Combating poor-quality anti-malarial medicines: a call to action.

PubMed

Bassat, Quique; Tanner, Marcel; Guerin, Philippe J; Stricker, Kirstin; Hamed, Kamal

2016-06-01

The circulation of poor-quality medicines continues to undermine the fight against many life-threatening diseases. Anti-malarial medicines appear to have been particularly compromised and present a major public health threat in malaria-endemic countries, negatively affecting individuals and their communities. Concerted collaborative efforts are required from global, regional and national organizations, involving the public and private sectors, to address the problem. While many initiatives are underway, a number of unmet needs deserve urgent and increased multisector attention. At the global level, there is a need for an international public health legal framework or treaty on poor-quality medicines, with statutes suitable for integration into national laws. In addition, increased international efforts are required to strengthen the governance of global supply chains and enhance cooperation between national medicine regulation authorities and law enforcement bodies. Increased investment is needed in innovative technologies that will enable healthcare teams to detect poor-quality medicines at all levels of the supply chain. At the regional level, a number of initiatives would be beneficial-key areas are standardization, simplification, and reciprocal recognition of registration processes and development of quality control capacity in regional centres of excellence that are better aligned with public health needs; improved surveillance methods and creation of a framework for compulsory and transparent reporting of poor-quality medicines; additional support for national medicine regulation authorities and other national partner authorities; and an increase in support for regional laboratories to boost their capabilities in detecting poor-quality medicines. It is vital that all stakeholders involved in efforts against poor-quality anti-malarial medicines extend and strengthen their actions in these critical areas and thus effectively support global health development and malaria elimination programmes.

Postural Control and Automaticity in Dyslexic Children: The Relationship between Visual Information and Body Sway

ERIC Educational Resources Information Center

Barela, Jose A.; Dias, Josenaldo L.; Godoi, Daniela; Viana, Andre R.; de Freitas, Paulo B.

2011-01-01

Difficulty with literacy acquisition is only one of the symptoms of developmental dyslexia. Dyslexic children also show poor motor coordination and postural control. Those problems could be associated with automaticity, i.e., difficulty in performing a task without dispending a fair amount of conscious efforts. If this is the case, dyslexic…

Methylphenidate blocks effort-induced depletion of regulatory control in healthy volunteers.

PubMed

Sripada, Chandra; Kessler, Daniel; Jonides, John

2014-06-01

A recent wave of studies--more than 100 conducted over the last decade--has shown that exerting effort at controlling impulses or behavioral tendencies leaves a person depleted and less able to engage in subsequent rounds of regulation. Regulatory depletion is thought to play an important role in everyday problems (e.g., excessive spending, overeating) as well as psychiatric conditions, but its neurophysiological basis is poorly understood. Using a placebo-controlled, double-blind design, we demonstrated that the psychostimulant methylphenidate (commonly known as Ritalin), a catecholamine reuptake blocker that increases dopamine and norepinephrine at the synaptic cleft, fully blocks effort-induced depletion of regulatory control. Spectral analysis of trial-by-trial reaction times revealed specificity of methylphenidate effects on regulatory depletion in the slow-4 frequency band. This band is associated with the operation of resting-state brain networks that produce mind wandering, which raises potential connections between our results and recent brain-network-based models of control over attention. © The Author(s) 2014.

Parasites and poverty: the case of schistosomiasis.

PubMed

King, Charles H

2010-02-01

Simultaneous and sequential transmission of multiple parasites, and their resultant overlapping chronic infections, are facts of life in many underdeveloped rural areas. These represent significant but often poorly measured health and economic burdens for affected populations. For example, the chronic inflammatory process associated with long-term schistosomiasis contributes to anaemia and undernutrition, which, in turn, can lead to growth stunting, poor school performance, poor work productivity, and continued poverty. To date, most national and international programs aimed at parasite control have not considered the varied economic and ecological factors underlying multi-parasite transmission, but some are beginning to provide a coordinated approach to control. In addition, interest is emerging in new studies for the re-evaluation and recalibration of the health burden of helminthic parasite infection. Their results should highlight the strong potential of integrated parasite control in efforts for poverty reduction. Copyright 2009 Elsevier B.V. All rights reserved.

Reforestation Efforts in Indiana Following the Surface Mining Control and Reclamation Act of 1977

Treesearch

Stephen D. Fillmore; John W. Groninger

2004-01-01

During the summer of 2002, data were collected from 22 post-Surface Mining Control and Reclamation Act sites in southwestern Indiana. Tree growth across these sites was generally poor, with site index values typically less than 40 feet (base age 50) for upland oaks. Robinina pseudoacacia (black locust) was observed to be the primary overstory tree...

Children’s Sleep and Academic Achievement: The Moderating Role of Effortful Control

PubMed Central

Diaz, Anjolii; Berger, Rebecca; Valiente, Carlos; Eisenberg, Nancy; VanSchyndel, Sarah; Tao, Chun; Spinrad, Tracy L.; Doane, Leah D.; Thompson, Marilyn S.; Silva, Kassondra M.; Southworth, Jody

2016-01-01

Poor sleep is thought to interfere with children’s learning and academic achievement (AA). However, existing research and theory indicate there are factors that may mitigate the academic risk associated with poor sleep. The purpose of this study was to examine the moderating role of children’s effortful control (EC) on the relation between sleep and AA in young children. One hundred and three 4.5- to 7-year-olds (M = 5.98 years, SD = 0.61) wore a wrist-based actigraph for five continuous weekday nights. Teachers and coders reported on children’s EC. EC was also assessed with a computer-based task at school. Additionally, we obtained a standardized measure of children’s AA. There was a positive main effect of sleep efficiency to AA. Several relations between sleep and AA were moderated by EC and examination of the simple slopes indicated that the negative relation between sleep and AA was only significant at low levels of EC. PMID:28255190

Clinical utility of the Conners' Continuous Performance Test-II to detect poor effort in U.S. military personnel following traumatic brain injury.

PubMed

Lange, Rael T; Iverson, Grant L; Brickell, Tracey A; Staver, Tara; Pancholi, Sonal; Bhagwat, Aditya; French, Louis M

2013-06-01

The purpose of this study is to examine the clinical utility of the Conners' Continuous Performance Test (CPT-II) as an embedded marker of poor effort in military personnel undergoing neuropsychological evaluations following traumatic brain injury. Participants were 158 U.S. military service members divided into 3 groups on the basis of brain injury severity and performance (pass/fail) on 2 symptom validity tests: Mild Traumatic Brain Injury (MTBI)-Pass (n = 87), MTBI-Fail (n = 42), and severe traumatic brain injury (STBI)-Pass (n = 29). The MTBI-Fail group performed worse on the majority of CPT-II measures compared with both the MTBI-Pass and STBI-Pass groups. When comparing the MTBI-Fail group and MTBI-Pass groups, the most accurate measure for identifying poor effort was the Commission T score. When selected measures were combined (i.e., Omissions, Commissions, and Perseverations), there was a very small increase in sensitivity (from .26 to .29). When comparing the MTBI-Fail group and STBI-Pass groups, the most accurate measure for identifying poor effort was the Omission and Commissions T score. When selected measures were combined, sensitivity again increased (from .24 to .45). Overall, these results suggest that individual CPT-II measures can be useful for identifying people who are suspected of providing poor effort from those who have provided adequate effort. However, due to low sensitivity and modest negative predictive power values, this measure cannot be used in isolation to detect poor effort, and is largely useful as a test to "rule in," not "rule out" poor effort. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Adverse psychosocial working conditions and poor quality of life among financial service employees in Brazil.

PubMed

Silva, Luiz Sergio; Barreto, Sandhi Maria

2012-01-01

Workers in the financial services sector are exposed to great stress at work. This study investigates whether exposure to adverse psychosocial work conditions is independently associated with poor health-related physical and mental quality of life among financial services workers. We studied a nationwide representative sample of 2,054 workers of a large Brazilian state bank in 2008. Adverse psychosocial work conditions were investigated by the Effort-reward imbalance (ERI) scale and the Job content questionnaire (JCQ). Health-related quality of life (HRQL) was assessed using the Medical Outcomes Study Short-Form General Health Survey (SF-12). Poor mental and physical HRQL was defined by the lowest quartiles of the SF-12 final score distributions. Associations were investigated using multiple logistic regression analysis. In the multivariate analysis, exposures to low control and lack of social support at work (JCQ) were associated with poor HRQL in the physical domain. Increasing effort-reward imbalance and overcommitment (ERI), on the other hand, were associated with poor HRQL in the mental domain, with a significant statistical trend. Overcommitment was also associated with poor physical HRQL. The results suggest that exposure to adverse psychosocial work conditions has a negative impact on both domains of HRQL among financial service workers. They also indicate that ERI and DC models capture different aspects of job strain.

Maximum Oxygen Uptake Determination in Insulin-Dependent Diabetes Mellitus.

ERIC Educational Resources Information Center

Fremion, Amy S.; And Others

1987-01-01

A study of 10 children with insulin-dependent diabetes mellitus performing a maximum-effort cycling test indicated blood glucose levels did not change appreciably during test, while maximal oxygen uptake was substandard for their age groups. Findings suggest patients in fair to poor metabolic control can tolerate stress testing without…

Effort testing in children: can cognitive and symptom validity measures differentiate malingered performances?

PubMed

Rambo, Philip L; Callahan, Jennifer L; Hogan, Lindsey R; Hullmann, Stephanie; Wrape, Elizabeth

2015-01-01

Recent efforts have contributed to significant advances in the detection of malingered performances in adults during cognitive assessment. However, children's ability to purposefully underperform has received relatively little attention. The purpose of the present investigation was to examine children's performances on common intellectual measures, as well as two symptom validity measures: the Test of Memory Malingering and the Dot-Counting Test. This was accomplished through the administration of measures to children ages 6 to 12 years old in randomly assigned full-effort (control) and poor-effort (treatment) conditions. Prior to randomization, children's general intellectual functioning (i.e., IQ) was estimated via administration of the Kaufman Brief Intellectual Battery-Second Edition (KBIT-2). Multivariate analyses revealed that the conditions significantly differed on some but not all administered measures. Specifically, children's estimated IQ in the treatment condition significantly differed from the full-effort IQ initially obtained from the same children on the KBIT-2, as well as from the IQs obtained in the full-effort control condition. These findings suggest that children are fully capable of willfully underperforming during cognitive testing; however, consistent with prior investigations, some measures evidence greater sensitivity than others in evaluating effort.

Detection of suboptimal effort with symbol span: development of a new embedded index.

PubMed

Young, J Christopher; Caron, Joshua E; Baughman, Brandon C; Sawyer, R John

2012-03-01

Developing embedded indicators of suboptimal effort on objective neurocognitive testing is essential for detecting increasingly sophisticated forms of symptom feigning. The current study explored whether Symbol Span, a novel Wechsler Memory Scale-fourth edition measure of supraspan visual attention, could be used to discriminate adequate effort from suboptimal effort. Archival data were collected from 136 veterans classified into Poor Effort (n = 42) and Good Effort (n = 94) groups based on symptom validity test (SVT) performance. The Poor Effort group had significantly lower raw scores (p < .001) and age-corrected scaled scores (p < .001) than the Good Effort group on the Symbol Span test. A raw score cutoff of <14 produced 83% specificity and 50% sensitivity for detection of Poor Effort. Similarly, sensitivity was 52% and specificity was 84% when employing a cutoff of <7 for Age-Corrected Scale Score. Collectively, present results suggest that Symbol Span can effectively differentiate veterans with multiple failures on established free-standing and embedded SVTs.

The Evolution of U.S. Strategic Command and Control and Warning, 1945-1972,

DTIC Science & Technology

1975-06-01

steps were taken in these years to ration - alize the command and control structure. These efforts were in part inspired by the poor performance of...Secretary of the NSC finally submitted a report (NSC 30) to the NSC on "US Policy on Atomic Warfare." It dealt with the feasibility of formulating at...1950, plans were formulated for the con- struction and activation of the Strategic Operational Control System (SOCS). This net made use of a

What parents know, how they know it, and several forms of adolescent adjustment: further support for a reinterpretation of monitoring.

PubMed

Kerr, M; Stattin, H

2000-05-01

Parental monitoring has been conceptualized as tracking and surveillance but operationalized as knowledge of daily activities. This study tested the tracking and surveillance explanation of why parental knowledge is linked to better adolescent adjustment. Participants were 1,186 14-year-olds in central Sweden and their parents. The results supported and extended a reinterpretation of parental monitoring (H. Stattin & M. Kerr, in press). Across sex and informant, high parental knowledge was linked to multiple measures of good adjustment. But children's spontaneous disclosure of information explained more of these relations than parents' tracking and surveillance efforts did. Parents' control efforts were related to good adjustment only after the child's feelings of being controlled, which were linked to poor adjustment, were partialed out. The findings suggest that parents' tracking and surveillance efforts are not as effective as previously thought.

Psychosocial work environment, job mobility and gender differences in turnover behaviour: a prospective study among the Swedish general population.

PubMed

Söderberg, Mia; Härenstam, Annika; Rosengren, Annika; Schiöler, Linus; Olin, Anna-Carin; Lissner, Lauren; Waern, Margda; Torén, Kjell

2014-06-14

Throughout the literature, substantial evidence supports associations between poor psychosocial work characteristics and a variety of ill-health outcomes. Yet, few reports strategies workers carry out to improve detrimental work conditions and consequently their health, such as changing jobs. The aim of this study was to examine if adverse psychosocial work exposure, as measured with the job demand-control and effort-reward imbalance models, could predict job mobility over a 5 years observation period. Participants were working men and women (n = 940; 54.3% women), aged 24-60 years from the population of Gothenburg and surrounding metropolitan area. Job demand-control and effort-reward variables were compared with independent t-tests and chi2-test in persons with and without job mobility. Multivariate logistic regression was used to analyse whether psychosocial factors could predict job mobility. All regression analyses were stratified by gender. Exposure to a combination of high demands-low control or high imbalance between effort and reward was related to increased odds of changing jobs (OR 1.63; CI 1.03-2.59 and OR 1.46; CI 1.13-1.89 respectively). When analysing men and women separately, men had a higher OR of changing jobs when exposed to either high demands-low control (OR 2.72; CI 1.24-5.98) or high effort-reward imbalance (OR 1.74; CI 1.11-2.72) compared to reference values. The only significant associations for women was slightly decreased odds for turnover in high reward jobs (OR 0.96; CI 0.92-0.99). The results indicate that workers will seek to improve poor work environment by changing jobs. There were notable gender differences, where men tended to engage in job mobility when exposed to adverse psychosocial factors, while women did not. The lack of measures for mechanisms driving job mobility was a limitation of this study, thus preventing conclusions regarding psychosocial factors as the primary source for job mobility.

Deadly Flies, Poor Profits, and Veterinary Pharmaceuticals: Sustaining the Control of Sleeping Sickness in Uganda.

PubMed

Bardosh, Kevin Louis

2016-01-01

Efforts to control neglected tropical diseases have increasingly focused on questions of implementation. But how should we conceptualize the implementation process? Drawing on ethnographic fieldwork between 2010 and 2012, in this article I explore efforts by a small-scale public-private partnership to use private veterinarians to sustainably control zoonotic sleeping sickness in Uganda. With a fundamental tension between business incentives and vector control, I show how divergences in knowledge, power, values, and social norms shaped project implementation and community responses. Reflecting more widely on the relationships between project plans and local realities, I argue that these encounters reveal the heuristic value in approaching global health interventions as evolving 'social experiments.' This metaphor reveals the uncertainty inherent to dominant narratives and models, the role of available expertise in defining the limits of action, and the need for continuous adaption to synchronize with emergent social and institutional topographies.

A driver-adaptive stability control strategy for sport utility vehicles

NASA Astrophysics Data System (ADS)

Zhu, Shenjin; He, Yuping

2017-08-01

Conventional vehicle stability control (VSC) systems are designed for average drivers. For a driver with a good driving skill, the VSC systems may be redundant; for a driver with a poor driving skill, the VSC intervention may be inadequate. To increase safety of sport utility vehicles (SUVs), this paper proposes a novel driver-adaptive VSC (DAVSC) strategy based on scaling the target yaw rate commanded by the driver. The DAVSC system is adaptive to drivers' driving skills. More control effort would be exerted for drivers with poor driving skills, and vice versa. A sliding mode control (SMC)-based differential braking (DB) controller is designed using a three degrees of freedom (DOF) yaw-plane model. An eight DOF nonlinear yaw-roll model is used to simulate the SUV dynamics. Two driver models, namely longitudinal and lateral, are used to 'drive' the virtual SUV. By integrating the virtual SUV, the DB controller, and the driver models, the performance of the DAVSC system is investigated. The simulations demonstrate the effectiveness of the DAVSC strategy.

Efforts To Solve Quality Problems. Background Paper No. 36.

ERIC Educational Resources Information Center

Smith, Michael J.; And Others

Producing goods and services of high quality is not expensive, but correcting poor quality costs U.S. companies as much as 20 percent of sales revenues annually. One survey reported that only 1 out of 300 U.S. companies involved management and engineering staff in quality training. The tendency is to have a quality control department, separate…

Reduced substrate supply limits the temperature response of soil organic carbon decomposition

Treesearch

Cinzia Fissore; Christian P. Giardina; Randall K. Kolka

2013-01-01

Controls on the decomposition rate of soil organic carbon (SOC), especially the more stable fraction of SOC, remain poorly understood, with implications for confidence in efforts to model terrestrial C balance under future climate. We investigated the role of substrate supply in the temperature sensitivity of SOC decomposition in laboratory incubations of coarse-...

The effects of substrate supply on the temperature sensitivity of soil carbon decomposition

Treesearch

Cinzia Fissore; Christian P. Giardina; Randall K. Kolka

2013-01-01

Controls on the decomposition rate of soil organic carbon (SOC), especially the more stable fraction of SOC, remain poorly understood, with implications for confidence in efforts to model terrestrial C balance under future climate. We investigated the role of substrate supply in the temperature sensitivity of SOC decomposition in laboratory incubations of coarse-...

Human Factors in Training

NASA Technical Reports Server (NTRS)

Barshi, Immanuel; Byme, Vicky; Arsintescu, Lucia

2008-01-01

Future space missions will be significantly longer than current Shuttle missions and new systems will be more complex than current systems. Increasing communication delays between crews and Earth-based support means that astronauts need to be prepared to handle the unexpected on their own. As crews become more autonomous, their potential span of control and required expertise must grow to match their autonomy. It is not possible to train for every eventuality ahead of time on the ground, or to maintain trained skills across long intervals of disuse. To adequately prepare NASA personnel for these challenges, new training approaches, methodologies, and tools are required. This research project aims at developing these training capabilities. Training efforts in FY07 strongly focused on crew medical training, but also began exploring how Space Flight Resource Management training for Mission Operations Directorate (MOD) Flight Controllers could be integrated with systems training for optimal Mission Control Center operations. Beginning in January 2008, the training research effort will include team training prototypes and tools. The Training Task addresses Program risks that lie at the intersection of the following three risks identified by the Project: 1) Risk associated with poor task design; 2) Risk of error due to inadequate information; 3) Risk associated with reduced safety and efficiency due to poor human factors design.

Multi-level modeling of aspects associated with poor mental health in a sample of prehospital emergency professionals.

PubMed

Arial, Marc; Wild, Pascal; Benoit, Damien; Chouaniere, Dominique; Danuser, Brigitta

2011-11-01

The goal of this paper is to investigate the respective influence of work characteristics, the effort-reward ratio, and overcommitment on the poor mental health of out-of-hospital care providers. 333 out-of-hospital care providers answered a questionnaire that included queries on mental health (GHQ-12), demographics, health-related information and work characteristics, questions from the Effort-Reward Imbalance Questionnaire, and items about overcommitment. A two-level multiple regression was performed between mental health (the dependent variable) and the effort-reward ratio, the overcommitment score, weekly number of interventions, percentage of non-prehospital transport of patients out of total missions, gender, and age. Participants were first-level units, and ambulance services were second-level units. We also shadowed ambulance personnel for a total of 416 hr. With cutoff points of 2/3 and 3/4 positive answers on the GHQ-12, the percentages of potential cases with poor mental health were 20% and 15%, respectively. The effort-reward ratio was associated with poor mental health (P < 0.001), irrespective of age or gender. Overcommitment was associated with poor mental health; this association was stronger in women (β = 0.054) than in men (β = 0.020). The percentage of prehospital missions out of total missions was only associated with poor mental health at the individual level. Emergency medical services should pay attention to the way employees perceive their efforts and the rewarding aspects of their work: an imbalance of those aspects is associated with poor mental health. Low perceived esteem appeared particularly associated with poor mental health. This suggests that supervisors of emergency medical services should enhance the value of their employees' work. Employees with overcommitment should also receive appropriate consideration. Preventive measures should target individual perceptions of effort and reward in order to improve mental health in prehospital care providers. Copyright © 2011 Wiley Periodicals, Inc.

Parental coping, depressive symptoms, and children's asthma control and school attendance in low-income, racially, and ethnically diverse urban families.

PubMed

Rodríguez, Erin M; Kumar, Harsha; Alba-Suarez, Juliana; Sánchez-Johnsen, Lisa

2017-10-01

Low-income urban children of color are at elevated risk for poor asthma control. This cross-sectional study examined associations among parents' coping (primary control, secondary control, and disengagement), parental depressive symptoms, and children's asthma outcomes (asthma control and school attendance) in a predominantly low-income, racially/ethnically diverse sample of families. Parents (N = 78; 90% female) of children (33% female; 46% Black; 38% Latino) aged 5-17 years (M = 9.5 years) reported on their own coping and depressive symptoms, their child's asthma control, and full and partial days of school missed due to asthma. Parents' secondary control coping (i.e., coping efforts to accommodate/adapt to asthma-related stressors) was negatively correlated, and disengagement coping (i.e. coping efforts to avoid/detach from stressors) was positively correlated, with their depressive symptoms. Secondary control coping was also correlated with fewer partial days of school missed. Primary control coping (i.e., coping efforts to change stressors) was not associated with depressive symptoms or asthma outcomes. Parents' depressive symptoms were also positively correlated with poorer asthma control and partial days of school missed. Regression models showed direct and indirect effects of secondary control and disengagement coping on asthma outcomes via depressive symptoms, after controlling for demographic factors. Parents' secondary control and disengagement coping are related to children's asthma outcomes. Secondary control coping may support parents' mental health and children's asthma control in low-income urban families.

Control of corruption, democratic accountability, and effectiveness of HIV/AIDS official development assistance.

PubMed

Lee, Hwa-Young; Yang, Bong-Ming; Kang, Minah

2016-01-01

Despite continued global efforts, HIV/AIDS outcomes in developing countries have not made much progress. Poor governance in recipient countries is often seen as one of the reasons for ineffectiveness of aid efforts to achieve stated objectives and desired outcomes. This study examines the impact of two important dimensions of governance - control of corruption and democratic accountability - on the effectiveness of HIV/AIDS official development assistance. An empirical analysis using dynamic panel Generalized Method of Moments estimation was conducted on 2001-2010 datasets. Control of corruption and democratic accountability revealed an independent effect and interaction with the amount of HIV/AIDS aid on incidence of HIV/AIDS, respectively, while none of the two governance variables had a significant effect on HIV/AIDS prevalence. Specifically, in countries with accountability level below -2.269, aid has a detrimental effect on incidence of HIV/AIDS. The study findings suggest that aid programs need to be preceded or at least accompanied by serious efforts to improve governance in recipient countries and that democratic accountability ought to receive more critical attention.

Impact of Fathers’ Alcohol Problems on the Development of Effortful Control in Early Adolescence

PubMed Central

Adkison, Sarah E.; Grohman, Kerry; Colder, Craig R.; Leonard, Kenneth; Orrange-Torchia, Toni; Peterson, Ellen; Eiden, Rina D.

2013-01-01

Objective: This article examines the association between fathers’ alcohol problems and children’s effortful control during the transition from middle childhood to early adolescence (fourth to sixth grade). Additionally, we examined the role of two potential moderators of this association, fathers’ antisocial behavior and child gender. Method: The sample consisted of 197 families (102 nonalcoholic [NA]; 95 father alcoholic [FA], in which only the father met diagnostic criteria for alcohol abuse or dependence). The sample was recruited from New York State birth records when the children were 12 months old. This analysis focused on 12-month alcohol problem data and child effortful control data measured in the fourth and sixth grades. Results: Structural equation modeling revealed that FA status was associated with lower effortful control on the Stroop Color and Word and Tower of London tasks in the sixth grade, but antisocial behavior did not moderate this association. Multiple group analysis revealed that FA status was associated with higher Stroop interference scores in fourth and sixth grade and lower move scores on the Tower of London task for boys but not girls. Conclusions: The association between FA status and effortful control may be attenuated in middle childhood (fourth grade) but emerge again in early adolescence (sixth grade). The results indicate that sons of alcoholics may be particularly vulnerable to poor self-regulatory strategies and that early adolescence may be an important time for intervening with these families to facilitate higher self-regulation before the transition to high school. PMID:23948526

The Rey Auditory Verbal Learning Test forced-choice recognition task: Base-rate data and norms.

PubMed

Poreh, Amir; Bezdicek, Ondrej; Korobkova, Irina; Levin, Jennifer B; Dines, Philipp

2016-01-01

The present study describes a novel Forced-Choice Response (FCR) index for detecting poor effort on the Rey Auditory Verbal Learning Test (RAVLT). This retrospective study analyzes the performance of 4 groups on the new index: clinically referred patients with suspected dementia, forensic patients identified as not exhibiting adequate effort on other measures of response bias, students who simulated poor effort, and a large normative sample collected in the Gulf State of Oman. Using sensitivity and specificity analyses, the study shows that much like the California Verbal Learning Test-Second Edition FCR index, the RAVLT FCR index misses a proportion of individuals with inadequate effort (low sensitivity), but those who fail this measure are highly likely to be exhibiting poor effort (high specificity). The limitations and benefits of utilizing the RAVLT FCR index in clinical practice are discussed.

Priorities and realities: addressing the rich-poor gaps in health status and service access in Indonesia

PubMed Central

2011-01-01

Introduction Over the past four decades, the Indonesian health care system has greatly expanded and the health of Indonesian people has improved although the rich-poor gap in health status and service access remains an issue. The government has been trying to address these gaps and intensify efforts to improve the health of the poor following the economic crisis in 1998. Methods This paper examines trends and levels in socio-economic inequity of health and identifies critical factors constraining efforts to improve the health of the poor. Quantitative data were taken from the Indonesian Demographic Health Surveys and the National Socio-Economic Surveys, and qualitative data were obtained from interviews with individuals and groups representing relevant stakeholders. Results The health of the population has improved as indicated by child mortality decline and the increase in community access to health services. However, the continuing prevalence of malnourished children and the persisting socio-economic inequity of health suggest that efforts to improve the health of the poor have not yet been effective. Factors identified at institution and policy levels that have constrained improvements in health care access and outcomes for the poor include: the high cost of electing formal governance leaders; confused leadership roles in the health sector; lack of health inequity indicators; the generally weak capacity in the health care system, especially in planning and budgeting; and the leakage and limited coverage of programs for the poor. Conclusions Despite the government's efforts to improve the health of the poor, the rich-poor gap in health status and service access continues. Factors at institutional and policy levels are critical in contributing to the lack of efficiency and effectiveness for health programs that address the poor. PMID:22067727

Development of Plant Control Diagnosis Technology and Increasing Its Applications

NASA Astrophysics Data System (ADS)

Kugemoto, Hidekazu; Yoshimura, Satoshi; Hashizume, Satoru; Kageyama, Takashi; Yamamoto, Toru

A plant control diagnosis technology was developed to improve the performance of plant-wide control and maintain high productivity of plants. The control performance diagnosis system containing this technology picks out the poor performance loop, analyzes the cause, and outputs the result on the Web page. Meanwhile, the PID tuning tool is used to tune extracted loops from the control performance diagnosis system. It has an advantage of tuning safely without process changes. These systems are powerful tools to do Kaizen (continuous improvement efforts) step by step, coordinating with the operator. This paper describes a practical technique regarding the diagnosis system and its industrial applications.

The upside down world of diabetes care medical economics and what we might do to improve it.

PubMed

Harlan, David M; Hirsch, Irl B

2017-04-01

Increasingly over the past generation, the American healthcare delivery system has received consistently poor marks with regard to public health outcomes and costs. This review by two seasoned diabetes care providers is intended to shed light on the fundamental flaws we believe to underlie that poor performance, and suggest options for better outcomes and cost efficiencies. Despite major advances in diabetes management medications and tools, overall public health with regard to diabetes outcomes remains poor. Efforts focused on controlling costs appear to be exacerbating the problem. For chronic diseases like diabetes, fee-for-service care models are fundamentally flawed and predictably fail. We suggest that a major overhaul of the medical economics underlying diabetes care can improve patient outcomes and decrease costs.

Effort-reward imbalance and burnout among nurses.

PubMed

Bakker, A B; Killmer, C H; Siegrist, J; Schaufeli, W B

2000-04-01

This study among a sample of 204 German nurses tested the hypothesis that an imbalance of high extrinsic efforts spent (i.e. job demands) and low extrinsic rewards obtained (e.g. poor promotion prospects) are associated with the burnout syndrome: the depletion of nurses' emotional resources. The results of a series of analyses of variances confirmed this hypothesis, by showing that those nurses who experienced an effort-reward imbalance (ERI) reported higher levels on two of the three core dimensions of burnout (i.e. emotional exhaustion and depersonalization) than those who did not experience such an imbalance. Moreover - as additionally hypothesized - significant interaction effects indicated that burnout (i.e. emotional exhaustion and reduced personal accomplishment) was particularly prevalent among those nurses who experienced ERI and put relatively high intrinsic effort into their jobs, as reflected by their strong tendency to be personally in control over job conditions.

Defining and refining international donor support for combating the AIDS pandemic.

PubMed

Attaran, A; Sachs, J

2001-01-06

The international aid effort against AIDS is greatly incommensurate with the severity of the epidemic. Drawing on the data that international aid donors self-reported to the Organization for Economic Cooperation and Development (OECD), we find that, between 1996 and 1998, finance from all rich countries to sub-Saharan Africa for projects designated as AIDS control averaged US $69 million annually, and, assuming a safe margin for under-reporting and misreporting, we estimate that total donor spending on HIV/AIDS control was perhaps twice that at most. Since the late 1980s, aid levels have dropped relative to the prevalence of HIV infection, and stood recently at about $3 per HIV-infected person. Lack of finance is now the primary constraint on progress against AIDS, notwithstanding the widespread belief that a lack of interest from the goveements of poor countries is limiting. We argue that to produce a meaningful response to the pandemic, international assistance must be based on grants, not loans, for the poorest countries; be increased within the next 3 years to a minimum of $7.5 billion or more; be directed toward funding projects which are proposed and desired by the affected countries themselves, and which are judged as having epidemiological merit against the pandemic by a panel of independent scientific experts; and fund concurrent needs, including prevention, drug treatment (such as highly active antiretroviral therapy), and blocking mother-to-child HIV transmission. An effort of this scope and scale will both radically alter the prospects for intervention against AIDS in poor countries, and together with comparable efforts to control other infectious diseases, is easily afforded by the OECD donor economies, whose aggregate national income recently surpassed $21 trillion annually.

Psychosocial work environment, job mobility and gender differences in turnover behaviour: a prospective study among the Swedish general population

PubMed Central

2014-01-01

Background Throughout the literature, substantial evidence supports associations between poor psychosocial work characteristics and a variety of ill-health outcomes. Yet, few reports strategies workers carry out to improve detrimental work conditions and consequently their health, such as changing jobs. The aim of this study was to examine if adverse psychosocial work exposure, as measured with the job demand-control and effort-reward imbalance models, could predict job mobility over a 5 years observation period. Method Participants were working men and women (n = 940; 54.3% women), aged 24–60 years from the population of Gothenburg and surrounding metropolitan area. Job demand-control and effort-reward variables were compared with independent t-tests and chi2-test in persons with and without job mobility. Multivariate logistic regression was used to analyse whether psychosocial factors could predict job mobility. All regression analyses were stratified by gender. Results Exposure to a combination of high demands-low control or high imbalance between effort and reward was related to increased odds of changing jobs (OR 1.63; CI 1.03-2.59 and OR 1.46; CI 1.13-1.89 respectively). When analysing men and women separately, men had a higher OR of changing jobs when exposed to either high demands-low control (OR 2.72; CI 1.24-5.98) or high effort-reward imbalance (OR 1.74; CI 1.11-2.72) compared to reference values. The only significant associations for women was slightly decreased odds for turnover in high reward jobs (OR 0.96; CI 0.92-0.99). Conclusions The results indicate that workers will seek to improve poor work environment by changing jobs. There were notable gender differences, where men tended to engage in job mobility when exposed to adverse psychosocial factors, while women did not. The lack of measures for mechanisms driving job mobility was a limitation of this study, thus preventing conclusions regarding psychosocial factors as the primary source for job mobility. PMID:24927628

A Systematic Approach to the Study of Accelerated weathering of Building Joint Sealants

Treesearch

Christopher C. White; Donald L. Hunston; Kar Tean Tan; James J. Filliben; Adam L. Pintar; Greg Schueneman

2012-01-01

An accurate service life prediction model is needed for building joint sealants in order to greatly reduce the time to market of a new product and reduce the risk of introducing a poorly performing product into the marketplace. A stepping stone to the success of this effort is the precise control of environmental variables in a laboratory accelerated test apparatus in...

Dialectic of control and emancipation in organizing for social change: a multitheoretic study of the Grameen Bank in Bangladesh.

PubMed

Papa, M J; Auwal, M A; Singhal, A

1995-08-01

Dedicated to helping the poorest of the poor obtain the financial means to become productively self-employed, the Grameen Bank in Bangladesh is founded upon the belief that credit is a fundamental human right and that development should be measured according to the per capita income of the bottom 50% of the population. The bank provides collateral-free loans and social services for the poor, charging 20% interest on capital, all the while maintaining a 99% loan recovery rate. The bank has 1.9 million members, 94% of whom are women, and has successfully organized grassroots microenterprises for productive self-employment and social change. The authors use the coorientation, concertive control, and critical feminist theories to analyze the bank's programs in an effort to explain the dialectic between control and emancipation in organizing for social change. Examining the bank's organizational processes from multiple theoretical perspectives allows insights to be drawn about theory and praxis in organizing for social change. The Grameen Bank has effectively demonstrated that development is an organized process of education, environmentally sound productivity, and improvement in the quality of life for the poorest of the poor.

International Guidelines on Human Rights and Drug Control: A Tool for Securing Women's Rights in Drug Control Policy.

PubMed

Schleifer, Rebecca; Pol, Luciana

2017-06-01

Discrimination and inequality shape women's experiences of drug use and in the drug trade and the impact of drug control efforts on them, with disproportionate burdens faced by poor and otherwise marginalized women. In recent years, UN member states and UN drug control and human rights entities have recognized this issue and made commitments to integrate a 'gender perspective' into drug control policies, with 'gender' limited to those conventionally deemed women. But the concept of gender in international law is broader, rooted in socially constructed and culturally determined norms and expectations around gender roles, sex, and sexuality. Also, drug control policies often fail to meaningfully address the specific needs and circumstances of women (inclusively defined), leaving them at risk of recurrent violations of their rights in the context of drugs. This article explores what it means to 'mainstream' this narrower version of gender into drug control efforts, using as examples various women's experiences as people who use drugs, in the drug trade, and in the criminal justice system. It points to international guidelines on human rights and drug control as an important tool to ensure attention to women's rights in drug control policy design and implementation.

Relations of Positive and Negative Expressivity and Effortful Control to Kindergarteners’ Student-Teacher Relationship, Academic Engagement, and Externalizing Problems at School

PubMed Central

Diaz, Anjolii; Eisenberg, Nancy; Valiente, Carlos; VanSchyndel, Sarah; Spinrad, Tracy L.; Berger, Rebecca; Hernandez, Maciel M.; Silva, Kassondra M.; Southworth, Jody

2015-01-01

The current study examined the role of naturally-occurring negative and positive emotion expressivity in kindergarten and children’s effortful control (EC) on their relationships with teachers, academic engagement, and problems behaviors in school. Further, the potential moderating role of EC on these important school outcomes was assessed. Emotion and engagement were observed at school. EC was assessed by multiple methods. Teachers reported on their student–teacher relationships and student’s externalizing behaviors. Children’s emotion expressivity and EC were related to engagement and relationships with teachers as well as behavioral problems at school. Children low in EC may be particularly vulnerable to the poor outcomes associated with relatively intense emotion expressivity as they struggle to manage their emotions and behaviors in the classroom. PMID:28584388

The Influence of Chronic Ego Depletion on Goal Adherence: An Experience Sampling Study.

PubMed

Wang, Ligang; Tao, Ting; Fan, Chunlei; Gao, Wenbin; Wei, Chuguang

2015-01-01

Although ego depletion effects have been widely observed in experiments in which participants perform consecutive self-control tasks, the process of ego depletion remains poorly understood. Using the strength model of self-control, we hypothesized that chronic ego depletion adversely affects goal adherence and that mental effort and motivation are involved in the process of ego depletion. In this study, 203 students reported their daily performance, mental effort, and motivation with respect to goal directed behavior across a 3-week time period. People with high levels of chronic ego depletion were less successful in goal adherence than those with less chronic ego depletion. Although daily effort devoted to goal adherence increased with chronic ego depletion, motivation to adhere to goals was not affected. Participants with high levels of chronic ego depletion showed a stronger positive association between mental effort and performance, but chronic ego depletion did not play a regulatory role in the effect of motivation on performance. Chronic ego depletion increased the likelihood of behavior regulation failure, suggesting that it is difficult for people in an ego-depletion state to adhere to goals. We integrate our results with the findings of previous studies and discuss possible theoretical implications.

The Influence of Chronic Ego Depletion on Goal Adherence: An Experience Sampling Study

PubMed Central

Wang, Ligang; Tao, Ting; Fan, Chunlei; Gao, Wenbin; Wei, Chuguang

2015-01-01

Although ego depletion effects have been widely observed in experiments in which participants perform consecutive self-control tasks, the process of ego depletion remains poorly understood. Using the strength model of self-control, we hypothesized that chronic ego depletion adversely affects goal adherence and that mental effort and motivation are involved in the process of ego depletion. In this study, 203 students reported their daily performance, mental effort, and motivation with respect to goal directed behavior across a 3-week time period. People with high levels of chronic ego depletion were less successful in goal adherence than those with less chronic ego depletion. Although daily effort devoted to goal adherence increased with chronic ego depletion, motivation to adhere to goals was not affected. Participants with high levels of chronic ego depletion showed a stronger positive association between mental effort and performance, but chronic ego depletion did not play a regulatory role in the effect of motivation on performance. Chronic ego depletion increased the likelihood of behavior regulation failure, suggesting that it is difficult for people in an ego-depletion state to adhere to goals. We integrate our results with the findings of previous studies and discuss possible theoretical implications. PMID:26562839

Control of corruption, democratic accountability, and effectiveness of HIV/AIDS official development assistance

PubMed Central

Lee, Hwa-Young; Yang, Bong-Ming; Kang, Minah

2016-01-01

Background Despite continued global efforts, HIV/AIDS outcomes in developing countries have not made much progress. Poor governance in recipient countries is often seen as one of the reasons for ineffectiveness of aid efforts to achieve stated objectives and desired outcomes. Objective This study examines the impact of two important dimensions of governance – control of corruption and democratic accountability – on the effectiveness of HIV/AIDS official development assistance. Design An empirical analysis using dynamic panel Generalized Method of Moments estimation was conducted on 2001–2010 datasets. Results Control of corruption and democratic accountability revealed an independent effect and interaction with the amount of HIV/AIDS aid on incidence of HIV/AIDS, respectively, while none of the two governance variables had a significant effect on HIV/AIDS prevalence. Specifically, in countries with accountability level below −2.269, aid has a detrimental effect on incidence of HIV/AIDS. Conclusion The study findings suggest that aid programs need to be preceded or at least accompanied by serious efforts to improve governance in recipient countries and that democratic accountability ought to receive more critical attention. PMID:27189199

Psychosocial work environment and well-being: a cross-sectional study at a thermal power plant in China.

PubMed

Yu, Shanfa; Gu, Guizhen; Zhou, Wenhui; Wang, Sheng

2008-01-01

To investigate the effects of the job demand-control (DC) model and the effort-reward imbalance (ERI) model on worker's well-being, self-reports for psychosocial work conditions and well-being were made by a sample of 878 workers at a thermal power plant in China using the main dimensions of DC and ERI questionnaires. Logistic regression analyses were employed controlling for age, gender, and educational level, and negative and positive affection among others. Workers reporting high job demands and low job control or high efforts and low rewards had elevated risks of job dissatisfaction, psychosomatic complaints and depressive symptoms. Odds ratios were generally higher in workers reporting both high efforts and low rewards. Furthermore, low reward proved to be a stronger predictor of poor well-being when both job stress models were simultaneously adjusted. To some extent, interaction effects were found for social support, but no interaction effects were found for overcommitment. The findings indicate independent effects of both the DC model and the ERI model on well-being. Future work should explore the combined effects of these two models of psychosocial stress at work on health more thoroughly.

International Guidelines on Human Rights and Drug Control

PubMed Central

Pol, Luciana

2017-01-01

Abstract Discrimination and inequality shape women’s experiences of drug use and in the drug trade and the impact of drug control efforts on them, with disproportionate burdens faced by poor and otherwise marginalized women. In recent years, UN member states and UN drug control and human rights entities have recognized this issue and made commitments to integrate a ‘gender perspective’ into drug control policies, with ‘gender’ limited to those conventionally deemed women. But the concept of gender in international law is broader, rooted in socially constructed and culturally determined norms and expectations around gender roles, sex, and sexuality. Also, drug control policies often fail to meaningfully address the specific needs and circumstances of women (inclusively defined), leaving them at risk of recurrent violations of their rights in the context of drugs. This article explores what it means to ‘mainstream’ this narrower version of gender into drug control efforts, using as examples various women’s experiences as people who use drugs, in the drug trade, and in the criminal justice system. It points to international guidelines on human rights and drug control as an important tool to ensure attention to women’s rights in drug control policy design and implementation. PMID:28630557

Locus of Control and Coping Style as Stress Moderators in Achievement Oriented Individuals

DTIC Science & Technology

1995-05-01

stressfulness of events by coloring them as stimulating rather than threatening. This leads to attempts to transform oneself and grow by fostering ...efforts to master conditions of uncertainty that tax or exceed adaptive resources ( Latack , 1986). II includes any response thai prevents, avoids, or...more likely to be depressed, function poorly, experience more marital distress, and consume more alcohol. Latack (1986) classifying coping responses

Irregular Applications: Architectures & Algorithms

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

Feo, John T.; Villa, Oreste; Tumeo, Antonino

Irregular applications are characterized by irregular data structures, control and communication patterns. Novel irregular high performance applications which deal with large data sets and require have recently appeared. Unfortunately, current high performance systems and software infrastructures executes irregular algorithms poorly. Only coordinated efforts by end user, area specialists and computer scientists that consider both the architecture and the software stack may be able to provide solutions to the challenges of modern irregular applications.

Threats from emerging and re-emerging neglected tropical diseases (NTDs).

PubMed

Mackey, Tim K; Liang, Bryan A

2012-01-01

Neglected tropical diseases impact over 1 billion of the world's poorest populations and require special attention. However, within the NTDs recognized by the World Health Organization, some are also dually categorized as emerging and re-emerging infectious diseases requiring more detailed examination on potential global health risks. We reviewed the 17 NTDs classified by the WHO to determine if those NTDs were also categorized by the US Centers for Disease Control and Prevention as emerging and re-emerging infectious diseases (''EReNTDs''). We then identified common characteristics and risks associated with EReNTDs. Identified EReNTDs of dengue, rabies, Chagas Disease, and cysticercosis disproportionately impact resource-poor settings with poor social determinants of health, spread through globalization, are impacted by vector control, lack available treatments, and threaten global health security. This traditionally neglected subset of diseases requires urgent attention and unique incentive structures to encourage investment in innovation and coordination. Multi-sectorial efforts and targeted public-private partnerships would spur needed R&D for effective and accessible EReNTD treatments, improvement of social determinants of health, crucial low-income country development, and health system strengthening efforts. Utilization of One Health principles is essential for enhancing knowledge to efficaciously address public health aspects of these EReNTDs globally.

Economic Benefit for Cuban Laurel Thrips Biological Control.

PubMed

Shogren, C; Paine, T D

2016-02-01

The Cuban laurel thrips, Gynaikothrips ficorum Marchal (Thysanoptera: Phlaeothripidae), is a critical insect pest of Ficus microcarpa in California urban landscapes and production nurseries. Female thrips feed and oviposit on young Ficus leaves, causing the expanding leaves to fold or curl into a discolored leaf gall. There have been attempts to establish specialist predator natural enemies of the thrips, but no success has been reported. We resampled the same areas in 2013-2014 where we had released Montandoniola confusa (= morguesi) Streito and Matocq (Hemiptera: Anthocoridae) in southern California in 1995 but had been unable to recover individuals in 1997-1998. Thrips galls were significantly reduced in all three of the locations in the recent samples compared with the earlier samples. M. confusa was present in all locations and appears to be providing successful biological control. The value of the biological control, the difference between street trees in good foliage condition and trees with poor foliage, was $58,766,166. If thrips damage reduced the foliage to very poor condition, the value of biological control was $73,402,683. Total cost for the project was $61,830. The benefit accrued for every dollar spent on the biological control of the thrips ranged from $950, if the foliage was in poor condition, to $1,187, if the foliage was in very poor condition. The value of urban forest is often underappreciated. Economic analyses that clearly demonstrate the very substantial rates of return on investment in successful biological control in urban forests provide compelling arguments for supporting future efforts. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Socioemotional Features and Resilience in Italian University Students with and without Dyslexia

PubMed Central

Ghisi, Marta; Bottesi, Gioia; Re, Anna M.; Cerea, Silvia; Mammarella, Irene C.

2016-01-01

Dyslexia is a permanent condition characterized by reading difficulties that include inaccurate or slow and effortful word reading, poor decoding, and poor spelling abilities. People with dyslexia may have psychological and psychopathological issues such as low self-esteem, poor resilience, and symptoms of depression and anxiety. They may also develop social problems and emotional issues, as well as low academic and social self-efficacy. The present study aimed to assess the psychological features of a sample of 28 Italian university students with dyslexia, comparing them with a control group of typically developing students matched for gender, education, and academic discipline, to enhance our knowledge of dyslexia outcomes in an Italian setting. The results show that university students with dyslexia experience higher levels of somatic complaints, social and attentional problems, lower self-esteem, and higher depression scores than controls, while no difference emerged between the two groups’ resilience scores. In conclusion, the present findings suggest that university students with dyslexia report more psychological issues than students without dyslexia and could benefit from intervention to improve their psychological and physical well-being. PMID:27065220

Soil-Transmitted Helminths: Mathematical Models of Transmission, the Impact of Mass Drug Administration and Transmission Elimination Criteria.

PubMed

Truscott, J E; Turner, H C; Farrell, S H; Anderson, R M

2016-01-01

Infections caused by soil-transmitted helminthias (STHs) affect over a billion people worldwide, causing anaemia and having a large social and economic impact through poor educational outcomes. They are identified in the World Health Organization (WHO) 2020 goals for neglected tropical diseases as a target for renewed effort to ameliorate their global public health burden through mass drug administration (MDA) and water and hygiene improvement. In this chapter, we review the underlying biology and epidemiology of the three causative intestinal nematode species that are mostly considered under the STH umbrella term. We review efforts to model the transmission cycle of these helminths in populations and the effects of preventative chemotherapy on their control and elimination. Recent modelling shows that the different epidemiological characteristics of the parasitic nematode species that make up the STH group can lead to quite distinct responses to any given form of MDA. When connected with models of treatment cost-effectiveness, these models are potentially a powerful tool for informing public policy. A number of shortcomings are identified; lack of critical types of data and poor understanding of diagnostic sensitivities hamper efforts to test and hence improve models. Copyright © 2016 Elsevier Ltd. All rights reserved.

The RBANS Effort Index: base rates in geriatric samples.

PubMed

Duff, Kevin; Spering, Cynthia C; O'Bryant, Sid E; Beglinger, Leigh J; Moser, David J; Bayless, John D; Culp, Kennith R; Mold, James W; Adams, Russell L; Scott, James G

2011-01-01

The Effort Index (EI) of the RBANS was developed to assist clinicians in discriminating patients who demonstrate good effort from those with poor effort. However, there are concerns that older adults might be unfairly penalized by this index, which uses uncorrected raw scores. Using five independent samples of geriatric patients with a broad range of cognitive functioning (e.g., cognitively intact, nursing home residents, probable Alzheimer's disease), base rates of failure on the EI were calculated. In cognitively intact and mildly impaired samples, few older individuals were classified as demonstrating poor effort (e.g., 3% in cognitively intact). However, in the more severely impaired geriatric patients, over one third had EI scores that fell above suggested cutoff scores (e.g., 37% in nursing home residents, 33% in probable Alzheimer's disease). In the cognitively intact sample, older and less educated patients were more likely to have scores suggestive of poor effort. Education effects were observed in three of the four clinical samples. Overall cognitive functioning was significantly correlated with EI scores, with poorer cognition being associated with greater suspicion of low effort. The current results suggest that age, education, and level of cognitive functioning should be taken into consideration when interpreting EI results and that significant caution is warranted when examining EI scores in elders suspected of having dementia.

Multi-domain predictors of Oppositional Defiant Disorder symptoms in preschool children: Cross-informant differences

PubMed Central

Lavigne, John V.; Dahl, Katharine P.; Gouze, Karen R.; LeBailly, Susan A.; Hopkins, Joyce

2014-01-01

Existing research suggests that parent and teacher reports of children's behavior problems are often discrepant. The current study examined whether contextual (stress and family conflict), parent (depression), parenting (hostility, support, and scaffolding), and child factors (receptive vocabulary; negative affect, NA; effortful control, EC; inhibitory control, IC; attachment; and sensory regulation, SR) are related to parent-teacher reporting discrepancies. Participants included a community sample of 344 4-year-old children. A multi-informant approach was used to assess contextual, parent, parenting, and child factors. Parents and teachers completed the Oppositional Defiant Disorder (ODD) scale of the Child Symptom Inventory. Consistent with previous data, there was poor agreement between parents and teachers (r =.17). After correcting for multiple comparisons, child effortful control, parent hostility, and family conflict were significant predictors of parent-rated symptoms of ODD symptoms but not teacher-rated ODD symptoms. Only family conflict was a significant predictor of discrepancies in parent and teacher ratings. PMID:24997089

State of inequality in malaria intervention coverage in sub-Saharan African countries.

PubMed

Galactionova, Katya; Smith, Thomas A; de Savigny, Don; Penny, Melissa A

2017-10-18

Scale-up of malaria interventions over the last decade have yielded a significant reduction in malaria transmission and disease burden in sub-Saharan Africa. We estimated economic gradients in the distribution of these efforts and of their impacts within and across endemic countries. Using Demographic and Health Surveys we computed equity metrics to characterize the distribution of malaria interventions in 30 endemic countries proxying economic position with an asset-wealth index. Gradients were summarized in a concentration index, tabulated against level of coverage, and compared among interventions, across countries, and against respective trends over the period 2005-2015. There remain broad differences in coverage of malaria interventions and their distribution by wealth within and across countries. In most, economic gradients are lacking or favor the poorest for vector control; malaria services delivered through the formal healthcare sector are much less equitable. Scale-up of interventions in many countries improved access across the wealth continuum; in some, these efforts consistently prioritized the poorest. Expansions in control programs generally narrowed coverage gaps between economic strata; gradients persist in countries where growth was slower in the poorest quintile or where baseline inequality was large. Despite progress, malaria is consistently concentrated in the poorest, with the degree of inequality in burden far surpassing that expected given gradients in the distribution of interventions. Economic gradients in the distribution of interventions persist over time, limiting progress toward equity in malaria control. We found that, in countries with large baseline inequality in the distribution of interventions, even a small bias in expansion favoring the least poor yielded large gradients in intervention coverage while pro-poor growth failed to close the gap between the poorest and least poor. We demonstrated that dimensions of disadvantage compound for the poor; a lack of economic gradients in the distribution of malaria services does not translate to equity in coverage nor can it be interpreted to imply equity in distribution of risk or disease burden. Our analysis testifies to the progress made by countries in narrowing economic gradients in malaria interventions and highlights the scope for continued monitoring of programs with respect to equity.

Canadianization a red flag to US firms and their friends in Congress

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

Corrigan, R.

1981-08-01

Efforts to gain control over its own petroleum industry are squeezing US-based oil and gas companies that have dominated Canadian energy development. Foreign-owned firms account for 72% of Canada's industry revenues. The effort is more a de-Americanization than a nationalization in the series of take-over moves and countermoves. The US views this as an abrupt shift in traditional business and trade relationships, with angry industry leaders lobbying Congress for retaliatory action. Trudeau's program to slow the drain of wealth from energy-poor eastern provinces to the west has also sparked controversy in Canada. The program enlarges the federal role in oilmore » companies, regulates foreign acquisitions, gives preferential treatment to Canadian firms, and continues price controls in Canadian crude oil. Several American interagency groups are evaluating Canada's moves, but the administraion is reluctant to move beyond diplomatic persuasion. (DCK)« less

Difficulties in estimating the human burden of canine rabies.

PubMed

Taylor, Louise H; Hampson, Katie; Fahrion, Anna; Abela-Ridder, Bernadette; Nel, Louis H

2017-01-01

Current passive surveillance data for canine rabies, particularly for the regions where the burden is highest, are inadequate for appropriate decision making on control efforts. Poor enforcement of existing legislation and poor implementation of international guidance reduce the effectiveness of surveillance systems, but another set of problems relates to the fact that canine rabies is an untreatable condition which affects very poor sectors of society. This results in an unknown, but potentially large proportion of rabies victims dying outside the health system, deaths that are unlikely to be recorded by surveillance systems based on health center records. This article critically evaluates the potential sources of information on the number of human deaths attributable to canine rabies, and how we might improve the estimates required to move towards the goal of global canine rabies elimination. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Improving outcomes in cancer diagnosis, prevention and control: barriers, facilitators and the need for health literacy in Ibadan Nigeria.

PubMed

Adedimeji, Adebola A; Lounsbury, David; Popoola, Oluwafemi; Asuzu, Chioma; Lawal, Akinmayowa; Oladoyin, V; Crifase, Cassandra; Agalliu, Ilir; Shankar, Viswanathan; Adebiyi, Akindele

2017-10-01

Cancers constitute a significant public health problem in Nigeria. Breast, cervix and prostate cancers are leading causes of cancer-related deaths. Changing diets, lifestyles, HIV/AIDS and macro-structural factors contribute to cancer morbidity and mortality. Poor health information linking cancer risk to individual behaviors, environmental pollutants and structural barriers undermine prevention/control efforts. Studies suggest increasing health literacy and empowering individuals to take preventive action will improve outcomes and mitigate impact on a weak health system. We obtained qualitative data from 80 men, women, and young adults in 11 focus groups to assess beliefs, risk-perceptions, preventive behaviors and perceptions of barriers and facilitators to cancer control in Ibadan, Nigeria and conducted thematic analysis. Participants demonstrated awareness of cancers and mentioned several risk factors related to individual behaviors and the environment. Nonetheless, myths and misconceptions as well as micro, meso and macro level barriers impede prevention and control efforts. Developing and implementing comprehensive context-relevant health literacy interventions in community settings are urgently needed.Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

The Role of Private Health Sector for Tuberculosis Control in Debre Markos Town, Northwest Ethiopia.

PubMed

Reta, Alemayehu; Simachew, Addis

2018-01-01

Tuberculosis has been declared to be a global epidemic. Despite all the effort, only less than half the annual estimated cases are reported by health authorities to the WHO. This could be due to poor reporting from the private sector. In Ethiopia, tuberculosis has also been a major public health problem. The aim of this study was to assess the role of the private health sector in tuberculosis control in Debre Markos. An institution based cross-sectional descriptive study was carried out in private health facilities. A total of 260 tuberculosis suspects attending the private clinics were interviewed. Focus group discussion, checklist, and structured questionnaire were used. Majority of the private clinics were less equipped, poorly regulated, and owned by health workers who were self-employed on a part-time basis. Provider delay of 4 and more months was significantly associated higher likelihood of turning to a private provider (OR = 2.70, 95% CI = (1.20, 6.08)). There is significant delay among tuberculosis patients. Moreover, there is poor regulation of the private health sector by public health authorities. The involvement of the private sector in tuberculosis control should be limited to identification and refer to tuberculosis cases and suspects.

The RBANS Effort Index: Base rates in geriatric samples

PubMed Central

Duff, Kevin; Spering, Cynthia C.; O’Bryant, Sid E.; Beglinger, Leigh J.; Moser, David J.; Bayless, John D.; Culp, Kennith R.; Mold, James W.; Adams, Russell L.; Scott, James G.

2011-01-01

The Effort Index (EI) of the RBANS was developed to assist clinicians in discriminating patients who demonstrate good effort from those with poor effort. However, there are concerns that older adults might be unfairly penalized by this index, which uses uncorrected raw scores. Using five independent samples of geriatric patients with a broad range of cognitive functioning (e.g., cognitively intact, nursing home residents, probable Alzheimer’s disease), base rates of failure on the EI were calculated. In cognitively intact and mildly impaired samples, few older individuals were classified as demonstrating poor effort (e.g., 3% in cognitively intact). However, in the more severely impaired geriatric patients, over one third had EI scores that fell above suggested cut-off scores (e.g., 37% in nursing home residents, 33% in probable Alzheimer’s disease). In the cognitively intact sample, older and less educated patients were more likely to have scores suggestive of poor effort. Education effects were observed in 3 of the 4 clinical samples. Overall cognitive functioning was significantly correlated with EI scores, with poorer cognition being associated with greater suspicion of low effort. The current results suggest that age, education, and level of cognitive functioning should be taken into consideration when interpreting EI results and that significant caution is warranted when examining EI scores in elders suspected of having dementia. PMID:21390895

Rethinking multifamily resets and cutouts

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

Jablonski, F.

In multifamily applications, where heating bills often run into thousands of dollars, reset-cutout combinations appear to be very attractive retrofits because, when properly operated, they meet owners' needs for very quick returns on energy saving investments. Unfortunately, the author's observation of resets and cutouts operating under conditions the author typically found in residential multifamily buildings indicates that adjustable controls, such as most resets and cutouts, will often be defeated through poor installation and maladjustment. This appears to be true even when programs incorporate mechanisms aimed at training building operators to manage the controls correctly, and reinforce that training with writtenmore » instructions and periodic reminders. Despite the massive and frequently reinforced education effort for control operators, his post-installation site visits revealed that resets and cutouts were still routinely defeated. Out of curiosity, he conducted a survey of cutout controls in spring 1990. The author has found that 19 of 19 cutout controls surveyed, all of which had been installed under the enhanced program, were rendered functionally inoperable because they were turned off or set far too high. Because this preliminary survey showed such poor results, additional research is now underway to assess the maintenance or disablement of these adjustable resets and cutouts.« less

Motivation, effort and life circumstances as predictors of foot ulcers and amputations in people with Type 2 diabetes mellitus.

PubMed

Bruun, C; Guassora, A D; Nielsen, A B S; Siersma, V; Holstein, P E; de Fine Olivarius, N

2014-11-01

To investigate the predictive value of both patients' motivation and effort in their management of Type 2 diabetes and their life circumstances for the development of foot ulcers and amputations. This study was based on the Diabetes Care in General Practice study and Danish population and health registers. The associations between patient motivation, effort and life circumstances and foot ulcer prevalence 6 years after diabetes diagnosis and the incidence of amputation in the following 13 years were analysed using odds ratios from logistic regression and hazard ratios from Cox regression models, respectively. Foot ulcer prevalence 6 years after diabetes diagnosis was 2.93% (95% CI 1.86-4.00) among 956 patients. General practitioners' indication of 'poor' vs 'very good' patient motivation for diabetes management was associated with higher foot ulcer prevalence (odds ratio 6.11, 95% CI 1.22-30.61). The same trend was seen for 'poor' vs 'good' influence of the patient's own effort in diabetes treatment (odds ratio 7.06, 95% CI 2.65-18.84). Of 1058 patients examined at 6-year follow-up, 45 experienced amputation during the following 13 years. 'Poor' vs 'good' influence of the patients' own effort was associated with amputation (hazard ratio 7.12, 95% CI 3.40-14.92). When general practitioners assessed the influence of patients' life circumstances as 'poor' vs 'good', the amputation incidence increased (hazard ratio 2.97, 95% CI 1.22-7.24). 'Poor' vs 'very good' patient motivation was also associated with a higher amputation incidence (hazard ratio 7.57, 95% CI 2.43-23.57), although not in fully adjusted models. General practitioners' existing knowledge of patients' life circumstances, motivation and effort in diabetes management should be included in treatment strategies to prevent foot complications. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

Evaluation of model-based methods in estimating respiratory mechanics in the presence of variable patient effort.

PubMed

Redmond, Daniel P; Chiew, Yeong Shiong; Major, Vincent; Chase, J Geoffrey

2016-09-23

Monitoring of respiratory mechanics is required for guiding patient-specific mechanical ventilation settings in critical care. Many models of respiratory mechanics perform poorly in the presence of variable patient effort. Typical modelling approaches either attempt to mitigate the effect of the patient effort on the airway pressure waveforms, or attempt to capture the size and shape of the patient effort. This work analyses a range of methods to identify respiratory mechanics in volume controlled ventilation modes when there is patient effort. The models are compared using 4 Datasets, each with a sample of 30 breaths before, and 2-3 minutes after sedation has been administered. The sedation will reduce patient efforts, but the underlying pulmonary mechanical properties are unlikely to change during this short time. Model identified parameters from breathing cycles with patient effort are compared to breathing cycles that do not have patient effort. All models have advantages and disadvantages, so model selection may be specific to the respiratory mechanics application. However, in general, the combined method of iterative interpolative pressure reconstruction, and stacking multiple consecutive breaths together has the best performance over the Dataset. The variability of identified elastance when there is patient effort is the lowest with this method, and there is little systematic offset in identified mechanics when sedation is administered. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Option Generation Techniques for Command and Control.

DTIC Science & Technology

1983-01-01

and discuss some reasons why decision making is often less than perfect. 3.2. The Process of Decision Making Figure 3.1 shows a model of the various...responses to changes in the problem context. Most of these potential reasons for poor decision making stem from the human decision maker’s cognitive...several advantages: (1) It provides a mechanism for quickly estimating the scope of the effort that should be involved in making the decison and a road map

Improvement of Human Resources Quality through Vocational Training in Tourism in Karimunjawa Islands (Central Java, Indonesia): A Pro-Economical Tourism Approach

ERIC Educational Resources Information Center

Putro, S. Eko; Sukirno; Budi, S.; Didik, W.

2016-01-01

The effort to improve human resource quality is not easy to be implemented. This effort becomes more complicated to do when implemented to the group of poor community, especially in this case marginal community of small island. This research analyzes the characteristic of poor household in small island as well as the strategy of poverty…

The impact of ill health on exit from paid employment in Europe among older workers.

PubMed

van den Berg, Tilja; Schuring, Merel; Avendano, Mauricio; Mackenbach, Johan; Burdorf, Alex

2010-12-01

To determine the impact of ill health on exit from paid employment in Europe among older workers. Participants of the Survey on Health and Ageing in Europe (SHARE) in 11 European countries in 2004 and 2006 were selected when 50-63 years old and in paid employment at baseline (n=4611). Data were collected on self-rated health, chronic diseases, mobility limitations, obesity, smoking, alcohol use, physical activity and work characteristics. Participants were classified into employed, retired, unemployed and disabled at the end of the 2-year follow-up. Multinomial logistic regression was used to estimate the effect of different measures of ill health on exit from paid employment. During the 2-year follow-up, 17% of employed workers left paid employment, mainly because of early retirement. Controlling for individual and work related characteristics, poor self-perceived health was strongly associated with exit from paid employment due to retirement, unemployment or disability (ORs from 1.32 to 4.24). Adjustment for working conditions and lifestyle reduced the significant associations between ill health and exit from paid employment by 0-18.7%. Low education, obesity, low job control and effort-reward imbalance were associated with measures of ill health, but also risk factors for exit from paid employment after adjustment for ill health. Poor self-perceived health was strongly associated with exit from paid employment among European workers aged 50-63 years. This study suggests that the influence of ill health on exit from paid employment could be lessened by measures targeting obesity, problematic alcohol use, job control and effort-reward balance.

Poor neuro-motor tuning of the human larynx: a comparison of sung and whistled pitch imitation

PubMed Central

Johnson, Joseph F.; Kotz, Sonja A.

2018-01-01

Vocal imitation is a hallmark of human communication that underlies the capacity to learn to speak and sing. Even so, poor vocal imitation abilities are surprisingly common in the general population and even expert vocalists cannot match the precision of a musical instrument. Although humans have evolved a greater degree of control over the laryngeal muscles that govern voice production, this ability may be underdeveloped compared with control over the articulatory muscles, such as the tongue and lips, volitional control of which emerged earlier in primate evolution. Human participants imitated simple melodies by either singing (i.e. producing pitch with the larynx) or whistling (i.e. producing pitch with the lips and tongue). Sung notes were systematically biased towards each individual's habitual pitch, which we hypothesize may act to conserve muscular effort. Furthermore, while participants who sung more precisely also whistled more precisely, sung imitations were less precise than whistled imitations. The laryngeal muscles that control voice production are under less precise control than the oral muscles that are involved in whistling. This imprecision may be due to the relatively recent evolution of volitional laryngeal-motor control in humans, which may be tuned just well enough for the coarse modulation of vocal-pitch in speech. PMID:29765635

Associations between supportive leadership and employees self-rated health in an occupational sample.

PubMed

Schmidt, Burkhard; Loerbroks, Adrian; Herr, Raphael M; Wilson, Mark G; Jarczok, Marc N; Litaker, David; Mauss, Daniel; Bosch, Jos A; Fischer, Joachim E

2014-01-01

Protecting the health of the work force has become an important issue in public health research. This study aims to explore potential associations between supportive leadership style (SLS), an aspect of leadership behavior, and self-rated health (SRH) among employees. We drew on cross-sectional data from a cohort of industrial workers (n = 3,331), collected in 2009. We assessed employees' ratings of supportive, employee-oriented leadership behavior at their job, their SRH, and work stress as measured by the effort-reward model and scales measuring demands, control, and social support. Logistic regression estimated odds ratios (ORs) and corresponding 95 % confidence intervals (CIs) for the association between the perception of poor SLS and poor SRH controlling for work-related stress and other confounders. Sensitivity analyses stratified models by sex, age, and managerial position to test the robustness of associations. Perception of poor SLS was associated with poor SRH [OR 2.39 (95 % CI 1.95-2.92)]. Although attenuated following adjustment for measures of work-related stress and other confounders [OR 1.60 (95 % CI 1.26-2.04)], the magnitude, direction, and significance of this association remained robust in stratified models in most subgroups. SLS appears to be relevant to health in the workplace. Leadership behavior may represent a promising area for future research with potential for promoting better health in a large segment of the adult population.

Eradication of Yaws: Historical Efforts and Achieving WHO's 2020 Target

PubMed Central

Asiedu, Kingsley; Fitzpatrick, Christopher; Jannin, Jean

2014-01-01

Background Yaws, one of the 17 neglected tropical diseases (NTDs), is targeted for eradication by 2020 in resolution WHA66.12 of the World Health Assembly (2013) and the WHO roadmap on NTDs (2012). The disease frequently affects children who live in poor socioeconomic conditions. Between 1952 and 1964, WHO and the United Nations Children's Fund (UNICEF) led a global eradication campaign using injectable benzathine penicillin. Recent developments using a single dose of oral azithromycin have renewed optimism that eradication can be achieved through a comprehensive large-scale treatment strategy. We review historical efforts to eradicate yaws and argue that this goal is now technically feasible using new tools and with the favorable environment for control of NTDs. We also summarize the work of WHO's Department of Control of Neglected Tropical Diseases in leading the renewed eradication initiative and call on the international community to support efforts to achieve the 2020 eradication goal. The critical factor remains access to azithromycin. Excluding medicines, the financial cost of yaws eradication could be as little as US$ 100 million. Conclusions The development of new tools has renewed interest in eradication of yaws; with modest support, the WHO eradication target of 2020 can be achieved. PMID:25254372

Psychosocial work conditions and quality of life among primary health care employees: a cross sectional study.

PubMed

Teles, Mariza Alves Barbosa; Barbosa, Mirna Rossi; Vargas, Andréa Maria Duarte; Gomes, Viviane Elizângela; Ferreira, Efigênia Ferreira e; Martins, Andréa Maria Eleutério de Barros Lima; Ferreira, Raquel Conceição

2014-05-15

Workers in Primary Health Care are often exposed to stressful conditions at work. This study investigated the association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers. This cross-sectional study included all 797 Primary Health Care workers of a medium-sized city, Brazil: doctors, nurses, nursing technicians and nursing assistants, dentists, oral health technicians, and auxiliary oral hygienists, and community health workers. Data were collected by interviews. Quality of life was assessed using the WHOQOL-BREF; general quality of life, as well as the physical, psychological, social and environmental domains were considered, with scores from 0 to 100. Higher scores indicate a better quality of life. Poor quality of life was defined by the lowest quartiles of the WHOQOL score distributions for each of the domains. Adverse psychosocial work conditions were investigated by the Effort-Reward Imbalance model. Associations were verified using multiple logistic regression. Poor quality of life was observed in 117 (15.4%) workers. Workers with imbalanced effort-reward (high effort/low reward) had an increased probability of general poor quality of life (OR = 1.91; 1.07–3.42), and in the physical (OR = 1.62; 1.02–2.66), and environmental (OR = 2.39; 1.37–4.16) domains; those with low effort/low reward demonstrated a greater probability of poor quality of life in the social domain (OR = 1.82; 1.00–3.30). Workers with overcommitment at work had an increased likelihood of poor quality of life in the physical (OR = 1.55, 1.06–2.26) and environmental (OR = 1.69; 1.08–2.65) domains. These associations were independent of individual characteristics, job characteristics, lifestyle, perception of general health, or psychological and biological functions. There is an association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers.

Psychosocial work conditions and quality of life among primary health care employees: a cross sectional study

PubMed Central

2014-01-01

Background Workers in Primary Health Care are often exposed to stressful conditions at work. This study investigated the association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers. Methods This cross-sectional study included all 797 Primary Health Care workers of a medium-sized city, Brazil: doctors, nurses, nursing technicians and nursing assistants, dentists, oral health technicians, and auxiliary oral hygienists, and community health workers. Data were collected by interviews. Quality of life was assessed using the WHOQOL-BREF; general quality of life, as well as the physical, psychological, social and environmental domains were considered, with scores from 0 to 100. Higher scores indicate a better quality of life. Poor quality of life was defined by the lowest quartiles of the WHOQOL score distributions for each of the domains. Adverse psychosocial work conditions were investigated by the Effort-Reward Imbalance model. Associations were verified using multiple logistic regression. Results Poor quality of life was observed in 117 (15.4%) workers. Workers with imbalanced effort-reward (high effort/low reward) had an increased probability of general poor quality of life (OR = 1.91; 1.07–3.42), and in the physical (OR = 1.62; 1.02–2.66), and environmental (OR = 2.39; 1.37–4.16) domains; those with low effort/low reward demonstrated a greater probability of poor quality of life in the social domain (OR = 1.82; 1.00–3.30). Workers with overcommitment at work had an increased likelihood of poor quality of life in the physical (OR = 1.55, 1.06–2.26) and environmental (OR = 1.69; 1.08–2.65) domains. These associations were independent of individual characteristics, job characteristics, lifestyle, perception of general health, or psychological and biological functions. Conclusions There is an association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers. PMID:24884707

[Rethinking clinical research in surgical oncology. From comic opera to quality control].

PubMed

Evrard, Serge

2016-01-01

The evidence base for the effectiveness of surgical interventions is relatively poor and data from large, randomized prospective studies are rare with often a poor quality. Many efforts have been made to increase the number of high quality randomized trials in surgery and theoretical proposals have been put forward to improve the situation, but practical implementation of these proposals is seriously lacking. The consequences of this policy are not trivial; with very few patients included in surgical oncology trials, this represents wasted opportunity for advances in cancer treatment. In this review, we cover the difficulties inherent to clinical research in surgical oncology, such as quality control, equipoise, accrual, and funding and promote alternative designs to the randomized controlled trial. Although the classic randomized controlled trial has a valid but limited place in surgical oncology, other prospective designs need to be promoted as a new deal. This new deal not only implicates surgeons but also journal editors, tender jury, as well as regulatory bodies to cover legal gaps currently surrounding surgical innovation. Copyright © 2015 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Mass drug administration and the global control of schistosomiasis: successes, limitations and clinical outcomes.

PubMed

Olveda, David U; McManus, Donald P; Ross, Allen G P

2016-12-01

Preventive chemotherapy is advocated for the global control and elimination of schistosomiasis. Despite the well known short-term benefits of treating patients for schistosomiasis, the impact of mass drug administration (MDA) campaigns to control the disease in the long term remains unresolved. Many studies have advocated the success of MDA programs in order to attract donor funds for elimination efforts but such successes are often short-lived given the drug does not alter the life cycle of the organism or prevent reinfection. Within a matter of months to years after halting treatment, the prevalence, intensity of infection and morbidity of disease return to baseline levels. Other mitigating factors contribute to the failings of MDA campaigns namely: poverty, poor drug coverage, poor drug compliance, and, in the case of Asiatic schistosomiasis, zoonotic transmission. Genetic and innate and acquired immunologic mechanisms complicate the epidemiologic picture of schistosomiasis globally, and may contribute indirectly to MDA shortcomings. The possibility of drug resistance is an ever present concern because of the sole reliance on one drug, praziquantel. Preventive chemotherapy is advocated for the global control and elimination of schistosomiasis. The short-term benefits of MDA campaigns are well documented but the long-term benefits are questionable.

How leaders self-regulate their task performance: evidence that power promotes diligence, depletion, and disdain.

PubMed

DeWall, C Nathan; Baumeister, Roy F; Mead, Nicole L; Vohs, Kathleen D

2011-01-01

When leaders perform solitary tasks, do they self-regulate to maximize their effort, or do they reduce effort and conserve their resources? Our model suggests that power motivates self-regulation toward effective performance-unless the task is perceived as unworthy of leaders. Our 1st studies showed that power improves self-regulation and performance, even when resources for self-regulation are low (ego depletion). Additional studies showed that leaders sometimes disdain tasks they deem unworthy, by withholding effort (and therefore performing poorly). Ironically, during ego depletion, leaders skip the appraisal and, therefore, work hard regardless of task suitability, so that depleted leaders sometimes outperform nondepleted ones. Our final studies replicated these patterns with different tasks and even with simple manipulation of framing and perception of the same task (Experiment 5). Experiment 4 also showed that the continued high exertion of leaders when depleted takes a heavy toll, resulting in larger impairments later. The judicious expenditure of self-control resources among powerful people may help them prioritize their efforts to pursue their goals effectively. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

An evaluation of the cost-effectiveness of policy navigators to improve access to care for the poor in the Philippines.

PubMed

Solon, Orville; Peabody, John W; Woo, Kimberly; Quimbo, Stella A; Florentino, Jhiedon; Shimkhada, Riti

2009-09-01

Even when health insurance coverage is available, health policies may not be effective at increasing coverage among vulnerable populations. New approaches are needed to improve access to care. We experimentally introduced a novel intervention that uses Policy Navigators to increase health insurance enrollment in a poor population. We used data from the Quality Improvement Demonstration Study (QIDS), a randomized experiment taking place at the district level in the Visayas region of the Philippines. In two arms of the study, we compared the effects of introducing Policy Navigators to controls. The Policy Navigators advocated for improved access to care by providing regular system-level expertise directly to the policy-makers, municipal mayors and governors responsible for paying for and enrolling poor households into the health insurance program. Using regression models, we compared levels of enrollment in our intervention versus control sites. We also assessed the cost-effectiveness of marginal increases in enrollment. We found that Policy Navigators improved enrollment in health insurance between 39% and 102% compared to the controls. Policy navigators were cost-effective at 0.86 USD per enrollee. However, supplementary national government campaigns, which were implemented to further increase coverage, attenuated normal enrollment efforts. Policy Navigators appear to be effective in improving access to care and their success underscores the importance of local-level strategies for improving enrollment.

An Evaluation of the Cost-effectiveness of Policy Navigators to Improve Access to Care for the Poor in the Philippines

PubMed Central

Solon, Orville; Peabody, John W.; Woo, Kimberly; Quimbo, Stella A.; Florentino, Jhiedon; Shimkhada, Riti

2009-01-01

Objectives Even when health insurance coverage is available, health policies may not be effective at increasing coverage among vulnerable populations. New approaches are needed to improve access to care. We experimentally introduced a novel intervention that uses Policy Navigators to increase health insurance enrollment in a poor population. Methods We used data from the Quality Improvement Demonstration Study (QIDS), a randomized experiment taking place at the district level in the Visayas region of the Philippines. In two arms of the study, we compared the effects of introducing Policy Navigators to controls. The Policy Navigators advocated for improved access to care by providing regular system-level expertise directly to the policy-makers, municipal mayors and governors responsible for paying for and enrolling poor households into the health insurance program. Using regression models, we compared levels of enrollment in our intervention versus control sites. We also assessed the cost effectiveness of marginal increases in enrollment. Results We found that Policy Navigators improved enrollment in health insurance between 39 and 102% compared to the controls. Policy navigators were cost-effective at $0.86 USD per enrollee. However, supplementary national government campaigns, which were implemented to further increase coverage, attenuated normal enrollment efforts. Conclusion Policy Navigators appear to be effective in improving access to care and their success underscores the importance of local-level strategies for improving enrollment. PMID:19349090

Executive functioning, emotion regulation, eating self-regulation, and weight status in low-income preschool children: How do they relate?

PubMed Central

Hughes, Sheryl O.; Power, Thomas G.; O’Connor, Teresia M.; Fisher, Jennifer Orlet

2016-01-01

The purpose of the present study was to examine relationships between child eating self-regulation, child non-eating self-regulation, and child BMIz in a low-income sample of Hispanic families with preschoolers. The eating in the absence of hunger task as well as parent-report of child satiety responsiveness and food responsiveness were used to assess child eating self-regulation. Two laboratory tasks assessing executive functioning, a parent questionnaire assessing child effortful control (a temperament dimension related to executive functioning), and the delay of gratification and gift delay tasks assessing child emotion regulation were used to assess child non-eating self-regulation. Bivariate correlations were run among all variables in the study. Hierarchical linear regression analyses assessed: 1) child eating self-regulation associations with the demographic, executive functioning, effortful control, and emotion regulation measures; and 2) child BMI z-scores associations with executive functioning, effortful control, emotion regulation measures, and eating self-regulation measures. Within child eating self-regulation, only the two parent-report measures were related. Low to moderate positive correlations were found between measures of executive functioning, effortful control, and emotion regulation. Only three relationships were found between child eating self-regulation and other forms of child self-regulation: eating in the absence of hunger was positively associated with delay of gratification, and poor regulation on the gift delay task was associated positively with maternal reports of food responsiveness and negatively with parent-reports of satiety responsiveness. Regression analyses showed that child eating self-regulation was associated with child BMIz but other forms of child self-regulation were not. Implications for understanding the role of self-regulation in the development of child obesity are discussed. PMID:25596501

Executive functioning, emotion regulation, eating self-regulation, and weight status in low-income preschool children: how do they relate?

PubMed

Hughes, Sheryl O; Power, Thomas G; O'Connor, Teresia M; Orlet Fisher, Jennifer

2015-06-01

The purpose of the present study was to examine relationships between child eating self-regulation, child non-eating self-regulation, and child BMIz in a low-income sample of Hispanic families with preschoolers. The eating in the absence of hunger task as well as parent-report of child satiety responsiveness and food responsiveness were used to assess child eating self-regulation. Two laboratory tasks assessing executive functioning, a parent questionnaire assessing child effortful control (a temperament dimension related to executive functioning), and the delay of gratification and gift delay tasks assessing child emotion regulation were used to assess child non-eating self-regulation. Bivariate correlations were run among all variables in the study. Hierarchical linear regression analyses assessed: (1) child eating self-regulation associations with the demographic, executive functioning, effortful control, and emotion regulation measures; and (2) child BMI z-score associations with executive functioning, effortful control, emotion regulation measures, and eating self-regulation measures. Within child eating self-regulation, only the two parent-report measures were related. Low to moderate positive correlations were found between measures of executive functioning, effortful control, and emotion regulation. Only three relationships were found between child eating self-regulation and other forms of child self-regulation: eating in the absence of hunger was positively associated with delay of gratification, and poor regulation on the gift delay task was associated positively with maternal reports of food responsiveness and negatively with parent-reports of satiety responsiveness. Regression analyses showed that child eating self-regulation was associated with child BMIz but other forms of child self-regulation were not. Implications for understanding the role of self-regulation in the development of child obesity are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Reviewing the effort-reward imbalance model: drawing up the balance of 45 empirical studies.

PubMed

van Vegchel, Natasja; de Jonge, Jan; Bosma, Hans; Schaufeli, Wilmar

2005-03-01

The present paper provides a review of 45 studies on the Effort-Reward Imbalance (ERI) Model published from 1986 to 2003 (inclusive). In 1986, the ERI Model was introduced by Siegrist et al. (Biological and Psychological Factors in Cardiovascular Disease, Springer, Berlin, 1986, pp. 104-126; Social Science & Medicine 22 (1986) 247). The central tenet of the ERI Model is that an imbalance between (high) efforts and (low) rewards leads to (sustained) strain reactions. Besides efforts and rewards, overcommitment (i.e., a personality characteristic) is a crucial aspect of the model. Essentially, the ERI Model contains three main assumptions, which could be labeled as (1) the extrinsic ERI hypothesis: high efforts in combination with low rewards increase the risk of poor health, (2) the intrinsic overcommitment hypothesis: a high level of overcommitment may increase the risk of poor health, and (3) the interaction hypothesis: employees reporting an extrinsic ERI and a high level of overcommitment have an even higher risk of poor health. The review showed that the extrinsic ERI hypothesis has gained considerable empirical support. Results for overcommitment remain inconsistent and the moderating effect of overcommitment on the relation between ERI and employee health has been scarcely examined. Based on these review results suggestions for future research are proposed.

[The year 2000: one billion couples of child-bearing age].

PubMed

Lintong, L J

1988-04-01

Out of 1 billion couples there are only 124 million who use modern and effective contraceptives. World abortions number 33 million/year. 250 million sexually active women of child-bearing age in developing countries outside China do not use modern and effective contraceptives. Fertility control costs on the average US$2.5 billion a year in each developing country, 20% of which is assistance from developed countries. Expanding the family planning service to the 250 million sexually active child-bearing aged women costs an additional U.S. $5 billion yearly. A family planning accessibility survey was conducted by the Population Crisis Committee. PCC divided the countries into 2 categories: Developed and developing countries. The 110 countries (15 developed and 95 developing) covered 96% of the world population. The survey placed the countries in 5 classes according to accessibility levels: Excellent, good, fair, poor, very poor. The developed countries were analyzed according to effective contraceptive methods, service to the poor and minorities, sex education in the schools, and family planning information and advertisement. The developing countries were analyzed according to effective contraceptive methods, performance of service and distribution, public information and education, private sector participation, government finance and policies. Of the 15 developed countries, 43% were excellent, 22% good, 24% fair, and 2% poor. Of the 95 developing countries, 5 were excellent, 10 good, 16 fair, and 64 either poor or very poor countries in respect to family planning accessibility. In the face of a population explosion in the year 2000, many countries lack of government support for family planning programs. After 30 years of world effort in population control, half of the world population still has no effective family planning services.

The relationship between signal quality and physical condition: is sexual signalling honest in the three-spined stickleback?

PubMed

Candolin

1999-12-01

Honest sexual signalling requires that the level of advertisement reveals mate quality. In the three-spined stickleback, Gasterosteus aculeatus, females base their mate choice mainly on the intensity of the males' red breeding coloration. Different results have, however, been obtained on the relationship between red breeding coloration and physical condition. In this study, the relationship was curvilinear in a natural population, with males in good and poor condition (measured as lipid content) having larger red areas than males of intermediate condition. By manipulating food intake and thus male condition prior to breeding, I further show that poor condition can induce an increase in signalling effort. This effect was further strengthened when the predation cost of signalling was increased by exposing the males to predators. This suggests that the reason for the high signalling effort of males in poor condition is their low probability of future reproduction and thus lower cost of signalling in terms of loss of future reproductive opportunities. Males in poor condition signal as a terminal effort and take larger risks and invest more in current reproduction than males in good condition. Finally, I discuss whether an effect of decreasing residual reproductive value on signalling effort could result in the breakdown of the honesty of the signal. Copyright 1999 The Association for the Study of Animal Behaviour.

Airway smooth muscle: a potential target for asthma therapy.

PubMed

Dowell, Maria L; Lavoie, Tera L; Solway, Julian; Krishnan, Ramaswamy

2014-01-01

Asthma is a major public health problem that afflicts nearly one in 20 people worldwide. Despite available treatments, asthma symptoms remain poorly controlled in a significant minority of asthma patients, especially those with severe disease. Accordingly, much ongoing effort has been directed at developing new therapeutic strategies; these efforts are described in detail below. Although mucus hypersecretion is an important component of asthma pathobiology, the primary mechanism of morbidity and mortality in asthma is excessive narrowing of the airway. The key end- effector of excessive airway narrowing is airway smooth muscle (ASM) contraction; overcoming ASM contraction is therefore a prominent therapeutic strategy. Here, we review exciting new advances aimed at ASM relaxation. Exciting advances in ASM biology have identified new therapeutic targets for the prevention or reversal of bronchoconstriction in asthma.

Perceived discrimination and health-related quality-of-life: gender differences among older African Americans.

PubMed

Coley, Sheryl L; Mendes de Leon, Carlos F; Ward, Earlise C; Barnes, Lisa L; Skarupski, Kimberly A; Jacobs, Elizabeth A

2017-12-01

Emerging data suggest that African-American women may fare worse than African-American men in health-related quality-of-life (HRQOL). Perceived discrimination is an important contributor to poor health overall among African Americans, but few studies examined the intersecting effects of perceived discrimination and gender in explaining HRQOL disparities. We investigated gender differences in HRQOL and tested whether perceived discrimination accounted for these differences. We examined data from the Chicago Health and Aging Project in which 5652 African-American adults aged 65 and older completed structured questionnaires about demographic and socioeconomic characteristics, HRQOL, perceived discrimination, and health-related variables. Logistic regression models were used to identify associations between perceived discrimination and gender differences in poor HRQOL outcomes (defined as 14+ unhealthy days in overall, physical, or mental health over the past 30 days) when controlling for the other variables. More women reported poor overall HRQOL than men (24 vs. 16% respectively). Higher perceived discrimination was significantly associated with worse overall HRQOL (OR 1.11; 95% CI 1.08, 1.15), with stronger effects for women in overall and mental HRQOL. These gender disparities remained significant until controlling for potentially confounding variables. Perceived discrimination did not account for gender differences in poor physical HRQOL. Perceived discrimination is associated with poor HRQOL in older African Americans, with this association appearing stronger in women than men for mental HRQOL. These findings warrant further investigation of effects of perceived discrimination in gender disparities in overall health, and such research can inform and guide efforts for reducing these disparities.

Anterior cingulate cortex supports effort allocation towards a qualitatively preferred option.

PubMed

Hart, Evan E; Gerson, Julian O; Zoken, Yael; Garcia, Marisella; Izquierdo, Alicia

2017-07-01

The anterior cingulate cortex (ACC) is known to be involved in effortful choice, yet its role in cost-benefit evaluation of qualitatively different rewards (more/less preferred), beyond magnitude differences (larger/smaller), is poorly understood. Selecting between qualitatively different options is a decision type commonly faced by humans. Here, we assessed the role of ACC on a task that has primarily been used to probe striatal function in motivation. Rats were trained to stable performance on a progressive ratio schedule for sucrose pellets and were then given sham surgeries (control) or excitotoxic NMDA lesions of ACC. Subsequently, a choice was introduced: chow was concurrently available while animals could work for the preferred sucrose pellets. ACC lesions produced a significant decrease in lever presses for sucrose pellets compared to control, whereas chow consumption was unaffected. Lesions had no effect on sucrose pellet preference when both options were freely available. When laboratory chow was not concurrently available, ACC-lesioned rats exhibited similar lever pressing as controls. During a test under specific satiety for sucrose pellets, ACC-lesioned rats also showed intact devaluation effects. The effects of ACC lesions in our task are not mediated by decreased appetite, a change in food preference, a failure to update value or a learning deficit. Taken together, we found that ACC lesions decreased effort for a qualitatively preferred option. These results are discussed with reference to effects of striatal manipulations and our recent report of a role for basolateral amygdala in effortful choice. © 2017 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

Agents of Change: The Role of Healthcare Workers in the Prevention of Nosocomial and Occupational Tuberculosis

PubMed Central

Nathavitharana, Ruvandhi R.; Bond, Patricia; Dramowski, Angela; Kotze, Koot; Lederer, Philip; Oxley, Ingrid; Peters, Jurgens A.; Rossouw, Chanel; van der Westhuizen, Helene-Mari; Willems, Bart; Ting, Tiong Xun; von Delft, Arne; von Delft, Dalene; Duarte, Raquel; Nardell, Edward; Zumla, Alimuddin

2018-01-01

Healthcare workers (HCWs) play a central role in global tuberculosis (TB) elimination efforts but their contributions are undermined by occupational TB. HCWs have higher rates of latent and active TB than the general population due to persistent occupational TB exposure, particularly in settings where there is a high prevalence of undiagnosed TB in healthcare facilities and TB infection control (TB-IC) programmes are absent or poorly implemented. Occupational health programmes in high TB burden settings are often weak or non-existent and thus data that record the extent of the increased risk of occupational TB globally are scarce. HCWs represent a limited resource in high TB burden settings and occupational TB can lead to workforce attrition. Stigma plays a role in delayed diagnosis, poor treatment outcomes and impaired wellbeing in HCWs who develop TB. Ensuring the prioritization and implementation of TB-IC interventions and occupational health programmes, which include robust monitoring and evaluation, is critical to reduce nosocomial TB transmission to patients and HCWs. The provision of preventive therapy for HCWs with latent TB infection can also prevent progression to active TB. Unlike other patient groups, HCWs are in a unique position to serve as agents of change to raise awareness, advocate for necessary resource allocation and implement TB-IC interventions, with appropriate support from dedicated TB-IC officers at the facility and national TB programme level. Students and community health workers (CHWs) must be engaged and involved in these efforts. Nosocomial TB transmission is an urgent public health problem and adopting rights-based approaches can be helpful. However, these efforts cannot succeed without increased political will, supportive legal frameworks and financial investments to support HCWs in efforts to decrease TB transmission. PMID:28256382

Agents of change: The role of healthcare workers in the prevention of nosocomial and occupational tuberculosis.

PubMed

Nathavitharana, Ruvandhi R; Bond, Patricia; Dramowski, Angela; Kotze, Koot; Lederer, Philip; Oxley, Ingrid; Peters, Jurgens A; Rossouw, Chanel; van der Westhuizen, Helene-Mari; Willems, Bart; Ting, Tiong Xun; von Delft, Arne; von Delft, Dalene; Duarte, Raquel; Nardell, Edward; Zumla, Alimuddin

2017-03-01

Healthcare workers (HCWs) play a central role in global tuberculosis (TB) elimination efforts but their contributions are undermined by occupational TB. HCWs have higher rates of latent and active TB than the general population due to persistent occupational TB exposure, particularly in settings where there is a high prevalence of undiagnosed TB in healthcare facilities and TB infection control (TB-IC) programmes are absent or poorly implemented. Occupational health programmes in high TB burden settings are often weak or non-existent and thus data that record the extent of the increased risk of occupational TB globally are scarce. HCWs represent a limited resource in high TB burden settings and occupational TB can lead to workforce attrition. Stigma plays a role in delayed diagnosis, poor treatment outcomes and impaired well-being in HCWs who develop TB. Ensuring the prioritization and implementation of TB-IC interventions and occupational health programmes, which include robust monitoring and evaluation, is critical to reduce nosocomial TB transmission to patients and HCWs. The provision of preventive therapy for HCWs with latent TB infection (LTBI) can also prevent progression to active TB. Unlike other patient groups, HCWs are in a unique position to serve as agents of change to raise awareness, advocate for necessary resource allocation and implement TB-IC interventions, with appropriate support from dedicated TB-IC officers at the facility and national TB programme level. Students and community health workers (CHWs) must be engaged and involved in these efforts. Nosocomial TB transmission is an urgent public health problem and adopting rights-based approaches can be helpful. However, these efforts cannot succeed without increased political will, supportive legal frameworks and financial investments to support HCWs in efforts to decrease TB transmission. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Employee worktime control moderates the effects of job strain and effort-reward imbalance on sickness absence: the 10-town study.

PubMed

Ala-Mursula, Leena; Vahtera, Jussi; Linna, Anne; Pentti, Jaana; Kivimäki, Mika

2005-10-01

To examine whether the effects of work stress on sickness absence vary by the level of control the employees have over their working times. Prospective cohort study. A survey of job strain, effort-reward imbalance, and control over daily working hours and days off was carried out in 2000-01. The survey responses were linked with registered data on the number of medically certified (>3 days) sickness absences from one year before the survey until the end of 2003. The mean follow up period was 28.2 (SD 8.1) months. Adjustments were made for demographics and behavioural health risks. Aggregated measures of worktime control according to workplaces were used to control for differences in reactivity and response style. Ten towns in Finland. 16 139 public sector employees who had no medically certified sickness absences in the year preceding the survey. Among the women, individually measured control over daily working hours and days off moderated the association between work stress and sickness absence. The combination of high stress and good worktime control was associated with lower absence rates than a combination of high stress and poor worktime control. This finding was replicated in the analyses using workplace aggregates of worktime control. Among the men, the findings were less consistent and not replicable using aggregated measures of worktime control. Good control over working times reduces the adverse effect of work stress on sickness absence especially among female employees.

Crosslinked hydrogels-a promising class of insoluble solid molecular dispersion carriers for enhancing the delivery of poorly soluble drugs.

PubMed

Sun, Dajun D; Lee, Ping I

2014-02-01

Water-insoluble materials containing amorphous solid dispersions (ASD) are an emerging category of drug carriers which can effectively improve dissolution kinetics and kinetic solubility of poorly soluble drugs. ASDs based on water-insoluble crosslinked hydrogels have unique features in contrast to those based on conventional water-soluble and water-insoluble carriers. For example, solid molecular dispersions of poorly soluble drugs in poly(2-hydroxyethyl methacrylate) (PHEMA) can maintain a high level of supersaturation over a prolonged period of time via a feedback-controlled diffusion mechanism thus avoiding the initial surge of supersaturation followed by a sharp decline in drug concentration typically encountered with ASDs based on water-soluble polymers. The creation of both immediate- and controlled-release ASD dosage forms is also achievable with the PHEMA based hydrogels. So far, ASD systems based on glassy PHEMA have been shown to be very effective in retarding precipitation of amorphous drugs in the solid state to achieve a robust physical stability. This review summarizes recent research efforts in investigating the potential of developing crosslinked PHEMA hydrogels as a promising alternative to conventional water-soluble ASD carriers, and a related finding that the rate of supersaturation generation does affect the kinetic solubility profiles implications to hydrogel based ASDs.

Crosslinked hydrogels—a promising class of insoluble solid molecular dispersion carriers for enhancing the delivery of poorly soluble drugs

PubMed Central

Sun, Dajun D.; Lee, Ping I.

2014-01-01

Water-insoluble materials containing amorphous solid dispersions (ASD) are an emerging category of drug carriers which can effectively improve dissolution kinetics and kinetic solubility of poorly soluble drugs. ASDs based on water-insoluble crosslinked hydrogels have unique features in contrast to those based on conventional water-soluble and water-insoluble carriers. For example, solid molecular dispersions of poorly soluble drugs in poly(2-hydroxyethyl methacrylate) (PHEMA) can maintain a high level of supersaturation over a prolonged period of time via a feedback-controlled diffusion mechanism thus avoiding the initial surge of supersaturation followed by a sharp decline in drug concentration typically encountered with ASDs based on water-soluble polymers. The creation of both immediate- and controlled-release ASD dosage forms is also achievable with the PHEMA based hydrogels. So far, ASD systems based on glassy PHEMA have been shown to be very effective in retarding precipitation of amorphous drugs in the solid state to achieve a robust physical stability. This review summarizes recent research efforts in investigating the potential of developing crosslinked PHEMA hydrogels as a promising alternative to conventional water-soluble ASD carriers, and a related finding that the rate of supersaturation generation does affect the kinetic solubility profiles implications to hydrogel based ASDs. PMID:26579361

Validating the short measure of the Effort-Reward Imbalance Questionnaire in older workers in the context of New Zealand.

PubMed

Li, Jian; Herr, Raphael M; Allen, Joanne; Stephens, Christine; Alpass, Fiona

2017-11-25

The objective of this study was to validate a short version of the Effort-Reward-Imbalance (ERI) questionnaire in the context of New Zealand among older full-time and part-time employees. Data were collected from 1694 adults aged 48-83 years (mean 60 years, 53% female) who reported being in full- or part-time paid employment in the 2010 wave of the New Zealand Health, Work and Retirement study. Scale reliability was evaluated by item-total correlations and Cronbach's alpha. Factorial validity was assessed using multi-group confirmatory factor analyses assessing nested models of configural, metric, scalar and strict invariance across full- and part-time employment groups. Logistic regressions estimated associations of effort-reward ratio and over-commitment with poor physical/mental health, and depressive symptoms. Internal consistency of ERI scales was high across employment groups: effort 0.78-0.76; reward 0.81-0.77, and over-commitment 0.83-0.80. The three-factor model displayed acceptable fit in the overall sample (X 2 /df = 10.31; CFI = 0.95; TLI = 0.94; RMSEA = 0.075), and decrements in model fit indices provided evidence for strict invariance of the three-factor ERI model across full-time and part-time employment groups. High effort-reward ratio scores were consistently associated with poor mental health and depressive symptoms for both employment groups. High over-commitment was associated with poor mental health and depressive symptoms in both groups and also with poor physical health in the full-time employment group. The short ERI questionnaire appears to be a valid instrument to assess adverse psychosocial work characteristics in old full-time and part-time employees in New Zealand.

Validating the short measure of the Effort-Reward Imbalance Questionnaire in older workers in the context of New Zealand

PubMed Central

Li, Jian; Herr, Raphael M.; Allen, Joanne; Stephens, Christine; Alpass, Fiona

2017-01-01

Objectives: The objective of this study was to validate a short version of the Effort-Reward-Imbalance (ERI) questionnaire in the context of New Zealand among older full-time and part-time employees. Methods: Data were collected from 1694 adults aged 48-83 years (mean 60 years, 53% female) who reported being in full- or part-time paid employment in the 2010 wave of the New Zealand Health, Work and Retirement study. Scale reliability was evaluated by item-total correlations and Cronbach's alpha. Factorial validity was assessed using multi-group confirmatory factor analyses assessing nested models of configural, metric, scalar and strict invariance across full- and part-time employment groups. Logistic regressions estimated associations of effort-reward ratio and over-commitment with poor physical/mental health, and depressive symptoms. Results: Internal consistency of ERI scales was high across employment groups: effort 0.78-0.76; reward 0.81-0.77, and over-commitment 0.83-0.80. The three-factor model displayed acceptable fit in the overall sample (X2/df = 10.31; CFI = 0.95; TLI = 0.94; RMSEA = 0.075), and decrements in model fit indices provided evidence for strict invariance of the three-factor ERI model across full-time and part-time employment groups. High effort-reward ratio scores were consistently associated with poor mental health and depressive symptoms for both employment groups. High over-commitment was associated with poor mental health and depressive symptoms in both groups and also with poor physical health in the full-time employment group. Conclusions: The short ERI questionnaire appears to be a valid instrument to assess adverse psychosocial work characteristics in old full-time and part-time employees in New Zealand. PMID:28835574

Infection Control for Drug-Resistant Tuberculosis: Early Diagnosis and Treatment Is the Key

PubMed Central

van Cutsem, Gilles; Isaakidis, Petros; Farley, Jason; Nardell, Ed; Volchenkov, Grigory; Cox, Helen

2016-01-01

Multidrug-resistant (MDR) tuberculosis, “Ebola with wings,” is a significant threat to tuberculosis control efforts. Previous prevailing views that resistance was mainly acquired through poor treatment led to decades of focus on drug-sensitive rather than drug-resistant (DR) tuberculosis, driven by the World Health Organization's directly observed therapy, short course strategy. The paradigm has shifted toward recognition that most DR tuberculosis is transmitted and that there is a need for increased efforts to control DR tuberculosis. Yet most people with DR tuberculosis are untested and untreated, driving transmission in the community and in health systems in high-burden settings. The risk of nosocomial transmission is high for patients and staff alike. Lowering transmission risk for MDR tuberculosis requires a combination approach centered on rapid identification of active tuberculosis disease and tuberculosis drug resistance, followed by rapid initiation of appropriate treatment and adherence support, complemented by universal tuberculosis infection control measures in healthcare facilities. It also requires a second paradigm shift, from the classic infection control hierarchy to a novel, decentralized approach across the continuum from early diagnosis and treatment to community awareness and support. A massive scale-up of rapid diagnosis and treatment is necessary to control the MDR tuberculosis epidemic. This will not be possible without intense efforts toward the implementation of decentralized, ambulatory models of care. Increasing political will and resources need to be accompanied by a paradigm shift. Instead of focusing on diagnosed cases, recognition that transmission is driven largely by undiagnosed, untreated cases, both in the community and in healthcare settings, is necessary. This article discusses this comprehensive approach, strategies available, and associated challenges. PMID:27118853

A spatial method to calculate small-scale fisheries effort in data poor scenarios.

PubMed

Johnson, Andrew Frederick; Moreno-Báez, Marcia; Giron-Nava, Alfredo; Corominas, Julia; Erisman, Brad; Ezcurra, Exequiel; Aburto-Oropeza, Octavio

2017-01-01

To gauge the collateral impacts of fishing we must know where fishing boats operate and how much they fish. Although small-scale fisheries land approximately the same amount of fish for human consumption as industrial fleets globally, methods of estimating their fishing effort are comparatively poor. We present an accessible, spatial method of calculating the effort of small-scale fisheries based on two simple measures that are available, or at least easily estimated, in even the most data-poor fisheries: the number of boats and the local coastal human population. We illustrate the method using a small-scale fisheries case study from the Gulf of California, Mexico, and show that our measure of Predicted Fishing Effort (PFE), measured as the number of boats operating in a given area per day adjusted by the number of people in local coastal populations, can accurately predict fisheries landings in the Gulf. Comparing our values of PFE to commercial fishery landings throughout the Gulf also indicates that the current number of small-scale fishing boats in the Gulf is approximately double what is required to land theoretical maximum fish biomass. Our method is fishery-type independent and can be used to quantitatively evaluate the efficacy of growth in small-scale fisheries. This new method provides an important first step towards estimating the fishing effort of small-scale fleets globally.

Cost effective means to managing pavements in poor condition.

DOT National Transportation Integrated Search

2014-06-01

Tight budgets and dwindling state and federal revenue hinder efforts of transportation agencies to resurrect pavements in poor : condition. As a stop-gap measure, some agencies simply allow roads to deteriorate to gravel. However, this approach...

The President's Veto of the Minimum Wage Bill: Impact on Poor and Minority Workers.

ERIC Educational Resources Information Center

Shapiro, Isaac

Restoration of an adequate minimum wage remains a critical ingredient in efforts to provide income security for poor and minority workers. The experience of recent years indicates that work does not provide economic security for many poor, Black, and Hispanic workers. National and minority unemployment rates have dropped during the economic…

Attributing discrimination to weight: Associations with well-being, self-care, and disease status in patients with type 2 diabetes mellitus

PubMed Central

Potter, Lindsey; Wallston, Kenneth; Trief, Paula; Ulbrecht, Jan; Juth, Vanessa; Smyth, Joshua

2015-01-01

This study examined the association between attributing self-reported discrimination to weight and diabetes outcomes (glycemic control, diabetes-related distress, and diabetes self-care). A community dwelling sample of 185 adults (mean age = 55.4; 80% White/Caucasian, 65% female) with poorly controlled Type 2 diabetes (HbA1c level ≥7.5%) provided demographic and several self-report measures (including diabetes-related distress, diabetes self-care activities, discrimination, and attributions of discrimination), and had height, weight, and glycated hemoglobin (HbA1c) assessed by trained research staff as part of a larger research study. Individuals who attributed self-reported discrimination to weight had significantly higher HbA1c levels, higher levels of diabetes-related distress, and worse diabetes-related self-care behaviors (general diet, exercise, and glucose testing). These relationships persisted even when controlling for BMI, overall discrimination, depressive symptoms, and demographic characteristics. Results indicate that the perception of weight stigma among individuals with type 2 diabetes is strongly associated with a range of poor diabetes outcomes. Efforts to reduce exposure to and/or teach adaptive coping for weight stigma may benefit patients with type 2 diabetes. PMID:26133488

Five years later: poor women's health care coverage after welfare reform.

PubMed

Mann, Cindy; Hudman, Julie; Salganicoff, Alina; Folsom, Amanda

2002-01-01

The 1996 welfare reform law aims to increase poor women's participation in the work force and encourage their financial independence. Because women's ability to obtain and retain employment is affected by their health status, welfare reform's success is fundamentally tied to poor women's access to health care and to health insurance. Despite this, the rate of uninsurance among poor women with children has grown by half in recent years, leaving 37% of poor mothers uninsured in 2000. Coverage through employer-sponsored insurance has increased only slightly, and Medicaid participation has dropped. Although many factors contributed to this, welfare policies and procedures and low Medicaid eligibility levels had unintended yet significant negative effects on women's health care coverage. The sharp decline in poor women's health care coverage is likely to be one of several health-related issues that Congress will consider as it debates the reauthorization of the welfare law in 2002. Both public and private efforts will be necessary to improve coverage for poor women with children. Much progress has been made during the past 5 years in covering poor and near-poor children, but their parents have been left behind. The same efforts that proved successful for children, including broadening eligibility for coverage and simplifying the application process, can be used to improve the health and well-being of parents and to strengthen their ability to care for and support their families.

You make me tired: An experimental test of the role of interpersonal operant conditioning in fatigue.

PubMed

Lenaert, Bert; Jansen, Rebecca; van Heugten, Caroline M

2018-04-01

Chronic fatigue is highly prevalent in the general population as well as in multiple chronic diseases and psychiatric disorders. Its etiology however remains poorly understood and cannot be explained by biological factors alone. Occurring in a psychosocial context, the experience and communication of fatigue may be shaped by social interactions. In particular, interpersonal operant conditioning may strengthen and perpetuate fatigue complaints. In this experiment, individuals (N = 44) repeatedly rated their currently experienced fatigue while engaging in cognitive effort (working memory task). Subtle social reward was given when fatigue increased relative to the previous rating; or disapproval when fatigue decreased. In the control condition, only neutral feedback was given. Although all participants became more fatigued during cognitive effort, interpersonal operant conditioning led to increased fatigue reporting relative to neutral feedback. This effect occurred independently of conscious awareness. Interestingly, the experimental condition also performed worse on the working memory task. Results suggest that fatigue complaints (and cognitive performance) may become controlled by their consequences such as social reward, and not exclusively by their antecedents such as effort. Results have implications for treatment development and suggest that interpersonal operant conditioning may contribute to fatigue becoming a chronic symptom. Copyright © 2018 Elsevier Ltd. All rights reserved.

Bilharzia in the Philippines: past, present, and future.

PubMed

Olveda, David U; Li, Yuesheng; Olveda, Remigio M; Lam, Alfred K; McManus, Donald P; Chau, Thao N P; Harn, Donald A; Williams, Gail M; Gray, Darren J; Ross, Allen G P

2014-01-01

Schistosomiasis japonica has a long history in the Philippines. In 1975, 24 endemic provinces were identified in the northern, central, and southern islands of the Philippines. More than five million people were at risk, with approximately one million infected. In 2003, new foci of infection were found in two provinces in the north and central areas. For the past 30 years, human mass drug administration (MDA), utilizing the drug praziquantel, has been the mainstay of control in the country. Recent studies have shown that the schistosomiasis prevalence ranges from 1% to 50% within different endemic zones. Severe end-organ morbidity is still present in many endemic areas, particularly in remote villages with poor treatment coverage. Moreover, subtle morbidities such as growth retardation, malnutrition, anemia, and poor cognitive function in infected children persist. There is now strong evidence that large mammals (e.g. water buffaloes, cattle) contribute significantly to disease transmission, complicating control efforts. Given the zoonotic nature of schistosomiasis in the Philippines, it is evident that the incidence, prevalence, and morbidity of the disease will not be controlled by MDA alone. There is a need for innovative cost-effective strategies to control schistosomiasis in the long term. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Lipopolysaccharide Alters Motivated Behavior in a Monetary Reward Task: a Randomized Trial.

PubMed

Lasselin, Julie; Treadway, Michael T; Lacourt, Tamara E; Soop, Anne; Olsson, Mats J; Karshikoff, Bianka; Paues-Göranson, Sofie; Axelsson, John; Dantzer, Robert; Lekander, Mats

2017-03-01

Inflammation-induced sickness is associated with a large set of behavioral alterations; however, its motivational aspects remain poorly explored in humans. The present study assessed the effect of lipopolysaccharide (LPS) administration at a dose of 2 ng/kg of body weight on motivation in 21 healthy human subjects in a double-blinded, placebo (saline)-controlled, cross-over design. Incentive motivation and reward sensitivity were measured using the Effort Expenditure for Rewards Task (EEfRT), in which motivation for high-effort/high-reward trials vs low-effort/low-reward trials are manipulated by variations in reward magnitude and probability to win. Because of the strong interactions between sleepiness and motivation, the role of sleepiness was also determined. As expected, the probability to win predicted the choice to engage in high-effort/high-reward trials; however, this occurred at a greater extent after LPS than after saline administration. This effect was related to the level of sleepiness. Sleepiness increased motivation to choose the high-effort/high-reward mode of response, but only when the probability to win was the highest. LPS had no effect on reward sensitivity either directly or via sleepiness. These results indicate that systemic inflammation induced by LPS administration causes motivational changes in young healthy subjects, which are associated with sleepiness. Thus, despite its association with energy-saving behaviors, sickness allows increased incentive motivation when the effort is deemed worthwhile.

Lipopolysaccharide Alters Motivated Behavior in a Monetary Reward Task: a Randomized Trial

PubMed Central

Lasselin, Julie; Treadway, Michael T; Lacourt, Tamara E; Soop, Anne; Olsson, Mats J; Karshikoff, Bianka; Paues-Göranson, Sofie; Axelsson, John; Dantzer, Robert; Lekander, Mats

2017-01-01

Inflammation-induced sickness is associated with a large set of behavioral alterations; however, its motivational aspects remain poorly explored in humans. The present study assessed the effect of lipopolysaccharide (LPS) administration at a dose of 2 ng/kg of body weight on motivation in 21 healthy human subjects in a double-blinded, placebo (saline)-controlled, cross-over design. Incentive motivation and reward sensitivity were measured using the Effort Expenditure for Rewards Task (EEfRT), in which motivation for high-effort/high-reward trials vs low-effort/low-reward trials are manipulated by variations in reward magnitude and probability to win. Because of the strong interactions between sleepiness and motivation, the role of sleepiness was also determined. As expected, the probability to win predicted the choice to engage in high-effort/high-reward trials; however, this occurred at a greater extent after LPS than after saline administration. This effect was related to the level of sleepiness. Sleepiness increased motivation to choose the high-effort/high-reward mode of response, but only when the probability to win was the highest. LPS had no effect on reward sensitivity either directly or via sleepiness. These results indicate that systemic inflammation induced by LPS administration causes motivational changes in young healthy subjects, which are associated with sleepiness. Thus, despite its association with energy-saving behaviors, sickness allows increased incentive motivation when the effort is deemed worthwhile. PMID:27620550

A unifying theory for cognitive abnormalities in functional neurological disorders, fibromyalgia and chronic fatigue syndrome: systematic review.

PubMed

Teodoro, Tiago; Edwards, Mark J; Isaacs, Jeremy D

2018-05-07

Functional cognitive disorder (FCD) describes cognitive dysfunction in the absence of an organic cause. It is increasingly prevalent in healthcare settings yet its key neuropsychological features have not been reported in large patient cohorts. We hypothesised that cognitive profiles in fibromyalgia (FM), chronic fatigue syndrome (CFS) and functional neurological disorders (FNDs) would provide a template for characterising FCD. We conducted a systematic review of studies with cognition-related outcomes in FM, CFS and FND. We selected 52 studies on FM, 95 on CFS and 39 on FND. We found a general discordance between high rates of subjective cognitive symptoms, including forgetfulness, distractibility and word-finding difficulties, and inconsistent objective neuropsychological deficits. Objective deficits were reported, including poor selective and divided attention, slow information processing and vulnerability to distraction. In some studies, cognitive performance was inversely correlated with pain, exertion and fatigue. Performance validity testing demonstrated poor effort in only a minority of subjects, and patients with CFS showed a heightened perception of effort. The cognitive profiles of FM, CFS and non-cognitive FND are similar to the proposed features of FCD, suggesting common mechanistic underpinnings. Similar findings have been reported in patients with mild traumatic brain injury and whiplash. We hypothesise that pain, fatigue and excessive interoceptive monitoring produce a decrease in externally directed attention. This increases susceptibility to distraction and slows information processing, interfering with cognitive function, in particular multitasking. Routine cognitive processes are experienced as unduly effortful. This may reflect a switch from an automatic to a less efficient controlled or explicit cognitive mode, a mechanism that has also been proposed for impaired motor control in FND. These experiences might then be overinterpreted due to memory perfectionism and heightened self-monitoring of cognitive performance. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Poor Performance in Mathematics: Is There a Basis for a Self-Worth Explanation for Women?

ERIC Educational Resources Information Center

Thompson, Ted; Dinnel, Dale L.

2007-01-01

The self-worth theory of achievement motivation holds that in situations in which poor performance is likely to reveal low ability, certain students (known as self-worth protective students) intentionally withdraw effort in order to avoid the negative implications of poor performance in terms of damage to self-worth. In this study, evidence of…

School Feeding and Educational Access in Rural Ghana: Is Poor Targeting and Delivery Limiting Impact?

ERIC Educational Resources Information Center

Essuman, Ato; Bosumtwi-Sam, Cynthia

2013-01-01

In an effort to address social imbalances and equity in Ghana's education delivery and to achieve her Education for All (EFA) agenda, some pro-poor programmes have been introduced. Among these is the Ghana School Feeding Programme (GSFP) that aims among others, at providing safety nets for the poor, increasing school enrolment in addition to…

Evaluation of task shifting in community-based DOTS program as an effective control strategy for tuberculosis.

PubMed

Gabriel, André P; Mercado, Charles P

2011-01-01

Tuberculosis (TB) remains to be the most prevalent and debilitating pulmonary (PTB) infection in the world today, affecting about one-third of the world's population. TB is an endemic disease in many developing countries, and efforts at eliminating the disease remain futile. While the course of the disease is indolent with years of latency, the reactivation of the disease can pose serious pulmonary and systemic infections that compromise multiple organ functions which lead to respiratory failure or end-organ damage. Despite attempts to control and eradicate the mycobacterium, the prevalence of the disease remains high due to increasing population rate, persistence of poverty and poor health care, treatment failure, increasing multidrug resistance as a consequence of treatment failure and poor compliance, and existence of comorbid conditions that compromise immune response. Limited government resources to screen and monitor disease progression of TB in third world countries hamper the eradication of the disease. In response, we have evaluated the efficiency and effectivity of a Community-Based Directly Observed Treatment, Short-Course (CB-DOTS), which is an equally effective alternative strategy to health center DOTS.

Baby steps.

PubMed

Bader, E J; Truax, H

1991-01-01

The focus of the discussion of US national environmental efforts on population growth issues is on carrying capacity, the impact of the antiabortion movement, the insensitivity of some population control advocated to people of color, and congressional and presidential actions. Efforts are being made to surmount the mistrust that has characterized efforts to deal with population issues. The World Wildlife Fund, the Sierra Club, and the National Audubon Society recognize the need for population stabilization, albeit with meager budgets. Carrying capacity is the number of people the earth can sustain without rapidly depleting non-renewable resources or degrading resources necessary to sustain life. In 1970, Earth Day called for stabilization of the global population, but most celebrations of Earth Day in 1990 did not recognize this. Sensitive issues are involved, and the abortion controversy has muffled open forums on population growth. Lobbyists were successful in having the US withdraw funding for international family planning (FP) programs that had abortion components. Then Reagan eliminated all funding to the UN Fund for Population Activities, because of China's FP policies. The results for women have been disastrous. Zero Population Growth has been conducting information meetings for environmental groups. The National wildlife Federation has a new program linking population and environmental issues but will not deal with the issue of abortion. A Philadelphia editorial recommended implanted contraceptives for welfare mothers, which raised fears of the reemergence of the eugenic movement which sought involuntary sterilization or population control for the poor. Another effort was to protect the US from immigration as a way of curbing population growth. Meaningful change means education women, changing unfavorable survival conditions, and heeding the reasons women have children. Japan's FP Association criticizes population control efforts undertaken for economic and political benefit without attention being paid to people's lives. An informal coalition is supporting a large FP grant to the USAID. Senate leadership is more open for FP issues, and a bill has been proposed to increase international FP funds.

Employee worktime control moderates the effects of job strain and effort-reward imbalance on sickness absence: the 10-town study

PubMed Central

Ala-Mursula, L.; Vahtera, J.; Linna, A.; Pentti, J.; Kivimaki, M.

2005-01-01

Study objective: To examine whether the effects of work stress on sickness absence vary by the level of control the employees have over their working times. Design: Prospective cohort study. A survey of job strain, effort-reward imbalance, and control over daily working hours and days off was carried out in 2000–01. The survey responses were linked with registered data on the number of medically certified (>3 days) sickness absences from one year before the survey until the end of 2003. The mean follow up period was 28.2 (SD 8.1) months. Adjustments were made for demographics and behavioural health risks. Aggregated measures of worktime control according to workplaces were used to control for differences in reactivity and response style. Setting: Ten towns in Finland. Participants: 16 139 public sector employees who had no medically certified sickness absences in the year preceding the survey. Main results: Among the women, individually measured control over daily working hours and days off moderated the association between work stress and sickness absence. The combination of high stress and good worktime control was associated with lower absence rates than a combination of high stress and poor worktime control. This finding was replicated in the analyses using workplace aggregates of worktime control. Among the men, the findings were less consistent and not replicable using aggregated measures of worktime control. Conclusions: Good control over working times reduces the adverse effect of work stress on sickness absence especially among female employees. PMID:16166358

Saving the child to save the nation: poverty, whiteness and childhood in the Cape Colony, c.1870-1895.

PubMed

Duff, S E

2011-01-01

Children were central to efforts to eradicate white impoverishment in the Cape Colony in the late nineteenth century. The education and training of poor, white children were believed to be the most effective ways of breaking cycles of poverty, and of ensuring continuing white control over the Cape's resources. Yet a closer reading of the evidence presented to the 1894 Labour Commission and the committee appointed to investigate the Destitute Children Relief Bill suggests that this interest in poor, white children also stemmed from concerns about the children themselves. Destitute white children - both male and female - were described, frequently, as representing a threat to the social, moral, and even economic order, and this view of poor white children shaped official responses to white poverty. This concern for white children reflected not solely their status as 'children' - that they represented the colony's future, were fairly malleable, and could be more easily 'reached' by projects and schemes to eradicate white poverty - but also their problematic class position in a colonial racial order that sought their reform, direction and education into acceptable productive citizens.

RVUs poorly correlate with measures of surgical effort and complexity

PubMed Central

Shah, Dhruvil R.; Bold, Richard J.; Yang, Anthony D.; Khatri, Vijay P.; Martinez, Steve R.; Canter, Robert J.

2014-01-01

Background The relationship between procedural relative value units (RVUs) for surgical procedures and other measures of surgeon effort are poorly characterized. We hypothesized that RVUs would poorly correlate with quantifiable metrics of surgeon effort. Methods Using the 2010 ACS-NSQIP database, we selected 11 primary CPT codes associated with high volume surgical procedures. We then identified all patients with a single reported procedural RVU who underwent non-emergent, inpatient general surgical operations. We used linear regression to correlate length of stay, operative time, overall morbidity, frequency of serious adverse events (SAEs), and mortality with RVUs. We used multivariable logistic regression using all pre-operative NSQIP variables to determine other significant predictors of our outcome measures. Results Among 14,481 patients, RVUs poorly correlated with individual length of stay (R2=0.05), operative time (R2=0.10), and mortality (R2=0.35). There was a moderate correlation between RVUs and SAEs (R2 =0.79), and RVUs and overall morbidity (R2=0.75). However, among low to mid-level RVU procedures (11 to 35) there was a poor correlation between SAEs (R2=0.15), overall morbidity (R2=0.05), and RVUs. On multivariable analysis, RVUs were significant predictors of operative time, length of stay, and SAEs (OR 1.06, 95%CI: 1.05–1.07), but RVUs were not a significant predictor of mortality (OR 1.02, 95%CI: 0.99–1.05) Conclusion For common, index general surgery procedures, the current RVU assignments poorly correlate with certain metrics of surgeon work, while moderately correlating with others. Given the increasing emphasis on measuring and tracking surgeon productivity, more objective measures of surgeon work and productivity should be developed. PMID:24953983

Minorities, the Poor and School Finance Reform. Vol. 3: The Impact of California's 1972 School Finance Reform on Poor and Minority Children.

ERIC Educational Resources Information Center

Singleton, Robert; And Others

Examination of California's experience with school finance reform was part of a nine-volume, six-state study of the impact of finance reform on poor and minority students. Researchers used correlation coefficients and measures of central tendency and dispersion to analyze data on educational revenues, school district wealth, tax effort, district…

Poverty, development, and women: why should we care?

PubMed

Thompson, Joyce E Beebe

2007-01-01

Healthy, prosperous nations require healthy women and newborns. Young girls and women in resource-poor nations suffer the greatest ill-health consequences from low status, denial of basic human rights, and poverty. Poverty and poor health result in poor economic development. The Millennium Development Goals call for immediate efforts to reduce poverty, improve health, especially of girls and women, and foster development in the world's poorest nations.

Regulation of gene expression in protozoa parasites.

PubMed

Gomez, Consuelo; Esther Ramirez, M; Calixto-Galvez, Mercedes; Medel, Olivia; Rodríguez, Mario A

2010-01-01

Infections with protozoa parasites are associated with high burdens of morbidity and mortality across the developing world. Despite extensive efforts to control the transmission of these parasites, the spread of populations resistant to drugs and the lack of effective vaccines against them contribute to their persistence as major public health problems. Parasites should perform a strict control on the expression of genes involved in their pathogenicity, differentiation, immune evasion, or drug resistance, and the comprehension of the mechanisms implicated in that control could help to develop novel therapeutic strategies. However, until now these mechanisms are poorly understood in protozoa. Recent investigations into gene expression in protozoa parasites suggest that they possess many of the canonical machineries employed by higher eukaryotes for the control of gene expression at transcriptional, posttranscriptional, and epigenetic levels, but they also contain exclusive mechanisms. Here, we review the current understanding about the regulation of gene expression in Plasmodium sp., Trypanosomatids, Entamoeba histolytica and Trichomonas vaginalis.

Rinderpest eradication: appropriate technology and social innovations.

PubMed

Mariner, Jeffrey C; House, James A; Mebus, Charles A; Sollod, Albert E; Chibeu, Dickens; Jones, Bryony A; Roeder, Peter L; Admassu, Berhanu; van 't Klooster, Gijs G M

2012-09-14

Rinderpest is only the second infectious disease to have been globally eradicated. In the final stages of eradication, the virus was entrenched in pastoral areas of the Greater Horn of Africa, a region with weak governance, poor security, and little infrastructure that presented profound challenges to conventional control methods. Although the eradication process was a development activity rather than scientific research, its success owed much to several seminal research efforts in vaccine development and epidemiology and showed what scientific decision-making and management could accomplish with limited resources. The keys to success were the development of a thermostable vaccine and the application of participatory epidemiological techniques that allowed veterinary personnel to interact at a grassroots level with cattle herders to more effectively target control measures.

Good decision-making is associated with an adaptive cardiovascular response to social competitive stress.

PubMed

Alacreu-Crespo, Adrián; Costa, Raquel; Abad-Tortosa, Diana; Salvador, Alicia; Serrano, Miguel Ángel

2018-06-22

Competition elicits different psychological and cardiovascular responses depending on a person's skills. Decision-making has been considered a distal factor that influences competition, but there are no studies analyzing this relationship. Our objective was to analyze whether decision-making affects the response to competition. Specifically, we aimed to test whether good performers on a decision-making test, the Iowa Gambling Task (IGT), showed an adaptive cardiovascular response to competition. In all, 116 participants (44 women) performed the IGT and were classified into Good or Poor decision-makers. Subsequently, they were exposed to a stress task in two different conditions: a face-to-face competition (winners/losers) or a control condition, while an electrocardiogram was recorded. In the competition group, good decision-makers increased their high-frequency respect to the total heart rate variability (HF/HRV) levels during the task, compared to Poor decision-makers. Again, competition group good decision-makers, showed lower LF and higher HF/HRV reactivity than the control group, which represents lower HRV stress pattern. Moreover, in the group of losers, good decision-makers had a decline in low frequency (LF) during the task and faster recovery than poor decision-makers. In conclusion, good decision-makers have a more adaptive stress response and higher levels of mental effort, based on total HRV interpretation. Decision-making skills could be a factor in a more adaptive cardiovascular response to competition.

Factors affecting the implementation of health legislation and its impact on the rural poor in China: a case study of implementation of the maternal and infant health care law in two poor counties.

PubMed

Tolhurst, Rachel; Zhang, Tuohong; Yang, Hui; Gao, Jun; Tang, Shenglan

2004-01-01

This paper presents and discusses a case study of health legislation in China. In the transition to a market economy, legislation has been developed to offset the weakening in the central planning mechanism and political control that have historically influenced the behaviour of institutions and individuals in the Ministry of Health. There has been relatively little empirical examination of the implementation and impact of legislation as a tool for influencing health service provision in low-income countries. The study aimed to contribute towards filling this gap by exploring the factors affecting the implementation and impact of the Maternal and Infant Health Care Law, through a case study of two poor, rural counties in Chongqing municipality, China. The study found that key local actors perceive health legislation to be an important tool for safeguarding access to essential health care. However, the implementation of health legislation is inevitably a political process. The study illustrates the difficulties involved in efforts to influence provider behaviour through a national level legislative framework in a situation of decentralization of control over those providers, due to extreme regional variation in economic situations and limited resource inputs from the centre. Lessons are drawn for Chinese and international policy makers.

The Effect of Empowerment and Self-Determination on Health Outcomes.

PubMed

Garces-Ozanne, Arlene; Kalu, Edna Ikechi; Audas, Richard

2016-12-01

There remains a persistent gap in health outcomes between wealthy and poor countries. Basic measures such as life expectancy and infant and under-five mortality remain divergent, with preventable deaths being unacceptably high, despite significant efforts to reduce these disparities. We examine the impact of empowerment, measured by Freedom House's ratings of country's political rights and civil liberties, while controlling for per capita gross domestic product, secondary school enrollment, and income inequality, on national health outcomes. Using data from 1970 to 2013 across 149 countries, our results suggest, quite strongly, that higher levels of empowerment have a significant positive association with life expectancy, particularly for females, and lower rates of infant and under-five mortality. Our results point to the need for efforts to stimulate economic growth be accompanied with reforms to increase the levels empowerment through increasing political rights and civil liberties. © 2016 Society for Public Health Education.

Vaccines Against Malaria

PubMed Central

Ouattara, Amed; Laurens, Matthew B.

2015-01-01

Despite global efforts to control malaria, the illness remains a significant public health threat. Currently, there is no licensed vaccine against malaria, but an efficacious vaccine would represent an important public health tool for successful malaria elimination. Malaria vaccine development continues to be hindered by a poor understanding of antimalarial immunity, a lack of an immune correlate of protection, and the genetic diversity of malaria parasites. Current vaccine development efforts largely target Plasmodium falciparum parasites in the pre-erythrocytic and erythrocytic stages, with some research on transmission-blocking vaccines against asexual stages and vaccines against pregnancy-associated malaria. The leading pre-erythrocytic vaccine candidate is RTS,S, and early results of ongoing Phase 3 testing show overall efficacy of 46% against clinical malaria. The next steps for malaria vaccine development will focus on the design of a product that is efficacious against the highly diverse strains of malaria and the identification of a correlate of protection against disease. PMID:25452593

The Case for a Smoker's License

PubMed Central

Chapman, Simon

2012-01-01

Background to the debate Tobacco continues to kill millions of people around the world each year and its use is increasing in some countries, which makes the need for new, creative, and radical efforts to achieve the tobacco control endgame vitally important. One such effort is discussed in this PLOS Medicine Debate, where Simon Chapman presents his proposal for a “smoker's license” and Jeff Collin argues against. Chapman sets out a case for introducing a smart card license for smokers designed to limit access to tobacco products and encourage cessation. Key elements of the smoker's license include smokers setting daily limits, financial incentives for permanent license surrender, and a test of health risk knowledge for commencing smokers. Collin argues against the proposal, saying that it would shift focus away from the real vector of the epidemic—the tobacco industry—and that by focusing on individuals it would censure victims, increase stigmatization of smokers, and marginalize the poor. PMID:23152726

The Relationship Between Experiences of Lateral Violence and Career Choice Satisfaction Among Nursing Students.

PubMed

Furst, Cari

This article explores associate degree nursing students' experiences with lateral violence and its impact on career choice satisfaction. Lateral violence has been linked to decreased professional identity, increased errors, and poor self-esteem, leading to a negative culture and attrition. A nonexperimental, quantitative, cross-sectional, correlational design was used; 13.4 percent of respondents (n = 32) met the criteria for intermittent bullying. Analysis confirmed a significant negative correlation between experiences of lateral/vertical violence and career choice satisfaction (r = - .140, p < .05) even after controlling for affect and support. Improved efforts are needed to prevent lateral violence.

The forest for the trees: tuberculosis control efforts in west Kalimantan.

PubMed

Shoeb, Marwa; Lopez de Castilla, Diego; Pottinger, Paul

2011-01-01

Alam Sehat Lestari (ASRI), an Indonesian-American, non-profit organization located on the border of Gunung Palung National Park in west Kalimantan on the island of Borneo, is linking the delivery of health care to the conservation of natural resources. The clinic's experience shows that an unconventional 'forests-for-health care' incentive programme can provide a powerful way to break the cycle that links poverty, poor health and environmental destruction around the park. However, the challenges of preventing, diagnosing and treating tuberculosis in this setting remain considerable and success will still depend upon a multilateral collaborative approach.

Converting hardwoods on poor sites to white pine by planting and direct seeding

Treesearch

G.W. Wendel; G.W. Wendel

1971-01-01

Until recently, conversion of hardwood stands on poor sites to white pine (Pinus strobus L.) was limited mostly to natural white pine reproduction released from a hardwood overstory, either by killing the hardwoods or by removing them through a timber sale. However, in our effort to increase the returns from poor sites in West Virginia (oak site index 45 to 60) we have...

Great expectations: top-down attention modulates the costs of clutter and eccentricity.

PubMed

Steelman, Kelly S; McCarley, Jason S; Wickens, Christopher D

2013-12-01

An experiment and modeling effort examined interactions between bottom-up and top-down attentional control in visual alert detection. Participants performed a manual tracking task while monitoring peripheral display channels for alerts of varying salience, eccentricity, and spatial expectancy. Spatial expectancy modulated the influence of salience and eccentricity; alerts in low-probability locations engendered higher miss rates, longer detection times, and larger costs of visual clutter and eccentricity, indicating that top-down attentional control offset the costs of poor bottom-up stimulus quality. Data were compared to the predictions of a computational model of scanning and noticing that incorporates bottom-up and top-down sources of attentional control. The model accounted well for the overall pattern of miss rates and response times, predicting each of the observed main effects and interactions. Empirical results suggest that designers should expect the costs of poor bottom-up visibility to be greater for low expectancy signals, and that the placement of alerts within a display should be determined based on the combination of alert expectancy and response priority. Model fits suggest that the current model can serve as a useful tool for exploring a design space as a precursor to empirical data collection and for generating hypotheses for future experiments. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Effort-reward imbalance and self-rated health among Gambian healthcare professionals.

PubMed

Darboe, Amadou; Lin, I-Feng; Kuo, Hsien-Wen

2016-04-11

The effort-reward imbalance (ERI) model of work stress has been widely applied in investigating association between psychosocial factors at work and health. This study examined associations between perceived psychosocial work stress as measured by the ERI model and self-rated health (SRH) among nurses and environmental health officers (EHOs) working in secondary public healthcare facilities in the Gambia. A cross-sectional study on a random sample of 287 health care professionals (201 nurses and 86 EHOs). A 22-item ERI questionnaire was used to collect data on the psychosocial factors defined by the ERI model. SRH was assessed using a single item measure. The distribution of subjective health was not statistically different between nurses and EHOs. However, our study uncovered significant associations between perceived psychosocial work stress and subjective health. Specifically, we found that a perceived high effort-reward imbalance (ER-ratio > 1) is a significant risk factor for poor SRH, in both occupational groups. However, over-commitment was not significantly associated with poor SRH in the two groups. When efforts and rewards were considered as separate variables in the analysis, rewards were inversely associated with poor SRH in both groups. Because of the high perceived Effort-Reward Imbalance among healthcare professionals at secondary public healthcare facilities, it is necessary to modify working conditions through improvement of psychosocial work environment, such as reasonable allocation of resources to increase pay, incentives or other forms of rewards from government. Interventions that could mitigate and prevent stress at work are worth considering in future healthcare policies.

The NGO Sector in Pakistan: Past, Present and Future.

ERIC Educational Resources Information Center

Anzar, Uzma

Despite significant developments on the economic front, the Pakistani government's human development efforts have failed to serve the needs of the poor. Whereas the rural poor do not trust government schemes, they do trust nongovernmental organizations (NGOs), most of which are apolitical community-based grassroots organizations accountable to…

Allocating effort and anticipating pleasure in schizophrenia: Relationship with real world functioning.

PubMed

Serper, M; Payne, E; Dill, C; Portillo, C; Taliercio, J

2017-10-01

Poor motivation to engage in goal-oriented behavior has been recognized as a hallmark feature of schizophrenia spectrum disorders (SZ). Low drive in SZ may be related to anticipating rewards as well as to poor working memory. However, few studies to date have examined beliefs about self-efficacy and satisfaction for future rewards (anticipatory pleasure). Additionally, few studies to date have examined how these deficits may impact SZ patients' real world functioning. The present study examined SZ patients' (n=57) anticipatory pleasure, working memory, self-efficacy and real world functioning in relation to their negative symptom severity. Results revealed that SZ patients' negative symptom severity was related to decisions in effort allocation and reward probability, working memory deficits, self-efficacy and anticipatory pleasure for future reward. Effort allocation deficits also predicted patients' daily functioning skills. SZ patients with high levels of negative symptoms are not merely effort averse, but have more difficulty effectively allocating effort and anticipating pleasure engaging in effortful activities. It may be the case that continuously failing to achieve reinforcement from engagement and participation may lead SZ patients to form certain negative beliefs about their abilities which contributes to amotivation and cognitive deficits. Lastly, our findings provide further support for a link between SZ patients functional daily living skills their effort allocation. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

The Impact of Perception and Knowledge on the Treatment and Prevention of Intestinal Worms in the Manikganj District of Bangladesh

PubMed Central

Bath, Jennifer L.; Eneh, Peace N.; Bakken, Amanda J.; Knox, Megan E.; Schiedt, Michael D.; Campbell, Jarryd M.

2010-01-01

Soil transmitted helminths (STHs) affect more than one billion of the world’s population and are very prevalent in regions with high poverty rates and poor sanitation. Efforts to achieve Millennium Development Goals, such as combating diseases and increasing the number of people with access to safe drinking water and proper sanitation facilities, will directly help in eliminating STHs. The Plains regions of Bangladesh has one of the highest prevalence rates of STHs, and the efforts made by the World Health Organization might not be enough to eradicate these diseases in this region before the 2015 goal. This survey was conducted in the Manikganj district of Central Bangladesh to evaluate local awareness about the transmission and prevention of STHs. The results from this survey show that although a large percentage of the respondents were knowledgeable about the spread and impact of intestinal worms, the majority of individuals still do not take the necessary steps to prevent infection. Our findings demonstrate the complexity of controlling and eliminating STHs and show that concluding efforts should incorporate additional measures for vaccine development as well as improved educational efforts that are sensitive to the region’s traditions and cultures. PMID:21165336

From the Floor: Raising Child Care Salaries.

ERIC Educational Resources Information Center

Whitebook, Marcy; And Others

The comprehensive National Child Care Staffing Study confirmed that American children are in jeopardy because their teachers are poorly compensated and minimally trained. An increasing number of local and state efforts have begun to face this crisis head-on. This booklet reviews these efforts, focusing primarily on strategies for raising salaries.…

A Look at Poor Dads Who Don't Pay Child Support. Discussion Papers. Assessing the New Federalism: An Urban Institute Program To Assess Changing Social Policies.

ERIC Educational Resources Information Center

Sorensen, Elaine; Zibman, Chava

The barriers that poor fathers face in paying child support and how existing programs assist them were studied and contrasted to the barriers faced by poor custodial mothers using data from the National Survey of America's Families (NSAF). Efforts to serve these fathers through Temporary Assistance for Needy Families welfare-to-work grants, and…

Minorities, the Poor and School Finance Reform. Vol. 8: A History of School Finance Reform Litigation and the Interests of Urban, Poor and Minority Children.

ERIC Educational Resources Information Center

Dimond, Paul R.

As part of a nine-volume, six-state study of the impact of school finance reform on minorities and the poor, this report describes the history of court litigation concerning finance reform. The report's first part traces school finance reform from roughly 1900 through 1971 and summarizes parallel reform efforts by racial and ethnic minorities and…

Outbreaks-of Ebola virus disease in the West African sub-region.

PubMed

Osungbade, K O; Oni, A A

2014-06-01

Five West African countries, including Nigeria are currently experiencing the largest, most severe, most complex outbreak of Ebola virus disease in history. This paper provided a chronology of outbreaks of Ebola virus disease in the West African sub-region and provided an update on efforts at containing the present outbreak. Literature from Pubmed (MEDLINE), AJOL, Google Scholar and Cochrane database were reviewed. Outbreaks of Ebola, virus disease had frequently occurred mainly in Central and East African countries. Occasional outbreaks reported from outside of Africa were due to laboratory contamination and imported monkeys in quarantine facilities. The ongoing outbreak in West Africa is the largest and first in the sub-region; the number of suspected cases and deaths from this single current outbreak is already about three times the total of all cases and deaths from previous known outbreaks in 40 years. Prevention and control efforts are hindered not only by lack of a known vaccine and virus-specific treatment, but also by weak health systems, poor sanitation, poor personal hygiene and cultural beliefs and practices, including myths and misconceptions about Ebola virus disease--all of which are prevalent in affected countries. Constrained by this situation, the World Health Organisation departed from the global standard and recommended the use of not yet proven treatments to treat or prevent the disease in humans on ethical and evidential grounds. The large number of people affected by the present outbreak in West Africa and the high case-fatality rate calls for accelerated evaluation and development of the investigational medical interventions for life saving and curbing the epidemic. Meanwhile, existing interventions such as early detection and isolation, contact tracing and monitoring, and adherence to rigorous procedures of infection prevention and control should be intensified.

Scaling up interventions to achieve global tuberculosis control: progress and new developments.

PubMed

Raviglione, Mario; Marais, Ben; Floyd, Katherine; Lönnroth, Knut; Getahun, Haileyesus; Migliori, Giovanni B; Harries, Anthony D; Nunn, Paul; Lienhardt, Christian; Graham, Steve; Chakaya, Jeremiah; Weyer, Karin; Cole, Stewart; Kaufmann, Stefan H E; Zumla, Alimuddin

2012-05-19

Tuberculosis is still one of the most important causes of death worldwide. The 2010 Lancet tuberculosis series provided a comprehensive overview of global control efforts and challenges. In this update we review recent progress. With improved control efforts, the world and most regions are on track to achieve the Millennium Development Goal of decreasing tuberculosis incidence by 2015, and the Stop TB Partnership target of halving 1990 mortality rates by 2015; the exception is Africa. Despite these advances, full scale-up of tuberculosis and HIV collaborative activities remains challenging and emerging drug-resistant tuberculosis is a major threat. Recognition of the effect that non-communicable diseases--such as smoking-related lung disease, diet-related diabetes mellitus, and alcohol and drug misuse--have on individual vulnerability, as well as the contribution of poor living conditions to community vulnerability, shows the need for multidisciplinary approaches. Several new diagnostic tests are being introduced in endemic countries and for the first time in 40 years a coordinated portfolio of promising new tuberculosis drugs exists. However, none of these advances offer easy solutions. Achievement of international tuberculosis control targets and maintenance of these gains needs optimum national health policies and services, with ongoing investment into new approaches and strategies. Despite growing funding in recent years, a serious shortfall persists. International and national financial uncertainty places gains at serious risk. Perseverance and renewed commitment are needed to achieve global control of tuberculosis, and ultimately, its elimination. Copyright © 2012 Elsevier Ltd. All rights reserved.

Effects of psychosocial work factors on lifestyle changes: a cohort study.

PubMed

Allard, Karin Olofsson; Thomsen, Jane Frølund; Mikkelsen, Sigurd; Rugulies, Reiner; Mors, Ole; Kærgaard, Anette; Kolstad, Henrik A; Kaerlev, Linda; Andersen, Johan Hviid; Hansen, Ase Marie; Bonde, Jens Peter

2011-12-01

To evaluate the effect of the demand-control-support model, the effort-reward imbalance model, and emotional demands on smoking, alcohol consumption, physical activity, and body mass index. This is a 2-year prospective cohort study of 3224 public sector employees. Measures were assessed with questionnaires. Multiple regression analyses were used to predict changes in lifestyle factors. Low reward predicted smoking, low-decision latitude predicted being inactive, and high demands predicted high-alcohol consumption but only for men at follow-up even after controlling for potential confounders. There were no other significant findings in the expected direction except for some of the confounders. We found only limited and inconsistent support for the hypothesis that a poor psychosocial work environment is associated with an adverse lifestyle.

Facilitating energy savings with programmable thermostats: evaluation and guidelines for the thermostat user interface.

PubMed

Peffer, Therese; Perry, Daniel; Pritoni, Marco; Aragon, Cecilia; Meier, Alan

2013-01-01

Thermostats control heating and cooling in homes - representing a major part of domestic energy use - yet, poor ergonomics of these devices has thwarted efforts to reduce energy consumption. Theoretically, programmable thermostats can reduce energy by 5-15%, but in practice little to no savings compared to manual thermostats are found. Several studies have found that programmable thermostats are not installed properly, are generally misunderstood and have poor usability. After conducting a usability study of programmable thermostats, we reviewed several guidelines from ergonomics, general device usability, computer-human interfaces and building control sources. We analysed the characteristics of thermostats that enabled or hindered successfully completing tasks and in a timely manner. Subjects had higher success rates with thermostat displays with positive examples of guidelines, such as visibility of possible actions, consistency and standards, and feedback. We suggested other guidelines that seemed missing, such as navigation cues, clear hierarchy and simple decision paths. Our evaluation of a usability test of five residential programmable thermostats led to the development of a comprehensive set of specific guidelines for thermostat design including visibility of possible actions, consistency, standards, simple decision paths and clear hierarchy. Improving the usability of thermostats may facilitate energy savings.

Household instability and self-regulation among poor children.

PubMed

McCoy, Dana Charles; Raver, C Cybele

Past research suggests that poverty may negatively influence children's psychological and behavioral health by increasing their exposure to chaotic living conditions in the household. The present study provides a descriptive 'snapshot' of instability in low-income households, and examines the associations between exposure to major destabilizing events over the course of a year and three domains of poor urban children's self-regulation. Descriptive analyses suggest that although caregivers from unstable households report higher average levels of health problems and depression, they also have greater assets/savings, are more educated, and are less likely to be immigrants than caregivers from stable households. Results of propensity score-matched regression analyses reveal that high levels of household instability are significantly and negatively associated with preschoolers' effortful control and global attention/impulsivity control, but not with their executive function. Children from mildly unstable homes (i.e., those who had experienced a single destabilizing event in the past year) showed no significant differences in any domain of self-regulation relative to their peers from stable households, suggesting a dose-response relationship between the number of destabilizing events experienced by children and their outcomes. Implications for theories of poverty-related adversity, stress, and parenting are discussed in addition to future directions for research.

Community knowledge, attitudes and practices in relation to tuberculosis in Cameroon.

PubMed

Kwedi Nolna, S; Kammogne, I D; Ndzinga, R; Afanda, B; Ntonè, R; Boum, Y; Nolna, D

2016-09-01

With 15 080 new cases in 2013, Cameroon is a country with high tuberculosis (TB) incidence and prevalence. Understanding the community's knowledge, attitude and practice (KAP) about TB is key to TB control in such endemic settings. To assess TB-related KAP in Cameroon by describing the sociodemographics of respondents, to identify barriers to seeking care and to explore attitudes and experiences of stigma and discrimination related to TB in communities. We conducted a cross-sectional descriptive study using structured questionnaires to assess and compare TB KAP in the entire territory. The results showed that Cameroonians have insufficient understanding of TB, numerous erroneous health assumptions and beliefs concerning TB, and erroneous information about the symptoms and mode of transmission of the disease. Negative attitudes and poor practices are obstacles to elimination and control efforts. The National Tuberculosis Control Programme should generate more effective strategies to reach the populations, paying particular attention to rural populations.

Self-reported empathy deficits are uniquely associated with poor functioning in schizophrenia.

PubMed

Smith, Matthew J; Horan, William P; Karpouzian, Tatiana M; Abram, Samantha V; Cobia, Derin J; Csernansky, John G

2012-05-01

Social cognitive deficits have been proposed to be among the causes of poor functional outcome in schizophrenia. Empathy, or sharing and understanding the unique emotions and experiences of other people, is one of the key elements of social cognition, and prior studies suggest that empathic processes are impaired in schizophrenia. The current study examined whether impairments in self-reported empathy were associated with poor functioning, above and beyond the influences of neurocognitive deficits and psychopathology. Individuals with schizophrenia (n=46) and healthy controls (n=37) completed the Interpersonal Reactivity Index (IRI), a measure of emotional and cognitive empathy. Participants also completed a neuropsychological test battery, clinical ratings of psychopathology, and functional outcome measures assessing both functional capacity and community functioning. After testing for between-group differences, we assessed the relationships between self-reported empathy and the measures of functioning, neurocognition, and psychopathology. Regression analyses examined whether empathic variables predicted functional outcomes. Individuals with schizophrenia reported lower IRI scores for perspective-taking and empathic concern, and higher IRI scores for personal distress than controls. Among individuals with schizophrenia, lower perspective-taking, greater disorganized symptoms, and deficits in working memory and episodic memory were correlated with poorer functional capacity and community functioning. Lower scores for perspective-taking explained significant incremental variance in both functional capacity (ΔR(2)=.09, p<.05) and community functioning (ΔR(2)=.152, p<.01) after accounting for relevant neurocognitive and psychopathological variables. Impaired perspective-taking, a component of cognitive empathy, is associated with poor functioning even after taking into account the influences of neurocognitive deficits and psychopathology. These findings support further efforts to clarify the underlying causes of empathic disturbances and suggest that treatments for these disturbances may help functional recovery in schizophrenia. Copyright © 2012 Elsevier B.V. All rights reserved.

Women's Religious Education: Liberation or Socialization? A Case Study.

ERIC Educational Resources Information Center

Bowman, Lorna M. A.

1993-01-01

Describes the efforts of Cornelia Peacock Connelly to establish Roman Catholic teacher training schools and schools for poor, working girls in England. Questions whether or not religious education within a specific tradition can be liberating or merely socialization. Concludes that both liberation and socialization were the result of her efforts.…

Entitlement Attitudes Predict Students' Poor Performance in Challenging Academic Conditions

ERIC Educational Resources Information Center

Anderson, Donna; Halberstadt, Jamin; Aitken, Robert

2013-01-01

Excessive entitlement--an exaggerated or unrealistic belief about what one deserves--has been associated with a variety of maladaptive behaviors, including a decline in motivation and effort. In the context of tertiary education, we reasoned that if students expend less effort to obtain positive outcomes to which they feel entitled, this should…

NASA in Crisis: The Space Agency's Public Relations Efforts Regarding the Hubble Space Telescope.

ERIC Educational Resources Information Center

Kauffman, James

1997-01-01

Examines the National Aeronautics and Space Administration's (NASA) public relations efforts concerning the Hubble telescope. Proposes that NASA's poor public relations exacerbated problems: NASA oversold the telescope before it was deployed, failed to develop a plan for release of images, provided misleading flight reports, and reported…

Factors associated with poor control of 9/11-related asthma 10–11 years after the 2001 World Trade Center terrorist attacks

PubMed Central

Jordan, Hannah T.; Stellman, Steven D.; Reibman, Joan; Farfel, Mark R.; Brackbill, Robert M.; Friedman, Stephen M.; Li, Jiehui; Cone, James E.

2015-01-01

Abstract Objective: To identify key factors associated with poor asthma control among adults in the World Trade Center (WTC) Health Registry, a longitudinal study of rescue/recovery workers and community members who were directly exposed to the 2001 WTC terrorist attacks and their aftermath. Methods: We studied incident asthma diagnosed by a physician from 12 September 2001 through 31 December 2003 among participants aged ≥18 on 11 September 2001, as reported on an enrollment (2003–2004) or follow-up questionnaire. Based on modified National Asthma Education and Prevention Program criteria, asthma was considered controlled, poorly-controlled, or very poorly-controlled at the time of a 2011–2012 follow-up questionnaire. Probable post-traumatic stress disorder, depression, and generalized anxiety disorder were defined using validated scales. Self-reported gastroesophageal reflux symptoms (GERS) and obstructive sleep apnea (OSA) were obtained from questionnaire responses. Multinomial logistic regression was used to examine factors associated with poor or very poor asthma control. Results: Among 2445 participants, 33.7% had poorly-controlled symptoms and 34.6% had very poorly-controlled symptoms in 2011–2012. Accounting for factors including age, education, body mass index, and smoking, there was a dose–response relationship between the number of mental health conditions and poorer asthma control. Participants with three mental health conditions had five times the odds of poor control and 13 times the odds of very poor control compared to participants without mental health comorbidities. GERS and OSA were significantly associated with poor or very poor control. Conclusions: Rates of poor asthma control were very high in this group with post-9/11 diagnosed asthma. Comprehensive care of 9/11-related asthma should include management of mental and physical health comorbidities. PMID:25539137

An exploration of the feasibility, acceptability, and effectiveness of professional, multitasked community health workers in Tanzania.

PubMed

Baynes, Colin; Semu, Helen; Baraka, Jitihada; Mushi, Hildegalda; Ramsey, Kate; Kante, Almamy Malick; Phillips, James F

2017-08-01

Despite four decades of global experience with community-based primary health care, the strategic details of community health worker (CHW) recruitment, training, compensation, and deployment remain the subject of continuing discussion and debate. Responsibilities and levels of clinical expertise also vary greatly, as well as contrasting roles of public- versus private-sector organisations as organisers of CHW effort. This paper describes a programme of implementation research in Tanzania, known as the Connect Project, which aims to guide national policies with evidence on the impact and process of deploying of paid, professional CHWs. Connect is a randomised-controlled trial of community exposure to CHW integrated primary health-care services. A qualitative appraisal of reactions to CHW implementation of community stakeholders, frontline workers, supervisors, and local managers is reviewed. Results highlight the imperative to plan and implement CHW programmes as a component of a broader, integrated effort to strengthen the health system. Specifically, the introduction of a CHW programme in Tanzania should draw upon community structures and institutions and strengthen mechanisms to sustain their participation in primary health care. This should be coordinated with efforts to address poorly functioning logistics and supervisory systems and human resource and management challenges.

Sugar-sweetened beverages in Pacific Island countries and territories: problems and solutions?

PubMed

Snowdon, W

2014-03-01

Non-communicable diseases are a major problem in the Pacific Islands, with poor diets an important contributing factor. Available data suggests high levels of intake of sugar-sweetened beverages (SSBs) across the region, and particularly in adolescents. Due to concerns about the risks to health of high intakes, efforts have been made across the region to reduce the intake of SSBs. French Polynesia, Nauru, Cook Islands, Tonga and Fiji have implemented sales or excise taxes on SSBs to increase the price to the consumer. Many countries in the region have adopted school food policies which intend to limit or ban access to SSBs in schools. Guam also adopted legislation to ensure that healthier foods and beverages were available in all vending machines in schools. Efforts to control advertising and sponsorship of SSBs have been limited to-date in the region, although some school food policies do restrict advertising and sponsorship in schools, school grounds and school vehicles. Efforts around education and awareness raising have shown mixed success in terms of changing behaviour. Greater attention is needed to evaluate the impact of these measures to ensure that actions are effective, and to increase the evidence regionally of the most effective approaches to tackle SSBs.

Public spending on health care in Africa: do the poor benefit?

PubMed Central

Castro-Leal, F.; Dayton, J.; Demery, L.; Mehra, K.

2000-01-01

Health care is a basic service essential in any effort to combat poverty, and is often subsidized with public funds to help achieve that aim. This paper examines public spending on curative health care in several African countries and finds that this spending favours mostly the better-off rather than the poor. It concludes that this targeting problem cannot be solved simply by adjusting the subsidy allocations. The constraints that prevent the poor from taking advantage of these services must also be addressed if the public subsidies are to be effective in reaching the poor. PMID:10686734

Utah Cancer Survivors: A Comprehensive Comparison of Health-Related Outcomes Between Survivors and Individuals Without a History of Cancer.

PubMed

Fowler, Brynn; Ding, Qian; Pappas, Lisa; Wu, Yelena P; Linder, Lauri; Yancey, Jeff; Wright, Jennifer; Clayton, Margaret; Kepka, Deanna; Kirchhoff, Anne C

2018-02-01

Assessments of cancer survivors' health-related needs are often limited to national estimates. State-specific information is vital to inform state comprehensive cancer control efforts developed to support patients and providers. We investigated demographics, health status/quality of life, health behaviors, and health care characteristics of long-term Utah cancer survivors compared to Utahans without a history of cancer. Utah Behavioral Risk Factor Surveillance System (BRFSS) 2009 and 2010 data were used. Individuals diagnosed with cancer within the past 5 years were excluded. Multivariable survey weighted logistic regressions and computed predictive marginals were used to estimate age-adjusted percentages and 95 % confidence intervals (CI). A total of 11,320 eligible individuals (727 cancer survivors, 10,593 controls) were included. Respondents were primarily non-Hispanic White (95.3 % of survivors, 84.1 % of controls). Survivors were older (85 % of survivors ≥40 years of age vs. 47 % of controls). Survivors reported the majority of their cancer survivorship care was managed by primary care physicians or non-cancer specialists (93.5 %, 95 % CI = 87.9-99.1). Furthermore, 71.1 % (95 % CI = 59.2-82.9) of survivors reported that they did not receive a cancer treatment summary. In multivariable estimates, fair/poor general health was more common among survivors compared to controls (17.8 %, 95 % CI = 12.5-23.1 vs. 14.2 %, 95 % CI = 12.4-16.0). Few survivors in Utah receive follow-up care from a cancer specialist. Provider educational efforts are needed to promote knowledge of cancer survivor issues. Efforts should be made to improve continuity in follow-up care that addresses the known issues of long-term survivors that preclude optimal quality of life, resulting in a patient-centered approach to survivorship.

Artificial Intelligence In Computational Fluid Dynamics

NASA Technical Reports Server (NTRS)

Vogel, Alison Andrews

1991-01-01

Paper compares four first-generation artificial-intelligence (Al) software systems for computational fluid dynamics. Includes: Expert Cooling Fan Design System (EXFAN), PAN AIR Knowledge System (PAKS), grid-adaptation program MITOSIS, and Expert Zonal Grid Generation (EZGrid). Focuses on knowledge-based ("expert") software systems. Analyzes intended tasks, kinds of knowledge possessed, magnitude of effort required to codify knowledge, how quickly constructed, performances, and return on investment. On basis of comparison, concludes Al most successful when applied to well-formulated problems solved by classifying or selecting preenumerated solutions. In contrast, application of Al to poorly understood or poorly formulated problems generally results in long development time and large investment of effort, with no guarantee of success.

Minorities, the Poor and School Finance Reform. Vol. 1: An Impact Study of Six States.

ERIC Educational Resources Information Center

Brischetto, Robert; Vaughan, David

To study the impact of school finance reform on minorities and the poor, researchers gathered data on educational revenues and spending, tax effort, district wealth and income, ethnicity, and urban location in California, Colorado, Florida, Michigan, New Mexico, and Texas. Their data analysis used various measures of educational equity and fiscal…

Latino Child Poverty in the United States.

ERIC Educational Resources Information Center

Miranda, Leticia C.

Poverty among Latino children has soared during the past decade, accounting for half of the total growth in the number of American children who are poor. One in three Latino children was living in poverty as of 1989. Many Latino children are poor despite their parents' best efforts to pull their families out of poverty and despite the fact that…

Why Don't They Just Get Married? Barriers to Marriage among the Disadvantaged

ERIC Educational Resources Information Center

Edin, Kathryn; Reed, Joanna M.

2005-01-01

Kathryn Edin and Joanna Reed review recent research on social and economic barriers to marriage among the poor and discuss the efficacy of efforts by federal and state policymakers to promote marriage among poor unmarried couples, especially those with children, in light of these findings. Social barriers include marital aspirations and…

Dual-task effects of simulated lane navigation and story recall in older adults with and without memory impairment

PubMed Central

Cook, Sarah E.; Sisco, Shannon M.; Marsiske, Michael

2013-01-01

While driving is a complex task, it becomes relatively automatic over time although unfamiliar situations require increased cognitive effort. Much research has examined driving risk in cognitively impaired elders and found little effect. This study assessed whether mildly memory impaired elders made disproportionate errors in driving or story recall, under simultaneous simulated driving and story recall. Forty-six healthy (61% women; mean age = 76.4) and 15 memory impaired (66% women, mean age = 79.4) elders participated. Cognitive status was determined by neuropsychological performance. Results showed that during dual-task conditions, participants stayed in lane more, and recalled stories more poorly, than when they did the tasks separately. Follow-up analysis revealed that verbatim recall, in particular, was reduced while driving for healthy participants. While memory impaired participants performed more poorly than healthy controls on both tasks, cognitive status was not associated with greater dual-task costs when driving and story recall were combined. PMID:23043546

Chronic Methamphetamine Abuse and Corticostriatal Deficits Revealed by Neuroimaging

PubMed Central

London, Edythe D.; Kohno, Milky; Morales, Angelica; Ballard, Michael E.

2014-01-01

Despite aggressive efforts to contain it, methamphetamine use disorder continues to be major public health problem; and with generic behavioral therapies still the mainstay of treatment for methamphetamine abuse, rates of attrition and relapse remain high. This review summarizes the findings of structural, molecular, and functional neuroimaging studies of methamphetamine abusers, focusing on cortical and striatal abnormalities and their potential contributions to cognitive and behavioral phenotypes that can serve to promote compulsive drug use. These studies indicate that individuals with a history of chronic methamphetamine abuse often display several signs of corticostriatal dysfunction, including abnormal gray- and white-matter integrity, monoamine neurotransmitter system deficiencies, neuroinflammation, poor neuronal integrity, and aberrant patterns of brain connectivity and function, both when engaged in cognitive tasks and at rest. More importantly, many of these neural abnormalities were found to be linked with certain addiction-related phenotypes that may influence treatment response (e.g., poor self-control, cognitive inflexibility, maladaptive decision-making), raising the possibility that they may represent novel therapeutic targets. PMID:25451127

Dual-task effects of simulated lane navigation and story recall in older adults with and without memory impairment.

PubMed

Cook, Sarah E; Sisco, Shannon M; Marsiske, Michael

2013-01-01

While driving is a complex task, it becomes relatively automatic over time although unfamiliar situations require increased cognitive effort. Much research has examined driving risk in cognitively impaired elders and found little effect. This study assessed whether mildly memory impaired elders made disproportionate errors in driving or story recall, under simultaneous simulated driving and story recall. Forty-six healthy (61% women; mean age = 76.4) and 15 memory impaired (66% women, mean age = 79.4) elders participated. Cognitive status was determined by neuropsychological performance. Results showed that during dual-task conditions, participants stayed in lane more, and recalled stories more poorly, than when they did the tasks separately. Follow-up analysis revealed that verbatim recall, in particular, was reduced while driving for healthy participants. While memory impaired participants performed more poorly than healthy controls on both tasks, cognitive status was not associated with greater dual-task costs when driving and story recall were combined.

Critical role of developing national strategic plans as a guide to strengthen laboratory health systems in resource-poor settings.

PubMed

Nkengasong, John N; Mesele, Tsehaynesh; Orloff, Sherry; Kebede, Yenew; Fonjungo, Peter N; Timperi, Ralph; Birx, Deborah

2009-06-01

Medical laboratory services are an essential, yet often neglected, component of health systems in developing countries. Their central role in public health, disease control and surveillance, and patient management is often poorly recognized by governments and donors. However, medical laboratory services in developing countries can be strengthened by leveraging funding from other sources of HIV/AIDS prevention, care, surveillance, and treatment programs. Strengthening these services will require coordinated efforts by national governments and partners and can be achieved by establishing and implementing national laboratory strategic plans and policies that integrate laboratory systems to combat major infectious diseases. These plans should take into account policy, legal, and regulatory frameworks; the administrative and technical management structure of the laboratories; human resources and retention strategies; laboratory quality management systems; monitoring and evaluation systems; procurement and maintenance of equipment; and laboratory infrastructure enhancement. Several countries have developed or are in the process of developing their laboratory plans, and others, such as Ethiopia, have implemented and evaluated their plan.

Basolateral amygdala supports the maintenance of value and effortful choice of a preferred option.

PubMed

Hart, Evan E; Izquierdo, Alicia

2017-02-01

The basolateral amygdala (BLA) is known to be involved in appetitive behavior, yet its role in cost-benefit choice of qualitatively different rewards (more/less preferred), beyond magnitude differences (larger/smaller), is poorly understood. We assessed the effects of BLA inactivations on effortful choice behavior. Rats were implanted with cannulae in BLA and trained to stable lever pressing for sucrose pellets on a progressive ratio schedule. Rats were then introduced to a choice: chow was concurrently available while they could work for the preferred sucrose pellets. Rats were infused with either vehicle control (aCSF) or baclofen/muscimol prior to test. BLA inactivations produced a significant decrease in lever presses for sucrose pellets compared to vehicle, and chow consumption was unaffected. Inactivation had no effect on sucrose pellet preference when both options were freely available. Critically, when lab chow was not concurrently available, BLA inactivations had no effect on the number of lever presses for sucrose pellets, indicating that primary motivation in the absence of choice remains intact with BLA offline. After a test under specific satiety for sucrose pellets, BLA inactivation rendered animals less sensitive to devaluation relative to control. The effects of BLA inactivations in our task are not mediated by decreased appetite, an inability to perform the task, a change in food preference, or decrements in primary motivation. Taken together, BLA supports the specific value and effortful choice of a preferred option. © 2016 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

Landscape controls on dissolved organic carbon export from watersheds of the British Columbia outer-coast

NASA Astrophysics Data System (ADS)

Giesbrecht, I.; Tank, S. E.; Frazer, G. W.; Gonzalez Arriola, S.; Korver, M.; Floyd, B. C.; Oliver, A. A.; Lertzman, K. P.

2016-12-01

Global models suggest that the Pacific Coastal Temperate Rainforest of North America (PCTR) exports significant quantities of dissolved organic carbon (DOC) to the coastal ocean. This aquatic flux from land to sea has implications for marine ecosystems and regional carbon budgets. However, DOC concentrations and flux estimates vary substantially across watersheds and drivers of spatial variation are poorly described for this region. For an outer-coast area of the PCTR, with among the highest per unit area DOC yields in the world (Oliver et al. in prep.), we describe and model landscape controls on DOC exports to the coastal ocean. In 2015 we collected three rounds of synoptic samples on Calvert Island, observing a nine-fold variation in DOC concentration (3.8 - 34.3 mg/L) across 59 watersheds that range in size from 0.26 to 21.12 km2 and reach a maximum elevation of 1012 m. We use standard ecosystem maps (Province of BC), LiDAR and other remote sensing data to measure watershed attributes. We use freshwater cation concentrations to explore geochemical signals of bedrock and surficial deposits that may be poorly represented by available geospatial data. We examine the role of topography, climate, waterbodies, geology and the local ecosystem mosaic in controlling DOC concentration and flux. An improved model of spatial controls on freshwater DOC export from the outer-coast of the PCTR will inform regional carbon modeling efforts and enhance our understanding of ecosystem processes at the coastal margin.

Human Factors in Training

NASA Technical Reports Server (NTRS)

Barshi, Immanuel; Byrne, Vicky; Arsintescu, Lucia; Connell, Erin

2010-01-01

Future space missions will be significantly longer than current shuttle missions and new systems will be more complex than current systems. Increasing communication delays between crews and Earth-based support means that astronauts need to be prepared to handle the unexpected on their own. As crews become more autonomous, their potential span of control and required expertise must grow to match their autonomy. It is not possible to train for every eventuality ahead of time on the ground, or to maintain trained skills across long intervals of disuse. To adequately prepare NASA personnel for these challenges, new training approaches, methodologies, and tools are required. This research project aims at developing these training capabilities. By researching established training principles, examining future needs, and by using current practices in space flight training as test beds, both in Flight Controller and Crew Medical domains, this research project is mitigating program risks and generating templates and requirements to meet future training needs. Training efforts in Fiscal Year 09 (FY09) strongly focused on crew medical training, but also began exploring how Space Flight Resource Management training for Mission Operations Directorate (MOD) Flight Controllers could be integrated with systems training for optimal Mission Control Center (MCC) operations. The Training Task addresses Program risks that lie at the intersection of the following three risks identified by the Project: 1) Risk associated with poor task design; 2) Risk of error due to inadequate information; and 3) Risk associated with reduced safety and efficiency due to poor human factors design.

Human Factors in Training

NASA Technical Reports Server (NTRS)

Barshi, Immanuel; Byrne, Vicky; Arsintescu, Lucia; Connell, Erin; Sandor, Aniko

2009-01-01

Future space missions will be significantly longer than current shuttle missions and new systems will be more complex than current systems. Increasing communication delays between crews and Earth-based support means that astronauts need to be prepared to handle the unexpected on their own. As crews become more autonomous, their potential span of control and required expertise must grow to match their autonomy. It is not possible to train for every eventuality ahead of time on the ground, or to maintain trained skills across long intervals of disuse. To adequately prepare NASA personnel for these challenges, new training approaches, methodologies, and tools are required. This research project aims at developing these training capabilities. By researching established training principles, examining future needs, and by using current practices in space flight training as test beds, both in Flight Controller and Crew Medical domains, this research project is mitigating program risks and generating templates and requirements to meet future training needs. Training efforts in Fiscal Year 08 (FY08) strongly focused on crew medical training, but also began exploring how Space Flight Resource Management training for Mission Operations Directorate (MOD) Flight Controllers could be integrated with systems training for optimal Mission Control Center (MCC) operations. The Training Task addresses Program risks that lie at the intersection of the following three risks identified by the Project: (1) Risk associated with poor task design (2) Risk of error due to inadequate information (3) Risk associated with reduced safety and efficiency due to poor human factors design

30,000 fewer heart attacks and strokes in North Carolina: a challenge to prioritize prevention.

PubMed

Bertoni, Alain G; Ensley, Don; Goff, David C

2012-01-01

Heart disease and stroke are leading causes of death in North Carolina and are also important contributors to poor health and excess health care expenditures. The risk factors for heart disease, stroke, and other forms of cardiovascular disease are well known, and include smoking, high blood pressure, elevated serum cholesterol levels, diabetes mellitus, and obesity. These risk factors persist as a result of suboptimal assessment, treatment, and control; adverse trends in health behaviors; and environmental and societal conditions negatively affecting the pursuit of optimal cardiovascular health. If North Carolina is to do its share in making it possible for the national Million Hearts initiative to meet its goals, then 30,000 heart attacks and strokes need to be prevented in the state over the next 5 years. Both the Million Hearts initiative and North Carolina's Justus-Warren Heart Disease and Stroke Prevention Task Force Plan include specific recommendations aimed at the primary and secondary prevention of heart disease and stroke. Million Hearts focuses on the ABCS: aspirin use when appropriate, blood pressure control, cholesterol control, and smoking cessation or abstention. The task force plan also addresses physical inactivity, poor nutrition, and the control of obesity and diabetes. The commentaries published in this issue of the NCMJ address the challenge of cardiovascular disease prevention among children and adults across the state and highlight efforts to enhance prevention via public policies and legislation, community coalitions, and quality improvement in the clinical arena.

Toward Making Good on All Youth: Engaging Underrepresented Youth Populations in Community Youth Development. REACH Issue Brief Series. Number Six

ERIC Educational Resources Information Center

Erbstein, Nancy

2010-01-01

Youth who are most vulnerable to challenging community conditions, more limited opportunities and poor health, educational and economic trajectories derive especially strong benefits from engagement in community youth development efforts (Gambone, Yu, et al. 2004). Like many community youth development efforts, the REACH Youth Program called upon…

Tuberculosis stigma in Gezira State, Sudan: a case-control study.

PubMed

Ahmed Suleiman, M M; Sahal, N; Sodemann, M; El Sony, A; Aro, A R

2013-03-01

To evaluate the prevalence of tuberculosis (TB) stigma and to determine the relation between socio-demographic characteristics and TB stigma among TB cases and their controls in Gezira State, Sudan. A case-control study design was used. New smear-positive TB patients registered in Gezira State in 2010 (n = 425) and controls who attended the same health facility for other reasons (n < 850) formed the study population. Stigma was measured using a standard modified World Health Organization TB KAP (knowledge, attitudes, practice) instrument. TB stigma did not differ between TB cases and controls; mild stigma was found in both groups. The higher degree of stigma among both groups was significantly associated with higher age, lower level of education, residence in rural areas, unemployment and poor TB awareness, while sex had no association with the degree of stigma in either group. Although TB stigma among the Gezira population was found to be mild, it can affect treatment adherence. Empowering both TB patients and communities by increasing their knowledge through proper education programmes could effectively contribute to the effort of controlling TB in the state.

Complementary p- and n-type polymer doping for ambient stable graphene inverter.

PubMed

Yun, Je Moon; Park, Seokhan; Hwang, Young Hwan; Lee, Eui-Sup; Maiti, Uday; Moon, Hanul; Kim, Bo-Hyun; Bae, Byeong-Soo; Kim, Yong-Hyun; Kim, Sang Ouk

2014-01-28

Graphene offers great promise to complement the inherent limitations of silicon electronics. To date, considerable research efforts have been devoted to complementary p- and n-type doping of graphene as a fundamental requirement for graphene-based electronics. Unfortunately, previous efforts suffer from undesired defect formation, poor controllability of doping level, and subtle environmental sensitivity. Here we present that graphene can be complementary p- and n-doped by simple polymer coating with different dipolar characteristics. Significantly, spontaneous vertical ordering of dipolar pyridine side groups of poly(4-vinylpyridine) at graphene surface can stabilize n-type doping at room-temperature ambient condition. The dipole field also enhances and balances the charge mobility by screening the impurity charge effect from the bottom substrate. We successfully demonstrate ambient stable inverters by integrating p- and n-type graphene transistors, which demonstrated clear voltage inversion with a gain of 0.17 at a 3.3 V input voltage. This straightforward polymer doping offers diverse opportunities for graphene-based electronics, including logic circuits, particularly in mechanically flexible form.

Perception of effort in Exercise Science: Definition, measurement and perspectives.

PubMed

Pageaux, Benjamin

2016-11-01

Perception of effort, also known as perceived exertion or sense of effort, can be described as a cognitive feeling of work associated with voluntary actions. The aim of the present review is to provide an overview of what is perception of effort in Exercise Science. Due to the addition of sensations other than effort in its definition, the neurophysiology of perceived exertion remains poorly understood. As humans have the ability to dissociate effort from other sensations related to physical exercise, the need to use a narrower definition is emphasised. Consequently, a definition and some brief guidelines for its measurement are provided. Finally, an overview of the models present in the literature aiming to explain its neurophysiology, and some perspectives for future research are offered.

Factors associated with treatment-seeking for malaria in urban poor communities in Accra, Ghana.

PubMed

Awuah, Raphael Baffour; Asante, Paapa Yaw; Sakyi, Lionel; Biney, Adriana A E; Kushitor, Mawuli Komla; Agyei, Francis; de-Graft Aikins, Ama

2018-04-16

In Ghana, about 3.5 million cases of malaria are recorded each year. Urban poor residents particularly have a higher risk of malaria mainly due to poor housing, low socio-economic status and poor sanitation. Alternative treatment for malaria (mainly African traditional/herbal and/or self-medication) is further compounding efforts to control the incidence of malaria in urban poor communities. This study assesses factors associated with seeking alternative treatment as the first response to malaria, relative to orthodox treatment in three urban poor communities in Accra, Ghana. This cross-sectional study was conducted in three urban poor localities in Accra, Ghana among individuals in their reproductive ages (15-59 years for men and 15-49 years for women). The analytic sample for the study was 707. A multinomial regression model was used to assess individual, interpersonal and structural level factors associated with treatment-seeking for malaria. Overall, 31% of the respondents sought orthodox treatment, 8% sought traditional/herbal treatment and 61% self-medicated as the first response to malaria. At the bivariate level, more males than females used traditional/herbal treatment and self-medicated for malaria. The results of the regression analysis showed that current health insurance status, perceived relative economic standing, level of social support, and locality of residence were associated with seeking alternative treatment for malaria relative to orthodox treatment. The findings show that many urban poor residents in Accra self-medicate as the first response to malaria. Additionally, individuals who were not enrolled in a health insurance scheme, those who perceived they had a low economic standing, those with a high level of social support, and locality of residence were significantly associated with the use of alternative treatment for malaria. Multi-level strategies should be employed to address the use of alternative forms of treatment for malaria within the context of urban poverty.

Susceptibility of the MMPI-2-RF neurological complaints and cognitive complaints scales to over-reporting in simulated head injury.

PubMed

Bolinger, Elizabeth; Reese, Caitlin; Suhr, Julie; Larrabee, Glenn J

2014-02-01

We examined the effect of simulated head injury on scores on the Neurological Complaints (NUC) and Cognitive Complaints (COG) scales of the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF). Young adults with a history of mild head injury were randomly assigned to simulate head injury or give their best effort on a battery of neuropsychological tests, including the MMPI-2-RF. Simulators who also showed poor effort on performance validity tests (PVTs) were compared with controls who showed valid performance on PVTs. Results showed that both scales, but especially NUC, are elevated in individuals simulating head injury, with medium to large effect sizes. Although both scales were highly correlated with all MMPI-2-RF over-reporting validity scales, the relationship of Response Bias Scale to both NUC and COG was much stronger in the simulators than controls. Even accounting for over-reporting on the MMPI-2-RF, NUC was related to general somatic complaints regardless of group membership, whereas COG was related to both psychological distress and somatic complaints in the control group only. Neither scale was related to actual neuropsychological performance, regardless of group membership. Overall, results provide further evidence that self-reported cognitive symptoms can be due to many causes, not necessarily cognitive impairment, and can be exaggerated in a non-credible manner.

Ocular delivery of macromolecules

PubMed Central

Kim, Yoo-Chun; Chiang, Bryce; Wu, Xianggen; Prausnitz, Mark R.

2014-01-01

Biopharmaceuticals are making increasing impact on medicine, including treatment of indications in the eye. Macromolecular drugs are typically given by physician-administered invasive delivery methods, because non--invasive ocular delivery methods, such as eye drops, and systemic delivery, have low bioavailability and/or poor ocular targeting. There is a need to improve delivery of biopharmaceuticals to enable less-invasive delivery routes, less-frequent dosing through controlled-release drug delivery and improved drug targeting within the eye to increase efficacy and reduce side effects. This review discusses the barriers to drug delivery via various ophthalmic routes of administration in the context of macromolecule delivery and discusses efforts to develop controlled-release systems for delivery of biopharmaceuticals to the eye. The growing number of macromolecular therapies in the eye needs improved drug delivery methods that increase drug efficacy, safety and patient compliance. PMID:24998941

Strategic Implications of Global Health

DTIC Science & Technology

2008-12-01

National Intelligence Officer for Economic Issues, with the active collaboration of CIA, DIA/National Center for Medical Intelligence, and the...participating in other forms of economic activity . • A degraded health sector, shortages of medical personnel, and infections stemming from deficient...country, and poor health undercuts efforts to diversify economic activity away from oil into more skill-intensive and value-added sectors. Poor health of

What does productivity really mean? Towards an integrative paradigm in the search for biodiversity-productivity relationships

Treesearch

Liangjun Hu; Qinfeng Guo

2013-01-01

How species diversity relates to productivity remains a major debate. To date, however, the underlying mechanisms that regulate the ecological processes involved are still poorly understood. Three major issues persist in early efforts at resolution. First, in the context that productivity drives species diversity, how the pathways operate is poorly-explained. Second,...

Effect of mechanical site preparation treatments on oak survival in a retired field afforestation effort -- first-year results

Treesearch

Andrew B. Self; Andrew W. Ezell; Damon B. Hollis; Derek. Alkire

2011-01-01

Mechanical site preparation is frequently proposed to alleviate poor soil conditions when afforesting retired agricultural fields. Without management of soil problems, oak seedlings planted in these areas may exhibit poor survival. While mechanical site preparation methods currently employed in hardwood afforestation are proven, there is a substantial void in research...

Reaching the unreached: enabling Dalit girls to get schooling.

PubMed

Sreedhar, M V

1999-01-01

The 1991 census showed a female illiteracy rate of over 39%, requiring a major new effort to include all women, especially the poor, in a program of universal primary education. Institute for Socially Disadvantaged Groups' Educational Improvement (ISDGEI) based in Kolhapur (Maharashtra) is working for social transformation through education. Most disadvantaged are poor Dalit women and girls living in urban slums. The institute has been providing primary education to Dalit girls in the Rajendranagar slum of Kolhapur for the past 12 years. In the beginning they also had boy students in their schools, but as they grew they recognized that the need for schools for poor girls, especially Dalits, was so vastly unmet that they decided to put all their efforts into devising an appropriate and effective educational experience for these children. In this article, the Honorary Director of the ISDGEI, M. V. Sreedhar, explains the challenges they face and the many innovations they have evolved in order to make education accessible to the most disadvantaged of India's children--Dalit girls.

Community cost-benefit discussions that launched the Camino Verde intervention in Nicaragua.

PubMed

Hernandez-Alvarez, Carlos; Arosteguí, Jorge; Suazo-Laguna, Harold; Reyes, Rosa Maria; Coloma, Josefina; Harris, Eva; Andersson, Neil; Ledogar, Robert J

2017-05-30

Recent literature on community intervention research stresses system change as a condition for durable impact. This involves highly participatory social processes leading to behavioural change. Before launching the intervention in the Nicaraguan arm of Camino Verde, a cluster-randomised controlled trial to show that pesticide-free community mobilisation adds effectiveness to conventional dengue controls, we held structured discussions with leaders of intervention communities on costs of dengue illness and dengue control measures taken by both government and households. These discussions were the first step in an effort at Socialising Evidence for Participatory Action (SEPA), a community mobilisation method used successfully in other contexts. Theoretical grounding came from community psychology and behavioural economics. The leaders expressed surprise at how large and unexpected an economic burden dengue places on households. They also acknowledged that large investments of household and government resources to combat dengue have not had the expected results. Many were not ready to see community preventive measures as a substitute for chemical controls but all the leaders approved the formation of "brigades" to promote chemical-free household control efforts in their own communities. Discussions centred on household budget decisions provide a good entry point for researchers to engage with communities, especially when the evidence showed that current expenditures were providing a poor return. People became motivated not only to search for ways to reduce their costs but also to question the current response to the problem in question. This in turn helped create conditions favourable to community mobilisation for change. ISRCTN27581154 .

The SARE tool for rabies control: Current experience in Ethiopia.

PubMed

Coetzer, A; Kidane, A H; Bekele, M; Hundera, A D; Pieracci, E G; Shiferaw, M L; Wallace, R; Nel, L H

2016-11-01

The Stepwise Approach towards Rabies Elimination (SARE) tool was developed through a joint effort of the Food and Agriculture Organization (FAO) of the United Nations and the Global Alliance for Rabies Control (GARC), to provide a standard mechanism for countries to assess their rabies situation and measure progress in eliminating the disease. Because the African continent has the highest per capita death rate from rabies, and Ethiopia is estimated to have the second largest number of rabies deaths of all African countries, Ethiopia undertook a self-assessment by means of the Stepwise Approach towards Rabies Elimination (SARE) tool. In February 2016, the Ethiopian government hosted an intersectoral consultative meeting in an effort to assess the progress that has been made towards the control and elimination of canine rabies. The SARE assessment identified a number of critical gaps, including poor inter-sectoral collaboration and limited availability and access to dog vaccine, while the existence of a surveillance system for rabies and legislation for outbreak declaration and response were among the strengths identified. The SARE tool enabled key criteria to be prioritized, thereby accelerating the National Strategy and ensuring that Ethiopia will progress rapidly in line with the goals set by the global community for the elimination of human rabies deaths by 2030. Although the analysis showed that Ethiopia is still in the early stages of rabies control (Stage 0.5/5), the country shows great promise in terms of developing a SARE-guided National Rabies Prevention and Control Strategy. Copyright © 2016 Elsevier B.V. All rights reserved.

Risk factors for postconcussion symptom reporting after traumatic brain injury in U.S. military service members.

PubMed

Lange, Rael T; Brickell, Tracey; French, Louis M; Ivins, Brian; Bhagwat, Aditya; Pancholi, Sonal; Iverson, Grant L

2013-02-15

The purpose of this study was to identify factors that are predictive of, or associated with, postconcussion symptom reporting after traumatic brain injury (TBI) in the U.S. military. Participants were 125 U.S. military service members (age: M=29.6 years, standard deviation [SD]=8.9, range=18-56 years) who sustained a TBI, divided into two groups based on symptom criteria for postconcussional disorder (PCD): PCD-Present (n=65) and PCD-Absent (n=60). Participants completed a neuropsychological evaluation at Walter Reed Army Medical Center (M=9.4 months after injury, SD=9.9; range: 1.1 to 44.8). Factors examined included demographic characteristics, injury-related variables, psychological testing, and effort testing. There were no significant group differences for age, sex, education, race, estimated premorbid intelligence, number of deployments, combat versus non-combat related injury, or mechanism of injury (p>0.098 for all). There were significant main effects for severity of body injury, duration of loss of consciousness, duration of post-traumatic amnesia, intracranial abnormality, time tested post-injury, possible symptom exaggeration, poor effort, depression, and traumatic stress (p<0.044 for all). PCD symptom reporting was most strongly associated with possible symptom exaggeration, poor effort, depression, and traumatic stress. PCD rarely occurred in the absence of depression, traumatic stress, possible symptom exaggeration, or poor effort (n=7, 5.6%). Many factors unrelated to brain injury were influential in self-reported postconcussion symptoms in this sample. Clinicians cannot assume uncritically that endorsement of items on a postconcussion symptom checklist is indicative of residual effects from a brain injury.

A pilot study of routine immunization data quality in Bunza Local Government area: causes and possible remedies.

PubMed

Omoleke, Semeeh Akinwale; Tadesse, Menberu Getachew

2017-01-01

As a result of poor quality administrative data for routine immunisation (RI) in Nigeria, the real coverage of RI remains unknown, constituting a setback in curtailing vaccine preventable diseases (VPDs). Consequently, the purpose of this pilot study is to identify source(s) and evaluate the magnitude of poor data quality as well as propose recommendations to address the problem. The authors conducted a cross-sectional study in which 5 out of the 22 health facilities providing routine immunization services in Bunza Local Government Area (LGA), Kebbi State, Nigeria, were selected for data quality assessment. The reported coverage of RI in August and September, 2016 was the primary element of evaluation in the selected Health Facilities (HFs). Administered questionnaires were adapted from WHO Data Quality Assurance and RI monitoring tools to generate data from the HFs, as well as standardised community survey tool for household surveys. Data inconsistency was detected in 100% of the selected HFs. Maximum difference between HF monthly summary and RI registration book for penta 3 data quality report analysis was 820% and 767% in MCH Bunza and PHC Balu respectively. However, a minimum difference of 3% was observed at Loko Dispensary. Maximum difference between HF summary and RI registration for measles was 614% at MCH Bunza and 43% minimum difference at Loko. In contrast to the administrative coverage, 60-80% of the children sampled from households were either not immunised or partially immunised. Further, the main sources of poor data quality include heavy workload on RI providers, over-reliance on administrative coverage report, and lack of understanding of the significance of high data quality by RI providers. Substantial data discrepancies were observed in RI reports from all the Health Facilities which is indicative of poor data quality at the LGA level. Community surveys also revealed an over-reporting from administrative coverage data. Consequently, efforts should be geared towards achieving good data quality by immunisation stakeholders as it has implication on disease prevention and control efforts.

A pilot study of routine immunization data quality in Bunza Local Government area: causes and possible remedies

PubMed Central

Omoleke, Semeeh Akinwale; Tadesse, Menberu Getachew

2017-01-01

Introduction As a result of poor quality administrative data for routine immunisation (RI) in Nigeria, the real coverage of RI remains unknown, constituting a setback in curtailing vaccine preventable diseases (VPDs). Consequently, the purpose of this pilot study is to identify source(s) and evaluate the magnitude of poor data quality as well as propose recommendations to address the problem. Methods The authors conducted a cross-sectional study in which 5 out of the 22 health facilities providing routine immunization services in Bunza Local Government Area (LGA), Kebbi State, Nigeria, were selected for data quality assessment. The reported coverage of RI in August and September, 2016 was the primary element of evaluation in the selected Health Facilities (HFs). Administered questionnaires were adapted from WHO Data Quality Assurance and RI monitoring tools to generate data from the HFs, as well as standardised community survey tool for household surveys. Results Data inconsistency was detected in 100% of the selected HFs. Maximum difference between HF monthly summary and RI registration book for penta 3 data quality report analysis was 820% and 767% in MCH Bunza and PHC Balu respectively. However, a minimum difference of 3% was observed at Loko Dispensary. Maximum difference between HF summary and RI registration for measles was 614% at MCH Bunza and 43% minimum difference at Loko. In contrast to the administrative coverage, 60-80% of the children sampled from households were either not immunised or partially immunised. Further, the main sources of poor data quality include heavy workload on RI providers, over-reliance on administrative coverage report, and lack of understanding of the significance of high data quality by RI providers. Conclusion Substantial data discrepancies were observed in RI reports from all the Health Facilities which is indicative of poor data quality at the LGA level. Community surveys also revealed an over-reporting from administrative coverage data. Consequently, efforts should be geared towards achieving good data quality by immunisation stakeholders as it has implication on disease prevention and control efforts. PMID:28979641

Effort-reward imbalance at work and self-rated health of Las Vegas hotel room cleaners.

PubMed

Krause, Niklas; Rugulies, Reiner; Maslach, Christina

2010-04-01

This study investigates the relationship between effort-reward-imbalance (ERI) at work and self-rated health (SF-36) among 941 Las Vegas hotel room cleaners (99% female, 84% immigrant). Logistic regression models adjust for age, health behaviors, physical workload and other potential confounders. 50% reported ERI and 60% poor or fair general health. Significant associations were found between ERI and all SF-36 health measures. Workers in the upper quartile of the efforts/rewards ratio were 2-5 times more likely to experience poor or fair general health, low physical function, high levels of pain, fatigue, and role limitations due to physical and mental health problems. The cross-sectional design limits causal interpretation of these associations. However, the development of interventions to reduce ERI and to improve general health among room cleaners deserves high priority considering that both high ERI and low self-rated health have predicted chronic diseases and mortality in prospective studies. (c) 2009 Wiley-Liss, Inc.

"It was a Long Way from Perfect, but it was Working": The Canning and Home Production Initiatives in Greene County, Georgia, 1940-1942 .

PubMed

Kuhn, Clifford M

2012-01-01

During the early 1940s Greene County, Georgia's, Unified Farm Program, a model undertaking coordinating the efforts of federal, state, and local agencies, attracted national attention, largely through the work of sociologist Arthur Raper. At the core of the program was the effort to raise the standard of living for the county's rural poor through increasing home-farm production and improving diet. The initiative entailed active intervention by Farm Security Administration farm and home supervisors and illustrates the tension between the desire to promote independence among poor farmers and the impulse to closely supervise and monitor them. This treatment contributes to the discussion of modernism during the late rural New Deal.

To Mrs. Roosevelt, Who "Looks for the Poor" and to FDR: The CCC Is "A Vain Effort to Placate Youth." Teaching Ideas.

ERIC Educational Resources Information Center

Cohen, Robert

1996-01-01

Utilizes letters to the First Lady and President Roosevelt as primary sources for a series of activities supporting a unit on the Great Depression. The letter to Mrs. Roosevelt asks for some old clothes for a needy family. The letter to President Roosevelt expresses dissatisfaction with his efforts. (MJP)

Three methods to monitor utilization of healthcare services by the poor

PubMed Central

Bhuiya, Abbas; Hanifi, SMA; Urni, Farhana; Mahmood, Shehrin Shaila

2009-01-01

Background Achieving equity by way of improving the condition of the economically poor or otherwise disadvantaged is among the core goals of contemporary development paradigm. This places importance on monitoring outcome indicators among the poor. National surveys allow disaggregation of outcomes by socioeconomic status at national level and do not have statistical adequacy to provide estimates for lower level administrative units. This limits the utility of these data for programme managers to know how well particular services are reaching the poor at the lowest level. Managers are thus left without a tool for monitoring results for the poor at lower levels. This paper demonstrates that with some extra efforts community and facility based data at the lower level can be used to monitor utilization of healthcare services by the poor. Methods Data used in this paper came from two sources- Chakaria Health and Demographic Surveillance System (HDSS) of ICDDR,B and from a special study conducted during 2006 among patients attending the public and private health facilities in Chakaria, Bangladesh. The outcome variables included use of skilled attendants for delivery and use of facilities. Rate-ratio, rate-difference, concentration index, benefit incidence ratio, sequential sampling, and Lot Quality Assurance Sampling were used to assess how pro-poor is the use of skilled attendants for delivery and healthcare facilities. Findings Poor are using skilled attendants for delivery far less than the better offs. Government health service facilities are used more than the private facilities by the poor. Benefit incidence analysis and sequential sampling techniques could assess the situation realistically which can be used for monitoring utilization of services by poor. The visual display of the findings makes both these methods attractive. LQAS, on the other hand, requires small fixed sample and always enables decision making. Conclusion With some extra efforts monitoring of the utilization of healthcare services by the poor at the facilities can be done reliably. If monitored, the findings can guide the programme and facility managers to act in a timely fashion to improve the effectiveness of the programme in reaching the poor. PMID:19650938

Integrating tobacco control into health and development agendas.

PubMed

Reddy, K Srinath; Yadav, Amit; Arora, Monika; Nazar, Gaurang P

2012-03-01

Tobacco use is one of the major risk factors for non-communicable diseases, with a profound impact on resource-poor low-income and middle-income countries such as India, where tobacco use is high and where socioeconomic as well as health inequalities are rampant. Effective implementation of the Framework Convention on Tobacco Control requires multisectoral efforts that can fructify through integration of tobacco control into broader health and development agendas such as food and water security, environment, the right to education and human rights. The global tobacco control community will need to explore innovative partnerships beyond its traditional confines and build a global coalition that supports tobacco control by partnering with others having convergent concerns on common determinants. A firm political commitment and intersectoral coordination between government and non-government agencies is paramount in order to implement effective tobacco control programmes. Integration of tobacco control into other health and development agendas as described in this paper has the potential to contribute to the achievement of all the eight United Nations Millennium Development Goals. This paper explores why the whole of government should accord a high priority to tobacco control, and how this integration could be achieved.

The influence of television and video game use on attention and school problems: a multivariate analysis with other risk factors controlled.

PubMed

Ferguson, Christopher J

2011-06-01

Research on youth mental health has increasingly indicated the importance of multivariate analyses of multiple risk factors for negative outcomes. Television and video game use have often been posited as potential contributors to attention problems, but previous studies have not always been well-controlled or used well-validated outcome measures. The current study examines the multivariate nature of risk factors for attention problems symptomatic of attention deficit hyperactivity disorder and poor school performance. A predominantly Hispanic population of 603 children (ages 10-14) and their parents/guardians responded to multiple behavioral measures. Outcome measures included parent and child reported attention problem behaviors on the Child Behavior Checklist (CBCL) as well as poor school performance as measured by grade point average (GPA). Results found that internal factors such as male gender, antisocial traits, family environment and anxiety best predicted attention problems. School performance was best predicted by family income. Television and video game use, whether total time spent using, or exposure to violent content specifically, did not predict attention problems or GPA. Television and video game use do not appear to be significant predictors of childhood attention problems. Intervention and prevention efforts may be better spent on other risk factors. Copyright © 2010 Elsevier Ltd. All rights reserved.

Factors related to severe untreated tooth decay in rural adolescents: a case-control study for public health planning.

PubMed

Skaret, E; Weinstein, P; Milgrom, P; Kaakko, T; Getz, T

2004-01-01

In this case-control study of rural adolescents we identified factors to discriminate those who have high levels of tooth decay and receive treatment from those with similar levels who receive no treatment. The sample was drawn from all 12-20-year-olds (n = 439) in a rural high school in Washington State, U.S. The criterion for being included was 5 or more decayed, missing or filled teeth. The questionnaire included structure, history, cognition and expectation variables based on a model by Grembowski, Andersen and Chen. No structural variable was related to the dependent variable. Two of 10 history variables were related: perceived poor own dental health and perceived poor mother's dental health. Four of eight cognition variables were also predictive: negative beliefs about the dentist, not planning to go to a dentist even if having severe problems, not being in any club or playing on a sports team and not having a best friend. No relationship was found for the expectation variable 'usual source of care'. These data are consistent with the hypothesis that untreated tooth decay is associated with avoidance of care and point to the importance of history and cognition variables in planning efforts to improve oral health of rural adolescents.

Household instability and self-regulation among poor children

PubMed Central

McCoy, Dana Charles; Raver, C. Cybele

2015-01-01

Past research suggests that poverty may negatively influence children’s psychological and behavioral health by increasing their exposure to chaotic living conditions in the household. The present study provides a descriptive ‘snapshot’ of instability in low-income households, and examines the associations between exposure to major destabilizing events over the course of a year and three domains of poor urban children’s self-regulation. Descriptive analyses suggest that although caregivers from unstable households report higher average levels of health problems and depression, they also have greater assets/savings, are more educated, and are less likely to be immigrants than caregivers from stable households. Results of propensity score-matched regression analyses reveal that high levels of household instability are significantly and negatively associated with preschoolers’ effortful control and global attention/impulsivity control, but not with their executive function. Children from mildly unstable homes (i.e., those who had experienced a single destabilizing event in the past year) showed no significant differences in any domain of self-regulation relative to their peers from stable households, suggesting a dose-response relationship between the number of destabilizing events experienced by children and their outcomes. Implications for theories of poverty-related adversity, stress, and parenting are discussed in addition to future directions for research. PMID:26924923

Chinese children's effortful control and dispositional anger/frustration: relations to parenting styles and children's social functioning.

PubMed

Zhou, Qing; Eisenberg, Nancy; Wang, Yun; Reiser, Mark

2004-05-01

Relations among authoritative and authoritarian parenting styles, children's effortful control and dispositional anger/frustration, and children's social functioning were examined for 425 first and second graders (7-10 years old) in Beijing, China. Parents reported on parenting styles; parents and teachers rated children's effortful control, anger/frustration, externalizing problems, and socially appropriate behaviors: and peers rated aggression and leadership/sociability. High effortful control and low dispositional anger/frustration uniquely predicted Chinese children's high social functioning, and the relation of anger/frustration to social functioning was moderated by effortful control. Authoritarian parenting was associated with children's low effortful control and high dispositional anger/frustration, which (especially effortful control) mediated the negative relation between authoritarian parenting and children's social functioning. Effortful control weakly mediated the positive relation of authoritative parenting to social functioning.

Association between adherence to concomitant proton pump inhibitor therapy in current NSAID users and upper gastrointestinal complications.

PubMed

Jonasson, Christian; Hatlebakk, Jan G; Lundell, Lars; Kouri, Jukka P; Andersen, Morten; Granath, Fredrik

2013-05-01

Proton pump inhibitors (PPIs) play a well-documented role as a gastroprotective agent among NSAID users at an increased risk of peptic ulcer and bleeding. Observational studies have, however, suggested that the clinical efficacy of PPI therapy may be reduced because of poor adherence. To study the association between adherence to concomitant PPI in current NSAID users and the risk of peptic ulcer and bleeding. Case-control study linking nationwide data from the Swedish Patient Registry with the Swedish Drug Prescription Database. The study population included patients admitted for a first-time peptic ulcer or bleeding and who were incident users of NSAID. Each case was matched on age, sex, NSAID duration, and calendar month with five controls. PPI adherence was calculated as the proportion of NSAID days being covered by PPI therapy. Matched and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using conditional logistic regression. A total of 3649 cases were identified. Patients with poor adherence (<20% PPI coverage) had a significantly increased risk of upper gastrointestinal complications (OR=1.88, 95% CI 1.22-2.88) compared with fully adherent patients (≥80% PPI coverage). As a continuous variable, the risk of an event increased with 6% points for every 10% decrease in PPI adherence (OR=1.06, 95% CI 1.03-1.10). The gastroprotective effect of PPI in NSAID users is highly dependent on adherence, with about twice the risk in patients with poor adherence. Efforts to increase adherence should be an integrated part of clinical practice.

Proteomic analysis of serum and sputum analytes distinguishes controlled and poorly controlled asthmatics.

PubMed

Kasaian, M T; Lee, J; Brennan, A; Danto, S I; Black, K E; Fitz, L; Dixon, A E

2018-04-17

A major goal of asthma therapy is to achieve disease control, with maintenance of lung function, reduced need for rescue medication, and prevention of exacerbation. Despite current standard of care, up to 70% of patients with asthma remain poorly controlled. Analysis of serum and sputum biomarkers could offer insights into parameters associated with poor asthma control. To identify signatures as determinants of asthma disease control, we performed proteomics using Olink proximity extension analysis. Up to 3 longitudinal serum samples were collected from 23 controlled and 25 poorly controlled asthmatics. Nine of the controlled and 8 of the poorly controlled subjects also provided 2 longitudinal sputum samples. The study included an additional cohort of 9 subjects whose serum was collected within 48 hours of asthma exacerbation. Two separate pre-defined Proseek Multiplex panels (INF and CVDIII) were run to quantify 181 separate protein analytes in serum and sputum. Panels consisting of 9 markers in serum (CCL19, CCL25, CDCP1, CCL11, FGF21, FGF23, Flt3L, IL-10Rβ, IL-6) and 16 markers in sputum (tPA, KLK6, RETN, ADA, MMP9, Chit1, GRN, PGLYRP1, MPO, HGF, PRTN3, DNER, PI3, Chi3L1, AZU1, and OPG) distinguished controlled and poorly controlled asthmatics. The sputum analytes were consistent with a pattern of neutrophil activation associated with poor asthma control. The serum analyte profile of the exacerbation cohort resembled that of the controlled group rather than that of the poorly controlled asthmatics, possibly reflecting a therapeutic response to systemic corticosteroids. Proteomic profiles in serum and sputum distinguished controlled and poorly controlled asthmatics, and were maintained over time. Findings support a link between sputum neutrophil markers and loss of asthma control. © 2018 John Wiley & Sons Ltd.

Hand Washing Practices Among Emergency Medical Services Providers.

PubMed

Bucher, Joshua; Donovan, Colleen; Ohman-Strickland, Pamela; McCoy, Jonathan

2015-09-01

Hand hygiene is an important component of infection control efforts. Our primary and secondary goals were to determine the reported rates of hand washing and stethoscope cleaning in emergency medical services (EMS) workers, respectively. We designed a survey about hand hygiene practices. The survey was distributed to various national EMS organizations through e-mail. Descriptive statistics were calculated for survey items (responses on a Likert scale) and subpopulations of survey respondents to identify relationships between variables. We used analysis of variance to test differences in means between the subgroups. There were 1,494 responses. Overall, reported hand hygiene practices were poor among pre-hospital providers in all clinical situations. Women reported that they washed their hands more frequently than men overall, although the differences were unlikely to be clinically significant. Hygiene after invasive procedures was reported to be poor. The presence of available hand sanitizer in the ambulance did not improve reported hygiene rates but improved reported rates of cleaning the stethoscope (absolute difference 0.4, p=0.0003). Providers who brought their own sanitizer were more likely to clean their hands. Reported hand hygiene is poor amongst pre-hospital providers. There is a need for future intervention to improve reported performance in pre-hospital provider hand washing.

The Rotator Cuff Organ: Integrating Developmental Biology, Tissue Engineering, and Surgical Considerations to Treat Chronic Massive Rotator Cuff Tears.

PubMed

Rothrauff, Benjamin B; Pauyo, Thierry; Debski, Richard E; Rodosky, Mark W; Tuan, Rocky S; Musahl, Volker

2017-08-01

The torn rotator cuff remains a persistent orthopedic challenge, with poor outcomes disproportionately associated with chronic, massive tears. Degenerative changes in the tissues that comprise the rotator cuff organ, including muscle, tendon, and bone, contribute to the poor healing capacity of chronic tears, resulting in poor function and an increased risk for repair failure. Tissue engineering strategies to augment rotator cuff repair have been developed in an effort to improve rotator cuff healing and have focused on three principal aims: (1) immediate mechanical augmentation of the surgical repair, (2) restoration of muscle quality and contractility, and (3) regeneration of native enthesis structure. Work in these areas will be reviewed in sequence, highlighting the relevant pathophysiology, developmental biology, and biomechanics, which must be considered when designing therapeutic applications. While the independent use of these strategies has shown promise, synergistic benefits may emerge from their combined application given the interdependence of the tissues that constitute the rotator cuff organ. Furthermore, controlled mobilization of augmented rotator cuff repairs during postoperative rehabilitation may provide mechanotransductive cues capable of guiding tissue regeneration and restoration of rotator cuff function. Present challenges and future possibilities will be identified, which if realized, may provide solutions to the vexing condition of chronic massive rotator cuff tears.

Hand Washing Practices Among Emergency Medical Services Providers

PubMed Central

Bucher, Joshua; Donovan, Colleen; Ohman-Strickland, Pamela; McCoy, Jonathan

2015-01-01

Introduction Hand hygiene is an important component of infection control efforts. Our primary and secondary goals were to determine the reported rates of hand washing and stethoscope cleaning in emergency medical services (EMS) workers, respectively. Methods We designed a survey about hand hygiene practices. The survey was distributed to various national EMS organizations through e-mail. Descriptive statistics were calculated for survey items (responses on a Likert scale) and subpopulations of survey respondents to identify relationships between variables. We used analysis of variance to test differences in means between the subgroups. Results There were 1,494 responses. Overall, reported hand hygiene practices were poor among pre-hospital providers in all clinical situations. Women reported that they washed their hands more frequently than men overall, although the differences were unlikely to be clinically significant. Hygiene after invasive procedures was reported to be poor. The presence of available hand sanitizer in the ambulance did not improve reported hygiene rates but improved reported rates of cleaning the stethoscope (absolute difference 0.4, p=0.0003). Providers who brought their own sanitizer were more likely to clean their hands. Conclusion Reported hand hygiene is poor amongst pre-hospital providers. There is a need for future intervention to improve reported performance in pre-hospital provider hand washing. PMID:26587098

A Model for Pharmacological Research-Treatment of Cocaine Dependence

PubMed Central

Montoya, Ivan D.; Hess, Judith M.; Preston, Kenzie L.; Gorelick, David A.

2008-01-01

Major problems for research on pharmacological treatments for cocaine dependence are lack of comparability of results from different treatment research programs and poor validity and/or reliability of results. Double-blind, placebo-controlled, random assignment, experimental designs, using standard intake and assessment procedures help to reduce these problems. Cessation or reduction of drug use and/or craving, retention in treatment, and medical and psychosocial improvement are some of the outcome variables collected in treatment research programs. A model to be followed across different outpatient clinical trials for pharmacological treatment of cocaine dependence is presented here. This model represents an effort to standardize data collection to make results more valid and comparable. PMID:8749725

Are we doing enough to prevent poor-quality antimalarial medicines in the developing world?

PubMed

Walker, Erin J; Peterson, Gregory M; Grech, James; Paragalli, Evie; Thomas, Jackson

2018-05-15

Malaria is a deadly parasitic disease that affects more than 3 billion people worldwide, in predominantly resource-poor countries. Despite malaria being preventable and treatable, a large number of adults and children, mostly in Africa, die from this disease each year. One contributor to needless morbidity and mortality is the production and distribution of poor-quality antimalarial medicines; indeed, it is estimated that over 122,000 deaths of children under 5 years of age in sub-Saharan countries were caused by poor-quality antimalarial medicines, in 2013 alone. Poor-quality medicines include those that are deliberately falsified for monetary gain and may contain incorrect amounts or even no active ingredients at all, as well as products that are inadequate due to poor compliance to conventional quality standards and medicines that have degraded over time. Across a number of studies it has been reported that 4-92% of antimalarials tested are poor quality. This represents a massive risk to the population subjected to the use of these medicines, in the form of more severe and prolonged illness, additional costs to individuals who already have very little money, and lack of confidence in treatments. The continuing circulation of poor-quality medicines results from a number of factors, including insufficient regulatory capacity in susceptible countries, inadequate funding to perform regulatory functions, poor coordination between regulatory authorities, and inefficient import/export control systems. To combat the distribution of poor-quality medicines a number of organisations have developed guidelines for the procurement of antimalarials, and programs to educate consumers about the risks of poor-quality medicines and incentivise retailers to identify and report falsified medicines. The development of new technologies to quickly identify poor-quality medicines in the field is also essential, and some significant advances have been made. There has been considerable improvement in the delivery of high-quality antimalarials to those who need them; however, there is still an urgent need for a collective response by the international community, political leaders, regulatory bodies, and pharmaceutical companies. This should include political commitment for enhanced research and development funding, such as for new innovative track-and-trace field devices, and international efforts to strengthen and harmonise drug regulation practices.

Why does Bangladesh remain so poor? Part I: the situation and efforts to change it.

PubMed

Maloney, C

1985-01-01

This 1st part of the discussion of the poverty in Bangladesh reviews efforts on the part of individuals, donor agencies, and the government to alleviate poverty, and some goals of the new Third Five Year Plan. More than 3/4 of the people of Bangladesh live in poverty or close to it, according to development and economic criteria. Bangladesh society has hardly any parallel in the world if viewed from the perspective of its capacity, like a biological species, to adapt to an ecological niche and then reproduce to fill that niche. This defines success in biological terms. The Bangladesh society that developed was highly in tune with the natural environment of the rice growing plains. Social organization, kinship, settlement pattern, economic transactions, beliefs systems, and reproductive biology all developed in close symbiosis with the land. From a humanitarian perspective, Bangladesh is also highly successful. The human interaction, the expressive culture, the fullness of life, and the verbal arts all are more fully expressed than in many cultures. By "development" criteria, Bangladesh appears highly unsuccessful. Per capita income is about $130 a year. Bangladesh ranks very low in such indices as literacy, housing, roads, health services, infant survival, loan recovery, exportable goods, and control of the population growth rate. There is no question but that individuals usually are well aware if their situation is precarious, and they take rational action to improve their security; the government and private agencies have a multitude of programs aimed at alleviating poverty. For Bangladesh as a whole, domestic savings in 1984-85 was 8%, and during the Second Five Year Plan the rate of domestic savings increased faster than was expected, compared with income. Almost all the nongovernmental organizations (NGOs), many bilateral donor agencies, and huge segments of government target their efforts to the poor and the small farmers. There are over 150 NGOs of substantial size in Bangladesh, besides many local ones. A 1985 survey of NGO programs to help the poor save and invest found that they have been successful generally in improving the economic condition of the target people. In comparison with the private agencies, government programs to reach small farmers and the poor tend not to work as well because they suffer from the pervasive malaise that affects almost all such attempts through the bureaucracy. Yet, the success they have achieved, as in raising agricultural productivity, accounts in significant measure for the economic stability of the country to date. The key goals of the country to date. The key goals of the Third Five Year Plan are: annual economic growth of 5.4%; reduction of annual population growth to 1.8%; and by the end of the plan raising at least 10% of the rural poor above the poverty line.

Neurophysiological Studies of Auditory Verbal Hallucinations

PubMed Central

Ford, Judith M.; Dierks, Thomas; Fisher, Derek J.; Herrmann, Christoph S.; Hubl, Daniela; Kindler, Jochen; Koenig, Thomas; Mathalon, Daniel H.; Spencer, Kevin M.; Strik, Werner; van Lutterveld, Remko

2012-01-01

We discuss 3 neurophysiological approaches to study auditory verbal hallucinations (AVH). First, we describe “state” (or symptom capture) studies where periods with and without hallucinations are compared “within” a patient. These studies take 2 forms: passive studies, where brain activity during these states is compared, and probe studies, where brain responses to sounds during these states are compared. EEG (electroencephalography) and MEG (magnetoencephalography) data point to frontal and temporal lobe activity, the latter resulting in competition with external sounds for auditory resources. Second, we discuss “trait” studies where EEG and MEG responses to sounds are recorded from patients who hallucinate and those who do not. They suggest a tendency to hallucinate is associated with competition for auditory processing resources. Third, we discuss studies addressing possible mechanisms of AVH, including spontaneous neural activity, abnormal self-monitoring, and dysfunctional interregional communication. While most studies show differences in EEG and MEG responses between patients and controls, far fewer show symptom relationships. We conclude that efforts to understand the pathophysiology of AVH using EEG and MEG have been hindered by poor anatomical resolution of the EEG and MEG measures, poor assessment of symptoms, poor understanding of the phenomenon, poor models of the phenomenon, decoupling of the symptoms from the neurophysiology due to medications and comorbidites, and the possibility that the schizophrenia diagnosis breeds truer than the symptoms it comprises. These problems are common to studies of other psychiatric symptoms and should be considered when attempting to understand the basic neural mechanisms responsible for them. PMID:22368236

Influence of poor effort on neuropsychological test performance in U.S. military personnel following mild traumatic brain injury.

PubMed

Lange, Rael T; Pancholi, Sonal; Bhagwat, Aditya; Anderson-Barnes, Victoria; French, Louis M

2012-01-01

The purpose of this study was to examine the influence of poor effort on neuropsychological test performance in military personnel following mild traumatic brain injury (MTBI). Participants were 143 U.S. service members who sustained a TBI, divided into three groups based on injury severity and performance on the Word Memory Test and four embedded markers of poor effort: MTBI-pass (n = 87), MTBI-fail (n = 21), and STBI-pass (n = 35; where STBI denotes severe TBI). Patients were evaluated at the Walter Reed Army Medical Center on average 3.9 months (SD = 3.4) post injury. The majority of the sample was Caucasian (84.6%), was male (93.0%), and had 12+ years of education (96.5%). Measures included the Personality Assessment Inventory (PAI) and 13 common neurocognitive measures. Patients in the MTBI-fail group performed worse on the majority of neurocognitive measures, followed by the Severe TBI-Pass group and the MTBI-pass group. Using a criterion of three or more low scores <10th percentile, the MTBI-fail group had the greatest rate of impairment (76.2%), followed by the Severe TBI-Pass group (34.3%) and MTBI-pass group (16.1%). On the PAI, the MTBI-fail group had higher scores on the majority of clinical scales (p < .05). There were a greater number of elevated scales (e.g., 5 or more elevated mild or higher) in the MTBI-fail group (71.4%) than in the MTBI-pass group (32.2%) and Severe TBI-Pass group (17.1%). Effort testing is an important component of postacute neuropsychological evaluations following combat-related MTBI. Those who fail effort testing are likely to be misdiagnosed as having severe cognitive impairment, and their symptom reporting is likely to be inaccurate.

Antimicrobial Materials for Advanced Microbial Control in Spacecraft Water Systems

NASA Technical Reports Server (NTRS)

Birmele, Michele; Caro, Janicce; Newsham, Gerard; Roberts, Michael; Morford, Megan; Wheeler, Ray

2012-01-01

Microbial detection, identification, and control are essential for the maintenance and preservation of spacecraft water systems. Requirements set by NASA put limitations on the energy, mass, materials, noise, cost, and crew time that can be devoted to microbial control. Efforts are being made to attain real-time detection and identification of microbial contamination in microgravity environments. Research for evaluating technologies for capability enhancement on-orbit is currently focused on the use of adenosine triphosphate (ATP) analysis for detection purposes and polymerase chain reaction (peR) for microbial identification. Additional research is being conducted on how to control for microbial contamination on a continual basis. Existing microbial control methods in spacecraft utilize iodine or ionic silver biocides, physical disinfection, and point-of-use sterilization filters. Although these methods are effective, they require re-dosing due to loss of efficacy, have low human toxicity thresholds, produce poor taste, and consume valuable mass and crew time. Thus, alternative methods for microbial control are needed. This project also explores ultraviolet light-emitting diodes (UV-LEDs), surface passivation methods for maintaining residual biocide levels, and several antimicrobial materials aimed at improving current microbial control techniques, as well as addressing other materials presently under analysis and future directions to be pursued.

The effects of community income inequality on health: Evidence from a randomized control trial in the Bolivian Amazon.

PubMed

Undurraga, Eduardo A; Behrman, Jere R; Leonard, William R; Godoy, Ricardo A

2016-01-01

Research suggests that poorer people have worse health than the better-off and, more controversially, that income inequality harms health. But causal interpretations suffer from endogeneity. We addressed the gap by using a randomized control trial among a society of forager-farmers in the Bolivian Amazon. Treatments included one-time unconditional income transfers (T1) to all households and (T2) only to the poorest 20% of households, with other villages as controls. We assessed the effects of income inequality, absolute income, and spillovers within villages on self-reported health, objective indicators of health and nutrition, and adults' substance consumption. Most effects came from relative income. Targeted transfers increased the perceived stress of participants in better-off households. Evidence suggests increased work efforts among better-off households when the lot of the poor improved, possibly due to a preference for rank preservation. The study points to new paths by which inequality might affect health. Copyright © 2015 Elsevier Ltd. All rights reserved.

The effects of community income inequality on health: Evidence from a randomized control trial in the Bolivian Amazon

PubMed Central

Undurraga, Eduardo A.; Behrman, Jere R.; Leonard, William R.; Godoy, Ricardo A.

2015-01-01

Research suggests that poorer people have worse health than the better-off and, more controversially, that income inequality harms health. But causal interpretations suffer from endogeneity. We addressed the gap by using a randomized control trial among a society of forager-farmers in the Bolivian Amazon. Treatments included one-time unconditional income transfers (T1) to all households and (T2) only to the poorest 20% of households, with other villages as controls. We assessed the effects of income inequality, absolute income, and spillovers within villages on self-reported health, objective indicators of health and nutrition, and adults’ substance consumption. Most effects came from relative income. Targeted transfers increased the perceived stress of participants in better-off households. Evidence suggests increased work efforts among better-off households when the lot of the poor improved, possibly due to a preference for rank preservation. The study points to new paths by which inequality might affect health. PMID:26706403

Alarms Philosophy

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

White, Karen S; Kasemir, Kay

2009-01-01

An effective alarm system consists of a mechanism to monitor control points and generate alarm notifications, tools for operators to view, hear, acknowledge and handle alarms and a good configuration. Despite the availability of numerous fully featured tools, accelerator alarm systems continue to be disappointing to operations, frequently to the point of alarms being permanently silenced or totally ignored. This is often due to configurations that produce an excessive number of alarms or fail to communicate the required operator response. Most accelerator controls systems do a good job of monitoring specified points and generating notifications when parameters exceed predefined limits.more » In some cases, improved tools can help, but more often, poor configuration is the root cause of ineffective alarm systems. A SNS, we have invested considerable effort in generating appropriate configurations using a rigorous set of rules based on best practices in the industrial process controls community. This paper will discuss our alarm configuration philosophy and operator response to our new system.« less

Traits, States, and Attentional Gates: Temperament and Threat Relevance as Predictors of Attentional Bias to Social Threat

PubMed Central

Helzer, Erik G.; Connor-Smith, Jennifer K.; Reed, Marjorie A.

2009-01-01

This study investigated the influence of situational and dispositional factors on attentional biases toward social threat, and the impact of these attentional biases on distress in a sample of adolescents. Results suggest greater biases for personally-relevant threat cues, as individuals reporting high social stress were vigilant to subliminal social threat cues, but not physical threat cues, and those reporting low social stress showed no attentional biases. Individual differences in fearful temperament and attentional control interacted to influence attentional biases, with fearful temperament predicting biases to supraliminal social threat only for individuals with poor attentional control. Multivariate analyses exploring relations between attentional biases for social threat and symptoms of anxiety and depression revealed that attentional biases alone were rarely related to symptoms. However, biases did interact with social stress, fearful temperament, and attentional control to predict distress. Results are discussed in terms of automatic and effortful cognitive mechanisms underlying threat cue processing. PMID:18791905

Soil-Transmitted Helminthiasis and Schistosomiasis in Children of Poor Families in Leyte, Philippines: Lessons for Disease Prevention and Control.

PubMed

Liwanag, Harvy Joy; Uy, Jhanna; Bataller, Ramil; Gatchalian, Janis Ruth; De La Calzada, Betty; Uy, Justine Alessandra; Dayrit, Manuel

2017-10-01

Neglected tropical diseases (NTDs) continue to be a public health problem in the Philippines. We assessed the association of soil-transmitted helminthiasis (STH) and schistosomiasis with selected health-related and socioeconomic variables in four villages in Leyte, Philippines. Stool specimens from 418 adults and 533 of their children from 209 families were examined through the Kato-Katz technique. STH and schistosomiasis were present in 64.6% and 12.5%, respectively, of study participants. Analysis through the generalized linear mixed model revealed a number of associations between infection in parents and their children. Findings indicate that years of disease prevention and control efforts in these areas have been unable to bring down prevalence in children and their parents. Eliminating NTDs as public health problems will require a systems thinking approach beyond implementation of vertical control programs alone. © The Author [2017]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Biology, diversity and strategies for the monitoring and control of triatomines--Chagas disease vectors.

PubMed

Costa, Jane; Lorenzo, Marcelo

2009-07-01

Despite the relevant achievements in the control of the main Chagas disease vectors Triatoma infestans and Rhodnius prolixus, several factors still promote the risk of infection. The disease is a real threat to the poor rural regions of several countries in Latin America. The current situation in Brazil requires renewed attention due to its high diversity of triatomine species and to the rapid and drastic environmental changes that are occurring. Using the biology, behaviour and diversity of triatomines as a basis for new strategies for monitoring and controlling the vectorial transmission are discussed here. The importance of ongoing long-term monitoring activities for house infestations by T. infestans, Triatoma brasiliensis, Panstrongylus megistus, Triatoma rubrovaria and R. prolixus is also stressed, as well as understanding the invasion by sylvatic species. Moreover, the insecticide resistance is analysed. Strong efforts to sustain and improve surveillance procedures are crucial, especially when the vectorial transmission is considered interrupted in many endemic areas.

Minority Programs and Activities of the College Entrance Examination Board: A Critical Review and a Brief Look Ahead.

ERIC Educational Resources Information Center

Hanford, George H.

The College Entrance Examination Board's (CEEB) internal review of its efforts to develop and implement programs to expand educational opportunities for minorities and the poor revealed that the Board had not been as successful as it had hoped. Most of the Board's efforts to ensure equal access to higher education focused on guidance programs,…

Challenges in controlling the Ebola outbreak in two prefectures in Guinea: why did communities continue to resist?

PubMed

Thiam, Sylla; Delamou, Alexandre; Camara, Soriba; Carter, Jane; Lama, Eugene Kaman; Ndiaye, Bara; Nyagero, Josephat; Nduba, John; Ngom, Mor

2015-01-01

The Ebola outbreak emerged in a remote corner of Guinea in December 2013, and spread into Liberia and Sierra Leone in the context of weak health systems. In this paper, we report on the main challenges faced by frontline health services and by communities including their perceptions and views on the current Ebola response in the Prefectures of Coyah and Forecariah in Guinea. A cross-sectional study was conducted in December 2014 using mixed approaches: (i) Desk review; (ii) Interviews; and (iii) Direct observation. Almost one year after the beginning of the Ebola virus disease outbreak in West Africa, the perceptions of stakeholders and the observed reality were that the level of preparedness in the two health districts was low. The study identified poor coordination mechanisms, inadequate training of human resources and lack of equipment and supplies to field teams and health facilities as key elements that affected the response. The situation was worsened by the inadequate communication strategy, misconceptions around the disease, ignorance of local culture and customs and lack of involvement of local communities in the control strategies, within the context of poor socioeconomic development. As a result distrust developed between communities and those seeking to control the epidemic and largely contributed to the reluctance of the communities to participate and contribute to the effort. There is a need to rethink the way disease control interventions in the context of an emergency such as Ebola virus disease are designed, planned and implemented in low income countries.

Challenges in controlling the Ebola outbreak in two prefectures in Guinea: why did communities continue to resist?

PubMed Central

Thiam, Sylla; Delamou, Alexandre; Camara, Soriba; Carter, Jane; Lama, Eugene Kaman; Ndiaye, Bara; Nyagero, Josephat; Nduba, John; Ngom, Mor

2015-01-01

Introduction The Ebola outbreak emerged in a remote corner of Guinea in December 2013, and spread into Liberia and Sierra Leone in the context of weak health systems. In this paper, we report on the main challenges faced by frontline health services and by communities including their perceptions and views on the current Ebola response in the Prefectures of Coyah and Forecariah in Guinea. Methods A cross-sectional study was conducted in December 2014 using mixed approaches: (i) Desk review; (ii) Interviews; and (iii) Direct observation. Results Almost one year after the beginning of the Ebola virus disease outbreak in West Africa, the perceptions of stakeholders and the observed reality were that the level of preparedness in the two health districts was low. The study identified poor coordination mechanisms, inadequate training of human resources and lack of equipment and supplies to field teams and health facilities as key elements that affected the response. The situation was worsened by the inadequate communication strategy, misconceptions around the disease, ignorance of local culture and customs and lack of involvement of local communities in the control strategies, within the context of poor socioeconomic development. As a result distrust developed between communities and those seeking to control the epidemic and largely contributed to the reluctance of the communities to participate and contribute to the effort. Conclusion There is a need to rethink the way disease control interventions in the context of an emergency such as Ebola virus disease are designed, planned and implemented in low income countries. PMID:26740850

Elementary Students' Effortful Control and Academic Achievement: The Mediating Role of Teacher-Student Relationship Quality

PubMed Central

Hernández, Maciel M.; Valiente, Carlos; Eisenberg, Nancy; Berger, Rebecca H.; Spinrad, Tracy L.; VanSchyndel, Sarah K.; Silva, Kassondra M.; Southworth, Jody; Thompson, Marilyn S.

2017-01-01

This study evaluated the association between effortful control in kindergarten and academic achievement one year later (N = 301), and whether teacher–student closeness and conflict in kindergarten mediated the association. Parents, teachers, and observers reported on children's effortful control, and teachers reported on their perceived levels of closeness and conflict with students. Students completed the passage comprehension and applied problems subtests of the Woodcock–Johnson tests of achievement, as well as a behavioral measure of effortful control. Analytical models predicting academic achievement were estimated using a structural equation model framework. Effortful control positively predicted academic achievement even when controlling for prior achievement and other covariates. Mediation hypotheses were tested in a separate model; effortful control positively predicted teacher–student closeness and strongly, negatively predicted teacher–student conflict. Teacher–student closeness and effortful control, but not teacher–student conflict, had small, positive associations with academic achievement. Effortful control also indirectly predicted higher academic achievement through its positive effect on teacher–student closeness and via its positive relation to early academic achievement. The findings suggest that teacher–student closeness is one mechanism by which effortful control is associated with academic achievement. Effortful control was also a consistent predictor of academic achievement, beyond prior achievement levels and controlling for teacher–student closeness and conflict, with implications for intervention programs on fostering regulation and achievement concurrently. PMID:28684888

Elementary Students' Effortful Control and Academic Achievement: The Mediating Role of Teacher-Student Relationship Quality.

PubMed

Hernández, Maciel M; Valiente, Carlos; Eisenberg, Nancy; Berger, Rebecca H; Spinrad, Tracy L; VanSchyndel, Sarah K; Silva, Kassondra M; Southworth, Jody; Thompson, Marilyn S

This study evaluated the association between effortful control in kindergarten and academic achievement one year later ( N = 301), and whether teacher-student closeness and conflict in kindergarten mediated the association. Parents, teachers, and observers reported on children's effortful control, and teachers reported on their perceived levels of closeness and conflict with students. Students completed the passage comprehension and applied problems subtests of the Woodcock-Johnson tests of achievement, as well as a behavioral measure of effortful control. Analytical models predicting academic achievement were estimated using a structural equation model framework. Effortful control positively predicted academic achievement even when controlling for prior achievement and other covariates. Mediation hypotheses were tested in a separate model; effortful control positively predicted teacher-student closeness and strongly, negatively predicted teacher-student conflict. Teacher-student closeness and effortful control, but not teacher-student conflict, had small, positive associations with academic achievement. Effortful control also indirectly predicted higher academic achievement through its positive effect on teacher-student closeness and via its positive relation to early academic achievement. The findings suggest that teacher-student closeness is one mechanism by which effortful control is associated with academic achievement. Effortful control was also a consistent predictor of academic achievement, beyond prior achievement levels and controlling for teacher-student closeness and conflict, with implications for intervention programs on fostering regulation and achievement concurrently.

Work stress and health in Western European and post-communist countries: an East-West comparison study.

PubMed

Salavecz, G; Chandola, T; Pikhart, H; Dragano, N; Siegrist, J; Jöckel, K-H; Erbel, R; Pajak, A; Malyutina, S; Kubinova, R; Marmot, M; Bobak, M; Kopp, M

2010-01-01

There is evidence that psychosocial factors at work influence the risk of poor health in Western societies, but little is known about the effect of work stress in the former communist countries. The aim of this paper is to compare the association of work stress with self-rated health in Western European and post-communist countries. Data from four epidemiological studies were used: the HAPIEE study (Poland, Russia and the Czech Republic), the Hungarian Epidemiological Panel (Hungary), the Heinz Nixdorf Recall study (Germany) and the Whitehall II study (UK). The overall sample consisted of 18 494 male and female workers aged 35-65 years. High effort-reward imbalance at work was associated with poor self-rated health. The adjusted odds ratios for the highest versus lowest quartile of the effort-reward ratio were 3.8 (95% CI 1.9 to 7.7) in Hungary, 3.6 (95% CI 2.3 to 5.7) in the Czech Republic, 2.5 (95% CI 1.5 to 4.1) in the UK, 2.3 (95% CI 1.6 to 3.5) in Germany, 1.5 (95% CI 1.0 to 2.1) in Poland and 1.4 (95% CI 1.1 to 1.8) in Russia. The differences in odds ratios between countries were statistically significant (p<0.05). A similar pattern was observed for the effect of overcommitment on poor health. The association of effort-reward imbalance at work and of a high degree of work-related overcommitment with poor self-rated health was seen in all countries, but the size of the effects differed considerably. It does not appear that the effects in Eastern Europe are systematically stronger than in the West.

Work stress and health in Western European and post-communist countries: an East–West comparison study

PubMed Central

Salavecz, G; Chandola, T; Pikhart, H; Dragano, N; Siegrist, J; Jöckel, K-H; Erbel, R; Pajak, A; Malyutina, S; Kubinova, R; Marmot, M; Bobak, M; Kopp, M

2014-01-01

Background There is evidence that psychosocial factors at work influence the risk of poor health in Western societies, but little is known about the effect of work stress in the former communist countries. The aim of this paper is to compare the association of work stress with self-rated health in Western European and post-communist countries. Methods Data from four epidemiological studies were used: the HAPIEE study (Poland, Russia and the Czech Republic), the Hungarian Epidemiological Panel (Hungary), the Heinz Nixdorf Recall study (Germany) and the Whitehall II study (UK). The overall sample consisted of 18 494 male and female workers aged 35–65 years. Results High effort-reward imbalance at work was associated with poor self-rated health. The adjusted odds ratios for the highest versus lowest quartile of the effort-reward ratio were 3.8 (95% CI 1.9 to 7.7) in Hungary, 3.6 (95% CI 2.3 to 5.7) in the Czech Republic, 2.5 (95% CI 1.5 to 4.1) in the UK, 2.3 (95% CI 1.6 to 3.5) in Germany, 1.5 (95% CI 1.0 to 2.1) in Poland and 1.4 (95% CI 1.1 to 1.8) in Russia. The differences in odds ratios between countries were statistically significant (p<0.05). A similar pattern was observed for the effect of overcommitment on poor health. Conclusion The association of effort-reward imbalance at work and of a high degree of work-related overcommitment with poor self-rated health was seen in all countries, but the size of the effects differed considerably. It does not appear that the effects in Eastern Europe are systematically stronger than in the West. PMID:19692735

Epidemiology and challenges to the elimination of global tuberculosis.

PubMed

Jassal, Mandeep S; Bishai, William R

2010-05-15

Recent epidemiological indicators of tuberculosis (TB) indicate that the Millennium Development Goal of TB elimination by 2050 will not be achieved. The majority of incident cases are occurring in population-dense regions of Africa and Asia where TB is endemic. The persistence of TB in the setting of poor existing health infrastructure has led to an increase in drug-resistant cases, exacerbated by the strong association with human immunodeficiency virus coinfection. Spreading drug resistance threatens to undo decades of progress in controlling the disease. Several significant gaps can be identified in various aspects of national- and international-directed TB-control efforts. Various governing bodies and international organizations need to address the immediate challenges. This article highlights some of the major policies that lawmakers and funding institutions should consider. Existing economic and social obstacles must be overcome if TB elimination is to be a reachable goal.

The control of measles in tropical Africa: a review of past and present efforts.

PubMed

Ofosu-Amaah, S

1983-01-01

Measles in tropical Africa is endemic and cyclical, with a high incidence that usually peaks during the dry seasons. Measles may be a contributing factor in 10% of all deaths among African children. Several problems have hindered measles immunization programs in Africa; these include difficulties in maintaining the cold chain, poor epidemiologic surveillance, and the logistical problems involved in reaching a population that is 80% rural. The United States Agency for International Development and the World Health Organization both have programs that are helping to increase immunization coverage and to solve the problems just mentioned. Many countries have begun to train their own personnel to administer immunization programs. However, because of limited staff and equipment, a high birth rate, and an uncertain social situation, no firm predictions can be made concerning the permanent control of measles in tropical Africa.

Strategies for prevention of road traffic injuries (RTIs) in Pakistan: situational analysis.

PubMed

Khan, Adeel Ahmed; Fatmi, Zafar

2014-05-01

Road traffic injuries (RTIs) are one of the leading causes of death among productive age group. Using systems approach framework (SAF), current preventive strategies for RTI control were reviewed in Pakistan. A review of the literature was done using four international search engines. Only ten studies on preventive strategies for RTI stemming from Pakistan were found. The first Road Traffic Injuries Research Network (RTIRN) surveillance system for road traffic injuries was established in urban city (Karachi) in Pakistan has shown promise for injury control and should be scaled up to other cities. Enforcement of traffic laws on seat-belt and helmet wearing is poor. National Highway and Motorway Police Ordinance (2000) was one of the few legislative measure so far taken in Pakistan. Using SAF, efforts are required to implement interventions targeting human, vehicle design and also making environment safer for road users.

Parental practices for prevention of home poisoning in children 1-6 years of age.

PubMed

Gutierrez, Jessica; Negrón, Juanita; García-Fragoso, Lourdes

2011-10-01

On the basis of calls to the US poison control centers, each year more than 1 million children less than 5 years of age experience potentially toxic ingestions. Several prevention efforts and interventions have been tried to protect young children from poisonings occurring in their homes. The purpose of this study was to determine practices of parents and caregivers of children 1-6 years of age about home poisoning prevention. Seventy-six participants answered an anonymous survey. Caregivers demonstrated poor knowledge about the home poisoning prevention strategies. Only 20% of the participants knew the telephone number of the poison control center and 49% had it near the telephone in case of an emergency. This lack of knowledge was not related to gender, educational level, or occupation. Primary care physicians need to reinforce the orientation about poisoning prevention techniques to all caregivers in order to prevent accidental poisonings in small children.

Fundamental Design Principles for Transcription-Factor-Based Metabolite Biosensors.

PubMed

Mannan, Ahmad A; Liu, Di; Zhang, Fuzhong; Oyarzún, Diego A

2017-10-20

Metabolite biosensors are central to current efforts toward precision engineering of metabolism. Although most research has focused on building new biosensors, their tunability remains poorly understood and is fundamental for their broad applicability. Here we asked how genetic modifications shape the dose-response curve of biosensors based on metabolite-responsive transcription factors. Using the lac system in Escherichia coli as a model system, we built promoter libraries with variable operator sites that reveal interdependencies between biosensor dynamic range and response threshold. We developed a phenomenological theory to quantify such design constraints in biosensors with various architectures and tunable parameters. Our theory reveals a maximal achievable dynamic range and exposes tunable parameters for orthogonal control of dynamic range and response threshold. Our work sheds light on fundamental limits of synthetic biology designs and provides quantitative guidelines for biosensor design in applications such as dynamic pathway control, strain optimization, and real-time monitoring of metabolism.

Malaria's contribution to World War One - the unexpected adversary.

PubMed

Brabin, Bernard J

2014-12-16

Malaria in the First World War was an unexpected adversary. In 1914, the scientific community had access to new knowledge on transmission of malaria parasites and their control, but the military were unprepared, and underestimated the nature, magnitude and dispersion of this enemy. In summarizing available information for allied and axis military forces, this review contextualizes the challenge posed by malaria, because although data exist across historical, medical and military documents, descriptions are fragmented, often addressing context specific issues. Military malaria surveillance statistics have, therefore, been summarized for all theatres of the War, where available. These indicated that at least 1.5 million solders were infected, with case fatality ranging from 0.2 -5.0%. As more countries became engaged in the War, the problem grew in size, leading to major epidemics in Macedonia, Palestine, Mesopotamia and Italy. Trans-continental passages of parasites and human reservoirs of infection created ideal circumstances for parasite evolution. Details of these epidemics are reviewed, including major epidemics in England and Italy, which developed following home troop evacuations, and disruption of malaria control activities in Italy. Elsewhere, in sub-Saharan Africa many casualties resulted from high malaria exposure combined with minimal control efforts for soldiers considered semi-immune. Prevention activities eventually started but were initially poorly organized and dependent on local enthusiasm and initiative. Nets had to be designed for field use and were fundamental for personal protection. Multiple prevention approaches adopted in different settings and their relative utility are described. Clinical treatment primarily depended on quinine, although efficacy was poor as relapsing Plasmodium vivax and recrudescent Plasmodium falciparum infections were not distinguished and managed appropriately. Reasons for this are discussed and the clinical trial data summarized, as are controversies that arose from attempts at quinine prophylaxis (quininization). In essence, the First World War was a vast experiment in political, demographic, and medical practice which exposed large gaps in knowledge of tropical medicine and unfortunately, of malaria. Research efforts eventually commenced late in the War to address important clinical questions which established a platform for more effective strategies, but in 1918 this relentless foe had outwitted and weakened both allied and axis powers.

Diagnostic accuracy of a bayesian latent group analysis for the detection of malingering-related poor effort.

PubMed

Ortega, Alonso; Labrenz, Stephan; Markowitsch, Hans J; Piefke, Martina

2013-01-01

In the last decade, different statistical techniques have been introduced to improve assessment of malingering-related poor effort. In this context, we have recently shown preliminary evidence that a Bayesian latent group model may help to optimize classification accuracy using a simulation research design. In the present study, we conducted two analyses. Firstly, we evaluated how accurately this Bayesian approach can distinguish between participants answering in an honest way (honest response group) and participants feigning cognitive impairment (experimental malingering group). Secondly, we tested the accuracy of our model in the differentiation between patients who had real cognitive deficits (cognitively impaired group) and participants who belonged to the experimental malingering group. All Bayesian analyses were conducted using the raw scores of a visual recognition forced-choice task (2AFC), the Test of Memory Malingering (TOMM, Trial 2), and the Word Memory Test (WMT, primary effort subtests). The first analysis showed 100% accuracy for the Bayesian model in distinguishing participants of both groups with all effort measures. The second analysis showed outstanding overall accuracy of the Bayesian model when estimates were obtained from the 2AFC and the TOMM raw scores. Diagnostic accuracy of the Bayesian model diminished when using the WMT total raw scores. Despite, overall diagnostic accuracy can still be considered excellent. The most plausible explanation for this decrement is the low performance in verbal recognition and fluency tasks of some patients of the cognitively impaired group. Additionally, the Bayesian model provides individual estimates, p(zi |D), of examinees' effort levels. In conclusion, both high classification accuracy levels and Bayesian individual estimates of effort may be very useful for clinicians when assessing for effort in medico-legal settings.

Prevalence and control of cardiovascular risk factors in stable coronary artery outpatients in India compared with the rest of the world: An analysis from international CLARIFY registry.

PubMed

KauL, Upendra; Natrajan, Subramaniam; Dalal, Jamshed; Saran, Ram Kirti

We describe the clinical characteristics, prevalence and control of coronary artery disease (CAD) risk factors of the Indian cohort enrolled in the CLARIFY registry and compare them with data from rest of the world (ROW). CLARIFY is an international, prospective, observational, longitudinal cohort study in stable CAD outpatients. The baseline data of Indian cohort (n=709) were compared to ROW (n=31994). The CLARIFY India patients were significantly younger than the ROW (59.6±10.9 vs 64.3±10.4). Indian patients were more likely than those in ROW to have diabetes (42.9% vs 28.8%) and angina (27.8% vs 21.9%). Mean heart rate was significantly greater in Indians measured by either palpatory method (76.1±10.4 vs 68.0±10.5) or ECG (74.9±12.9 vs 67.0±11.3). The use of aspirin (85.6% vs 87.8%), β-blockers (69.4% vs 75.4%), and lipid-lowering agents (90% vs 92.4%) was lower in India. A significantly greater proportion of patients in India exhibited low HDL cholesterol (41.6% vs 31.2%), and heart rate ≥70bpm (82.2% vs 48.5%). The risk factors control was poor in India with heart rate goal of ≤60bpm achieved in 2.5%; HbA1c <7% in 9.9%; and HbA1c <6.5% in 4.6% patients. The CLARIFY registry demonstrates a high prevalence and poor control of cardiovascular risk factors in Indian patients. Systematic efforts to improve risk factor control are required. Copyright © 2017. Published by Elsevier B.V.

U.S. Efforts to Educate and Train the Poor in Developing Countries. Report to the Congress of the United States by the Comptroller General.

ERIC Educational Resources Information Center

Comptroller General of the U.S., Washington, DC.

Agency for International Development (AID) education and training assistance to developing countries is herein reviewed by the General Accounting Office (GAO), with particular attention paid to the changes in emphasis since the 1973 New Directions Mandate by Congress and to the nature of recurring problems in improving education of the poor. One…

Community Organization Efforts, Political and Institutional Change, and the Diffusion of Change Produced by Community Action Programs. Final Report on Phase I.

ERIC Educational Resources Information Center

Vanecko, James J.; And Others

The first part of a two phase project, this was an evaluation of characteristics of community action agencies (CAAs) which make them more or less effective in influencing other institutions to be more responseive to the needs and demands of the poor. CAA board members, representatives of the poor and other segments of the community, and…

Promise and problems with supply chain management approaches to health care purchasing.

PubMed

Ford, Eric W; Scanlon, Dennis P

2007-01-01

Double-digit health care inflation, coupled with widespread reports of poor care quality and deadly medical errors, has caused private sector employers to reevaluate their health benefits purchasing strategies, with a focus on supply chain management approaches. In other industries, this strategy has proven to be an effective method for simultaneously reducing costs and increasing quality. This article describes four current applications of supply chain management network methodologies to health care systems and identifies potential ways to improve purchasers' return on investment. In particular, information exchanges, purchase decision, and payment agreement components of integrated supply chains are described. First, visual depictions of the health care supply chain are developed from a purchaser's perspective. Next, five nationwide programs designed to realign incentives and rewards across the health care supply chain are described. Although several nationwide efforts are gaining traction in the marketplace, at this time, no cost reduction and quality improvement program initiative appears to systematically align the entire health care supply chain from providers to purchasers, raising doubt about the ability of supply chain management network techniques to significantly impact the health care marketplace in the short run. Current individual efforts to coordinate the health care supply chain do not act on all of the actors necessary to improve outcomes, promote safety, and control costs. Nevertheless, there are indications that several of the individual efforts are coming together. If national efforts touching on all critical elements can coordinate with purchasers, then the health care supply chain's performance may improve significantly.

Child and adolescent obesity: part of a bigger picture

PubMed Central

Lobstein, Tim; Jackson-Leach, Rachel; Moodie, Marjory L; Hall, Kevin D; Gortmaker, Steven L; Swinburn, Boyd A; James, W Philip T; Wang, Youfa; McPherson, Klim

2015-01-01

The prevalence of childhood overweight and obesity has risen substantially worldwide in less than one generation. In the USA, the average weight of a child has risen by more than 5 kg within three decades, to a point where a third of the country’s children are overweight or obese. Some low-income and middle-income countries have reported similar or more rapid rises in child obesity, despite continuing high levels of undernutrition. Nutrition policies to tackle child obesity need to promote healthy growth and household nutrition security and protect children from inducements to be inactive or to overconsume foods of poor nutritional quality. The promotion of energy-rich and nutrient-poor products will encourage rapid weight gain in early childhood and exacerbate risk factors for chronic disease in all children, especially those showing poor linear growth. Whereas much public health effort has been expended to restrict the adverse marketing of breastmilk substitutes, similar effort now needs to be expanded and strengthened to protect older children from increasingly sophisticated marketing of sedentary activities and energy-dense, nutrient-poor foods and beverages. To meet this challenge, the governance of food supply and food markets should be improved and commercial activities subordinated to protect and promote children’s health. PMID:25703114

Global aspirations, local realities: the role of social science research in controlling neglected tropical diseases.

PubMed

Bardosh, Kevin

2014-01-01

Neglected Tropical Diseases (NTDs) are both drivers and manifestations of poverty and social inequality. Increased advocacy efforts since the mid-2000s have led to ambitious new control and elimination targets set for 2020 by the World Health Organisation. While these global aspirations represent significant policy momentum, there are multifaceted challenges in controlling infectious diseases in resource-poor local contexts that need to be acknowledged, understood and engaged. However a number of recent publications have emphasised the "neglected" status of applied social science research on NTDs. In light of the 2020 targets, this paper explores the social science/NTD literature and unpacks some of the ways in which social inquiry can help support effective and sustainable interventions. Five priority areas are discussed, including on policy processes, health systems capacity, compliance and resistance to interventions, education and behaviour change, and community participation. The paper shows that despite the multifaceted value of having anthropological and sociological perspectives integrated into NTD programmes, contemporary efforts underutilise this potential. This is reflective of the dominance of top-down information flows and technocratic approaches in global health. To counter this tendency, social research needs to be more than an afterthought; integrating social inquiry into the planning, monitoring and evaluating process will help ensure that flexibility and adaptability to local realities are built into interventions. More emphasis on social science perspectives can also help link NTD control to broader social determinants of health, especially important given the major social and economic inequalities that continue to underpin transmission in endemic countries.

The relationship between dorsolateral prefrontal activation and speech performance-based social anxiety using functional near infrared spectroscopy.

PubMed

Glassman, Lisa H; Kuster, Anootnara T; Shaw, Jena A; Forman, Evan M; Izzetoglu, Meltem; Matteucci, Alyssa; Herbert, James D

2017-06-01

Functional near-infrared (fNIR) spectroscopy is a promising new technology that has demonstrated utility in the study of normal human cognition. We utilized fNIR spectroscopy to examine the effect of social anxiety and performance on hemodynamic activity in the dorsolateral prefrontal cortex (DLPFC). Socially phobic participants and non-clinical participants with varying levels of social anxiety completed a public speaking task in front of a small virtual audience while the DLPFC was being monitored by the fNIR device. The relationship between anxiety and both blood volume (BV) and deoxygenated hemoglobin (Hb) varied significantly as a function of speech performance, such that individuals with low social anxiety who performed well showed an increase in DLPFC activation relative to those who did not perform well. This result suggests that effortful thinking and/or efficient top-down inhibitory control may have been required to complete an impromptu speech task with good performance. In contrast, good performers who were highly socially anxious showed lower DLPFC activation relative to good performers who were low in social anxiety, suggesting autopilot thinking or less-effortful thinking. In poor performers, slight increases in DLPFC activation were observed from low to highly anxious individuals, which may reflect a shift from effortless thinking to heightened self-focused attention. Heightened self-focused attention, poor inhibitory control resulting in excessive fear or anxiety, or low motivation may lower performance. These results suggest that there can be different underlying mechanisms in the brain that affect the level of speech performance in individuals with varying degrees of social anxiety. This study highlights the utility of the fNIR device in the assessment of changes in DLPFC in response to exposure to realistic phobic stimuli, and further supports the potential utility of this technology in the study of the neurophysiology of anxiety disorders.

Metastatic pancreatic cancer: Is there a light at the end of the tunnel?

PubMed Central

Vaccaro, Vanja; Sperduti, Isabella; Vari, Sabrina; Bria, Emilio; Melisi, Davide; Garufi, Carlo; Nuzzo, Carmen; Scarpa, Aldo; Tortora, Giampaolo; Cognetti, Francesco; Reni, Michele; Milella, Michele

2015-01-01

Due to extremely poor prognosis, pancreatic cancer (PDAC) represents the fourth leading cause of cancer-related death in Western countries. For more than a decade, gemcitabine (Gem) has been the mainstay of first-line PDAC treatment. Many efforts aimed at improving single-agent Gem efficacy by either combining it with a second cytotoxic/molecularly targeted agent or pharmacokinetic modulation provided disappointing results. Recently, the field of systemic therapy of advanced PDAC is finally moving forward. Polychemotherapy has shown promise over single-agent Gem: regimens like PEFG-PEXG-PDXG and GTX provide significant potential advantages in terms of survival and/or disease control, although sometimes at the cost of poor tolerability. The PRODIGE 4/ACCORD 11 was the first phase III trial to provide unequivocal benefit using the polychemotherapy regimen FOLFIRINOX; however the less favorable safety profile and the characteristics of the enrolled population, restrict the use of FOLFIRINOX to young and fit PDAC patients. The nanoparticle albumin-bound paclitaxel (nab-Paclitaxel) formulation was developed to overcome resistance due to the desmoplastic stroma surrounding pancreatic cancer cells. Regardless of whether or not this is its main mechanisms of action, the combination of nab-Paclitaxel plus Gem showed a statistically and clinically significant survival advantage over single agent Gem and significantly improved all the secondary endpoints. Furthermore, recent findings on maintenance therapy are opening up potential new avenues in the treatment of advanced PDAC, particularly in a new era in which highly effective first-line regimens allow patients to experience prolonged disease control. Here, we provide an overview of recent advances in the systemic treatment of advanced PDAC, mostly focusing on recent findings that have set new standards in metastatic disease. Potential avenues for further development in the metastatic setting and current efforts to integrate new effective chemotherapy regimens in earlier stages of disease (neoadjuvant, adjuvant, and multimodal approaches in both resectable and unresectable patients) are also briefly discussed. PMID:25944992

Metastatic pancreatic cancer: Is there a light at the end of the tunnel?

PubMed

Vaccaro, Vanja; Sperduti, Isabella; Vari, Sabrina; Bria, Emilio; Melisi, Davide; Garufi, Carlo; Nuzzo, Carmen; Scarpa, Aldo; Tortora, Giampaolo; Cognetti, Francesco; Reni, Michele; Milella, Michele

2015-04-28

Due to extremely poor prognosis, pancreatic cancer (PDAC) represents the fourth leading cause of cancer-related death in Western countries. For more than a decade, gemcitabine (Gem) has been the mainstay of first-line PDAC treatment. Many efforts aimed at improving single-agent Gem efficacy by either combining it with a second cytotoxic/molecularly targeted agent or pharmacokinetic modulation provided disappointing results. Recently, the field of systemic therapy of advanced PDAC is finally moving forward. Polychemotherapy has shown promise over single-agent Gem: regimens like PEFG-PEXG-PDXG and GTX provide significant potential advantages in terms of survival and/or disease control, although sometimes at the cost of poor tolerability. The PRODIGE 4/ACCORD 11 was the first phase III trial to provide unequivocal benefit using the polychemotherapy regimen FOLFIRINOX; however the less favorable safety profile and the characteristics of the enrolled population, restrict the use of FOLFIRINOX to young and fit PDAC patients. The nanoparticle albumin-bound paclitaxel (nab-Paclitaxel) formulation was developed to overcome resistance due to the desmoplastic stroma surrounding pancreatic cancer cells. Regardless of whether or not this is its main mechanisms of action, the combination of nab-Paclitaxel plus Gem showed a statistically and clinically significant survival advantage over single agent Gem and significantly improved all the secondary endpoints. Furthermore, recent findings on maintenance therapy are opening up potential new avenues in the treatment of advanced PDAC, particularly in a new era in which highly effective first-line regimens allow patients to experience prolonged disease control. Here, we provide an overview of recent advances in the systemic treatment of advanced PDAC, mostly focusing on recent findings that have set new standards in metastatic disease. Potential avenues for further development in the metastatic setting and current efforts to integrate new effective chemotherapy regimens in earlier stages of disease (neoadjuvant, adjuvant, and multimodal approaches in both resectable and unresectable patients) are also briefly discussed.

Associations Among Parental Education, Home Environment Quality, Effortful Control, and Preacademic Knowledge

PubMed Central

Merz, Emily C.; Landry, Susan H.; Williams, Jeffrey M.; Barnes, Marcia A.; Eisenberg, Nancy; Spinrad, Tracy L.; Valiente, Carlos; Assel, Michael; Taylor, Heather B.; Lonigan, Christopher J.; Phillips, Beth M.; Clancy-Menchetti, Jeanine

2014-01-01

This study used a longitudinal design to examine whether effortful control mediated the associations of parental education and home environment quality with preacademic knowledge in toddlers and young preschoolers. The sample consisted of 226 children (2 to 4 years of age at T1) from socioeconomically disadvantaged backgrounds. Parents provided data on parent education and home environment quality. Children completed effortful control, early literacy, and early math assessments. T2 effortful control partially mediated the associations of T1 parental education and T1 home environment quality with T3 emergent literacy after accounting for child age, gender, race/ethnicity, T1 effortful control, and T2 early literacy. T2 effortful control partially mediated the association between T1 parental education and T3 emergent math after accounting for child age, gender, race/ethnicity, T1 effortful control, and T2 early math. Prior to entry into preschool, parental education and home environment quality may shape effortful control which in turn influences preacademic knowledge. PMID:25110382

Use of a Business Approach to Improve Disease Surveillance Data Management Systems and Information Technology Process in Florida's Bureau of STD Prevention and Control.

PubMed

Shiver, Stacy A; Schmitt, Karla; Cooksey, Adrian

2009-01-01

The business of sexually transmitted disease (STD) prevention and control demands technology that is capable of supporting a wide array of program activities-from the processing of laboratory test results to the complex and confidential process involved in contact investigation. The need for a tool that enables public health officials to successfully manage the complex operations encountered in an STD prevention and control program, and the need to operate in an increasingly poor resource environment, led the Florida Bureau of STD to develop the Patient Reporting Investigation Surveillance Manager. Its unique approach, technical architecture, and sociotechnical philosophy have made this business application successful in real-time monitoring of disease burden for local communities, identification of emerging outbreaks, monitoring and assurance of appropriate treatments, improving access to laboratory data, and improving the quality of data for epidemiologic analysis. Additionally, the effort attempted to create and release a product that promoted the Centers for Disease Control and Prevention's ideas for integration of programs and processes.

Assessing dental professionals' understanding of tobacco prevention and control: a qualitative study in Västerbotten County, Sweden.

PubMed

Preet, Raman; Khan, Nausheen; Blomstedt, Yulia; Nilsson, Maria; Stewart Williams, Jennifer

2016-01-01

To assess dental professionals' understanding of tobacco prevention and control. In Sweden dental hygienists receive training in tobacco prevention and control. The study setting is Västerbotton County in the north of Sweden where a number of successful tobacco control initiatives have been established. A purposeful sample comprising five male and four female dental professionals and trainees was selected. Data were collected through in-depth semi-structured individual interviews and analysed using content analysis. Informants acknowledged limited adherence to tobacco prevention. They were not confident of their knowledge of tobacco and non-communicable disease prevention and had limited awareness of global oral health policies. Reasons for poor adherence included professional fragmentation, lack of training, and the absence of reimbursement for time spent on prevention activities. The success of efforts to reduce smoking in Västerbotton County is attributed to the network of local public health initiatives with very limited involvement by local dental professionals. The findings highlight the need to more actively engage the dental workforce in tobacco control and prevention. Moreover, it is important to recognise that dental professionals can be public health advocates for tobacco control and prevention at global, national and local levels.

Effortful Control, Behavior Problems and Peer Relations: What Predicts Academic Adjustment in Kindergarteners from Low-income Families?

PubMed Central

Morris, Amanda Sheffield; John, Aesha; Halliburton, Amy L.; Morris, Michael D. S.; Robinson, Lara R.; Myers, Sonya S.; Aucoin, Katherine J.; Keyes, Angela W.; Terranova, Andrew

2013-01-01

This study examined the role of effortful control, behavior problems, and peer relations in the academic adjustment of 74 kindergarten children from primarily low-income families using a short-term longitudinal design. Teachers completed standardized measures of children’s effortful control, internalizing and externalizing problems, school readiness, and academic skills. Children participated in a sociometric interview to assess peer relations. Research Findings: Correlational analyses indicate that children’s effortful control, behavior problems in school, and peer relations are associated with academic adjustment variables at the end of the school year, including school readiness, reading skills, and math skills. Results of regression analyses indicate that household income and children’s effortful control primarily account for variation in children’s academic adjustment. The associations between children’s effortful control and academic adjustment did not vary across sex of the child or ethnicity. Mediational analyses indicate an indirect effect of effortful control on school readiness, through children’s internalizing problems. Practice or Policy: Effortful control emerged as a strong predictor of academic adjustment among kindergarten children from low-income families. Strategies for enhancing effortful control and school readiness among low-income children are discussed. PMID:24163572

Substandard drugs: a potential crisis for public health

PubMed Central

Johnston, Atholl; Holt, David W

2014-01-01

Poor-quality medicines present a serious public health problem, particularly in emerging economies and developing countries, and may have a significant impact on the national clinical and economic burden. Attention has largely focused on the increasing availability of deliberately falsified drugs, but substandard medicines are also reaching patients because of poor manufacturing and quality-control practices in the production of genuine drugs (either branded or generic). Substandard medicines are widespread and represent a threat to health because they can inadvertently lead to healthcare failures, such as antibiotic resistance and the spread of disease within a community, as well as death or additional illness in individuals. This article reviews the different aspects of substandard drug formulation that can occur (for example, pharmacological variability between drug batches or between generic and originator drugs, incorrect drug quantity and presence of impurities). The possible means of addressing substandard manufacturing practices are also discussed. A concerted effort is required on the part of governments, drug manufacturers, charities and healthcare providers to ensure that only drugs of acceptable quality reach the patient. PMID:24286459

Concurrent and longitudinal associations of peers' acceptance with emotion and effortful control in kindergarten

PubMed Central

Hernández, Maciel M.; Eisenberg, Nancy; Valiente, Carlos; Diaz, Anjolii; VanSchyndel, Sarah K.; Berger, Rebecca H.; Terrell, Nathan; Silva, Kassondra M.; Spinrad, Tracy L.; Southworth, Jody

2015-01-01

The purpose of the study was to evaluate bidirectional associations between peer acceptance and both emotion and effortful control during kindergarten (N = 301). In both the fall and spring semesters, we obtained peer nominations of acceptance, measures of positive and negative emotion based on naturalistic observations in school (i.e., classroom, lunch/recess), and observers’ reports of effortful control (i.e., inhibitory control, attention focusing) and emotions (i.e., positive, negative). In structural equation panel models, peer acceptance in fall predicted higher effortful control in spring. Effortful control in fall did not predict peer acceptance in spring. Negative emotion predicted lower peer acceptance across time for girls but not for boys. Peer acceptance did not predict negative or positive emotion over time. In addition, we tested interactions between positive or negative emotion and effortful control predicting peer acceptance. Positive emotion predicted higher peer acceptance for children low in effortful control. PMID:28348445

Effect of Community Engagement Interventions on Patient Safety and Risk Reduction Efforts in Primary Health Facilities: Evidence from Ghana

PubMed Central

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Spieker, Nicole; Arhinful, Daniel Kojo; Ogink, Alice; van Ostenberg, Paul; Rinke de Wit, Tobias F.

2015-01-01

Background Patient safety and quality care remain major challenges to Ghana’s healthcare system. Like many health systems in Africa, this is largely because demand for healthcare is outstripping available human and material resource capacity of healthcare facilities and new investment is insufficient. In the light of these demand and supply constraints, systematic community engagement (SCE) in healthcare quality assessment can be a feasible and cost effective option to augment existing quality improvement interventions. SCE entails structured use of existing community groups to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements identified and rewards provided if the quality gaps are closed. Purpose This paper evaluates whether or not SCE, through the assessment of health service quality, improves patient safety and risk reduction efforts by staff in healthcare facilities. Methods A randomized control trail was conducted in 64 primary healthcare facilities in the Greater Accra and Western regions of Ghana. Patient risk assessments were conducted in 32 randomly assigned intervention and control facilities. Multivariate multiple regression test was used to determine effect of the SCE interventions on staff efforts towards reducing patient risk. Spearman correlation test was used to ascertain associations between types of community groups engaged and risk assessment scores of healthcare facilities. Findings Clinic staff efforts towards increasing patient safety and reducing risk improved significantly in intervention facilities especially in the areas of leadership/accountability (Coef. = 10.4, p<0.05) and staff competencies (Coef. = 7.1, p<0.05). Improvement in service utilization and health resources could not be attributed to the interventions because these were outside the control of the study and might have been influenced by institutional or national level developments between the baseline and follow-up period. Community groups that were gender balanced, religious/faith-based, and had structured leadership appeared to be better options for effective SCE in healthcare quality assessment. Conclusion Community engagement in healthcare quality assessment is a feasible client-centered quality improvement option that should be discussed for possible scale-up in Ghana and other resource poor countries in Africa. PMID:26619143

Effect of Community Engagement Interventions on Patient Safety and Risk Reduction Efforts in Primary Health Facilities: Evidence from Ghana.

PubMed

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Spieker, Nicole; Arhinful, Daniel Kojo; Ogink, Alice; van Ostenberg, Paul; Rinke de Wit, Tobias F

2015-01-01

Patient safety and quality care remain major challenges to Ghana's healthcare system. Like many health systems in Africa, this is largely because demand for healthcare is outstripping available human and material resource capacity of healthcare facilities and new investment is insufficient. In the light of these demand and supply constraints, systematic community engagement (SCE) in healthcare quality assessment can be a feasible and cost effective option to augment existing quality improvement interventions. SCE entails structured use of existing community groups to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements identified and rewards provided if the quality gaps are closed. This paper evaluates whether or not SCE, through the assessment of health service quality, improves patient safety and risk reduction efforts by staff in healthcare facilities. A randomized control trail was conducted in 64 primary healthcare facilities in the Greater Accra and Western regions of Ghana. Patient risk assessments were conducted in 32 randomly assigned intervention and control facilities. Multivariate multiple regression test was used to determine effect of the SCE interventions on staff efforts towards reducing patient risk. Spearman correlation test was used to ascertain associations between types of community groups engaged and risk assessment scores of healthcare facilities. Clinic staff efforts towards increasing patient safety and reducing risk improved significantly in intervention facilities especially in the areas of leadership/accountability (Coef. = 10.4, p<0.05) and staff competencies (Coef. = 7.1, p<0.05). Improvement in service utilization and health resources could not be attributed to the interventions because these were outside the control of the study and might have been influenced by institutional or national level developments between the baseline and follow-up period. Community groups that were gender balanced, religious/faith-based, and had structured leadership appeared to be better options for effective SCE in healthcare quality assessment. Community engagement in healthcare quality assessment is a feasible client-centered quality improvement option that should be discussed for possible scale-up in Ghana and other resource poor countries in Africa.

Psychosocial work characteristics and social support as predictors of SF-36 health functioning: the Whitehall II study.

PubMed

Stansfeld, S A; Bosma, H; Hemingway, H; Marmot, M G

1998-01-01

To assess whether work characteristics and social support are predictors of physical, psychological, and social functioning. Work characteristics (Karasek and Siegrist models) and social support at baseline were used to predict health functioning measured by the SF-36 General Health Survey 5 years later in a prospective cohort study of 10,308 British male and female civil servants. Effort-reward imbalance and negative aspects of close relationships predicted poor physical, psychological, and social functioning after adjustment for the potential confounding effects of age, employment grade, baseline ill health, and negative affectivity. These psychosocial characteristics seem to act in a similar way in the healthy and those with existing illness. Psychological demands at work in women, and low confiding/emotional support in men, also predicted poor functioning. Etiologically. these effects are not mediated through health-related behaviors. Negative aspects of work (high demands and effort-reward imbalance) and negative aspects of close relationships are independent powerful predictors of poor health functioning. They may have an etiological role, which is independent of baseline illness.

Cognitive Effort Requirements in Recall, Recognition, and Lexical Decision

DTIC Science & Technology

1985-05-01

that the amount of integrative processing required for an item is a function of its preexisting or baseline familiarity level . Low frequency words... Lockhart , Craik , & Jacoby, 1976). In the present study, increased effort, and possibly increased distinctiveness, does not influence hit rates, which are...ing of items. Second, a lexical decision task, which does not require elabo- rative processing , leads to an overall poor level of recall. Furthermore

Visual indices of motor vehicle drivers in relation to road safety in Nigeria.

PubMed

Emerole, C G; Nneli, R O

2013-06-30

This study assessed the visual profile of motor vehicle drivers in Owerri, Nigeria and to analyse the relationship between the various aspects of visual function in relation to road safety. A cross-sectional descriptive study of 150 commercial vehicles drivers and 130 private vehicles drivers was conducted between November 2005 and February 2006. Data were obtained using structured interviewer administered questionnaires and clinical examination was done. Standards procedures were used to determine visual indices. Data from the better eye (eye with a better visual acuity according to international and national standards) were reported, except in the analysis of near vision of the respondents. Twenty percent of the study group had normal visual acuity of ≥6/6 compared with 46.2% in the control group. The tonometric value in 88.0% and 93.1% of study and control groups respectively was less than 24mmHg. Both groups (96.8%) had normal confrontation visual field while 95.3% of study group and 97.7% of control group had normal colour vision. The most prevailing eye conditions that may reduce visual acuity were pterygium (51.3% in study group and 13.8% in the control group), retinopathy (16.7% of study group and 6.2% of control group) and glaucoma (12.0% and 6.9% of study and control groups respectively). Nineteen percent of the study group had regular eye examination compared with 38.5% in the control group. Alcohol consumption was 64.7% in the study group and 32.3% in the control group. Most of the commercial motor drivers in Owerri, Nigeria did not meet the Federal Road Safety Commission visual acuity standard for commercial motor drivers. Visual impairments and poor visibility are strongly associated with RTA among Nigerian motor vehicle drivers. Visual acuity and visual health care were poor among commercial motor drivers. There is need for renewed efforts to enforce a compulsory periodic visual examination for drivers, and to ensure that visual requirements for driving are met.

Global Burden of Skin Disease: Inequities and Innovations.

PubMed

Seth, Divya; Cheldize, Khatiya; Brown, Danielle; Freeman, Esther F

2017-09-01

We review the current understanding of the burden of dermatological disease through the lens of the Global Burden of Disease project, evaluate the impact of skin disease on quality of life in a global context, explore socioeconomic implications, and finally summarize interventions towards improving quality of dermatologic care in resource-poor settings. The Global Burden of Disease project has shown that skin diseases continue to be the 4 th leading cause of nonfatal disease burden world-wide. However, research efforts and funding do not match with the relative disability of skin diseases. International and national efforts, such as the WHO List of Essential Medicines, are critical towards reducing the socioeconomic burden of skin diseases and increasing access to care. Recent innovations such as teledermatology, point-of-care diagnostic tools, and task-shifting help to provide dermatological care to underserved regions in a cost-effective manner. Skin diseases cause significant non-fatal disability worldwide, especially in resource-poor regions. Greater impetus to study the burden of skin disease in low resource settings and policy efforts towards delivering high quality care are essential in improving the burden of skin diseases.

Adjuvant radiation therapy for pancreatic cancer: a review of the old and the new.

PubMed

Boyle, John; Czito, Brian; Willett, Christopher; Palta, Manisha

2015-08-01

Surgery represents the only potential curative treatment option for patients diagnosed with pancreatic adenocarcinoma. Despite aggressive surgical management for patients deemed to be resectable, rates of local recurrence and/or distant metastases remain high, resulting in poor long-term outcomes. In an effort to reduce recurrence rates and improve survival for patients having undergone resection, adjuvant therapies (ATs) including chemotherapy and chemoradiation therapy (CRT) have been explored. While adjuvant chemotherapy has been shown to consistently improve outcomes, the data regarding adjuvant radiation therapy (RT) is mixed. Although the ability of radiation to improve local control has been demonstrated, it has not always led to improved survival outcomes for patients. Early trials are flawed in their utilization of sub-optimal radiation techniques, limiting their generalizability. Recent and ongoing trials incorporate more optimized RT approaches and seek to clarify its role in treatment strategies. At the same time novel radiation techniques such as intensity modulated RT (IMRT) and stereotactic body RT (SBRT) are under active investigation. It is hoped that these efforts will lead to improved disease-related outcomes while reducing toxicity rates.

Adjuvant radiation therapy for pancreatic cancer: a review of the old and the new

PubMed Central

Boyle, John; Czito, Brian; Willett, Christopher

2015-01-01

Surgery represents the only potential curative treatment option for patients diagnosed with pancreatic adenocarcinoma. Despite aggressive surgical management for patients deemed to be resectable, rates of local recurrence and/or distant metastases remain high, resulting in poor long-term outcomes. In an effort to reduce recurrence rates and improve survival for patients having undergone resection, adjuvant therapies (ATs) including chemotherapy and chemoradiation therapy (CRT) have been explored. While adjuvant chemotherapy has been shown to consistently improve outcomes, the data regarding adjuvant radiation therapy (RT) is mixed. Although the ability of radiation to improve local control has been demonstrated, it has not always led to improved survival outcomes for patients. Early trials are flawed in their utilization of sub-optimal radiation techniques, limiting their generalizability. Recent and ongoing trials incorporate more optimized RT approaches and seek to clarify its role in treatment strategies. At the same time novel radiation techniques such as intensity modulated RT (IMRT) and stereotactic body RT (SBRT) are under active investigation. It is hoped that these efforts will lead to improved disease-related outcomes while reducing toxicity rates. PMID:26261730

Vaccines against malaria.

PubMed

Ouattara, Amed; Laurens, Matthew B

2015-03-15

Despite global efforts to control malaria, the illness remains a significant public health threat. Currently, there is no licensed vaccine against malaria, but an efficacious vaccine would represent an important public health tool for successful malaria elimination. Malaria vaccine development continues to be hindered by a poor understanding of antimalarial immunity, a lack of an immune correlate of protection, and the genetic diversity of malaria parasites. Current vaccine development efforts largely target Plasmodium falciparum parasites in the pre-erythrocytic and erythrocytic stages, with some research on transmission-blocking vaccines against asexual stages and vaccines against pregnancy-associated malaria. The leading pre-erythrocytic vaccine candidate is RTS,S, and early results of ongoing Phase 3 testing show overall efficacy of 46% against clinical malaria. The next steps for malaria vaccine development will focus on the design of a product that is efficacious against the highly diverse strains of malaria and the identification of a correlate of protection against disease. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

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

DTIC Science & Technology

2001-02-01

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

Guilt and Effortful Control: Two Mechanisms that Prevent Disruptive Developmental Trajectories

PubMed Central

Kochanska, Grazyna; Barry, Robin A.; Jimenez, Natasha B.; Hollatz, Amanda L.; Woodard, Jarilyn

2009-01-01

Children's guilt associated with transgressions and their capacity for effortful control are both powerful forces that inhibit disruptive conduct. We examined how guilt and effortful control, repeatedly observed from toddler to preschool age, jointly predict children's disruptive outcomes in two multi-method multi-trait longitudinal studies (N's 57 and 99). Disruptive outcomes were rated by mothers at 73 months (Study 1) and mothers, fathers, and teachers at 52 and 67 months (Study 2). In both studies, guilt moderated effects of effortful control: For highly guilt-prone children, variations in effortful control were unrelated to future disruptive outcomes, but for children who were less guilt prone, effortful control predicted such outcomes. Guilt may inhibit transgressions through an automatic response due to negative arousal triggered by memories of past wrongdoing, regardless of child capacity for deliberate inhibition. Effortful control that engages a deliberate restraint may offset risk for disruptive conduct conferred by low guilt. PMID:19634978

What Point-of-Use Water Treatment Products Do Consumers Use? Evidence from a Randomized Controlled Trial among the Urban Poor in Bangladesh

PubMed Central

Luoto, Jill; Najnin, Nusrat; Mahmud, Minhaj; Albert, Jeff; Islam, M. Sirajul; Luby, Stephen; Unicomb, Leanne; Levine, David I.

2011-01-01

Background There is evidence that household point-of-use (POU) water treatment products can reduce the enormous burden of water-borne illness. Nevertheless, adoption among the global poor is very low, and little evidence exists on why. Methods We gave 600 households in poor communities in Dhaka, Bangladesh randomly-ordered two-month free trials of four water treatment products: dilute liquid chlorine (sodium hypochlorite solution, marketed locally as Water Guard), sodium dichloroisocyanurate tablets (branded as Aquatabs), a combined flocculant-disinfectant powdered mixture (the PUR Purifier of Water), and a silver-coated ceramic siphon filter. Consumers also received education on the dangers of untreated drinking water. We measured which products consumers used with self-reports, observation (for the filter), and chlorine tests (for the other products). We also measured drinking water's contamination with E. coli (compared to 200 control households). Findings Households reported highest usage of the filter, although no product had even 30% usage. E. coli concentrations in stored drinking water were generally lowest when households had Water Guard. Households that self-reported product usage had large reductions in E. coli concentrations with any product as compared to controls. Conclusion Traditional arguments for the low adoption of POU products focus on affordability, consumers' lack of information about germs and the dangers of unsafe water, and specific products not meshing with a household's preferences. In this study we provided free trials, repeated informational messages explaining the dangers of untreated water, and a variety of product designs. The low usage of all products despite such efforts makes clear that important barriers exist beyond cost, information, and variation among these four product designs. Without a better understanding of the choices and aspirations of the target end-users, household-based water treatment is unlikely to reduce morbidity and mortality substantially in urban Bangladesh and similar populations. PMID:22028817

AIDS and the cycle of poverty.

PubMed

Evian, C

1993-01-01

The comments presented are a summary from a presentation on poverty and AIDS made at the CHASA conference in Johannesburg, South Africa. AIDS is a complex and malignant disease in epidemic proportions; poverty and AIDS are linked with biological features such as a long, silent, latent period as HIV infection, the paralysis of the bodies immune system. The prevention of natural or herd immunity, the vertical perinatal transmission, and the links with sexually transmitted diseases. South Africa has been one of the last to be affected by AIDS/HIV. The impact is expected to be devastating because of the history of apartheid and its destructive impact on people and traditions of family life, and the contribution to poverty. The industrial base promotes migration, mobility, and exploitation. Leaving home breaks down the communities of departure and places the migrant in a vulnerable position as a nobody. The consequence of this status is multipartner sexual practices and prostitution as a means of economic support. Gender inequalities are further exacerbated by family disruption and instability. Women become less able to take control over their own sexual lives. The elite control scarce resources and wealth and have ample opportunity to exploit the poor. The poor also have less access to health care and condoms, and thus treatment of sexually transmitted diseases or prevention of HIV infections. Poor educational experiences can prevent their understanding of the issues, if they reach a health clinic. The silent nature of AIDS transmission is a difficult concept to grasp. Leisure and entertainment opportunities are limited, which leaves alcohol and sex as the preferred means of attaining pleasure, comfort, and intimacy. Urban violence and crime breed fatalism and despondency, which hurts prevention effort. AIDS also increases poverty through job loss, rejection, and discrimination.

Predictors of Nightly Subjective-Objective Sleep Discrepancy in Poor Sleepers over a Seven-Day Period

PubMed Central

Herbert, Vanessa; Pratt, Daniel; Emsley, Richard; Kyle, Simon D.

2017-01-01

This study sought to examine predictors of subjective/objective sleep discrepancy in poor sleepers. Forty-two individuals with insomnia symptoms (mean age = 36.2 years, 81% female) were recruited to take part in a prospective study which combined seven days of actigraphy with daily assessment of sleep perceptions, self-reported arousal, sleep effort, and mood upon awakening. A high level of intra-individual variability in measures of sleep discrepancy was observed. Multilevel modelling revealed that higher levels of pre-sleep cognitive activity and lower mood upon awakening were significantly and independently predictive of the underestimation of total sleep time. Greater levels of sleep effort predicted overestimation of sleep onset latency. These results indicate that psychophysiological variables are related to subjective/objective sleep discrepancy and may be important therapeutic targets in the management of insomnia. PMID:28282912

Self-perceived oral health and salivary proteins in children with type 1 diabetes.

PubMed

Javed, F; Sundin, U; Altamash, M; Klinge, B; Engström, P-E

2009-01-01

The aim was to validate self-perceived oral health with salivary IgG as an inflammatory parameter in children with type 1 diabetes. Unstimulated whole saliva samples were collected from 36 children with well controlled and 12 with poorly controlled type 1 diabetes and 40 non-diabetic children (Controls). Salivary flow rate, random blood glucose level, salivary protein concentration and immunoglobulin A and G levels were recorded using standard techniques. Data concerning oral health and diabetes status were collected. Self-perceived gingival bleeding (bleeding gums), bad breath and dry mouth were higher in diabetic children when compared with those in controls (P < 0.05). Gingival bleeding was frequently perceived by children with poorly controlled compared to well-controlled type 1 diabetes (P < 0.05) and controls (P < 0.001). Bad breath was common perceived by children with poorly controlled compared to well-controlled type 1 diabetes (P < 0.05) and controls (P < 0.0001). Salivary flow rate was lower in the diabetic children compared to controls (P < 0.01) with no difference between children with poorly controlled and well-controlled type 1 diabetes. Salivary IgG per mg protein concentration was higher in the diabetics when compared with the control group (P < 0.0001). IgG per mg protein levels were also higher in children with poorly controlled when compared with well-controlled type 1 diabetes (P < 0.05). There was no difference in IgA per mg protein and total protein concentrations between children with poorly controlled and well-controlled type 1 diabetes. Self-perceived gingival bleeding and salivary IgG per mg protein concentration were increased in children with type 1 diabetes compared with controls. These variables were also increased in children with poorly controlled compared with well-controlled type 1 diabetes.

Breast cancer statistics, 2011.

PubMed

DeSantis, Carol; Siegel, Rebecca; Bandi, Priti; Jemal, Ahmedin

2011-01-01

In this article, the American Cancer Society provides an overview of female breast cancer statistics in the United States, including trends in incidence, mortality, survival, and screening. Approximately 230,480 new cases of invasive breast cancer and 39,520 breast cancer deaths are expected to occur among US women in 2011. Breast cancer incidence rates were stable among all racial/ethnic groups from 2004 to 2008. Breast cancer death rates have been declining since the early 1990s for all women except American Indians/Alaska Natives, among whom rates have remained stable. Disparities in breast cancer death rates are evident by state, socioeconomic status, and race/ethnicity. While significant declines in mortality rates were observed for 36 states and the District of Columbia over the past 10 years, rates for 14 states remained level. Analyses by county-level poverty rates showed that the decrease in mortality rates began later and was slower among women residing in poor areas. As a result, the highest breast cancer death rates shifted from the affluent areas to the poor areas in the early 1990s. Screening rates continue to be lower in poor women compared with non-poor women, despite much progress in increasing mammography utilization. In 2008, 51.4% of poor women had undergone a screening mammogram in the past 2 years compared with 72.8% of non-poor women. Encouraging patients aged 40 years and older to have annual mammography and a clinical breast examination is the single most important step that clinicians can take to reduce suffering and death from breast cancer. Clinicians should also ensure that patients at high risk of breast cancer are identified and offered appropriate screening and follow-up. Continued progress in the control of breast cancer will require sustained and increased efforts to provide high-quality screening, diagnosis, and treatment to all segments of the population. Copyright © 2011 American Cancer Society, Inc.

Utilisation of health services and the poor: deconstructing wealth-based differences in facility-based delivery in the Philippines.

PubMed

Hodge, Andrew; Firth, Sonja; Bermejo, Raoul; Zeck, Willibald; Jimenez-Soto, Eliana

2016-07-06

Despite achieving some success, wealth-related disparities in the utilisation of maternal and child health services persist in the Philippines. The aim of this study is to decompose the principal factors driving the wealth-based utilisation gap. Using national representative data from the 2013 Philippines Demographic and Health Survey, we examine the extent overall differences in the utilisation of maternal health services can be explained by observable factors. We apply nonlinear Blinder-Oaxaca-type decomposition methods to quantify the effect of differences in measurable characteristics on the wealth-based coverage gap in facility-based delivery. The mean coverage of facility-based deliveries was respectively 41.1 % and 74.6 % for poor and non-poor households. Between 67 and 69 % of the wealth-based coverage gap was explained by differences in observed characteristics. After controlling for factors characterising the socioeconomic status of the household (i.e. the mothers' and her partners' education and occupation), the birth order of the child was the major factor contributing to the disparity. Mothers' religion and the subjective distance to the health facility were also noteworthy. This study has found moderate wealth-based disparities in the utilisation of institutional delivery in the Philippines. The results confirm the importance of recent efforts made by the Philippine government to implement equitable, pro-poor focused health programs in the most deprived geographic areas of the country. The importance of addressing the social determinants of health, particularly education, as well as developing and implementing effective strategies to encourage institutional delivery for higher order births, should be prioritised.

A model of growth and carbon storage in Eriophorum Vaginatum L.

NASA Astrophysics Data System (ADS)

Curasi, S. R.; Rocha, A. V.; Bolster, D.; Fetcher, N.; Parker, T.

2016-12-01

Eriophorum Vaginatum L. is a rhizomatous, tussock forming, perennial sedge commonly found in Arctic tundra environments. Tussocks are well suited to harsh nutrient poor environments and tussock tundra is common in Alaska, Canada and Northeastern Russia accounting for 24% of Arctic land area. Tussocks play important roles in Arctic ecosystem biogeochemistry and C storage. However, the environmental and biological factors controlling their size, distribution across the landscape and growth are poorly understood as a result of their growth form and slow growth rate ( 150 years). In order to better understand the role of tussocks in tussock tundra ecosystem C stocks and the potential impacts of climate change on tussock tundra we amassed data from a core site at Toolik field station in North Slope Alaska as well as other Arctic locations. Using this information we constructed a model of carbon storage and growth in E. Vaginatum. We conclude that environmental conditions and the physical properties of the tussock growth form control the rate of tussock growth and retention of C. This work highlights the role of plant growth forms in the retention of tundra ecosystem C stocks. It also has broader applicability to those interested in predicating the impacts of climate change and shifts in vegetation species composition on C storage and fuel loading as well as broader vegetation modeling efforts in tundra ecosystems.

Socioeconomic, Family, and Pediatric Practice Factors Affecting the Level of Asthma Control

PubMed Central

Bloomberg, Gordon R; Banister, Christina; Sterkel, Randall; Epstein, Jay; Bruns, Julie; Swerczek, Lisa; Wells, Suzanne; Yan, Yan; Garbutt, Jane M

2008-01-01

Background Multiple issues bear on effective control of childhood asthma. Objective To identify factors related to the level of asthma control in children receiving asthma care from community pediatricians. Patients and Methods Data for 362 children participating in an intervention study to reduce asthma morbidity were collected by telephone administered questionnaire. Level of asthma control (“well controlled,” partially controlled,” or “poorly controlled”) was derived from measures of recent impairment (symptoms, activity limitations, albuterol use) and the number of exacerbations in a 12 month period. Data also included demographic characteristics, asthma-related quality of life, pediatric management practices, and medication usage. Univariable and multivariable analyses were used to identify factors associated with poor asthma control and to explore the relationship between control and use of daily controller medications. Results Asthma was “well controlled” for 24% of children, “partially controlled” for 20%, and “poorly controlled” for 56%. Medicaid insurance (p=0.016), the presence of another family member with asthma (p=0.0168), and outside the home maternal employment, (p=0.025), were significant univariable factors associated with poor asthma control. Medicaid insurance had an independent association with poor control (OR 0.49, 95% CI 0.28-0.9). Seventy-six percent of children were reported by parents as receiving a daily controller medication. Comparison of guidelines recommended controller medication with level of control indicated that a higher step level of medication would have been appropriate for 74% of these children. Significantly lower overall quality of life scores were observed in both parents and children with poor control. (ANOVA, p<0.05) Conclusion Despite substantial use of daily controller medication, children with asthma continue to experience poorly controlled asthma and reduced quality of life. While Medicaid insurance and aspects of family structure are significant factors associated with poorly controlled asthma, attention to medication use and quality of life indicators may further reduce morbidity. PMID:19255010

[Tuberculosis among the socially vulnerable populations; perspectives from human security concept].

PubMed

Ishikawa, Nobukatsu

2009-07-01

Tuberculosis (TB) has been and will continue to be the disease of the poor and the socially vulnerable. Current TB epidemiology in Japan shows increasing proportion of TB among the economically and socially poor or vulnerable populations. Though there is no universally recognized set of the definitions, the economically poor who are covered under the social security services including the homeless, foreign migrants, or the aged over 80 years may be considered as consisting the "socially vulnerable population" for TB in Japan. TB among the socially vulnerable has several characteristics, for example, patients are often detected with severe conditions due to delayed diagnosis, and have high defaulter rate during treatment, which causes immature death, or drug-resistant disease. Stop TB Strategy by WHO, responding to the Millennium Development Goals, proposes a new approach which focuses on empowering the patients and the community. Observations from various studies show that DOTS contributes to empowering the patients and the communities. Further effort will be needed to reorient TB programs towards the perspective of patients' empowerment. Solely relying on static analyses of TB among the socially vulnerable has its limitations. Dynamic approach, which utilizes human security concepts such as empowerment and patients' perspective, will be required not only to control TB among the socially vulnerable population but also to holistically tackle the problem of TB for Japan.

Influences of sampling effort on detected patterns and structuring processes of a Neotropical plant-hummingbird network.

PubMed

Vizentin-Bugoni, Jeferson; Maruyama, Pietro K; Debastiani, Vanderlei J; Duarte, L da S; Dalsgaard, Bo; Sazima, Marlies

2016-01-01

Virtually all empirical ecological interaction networks to some extent suffer from undersampling. However, how limitations imposed by sampling incompleteness affect our understanding of ecological networks is still poorly explored, which may hinder further advances in the field. Here, we use a plant-hummingbird network with unprecedented sampling effort (2716 h of focal observations) from the Atlantic Rainforest in Brazil, to investigate how sampling effort affects the description of network structure (i.e. widely used network metrics) and the relative importance of distinct processes (i.e. species abundances vs. traits) in determining the frequency of pairwise interactions. By dividing the network into time slices representing a gradient of sampling effort, we show that quantitative metrics, such as interaction evenness, specialization (H2 '), weighted nestedness (wNODF) and modularity (Q; QuanBiMo algorithm) were less biased by sampling incompleteness than binary metrics. Furthermore, the significance of some network metrics changed along the sampling effort gradient. Nevertheless, the higher importance of traits in structuring the network was apparent even with small sampling effort. Our results (i) warn against using very poorly sampled networks as this may bias our understanding of networks, both their patterns and structuring processes, (ii) encourage the use of quantitative metrics little influenced by sampling when performing spatio-temporal comparisons and (iii) indicate that in networks strongly constrained by species traits, such as plant-hummingbird networks, even small sampling is sufficient to detect their relative importance for the frequencies of interactions. Finally, we argue that similar effects of sampling are expected for other highly specialized subnetworks. © 2015 The Authors. Journal of Animal Ecology © 2015 British Ecological Society.

Trajectories of child externalizing problems between ages 3 and 10 years: Contributions of children's early effortful control, theory of mind, and parenting experiences.

PubMed

Olson, Sheryl L; Choe, Daniel Ewon; Sameroff, Arnold J

2017-10-01

Preventing problem behavior requires an understanding of earlier factors that are amenable to intervention. The main goals of our prospective longitudinal study were to trace trajectories of child externalizing behavior between ages 3 and 10 years, and to identify patterns of developmentally significant child and parenting risk factors that differentiated pathways of problem behavior. Participants were 218 3-year-old boys and girls who were reassessed following the transition to kindergarten (age 5-6 years) and during the late school-age years (age 10). Mothers contributed ratings of children's externalizing behavior at all three time points. Children's self-regulation abilities and theory of mind were assessed during a laboratory visit, and parenting risk (frequent corporal punishment and low maternal warmth) was assessed using interview-based and questionnaire measures. Four developmental trajectories of externalizing behavior yielded the best balance of parsimony and fit with our longitudinal data and latent class growth analysis. Most young children followed a pathway marked by relatively low levels of symptoms that continued to decrease across the school-age years. Atypical trajectories marked chronically high, increasing, and decreasing levels of externalizing problems across early and middle childhood. Three-year-old children with low levels of effortful control were far more likely to show the chronic pattern of elevated externalizing problems than changing or low patterns. Early parental corporal punishment and maternal warmth, respectively, differentiated preschoolers who showed increasing and decreasing patterns of problem behavior compared to the majority of children. The fact that children's poor effortful regulation skills predicted chronic early onset problems reinforces the need for early childhood screening and intervention services.

Factors related to poor asthma control in Latvian asthma patients between 2013 and 2015

PubMed Central

Smits, Dins; Brigis, Girts; Pavare, Jana; Maurina, Baiba; Barengo, Noël Christopher

2017-01-01

Objectives To investigate whether beliefs about asthma medication, cognitive and emotional factors are related to poor asthma control in a sample of Latvian asthma patients in 2015. Design Cross-sectional, self-administered survey. Subjects Three hundred and fifty two asthma patients (mean age 57.5 years) attending outpatient pulmonologist consultations in Riga, Latvia during September 2013 to December 2015. The sample size was calculated to detect a prevalence of poor asthma control of 50% with a margin of error of 5% and a power of 95%. Main outcome measures The validated Beliefs about Medication Questionnaire (BMQ) and the Brief Illness Perception Questionnaire (brief IPQ) were used. Good asthma control was assessed using the asthma control test (ACT), a validated five-item scale that reliably assesses asthma control over a recall period of four weeks. Logistic regression models were used to predict poor asthma control. Results Patients who had a good control of asthma medication (OR 0.70; 95% CI 0.61–0.79) or were confident that their asthma medication improves illness (OR 0.84; 95% CI 0.74–0.95) had a reduced risk of poor asthma control. The more symptoms (OR 1.63; 95% CI 1.44–1.84) the asthma patients perceived or the more their illness affects their life, the higher the probability of poor asthma control (OR 1.47; 95% CI 1.31–1.65). Some beliefs of necessity and concerns of asthma medication were also statistically significantly related to poor asthma control. Conclusions Beliefs of necessity of asthma medication, cognitive and emotional illness perception factors correlate well with poor asthma control in Latvian patients. PMID:28585881

Using the community pharmacy to identify patients at risk of poor asthma control and factors which contribute to this poor control.

PubMed

Armour, Carol L; Lemay, Kate; Saini, Bandana; Reddel, Helen K; Bosnic-Anticevich, Sinthia Z; Smith, Lorraine D; Burton, Deborah; Song, Yun Ju Christine; Alles, Marie Chehani; Stewart, Kay; Emmerton, Lynne; Krass, Ines

2011-11-01

Although asthma can be well controlled by appropriate medication delivered in an appropriate way at an appropriate time, there is evidence that management is often suboptimal. This results in poor asthma control, poor quality of life, and significant morbidity. The objective of this study was to describe a population recruited in community pharmacy identified by trained community pharmacists as being at risk for poor asthma outcomes and to identify factors associated with poor asthma control. It used a cross-sectional design in 96 pharmacies in metropolitan and regional New South Wales, Victoria, Queensland, and Australian Capital Territory in Australia. Community pharmacists with specialized asthma training enrolled 570 patients aged ≥18 years with doctor-diagnosed asthma who were considered at risk of poor asthma outcomes and then conducted a comprehensive asthma assessment. In this assessment, asthma control was classified using a symptom and activity tool based on self-reported frequency of symptoms during the previous month and categorized as poor, fair, or good. Asthma history was discussed, and lung function and inhaler technique were also assessed by the pharmacist. Medication use/adherence was recorded from both pharmacy records and the Brief Medication Questionnaire (BMQ). The symptom and activity tool identified that 437 (77%) recruited patients had poor asthma control. Of the 570 patients, 117 (21%) smoked, 108 (19%) had an action plan, 372 (69%) used combination of inhaled corticosteroid (ICS)/long-acting β(2)-agonist (LABA) medications, and only 17-28% (depending on device) used their inhaler device correctly. In terms of adherence, 90% had their ICS or ICS/LABA dispensed <6 times in the previous 6 months, which is inconsistent with regular use; this low adherence was confirmed from the BMQ scores. A logistic regression model showed that patients who smoked had incorrect inhaler technique or low adherence (assessed by either dispensing history or BMQ) and were more likely to have poor control. Community pharmacists were able to identify patients with asthma at risk of suboptimal control, and factors that contributed to this were elicited. This poorly controlled group that was identified may not be visible or accessible to other health-care professionals. There is an opportunity within pharmacies to target poorly controlled asthma and provide timely and tailored interventions.

Addressing policy needs for prevention and control of type 2 diabetes in India.

PubMed

Atre, Sachin

2015-09-01

India carries nearly one-fifth of the global burden of diabetes cases, the majority of which are of type 2 diabetes. Recognising the need for controlling diabetes, the Government of India has initiated a national level programme for prevention and control of diabetes along with other non-communicable diseases in 2008. Despite being piloted and implemented, there is hardly any published literature about the national level situation of diabetes and its control efforts. The present article is written with the aim to fill this gap to some extent and to provide a situational analysis of the diabetes problem in India in a holistic way, addressing policy needs for the national programme. It focuses on three main areas, namely, awareness of diabetes, costs of drugs for its treatment and healthcare-system related issues. It argues that poor coverage and weak implementation of the national level programme are major forces that push patients to seek help in the weakly regulated private sector. Approaching the private sector is likely to increase the cost of care, which in turn can lead to an increased financial burden for patients and their families due to factors such as patients' lack of awareness about diabetes, poor drug price regulation and prescriptions including combinations and/or patented products of medicines used for treating diabetes by the private sector. This article addresses several needs such as strengthening the national programme and increasing its reach to unreached districts, exerting drug price regulation and implementing community-based participatory programmes for prevention and management of type 2 diabetes. It also underscores a need for piloting and implementing a robust national level electronic reporting system for diabetes programmes. © Royal Society for Public Health 2015.

The Role of Socialization, Effortful Control, and Ego Resiliency in French Adolescents’ Social Functioning

PubMed Central

Hofer, Claire; Eisenberg, Nancy; Reiser, Mark

2010-01-01

The relations among effortful control, ego resiliency, socialization, and social functioning were examined with a sample of 182 French adolescents (14–20 years old). Adolescents, their parents, and/or teachers completed questionnaires on these constructs. Effortful control and ego resiliency were correlated with adolescents’ social functioning, especially with low externalizing and internalizing behaviors and sometimes with high peer competence. Furthermore, aspects of socialization (parenting practices more than family expressiveness) were associated with adolescents’ effortful control, ego resiliency, and social functioning. Effortful control and ego resiliency mediated the relations between parental socialization and adolescents’ peer competence and internalizing problems. Furthermore, effortful control mediated the relations between socialization and adolescents’ externalizing behavior. Findings are discussed in terms of cultural and developmental variation. PMID:21228912

Is the association between posttraumatic stress disorder symptoms and poor health due to a common familial or genetic factor?

PubMed Central

Roy-Byrne, Peter P.; Noonan, Carolyn; Afari, Niloofar; Buchwald, Dedra; Goldberg, Jack

2010-01-01

Objective The objective of this study was to identify genetic, familial and environmental contributions to the association between posttraumatic stress disorder (PTSD) symptoms and poor health. Methods A community sample of 1852 twin pairs was assessed for symptoms of PTSD [with the Impact of Events Scale (IES)] and self-reported global health status using a single five-level question. An ordinal logistic regression model estimated odds ratio/s (OR) for the association between PTSD and health status. Within-pair analysis assessed confounding by familial and genetic factors and adjusted for the possible confounding influence of age, sex, race, education and self-reported physician diagnosis of depression. Results The IES was strongly and significantly associated with self-reported health [OR = 1.8; 95% confidence interval (95% CI) = 1.5–2.2; highest quartile vs. lowest quartile]. This association remained significant in within-pair analysis (OR = 1.3; 95% CI=1.0–1.7), but after further adjustment for sociodemographics and depression, it was no longer significant (Ptrend=.17). Separate analysis by zygosity did not show differential effect in monozygotic or dizygotic pairs. Conclusion These findings suggest that the association between PTSD symptoms and poor health is, in part, due to familial confounding and sociodemographic factors. Little evidence of confounding by genetic factors was found. These findings suggest that early prevention efforts would have the greatest potential for improving poor health in PTSD-prone patients, whereas later intervention efforts directed at treating PTSD may have a more limited impact on improving poor health. PMID:16950376

Human health alters the sustainability of fishing practices in East Africa.

PubMed

Fiorella, Kathryn J; Milner, Erin M; Salmen, Charles R; Hickey, Matthew D; Omollo, Dan O; Odhiambo, Abdi; Mattah, Brian; Bukusi, Elizabeth A; Fernald, Lia C H; Brashares, Justin S

2017-04-18

Understanding feedbacks between human and environmental health is critical for the millions who cope with recurrent illness and rely directly on natural resources for sustenance. Although studies have examined how environmental degradation exacerbates infectious disease, the effects of human health on our use of the environment remains unexplored. Human illness is often tacitly assumed to reduce human impacts on the environment. By this logic, ill people reduce the time and effort that they put into extractive livelihoods and, thereby, their impact on natural resources. We followed 303 households living on Lake Victoria, Kenya over four time points to examine how illness influenced fishing. Using fixed effect conditional logit models to control for individual-level and time-invariant factors, we analyzed the effect of illness on fishing effort and methods. Illness among individuals who listed fishing as their primary occupation affected their participation in fishing. However, among active fishers, we found limited evidence that illness reduced fishing effort. Instead, ill fishers shifted their fishing methods. When ill, fishers were more likely to use methods that were illegal, destructive, and concentrated in inshore areas but required less travel and energy. Ill fishers were also less likely to fish using legal methods that are physically demanding, require travel to deep waters, and are considered more sustainable. By altering the physical capacity and outlook of fishers, human illness shifted their effort, their engagement with natural resources, and the sustainability of their actions. These findings show a previously unexplored pathway through which poor human health may negatively impact the environment.

Human health alters the sustainability of fishing practices in East Africa

PubMed Central

Milner, Erin M.; Salmen, Charles R.; Hickey, Matthew D.; Omollo, Dan O.; Odhiambo, Abdi; Mattah, Brian; Bukusi, Elizabeth A.; Fernald, Lia C. H.; Brashares, Justin S.

2017-01-01

Understanding feedbacks between human and environmental health is critical for the millions who cope with recurrent illness and rely directly on natural resources for sustenance. Although studies have examined how environmental degradation exacerbates infectious disease, the effects of human health on our use of the environment remains unexplored. Human illness is often tacitly assumed to reduce human impacts on the environment. By this logic, ill people reduce the time and effort that they put into extractive livelihoods and, thereby, their impact on natural resources. We followed 303 households living on Lake Victoria, Kenya over four time points to examine how illness influenced fishing. Using fixed effect conditional logit models to control for individual-level and time-invariant factors, we analyzed the effect of illness on fishing effort and methods. Illness among individuals who listed fishing as their primary occupation affected their participation in fishing. However, among active fishers, we found limited evidence that illness reduced fishing effort. Instead, ill fishers shifted their fishing methods. When ill, fishers were more likely to use methods that were illegal, destructive, and concentrated in inshore areas but required less travel and energy. Ill fishers were also less likely to fish using legal methods that are physically demanding, require travel to deep waters, and are considered more sustainable. By altering the physical capacity and outlook of fishers, human illness shifted their effort, their engagement with natural resources, and the sustainability of their actions. These findings show a previously unexplored pathway through which poor human health may negatively impact the environment. PMID:28377522

The Effect of the Demand Control and Effort Reward Imbalance Models on the Academic Burnout of Korean Adolescents

ERIC Educational Resources Information Center

Lee, Jayoung; Puig, Ana; Lee, Sang Min

2012-01-01

The purpose of this study was to examine the effects of the Demand Control Model (DCM) and the Effort Reward Imbalance Model (ERIM) on academic burnout for Korean students. Specifically, this study identified the effects of the predictor variables based on DCM and ERIM (i.e., demand, control, effort, reward, Demand Control Ratio, Effort Reward…

A pilot investigation of the Motivation Behaviors Checklist (MBC): An observational rating scale of effort towards testing for baseline sports-concussion assessment.

PubMed

Rabinowitz, Amanda R; Merritt, Victoria; Arnett, Peter A

2016-08-01

Baseline neuropsychological testing is commonly used in the management of sports-related concussion. However, underperformance due to poor effort could lead to invalid conclusions regarding postconcussion cognitive decline. We designed the Motivation Behaviors Checklist (MBC) as an observational rating scale to assess effort towards baseline neuropsychological testing. Here we present preliminary data in support of its reliability and validity. MBC items were generated based on the consensus of a panel of graduate students, undergraduates, and a clinical neuropsychologist who conduct neuropsychological evaluations for a sports concussion management program. A total of 261 college athletes were administered a standard neuropsychological test battery in addition to the MBC. A subset of evaluations (n= 101) was videotape and viewed by a second rater. Exploratory factor analysis (EFA) was used to refine the scale, and reliability and validity were evaluated. EFA revealed that the MBC items represent four latent factors-Complaints, Poor Focus, Psychomotor Agitation, and Impulsivity. Reliability analyses demonstrated that the MBC has good inter-rater reliability (intraclass correlation coefficient, ICC = .767) and internal consistency (α = .839). The construct validity of the MBC is supported by large correlations with examiners' ratings of effort (ρ = -.623) and medium-sized relationships with cognitive performance and self-ratings of effort (|ρ| between .263 and .345). Discriminant validity was supported by nonsignificant correlations with measures of depression and postconcussion symptoms (ρ = .056 and .082, respectively). These findings provide preliminary evidence that the MBC could be a useful adjunct to baseline neuropsychological evaluations for sports-concussion management.

Longitudinal Relations of Intrusive Parenting and Effortful Control to Ego-Resiliency During Early Childhood

PubMed Central

Taylor, Zoe E.; Eisenberg, Nancy; Spinrad, Tracy L.; Widaman, Keith F.

2012-01-01

Longitudinal relations among ego-resiliency, effortful control, and observed intrusive parenting were examined at 18, 30, and 42 months of age (Ns = 256, 230, and 210) using structural equation modeling. Intrusive parenting at 18 and 30 months negatively predicted effortful control a year later, over and above earlier levels. Effortful control at 30 months mediated the negative relation between 18-month intrusive parenting and ego-resiliency at 42 months when controlling for stability of the variables. Ego-resiliency did not predict effortful control. The findings suggest that intrusive parenting may have a negative effect on children’s personality resiliency through its effects on the abilities to regulate attention and behavior. PMID:23379965

Developing markets for forest environmental services: an opportunity for promoting equity while securing efficiency?

PubMed

Landell-Mills, Natasha

2002-08-15

Market-based approaches to environmental management are all the rage. Claims that market mechanisms can encourage environmental protection and promote greater economic efficiency while saving taxpayers' money are tantalizing. In the forestry sector, policy makers are widely heeding this advice and shrinking command-and-control systems in favour of incentive mechanisms that seek to align private enthusiasm with the public good. In some cases, governments are even promoting the creation of markets where none existed before. In others, markets are evolving of their own accord. In such times of change, it is difficult to stand back and take stock. Yet, it is during such times that guidance is most needed. In the rush to introduce market-based solutions to environmental problems, a particular concern is how markets are impacting on the poor. In this paper an effort is made to draw on a recent review of markets for four forest environmental services (biodiversity conservation, carbon sequestration, watershed protection and landscape beauty) to draw out preliminary insights into how markets are performing with respect to their impacts on the poor. The evidence suggests a need for caution. While the potential benefits are significant, the poor face an uphill battle in realizing them. Key constraints facing the poor include a lack of property rights over forest resources and their environmental services; inadequate skills and education; poor market information; lack of market contacts; inadequate communication infrastructure; inappropriate contract design; and lack of access to financial resources. To tackle these, four potential ways forward are highlighted: (1) assign property rights to forest assets and their related environmental services in ways that respect customary arrangements and poor people's tenure; (2) strengthen capacity for market participation, e.g. through training and education; (3) invest in the provision of market information, advice and, essentially, a contact point for buyers and sellers, perhaps through the establishment of a 'market support centre'; and (4) improve access to finance so that poor individuals can make necessary up-front investments in market participation.

Mechanisms of transport and electron transfer at conductive polymer/liquid interfaces

NASA Astrophysics Data System (ADS)

Ratcliff, Erin

Organic semiconductors (OSCs) have incredible prospects for next-generation, flexible electronic devices including bioelectronics, thermoelectrics, opto-electronics, and energy storage and conversion devices. Yet many fundamental challenges still exist. First, solution processing prohibits definitive control over microstructure, which is fundamental for controlling electrical, ionic, and thermal transport properties. Second, OSCs generally suffer from poor electrical conductivities due to a combination of low carriers and low mobility. Third, polymeric semiconductors have potential-dependent, dynamically evolving electronic and chemical states, leading to complex interfacial charge transfer properties in contact with liquids. This talk will focus on the use of alternative synthetic strategies of oxidative chemical vapor deposition and electrochemical deposition to control physical, electronic, and chemical structure. We couple our synthetic efforts with energy-, time-, and spatially resolved spectroelectrochemical and microscopy techniques to understand the critical interfacial chemistry-microstructure-property relationships: first at the macroscale, and then moving towards the nanoscale. In particular, approaches to better understand electron transfer events at polymer/liquid interfaces as a function of: 1.) chemical composition; 2.) electronic density of states (DOS); and 3.) crystallinity and microstructure will be discussed.

Problem solving for breast health care delivery in low and middle resource countries (LMCs): consensus statement from the Breast Health Global Initiative.

PubMed

Harford, Joe B; Otero, Isabel V; Anderson, Benjamin O; Cazap, Eduardo; Gradishar, William J; Gralow, Julie R; Kane, Gabrielle M; Niëns, Laurens M; Porter, Peggy L; Reeler, Anne V; Rieger, Paula T; Shockney, Lillie D; Shulman, Lawrence N; Soldak, Tanya; Thomas, David B; Thompson, Beti; Winchester, David P; Zelle, Sten G; Badwe, Rajendra A

2011-04-01

International collaborations like the Breast Health Global Initiative (BHGI) can help low and middle income countries (LMCs) to establish or improve breast cancer control programs by providing evidence-based, resource-stratified guidelines for the management and control of breast cancer. The Problem Solving Working Group of the BHGI 2010 Global Summit met to develop a consensus statement on problem-solving strategies addressing breast cancer in LMCs. To better assess breast cancer burden in poorly studied populations, countries require accurate statistics regarding breast cancer incidence and mortality. To better identify health care system strengths and weaknesses, countries require reasonable indicators of true health system quality and capacity. Using qualitative and quantitative research methods, countries should formulate cancer control strategies to identify both system inefficiencies and patient barriers. Patient navigation programs linked to public advocacy efforts feed and strengthen functional early detection and treatment programs. Cost-effectiveness research and implementation science are tools that can guide and expand successful pilot programs. Copyright © 2011 Elsevier Ltd. All rights reserved.

Explosive activity associated with the growth of volcanic domes

USGS Publications Warehouse

Newhall, C.G.; Melson, W.G.

1983-01-01

Domes offer unique opportunities to measure or infer the characteristics of magmas that, at domes and elsewhere, control explosive activity. A review of explosive activity associated with historical dome growth shows that: 1. (1) explosive activity has occurred in close association with nearly all historical dome growth; 2. (2) whole-rock SiO2 content, a crude but widely reported indicator of magma viscosity, shows no systematic relationship to the timing and character of explosions; 3. (3) the average rate of dome growth, a crude indicator of the rate of supply of magma and volatiles to the near-surface enviornment, shows no systematic relationship to the timing or character of explosions; and 4. (4) new studies at Arenal and Mount St. Helens suggest that water content is the dominant control on explosions from water-rich magmas, whereas the crystal content and composition of the interstitial melt (and hence magma viscosity) are equally or more important controls on explosions from water-poor magmas. New efforts should be made to improve current, rather limited techniques for monitoring pre-eruption volatile content and magma viscosity, and thus the explosive potential of magmas. ?? 1983.

Emerging therapeutic targets in myeloproliferative neoplasms and peripheral T-cell leukemia and lymphomas

PubMed Central

Orlova, Anna; Wingelhofer, Bettina; Neubauer, Heidi A.; Maurer, Barbara; Berger-Becvar, Angelika; Keserű, György Miklós; Gunning, Patrick T.; Valent, Peter; Moriggl, Richard

2018-01-01

ABSTRACT Introduction: Hematopoietic neoplasms are often driven by gain-of-function mutations of the JAK-STAT pathway together with mutations in chromatin remodeling and DNA damage control pathways. The interconnection between the JAK-STAT pathway, epigenetic regulation or DNA damage control is still poorly understood in cancer cell biology. Areas covered: Here, we focus on a broader description of mutational insights into myeloproliferative neoplasms and peripheral T-cell leukemia and lymphomas, since sequencing efforts have identified similar combinations of driver mutations in these diseases covering different lineages. We summarize how these pathways might be interconnected in normal or cancer cells, which have lost differentiation capacity and drive oncogene transcription. Expert opinion: Due to similarities in driver mutations including epigenetic enzymes, JAK-STAT pathway activation and mutated checkpoint control through TP53, we hypothesize that similar therapeutic approaches could be of benefit in these diseases. We give an overview of how driver mutations in these malignancies contribute to hematopoietic cancer initiation or progression, and how these pathways can be targeted with currently available tools. PMID:29148847

Controlled n-Type Doping of Carbon Nanotube Transistors by an Organorhodium Dimer.

PubMed

Geier, Michael L; Moudgil, Karttikay; Barlow, Stephen; Marder, Seth R; Hersam, Mark C

2016-07-13

Single-walled carbon nanotube (SWCNT) transistors are among the most developed nanoelectronic devices for high-performance computing applications. While p-type SWCNT transistors are easily achieved through adventitious adsorption of atmospheric oxygen, n-type SWCNT transistors require extrinsic doping schemes. Existing n-type doping strategies for SWCNT transistors suffer from one or more issues including environmental instability, limited carrier concentration modulation, undesirable threshold voltage control, and/or poor morphology. In particular, commonly employed benzyl viologen n-type doping layers possess large thicknesses, which preclude top-gate transistor designs that underlie high-density integrated circuit layouts. To overcome these limitations, we report here the controlled n-type doping of SWCNT thin-film transistors with a solution-processed pentamethylrhodocene dimer. The charge transport properties of organorhodium-treated SWCNT thin films show consistent n-type behavior when characterized in both Hall effect and thin-film transistor geometries. Due to the molecular-scale thickness of the organorhodium adlayer, large-area arrays of top-gated, n-type SWCNT transistors are fabricated with high yield. This work will thus facilitate ongoing efforts to realize high-density SWCNT integrated circuits.

Cognitive control components and speech symptoms in people with schizophrenia.

PubMed

Becker, Theresa M; Cicero, David C; Cowan, Nelson; Kerns, John G

2012-03-30

Previous schizophrenia research suggests poor cognitive control is associated with schizophrenia speech symptoms. However, cognitive control is a broad construct. Two important cognitive control components are poor goal maintenance and poor verbal working memory storage. In the current research, people with schizophrenia (n=45) performed three cognitive tasks that varied in their goal maintenance and verbal working memory storage demands. Speech symptoms were assessed using clinical rating scales, ratings of disorganized speech from typed transcripts, and self-reported disorganization. Overall, alogia was associated with both goal maintenance and verbal working memory tasks. Objectively rated disorganized speech was associated with poor goal maintenance and with a task that included both goal maintenance and verbal working memory storage demands. In contrast, self-reported disorganization was unrelated to either amount of objectively rated disorganized speech or to cognitive control task performance, instead being associated with negative mood symptoms. Overall, our results suggest that alogia is associated with both poor goal maintenance and poor verbal working memory storage and that disorganized speech is associated with poor goal maintenance. In addition, patients' own assessment of their disorganization is related to negative mood, but perhaps not to objective disorganized speech or to cognitive control task performance. Published by Elsevier Ireland Ltd.

The Household Costs of Visceral Leishmaniasis Care in South-eastern Nepal

PubMed Central

Baltussen, Rob; Rijal, Suman; Boelaert, Marleen

2013-01-01

Background and objectives Visceral leishmaniasis (VL) is an important public health problem in south-eastern Nepal affecting very poor rural communities. Since 2005, Nepal is involved in a regional initiative to eliminate VL. This study assessed the economic impact of VL on households and examined whether the intensified VL control efforts induced by the government resulted in a decrease in household costs. Methods Between August and September 2010, a household survey was conducted among 168 patients that had been treated for VL within 12 months prior to the survey in five districts in south-eastern Nepal. We collected data on health-seeking behaviour, direct and indirect costs and coping strategies. Results The median total cost of one episode of VL was US$ 165 or 11% of annual household income. The median delay between the onset of symptoms and presentation to a qualified provider was 25 days. Once the patient presented to a qualified provider, the delay to correct diagnosis was minimal (median 3 days). Direct and indirect costs (income losses) represented 47% and 53% of total costs respectively. Households used multiple strategies to cope with the cost of illness, mainly mobilizing cash/savings (71%) or taking a loan (56%). Conclusions The provision of free VL diagnosis and drugs by the Nepalese control programme has been an important policy measure to reduce the cost of VL to households. But despite the free VL drugs, the economic burden is still important for households. More effort should be put into reducing indirect costs, in particular the length of treatment, and preventing the transmission of VL through vector control. PMID:23469298

Assessing predation risk to threatened fauna from their prevalence in predator scats: dingoes and rodents in arid Australia.

PubMed

Allen, Benjamin L; Leung, Luke K-P

2012-01-01

The prevalence of threatened species in predator scats has often been used to gauge the risks that predators pose to threatened species, with the infrequent occurrence of a given species often considered indicative of negligible predation risks. In this study, data from 4087 dingo (Canis lupus dingo and hybrids) scats were assessed alongside additional information on predator and prey distribution, dingo control effort and predation rates to evaluate whether or not the observed frequency of threatened species in dingo scats warrants more detailed investigation of dingo predation risks to them. Three small rodents (dusky hopping-mice Notomys fuscus; fawn hopping-mice Notomys cervinus; plains mice Pseudomys australis) were the only threatened species detected in <8% of dingo scats from any given site, suggesting that dingoes might not threaten them. However, consideration of dingo control effort revealed that plains mice distribution has largely retracted to the area where dingoes have been most heavily subjected to lethal control. Assessing the hypothetical predation rates of dingoes on dusky hopping-mice revealed that dingo predation alone has the potential to depopulate local hopping-mice populations within a few months. It was concluded that the occurrence of a given prey species in predator scats may be indicative of what the predator ate under the prevailing conditions, but in isolation, such data can have a poor ability to inform predation risk assessments. Some populations of threatened fauna assumed to derive a benefit from the presence of dingoes may instead be susceptible to dingo-induced declines under certain conditions.

The household costs of visceral leishmaniasis care in south-eastern Nepal.

PubMed

Uranw, Surendra; Meheus, Filip; Baltussen, Rob; Rijal, Suman; Boelaert, Marleen

2013-01-01

Visceral leishmaniasis (VL) is an important public health problem in south-eastern Nepal affecting very poor rural communities. Since 2005, Nepal is involved in a regional initiative to eliminate VL. This study assessed the economic impact of VL on households and examined whether the intensified VL control efforts induced by the government resulted in a decrease in household costs. Between August and September 2010, a household survey was conducted among 168 patients that had been treated for VL within 12 months prior to the survey in five districts in south-eastern Nepal. We collected data on health-seeking behaviour, direct and indirect costs and coping strategies. The median total cost of one episode of VL was US$ 165 or 11% of annual household income. The median delay between the onset of symptoms and presentation to a qualified provider was 25 days. Once the patient presented to a qualified provider, the delay to correct diagnosis was minimal (median 3 days). Direct and indirect costs (income losses) represented 47% and 53% of total costs respectively. Households used multiple strategies to cope with the cost of illness, mainly mobilizing cash/savings (71%) or taking a loan (56%). The provision of free VL diagnosis and drugs by the Nepalese control programme has been an important policy measure to reduce the cost of VL to households. But despite the free VL drugs, the economic burden is still important for households. More effort should be put into reducing indirect costs, in particular the length of treatment, and preventing the transmission of VL through vector control.

Relations of Effortful Control, Reactive Undercontrol, and Anger to Chinese Children’s Adjustment

PubMed Central

Eisenberg, Nancy; Ma, Yue; Chang, Lei; Zhou, Qing; West, Stephen G.; Aiken, Leona

2006-01-01

The purpose of the study was to examine the zero-order and unique relations of effortful attentional and behavioral regulation, reactive impulsivity, and anger/frustration to Chinese first and second graders’ internalizing and externalizing symptoms, as well as the prediction of adjustment from the interaction of anger/frustration and effortful control or impulsivity. A parent and teacher reported on children’s anger/frustration, effortful control, and impulsivity; parents reported on children’s internalizing symptoms; and teachers and peers reported on children’s externalizing symptoms. Children were classified as relatively high on externalizing (or comorbid), internalizing, or nondisordered. High impulsivity and teacher-reported anger/frustration, and low effortful control, were associated with externalizing problems whereas low effortful control and high parent-reported anger were predictive of internalizing problems. Unique prediction from effortful and reactive control was obtained and these predictors (especially when reported by teachers) often interacted with anger/frustration when predicting problem behavior classification. PMID:17459176

Control and Effort Costs Influence the Motivational Consequences of Choice

PubMed Central

Sullivan-Toole, Holly; Richey, John A.; Tricomi, Elizabeth

2017-01-01

The act of making a choice, apart from any outcomes the choice may yield, has, paradoxically, been linked to both the enhancement and the detriment of intrinsic motivation. Research has implicated two factors in potentially mediating these contradictory effects: the personal control conferred by a choice and the costs associated with a choice. Across four experiments, utilizing a physical effort task disguised as a simple video game, we systematically varied costs across two levels of physical effort requirements (Low-Requirement, High-Requirement) and control over effort costs across three levels of choice (Free-Choice, Restricted-Choice, and No-Choice) to disambiguate how these factors affect the motivational consequences of choosing within an effortful task. Together, our results indicated that, in the face of effort requirements, illusory control alone may not sufficiently enhance perceptions of personal control to boost intrinsic motivation; rather, the experience of actual control may be necessary to overcome effort costs and elevate performance. Additionally, we demonstrated that conditions of illusory control, while otherwise unmotivating, can through association with the experience of free-choice, be transformed to have a positive effect on motivation. PMID:28515705

Follow the money: how the billions of dollars that flow from smokers in poor nations to companies in rich nations greatly exceed funding for global tobacco control and what might be done about it.

PubMed

Callard, Cynthia

2010-08-01

The business of selling cigarettes is increasingly concentrated in the hands of five tobacco companies that collectively control almost 90% of the world's cigarette market, four of which are publicly traded corporations. The economic activities of these cigarette manufacturers can be monitored through their reports to shareholders and other public documents. Reports for 2008 show that the revenues of these five companies exceeded $300 billion, of which more than $160 billion was provided to governments as taxes, and that corporate earnings of the four publicly traded companies were over $25 billion, of which $14 billion was retained after corporate income taxes were paid. By contrast, funding for domestic and international tobacco control is not reliably reported. Estimated funding for global tobacco control in 2008, at $240 million, is significantly lower than resources provided to address other highmortality global health challenges. Tobacco control has not yet benefited from the innovative finance mechanisms that are in place for HIV/AIDS, tuberculosis and malaria. The Framework Convention On Tobacco Control (FCTC) process could be used to redirect some of the earnings from transnational tobacco sales to fund FCTC implementation or other global health efforts.

Follow the money: How the billions of dollars that flow from smokers in poor nations to companies in rich nations greatly exceed funding for global tobacco control and what might be done about it

PubMed Central

2010-01-01

The business of selling cigarettes is increasingly concentrated in the hands of five tobacco companies that collectively control almost 90% of the world's cigarette market, four of which are publicly traded corporations. The economic activities of these cigarette manufacturers can be monitored through their reports to shareholders and other public documents. Reports for 2008 show that the revenues of these five companies exceeded $300 billion, of which more than $160 billion was provided to governments as taxes, and that corporate earnings of the four publicly traded companies were over $25 billion, of which $14 billion was retained after corporate income taxes were paid. By contrast, funding for domestic and international tobacco control is not reliably reported. Estimated funding for global tobacco control in 2008, at $240 million, is significantly lower than resources provided to address other high-mortality global health challenges. Tobacco control has not yet benefited from the innovative finance mechanisms that are in place for HIV/AIDS, tuberculosis and malaria. The Framework Convention On Tobacco Control (FCTC) process could be used to redirect some of the earnings from transnational tobacco sales to fund FCTC implementation or other global health efforts. PMID:20610436

Language Anxiety and Achievement.

ERIC Educational Resources Information Center

Horwitz, Elaine K.

2001-01-01

Considers the literature on language learning anxiety in an effort to clarify the relationship between anxiety and second language learning. Suggests that anxiety is indeed a cause of poor language learning in some individuals and discusses possible sources of this anxiety. (Author/VWL)

Athletes' Headaches: Not Necessarily 'Little' Problems.

ERIC Educational Resources Information Center

McCarthy, Paul

1988-01-01

Headaches experienced by athletes are categorized (exertional, effort, and trauma-triggered migraines), and treatment methods related. Consequences of misdiagnosis, lack of reporting, and poor monitoring are discussed as well as categories of athletes most likely to suffer sports-related headaches. (IAH)

The Idea of Justice.

ERIC Educational Resources Information Center

Chambers, Julius

1987-01-01

Reviews constitutional principles and case law in three areas of U.S. society where black Americans have made efforts to effect change. Specific changes are for fairness in education, the abolition of capital punishment, and the prohibition of discrimination against the poor. (JDH)

What's Your IAQ? It Could Mean Your Health.

ERIC Educational Resources Information Center

Malone, Bobby G.; Cox, Edward P.

2002-01-01

Describes causes and health consequences of poor indoor air quality in schools; describes Office of Safety and Health Association and Environmental Protection Agency efforts to improve indoor air quality through the promulgation and enforcement of standards and regulations. (PKP)

Role of metabolic phenotyping in understanding obesity and related conditions in Gulf Co-operation Council countries.

PubMed

Ahmad, M S; Ashrafian, H; Alsaleh, M; Holmes, E

2015-12-01

Obesity is a major health concern in the Middle East and the incidence is rising in all sections of the population. Efforts to control obesity through diet and lifestyle interventions, and by surgical means, have had limited effect, and the gene-environment interactions underpinning the development of obesity and related pathologies such as metabolic syndrome, cardiovascular disease and certain cancers are poorly defined. Lifestyle, genetics, inflammation and the interaction between the intestinal bacteria and host metabolism have all been implicated in creating an obesogenic environment. We summarize the role of metabolic and microbial phenotyping in understanding the aetiopathogenesis of obesity and in characterizing the metabolic responses to surgical and non-surgical interventions, and explore the potential for clinical translation of this approach. © 2015 World Obesity.

Sleep quality and temperament among university students: differential associations with nighttime sleep duration and sleep disruptions.

PubMed

Lukowski, Angela F; Milojevich, Helen M

2015-01-01

Sleep-temperament associations have not yet been examined among university students, despite awareness of the high incidence of sleep problems in this population. The present study was conducted (a) to examine whether sleep quality was associated with temperament among university-attending young adults and (b) to determine whether particular components of sleep quality were differentially associated with temperament. University students completed questionnaires designed to assess sleep quality and temperament. Poor sleep quality was associated with increased negative affect and orienting sensitivity as well as decreased effortful control; regression analyses revealed differential associations between components of nighttime sleep quality and temperament ratings. The presented study reveals conceptual continuity in sleep-temperament relations from infancy to young adulthood and highlights important avenues for future research.

Progress and challenges in the prevention and control of nonalcoholic fatty liver disease.

PubMed

Cai, Jingjing; Zhang, Xiao-Jing; Li, Hongliang

2018-05-30

Nonalcoholic fatty liver disease (NAFLD) is rapidly becoming the most common liver disease worldwide. Individuals with NAFLD have a high frequency of developing progressive liver disease and metabolism-related comorbidities, which result from of a lack of awareness and poor surveillance of the disease and a paucity of approved and effective therapies. Managing the complications of NAFLD has already begun to place a tremendous burden on health-care systems. Although efforts to identify effective therapies are underway, the lack of validated preclinical NAFLD models that represent the biology and outcomes of human disease remains a major barrier. This review summarizes the characteristics and prevalence of the disease and the status of our understanding of its mechanisms and potential therapeutic targets. © 2018 Wiley Periodicals, Inc.

Biomedical periodicals in Nigerian Medical Libraries: the medical librarian's dilemma.

PubMed Central

Okwuowulu, A O

1976-01-01

The Nigerian medical librarian has an uphill task in his effort to satisfy the journal needs of users of his library. His problems stem from difficulties in the selection and acquisition of journals, delay in postal services, budgetary and other administrative controls, and the changing nature of medical education and health-care services in Nigeria. The librarian's attempts to solve these problems include increased subscriptions to journals and use of interlibrary loans, but the absence of union lists of holdings of other libraries, the heavy cost of photocopying services, and poor postal facilities present another dimension to his problems. Eventually his best solution seems to lie in the establishment of a national center for "least used" journals to serve as a source stock for the country's medical libraries. PMID:938777

Hair epilation versus surgical excision as primary management of pilonidal disease in the pediatric population

PubMed Central

Bütter, Andreana; Hanson, Melissa; VanHouwelingen, Lisa; Merritt, Neil; Seabrook, Jamie

2015-01-01

Summary Pilonidal disease is a chronic, acquired inflammatory process of the skin due to entrapped hair at the natal cleft. Reported recurrence rates are as high as 30%, and recurrence has been attributed to persistent hair near the surgical site. Although conservative measures, such as meticulous hair control and improved perineal hygiene, have been shown to be effective, these techniques typically require much effort on behalf of the patient. Laser hair epilation (LE) might solve this issue of poor patient compliance while helping patients to avoid surgical excision. In this article, we discuss recurrence rates of pilonidal disease in children treated with LE versus surgical excision in relation to findings from our institution between 2005 and 2013 as well as patient satisfaction with the treatment method. PMID:26011854

Contraception in the prepill era.

PubMed

Connell, E B

1999-01-01

Although medical history has documented the desire to control fertility since ancient times, safe and effective contraception did not exist until this century and has not been equally available to all people. Strong moral sentiments, economic and social class factors, religious beliefs, familial and gender relations, and political as well as legal constraints have often limited the ability of physicians in favor of contraception to provide advice and methods of birth control to their patients. By the early 1900s, a constellation of factors--in particular, the large influx of poor immigrants, and feminist groups advocating women's rights--helped to move forward a birth-control movement in this country and abroad. In the early 20th century, Margaret Sanger became one of the most avid proponents of contraception in the United States. By 1950, she and Katharine McCormick had contracted with biologist Gregory Pincus to develop an effective birth control pill. A collaborative effort by Pincus and other researchers led to trials of the pill in Puerto Rico, Haiti, and Mexico between 1956 and 1957, which provided the basis for an application to the Food and Drug Administration for approval of the first oral contraceptive.

Stabilization of Tetanus Toxoid Encapsulated in PLGA Microspheres

PubMed Central

Jiang, Wenlei; Schwendeman, Steven P.

2014-01-01

Delivery of vaccine antigens from controlled-release poly(lactic/glycolic acid) (PLGA) microspheres is a novel approach to reduce the number of antigen doses required for protection against infection. A major impediment to developing single-shot vaccines is encapsulated antigen instability during months of exposure to physiological conditions. For example, efforts to control neonatal tetanus in developing countries with a single-dose TT vaccine have been plagued by poor stability of the 150 kDa formaldehyde-detoxified protein antigen, tetanus toxoid (TT) in PLGA microspheres. We examined the denatured states of PLGA-encapsulated TT, revealing two primary TT instability mechanisms: 1) protein aggregation mediated by formaldehyde and 2) acid-induced protein unfolding and epitope damage. Further, we systemically identified excipients which can efficiently inhibit TT aggregation and retain TT antigenicity under simulated deleterious conditions, i.e., elevated temperature and humidity. By employing these novel additives in the PLGA system, we report the slow and continuous release of high doses of TT for one month with retained antigen stability during bioerosion of PLGA. PMID:18710256

The current status of opisthorchiasis and clonorchiasis in the Mekong Basin

PubMed Central

Sithithaworn, Paiboon; Andrews, Ross H.; Van De, Nguyen; Wongsaroj, Thitima; Sinuon, Muth; Odermatt, Peter; Nawa, Yukifumi; Liang, Song; Brindley, Paul J.; Sripa, Banchob

2013-01-01

This review highlights the current status and control of liver fluke infections in the Mekong Basin countries where Opisthorchis and Clonorchis are highly endemic. Updated data on prevalence and distribution have been summarized from presentations in the “96 Years of Opisthorchiasis. International Congress of Liver Flukes”. It is disturbing that despite treatment and control programs have been in place for decades, all countries of the Lower Mekong Basin are still highly endemic with O. viverrini and/or C. sinensis as well as alarmingly high levels of CCA incidence. A common pattern that is emerging in each country is the difference in transmission of O. viverrini between lowlands which have high prevalence versus highlands which have low prevalence. This seems to be associated with wetlands, flooding patterns and human movement and settlement. A more concerted effort from all community, educational, public health and government sectors is necessary to successfully combat this fatal liver disease of the poor. PMID:21893213

Enhancing Surveillance and Diagnostics in Anthrax-Endemic Countries

PubMed Central

Salzer, Johanna S.; Traxler, Rita M.; Hendricks, Katherine A.; Kadzik, Melissa E.; Marston, Chung K.; Kolton, Cari B.; Stoddard, Robyn A.; Hoffmaster, Alex R.; Bower, William A.; Walke, Henry T.

2017-01-01

Naturally occurring anthrax disproportionately affects the health and economic welfare of poor, rural communities in anthrax-endemic countries. However, many of these countries have limited anthrax prevention and control programs. Effective prevention of anthrax outbreaks among humans is accomplished through routine livestock vaccination programs and prompt response to animal outbreaks. The Centers for Disease Control and Prevention uses a 2-phase framework when providing technical assistance to partners in anthrax-endemic countries. The first phase assesses and identifies areas for improvement in existing human and animal surveillance, laboratory diagnostics, and outbreak response. The second phase provides steps to implement improvements to these areas. We describe examples of implementing this framework in anthrax-endemic countries. These activities are at varying stages of completion; however, the public health impact of these initiatives has been encouraging. The anthrax framework can be extended to other zoonotic diseases to build on these efforts, improve human and animal health, and enhance global health security. PMID:29155651

Cardiovascular Risk Factors in Patients with Poorly Controlled Diabetes Mellitus.

PubMed

Dizdarevic-Bostandzic, Amela; Begovic, Ermin; Burekovic, Azra; Velija-Asimi, Zelija; Godinjak, Amina; Karlovic, Vanja

2018-02-01

Diabetes mellitus(DM) is considered an independent cardiovascular risk factor. Having in mind concomitant occurence of diabetes and other cardiovascular risk factors, it is expected that patients with poor glucoregulation will have more cardiovascular risk factors and higher cardiovascular risk than patients with good glucoregulation. To compare cardiovascular risk and cardiovascular risk factors between patients with poorly controlled and patients with well-controlled Diabetes mellitus. Hundered ten patients aged 40-70 years suffering from Diabetes mellitus type 2 were included. Research is designed as a retrospective, descriptive study. Patients with glycosylated hemoglobin (HbA1c) > 7% were considered to have poorly controlled diabetes. The following data and parameters were monitored: age,sex, family history, data on smoking and alcohol consumption, BMI (body mass index), blood pressure, blood glucose, total cholesterol, triglycerides, LDL, HDL, fibrinogen, uric acid. For the assessment of cardiovascular risk, the WHO / ISH (World Health Organization/International Society of hypertension) tables of the 10-year risk were used, and due to the assessment of the risk factors prevalence, the optimal values of individual numerical variables were defined. Differences in the mean values of systolic, diastolic blood pressure, fasting glucose, total cholesterol, LDL cholesterol are statistically significant higher in patients with poorly controlled diabetes. Hypertension more frequently occurre in patients with poorly controlled DM. The majority of patients with well-controlled DM belong to the group of low and medium cardiovascular risk, while the majority of patients with poorly controlled DM belong to the group of high and very high cardiovascular risk. In our research, there was a significant difference in cardiovascular risk in relation to the degree of DM regulation, and HbA1c proved to be an important indicator for the emergence of the CVD. There are significant differences in certain risk factors between patients with poorly controlled and well controlled DM. Patients with poorly controlled diabetes mellitus have a higher cardiovascular risk than patients with well controlled diabetes. The value of HbA1c should be considered when assessing cardiovascular risk.

Effortful Control, Explicit Processing, and the Regulation of Human Evolved Predispositions

ERIC Educational Resources Information Center

MacDonald, Kevin B.

2008-01-01

This article analyzes the effortful control of automatic processing related to social and emotional behavior, including control over evolved modules designed to solve problems of survival and reproduction that were recurrent over evolutionary time. The inputs to effortful control mechanisms include a wide range of nonrecurrent…

[Experience of Handicap International in providing humanitarian relief in region near Aceh, Indonesia from March 1 to 27, 2005].

PubMed

Gillet, Y

2005-01-01

This report describes the experience of the author in March 2005 during the relief efforts deployed in the region near Aceh, Indonesia (North Sumatra) by Handicap International, one of the 400 NGO that provided humanitarian aid following the tsunami disaster that struck Southeast Asia on December 26, 2004. Working in Banda Aceh and Meulaboh, the author was confronted with the extent of the devastation both in terms of property damage and human suffering. Clinical cases were often severe and rarely encountered in industrialized countries. The tsunami worsened the already poor sanitary conditions: rundown care facilities, poorly trained health care personnel, tropical disease, poor hygiene, and AVP.

Unsafe abortion: a cruel way of birth control.

PubMed

Shrivastava, Saurabh RamBihariLal; Shrivastava, Prateek Saurabh; Ramasamy, Jegadeesh

2014-06-01

Unsafe abortion refers to a procedure for terminating an unintended pregnancy performed either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both. The objectives of the study are to assess the factors attributing to practice of unsafe abortion and to suggest feasible and cost-effective measures to counter the same. An extensive search of all materials related to the topic was made using library sources including Pubmed, Medline and World Health Organization. Keywords used in the search include unsafe abortion and unintended pregnancy. Multiple socio-demographic determinants and barriers such as illiterate women, poor socio-economic status, poor awareness about abortion services, associated stigma, and untrained health professionals have been identified resulting in restricted utilization/access of women to safe abortion services. Consequences of unsafe abortion have been alarming, seriously questioning the quality of health care delivery system. Concerted and dedicated efforts of government in collaboration with the private sector, community members and non-governmental organizations are needed to ensure that women have a better access to contraceptives, abortion services, and post-abortion care that are safe, affordable, and free from stigma.

Saving maternal lives in resource-poor settings: facing reality.

PubMed

Prata, Ndola; Sreenivas, Amita; Vahidnia, Farnaz; Potts, Malcolm

2009-02-01

Evaluate safe-motherhood interventions suitable for resource-poor settings that can be implemented with current resources. Literature review to identify interventions that require minimal treatment/infrastructure and are not dependent on skilled providers. Simulations were run to assess the potential number of maternal lives that could be saved through intervention implementation according to potential program impact. Regional and country level estimates are provided as examples of settings that would most benefit from proposed interventions. Three interventions were identified: (i) improve access to contraception; (ii) increase efforts to reduce deaths from unsafe abortion; and (iii) increase access to misoprostol to control postpartum hemorrhage (including for home births). The combined effect of postpartum hemorrhage and unsafe abortion prevention would result in the greatest gains in maternal deaths averted. Bold new initiatives are needed to achieve the Millennium Development Goal of reducing maternal mortality by three-quarters. Ninety-nine percent of maternal deaths occur in developing countries and the majority of these women deliver alone, or with a traditional birth attendant. It is time for maternal health program planners to reprioritize interventions in the face of human and financial resource constraints. The three proposed interventions address the largest part of the maternal health burden.

[The impact of therapeutic inertia and the degree of the medication adherence on the control goals for patients with diabetes].

PubMed

López-Simarro, F; Moral, I; Aguado-Jodar, A; Cols-Sagarra, C; Mancera-Romero, J; Alonso-Fernández, M; Miravet-Jiménez, S; Brotons, C

2017-11-21

The purpose of this study was to analyse both the impact of low therapeutic adherence (TA) and therapeutic inertia (TI) on poor blood glucose control and on risk factors for heart disease in patients with DM2. A cross-sectional study was conducted in a Primary Halth Care centre. A total of 320 patients with DM2 were included and an assessment was made of control goals (HbA1c≤7%, blood pressure ≤130/80mmHg, and LDL-cholesterol≤100mg/dl). A pharmacy retrieval <80% was considered as a lack of TA and the non-modification of treatment in badly controlled patient as TI. The percentage of patients with good control of HbA1c, blood pressure and LDL-cholesterol was 62.5%, 40.9%, and 35.9%, respectively. Lower figures of TA were present in poorly controlled patients, and TI was not found to be related to TA. In the patients with poor HbA1c control, 25.8% had TI, 24.8% poor TA, and 11.9% had both of them. As regards LDL-cholesterol, 3.6% presented poor TA, 70.4% showed TI, and 16% with poor TA and TI (P<.001). As for blood pressure, 3.5% of patients had poor TA, 54.6% had TI, and 21.5% of them had poor TA as well as TI (P<.01). Lack of therapeutic adherence and therapeutic inertia were found in a high percentage of poorly-controlled DM2 patients with bad control. Therapeutic inertia was found to be of great relevance in this study. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Effect of effort-reward imbalance and burnout on infection control among Ecuadorian nurses.

PubMed

Colindres, C V; Bryce, E; Coral-Rosero, P; Ramos-Soto, R M; Bonilla, F; Yassi, A

2018-06-01

Nurses are frequently exposed to transmissible infections, yet adherence to infection control measures is suboptimal. There has been inadequate research into how the psychosocial work environment affects compliance with infection control measures, especially in low- and middle-income countries. To examine the association between effort-reward imbalance, burnout and adherence to infection control measures among nurses in Ecuador. A cross-sectional study linking psychosocial work environment indicators to infection control adherence. The study was conducted among 333 nurses in four Ecuadorian hospitals. Self-administered questionnaires assessed demographic variables, perceived infection risk, effort-reward imbalance, burnout and infection control adherence. Increased effort-reward imbalance was found to be a unique incremental predictor of exposure to burnout, and burnout was a negative unique incremental predictor of nurses' self-reported adherence with infection control measures. Results suggest an effort-reward imbalance-burnout continuum, which, at higher levels, contributes to reduce adherence to infection control. The Ecuadorean government has made large efforts to improve universal access to health care, yet this study suggests that workplace demands on nurses remain problematic. This study highlights the contribution of effort-reward-imbalance-burnout continuum to the chain of infection by decreased adherence to infection control of nurses. Health authorities should closely monitor the effect of new policies on psychosocial work environment, especially when expanding services and increasing public accessibility with limited resources. Additionally, organizational and psychosocial interventions targeting effort-reward imbalance and burnout in nurses should be considered part of a complete infection prevention and control strategy. Further study is warranted to identify interventions that best ameliorate effort-reward imbalance and burnout in low- and middle-income settings. © 2017 The Authors International Nursing Review published by John Wiley & Sons Ltd on behalf of International Council of Nurses.

Knowledge, practices and perceptions of geo-helminthes infection among parents of pre-school age children of coastal region, Kenya.

PubMed

Masaku, Janet; Mwende, Faith; Odhiambo, Gladys; Musuva, Rosemary; Matey, Elizabeth; Kihara, Jimmy H; Thuita, Isaac G; Njomo, Doris W

2017-03-01

Soil-transmitted helminthes (STHs) are common human parasitic diseases in most of the developing world particularly in Kenya. The ongoing National School-Based Deworming Programme (NSBDP) was launched in 2012 and is currently targeting 28 of the 47 endemic Counties. In an effort to improve treatment intervention strategies among Pre-School Age Children (PSAC) attending Early Childhood Development Centres (ECDC), we sought to assess parents' knowledge, perceptions and practices on worm infection. We conducted a qualitative cross-sectional study in four endemic sub-counties of two counties of coastal region of Kenya. A total of 20 focus group discussions (FGDs) categorized by gender were conducted among parents of pre-school age children. Participants were purposively selected based on homogenous characteristics with the saturation model determining the number of focus group discussions conducted. The data collected was analyzed manually by study themes. The majority of the parents had knowledge on worms and modes of transmission of the parasitic infections among the pre-school children. Also, most of the participants knew the causes of worm infection and the pre- disposing factors mentioned included poor hygiene and sanitation practices. Due to poor knowledge of signs and symptoms, misconceptions about the drugs administered during the NSBDP were common with a large majority of the parents indicating that the drugs were ineffective in worm control. The findings also indicated that most of the participants sought medical care on the onset of the signs and symptoms of worm infestation and preferred services provided at public health facilities as opposed to private health facilities or buying drugs from the local market citing mistrust of such services. Cultural beliefs, high cost of building and availability of vast pieces of land for human waste disposal were factors that contributed to low or lack of latrine ownership and usage by a large majority of the respondents. Our results show that to a large extent the parents of the pre-school age children have information on worm infections. However, some cultural beliefs and practices on the pathology and mode of transmission mentioned could be a hindrance to prevention and control efforts. There is need to implement health promotion campaigns to strengthen the impact of control strategies and reduce infection.

Knowledge, practices and perceptions of geo-helminthes infection among parents of pre-school age children of coastal region, Kenya

PubMed Central

Mwende, Faith; Odhiambo, Gladys; Musuva, Rosemary; Matey, Elizabeth; Kihara, Jimmy H.; Thuita, Isaac G.; Njomo, Doris W.

2017-01-01

Background Soil-transmitted helminthes (STHs) are common human parasitic diseases in most of the developing world particularly in Kenya. The ongoing National School-Based Deworming Programme (NSBDP) was launched in 2012 and is currently targeting 28 of the 47 endemic Counties. In an effort to improve treatment intervention strategies among Pre-School Age Children (PSAC) attending Early Childhood Development Centres (ECDC), we sought to assess parents’ knowledge, perceptions and practices on worm infection. Methodology We conducted a qualitative cross-sectional study in four endemic sub-counties of two counties of coastal region of Kenya. A total of 20 focus group discussions (FGDs) categorized by gender were conducted among parents of pre-school age children. Participants were purposively selected based on homogenous characteristics with the saturation model determining the number of focus group discussions conducted. The data collected was analyzed manually by study themes. Findings The majority of the parents had knowledge on worms and modes of transmission of the parasitic infections among the pre-school children. Also, most of the participants knew the causes of worm infection and the pre- disposing factors mentioned included poor hygiene and sanitation practices. Due to poor knowledge of signs and symptoms, misconceptions about the drugs administered during the NSBDP were common with a large majority of the parents indicating that the drugs were ineffective in worm control. The findings also indicated that most of the participants sought medical care on the onset of the signs and symptoms of worm infestation and preferred services provided at public health facilities as opposed to private health facilities or buying drugs from the local market citing mistrust of such services. Cultural beliefs, high cost of building and availability of vast pieces of land for human waste disposal were factors that contributed to low or lack of latrine ownership and usage by a large majority of the respondents. Conclusions Our results show that to a large extent the parents of the pre-school age children have information on worm infections. However, some cultural beliefs and practices on the pathology and mode of transmission mentioned could be a hindrance to prevention and control efforts. There is need to implement health promotion campaigns to strengthen the impact of control strategies and reduce infection. PMID:28358802

Addressing poverty through disease control programmes: examples from Tuberculosis control in India.

PubMed

Kamineni, Vishnu Vardhan; Wilson, Nevin; Das, Anand; Satyanarayana, Srinath; Chadha, Sarabjit; Sachdeva, Kuldeep Singh; Chauhan, Lakbir Singh

2012-03-26

Tuberculosis remains a major public health problem in India with the country accounting for one-fifth or 21% of all tuberculosis cases reported globally. The purpose of the study was to obtain an understanding on pro-poor initiatives within the framework of tuberculosis control programme in India and to identify mechanisms to improve the uptake and access to TB services among the poor. A national level workshop was held with participation from all relevant stakeholder groups. This study conducted during the stakeholder workshop adopted participatory research methods. The data was elicited through consultative and collegiate processes. The research study also factored information from primary and secondary sources that included literature review examining poverty headcount ratios and below poverty line population in the country; and quasi-profiling assessments to identify poor, backward and tribal districts as defined by the TB programme in India. Results revealed that current pro-poor initiatives in TB control included collaboration with private providers and engaging community to improve access among the poor to TB diagnostic and treatment services. The participants identified gaps in existing pro-poor strategies that related to implementation of advocacy, communication and social mobilisation; decentralisation of DOT; and incentives for the poor through the available schemes for public-private partnerships and provided key recommendations for action. Synergies between TB control programme and centrally sponsored social welfare schemes and state specific social welfare programmes aimed at benefitting the poor were unclear. Further in-depth analysis and systems/policy/operations research exploring pro-poor initiatives, in particular examining service delivery synergies between existing poverty alleviation schemes and TB control programme is essential. The understanding, reflection and knowledge of the key stakeholders during this participatory workshop provides recommendations for action, further planning and research on pro-poor TB centric interventions in the country.

Weight, Weight Perceptions and Health-Related Quality of Life among a National Sample of US Girls

PubMed Central

Farhat, Tilda; Iannotti, Ronald J.; Summersett-Ringgold, Faith

2015-01-01

Objective To examine associations between three weight indices (weight status, perceived weight, weight status perception accuracy) and HRQOL. Methods Data are for girls in the 2009 Health Behaviors in School-Age Children survey, a nationally representative sample of students in grades 5-10 during the 2009/10 school-year (n=5,018). Controlling for sociodemographics, multivariate linear regressions examined associations between self-reported weight status (Underweight/Normal/Overweight/Obese), perceived weight (how children categorize their weight), weight status perception accuracy (Underestimate/Accurate perception/Overestimate) and dimensions of HRQOL including physical, emotional, social, and school functioning. Results While obesity was only associated with poor physical and emotional HRQOL, perceptions of being overweight were associated with worse physical, emotional, school and social HRQOL. Further, girls who overestimated their weight reported poorer HRQOL than those with accurate weight perceptions. Associations of perceptions of being overweight and weight status overestimation with poor HRQOL despite, in most instances, the absence of associations between weight status and HRQOL, suggest that weight status perceptions may not merely be a mediator of a weight status-HRQOL association, but a significant independent correlate of poor HRQOL. Conclusion These findings raise the issue of whether there is a need to prioritize intervention efforts to promote better HRQOL by re-defining the population of girls most at risk. Parents, teachers and clinicians should be aware that, rather that overweight status, perceptions of being overweight (accurately or not) are associated with a poor HRQOL among girls. Future research should examine the potential negative effect of using specific body image terminologies on adolescents' psychological health. PMID:25961900

An integration programme of poverty alleviation and development with family planning.

PubMed

1997-04-01

The State Council (the central government) recently issued a Circular for Speeding Up the Integration of Poverty Alleviation and Development with the Family Planning Programme during the Ninth Five-year Plan (1996-2000). The Circular was jointly submitted by the State Family Planning Commission and the Leading Group for Poverty Alleviation and Development. The document sets the two major tasks as solving the basic needs for food and clothing of the rural destitute and the control of over-rapid growth of China's population. Practice indicates that a close Integration Programme is the best way for impoverished farmers to alleviate poverty and become better-off. Overpopulation and low educational attainments and poor health quality of population in backward areas are the major factors retarding socioeconomic development. Therefore, it is inevitable to integrate poverty alleviation with family planning. It is a path with Chinese characteristics for a balanced population and sustainable socioeconomic development. The targets of the Integration Programme are as follows: The first is that preferential policies should be worked out to guarantee family planning acceptors, especially households with an only daughter or two daughters, are the first to be helped to eradicate poverty and become well-off. They should become good examples for other rural poor in practicing fewer but healthier births, and generating family income. The second target is that the population plans for the poor counties identified by the central government and provincial governments must be fulfilled. This should contribute to breaking the vicious circle of poverty leading to more children, in turn generating more poverty. The circular demands that more efforts should focus on the training of cadres for the Integrated Programme and on services for poor family planning acceptors. full text

Effort-reward imbalance and work ability: cross-sectional and longitudinal findings from the Second German Sociomedical Panel of Employees

PubMed Central

2012-01-01

Background Although data from longitudinal studies are sparse, effort-reward imbalance (ERI) seems to affect work ability. However, the potential pathway from restricted work ability to ERI must also be considered. Therefore, the aim of our study was to analyse cross-sectional and longitudinal associations between ERI and work ability and vice versa. Methods Data come from the Second German Sociomedical Panel of Employees. Logistic regression models were estimated to determine cross-sectional and longitudinal associations. The sample used to predict new cases of poor or moderate work ability was restricted to cases with good or excellent work ability at baseline. The sample used to predict new cases of ERI was restricted to persons without ERI at baseline. Results The cross-sectional analysis included 1501 full-time employed persons. The longitudinal analyses considered 600 participants with good or excellent baseline work ability and 666 participants without baseline ERI, respectively. After adjustment for socio-demographic variables, health-related behaviour and factors of the work environment, ERI was cross-sectionally associated with poor or moderate work ability (OR = 1.980; 95% CI: 1.428 to 2.747). Longitudinally, persons with ERI had 2.1 times higher odds of poor or moderate work ability after one year (OR = 2.093; 95% CI: 1.047 to 4.183). Conversely, persons with poor or moderate work ability had 2.6 times higher odds of an ERI after one year (OR = 2.573; 95% CI: 1.314 to 5.041). Conclusions Interventions that enable workers to cope with ERI or address indicators of ERI directly could promote the maintenance of work ability. Integration management programmes for persons with poor work ability should also consider their psychosocial demands. PMID:23067110

Determinants of immunization inequality among urban poor children: evidence from Nairobi's informal settlements.

PubMed

Egondi, Thaddaeus; Oyolola, Maharouf; Mutua, Martin Kavao; Elung'ata, Patricia

2015-02-27

Despite the relentless efforts to reduce infant and child mortality with the introduction of the National Expanded Programmes on Immunization (EPI) in 1974, major disparities still exist in immunizations coverage across different population sub-groups. In Kenya, for instance, while the proportion of fully immunized children increased from 57% in 2003 to 77% in 2008-9 at national level and 73% in Nairobi, only 58% of children living in informal settlement areas are fully immunized. The study aims to determine the degree and determinants of immunization inequality among the urban poor of Nairobi. We used data from the Nairobi Cross-Sectional Slum Survey of 2012 and the health outcome was full immunization status among children aged 12-23 months. The wealth index was used as a measure of social economic position for inequality analysis. The potential determinants considered included sex of the child and mother's education, their occupation, age at birth of the child, and marital status. The concentration index (CI) was used to quantify the degree of inequality and decomposition approach to assess determinants of inequality in immunization. The CI for not fully immunized was -0.08 indicating that immunization inequality is mainly concentrated among children from poor families. Decomposition of the results suggests that 78% of this inequality is largely explained by the mother's level of education. There exists immunization inequality among urban poor children in Nairobi and efforts to reduce this inequality should aim at targeting mothers with low level of education during immunization campaigns.

The cost of model reference adaptive control - Analysis, experiments, and optimization

NASA Technical Reports Server (NTRS)

Messer, R. S.; Haftka, R. T.; Cudney, H. H.

1993-01-01

In this paper the performance of Model Reference Adaptive Control (MRAC) is studied in numerical simulations and verified experimentally with the objective of understanding how differences between the plant and the reference model affect the control effort. MRAC is applied analytically and experimentally to a single degree of freedom system and analytically to a MIMO system with controlled differences between the model and the plant. It is shown that the control effort is sensitive to differences between the plant and the reference model. The effects of increased damping in the reference model are considered, and it is shown that requiring the controller to provide increased damping actually decreases the required control effort when differences between the plant and reference model exist. This result is useful because one of the first attempts to counteract the increased control effort due to differences between the plant and reference model might be to require less damping, however, this would actually increase the control effort. Optimization of weighting matrices is shown to help reduce the increase in required control effort. However, it was found that eventually the optimization resulted in a design that required an extremely high sampling rate for successful realization.

Rocky Mountain Rift.

ERIC Educational Resources Information Center

Broderick, Christopher

1995-01-01

Describes the efforts of teachers and parents to open a charter school in Denver, which is being vigorously blocked by the school board. Discusses the pros (offer nontraditional teaching methods and institutional autonomy) and cons (drain public funds from poor schools) of charter schools. (LMI)

EPA Awards $25K Grant to Lewiston, Maine Non-profit for Indoor Air Quality Efforts

EPA Pesticide Factsheets

A non-profit in Lewiston, Maine, has received $25,000 from the US Environmental Protection Agency to reduce health threats caused by poor indoor air quality, including radon indoors, mold and secondhand smoke.

Effortful Control and Academic Achievement in Rural China

ERIC Educational Resources Information Center

Zhang, Li; Rao, Nirmala

2017-01-01

Research Findings: This study investigated the relationships between effortful control and early literacy and mathematics achievement. A total of 181 children (85 girls and 96 boys) from rural China were assessed when they were in Grades 1 and 2. Path analyses controlling for maternal education indicated that effortful control at the beginning of…

Associations between working environment and weight control efforts among workers with obesity in Korea.

PubMed

Hyun, Hye Sun; Kim, Yunyoung

2018-06-01

Objective The aim of this study was to investigate the relationship between working environment and weight control efforts among obese workers in Korea. Methods This study was based on the 2011 3rd Korean Working Conditions Survey, which was conducted on workers aged 15 years or older. A sample of 484 obese workers was included in the study. Multivariable logistic regression analysis was used to investigate the relationship between working environment and weight control efforts after controlling for individual variables. Adjusted odds ratios (ORs) and 95% confidence intervals were calculated. Results Of the participants, 63.4% reported that they made efforts to control their weight. After controlling for personal factors, the OR of weight control efforts for individuals working 40-49 hours per week was 2.4 times that for individuals working 60 hours or more per week. The OR of regular employment workers was 2.2 times that of non-regular workers. Conclusion We established that working hours and employment type were significantly related to weight control efforts. Therefore, we recommend that working conditions should be considered in designing effective workplace health promotion programs.

Resident Wellness Matters: Optimizing Resident Education and Wellness Through the Learning Environment.

PubMed

Jennings, M L; Slavin, Stuart J

2015-09-01

The problem of poor mental health in residency is well established. Burnout, depression, and suicidal ideation are prevalent among resident physicians, and these problems appear to persist into practice. Leaders in graduate medical education such as policy makers at the Accreditation Council for Graduate Medical Education (ACGME) and directors of individual programs and institutions should acknowledge these important issues and take steps to address them. The ACGME's Clinical Learning Environment Review (CLER) Program currently outlines an expectation that institutions both educate residents about burnout and measure burnout annually. The CLER Program could go further by expecting institutions to create quality initiatives to enhance resident wellness and increase resident engagement. The ACGME should also call for and support research in this area. Leaders or directors of individual programs and institutions should consider wellness initiatives that both (1) identify and address suboptimal aspects of the learning environment and (2) train residents in resilience skills. Efforts to improve the residency learning environment could be guided by the work of Maslach and Leiter, who describe six categories of work stress that can contribute to burnout: (1) workload, (2) control, (3) balance between effort and reward, (4) community, (5) fairness, and (6) values.

Containing a Lassa fever epidemic in a resource-limited setting: outbreak description and lessons learned from Abakaliki, Nigeria (January-March 2012).

PubMed

Ajayi, Nnennaya A; Nwigwe, Chinedu G; Azuogu, Ben N; Onyire, Benson N; Nwonwu, Elizabeth U; Ogbonnaya, Lawrence U; Onwe, Francis I; Ekaete, Tobin; Günther, Stephan; Ukwaja, Kingsley N

2013-11-01

Despite the epidemic nature of Lassa fever (LF), details of outbreaks and response strategies have not been well documented in resource-poor settings. We describe the course of a LF outbreak in Ebonyi State, Nigeria, during January to March 2012. We analyzed clinical, epidemiological, and laboratory data from surveillance records and hospital statistics during the outbreak. Fisher's exact tests were used to compare proportions and t-tests to compare differences in means. The outbreak response consisted of effective coordination, laboratory testing, active surveillance, community mobilization, contact and suspected case evaluation, and case management. Twenty LF cases (10 confirmed and 10 suspected) were recorded during the outbreak. Nosocomial transmission to six health workers occurred through the index case. Only 1/110 contacts had an asymptomatic infection. Overall, there was high case fatality rate among all cases (6/20; 30%). Patients who received ribavirin were less likely to die than those who did not (p=0.003). The mean delay to presentation for patients who died was 11 ± 3.5 days, while for those who survived was 6 ± 2.6 days (p<0.001). The response strategies contained the epidemic. Challenges to control efforts included poor local laboratory capacity, inadequate/poor quality of protective materials, fear among health workers, and inadequate emergency preparedness. Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

High Awareness but Low Coverage of a Locally Produced Fortified Complementary Food in Abidjan, Côte d'Ivoire: Findings from a Cross-Sectional Survey.

PubMed

Leyvraz, Magali; Rohner, Fabian; Konan, Amoin G; Esso, Lasme J C E; Woodruff, Bradley A; Norte, Augusto; Adiko, Adiko F; Bonfoh, Bassirou; Aaron, Grant J

2016-01-01

Poor complementary feeding practices among infants and young children in Côte d'Ivoire are major contributing factors to the country's high burden of malnutrition. As part of a broad effort to address this issue, an affordable, nutritious, and locally produced fortified complementary food product was launched in the Côte d'Ivoire in 2011. The objective of the current research was to assess various levels of coverage of the program and to identify coverage barriers. A cross-sectional household survey was conducted among caregivers of children less than 2-years of age living in Abidjan, Côte d'Ivoire. Four measures of coverage were assessed: "message coverage" (i.e., has the caregiver ever heard of the product?), "contact coverage" (i.e., has the caregiver ever fed the child the product?), "partial coverage" (i.e., has the caregiver fed the child the product in the previous month?), and "effective coverage" (i.e., has the caregiver fed the child the product in the previous 7 days?). A total of 1,113 caregivers with children between 0 and 23 months of age were interviewed. Results showed high message coverage (85.0%), moderate contact coverage (37.8%), and poor partial and effective coverages (8.8% and 4.6%, respectively). Product awareness was lower among caregivers from poorer households, but partial and effective coverages were comparable in both poor and non-poor groups. Infant and young child feeding (IYCF) practices were generally poor and did not appear to have improved since previous assessments. In conclusion, the results from the present study indicate that availability on the market and high awareness among the target population is not sufficient to achieve high and effective coverage. With market-based delivery models, significant efforts are needed to improve demand. Moreover, given the high prevalence of malnutrition and poor IYCF practices, additional modes of delivering IYCF interventions and improving IYCF practices should be considered.

Balancing personal maintenance with parental investment in a chick-rearing seabird: physiological indicators change with foraging conditions.

PubMed

Storey, Anne E; Ryan, Morag G; Fitzsimmons, Michelle G; Kouwenberg, Amy-Lee; Takahashi, Linda S; Robertson, Gregory J; Wilhelm, Sabina I; McKay, Donald W; Herzberg, Gene R; Mowbray, Frances K; MacMillan, Luke; Walsh, Carolyn J

2017-01-01

Seabird parents use a conservative breeding strategy that favours long-term survival over intensive parental investment, particularly under harsh conditions. Here, we examine whether variation in several physiological indicators reflects the balance between parental investment and survival in common murres ( Uria aalge ) under a wide range of foraging conditions. Blood samples were taken from adults during mid-chick rearing from 2007 to 2014 and analysed for corticosterone (CORT, stress hormone), beta-hydroxybutyrate (BUTY, lipid metabolism reflecting ongoing mass loss), and haematocrit (reflecting blood oxygen capacity). These measures, plus body mass, were related to three levels of food availability (good, intermediate, and poor years) for capelin, the main forage fish for murres in this colony. Adult body mass and chick-feeding rates were higher in good years than in poor years and heavier murres were more likely to fledge a chick than lighter birds. Contrary to prediction, BUTY levels were higher in good years than in intermediate and poor years. Murres lose body mass just after their chicks hatch and these results for BUTY suggest that mass loss may be delayed in good years. CORT levels were higher in intermediate years than in good or poor years. Higher CORT levels in intermediate years may reflect the necessity of increasing foraging effort, whereas extra effort is not needed in good years and it is unlikely to increase foraging success in poor years. Haematocrit levels were higher in poor years than in good years, a difference that may reflect either their poorer condition or increased diving requirements when food is less available. Our long-term data set provided insight into how decisions about resource allocation under different foraging conditions are relating to physiological indicators, a relationship that is relevant to understanding how seabirds may respond to changes in marine ecosystems as ocean temperatures continue to rise.

Factors associated with glycemic control among diabetic adult out-patients in Northeast Ethiopia.

PubMed

Fiseha, Temesgen; Alemayehu, Ermiyas; Kassahun, Wongelawit; Adamu, Aderaw; Gebreweld, Angesom

2018-05-18

The aim of this study was to determine the status of glycemic control and identify factors associated with poor glycemic control among diabetic out-patients. A hospital based cross-sectional study was conducted among randomly selected 384 (126 type 1 and 258 type 2) diabetic adults attending a hospital in Northeast Ethiopia from January 1 to April 30, 2017. Of the total participants, 70.8% had poor status of glycemic control (defined as mean fasting blood glucose level above 130 mg/dl). In the multivariate analysis, rural residence (AOR = 2.61, 95% CI 1.37-4.96), low educational level (AOR = 7.10, 95% CI 2.94-17.17) and longer duration of diabetes (AOR = 2.20, 95% CI 1.18-4.08) were significantly associated with increased odds of poor glycemic control. Moreover, merchants (AOR = 3.39, 95% CI 1.16-9.96) were significantly more likely to have poor glycemic control compared to government employee. Diabetic patients receiving oral anti-diabetics (AOR = 5.12, 95% CI 2.10-12.52) or insulin (AOR = 3.26, 95% CI 1.26-8.48) were more likely to be poorly controlled. These results highlight the needed for appropriate management of patients focusing on associated factors identified for poor glycemic control to maintain good glycemic control and improve adverse outcomes of the disease in this study setting.

Online maritime health information: an overview of the situation.

PubMed

Guitton, Matthieu J

2015-01-01

Due to their working conditions, seafarers often don't benefit from the same medical coverage than the onshore population. Therefore, seafarers and their relatives often need to locate health information by themselves. While the rise of the Internet has drastically transformed the way people can gather information, the availability of specific maritime health information online still need to be evaluated scientifically. We aim here to document of the characteristic of maritime health-related online information. A web survey was performed, articulated on two complementary analyses. First, an overall analysis of websites related to maritime health compared to websites related to two other health areas relevant for the general population (dental health and otorhinolaryngology) used as control. Second, an analysis of the understandability and actionability of a series of Wikipedia articles related to pathologies relevant for seafarers using the Patient Education Materials Assessment Tool (PEMAT). Online resources associated with maritime health were sparse and difficult to locate. When compared to other medical fields, maritime health websites were extremely poor in displaying useful information for seafarers. Available online resources regarding specific diseases affecting seafarers were mainly not adapted for a general audience and scored poorly both in terms of understandability and of actionability. This study provides a general overview of the degree of adaption of online material related to maritime health to seafarers' potential needs. Considerably more efforts need to be made in order to provide controlled online materials to answer the health information needs of the seafarers and their relatives.

Job Strain, Workplace Discrimination, and Hypertension among Older Workers: The Health and Retirement Study.

PubMed

Mezuk, Briana; Kershaw, Kiarri N; Hudson, Darrell; Lim, Kyuang Ah; Ratliff, Scott

2011-03-01

Job strain has been associated with hypertension among younger workers; however, whether this relationship persists among older workers, particularly older racial/ethnic minorities, is unresolved. This study evaluated whether job strain and workplace discrimination are associated with hypertension and poor blood pressure control among older workers and whether these relationships vary by gender and race/ethnicity. Data were drawn from the Health and Retirement Study, and analysis was restricted to employed participants with complete information on job strain and blood pressure (N = 3,794). In adjusted models, high job strain was associated with lower likelihood of hypertension (odds ratio (OR): 0.75, 95% confidence interval (CI): 0.63, 0.89) relative to low job strain. Stratified analyses indicated this association was only significant among white (OR: 0.71, 95% CI: 0.58, 0.86) and male (OR: 0.61, 95% CI: 0.47, 0.79) workers. High job strain was not significantly associated with hypertension among African American (OR: 1.14, 95% CI: 0.63, 2.07) or Hispanic (OR: 0.56, 95% CI: 0.29, 1.09) workers. Workplace discrimination was not associated with hypertension among any group. Neither job strain nor discrimination was associated with poor blood pressure control. These findings suggest that persistence in work characterized by high job strain in later life may signal resilience to the influence of work-related stressors on health. Future research efforts should examine the factors that contribute to gender and racial differences in these relationships.

Job Strain, Workplace Discrimination, and Hypertension among Older Workers: The Health and Retirement Study

PubMed Central

Kershaw, Kiarri N.; Hudson, Darrell; Lim, Kyuang Ah; Ratliff, Scott

2011-01-01

Job strain has been associated with hypertension among younger workers; however, whether this relationship persists among older workers, particularly older racial/ethnic minorities, is unresolved. This study evaluated whether job strain and workplace discrimination are associated with hypertension and poor blood pressure control among older workers and whether these relationships vary by gender and race/ethnicity. Data were drawn from the Health and Retirement Study, and analysis was restricted to employed participants with complete information on job strain and blood pressure (N = 3,794). In adjusted models, high job strain was associated with lower likelihood of hypertension (odds ratio (OR): 0.75, 95% confidence interval (CI): 0.63, 0.89) relative to low job strain. Stratified analyses indicated this association was only significant among white (OR: 0.71, 95% CI: 0.58, 0.86) and male (OR: 0.61, 95% CI: 0.47, 0.79) workers. High job strain was not significantly associated with hypertension among African American (OR: 1.14, 95% CI: 0.63, 2.07) or Hispanic (OR: 0.56, 95% CI: 0.29, 1.09) workers. Workplace discrimination was not associated with hypertension among any group. Neither job strain nor discrimination was associated with poor blood pressure control. These findings suggest that persistence in work characterized by high job strain in later life may signal resilience to the influence of work-related stressors on health. Future research efforts should examine the factors that contribute to gender and racial differences in these relationships. PMID:22096475

Methodologies for Investigating Performance Changes With Supplement Use.

PubMed

Burke, Louise M; Peeling, Peter

2018-03-01

Many expert sporting bodies now support a pragmatic acceptance of the use of performance supplements which have passed a risk:benefit analysis of being safe, effective, and permitted for use, while also being appropriate to the athlete's age and maturation in their sport. However, gaining evidence of the performance benefits of these supplements is a process challenged by the scarcity of research in relation to the number of available products, and the limitations of the poor quality of some studies. While meta-analyses and systematic reviews can help to provide information about the general use of performance supplements, the controlled scientific trial provides the basis on which these reviews are undertaken, as well as an opportunity to address more specific questions about supplement applications. Guidelines for the design of studies include the choice of well-trained athletes who are familiarized with performance tasks that have been chosen on their basis of their known reliability and validity. Supplement protocols should be chosen to maximize the likely benefits, and researchers should also make efforts to control confounding variables, while keeping conditions similar to real-life practices. Performance changes should be interpreted in light of what is meaningful to the outcomes of sporting competition. Issues that have been poorly addressed to date include the use of several supplements in combination and the use of the same supplement over successive events, both within a single, and across multiple competition days. Strategies to isolate and explain the variability of benefits to individuals are also a topic for future investigation.

Differential Impact of Homelessness on Glycemic Control in Veterans with Type 2 Diabetes Mellitus.

PubMed

Axon, R Neal; Gebregziabher, Mulugeta; Dismuke, Clara E; Hunt, Kelly J; Yeager, Derik; Ana, Elizabeth J Santa; Egede, Leonard E

2016-11-01

Veterans with evidence of homelessness have high rates of mental health and substance abuse disorders, but chronic medical conditions such as diabetes are also prevalent. We aimed to determine the impact of homelessness on glycemic control in patients with type 2 diabetes mellitus. Longitudinal analysis of a retrospective cohort. A national cohort of 1,263,906 Veterans with type 2 diabetes. Subjects with evidence of homelessness were identified using a combination of diagnostic and administrative codes. Odds for poor glycemic control using hemoglobin A1C (HbA1C) cutoff values of 8 % and 9 %. Homeless defined as a score based on the number of indicator variables for homelessness within a veterans chart. Veterans with evidence of homelessness had a significantly greater annual mean HbA1C ≥ 8 (32.6 % vs. 20.43 %) and HbA1C ≥ 9 (21.4 % vs. 9.9 %), tended to be younger (58 vs. 67 years), were more likely to be non-Hispanic black (39.1 %), divorced (43 %) or never married (34 %), to be urban dwelling (88.8 %), and to have comorbid substance abuse (46.7 %), depression (42.3 %), psychoses (39.7 %), liver disease (18.8 %), and fluid/electrolyte disorders (20.4 %), relative to non-homeless veterans (all p < 0.0001). Homelessness was modeled as an ordinal variable that scored the number of times a homelessness indicator was found in the Veterans medical record. We observed a significant interaction between homelessness and race/ethnicity on the odds of poor glycemic control. Homelessness, across all racial-ethnic groups, was associated with increased odds of uncontrolled diabetes at a cut-point of 8 % and 9 % for hemoglobin A1C ; however, the magnitude of the association was greater in non-Hispanic whites [8 %, OR 1.55 (1.47;1.63)] and Hispanics [8 %, OR 2.11 (1.78;2.51)] than in non-Hispanic blacks [8 %, OR 1.22 (1.15;1.28)]. Homelessness is a significant risk factor for uncontrolled diabetes in Veterans, especially among non-Hispanic white and Hispanic patients. While efforts to engage homeless patients in primary care services have had some success in recent years, these data suggest that broader efforts targeting management of diabetes and other chronic medical conditions remain warranted.

The Contribution of Adolescent Effortful Control to Early Adult Educational Attainment

PubMed Central

Véronneau, Marie-Hélène; Racer, Kristina Hiatt; Fosco, Gregory M.; Dishion, Thomas J.

2014-01-01

Effortful control has been proposed as a set of neurocognitive competencies that is relevant to self-regulation and educational attainment (Posner & Rothbart, 2007). This study tested the hypothesis that a multiagent report of adolescents’ effortful control (age 17) would be predictive of academic persistence and educational attainment (age 23–25), after controlling for other established predictors (family factors, problem behavior, grade point average, and substance use). Participants were 997 students recruited in 6th grade from 3 urban public middle schools (53% males; 42.4% European American; 29.2% African American). Consistent with the hypothesis, the unique association of effortful control with future educational attainment was comparable in strength to that of parental education and students’ past grade point average, suggesting that effortful control contributes to this outcome above and beyond well-established predictors. Path coefficients were equivalent across gender and ethnicity (European Americans and African Americans). Effortful control appears to be a core feature of the self-regulatory competencies associated with achievement of educational success in early adulthood. These findings suggest that the promotion of self-regulation in general and effortful control in particular may be an important focus not only for resilience to stress and avoidance of problem behavior, but also for growth in academic competence. PMID:25308996

Operator interface for vehicles

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

Bissontz, Jay E

2015-03-10

A control interface for drivetrain braking provided by a regenerative brake and a non-regenerative brake is implemented using a combination of switches and graphic interface elements. The control interface comprises a control system for allocating drivetrain braking effort between the regenerative brake and the non-regenerative brake, a first operator actuated control for enabling operation of the drivetrain braking, and a second operator actuated control for selecting a target braking effort for drivetrain braking. A graphic display displays to an operator the selected target braking effort and can be used to further display actual braking effort achieved by drivetrain braking.

Even Students Are What They Eat.

ERIC Educational Resources Information Center

Christie, Kathy

2003-01-01

Describes research reports dealing with child nutrition and efforts to improve it through state and federal sponsorship of school breakfast and lunch programs for poor children, the reduction of fat and sugar in school lunches, and banning the sale of "junk food" at school. (PKP)

Breathing Easier.

ERIC Educational Resources Information Center

Smolkin, Rachel

2003-01-01

Describes use of Environmental Protection Agency's Tools for Schools tool kit to improve indoor air quality aimed specifically at eliminating asthma triggers such as dust mites and mold. Includes several examples of school district efforts to reduce or eliminate student health problems associated with poor indoor air quality. (PKP)

Report on Condition Assessment Technology of Wastewater Collection Systems

EPA Science Inventory

The wastewater collection system infrastructure in the United States is recognized as being in poor condition and in urgent need of condition assessment and rehabilitation. As part of an effort to address aging infrastructure needs, the U.S. Environmental Protection Agency (USEP...

A bench study of intensive-care-unit ventilators: new versus old and turbine-based versus compressed gas-based ventilators

PubMed Central

Thille, Arnaud W.; Lyazidi, Aissam; Richard, Jean-Christophe M.; Galia, Fabrice; Brochard, Laurent

2009-01-01

Objective To compare 13 commercially available, new-generation, intensive-care-unit (ICU) ventilators regarding trigger function, pressurization capacity during pressure-support ventilation (PSV), accuracy of pressure measurements and expiratory resistance. Design and Setting Bench study at a research laboratory in a university hospital. Material Four turbine-based ventilators and nine conventional servo-valve compressed-gas ventilators were tested using a two-compartment lung model. Results Three levels of effort were simulated. Each ventilator was evaluated at four PSV levels (5, 10, 15, and 20 cm H2O), with and without positive end-expiratory pressure (5 cm H2O, Trigger function was assessed as the time from effort onset to detectable pressurization. Pressurization capacity was evaluated using the airway pressure-time product computed as the net area under the pressure-time curve over the first 0.3 s after inspiratory effort onset. Expiratory resistance was evaluated by measuring trapped volume in controlled ventilation. Significant differences were found across the ventilators, with a range of triggering-delay from 42 ms to 88 ms for all conditions averaged (P<.001). Under difficult conditions, the triggering delay was longer than 100 ms and the pressurization was poor with five ventilators at PSV5 and three at PSV10, suggesting an inability to unload patient’s effort. On average, turbine-based ventilators performed better than conventional ventilators, which showed no improvement compared to a 2000 bench comparison. Conclusion Technical performances of trigger function, pressurization capacity and expiratory resistance vary considerably across new-generation ICU ventilators. ICU ventilators seem to have reached a technical ceiling in recent years, and some ventilators still perform inadequately. PMID:19352622

A bench study of intensive-care-unit ventilators: new versus old and turbine-based versus compressed gas-based ventilators.

PubMed

Thille, Arnaud W; Lyazidi, Aissam; Richard, Jean-Christophe M; Galia, Fabrice; Brochard, Laurent

2009-08-01

To compare 13 commercially available, new-generation, intensive-care-unit (ICU) ventilators in terms of trigger function, pressurization capacity during pressure-support ventilation (PSV), accuracy of pressure measurements, and expiratory resistance. Bench study at a research laboratory in a university hospital. Four turbine-based ventilators and nine conventional servo-valve compressed-gas ventilators were tested using a two-compartment lung model. Three levels of effort were simulated. Each ventilator was evaluated at four PSV levels (5, 10, 15, and 20 cm H2O), with and without positive end-expiratory pressure (5 cm H2O). Trigger function was assessed as the time from effort onset to detectable pressurization. Pressurization capacity was evaluated using the airway pressure-time product computed as the net area under the pressure-time curve over the first 0.3 s after inspiratory effort onset. Expiratory resistance was evaluated by measuring trapped volume in controlled ventilation. Significant differences were found across the ventilators, with a range of triggering delays from 42 to 88 ms for all conditions averaged (P < 0.001). Under difficult conditions, the triggering delay was longer than 100 ms and the pressurization was poor for five ventilators at PSV5 and three at PSV10, suggesting an inability to unload patient's effort. On average, turbine-based ventilators performed better than conventional ventilators, which showed no improvement compared to a bench comparison in 2000. Technical performance of trigger function, pressurization capacity, and expiratory resistance differs considerably across new-generation ICU ventilators. ICU ventilators seem to have reached a technical ceiling in recent years, and some ventilators still perform inadequately.

Posttraumatic stress, effort regulation, and academic outcomes among college students: A longitudinal study.

PubMed

Boyraz, Güler; Granda, Rebecca; Baker, Camille N; Tidwell, Lacey Lorehn; Waits, J Brandon

2016-07-01

Entering college with posttraumatic stress disorder (PTSD) symptomatology has been linked to poor academic performance and increased risk for dropping out of college; however, little is known regarding the mechanisms by which PTSD symptoms have deleterious effects on college outcomes. Drawing from a self-regulated learning (SRL) perspective, which suggests that students' learning behaviors and outcomes can be influenced by contextual and developmental factors, we hypothesized that students who enter college with high PTSD symptomatology may experience difficulties in effort regulation, which in turn, may have deleterious effects on their academic performance and college persistence. These hypothesized relationships, as well as the potential gender differences in these relationships were examined using a longitudinal study design and a multigroup structural equation modeling approach. Of the 928 1st-year students who participated in the study, 484 (52.2%) students who reported lifetime exposure to traumatic events constituted the final sample of the study. The prevalence of PTSD among the trauma-exposed participants was 12.4%. After controlling for participation in on-campus activities and American College Testing (ACT) assessment scores, the relationship between PTSD symptomatology in the 1st semester of college and 2nd-year enrollment was mediated by effort regulation and 1st-year cumulative grade-point average (GPA). Specifically, participants who started college with higher levels of PTSD symptomatology also reported lower levels of effort regulation, which in turn, had a significant indirect effect on 2nd-year enrollment through 1st-year GPA. Results also indicated that the paths in the hypothesized model were not significantly different for men and women. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Overall and peripheral lung function assessment by spirometry and forced oscillation technique in relation to asthma diagnosis and control.

PubMed

Heijkenskjöld Rentzhog, C; Janson, C; Berglund, L; Borres, M P; Nordvall, L; Alving, K; Malinovschi, A

2017-12-01

Classic spirometry is effort dependent and of limited value in assessing small airways. Peripheral airway involvement, and relation to poor control, in asthma, has been highlighted recently. Forced oscillation technique (FOT) offers an effort-independent assessment of overall and peripheral lung mechanics. We studied the association between lung function variables, obtained either by spirometry or multifrequency (5, 11 and 19 Hz) FOT, and asthma diagnosis and control. Spirometry measures, resistance at 5 (R5) and 19 Hz (R19), reactance at 5 Hz (X5), resonant frequency (f res ), resistance difference between 5-19 Hz (R5-R19) and Asthma Control Test scores were determined in 234 asthmatic and 60 healthy subjects (aged 13-39 years). We used standardized lung function variables in logistic regression analyses, unadjusted and adjusted for age, height, gender and weight. Lower FEV 1 /FVC (OR [95% CI] 0.47 [0.32, 0.69]) and FEF 50 (0.62 [0.46, 0.85]) per standard deviation increase, and higher R5 (3.31 [1.95, 5.62]) and R19 (2.54 [1.65, 3.91]) were associated with asthma diagnosis. Independent predictive effects of FEV 1 /FVC and R5 or R19, respectively, were found for asthma diagnosis. Lower FEV 1 /FVC and altered peripheral FOT measures (X5, f res and R5-R19) were associated with uncontrolled asthma (P-values < .05). Resistance FOT measures were equally informative as spirometry, related to asthma diagnosis, and, furthermore, offered additive information to FEV 1 /FVC, supporting a complementary role for FOT. Asthma control was related to FOT measures of peripheral airways, suggesting a potential use in identifying such involvement. Further studies are needed to determine a clinical value and relevant reference values in children, for the multifrequency FOT measurements. © 2017 John Wiley & Sons Ltd.

Quality of Vitamin K Antagonist Anticoagulation in Spain: Prevalence of Poor Control and Associated Factors.

PubMed

Anguita Sánchez, Manuel; Bertomeu Martínez, Vicente; Cequier Fillat, Ángel

2015-09-01

To study the prevalence of poorly controlled vitamin K antagonist anticoagulation in Spain in patients with nonvalvular atrial fibrillation, and to identify associated factors. We studied 1056 consecutive patients seen at 120 cardiology clinics in Spain between November 2013 and March 2014. We analyzed the international normalized ratio from the 6 months prior to the patient's visit, calculating the prevalence of poorly controlled anticoagulation, defined as < 65% time in therapeutic range using the Rosendaal method. Mean age was 73.6 years (standard deviation, 9.8 years); women accounted for 42% of patients. The prevalence of poorly controlled anticoagulation was 47.3%. Mean time in therapeutic range was 63.8% (25.9%). The following factors were independently associated with poorly controlled anticoagulation: kidney disease (odds ratio = 1.53; 95% confidence interval, 1.08-2.18; P = .018), routine nonsteroidal anti-inflammatory drugs (odds ratio = 1.79; 95% confidence interval, 1.20-2.79; P = .004), antiplatelet therapy (odds ratio = 2.16; 95% confidence interval, 1.49-3.12; P < .0001) and absence of angiotensin receptor blockers (odds ratio = 1.39; 95% confidence interval, 1.08-1.79; P = .011). There is a high prevalence of poorly controlled vitamin K antagonist anticoagulation in Spain. Factors associated with poor control are kidney disease, routine nonsteroidal anti-inflammatory drugs, antiplatelet use, and absence of angiotensin receptor blockers. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Impact of poor-quality medicines in the 'developing' world.

PubMed

Newton, Paul N; Green, Michael D; Fernández, Facundo M

2010-03-01

Since our ancestors began trading several millennia ago, counterfeit and substandard medicines have been a recurring problem, with history punctuated by crises in the supply of anti-microbials, such as fake cinchona bark in the 1600s and fake quinine in the 1800s. Unfortunately this problem persists, in particular afflicting unsuspecting patients in 'developing' countries. Poor-quality drugs are a vital (but neglected) public health problem. They contribute to a 'crevasse' between the enormous effort in therapeutic research and policy decisions and implementation of good-quality medicines. 2009 Elsevier Ltd. All rights reserved.

Impact of poor-quality medicines in the ‘developing’ world

PubMed Central

Newton, Paul N.; Green, Michael D.; Fernández, Facundo M.

2010-01-01

Since our ancestors began trading several millennia ago, counterfeit and substandard medicines have been a recurring problem, with history punctuated by crises in the supply of anti-microbials, such as fake cinchona bark in the 1600s and fake quinine in the 1800s. Unfortunately this problem persists, in particular afflicting unsuspecting patients in ‘developing’ countries. Poor-quality drugs are a vital (but neglected) public health problem. They contribute to a ‘crevasse’ between the enormous effort in therapeutic research and policy decisions and implementation of good-quality medicines. PMID:20117849

Promoting safer blood transfusion practice in hospital.

PubMed

Parris, E; Grant-Casey, J

Results from a national comparative audit of bedside transfusion practice show that patients in the UK are at risk of misidentification and poor monitoring when undergoing a blood transfusion. A commonly identified reason for poor compliance with guidelines from the British Committee for Standards in Haematology (BCSH et al 1999) is a lack of awareness of good transfusion practice (National Blood Service (NBS) 2005). This article discusses the implications of the audit findings for the administration of blood at the bedside and examines initiatives to support hospital staff in their efforts to improve blood transfusion safety.

Peptides: important tools for the treatment of central nervous system disorders.

PubMed

Malavolta, Luciana; Cabral, Francisco Romero

2011-10-01

This review shows some classical applications of peptides and suggests there is great promise for the treatment of various central nervous system diseases. Actually, peptides are considered the new generation of biologically active tools because they are key regulators in cellular and intercellular physiological responses, which possess enormous potential for the treatment of various diseases. In spite of their clinical potential, native peptides have seen limited use due to their poor bioavailability and low stability in physiological conditions. Moreover, most peptide or protein pharmaceuticals currently in use are delivered by invasive routes such as via subcutaneous injection. Considerable efforts have been made to design new drugs based on peptides and recent developments in technology and science have provided the means and opportunity to produce a stable as well as controlled-release form of peptide and protein drugs to combat poorly controlled diseases and to increase patients' quality of life. A major challenge in this regard, however, is the delivery of peptides over the blood-brain barrier. This review gives an overview of some strategies used to improve both bioavailability and uptake of peptide drugs for delivery into the brain. Indeed, recent findings suggest that the use of peptides by conjugation to a polymer such as nanoparticles can offer tremendous hope in the treatment of brain disorders. The polymer conjugation improves pharmacokinetics by increasing the molecular mass of proteins and peptides and shielding them from proteolytic enzymes. These new strategies will create new opportunities for the future development of neurotherapeutic drugs. In the present review we have focused our attention on the peptide controlled delivery, summarizing literature reports on the use of peptides and nanotechnology for the treatment and diagnosis of brain disorders. Copyright © 2011 Elsevier Ltd. All rights reserved.

Sexual minorities in England have poorer health and worse health care experiences: a national survey.

PubMed

Elliott, Marc N; Kanouse, David E; Burkhart, Q; Abel, Gary A; Lyratzopoulos, Georgios; Beckett, Megan K; Schuster, Mark A; Roland, Martin

2015-01-01

The health and healthcare of sexual minorities have recently been identified as priorities for health research and policy. To compare the health and healthcare experiences of sexual minorities with heterosexual people of the same gender, adjusting for age, race/ethnicity, and socioeconomic status. Multivariate analyses of observational data from the 2009/2010 English General Practice Patient Survey. The survey was mailed to 5.56 million randomly sampled adults registered with a National Health Service general practice (representing 99 % of England's adult population). In all, 2,169,718 people responded (39 % response rate), including 27,497 people who described themselves as gay, lesbian, or bisexual. Two measures of health status (fair/poor overall self-rated health and self-reported presence of a longstanding psychological condition) and four measures of poor patient experiences (no trust or confidence in the doctor, poor/very poor doctor communication, poor/very poor nurse communication, fairly/very dissatisfied with care overall). Sexual minorities were two to three times more likely to report having a longstanding psychological or emotional problem than heterosexual counterparts (age-adjusted for 5.2 % heterosexual, 10.9 % gay, 15.0 % bisexual for men; 6.0 % heterosexual, 12.3 % lesbian and 18.8 % bisexual for women; p < 0.001 for each). Sexual minorities were also more likely to report fair/poor health (adjusted 19.6 % heterosexual, 21.8 % gay, 26.4 % bisexual for men; 20.5 % heterosexual, 24.9 % lesbian and 31.6 % bisexual for women; p < 0.001 for each). Adjusted for sociodemographic characteristics and health status, sexual minorities were about one and one-half times more likely than heterosexual people to report unfavorable experiences with each of four aspects of primary care. Little of the overall disparity reflected concentration of sexual minorities in low-performing practices. Sexual minorities suffer both poorer health and worse healthcare experiences. Efforts should be made to recognize the needs and improve the experiences of sexual minorities. Examining patient experience disparities by sexual orientation can inform such efforts.

Job role quality and intention to leave current facility and to leave profession of direct care workers in Japanese residential facilities for elderly.

PubMed

Nakanishi, Miharu; Imai, Hisato

2012-01-01

The aim of the present study is to examine job role quality relating to intention to leave current facility and to leave profession among direct care workers in residential facilities for elderly in Japan. Direct care workers completed a paper questionnaire on October 2009. From 746 facilities in three prefectures (Tokyo, Shizuoka, and Yamagata) 6428 direct care workers with complete data were included in the analyses. The Job Role Quality (JRQ) scale was translated into Japanese language to assess job role quality. Hierarchical multiple regression analysis showed that intention to leave current facility was primarily associated with job role quality: poor skill discretion, high job demand, and poor relationship with supervisor. Intention to leave profession was primarily associated with poor skill discretion. The results of the present study imply the strategies to direct care worker retention for each facility and policy efforts. Each facility can implement specific strategies such as enhanced variety of work and opportunity for use of skills, adequate job allocation, and improvement of supervisor-employee relationship in work place. Policy efforts should enhance broader career opportunities in care working such as advanced specialization and authorized medical practice. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

State Clean Indoor Air Laws and smoking among adults with poor mental health.

PubMed

Larson, Anne; Bovbjerg, Victor; Luck, Jeff

2016-12-01

Persons with mental illness smoke at twice the rate of the general United States (US) population and die an average of 25-years younger, often from preventable diseases. This study seeks to determine whether disparities in smoking have increased over the past decade and whether Clean Indoor Air Laws (CIALs) are associated with changes in smoking among those with poor mental health. We used a fixed-effects model for estimation. CIALs were associated with 15 per cent decreased odds of smoking among adults in the US. Among those with poor mental health, these same laws had no effect. Between 2000 and 2010, the disparity in smoking rates between these two populations has steadily increased from 1.8 to 2.2 times greater. Given the lack of association between tobacco laws and smoking among those with poor mental health, alternative and more targeted tobacco reduction efforts may be necessary.

Views from below on the pro-poor growth challenge: the case of rural Rwanda.

PubMed

Ansoms, An

2010-01-01

This article focuses on the Rwandan peasantry to confirm how "views from below" can contribute to a better understanding of the "pro-poor" growth challenge. Based on micro-level evidence gathered in 2007, it examines local peasants' perceptions of the characteristics and degree of poverty for different socioeconomic categories (i.e., peasant groups). It looks at the various opportunities and constraints that influence the potential of these categories or groups for social mobility and their capacity to participate in growth strategies. Further, it considers how local peasants perceive specific policy measures in the Rwandan government's "pro-poor" rural strategies. Their insights could inspire Rwandan policymakers and supporting donors to redirect their efforts toward distribution-oriented growth strategies.

Speech effort measurement and stuttering: investigating the chorus reading effect.

PubMed

Ingham, Roger J; Warner, Allison; Byrd, Anne; Cotton, John

2006-06-01

The purpose of this study was to investigate chorus reading's (CR's) effect on speech effort during oral reading by adult stuttering speakers and control participants. The effect of a speech effort measurement highlighting strategy was also investigated. Twelve persistent stuttering (PS) adults and 12 normally fluent control participants completed 1-min base rate readings (BR-nonchorus) and CRs within a BR/CR/BR/CR/BR experimental design. Participants self-rated speech effort using a 9-point scale after each reading trial. Stuttering frequency, speech rate, and speech naturalness measures were also obtained. Instructions highlighting speech effort ratings during BR and CR phases were introduced after the first CR. CR improved speech effort ratings for the PS group, but the control group showed a reverse trend. Both groups' effort ratings were not significantly different during CR phases but were significantly poorer than the control group's effort ratings during BR phases. The highlighting strategy did not significantly change effort ratings. The findings show that CR will produce not only stutter-free and natural sounding speech but also reliable reductions in speech effort. However, these reductions do not reach effort levels equivalent to those achieved by normally fluent speakers, thereby conditioning its use as a gold standard of achievable normal fluency by PS speakers.

Examining asthma quality of care using a population-based approach

PubMed Central

Klomp, Helena; Lawson, Joshua A.; Cockcroft, Donald W.; Chan, Benjamin T.; Cascagnette, Paul; Gander, Laurie; Jorgenson, Derek

2008-01-01

Background Asthma accounts for considerable burden on health care, but in most cases, asthma can be controlled. Quality-of-care indicators would aid in monitoring asthma management. We describe the quality of asthma care using a set of proposed quality indicators. Methods We performed a retrospective cross-sectional study using health databases in Saskatchewan, a Canadian province with a population of about 1 million people. We assessed 6 quality-of-care indicators among people with asthma: admission to hospital because of asthma; poor asthma control (high use of short-acting β-agonists, admission to hospital because of asthma or death due to asthma); no inhaled corticosteroid use among patients with poor control; at least moderate inhaled corticosteroid use among patients with poor control; high inhaled corticosteroid use and use of another preventer medication among patients with poor control; and any main preventer use among patients with poor control. We calculated crude and adjusted rates with 95% confidence intervals. We tested for differences using the χ2 test for proportions and generalized linear modelling techniques. Results In 2002/03, there were 24 616 people aged 5–54 years with asthma in Saskatchewan, representing a prevalence of 3.8%. Poor symptom control was observed in 18% of patients with asthma. Among those with poor control, 37% were not dispensed any inhaled corticosteroids, and 40% received potentially inadequate doses. Among those with poor control who were dispensed high doses of inhaled corticosteroids, 26% also used another preventer medication. Hospital admissions because of asthma were highest among those aged 6–9 years and females aged 20–44 years. Males and those in adult age groups (predominantly 20–44 years) had worse quality of care for 4 indicators examined. Interpretation Suboptimal asthma management would be improved through increased use of inhaled corticosteroids and preventer medications, and reduced reliance on short-acting β-agonist medications as recommended by consensus guidelines. PMID:18390944

Factors Associated With Poor Glycemic Control or Wide Glycemic Variability Among Diabetes Patients in Hawaii, 2006–2009

PubMed Central

Sentell, Tetine; Tokumaru, Sheri; Goo, Roy; Davis, James W.; Mau, Marjorie M.

2012-01-01

Introduction Although glycemic control is known to reduce complications associated with diabetes, it is an elusive goal for many patients with diabetes. The objective of this study was to identify factors associated with sustained poor glycemic control, some glycemic variability, and wide glycemic variability among diabetes patients over 3 years. Methods This retrospective study was conducted among 2,970 diabetes patients with poor glycemic control (hemoglobin A1c [HbA1c] >9%) who were enrolled in a health plan in Hawaii in 2006. We conducted multivariable logistic regressions to examine factors related to sustained poor control, some glycemic variability, and wide glycemic variability during the next 3 years. Independent variables evaluated as possible predictors were age, sex, type of insurance coverage, morbidity, diabetes duration, history of cardiovascular disease, and number of medications. Results Longer duration of diabetes, being under age 35, and taking 15 or more medications were significantly associated with sustained poor glycemic control. Preferred provider organization and Medicare (vs health maintenance organization) enrollees and patients with high morbidity were less likely to have sustained poor glycemic control. Wide glycemic variability was significantly related to being younger than age 50, longer duration of diabetes, having coronary artery disease, and taking 5 to 9 medications per year. Conclusion Results indicate that duration of diabetes, age, number of medications, morbidity, and type of insurance coverage are risk factors for sustained poor glycemic control. Patients with these characteristics may need additional therapies and targeted interventions to improve glycemic control. Patients younger than age 50 and those with a history of coronary heart disease should be warned of the health risks of wide glycemic variability. PMID:23017247

Estimated Under-Five Deaths Associated with Poor-Quality Antimalarials in Sub-Saharan Africa

PubMed Central

Renschler, John P.; Walters, Kelsey M.; Newton, Paul N.; Laxminarayan, Ramanan

2015-01-01

Many antimalarials sold in sub-Saharan Africa are poor-quality (falsified, substandard, or degraded), and the burden of disease caused by this problem is inadequately quantified. In this article, we estimate the number of under-five deaths caused by ineffective treatment of malaria associated with consumption of poor-quality antimalarials in 39 sub-Saharan countries. Using Latin hypercube sampling our estimates were calculated as the product of the number of private sector antimalarials consumed by malaria-positive children in 2013; the proportion of private sector antimalarials consumed that were of poor-quality; and the case fatality rate (CFR) of under-five malaria-positive children who did not receive appropriate treatment. An estimated 122,350 (interquartile range [IQR]: 91,577–154,736) under-five malaria deaths were associated with consumption of poor-quality antimalarials, representing 3.75% (IQR: 2.81–4.75%) of all under-five deaths in our sample of 39 countries. There is considerable uncertainty surrounding our results because of gaps in data on case fatality rates and prevalence of poor-quality antimalarials. Our analysis highlights the need for further investigation into the distribution of poor-quality antimalarials and the need for stronger surveillance and regulatory efforts to prevent the sale of poor-quality antimalarials. PMID:25897068

Effortful Control Moderates Bidirectional Effects Between Children’s Externalizing Behavior and their Mothers’ Depressive Symptoms

PubMed Central

Choe, Daniel Ewon; Olson, Sheryl L.; Sameroff, Arnold J.

2013-01-01

This study examined bidirectional associations between mothers’ depressive symptoms and children’s externalizing behavior and whether they were moderated by preschool-age effortful control and gender. Mothers and teachers reported on 224 primarily White, middle-class children at ages 3, 5, and 10. Effortful control was assessed via behavioral battery and mother ratings. Structural equation modeling indicated that maternal depressive symptoms at child age 3 predicted more externalizing behavior at age 10 among children with low effortful control and among boys. Externalizing behavior at age 3 predicted fewer depressive symptoms at the age 10 assessments among mothers of children with high effortful control. Boys with suboptimal self-regulation exposed to high levels of maternal depressive symptoms were at greatest risk for school-age behavioral problems. PMID:23668713

Enthalpy measurement of coal-derived liquids. Technical progress report, August-October 1982

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

Kidnay, A.J.; Yesavage, V.F.

The correlational effort on the coal syncrudes and model compounds has been proceeding along two fronts. The first involves experimental work on a correlating factor for association in the liquids and the second involves an investigation of the modeling capabilities of cubic equations of state. The first area of investigation is the experimental measurement of a correlating factor for assocition in coal liquids. The procedure involves molecular weight measurement by freezing point depression. To facilitate these measurements, a simple Beckman freezing point depression apparatus is being currently modified to increase the accuracy, speed, and ease of measurement. The second areamore » of effort has involved establishing a set of cubic equations of state which can adequately model the enthalpy departures of quinoline and m-cresol. To this effort, a number of standard and association specific equations of state have been tested against a data base of previously measured enthalpy departures of m-cresol and quinoline. It has been found that these equations do quantitatively a poor job on m-cresol and quinoline. These problems are probably due to the highly polar nature of m-cresol and to a lesser extent quinoline, and to the poor quality of critical parameters for quinoline.« less

Philosophy in medical education: a means of protecting mental health.

PubMed

Keller, Eric J

2014-08-01

This study sought to identify and examine less commonly discussed challenges to positive mental health faced by medical students, residents, and physicians with hopes of improving current efforts to protect the mental health of these groups. Additionally, this work aimed to suggest an innovative means of preventing poor mental health during medical education. Literature on medical student, resident, and physician mental health was carefully reviewed and a number of psychiatrists who treat physician-patients were interviewed. The culture of medicine, medical training, common physician psychology and identity, and conflicting professional expectations all seem to contribute to poor mental health among medical students, residents, and physicians. Many current efforts may be more successful by better addressing the negative effects of these characteristics of modern medicine. Programs aimed at promoting healthy mental lifestyles during medical education should continue to be developed and supported to mitigate the deleterious effects of the challenging environment of modern medicine. To improve these efforts, educators may consider incorporating philosophical discussions on meaning and fulfillment in life between medical students and faculty. Through medical school faculty members sharing and living out their own healthy outlooks on life, students may emulate these habits and the culture of medicine may become less challenging for positive mental health.

Progress of Stirling cycle analysis and loss mechanism characterization

NASA Technical Reports Server (NTRS)

Tew, R. C., Jr.

1986-01-01

An assessment of Stirling engine thermodynamic modeling and design codes shows a general deficiency; this deficiency is due to poor understanding of the fluid flow and heat transfer phenomena that occur in the oscillating flow and pressure level environment within the engines. Stirling engine thermodynamic loss mechanisms are listed. Several experimental and computational research efforts now underway to characterize various loss mechanisms are reviewed. The need for additional experimental rigs and rig upgrades is discussed. Recent developments and current efforts in Stirling engine thermodynamic modeling are also reviewed.

Tobacco lobby political influence on US state legislatures in the 1990s

PubMed Central

Givel, M.; Glantz, S.

2001-01-01

BACKGROUND—Throughout the 1990s the tobacco lobby was a potent political force in US state legislatures advancing its pro-tobacco agenda.
OBJECTIVE—To describe the market and political motivations of the tobacco lobby and the strategies they use to achieve these goals in US state legislatures.
DESIGN—This study is a content analysis and summary overview of recently released historical tobacco industry documents; tobacco related government documents; and recent state tobacco control policy reports.
RESULTS—In the 1990s, the tobacco lobby engaged in a comprehensive and aggressive political effort in state legislatures to sell tobacco with the least hindrance using lobbying, the media, public relations, front groups, industry allies, and contributions to legislators. These efforts included campaigns to neutralise clean indoor air legislation, minimise tax increases, and preserve the industry's freedom to advertise and sell tobacco. The tobacco lobby succeeded in increasing the number of states that enacted state pre-emption of stricter local tobacco control laws and prevented the passage of many state tobacco control policies. Public health advocates were able to prevent pre-emption and other pro-tobacco policies from being enacted in several states.
CONCLUSIONS—The tobacco lobby is a powerful presence in state legislatures. Because of the poor public image of the tobacco lobby, it seeks to wield this power quietly and behind the scenes. State and local health advocates, who often have high public credibility, can use this fact against the tobacco lobby by focusing public attention on the tobacco lobby's political influence and policy goals and expose links between the tobacco lobby and its legislative supporters.


Keywords: political lobbying; state legislatures; industry PMID:11387532

Preparing Alumni for Student Recruitment.

ERIC Educational Resources Information Center

Mount, Brian

As recruitment budgets continue to tighten and with fewer colleges reporting application increases for their freshmen classes, enrollment managers must continue to explore all potential sources of recruitment talent. Alumni are often an underutilized or sometimes poorly utilized resource in recruitment efforts. Younger alumni, for example, may…

Starch-based Foam Composite Materials: processing and bioproducts

USDA-ARS?s Scientific Manuscript database

Starch is an abundant, biodegradable, renewable and low-cost commodity that has been explored as a replacement for petroleum-based plastics. By itself, starch is a poor replacement for plastics because of its moisture sensitivity and brittle properties. Efforts to improve starch properties and funct...

Production of PLA-Starch Fibers

USDA-ARS?s Scientific Manuscript database

Composites of polylactic acid (PLA) with starch have been prepared previously in an effort to reduce cost as well as to modify other properties such as biodegradation rate. However, strength and elongation both decrease on addition of starch due to poor adhesion and stress concentration at the inte...

Modeling Fecundity in Birds: Conceptual Overview, Current Models, and Considerations for Future Developments

EPA Science Inventory

Understanding fecundity is fundamental to understanding fitness, population dynamics, conservation, ecological risk, and management issues of birds. For all the efforts placed in measuring fecundity or its surrogates over the past century of avian research, it is still poorly me...

Ecosystem Development after Mangrove Wetland Creation: Plant-Soil Change across a 20-year Chronosequence

EPA Science Inventory

Mangrove wetland restoration and creation efforts are increasingly proposed as mechanisms to compensate for mangrove wetland loss. However, ecosystem development and functional equivalence in restored and created mangrove wetlands is poorly understood. We compared a 20-yr chrono...

Narrative Review of Statistical Reporting Checklists, Mandatory Statistical Editing, and Rectifying Common Problems in the Reporting of Scientific Articles.

PubMed

Dexter, Franklin; Shafer, Steven L

2017-03-01

Considerable attention has been drawn to poor reproducibility in the biomedical literature. One explanation is inadequate reporting of statistical methods by authors and inadequate assessment of statistical reporting and methods during peer review. In this narrative review, we examine scientific studies of several well-publicized efforts to improve statistical reporting. We also review several retrospective assessments of the impact of these efforts. These studies show that instructions to authors and statistical checklists are not sufficient; no findings suggested that either improves the quality of statistical methods and reporting. Second, even basic statistics, such as power analyses, are frequently missing or incorrectly performed. Third, statistical review is needed for all papers that involve data analysis. A consistent finding in the studies was that nonstatistical reviewers (eg, "scientific reviewers") and journal editors generally poorly assess statistical quality. We finish by discussing our experience with statistical review at Anesthesia & Analgesia from 2006 to 2016.

Addressing poverty through disease control programmes: examples from Tuberculosis control in India

PubMed Central

2012-01-01

Introduction Tuberculosis remains a major public health problem in India with the country accounting for one-fifth or 21% of all tuberculosis cases reported globally. The purpose of the study was to obtain an understanding on pro-poor initiatives within the framework of tuberculosis control programme in India and to identify mechanisms to improve the uptake and access to TB services among the poor. Methodology A national level workshop was held with participation from all relevant stakeholder groups. This study conducted during the stakeholder workshop adopted participatory research methods. The data was elicited through consultative and collegiate processes. The research study also factored information from primary and secondary sources that included literature review examining poverty headcount ratios and below poverty line population in the country; and quasi-profiling assessments to identify poor, backward and tribal districts as defined by the TB programme in India. Results Results revealed that current pro-poor initiatives in TB control included collaboration with private providers and engaging community to improve access among the poor to TB diagnostic and treatment services. The participants identified gaps in existing pro-poor strategies that related to implementation of advocacy, communication and social mobilisation; decentralisation of DOT; and incentives for the poor through the available schemes for public-private partnerships and provided key recommendations for action. Synergies between TB control programme and centrally sponsored social welfare schemes and state specific social welfare programmes aimed at benefitting the poor were unclear. Conclusion Further in-depth analysis and systems/policy/operations research exploring pro-poor initiatives, in particular examining service delivery synergies between existing poverty alleviation schemes and TB control programme is essential. The understanding, reflection and knowledge of the key stakeholders during this participatory workshop provides recommendations for action, further planning and research on pro-poor TB centric interventions in the country. PMID:22449205

Understanding words, understanding numbers: an exploration of the mathematical profiles of poor comprehenders.

PubMed

Pimperton, Hannah; Nation, Kate

2010-06-01

Poor comprehenders are children who show significant deficits in their reading comprehension performance, despite average, or above-average word reading ability. To date, there have been no in-depth studies of the mathematical performance profiles of such children. This study aimed to explore the mathematical profiles of poor comprehenders. Given that language impairment is associated with difficulties with mathematics, and that poor comprehenders tend to have oral language weaknesses, we hypothesized that poor comprehenders would show relative weaknesses in aspects of mathematical performance. From a sample of 109 children aged 7-8 years, we selected 14 poor comprehenders and 14 controls with age-appropriate reading comprehension ability. The groups were matched on non-verbal ability, multiple measures of reading accuracy, and chronological age. We compared the performance of the group of poor comprehenders with that of the matched controls on two standardized measures of mathematical ability, one measuring procedural arithmetic prowess and the other tapping higher-level mathematical reasoning. Although there were no group differences in performance on the arithmetic measure, the poor comprehenders showed significantly lower scores than the controls on the mathematical reasoning task. The poor comprehenders exhibited impaired verbal ability relative to controls, with these differences in verbal ability associated with the group differences found on the test of mathematical reasoning. Poor comprehenders' deficits are not limited to the domain of literacy; their underlying profile of impairments also seems to selectively impact on certain components of mathematical ability.

Curcumin Nanotechnologies and Its Anticancer Activity.

PubMed

Subramani, Parasuraman Aiya; Panati, Kalpana; Narala, Venkata Ramireddy

2017-04-01

Cancer is one of the leading causes of death worldwide. Curcumin is a well-established anticancer agent in vitro but its efficacy is yet to be proven in clinical trials. Poor bioavailability of curcumin is the principal reason behind the lack of efficiency of curcumin in clinical trials. Many studies prove that the bioavailability of curcumin can be improved by administering it through nanoparticle drug carriers. This review focuses on the efforts made in the field of nanotechnology to improve the bioavailability of curcumin. Nanotechnologies of curcumin come in various shapes and sizes. The simplest curcumin nanoparticle that increased the bioavailability of curcumin is the curcumin-metal complex. On the other hand, we have intricate thermoresponsive nanoparticles that can release curcumin upon stimulation (analogous to a remote control). Future research required for developing potent curcumin nanoparticles is also discussed.

Poor health but not absent: prevalence, predictors, and outcomes of presenteeism.

PubMed

Robertson, Ivan; Leach, Desmond; Doerner, Nadin; Smeed, Matthew

2012-11-01

The objective of this study was to examine the prevalence of presenteeism, to develop and test a model of the relationship between workplace factors and presenteeism, and to assess the perceived influence of manager, coworkers, and self on presenteeism. We used survey data collected for 6309 employees from seven different organizations. Nearly 60% of the sample reported presenteeism during a 3-month period. The model was supported, with presenteeism linking workplace factors and health outcomes to productivity, as predicted. The majority of participants (67%) indicated that the primary pressure to attend work while sick came from themselves. A substantial minority (20%) also indicated the manager as a source of pressure. Psychosocial workplace factors are predictive of presenteeism, and efforts to control them, including the use of more effective management, may impact presenteeism rates and the resulting levels of productivity.

Interactions between human behaviour and ecological systems.

PubMed

Milner-Gulland, E J

2012-01-19

Research on the interactions between human behaviour and ecological systems tends to focus on the direct effects of human activities on ecosystems, such as biodiversity loss. There is also increasing research effort directed towards ecosystem services. However, interventions to control people's use of the environment alter the incentives that natural resource users face, and therefore their decisions about resource use. The indirect effects of conservation interventions on biodiversity, modulated through human decision-making, are poorly studied but are likely to be significant and potentially counterintuitive. This is particularly so where people are dependent on multiple natural resources for their livelihoods, when both poverty and biodiversity loss are acute. An inter-disciplinary approach is required to quantify these interactions, with an understanding of human decision-making at its core; otherwise, predictions about the impacts of conservation policies may be highly misleading.

New Campaign in Thailand.

PubMed

Phelan, B J

1975-02-09

A program run by Community-Based Family Planning Services in rural Banglamoong, Thailand, is completing its first year of family planning efforts with considerable success. Under the program, district leaders such as the police chief, doctor, school prinicipal and pharmacist, are approached and asked to recommend village inhabitants to serve as distributors of birth control pills and condoms and as referral agents for people desiring IUD insertion and sterilization. These people, who receive 5 cents for every pill or condom sale, act as salemen with a simple message, "Too many children make you poor." The fact that they are members of the community and convenient to the inhabitants has made the program more successful than some programs at the district and national level. In addition, the volunteers have formed the nucleus of a broad-based paramedical corps trained to recognize signs of certain deseases.

Automated Monitoring and Analysis of Social Behavior in Drosophila

PubMed Central

Dankert, Heiko; Wang, Liming; Hoopfer, Eric D.; Anderson, David J.; Perona, Pietro

2009-01-01

We introduce a method based on machine vision for automatically measuring aggression and courtship in Drosophila melanogaster. The genetic and neural circuit bases of these innate social behaviors are poorly understood. High-throughput behavioral screening in this genetically tractable model organism is a potentially powerful approach, but it is currently very laborious. Our system monitors interacting pairs of flies, and computes their location, orientation and wing posture. These features are used for detecting behaviors exhibited during aggression and courtship. Among these, wing threat, lunging and tussling are specific to aggression; circling, wing extension (courtship “song”) and copulation are specific to courtship; locomotion and chasing are common to both. Ethograms may be constructed automatically from these measurements, saving considerable time and effort. This technology should enable large-scale screens for genes and neural circuits controlling courtship and aggression. PMID:19270697

Interactions between human behaviour and ecological systems

PubMed Central

Milner-Gulland, E. J.

2012-01-01

Research on the interactions between human behaviour and ecological systems tends to focus on the direct effects of human activities on ecosystems, such as biodiversity loss. There is also increasing research effort directed towards ecosystem services. However, interventions to control people's use of the environment alter the incentives that natural resource users face, and therefore their decisions about resource use. The indirect effects of conservation interventions on biodiversity, modulated through human decision-making, are poorly studied but are likely to be significant and potentially counterintuitive. This is particularly so where people are dependent on multiple natural resources for their livelihoods, when both poverty and biodiversity loss are acute. An inter-disciplinary approach is required to quantify these interactions, with an understanding of human decision-making at its core; otherwise, predictions about the impacts of conservation policies may be highly misleading. PMID:22144389

Developmental Course of Impulsivity and Capability from Age 10 to Age 25 as Related to Trajectory of Suicide Attempt in a Community Cohort

PubMed Central

Kasen, Stephanie; Cohen, Patricia; Chen, Henian

2011-01-01

Hierarchical linear models were used to examine trajectories of impulsivity and capability between ages 10 and 25 in relation to suicide attempt in 770 youths followed longitudinally: intercepts were set at age 17. The impulsivity measure assessed features of urgency (e.g., poor control, quick provocation, and disregard for external constraints); the capability measure assessed aspects of self-esteem and mastery. Compared to nonattempters, attempters reported significantly higher impulsivity levels with less age-related decline, and significantly lower capability levels with less age-related increase. Independent of other risks, suicide attempt was related significantly to higher impulsivity between ages 10 and 25, especially during the younger years, and lower capability. Implications of those findings for further suicidal behavior and preventive/intervention efforts are discussed. PMID:21342218

Quantifying control effort of biological and technical movements: an information-entropy-based approach.

PubMed

Haeufle, D F B; Günther, M; Wunner, G; Schmitt, S

2014-01-01

In biomechanics and biorobotics, muscles are often associated with reduced movement control effort and simplified control compared to technical actuators. This is based on evidence that the nonlinear muscle properties positively influence movement control. It is, however, open how to quantify the simplicity aspect of control effort and compare it between systems. Physical measures, such as energy consumption, stability, or jerk, have already been applied to compare biological and technical systems. Here a physical measure of control effort based on information entropy is presented. The idea is that control is simpler if a specific movement is generated with less processed sensor information, depending on the control scheme and the physical properties of the systems being compared. By calculating the Shannon information entropy of all sensor signals required for control, an information cost function can be formulated allowing the comparison of models of biological and technical control systems. Exemplarily applied to (bio-)mechanical models of hopping, the method reveals that the required information for generating hopping with a muscle driven by a simple reflex control scheme is only I=32 bits versus I=660 bits with a DC motor and a proportional differential controller. This approach to quantifying control effort captures the simplicity of a control scheme and can be used to compare completely different actuators and control approaches.

The Emergence of Effortful Control in Young Boys with Fragile X Syndrome

ERIC Educational Resources Information Center

Robinson, Marissa; Klusek, Jessica; Poe, Michele D.; Hatton, Deborah D.; Roberts, Jane E.

2018-01-01

Effortful control, or the ability to suppress a dominant response to perform a subdominant response, is an early-emerging temperament trait that is linked with positive social-emotional development. Fragile X syndrome (FXS) is a single-gene disorder characterized by hallmark regulatory impairments, suggesting diminished effortful control. This…

Private Speech Moderates the Effects of Effortful Control on Emotionality

ERIC Educational Resources Information Center

Day, Kimberly L.; Smith, Cynthia L.; Neal, Amy; Dunsmore, Julie C.

2018-01-01

Research Findings: In addition to being a regulatory strategy, children's private speech may enhance or interfere with their effortful control used to regulate emotion. The goal of the current study was to investigate whether children's private speech during a selective attention task moderated the relations of their effortful control to their…

Chinese Children's Effortful Control and Dispositional Anger/Frustration: Relations to Parenting Styles and Children's Social Functioning

ERIC Educational Resources Information Center

Zhou, Qing; Eisenberg, Nancy; Wang, Yun; Reiser, Mark

2004-01-01

Relations among authoritative and authoritarian parenting styles, children's effortful control and dispositional anger/frustration, and children's social functioning were examined for 425 first and second graders (7-10 years old) in Beijing, China. Parents reported on parenting styles; parents and teachers rated children's effortful control,…

The Role of Socialization, Effortful Control, and Ego Resiliency in French Adolescents' Social Functioning

ERIC Educational Resources Information Center

Hofer, Claire; Eisenberg, Nancy; Reiser, Mark

2010-01-01

The relations among effortful control, ego resiliency, socialization, and social functioning were examined with a sample of 182 French adolescents (14-20 years old). Adolescents, their parents, and/or teachers completed questionnaires on these constructs. Effortful control and ego resiliency were correlated with adolescents' social functioning,…

Prediction of Children's Empathy-Related Responding from Their Effortful Control and Parents' Expressivity

ERIC Educational Resources Information Center

Valiente, Carlos; Eisenberg, Nancy; Fabes, Richard A.; Shepard, Stephanie A.; Cumberland, Amanda; Losoya, Sandra H.

2004-01-01

In this study, the linear and interactive relations of children's effortful control and parents' emotional expressivity to children's empathy-related responses were examined. Participants were 214 children, 4.5 to 8 years old. Children's effortful control was negatively related to their personal distress and was positively related to their…

Prediction of Kindergartners' Academic Achievement from Their Effortful Control and Emotionality: Evidence for Direct and Moderated Relations

ERIC Educational Resources Information Center

Valiente, Carlos; Lemery-Chalfant, Kathryn; Swanson, Jodi

2010-01-01

The relations between effortful control, emotionality (anger, sadness, and shyness), and academic achievement were examined in a short-term longitudinal study of 291 kindergartners. Teachers and parents reported on students' effortful control and emotionality. Students completed the Continuous Performance Task and the Letter-Word, Passage…

Respiratory Sinus Arrhythmia, Effortful Control, and Parenting as Predictors of Children’s Sympathy Across Early Childhood

PubMed Central

Taylor, Zoe E.; Eisenberg, Nancy; Spinrad, Tracy L.

2015-01-01

The goal of this study was to examine physiological and environmental predictors of children’s sympathy (an emotional response consisting of feelings of concern or sorrow for others who are distressed or in need) and whether temperamental effortful control mediated these relations. Specifically, in a study of 192 children (23% Hispanic; 54% male), respiratory sinus arrhythmia (RSA), a measure thought to reflect physiological regulation, and observed authoritative parenting (both at 42 months) were examined as predictors of children’s effortful control (at 54 months) and, in turn, children’s sympathy (at 72 and 84 months). Measures of both baseline RSA and RSA suppression were examined. In a structural equation model, observed parenting was positively related to children’s subsequent sympathy through its positive relation to effortful control. Furthermore, the indirect path from baseline RSA to higher sympathy through effortful control was marginally significant. Authoritative parenting and baseline RSA uniquely predicted individual differences in children’s effortful control. Findings highlight the potential role of both authoritative parenting and physiological regulation in the development of children’s sympathy. PMID:25329555

Respiratory sinus arrhythmia, effortful control, and parenting as predictors of children's sympathy across early childhood.

PubMed

Taylor, Zoe E; Eisenberg, Nancy; Spinrad, Tracy L

2015-01-01

The goal of this study was to examine physiological and environmental predictors of children's sympathy (an emotional response consisting of feelings of concern or sorrow for others who are distressed or in need) and whether temperamental effortful control mediated these relations. Specifically, in a study of 192 children (23% Hispanic; 54% male), respiratory sinus arrhythmia (RSA), a measure thought to reflect physiological regulation, and observed authoritative parenting (both at 42 months) were examined as predictors of children's effortful control (at 54 months) and, in turn, children's sympathy (at 72 and 84 months). Measures of both baseline RSA and RSA suppression were examined. In a structural equation model, observed parenting was positively related to children's subsequent sympathy through its positive relation to effortful control. Furthermore, the indirect path from baseline RSA to higher sympathy through effortful control was marginally significant. Authoritative parenting and baseline RSA uniquely predicted individual differences in children's effortful control. Findings highlight the potential role of both authoritative parenting and physiological regulation in the development of children's sympathy.

Temperamental factors in remitted depression: The role of effortful control and attentional mechanisms.

PubMed

Marchetti, Igor; Shumake, Jason; Grahek, Ivan; Koster, Ernst H W

2018-08-01

Temperamental effortful control and attentional networks are increasingly viewed as important underlying processes in depression and anxiety. However, it is still unknown whether these factors facilitate depressive and anxiety symptoms in the general population and, more specifically, in remitted depressed individuals. We investigated to what extent effortful control and attentional networks (i.e., Attention Network Task) explain concurrent depressive and anxious symptoms in healthy individuals (n = 270) and remitted depressed individuals (n = 90). Both samples were highly representative of the US population. Increased effortful control predicted a substantial decrease in symptoms of both depression and anxiety in the whole sample, whereas decreased efficiency of executive attention predicted a modest increase in depressive symptoms. Remitted depressed individuals did not show less effortful control nor less efficient attentional networks than healthy individuals. Moreover, clinical status did not moderate the relationship between temperamental factors and either depressive or anxiety symptoms. Limitations include the cross-sectional nature of the study. Our study shows that temperamental effortful control represents an important transdiagnostic process for depressive and anxiety symptoms in adults. Copyright © 2018 Elsevier B.V. All rights reserved.

Effort-Based Decision-Making Paradigms for Clinical Trials in Schizophrenia: Part 1—Psychometric Characteristics of 5 Paradigms

PubMed Central

Reddy, L. Felice; Horan, William P.; Barch, Deanna M.; Buchanan, Robert W.; Dunayevich, Eduardo; Gold, James M.; Lyons, Naomi; Marder, Stephen R.; Treadway, Michael T.; Wynn, Jonathan K.; Young, Jared W.; Green, Michael F.

2015-01-01

Impairments in willingness to exert effort contribute to the motivational deficits characteristic of the negative symptoms of schizophrenia. The current study evaluated the psychometric properties of 5 new or adapted paradigms to determine their suitability for use in clinical trials of schizophrenia. This study included 94 clinically stable participants with schizophrenia and 40 healthy controls. The effort-based decision-making battery was administered twice to the schizophrenia group (baseline, 4-week retest) and once to the control group. The 5 paradigms included 1 that assesses cognitive effort, 1 perceptual effort, and 3 that assess physical effort. Each paradigm was evaluated on (1) patient vs healthy control group differences, (2) test-retest reliability, (3) utility as a repeated measure (ie, practice effects), and (4) tolerability. The 5 paradigms showed varying psychometric strengths and weaknesses. The Effort Expenditure for Rewards Task showed the best reliability and utility as a repeated measure, while the Grip Effort Task had significant patient-control group differences, and superior tolerability and administration duration. The other paradigms showed weaker psychometric characteristics in their current forms. These findings highlight challenges in adapting effort and motivation paradigms for use in clinical trials. PMID:26142081

DISTRIBUTION AND UTILISATION OF IVERMECTIN (MECTIZAN): A CHEMOTHERAPEUTIC APPROACH TO THE CONTROL OF ONCHOCERCIASIS IN OLD OHAOZARA LGA, EBONYI STATE, EASTERN NIGERIA.

PubMed

Okpara, Elom Michael; Mnaemeka, Alo Moses; Iyioku, Ugah Uchenna; Udoh, Usanga Victor

2015-12-01

Onchocerciasis (river blindness) is a devastating, debilitating Stigmatising and incapacitating parasitic disease that is endemic in tropical and subtropical regions of the world, including Nigeria. Mass distribution of ivermectin (Mectizan) to the endemic parts of the world was initiated by the Onchocerciasis Control Programmes (OCPs). Absolute compliance to the regimen for up to 15 years has been reported to be effective in the control of the disease. The study was carried out in Ohaozara LGA, Onicha LGA and Ivo LGA. The three (3) LGAs made up the defunct Old Ohaozara LGA. A structured questionnaire was used to generate information on knowledge of Onchocerciasis and on the use of ivermectin by the inhabitants of the communities of the study areas. The distribution coverage of ivermectin in the study areas dating from 2010 to 2014 was ascertained with drug distribution charts obtained from Ebonyi State Health Management Board (ESHMB), Abakaliki (the point source of distribution in the state), and from the health centres in communities of old Ohaozara LGA (the service delivery points (SDPs) to inhabitants of the communities. Data was analysed using descriptive statistics. Utilization of the regimen was ascertained by determining the actual number of tablets of mectizan that was administered to the patients at the various health cenrtes (service delivery points (SDPs) in the communities. The percentage utilization of the regimen was determined by dividing the number of mectizan tablets administered to the patients at SDPs with the number of mectizan tablets supplied from state point source of distribution and multiplying by 100. A total of 347, 299 out of 1, 919135 tablets of mectizan supplied to the study areas from 2010 to 2014 were actually utilized, forming an overall percentage utilization of 18.10%. There was adequate supply but very poor utilization of the regimen. The poor utilization resulted from factors including locating of health centres very far from homes of some of the rural villagers, non-yearly compliance with regimen administration, poor health sensitization and education and lack of incentives orpoor incentives to the village-based health workers (VBHWs). Intensification of efforts to cover the lapses in the utilization of the regimen is advocated for a more effective control of the disease.

The status of states' policies to support evidence-based practices in children's mental health.

PubMed

Cooper, Janice L; Aratani, Yumiko

2009-12-01

This study examined the efforts of states' mental health authorities to promote the use of evidence-based practices through policy. Data were drawn from three components of a national study, including a survey of state children's mental health directors (N=53), which was developed using a three-step process that involved stakeholders. Data from the directors' survey revealed that over 90% of states are implementing strategies to support the use of evidence-based practices. The scope of these efforts varies, with 36% reporting statewide reach. Further, states' strategies for implementing evidence-based practices are often not accompanied by comparable efforts to enhance information systems, even though enhancing such systems can bolster opportunities for successful implementation. Variability in the adoption of evidence-based practices, poor attention to information systems, and inconsistent fiscal policies threaten states' efforts to improve the quality of children's mental health services.

Self-control, future orientation, smoking, and the impact of Dutch tobacco control measures.

PubMed

Daly, Michael; Delaney, Liam; Baumeister, Roy F

2015-06-01

The pronounced discrepancy between smokers' intentions to quit and their smoking behavior has led researchers to suggest that many smokers are time inconsistent, have self-control problems, and may benefit from external efforts to constrain their consumption. This study aims to test whether self-control and future orientation predict smoking levels and to identify if these traits modify how cigarette consumption responds to the introduction of tobacco control measures. A sample of Dutch adults (N = 1585) completed a measure of self-control and the Consideration of Future Consequences Scale (CFCS) in 2001 and indicated their tobacco consumption each year from 2001 to 2007. In 2004, a workplace smoking ban and substantial tax increase on tobacco was introduced in the Netherlands. To identify the potential impact of these tobacco control measures we examined whether participants smoked or were heavy smokers (20 + cigarettes per day) each year from 2001 to 2007. Participants with high self-control and CFCS scores showed lower rates of smoking across the seven year period of the study. The 2004 smoking restrictions were linked with a subsequent decline in heavy smoking. This decline was moderated by self-control levels. Those with low self-control showed a large reduction in heavy smoking whereas those with high self-control did not. The effects were, however, temporary: many people with low self-control resumed heavy smoking 2-3 years after the introduction of the tobacco restrictions. The immediate costs which national tobacco control measures impose on smokers may assist smokers with poor self-control in reducing their cigarette consumption.

Vector control for malaria and other mosquito-borne diseases. Report of a WHO study group.

PubMed

1995-01-01

Since the Ministerial Conference on Malaria in 1992, which acknowledged the urgent need for worldwide commitment to malaria control, efforts have been directed to implementation of a Global Malaria Control Strategy. Vector control, an essential component of malaria control, has become less effective in recent years, partly as a result of poor use of alternative control tools, inappropriate use of insecticides, lack of an epidemiological basis for interventions, inadequate resources and infrastructure, and weak management. Changing environmental conditions, the behavioural characteristics of certain vectors, and resistance to insecticides have added to the difficulties. This report of a WHO Study Group provides guidelines for the planning, implementation and evaluation of cost-effective and sustainable vector control in the context of the Global Malaria Control Strategy. It reviews the available methods - indoor residual spraying, personal protection, larval control and environmental management - stressing the need for selective and flexible use of interventions according to local conditions. Requirements for data collection and the appropriate use of entomological parameters and techniques are discussed and priorities identified for the development of local capacity for vector control and for operational research. Emphasis is placed both on the monitoring and evaluation of vector control to ensure cost-effectiveness and on the development of strong managerial structures, which can support community participation and intersectoral collaboration and accommodate the control of other vector-borne diseases. The report concludes with recommendations aimed at promoting the targeted and efficient use of vector control in preventing and controlling malaria, thereby reducing the threat to health and socioeconomic development in many tropical countries.

Dynamics Control Approaches to Improve Vibratory Environment of the Helicopter Aircrew

NASA Astrophysics Data System (ADS)

Wickramasinghe, Viresh Kanchana

Although helicopter has become a versatile mode of aerial transportation, high vibration levels leads to poor ride quality for its passengers and aircrew. Undesired vibration transmitted through the helicopter seats have been known to cause fatigue and discomfort to the aircrew in the short-term as well as neck strain and back pain injuries due to long-term exposure. This research study investigated the use of novel active as well as passive methodologies integrated in helicopter seats to mitigate the aircrew exposure to high vibration levels. Due to significantly less certification effort required to modify the helicopter seat structure, application of novel technologies to the seat is more practical compared to flight critical components such as the main rotor to reduce aircrew vibration. In particular, this research effort developed a novel adaptive seat mount approach based on active vibration control technology. This novel design that incorporated two stacked piezoelectric actuators as active struts increases the bending stiffness to avoid the low frequency resonance while generating forces to counteract higher harmonic vibration peaks. A real-time controller implemented using a feed-forward algorithm based on adaptive notches counteracted the forced vibration peaks while a robust feedback control algorithm suppressed the resonance modes. The effectiveness of the adaptive seat mount system was demonstrated through extensive closed-loop control tests on a full-scale helicopter seat using representative helicopter floor vibration profiles. Test results concluded that the proposed adaptive seat mount approach based on active control technology is a viable solution for the helicopter seat vibration control application. In addition, a unique flight test using a Bell-412 helicopter demonstrated that the aircrew is exposed to high levels of vibration during flight and that the whole body vibration spectrum varied substantially depending on operating conditions as well as the aircrew configurations. This investigation also demonstrated the suitability of integrating novel energy absorbing cushion materials to the seat as a low cost solution to improve aircrew vibration suppression. Therefore, it was recommended to pursue certification of novel seat cushion materials as a near-term solution to mitigate undesirable occupational health hazards in helicopter aircrew due to vibration exposure.

Behavioral and Emotional Regulation and Adolescent Substance Use Problems: A Test of Moderation Effects in a Dual-Process Model

PubMed Central

Wills, Thomas A.; Pokhrel, Pallav; Morehouse, Ellen; Fenster, Bonnie

2011-01-01

In a structural model, we tested how relations of predictors to level of adolescent substance use (tobacco, alcohol, marijuana), and to substance-related impaired-control and behavior problems, are moderated by good self-control and poor regulation in behavioral and emotional domains. The participants were a sample of 1,116 public high-school students. In a multiple-group analysis for good self-control, the paths from negative life events to substance use level and from level to behavior problems were lower among persons scoring higher on good behavioral self-control. In a multiple-group analysis for poor regulation, the paths from negative life events to level and from peer substance use to level were greater among persons scoring higher on poor behavioral (but not emotional) regulation; an inverse path from academic competence to level was greater among persons scoring higher on both aspects of poor regulation. Paths from level to impaired-control and behavior problems were greater among persons scoring higher on both poor behavioral and poor emotional regulation. Theoretical implications for the basis of moderation effects are discussed. PMID:21443302

Vestibular system and neural correlates of motion sickness

NASA Technical Reports Server (NTRS)

Miller, Alan D.

1986-01-01

Initial studies re-examine the role of certain central nervous system structures in the production of vestibular-induced vomiting and vomiting in general. All experiments were conducted using cats. Since these studies demonstrated that the essential role of various central structures in vestibular-induced vomiting is only poorly understood, efforts were re-directed to study the control of the effector muscles (diaphragm and abdominal muscles) that produce the pressure changes responsible for vomiting, with the goal of determining how this control mechanism is engaged during motion sickness. Experiments were conducted to localize the motoneurons that innervate the individual abdominal muscles and the portion of the diaphragm that surrounds the esophagus. A central question regarding respiratory muscle control during vomiting is whether these muscles are activated via the same brain stem pre-motor neurons that provide descending respiratory drive and/or by other descending input(s). In other experiments, the use of a combination of pitch and roll motions to produce motion sickness in unrestrained cats was evaluated. This stimulus combination can produce vomiting in only the most susceptible cats and is thus not as provacative a stimulus for cats as vertical linear acceleration.

Independent Orbiter Assessment (IOA): Analysis of the nose wheel steering subsystem

NASA Technical Reports Server (NTRS)

Mediavilla, Anthony Scott

1986-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The independent analysis results for the Orbiter Nose Wheel Steering (NWS) hardware are documented. The NWS hardware provides primary directional control for the Orbiter vehicle during landing rollout. Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode. The original NWS design was envisioned as a backup system to differential braking for directional control of the Orbiter during landing rollout. No real effort was made to design the NWS system as fail operational. The brakes have much redundancy built into their design but the poor brake/tire performance has forced the NSTS to upgrade NWS to the primary mode of directional control during rollout. As a result, a large percentage of the NWS system components have become Potential Critical Items (PCI).

Dendritic Immunotherapy Improvement for an Optimal Control Murine Model

PubMed Central

Chimal-Eguía, J. C.; Castillo-Montiel, E.

2017-01-01

Therapeutic protocols in immunotherapy are usually proposed following the intuition and experience of the therapist. In order to deduce such protocols mathematical modeling, optimal control and simulations are used instead of the therapist's experience. Clinical efficacy of dendritic cell (DC) vaccines to cancer treatment is still unclear, since dendritic cells face several obstacles in the host environment, such as immunosuppression and poor transference to the lymph nodes reducing the vaccine effect. In view of that, we have created a mathematical murine model to measure the effects of dendritic cell injections admitting such obstacles. In addition, the model considers a therapy given by bolus injections of small duration as opposed to a continual dose. Doses timing defines the therapeutic protocols, which in turn are improved to minimize the tumor mass by an optimal control algorithm. We intend to supplement therapist's experience and intuition in the protocol's implementation. Experimental results made on mice infected with melanoma with and without therapy agree with the model. It is shown that the dendritic cells' percentage that manages to reach the lymph nodes has a crucial impact on the therapy outcome. This suggests that efforts in finding better methods to deliver DC vaccines should be pursued. PMID:28912828

Schools for the World's Poor: Honduras.

ERIC Educational Resources Information Center

DeJong, William S.

1999-01-01

Presents the author's observations in Honduras, their need for better educational facilities, and the involvement of the Council of Educational Facility Planners, International's efforts in building a new school in one rural village. Each phase from planning to dedication is discussed. Concluding comments address the future of continued facility…

CEFPI's Heart to Honduras Educational Facilities Team.

ERIC Educational Resources Information Center

Jennings, James E.

1997-01-01

Describes efforts by the Council of Educational Facility Planners International to evaluate and modernize poor, rural schools in Honduras. A positive reaction to the visitation by government officials and teachers is revealed leading to the planned use of a model school program to guide school transformation. (GR)

Integration in a Segregated Society.

ERIC Educational Resources Information Center

Rothstein, Stanley William

1979-01-01

At the end of two decades of integration efforts, America's urban schools have been completely re-segregated by White flight to the suburbs, and our nation is still blighted by a deep-seated segregationist mentality among Whites who continue to dread contact with the Black and the poor. (Author/SJL)

High Risk Behavior among Adolescent Mothers: The Problem in Context.

ERIC Educational Resources Information Center

Kissman, Kris

1998-01-01

Discusses the particular consequences of high-risk behavior for adolescent women, including unintended pregnancies, sexually transmitted diseases, school dropout and poverty, developmental disabilities, and poor school performance. Considers the role of male partners in teenage women's high risk behavior. Describes prevention efforts such as…

Impact of switchgrass harvest time on biomass yield and conversion

USDA-ARS?s Scientific Manuscript database

Switchgrass (Panicum virgatum L.) is a perennial grass native to much of North America being developed as a dedicated energy crop for conversion to biofuels. Breeding efforts are focused on producing high-yielding cultivars that can maintain high yield across multiple environments, including poor so...

MASLOW: The First Step in Coin

DTIC Science & Technology

2009-01-06

the populace, but with little money or King 5   supervision to achieve them. Poorly run reconstruction efforts vulnerable to corruption and...population, Stewart was told, “I don’t give a fucking monkey’s about their welfare.” (Stewart 2006) In retrospect, it’s apparent that the security

From Black to White: The Transformation of Educational Reform in the New South 1890-1910.

ERIC Educational Resources Information Center

Mitchell, Theodore R.

1989-01-01

This article examines the efforts and impact of New South reformers to use the examples of industrial training developed at Tuskegee and Hampton Institutes, which were designed to uplift African-Americans, as models of appropriate education for poor Whites. (IAH)

The State of Middle Eastern Studies.

ERIC Educational Resources Information Center

Lewis, Bernard

1979-01-01

After tracing European study of the Middle East from medieval times, the author concludes that, for all the money and effort being expended in English and American universities, results are disappointing. He notes problems of partisanship, influence of outside financial benefactors, poor academic standards, the language difficulty, and…

[Analysis of population survey for determining the factors associated with the control diabetes mellitus in Mexico].

PubMed

Hernández-Romieu, Alfonso Claudio; Elnecavé-Olaiz, Alejandro; Huerta-Uribe, Nidia; Reynoso-Noverón, Nancy

2011-01-01

Determine the influence of nutritional counseling, exercise, access to social healthcare and drugs, and the quality of medical care on the control of diabetics. The information and blood samples were obtained in 2005. Glycemic control was defined as good if HbA1c was ≤7.0%, poor from 7.01%-9.50% and very poor if HbA1c >9.5%. Binary logistic regression models were used to determine the association of these factors with HbA1c>9.5%. Thirty percent of the patients with a medical diagnosis of diabetes had adequate metabolic control. Nutritional guidance was associated with an increase in the degree of control. A majority of diabetics have poor or very poor glycemic control. Strengthening the quality of and access to medical care for these patients is urgently needed.

Adjustment among Youth in Military Families: The Protective Roles of Effortful Control and Maternal Social Support

ERIC Educational Resources Information Center

Morris, Amanda Sheffield; Age, Tolonda Ricard

2009-01-01

This study examined coping, effortful control, and mental health among 65 youth (ages 9-15) residing in families where at least one parent was serving in the United States military. Parents provided basic demographic and deployment information. Youth reported on their coping, effortful control, and adjustment using standardized self-report…

Effortful Control Moderates Bidirectional Effects between Children's Externalizing Behavior and Their Mothers' Depressive Symptoms

ERIC Educational Resources Information Center

Choe, Daniel E.; Olson, Sheryl L.; Sameroff, Arnold J.

2014-01-01

This study examined bidirectional associations between mothers' depressive symptoms and children's externalizing behavior and whether they were moderated by preschool-age effortful control and gender. Mothers and teachers reported on 224 primarily White, middle-class children at ages 3, 5, and 10. Effortful control was assessed via…

50 CFR 648.262 - Effort-control program for red crab limited access vessels.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Effort-control program for red crab... UNITED STATES Management Measures for the Atlantic Deep-Sea Red Crab Fishery § 648.262 Effort-control program for red crab limited access vessels. (a) General. A vessel issued a limited access red crab permit...

Role of cytopathology in cancer control in low-resource settings: sub-Saharan Africa's perspective.

PubMed

Thomas, Jaiyeola

2011-03-01

Cancer is an emerging public health problem in Africa especially with increasing exposure to risky life styles, environmental carcinogens and emergence of AIDS-associated cancers. Of the WHO estimated 7.9 million cancer-related deaths in 2007 more than 72% occurred in the low- and middle-income countries and 80% presented in the late stages. To implement the WHO resolution on cancer control programs in these settings, feasible evidence-based interventions for prevention, early diagnosis and detection need to be widely introduced. Fundamental to appropriate cancer treatment and statistics is accurate diagnosis. In low-resource settings, the diagnostic techniques and procedures should be reliable, cost-effective, simple and acceptable to patients. In addition, the required equipment should be affordable, requiring minimal maintenance and with readily available consumables. Cytology, as a simple standardized low-technology procedure, fulfills these criteria and is most effective in addressing the major components of cancer control programs in these areas. The major obstacles to its widespread establishment are lack of awareness and inadequate numbers of trained personnel compounded by sociopolitical factors, poor national planning and implementation. Rather than investing in new technology or alternative screening methods, efforts should focus on the education and training of local personnel, as feasible options, to improve the chances of implementing meaningful cancer control programs.

Hierarchical demographic approaches for assessing invasion dynamics of non-indigenous species: An example using northern snakehead (Channa argus)

USGS Publications Warehouse

Jiao, Y.; Lapointe, N.W.R.; Angermeier, P.L.; Murphy, B.R.

2009-01-01

Models of species' demographic features are commonly used to understand population dynamics and inform management tactics. Hierarchical demographic models are ideal for the assessment of non-indigenous species because our knowledge of non-indigenous populations is usually limited, data on demographic traits often come from a species' native range, these traits vary among populations, and traits are likely to vary considerably over time as species adapt to new environments. Hierarchical models readily incorporate this spatiotemporal variation in species' demographic traits by representing demographic parameters as multi-level hierarchies. As is done for traditional non-hierarchical matrix models, sensitivity and elasticity analyses are used to evaluate the contributions of different life stages and parameters to estimates of population growth rate. We applied a hierarchical model to northern snakehead (Channa argus), a fish currently invading the eastern United States. We used a Monte Carlo approach to simulate uncertainties in the sensitivity and elasticity analyses and to project future population persistence under selected management tactics. We gathered key biological information on northern snakehead natural mortality, maturity and recruitment in its native Asian environment. We compared the model performance with and without hierarchy of parameters. Our results suggest that ignoring the hierarchy of parameters in demographic models may result in poor estimates of population size and growth and may lead to erroneous management advice. In our case, the hierarchy used multi-level distributions to simulate the heterogeneity of demographic parameters across different locations or situations. The probability that the northern snakehead population will increase and harm the native fauna is considerable. Our elasticity and prognostic analyses showed that intensive control efforts immediately prior to spawning and/or juvenile-dispersal periods would be more effective (and probably require less effort) than year-round control efforts. Our study demonstrates the importance of considering the hierarchy of parameters in estimating population growth rate and evaluating different management strategies for non-indigenous invasive species. ?? 2009 Elsevier B.V.

Volume-controlled Ventilation Does Not Prevent Injurious Inflation during Spontaneous Effort.

PubMed

Yoshida, Takeshi; Nakahashi, Susumu; Nakamura, Maria Aparecida Miyuki; Koyama, Yukiko; Roldan, Rollin; Torsani, Vinicius; De Santis, Roberta R; Gomes, Susimeire; Uchiyama, Akinori; Amato, Marcelo B P; Kavanagh, Brian P; Fujino, Yuji

2017-09-01

Spontaneous breathing during mechanical ventilation increases transpulmonary pressure and Vt, and worsens lung injury. Intuitively, controlling Vt and transpulmonary pressure might limit injury caused by added spontaneous effort. To test the hypothesis that, during spontaneous effort in injured lungs, limitation of Vt and transpulmonary pressure by volume-controlled ventilation results in less injurious patterns of inflation. Dynamic computed tomography was used to determine patterns of regional inflation in rabbits with injured lungs during volume-controlled or pressure-controlled ventilation. Transpulmonary pressure was estimated by using esophageal balloon manometry [Pl(es)] with and without spontaneous effort. Local dependent lung stress was estimated as the swing (inspiratory change) in transpulmonary pressure measured by intrapleural manometry in dependent lung and was compared with the swing in Pl(es). Electrical impedance tomography was performed to evaluate the inflation pattern in a larger animal (pig) and in a patient with acute respiratory distress syndrome. Spontaneous breathing in injured lungs increased Pl(es) during pressure-controlled (but not volume-controlled) ventilation, but the pattern of dependent lung inflation was the same in both modes. In volume-controlled ventilation, spontaneous effort caused greater inflation and tidal recruitment of dorsal regions (greater than twofold) compared with during muscle paralysis, despite the same Vt and Pl(es). This was caused by higher local dependent lung stress (measured by intrapleural manometry). In injured lungs, esophageal manometry underestimated local dependent pleural pressure changes during spontaneous effort. Limitation of Vt and Pl(es) by volume-controlled ventilation could not eliminate harm caused by spontaneous breathing unless the level of spontaneous effort was lowered and local dependent lung stress was reduced.

School climate and delinquency among Chinese adolescents: analyses of effortful control as a moderator and deviant peer affiliation as a mediator.

PubMed

Bao, Zhenzhou; Li, Dongping; Zhang, Wei; Wang, Yanhui

2015-01-01

School climate is the quality and character of school life and reflects the norms, goals, values, interpersonal relationships, teaching and learning practices, and the organizational structure of a school. There is substantial literature documenting the negative association between positive school climate and adolescent delinquency, but little is known about the moderating and mediating mechanisms underlying this relationship. The aim of this study was to examine whether the direct and indirect pathways between school climate and adolescent delinquency would be moderated by effortful control. A sample of 2,758 Chinese adolescents (M age = 13.53 years, SD = 1.06) from 10 middle schools completed anonymous questionnaires regarding school climate, effortful control, deviant peer affiliation, and delinquency. After gender, age, geographical area, and socioeconomic status were included as covariates, the results revealed that school climate was significantly associated with adolescent delinquent behavior. This direct association was moderated by effortful control, such that the negative relationship between positive school climate and delinquency was only significant among adolescents low in effortful control. Moreover, the indirect association between school climate and delinquency via deviant peer affiliation was also moderated by effortful control. Specifically, the moderating effect of effortful control was not only manifested in the relationship between school climate and deviant peer affiliation, but also in the relationship between deviant peer affiliation and delinquency. These findings contribute to understanding the mechanisms through which positive school climate might reduce delinquent behavior and have important implications for prevention efforts aimed at diminishing adolescent delinquency.

Pathways from maternal effortful control to child self-regulation: The role of maternal emotional support.

PubMed

Zeytinoglu, Selin; Calkins, Susan D; Swingler, Margaret M; Leerkes, Esther M

2017-03-01

This study examined the direct and indirect pathways from maternal effortful control to 2 aspects of children's self-regulation-executive functioning and behavioral regulation-via maternal emotional support. Two hundred seventy-eight children and their primary caregivers (96% mothers) participated in laboratory visits when children were 4 and 5 years, and teachers reported on children's behavior at kindergarten. At the 4-year assessment, maternal effortful control was measured using the Adult Temperament Questionnaire (Evans & Rothbart, 2007) and maternal emotional support was observed during a semistructured mother-child problem-solving task. At the 5-year assessment, children's executive functioning was measured using laboratory tasks designed to assess updating/working memory, inhibitory control, and cognitive flexibility, whereas behavioral regulation was assessed via teacher-report questionnaires on children's attention control, discipline and persistence, and work habits. Results from structural equation modeling indicated that, after controlling for child gender and minority status, and maternal education, maternal effortful control was indirectly associated with both child executive functioning and behavioral regulation through maternal emotional support. Maternal effortful control had a direct association with children's teacher-reported behavioral regulation but not observed executive functioning. These findings suggest that maternal effortful control may be a key contributing factor to the development of children's self-regulatory competencies through its impact on maternal emotional support. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Pathways from Maternal Effortful Control to Child Self-Regulation: The Role of Maternal Emotional Support

PubMed Central

Zeytinoglu, Selin; Calkins, Susan D.; Swingler, Margaret M.; Leerkes, Esther M.

2016-01-01

This study examined the direct and indirect pathways from maternal effortful control to two aspects of children’s self-regulation – executive functioning and behavioral regulation – via maternal emotional support. Two hundred and seventy eight children and their primary caregivers (96% mothers) participated in laboratory visits when children were 4 and 5 years, and teachers reported on children’s behavior at kindergarten. At the 4-year assessment, maternal effortful control was measured using the Adult Temperament Questionnaire (ATQ; Evans & Rothbart, 2007) and maternal emotional support was observed during a semi-structured mother-child problem-solving task. At the 5-year assessment, children’s executive functioning was measured using laboratory tasks designed to assess updating/working memory, inhibitory control, and cognitive flexibility, whereas behavioral regulation was assessed via teacher-report questionnaires on children’s attention control, discipline and persistence, and work habits. Results from structural equation modeling indicated that, after controlling for child gender and minority status, and maternal education, maternal effortful control was indirectly associated with both child executive functioning and behavioral regulation through maternal emotional support. Maternal effortful control had a direct association with children’s teacher-reported behavioral regulation but not observed executive functioning. These findings suggest that maternal effortful control may be a key contributing factor to the development of children’s self-regulatory competencies through its impact on maternal emotional support. PMID:27929315

Effortful control mediates relations between children's attachment security and their regard for rules of conduct

PubMed Central

Nordling, Jamie Koenig; Boldt, Lea J.; O'Bleness, Jessica; Kochanska, Grazyna

2015-01-01

Although attachment security has been associated with children's rule-compatible conduct, the mechanism through which attachment influences early regard for rules is not well established. We hypothesized that effortful control would mediate the link between security and indicators of children's emerging regard for rules (discomfort following rule violations, internalization of parents' and experimenter's rules, few externalizing behaviors). In a longitudinal study, the Attachment Q-Set was completed by parents, effortful control was observed, and Regard for Rules was observed and rated by parents. The proposed model fit the data well: Children's security to mothers predicted their effortful control, which in turn had a direct link to a greater Regard for Rules. Children's security with fathers did not predict effortful control. The mother-child relationship appears particularly important for positive developmental cascades of self-regulation and socialization. PMID:27158193

Modifying the brain activation of poor readers during sentence comprehension with extended remedial instruction: a longitudinal study of neuroplasticity.

PubMed

Meyler, Ann; Keller, Timothy A; Cherkassky, Vladimir L; Gabrieli, John D E; Just, Marcel Adam

2008-08-01

This study used fMRI to longitudinally assess the impact of intensive remedial instruction on cortical activation among 5th grade poor readers during a sentence comprehension task. The children were tested at three time points: prior to remediation, after 100 h of intensive instruction, and 1 year after the instruction had ended. Changes in brain activation were also measured among 5th grade good readers at the same time points for comparison. The central finding was that prior to instruction, the poor readers had significantly less activation than good readers bilaterally in the parietal cortex. Immediately after instruction, poor readers made substantial gains in reading ability, and demonstrated significantly increased activation in the left angular gyrus and the left superior parietal lobule. Activation in these regions continued to increase among poor readers 1 year post-remediation, resulting in a normalization of the activation. These results are interpreted as reflecting changes in the processes involved in word-level and sentence-level assembly. Areas of overactivation were also found among poor readers in the medial frontal cortex, possibly indicating a more effortful and attentive guided reading strategy.

Modifying the Brain Activation of Poor Readers during Sentence Comprehension with Extended Remedial Instruction: A Longitudinal Study of Neuroplasticity

PubMed Central

Meyler, Ann; Keller, Timothy A.; Cherkassky, Vladimir L.; Gabrieli, John D. E.; Just, Marcel Adam

2008-01-01

This study used fMRI to longitudinally assess the impact of intensive remedial instruction on cortical activation among 5th grade poor readers during a sentence comprehension task. The children were tested at 3 time points: prior to remediation, after 100 hours of intensive instruction, and 1 year after the instruction had ended. Changes in brain activation were also measured among 5th grade good readers at the same time points for comparison. The central finding was that prior to instruction, the poor readers had significantly less activation than good readers bilaterally in the parietal cortex. Immediately after instruction, poor readers made substantial gains in reading ability, and demonstrated significantly increased activation in the left angular gyrus and the left superior parietal lobule. Activation in these regions continued to increase among poor readers 1 year post-remediation, resulting in a normalization of the activation. These results are interpreted as reflecting changes in the processes involved in word-level and sentence-level assembly. Areas of overactivation were also found among poor readers in the medial frontal cortex, possibly indicating a more effortful and attentionally-guided reading strategy. PMID:18495180

Debt relief and public health spending in heavily indebted poor countries.

PubMed Central

Gupta, Sanjeev; Clements, Benedict; Guin-Siu, Maria Teresa; Leruth, Luc

2002-01-01

The Heavily Indebted Poor Countries (HIPC) Initiative, which was launched in 1996, is the first comprehensive effort by the international community to reduce the external debt of the world's poorest countries. The Initiative will generate substantial savings relative to current and past public spending on health and education in these countries. Although there is ample scope for raising public health spending in heavily indebted poor countries, it may not be advisable to spend all the savings resulting from HIPC resources for this purpose. Any comprehensive strategy for tackling poverty should also focus on improving the efficiency of public health outlays and on reallocating funds to programmes that are most beneficial to the poor. In order to ensure that debt relief increases poverty-reducing spending and benefits the poor, all such spending, not just that financed by HIPC resources, should be tracked. This requires that countries improve all aspects of their public expenditure management. In the short run, heavily indebted poor countries can take some pragmatic tracking measures based on existing public expenditure management systems, but in the longer run they should adopt a more comprehensive approach so as to strengthen their budget formulation, execution, and reporting systems. PMID:11953794

The role of preoccupation in attributions for poor sleep.

PubMed

Ellis, Jason; Hampson, Sarah E; Cropley, Mark

2007-04-01

Studies examining the impact of daytime preoccupations with sleep are rare. The aim of the present study was to determine whether daytime preoccupations mediate the relationship between anxiety and attributions for poor sleep within older adults. A cross-sectional study examined the mediational role of sleep preoccupations in the link between anxiety and attributions for poor sleep in a sample of late-life insomniacs (n=92). The findings show that a preoccupation with sleep during the day mediates the relationship between anxiety and both sleep effort and sleep pattern problem attributions but does not mediate cognitive arousal attributions for insomnia and only partially mediates the relationship between anxiety and physical tension attributions for insomnia. The results are discussed in terms of the existing models of insomnia and cognitive intervention strategies.

Study of the buffering capacity, pH and salivary flow rate in type 2 well-controlled and poorly controlled diabetic patients.

PubMed

Bernardi, Maria José; Reis, Alessandra; Loguercio, Alessandro Dourado; Kehrig, Ruth; Leite, Mariana Ferreira; Nicolau, José

2007-01-01

This study measured the flow rate, pH and buffering capacity of saliva from well- and poorly metabolically controlled Type 2 diabetic patients in three cities of the southern part of Brazil, compared with healthy individuals from the same cities. Whole saliva was collected by mechanical stimulation and buffering capacity and glucose level were measured. Blood was collected after 12 hours fasting and glucose and glycosylated haemoglobin concentrations were determined. The data were analysed by one-way ANOVA and Student-Newman-Keuls (alpha= 0.05). The flow rate was lower in the Type 2 diabetic patients, regardless of whether they were well or poorly metabolically controlled, compared with healthy individuals (p < 0.05). Salivary glucose concentration was higher in both diabetic patient groups, i.e. well and poorly metabolically controlled, than in the control (p < 0.05). The metabolic control of hyperglycaemia was not sufficient to improve the salivary flow rate or the salivary glucose concentration.

Shifting the Abject: Examining Abjected Adolescence in Teacher Thinking

ERIC Educational Resources Information Center

Sarigianides, Sophia Tatiana

2016-01-01

Teachers' efforts to re-consider adolescence as a historically-situated social category exposes how dominant biological and psychological discourses of adolescence position youth who do not fit "proper" expectations of adolescence as abject. In this seven-month study with experienced White and Black teachers working with poor youth of…

Mangrove soil and vegetation change after tidal wetland creation: a 20-year chronosequence in Tampa Bay, FL

EPA Science Inventory

Mangrove restoration and creation efforts are increasingly proposed as mechanisms to compensate for mangrove loss (which has been high in recent decades: ~30-50% global loss). However, ecosystem development and functionality following mangrove restoration and creation is poorly u...

Raising the Bar of Teacher Quality: Accountability, Collaboration, and Social Justice

ERIC Educational Resources Information Center

Ganley, DeLacy Derin; Quintanar, Anita P.; Loop, Lisa S.

2007-01-01

Historically, reform efforts to address poor student achievement have focused on a variety of issues other than teacher quality. Movements such as TQM (Total Quality Management), class size reduction (CSR), school leadership, parental involvement, and multicultural curriculum have not directly addressed the power or influence of the individual…

Dear Mrs. Roosevelt: Cries for Help from Depression Youth.

ERIC Educational Resources Information Center

Cohen, Robert

1996-01-01

Personalizes the devastating effect of the Great Depression on young people through excerpts of letters sent to Eleanor Roosevelt. Young people across the country responded to the First Lady's efforts on behalf of the poor and dispossessed. Discusses the many relief and work programs created by the New Deal. (MJP)

Formative Evaluation: Interpretation and Participation.

ERIC Educational Resources Information Center

Cox, Roy

An Approach to formative evaluation is described that attempts to actively involve students and explore the meaning of processes, activities, and performances in terms of the wide variety of students' perceptions and responses. When poor student performance is not attributable to lack of effort or ability, the need for a more personal…

Effort versus reward: preparing samples for fungal community characterization in high-throughput sequencing surveys of soils

USDA-ARS?s Scientific Manuscript database

Next generation fungal amplicon sequencing is being used with increasing frequency to study fungal diversity in various ecosystems; however, the influence of sample preparation on the characterization of fungal community is poorly understood. We investigated the effects of four procedural modificati...

Advertising the University: A Professional Approach to Promoting the College or University.

ERIC Educational Resources Information Center

Jugenheimer, Donald W.

1995-01-01

Colleges and universities generally advertise themselves poorly because of improper planning, resistance, inexperience, and lack of marketing plan. Components of effective advertising include an appropriate and strategic plan, correct choice of planner, coordination with other marketing efforts, contingency planning, and follow-up activities. (MSE)

Why Standards Matter

ERIC Educational Resources Information Center

Anthony, Michael A.; Caleb, Derry; Mitchell, Stanley G.

2012-01-01

When standards are absent, people soon notice. They care when products turn out to be of poor quality, are unreliable, or dangerous because of counterfeiting. By positioning their products in relation to a common standard, firms grow the total size of the market, and can focus their innovation efforts in areas where they have a comparative…

CATV; A History of Community Antenna Television.

ERIC Educational Resources Information Center

Phillips, Mary Alice Mayer

The development of community antenna television (CATV) is traced from its beginnings in various local efforts to bring television to areas of poor reception. The history of federal, state, and municipal regulatory practices and problems are examined, and the potential applications of cable television are discussed in some detail. (JY)

Genome-wide association mapping of provitamin A carotenoid content in cassava

USDA-ARS?s Scientific Manuscript database

Global efforts are underway to develop staple crops with improved levels of provitamin A carotenoids to help combat dietary vitamin A deficiency, which is widespread among resource-poor farmers in the developing world. As a staple crop for more than 500 million people in sub-Saharan Africa, cassava ...

Building software tools to help contextualize and interpret monitoring data

USDA-ARS?s Scientific Manuscript database

Even modest monitoring efforts at landscape scales produce large volumes of data.These are most useful if they can be interpreted relative to land potential or other similar sites. However, for many ecological systems reference conditions may not be defined or are poorly described, which hinders und...

Evaluation of the Teaching American History Program

ERIC Educational Resources Information Center

Humphrey, Daniel C.; Chang-Ross, Christopher; Donnelly, Mary Beth; Hersh, Lauren; Skolnik, Heidi

2005-01-01

Nearly 20 years ago, the first national assessment of student achievement in U.S. history yielded disappointing results. Although policy-makers and researchers expressed great concern about the low scores, the federal government did not undertake large-scale efforts to address poor student performance, and few research dollars were dedicated to…

Stressful Psychosocial Work Environment, Poor Sleep, and Depressive Symptoms among Primary School Teachers

ERIC Educational Resources Information Center

Gluschkoff, Kia; Elovainio, Marko; Keltikangas-Järvinen, Liisa; Hintsanen, Mirka; Mullola, Sari; Hintsa, Taina

2016-01-01

Introduction: We examined the associations and proportionate contributions of three well-validated models of stressful psychosocial work environment (job strain, effort-reward imbalance, and organizational injustice) in explaining depressive symptoms among primary school teachers. In addition, we tested the mediating role of different types of…

After the Identification of Incompetence: Then What?

ERIC Educational Resources Information Center

Bryant, Miles T.

Many factors make it difficult to identify a teacher formally as incompetent and to act on that identification once it is made. These factors include time constraints, bureaucratic requirements, and reluctance to face emotional stress. Once a poor teacher is identified, efforts are rarely made to help the teacher improve. Unsatisfactory…

Learning from Real-Life Problems: Functional Education in Bangladesh.

ERIC Educational Resources Information Center

Islam, Mahmood Aminul

1980-01-01

Describes a program in Bangladesh designed to make the rural poor understand their social and economic problems in order to begin to bring about change through their own efforts. The program is functional education and includes topics in family planning, health, housing, nutrition, and agriculture. (Author/SA)

Behavioral Interventions to Advance Self-Sufficiency

ERIC Educational Resources Information Center

MDRC, 2017

2017-01-01

As the first major effort to use a behavioral economics lens to examine human services programs that serve poor and vulnerable families in the United States, the Behavioral Interventions to Advance Self-Sufficiency (BIAS) project demonstrated the value of applying behavioral insights to improve the efficacy of human services programs. The BIAS…

Overshadowed

ERIC Educational Resources Information Center

Lum, Lydia

2007-01-01

Ask the average person what comes to mind at the mention of the Black Panther Party (BPP). Odds are the answer involves armed African-Americans winding up in shootouts with police. Those images have overshadowed the Panthers' free breakfast programs, medical clinics and other efforts to improve poor Black neighborhoods in the late 1960s. Also…

Seedbed Requirements For Regenerating Table Mountain Pine With Prescribed Fire

Treesearch

Thomas A. Waldrop; Helen H. Mohr; Patrick H. Brose; Richard B. Baker

1999-01-01

High-intensity, stand-replacement fires have been recommnded to regenerate stands of Table Mountain pine (Pinus pungens Lamb.) because its seeds require mineral soil to germinate and seedlings are intolerant of shade. Early prescribed fire efforts resulted in poor regeneration success where crown fires created seedbeds with abundant insolation....

Flipping the Business College on Its Side

ERIC Educational Resources Information Center

Brozik, Dallas; Cassidy, Chris

2013-01-01

Colleges of business are typically formed around functional divisions like accounting, finance, management, and marketing. This discipline-based structure serves to convey basic information to the students, but it is poorly suited to provide an educational experience that integrates the functional areas into a holistic framework. Efforts to refine…

The Effect of Empowerment and Self-Determination on Health Outcomes

ERIC Educational Resources Information Center

Garces-Ozanne, Arlene; Kalu, Edna Ikechi; Audas, Richard

2016-01-01

There remains a persistent gap in health outcomes between wealthy and poor countries. Basic measures such as life expectancy and infant and under-five mortality remain divergent, with preventable deaths being unacceptably high, despite significant efforts to reduce these disparities. We examine the impact of empowerment, measured by Freedom…

EPA Pushing Improved Air Quality in Schools.

ERIC Educational Resources Information Center

Sack, Joetta L.

2002-01-01

Discusses how, in response to the growing problem of poor air quality in schools, the Environmental Protection Agency (EPA) has set new voluntary air-quality guidelines for schools. Addresses common air-related irritants; successful efforts at Guerrero Elementary School in Mesa, Arizona; preventive maintenance; and a sample of the EPA's…

Impacts of Community-Based Natural Resource Management on Wealth, Food Security and Child Health in Tanzania.

PubMed

Pailler, Sharon; Naidoo, Robin; Burgess, Neil D; Freeman, Olivia E; Fisher, Brendan

2015-01-01

Community-based natural resource management (CBNRM) is a major global strategy for enhancing conservation outcomes while also seeking to improve rural livelihoods; however, little evidence of socioeconomic outcomes exists. We present a national-level analysis that empirically estimates socioeconomic impacts of CBNRM across Tanzania, while systematically controlling for potential sources of bias. Specifically, we apply a difference-in-differences model to national-scale, cross-sectional data to estimate the impact of three different CBNRM governance regimes on wealth, food security and child health, considering differential impacts of CBNRM on wealthy and poor populations. We also explore whether or not longer-standing CBNRM efforts provide more benefits than recently-established CBNRM areas. Our results show significant improvements in household food security in CBNRM areas compared with non-CBNRM areas, but household wealth and health outcomes in children are generally not significantly different. No one CBNRM governance regime demonstrates consistently different welfare outcomes than the others. Wealthy households benefit more from CBNRM than poor households and CBNRM benefits appear to increase with longer periods of implementation. Perhaps evidence of CBNRM benefits is limited because CBNRM hasn't been around long enough to yield demonstrable outcomes. Nonetheless, achieving demonstrable benefits to rural populations will be crucial for CBNRM's future success in Tanzania.

Impacts of Community-Based Natural Resource Management on Wealth, Food Security and Child Health in Tanzania

PubMed Central

Pailler, Sharon; Naidoo, Robin; Burgess, Neil D.; Freeman, Olivia E.; Fisher, Brendan

2015-01-01

Community-based natural resource management (CBNRM) is a major global strategy for enhancing conservation outcomes while also seeking to improve rural livelihoods; however, little evidence of socioeconomic outcomes exists. We present a national-level analysis that empirically estimates socioeconomic impacts of CBNRM across Tanzania, while systematically controlling for potential sources of bias. Specifically, we apply a difference-in-differences model to national-scale, cross-sectional data to estimate the impact of three different CBNRM governance regimes on wealth, food security and child health, considering differential impacts of CBNRM on wealthy and poor populations. We also explore whether or not longer-standing CBNRM efforts provide more benefits than recently-established CBNRM areas. Our results show significant improvements in household food security in CBNRM areas compared with non-CBNRM areas, but household wealth and health outcomes in children are generally not significantly different. No one CBNRM governance regime demonstrates consistently different welfare outcomes than the others. Wealthy households benefit more from CBNRM than poor households and CBNRM benefits appear to increase with longer periods of implementation. Perhaps evidence of CBNRM benefits is limited because CBNRM hasn’t been around long enough to yield demonstrable outcomes. Nonetheless, achieving demonstrable benefits to rural populations will be crucial for CBNRM’s future success in Tanzania. PMID:26186210

Toward the modelling of safety violations in healthcare systems.

PubMed

Catchpole, Ken

2013-09-01

When frontline staff do not adhere to policies, protocols, or checklists, managers often regard these violations as indicating poor practice or even negligence. More often than not, however, these policy and protocol violations reflect the efforts of well intentioned professionals to carry out their work efficiently in the face of systems poorly designed to meet the diverse demands of patient care. Thus, non-compliance with institutional policies and protocols often signals a systems problem, rather than a people problem, and can be influenced among other things by training, competing goals, context, process, location, case complexity, individual beliefs, the direct or indirect influence of others, job pressure, flexibility, rule definition, and clinician-centred design. Three candidates are considered for developing a model of safety behaviour and decision making. The dynamic safety model helps to understand the relationship between systems designs and human performance. The theory of planned behaviour suggests that intention is a function of attitudes, social norms and perceived behavioural control. The naturalistic decision making paradigm posits that decisions are based on a wider view of multiple patients, expertise, systems complexity, behavioural intention, individual beliefs and current understanding of the system. Understanding and predicting behavioural safety decisions could help us to encourage compliance to current processes and to design better interventions.

Prevalence of poor sleep quality and its relationship with body mass index among teenagers: evidence from Taiwan.

PubMed

Chen, Duan-Rung; Truong, Khoa D; Tsai, Meng-Ju

2013-08-01

The linkage between sleep quality and weight status among teenagers has gained more attention in the recent literature and health policy but no consensus has been reached. Using both a propensity score method and multivariate linear regression for a cross-sectional sample of 2,113 teenagers, we analyzed their body mass index (BMI) in relation to sleep quality while controlling for family characteristics (household income, parent/guardian level of education, disability status, work night shift, and smoking) and individual factors (age, sex, regular exercise, smoking, employment, and feeling secure in the neighborhood). Sleep quality was assessed using 3 scales: difficulty in initiating sleep, difficulty in maintaining sleep, and non-restorative sleep, based on Diagnostic and Statistical Manual of Mental Disorders-IV-defined insomnia. Considering all 3 types of poor sleep quality, 20.9% of teenagers in Taiwan experienced some form of sleep problems. After adjusting for the other variables, 2 factors independently and statistically predicted sleep problems: current smoking and working night shifts by the head of the household. Teens experiencing difficulty in initiating sleep had higher BMIs ranging from 0.86 to 1.41 units. Efforts to address childhood obesity need to take into consideration sleep problems that are highly prevalent among teenagers. © 2013, American School Health Association.

Anomalous Resistance Hysteresis in Oxide ReRAM: Oxygen Evolution and Reincorporation Revealed by In Situ TEM.

PubMed

Cooper, David; Baeumer, Christoph; Bernier, Nicolas; Marchewka, Astrid; La Torre, Camilla; Dunin-Borkowski, Rafal E; Menzel, Stephan; Waser, Rainer; Dittmann, Regina

2017-06-01

The control and rational design of redox-based memristive devices, which are highly attractive candidates for next-generation nonvolatile memory and logic applications, is complicated by competing and poorly understood switching mechanisms, which can result in two coexisting resistance hystereses that have opposite voltage polarity. These competing processes can be defined as regular and anomalous resistive switching. Despite significant characterization efforts, the complex nanoscale redox processes that drive anomalous resistive switching and their implications for current transport remain poorly understood. Here, lateral and vertical mapping of O vacancy concentrations is used during the operation of such devices in situ in an aberration corrected transmission electron microscope to explain the anomalous switching mechanism. It is found that an increase (decrease) in the overall O vacancy concentration within the device after positive (negative) biasing of the Schottky-type electrode is associated with the electrocatalytic release and reincorporation of oxygen at the electrode/oxide interface and is responsible for the resistance change. This fundamental insight presents a novel perspective on resistive switching processes and opens up new technological opportunities for the implementation of memristive devices, as anomalous switching can now be suppressed selectively or used deliberately to achieve the desirable so-called deep Reset. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Snake Bite in South Asia: A Review

PubMed Central

Alirol, Emilie; Sharma, Sanjib Kumar; Bawaskar, Himmatrao Saluba; Kuch, Ulrich; Chappuis, François

2010-01-01

Snake bite is one of the most neglected public health issues in poor rural communities living in the tropics. Because of serious misreporting, the true worldwide burden of snake bite is not known. South Asia is the world's most heavily affected region, due to its high population density, widespread agricultural activities, numerous venomous snake species and lack of functional snake bite control programs. Despite increasing knowledge of snake venoms' composition and mode of action, good understanding of clinical features of envenoming and sufficient production of antivenom by Indian manufacturers, snake bite management remains unsatisfactory in this region. Field diagnostic tests for snake species identification do not exist and treatment mainly relies on the administration of antivenoms that do not cover all of the important venomous snakes of the region. Care-givers need better training and supervision, and national guidelines should be fed by evidence-based data generated by well-designed research studies. Poorly informed rural populations often apply inappropriate first-aid measures and vital time is lost before the victim is transported to a treatment centre, where cost of treatment can constitute an additional hurdle. The deficiency of snake bite management in South Asia is multi-causal and requires joint collaborative efforts from researchers, antivenom manufacturers, policy makers, public health authorities and international funders. PMID:20126271

Cross-Border Cholera Outbreaks in Sub-Saharan Africa, the Mystery behind the Silent Illness: What Needs to Be Done?

PubMed Central

Mwesawina, Maurice; Baluku, Yosia; Kanyanda, Setiala S. E.; Orach, Christopher Garimoi

2016-01-01

Introduction Cross-border cholera outbreaks are a major public health problem in Sub-Saharan Africa contributing to the high annual reported cholera cases and deaths. These outbreaks affect all categories of people and are challenging to prevent and control. This article describes lessons learnt during the cross-border cholera outbreak control in Eastern and Southern Africa sub-regions using the case of Uganda-DRC and Malawi-Mozambique borders and makes recommendations for future outbreak prevention and control. Materials and Methods We reviewed weekly surveillance data, outbreak response reports and documented experiences on the management of the most recent cross-border cholera outbreaks in Eastern and Southern Africa sub-regions, namely in Uganda and Malawi respectively. Uganda-Democratic Republic of Congo and Malawi-Mozambique borders were selected because the countries sharing these borders reported high cholera disease burden to WHO. Results A total of 603 cross-border cholera cases with 5 deaths were recorded in Malawi and Uganda in 2015. Uganda recorded 118 cases with 2 deaths and CFR of 1.7%. The under-fives and school going children were the most affected age groups contributing 24.2% and 36.4% of all patients seen along Malawi-Mozambique and Uganda-DRC borders, respectively. These outbreaks lasted for over 3 months and spread to new areas leading to 60 cases with 3 deaths, CRF of 5%, and 102 cases 0 deaths in Malawi and Uganda, respectively. Factors contributing to these outbreaks were: poor sanitation and hygiene, use of contaminated water, floods and rampant cross-border movements. The outbreak control efforts mainly involved unilateral measures implemented by only one of the affected countries. Conclusions Cross-border cholera outbreaks contribute to the high annual reported cholera burden in Sub-Saharan Africa yet they remain silent, marginalized and poorly identified by cholera actors (governments and international agencies). The under-fives and the school going children were the most affected age groups. To successfully prevent and control these outbreaks, guidelines and strategies should be reviewed to assign clear roles and responsibilities to cholera actors on collaboration, prevention, detection, monitoring and control of these epidemics. PMID:27258124

Association of Maternal Depressive Symptoms and Offspring Physical Health in Low-Income Families.

PubMed

Thompson, Sarah M; Jiang, Lu; Hammen, Constance; Whaley, Shannon E

2018-06-01

Objectives The present study sought to examine the association between maternal depressive symptoms and characteristics of offspring physical health, including health status, health behaviors, and healthcare utilization, among low-income families. Maternal engagement was explored as a mediator of observed effects. Methods Cross-sectional survey data from a community sample of 4589 low-income women and their preschool-age children participating in the WIC program in Los Angeles County were analyzed using logistic, Poisson, and zero-inflated negative binomial regression. Mediation was tested via conditional process analyses. Results After controlling for the effects of demographic characteristics including maternal health insurance coverage, employment status, education, and preferred language, children of depressed women (N = 1025) were significantly more likely than children of non-depressed women (N = 3564) to receive a "poor" or "fair" maternal rating of general health (OR 2.34), eat fewer vegetables (IRR: 0.94) more sweets (IRR: 1.20) and sugary drinks daily (IRR: 1.32), and consume fast food more often (OR 1.21). These children were also less likely to have health insurance (OR 1.59) and more likely to receive medical care from a public medical clinic or hospital emergency room (OR 1.30). Reduced maternal engagement partially mediated associations between maternal depressive symptoms and several child health outcomes including poor diet, health insurance coverage, and use of public medical services. Conclusions for Practice Maternal depressive symptoms are associated with poor health among preschool-age children in low-income families. Prevention, screening, and treatment efforts aimed at reducing the prevalence of maternal depression may positively affect young children's health.

The Effect of the Removal of User Fees for Delivery at Public Health Facilities on Institutional Delivery in Urban Kenya.

PubMed

Calhoun, Lisa M; Speizer, Ilene S; Guilkey, David; Bukusi, Elizabeth

2018-03-01

Objectives In 2013, Kenya removed delivery fees at public health facilities in an effort to promote equity in access to health services and address high maternal mortality. This study determines the effect of the policy to remove user fees on institutional delivery in a population-based sample of women from urban Kenya. Methods Longitudinal data were collected from a representative sample of 8500 women from five cities in Kenya in 2010 with a follow-up interview in 2014 (response rate 58.9%). Respondents were asked about their most recent birth since 2008 at baseline and 2012 at endline, including the delivery location. Multinomial logistic regression is used, controlling for the temporal time trend and background characteristics, to determine if births which occurred after the national policy change were more likely to occur at a public facility than at home or a private facility. Results Multivariate findings show that women were significantly more likely to deliver at a public facility as compared to a private facility after the policy. Among the poor, the results show that poor women were significantly more likely to deliver in a public facility compared to home or a private facility after policy change. Conclusions for Practice These findings show Kenya's progress towards achieving universal access to delivery services and meeting its national development targets. The removal of delivery fees in the public sector is leading to increased use of facilities for delivery among the urban poor; this is an important first step in reducing maternal death.

Effort-Based Decision-Making Paradigms for Clinical Trials in Schizophrenia: Part 1—Psychometric Characteristics of 5 Paradigms.

PubMed

Reddy, L Felice; Horan, William P; Barch, Deanna M; Buchanan, Robert W; Dunayevich, Eduardo; Gold, James M; Lyons, Naomi; Marder, Stephen R; Treadway, Michael T; Wynn, Jonathan K; Young, Jared W; Green, Michael F

2015-09-01

Impairments in willingness to exert effort contribute to the motivational deficits characteristic of the negative symptoms of schizophrenia. The current study evaluated the psychometric properties of 5 new or adapted paradigms to determine their suitability for use in clinical trials of schizophrenia. This study included 94 clinically stable participants with schizophrenia and 40 healthy controls. The effort-based decision-making battery was administered twice to the schizophrenia group (baseline, 4-week retest) and once to the control group. The 5 paradigms included 1 that assesses cognitive effort, 1 perceptual effort, and 3 that assess physical effort. Each paradigm was evaluated on (1) patient vs healthy control group differences, (2) test-retest reliability, (3) utility as a repeated measure (ie, practice effects), and (4) tolerability. The 5 paradigms showed varying psychometric strengths and weaknesses. The Effort Expenditure for Rewards Task showed the best reliability and utility as a repeated measure, while the Grip Effort Task had significant patient-control group differences, and superior tolerability and administration duration. The other paradigms showed weaker psychometric characteristics in their current forms. These findings highlight challenges in adapting effort and motivation paradigms for use in clinical trials. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center 2015.

Short-term poor glycemic control and retinal microvascular changes in pediatric Type 1 Diabetes patients in Singapore: a pilot study.

PubMed

Li, Ling-Jun; Lamoureux, Ecosse; Wong, Tien Yin; Lek, Ngee

2017-06-15

Poor glycemic control in Type 1 Diabetes (T1D) patients is strongly associated with an increased risk of diabetes-related microvascular complications later in life, but it is unclear whether short period of poor glycemic control in children with T1D can cause evident microvascular morphological changes long before any pathological manifestation. Our study aimed to investigate the longitudinal association between poor glycemic control and subsequent changes in retinal microvasculature, in a pilot study of 55 pediatric T1D patients from Singapore after a one-year follow-up. This is a hospital-based, exposure-matched and retrospective longitudinal study. A total of 55 T1D patients were included from Singapore KK Women's and Children Hospital, 28 of whom had poor glycemic control (average glycated hemoglobin [HbA1c] ≥8% during the year) while the other 27 age- and gender-matched subjects had good glycemic control (HbA1c <8%). Retinal photography was taken at diabetes annual screening and images were graded by trained graders using a semi-automated computer-based program (Singapore I Vessel Assessment [SIVA], version 4.0, Singapore Eye Research Institute, Singapore) and a spectrum of retinal vascular parameters (e.g. caliber, tortuosity, branching angle and fractal dimension) were measured quantitatively from 0.5 to 2.0 disc diameters. There was no significant difference in ethnicity, duration of T1D, blood pressure, body mass index (BMI) and low-density cholesterol lipoprotein (LDL) between the two groups. Retinal imaging was obtained at the end of 1 year of glycemic control assessment. In multiple linear regression adjusting for ethnicity, BMI, LDL and duration of T1D, patients with poor glycemic control tended to have marginally wider retinal arteriolar caliber (6.0 μm, 95% CI: -0.9, 12.8) and had significantly larger retinal arteriolar branching angle (10.1 degrees, 95% CI: 1.4, 18.9) compared with their age- and gender- matched counterparts with good glycemic control. Our findings showed that abnormal retinal microvascular morphology was evident in pediatric patients with T1D after one-year's poor glycemic control. Such morphological abnormalities may lead to future development of microvascular complications among T1D pediatric patients with poor glycemic control.

Stabilization of tetanus toxoid encapsulated in PLGA microspheres.

PubMed

Jiang, Wenlei; Schwendeman, Steven P

2008-01-01

Delivery of vaccine antigens from controlled-release poly(lactic/glycolic acid) (PLGA) microspheres is a novel approach to reduce the number of antigen doses required for protection against infection. A major impediment to developing single-shot vaccines is encapsulated antigen instability during months of exposure to physiological conditions. For example, efforts to control neonatal tetanus in developing countries with a single-dose TT vaccine based on PLGA microspheres have been plagued by poor stability of the 150 kDa formaldehyde-detoxified protein antigen, tetanus toxoid (TT), in the polymer. We examined the denatured states of PLGA-encapsulated TT, revealing two primary TT instability mechanisms: (1) protein aggregation mediated by formaldehyde and (2) acid-induced protein unfolding and epitope damage. Further, we systematically identified excipients, which can efficiently inhibit TT aggregation and retain TT antigenicity under simulated deleterious conditions, i.e., elevated temperature and humidity. By employing these novel additives in the PLGA system, we report the slow and continuous release of high doses of TT for one month with retained antigen stability during bioerosion of PLGA.

SRC-2 orchestrates polygenic inputs for fine-tuning glucose homeostasis

PubMed Central

Fleet, Tiffany; Zhang, Bin; Lin, Fumin; Zhu, Bokai; Dasgupta, Subhamoy; Stashi, Erin; Tackett, Bryan; Thevananther, Sundararajah; Rajapakshe, Kimal I.; Gonzales, Naomi; Dean, Adam; Mao, Jianqiang; Timchenko, Nikolai; Malovannaya, Anna; Qin, Jun; Coarfa, Cristian; DeMayo, Francesco; Dacso, Clifford C.; Foulds, Charles E.; O’Malley, Bert W.; York, Brian

2015-01-01

Despite extensive efforts to understand the monogenic contributions to perturbed glucose homeostasis, the complexity of genetic events that fractionally contribute to the spectrum of this pathology remain poorly understood. Proper maintenance of glucose homeostasis is the central feature of a constellation of comorbidities that define the metabolic syndrome. The ability of the liver to balance carbohydrate uptake and release during the feeding-to-fasting transition is essential to the regulation of peripheral glucose availability. The liver coordinates the expression of gene programs that control glucose absorption, storage, and secretion. Herein, we demonstrate that Steroid Receptor Coactivator 2 (SRC-2) orchestrates a hierarchy of nutritionally responsive transcriptional complexes to precisely modulate plasma glucose availability. Using DNA pull-down technology coupled with mass spectrometry, we have identified SRC-2 as an indispensable integrator of transcriptional complexes that control the rate-limiting steps of hepatic glucose release and accretion. Collectively, these findings position SRC-2 as a major regulator of polygenic inputs to metabolic gene regulation and perhaps identify a previously unappreciated model that helps to explain the clinical spectrum of glucose dysregulation. PMID:26487680

Tuberculosis in prisons in sub-Saharan Africa--the need for improved health services, surveillance and control.

PubMed

O'Grady, Justin; Hoelscher, Michael; Atun, Rifat; Bates, Matthew; Mwaba, Peter; Kapata, Nathan; Ferrara, Giovanni; Maeurer, Markus; Zumla, Alimuddin

2011-03-01

Prisons have long been associated with rapid transmission of infectious diseases. The HIV/AIDS epidemic in sub-Saharan Africa (SSA) has fuelled the spread of TB and HIV in prisons. The poor living conditions and ineffective health services in prisons in SSA are a major breeding ground of Mycobacterium tuberculosis (Mtb). The spread of TB between prisoners, prison staff and visitors and the emergence of drug-resistant TB in prisons now poses a threat to control efforts of national TB programmes in SSA. Accurate data required to develop appropriate interventions to tackle the ominous problem of TB in African prisons are scanty and unreliable. The health of prisoners is by default a neglected political issue. This article reviews the available literature on TB and drug-resistant TB in prisons from SSA countries, discusses the risk factors for acquiring TB and highlights the priorities for further translational research in prisons. Ethical issues pertaining to research on captive African populations are discussed. Scientific, political and funder attention is required urgently to improve prison health services. Copyright © 2010. Published by Elsevier Ltd.

The effects of television and Internet food advertising on parents and children.

PubMed

Pettigrew, Simone; Tarabashkina, Liudmila; Roberts, Michele; Quester, Pascale; Chapman, Kathy; Miller, Caroline

2013-12-01

The current study examined the impact of television and Internet food advertising on Australian parents and children. Parents and their children aged 8 to 14 years were exposed to a television advertisement, an Internet advertisement or a control picture for four commonly advertised energy-dense, nutrient-poor foods. Online web panel survey, Australia. Parents (n 1302) and their children aged 8 to 14 years (n 1302). After a single exposure to each advertisement, parent respondents in the two exposure conditions evaluated the products more favourably, had a greater desire to consume the products and thought the product could be consumed more frequently than those in the control condition. Similar trends were observed among children, although the differences were statistically significant only for the frequency of food consumption in the Internet advertisement condition and the evaluation of one product. The results have implications for assumptions of adults’ immunity to advertising. This is of particular importance in efforts to address child obesity and the reliance on parents to mediate the effects of food advertising.

Pollination: a key event controlling the expression of genes related to phytohormone biosynthesis during grapevine berry formation.

PubMed

Kühn, Nathalie; Arce-Johnson, Patricio

2012-01-01

Berry formation is the process of ovary conversion into a functional fruit, and is characterized by abrupt changes in the content of several phytohormones, associated with pollination and fertilization. Much effort has been made in order to improve our understanding of berry development, particularly from veraison to post-harvest time. However, the period of berry formation has been poorly investigated, despite its importance. Phytohormones are involved in the control of fruit formation; hence it is important to understand the regulation of their content at this stage. Grapevine is an excellent fleshy-fruit plant model since its fruits have particularities that differentiate them from those of commonly studied organisms. For instance, berries are prepared to cope with stress by producing several antioxidants and they are non-climacteric fruits. Also its genome is fully sequenced, which allows to identify genes involved in developmental processes. In grapevine, no link has been established between pollination and phytohormone biosynthesis, until recently. Here we highlight relevant findings regarding pollination effect on gene expression related to phytohormone biosynthesis, and present unpublished results showing how quickly this effect is achieved.

How to Invest in Getting Cost-effective Technologies into Practice? A Framework for Value of Implementation Analysis Applied to Novel Oral Anticoagulants.

PubMed

Faria, Rita; Walker, Simon; Whyte, Sophie; Dixon, Simon; Palmer, Stephen; Sculpher, Mark

2017-02-01

Cost-effective interventions are often implemented slowly and suboptimally in clinical practice. In such situations, a range of implementation activities may be considered to increase uptake. A framework is proposed to use cost-effectiveness analysis to inform decisions on how best to invest in implementation activities. This framework addresses 2 key issues: 1) how to account for changes in utilization in the future in the absence of implementation activities; and 2) how to prioritize implementation efforts between subgroups. A case study demonstrates the framework's application: novel oral anticoagulants (NOACs) for the prevention of stroke in the National Health Service in England and Wales. The results suggest that there is value in additional implementation activities to improve uptake of NOACs, particularly in targeting patients with average or poor warfarin control. At a cost-effectiveness threshold of £20,000 per quality-adjusted life-year (QALY) gained, additional investment in an educational activity that increases the utilization of NOACs by 5% in all patients currently taking warfarin generates an additional 254 QALYs, compared with 973 QALYs in the subgroup with average to poor warfarin control. However, greater value could be achieved with higher uptake of anticoagulation more generally: switching 5% of patients who are potentially eligible for anticoagulation but are currently receiving no treatment or are using aspirin would generate an additional 4990 QALYs. This work can help health services make decisions on investment at different points of the care pathway or across disease areas in a manner consistent with the value assessment of new interventions.

Socioeconomic health inequality in malaria indicators in rural western Kenya: evidence from a household malaria survey on burden and care-seeking behaviour.

PubMed

Were, Vincent; Buff, Ann M; Desai, Meghna; Kariuki, Simon; Samuels, Aaron; Ter Kuile, Feiko O; Phillips-Howard, Penelope A; Patrick Kachur, S; Niessen, Louis

2018-04-16

Health inequality is a recognized barrier to achieving health-related development goals. Health-equality data are essential for evidence-based planning and assessing the effectiveness of initiatives to promote equity. Such data have been captured but have not always been analysed or used to manage programming. Health data were examined for microeconomic differences in malaria indices and associated malaria control initiatives in western Kenya. Data was analysed from a malaria cross-sectional survey conducted in July 2012 among 2719 people in 1063 households in Siaya County, Kenya. Demographic factors, history of fever, malaria parasitaemia, malaria medication usage, insecticide-treated net (ITN) use and expenditure on malaria medications were collected. A composite socioeconomic status score was created using multiple correspondence analyses (MCA) of household assets; households were classified into wealth quintiles and dichotomized into poorest (lowest 3 quintiles; 60%) or less-poor (highest 2 quintiles; 40%). Prevalence rates were calculated using generalized linear modelling. Overall prevalence of malaria infection was 34.1%, with significantly higher prevalence in the poorest compared to less-poor households (37.5% versus 29.2%, adjusted prevalence ratio [aPR] 1.23; 95% CI = 1.08-1.41, p = 0.002). Care seeking (aPR = 0.95; 95% CI 0.87-1.04, p = 0.229), medication use (aPR = 0.94; 95% CI 0.87-1.00, p = 0.087) and ITN use (aPR = 0.96; 95% CI = 0.87-1.05, p = 0.397) were similar between households. Among all persons surveyed, 36.4% reported taking malaria medicines in the prior 2 weeks; 92% took artemether-lumefantrine, the recommended first-line malaria medication. In the poorest households, 4.9% used non-recommended medicines compared to 3.5% in less-poor (p = 0.332). Mean and standard deviation [SD] for expenditure on all malaria medications per person was US$0.38 [US$0.50]; the mean was US$0.35 [US$0.52] amongst the poorest households and US$0.40 [US$0.55] in less-poor households (p = 0.076). Expenditure on non-recommended malaria medicine was significantly higher in the poorest (mean US$1.36 [US$0.91]) compared to less-poor households (mean US$0.98 [US$0.80]; p = 0.039). Inequalities in malaria infection and expenditures on potentially ineffective malaria medication between the poorest and less-poor households were evident in rural western Kenya. Findings highlight the benefits of using MCA to assess and monitor the health-equity impact of malaria prevention and control efforts at the microeconomic level.

Self-control and Task Timing Shift Self-efficacy and Influence Willingness to Engage in Effortful Tasks

PubMed Central

Ein-Gar, Danit; Steinhart, Yael

2017-01-01

Self-efficacy constitutes a key factor that influences people's inclination to engage in effortful tasks. In this study, we focus on an interesting interplay between two prominent factors known to influence engagement in effortful tasks: the timing of the task (i.e., whether the task is scheduled to take place in the near or distant future) and individuals' levels of self-control. Across three studies, we show that these two factors have an interacting effect on self-efficacy. Low self-control (LSC) individuals report higher self-efficacy for distant-future effortful tasks than for near-future tasks, whereas high self-control (HSC) individuals report higher self-efficacy for near-future tasks than for distant future tasks. We further demonstrate how self-efficacy then molds individuals' willingness to engage in those effortful tasks. Given that a particular task may comprise effortful aspects alongside more enjoyable aspects, we show that the effects we observe emerge with regard to a task whose effortful aspects are salient and that the effects are eliminated when the enjoyable aspects of that same task are highlighted. PMID:29075225

Work stress, poor recovery and burnout in teachers.

PubMed

Gluschkoff, K; Elovainio, M; Kinnunen, U; Mullola, S; Hintsanen, M; Keltikangas-Järvinen, L; Hintsa, T

2016-10-01

Both work stress and poor recovery have been shown to contribute to the development of burnout. However, the role of recovery as a mediating mechanism that links work stress to burnout has not been sufficiently addressed in research. To examine recovery as a mediator in the relationship between work stress and burnout among teachers. A cross-sectional study of Finnish primary school teachers, in whom burnout was measured with the Maslach Burnout Inventory-General Survey and work stress was conceptualized using the effort-reward imbalance (ERI) model. Recovery was measured with the Recovery Experience Questionnaire and the Jenkins Sleep Problems Scale. Multiple linear regression analyses and bootstrap mediation analyses adjusted for age, gender and total working hours were performed. Among the 76 study subjects, high ERI was associated with burnout and its dimensions of exhaustion, cynicism and reduced professional efficacy. Poor recovery experiences, in terms of low relaxation during leisure time, partially mediated the relationship between ERI and reduced professional efficacy. Sleep problems, in the form of non-restorative sleep, partially mediated the relationship between ERI and both burnout and exhaustion. Supporting a balance between effort and reward at work may enhance leisure time recovery and improve sleep quality, as well as help to reduce burnout rates. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Successfully using optical components and systems in novel ways during educational outreach programs for K-12 grades

NASA Astrophysics Data System (ADS)

Silberman, Donn

2006-08-01

Much work has been done in efforts to reach students in the K-12 grades to encourage them to learn about optics and related sciences and technologies. One goal of these efforts is to develop the future optical scientists and engineers to carry on the work of this and related societies. One main obstacle is to create low costs novel and effective hands-on optical components and systems for these students to use and from which to get excited. Students at different grade levels and abilities are receptive to different kinds of components and systems and this must be taken into account when preparing for outreach programs. There are, however, some guiding principles which can be used throughout the various levels, including making sure the components and systems are good examples and not marginal. Small telescopes or microscopes that use poor quality optics which provide poor quality images do more to discourage young students from going into the sciences than if they never had the experience at all. Some examples of both poor and good quality optical components and systems that will be described and demonstrated include: lenses, telescopes, microscopes, diffraction gratings, Kaleidoscopes, Fresnel Lenses, polarization filters and liquid crystals. The figures in this paper are in color and best viewed on-line or printed with a good color printer.

Internet-based self-management offers an opportunity to achieve better asthma control in adolescents.

PubMed

van der Meer, Victor; van Stel, Henk F; Detmar, Symone B; Otten, Wilma; Sterk, Peter J; Sont, Jacob K

2007-07-01

Internet and short message service are emerging tools for chronic disease management in adolescents, but few data exist on the barriers to and benefits of internet-based asthma self-management. Our objective was to reveal the barriers and benefits perceived by adolescents with well-controlled and poorly controlled asthma to current and internet-based asthma management. Ninety-seven adolescents with mild-to-moderate persistent asthma monitored their asthma control on a designated Web site. After 4 weeks, 35 adolescents participated in eight focus groups. Participants were stratified in terms of age, gender, and asthma control level. We used qualitative and quantitative methods to analyze the written focus group transcripts. Limited self-efficacy to control asthma was a significant barrier to current asthma management in adolescents with poor asthma control (65%) compared to adolescents with good asthma control (17%; p < 0.01). The former group revealed the following several benefits from internet-based asthma self-management: feasible electronic monitoring; easily accessible information; e-mail communication; and use of an electronic action plan. Personal benefits included the ability to react to change and to optimize asthma control. Patients with poor asthma control were able and ready to incorporate internet-based asthma self-management for a long period of time (65%), whereas patients with good control were not (11%; p < 0.01). Our findings reveal a need for the support of self-management in adolescents with poorly controlled asthma that can be met by the application of novel information and communication technologies. Internet-based self-management should therefore target adolescents with poor asthma control.

What makes a reach movement effortful? Physical effort discounting supports common minimization principles in decision making and motor control

PubMed Central

Ulbrich, Philipp; Gail, Alexander

2017-01-01

When deciding between alternative options, a rational agent chooses on the basis of the desirability of each outcome, including associated costs. As different options typically result in different actions, the effort associated with each action is an essential cost parameter. How do humans discount physical effort when deciding between movements? We used an action-selection task to characterize how subjective effort depends on the parameters of arm transport movements and controlled for potential confounding factors such as delay discounting and performance. First, by repeatedly asking subjects to choose between 2 arm movements of different amplitudes or durations, performed against different levels of force, we identified parameter combinations that subjects experienced as identical in effort (isoeffort curves). Movements with a long duration were judged more effortful than short-duration movements against the same force, while movement amplitudes did not influence effort. Biomechanics of the movements also affected effort, as movements towards the body midline were preferred to movements away from it. Second, by introducing movement repetitions, we further determined that the cost function for choosing between effortful movements had a quadratic relationship with force, while choices were made on the basis of the logarithm of these costs. Our results show that effort-based action selection during reaching cannot easily be explained by metabolic costs. Instead, force-loaded reaches, a widely occurring natural behavior, imposed an effort cost for decision making similar to cost functions in motor control. Our results thereby support the idea that motor control and economic choice are governed by partly overlapping optimization principles. PMID:28586347

To do it or to let an automatic tool do it? The priority of control over effort.

PubMed

Osiurak, François; Wagner, Clara; Djerbi, Sara; Navarro, Jordan

2013-01-01

The aim of the present study is to provide experimental data relevant to the issue of what leads humans to use automatic tools. Two answers can be offered. The first is that humans strive to minimize physical and/or cognitive effort (principle of least effort). The second is that humans tend to keep their perceived control over the environment (principle of more control). These two factors certainly play a role, but the question raised here is to what do people give priority in situations wherein both manual and automatic actions take the same time - minimizing effort or keeping perceived control? To answer that question, we built four experiments in which participants were confronted with a recurring choice between performing a task manually (physical effort) or in a semi-automatic way (cognitive effort) versus using an automatic tool that completes the task for them (no effort). In this latter condition, participants were required to follow the progression of the automatic tool step by step. Our results showed that participants favored the manual or semi-automatic condition over the automatic condition. However, when they were offered the opportunity to perform recreational tasks in parallel, the shift toward manual condition disappeared. The findings give support to the idea that people give priority to keeping control over minimizing effort.

Efffect of Aeroallergen Sensitization on Asthma Control in African-American Teens with Persistent Asthma

EPA Science Inventory

In African-American adolescents with persistent asthma, allergic profile predicted the likelihood of having poorly controlled asthma despite guidelines-directed therapies. Our results suggest that tree and weed pollen sensitization are independent risk factors for poorly controll...

Reading, Mathematics, and Behavioral Difficulties Interrelate: Evidence from a Cross-lagged Panel Design and Population-based Sample

PubMed Central

Lin, Yu-Chu; Morgan, Paul L.; Farkas, George; Hillemeier, Marianne; Cook, Michael

2015-01-01

We examined three questions. First, do reading difficulties increase children’s risk of behavior difficulties? Second, do behavioral difficulties increase children’s risk of reading difficulties? Third, do mathematics difficulties increase children’s risk of reading or behavioral difficulties? We investigated these questions using a sample of 9,324 children followed from third to fifth grade as they participated in a nationally representative dataset, conducting multilevel logistic regression modeling and including statistical control for many potential confounds. Results indicated that poor readers in third grade were significantly more likely to display poor task management, poor self-control, poor interpersonal skills, internalizing behavior problems, and externalizing behavior problems in fifth grade (odds ratio [OR] range = 1.30 – 1.57). Statistically controlling for a prior history of reading difficulties, children with poor mathematics skills in third grade were also significantly more likely to display poor task management, poor interpersonal skills, internalizing behavior problems, and reading difficulties in fifth grade (OR range = 1.38 – 5.14). In contrast, only those children exhibiting poor task management, but not other types of problem behaviors, in third grade were more likely to be poor readers in fifth grade (OR = 1.49). PMID:26097274

Collaborative drug discovery for More Medicines for Tuberculosis (MM4TB)

PubMed Central

Ekins, Sean; Spektor, Anna Coulon; Clark, Alex M.; Dole, Krishna; Bunin, Barry A.

2016-01-01

Neglected disease drug discovery is generally poorly funded compared with major diseases and hence there is an increasing focus on collaboration and precompetitive efforts such as public–private partnerships (PPPs). The More Medicines for Tuberculosis (MM4TB) project is one such collaboration funded by the EU with the goal of discovering new drugs for tuberculosis. Collaborative Drug Discovery has provided a commercial web-based platform called CDD Vault which is a hosted collaborative solution for securely sharing diverse chemistry and biology data. Using CDD Vault alongside other commercial and free cheminformatics tools has enabled support of this and other large collaborative projects, aiding drug discovery efforts and fostering collaboration. We will describe CDD's efforts in assisting with the MM4TB project. PMID:27884746

Fabrication of Wearable Sensors for Human Health Monitoring through Magnetically Directed Assembly Techniques

NASA Astrophysics Data System (ADS)

Alizadeh, Azar; Ashe, Jeffrey; Misner, Matthew; Yang, Yanzhe; Zhong, Sheng; Yin, Ming; Brewer, Joleyn; Karp, Jason

2013-03-01

Many previous efforts to modify patient monitors for remote or wearable use have suffered from high cost, poor performance, and low medical acceptance. A new technology approach is needed to enable these clinical benefits and to satisfy challenging economic, clinical, and user-acceptance criteria. Here, we present results on our initial efforts aimed at designing and building a prototype multi-wavelength arrayed photoplethysmograph (PPG) by using magnetically directed self-assembly (MDSA). We will discuss novel approaches in magnetic nanomaterial design, synthesis and deposition to enable MDSA based manufacturing. We will also demonstrate that multiple devices can be deposited through heterogeneous MDSA. The novel MDSA technology could make such PPG sensors a reality. This effort is sponsored by the Department of the Army under award W81XWH1110833

Stakeholders understanding of the concept of benefit sharing in health research in Kenya: a qualitative study.

PubMed

Lairumbi, Geoffrey M; Parker, Michael; Fitzpatrick, Raymond; Mike, English C

2011-10-03

The concept of benefit sharing to enhance the social value of global health research in resource poor settings is now a key strategy for addressing moral issues of relevance to individuals, communities and host countries in resource poor settings when they participate in international collaborative health research.The influence of benefit sharing framework on the conduct of collaborative health research is for instance evidenced by the number of publications and research ethics guidelines that require prior engagement between stakeholders to determine the social value of research to the host communities. While such efforts as the production of international guidance on how to promote the social value of research through such strategies as benefit sharing have been made, the extent to which these ideas and guidelines have been absorbed by those engaged in global health research especially in resource poor settings remains unclear. We examine this awareness among stakeholders involved in health related research in Kenya. We conducted in-depth interviews with key informants drawn from within the broader health research system in Kenya including researchers from the mainstream health research institutions, networks and universities, teaching hospitals, policy makers, institutional review boards, civil society organisations and community representative groups. Our study suggests that although people have a sense of justice and the moral aspects of research, this was not articulated in terms used in the literature and the guidelines on the ethics of global health research. This study demonstrates that while in theory several efforts can be made to address the moral issues of concern to research participants and their communities in resource poor settings, quick fixes such as benefit sharing are not going to be straightforward. We suggest a need to pay closer attention to the processes through which ethical principles are enacted in practice and distil lessons on how best to involve individuals and communities in promoting ethical conduct of global health research in resource poor settings.

Stakeholders understanding of the concept of benefit sharing in health research in Kenya: a qualitative study

PubMed Central

2011-01-01

Background The concept of benefit sharing to enhance the social value of global health research in resource poor settings is now a key strategy for addressing moral issues of relevance to individuals, communities and host countries in resource poor settings when they participate in international collaborative health research. The influence of benefit sharing framework on the conduct of collaborative health research is for instance evidenced by the number of publications and research ethics guidelines that require prior engagement between stakeholders to determine the social value of research to the host communities. While such efforts as the production of international guidance on how to promote the social value of research through such strategies as benefit sharing have been made, the extent to which these ideas and guidelines have been absorbed by those engaged in global health research especially in resource poor settings remains unclear. We examine this awareness among stakeholders involved in health related research in Kenya. Methods We conducted in-depth interviews with key informants drawn from within the broader health research system in Kenya including researchers from the mainstream health research institutions, networks and universities, teaching hospitals, policy makers, institutional review boards, civil society organisations and community representative groups. Results Our study suggests that although people have a sense of justice and the moral aspects of research, this was not articulated in terms used in the literature and the guidelines on the ethics of global health research. Conclusion This study demonstrates that while in theory several efforts can be made to address the moral issues of concern to research participants and their communities in resource poor settings, quick fixes such as benefit sharing are not going to be straightforward. We suggest a need to pay closer attention to the processes through which ethical principles are enacted in practice and distil lessons on how best to involve individuals and communities in promoting ethical conduct of global health research in resource poor settings. PMID:21961798

[Factors affecting the control of blood pressure and lipid levels in patients with cardiovascular disease: the PREseAP Study].

PubMed

Orozco-Beltrán, Domingo; Brotons, Carlos; Moral, Irene; Soriano, Nuria; Del Valle, María A; Rodríguez, Ana I; Pepió, Josep M; Pastor, Ana

2008-03-01

The aim of this observational study was to identify factors influencing the control of blood pressure (i.e., <140/90 mmHg, or <130/80 mmHg in diabetic patients) and low-density lipoprotein (LDL) cholesterol level (<100 mg/dL) in 1223 patients with cardiovascular disease. Overall, 70.2% of patients were men, and their mean age was 66.4 years. Blood pressure was poorly controlled in 50.9% (95% confidence interval [CI], 46.9%-54.8%) and the LDL cholesterol level was poorly controlled in 60.1% (95% CI, 56.3%-63.9%). Determinants of poor blood pressure control were diabetes, hypertension, no previous diagnosis of heart failure, previous diagnosis of peripheral artery disease or stroke, obesity, and no lipid-lowering treatment. Determinants of poor LDL cholesterol control were no lipid-lowering treatment, no previous diagnosis of ischemic heart disease, no antihypertensive treatment, and dyslipidemia. The factors affecting blood pressure control were different from those affecting LDL cholesterol control, an observation that should be taken into account when implementing treatment recommendations for achieving therapeutic objectives in secondary prevention.

Poverty and access to health care in developing countries.

PubMed

Peters, David H; Garg, Anu; Bloom, Gerry; Walker, Damian G; Brieger, William R; Rahman, M Hafizur

2008-01-01

People in poor countries tend to have less access to health services than those in better-off countries, and within countries, the poor have less access to health services. This article documents disparities in access to health services in low- and middle-income countries (LMICs), using a framework incorporating quality, geographic accessibility, availability, financial accessibility, and acceptability of services. Whereas the poor in LMICs are consistently at a disadvantage in each of the dimensions of access and their determinants, this need not be the case. Many different approaches are shown to improve access to the poor, using targeted or universal approaches, engaging government, nongovernmental, or commercial organizations, and pursuing a wide variety of strategies to finance and organize services. Key ingredients of success include concerted efforts to reach the poor, engaging communities and disadvantaged people, encouraging local adaptation, and careful monitoring of effects on the poor. Yet governments in LMICs rarely focus on the poor in their policies or the implementation or monitoring of health service strategies. There are also new innovations in financing, delivery, and regulation of health services that hold promise for improving access to the poor, such as the use of health equity funds, conditional cash transfers, and coproduction and regulation of health services. The challenge remains to find ways to ensure that vulnerable populations have a say in how strategies are developed, implemented, and accounted for in ways that demonstrate improvements in access by the poor.

[Nursing Workforce Characteristics and Control of Diabetes Mellitus in Primary Care: a Multilevel Analysis].

PubMed

Parro Moreno, Ana; Santiago Pérez, M Isolina; Abraira Santos, Victor; Aréjula Torres, José Luis Aréjula Torres; Díaz Holgado, Antonio; Gandarillas Grande, Ana; Morales Asencio, José Miguel; Serrano Gallardo, Pilar

2016-03-04

Nurse activity is determined by the characteristics of nursing staff. The objective was to determine the impact of Primary Health Care (PHC) nursing workforce characteristics on the control of Diabetes Mellitus (DM) in adults. Cross-sectional analytical study. Administrative and clinical registries and questionnaire PES-Nursing Work Index from PHC nurses. Participants 44.214 diabetic patients in two health zones within the Community of Madrid, North-West Zone (NWZ) with higher socioeconomic situation and South-West Zone (SWZ) with lower socioeconomic situation, and their 507 reference nurses. Analyses were performed to multivariate multilevel logistic regression models. Poor DM control (figures equal or higher than 7% HbA1c). The prevalence of poor DM control was 40.1% [CI95%: 38.2-42.1]. There was a risk of 25% more of poor control if the patient changed centre and of 27% if changed of doctor-nurse pair. In the multilevel multivariate regression models: in SWZ increasing the ratio of patients over 65 years per nurse increased the poor control (OR=1.00008 [CI95%:1.00006-1.001]); and higher proportion of patients whose Hb1Ac was not measured at the centre contributed to poor DM control (OR=5.1 [CI95%:1.6-15.6]). In two models for health zone, the economic immigration condition increased poor control, in SWZ (OR=1.3 [CI95%:1.03-1.7]); and in NWZ (OR=1.29 [CI95%:1.03-1.6]). Higher 65 years old patients ratio per nurse, economic immigration condition and a higher proportion of patients whose Hb1Ac was not measured contribute to worse DM control.

Enhancing retention of occupational therapists working in mental health: relationships between wellbeing at work and turnover intention.

PubMed

Scanlan, Justin Newton; Meredith, Pamela; Poulsen, Anne A

2013-12-01

Occupational therapists working in mental health who experience burnout, low work engagement or poor job satisfaction are at risk of poor wellbeing at work and may be more likely to leave their jobs. The aim of this project was to explore factors associated with wellbeing at work and turnover intention in a sample of occupational therapists working in mental health. One hundred and three occupational therapists working in mental health in Queensland completed a survey exploring work/life balance, effort invested in work, rewards received from work, wellbeing at work (job satisfaction, burnout and work engagement) and turnover intention. Analyses were conducted to explore relationships between work/life balance, effort, reward, wellbeing at work and turnover intention. All measures of wellbeing at work were significantly associated with turnover intention. A large proportion (33%) of the variance in turnover intention was predicted by job satisfaction. Perceptions of both work/life balance and effort invested in work, as well as perceived rewards in terms of recognition, prestige and personal satisfaction were significantly associated with work-related wellbeing scores. Results from this study deepen the understanding of factors associated with wellbeing at work and turnover intention for occupational therapists in mental health. This knowledge will support the development of interventions aimed at reducing turnover intention and enhancing retention of occupational therapists in the mental health workforce. © 2013 Occupational Therapy Australia.

Effort-reward imbalance and quality of life of healthcare workers in military hospitals: a cross-sectional study.

PubMed

Tzeng, Dong-Sheng; Chung, Wei-Ching; Lin, Chi-Hung; Yang, Chun-Yuh

2012-09-08

Taiwan's National Defense Bureau has been merging its hospitals and adjusting hospital accreditation levels since the beginning of 2006. These changes have introduced many stressors to the healthcare workers in these hospitals. This study investigates the association between job stress, psychological morbidity and quality of life in healthcare workers in three military hospitals. We posted surveys to 1269 healthcare workers in three military hospitals located in southern Taiwan. The surveys included the General Health Questionnaire (GHQ), the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), and the Effort-Reward Imbalance (ERI) Questionnaire. High effort-reward (ER) ratio and overcommitment were defined when scores fell into the upper tertile of the total distribution. The survey was completed by 791 healthcare workers. On average, women reported a higher ERI than men. High ERI was associated with younger age, higher psychological morbidity, and poor physical and psychological QOL domains in this population. High ER ratio and high overcommitment were associated with psychological morbidity and poor QOL in both sexes. However, high ER ratio was not significantly associated with the social QOL domain in either sexes or the physical QOL domain in males. There was a clear association between ERI and QOL in the healthcare workers in the military hospitals under reorganization and accreditation in this study. We found ER ratio and overcommitment to be suitable indicators of job stress.

Effects of Obstructive Sleep Apnea and Gastroesophageal Reflux Disease on Asthma Control in Obesity

PubMed Central

Dixon, Anne E.; Clerisme-Beaty, Emmanuelle M.; Sugar, Elizabeth A.; Cohen, Rubin I.; Lang, Jason E.; Brown, Ellen D.; Richter, Joel E.; Irvin, Charles G.; Mastronarde, John G.

2011-01-01

Background Obesity is a risk factor for asthma. Obese asthmatics often have poor asthma control and respond poorly to therapy. It has been suggested that co-morbidities associated with obesity, such as reflux and obstructive sleep apnea, could be important factors contributing to poor asthma control in obese patients. Objectives The purpose of this study was to determine if (i) reflux and/or (ii) symptoms of sleep apnea contribute to poor asthma control in obesity. Methods We studied asthmatic subjects participating in a trial of reflux treatment. Participants underwent baseline evaluation of asthma symptoms and lung function. 304 participants underwent esophageal pH probe testing. 246 participants were evaluated for obstructive sleep apnea symptoms. Results Of 402 participants in this trial, 51% were obese. Role of reflux in asthma control Those with higher body mass index reported a higher prevalence of reflux symptoms, but the prevalence of pH probe acid reflux was similar in all groups. Reflux was not associated with measures of asthma control in obese patients. Role of obstructive sleep apnea in asthma control Symptoms and self-report of obstructive sleep apnea were more common with increasing body mass index and associated with worse asthma control as measured by the Juniper Asthma Control Questionnaire and Asthma Symptom Utility Index. Conclusions Our data suggest that obstructive sleep apnea, but not gastroesophageal reflux disease may contribute significantly to poor asthma control in obese patients. PMID:21819338

A Complex Interplay among the Parent-Child Relationship, Effortful Control, and Internalized, Rule-Compatible Conduct in Young Children: Evidence from Two Studies

ERIC Educational Resources Information Center

Kochanska, Grazyna; Kim, Sanghag

2014-01-01

We propose a model linking the early parent-child mutually responsive orientation (MRO), children's temperament trait of effortful control, and their internalization of conduct rules. In a developmental chain, effortful control was posited as a mediator of the links between MRO and children's internalization. MRO was further posited as a moderator…

Human immunization in developing countries: practical and theoretical problems and prospects.

PubMed

Arya, S C

1994-11-01

While measles, pertussis and tetanus were responsible during the early 1990s for nearly two million deaths in developing countries, no deaths were attributable to them in industrialized countries. More than 96% of global deaths by communicable diseases were also from developing countries. Respiratory infections ranked first in communicable morbidity at all ages. Even though vaccines of bacterial or viral origin or a prophylactic for passive immunization are produced in 24, 16 and 15 developing countries, respectively, none of the developing countries manufactures a plasma-derived prophylactic or biological response modifier. Nearly every country relies on import of one or more vaccines. The suboptimal performance of otherwise meritorious products has been due to faulty vaccine administration practices. Expanding populations, poverty and lack of education, cold-chain defects, and inadequate facilities for transport of vaccines to target populations in remote areas have been responsible for the poor performance of vaccines in the community. Mounting foreign debts and budgetary strains resulting from the care and prevention of AIDS/HIV have considerably strained national and international efforts to offer routine vaccinations in childhood and pregnancy. This dismal situation could be tackled through research to obtain environmentally stable products for prophylactic use and monoclonal antibody formulations for passive immunization, and through international financial and technical support. All countries should exercise some technical control of the quality of imported and indigenous vaccines during their use for curative or prophylactic purposes. The involvement of private clinicians in immunizations would strengthen national efforts for control of communicable diseases including AIDS, but this is not enough if the local factors cited above are not improved.

Adolescent emotionality and effortful control: Core latent constructs and links to psychopathology and functioning

PubMed Central

Snyder, Hannah R.; Gulley, Lauren D.; Bijttebier, Patricia; Hartman, Catharina A.; Oldehinkel, Albertine J.; Mezulis, Amy; Young, Jami F.; Hankin, Benjamin L.

2015-01-01

Temperament is associated with important outcomes in adolescence, including academic and interpersonal functioning and psychopathology. Rothbart’s temperament model is among the most well-studied and supported approaches to adolescent temperament, and contains three main components: positive emotionality (PE), negative emotionality (NE), and effortful control (EC). However, the latent factor structure of Rothbart’s temperament measure for adolescents, the Early Adolescent Temperament Questionnaire Revised (EATQ-R, Ellis & Rothbart, 2001) has not been definitively established. To address this problem and investigate links between adolescent temperament and functioning, we used confirmatory factor analysis to examine the latent constructs of the EATQ-R in a large combined sample. For EC and NE, bifactor models consisting of a common factor plus specific factors for some sub-facets of each component fit best, providing a more nuanced understanding of these temperament dimensions. The nature of the PE construct in the EATQ-R is less clear. Models replicated in a hold-out dataset. The common components of high NE and low EC where broadly associated with increased psychopathology symptoms, and poor interpersonal and school functioning, while specific components of NE were further associated with corresponding specific components of psychopathology. Further questioning the construct validity of PE as measured by the EATQ-R, PE factors did not correlate with construct validity measures in a way consistent with theories of PE. Bringing consistency to the way the EATQ-R is modeled and using purer latent variables has the potential to advance the field in understanding links between dimensions of temperament and important outcomes of adolescent development. PMID:26011660

Adolescent emotionality and effortful control: Core latent constructs and links to psychopathology and functioning.

PubMed

Snyder, Hannah R; Gulley, Lauren D; Bijttebier, Patricia; Hartman, Catharina A; Oldehinkel, Albertine J; Mezulis, Amy; Young, Jami F; Hankin, Benjamin L

2015-12-01

Temperament is associated with important outcomes in adolescence, including academic and interpersonal functioning and psychopathology. Rothbart's temperament model is among the most well-studied and supported approaches to adolescent temperament, and contains 3 main components: positive emotionality (PE), negative emotionality (NE), and effortful control (EC). However, the latent factor structure of Rothbart's temperament measure for adolescents, the Early Adolescent Temperament Questionnaire Revised (EATQ-R; Ellis & Rothbart, 2001) has not been definitively established. To address this problem and investigate links between adolescent temperament and functioning, we used confirmatory factor analysis to examine the latent constructs of the EATQ-R in a large combined sample. For EC and NE, bifactor models consisting of a common factor plus specific factors for some subfacets of each component fit best, providing a more nuanced understanding of these temperament dimensions. The nature of the PE construct in the EATQ-R is less clear. Models replicated in a hold-out dataset. The common components of high NE and low EC where broadly associated with increased psychopathology symptoms, and poor interpersonal and school functioning, while specific components of NE were further associated with corresponding specific components of psychopathology. Further questioning the construct validity of PE as measured by the EATQ-R, PE factors did not correlate with construct validity measures in a way consistent with theories of PE. Bringing consistency to the way the EATQ-R is modeled and using purer latent variables has the potential to advance the field in understanding links between dimensions of temperament and important outcomes of adolescent development. (c) 2015 APA, all rights reserved).

Examining the Effect of Household Wealth and Migration Status on Safe Delivery Care in Urban India, 1992–2006

PubMed Central

Singh, Prashant Kumar; Rai, Rajesh Kumar; Singh, Lucky

2012-01-01

Background Although the urban health issue has been of long-standing interest to public health researchers, majority of the studies have looked upon the urban poor and migrants as distinct subgroups. Another concern is, whether being poor and at the same time migrant leads to a double disadvantage in the utilization of maternal health services? This study aims to examine the trends and factors that affect safe delivery care utilization among the migrants and the poor in urban India. Methodology/Principal Findings Using data from the National Family Health Survey, 1992–93 and 2005–06, this study grouped the household wealth and migration status into four distinct categories poor-migrant, poor-non migrant, non poor-migrant, non poor-non migrant. Both chi-square test and binary logistic regression were performed to examine the influence of household wealth and migration status on safe delivery care utilization among women who had experienced a birth in the four years preceding the survey. Results suggest a decline in safe delivery care among poor-migrant women during 1992–2006. The present study identifies two distinct groups in terms of safe delivery care utilization in urban India – one for poor-migrant and one for non poor-non migrants. While poor-migrant women were most vulnerable, non poor-non migrant women were the highest users of safe delivery care. Conclusion This study reiterates the inequality that underlies the utilization of maternal healthcare services not only by the urban poor but also by poor-migrant women, who deserve special attention. The ongoing programmatic efforts under the National Urban Health Mission should start focusing on the poorest of the poor groups such as poor-migrant women. Importantly, there should be continuous evaluation to examine the progress among target groups within urban areas. PMID:22970324

Characterization of reward and effort mechanisms in apathy

PubMed Central

Bonnelle, Valerie; Veromann, Kai-Riin; Burnett Heyes, Stephanie; Lo Sterzo, Elena; Manohar, Sanjay; Husain, Masud

2015-01-01

Apathy is a common but poorly understood condition with a wide societal impact observed in several brain disorders as well as, to some extent, in the normal population. Hence the need for better characterization of the underlying mechanisms. The processes by which individuals decide to attribute physical effort to obtain rewards might be particularly relevant to relate to apathy traits. Here, we designed two paradigms to assess individual differences in physical effort production and effort-based decision-making and their relation to apathy in healthy people. Apathy scores were measured using a modified version of the Lille Apathy Rating Scale, suitable for use in a non-clinical population. In the first study, apathy scores were correlated with the degree to which stake (reward on offer) and difficulty level impacts on physical effort production. Individuals with relatively high apathy traits showed an increased modulation of effort while more motivated individuals generally exerted greater force across different levels of stake. To clarify the underlying mechanisms for this behavior, we designed a second task that allows independent titration of stake and effort levels for which subjects are willing to engage in an effortful response to obtain a reward. Our results suggest that apathy traits in the normal population are related to the way reward subjectively affects the estimation of effort costs, and more particularly manifest as decreased willingness to exert effort when rewards are small, or below threshold. The tasks we introduce here may provide useful tools to further investigate apathy in clinical populations. PMID:24747776

The Effect of Tinnitus on Listening Effort in Normal-Hearing Young Adults: A Preliminary Study.

PubMed

Degeest, Sofie; Keppler, Hannah; Corthals, Paul

2017-04-14

The objective of this study was to investigate the effect of chronic tinnitus on listening effort. Thirteen normal-hearing young adults with chronic tinnitus were matched with a control group for age, gender, hearing thresholds, and educational level. A dual-task paradigm was used to evaluate listening effort in different listening conditions. A primary speech-recognition task and a secondary memory task were performed both separately and simultaneously. Furthermore, subjective listening effort was questioned for various listening situations. The Tinnitus Handicap Inventory was used to control for tinnitus handicap. Listening effort significantly increased in the tinnitus group across listening conditions. There was no significant difference in listening effort between listening conditions, nor was there an interaction between groups and listening conditions. Subjective listening effort did not significantly differ between both groups. This study is a first exploration of listening effort in normal-hearing participants with chronic tinnitus showing that listening effort is increased as compared with a control group. There is a need to further investigate the cognitive functions important for speech understanding and their possible relation with the presence of tinnitus and listening effort.

An improved design of electrodes for measurement of streaming potentials on wet bone in vitro and in vivo.

PubMed

Cochran, G V; Dell, D G; Palmieri, V R; Johnson, M W; Otter, M W; Kadaba, M P

1989-01-01

Streaming potentials are generated by mechanical stress in wet bone and may constitute a control mechanism for bone remodeling. Measurement of streaming potentials in bone has attracted considerable effort in past years but quantitative studies have been hampered by relatively poor repeatability when using Ag.AgCl electrodes which contact bone via a wick moistened with electrolyte. Improvement now has been achieved with an electrode design that limits the specific area of contact of an agar/salt bridge by means of a silastic seal, thus permitting the same equipotential surface to be contacted for each set of measurements. This reduces variations caused by bone structure and impedance, and facilitates quantitative comparisons of the response of bone samples to selected variables. The new design also permits considerable qualitative improvement in recordings made from bone during locomotor function in experimental animals in vivo.

Long-term trends in midwestern milkweed abundances and their relevance to monarch butterfly declines

USGS Publications Warehouse

Zaya, David N.; Pearse, Ian; Spyreas, Gregory

2017-01-01

Declines in monarch butterfly populations have prompted investigation into the sensitivity of their milkweed host plants to land-use change. Documented declines in milkweed abundance in croplands have spurred efforts to promote milkweeds in other habitats. Nevertheless, our current understanding of milkweed populations is poor. We used a long-term plant survey from Illinois to evaluate whether trends in milkweed abundance have caused monarch decline and to highlight the habitat-management practices that promote milkweeds. Milkweed abundance in natural areas has not declined precipitously, although when croplands are considered, changes in agricultural weed management have led to a 68% loss of milkweed available for monarchs across the region. Midsuccessional plant communities with few invasive species provide optimal milkweed habitat. The augmentation of natural areas and the management of existing grasslands, such as less frequent mowing and woody- and exotic-species control, may replace some of the milkweed that has been lost from croplands.

Stability of Chitosan—A Challenge for Pharmaceutical and Biomedical Applications

PubMed Central

Szymańska, Emilia; Winnicka, Katarzyna

2015-01-01

Chitosan—one of the natural multifunctional polymers—due to its unique and versatile biological properties is regarded as a useful compound in medical and pharmaceutical technology. Recently, considerable research effort has been made in order to develop safe and efficient chitosan products. However, the problem of poor stability of chitosan-based systems restricts its practical applicability; thus, it has become a great challenge to establish sufficient shelf-life for chitosan formulations. Improved stability can be assessed by controlling the environmental factors, manipulating processing conditions (e.g., temperature), introducing a proper stabilizing compound, developing chitosan blends with another polymer, or modifying the chitosan structure using chemical or ionic agents. This review covers the influence of internal, environmental, and processing factors on the long-term stability of chitosan products. The aim of this paper is also to highlight the latest developments which enable the physicochemical properties of chitosan-based applications to be preserved upon storage. PMID:25837983

The influence of bacteria on multitrophic interactions among plants, psyllids, and pathogen.

PubMed

Tamborindeguy, Cecilia; Huot, Ordom Brian; Ibanez, Freddy; Levy, Julien

2017-12-01

The recent emergence of several plant diseases caused by psyllid-borne bacterial pathogens worldwide (Candidatus Liberibacter spp.) has created renewed interest on the interaction between psyllids and bacteria. In spite of these efforts to understand psyllid association with bacteria, many aspects of their interactions remain poorly understood. As more organisms are studied, subtleties on the molecular interactions as well as on the effects of the bacteria on the psyllid host are being uncovered. Additionally, psyllid-borne bacterial phytopathogens can also affect the host plant, which in turn can impact psyllid physiology and behavior. Here, we review the current literature on different aspects of the influence of bacteria on multitrophic interactions among plants, psyllids, and pathogens. We then highlight gaps that need to be addressed to advance this field, which can have significant implications for controlling these newly emergent and other plant diseases. © 2017 Institute of Zoology, Chinese Academy of Sciences.

Evaluation of fuzzy inference systems using fuzzy least squares

NASA Technical Reports Server (NTRS)

Barone, Joseph M.

1992-01-01

Efforts to develop evaluation methods for fuzzy inference systems which are not based on crisp, quantitative data or processes (i.e., where the phenomenon the system is built to describe or control is inherently fuzzy) are just beginning. This paper suggests that the method of fuzzy least squares can be used to perform such evaluations. Regressing the desired outputs onto the inferred outputs can provide both global and local measures of success. The global measures have some value in an absolute sense, but they are particularly useful when competing solutions (e.g., different numbers of rules, different fuzzy input partitions) are being compared. The local measure described here can be used to identify specific areas of poor fit where special measures (e.g., the use of emphatic or suppressive rules) can be applied. Several examples are discussed which illustrate the applicability of the method as an evaluation tool.

Lessons Learned during Public Health Response to Cholera Epidemic in Haiti and the Dominican Republic

PubMed Central

Tappero, Jordan W.

2011-01-01

After epidemic cholera emerged in Haiti in October 2010, the disease spread rapidly in a country devastated by an earthquake earlier that year, in a population with a high proportion of infant deaths, poor nutrition, and frequent infectious diseases such as HIV infection, tuberculosis, and malaria. Many nations, multinational agencies, and nongovernmental organizations rapidly mobilized to assist Haiti. The US government provided emergency response through the Office of Foreign Disaster Assistance of the US Agency for International Development and the Centers for Disease Control and Prevention. This report summarizes the participation by the Centers and its partners. The efforts needed to reduce the spread of the epidemic and prevent deaths highlight the need for safe drinking water and basic medical care in such difficult circumstances and the need for rebuilding water, sanitation, and public health systems to prevent future epidemics. PMID:22099111

Tuberculosis outbreak investigation of a U.S. Navy amphibious ship crew and the Marine expeditionary unit aboard, 1998.

PubMed

Lamar, James E; Malakooti, Mark A

2003-07-01

A Marine deployed aboard a U.S. Navy amphibious ship had smear-positive, cavitary pulmonary tuberculosis (TB). Contact investigation ultimately found 21 active cases of TB among sailors and Marines who were aboard the affected ship. Approximately 3 months lapsed between onset of the source patient's illness and appropriate diagnosis and treatment. During the contact investigation, 3,338 persons received tuberculin skin tests and 712 were identified as new latent tuberculosis infection cases. Four persons diagnosed with latent tuberculosis infection developed active TB because of poor compliance with treatment. After personnel disembarked from the ship, persistent efforts to identify persons with active disease and latent infections were successful in controlling further spread of tuberculosis in military units and local communities. The Mycobacterium tuberculosis bacteria isolated from the source patient and 16 of the other active cases were susceptible to all drugs commonly used to treat TB.

Women's knowledge in Madagascar: a health needs assessment study.

PubMed

Dell, Evelyn M; Erikson, S L; Andrianirina, E; Smith, Gabrielle

2012-01-01

Nutritional and hygienic practices contribute to high morbidity and mortality rates related to malnutrition in Madagascar. This study, a research effort that brought together charitable organisations, non-governmental organisations (NGOs) and university collaborators, investigates women's health knowledge in the Anosy region of Madagascar. The needs assessment sought to characterise women's knowledge and understanding of nutrition and hygiene. Eight focus groups of 13-60 women each were conducted in the seven most impoverished communes of the Anosy region (n=373). Participants were recruited with the aid of a UK-Malagasy partnered NGO, Azafady. Study findings show that women fully understand the interplay between poor nutrition, hygiene and malnutrition but are unable to change everyday practices because the barriers to better nutrition and hygiene seem beyond their control. These findings may be used to prioritise projects and research seeking to improve nutrition and hygiene, thus reducing malnutrition in the Anosy region.

Treatment of hyperglycaemia in patients with acute stroke.

PubMed

Castilla-Guerra, L; Fernández-Moreno, M C; Hewitt, J

2016-03-01

The proportion of diabetic patients who are hospitalised for stroke has been increasing in recent years, currently reaching almost a third of all cases of stroke. In addition, about half of patients with acute stroke present hyperglycaemia in the first hours of the stroke. Although hyperglycaemia in the acute phase of stroke is associated with a poor prognosis, its treatment is currently a topic of debate. There is no evidence that the adminstration of intravenous insulin to these patients offers benefits in terms of the evolution of the stroke. New studies in development, such as the SHINE study (Stroke Hyperglycemia Insulin Network Effort), may contribute to clarifying the role of intensive control of glycaemia during the acute phase of the stroke. Ultimately, patients who have presented with stroke should be screened for diabetes. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Health programs at risk in wake of '84 election.

PubMed

Iglehart, J K

1985-01-01

President Ronald Reagan's reelection suggests that government will continue to promote policies that favor marketplace allocation of medical care resources and that it will continue to cut social welfare programs, particularly health programs for the elderly and the poor. Unlike previous administrations, which focused on controlling private and public health care costs, President Reagan has targeted Medicare and Medicaid expenditures--a policy which has caused substantial cost shifting to underwrite hospitals' uncompensated and undercompensated care. Physician payment policies likely will receive the greatest attention in spending reduction efforts. Congress, as it showed in the president's first term, can cut spending sharply. Its task, however, has been complicated by the president's campaign declaration that defense spending and Social Security benefits were off-limits. Expected to lead health care debate on Capitol Hill are Sens. Albert Gore, Jr., D-TN, and Phil Gramm, R-TX, and Rep. James Jones, D-OK.

Developmental course of impulsivity and capability from age 10 to age 25 as related to trajectory of suicide attempt in a community cohort.

PubMed

Kasen, Stephanie; Cohen, Patricia; Chen, Henian

2011-04-01

Hierarchical linear models were used to examine trajectories of impulsivity and capability between ages 10 and 25 in relation to suicide attempt in 770 youths followed longitudinally: intercepts were set at age 17. The impulsivity measure assessed features of urgency (e.g., poor control, quick provocation, and disregard for external constraints); the capability measure assessed aspects of self-esteem and mastery. Compared to nonattempters, attempters reported significantly higher impulsivity levels with less age-related decline, and significantly lower capability levels with less age-related increase. Independent of other risks, suicide attempt was related significantly to higher impulsivity between ages 10 and 25, especially during the younger years, and lower capability. Implications of those findings for further suicidal behavior and preventive/intervention efforts are discussed. © 2011 The American Association of Suicidology.

The Impact of Consumer Numeracy on the Purchase of Long-Term Care Insurance.

PubMed

McGarry, Brian E; Temkin-Greener, Helena; Chapman, Benjamin P; Grabowski, David C; Li, Yue

2016-08-01

To determine the effect of consumers' numeric abilities on the likelihood of owning private long-term care insurance. The 2010 wave of the Health and Retirement Study, a nationally representative survey of Americans age 50 and older, was used (n = 12,796). Multivariate logistic regression was used to isolate the relationship between numeracy and long-term care insurance ownership. Each additional question answered correctly on a numeracy scale was associated with a 13 percent increase in the likelihood of holding LTCI, after controlling for predictors of policy demand, education, and cognitive function. Poor numeracy may create barriers to long-term care insurance purchase. Policy efforts aimed at increasing consumer decision support or restructuring the marketplace for long-term care insurance may be needed to increase older adults' ability to prepare for future long-term care expenses. © Health Research and Educational Trust.

Multidrug-resistant tuberculosis/rifampicin-resistant tuberculosis: Principles of management

PubMed Central

Prasad, Rajendra; Gupta, Nikhil; Banka, Amitabh

2018-01-01

Multidrug-resistant tuberculosis (MDR-TB)/rifampicin-resistant TB (RR-TB) is human-made problem and emerging due to poor management of TB and is a threat to control of TB. Early suspicion and diagnosis are important. Culture and drug susceptibility testing are gold standards, but newer molecular methods help in rapid diagnosis. Once diagnosed, prompt treatment should be started, preferably under direct observation. Treatment can be standardized or individualized. Conventional regimen takes up to 24 months but recently shorter regimen of up to 12 months was introduced in specific subset of MDR-TB/RR-TB patients. Management of MDR-TB/RR-TB is complicated, costlier, and challenging and is a concern for human health worldwide. It must be emphasized that optimal treatment of MDR-TB/RR-TB alone is not sufficient. Efforts must be made to ensure effective use of first- and second-line anti-TB drugs. PMID:29319042

Multidrug-resistant tuberculosis/rifampicin-resistant tuberculosis: Principles of management.

PubMed

Prasad, Rajendra; Gupta, Nikhil; Banka, Amitabh

2018-01-01

Multidrug-resistant tuberculosis (MDR-TB)/rifampicin-resistant TB (RR-TB) is human-made problem and emerging due to poor management of TB and is a threat to control of TB. Early suspicion and diagnosis are important. Culture and drug susceptibility testing are gold standards, but newer molecular methods help in rapid diagnosis. Once diagnosed, prompt treatment should be started, preferably under direct observation. Treatment can be standardized or individualized. Conventional regimen takes up to 24 months but recently shorter regimen of up to 12 months was introduced in specific subset of MDR-TB/RR-TB patients. Management of MDR-TB/RR-TB is complicated, costlier, and challenging and is a concern for human health worldwide. It must be emphasized that optimal treatment of MDR-TB/RR-TB alone is not sufficient. Efforts must be made to ensure effective use of first- and second-line anti-TB drugs.

Interference control in working memory: comparing groups of children with atypical development.

PubMed

Palladino, Paola; Ferrari, Marcella

2013-01-01

The study aimed to test whether working memory deficits in children at risk of Learning Disabilities (LD) and/or attention deficit/hyperactivity disorder (ADHD) can be attributed to deficits in interference control, thereby implicating prefrontal systems. Two groups of children known for showing poor working memory (i.e., children with poor comprehension and children with ADHD) were compared to a group of children with specific reading decoding problems (i.e., having severe problems in phonological rather than working memory) and to a control group. All children were tested with a verbal working memory task. Interference control of irrelevant items was examined by a lexical decision task presented immediately after the final recall in about half the trials, selected at random. The interference control measure was therefore directly related to working memory performance. Results confirmed deficient working memory performance in poor comprehenders and children at risk of ADHD + LD. More interestingly, this working memory deficit was associated with greater activation of irrelevant information than in the control group. Poor decoders showed more efficient interference control, in contrast to poor comprehenders and ADHD + LD children. These results indicated that interfering items were still highly accessible to working memory in children who fail the working memory task. In turn, these findings strengthen and clarify the role of interference control, one of the most critical prefrontal functions, in working memory.

Follow up observationes of extremely metal-poor stars identified from SDSS and LAMOST

NASA Astrophysics Data System (ADS)

Aguado, David; Allende Prieto, Carlos; González Hernández, Jonay I.; Rebolo, Rafael

2017-06-01

The most metal-poor stars in the Milky Way witnessed the early phases of formation of the Galaxy, and have chemical compositions close to the pristine mixture from Big Bang nucleosynthesis, polluted by one or very few supernovae. Here we present a program to search for and characterize new ultra metal-poor stars in the Galactic halo. These stars are extremely rare; despite significant efforts, only a handful of stars have been identified with a metallicity [Fe/H]< -5. We select candidates from SDSS and LAMOST. Dozens of them have already been observed with the ISIS spectrograph on the 4.2 m William Herschel Telescope. The most interesting objects have been confirmed with OSIRIS on the 10.4m-GTC and HRS on the 9.2 m HET. Our analysis is highly automated, and based on the FERRE code. We report the discovery of a new carbon-rich ultra metal-poor (CRUMP) dwarf star at [Fe/H]~ -5.8 with an extreme carbon over-abundance [C/Fe]~ +5.0.

Attention Control, Memory Updating, and Emotion Regulation Temporarily Reduce the Capacity for Executive Control

ERIC Educational Resources Information Center

Schmeichel, Brandon J.

2007-01-01

This research tested the hypothesis that initial efforts at executive control temporarily undermine subsequent efforts at executive control. Four experiments revealed that controlling the focus of visual attention (Experiment 1), inhibiting predominant writing tendencies (Experiment 2), taking a working memory test (Experiment 3), or exaggerating…

Components of Effortful Control and Their Relations to Children's Shyness

ERIC Educational Resources Information Center

Eggum-Wilkens, Natalie D.; Reichenberg, Ray E.; Eisenberg, Nancy; Spinrad, Tracy L.

2016-01-01

Relations between children's (n = 213) mother-reported effortful control components (attention focusing, attention shifting, inhibitory control at 42 months; activational control at 72 months) and mother-reported shyness trajectories across 42, 54, 72, and 84 months of age were examined. In growth models, shyness decreased. Inhibitory control and…

What predicts dissemination efforts among public health researchers in the United States?

PubMed

Tabak, Rachel G; Stamatakis, Katherine A; Jacobs, Julie A; Brownson, Ross C

2014-01-01

We identified factors related to dissemination efforts by researchers to non-research audiences to reduce the gap between research generation and uptake in public health practice. We conducted a cross-sectional study of 266 researchers at universities, the National Institutes of Health (NIH), and CDC. We identified scientists using a search of public health journals and lists from government-sponsored research. The scientists completed a 35-item online survey in 2012. Using multivariable logistic regression, we compared self-rated effort to disseminate findings to non-research audiences (excellent/good vs. poor) across predictor variables in three categories: perceptions or reasons to disseminate, perceived expectation by employer/funders, and professional training and experience. One-third of researchers rated their dissemination efforts as poor. Many factors were significantly related to whether a researcher rated him/herself as excellent/good, including obligation to disseminate findings (odds ratio [OR] = 2.7, 95% confidence interval [CI] 1.1, 6.8), dissemination important for their department (OR=2.3, 95% CI 1.2, 4.5), dissemination expected by employer (OR=2.0, 95% CI 1.2, 3.2) or by funder (OR=2.1, 95% CI 1.3, 3.2), previous work in a practice/policy setting (OR=4.4, 95% CI 2.1, 9.3), and university researchers with Prevention Research Center affiliation vs. NIH researchers (OR=4.7, 95% CI 1.4, 15.7). With all variables in the model, dissemination expected by funder (OR=2.0, 95% CI 1.2, 3.1) and previous work in a practice/policy setting (OR=3.5, OR 1.7, 7.1) remained significant. These findings support the need for structural changes to the system, including funding agency priorities and participation of researchers in practice- and policy-based experiences, which may enhance efforts to disseminate by researchers.

Multisystemic Therapy for Adolescents with Poorly Controlled Type I Diabetes: Stability of Treatment Effects in a Randomized Controlled Trial

ERIC Educational Resources Information Center

Ellis, Deborah A.; Templin, Thomas; Naar-King, Sylvie; Frey, Maureen A.; Cunningham, Phillippe B.; Podolski, Cheryl-Lynn; Cakan, Nedim

2007-01-01

The primary purpose of the present study was to determine whether multisystemic therapy (MST), an intensive, home-based psychotherapy, improved regimen adherence, metabolic control, and rates of hospitalization for diabetic ketoacidosis (DKA) among adolescents with chronically poorly controlled Type 1 diabetes 6 months after the completion of…