents aged 1 to 17 years in Germany (KiGGS) were analysed (n = 12,614) to assess the seroprevalence of anti-Borrelia antibodies. Data from standardized interviews were used to assess potential risk factors. First, sera were screened for anti-Borrelia antibodies by ELISA. The overall prevalence was 4.8% (95% confidence interval (CI) 4.3–5.4%). Positive and borderline ELISA test results were confirmed by a line blot revealing a combined prevalence of 4.0% (95% CI 3.6–4.5%). Seroprevalence of ELISA was significantly higher in males (odds ratio (OR) = 1.37; CI 1.15–1.63) and in the southern part of Germany (OR = 1.41; CI 1.09–1.83), but significantly lower in children and adolescents with migration background (OR = 0.33; CI 0.24–0.44). Study participants from households with cats had a higher chance of seropositivity (OR = 6.7; CI 5.6–8.0). In a multivariable model the odds of seropositivity increases by 11% for every year of age for boys and 6% for girls. Conclusions/Significance This survey is the first nationwide, representative seroprevalence survey of LB in children and young adolescents. The study shows that infections with Borrelia burgdorferi are endemic in all parts of Germany despite regional differences. Even at a young age children are exposed to tick bites including seropositivity. Encouraging a thorough check for ticks and promptly removal of ticks are the key public health strategies to reduce the risk of LB and other tick-borne diseases in children and adolescents. Further epidemiological studies are warranted to better understand the burden of disease related to LB. PMID:22905101

Demographic and clinical characteristics of carbon monoxide poisoning: nationwide data between 1999 and 2012 in Taiwan.

PubMed

Huang, Chien-Cheng; Ho, Chung-Han; Chen, Yi-Chen; Lin, Hung-Jung; Hsu, Chien-Chin; Wang, Jhi-Joung; Su, Shih-Bin; Guo, How-Ran

2017-07-14

Carbon monoxide poisoning (COP) is not uncommon, but nationwide epidemiological data are limited. We conducted a study in Taiwan to fill the data gaps. We used a nationwide poisoning database to study all COP patients in Taiwan diagnosed between 1999 and 2012. We conducted descriptive analyses and compared the differences between the two sexes. In addition, we assessed the trends in suicide and mortality rates from 1999 to 2012. We identified 25,912 COP patients with an almost equal female and male distribution (50.6% vs. 49.4%). The mean age was 36.0 years, and most of the patients were between 20 and 50 years old. The highest incidence rate in the year occurred during winter. While female patients were more likely to have mental disorders (35.9% vs. 28.1%, p < 0.001), male patients were more likely to be resulted from suicide attempts (22.9% vs. 17.7%, p < 0.001). In both sexes, the suicidal rate increased from 1999, reached the peak in 2007, and then decreased gradually. Hyperbaric oxygen therapy was performed in 24.2% of the patients. Neurological sequelae developed in 9.1% of the patients, and chronic respiratory failure and requirement of long-term care were observed in 5.0% and 0.1% of the patients. The 1-month and 3-month mortality rates were 1.6% and 5.0%. The 3-month mortality rate did not show significant change between 1999 and 2012. This study showed a whole picture of COP in Taiwan, which could add to the important knowledge of this disastrous problem in public health. Some important findings, including higher percentages of mental disorders in female patients and suicide attempt in male patients, seasonal changes, and trends in mortality and morbidity (suicide) rates, may help developing strategies for prevention and treatment of COP.

Quantitative estimates of the impact of sensitivity and specificity in mammographic screening in Germany.

PubMed Central

Warmerdam, P G; de Koning, H J; Boer, R; Beemsterboer, P M; Dierks, M L; Swart, E; Robra, B P

1997-01-01

STUDY OBJECTIVE: To estimate quantitatively the impact of the quality of mammographic screening (in terms of sensitivity and specificity) on the effects and costs of nationwide breast cancer screening. DESIGN: Three plausible "quality" scenarios for a biennial breast cancer screening programme for women aged 50-69 in Germany were analysed in terms of costs and effects using the Microsimulation Screening Analysis model on breast cancer screening and the natural history of breast cancer. Firstly, sensitivity and specificity in the expected situation (or "baseline" scenario) were estimated from a model based analysis of empirical data from 35,000 screening examinations in two German pilot projects. In the second "high quality" scenario, these properties were based on the more favourable diagnostic results from breast cancer screening projects and the nationwide programme in The Netherlands. Thirdly, a worst case, "low quality" hypothetical scenario with a 25% lower sensitivity than that experienced in The Netherlands was analysed. SETTING: The epidemiological and social situation in Germany in relation to mass screening for breast cancer. RESULTS: In the "baseline" scenario, an 11% reduction in breast cancer mortality was expected in the total German female population, ie 2100 breast cancer deaths would be prevented per year. It was estimated that the "high quality" scenario, based on Dutch experience, would lead to the prevention of an additional 200 deaths per year and would also cut the number of false positive biopsy results by half. The cost per life year gained varied from Deutsche mark (DM) 15,000 on the "high quality" scenario to DM 21,000 in the "low quality" setting. CONCLUSIONS: Up to 20% of the total costs of a screening programme can be spent on quality improvement in order to achieve a substantially higher reduction in mortality and reduce undesirable side effects while retaining the same cost effectiveness ratio as that estimated from the German data. PMID:9196649

Visual loss after corrective surgery for pediatric scoliosis: incidence and risk factors from a nationwide database.

PubMed

De la Garza-Ramos, Rafael; Samdani, Amer F; Sponseller, Paul D; Ain, Michael C; Miller, Neil R; Shaffrey, Christopher I; Sciubba, Daniel M

2016-04-01

Perioperative visual loss (POVL) after spinal deformity surgery is an uncommon but severe complication. Data on the incidence and risk factors of this complication after corrective surgery in the pediatric population are limited. The present study aimed to investigate nationwide estimates of POVL after corrective surgery for pediatric scoliosis. This is a retrospective study that uses a nationwide database. The sample includes 42,339 patients under the age of 18 who underwent surgery for idiopathic scoliosis. The outcome measures were incidence of POVL and risk factors. Patients under the age of 18 who underwent elective surgery for idiopathic scoliosis between 2002 and 2011 were identified using the Nationwide Inpatient Sample database. The incidence of POVL (ischemic optic neuropathy, central retinal artery occlusion, or cortical blindness) was estimated after application of discharge weights. Demographics, comorbidities, and operative parameters were compared between patients with and without visual loss. A multivariate logistic regression was performed to identify significant risk factors for POVL development. No funds were received in support of this work. The incidence of POVL was 1.6 per 1,000 procedures (0.16%). Patients with visual loss were significantly more likely to be younger and male, have Medicaid as insurance, and undergo fusion of eight or more spinal levels compared with patients without visual loss. Following multivariate analysis, older patients (odds ratio [OR]: 0.84; 95% confidence interval [CI]: 0.77-0.91) and female patients (OR: 0.08; 95% CI: 0.04-0.14) were significantly less likely to develop POVL compared with younger and male patients. On the other hand, having Medicaid as insurance (OR: 2.13;95% CI: 1.32-3.45), history of deficiency anemia (OR: 8.64; 95% CI: 5.46-14.31), and fusion of eight or more spinal levels (OR: 2.40; 95% CI: 1.34-4.30) were all independently associated with POVL. In this nationwide study, the incidence of POVL after scoliosis surgery in patients under the age of 18 was estimated at 0.16%, similar to the rate reported in adult patients. Cortical blindness accounted for all cases of POVL in the present study. Younger patients, patients with history of deficiency anemia, and patients undergoing long-segment fusions may be at increased risk of POVL after corrective surgery for pediatric scoliosis. Copyright © 2016 Elsevier Inc. All rights reserved.

Assessing the Organizational Social Context (OSC) of child welfare systems: implications for research and practice.

PubMed

Glisson, Charles; Green, Philip; Williams, Nathaniel J

2012-09-01

The study: (1) provides the first assessment of the a priori measurement model and psychometric properties of the Organizational Social Context (OSC) measurement system in a US nationwide probability sample of child welfare systems; (2) illustrates the use of the OSC in constructing norm-based organizational culture and climate profiles for child welfare systems; and (3) estimates the association of child welfare system-level organizational culture and climate profiles with individual caseworker-level job satisfaction and organizational commitment. The study applies confirmatory factor analysis (CFA) and hierarchical linear models (HLM) analysis to a US nationwide sample of 1,740 caseworkers from 81 child welfare systems participating in the second National Survey of Child and Adolescent Wellbeing (NSCAW II). The participating child welfare systems were selected using a national probability procedure reflecting the number of children served by child welfare systems nationwide. The a priori OSC measurement model is confirmed in this nationwide sample of child welfare systems. In addition, caseworker responses to the OSC scales generate acceptable to high scale reliabilities, moderate to high within-system agreement, and significant between-system differences. Caseworkers in the child welfare systems with the best organizational culture and climate profiles report higher levels of job satisfaction and organizational commitment. Organizational climates characterized by high engagement and functionality, and organizational cultures characterized by low rigidity are associated with the most positive work attitudes. The OSC is the first valid and reliable measure of organizational culture and climate with US national norms for child welfare systems. The OSC provides a useful measure of Organizational Social Context for child welfare service improvement and implementation research efforts which include a focus on child welfare system culture and climate. Copyright © 2012 Elsevier Ltd. All rights reserved.

Analysis of subarachnoid hemorrhage using the Nationwide Inpatient Sample: the NIS-SAH Severity Score and Outcome Measure.

PubMed

Washington, Chad W; Derdeyn, Colin P; Dacey, Ralph G; Dhar, Rajat; Zipfel, Gregory J

2014-08-01

Studies using the Nationwide Inpatient Sample (NIS), a large ICD-9-based (International Classification of Diseases, Ninth Revision) administrative database, to analyze aneurysmal subarachnoid hemorrhage (SAH) have been limited by an inability to control for SAH severity and the use of unverified outcome measures. To address these limitations, the authors developed and validated a surrogate marker for SAH severity, the NIS-SAH Severity Score (NIS-SSS; akin to Hunt and Hess [HH] grade), and a dichotomous measure of SAH outcome, the NIS-SAH Outcome Measure (NIS-SOM; akin to modified Rankin Scale [mRS] score). Three separate and distinct patient cohorts were used to define and then validate the NIS-SSS and NIS-SOM. A cohort (n = 148,958, the "model population") derived from the 1998-2009 NIS was used for developing the NIS-SSS and NIS-SOM models. Diagnoses most likely reflective of SAH severity were entered into a regression model predicting poor outcome; model coefficients of significant factors were used to generate the NIS-SSS. Nationwide Inpatient Sample codes most likely to reflect a poor outcome (for example, discharge disposition, tracheostomy) were used to create the NIS-SOM. Data from 716 patients with SAH (the "validation population") treated at the authors' institution were used to validate the NIS-SSS and NIS-SOM against HH grade and mRS score, respectively. Lastly, 147,395 patients (the "assessment population") from the 1998-2009 NIS, independent of the model population, were used to assess performance of the NIS-SSS in predicting outcome. The ability of the NIS-SSS to predict outcome was compared with other common measures of disease severity (All Patient Refined Diagnosis Related Group [APR-DRG], All Payer Severity-adjusted DRG [APS-DRG], and DRG). RESULTS The NIS-SSS significantly correlated with HH grade, and there was no statistical difference between the abilities of the NIS-SSS and HH grade to predict mRS-based outcomes. As compared with the APR-DRG, APSDRG, and DRG, the NIS-SSS was more accurate in predicting SAH outcome (area under the curve [AUC] = 0.69, 0.71, 0.71, and 0.79, respectively). A strong correlation between NIS-SOM and mRS was found, with an agreement and kappa statistic of 85% and 0.63, respectively, when poor outcome was defined by an mRS score > 2 and 95% and 0.84 when poor outcome was defined by an mRS score > 3. Data in this study indicate that in the analysis of NIS data sets, the NIS-SSS is a valid measure of SAH severity that outperforms previous measures of disease severity and that the NIS-SOM is a valid measure of SAH outcome. It is critically important that outcomes research in SAH using administrative data sets incorporate the NIS-SSS and NIS-SOM to adjust for neurology-specific disease severity.

Taiwan's Ban on Corporal Punishment--Teachers' Perceptions of Impact and Meanings

ERIC Educational Resources Information Center

Chiang, Yi-Ching

2009-01-01

Corporal punishment was long used in Taiwanese schools as an informal disciplinary tool for improving students' academic performance as well as for disciplinary violations. Based on thirty-five interviews and three school activity observations across a nationwide sample of junior high teachers and schools, this study examines the impact of…

Title I Funding: Poor Children Benefit though Funding Per Poor Child Differs. Report to Congressional Addressees.

ERIC Educational Resources Information Center

Shaul, Marnie S.

This study examined Title I funding allocations for school years 1999-2002 and actual allocations received by school districts, interviewing state Title I directors, surveying school district administrators nationwide, and interviewing representatives from relevant federal and national organizations. Title I funds were generally targeted based on…

Widening Participation Creatively: Creative Arts Education for Social Inclusion

ERIC Educational Resources Information Center

Felton, Emma; Vichie, Krystle; Moore, Eloise

2016-01-01

University participation among students from low socio-economic backgrounds in Australia is low and nationwide strategies are in place to help bridge the gap. This article presents a preliminary evaluation of a creative arts-based outreach program to raise awareness and aspiration for university study among students from low-income backgrounds.…

Pioneer Mentoring in Teacher Preparation: From the Voices of Women Religious.

ERIC Educational Resources Information Center

Keating, Kevina; Traviss, Mary Peter

This book includes the observations of educational leaders and classroom teachers within religious institutions recognized as pioneers in implementing a teacher preparation model that has prepared thousands of Catholic school teachers nationwide. It is based on a study that interviewed 60 women religious belonging to 12 religious institutions that…

Strengthening Families in Illinois: Increasing Family Engagement in Early Childhood Programs

ERIC Educational Resources Information Center

Jor'dan, Jamilah R.; Wolf, Kathy Goetz; Douglass, Anne

2012-01-01

Strengthening Families is a relationship-based child abuse and neglect prevention initiative started nationally in 2001 through a partnership between the Doris Duke Charitable Foundation and the Center for the Study of Social Policy (CSSP) in Washington, DC. Thirty-five states and several thousand early childhood programs nationwide implement…

Increased risk of deep vein thrombosis and pulmonary thromboembolism in patients with organophosphate intoxication: a nationwide prospective cohort study.

PubMed

Lim, Yun-Ping; Lin, Cheng-Li; Hung, Dong-Zong; Ma, Wei-Chih; Lin, Yen-Ning; Kao, Chia-Hung

2015-01-01

Organophosphate (OP) poisoning is a critical cause of morbidity and mortality worldwide. We conducted a nationwide longitudinal cohort study to investigate the development of deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) among patients admitted with OP intoxication.We identified patients with OP intoxication by using the Taiwan National Health Insurance Research Database and enrolled 9223 patients who were hospitalized for OP intoxication between 2000 and 2011. OP intoxication was diagnosed based on a clinical assessment and serum acetylcholinesterase levels at the time of hospital admission. Each patient in the OP intoxication cohort was randomly frequency matched with 4 patients without OP intoxication based on their age, sex, and index year (36,892 patients as control cohort), and all patients were observed from the index date until the appearance of a DVT or a PTE event, or until December 31, 2011. We analyzed the risks of DVT and PTE by using Cox proportional hazards regression models that included the demographic variables of sex, age, and comorbidities (eg, hypertension, diabetes, cerebral vascular disease, heart failure, all cancer types, and lower leg fracture or surgery).The results revealed a significantly increased risk of developing DVT among patients with OP poisoning (adjusted hazard ratio [HR] = 1.55; 95% confidence interval [CI] = 1.03-2.34) but not PTE (adjusted HR = 1.44; 95% CI = 0.83-2.52). Among the patients without comorbidities, the OP poisoning patients compared with controls had a higher adjusted HR of 2.12 (95% CI = 1.21-3.71) for DVT.The results of this nationwide cohort study indicate that the risk of developing DVT is markedly higher in patients with OP intoxication compared with that of the general population.

Novel measurement of spreading pattern of influenza epidemic by using weighted standard distance method: retrospective spatial statistical study of influenza, Japan, 1999-2009.

PubMed

Shobugawa, Yugo; Wiafe, Seth A; Saito, Reiko; Suzuki, Tsubasa; Inaida, Shinako; Taniguchi, Kiyosu; Suzuki, Hiroshi

2012-06-19

Annual influenza epidemics occur worldwide resulting in considerable morbidity and mortality. Spreading pattern of influenza is not well understood because it is often hampered by the quality of surveillance data that limits the reliability of analysis. In Japan, influenza is reported on a weekly basis from 5,000 hospitals and clinics nationwide under the scheme of the National Infectious Disease Surveillance. The collected data are available to the public as weekly reports which were summarized into number of patient visits per hospital or clinic in each of the 47 prefectures. From this surveillance data, we analyzed the spatial spreading patterns of influenza epidemics using weekly weighted standard distance (WSD) from the 1999/2000 through 2008/2009 influenza seasons in Japan. WSD is a single numerical value representing the spatial compactness of influenza outbreak, which is small in case of clustered distribution and large in case of dispersed distribution. We demonstrated that the weekly WSD value or the measure of spatial compactness of the distribution of reported influenza cases, decreased to its lowest value before each epidemic peak in nine out of ten seasons analyzed. The duration between the lowest WSD week and the peak week of influenza cases ranged from minus one week to twenty weeks. The duration showed significant negative association with the proportion of influenza A/H3N2 cases in early phase of each outbreak (correlation coefficient was -0.75, P = 0.012) and significant positive association with the proportion of influenza B cases in the early phase (correlation coefficient was 0.64, P = 0.045), but positively correlated with the proportion of influenza A/H1N1 strain cases (statistically not significant). It is assumed that the lowest WSD values just before influenza peaks are due to local outbreak which results in small standard distance values. As influenza cases disperse nationwide and an epidemic reaches its peak, WSD value changed to be a progressively increasing. The spatial distribution of nationwide influenza outbreak was measured by using a novel WSD method. We showed that spreading rate varied by type and subtypes of influenza virus using WSD as a spatial indicator. This study is the first to show a relationship between influenza epidemic trend by type/subtype and spatial distribution of influenza nationwide in Japan.

Signal Processing Algorithms for the Terminal Doppler Weather Radar: Build 2

DTIC Science & Technology

2010-04-30

the various TDWR base data quality issues, range-velocity (RV) ambiguity was deemed to be the most severe challenge nationwide. Compared to S - band ... power is computed as PN = median(|5«| 2)/(ln 2), where s is the complex I&Q signal, k is the range gate number, and / is the pulse time index. The...frequencies to the ground-clutter band around zero, the clutter filtering also removes power from the aliased frequencies and distorts the phase response

Issues in Estimating Program Effects and Studying Implementation in Large-Scale Educational Experiments: The Case of a Connected Classroom Technology Program

ERIC Educational Resources Information Center

Shin, Hye Sook

2009-01-01

Using data from a nationwide, large-scale experimental study of the effects of a connected classroom technology on student learning in algebra (Owens et al., 2004), this dissertation focuses on challenges that can arise in estimating treatment effects in educational field experiments when samples are highly heterogeneous in terms of various…

A nationwide classification of New Zealand aquifer properties

NASA Astrophysics Data System (ADS)

Westerhoff, Rogier; Tschritter, Constanze; Rawlinson, Zara; White, Paul

2017-04-01

Groundwater plays an essential role in water provision for domestic, industrial and agricultural use. Groundwater is also vital for ecology and environment, since it provides baseflow to many streams, rivers and wetlands. As groundwater is a 'hidden' resource that is typically poorly understood by the public, simple and informative maps can assist to enhance awareness for understanding groundwater and associated environmental issues. The first national aquifer map for New Zealand (2001) identified 200 aquifers at a scale of approximately 1:5 Million. Subsequently, regional councils and unitary authorities have updated their aquifer boundaries using a variety of methods. However, with increasing demand of groundwater in New Zealand and drought impacts expected to be more significant in the future, more consistent and more advanced aquifer characterisation and mapping techniques are needed to improve our understanding of the available resources. Significant resources have gone into detailed geological mapping in recent years, and the New Zealand 1:250,000 Geological Map (QMAP) was developed and released as a seamless GIS database in 2014. To date, there has been no national assessment of this significant data set for aquifer characterisation purposes. This study details the use of the QMAP lithological and chrono-stratigraphic information to develop a nationwide assessment of hydrogeological units and their properties. The aim of this study is to map hydrogeological units in New Zealand, with a long-term goal to use this as a basis for a nationally-consistent map of aquifer systems and aquifer properties (e.g., hydraulic conductivity estimates). Internationally accepted aquifer mapping studies were reviewed and a method was devised that classifies hydrogeological units based on the geological attributes of the QMAP ArcGIS polygons. The QMAP attributes used in this study were: main rock type; geological age; and secondary rock type. The method was mainly based on values of permeability after global, continental and New Zealand studies. The classification followed a tiered workflow. Tier 1 ('Hydrolithological units') consisted of the classification of only the main rock type, based on median permeability value. Tier 2 ('Hydrogeological units') consisted of a combined classification of main rock type and age, assuming that permeability shows an exponential decay over geological age. Tier 3 ('Hydrogeological units') included all three attributes, where the permeabilities of main and secondary rock types were averaged with weighting. Tier 4 was a simplification of the 10 classes in Tier 3 to four 'Aquifer Potential' classes, i.e., 'Poor', 'Low', 'Medium', and 'High'. The results show a good match with existing overlaying maps of aquifer boundaries The map is capable of refining aquifer boundaries at the regional scale where these boundaries have not been updated since 2001. Additionally, the map provides a quick and simple way to communicate hydrogeological information. This fundamental dataset is essential for future studies of the impact of climate and humans on groundwater in New Zealand. Future work will include categorising geological system knowledge (e.g., depositional environment) to allow for 3D mapping and characterisation, compilation and incorporation of nation-wide measured hydraulic conductivity values, including uncertainty, and linking with other national data sets.

Association between enterovirus infection and speech and language impairments: A nationwide population-based study.

PubMed

Hung, Tai-Hsin; Chen, Vincent Chin-Hung; Yang, Yao-Hsu; Tsai, Ching-Shu; Lu, Mong-Liang; McIntyre, Roger S; Lee, Yena; Huang, Kuo-You

2018-06-01

Delay and impairment in Speech and language are common developmental problems in younger populations. Hitherto, there has been minimal study of the association between common childhood infections (e.g. enterovirus [EV]) and speech and language. The impetus for evaluating this association is provided by evidence linking inflammation to neurodevelopmental disorders. Herein we sought to determine whether an association exists between EV infection and subsequent diagnoses of speech and language impairments in a nationwide population-based sample in Taiwan. Our study acquired data from the Taiwan National Health Insurance Research Database. The sample was comprised of individuals under 18 years of age with newly diagnosed EV infection during the period from January 1998 to December 2011. 39669 eligible cases were compared to matched controls and assessed during the study period for incident cases of speech and language impairments. Cox regression analyses were applied, adjusting for sex, age and other physical and mental problems. In the fully adjusted Cox regression model for hazard ratios, EV infection as positively associated with speech and language impairments (HR = 1.14, 95% CI: 1.06-1.22) after adjusting for age, sex and other confounds. Compared to the control group, the hazard ratio for speech and language impairments was 1.12 (95% CI: 1.03-1.21) amongst the group of EV infection without hospitalization, and 1.26 (95% CI: 1.10-1.45) amongst the group of EV infection with hospitalization. EV infection is temporally associated with incident speech and language impairments. Our findings herein provide rationale for educating families that EV infection may be associated with subsequent speech and language problems in susceptible individuals and that monitoring for such a presentation would be warranted. WHAT THIS PAPER ADDS?: Speech and language impairments associated with central nervous system infections have been reported in the literature. EV are medically important human pathogens and associated with select neuropsychiatric diseases. Notwithstanding, relatively few reports have mentioned the effects of EV infection on speech and language problems. Our study used a nationwide longitudinal dataset and identified that children with EV infection have a greater risk for speech and language impairments as compared with control group. Infected children combined other comorbidities or risk factors might have greater possibility to develop speech problems. Clinicians should be vigilant for the onset of language developmental abnormalities of preschool children with EV infection. Copyright © 2018 Elsevier Ltd. All rights reserved.

Nonformal Learning and Well-Being among Older Adults: Links between Participation in Swedish Study Circles, Feelings of Well-Being and Social Aspects of Learning

ERIC Educational Resources Information Center

Åberg, Pelle

2016-01-01

How does participation in nonformal learning influence the self-perceived well-being among older adults? This article looks into that issue through a study of people aged 65 years or older who have participated in Swedish study circles. The data analyzed consists of a nation-wide survey of study circle participants. The results show that there are…

THE OCCURRENCE OF DISINFECTION BY-PRODUCTS OF HEALTH CONCERN IN DRINKING WATER: RESULTS OF A NATIONWIDE DBP OCCURRENCE STUDY

EPA Science Inventory

The motivation for this Nationwide Disinfection By-product (DBP) Occurrence Study was two-fold: First, more than 500 DBPs have been reported in the literature, yet there is almost no quantitative occurrence information for most. As a result, there is significant uncertainty ove...

Cardiopulmonary resuscitation of out-of-hospital traumatic cardiac arrest in Qatar: A nationwide population-based study.

PubMed

Irfan, Furqan B; Consunji, Rafael; El-Menyar, Ayman; George, Pooja; Peralta, Ruben; Al-Thani, Hassan; Thomas, Stephen Hodges; Alinier, Guillaume; Shuaib, Ashfaq; Al-Suwaidi, Jassim; Singh, Rajvir; Castren, Maaret; Cameron, Peter A; Djarv, Therese

2017-08-01

Traumatic cardiac arrest studies have reported improved survival rates recently, ranging from 1.7-7.5%. This population-based nationwide study aims to describe the epidemiology, interventions and outcomes, and determine predictors of survival from out-of-hospital traumatic cardiac arrest (OHTCA) in Qatar. An observational retrospective population-based study was conducted on OHTCA patients in Qatar, from January 2010 to December 2015. Traumatic cardiac arrest was redefined to include out-of-hospital traumatic cardiac arrest (OHTCA) and in-hospital traumatic cardiac arrest (IHTCA). A total of 410 OHTCA patients were included in the 6-year study period. The mean annual crude incidence rate of OHTCA was 4.0 per 100,000 population, in Qatar. OHTCA mostly occurred in males with a median age of 33. There was a preponderance of blunt injuries (94.3%) and head injuries (66.3%). Overall, the survival rate was 2.4%. Shockable rhythm, prehospital external hemorrhage control, in-hospital blood transfusion, and surgery were associated with higher odds of survival. Adrenaline (Epinephrine) lowered the odds of survival. The incidence of OHTCA was less than expected, with a low rate of survival. Thoracotomy was not associated with improved survival while Adrenaline administration lowered survival in OHTCA patients with majority blunt injuries. Interventions to enable early prehospital control of hemorrhage, blood transfusion, thoracostomy and surgery improved survival. Copyright © 2017 Elsevier B.V. All rights reserved.

Increased risk of bipolar disorder in patients with scabies: A nationwide population-based matched-cohort study.

PubMed

Lin, Chien-Yu; Chang, Fung-Wei; Yang, Jing-Jung; Chang, Chun-Hung; Yeh, Chia-Lun; Lei, Wei-Te; Huang, Chun-Fa; Liu, Jui-Ming; Hsu, Ren-Jun

2017-11-01

Both scabies and bipolar disorder (BD) are common and troublesome disorders. There are several similarities in both diseases: pruritus, a higher prevalence in crowded environments, and cytokine-mediated inflammatory processes in the pathophysiology. We conducted this nationwide population-based study to investigate the possible relationship between scabies and BD. Based on the National Health Insurance Research Database (NHIRD) of Taiwan, a total of 7096 patients with scabies were identified as a study group and 28,375 matched patients as a control. We tracked the patients in both groups for a 7-year period to identify those newly diagnosed with BD. The demographic characteristics and comorbidities of the patients were analyzed, and Cox proportional hazard regressions were performed to calculate the hazard ratio (HR) of BD. Of the 35,471 patients in this study, 183 (0.5%) patients with newly diagnosed BD were identified, with 58 (0.8%) from the scabies group and 125 (0.4%) from the control group. The patients with scabies had a higher risk of subsequent BD, with a crude hazard ratio of 1.86 and an adjusted hazard ratio of 1.55 (95% confidence interval: 1.12-2.09, P < 0.05). This study shows there is an increased risk for BD among patients with scabies. Immunopathology may contribute to this association. Copyright © 2017 Elsevier B.V. All rights reserved.

Inadequate Diagnostic Evaluation in Young Patients Registered with a Diagnosis of Dementia: A Nationwide Register-Based Study

PubMed Central

Salem, Lise Cronberg; Andersen, Birgitte Bo; Nielsen, T. Rune; Stokholm, Jette; Jørgensen, Martin Balslev; Waldemar, Gunhild

2014-01-01

Background Establishing a diagnosis of dementia in young patients may be complex and have significant implications for the patient. The aim of this study was to evaluate the quality of the diagnostic work-up in young patients diagnosed with dementia in the clinical routine. Methods Two hundred patients were randomly selected from 891 patients aged ≤65 years registered with a diagnosis of dementia for the first time in 2008 in Danish hospitals, and 159 medical records were available for review. Three raters evaluated their medical records for the completeness of the diagnostic work-up on which the diagnosis of dementia had been based, using evidence-based guidelines for the diagnostic evaluation of dementia as reference standards. Results According to the rater review, only 111 (70%) patients met the clinical criteria for dementia. An acceptable diagnostic work-up including all items of recommended basic diagnostic evaluation was performed in only 24%, although more often (28%) in the subgroup of patients where dementia was confirmed by raters. Conclusion This first nationwide study of unselected young patients registered with a diagnosis of dementia indicated that the concept of dementia may be misinterpreted by clinicians and that a diagnosis of dementia in the young is only rarely based on a complete basic diagnostic work-up, calling for increased competency. PMID:24711812

75 FR 39589 - Nationwide Life Insurance Company,et al.; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-09

...] Nationwide Life Insurance Company, et al.; Notice of Application July 2, 2010. AGENCY: The Securities and...: Nationwide Life Insurance Company (``NWL''); Nationwide Variable Account-II (the ``Separate Account''); and... Commission, 100 F Street, NE., Washington, DC 20549-1090. Applicants, c/o Nationwide Life Insurance Company...

Modeling Optimal Cutoffs for the Brazilian Household Food Insecurity Measurement Scale in a Nationwide Representative Sample.

PubMed

Interlenghi, Gabriela S; Reichenheim, Michael E; Segall-Corrêa, Ana M; Pérez-Escamilla, Rafael; Moraes, Claudia L; Salles-Costa, Rosana

2017-07-01

Background: This is the second part of a model-based approach to examine the suitability of the current cutoffs applied to the raw score of the Brazilian Household Food Insecurity Measurement Scale [Escala Brasileira de Insegurança Alimentar (EBIA)]. The approach allows identification of homogeneous groups who correspond to severity levels of food insecurity (FI) and, by extension, discriminant cutoffs able to accurately distinguish these groups. Objective: This study aims to examine whether the model-based approach for identifying optimal cutoffs first implemented in a local sample is replicated in a countrywide representative sample. Methods: Data were derived from the Brazilian National Household Sample Survey of 2013 ( n = 116,543 households). Latent class factor analysis (LCFA) models from 2 to 5 classes were applied to the scale's items to identify the number of underlying FI latent classes. Next, identification of optimal cutoffs on the overall raw score was ascertained from these identified classes. Analyses were conducted in the aggregate data and by macroregions. Finally, model-based classifications (latent classes and groupings identified thereafter) were contrasted to the traditionally used classification. Results: LCFA identified 4 homogeneous groups with a very high degree of class separation (entropy = 0.934-0.975). The following cutoffs were identified in the aggregate data: between 1 and 2 (1/2), 5 and 6 (5/6), and 10 and 11 (10/11) in households with children and/or adolescents <18 y of age (score range: 0-14), and 1/2, between 4 and 5 (4/5), and between 6 and 7 (6/7) in adult-only households (range: 0-8). With minor variations, the same cutoffs were also identified in the macroregions. Although our findings confirm, in general, the classification currently used, the limit of 1/2 (compared with 0/1) for separating the milder from the baseline category emerged consistently in all analyses. Conclusions: Nationwide findings corroborate previous local evidence that households with an overall score of 1 are more akin to those scoring negative on all items. These results may contribute to guide experts' and policymakers' decisions on the most appropriate EBIA cutoffs. © 2017 American Society for Nutrition.