Primary Tumor Thickness is a Prognostic Factor in Stage IV Melanoma: A Retrospective Study of Primary Tumor Characteristics.

PubMed

Luen, Stephen; Wong, Siew Wei; Mar, Victoria; Kelly, John W; McLean, Catriona; McArthur, Grant A; Haydon, Andrew

2018-01-01

Stage IV melanoma exhibits a diverse range of tumor biology from indolent to aggressive disease. Many important prognostic factors have already been identified. Despite this, the behavior of metastatic melanoma remains difficult to predict. We sought to determine if any primary tumor characteristics affect survival following the diagnosis of stage IV melanoma. All patients diagnosed with stage IV melanoma between January 2003 and December 2012 were identified from the Victorian Melanoma Service database. Retrospective chart review was performed to collect data on primary tumor characteristics (thickness, ulceration, mitotic rate, melanoma subtype, or occult primary). Known and suspected prognostic factors were additionally collected (time to diagnosis of stage IV disease, age, sex, stage, receipt of chemotherapy, and era of recurrence). The effect of primary tumor characteristics on overall survival from the date of diagnosis of stage IV disease was assessed. A total of 227 patients with a median follow-up of 5 years from diagnosis of stage IV disease were identified. Median overall survival of the cohort was 250 days.Of the primary tumor characteristics assessed, only tumor thickness affected survival from diagnosis of stage IV disease, hazard ratio=1.09 (1.02 to 1.16), P=0.008. This remained significant in multivariate analysis, P=0.007. Other primary tumor characteristics did not significantly influence survival. Primary tumor thickness is a significant prognostic factor in stage IV melanoma. Our data suggest that the biology of the primary melanoma may persist to influence the behavior of metastatic disease.

Effect of day of the week of primary total hip arthroplasty on length of stay at a university-based teaching medical center.

PubMed

Rathi, Pranav; Coleman, Sheldon; Durbin-Johnson, Blythe; Giordani, Mauro; Pereira, Gavin; Di Cesare, Paul E

2014-12-01

Length of hospital stay (LHS) after primary total hip arthroplasty (THA) constitutes a critical outcome measure, as prolonged LHS implies increased resource expenditure. Investigations have highlighted factors that affect LHS after THA. These factors include advanced age, medical comorbidities, obesity, intraoperative time, anesthesia technique, surgical site infection, and incision length. We retrospectively analyzed the effect of day of the week of primary THA on LHS. We reviewed the surgery and patient factors of 273 consecutive patients who underwent THA at our institution, a tertiary-care teaching hospital. There was a 15% increase in LHS for patients who underwent THA on Thursday versus Monday when controlling for other covariates that can affect LHS. Other statistically significant variables associated with increased LHS included American Society of Anesthesiologists grade, transfusion requirements, and postoperative complications. The day of the week of THA may be an independent variable affecting LHS. Institutions with reduced weekend resources may want to perform THA earlier in the week to try to reduce LHS.

Effect of Day of the Week of Primary Total Hip Arthroplasty on Length of Stay at a University-Based Teaching Medical Center

PubMed Central

Rathi, Pranav; Coleman, Sheldon; Durbin-Johnson, Blythe; Giordani, Mauro; Pereira, Gavin; Di Cesare, Paul E.

2016-01-01

Length of hospital stay (LHS) after primary total hip arthroplasty (THA) constitutes a critical outcome measure, as prolonged LHS implies increased resource expenditure. Investigations have highlighted factors that affect LHS after THA. These factors include advanced age, medical comorbidities, obesity, intraoperative time, anesthesia technique, surgical site infection, and incision length. We retrospectively analyzed the effect of day of the week of primary THA on LHS. We reviewed the surgery and patient factors of 273 consecutive patients who underwent THA at our institution, a tertiary-care teaching hospital. There was a 15% increase in LHS for patients who underwent THA on Thursday versus Monday when controlling for other covariates that can affect LHS. Other statistically significant variables associated with increased LHS included American Society of Anesthesiologists grade, transfusion requirements, and post-operative complications. The day of the week of THA may be an independent variable affecting LHS. Institutions with reduced weekend resources may want to perform THA earlier in the week to try to reduce LHS. PMID:25490016

Predictors of pre- and post-competition affective states in male martial artists: a multilevel interactional approach

PubMed Central

Cerin, E; Barnett, A

2011-01-01

The aims of this study were to examine (a) the effects of competition-related and competition-extraneous concerns on affective states; (b) the relationships of primary and secondary appraisal with affective states and (c) the main and moderating effects of personality traits on pre- and post-competition affects. Thirty-nine male elite martial artists were assessed on 12 affective states, concerns and dimensions of primary and secondary appraisal at five random times a day across 1 week before and 3 days after a competition. On the competition day, they were assessed 1 h before and immediately after the contest. Competitive trait anxiety, neuroticism and extraversion were measured at the start of the study. The competition was the most significant and stressful event experienced in the examined period and had a pervasive influence on athletes' affective states. All examined appraisal and personality factors were somewhat associated with pre- and post-competition affective states. Competitive trait anxiety was a key moderator of the relationship between cognitive appraisal and affective states. This study supports the idea that cognitive appraisal and situational and personality factors exert main and interactive effects on athletes' pre- and post-competition affects. These factors need to be accounted for in planning of emotion regulation interventions. PMID:19883381

An investigation of factors related to the use of respite care services for children with severe motor and intellectual disabilities (SMID) living at home in Japan.

PubMed

Nishigaki, Kaori; Yoneyama, Akira; Ishii, Mitsuko; Kamibeppu, Kiyoko

2017-03-01

Limited time away from the child is cited as the main factor that increases the burden for the primary caregiver of severely disabled children. The aim of this study was to quantitatively elucidate the factors related to the desire to use social services and the actual use of respite care services by the primary caregivers of severely disabled children in Japan. In this study, we investigated the use of respite care services in accordance with the primary caregivers' wishes by examining inhibiting or promoting factors associated with respite care service use only among those who wished to use social services. A total of 169 Japanese mothers participated and answered the questionnaires. We conducted a logistic regression analysis and a multiple regression analysis to investigate the factors related to respite care service use. The most important factors affecting a primary caregiver's desire to use social services were the belief that the child would enjoy using social services and the family's approval of the social service use. The most important factors affecting respite care service use were the family's approval of the use and a large care burden on the primary caregiver. Respite care services should be sought out before the care burden becomes too great to enable the primary caregiver to more easily contribute to the continuation of home care. A background of mother-child separation anxiety disrupted the use of respite care. However, believing that the child enjoys using social services may reduce primary caregivers' psychological resistance to being separated from their child, which is supported by tradition. Thus, it is also important for respite care service providers to provide information about the children to their primary caregivers and families while they are using respite care services. © 2016 John Wiley & Sons Ltd.

Barriers and facilitators for the implementation of primary prevention and health promotion activities in primary care: a synthesis through meta-ethnography.

PubMed

Rubio-Valera, Maria; Pons-Vigués, Mariona; Martínez-Andrés, María; Moreno-Peral, Patricia; Berenguera, Anna; Fernández, Ana

2014-01-01

Evidence supports the implementation of primary prevention and health promotion (PP&HP) activities but primary care (PC) professionals show resistance to implementing these activities. The aim was to synthesize the available qualitative research on barriers and facilitators identified by PC physicians and nurses in the implementation of PP&HP in adults. A systematic search of three databases was conducted and supported by manual searches. The 35 articles included were translated into each other and a new interpretation of the concepts extracted was generated. The factors affecting the implementation of PP&HP activities in PC according to professionals were fitted into a five-level ecological model: intrapersonal factors, interpersonal processes, institutional factors, community factors and public policy. At the intrapersonal level we find professionals' beliefs about PP&HP, experiences, skills and knowledge, and selfconcept. The attitudes and behavior towards PP&HP of patients, specialists, practice managers and colleagues (interpersonal factors) affect the feasibility of implementing PP&HP. Institutional level: PC is perceived as well-placed to implement PP&HP but workload, lack of time and referral resources, and the predominance of the biomedical model (which prioritizes disease treatment) hamper the implementation of PP&HP. The effectiveness of financial incentives and tools such as guidelines and alarms/reminders is conditioned by professionals' attitudes to them. Community factors include patients' social and cultural characteristics (religion, financial resources, etc.), local referral resources, mass-media messages and pharmaceutical industry campaigns, and the importance given to PP&HP in the curriculum in university. Finally, policies affect the distribution of resources, thus affecting the implementation of PP&HP. Research on barriers and facilitators in the implementation of PP&HP activities in multirisk management is scarce. The conceptual overview provided by this synthesis resulted in the development of practical recommendations for the design of PP&HP in PC. However, the effectiveness of these recommendations needs to be demonstrated.

Barriers and Facilitators for the Implementation of Primary Prevention and Health Promotion Activities in Primary Care: A Synthesis through Meta-Ethnography

PubMed Central

Rubio-Valera, Maria; Pons-Vigués, Mariona; Martínez-Andrés, María; Moreno-Peral, Patricia; Berenguera, Anna; Fernández, Ana

2014-01-01

Background Evidence supports the implementation of primary prevention and health promotion (PP&HP) activities but primary care (PC) professionals show resistance to implementing these activities. The aim was to synthesize the available qualitative research on barriers and facilitators identified by PC physicians and nurses in the implementation of PP&HP in adults. Methods and Findings A systematic search of three databases was conducted and supported by manual searches. The 35 articles included were translated into each other and a new interpretation of the concepts extracted was generated. The factors affecting the implementation of PP&HP activities in PC according to professionals were fitted into a five-level ecological model: intrapersonal factors, interpersonal processes, institutional factors, community factors and public policy. At the intrapersonal level we find professionals' beliefs about PP&HP, experiences, skills and knowledge, and selfconcept. The attitudes and behavior towards PP&HP of patients, specialists, practice managers and colleagues (interpersonal factors) affect the feasibility of implementing PP&HP. Institutional level: PC is perceived as well-placed to implement PP&HP but workload, lack of time and referral resources, and the predominance of the biomedical model (which prioritizes disease treatment) hamper the implementation of PP&HP. The effectiveness of financial incentives and tools such as guidelines and alarms/reminders is conditioned by professionals' attitudes to them. Community factors include patients' social and cultural characteristics (religion, financial resources, etc.), local referral resources, mass-media messages and pharmaceutical industry campaigns, and the importance given to PP&HP in the curriculum in university. Finally, policies affect the distribution of resources, thus affecting the implementation of PP&HP. Conclusions Research on barriers and facilitators in the implementation of PP&HP activities in multirisk management is scarce. The conceptual overview provided by this synthesis resulted in the development of practical recommendations for the design of PP&HP in PC. However, the effectiveness of these recommendations needs to be demonstrated. PMID:24586867

Early Childhood Caries: A Review.

PubMed

Alazmah, Abdulfatah

2017-08-01

To review and update the current knowledge about early childhood caries (ECC) and its etiology, prevalence, risk factors, management, and preventive strategies. Early childhood caries is a disease affecting significantly both well-developed and industrial nations. The ECC can significantly affect the child's quality of life, as it may lead to infection, swelling, pain, and other symptoms. The ECC affects children after eruption of primary teeth until age of around 5 years. The ECC affects all parts of the tooth including the smooth surface. Upper anterior teeth and primary molars are usually affected. The lower anterior teeth are less likely affected. The risk factors for ECC are diet, bacteria, and host susceptibility. The additional factors, such as presence of enamel defect and the feeding practices also contribute to the initiation and progress of ECC. Dentists must focus on utilizing existing techniques to distinguish indications of right on time and propelled caries and give guidance on the best way to counteract and control caries in children. Approaches should be directed to preventive caries control strategies among children. Preventing and controlling the development of ECC among children is important to maintain effective eating, speech development, and formation of a positive self-image.

Factor structure of parent and teacher ratings of the ODD symptoms for Malaysian primary school children.

PubMed

Gomez, Rapson

2017-02-01

This present study used confirmatory factor analysis (CFA) to examine the applicability of one-, two- three- and second order Oppositional Defiant Disorder (ODD) factor models, proposed in previous studies, in a group of Malaysian primary school children. These models were primarily based on parent reports. In the current study, parent and teacher ratings of the ODD symptoms were obtained for 934 children. For both groups of respondents, the findings showing some support for all models examined, with most support for a second order model with Burke et al. (2010) three factors (oppositional, antagonistic, and negative affect) as the primary factors. The diagnostic implications of the findings are discussed. Copyright © 2016 Elsevier B.V. All rights reserved.

Regulatory Focus Affects Physician Risk Tolerance

PubMed Central

Veazie, Peter J.; McIntosh, Scott; Chapman, Benjamin P.; Dolan, James G.

2014-01-01

Risk tolerance is a source of variation in physician decision-making. This variation, if independent of clinical concerns, can result in mistaken utilization of health services. To address such problems, it will be helpful to identify nonclinical factors of risk tolerance, particularly those amendable to intervention – regulatory focus theory suggests such a factor. This study tested whether regulatory focus affects risk tolerance among primary care physicians. Twenty-seven primary care physicians were assigned to promotion-focused or prevention-focused manipulations and compared on the Risk Taking Attitudes in Medical Decision Making scale using a randomization test. Results provide evidence that physicians assigned to the promotion-focus manipulation adopted an attitude of greater risk tolerance than the physicians assigned to the prevention-focused manipulation (P=0.01). The Cohen’s d statistic was conventionally large at 0.92. Results imply that situational regulatory focus in primary care physicians affects risk tolerance and may thereby be a nonclinical source of practice variation. Results also provide marginal evidence that chronic regulatory focus is associated with risk tolerance (P=0.05), but the mechanism remains unclear. Research and intervention targeting physician risk tolerance may benefit by considering situational regulatory focus as an explanatory factor. PMID:25431799

Primary Care Providers' HIV Prevention Practices Among Older Adults

PubMed Central

Davis, Tracy; Teaster, Pamela B.; Thornton, Alice; Watkins, John F.; Alexander, Linda; Zanjani, Faika

2016-01-01

Purpose To explore primary care providers' HIV prevention practices for older adults. Primary care providers' perceptions and awareness were explored to understand factors that affect their provision of HIV prevention materials and HIV screening for older adults. Design and Method Data were collected through 24 semistructured interviews with primary care providers (i.e., physicians, physician assistants, and nurse practitioners) who see patients older than 50 years. Results Results reveal facilitators and barriers of HIV prevention for older adults among primary care providers and understanding of providers' HIV prevention practices and behaviors. Individual, patient, institutional, and societal factors influenced HIV prevention practices among participants, for example, provider training and work experience, lack of time, discomfort in discussing HIV/AIDS with older adults, stigma, and ageism were contributing factors. Furthermore, factors specific to primary and secondary HIV prevention were identified, for instance, the presence of sexually transmitted infections influenced providers' secondary prevention practices. Implications HIV disease, while preventable, is increasing among older adults. These findings inform future research and interventions aimed at increasing HIV prevention practices in primary care settings for patients older than 50. PMID:25736425

Association of general psychological factors with frequent attendance in primary care: a population-based cross-sectional observational study.

PubMed

Hajek, André; Bock, Jens-Oliver; König, Hans-Helmut

2017-03-24

Whereas several studies have examined the association between frequent attendance in primary care and illness-specific psychological factors, little is known about the relation between frequent attendance and general psychological factors. Thus, the aim of this study was to investigate the association between being a frequent attender in primary care and general psychological factors. Data were used from a large, population-based sample of community-dwelling individuals aged 40 and above in Germany in 2014 (n = 7,446). Positive and negative affect, life satisfaction, optimism, self-esteem, self-efficacy, and self-regulation were included as general psychological factors. The number of self-reported GP visits in the past twelve months was used to quantify frequency of attendance; individuals with more than 9 visits (highest decile) were defined as frequent attenders. Multiple logistic regressions showed that being a frequent attender was positively associated with less life satisfaction [OR: 0.79 (0.70-0.89)], higher negative affect [OR: 1.38 (1.17-1.62)], less self-efficacy [OR: 0.74 (0.63-0.86)], less self-esteem [OR: 0.65 (0.54-0.79)], less self-regulation [OR: 0.74 (0.60-0.91)], and higher perceived stress [OR: 1.46 (1.28-1.66)], after adjusting for sociodemographic factors, morbidity and lifestyle factors. However, frequent attendance was not significantly associated with positive affect and self-regulation. The present study highlights the association between general psychological factors and frequent attendance. As frequent GP visits produce high health care costs and are potentially associated with increased referrals and use of secondary health care services, this knowledge might help to address these individuals with high needs.

Implementing Cooperative Learning in Australian Primary Schools: Generalist Teachers' Perspectives

ERIC Educational Resources Information Center

Hennessey, Angela; Dionigi, Rylee A.

2013-01-01

To implement cooperative learning successfully in practice, teachers require knowledge of cooperative learning, its features and terms, and how it functions in classrooms. This qualitative study examined 12 Australian generalist primary teachers', understandings of cooperative learning and perceived factors affecting its implementation. Using…

Forecasting annual aboveground net primary production in the intermountain west

USDA-ARS?s Scientific Manuscript database

For many land manager’s annual aboveground net primary production, or plant growth, is a key factor affecting business success, profitability and each land manager's ability to successfully meet land management objectives. The strategy often utilized for forecasting plant growth is to assume every y...

A scoping review of the associations between mental health and factors related to HIV acquisition and disease progression in conflict-affected populations.

PubMed

Koegler, Erica; Kennedy, Caitlin E

2018-01-01

The association between poor mental health and factors related to HIV acquisition and disease progression (also referred to as HIV-related factors) may be stronger among conflict-affected populations given elevated rates of mental health disorders. We conducted a scoping review of the literature to identify evidence-based associations between mental health (depression, anxiety, and post-traumatic stress disorder [PTSD]) and factors related to HIV acquisition and progression in conflict-affected populations. Five electronic databases were searched on October 10, 2014 and updated on March 7, 2017 to identify peer-reviewed publications presenting primary data from January 1, 1994 to March 7, 2017. Articles were included if: 1) depression, anxiety, and/or PTSD was assessed using a validated scale, 2) HIV or HIV-related factors were a primary focus, 3) quantitative associations between depression/anxiety/PTSD and HIV or HIV-related factors were assessed, and 4) the study population was conflict-affected and from a conflict-affected setting. Of 714 citations identified, 33 articles covering 110,818 participants were included. Most were from sub-Saharan Africa ( n  = 25), five were from the USA, and one each was from the Middle East, Europe, and Latin America. There were 23 cross-sectional, 3 time-series, and 7 cohort studies. The search identified that mental health has been quantitatively associated with the following categories of HIV-related factors in conflict-affected populations: markers of HIV risk, HIV-related health status, sexual risk behaviors, and HIV risk exposures (i.e. sexual violence). Further, findings suggest that symptoms of poor mental health are associated with sexual risk behaviors and HIV markers, while HIV risk exposures and health status are associated with symptoms of poor mental health. Results suggest a role for greater integration and referrals across HIV and mental health programs for conflict-affected populations.

An Investigation of Factors Affecting Multi-Task Performance in an Immersive Environment

DTIC Science & Technology

2007-12-01

The general form of the MAACL-R was administered (appendix B; Zuckerman & Lubin, 1985). The MAACL-R consists of five primary subscales ( Anxiety ...or Negative Affect, is calculated by the addition of the Anxiety , Depression, and Hostility scores. The respondents were instructed to check all the...Activity, Aggression- Hostility, Sociability, Neuroticism- Anxiety , and Impulsive Risk Taking. This five-factor model is recommended for research

Prevalence of Primary Dysmenorrhea and Factors Associated with Its Intensity Among Undergraduate Students: A Cross-Sectional Study.

PubMed

Habibi, Nahal; Huang, Mary Soo Lee; Gan, Wan Ying; Zulida, Rejali; Safavi, Sayyed Morteza

2015-12-01

Primary dysmenorrhea is a womanhood problem around the world and negatively affects quality of life. This study was designed to investigate the prevalence of primary dysmenorrhea and to determine the factors associated with its intensity. A cross-sectional study was carried out among 311 undergraduate female students aged 18 to 27 years in Isfahan University of Medical Sciences, Iran. Socio-demographic characteristics and menstrual factors were obtained through interviews with the help of a pretested questionnaire. The prevalence of primary dysmenorrhea was 89.1%. Residing at home, younger age, lower number of years of formal education for the mother, positive family history of dysmenorrhea, higher severity of bleeding, and shorter menstrual period intervals were significantly associated with the higher intensity of primary dysmenorrhea. Primary dysmenorrhea is a common health concern among young women. Being aware of the factors that are associated with its intensity makes it possible for health professionals to organize better focused programs to reduce the adverse effects of dysmenorrhea. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

How do temperature and rainfall affect nitrous oxide emissions from open-lot beef cattle feedyard pens?

USDA-ARS?s Scientific Manuscript database

Temperature is a primary factor affecting greenhouse gas (GHG) emissions from agricultural soils, but little is known about how temperature affects nitrous oxide (N2O) emissions from manure. The majority of grain-fed cattle in the Texas Panhandle are finished in large, earthen-surfaced, open-lot fee...

Emerging Implications of Balancing Disinfection and Primary Treatment as an Element in CSO Control: Model Requirements. A presentation.

EPA Science Inventory

This paper describes early results and directions arising from ongoing research into factors that affect the preferred balance between primary treatment and disinfection in a conventional wastewater treatment plant during periods of wet weather overflow. Despite the fact that na...

Emerging Implications of Balancing Disinfection and Primary Treatment as an Element in CSO Control: Model Requirements

EPA Science Inventory

This paper describes early results and directions arising from ongoing research into factors that affect the preferred balance between primary treatment and disinfection in a conventional wastewater treatment plant during periods of wet weather overflow. Despite the fact that na...

Design Considerations for Construction of Rural Primary Schools.

ERIC Educational Resources Information Center

Siddiqui, Kalim A.; And Others

Widely differing local conditions, increased community participation in education, more lifelong education, and decentralization of schools are factors which should affect the architecture of rural primary schools in Pakistan. Also significant are the results of a 1977 survey which indicate that building quality is unrelated to school attendance…

Health system factors affecting communication with pediatricians: gendered work culture in primary care.

PubMed

Lynch, Sean

2011-01-01

This qualitative study examined the roles that practice setting, education level, and gender may play in social workers' communication satisfaction with pediatricians. Taking an ethnographic approach, the researcher interviewed social workers and pediatricians who worked together to provide mental health services in primary care. The results suggested that gender at the health system level may be an issue and that gendered work culture in primary care was a factor in communication. In particular, reimbursement, an aspect of the gendered work culture, was a substantial communication barrier, and the implications for Medicaid billing are discussed.

Suicide and occupation: further supportive evidence for their relevance.

PubMed

Nishimura, Mariko; Terao, Takeshi; Soeda, Shuji; Nakamura, Jun; Iwata, Noboru; Sakamoto, Kaoru

2004-01-01

In recent years, the relationship between occupation and suicide has been extensively investigated, but few definite conclusions regarding the nature of the relationship have been established. In the present study, this relationship was investigated by examining Japanese governmental statistics. First, correlations of suicide rate relative to industry categories were examined individually for primary industry (farmers, fishermen, and forest workers), secondary industry (construction workers, manufacture works, and miners), and tertiary industry (indoor workers) for all of the 47 prefectures of Japan. Second, in the industries that showed a significant correlation with suicide rate, the relationship to other factors was adjusted using possibly confounding factors. As a result, suicide rate was positively correlated with primary industry percentage, but not with secondary or tertiary industry percentages. Multiple regression analysis showed that suicide rate was positively associated with primary industry percentage with significant tendency while it was significantly and negatively associated with annual total sunshine. Limitations are that individual suicide rates according to occupational types were not available and direct correlations with the above variables could not be investigated. The present findings suggest a possibility that occupational factors associated with primary industry may be relevant to suicide, and that, additionally, annual total sunshine may affect suicide independently. Since workers with primary industry are likely to be exposed to sunshine than other workers, they may tend to be more affected by the decrease of annual total sunshine.

Short report: factors that affect specialty choice and career plans of Wisconsin's medical students.

PubMed

Knox, Kjersti E; Getzin, Anne; Bergum, Alison; McBride, Patrick; Rieselbach, Richard; Friedsam, Donna

2008-12-01

To identify factors that influence specialty choice among Wisconsin medical students and provide insight into approaches to encourage more students to pursue careers in primary care. The importance of several factors in medical student career choice was surveyed using a Web survey convenience sample of all Wisconsin medical students. Students intending to pursue a career in primary care and in other specialties were compared. Respondents, regardless of specialty choice or gender, identified a similar group of factors as highly influential, and similar group of factors as non-influential in their decision-making. However, significantly more primary care students than other specialty students considered interest in underserved populations, relationships with patients, scope of practice, and role models important in their career choice. Significantly more primary care students than other specialty students responded that salary and competitiveness were "not at all" important. A greater number of other specialty students than primary care students stated that interest in scope of practice, role models, and training years were "not at all" important. Debt-related factors were reported as "not at all" important by nearly one-third of respondents. Although primary care and other specialty students report making their career plans based on the impact of similar factors, significant differences between primary care and other specialty students were reported in key areas. These results validate many previously reported factors, and indicate that salary and years of training may have been overemphasized in understanding student career choice. The results of this survey may be useful for Wisconsin medical schools in order to sustain, support, and foster student interest in primary care.

Factors affecting caregivers' ability to make environmental modifications.

PubMed

Messecar, D C

2000-12-01

This study explored factors that family caregivers described as affecting their ability to use environmental modifications. Intensive interviews and participant observation were used to collect detailed data from 24 primary family caregivers. Several factors that affect the caregivers' ability to implement modification strategies were identified in the analysis. These factors included attributes of the elderly individual, attributes of the modification, quality of the caregiver-elderly relationship, caregivers' skills, personal resources of the caregiver, and the informal and formal supports available. Of these factors, the most important were the salient skills that caregivers need to implement environmental modifications. These findings point to the importance of caregivers receiving skills training in this important dimension of caregiving. Intervention should be based on a collaborative approach that ensures the caregiver and care receiver's needs and preferences are respected.

The brain's emotional foundations of human personality and the Affective Neuroscience Personality Scales.

PubMed

Davis, Kenneth L; Panksepp, Jaak

2011-10-01

Six of the primary-process subcortical brain emotion systems - SEEKING, RAGE, FEAR, CARE, GRIEF and PLAY - are presented as foundational for human personality development, and hence as a potentially novel template for personality assessment as in the Affective Neurosciences Personality Scales (ANPS), described here. The ANPS was conceptualized as a potential clinical research tool, which would help experimentalists and clinicians situate subjects and clients in primary-process affective space. These emotion systems are reviewed in the context of a multi-tiered framing of consciousness spanning from primary affect, which encodes biological valences, to higher level tertiary (thought mediated) processing. Supporting neuroscience research is presented along with comparisons to Cloninger's Temperament and Character Inventory and the Five Factor Model (FFM). Suggestions are made for grounding the internal structure of the FFM on the primal emotional systems recognized in affective neuroscience, which may promote substantive dialog between human and animal research traditions. Personality is viewed in the context of Darwinian "continuity" with the inherited subcortical brain emotion systems being foundational, providing major forces for personality development in both humans and animals, and providing an affective infrastructure for an expanded five factor descriptive model applying to normal and clinical human populations as well as mammals generally. Links with ontogenetic and epigenetic models of personality development are also presented. Potential novel clinical applications of the CARE maternal-nurturance system and the PLAY system are also discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.

Motivation among Public Primary School Teachers in Mauritius

ERIC Educational Resources Information Center

Seebaluck, Ashley Keshwar; Seegum, Trisha Devi

2013-01-01

Purpose: The purpose of this study was to critically analyse the factors that affect the motivation of public primary school teachers and also to investigate if there is any relationship between teacher motivation and job satisfaction in Mauritius. Design/methodology/approach: Simple random sampling method was used to collect data from 250 primary…

An Overview of Equal Educational Opportunities in Turkey: A Spatial Analysis of Classrooms in Rural and Urban Primary Schools

ERIC Educational Resources Information Center

Gökçe, Nazli; Kaya, Erdogan; Aktas, Semra Günay; Kantar, Yeliz Mert

2017-01-01

The number of students in a class is a primary factor affecting the quality of education. Therefore, this study examines the distribution of the number of students per class in rural and urban primary schools in Turkey, and efforts have been made to specify classroom needs. Statistical data was obtained from the Turkish Institute of Statistics and…

Variability in pesticides residues--the US experience.

PubMed

Suhre, F B

2000-07-01

The evolution of US Environmental Protection Agency's (EPA) process for estimating potential health risks from pesticide residues in or on food is examined in light of changes in US Legislation and the variability of residue data and assumptions used to estimate dietary exposure. In the 86 years since enactment of the Insecticide Act, pesticide laws have become progressively more health-based. Passage of the 1996 Food Quality Protection Act (FQPA) requires EPA to place particular emphasis on assessing potential risk from pesticides to infants and children. Primary factors affecting the actual pesticide residues in food include frequency of application, percentage of crop treated, and the interval from treatment to harvest. Primary factors affecting the estimated pesticide residues in food include the source of the residue data, calculation techniques for non-detected residues, and the availability of data reflecting post-harvest treatments. Risk assessors must thoroughly consider these factors when assessing dietary risk to pesticides. Risk managers will need to consider these factors as a means of mitigating dietary risk from pesticides.

Primary care patients' perspectives of barriers and enablers of primary prevention and health promotion-a meta-ethnographic synthesis.

PubMed

Moreno-Peral, Patricia; Conejo-Cerón, Sonia; Fernández, Ana; Berenguera, Anna; Martínez-Andrés, María; Pons-Vigués, Mariona; Motrico, Emma; Rodríguez-Martín, Beatriz; Bellón, Juan A; Rubio-Valera, Maria

2015-01-01

Primary care (PC) patients have difficulties in committing to and incorporating primary prevention and health promotion (PP&HP) activities into their long-term care. We aimed to re-interpret, for the first time, qualitative findings regarding factors affecting PC patients' acceptance of PP&HP activities. A meta-ethnographic synthesis was generated following electronic and manual searches that retrieved 29 articles. Papers were reviewed and translated to produce a re-interpretation of the extracted concepts. The factors affecting PC patients' receptiveness to PP&HP activities were framed in a four-level ecological model (intrapersonal, interpersonal, institutional and environment and society). Intrapersonal factors (patients' beliefs/attitudes, knowledge, skills, self-concept, motivation and resources) were the most numerous, with almost 25 different factors. Public health education to modify erroneous beliefs and values regarding PP&HP could encourage a transition to healthier lifestyles. Health care professionals' abilities to communicate and involve patients in the decision-making process can act as facilitators. Biopsychosocial training (with emphasis on communication skills) for health professionals must start with undergraduates. Increased consultation time, the use of reminders, follow-up visits and tools for communicating risk and motivating patients could be applied at the intrapersonal level. Collaborative care involving other health professionals (nutritionists or psychotherapists) and family and community stakeholders (teachers or gym trainers) was important in developing healthier habits. Patients also cited barriers related to the built environment and socioeconomic difficulties that highlighted the need for policies promoting social justice and equity. Encouraging PP&HP using social marketing strategies and regulating media to control its impact on health were also cited. Only the perspectives of PC patients in the context of chronic conditions were considered thus limiting extrapolation to other contexts. Several factors affect PP&HP. This must be taken into account when designing PP&HP activities if they are to be successfully implemented and maintained in routine practice.

Primary Care Patients’ Perspectives of Barriers and Enablers of Primary Prevention and Health Promotion—A Meta-Ethnographic Synthesis

PubMed Central

Moreno-Peral, Patricia; Conejo-Cerón, Sonia; Fernández, Ana; Berenguera, Anna; Martínez-Andrés, María; Pons-Vigués, Mariona; Motrico, Emma; Rodríguez-Martín, Beatriz; Bellón, Juan A.; Rubio-Valera, Maria

2015-01-01

Background Primary care (PC) patients have difficulties in committing to and incorporating primary prevention and health promotion (PP&HP) activities into their long-term care. We aimed to re-interpret, for the first time, qualitative findings regarding factors affecting PC patients' acceptance of PP&HP activities. Methods and Findings A meta-ethnographic synthesis was generated following electronic and manual searches that retrieved 29 articles. Papers were reviewed and translated to produce a re-interpretation of the extracted concepts. The factors affecting PC patients' receptiveness to PP&HP activities were framed in a four-level ecological model (intrapersonal, interpersonal, institutional and environment and society). Intrapersonal factors (patients' beliefs/attitudes, knowledge, skills, self-concept, motivation and resources) were the most numerous, with almost 25 different factors. Public health education to modify erroneous beliefs and values regarding PP&HP could encourage a transition to healthier lifestyles. Health care professionals' abilities to communicate and involve patients in the decision-making process can act as facilitators. Biopsychosocial training (with emphasis on communication skills) for health professionals must start with undergraduates. Increased consultation time, the use of reminders, follow-up visits and tools for communicating risk and motivating patients could be applied at the intrapersonal level. Collaborative care involving other health professionals (nutritionists or psychotherapists) and family and community stakeholders (teachers or gym trainers) was important in developing healthier habits. Patients also cited barriers related to the built environment and socioeconomic difficulties that highlighted the need for policies promoting social justice and equity. Encouraging PP&HP using social marketing strategies and regulating media to control its impact on health were also cited. Only the perspectives of PC patients in the context of chronic conditions were considered thus limiting extrapolation to other contexts. Conclusions Several factors affect PP&HP. This must be taken into account when designing PP&HP activities if they are to be successfully implemented and maintained in routine practice. PMID:25938509

Quantitative Analysis of Contributing Factors Affecting Patient Satisfaction in Family Medicine Service Clinics at Brooke Army Medical Center

DTIC Science & Technology

2008-06-06

Predictors of patient satisfaction for Brooke Army Medical Center Family Medicine Service primary care clinics was performed. Data was obtained from...Factors Affecting Patient Satisfaction in Family Medicine Service Clinics at Brooke Army Medical Center Presented to MAJ Eric Schmacker, Ph.D. In...study. All patients ’ medical information was protected at all times and under no circumstances will be discussed or released to any outside agency

Exploring Factors Affecting Users' Satisfaction toward E-Learning Systems

ERIC Educational Resources Information Center

Hammouri, Qais; Abu-Shanab, Emad

2018-01-01

E-learning is emerging as the new phenomenon of modern education. Universities are adopting e-learning as a strategy for the improving the teaching/learning process. The primary question addressed in this paper is related to the factors influencing the adoption of e-learning. An integrated model was used to explore the factors influencing…

20 CFR 418.3125 - What are redeterminations?

Code of Federal Regulations, 2010 CFR

2010-04-01

... from data exchanges with Federal and State agencies that may affect whether you should receive a full... random sample of cases for quality assurance purposes. For each collection of sample cases, all factors... with primary repositories of information relevant to each individual factor (e.g., we may contact...

Analysis on biomass and productivity of epilithic algae and their relations to environmental factors in the Gufu River basin, Three Gorges Reservoir area, China.

PubMed

Ge, Jiwen; Wu, Shuyuan; Touré, Dado; Cheng, Lamei; Miao, Wenjie; Cao, Huafen; Pan, Xiaoying; Li, Jianfeng; Yao, Minmin; Feng, Liang

2017-12-01

The main purpose of this study conducted from August 2010 was to find biomass and productivity of epilithic algae and their relations to environmental factors and try to explore the restrictive factors affecting the growth of algae in the Gufu River, the one of the branches of Xiangxi River located in the Three Gorges Reservoir of the Yangtze River, Hubei Province, Central China. An improved method of in situ primary productivity measurement was utilized to estimate the primary production of the epilithic algae. It was shown that in rivers, lakes, and reservoirs, algae are the main primary producers and have a central role in the ecosystem. Chlorophyll a concentration and ash-free dry mass (AFDM) were estimated for epilithic algae of the Gufu River basin in Three Gorges Reservoir area. Environmental factors in the Gufu River ecosystem highlighted differences in periphyton chlorophyll a ranging from 1.49 mg m -2 (origin) to 69.58 mg m -2 (terminal point). The minimum and maximum gross primary productivity of epilithic algae were 96.12 and 1439.89 mg C m -2  day -1 , respectively. The mean net primary productivity was 290.24 mg C m -2  day -1 . The mean autotrophic index (AFDM:chlorophyll a) was 407.40. The net primary productivity, community respiration ratio (P/R ratio) ranged from 0.98 to 9.25 with a mean of 2.76, showed that autotrophic productivity was dominant in the river. Relationship between physicochemical characteristics and biomass was discussed through cluster and stepwise regression analysis which indicated that altitude, total nitrogen (TN), NO 3 - -N, and NH 4 + -N were significant environmental factors affecting the biomass of epilithic algae. However, a negative logarithmic relationship between altitude and the chlorophyll a of epilithic algae was high. The results also highlighted the importance of epilithic algae in maintaining the Gufu River basin ecosystems health.

An Evaluation of Factors that Affect Performance of Primary Schools in Kenya: A Case Study of Gatanga District

ERIC Educational Resources Information Center

Gakure, Roselyn W.; Mukuria, Patrick; Kithae, Peter Paul

2013-01-01

Recently, the Kenyan government reaffirmed its commitment to enabling majority of its citizen's access to education through establishment of free primary education program and subsidizing secondary education. However, despite all these efforts, the education sector continues to face myriads of problems, major one being skewed performance in Kenya…

Rural Teachers' Views: What Are Gender-Based Challenges Facing Free Primary Education in Lesotho?

ERIC Educational Resources Information Center

Morojele, Pholoho

2013-01-01

This paper gives prominence to rural teachers' accounts of gender-based challenges facing Free Primary Education in Lesotho. It draws on feminist interpretations of social constructionism to discuss factors within the Basotho communities that affect gender equality in the schools. The inductive analysis offered makes use of the data generated from…

Analysis of Sesame Marketing Chain in Case of Gimbi Districts, Ethiopia

ERIC Educational Resources Information Center

Temesgen, Fikru; Gobena, Efa; Megersa, Hailu

2017-01-01

This study was aimed at marketing chain of sesames in Gimbi Woredas of Oromia Region with specific objectives of identifying marketing channels and factors affecting outlet choice decisions of farm households. The data were collected from both primary and secondary sources. The primary data for this study were collected from 127 farmers, 17…

Sources of Self-Efficacy in a Science Methods Course for Primary Teacher Education Students

ERIC Educational Resources Information Center

Palmer, D. H.

2006-01-01

Self-efficacy has been shown to be an issue of concern for primary teacher education students--many of them have low self-efficacy and this can negatively affect their future teaching of science. Previous research has identified four factors that may contribute towards self-efficacy: enactive mastery experiences, vicarious experiences, verbal…

Factors associated with stocked cutthroat trout populations in high-mountain lakes

USGS Publications Warehouse

Bailey, Paul E.; Hubert, W.A.

2003-01-01

High-mountain lakes provide important fisheries in the Rocky Mountains; therefore we sought to gain an understanding of the relationships among environmental factors, accessibility to anglers, stocking rates, and features of stocks of cutthroat trout Oncorhynchus clarki in high-mountain lakes of the Bighorn Mountains, Wyoming. We sampled fish with experimental gill nets, measured lake habitat features, and calculated factors affecting angler access among 19 lakes that lacked sufficient natural reproduction to support salmonid fisheries and that were stocked at 1-, 2-, or 4-year intervals with fingerling cutthroat trout. We found that angler accessibility was probably the primary factor affecting stock structure, whereas stocking rates affected the densities of cutthroat trout among lakes. The maximum number of years survived after stocking appeared to have the greatest affect on biomass and population structure. Our findings suggest that control of harvest and manipulation of stocking densities can affect the density, biomass, and structure of cutthroat trout stocks in high-elevation lakes.

Self-Regulatory Teaching in Mathematics: Relations to Teachers' Motivation, Affect and Professional Commitment

ERIC Educational Resources Information Center

Chatzistamatiou, Mariza; Dermitzaki, Irini; Bagiatis, Vasilios

2014-01-01

The purpose of this study was to examine the relationships between teachers' reports on self-regulatory strategy use in mathematics instruction and individual motivational and affective factors. Two hundred and ninety-two Greek primary school teachers responded to two questionnaires assessing (a) the strategies they use themselves to plan, monitor…

Where Is the Space for Education?

ERIC Educational Resources Information Center

Davidson, Ron; Henderson, Lynette K.; Knotts, Greg; Swain, John

2011-01-01

Many competing factors are now affecting how students think about higher education. One primary factor is the use of a business model for education--highlighting profit, patents, commercial investments, and the use of market competition, for example--appears to have become commonplace. Boards of education and university presidents now include a…

College Seniors' Theory of Their Academic Motivation

ERIC Educational Resources Information Center

Van Etten, Shawn; Pressley, Michael; McInerney, Dennis M.; Liem, Arief Darmanegara

2008-01-01

College seniors participated in an ethnographic interview study about their academic motivations. It was found that grades and graduation are 2 primary distal target goals that motivate their academic efforts during the senior year. A variety of proximal factors were also reported to affect the seniors' motivation. These factors can be divided…

Comparing Teacher Dispositions in China and the USA

ERIC Educational Resources Information Center

Shao, Kun; Tamashiro, Roy

2013-01-01

In studies conducted in the USA, teacher dispositional factors such as enthusiasm, professional esteem and learning motivation often emerge as the most significant variables affecting student learning and achievement from the primary grades through higher education. Do these factors play as significant a role in student learning and achievement in…

Role of school teachers in identifying attention deficit hyperactivity disorder among primary school children in Mansoura, Egypt.

PubMed

Awadalla, N J; Ali, O F; Elshaer, S; Eissa, M

2016-11-02

There is a knowledge gap in primary school teachers that affects their ability to detect attention deficit hyperactivity disorder (ADHD). This study measured primary school teachers' knowledge about ADHD, and implemented a training programme to improve early detection of ADHD. The prevalence and risk factors of ADHD were also studied. The training programme was implemented through a 2-day workshop for 39 primary school teachers who completed a validated Arabic version of the ADHD Rating Scale for 873 primary school children. The children's parents completed the questionnaire to explore ADHD risk factors. The teachers' pre-training knowledge scores of ADHD ranged from 17.9 to 46.2%. Post-training, their scores improved significantly to 69.2-94.9%. Prevalence rate of ADHD was 12.60%. On logistic regression, independent predictors of ADHD were female gender, unemployed fathers and rural residence. In conclusion, ADHD is a significant health problem among primary school children in Mansoura, Egypt. Efforts should be made to improve teachers' knowledge about ADHD and control modifiable risk factors.

Primary soft tissue Ewing's sarcoma of the maxillary sinus in elderly patients: presentation, management and prognosis.

PubMed

Dutta, M; Ghatak, S; Biswas, G; Sen, A

2014-06-01

Nonosseous or soft tissue Ewing's sarcoma is a rare form of Ewing's sarcoma/primitive neuroectodermal tumour that seldom affects the head and neck region. Involvement of the nose and paranasal sinuses is extremely uncommon, with only eight of such patients being reported to date, mostly affecting adolescents and young adults. To our knowledge, this study is the first comprehensive report of primary soft tissue Ewing's sarcoma involving the paranasal sinuses in an elderly patient who successfully completed treatment. We herein discuss the pathogenesis, management and factors affecting the prognosis of this rare group of tumours involving the nose and paranasal sinuses, in relation to the available literature.

Relationship between bacterial diversity and environmental parameters during composting of different raw materials.

PubMed

Wang, Xueqin; Cui, Hongyang; Shi, Jianhong; Zhao, Xinyu; Zhao, Yue; Wei, Zimin

2015-12-01

The aim of this study was to compare the bacterial structure of seven different composts. The primary environmental factors affecting bacterial species were identified, and a strategy to enhance the abundance of uncultured bacteria through controlling relevant environmental parameters was proposed. The results showed that the physical-chemical parameters of each different pile changed in its own manner during composting, which affected the structure and succession of bacteria in different ways. DGGE profiles showed that there were 10 prominent species during composting. Among them, four species existed in all compost types, two species existed in several piles and four species were detected in a single material. Redundancy analysis results showed that bacterial species compositions were significantly influenced by C/N and moisture (p<0.05). The optimal range of C/N was 14-27. Based on these results, the primary environmental factors affecting a certain species were further identified as a potential control of bacterial diversity. Copyright © 2015 Elsevier Ltd. All rights reserved.

Factors affecting healing and survival after finger amputations in patients with digital artery occlusive disease.

PubMed

Landry, Gregory J; McClary, Ashley; Liem, Timothy K; Mitchell, Erica L; Azarbal, Amir F; Moneta, Gregory L

2013-05-01

Finger amputations are typically performed as distal as possible to preserve maximum finger length. Failure of primary amputation leads to additional procedures, which could potentially be avoided if a more proximal amputation was initially performed. The effect of single versus multiple procedures on morbidity and mortality is not known. We evaluated factors that predicted primary healing and the effects of secondary procedures on survival. Patients undergoing finger amputations from 1995 to 2011 were evaluated for survival with uni- and multivariate analysis of demographic data and preoperative vascular laboratory studies to assess factors influencing primary healing. Seventy-six patients underwent 175 finger amputations (range 1 to 6 fingers per patient). Forty-one percent had diabetes, 33% had nonatherosclerotic digital artery disease, and 29% were on dialysis. Sex distribution was equal. Primary healing occurred in 78.9%, with the remainder requiring revisions. By logistic regression analysis, nonatherosclerotic digital artery disease was associated with failure of primary healing (odds ratio = 7.5; 95% confidence interval, 1.03 to 54; P = .047). Digital photoplethysmography did not predict primary healing. The overall healing of primary and secondary finger amputations was 96.0%. The mean survival after the initial finger amputation was 34.3 months and did not differ between patients undergoing single (35.6 months) versus multiple procedures (33.6 months). Dialysis dependence was associated with decreased survival (hazard ratio = 2.9; 95% confidence interval, 1.13 to 7.25; P = .026). Failure of primary healing is associated with the presence of nonatherosclerotic digital artery disease and is not predicted by digital photoplethysmographic studies. Dialysis dependence is associated with decreased survival in patients with finger amputations, but failure of primary healing does not adversely affect survival. A strategy of aggressive preservation of finger length is appropriate for most patients. Copyright © 2013. Published by Elsevier Inc.

Which features of primary care affect unscheduled secondary care use? A systematic review

PubMed Central

Huntley, Alyson; Lasserson, Daniel; Wye, Lesley; Morris, Richard; Checkland, Kath; England, Helen; Salisbury, Chris; Purdy, Sarah

2014-01-01

Objectives To conduct a systematic review to identify studies that describe factors and interventions at primary care practice level that impact on levels of utilisation of unscheduled secondary care. Setting Observational studies at primary care practice level. Participants Studies included people of any age of either sex living in Organisation for Economic Co-operation and Development (OECD) countries with any health condition. Primary and secondary outcome measures The primary outcome measure was unscheduled secondary care as measured by emergency department attendance and emergency hospital admissions. Results 48 papers were identified describing potential influencing features on emergency department visits (n=24 studies) and emergency admissions (n=22 studies). Patient factors associated with both outcomes were increased age, reduced socioeconomic status, lower educational attainment, chronic disease and multimorbidity. Features of primary care affecting unscheduled secondary care were more complex. Being able to see the same healthcare professional reduced unscheduled secondary care. Generally, better access was associated with reduced unscheduled care in the USA. Proximity to healthcare provision influenced patterns of use. Evidence relating to quality of care was limited and mixed. Conclusions The majority of research was from different healthcare systems and limited in the extent to which it can inform policy. However, there is evidence that continuity of care is associated with reduced emergency department attendance and emergency hospital admissions. PMID:24860000

Some behavioural risk factors for intestinal helminthiasis in nursery and primary school children in Enugu, south eastern Nigeria.

PubMed

Ilechukwu, G C; Ilechukwu, C G A; Ozumba, A N; Ojinnaka, N C; Ibe, B C; Onwasigwe, C N

2010-09-01

The objective of this study was to determine some common behavioural risk factors for intestinal helminthiasis in nursery and primary school children in Enugu. A cross-sectional survey on 460 children attending nursery and primary schools in Enugu was carried out in 2003 with a view to determine some behavioural risk factors for intestinal helminthiasis. This study was carried out in the research laboratory of the Federal Ministry of Health, National Arbovirus and Vector Research Centre, Enugu. Intestinal helminthiasis was diagnosed using the kato-katz method in analysing fresh stool samples collected from nursery and primary school children in Enugu. These fresh stool samples were collected into appropriately labeled clean containers. Questionnaires were administered by the researchers to obtain data from the children and their parents or guardians as regards some behavioural risk factors for intestinal helminthiasis. The results from this study showed that the prevalence of intestinal helminthiasis was significantly affected by various behavioural risk factors. The rate of helminthic infection varied significantly with hand washing habits after defeacation (chi2 = 75.77; df= 2; p = 0.001) and with different habits of washing fruits before eating (chi2 = 52.79; df=2; p = 0.001) among the pupils. Also, the rate ofhelminthic infection varied significantly with the source of drinking water (chi2 = 55.12; df = 3; p = 0.01), water boiling habits (chi2 = 40.89; df = 2; p = 0.001), use of footwear after school hours (chi2 = 30.72; df = 2; p = 0.001). Sites utilized for defeacation by the pupils (chi2 = 80.25; df=3; p = 0.001) also significantly influenced the rate ofhelminthic infection. Various behavioural factors which significantly affect the rate of helminthic infection abound in children living in Enugu. The government should give attention to the control of these behavioural risk factors. A lot of health education will be needed to curb the poor personal hygienic habits which are obvious risk factors for intestinal helminthiasis.

Perceptions of Democracy of Primary School Students

ERIC Educational Resources Information Center

Kus, Zafer; Cetin, Turhan

2014-01-01

The aim of this study is to identify the perceptions of democracy of primary school students, identify the factors that affect these, and compare the results with those obtained from other countries. The research was carried out during the 2011-2012 school year with 1,667 students from the 6th, 7th, and 8th grades who were chosen from 26 cities in…

Teacher Salaries and the Shortage of High-Quality Teachers in China's Rural Primary and Secondary Schools

ERIC Educational Resources Information Center

Xuehui, An

2018-01-01

Teacher salary level and structure are not only important factors affecting the supply of primary and secondary school teachers, but they are also crucial to attracting, training, and retaining high-quality teachers, thereby impacting the overall quality of education and teaching in schools. The reform of China's basic education management system…

Select Caribbean Teachers' Perspectives on the Socio-Emotional Skills Children Need to Successfully Transition to Primary School

ERIC Educational Resources Information Center

Kinkead-Clark, Zoyah

2017-01-01

Children's transition to primary school is affected by numerous factors. Many teachers, expect that children will have the academic and socioemotional competencies to negotiate and deal with new experiences they may encounter in a new learning environment. With an aim of contextualising our understanding of the transitory period from pre-primary…

Chemical variation for fiber cuticular wax levels in upland cotton (Gossypium hirsutum) evaluated under contrasting irrigation regimes

USDA-ARS?s Scientific Manuscript database

Fiber quality is important for the sale of bulk fiber to textile mills for processing but is affected by many environmental factors, including water deficit. These environmental factors have made it difficult to identify the primary determinants of fiber quality which has spurred renewed research ef...

Effect of Community Factors on Primary School Learners' Achievement in Rural Bangladesh

ERIC Educational Resources Information Center

Alam, Shafiqul

2015-01-01

Community plays an important role in childhood education. This research has identified the community factors that affect learners' achievement through the use of case studies. Qualitative data were captured by semi-structured interview and data interpretation was underpinned by concepts derived from human capital and social capital theories. This…

Problem Solving Skills of Hispanic College Students.

ERIC Educational Resources Information Center

Gerace, William J.; Mestre, Jose P.

Minorities have for some time been underrepresented in the technical fields, such as engineering and computer science. This development is known to be caused by a variety of factors, but the primary purpose of this report is to help identify those factors that adversely affect the cognitive development of the technical bilingual student in terms…

Teachers' Perceptions of Factors Affecting the Educational Use of ICT in Technology-Rich Classrooms

ERIC Educational Resources Information Center

Badia, Antoni; Meneses, Julio; Sigales, Carles

2013-01-01

Introduction: The purpose of this study is to identify the main factors that influence teachers' decision-making regarding the educational use of ICT (Information and Communication Technologies) in technology-rich classrooms. Method: We collected data from 278 teachers in Catalonia (Spain) working in eight primary and secondary education schools…

Organizational factors influencing successful primary care and public health collaboration.

PubMed

Valaitis, Ruta; Meagher-Stewart, Donna; Martin-Misener, Ruth; Wong, Sabrina T; MacDonald, Marjorie; O'Mara, Linda

2018-06-07

Public health and primary care are distinct sectors within western health care systems. Within each sector, work is carried out in the context of organizations, for example, public health units and primary care clinics. Building on a scoping literature review, our study aimed to identify the influencing factors within these organizations that affect the ability of these health care sectors to collaborate with one another in the Canadian context. Relationships between these factors were also explored. We conducted an interpretive descriptive qualitative study involving in-depth interviews with 74 key informants from three provinces, one each in western, central and eastern Canada, and others representing national organizations, government, or associations. The sample included policy makers, managers, and direct service providers in public health and primary care. Seven major organizational influencing factors on collaboration were identified: 1) Clear Mandates, Vision, and Goals; 2) Strategic Coordination and Communication Mechanisms between Partners; 3) Formal Organizational Leaders as Collaborative Champions; 4) Collaborative Organizational Culture; 5) Optimal Use of Resources; 6) Optimal Use of Human Resources; and 7) Collaborative Approaches to Programs and Services Delivery. While each influencing factor was distinct, the many interactions among these influences are indicative of the complex nature of public health and primary care collaboration. These results can be useful for those working to set up new or maintain existing collaborations with public health and primary care which may or may not include other organizations.

What are the important surgical factors affecting the wound healing after primary total knee arthroplasty?

PubMed

Harato, Kengo; Tanikawa, Hidenori; Morishige, Yutaro; Kaneda, Kazuya; Niki, Yasuo

2016-01-13

Wound condition after primary total knee arthroplasty (TKA) is an important issue to avoid any postoperative adverse events. Our purpose was to investigate and to clarify the important surgical factors affecting wound score after TKA. A total of 139 knees in 128 patients (mean 73 years) without severe comorbidity were enrolled in the present study. All primary unilateral or bilateral TKAs were done using the same skin incision line, measured resection technique, and wound closure technique using unidirectional barbed suture. In terms of the wound healing, Hollander Wound Evaluation Score (HWES) was assessed on postoperative day 14. We performed multiple regression analysis using stepwise method to identify the factors affecting HWES. Variables considered in the analysis were age, sex, body mass index (kg/m(2)), HbA1C (%), femorotibial angle (degrees) on plain radiographs, intraoperative patella eversion during the cutting phase of the femur and the tibia in knee flexion, intraoperative anterior translation of the tibia, patella resurfacing, surgical time (min), tourniquet time (min), length of skin incision (cm), postoperative drainage (ml), patellar height on postoperative lateral radiographs, and HWES. HWES was treated as a dependent variable, and others were as independent variables. The average HWES was 5.0 ± 0.8 point. According to stepwise forward regression test, patella eversion during the cutting phase of the femur and the tibia in knee flexion and anterior translation of the tibia were entered in this model, while other factors were not entered. Standardized partial regression coefficient was as follows: 0.57 in anterior translation of the tibia and 0.38 in patella eversion. Fortunately, in the present study using the unidirectional barbed suture, major wound healing problem did not occur. As to the surgical technique, intraoperative patella eversion and anterior translation of the tibia should be avoided for quality cosmesis in primary TKA.

[Child maltreatment prevention: the pediatrician's function. Part 1: Overview, evidence, risk factors, protective factors and triggers].

PubMed

Mouesca, Juan P

2015-12-01

Child maltreatment is a common and serious problem. It harms children in the short and long term, affecting their future health and their offspring. Primary, secondary, tertiary and quaternary preventing interventions target on child abuse are described. Evidence-based recommendations on child abuse prevention and examples of researches with proven efficacy are detailed. Risk factors, protective factors and triggers of child abuse and their relationships are described.

The effect of middle-age body weight and physical activity on the risk of early revision hip arthroplasty: a cohort study of 1,535 individuals.

PubMed

Flugsrud, Gunnar B; Nordsletten, Lars; Espehaug, Birgitte; Havelin, Leif I; Meyer, Haakon E

2007-02-01

Overweight and a high level of physical activity are known risk factors for loosening of a total hip arthroplasty (THA) due to primary osteoarthritis. We wanted to investigate how these factors, together with age and sex, affect the risk of revision surgery. We matched data from the Norwegian Arthroplasty Register with information on risk factors collected at a cardiovascular screening. We identified 1,535 primary THAs in the screened cohort (930 cemented implants using well-documented cement). Of the participants included, 969 were female. Mean age at screening was 49 years, at primary THA 63 years, and 69 years at the end of follow-up. We used Cox regression analysis to estimate relative risks (RRs). Event was defined as implant revision due to aseptic loosening of cup, stem or both. Follow-up was time from primary THA to event or censoring. Men were at greater risk than women of loosening of the femoral stem (RR 2.0, 95% CI 1.3-3.2). Both men and women with upper-quartile body weight were at increased risk of revision due to loosening of the stem (RR 2.5 and 2.7, respectively). Men with a high level of physical activity during leisure time were at increased risk of revision due to loosening of the cup (RR 4.8, 95% CI 1.3-18). In the multivariate model with adjustment for activity, there was little association between age at primary THA and risk of revision due to loosening. We found that body weight and physical activity recorded long before THA affected the survival of total hip arthroplasties. Controlling for these variables weakened the association between age at primary surgery and aseptic loosening. Men had an increased risk of loosening of the femoral stem, also after controlling for lifestyle factors.

A reassessment of the indicators of primary education quality in developing countries: Emerging evidence from Tanzania

NASA Astrophysics Data System (ADS)

Mosha, Herme Joseph

1988-03-01

This article seeks to identify factors affecting the quality of primary education in five regions of Tanzania by extensively reviewing relevant literature and empirical data. Some of the shortcomings emphasised by the author are: frequent staff turnover, declining financial support for primary education, ineffective curricula, shortage of teachers' guides and textbooks, and unfavourable working conditions for teachers in rural areas. Beyond this, the need for freely available material, efficient school management and regular inspections is stressed by the author.

Scabies among primary schoolchildren in Egypt: sociomedical environmental study in Kafr El-Sheikh administrative area

PubMed Central

Hegab, Doaa Salah; Kato, Abdullah Mahfouz; Kabbash, Ibrahim Ali; Dabish, Ghada Maged

2015-01-01

Background/objectives Scabies is a major global public health issue that might affect people from all socioeconomic levels. The primary contributing factors in contracting scabies seem to be poverty and overcrowded living conditions. Scabies often spreads among schoolchildren quite rapidly, owing to their close contact and overcrowding within the schools. However, limited information is available about its risk factors and the socioeconomic correlates among schoolchildren in Egypt. This study aimed to assess the prevalence of scabies and its risk factors among primary schoolchildren in Kafr El-Sheikh administrative area, Egypt. Methods This cross-sectional descriptive study was performed on primary schoolchildren in urban and rural areas of Kafr El-Sheikh administrative area. A predesigned questionnaire was used for data collection from the randomly selected 2,104 children, and clinical dermatological examination was done for them. Results Out of 2,104 children studied, there were 92 cases of scabies with a prevalence of 4.4%. The prevalence of scabies infestation in male students was 3.9%, while it was 4.8% in females, with no statistical significance. The results showed significant variations in the risk of scabies infestation by factors such as residence, paternal education and occupation, maternal education, sleeping with others, having animals at home, dealing with animals outside the house, type of building for living, family history of itchy rash, and sharing clothes with others. Conclusion In our community, scabies is still an important health problem affecting schoolchildren, especially in rural areas. It is characterized by a complex web of causation, particularly poor living conditions and low level of parents’ education. PMID:25759594

Scabies among primary schoolchildren in Egypt: sociomedical environmental study in Kafr El-Sheikh administrative area.

PubMed

Hegab, Doaa Salah; Kato, Abdullah Mahfouz; Kabbash, Ibrahim Ali; Dabish, Ghada Maged

2015-01-01

Scabies is a major global public health issue that might affect people from all socioeconomic levels. The primary contributing factors in contracting scabies seem to be poverty and overcrowded living conditions. Scabies often spreads among schoolchildren quite rapidly, owing to their close contact and overcrowding within the schools. However, limited information is available about its risk factors and the socioeconomic correlates among schoolchildren in Egypt. This study aimed to assess the prevalence of scabies and its risk factors among primary schoolchildren in Kafr El-Sheikh administrative area, Egypt. This cross-sectional descriptive study was performed on primary schoolchildren in urban and rural areas of Kafr El-Sheikh administrative area. A predesigned questionnaire was used for data collection from the randomly selected 2,104 children, and clinical dermatological examination was done for them. Out of 2,104 children studied, there were 92 cases of scabies with a prevalence of 4.4%. The prevalence of scabies infestation in male students was 3.9%, while it was 4.8% in females, with no statistical significance. The results showed significant variations in the risk of scabies infestation by factors such as residence, paternal education and occupation, maternal education, sleeping with others, having animals at home, dealing with animals outside the house, type of building for living, family history of itchy rash, and sharing clothes with others. In our community, scabies is still an important health problem affecting schoolchildren, especially in rural areas. It is characterized by a complex web of causation, particularly poor living conditions and low level of parents' education.

Ecological and Evolutionary Effects of Stickleback on Community Structure

PubMed Central

Des Roches, Simone; Shurin, Jonathan B.; Schluter, Dolph; Harmon, Luke J.

2013-01-01

Species’ ecology and evolution can have strong effects on communities. Both may change concurrently when species colonize a new ecosystem. We know little, however, about the combined effects of ecological and evolutionary change on community structure. We simultaneously examined the effects of top-predator ecology and evolution on freshwater community parameters using recently evolved generalist and specialist ecotypes of three-spine stickleback (Gasterosteus aculeatus). We used a mesocosm experiment to directly examine the effects of ecological (fish presence and density) and evolutionary (phenotypic diversity and specialization) factors on community structure at lower trophic levels. We evaluated zooplankton biomass and composition, periphyton and phytoplankton chlorophyll-a concentration, and net primary production among treatments containing different densities and diversities of stickleback. Our results showed that both ecological and evolutionary differences in the top-predator affect different aspects of community structure and composition. Community structure, specifically the abundance of organisms at each trophic level, was affected by stickleback presence and density, whereas composition of zooplankton was influenced by stickleback diversity and specialization. Primary productivity, in terms of chlorophyll-a concentration and net primary production was affected by ecological but not evolutionary factors. Our results stress the importance of concurrently evaluating both changes in density and phenotypic diversity on the structure and composition of communities. PMID:23573203

Gratitude is Associated with Greater Levels of Protective Factors and Lower Levels of Risks in African American Adolescents

PubMed Central

Ma, Mindy; Kibler, Jeffrey L.; Sly, Kaye

2013-01-01

The literature suggests gratitude is associated with positive youth development. The current study examined the relationship between gratitude and protective/risk factors among African American youth. Adolescents (N = 389; 50.4% males) ages 12 – 14 completed measures of gratitude (moral affect and life-orientation), protective factors (e.g., academic and activity engagement, family relationship), and high-risk behaviors (e.g., sexual attitudes and behaviors, drug/alcohol use). Results indicated greater moral affect gratitude was the only variable significantly associated with greater academic interest, better academic performance, and more extra-curricular activity engagement. Greater moral affect and life-orientation gratitude both significantly correlated with positive family relationship. Greater life-orientation gratitude was the only variable significantly associated with abstinence from sexual intimacy, sexual intercourse, likelihood of engaging in sex during primary school, and abstinence from drug/alcohol use. The findings suggest that moral affect gratitude may enhance protective factors while life-orientation gratitude may buffer against high-risk behaviors among African American youth. PMID:24011114

Effect of different professions' clothing on children's height perception.

PubMed

Rashidi, Mahmoud; Keshtkaran, Katayoun; Zabihidan, Sahar; Hosseinchari, Masoud; Pazhoohi, Farid

2012-11-01

Height is a biological factor that can affect how others perceive and behave toward an individual. Height is a biological factor that can affect how others perceive and behave toward an individual. Clothing, as a non-biological factor, can affect these perceptions of height. In this study weClothing, as a non-biological factor, can affect these perceptions of height. In this study we investigated the effect of different professions' clothing on children's perceptions of height. One investigated the effect of different professions' clothing on children's perceptions of height. One hundred and eighty primary school students participated in this study and estimated the height of an actor in the clothing of four different professions which differed in terms of prestige. The results of study showed that the difference between the perceived and actual height was larger when participants estimated the height of socially esteemed professions. Also there was no difference between girls' and boys' estimation of different professions' height. The implications of these findings are discussed.

Sources of Self-efficacy in a Science Methods Course for Primary Teacher Education Students

NASA Astrophysics Data System (ADS)

Palmer, D. H.

2006-12-01

Self-efficacy has been shown to be an issue of concern for primary teacher education students - many of them have low self-efficacy and this can negatively affect their future teaching of science. Previous research has identified four factors that may contribute towards self-efficacy: enactive mastery experiences, vicarious experiences, verbal persuasion and physiological/affective states. It could also be argued that there are additional sources of self-efficacy that apply to primary teacher education students, namely cognitive content mastery, cognitive pedagogical mastery and simulated modelling. The main purpose of the present paper was to investigate the relative importance of the various sources of self-efficacy in a primary science methods course. Data on changes in self-efficacy and sources of self-efficacy were collected throughout the course using formal and informal surveys. It was found that the main source of self-efficacy was cognitive pedagogical mastery.

Acute physical exercise affected processing efficiency in an auditory attention task more than processing effectiveness.

PubMed

Dutke, Stephan; Jaitner, Thomas; Berse, Timo; Barenberg, Jonathan

2014-02-01

Research on effects of acute physical exercise on performance in a concurrent cognitive task has generated equivocal evidence. Processing efficiency theory predicts that concurrent physical exercise can increase resource requirements for sustaining cognitive performance even when the level of performance is unaffected. This hypothesis was tested in a dual-task experiment. Sixty young adults worked on a primary auditory attention task and a secondary interval production task while cycling on a bicycle ergometer. Physical load (cycling) and cognitive load of the primary task were manipulated. Neither physical nor cognitive load affected primary task performance, but both factors interacted on secondary task performance. Sustaining primary task performance under increased physical and/or cognitive load increased resource consumption as indicated by decreased secondary task performance. Results demonstrated that physical exercise effects on cognition might be underestimated when only single task performance is the focus.

Factors Influencing Solar Electric Propulsion Vehicle Payload Delivery for Outer Planet Missions

NASA Technical Reports Server (NTRS)

Cupples, Michael; Green, Shaun; Coverstone, Victoria

2003-01-01

Systems analyses were performed for missions utilizing solar electric propulsion systems to deliver payloads to outer-planet destinations. A range of mission and systems factors and their affect on the delivery capability of the solar electric propulsion system was examined. The effect of varying the destination, the trip time, the launch vehicle, and gravity-assist boundary conditions was investigated. In addition, the affects of selecting propulsion system and power systems characteristics (including primary array power variation, number of thrusters, thruster throttling mode, and thruster Isp) on delivered payload was examined.

Crucial Dimensions of Human Altruism. Affective vs. Conceptual Factors Leading to Helping or Reinforcing Others

PubMed Central

Szuster, Anna

2016-01-01

The aim of this article is to identify factors leading to favorable attitudes toward other people from different social categories. The parts of article reflect diverse levels of altruism regulation from primary affective responses to the environment, through social norms, to abstract moral concepts related to good and evil. The latter allow understanding of the perspective of other people (including those belonging to out-groups), acceptance of their values and engagement not only in helping behavior but also in supporting the development of others. PMID:27148127

A Study of the Effect of Affective and Social Factors on Teaching for Conceptual Change in Primary Science

ERIC Educational Resources Information Center

Pimthong, P.

2015-01-01

The purpose of this research was to study primary science students' conceptual development as it related to their understanding of materials and their properties: in particular, to determine how and why some students changed their concepts while others did not. The participants were thirty-two Grade 5 (10-11 year old) students. An instructional…

Driving and dementia

PubMed Central

Lee, Linda; Molnar, Frank

2017-01-01

Abstract Objective To provide primary care physicians with an approach to driving safety concerns when older persons present with memory difficulties. Sources of information The approach is based on an accredited memory clinic training program developed by the Centre for Family Medicine Primary Care Collaborative Memory Clinic. Main message One of the most challenging aspects of dementia care is the assessment of driving safety. Drivers with dementia are at higher risk of motor vehicle collisions, yet many drivers with mild dementia might be safely able to continue driving for several years. Because safe driving is dependent on multiple cognitive and functional skills, clinicians should carefully consider many factors when determining if cognitive concerns affect driving safety. Specific findings on corroborated history and office-based cognitive testing might aid in the physician’s decisions to refer for comprehensive on-road driving evaluation and whether to notify transportation authorities in accordance with provincial reporting requirements. Sensitive communication and a person-centred approach are essential. Conclusion Primary care physicians must consider many factors when determining if cognitive concerns might affect driving safety in older drivers. PMID:28115437

Driving and dementia: Efficient approach to driving safety concerns in family practice.

PubMed

Lee, Linda; Molnar, Frank

2017-01-01

To provide primary care physicians with an approach to driving safety concerns when older persons present with memory difficulties. The approach is based on an accredited memory clinic training program developed by the Centre for Family Medicine Primary Care Collaborative Memory Clinic. One of the most challenging aspects of dementia care is the assessment of driving safety. Drivers with dementia are at higher risk of motor vehicle collisions, yet many drivers with mild dementia might be safely able to continue driving for several years. Because safe driving is dependent on multiple cognitive and functional skills, clinicians should carefully consider many factors when determining if cognitive concerns affect driving safety. Specific findings on corroborated history and office-based cognitive testing might aid in the physician's decisions to refer for comprehensive on-road driving evaluation and whether to notify transportation authorities in accordance with provincial reporting requirements. Sensitive communication and a person-centred approach are essential. Primary care physicians must consider many factors when determining if cognitive concerns might affect driving safety in older drivers. Copyright© the College of Family Physicians of Canada.

Factors affecting trip generation of motorcyclist for the purpose of non-mandatory activities

NASA Astrophysics Data System (ADS)

Anggraini, Renni; Sugiarto, Sugiarto; Pramanda, Heru

2017-11-01

The inadequate facilities and limited access to public transport reflect many people using private vehicles, in particular, motorcycle. The motorcycle is most widely used in Indonesia, recently, including Aceh Province. As a result, the number of motorcycle ownership is increasing significantly. The increasing number of motorcycles leads to complex traffic problems. Several factors tend to affect the trip generation of the motorcyclist, i.e., the social demographics of individuals and families, accessibility, etc. This study aims to analyze the characteristics of motorcyclists for non-mandatory activities, i.e. activities other than to work and school. It also aims to determine the dominant factors that affect their trips through trip generation models. The required data consist of primary data and secondary data. Primary data consists of a home interview survey that collects individual's daily trips. It is conducted by distributing the questionnaires to 400 families residing in Lhokseumawe City. Modeling the trip generation of the motorcyclist is done by multiple linear regression analysis. Parameters calibration uses OLS (Ordinary Least Square) method. The results showed that the dominant variables that affect the trip generation of motorcyclist for non-mandatory activities are license ownership, housewife, school-age children, middle-income household, and lower education level. It can be concluded that some factors affecting trip generation to non-work activities were female motorcyclists from the middle-income household with lower education level. As their status is mostly as the housewife, escorting children to non-school activities seems to the mother's task, instead of the father. It is clear that, most female ride motorcycle for doing household tasks. However, it should be noted that the use of the motorcycle in long-term does not suit for sustainable transportation.

The prevalence of food insecurity and associated factors among households with children in Head Start programs in Houston, Texas and Birmingham, Alabama

USDA-ARS?s Scientific Manuscript database

This study measured food security and hunger of households enrolled in Head Start in Houston, Texas, and Birmingham, Alabama and assessed factors that could affect food security. Interviewers collected data from primary caregivers on demographic characteristics, dietary intake, and the six-item US f...

Supporting mental health in South African HIV-affected communities: primary health care professionals’ understandings and responses

PubMed Central

Burgess, Rochelle Ann

2015-01-01

How do practitioners respond to the mental distress of HIV-affected women and communities? And do their understandings of patients’ distress matter? The World Health Organization (WHO) along with advocates from the Movement for Global Mental Health (MGMH) champion a primary mental health care model to address burgeoning mental health needs in resource-poor HIV-affected settings. Whilst a minority of studies have begun to explore interventions to target this group of women, there is a dearth of studies that explore the broader contexts that will likely shape service outcomes, such as health sector dynamics and competing definitions of mental ill-health. This study reports on an in-depth case study of primary mental health services in a rural HIV-affected community in Northern KwaZulu-Natal. Health professionals identified as the frontline staff working within the primary mental health care model (n = 14) were interviewed. Grounded thematic analysis of interview data highlighted that practitioners employed a critical and socially anchored framework for understanding their patients’ needs. Poverty, gender and family relationships were identified as intersecting factors driving HIV-affected patients’ mental distress. In a divergence from existing evidence, practitioner efforts to act on their understandings of patient needs prioritized social responses over biomedical ones. To achieve this whilst working within a primary mental health care model, practitioners employed a series of modifications to services to increase their ability to target the sociostructural realities facing HIV-affected women with mental health issues. This article suggests that beyond attention to the crucial issues of funding and human resources that face primary mental health care, attention must also be paid to promoting the development of policies that provide practitioners with increased and more consistent opportunities to address the complex social realities that frame the mental distress of HIV-affected women. PMID:25161270

Health professionals' knowledge and attitudes toward older people in primary care in Saudi Arabia.

PubMed

Alamri, Badrya H; Xiao, Lily D

2017-03-01

Previous international studies have indicated that a range of factors influence knowledge and attitudes toward older people were education, past work experiences, and social contact with healthy older people. This article reports on the findings of a literature review in relation to attitudes toward older people among health professionals working in primary healthcare centers in Saudi Arabia. The findings of this narrative literature are reported through 5 themes: the instruments used in the selected studies to measure attitudes toward older people; the instruments used to measure knowledge on ageing; attitudes toward older people; knowledge of the care of older people; and factors that influence knowledge and attitudes toward older people. Further investigation is needed to identify the level of knowledge on ageing, attitudes toward older people, and the factors which affect health professionals' knowledge and attitudes toward older people in primary healthcare centers in Saudi Arabia.

Health professionals’ knowledge and attitudes toward older people in primary care in Saudi Arabia

PubMed Central

Alamri, Badrya H.; Xiao, Lily D.

2017-01-01

Previous international studies have indicated that a range of factors influence knowledge and attitudes toward older people were education, past work experiences, and social contact with healthy older people. This article reports on the findings of a literature review in relation to attitudes toward older people among health professionals working in primary healthcare centers in Saudi Arabia. The findings of this narrative literature are reported through 5 themes: the instruments used in the selected studies to measure attitudes toward older people; the instruments used to measure knowledge on ageing; attitudes toward older people; knowledge of the care of older people; and factors that influence knowledge and attitudes toward older people. Further investigation is needed to identify the level of knowledge on ageing, attitudes toward older people, and the factors which affect health professionals’ knowledge and attitudes toward older people in primary healthcare centers in Saudi Arabia. PMID:28251216

[Frequency of self-reported vocal problems and associated occupational factors in primary schoolteachers in Londrina, Paraná State, Brazil].

PubMed

Fillis, Michelle Moreira Abujamra; Andrade, Selma Maffei de; González, Alberto Durán; Melanda, Francine Nesello; Mesas, Arthur Eumann

2016-01-01

This study aimed to estimate the prevalence of self-reported vocal problems among primary schoolteachers and to identify associated occupational factors, using a cross-sectional design and face-to-face interviews with 967 teachers in 20 public schools in Londrina, Paraná State, Brazil. Prevalence of self-reported vocal problems was 25.7%. Adjusted analyses showed associations with characteristics of the employment relationship (workweek ≥ 40 hours and poor perception of salaries and health benefits), characteristics of the work environment (number of students per class and exposure to chalk dust and microorganisms), psychological factors (low job satisfaction, limited opportunities to express opinions, worse relationship with superiors, and poor balance between professional and personal life), and violence (insults and bullying). Vocal disorders affected one in four primary schoolteachers and were associated with various characteristics of the teaching profession (both structural and work-related).

Risk Factors for Osteoporosis and Fractures in Postmenopausal Women Between 50 and 65 Years of Age in a Primary Care Setting in Spain: A Questionnaire

PubMed Central

Luz Rentero, Maria; Carbonell, Cristina; Casillas, Marta; González Béjar, Milagros; Berenguer, Rafael

2008-01-01

Introduction Osteoporosis (OP) is a major, highly prevalent health problem and osteoporosis-related fractures account for high morbidity and mortality. Therefore, prevention and early detection of osteoporosis should strive to substantially reduce this risk of fracture. Objective The present observational, descriptive, cross-sectional study sought to assess the prevalence of risk factors for osteoporosis and fractures in a large sample of postmenopausal women aged 50 to 65 years attending Primary Care facilities in Spain. Methods We recruited 4,960 women, at 96 Primary Care centers. Demographic and anthropometrical data, as well as information regarding risk factors for OP were collected using a questionnaire. Results The prevalence rates for the major osteoporosis risk factors in our population were: low calcium intake, 43%; benzodiazepine use, 35.1%, and height loss, 30.1%. Other relatively prevalent factors include: having suffered at least one fall during the preceding year; positive family history of falls (particularly on the mother’s side), smoking, kyphosis, presence of any disease affecting bone metabolism, personal history of falls, and inability to rise from a chair without using one’s arms. The least frequent factors were weight loss of greater than 10% over the preceding 10 years and problems in sensory perception that affect patient’s ability to walk. Conclusions The main risk factors for osteoporosis in women 50-65 years of age are low calcium intake, use of benzodiazepines, and observed loss of height. Our results may help physicians to identify groups at risk for OP and fractures at early stages and consequently, optimize prevention and early diagnosis of osteoporosis in postmenopausal women. PMID:19088873

Relevant principal factors affecting the reproducibility of insect primary culture.

PubMed

Ogata, Norichika; Iwabuchi, Kikuo

2017-06-01

The primary culture of insect cells often suffers from problems with poor reproducibility in the quality of the final cell preparations. The cellular composition of the explants (cell number and cell types), surgical methods (surgical duration and surgical isolation), and physiological and genetic differences between donors may be critical factors affecting the reproducibility of culture. However, little is known about where biological variation (interindividual differences between donors) ends and technical variation (variance in replication of culture conditions) begins. In this study, we cultured larval fat bodies from the Japanese rhinoceros beetle, Allomyrina dichotoma, and evaluated, using linear mixed models, the effect of interindividual variation between donors on the reproducibility of the culture. We also performed transcriptome analysis of the hemocyte-like cells mainly seen in the cultures using RNA sequencing and ultrastructural analyses of hemocytes using a transmission electron microscope, revealing that the cultured cells have many characteristics of insect hemocytes.

Primary Vaginal Melanoma, A Rare and Aggressive Entity. A Case Report and Review of the Literature

PubMed Central

KALAMPOKAS, EMMANOUIL; KALAMPOKAS, THEODOROS; DAMASKOS, CHRISTOS

2017-01-01

Malignant melanoma of the vagina is a rare, aggressive malignancy of poor prognosis. It principally affects post-menopausal women, with a mean age of 57 years, and the factors that contribute to its appearance are not well known. The first case of primary malignant vaginal melanoma was reported in 1887 and modern literature has noted about 500 cases, globally. Vaginal melanomas constitute 0.3% of all malignant melanomas and fewer than 3% of all vaginal carcinomas. To date there is no clear consensus regarding treatment. An early, accurate diagnosis and prompt investigation is essential in reaching appropriate treatment decisions. We present a clinical case of primary vaginal melanoma and review the literature briefly, presenting the current treatment plans and updates of this rare gynecological malignancy. Considerations, epidemiology, associated risk factors, response to therapy and expected outcome are also discussed. Conclusion: Primary malignant vaginal melanoma is a rare but aggressive melanoma that affects women in their 6th and 7th decade of life. The tumor appears as a dark node or spindle but can also be amelanotic. The size of the tumor is indicative of the prognostic factors. Surgery seems to be the only efficient treatment. Postoperative adjuvant therapy might help in preventing recurrence of the tumor. The survival rate is largely dependent on nodal and distant metastasis of the disease after initial tumor resection. There is a dire need to form a proper therapeutic regime to control this disease. PMID:28064232

The Consequences of Age at First Childbirth: Labor Force Participation and Earnings. Working Paper: 1146-04.

ERIC Educational Resources Information Center

Hofferth, Sandra L.; And Others

The primary focus of this paper is on the impact an early birth has on later labor force participation and earnings of women. Variables affecting the participation of women in a given year and factors affecting the total work experience are discussed in detail. These include: hours worked, annual earnings, hourly wages, occupational status, race,…

A Titan Explorer Mission Utilizing Solar Electric Propulsion and Chemical Propulsion Systems

NASA Technical Reports Server (NTRS)

Cupples, Michael; Coverstone, Vicki

2003-01-01

Mission and Systems analyses were performed for a Titan Explorer Mission scenario utilizing medium class launch vehicles, solar electric propulsion system (SEPS) for primary interplanetary propulsion, and chemical propulsion for capture at Titan. An examination of a range of system factors was performed to determine their affect on the payload delivery capability to Titan. The effect of varying the launch vehicle, solar array power, associated number of SEPS thrusters, chemical propellant combinations, tank liner thickness, and tank composite overwrap stress factor was investigated. This paper provides a parametric survey of the aforementioned set of system factors, delineating their affect on Titan payload delivery, as well as discussing aspects of planetary capture methodology.

[Structural recovering in Andean successional forests from Porce (Antioquia, Colombia)].

PubMed

Yepes, Adriana P; del Valle, Jorge I; Jaramillo, Sandra L; Orrego, Sergio A

2010-03-01

Places subjected to natural or human disturbance can recover forest through an ecological process called secondary succession. Tropical succession is affected by factors such as disturbances, distance from original forest, surface configuration and local climate. These factors determine the composition of species and the time trend of the succession itself. We studied succession in soils used for cattle ranching over various decades in the Porce Region of Colombia (Andean Colombian forests). A set of twenty five permanent plots was measured, including nine plots (20 x 50 m) in primary forests and sixteen (20 x 25 m) in secondary forests. All trees with diameter > or =1.0 cm were measured. We analyzed stem density, basal area, above-ground biomass and species richness, in a successional process of ca. 43 years, and in primary forests. The secondary forests' age was estimated in previous studies, using radiocarbon dating, aerial photographs and a high-resolution satellite image analysis (7 to >43 years). In total, 1,143 and 1,766 stems were measured in primary and secondary forests, respectively. Basal area (5.7 to 85.4 m2 ha(-1)), above-ground biomass (19.1 to 1,011.5 t ha(-1)) and species richness (4 to 69) directly increased with site age, while steam density decreased (3,180 to 590). Diametric distributions were "J-inverted" for primary forests and even-aged size-class structures for secondary forests. Three species of palms were abundant and exclusive in old secondary forests and primary forests: Oenocarpus mapora, Euterpe precatoria and Oenocarpus bataua. These palms happened in cohorts after forest disturbances. Secondary forest structure was 40% in more than 43 years of forest succession and indicate that many factors are interacting and affecting the forests succession in the area (e.g. agriculture, cattle ranching, mining, etc.).

The Psychometric Properties of the Center for Epidemiologic Studies Depression Scale in Chinese Primary Care Patients: Factor Structure, Construct Validity, Reliability, Sensitivity and Responsiveness.

PubMed

Chin, Weng Yee; Choi, Edmond P H; Chan, Kit T Y; Wong, Carlos K H

2015-01-01

The Center for Epidemiologic Studies Depression Scale (CES-D) is a commonly used instrument to measure depressive symptomatology. Despite this, the evidence for its psychometric properties remains poorly established in Chinese populations. The aim of this study was to validate the use of the CES-D in Chinese primary care patients by examining factor structure, construct validity, reliability, sensitivity and responsiveness. The psychometric properties were assessed amongst a sample of 3686 Chinese adult primary care patients in Hong Kong. Three competing factor structure models were examined using confirmatory factor analysis. The original CES-D four-structure model had adequate fit, however the data was better fit into a bi-factor model. For the internal construct validity, corrected item-total correlations were 0.4 for most items. The convergent validity was assessed by examining the correlations between the CES-D, the Patient Health Questionnaire 9 (PHQ-9) and the Short Form-12 Health Survey (version 2) Mental Component Summary (SF-12 v2 MCS). The CES-D had a strong correlation with the PHQ-9 (coefficient: 0.78) and SF-12 v2 MCS (coefficient: -0.75). Internal consistency was assessed by McDonald's omega hierarchical (ωH). The ωH value for the general depression factor was 0.855. The ωH values for "somatic", "depressed affect", "positive affect" and "interpersonal problems" were 0.434, 0.038, 0.738 and 0.730, respectively. For the two-week test-retest reliability, the intraclass correlation coefficient was 0.91. The CES-D was sensitive in detecting differences between known groups, with the AUC >0.7. Internal responsiveness of the CES-D to detect positive and negative changes was satisfactory (with p value <0.01 and all effect size statistics >0.2). The CES-D was externally responsive, with the AUC>0.7. The CES-D appears to be a valid, reliable, sensitive and responsive instrument for screening and monitoring depressive symptoms in adult Chinese primary care patients. In its original four-factor and bi-factor structure, the CES-D is supported for cross-cultural comparisons of depression in multi-center studies.

Affecting the supply of rural physicians.

PubMed Central

Cooper, J K; Heald, K; Samuels, M

1977-01-01

A model describing physician supply and distribution is described. Two surveys obtained information to examine elements of the model. The first survey identified a group of primary care physicians that had considered rural locations but ultimately selected an urban location. This sub-group, 29 per cent of the primary care supply pool, received a follow-up survey to provide more information about how they made their choice. About one-half of them finally chose on the basis of factors other than metropolitan/non-metropolitan considerations. For this half, some of the factors that entered into the decision were the availability of physician specialists, nearby hospital facilities, and access to medical school programs. Such factors could be affected by future policy decisions, but the cost is unknown. Even if such policy decisions were made, and appropriate programs instituted, the results would probably not solve the problem of disproportionate physician distribution. The most likely-to-succeed approach to increasing the number of rural physicians remains that of increasing the number of entrants to medical school with a rural background. PMID:888993

The pharmacoeconomic benefits of cholesterol reduction.

PubMed

Gonzalez, E R

1998-02-01

Recent studies show that cholesterol-lowering therapy can reduce morbidity and mortality in hypercholesterolemic patients without preexisting coronary heart disease (primary prevention) and with coronary heart disease (secondary prevention). The high cost of treatment per event prevented, especially for primary prevention, raises concerns about widespread use of cholesterol-lowering therapy. Does cholesterol reduction reduce utilization of healthcare resources, and can society afford to pay for reducing cholesterol in all patients with hypercholesterolemia, irrespective of risk factors? Is cost-effectiveness of therapy affected by differing cholesterol levels, age of the patients, the duration of therapy, or the presence of risk factors? Current pharmacoeconomic studies support the use of the statins for secondary prevention, and primary prevention in high-risk patients, and provide key information for policy decision making in the treatment of patients with hypercholesterolemia.

Sleep in the Aging Population.

PubMed

Miner, Brienne; Kryger, Meir H

2017-03-01

There are normal changes to sleep architecture throughout the lifespan. There is not, however, a decreased need for sleep and sleep disturbance is not an inherent part of the aging process. Sleep disturbance is common in older adults because aging is associated with an increasing prevalence of multimorbidity, polypharmacy, psychosocial factors affecting sleep, and certain primary sleep disorders. It is also associated with morbidity and mortality. Because many older adults have several factors from different domains affecting their sleep, these complaints are best approached as a multifactorial geriatric health condition, necessitating a multifaceted treatment approach. Copyright © 2016 Elsevier Inc. All rights reserved.

Psychometric properties of the Positive and Negative Affect Schedule (PANAS) in a heterogeneous sample of substance users.

PubMed

Serafini, Kelly; Malin-Mayor, Bo; Nich, Charla; Hunkele, Karen; Carroll, Kathleen M

2016-03-01

The Positive and Negative Affect Schedule (PANAS) is a widely used measure of affect. A comprehensive psychometric evaluation among substance users, however, has not been published. To examine the psychometric properties of the PANAS in a sample of outpatient treatment substance users. We used pooled data from four randomized clinical trials (N = 416; 34% female, 48% African American). A confirmatory factor analysis indicated adequate support for a two-factor correlated model comprised of Positive Affect and Negative Affect with correlated item errors (Comparative Fit Index = 0.93, Root Mean Square Error of Approximation = 0.07, χ(2) = 478.93, df = 156). Cronbach's α indicated excellent internal consistency for both factors (0.90 and 0.91, respectively). The PANAS factors had good convergence and discriminability (Composite Reliability > 0.7; Maximum Shared Variance < Average Variance Extracted). A comparison from baseline to Week 1 indicated acceptable test-retest reliability (Positive Affect = 0.80, Negative Affect = 0.76). Concurrent and discriminant validity were demonstrated with correlations with the Brief Symptom Inventory and Addiction Severity Index. The PANAS scores were also significantly correlated with treatment outcomes (e.g. Positive Affect was associated with the maximum days of consecutive abstinence from primary substance of abuse, r = 0.16, p = 0.001). Our data suggest that the psychometric properties of the PANAS are retained in substance using populations. Although several studies have focused on the role of Negative Affect, our findings suggest that Positive Affect may also be an important factor in substance use treatment outcomes.

Psychometric properties of the positive and negative affect schedule (PANAS) in a heterogeneous sample of substance users

PubMed Central

Serafini, Kelly; Malin-Mayor, Bo; Nich, Charla; Hunkele, Karen; Carroll, Kathleen M.

2016-01-01

Background The Positive and Negative Affect Schedule (PANAS) is a widely used measure of affect, and a comprehensive psychometric evaluation has never been conducted among substance users. Objective To examine the psychometric properties of the PANAS in a sample of outpatient treatment substance users. Methods We used pooled data from four randomized clinical trials (N = 416; 34% female, 48% African American). Results A confirmatory factor analysis indicated adequate support for a two-factor correlated model comprised of Positive Affect and Negative Affect with correlated item errors (Comparative Fit Index = .93, Root Mean Square Error of Approximation = .07, χ2 = 478.93, df = 156). Cronbach’s α indicated excellent internal consistency for both factors (.90 and .91, respectively). The PANAS factors had good convergence and discriminability (Composite Reliability >.7; Maximum Shared Variance < Average Variance Extracted). A comparison from baseline to Week 1 indicated acceptable test-retest reliability (Positive Affect = .80, Negative Affect = .76). Concurrent and discriminant validity were demonstrated with correlations with the Brief Symptom Inventory and Addiction Severity Index. The PANAS scores were also significantly correlated with treatment outcomes (e.g., Positive Affect was associated with the maximum days of consecutive abstinence from primary substance of abuse, r = .16, p = .001). Conclusion Our data suggest that the psychometric properties of the PANAS are retained in substance using populations. Although several studies have focused on the role of Negative Affect, our findings suggest that Positive Affect may also be an important factor in substance use treatment outcomes. PMID:26905228

Anxiety sensitivity cognitive concerns drive the relation between anxiety sensitivity and symptoms of depression.

PubMed

Saulnier, Kevin G; Allan, Nicholas P; Raines, Amanda M; Schmidt, Norman B

2018-05-29

Depression is typically treated as a homogeneous construct despite evidence for distinct cognitive, affective, and somatic symptom dimensions. Anxiety sensitivity (AS; the fear of consequences of anxiety symptoms) is a cognitive risk factor implicated in the development of depressive symptoms. However, it is unclear how lower order AS dimensions (i.e. physical, cognitive, and social concerns) relate to depressive symptom factors. Confirmatory factor analysis, followed by structural equation modeling, were conducted to examine the factor structure of depression and to then examine the relations between these factors and the lower order factors of AS. This study was conducted in a sample of 374 adults (M age = 35.5, 54.3% female) with elevated levels of psychopathology (89.2% meeting criteria for at least one DSM-5 diagnosis, 25.6% primary depressive disorder). In this study a two-factor model of depression, composed of Cognitive and Affective/Somatic factors, was superior to one- and three-factor solutions. AS cognitive concerns were related to both cognitive and affective/somatic symptoms of depression. Neither of the other AS dimensions was related to depression symptom dimensions. These findings provide a better understanding of the relations between AS and depression symptoms.

Arsenic in Drinking Water in Bangladesh: Factors Affecting Child Health

PubMed Central

Aziz, Sonia N.; Aziz, Khwaja M. S.; Boyle, Kevin J.

2014-01-01

The focus of this paper is to present an empirical model of factors affecting child health by observing actions households take to avoid exposure to arsenic in drinking water. Millions of Bangladeshis face multiple health hazards from high levels of arsenic in drinking water. Safe water sources are either expensive or difficult to access, affecting people’s individuals’ time available for work and ultimately affecting the health of household members. Since children are particularly susceptible and live with parents who are primary decision makers for sustenance, parental actions linking child health outcomes is used in the empirical model. Empirical results suggest that child health is significantly affected by the age and gender of the household water procurer. Adults with a high degree of concern for children’s health risk from arsenic contamination, and who actively mitigate their arsenic contaminated water have a positive effect on child health. PMID:24982854

Gratitude is associated with greater levels of protective factors and lower levels of risks in African American adolescents.

PubMed

Ma, Mindy; Kibler, Jeffrey L; Sly, Kaye

2013-10-01

The literature suggests gratitude is associated with positive youth development. The current study examined the relationship between gratitude and protective/risk factors among African American youth. Adolescents (N = 389; 50.4% males) ages 12-14 completed measures of gratitude (moral affect and life-orientation), protective factors (e.g., academic and activity engagement, family relationship), and high-risk behaviors (e.g., sexual attitudes and behaviors, drug/alcohol use). Results indicated greater moral affect gratitude was the only variable significantly associated with greater academic interest, better academic performance, and more extra-curricular activity engagement. Greater moral affect and life-orientation gratitude both significantly correlated with positive family relationship. Greater life-orientation gratitude was the only variable significantly associated with abstinence from sexual intimacy, sexual intercourse, likelihood of engaging in sex during primary school, and abstinence from drug/alcohol use. The findings suggest that moral affect gratitude may enhance protective factors while life-orientation gratitude may buffer against high-risk behaviors among African American youth. Copyright © 2013 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Disgust proneness predicts obsessive-compulsive disorder symptom severity in a clinical sample of youth: Distinctions from negative affect.

PubMed

Olatunji, Bunmi O; Ebesutani, Chad; Kim, Jingu; Riemann, Bradley C; Jacobi, David M

2017-04-15

Although studies have linked disgust proneness to the etiology and maintenance of obsessive-compulsive disorder (OCD) in adults, there remains a paucity of research examining the specificity of this association among youth. The present study employed structural equation modeling to examine the association between disgust proneness, negative affect, and OCD symptom severity in a clinical sample of youth admitted to a residential treatment facility (N =471). Results indicate that disgust proneness and negative affect latent factors independently predicted an OCD symptom severity latent factor. However, when both variables were modeled as predictors simultaneously, latent disgust proneness remained significantly associated with OCD symptom severity, whereas the association between latent negative affect and OCD symptom severity became nonsignificant. Tests of mediation converged in support of disgust proneness as a significant intervening variable between negative affect and OCD symptom severity. Subsequent analysis showed that the path from disgust proneness to OCD symptom severity in the structural model was significantly stronger among those without a primary diagnosis of OCD compared to those with a primary diagnosis of OCD. Given the cross-sectional design, the causal inferences that can be made are limited. The present study is also limited by the exclusive reliance on self-report measures. Disgust proneness may play a uniquely important role in OCD among youth. Copyright © 2017 Elsevier B.V. All rights reserved.

Which features of primary care affect unscheduled secondary care use? A systematic review.

PubMed

Huntley, Alyson; Lasserson, Daniel; Wye, Lesley; Morris, Richard; Checkland, Kath; England, Helen; Salisbury, Chris; Purdy, Sarah

2014-05-23

To conduct a systematic review to identify studies that describe factors and interventions at primary care practice level that impact on levels of utilisation of unscheduled secondary care. Observational studies at primary care practice level. Studies included people of any age of either sex living in Organisation for Economic Co-operation and Development (OECD) countries with any health condition. The primary outcome measure was unscheduled secondary care as measured by emergency department attendance and emergency hospital admissions. 48 papers were identified describing potential influencing features on emergency department visits (n=24 studies) and emergency admissions (n=22 studies). Patient factors associated with both outcomes were increased age, reduced socioeconomic status, lower educational attainment, chronic disease and multimorbidity. Features of primary care affecting unscheduled secondary care were more complex. Being able to see the same healthcare professional reduced unscheduled secondary care. Generally, better access was associated with reduced unscheduled care in the USA. Proximity to healthcare provision influenced patterns of use. Evidence relating to quality of care was limited and mixed. The majority of research was from different healthcare systems and limited in the extent to which it can inform policy. However, there is evidence that continuity of care is associated with reduced emergency department attendance and emergency hospital admissions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Primary Vaginal Melanoma, A Rare and Aggressive Entity. A Case Report and Review of the Literature.

PubMed

Kalampokas, Emmanouil; Kalampokas, Theodoros; Damaskos, Christos

2017-01-02

Malignant melanoma of the vagina is a rare, aggressive malignancy of poor prognosis. It principally affects post-menopausal women, with a mean age of 57 years, and the factors that contribute to its appearance are not well known. The first case of primary malignant vaginal melanoma was reported in 1887 and modern literature has noted about 500 cases, globally. Vaginal melanomas constitute 0.3% of all malignant melanomas and fewer than 3% of all vaginal carcinomas. To date there is no clear consensus regarding treatment. An early, accurate diagnosis and prompt investigation is essential in reaching appropriate treatment decisions. We present a clinical case of primary vaginal melanoma and review the literature briefly, presenting the current treatment plans and updates of this rare gynecological malignancy. Considerations, epidemiology, associated risk factors, response to therapy and expected outcome are also discussed. Primary malignant vaginal melanoma is a rare but aggressive melanoma that affects women in their 6th and 7th decade of life. The tumor appears as a dark node or spindle but can also be amelanotic. The size of the tumor is indicative of the prognostic factors. Surgery seems to be the only efficient treatment. Postoperative adjuvant therapy might help in preventing recurrence of the tumor. The survival rate is largely dependent on nodal and distant metastasis of the disease after initial tumor resection. There is a dire need to form a proper therapeutic regime to control this disease. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

PHYSICAL AND BIOLOGICAL CONTROLS ON DISSOLVED OXYGEN DYNAMICS IN PENSACOLA BAY, FL

EPA Science Inventory

Nutrient enrichment of estuaries and coastal waters can contribute to hypoxia (low dissolved oxygen) by increasing primary production and biological oxygen demand. Other factors, however, contribute to hypoxia and affect the susceptibility of coastal waters to hypoxia. Hypoxia fo...

Investigation of carbon dioxide emission in China by primary component analysis.

PubMed

Zhang, Jing; Wang, Cheng-Ming; Liu, Lian; Guo, Hang; Liu, Guo-Dong; Li, Yuan-Wei; Deng, Shi-Huai

2014-02-15

Principal component analysis (PCA) is employed to investigate the relationship between CO2 emissions (COEs) stemming from fossil fuel burning and cement manufacturing and their affecting factors. Eight affecting factors, namely, Population (P), Urban Population (UP); the Output Values of Primary Industry (PIOV), Secondary Industry (SIOV), and Tertiary Industry (TIOV); and the Proportions of Primary Industry's Output Value (PPIOV), Secondary Industry's Output Value (PSIOV), and Tertiary Industry's Output Value (PTIOV), are chosen. PCA is employed to eliminate the multicollinearity of the affecting factors. Two principal components, which can explain 92.86% of the variance of the eight affecting factors, are chosen as variables in the regression analysis. Ordinary least square regression is used to estimate multiple linear regression models, in which COEs and the principal components serve as dependent and independent variables, respectively. The results are given in the following. (1) Theoretically, the carbon intensities of PIOV, SIOV, and TIOV are 2573.4693, 552.7036, and 606.0791 kt per one billion $, respectively. The incomplete statistical data, the different statistical standards, and the ideology of self sufficiency and peasantry appear to show that the carbon intensity of PIOV is higher than those of SIOV and TIOV in China. (2) PPIOV, PSIOV, and PTIOV influence the fluctuations of COE. The parameters of PPIOV, PSIOV, and PTIOV are -2706946.7564, 2557300.5450, and 3924767.9807 kt, respectively. As the economic structure of China is strongly tied to technology level, the period when PIOV plays the leading position is characterized by lagging technology and economic developing. Thus, the influence of PPIOV has a negative value. As the increase of PSIOV and PTIOV is always followed by technological innovation and economic development, PSIOV and PTIOV have the opposite influence. (3) The carbon intensities of P and UP are 1.1029 and 1.7862 kt per thousand people, respectively. The carbon intensity of the rural population can be inferred to be lower than 1.1029 kt per thousand people. The characteristics of poverty and the use of bio-energy in rural areas result in a carbon intensity of the rural population that is lower than that of P. Copyright © 2013 Elsevier B.V. All rights reserved.

[Risk factors and burnout levels in Primary Care nurses: A systematic review].

PubMed

Gómez-Urquiza, Jose L; Monsalve-Reyes, Carolina S; San Luis-Costas, Concepción; Fernández-Castillo, Rafael; Aguayo-Estremera, Raimundo; Cañadas-de la Fuente, Guillermo A

2017-02-01

To determine the risk factors and levels of burnout in Primary Care nurses. A systematic review was performed. CINAHL, CUIDEN, LILACS, PubMed, ProQuest, ScienceDirect and Scopus databases were consulted. Search equations were 'burnout AND community health nursing' and 'burnout AND primary care nursing'. The search was performed in October 2015. The final sample was n=12 studies. Quantitative primary studies that used Maslach Burnout Inventory for burnout assessment in Primary Care nurses were included without restriction by publication date. The main variables were the mean and standard deviation of the three burnout dimensions, high, medium and low prevalence rates of each dimension, and socio-demographic, occupational and psychological variables that potentially influence burnout level. Studies show high prevalence rates, generally between 23% and 31%, of emotional exhaustion. The prevalence rates of high depersonalisation and low personal accomplishment show heterogeneity, varying between 8%-32% and 4%-92% of the sample, respectively. Studies show that older nurses with more seniority, anxiety and depression, among other variables, have higher burnout levels, while nurses with higher salary, high job satisfaction, organisational support, and good self-concept have less burnout. High emotional exhaustion is the main affected dimension of burnout in Primary Care nursing. There is heterogeneity in depersonalisation and personal accomplishment. Burnout must be prevented in these professionals, by increasing protective factors and monitoring its appearance in those with risk factors. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Reappraising factors affecting mourning dove perch coos

USGS Publications Warehouse

Sayre, M.W.; Atkinson, R.D.; Baskett, T.S.; Haas, G.H.

1978-01-01

Results confirmed pairing as the primary factor influencing perch-cooing rates of wild mourning doves (Zenaida macroura). Marked unmated males cooed at substantially higher rates (6.2x) than mated males, had greater probability of cooing (2.3x) during 3-minute periods, and continued cooing longer each morning than mated males. Population density was not a major factor affecting cooing. Unmated males cooed more frequently in the presence of other cooing doves (P < 0.05) than when alone, but the number of additional doves above 1 was unimportant. Cooing rates of both mated and unmated males on areas with dissimilar dove densities were not significantly different. Within limits of standard call-count procedure, weather exerted no detectable influence on cooing.

Association of Psychologic and Nonpsychologic Factors With Primary Dysmenorrhea

PubMed Central

Faramarzi, Mahbobeh; Salmalian, Hajar

2014-01-01

Background: Primary dysmenorrhea seems to be one the most common gynecologic condition in women of childbearing age. Objectives: The aim of this research was to evaluate psychologic and nonpsychologic risk factors of primary dysmenorrhea. Materials and Methods: A cross-sectional study was conducted on medical sciences students of Babol University of Medical Sciences. In this study, 180 females with dysmenorrhea and 180 females without dysmenorrhea were enrolled. Psychological risk factors were evaluated in four domains including affect, social support, personality, and alexithymia. Four questionnaires were used to assessed aforementioned domains, namely, Social Support Questionnaire (SSQ), depression, anxiety, stress (DAS-21), 20-item Toronto Alexithymia Scale (TAS-20), and NEO-Five Factor Inventory of Personality (NEO-FFI). In addition, nonpsychologic factors were evaluated in three domains including demographic characteristics, habits, and gynecologic factors. Data were analyzed using the χ2 test and multiple logistic regression analysis. Results: The strongest predictor of primary dysmenorrhea was low social support (OR = 4.25; 95% CI, 2.43-7.41). Risk of dysmenorrhea was approximately 3.3 times higher in women with alexithymia (OR = 3.26; 95% CI, 1.88-5.62), 3.1 times higher in women with menstrual bleeding duration ≥ 7 days (OR = 3.06; 95% CI, 1.73-5.41), 2.5 times higher in women with a neurotic character (OR = 2.53; 95% CI, 1.42-4.50), 2.4 times higher in women with a family history of dysmenorrhea (OR = 2.43; 95% CI, 1.42-4.50), and twice higher in women with high caffeine intake (OR = 1.97; 95% CI, 1.09-3.59). Conclusions: Low social support, alexithymia, neuroticism trait, long menstrual bleeding, family history of dysmenorrhea, and high-caffeine diet are important risk factors for women with primary dysmenorrhea. This study recommended considering psychologic factors as an adjuvant to medical risks in evaluation and treatment of primary dysmenorrhea. PMID:25389482

Thalidomide distinctly affected TNF-α, IL-6 and MMP secretion by an ovarian cancer cell line (SKOV-3) and primary ovarian cancer cells.

PubMed

Piura, Benjamin; Medina, Liat; Rabinovich, Alex; Dyomin, Victor; Huleihel, Mahmoud

2013-01-01

Thalidomide inhibits TNF-α production in lipopolysaccharide-stimulated monocytes. The aim of this study was to evaluate the effect of thalidomide on TNF-α, IL-6 and MMP secretion in epithelial ovarian carcinoma cells. SKOV-3 cells and primary epithelial ovarian carcinoma cells were cultured in the presence of various concentrations of thalidomide. Cell proliferation was examined by MTT proliferation assay. TNF-α and IL-6 levels were determined in the supernatants of the cell cultures by ELISA, and MMP activity was examined by gelatin zymography. Thalidomide did not significantly affect the proliferation and growth of SKOV-3 cells. However, it decreased significantly the capacity of SKOV-3 cells and primary epithelial ovarian carcinoma cells to secrete TNF-α. Thalidomide also significantly decreased the capacity of SKOV-3 cells, but not primary epithelial ovarian carcinoma cells, to secrete MMP-9 and MMP-2. However, thalidomide did not affect IL-6 secretion in SKOV-3 cells or primary epithelial ovarian carcinoma cells. Our study suggests that thalidomide distinctly affected TNF-α, IL-6 and MMPs secretion by an ovarian carcinoma cell line (SKOV-3) and primary ovarian cancer cells. This might suggest a different susceptibility of these two types of cells to thalidomide, and/or that the mechanisms of secretion of the factors examined are differently regulated in these cells. Our results may deepen our understanding the mechanism/s of action of thalidomide in ovarian carcinoma cells. The results might have important implications in future therapeutic strategies that will incorporate thalidomide and other cytokine inhibitors in the treatment of epithelial ovarian carcinoma.

Gastro-intestinal tract perforation in neonates.

PubMed

Kuremu, R T; Hadley, G P; Wiersma, R

2003-09-01

Gastro-intestinal tract (GIT) perforation in neonates is a serious problem associated with high mortality due to resulting sepsis. Co-morbid factors, eg. prematurity, respiratory problems, low birth weight, and nutritional factors, negatively affect the outcome. To review the management outcome of gastro-intestinal tract perforation in neonates in KwaZulu-Natal and identify factors that require attention for better survival of neonates with GIT perforation. Retrospective study of consecutive complete data sets of patients presenting with a diagnosis of GIT perforation. Department of Paediatric Surgery, Nelson R. Mandela School of Medicine, University of Natal, Durban, South Africa. Fifty four neonates treated for gastro-intestinal tract perforation between January 1998 and January 2003. Morbidity as determined by complications and mortality. More males (69%) were affected than females (31%). The median birth weight was 2.3 kg and median age at presentation was four days. Eighty nine percent were referred from peripheral hospitals. Abdominal distension was the leading symptom and sign (74%). Co-morbid factors were present in 89%, with prematurity as the leading factor (52%). Necrotising enterocolitis (NEC) was the main cause of perforation (33%) and the terminal ileum was the most common site. Most (56%) were treated by excision and primary repair of perforations. Sepsis was the leading complication (44%) and major cause of death (72%). Mortality was highest (56%) in perforations due to other primary pathology followed by NEC (53%). Overall mortality was 46%. It is essential to prevent secondary perforations by early recognition and management of primary pathology. Management of pneumoperitoneum in neonates with respiratory difficulties should be included in resuscitation before transfer. Rectal temperature monitoring and herbal enemas should be strongly discouraged.

Review: Factors affecting fouling in conventional pens for slaughter pigs.

PubMed

Larsen, M L V; Bertelsen, M; Pedersen, L J

2018-02-01

This review assesses factors affecting fouling in conventional pens for slaughter pigs. Fouling of the pen happens when pigs change their excretory behaviour from occurring in the designated dunging area to the lying area. This can result in a lower hygiene, bad air quality, extra work for the farmer, disturbance of the pigs' resting behaviour and an increase in agonistic interactions. A systematic search was conducted and results narrowed down to 21 articles. Four factors were found to affect fouling directly: insufficient space allowance, the flooring design of the pen, the thermal climate and pigs' earlier experience. Further, these primary factors are affected by secondary factors such as the shape of the pen, the weight of the pigs and especially the heat balance of the pigs, which is affected by several tertiary factors including, for example, temperature, humidity and draught. Results indicate that the most important factor to control when trying to prevent fouling of a pen is the pen climate. An appropriate climate may be accomplished through floor cooling in the designated lying area, sprinklers above the designated dunging area and by ensuring a more optimal ambient temperature curve that also fits the weight of the pigs in different stages of the production. All in all, fouling of the pen in conventional slaughter pigs is a multifactorial problem, but it is important to focus on increasing the comfortability, and especially the climate, of the designated lying area.

UV radiation is the primary factor driving the variation in leaf phenolics across Chinese grasslands

PubMed Central

Chen, Litong; Niu, Kechang; Wu, Yi; Geng, Yan; Mi, Zhaorong; Flynn, Dan FB; He, Jin-Sheng

2013-01-01

Due to the role leaf phenolics in defending against ultraviolet B (UVB) under previously controlled conditions, we hypothesize that ultraviolet radiation (UVR) could be a primary factor driving the variation in leaf phenolics in plants over a large geographic scale. We measured leaf total phenolics, ultraviolet-absorbing compounds (UVAC), and corresponding leaf N, P, and specific leaf area (SLA) in 151 common species. These species were from 84 sites across the Tibetan Plateau and Inner Mongolian grasslands of China with contrasting UVR (354 vs. 161 mW/cm2 on average). Overall, leaf phenolics and UVAC were all significantly higher on the Tibetan Plateau than in the Inner Mongolian grasslands, independent of phylogenetic relationships between species. Regression analyses showed that the variation in leaf phenolics was strongly affected by climatic factors, particularly UVR, and soil attributes across all sites. Structural equation modeling (SEM) identified the primary role of UVR in determining leaf phenolic concentrations, after accounting for colinearities with altitude, climatic, and edaphic factors. In addition, phenolics correlated positively with UVAC and SLA, and negatively with leaf N and N: P. These relationships were steeper in the lower-elevation Inner Mongolian than on the Tibetan Plateau grasslands. Our data support that the variation in leaf phenolics is controlled mainly by UV radiation, implying high leaf phenolics facilitates the adaptation of plants to strong irradiation via its UV-screening and/or antioxidation functions, particularly on the Tibetan Plateau. Importantly, our results also suggest that leaf phenolics may influence on vegetation attributes and indirectly affect ecosystem processes by covarying with leaf functional traits. PMID:24363898

Association of helicobacter pylori dupA with the failure of primary eradication.

PubMed

Shiota, Seiji; Nguyen, Lam Tung; Murakami, Kazunari; Kuroda, Akiko; Mizukami, Kazuhiro; Okimoto, Tadayoshi; Kodama, Masaaki; Fujioka, Toshio; Yamaoka, Yoshio

2012-04-01

To determine whether the presence of dupA Helicobacter pylori (H. pylori) influences the cure rate of primary eradication therapy. Several virulence factors of H. pylori have been reported to affect the efficacy of the eradication rate. However, no study has investigated whether the presence of dupA affects eradication failure. The presence of dupA was evaluated in 142 H. pylori strains isolated from 142 patients with gastrointestinal diseases. Of these patients, 104 received primary eradication therapy for 1 week. The risk factors for eradication failure were determined using univariate and multivariate analyses. Among 142 strains, 44 (31.0%) were dupA positive. There was no association between dupA status and gastroduodenal diseases (P>0.05). The clarithromycin (CLR) resistance rate was generally lower in the dupA-positive than in the dupA-negative group (20.4% vs. 35.7%, P=0.06). However, dupA prevalence was higher in the eradication failure group than in the success group (36.3% vs. 21.9%). Among the CLR-resistant H. pylori infected group, the successful eradication rate was significantly lower in patients infected with dupA-positive H. pylori than dupA-negative H. pylori (P=0.04). In multivariate analysis adjusted for age, sex, and type of disease, not only CLR resistance but also dupA presence was independent risk factors for eradication failure (adjusted odds ratio=3.71; 95% confidence interval,1.07-12.83). Although CLR resistant was more reliable predictor, the presence of dupA may also be an independent risk factor for eradication failure.

Association of Helicobacter pylori dupA with the failure of primary eradication

PubMed Central

Shiota, Seiji; Nguyen, Lam Tung; Murakami, Kazunari; Kuroda, Akiko; Mizukami, Kazuhiro; Okimoto, Tadayoshi; Kodama, Masaaki; Fujioka, Toshio; Yamaoka, Yoshio

2012-01-01

Goals To determine whether the presence of dupA Helicobacter pylori (H. pylori) influences the cure rate of primary eradication therapy. Background Several virulence factors of H. pylori have been reported to affect the efficacy of the eradication rate. However, no study has investigated whether the presence of dupA affects eradication failure. Study The presence of dupA was evaluated in 142 H. pylori strains isolated from 142 patients with gastrointestinal diseases. Of these patients, 104 received primary eradication therapy for 1 week. The risk factors for eradication failure were determined using univariate and multivariate analyses. Results Among 142 strains, 44 (31.0%) were dupA-positive. There was no association between dupA status and gastroduodenal diseases (P > 0.05). The clarithromycin (CLR) resistance rate was generally lower in the dupA-positive than in the dupA-negative group (20.4 vs. 35.7%, P = 0.06). However, dupA prevalence was higher in the eradication failure group than in the success group (36.3 vs. 21.9%). Among the CLR-resistant H. pylori infected group, the successful eradication rate was significantly lower in patients infected with dupA-positive H. pylori than -negative H. pylori (P = 0.04). In multivariate analysis adjusted for age, gender, and type of disease, not only CLR resistance but also dupA presence was independent risk factors for eradication failure (adjusted odds ratio = 3.71, 95% confidence interval = 1.07–12.83). Conclusions Although CLR resistant was more reliable predictor, the presence of dupA may also be an independent risk factor for eradication failure. PMID:22298090

Career Choice and Primary Care in the United Arab Emirates

PubMed Central

Schiess, Nicoline; Ibrahim, Halah; Shaban, Sami; Perez, Maria Nichole; Nair, Satish Chandrasekhar

2015-01-01

Background  The low number of medical trainees entering primary care is contributing to the lack of access to primary care services in many countries. Despite the need for primary care physicians in the Middle East, there is limited information regarding trainees' career choices, a critical determinant in the supply of primary care physicians. Objective  We analyzed the career choices of medical students in the United Arab Emirates (UAE), with a larger goal of reforming postgraduate training in the region and enhancing the focus on primary care. Methods  We conducted a cross-sectional survey of applicants to a large established internal medicine residency program in the UAE. We calculated data for demographics, subspecialty choice, and factors affecting subspecialty choice, and we also reported descriptive statistics. Results  Our response rate was 86% (183 of 212). Only 25% of applicants (n = 46) were interested in general internal medicine. The majority of respondents (n = 126, 69%) indicated a desire to pursue subspecialty training, and the remainder chose careers in research or administration. A majority of respondents (73%) were women, unmarried, and childless. Educational debt or lifestyle were not indicated as important factors in career choice. Conclusions  Low interest in primary care was similar to that in many Western countries, despite a much higher percentage of female applicants and a reduced emphasis on lifestyle or income factors in career decisions. Reasons for the reduced interest in primary care deserve further exploration, as do tests of interventions to increase interest, such as improving the primary care clerkship experience. PMID:26692983

Surgery for brain metastases: An analysis of outcomes and factors affecting survival.

PubMed

Sivasanker, Masillamany; Madhugiri, Venkatesh S; Moiyadi, Aliasgar V; Shetty, Prakash; Subi, T S

2018-05-01

For patients who develop brain metastases from solid tumors, age, KPS, primary tumor status and presence of extracranial metastases have been identified as prognostic factors. However, the factors that affect survival in patients who are deemed fit to undergo resection of brain metastases have not been clearly elucidated hitherto. This is a retrospective analysis of a prospectively maintained database. All patients who underwent resection of intracranial metastases from solid tumors were included. Various patient, disease and treatment related factors were analyzed to assess their impact on survival. Overall, 124 patients had undergone surgery for brain metastases from various primary sites. The median age and pre-operative performance score were 53 years and 80 respectively. Synchronous metastases were resected in 17.7% of the patients. The postoperative morbidity and mortality rates were 17.7% and 2.4% respectively. Adjuvant whole brain radiation was received by 64 patients. At last follow-up, 8.1% of patients had fresh post-surgical neurologic deficits. The median progression free and overall survival were 6.91 was 8.56 months respectively. Surgical resection of for brain metastases should be considered in carefully selected patients. Gross total resection and receiving adjuvant whole brain RT significantly improves survival in these patients. Copyright © 2018 Elsevier B.V. All rights reserved.

Laron syndrome (primary growth hormone insensitivity): a unique model to explore the effect of insulin-like growth factor 1 deficiency on human hair.

PubMed

Lurie, R; Ben-Amitai, D; Laron, Z

2004-01-01

Classical Laron syndrome is a recessive disease of primary insulin-like growth factor 1 (IGF-1) deficiency and primary growth hormone insensitivity. Affected children have, among other defects, sparse hair growth and frontal recessions. The hair is thin and easy to pluck. Young adults have various degrees of alopecia, more pronounced in males. The aim of the present study was to investigate the effect of primary IGF-1 deficiency on hair structure. The study sample included 11 patients with Laron syndrome--5 children (2 untreated) and 6 adults (5 untreated). Hairs were examined by light and electron microscopy. The most significant structured defect, pili torti et canaliculi, was found in 2 young, untreated patients. Grooving, tapered hair and trichorrhexis nodosa were found in the remainder. IGF-1-treated patients had either none or significantly fewer pathological changes compared to the untreated patients. This is the first documentation of the role of primary IGF-1 deficiency on hair structure in human beings. Copyright 2004 S. Karger AG, Basel

Factors affecting subspecialty referrals by pediatric primary care providers for children with obesity-related comorbidities.

PubMed

Walsh, Carolyn O; Milliren, Carly E; Feldman, Henry A; Taveras, Elsie M

2013-08-01

To determine referral patterns from pediatric primary care to subspecialists for overweight/obesity and related comorbidities. We used the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey to identify overweight/obesity and 5 related comorbidities in primary care visits between 2005 and 2009 by children 6 to 18 years. The primary outcome was whether the visit ended in referral. We used multivariable analysis to examine factors associated with referral. We identified 34,225 database visits. A total of 17.1% were with overweight (body mass index=85th to 94th percentile) or obese (body mass index≥95th percentile) patients. A total of 7.1% of primary care visits with overweight/obese children ended in referral. Referral was more likely when obesity was the reason for visit (odds ratio=2.83; 95% confidence interval=1.61-4.97) but was not associated with presence of a comorbidity (odds ratio=1.35; 95% confidence interval=0.75-2.44). Most overweight or obese children are not referred, regardless of comorbidity status. One reason may be low levels of appropriate diagnosis.

Toxicological assessment of particulate emissions from the exhaust of old and new model heavy- and light-duty vehicles.

DOT National Transportation Integrated Search

2011-06-01

The primary objective of this project is to develop an improved understanding of the factors affecting the toxicology of particulate exhaust emissions. Diesel particulate matter is a known carcinogen, and particulate exhaust emissions from both light...

LAND-COVER CHARACTERIZATION AND CHANGE DETECTION USING MULTI-TEMPORAL MODIS NDIV DATA

EPA Science Inventory

Land-cover (LC) composition and conversions are important factors that affect ecosystem condition and function. These data are frequently used as a primary data source to generate landscape-based metrics to assess landscape condition at multiple assessment scales. The use of sate...

Fencing Instruction for Children

ERIC Educational Resources Information Center

Shaw, Gerard

2008-01-01

Approximately 100 years ago, Clark Hetherington articulated the primary aims of physical education by identifying four separate areas: (1) psychomotor, which refers to motor skills; (2) organic, the fitness factor; (3) intellectual, or the cognitive component; and (4) character which refers to the affective domain. These categories can be used to…

Effects of cutbacks on motivating factors among nurses in primary health care.

PubMed

Halldorsdottir, Sigridur; Einarsdottir, Emilia J; Edvardsson, Ingi Runar

2018-03-01

When financial cuts are made, staff redundancies and reorganisation in the healthcare system often follow. Little is known how such cutbacks affect work motivation of nurses in primary health care. Examine the effects of cutbacks on motivating factors among nurses in primary health care. A phenomenological approach involving a purposeful sample of ten nurses in primary health care. Average age 44. The participants identified the job itself, autonomy, independence, good communication with co-workers, and the potential for professional training, learning and development as the main internal motivational factors related to their work. However, increased stress and uncertainty, growing fatigue and understaffing were starting to have a negative impact on these internal motivational factors. Moreover, reduced opportunities for professional training and development had negative effects on the participants. Many saw these opportunities as a vital part of recognition for their job performance. Regarding external motivation, the factors identified were job security, salaries and rewards, and interaction with management. The participants expressed their interest in more consultation with managers and most preferred an increased flow of information from managers to staff members during cutbacks. Salaries, professional training opportunities and appreciation were rewards named by participants for a job well done. All agreed that salaries are stronger motivational factors than before cutbacks. In the case of cutbacks, nursing managers should increase consultations with staff and make sure that nurses maintain their independence, autonomy, opportunities for professional training as well as appreciation for job well done. © 2017 Nordic College of Caring Science.

Socio-economic and locational determinants of accessibility and utilization of primary health-care.

PubMed

Field, K S; Briggs, D J

2001-09-01

Differences in levels of utilization vary and are a function of socio-economic and geographical factors. This paper presents the results of a questionnaire study involving twelve GP practices in Northamptonshire, UK, of factors which affect access and utilization in asthmatics and diabetics; these groups were selected to control for differences in utilization behaviour, as a result of different aetiologies. The questionnaire sought data on: residential location of patients, utilization characteristics of primary health-care, personal circumstances and mobility and hindrances to access and utilization. Key themes were identified relating to age, gender, social class, employment, ethnicity and proximity to the GP surgery. The young, elderly and females report higher rates of utilization, as do nonmanual workers and those who are unemployed. However, accessibility and utilization vary greatly in response to mobility and locational characteristics; these variations tend to be masked by data on overall rates of usage. Optimal scaling techniques were used to investigate the interactions between the factors affecting accessibility and utilization, and to characterize patients in terms of their levels of utilization. Results confirmed that current service provision afforded a differential level of service to patients, which does not directly reflect their level of need.

Determinants of undernutrition among primary school children residing in slum areas of a Nigerian city.

PubMed

Ndukwu, C I; Egbuonu, I; Ulasi, T O; Ebenebe, J C

2013-01-01

Undernutrition remains the largest contributor to the global disease burden. Different factors affecting the nutritional status of children need to be studied to determine those to be targeted in a country like Nigeria, characterized by widespread poverty and inequitable distribution of wealth. This study was aimed at ascertaining the relationship between prevailing socioeconomic and environmental factors, and the nutritional status of children residing in a typical urban slum. A cross-sectional descriptive study of 788 children aged 6-12 years selected by stratified, multistage random sampling method from public primary schools in slum and non-slum areas of Onitsha was carried out. Their nutritional status was determined using anthropometric measures. The socioeconomic and environmental variables of interest were analyzed to determine their relationship with undernutrition in the children. Socioeconomic status was the major determinant of nutritional status in this study. Poor housing also affected the nutritional status of the slum children who were significantly from poorer families than those residing in non-slum areas (χ2 = 66.69, P = 0.000). This study highlights the need for an effective nutrition program targeted at school children in urban slums surrounded by factors predisposing them to undernutrition.

Priorities for the primary prevention of breast cancer.

PubMed

Colditz, Graham A; Bohlke, Kari

2014-01-01

Despite recent calls to intensify the search for new risk factors for breast cancer, acting on information that we already have could prevent thousands of cases each year. This article reviews breast cancer primary prevention strategies that are applicable to all women, discusses the underutilization of chemoprevention in high-risk women, highlights the additional advances that could be made by including young women in prevention efforts, and comments on how the molecular heterogeneity of breast cancer affects prevention research and strategies. © 2014 American Cancer Society.

Upper aerodigestive tract cancer and the lung: a tale of two aspirations.

PubMed

Vaideeswar, P; Ghodke, R

2012-01-01

Patients with upper aerodigestive epithelial cancers frequently develop second primary cancers due to common risk factors or develop distant metastases depending on the locoregional status of the primary tumor. In most instances, the organ affected is the lung. Pulmonary spread usually occurs due to hematogenous or lymphatic dissemination. The following is a report of two patients with upper aerodigestive tract squamous cell carcinomas who developed lung metastases due to aspiration, a route not well documented in recent literature.

Maternal knowledge and awareness of factors affecting oral health in the paediatric population.

PubMed

Eigbobo, J O; Onyeaso, C O

2013-06-01

To assess expectant mothers on their knowledge and awareness of factors affecting paediatric oral health. Seven hundred and six women in different stages of pregnancy were recruited from the antenatal clinic of the University of Port Harcourt Teaching Hospital over a period of four weeks. A self-administered structured questionnaire on socio-demographic information, oral health knowledge and oral health behaviour was filled by the participants. Data was analyzed using SPSS version 17. The mean age of the subjects was 29.6 (SD + 4.4) years. Seventy percent of them had tertiary education and 63.9% were unemployed. A significant proportion (83.4%) of the women had medium to high score (> 50%) in the knowledge of causal and preventive factors in dental caries and gingivitis. Over seventy nine percent (79.2%) of them acknowledged that primary teeth are important, but 43.6% did not know whether primary teeth should be restored or not. Only 39.3% of the women knew that leaving a feeding bottle/breast in the mouth of a sleeping child could be harmful to the teeth. Knowledge of the role of bacteria in gingivitis (81.3%) and dental caries (86.6%) was high. Over 45% of participants agreed that mothers could transmit cariogenic bacteria to their children. Only 0.7% of the women had taken their children to the dental clinic for routine checkup. Most of the participants had medium to high knowledge of the factors that affect paediatric oral health, yet the participants did not demonstrate adequate and proper concomitant oral health practice.

A Model of the Spatial Structure and Productivity of Phytoplankton Populations during Variable Upwelling Off the Coast of Oregon

DTIC Science & Technology

1976-09-01

Univ., Corvallis, 71 p. barber, R. T. and J. H. Ryther, 1969. Organic chelators: factors affecting primary production in the Cromwell1 current upwelling...Mesoscale Air-Sea Interaction Group Technical Report I A MODEL OF THE SPATIAL STRUCTURE AND PRODUCTIVITY OF PHYTOPLANKTON POPULATIONS DURING...Variability in the wind stress affects the rate of ufpwelling and ultimtely the local biological productivity . To investigate the relationship between wind

Comparison of the basin-scale effect of dredging operations and natural estuarine processes on suspended sediment concentration

USGS Publications Warehouse

Schoellhamer, D.H.

2002-01-01

Suspended sediment concentration (SSC) data from San Pablo Bay, California, were analyzed to compare the basin-scale effect of dredging and disposal of dredged material (dredging operations) and natural estuarine processes. The analysis used twelve 3-wk to 5-wk periods of mid-depth and near-bottom SSC data collected at Point San Pablo every 15 min from 1993-1998. Point San Pablo is within a tidal excursion of a dredged-material disposal site. The SSC data were compared to dredging volume, Julian day, and hydrodynamic and meteorological variables that could affect SSC. Kendall's ??, Spearman's ??, and weighted (by the fraction of valid data in each period) Spearman's ??w correlation coefficients of the variables indicated which variables were significantly correlated with SSC. Wind-wave resuspension had the greatest effect on SSC. Median water-surface elevation was the primary factor affecting mid-depth SSC. Greater depths inhibit wind-wave resuspension of bottom sediment and indicate greater influence of less turbid water from down estuary. Seasonal variability in the supply of erodible sediment is the primary factor affecting near-bottom SSC. Natural physical processes in San Pablo Bay are more areally extensive, of equal or longer duration, and as frequent as dredging operations (when occurring), and they affect SSC at the tidal time scale. Natural processes control SSC at Point San Pablo even when dredging operations are occurring.

Testing different versions of the Affective Neuroscience Personality Scales in a clinical sample.

PubMed

Pedersen, Geir; Geir, Pedersen; Selsbakk, Johansen Merete; Theresa, Wilberg; Sigmund, Karterud

2014-01-01

As a tool to investigate the experiences of six primary emotions, Davis, Panksepp, and Normansell developed the Affective Neuroscience Personality Scales (ANPS). However, the psychometric properties of the ANPS have been questioned, and in particular the factor structure. This study replicates earlier psychometric studies on ANPS in a sample of (546) personality disordered patients, and also includes ANPS-S, a recent short version of ANPS by Pingault and colleagues, and a truncated version of BANPS by Barrett and colleagues. The study of the full ANPS revealed acceptable internal consistencies of the primary emotion subscales, ranging from 0.74-0.87. However, factor analyses revealed poor to mediocre fit for a six factor solution. Correlational analyses, in addition, revealed too high correlations between PLAY and SEEK, and between SADNESS and FEAR. The two short versions displayed better psychometric properties. The range of internal consistency was 0.61-0.80 for the BANPS scales and 0.65-84 for the ANPS-S. Backward Cronbach Alpha Curves indicated potentials for improvement on all three versions of the questionnaire. Items retained in the short versions did not systematically cover the full theoretical content of the long scales, in particular for CARE and SADNESS in the BANPS. The major problems seem to reside in the operationalization of the CARE and SADNESS subscales of ANPS. Further work needs to be done in order to realize a psychometrically sound instrument for the assessment of primary emotional experiences.

[Factors influencing antibiotics prescribing of primary health physicians in acute upper respiratory infections].

PubMed

Kim, Nam-Soon; Jang, Soong Nang; Jang, Sun-Mee

2005-02-01

To explore the factors influencing antibiotics prescription by primary health physicians for acute upper respiratory infections (URI). We performed a survey of 370 primary health physicians randomly sampled in April, 2003. The questionnaire consisted of a prescription on the scenario of acute bronchitis case, along with opinions and reasons for prescribing antibiotics on URI. We found that 54.7% of the physicians prescribed antibiotics on the example case of acute bronchitis which is known as not needing antibiotics. Female physicians and ENT physicians had a greater tendency to prescribe antibiotics. The factors influencing antibiotics prescription on URI were the belief about the effectiveness of antibiotics, preference for their own experiences rather than clinical guidelines, perception of patients' expectations, and perception of competitive environment. The prescription of antibiotics in the example case was affected by how much they usually prescribe antibiotics (OR = 2.400, 95% CI = 1.470-3.917) and the physicians who thought that antibiotics were helpful for their income prescribed antibiotics more than others (OR = 6.773, 95% CI = 1.816-25.254). These findings demonstrated that the false belief on the effectiveness of antibiotics, patient's expectation of medication and fast relief of symptoms, and perception of competitive environment all affected the physicians' prescription of antibiotics on URI. It may help to find barriers to accommodate scientific evidence and clinical guidelines among physicians and to specify subgroups for education about appropriate prescription behaviors.

Job Stressors, Personality and Burnout in Primary School Teachers

ERIC Educational Resources Information Center

Kokkinos, Constantinos M.

2007-01-01

Background: Teaching is considered a highly stressful occupation. Burnout is a negative affective response occurring as a result of chronic work stress. While the early theories of burnout focused exclusively on work-related stressors, recent research adopts a more integrative approach where both environmental and individual factors are studied.…

Primary Discussion on Standardized Management of Purchasing Large Equipments for Measurement Technology Institution

NASA Astrophysics Data System (ADS)

Hu, Chang; Hu, Juanli; Zhou, Qi; Yang, Yue

In view of current situation and existing problem on purchasing equipment for measurement technology institution, this paper analyzes key factors that affect the standardization of equipment procurement and it proposes a set of scientific and standardized solutions for equipment procurement based on actual work.

FACTORS AFFECTING REPRODUCTION AND THE IMPORTANCE OF ADULT SIZE ON REPRODUCTIVE OUTPUT OF THE MIDGE, CHIRONOMUS TENTANS

EPA Science Inventory

Incorporating reproductive endpoints into sediment toxicity tests has become an important consideration in ecological risk assessments. The capacity to assess reproduction was one of the primary objectives underlying the recent development of a life-cycle test with the midge, Ch...

Differential serotonergic mediation of aggression in roosters selected for resistance and susceptibility to Marek's disease

USDA-ARS?s Scientific Manuscript database

Serotonin (5-HT) is a primary regulating neurotransmitter involved in aggressive and impulsive behaviors in mammals. Previous studies have also demonstrated the function of serotonergic system in regulating aggression is affected by both genetic and environmental factors. The serotonergic system m...

Differential serotonergic mediation of aggression in roosters selected for resistance and susceptibility to Marek’s disease

USDA-ARS?s Scientific Manuscript database

1. Serotonin (5-HT) is a primary regulating neurotransmitter involved in aggressive and impulsive behaviors in mammals and birds. Previous studies have also demonstrated the function of serotonergic system in regulating aggression is affected by both genetic and environmental factors. 2. Our obje...

Growing Up in Kenya: Rural Schooling and Girls. Rethinking Childhood.

ERIC Educational Resources Information Center

Mungai, Anne M.

This book examines the education of rural girls in Kenya and reports on a study of factors influencing girls' educational success or failure. Three chapters provide background on traditional values and practices affecting girls' education; describe Kenya's education system, including preprimary, primary (grades 1-8), secondary, university,…

Experimental Study of Lightweight Tracked Vehicle Performance on Dry Granular Materials

DTIC Science & Technology

2013-11-04

most important factor affecting tractive performance, while track tension does not play a primary role on cohesive soils. The work by Watanabe et al...helping in collecting the experimental data, to Cecilia Cantu, and to Meccanotecnica Riesi SRL for collaborating on designing and manufacturing the

Oak Decline

Treesearch

Vernon Ammon; T. Evan Nebeker; Ted H. Filer; Francis I. McCracken; J. D. Solomon; H. E. Kennedy

1989-01-01

Occurrence of decline and mortality in this nation's hardwood forests has been documented in reports for the past 130 years. From 1856 through 1981, more than 26 decline events were reported from eight eastern states affecting almost all species of oaks. Fourteen factors have been implicated as either primary or secondary agents responsible for decline and...

Factors Related to Women's Undergraduate Success

ERIC Educational Resources Information Center

Baker, Tanya Michelle

2013-01-01

This quantitative study examined the relationships and effects of women's learning styles and achievement and success at a Midwestern, private, Catholic, liberal arts women's undergraduate program. The primary focus was on first-year female students' learning styles and how these learning styles may affect their GPAs and decisions to persist to…

SPATIAL AND TEMPORAL DISTRIBUTION OF COLORED DISSOLOVED ORGANIC MATTER (CDOM) IN SOUTHERN NEW ENGALND COASTAL WATERS

EPA Science Inventory

The concentration of colored dissolved organic matter (CDOM) is a primary factor affecting the absorption of incident sunlight in coastal and estuarine waters. CDOM is extracted from water-soluble humic substances and transported by runoff into lakes and coastal waters. CDOM is a...

[Distribution features of chlorophyll a and primary productivity in high frequency area of red tide in East China Sea during spring].

PubMed

Zhou, Weihua; Huo, Wenyi; Yuan, Xiangcheng; Yin, Kedong

2003-07-01

The distributions of chlorophyll a and primary productivity were determined during April to May 2002 in the East China Sea. The results showed that the average concentration of chlorophyll a was 1.086 mg.m-3 at surface layer, and that nano- and pico-phytoplankton (< 20 microns) dominated the phytoplankton biomass in this sea region during Spring (up to 64% of total chlorophyll a content). Ultra-phytoplankton (< 5 microns) consisted 27% of total phytoplankton biomass. Nutrients and feeding pressure of zooplankton affected the distribution of chlorophyll a and its size-fractionation. The average primary productivity was 10.091 mg.m-3.h-1, while that of red tide tracking stations R-03, RL-01 and RG-01 was 399.984 mg.m-3.h-1. Light and nutrients were the main factors affecting the distributions of chlorophyll a and primary productivity. The station DC-11 had a high concentration of phytoplankton biomass. The surface layer concentration of chlorophyll a and primary productivity were up to 9,082 mg.m-3 and 128,79 mg.m-3.h-1, respectively, but the color of the seawater was normal.

Projection of participant recruitment to primary care research: a qualitative study.

PubMed

White, David; Hind, Daniel

2015-10-20

Recruitment to clinical trials remains a challenge, particularly in primary care settings. Initial projections of participant recruitment need to be as accurate as possible in order to avoid the financial, clinical and ethical costs of trial extensions or failures. However, estimation of recruitment rates is challenging and often poorly executed, if attempted at all. We used qualitative methods to explore the experiences and views of researchers on the planning of recruitment in this setting. Participants had registered accrual to a UK-based primary care research study between April 2009 and March 2012. We conducted nine interviews with chief investigators or study managers, using a semi-structured topic guide. Analysis was conducted using the framework approach. Three themes are presented: 1) the factors affecting recruitment rates, 2) the use of planning techniques, and 3) influences on poor estimation. 1) A large number of factors affecting recruitment rates were discussed, including those relating to the study protocol, the clinical setting and the research setting. Use of targeted mail-outs to invite apparently eligible individuals to participate was preferred in order to eliminate some of the uncertainty in the recruitment rate associated with opportunistic clinician referrals. 2) The importance of pilot work was stressed. We identified significant uncertainty as to how best to schedule trial timelines to maximise efficiency. 3) Several potential sources of bias involved in the estimation of recruitment rates were explored and framed as technological, psychological or political factors. We found a large number of factors that interviewees felt impact recruitment rates to primary care research and highlighted the complexity of realistic estimation. Suitable early planning of the recruitment process is essential, and there may be potential to improve the projection of trial timelines by reducing biases involved in the process. Further research is needed to develop formal approaches that would be suitable for use in this setting.

A narrative systematic review of factors affecting diabetes prevention in primary care settings

PubMed Central

Eyles, Emily

2017-01-01

Background Type 2 diabetes is impacting millions of people globally; however, many future cases can be prevented through lifestyle changes and interventions. Primary care is an important setting for diabetes prevention, for at-risk populations, because it is a patient’s primary point of contact with the health care system and professionals can provide lifestyle counselling and support, as well as monitoring health outcomes. These are all essential elements for diabetes prevention for at-risk adults. Aim To understand the factors related to the delivery and uptake of type 2 diabetes prevention interventions within primary care in higher income countries. Methods For this narrative systematic review, we combined qualitative and quantitative studies of diabetes prevention within a primary care setting for patients at-risk of developing the condition. We used an iterative approach for evidence collection, which included using several databases (MEDLINE, Embase, Pysch info, BNI, SSCI, CINAHL, ASSIA), where we combined diabetes terms with primary care terms. Narrative and thematic synthesis were utilised to identify the prominent themes emerging from the data. Results A database of 6646 records was screened by the research team, and 18 papers were included. Three major themes were identified in this review. The first theme of context and setting of diabetes progression includes the risk and progression of diabetes, primary care as a setting, and where the responsibility for change is thought to lie. This review also found mixed views on the value of preventative services within primary care. The second theme focused on the various patient factors associated with diabetes prevention such as a patient’s motivation to modify their current lifestyle, perceptions and knowledge (or lack thereof) of the impacts of diabetes, lack of follow-up in healthcare settings, and trust in healthcare professionals. The third theme was centred on professional factors impacting on diabetes prevention which included workload, time constraints, resources, self-efficacy and knowledge as well as professionals’ perception of patient motivations towards change. Conclusion This review explored the factors influencing diabetes prevention in primary care, and identified the context of prevention, as well as patient and professional factors related to preventative services being offered in primary care. This systematic review complements previous reviews of real-world settings by exploring the significant factors in prevention, and the findings are relevant to academics, policymakers, patients and practitioners interested in understanding the factors associated with the delivery and uptake of diabetes prevention interventions. PMID:28531197

Factors affecting the estimate of primary production from space

NASA Technical Reports Server (NTRS)

Balch, W. M.; Byrne, C. F.

1994-01-01

Remote sensing of primary production in the euphotic zone has been based mostly on visible-band and water-leaving radiance measured with the coastal zone color scanner. There are some robust, simple relationships for calculating integral production based on surface measurements, but they also require knowledge for photoadaptive parameters such as maximum photosynthesis which currently cannot be obtained from spave. A 17,000-station data set is used to show that space-based estimates of maximum photosynthesis could improve predictions of psi, the water column light utiliztion index, which is an important term in many primary productivity models. Temperature is also examined as a factor for predicting hydrographic structure and primary production. A simple model is used to relate temperature and maximum photosynthesis; the model incorporates (1) the positive relationship between maximum photosynthesis and temperature and (2) the strongly negative relationship between temperature and nitrate in the ocean (which directly affects maximum growth rates via nitrogen limitation). Since these two factors relate to carbon and nitrogen, 'balanced carbon/nitrogen assimilation' was calculated using the Redfield ratio, It is expected that the relationship between maximum balanced carbon assimilation versus temperature is concave-down, with the peak dependent on nitrate uptake kinetics, temperature-nitrate relationships,a nd the carbon chlorophyll ration. These predictions were compared with the sea truth data. The minimum turnover time for nitrate was also calculated using this approach. Lastly, sea surface temperature gradients were used to predict the slope of isotherms (a proxy for the slope of isopycnals in many waters). Sea truth data show that at size scales of several hundred kilometers, surface temperature gradients can provide information on the slope of isotherms in the top 200 m of the water column. This is directly relevant to the supply of nutrients into the surface mixed layer, which is useful for predicting integral biomass and primary production.

Factors affecting aging cognitive function among community-dwelling older adults.

PubMed

Kim, Chun-Ja; Park, JeeWon; Kang, Se-Won; Schlenk, Elizabeth A

2017-08-01

The study purpose was to determine factors affecting aging cognitive function of 3,645 community-dwelling older adults in Korea. The Hasegawa Dementia Scale assessed aging cognitive function, blood analyses and anthropometrics assessed cardio-metabolic risk factors, and the Geriatric Depression Scale Short Form Korean Version assessed depressive symptoms. Participants with poor aging cognitive function were more likely to be in the late age group (≥75 y) and currently smoking and have a medical history of stroke, high body mass index, and high level of depressive symptoms; they were also less likely to engage in regular meals and physical activities. Regular meals and physical activities may be primary factors for clinical assessment to identify older adults at risk for aging cognitive function. With aging, depressive symptoms and other unhealthy lifestyle behaviours should be managed to prevent cognitive function disorders. © 2017 John Wiley & Sons Australia, Ltd.

Individual risk factors for deep infection and compromised fracture healing after intramedullary nailing of tibial shaft fractures: a single centre experience of 480 patients.

PubMed

Metsemakers, W-J; Handojo, K; Reynders, P; Sermon, A; Vanderschot, P; Nijs, S

2015-04-01

Despite modern advances in the treatment of tibial shaft fractures, complications including nonunion, malunion, and infection remain relatively frequent. A better understanding of these injuries and its complications could lead to prevention rather than treatment strategies. A retrospective study was performed to identify risk factors for deep infection and compromised fracture healing after intramedullary nailing (IMN) of tibial shaft fractures. Between January 2000 and January 2012, 480 consecutive patients with 486 tibial shaft fractures were enrolled in the study. Statistical analysis was performed to determine predictors of deep infection and compromised fracture healing. Compromised fracture healing was subdivided in delayed union and nonunion. The following independent variables were selected for analysis: age, sex, smoking, obesity, diabetes, American Society of Anaesthesiologists (ASA) classification, polytrauma, fracture type, open fractures, Gustilo type, primary external fixation (EF), time to nailing (TTN) and reaming. As primary statistical evaluation we performed a univariate analysis, followed by a multiple logistic regression model. Univariate regression analysis revealed similar risk factors for delayed union and nonunion, including fracture type, open fractures and Gustilo type. Factors affecting the occurrence of deep infection in this model were primary EF, a prolonged TTN, open fractures and Gustilo type. Multiple logistic regression analysis revealed polytrauma as the single risk factor for nonunion. With respect to delayed union, no risk factors could be identified. In the same statistical model, deep infection was correlated with primary EF. The purpose of this study was to evaluate risk factors of poor outcome after IMN of tibial shaft fractures. The univariate regression analysis showed that the nature of complications after tibial shaft nailing could be multifactorial. This was not confirmed in a multiple logistic regression model, which only revealed polytrauma and primary EF as risk factors for nonunion and deep infection, respectively. Future strategies should focus on prevention in high-risk populations such as polytrauma patients treated with EF. Copyright © 2014 Elsevier Ltd. All rights reserved.

Factors influencing the quality of life of infertile women in United Arab Emirates.

PubMed

Khayata, G M; Rizk, D E E; Hasan, M Y; Ghazal-Aswad, S; Asaad, M A N

2003-02-01

To measure the quality of life in a representative sample of infertile women and evaluate their sociocultural attitude to this condition. Two hundred sixty-nine infertile women attending the Assisted Reproduction clinic, Tawam Hospital were consecutively selected. They were interviewed about the effect of infertility on their quality of life using a structured, measurement-specific and pre-tested questionnaire. Parameters mostly affected were mood-related mainly in women above 30 years, with primary and female factor infertility and those in polygamous marriages. Quality of life did not affect sexual performance and was not affected by duration of infertility or cost of treatment. The results highlight the importance of bearing children and the stresses exerted on infertile women in Eastern societies. Thorough counseling and continuing support of infertile women is therefore indicated to improve their quality of life.

An exploratory study of factors that affect the performance and usage of rapid diagnostic tests for malaria in the Limpopo Province, South Africa.

PubMed

Moonasar, Devanand; Goga, Ameena Ebrahim; Frean, John; Kruger, Philip; Chandramohan, Daniel

2007-06-02

Malaria rapid diagnostic tests (RDTs) are relatively simple to perform and provide results quickly for making treatment decisions. However, the accuracy and application of RDT results depends on several factors such as quality of the RDT, storage, transport and end user performance. A cross sectional survey to explore factors that affect the performance and use of RDTs was conducted in the primary care facilities in South Africa. This study was conducted in three malaria risk sub-districts of the Limpopo Province, in South Africa. Twenty nurses were randomly selected from 17 primary health care facilities, three nurses from hospitals serving the study area and 10 other key informants, representing the managers of the malaria control programmes, routine and research laboratories, were interviewed, using semi-structured questionnaires. There was a high degree of efficiency in ordering and distribution of RDTs, however only 13/20 (65%) of the health facilities had appropriate air-conditioning and monitoring of room temperatures. Sixty percent (12/20) of the nurses did not receive any external training on conducting and interpreting RDT. Fifty percent of nurses (10/20) reported RDT stock-outs. Only 3/20 nurses mentioned that they periodically checked quality of RDT. Fifteen percent of nurses reported giving antimalarial drugs even if the RDT was negative. Storage, quality assurance, end user training and use of RDT results for clinical decision making in primary care facilities in South Africa need to be improved. Further studies of the factors influencing the quality control of RDTs, their performance of RDTs and the ways to improve their use of RDTs are needed.

An exploratory study of factors that affect the performance and usage of rapid diagnostic tests for malaria in the Limpopo Province, South Africa

PubMed Central

Moonasar, Devanand; Goga, Ameena Ebrahim; Frean, John; Kruger, Philip; Chandramohan, Daniel

2007-01-01

Background Malaria rapid diagnostic tests (RDTs) are relatively simple to perform and provide results quickly for making treatment decisions. However, the accuracy and application of RDT results depends on several factors such as quality of the RDT, storage, transport and end user performance. A cross sectional survey to explore factors that affect the performance and use of RDTs was conducted in the primary care facilities in South Africa. Methods This study was conducted in three malaria risk sub-districts of the Limpopo Province, in South Africa. Twenty nurses were randomly selected from 17 primary health care facilities, three nurses from hospitals serving the study area and 10 other key informants, representing the managers of the malaria control programmes, routine and research laboratories, were interviewed, using semi-structured questionnaires. Results There was a high degree of efficiency in ordering and distribution of RDTs, however only 13/20 (65%) of the health facilities had appropriate air-conditioning and monitoring of room temperatures. Sixty percent (12/20) of the nurses did not receive any external training on conducting and interpreting RDT. Fifty percent of nurses (10/20) reported RDT stock-outs. Only 3/20 nurses mentioned that they periodically checked quality of RDT. Fifteen percent of nurses reported giving antimalarial drugs even if the RDT was negative. Conclusion Storage, quality assurance, end user training and use of RDT results for clinical decision making in primary care facilities in South Africa need to be improved. Further studies of the factors influencing the quality control of RDTs, their performance of RDTs and the ways to improve their use of RDTs are needed. PMID:17543127

Factors Affecting Optimal Surface Roughness of AISI 4140 Steel in Turning Operation Using Taguchi Experiment

NASA Astrophysics Data System (ADS)

Novareza, O.; Sulistiyarini, D. H.; Wiradmoko, R.

2018-02-01

This paper presents the result of using Taguchi method in turning process of medium carbon steel of AISI 4140. The primary concern is to find the optimal surface roughness after turning process. The taguchi method is used to get a combination of factors and factor levels in order to get the optimum surface roughness level. Four important factors with three levels were used in experiment based on Taguchi method. A number of 27 experiments were carried out during the research and analysed using analysis of variance (ANOVA) method. The result of surface finish was determined in Ra type surface roughness. The depth of cut was found to be the most important factors for reducing the surface roughness of AISI 4140 steel. On the contrary, the other important factors i.e. spindle speed and rake side angle of the tool were proven to be less factors that affecting the surface finish. It is interesting to see the effect of coolant composition that gained the second important factors to reduce the roughness. It may need further research to explain this result.

Factors affecting electronic health record adoption in long-term care facilities.

PubMed

Cherry, Barbara; Carter, Michael; Owen, Donna; Lockhart, Carol

2008-01-01

Electronic health records (EHRs) hold the potential to significantly improve the quality of care in long-term care (LTC) facilities, yet limited research has been done on how facilities decide to adopt these records. This study was conducted to identify factors that hinder and facilitate EHR adoption in LTC facilities. Study participants were LTC nurses, administrators, and corporate executives. Primary barriers identified were costs, the need for training, and the culture change required to embrace technology. Primary facilitators were training programs, well-defined implementation plans, government assistance with implementation costs, evidence that EHRs will improve care outcomes, and support from state regulatory agencies. These results offer a framework of action for policy makers, LTC Leaders, and researchers.

Perinatal mortality in caribou from the Porcupine herd, Alaska

USGS Publications Warehouse

Roffe, T.J.

1993-01-01

During the 1989 caribou (Rangifer tarandus) calving season on the Arctic National Wildlife Refuge, Alaska (USA), 61 calf carcasses were examined for cause of death and associated pathology. Dead calves were located by low-level aerial searches with two fixed-wing aircraft and a helicopter over high density calving areas between the Hulahula and Aichilik rivers. Primary diagnoses included emaciation (39%), malnutrition (8%), stillbirth (21%), trauma (16%), other primary causes (7%), and undetermined causes (8%). Twenty calves had contributory renal tubular degeneration. The findings indicate that factors contributing to nutritional deprivation in calves were the major cause of neonatal mortality; however, factors affecting stillbirth, abortion, or the urogenital system may have major effects on neonatal caribou and warrant further investigation.

Perinatal mortality in caribou from the Porcupine herd, Alaska.

PubMed

Roffe, T J

1993-04-01

During the 1989 caribou (Rangifer tarandus) calving season on the Arctic National Wildlife Refuge, Alaska (USA), 61 calf carcasses were examined for cause of death and associated pathology. Dead calves were located by low-level aerial searches with two fixed-wing aircraft and a helicopter over high density calving areas between the Hulahula and Aichilik rivers. Primary diagnoses included emaciation (39%), malnutrition (8%), stillbirth (21%), trauma (16%), other primary causes (7%), and undetermined causes (8%). Twenty calves had contributory renal tubular degeneration. The findings indicate that factors contributing to nutritional deprivation in calves were the major cause of neonatal mortality; however, factors affecting stillbirth, abortion, or the urogenital system may have major effects on neonatal caribou and warrant further investigation.

[Clinical and socio-medical factors related to anemia in pregnant women: prevalence study in Mara Township, Venezuela, 2013].

PubMed

Avila, Ayari Guadalupe; García, Lenis; Gómez, María; Villanueva, Nixon; Benítez, Betty; Fuentes, Belkis

2014-07-11

Anemia during pregnancy is a frequent finding and can increase morbidity and mortality in both mother and child. This paper aims to identify clinical, social and healthcare-related factors that affect the incidence of anemia in pregnant patients in a primary care prenatal clinic in Mara municipality. This is a descriptive field study that took place between November and December, 2013. Sixty-two patients were selected through non-probability sampling among four primary care clinics in the municipality of Mara. A high prevalence of anemia (76%) was found, with normal MCV (mean corpuscular volume), normal MCH (mean corpuscular hemoglobin), and normal MCHC (mean corpuscular hemoglobin concentration). In only 36% of cases serum iron levels fell below 50 ug/dl. Some clinical factors found to be related to anemia in pregnancy are multiparity (69.9%), infections before or during pregnancy (77.5%), low protein intake (91.8%), less than a year birth interval (63.3%), and gestational age (89.8%). The main socioeconomic factor related to anemia is poverty (89.8%). Prenatal checkup schedule needs to be adjusted in primary care clinics in the municipality of Mara taking into consideration clinical and socioeconomic factors in order to lower the prevalence of anemia during pregnancy in this population.

Psychopathic Personality Traits and Environmental Contexts: Differential Correlates, Gender Differences, and Genetic Mediation

PubMed Central

Hicks, Brian M.; Carlson, Marie D.; Blonigen, Daniel M.; Patrick, Christopher J.; Iacono, William G.; MGue, Matt

2011-01-01

Theorists have speculated that primary psychopathy (or Factor 1 affective-interpersonal features) is prominently heritable whereas secondary psychopathy (or Factor 2 social deviance) is more environmentally determined. We tested this differential heritability hypothesis using a large adolescent twin sample. Trait-based proxies of primary and secondary psychopathic tendencies were assessed using Multidimensional Personality Questionnaire (MPQ; Tellegen & Waller, 2008) estimates of Fearless Dominance and Impulsive Antisociality, respectively (Benning et al., 2005). The environmental contexts of family, school, peers, and stressful life events were assessed using multiple raters and methods. Consistent with prior research, MPQ Impulsive Antisociality was robustly associated with each environmental risk factor, and these associations were significantly greater than those for MPQ Fearless Dominance. However, MPQ Fearless Dominance and Impulsive Antisociality exhibited similar heritability, and genetic effects mediated the associations between MPQ Impulsive Antisociality and the environmental measures. Results were largely consistent across male and female twins. We conclude that gene-environment correlations rather than main effects of genes and environments account for the differential environmental correlates of primary and secondary psychopathy. PMID:22452762

Physical attractiveness, issue agreement, and assimilation effects in candidate appraisal.

PubMed

Schubert, James N; Curran, Margaret Ann; Strungaru, Carmen

2011-01-01

This study examines the cognitive and affective factors of candidate appraisal by manipulating candidate attractiveness and levels of issue agreement with voters. Drawing upon research in evolutionary psychology and cognitive neuroscience, this analysis proposes that automatic processing of physical appearance predisposes affective disposition toward more attractive candidates, thereby influencing cognitive processing of issue information. An experimental design presented attractive and unattractive candidates who were either liberal or conservative in a mock primary election. The data show strong partial effects for appearance on vote intention, an interaction between appearance and issue agreement, and a tendency for voters to assimilate the dissimilar views of attractive candidates. We argue that physical appearance is important in primary elections when the differences in issue positions and ideology between candidates is small.

Community characteristics affecting emergency department use by Medicaid enrollees.

PubMed

Lowe, Robert A; Fu, Rongwei; Ong, Emerson T; McGinnis, Paul B; Fagnan, Lyle J; Vuckovic, Nancy; Gallia, Charles

2009-01-01

In seeking to identify modifiable, system-level factors affecting emergency department (ED) use, we used a statewide Medicaid database to study community variation in ED use and ascertain community characteristics associated with higher use. This historical cohort study used administrative data from July 1, 2003 to December 31, 2004. Residence ZIP codes were used to assign all 555,219 Medicaid enrollees to 130 primary care service areas (PCSAs). PCSA characteristics studied included rural/urban status, presence of hospital(s), driving time to hospital, and several measures of primary care capacity. Statistical analyses used a 2-stage model. In the first stage (enrollee level), ED utilization rates adjusted for enrollee demographics and medical conditions were calculated for each PCSA. In the second stage (community level), a mixed effects linear model was used to determine the association between PCSA characteristics and ED use. ED utilization rates varied more than 20-fold among the PCSAs. Compared with PCSAs with primary care capacity less than need, PCSAs with capacity 1 to 2 times the need had 0.12 (95% CI: -0.044, -0.20) fewer ED visits/person/yr. Compared with PCSAs with the nearest hospital accessible within 10 minutes, PCSAs with the nearest hospital >30 minutes' drive had 0.26 (95% CI: -0.38, -0.13) fewer ED visits/person/yr. Within this Medicaid population, ED utilization was determined not only by patient characteristics but by community characteristics. Better understanding of system-level factors affecting ED use can enable communities to improve their health care delivery systems-augmenting access to care and reducing reliance on EDs.

Factors that affect television viewing time in preschool and primary schoolchildren.

PubMed

Songül Yalçin, Siddika; Tugrul, Belma; Naçar, NazIre; Tuncer, Murat; Yurdakök, Kadriye

2002-12-01

Excessive viewing of television (TV) has been linked to aggressive behavior, violence and childhood obesity. A cross-sectional study was conducted among preschool children and primary schoolchildren in Ankara during March and April 1999 to detect the factors that affect TV viewing time and to evaluate their parents' knowledge, attitudes and practices with regard to TV. The parents were asked to fill out a questionnaire about TV habits of their family, the number and location of TVs in the household and the effect of TV on children. Of 400 questionnaires, 350 answered the questions appropriately for this study. Children were divided into two groups, preschool children and primary schoolchildren. Television viewing time was given daily, as a mean of weekday. The mean age for becoming a TV viewer was 2.7 +/- 1.6 years. Of all, 62% of children spent >/= 2h/day watching TV and 8.3% of children spent > 4 h. The TV viewing time of child was significantly and positively correlated with that of siblings, mother and father for both groups. Age and sleeping time of the child, age and the education level of mother, presence of TV in the child's room and the starting age watching TV did not affect the viewing time. One-half of parents reported that the TV programs watched included violence, and one-third thought TV depicts child abuse, especially emotional abuse. It was found that the TV watching habits of parents had an influence on those of their children. Therefore, pediatricians should take 'TV histories' of children and their parents and educate parents how to become good TV viewers.

Dietary Management in Hyperlipidemia. Nutrition in Primary Care Series, Number 12.

ERIC Educational Resources Information Center

Gallagher-Allred, Charlette R.; Townley, Nancy A.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

Dietary Management in Obesity. Nutrition in Primary Care Series, Number 9.

ERIC Educational Resources Information Center

Gallagher-Allred, Charlette R.; Townley, Nancy A.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

Appraisal of Nutritional Status. Nutrition in Primary Care Series, Number 2.

ERIC Educational Resources Information Center

Latanick, Maureen Rogan; Gallagher-Allred, Charlette R.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

The Role of Supervisors in Light of the Experience of Doctoral Students

ERIC Educational Resources Information Center

Begin, Christian; Gerard, Laetitia

2013-01-01

Doctoral supervision is one of the primary factors affecting doctoral degree completion and attrition rates. Basing their work on the concept of cognitive apprenticeship, the authors investigated the role that doctoral supervisors should adopt in supporting their students, in light of feedback from the latter. A total of 533 doctoral students…

Sources of Funding and Academic Performance in Economics Principles Courses

ERIC Educational Resources Information Center

Faulk, Dagney; Srinivasan, Arun K.; Bingham, Jon

2012-01-01

The authors examine two factors that may affect student achievement in economics principles courses: working for pay and the primary source of funds (employer tuition reimbursement, loans, scholarships, financial aid, self-financing, parental transfers, other) used to pay for college for a sample of students in economics principles classes at a…

Dietary Management in Hypertension. Nutrition in Primary Care Series, Number 11.

ERIC Educational Resources Information Center

Molleson, Ann L.; Gallagher-Allred, Charlette R.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

Normal Diet: Geriatrics. Nutrition in Primary Care Series, Number 8.

ERIC Educational Resources Information Center

Molleson, Ann L.; Gallagher-Allred, Charlette R.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

Problem Solving and Emotional Education in Initial Primary Teacher Education

ERIC Educational Resources Information Center

Caballero, Ana; Blanco, Lorenzo J.; Guerrero, Eloisa

2011-01-01

Our work is based on two premises. The first is that affective factors (beliefs, attitudes, and emotions) influence teaching and learning mathematics, and problem solving in particular. The second is that initial teacher education is an important element in the process of improving overall educational practice. On this basis, our research group…

Calcium homeostasis and bone metabolic responses to protein diets and energy restriction: a randomized control trial

USDA-ARS?s Scientific Manuscript database

Despite some beneficial effects on bone, high protein diets are conventionally considered a primary dietary risk factor for osteoporosis and bone fracture due to the acid load associated with protein catabolism. To test the hypothesis that high dietary protein diets do not negatively affect calcium ...

Classification of Concepts in Consumer Education. Consumer Education Development Program: A National Study.

ERIC Educational Resources Information Center

Bannister, Rosella; Monsma, Charles

This guide for program planners and curriculum developers identifies and describes the basic concepts in consumer education. Consumer education is defined as the process of gaining the knowledge and skills needed in managing consumer resources and taking actions to influence the factors which affect consumer decisions. The primary focus of…

Action Learning: How Learning Transfers from Entrepreneurs to Small Firms

ERIC Educational Resources Information Center

Jones, Karen; Sambrook, Sally A.; Pittaway, Luke; Henley, Andrew; Norbury, Heather

2014-01-01

This paper presents research with small- and medium-sized enterprise (SME) owners who have participated in a leadership development programme. The primary focus of this paper is on learning transfer and factors affecting it, arguing that entrepreneurs must engage in "action" in order to "learn" and that under certain conditions…

Nutrient and Drug Interactions. Nutrition in Primary Care Series, Number 3.

ERIC Educational Resources Information Center

Molleson, Ann L.; Gallagher-Allred, Charlette R.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

Exploring the Moderating Role of Perceived Flexibility Advantages in Mobile Learning Continuance Intention (MLCI)

ERIC Educational Resources Information Center

Huang, Rui-Ting; Hsiao, Chia-Hua; Tang, Tzy-Wen; Lien, Tsung-Cheng

2014-01-01

The primary purpose of this study was to explore the key factors that could affect mobile learning continuance intention (MLCI), and examine the moderating effect of perceived flexibility advantages (PFA) on the relationship between key mobile learning elements and continuance intention. Five hundred undergraduate students who had previously…

Significance of wall structure, macromolecular composition, and surface polymers to the survival and transport of Cryptosporidium parvum Oocysts

USDA-ARS?s Scientific Manuscript database

The structure and composition of the oocyst wall are primary factors determining the survival of Cryptosporidium parvum oocysts outside the host. An external polymer matrix (glycocalyx) may mediate interactions with environmental surfaces and, thus, affect the transport of oocysts in water, soil, an...

Climate change and stream temperature projections in the Columbia River Basin: biological implications of spatial variation in hydrologic drivers

USDA-ARS?s Scientific Manuscript database

Water temperature is a primary physical factor affecting aquatic organisms. Assessment of suitable thermal habitat in freshwater systems is critical for predicting aquatic species responses to changes in climate and for guiding adaptation strategies. We use a hydrologic model coupled with a stream t...

Standards, Testing, and Accountability: Misguided Intentions

ERIC Educational Resources Information Center

Alexander, James

2011-01-01

There are many factors affecting student achievement. It is misguided and a waste of time and effort to pursue the failed policies of more standards, tests, and accountability. The primary problems relative to student achievement are mainly societal. Rather than more failed policies, what our nation needs is a discussion about national values,…

The role and experiences of advanced nurse practitioners working in out of hours urgent care services in a primary care setting.

PubMed

Yuill, Jacci

2018-05-30

GPs' workload has increased significantly in recent years affecting their ability to provide high-quality services, and consequently there is increasing focus on nurses to provide a solution. There is little evidence of how advanced nurse practitioners (ANPs) experience their role in out of hours (OOH) services, and it is important to understand their perceptions of this and the challenges they may face in supporting service development and improvement. This article evaluates the role and experiences of ANPs working in an OOH urgent primary care service and identifies important factors that affect their roles. Positive factors enable job satisfaction, but challenges associated with knowledge base, perceptions, role definitions and isolation must be considered for quality and governance purposes. The article describes how supportive systems must be in place to enable mentorship, supervision programmes and development of this group of advanced practitioners. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Analysis of prognostic factors for survival in patients with primary spinal chordoma using the SEER Registry from 1973 to 2014.

PubMed

Pan, Yue; Lu, Lingyun; Chen, Junquan; Zhong, Yong; Dai, Zhehao

2018-04-06

Spinal chordomas are rare primary osseous tumors that arise from the remnants of the notochord. They are commonly considered slow-growing, locally invasive neoplasms with little tendency to metastasize, but the high recurrent rate of spinal chordomas may seriously affect the survival rate and quality of life of patients. The aim of the study is to describe the epidemiological data and determine the prognostic factors for decreased survival in patients with primary spinal chordoma. The Surveillance, Epidemiology, and End Results (SEER) Registry database, a US population-based cancer registry database, was used to identify all patients diagnosed with primary spinal chordoma from 1973 to 2014. We utilized Kaplan-Meier method and Cox proportional hazards regression analysis to evaluate the association between patients overall survival and relevant characteristics, including age, gender, race, disease stage, treatment methods, primary tumor site, marital status, and urban county background. In the data set between 1973 and 2014, a total of 808 patients were identified with primary spinal chordoma. The overall rate of distant metastatic cases in our cohort was only 7.7%. Spinal chordoma was more common occurred in men (62.6%) than women (37.3%). Majority of neoplasms were found in the White (87.9%), while the incidence of the Black is relatively infrequent (3.3%). Three hundred fifty-seven spinal chordomas (44.2%) were located in the vertebral column, while 451 patients' tumor (55.8%) was located in the sacrum or pelvis. Age ≥ 60 years (HR = 2.72; 95%CI, 1.71 to 2.89), distant metastasis (HR = 2.16; 95%CI, 1.54 to 3.02), and non-surgical therapy (HR = 2.14; 95%CI, 1.72 to 2.69) were independent risk factors for survival reduction in analysis. Survival did not significantly differ as a factor of tumor site (vertebrae vs sacrum/pelvis) for primary spinal chordoma (HR = 0.93, P = 0.16). Race (P = 0.52), gender (P = 0.11), marital status (P = 0.94), and urban background (P = 0.72) were not main factors which affected overall survival rate. There was no significant difference in overall survival rate between chordomas located in the sacrum and vertebral column. Spinal chordoma patients with an elderly age (age ≥ 60), performing non-surgical therapy, and distant metastasis were associated with worse overall survival. Performing surgery was an effective and reliable treatment method for patients with spinal chordoma, and public health efforts should pay more attention to the elderly patients with spinal chordoma prior to distant metastasis.

Exploring paraprofessional and classroom factors affecting teacher supervision.

PubMed

Irvin, Dwight W; Ingram, Paul; Huffman, Jonathan; Mason, Rose; Wills, Howard

2018-02-01

Paraprofessionals serve a primary role in supporting students with disabilities in the classroom, which necessitates teachers' supervision as a means to improve their practice. Yet, little is known regarding what factors affect teacher supervision. We sought to identify how paraprofessional competence and classroom type affected the levels of teacher direction. We administered an adapted version of the Paraprofessional Needs, Knowledge & Tasks Survey and the Survey for Teachers Supervising Paraprofessionals to teachers supervising paraprofessionals in elementary schools. Structural Equation Modeling was used to examine the link between paraprofessional competence and classroom factors affecting the level of teacher supervision. Our results indicated that when teachers perceived paraprofessionals as being more skilled, they provided more supervision, and when more supervision was provided the less they thought paraprofessionals should be doing their assigned tasks. Additionally, paraprofessionals working in classrooms with more students with mild disabilities received less supervision than paraprofessionals working in classrooms with more students with moderate-to-severe disabilities. Those paraprofessionals in classrooms serving mostly children with mild disabilities were also perceived as having lower levels of skill competence than those serving in classrooms with students with more moderate-to-severe disabilities. By understanding the factors that affect teacher supervision, policy and professional development opportunities can be refined/developed to better support both supervising teachers and paraprofessionals and, in turn, improve the outcomes of children with disabilities. Copyright © 2017 Elsevier Ltd. All rights reserved.

Which factors play a role in Dutch health promotion professionals’ decision to recruit actively primary schools to use a web-based smoking prevention programme?

PubMed Central

2013-01-01

Background Municipal Health Promotion Organisations (MHPOs) play an important role in promoting and disseminating prevention programmes, such as smoking prevention programmes, in schools. This study identifies factors that may facilitate or hinder MHPOs’ willingness to recruit actively primary schools to use a smoking prevention programme. Methods In 2011, 31 Dutch MHPOs were invited to recruit schools to use a smoking prevention programme. All MHPO employees involved in smoking prevention activities (n = 68) were asked to complete a questionnaire assessing psychological factors and characteristics of their organisation that might affect their decision to be involved in active recruitment of schools. T-tests and multivariate analysis of variance assessed potential differences in psychological and organisational factors between active and non-active recruiters. Results A total of 45 professionals returned the questionnaire (66.2%). Active recruiters (n = 12) had more positive attitudes (p = 0.02), higher self-efficacy expectations (p < 0.01) and formulated more plans (p < 0.01) to recruit primary schools, compared with non-active recruiters. Organisational factors did not discriminate between active and non-active recruiters. Conclusions Primarily psychological factors seem to be associated with MHPOs’ decision to recruit schools actively. This indicates that creating more positive attitude, self-efficacy beliefs and formation of plans may help in getting more MHPOs involved in active recruitment procedures. PMID:24298942

Which factors play a role in Dutch health promotion professionals' decision to recruit actively primary schools to use a web-based smoking prevention programme?

PubMed

Cremers, Henricus-Paul; Oenema, Anke; Mercken, Liesbeth; Candel, Math; de Vries, Hein

2013-12-03

Municipal Health Promotion Organisations (MHPOs) play an important role in promoting and disseminating prevention programmes, such as smoking prevention programmes, in schools. This study identifies factors that may facilitate or hinder MHPOs' willingness to recruit actively primary schools to use a smoking prevention programme. In 2011, 31 Dutch MHPOs were invited to recruit schools to use a smoking prevention programme. All MHPO employees involved in smoking prevention activities (n = 68) were asked to complete a questionnaire assessing psychological factors and characteristics of their organisation that might affect their decision to be involved in active recruitment of schools. T-tests and multivariate analysis of variance assessed potential differences in psychological and organisational factors between active and non-active recruiters. A total of 45 professionals returned the questionnaire (66.2%). Active recruiters (n = 12) had more positive attitudes (p = 0.02), higher self-efficacy expectations (p < 0.01) and formulated more plans (p < 0.01) to recruit primary schools, compared with non-active recruiters. Organisational factors did not discriminate between active and non-active recruiters. Primarily psychological factors seem to be associated with MHPOs' decision to recruit schools actively. This indicates that creating more positive attitude, self-efficacy beliefs and formation of plans may help in getting more MHPOs involved in active recruitment procedures.

Social workers in pediatric primary care: communication, gender, and scope of practice.

PubMed

Lynch, Sean

2014-01-01

While many child mental health issues manifest themselves in primary care, few pediatricians have received mental health training, and their communication with social workers may be limited due to unfamiliarity with mental health professions. The purpose of this study was to use ethnographic interviews to investigate factors affecting communication satisfaction between social workers and pediatricians. The study found that scope of practice issues were a communication barrier. This barrier is significant because health reform may lead social workers and pediatricians to collaborate more frequently in the future.

Psychosocial Risk Factors, Interventions, and Comorbidity in Patients with Non-Specific Low Back Pain in Primary Care: Need for Comprehensive and Patient-Centered Care

PubMed Central

Ramond-Roquin, Aline; Bouton, Céline; Bègue, Cyril; Petit, Audrey; Roquelaure, Yves; Huez, Jean-François

2015-01-01

Non-specific low back pain (LBP) affects many people and has major socio-economic consequences. Traditional therapeutic strategies, mainly focused on biomechanical factors, have had moderate and short-term impact. Certain psychosocial factors have been linked to poor prognosis of LBP and they are increasingly considered as promising targets for management of LBP. Primary health care providers (HCPs) are involved in most of the management of people with LBP and they are skilled in providing comprehensive care, including consideration of psychosocial dimensions. This review aims to discuss three pieces of recent research focusing on psychosocial issues in LBP patients in primary care. In the first systematic review, the patients’ or HCPs’ overall judgment about the likely evolution of LBP was the factor most strongly linked to poor outcome, with predictive validity similar to that of multidimensional scales. This result may be explained by the implicit aggregation of many prognostic factors underlying this judgment and suggests the relevance of considering the patients from biopsychosocial and longitudinal points of view. The second review showed that most of the interventions targeting psychosocial factors in LBP in primary care have to date focused on the cognitive-behavioral factors, resulting in little impact. It is unlikely that any intervention focusing on a single factor would ever fit the needs of most patients; interventions targeting determinants from several fields (mainly psychosocial, biomechanical, and occupational) may be more relevant. Should multiple stakeholders be involved in such interventions, enhanced interprofessional collaboration would be critical to ensure the delivery of coordinated care. Finally, in the third study, the prevalence of psychosocial comorbidity in chronic LBP patients was not found to be significantly higher than in other patients consulting in primary care. Rather than specifically screening for psychosocial conditions, this suggests taking into account any potential comorbidity in patients with chronic LBP, as in other patients. All these results support the adoption of a more comprehensive and patient-centered approach when dealing with patients with LBP in primary care. As this condition is illustrative of many situations encountered in primary care, the strategies proposed here may benefit most patients consulting in this setting. PMID:26501062

Chronic diseases are not being managed effectively in either high-risk or low-risk populations in South Africa.

PubMed

Brand, Martin; Woodiwiss, Angela J; Michel, Frederic; Booysens, Hendrik L; Majane, Olebogeng H I; Maseko, Muzi J; Veller, Martin G; Norton, Gavin R

2013-07-29

Primary healthcare is the foundation of a country's healthcare system. Without an efficient and cost-effective programme, the level of healthcare offered across all levels of health management is adversely affected. To analyse the effectiveness of the management of hypertension and diabetes mellitus (DM) among two distinct patient populations, one with significant cardiovascular risk factors and the other without. We performed a case control study of a high-risk group of patients presenting with chronic critical limb ischaemia (CLI) to the Divisions of Vascular Surgery at Charlotte Maxeke Johannesburg Academic Hospital and Chris Hani Baragwanath Academic Hospital, and a randomly selected group of 'healthy' community participants from Johannesburg's South Western Townships (Soweto). We assessed 217 patients with CLI and 1 030 participants from the community. We assessed the number of patients who were not achieving their therapeuatic targets, among those known to be hypertensive (CLI: 44.7%; community: 59.9%) and diabetic (CLI: 83.5%; community: 66%). Undiagnosed diabetes affected 10.8% of patients with CLI and 11% of the community sample. Traditional vascular risk factors are managed poorly at both primary healthcare and at tertiary care levels. There is a need to identify factors that will address this issue.

Associations between thin slice ratings of affect and rapport and perceived patient-centeredness in primary care: Comparison of audio and video recordings.

PubMed

Henry, Stephen G; Penner, Louis A; Eggly, Susan

2017-06-01

To investigate associations between ratings of "thin slices" from recorded clinic visits and perceived patient-centeredness; to compare ratings from video recordings (sound and images) versus audio recordings (sound only). We analyzed 133 video-recorded primary care visits and patient perceptions of patient-centeredness. Observers rated thirty-second thin slices on variables assessing patient affect, physician affect, and patient-physician rapport. Video and audio ratings were collected independently. In multivariable analyses, ratings of physician positive affect (but not patient positive affect) were significantly positively associated with perceived patient-centeredness using both video and audio thin slices. Patient-physician rapport was significantly positively associated with perceived patient-centeredness using audio, but not video thin slices. Ratings from video and audio thin slices were highly correlated and had similar underlying factor structures. Physician (but not patient) positive affect is significantly associated with perceptions of patient-centeredness and can be measured reliably using either video or audio thin slices. Additional studies are needed to determine whether ratings of patient-physician rapport are associated with perceived patient-centeredness. Observer ratings of physician positive affect have a meaningful positive association with patients' perceptions of patient-centeredness. Patients appear to be highly attuned to physician positive affect during patient-physician interactions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Accurate and reproducible measurements of RhoA activation in small samples of primary cells.

PubMed

Nini, Lylia; Dagnino, Lina

2010-03-01

Rho GTPase activation is essential in a wide variety of cellular processes. Measurement of Rho GTPase activation is difficult with limited material, such as tissues or primary cells that exhibit stringent culture requirements for growth and survival. We defined parameters to accurately and reproducibly measure RhoA activation (i.e., RhoA-GTP) in cultured primary keratinocytes in response to serum and growth factor stimulation using enzyme-linked immunosorbent assay (ELISA)-based G-LISA assays. We also established conditions that minimize RhoA-GTP in unstimulated cells without affecting viability, allowing accurate measurements of RhoA activation on stimulation or induction of exogenous GTPase expression. Copyright 2009 Elsevier Inc. All rights reserved.

Direct calibration of a reference standard against the air kerma strength primary standard, at 192Ir HDR energy.

PubMed

Rajan, K N Govinda; Selvam, T Palani; Bhatt, B C; Vijayam, M; Patki, V S; Vinatha; Pendse, A M; Kannan, V

2002-04-07

The primary standard of low air kerma rate sources or beams, maintained at the Radiological Standards Laboratory (RSL) of the Bhabha Atomic Research Centre (BARC), is a 60 cm3 spherical graphite ionization chamber. A 192Ir HDR source was standardized at the hospital site in units of air kerma strength (AKS) using this primary standard. A 400 cm3 bakelite chamber, functioning as a reference standard at the RSL for a long period, at low air kerma rates (compared to external beam dose rates), was calibrated against the primary standard. It was seen that the primary standard and the reference standard, both being of low Z, showed roughly the same scatter response and yielded the same calibration factor for the 400 cm3 reference chamber, with or without room scatter. However, any likelihood of change in the reference chamber calibration factor would necessitate the re-transport of the primary standard to the hospital site for re-calibration. Frequent transport of the primary standard can affect the long-term stability of the primary standard, due to its movement or other extraneous causes. The calibration of the reference standard against the primary standard at the RSL, for an industrial type 192Ir source maintained at the laboratory, showed excellent agreement with the hospital calibration, making it possible to check the reference chamber calibration at RSL itself. Further calibration procedures have been developed to offer traceable calibration of the hospital well ionization chambers.

Military service and other socioecological factors influencing weight and health behavior change in overweight and obese Veterans: a qualitative study to inform intervention development within primary care at the United States Veterans Health Administration.

PubMed

Jay, Melanie; Mateo, Katrina F; Squires, Allison P; Kalet, Adina L; Sherman, Scott E

2015-01-01

Obesity affects 37 % of patients at Veterans Health Administration (VHA) medical centers. The VHA offers an intensive weight management program (MOVE!) but less than 10 % of eligible patients ever attend. However, VHA patients see their primary care provider about 3.6 times per year, supporting the development of primary care-based weight management interventions. To address gaps in the literature regarding Veterans' experiences with weight management and determine whether and how to develop a primary care-based weight management intervention to both improve obesity counseling and increase attendance to MOVE!, we conducted a qualitative study to assess: 1) Veterans' personal experiences with healthy weight-related behavior change (including barriers and facilitators to behavior change and experiences with primary care providers, staff, and the MOVE! program), and 2) potential new approaches to improve weight management within primary care at the VHA including goal setting and technology. Overweight/obese VHA patients (aged 18-75, BMI greater than 30 or greater than 25 with at least 1 co-morbidity) were recruited for focus group sessions stratified by gender, MOVE! referral, and attendance. Each session was facilitated by a trained moderator, audio-recorded, and professionally transcribed. Using an iterative coding approach, two coders separately reviewed and coded transcripts, and met frequently to negotiate codes and synthesize emerging themes. Of 161 eligible patients, 54 attended one of 6 focus groups (2 female, 4 male, 9-11 participants per session): 63 % were male, 46 % identified as African-American, 32 % White/Caucasian, 74 % were college-educated or higher, and 61 % reported having attended MOVE!. We identified two major themes: Impact of Military Service and Promotion and Sustainability of Healthy Behaviors. After service in a highly structured military environment, Veterans had difficulty maintaining weight on their own. They perceived physical activity as having more impact than diet, but chronic pain was a barrier. We identified individual/interpersonal-, community/environment-, and healthcare system-related factors affecting healthy behaviors. We also received input about Veteran's preferences and experiences with technology and setting health goals. Unique factors influence weight management in Veterans. Findings will inform development of a technology-assisted weight management intervention with tailored counseling and goal-setting within primary care at the VHA.

City image towards tourist attraction (case in Solo, Central Java) examining city image of solo as tourist attraction

NASA Astrophysics Data System (ADS)

Wiyana, T.; Putranto, T. S.; Zulkarnain, A.; Kusdiana, R. N.

2018-03-01

Affective and cognitive image are two main factors that influence destination in Solo. The purpose of this research is to examine the two main factors of Solo towards tourist attraction. The research method is quantitative. Data collected from observation and survey. A total of 113 respondents obtained from accidental sampling method. The results indicate based on cognitive and affective image. Cognitive consists of culture, batik, city tagline, and community. While, affective consists of tradition, culinary, purposes, climate, and welcoming. The findings show that image has weak correlation towards tourist attraction of Solo. It means most of the tourists are not influenced by city image when they choose Solo as one of their travel destination. The differences between primary and minor image are also examined. Research implication is directed for local government to pursue continuous improvement particularly for the branding of Solo.

Identification, summary and comparison of tools used to measure organizational attributes associated with chronic disease management within primary care settings

PubMed Central

Lukewich, Julia; Corbin, Renée; VanDenKerkhof, Elizabeth G; Edge, Dana S; Williamson, Tyler; Tranmer, Joan E

2014-01-01

Rationale, aims and objectives Given the increasing emphasis being placed on managing patients with chronic diseases within primary care, there is a need to better understand which primary care organizational attributes affect the quality of care that patients with chronic diseases receive. This study aimed to identify, summarize and compare data collection tools that describe and measure organizational attributes used within the primary care setting worldwide. Methods Systematic search and review methodology consisting of a comprehensive and exhaustive search that is based on a broad question to identify the best available evidence was employed. Results A total of 30 organizational attribute data collection tools that have been used within the primary care setting were identified. The tools varied with respect to overall focus and level of organizational detail captured, theoretical foundations, administration and completion methods, types of questions asked, and the extent to which psychometric property testing had been performed. The tools utilized within the Quality and Costs of Primary Care in Europe study and the Canadian Primary Health Care Practice-Based Surveys were the most recently developed tools. Furthermore, of the 30 tools reviewed, the Canadian Primary Health Care Practice-Based Surveys collected the most information on organizational attributes. Conclusions There is a need to collect primary care organizational attribute information at a national level to better understand factors affecting the quality of chronic disease prevention and management across a given country. The data collection tools identified in this review can be used to establish data collection strategies to collect this important information. PMID:24840066

Preventive strategies for traumatic dental injuries.

PubMed

Bourguignon, Cecilia; Sigurdsson, Asgeir

2009-10-01

Traumatic dental and maxillofacial injuries are common occurrences, and affect worldwide approximately 20% to 30% of permanent dentition, often with serious aesthetic, functional, psychological, and economic consequences. With such a high frequency of injuries, prevention becomes a primary goal. A prevention approach relies on the identification of etiologic factors, and on giving rise to measures aimed at avoiding those factors or at reducing their impact. This article reviews the etiology and preventive strategy regarding dental injuries, and examines the role and manufacture of appliances, especially mouthguards, in preventive dentistry.

Clinical outcome after pulmonary metastasectomy from primary hepatocellular carcinoma: Analysis of prognostic factors

PubMed Central

Kwon, Jong-Bum; Park, Khun; Kim, Young-Du; Seo, Jong-Hee; Moon, Seok-Whan; Cho, Deog-Gon; Kim, Yong-Whan; Kim, Dong-Goo; Yoon, Seung-Kew; Lim, Hyeon-Woo

2008-01-01

AIM: To review the surgical outcomes in terms of the surgical indications and relevant prognostic factors. METHODS: Sixteen patients underwent therapeutic lung surgery between March 1999 and May 2006. The observation period was terminated on May 31, 2007. The surgical outcomes and the clinicopathological factors were compared. RESULTS: There was no mortality or major morbidity encountered in this study. The mean follow-up period after metastasectomy was 26.7 ± 28.2 (range: 1-99 mo), and the median survival time was 20 mo. The 1- and 5-year survival rates were 56% and 26%, respectively. At the end of the follow-up, 1 patient died from hepatic failure without recurrence, 6 died from hepatic failure with a recurrent hepatocellular carcinoma (HCC), and 4 died from recurrent HCC with cachexia. Among several clinical factors, Kaplan-Meier analysis revealed that liver transplantation as a treatment for the primary lesion, grade of cell differentiation, and negative evidence HBV infection were independent predictive factors. On Cox’s proportional hazard model, there were no significant factors affecting survival after pulmonary metastasectomy in patients with HCC. CONCLUSION: A metastasectomy should be performed before other treatments in selected patients. Although not significant, patients with liver transplantation of a primary HCC survived longer. Liver transplantation might be the most beneficial modality that can offer patients better survival. A multi-institutional and collaborative study would be needed for identifying clinical prognostic factors predicting survival in patients with HCC and lung metastasis. PMID:18837090

Posttraumatic stress disorder symptom severity and control beliefs as the predictors of academic burnout amongst adolescents following the Wenchuan Earthquake.

PubMed

Zhou, Xiao; Zhen, Rui; Wu, Xinchun

2017-01-01

Background : Previous studies indicate that posttraumatic stress disorder (PTSD) and control beliefs can affect burnout and their unique role in this situation has been examined, but fewer studies have examined their combined role in adolescent's academic burnout following traumatic events. Objective : This study examined the combined effect of PTSD symptom severity and control beliefs on academic burnout among adolescents, and assessed the moderating role of primary and secondary control beliefs in the relation between PTSD symptom severity and academic burnout. Methods : Seven hundred and forty-five adolescents were investigated using self-report questionnaires, and a series of regression equations examined the impact of PTSD severity and control beliefs on academic burnout. Results : PTSD symptom severity is associated positively with academic burnout, while primary and secondary control beliefs have a negative relation with academic burnout. In addition, primary control beliefs buffer the positive effects of PTSD symptom severity on academic burnout. We found that the positive relation between PTSD symptom severity and academic burnout in the low primary control beliefs group is more intense than that found in the high primary control beliefs group. Conclusions : PTSD symptom severity is a risk factor, whereas primary and secondary control beliefs are protective factors in academic burnout. In addition, PTSD symptom severity and primary control beliefs have a combined effect on academic burnout in adolescents following natural disasters.

Medication adherence among hypertensive patients of primary health clinics in Malaysia

PubMed Central

Ramli, Azuana; Ahmad, Nur Sufiza; Paraidathathu, Thomas

2012-01-01

Purpose Poor adherence to prescribed medications is a major cause for treatment failure, particularly in chronic diseases such as hypertension. This study was conducted to assess adherence to medications in patients undergoing hypertensive treatment in the Primary Health Clinics of the Ministry of Health in Malaysia. Factors affecting adherence to medications were studied, and the effect of nonadherence to blood pressure control was assessed. Patients and methods This was a cross-sectional study to assess adherence to medications by adult patients undergoing hypertensive treatment in primary care. Adherence was measured using a validated survey form for medication adherence consisting of seven questions. A retrospective medication record review was conducted to collect and confirm data on patients’ demographics, diagnosis, treatments, and outcomes. Results Good adherence was observed in 53.4% of the 653 patients sampled. Female patients were found to be more likely to adhere to their medication regime, compared to their male counterparts (odds ratio 1.46 [95% confidence intervals [CI]: 1.05–2.04; P < 0.05]). Patients in the ethnic Chinese were twice as likely (95% CI: 1.14–3.6; P < 0.05) to adhere, compared to those in the Indian ethnic group. An increase in the score for medicine knowledge was also found to increase the odds of adherence. On the other hand, increasing the number of drugs the patient was taking and the daily dose frequencies of the medications prescribed were found to negatively affect adherence. Blood pressure control was also found to be worse in noncompliers. Conclusion The medication adherence rate was found to be low among primary care hypertensive patients. A poor adherence rate was found to negatively affect blood pressure control. Developing multidisciplinary intervention programs to address the factors identified is necessary to improve adherence and, in turn, to improve blood pressure control. PMID:22969292

The Prevalence and Pattern of Superficial Fungal Infections among School Children in Ile-Ife, South-Western Nigeria

PubMed Central

Oke, Olaide Olutoyin; Onayemi, Olaniyi; Olasode, Olayinka Abimbola; Omisore, Akinlolu Gabriel; Oninla, Olumayowa Abimbola

2014-01-01

Fungal infections of the skin and nails are common global problems with attendant morbidity among affected individuals. Children are mostly affected due to predisposing factors such as overcrowding and low socioeconomic factors. The aim of this study was to determine the prevalence and the clinical patterns of superficial fungal infections among primary school children in Ile-Ife. A multistage sampling was conducted to select eight hundred pupils from ten primary schools in Ile-Ife. Data on epidemiological characteristics and clinical history was collected using a semistructured questionnaire and skin scrapings were done. The prevalence of superficial fungal infections among the 800 respondents was 35.0%. Male pupils constituted 51.0% of respondents while the females were 49.0%. The mean age for all the respondents was 9.42 ± 2.00. Tinea capitis was the commonest infection with a prevalence of 26.9% and tinea unguium, tinea corporis, and tinea faciei had a prevalence of 0.8%, 0.6%, and 0.5%, respectively. Tinea manuum had the least prevalence of 0.1%. Pityriasis versicolor had a prevalence of 4.4%. Microsporum audouinii was the leading organism isolated. The study shows that the prevalence of superficial fungal infection (SFI) among primary school children in Ile-Ife is high with tinea capitis as the commonest SFI. PMID:25574161

Landscape level influence: aquatic primary production in the Colorado River of Glen and Grand canyons

NASA Astrophysics Data System (ADS)

Yard, M. D.; Kennedy, T.; Yackulic, C. B.; Bennett, G. E.

2012-12-01

Irregular features common to canyon-bound regions intercept solar incidence (photosynthetic photon flux density [PPFD: μmol m-2 s-1]) and can affect ecosystem energetics. The Colorado River in Grand Canyon is topographically complex, typical of most streams and rivers in the arid southwest. Dam-regulated systems like the Colorado River have reduced sediment loads, and consequently increased water transparency relative to unimpounded rivers; however, sediment supply from tributaries and flow regulation that affects erosion and subsequent sediment transport, interact to create spatial and temporal variation in optical conditions in this river network. Solar incidence and suspended sediment loads regulate the amount of underwater light available for aquatic photosynthesis in this regulated river. Since light availability is depth dependent (Beer's law), benthic algae is often exposed to varying levels of desiccation or reduced light conditions due to daily flow regulation, additional factors that further constrain aquatic primary production. Considerable evidence suggests that the Colorado River food web is now energetically dependent on autotrophic production, an unusual condition since large river foodwebs are typically supported by allochthonous carbon synthesized and transported from terrestrial environments. We developed a mechanistic model to account for these regulating factors to predict how primary production might be affected by observed and alternative flow regimes proposed as part of ongoing adaptive management experimentation. Inputs to our model include empirical data (suspended sediment and temperature), and predictive relationships: 1) solar incidence reaching the water surface (topographic complexity), 2) suspended sediment-light extinction relationships (optical properties), 3) unsteady flow routing model (stage-depth relationship), 4) channel morphology (photosynthetic area), and 5) photosynthetic-irradiant response for dominant algae (Cladophora glomerata and associated epiphytes). Initial findings suggest that aquatic primary production varies spatially and temporally in response to natural processes occurring at varying spatial scales and that flow regulation per se has only a minor effect on primary production. All of these physical drivers combined are likely to structure the abundance, distribution, and interaction of aquatic biota found in this ecosystem.

Influence of metabolic-linked early life factors on the eruption timing of the first primary tooth.

PubMed

Un Lam, Carolina; Hsu, Chin-Ying Stephen; Yee, Robert; Koh, David; Lee, Yung Seng; Chong, Mary Foong-Fong; Cai, Meijin; Kwek, Kenneth; Saw, Seang Mei; Godfrey, Keith; Gluckman, Peter; Chong, Yap Seng

2016-11-01

Early eruption of permanent teeth has been associated with childhood obesity and diabetes mellitus, suggesting links between tooth eruption and metabolic conditions. This longitudinal study aimed to identify pre-, peri- and postnatal factors with metabolic consequences during infancy that may affect the eruption timing of the first primary tooth (ETFT) in children from an ethnically heterogeneous population residing within the same community. Participants were recruited (n = 1033) through the GUSTO (Growing Up in Singapore Towards healthy Outcomes) birth cohort (n = 1237). Oral examinations were performed at 3-month intervals from 6 to 18 months of age. Crude and adjusted analyses, with generalized linear modelling, were conducted to link ETFT to potential determinants occurring during pregnancy, delivery/birth and early infancy. Overall mean eruption age of the first primary tooth was 8.5 (SD 2.6) months. Earlier tooth eruption was significantly associated with infant's rate of weight gain during the first 3 months of life and increased maternal childbearing age. Compared to their Chinese counterparts, Malay and Indian children experienced significantly delayed tooth eruption by 1.2 and 1.7 months, respectively. Infant weight gain from birth to 3 months, ethnicity and maternal childbearing age were significant determinants of first tooth eruption timing. Early life influences can affect primary tooth development, possibly via metabolic pathways. Timing of tooth eruption is linked to general growth and metabolic function. Therefore, it has potential in forecasting oral and systemic conditions such as caries and obesity.

Phenomenology and neurobiology of self disorder in schizophrenia: Primary factors.

PubMed

Borda, Juan P; Sass, Louis A

2015-12-01

Schizophrenia is a heterogeneous syndrome, varying between persons and over course of illness. In this and a companion article, we argue that comprehension of this condition or set of conditions may require combining a phenomenological perspective emphasizing disorders of basic-self experience ("ipseity disturbance") with a multidimensional appreciation of possible neurobiological correlates--both primary and secondary. Previous attempts to link phenomenology and neurobiology generally focus on a single neurocognitive factor. We consider diverse aspects of schizophrenia in light of a diverse, albeit interacting, set of neurocognitive abnormalities, examining both synchronic (structural) interdependence and diachronic (temporal) succession. In this article we focus on the primary or foundational role of early perceptual and motoric disturbances that affect perceptual organization and especially intermodal or multisensory perceptual integration (“perceptual dys-integration”). These disturbances are discussed in terms of their implications for three interconnected aspects of selfhood in schizophrenia, primary forms of: disrupted "hold" or "grip" on the world, hyperreflexivity, diminished self-presence (self-affection). Disturbances of organization or integration imply forms of perceptual incoherence or diminished cognitive coordination. The effect is to disrupt one's ability to apprehend the world in holistic, vital, or contextually grounded fashion, or to fully identify with or experience the unity of one's own body or thinking--thereby generating an early and profound (albeit often subtle) disruption or diminishment of basic or core self and of the sense of existing in a coherent world. We discuss interrelationships or possible complementarities between these three aspects, and consider their relevance for a neurodevelopmental account of schizophrenia. Copyright © 2015 Elsevier B.V. All rights reserved.

Effects of climate and lifeform on dry matter yield (epsilon) from simulations using BIOME BGC. [ecosystem process model for vegetation biomass production using daily absorbed photosynthetically active radiation

NASA Technical Reports Server (NTRS)

Hunt, E. R., Jr.; Running, Steven W.

1992-01-01

An ecosystem process simulation model, BIOME-BGC, is used in a sensitivity analysis to determine the factors that may cause the dry matter yield (epsilon) and annual net primary production to vary for different ecosystems. At continental scales, epsilon is strongly correlated with annual precipitation. At a single location, year-to-year variation in net primary production (NPP) and epsilon is correlated with either annual precipitation or minimum air temperatures. Simulations indicate that forests have lower epsilon than grasslands. The most sensitive parameter affecting forest epsilon is the total amount of living woody biomass, which affects NPP by increasing carbon loss by maintenance respiration. A global map of woody biomass should significantly improve estimates of global NPP using remote sensing.

Factors Affecting Burden of South Koreans Providing Care to Disabled Older Family Members

ERIC Educational Resources Information Center

Lee, Minhong; Yoon, Eunkyung; Kropf, Nancy P.

2007-01-01

This study examined the determinants of caregiving burden among South Koreans who care for their disabled older family members. A sample of 1,000 primary caregivers taken from the Comprehensive Study for Elderly Welfare Policy in Seoul, South Korea was analyzed. Independent variables included the demographic characteristics of caregivers and care…

Psychosocial Processes and Sexual Initiation among Ghanaian Youth

ERIC Educational Resources Information Center

McQuestion, Michael; Ahiadeke, Clement; Posner, Jessica; Williams, Timothy

2012-01-01

This study models primary abstinence and age at first sex in a cross-sectional sample of Ghanaian youth aged 17 to 22 years. The aim is to examine how reproductive knowledge and social cognitive factors jointly affect the choice to initiate sex. Among males, the authors find that reproductive knowledge is negatively associated with abstinence. Its…

Dietary Management in Diabetes Mellitus. Nutrition in Primary Care Series, Number 10.

ERIC Educational Resources Information Center

Bossetti, Brenda; Gallagher-Allred, Charlette R.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

Normal Diet: Age of Parental Control. Nutrition in Primary Care Series, Number 5.

ERIC Educational Resources Information Center

Tuckermanty, Elizabeth; Gallagher-Allred, Charlette R.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

Normal Diet: Age of Dependency. Nutrition in Primary Care Series, Number 4.

ERIC Educational Resources Information Center

Cox, Janice Hovasi; Gallagher-Allred, Charlette R.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

What Influences Geography Teachers' Usage of Geographic Information Systems? A Structural Equation Analysis

ERIC Educational Resources Information Center

Lay, Jinn-Guey; Chi, Yu-Lin; Hsieh, Yeu-Sheng; Chen, Yu-Wen

2013-01-01

Understanding the usage of the geographic information system (GIS) among geography teachers is a crucial step in evaluating the current dissemination of GIS knowledge and skills in Taiwan's educational system. The primary contribution of this research is to further our understanding of the factors that affect teachers' GIS usage. The structural…

The Socioeconomic Context of Home-Based Learning by Women in Malaysia

ERIC Educational Resources Information Center

Loh-Ludher, Lee Lee

2007-01-01

A major goal of Asian distance education is the creation of effective formal and nonformal programs for the benefit of the poor and needy; and the primary place in which distance education usually takes place is the home. This article addresses issues fundamental to the spread of distance education in Asia--factors affecting domestic and social…

Normal Diet: Pregnancy and Lactation. Nutrition in Primary Care Series, Number 7.

ERIC Educational Resources Information Center

Cox, Janice Hovasi; Gallagher-Allred, Charlette R.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

Guidelines for developing and updating Bayesian belief networks applied to ecological modeling and conservation.

Treesearch

B.G. Marcot; J.D. Steventon; G.D. Sutherland; R.K. McCann

2006-01-01

We provide practical guidelines for developing, testing, and revising Bayesian belief networks (BBNs). Primary steps in this process include creating influence diagrams of the hypothesized "causal web" of key factors affecting a species or ecological outcome of interest; developing a first, alpha-level BBN model from the influence diagram; revising the model...

Factors Affecting Teachers' Motivation: An HRM Challenge for Public Sector Higher Educational Institutions of Pakistan (HEIs)

ERIC Educational Resources Information Center

Rasheed, Muhammad Imran; Humayon, Asad Afzal; Awan, Usama; Ahmed, Affan ud Din

2016-01-01

Purpose: The purpose of this paper is to explore/investigate various issues of teachers ' motivation in public sector Higher Educational Institutions of Pakistan. Design/methodology/approach: This is an exploratory research where surveys have been conducted in the well known public sector Universities of Pakistan; primary data have been collected…

Global attractors for a discrete selection model with periodic immigration

Treesearch

James F. Selgrade; James H. Roberds

2007-01-01

A one-island selection-migration model is used to study the periodic immigration of a population of fixed allele frequency into a natural population. Density-dependent selection and immigration are the primary factors affecting the demographic genetic change in the island population. With the assumptions of complete dominance (CD) or no dominance (ND) and homozygote...

Differential Profiles of Risk of Self-Harm among Clinically Referred Primary School Aged Children

ERIC Educational Resources Information Center

Angelkovska, Anne; Houghton, Stephen; Hopkins, Sarah

2012-01-01

Risk of self-harm among clinic referred children aged 6- to 12-years-old was investigated using the recently developed Self-Harm Risk Assessment for Children (SHRAC) instrument which comprises six factors: Affect traits; verbalizing of self-harm; socialization; dissociation; self-directing; and self-appraisal. The SHRAC was completed by the…

Trouble Ahead for Student Loans?

ERIC Educational Resources Information Center

Ergungor, O. Emre; Hathaway, Ian

2008-01-01

The market for student loans may differ in some respects from other financial markets, but private lenders are the primary source of funds. As in other markets, the incentive to lend those funds comes from the ability to make a profit. But recent turmoil in financial markets is affecting all of the factors that contribute to the profitability of…

Factors Affecting the Transition of Fifth Graders to the Academic Track in the Czech Republic

ERIC Educational Resources Information Center

Straková, Jana; Greger, David; Soukup, Petr

2016-01-01

The Czech education system is characterised by early tracking and high educational inequalities. The most controversial element of the system is the academic track, which is attended by students after the completion of primary school. The paper focuses on fifth graders' application process and their success in entrance examinations. The process is…

The Impact of Primary School Teachers' Educational Beliefs on the Classroom Use of Computers

ERIC Educational Resources Information Center

Hermans, R.; Tondeur, J.; van Braak, J.; Valcke, M.

2008-01-01

For many years, researchers have searched for the factors affecting the use of computers in the classroom. In studying the antecedents of educational computer use, many studies adopt a rather limited view because only technology-related variables, such as attitudes to computers and computer experience were taken into account. The present study…

Factors Affecting School Participation in Turkey: An Analysis of Regional Differences

ERIC Educational Resources Information Center

Gumus, Sedat; Chudgar, Amita

2016-01-01

There are thousands of children who remain out of school at both primary and secondary levels in Turkey. The current disparities in access to education in Turkey are mostly driven by systematic regional differences and high gender inequalities. Although several existing studies have paid close attention to gender-based inequities in school access,…

Parental Beliefs Concerning Development and Education, Family Educational Practices and Children's Intellectual and Academic Performances

ERIC Educational Resources Information Center

Tazouti, Youssef; Malarde, Amelie; Michea, Aurelie

2010-01-01

The present study examines the relationships between parental beliefs relating to development and education, parenting practices, and the intellectual and academic performances of children. Data were collected for 128 families with a child in the second or third year of primary school. Investigations of the factors affecting the children's…

Dietary Management for Alcoholic Patients. Nutrition in Primary Care Series, Number 14.

ERIC Educational Resources Information Center

Hurley, Roberta Smith; Gallagher-Allred, Charlette R.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

Dietary Management in Gastrointestinal Diseases. Nutrition in Primary Care Series, Number 13.

ERIC Educational Resources Information Center

Stein, Joan Z.; Gallagher-Allred, Charlette R.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

Changes in the U.S. Primary Standards for the Air Kerma From Gamma-Ray Beams

PubMed Central

Seltzer, Stephen M.; Bergstrom, Paul M.

2003-01-01

Monte Carlo photon-electron transport calculations have been done to derive new wall corrections for the six NBS-NIST standard graphite-wall, air-ionization cavity chambers that serve as the U.S. national primary standard for air kerma (and exposure) for gamma rays from 60Co, 137Cs, and 192Ir sources. The data developed for and from these calculations have also been used to refine a number of other factors affecting the standards. The largest changes are due to the new wall corrections, and the total changes are +0.87 % to +1.11 % (depending on the chamber) for 60Co beams, +0.64 % to +1.07 % (depending on the chamber) for 137Cs beams, and −0.06 % for the single chamber used in the measurement of the standardized 192Ir source. The primary standards for air kerma will be adjusted in the near future to reflect the changes in factors described in this work. PMID:27413615

Changes in the U.S. Primary Standards for the Air Kerma From Gamma-Ray Beams.

PubMed

Seltzer, Stephen M; Bergstrom, Paul M

2003-01-01

Monte Carlo photon-electron transport calculations have been done to derive new wall corrections for the six NBS-NIST standard graphite-wall, air-ionization cavity chambers that serve as the U.S. national primary standard for air kerma (and exposure) for gamma rays from (60)Co, (137)Cs, and (192)Ir sources. The data developed for and from these calculations have also been used to refine a number of other factors affecting the standards. The largest changes are due to the new wall corrections, and the total changes are +0.87 % to +1.11 % (depending on the chamber) for (60)Co beams, +0.64 % to +1.07 % (depending on the chamber) for (137)Cs beams, and -0.06 % for the single chamber used in the measurement of the standardized (192)Ir source. The primary standards for air kerma will be adjusted in the near future to reflect the changes in factors described in this work.

Lipopolysaccharide and hypoxia significantly alters interleukin-8 and macrophage chemoattractant protein-1 production by human fibroblasts but not fibrosis related factors.

PubMed

Eleftheriadis, T; Liakopoulos, V; Lawson, B; Antoniadi, G; Stefanidis, I; Galaktidou, G

2011-07-01

Besides extracellular matrix production, fibroblasts are able to produce various cytokines. Their ubiquitous position makes fibroblasts appropriate cells for sensing various noxious stimuli and for attracting immune cells in the affected area. In the present study the effect of lipopolysaccharide (LPS) and cobalt chloride (CoCl(2)) on the above fibroblasts functions were evaluated in primary human skin fibroblasts cultures. Collagen, matrix metalloproteinase-1, tissue inhibitor of metalloproteinases-1, transforming growth factor-β1, interleukin-8 (IL-8) and macrophage chemoattractant protein-1 (MCP-1) were measured in fibroblasts culture supernatants. Fibroblasts proliferation and viability were assessed as well. Hypoxia inducible factor-1α and the phosphorylated p65 portion of NF-κB were assessed in fibroblasts protein extracts. LPS and CoCl(2) had a minor effect on fibrosis related factors in human primary fibroblasts, possibly due to the absence of interplay with other cell types in the used experimental system. On the contrary both LPS and CoCl(2) increased significantly IL-8. LPS also increased considerably MCP-1, but CoCl(2) decreased it. Thus LPS and CoCl(2) induce a sentinel, nevertheless not identical, phenotype in primary human fibroblasts. The last disparity could result in different body response to infectious or hypoxic noxious stimuli.

Interacting factors associated with Low antibiotic prescribing for respiratory tract infections in primary health care - a mixed methods study in Sweden.

PubMed

Strandberg, Eva Lena; Brorsson, Annika; André, Malin; Gröndal, Hedvig; Mölstad, Sigvard; Hedin, Katarina

2016-07-18

Prescribing of antibiotics for common infections varies widely, and there is no medical explanation. Systematic reviews have highlighted factors that may influence antibiotic prescribing and that this is a complex process. It is unclear how factors interact and how the primary care organization affects diagnostic procedures and antibiotic prescribing. Therefore, we sought to explore and understand interactions between factors influencing antibiotic prescribing for respiratory tract infections in primary care. Our mixed methods design was guided by the Triangulation Design Model according to Creswell. Quantitative and qualitative data were collected in parallel. Quantitative data were collected by prescription statistics, questionnaires to patients, and general practitioners' audit registrations. Qualitative data were collected through observations and semi-structured interviews. From the analysis of the data from the different sources an overall theme emerged: A common practice in the primary health care centre is crucial for low antibiotic prescribing in line with guidelines. Several factors contribute to a common practice, such as promoting management and leadership, internalized guidelines including inter-professional discussions, the general practitioner's diagnostic process, nurse triage, and patient expectation. These factors were closely related and influenced each other. The results showed that knowledge must be internalized and guidelines need to be normative for the group as well as for every individual. Low prescribing is associated with adapted and transformed guidelines within all staff, not only general practitioners. Nurses' triage and self-care advice played an important role. Encouragement from the management level stimulated inter-professional discussions about antibiotic prescribing. Informal opinion moulders talking about antibiotic prescribing was supported by the managers. Finally, continuous professional development activities were encouraged for up-to-date knowledge.

Ebola Virus Disease in Children, Sierra Leone, 2014–2015

PubMed Central

Naveed, Asad; Wing, Kevin; Gbessay, Musa; Ross, J.C.G.; Checchi, Francesco; Youkee, Daniel; Jalloh, Mohammed Boie; Baion, David; Mustapha, Ayeshatu; Jah, Hawanatu; Lako, Sandra; Oza, Shefali; Boufkhed, Sabah; Feury, Reynold; Bielicki, Julia A.; Gibb, Diana M.; Klein, Nigel; Sahr, Foday; Yeung, Shunmay

2016-01-01

Little is known about potentially modifiable factors in Ebola virus disease in children. We undertook a retrospective cohort study of children <13 years old admitted to 11 Ebola holding units in the Western Area, Sierra Leone, during 2014–2015 to identify factors affecting outcome. Primary outcome was death or discharge after transfer to Ebola treatment centers. All 309 Ebola virus–positive children 2 days–12 years old were included; outcomes were available for 282 (91%). Case-fatality was 57%, and 55% of deaths occurred in Ebola holding units. Blood test results showed hypoglycemia and hepatic/renal dysfunction. Death occurred swiftly (median 3 days after admission) and was associated with younger age and diarrhea. Despite triangulation of information from multiple sources, data availability was limited, and we identified no modifiable factors substantially affecting death. In future Ebola virus disease epidemics, robust, rapid data collection is vital to determine effectiveness of interventions for children. PMID:27649367

The transcription factor AREB1 regulates primary metabolic pathways in tomato fruits

PubMed Central

Bastías, Adriana; Osorio, Sonia; Casaretto, José A.

2014-01-01

Tomato fruit development is regulated both by the action of plant hormones and by tight genetic control. Recent studies suggest that abscisic acid (ABA) signalling may affect different aspects of fruit maturation. Previously, it was shown that SlAREB1, an ABA-regulated transcription factor involved in stress-induced responses, is expressed in seeds and in fruit tissues in tomato. Here, the role of SlAREB1 in regulating the expression of genes relevant for primary metabolic pathways and affecting the metabolic profile of the fruit was investigated using transgenic tomato lines. Metabolite profiling using gas chromatography–time of flight mass spectrometry (GC-TOF-MS) and non-targeted liquid chromatography–mass spectrometry (LC-MS) was performed on pericarp tissue from fruits harvested at three stages of fruit development. Principal component analysis of the data could distinguish the metabolite profiles of non-transgenic fruits from those that overexpress and down-regulate SlAREB1. Overexpression of SlAREB1 resulted in increased content of organic acids, hexoses, hexose-phosphates, and amino acids in immature green, mature green, and red ripe fruits, and these modifications correlated with the up-regulation of enzyme-encoding genes involved in primary carbohydrate and amino acid metabolism. A non-targeted LC-MS analysis indicated that the composition of secondary metabolites is also affected in transgenic lines. In addition, gene expression data revealed that some genes associated with fruit ripening are also up-regulated in SlAREB1-overexpressing lines compared with wild-type and antisense lines. Taken together, the results suggest that SlAREB1 participates in the regulation of the metabolic programming that takes place during fruit ripening and that may explain part of the role of ABA in fruit development in tomato. PMID:24659489

Expression of hypoxia-induced factor-1 alpha in early-stage and in metastatic oral squamous cell carcinoma.

PubMed

Ribeiro, Maisa; Teixeira, Sarah R; Azevedo, Monarko N; Fraga, Ailton C; Gontijo, Antônio Pm; Vêncio, Eneida F

2017-04-01

To investigate hypoxia-induced factor-1 alpha expression in distinct oral squamous cell carcinoma subtypes and topographies and correlate with clinicopathological data. Hypoxia-induced factor-1 alpha expression was assessed by immunohistochemistry in 93 cases of OSCC. Clinical and histopathological data were reviewed from medical records. Hypoxia-induced factor-1 alpha status was distinct according to tumor location, subtype and topography affect. In superficial oral squamous cell carcinomas, most tumor cells overexpressed hypoxia-induced factor-1 alpha, whereas hypoxia-induced factor-1 alpha was restricted to the intratumoral region in conventional squamous cell carcinomas. All basaloid squamous cell carcinomas exhibited downregulation of hypoxia-induced factor-1 alpha. Interestingly, metastatic lymph nodes (91.7%, p = 0.001) and the intratumoral regions of corresponding primary tumors (58.3%, p = 0.142) showed hypoxia-induced factor-1 alpha-positive tumor cells. Overall survival was poor in patients with metastatic lymph nodes. Hypoxia-induced factor-1 alpha has distinct expression patterns in different oral squamous cell carcinoma subtypes and topographies, suggesting that low oxygen tension promotes the growth pattern of superficial and conventional squamous cell carcinoma, but not basaloid squamous cell carcinoma. Indeed, a hypoxic environment may facilitate regional metastasis, making it a useful diagnostic and prognostic marker in primary tumors.

Cancer patient autonomy and quality of dying-a prospective nationwide survey in Taiwan.

PubMed

Cheng, Shao-Yi; Lin, Wen-Yuan; Cheng, Ya-Hui; Huang, Chien Hsiun; Chen, Ching-Yu; Hwang, Shinn-Jang; Tsai, Shih-Tzu; Chiu, Tai-Yuan

2016-02-01

Patient autonomy is an essential factor in the measurement of quality of dying. We aimed to conduct a study to investigate the factors affecting the autonomy of advanced cancer patients in Taiwan. We conducted a prospective, multicenter study and recruited 574 advanced cancer patients from four inpatient hospice wards in Taiwan; their quality of dying was measured using the validated good death scale and the audit scale. Physician-assessed autonomy and the other scales were measured in a team conference by the primary care physician and the team 1 week after the patient had passed away. The good death scale was measured twice, once at admission and then after the patient had passed away for comparison. We measured factors affecting the improvement in quality of dying of these patients initially by applying multiple linear regression analysis. Then, taking physician-assessed autonomy as a dependent variable, we identified the factors that affected this variable. The good death score at admission, clear consciousness, number of admission days beyond 7, better physical care, higher physician-assessed autonomy, better emotional support, better communication, better continuity of life, and physician-reported rate of closure were factors affecting the quality of dying. Further analysis identified age (p = 0.031), consciousness (p = 0.01), and total good death scale score at death (p < 0.001) as determinants of physician-assessed autonomy. We concluded that physician-assessed autonomy would affect a good death and was highly correlated with age, consciousness level, and quality of dying at the end for advanced cancer patients in Taiwan. Copyright © 2015 John Wiley & Sons, Ltd.

Identifying the factors affecting bike-sharing usage and degree of satisfaction in Ningbo, China

PubMed Central

Guo, Yanyong; Zhou, Jibiao; Wu, Yao; Li, Zhibin

2017-01-01

The boom in bike-sharing is receiving growing attention as societies become more aware of the importance of active non-motorized traffic modes. However, the low usage of this transport mode in China raises concerns. The primary objective of this study is to explore factors affecting bike-sharing usage and satisfaction degree of bike-sharing among the bike-sharing user population in China. Data were collected by a questionnaire survey in Ningbo. A bivariate ordered probit (BOP) model was developed to examine simultaneously those factors associated with both bike-sharing usage and satisfaction degree of bike-sharing among users. Marginal effects for contributory factors were calculated to quantify their impacts on the outcomes. The results showed that the BOP model can account for commonly shared unobserved characteristics within usage and satisfaction of bike-sharing. The BOP model results showed that the usage of bike-sharing was affected by gender, household bicycle/e-bike ownership, trip model, travel time, bike-sharing stations location, and users’ perception of bike-sharing. The satisfaction degree of bike-sharing was affected by household income, bike-sharing stations location, and users’ perception of bike-sharing. It is also found that bike-sharing usage and satisfaction degree are strongly correlated and positive in direction. The results can enhance our comprehension of the factors that affect usage and satisfaction degree of bike-sharing. Based on the results, some suggestions regarding planning, engineering, and public advocacy were discussed to increase the usage of bike-sharing in Ningbo, China. PMID:28934321

Influence of hospital type on survival in stage IV colorectal cancer.

PubMed

Hoshino, Nobuaki; Hasegawa, Suguru; Hida, Koya; Kawada, Kenji; Okamura, Ryosuke; Hamada, Madoka; Munemoto, Yoshinori; Sakai, Yoshiharu; Watanabe, Masahiko

2016-08-01

Hospital factors along with various patient and surgeon factors are considered to affect the prognosis of colorectal cancer. Hospital volume is well known, but little is known regarding other hospital factors. We reviewed data on 853 patients with stage IV colorectal cancer who underwent elective palliative primary tumor resection between January 2006 and December 2007. To detect the hospital factors that could influence the prognosis of incurable colorectal cancer, the relationships between patient/hospital factors and overall survival were analyzed. Among hospital factors, hospital type (Group A: university hospital or cancer center; Group B: community hospital), hospital volume, and number of colorectal surgeons were examined. In univariate analysis, Group A hospitals showed significantly better prognosis than Group B hospitals (p = 0.034), while hospital volume and number of colorectal surgeons were not associated with overall survival. After adjustment for patient factors in multivariate analysis, hospital type was significantly associated with overall survival (hazard ratio: 1.31; 95 % confidence interval: 1.05-1.63; p = 0.016). However, there was no significant difference in short-term outcomes between hospital types. Hospital type was identified as a hospital factor that possibly affects the prognosis of stage IV colorectal cancer patients.

American primary care physicians' decisions to leave their practice: evidence from the 2009 commonwealth fund survey of primary care doctors.

PubMed

Gray, Bradford H; Stockley, Karen; Zuckerman, Stephen

2012-07-01

The status of the primary care workforce is a major health policy concern. It is affected not only by the specialty choices of young physicians but also by decisions of physicians to leave their practices. This study examines factors that may contribute to such decisions. We analyzed data from a 2009 Commonwealth Fund mail survey of American physicians in internal medicine, family or general practice, or pediatrics to examine characteristics associated with their plans to retire or leave their practice for other reasons in the next 5 years. Just over half (53%) of the physicians age 50 years or older and 30% of physicians between age 35 and 49 years may leave their practices for these reasons. Having such plans was associated with many factors, but the strongest predictor concerned problems regarding time spent coordinating care for their patients, possibly reflecting dissatisfaction with tasks that do not require medical expertise and are not generally paid for in fee-for-service medicine. Factors that predict plans to retire differ from those associated with plans to leave practices for other reasons. Provisions of the Patient Protection and Affordable Care Act that reduce the number of uninsured patients as well as innovations such as medical homes and accountable care organizations may reduce pressures that lead to attrition in the primary care workforce. Reasons why primary care physicians' decide to leave their practices deserve more attention from researchers and policy makers.

Clinical managers in the primary care sector: do the benefits stack up?

PubMed

O'Riordan, Chris; McDermott, Aoife

2012-01-01

The purpose of this paper is to explore the nature and value of the clinical management role undertaken by primary care doctors in Ireland. To date, a majority of research has focused on clinical management roles in the acute sector. The paper presents a sub-set of data from a mixed methods study. In total, 14 semi-structured interviews are drawn upon to identify the nature and value of the clinical management role in primary care. Comparison with acute sector research identifies considerable differences in the nature of the clinical management role across sectors--and in the associated value proposition. Structural and role-related contingencies affecting the potential value of clinical management roles in Irish primary care are discussed. Structural influences include the private ownership structure, low complexity and limited requirement for cross-professional coordination. Role-related influences include the primacy of the clinical identity, time constraints and lack of managerial training. The findings provide a limited basis for generalisation, premised on 14 interviews in one national context. However, given the international shift towards the provision of health services in primary care, they provide a research agenda for an important healthcare context. The findings draw attention to the need for policy consideration of the value of the clinical manager role in primary care; how policy can support effective primary care management; and the need for specialised management training, which takes account of the small-firm context. The paper identifies that primary-care clinical-management roles focus on operational management and oversight and discusses the structural and role-related factors which affect their efficacy.

Factors affecting morbidity and mortality on-farm and on-station in the Ethiopian highland sheep.

PubMed

Bekele, T; Woldeab, T; Lahlou-Kassi, A; Sherington, J

1992-12-01

Factors affecting morbidity and mortality of the Ethiopian highland sheep were studied both on-farm and on-station at Debre Berhan between 1989 and 1990. Primary causes of infectious origin resulted in high proportional morbidity (88.4% on-farm) and mortality (72.9% on-farm and 71.8% on-station) rates. Nutritional and managemental factors were also responsible for mortalities in lambs. The most frequent secondary causes of morbidity and/or mortality were ectoparasites and nasal myiasis. Health management interventions on-station were not high enough to produce performance improvements above the on-farm levels. However, the occurrence of gastrointestinal parasites significantly (P < 0.05) differed between the two management systems. The frequency of some of the major causes of morbidity and mortality such as pneumonia, fasciolasis and enteritis were significantly (P < 0.01) affected by season and age of an animal. In order to alleviate the major health constraints identified in this study, a proper health management intervention involving vaccination, strategic anthelmintic treatment and feeding management are suggested.

Risk, mobility or population size? Drivers of technological richness among contact-period western North American hunter-gatherers.

PubMed

Collard, Mark; Buchanan, Briggs; O'Brien, Michael J; Scholnick, Jonathan

2013-11-19

Identifying factors that influence technological evolution in small-scale societies is important for understanding human evolution. There have been a number of attempts to identify factors that influence the evolution of food-getting technology, but little work has examined the factors that affect the evolution of other technologies. Here, we focus on variation in technological richness (total number of material items and techniques) among recent hunter-gatherers from western North America and test three hypotheses: (i) technological richness is affected by environmental risk, (ii) population size is the primary determinant of technological richness, and (iii) technological richness is constrained by residential mobility. We found technological richness to be correlated with a proxy for environmental risk-mean rainfall for the driest month-in the manner predicted by the risk hypothesis. Support for the hypothesis persisted when we controlled for shared history and intergroup contact. We found no evidence that technological richness is affected by population size or residential mobility. These results have important implications for unravelling the complexities of technological evolution.

Risk, mobility or population size? Drivers of technological richness among contact-period western North American hunter–gatherers

PubMed Central

Collard, Mark; Buchanan, Briggs; O'Brien, Michael J.; Scholnick, Jonathan

2013-01-01

Identifying factors that influence technological evolution in small-scale societies is important for understanding human evolution. There have been a number of attempts to identify factors that influence the evolution of food-getting technology, but little work has examined the factors that affect the evolution of other technologies. Here, we focus on variation in technological richness (total number of material items and techniques) among recent hunter–gatherers from western North America and test three hypotheses: (i) technological richness is affected by environmental risk, (ii) population size is the primary determinant of technological richness, and (iii) technological richness is constrained by residential mobility. We found technological richness to be correlated with a proxy for environmental risk—mean rainfall for the driest month—in the manner predicted by the risk hypothesis. Support for the hypothesis persisted when we controlled for shared history and intergroup contact. We found no evidence that technological richness is affected by population size or residential mobility. These results have important implications for unravelling the complexities of technological evolution. PMID:24101622

Skin cancer concerns and genetic risk information-seeking in primary care.

PubMed

Hay, J; Kaphingst, K A; Baser, R; Li, Y; Hensley-Alford, S; McBride, C M

2012-01-01

Genomic testing for common genetic variants associated with skin cancer risk could enable personalized risk feedback to motivate skin cancer screening and sun protection. In a cross-sectional study, we investigated whether skin cancer cognitions and behavioral factors, sociodemographics, family factors, and health information-seeking were related to perceived importance of learning about how (a) genes and (b) health habits affect personal health risks using classification and regression trees (CART). The sample (n = 1,772) was collected in a large health maintenance organization as part of the Multiplex Initiative, ranged in age from 25-40, was 53% female, 41% Caucasian, and 59% African-American. Most reported that they placed somewhat to very high importance on learning about how genes (79%) and health habits (88%) affect their health risks. Social influence actors were associated with information-seeking about genes and health habits. Awareness of family history was associated with importance of health habit, but not genetic, information-seeking. The investment of family and friends in health promotion may be a primary motivator for prioritizing information-seeking about how genes and health habits affect personal health risks and may contribute to the personal value, or personal utility, of risk information. Individuals who seek such risk information may be receptive to interventions aimed to maximize the social implications of healthy lifestyle change to reduce their health risks. Copyright © 2011 S. Karger AG, Basel.

The drivers of facility-based immunization performance and costs. An application to Moldova.

PubMed

Maceira, Daniel; Goguadze, Ketevan; Gotsadze, George

2015-05-07

This paper identifies factors that affect the cost and performance of the routine immunization program in Moldova through an analysis of facility-based data collected as part of a multi-country costing and financing study of routine immunization (EPIC). A nationally representative sample of health care facilities (50) was selected through multi-stage, stratified random sampling. Data on inputs, unit prices and facility outputs were collected during October 3rd 2012-January 14th 2013 using a pre-tested structured questionnaire. Ordinary least square (OLS) regression analysis was performed to determine factors affecting facility outputs (number of doses administered and fully immunized children) and explaining variation in total facility costs. The study found that the number of working hours, vaccine wastage rates, and whether or not a doctor worked at a facility (among other factors) were positively and significantly associated with output levels. In addition, the level of output, price of inputs and share of the population with university education were significantly associated with higher facility costs. A 1% increase in fully immunized child would increase total cost by 0.7%. Few costing studies of primary health care services in developing countries evaluate the drivers of performance and cost. This exercise attempted to fill this knowledge gap and helped to identify organizational and managerial factors at a primary care district and national level that could be addressed by improved program management aimed at improved performance. Copyright © 2015 Elsevier Ltd. All rights reserved.

Primary Prevention of Atherosclerotic Cardiovascular Disease in Women

PubMed Central

McKibben, Rebeccah A.; Al Rifai, Mahmoud; Mathews, Lena M.; Michos, Erin D.

2016-01-01

Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality among women. Despite improvements in cardiovascular disease prevention efforts, there remain gaps in cardiovascular disease awareness among women, as well as age and racial disparities in ASCVD outcomes for women. Disparity also exists in the impact the traditional risk factors confer on ASCVD risk between women and men, with smoking and diabetes both resulting in stronger relative risks in women compared to men. Additionally there are risk factors that are unique to women (such as pregnancy-related factors) or that disproportionally affect women (such as auto-immune disease) where preventive efforts should be targeted. Risk assessment and management must also be sex-specific to effectively reduce cardiovascular disease and improve outcomes among women. Evidence supports the use of statin therapy for primary prevention in women at higher ASCVD risk. However, some pause should be given to prescribing aspirin therapy in women without known ASCVD, with most evidence supporting the use of aspirin for women≥65 years not at increased risk for bleeding. This review article will summarize (1) traditional and non-traditional assessments of ASCVD risk and (2) lifestyle and pharmacologic therapies for the primary prevention of ASCVD in women. PMID:28149430

Prognostic Significance of Blood Transfusion in Elderly Patients with Primary Diffuse Large B-Cell Lymphoma

PubMed Central

Fan, Liping; Fu, Danhui; Hong, Jinquan; He, Wenqian; Zeng, Feng; Lin, Qiuyan; Xie, Qianling

2018-01-01

The current study sought to evaluate whether blood transfusions affect survival of elderly patients with primary diffuse large B-cell lymphoma (DLBCL). A total of 104 patients aged 60 years and over were enrolled and divided into two groups: 24 patients who received transfusions and 80 patients who did not. Statistical analyses showed significant differences in LDH levels, platelet (Plt) counts, and hemoglobin (Hb) and albumin (Alb) levels between the two groups. Univariate analyses showed that LDH level ≥ 245 IU/L, cell of origin (germinal center/nongerminal center), and blood transfusion were associated with both overall survival (OS) and progression-free survival (PFS). Higher IPI (3–5), Alb level < 35 g/L, and rituximab usage were associated with OS. Appearance of B symptoms was associated with PFS. Multivariate analyses showed that cell of origin and rituximab usage were independent factors for OS and LDH level was an independent factor for PFS. Blood transfusion was an independent factor for PFS, but not for OS. Our preliminary results suggested that elderly patients with primary DLBCL may benefit from a restrictive blood transfusion strategy. PMID:29750167

Loss of ADAMTS3 activity causes Hennekam lymphangiectasia-lymphedema syndrome 3.

PubMed

Brouillard, Pascal; Dupont, Laura; Helaers, Raphael; Coulie, Richard; Tiller, George E; Peeden, Joseph; Colige, Alain; Vikkula, Miikka

2017-11-01

Primary lymphedema is due to developmental and/or functional defects in the lymphatic system. It may affect any part of the body, with predominance for the lower extremities. Twenty-seven genes have already been linked to primary lymphedema, either isolated, or as part of a syndrome. The proteins that they encode are involved in VEGFR3 receptor signaling. They account for about one third of all primary lymphedema cases, underscoring the existence of additional genetic factors. We used whole-exome sequencing to investigate the underlying cause in a non-consanguineous family with two children affected by lymphedema, lymphangiectasia and distinct facial features. We discovered bi-allelic missense mutations in ADAMTS3. Both were predicted to be highly damaging. These amino acid substitutions affect well-conserved residues in the prodomain and in the peptidase domain of ADAMTS3. In vitro, the mutant proteins were abnormally processed and sequestered within cells, which abolished proteolytic activation of pro-VEGFC. VEGFC processing is also affected by CCBE1 mutations that cause the Hennekam lymphangiectasia-lymphedema syndrome syndrome type1. Our data identifies ADAMTS3 as a novel gene that can be mutated in individuals affected by the Hennekam syndrome. These patients have distinctive facial features similar to those with mutations in CCBE1. Our results corroborate the recent in vitro and murine data that suggest a close functional interaction between ADAMTS3 and CCBE1 in triggering VEGFR3 signaling, a cornerstone for the differentiation and function of lymphatic endothelial cells. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Spirometry in primary care

PubMed Central

Coates, Allan L; Graham, Brian L; McFadden, Robin G; McParland, Colm; Moosa, Dilshad; Provencher, Steeve; Road, Jeremy

2013-01-01

Canadian Thoracic Society (CTS) clinical guidelines for asthma and chronic obstructive pulmonary disease (COPD) specify that spirometry should be used to diagnose these diseases. Given the burden of asthma and COPD, most people with these diseases will be diagnosed in the primary care setting. The present CTS position statement was developed to provide guidance on key factors affecting the quality of spirometry testing in the primary care setting. The present statement may also be used to inform and guide the accreditation process for spirometry in each province. Although many of the principles discussed are equally applicable to pulmonary function laboratories and interpretation of tests by respirologists, they are held to a higher standard and are outside the scope of the present statement. PMID:23457669

Brief assessments and screening for geriatric conditions in older primary care patients: a pragmatic approach.

PubMed

Seematter-Bagnoud, Laurence; Büla, Christophe

2018-01-01

This paper discusses the rationale behind performing a brief geriatric assessment as a first step in the management of older patients in primary care practice. While geriatric conditions are considered by older patients and health professionals as particularly relevant for health and well-being, they remain too often overlooked due to many patient- and physician-related factors. These include time constraints and lack of specific training to undertake comprehensive geriatric assessment. This article discusses the epidemiologic rationale for screening functional, cognitive, affective, hearing and visual impairments, and nutritional status as well as fall risk and social status. It proposes using brief screening tests in primary care practice to identify patients who may need further comprehensive geriatric assessment or specific interventions.

Language Barriers Impact Access to Services for Children with Autism Spectrum Disorders.

PubMed

St Amant, Helaine G; Schrager, Sheree M; Peña-Ricardo, Carolina; Williams, Marian E; Vanderbilt, Douglas L

2018-02-01

Racial and ethnic disparities in accessing health care have been described in children with autism spectrum disorder (ASD). In a retrospective chart review of 152 children with ASD, children of parents whose primary language was English were significantly more likely to have both social skills and communication goals within their individualized education plan (IEP) compared to children of parents whose primary language was not English. Additionally, children of primary English speakers received significantly more hours of direct services from their state disability program. After controlling for demographic covariates, findings suggest that language barriers may negatively affect parents' abilities to access health care services for their child with ASD. Acculturation factors must therefore be considered when analyzing disparities in autism.

Prognostic Factors in Patients with Primary Hemangiopericytomas of the Central Nervous System: A Series of 103 Cases at a Single Institution.

PubMed

Zhu, Hongda; Duran, Daniel; Hua, Lingyang; Tang, Hailiang; Chen, Hong; Zhong, Ping; Zheng, Kang; Wang, Yongfei; Che, Xiaoming; Bao, Weimin; Wang, Yin; Xie, Qing; Gong, Ye

2016-06-01

Hemangiopericytoma (HPC) is a rare mesenchymal tumor that tends to affect the central nervous system and is associated with distant metastasis and a high recurrence rate. The purpose of this study was to analyze the prognostic factors in patients with primary HPC who received surgical treatment. This retrospective study reviewed all adult patients with primary HPC of the central nervous system treated from 2001 to 2009 at our institution. Clinical information, adjuvant radiation, and expression levels of Ki-67 and p53 were correlated with patient outcomes. The final analysis included 103 patients. The mean follow-up period was 75.9 months ± 36.5 (range, 1-165 months). There was a significant difference in progression-free survival (PFS) (P < 0.001) and overall survival (P = 0.014) between patients who underwent gross total resection versus subtotal resection. Expression of p53 was found in 48.5% of patients and showed utility as an independent unfavorable prognostic factor for PFS (P = 0.006). Multivariate analysis revealed that only extent of tumor resection (P = 0.004) and p53 expression (P = 0.024) were independent prognostic factors for PFS. Adjuvant radiation was found to extend PFS only in the p53-negative expression group (P = 0.044). Gross total resection significantly improves the outcome of patients with primary HPCs, whereas adjuvant radiation contributes significantly to PFS only in patients with negative p53 expression and in patients with incomplete resections. Extent of resection and p53 expression may serve as prognostic markers for the outcome of patients with primary HPC. Copyright © 2016 Elsevier Inc. All rights reserved.

Identification, summary and comparison of tools used to measure organizational attributes associated with chronic disease management within primary care settings.

PubMed

Lukewich, Julia; Corbin, Renée; VanDenKerkhof, Elizabeth G; Edge, Dana S; Williamson, Tyler; Tranmer, Joan E

2014-12-01

Given the increasing emphasis being placed on managing patients with chronic diseases within primary care, there is a need to better understand which primary care organizational attributes affect the quality of care that patients with chronic diseases receive. This study aimed to identify, summarize and compare data collection tools that describe and measure organizational attributes used within the primary care setting worldwide. Systematic search and review methodology consisting of a comprehensive and exhaustive search that is based on a broad question to identify the best available evidence was employed. A total of 30 organizational attribute data collection tools that have been used within the primary care setting were identified. The tools varied with respect to overall focus and level of organizational detail captured, theoretical foundations, administration and completion methods, types of questions asked, and the extent to which psychometric property testing had been performed. The tools utilized within the Quality and Costs of Primary Care in Europe study and the Canadian Primary Health Care Practice-Based Surveys were the most recently developed tools. Furthermore, of the 30 tools reviewed, the Canadian Primary Health Care Practice-Based Surveys collected the most information on organizational attributes. There is a need to collect primary care organizational attribute information at a national level to better understand factors affecting the quality of chronic disease prevention and management across a given country. The data collection tools identified in this review can be used to establish data collection strategies to collect this important information. © 2014 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

Pediculosis capitis is a growing neglected infestation due to migration in southeast Turkey.

PubMed

Eroglu, Fadime; Basaran, Ümit; Kürklü, Cennet Gizem; Yüceer, Mervenur; Yalcıntürk, Rabia Gül; Tanrıverdi, Mustafa; Daglı, Eda Icbay; Koltas, Ismail Soner

2016-06-01

Demographic, socio-economical, and environmental changes affecting prevalence of Pediculosis capitis. The aim of this study was to investigate the prevalence of P. capitis and external factors affecting the distribution of P. capitis. A total of 6004 primary-school students between 5 and 11 years were screened for P. capitis at 28 different primary-schools in Gaziantep, located in southeastern of Turkey, during different two education terms (First education term is in September 2013 to May 2014, second education term is in September 2014 and May 2015). The prevalence of P. capitis was found to be positive 1.5 % (90/6004) and 6.9 % (415/6004) in first education term and in second education term, respectively. In this study shown that the rate of P. capitis's prevalence was increased 5.4 % in Gaziantep. P. capitis is a neglected infestation and it has re-emerged in Gaziantep, located in the southeastern of Turkey. Health staff member must improve health education programs in primary-school students especially girl students.

The Every Student Succeeds Act, State Efforts to Improve Access to Effective Educators, and the Importance of School Leadership

ERIC Educational Resources Information Center

Fuller, Edward J.; Hollingworth, Liz; Pendola, Andrew

2017-01-01

Purpose: Our primary purpose is to examine the degree to which state equity plans identify the distribution of principals and principal turnover as factors influencing three leadership mechanisms that affect student access to effective teachers--namely, hiring of teachers, building instructional capacity of teachers, and managing teacher turnover.…

Unfamiliar Instructional Practice and Its Relationship to Student Emotional Distress in the ESL Classroom.

ERIC Educational Resources Information Center

Bassano, Sharron Kay

It is generally recognized that students' feelings about learning affect their ability to learn. One of the three strongest influencing factors on second-language learning is classroom anxiety. This paper focuses on student emotional distress in the English as a second language (ESL) classroom, and suggests that one of the primary causes of this…

Does Empathy Predict Instructional Assignment-Related Stress? A Study in Special and General Education Teachers

ERIC Educational Resources Information Center

Platsidou, Maria; Agaliotis, Ioannis

2017-01-01

The role of empathy in the teaching profession has been vastly investigated in relation to its effect on students, but research on how teachers' empathy affects their own well-being at work is limited. This study investigated empathy and instructional assignment-related stress factors of primary school teachers serving in general or special…

Analysis of Early Military Attrition Behavior.

DTIC Science & Technology

1984-06-01

military separation. Although hizh school graduation status is the primary single factor affecting attrition, age and previous employment stability...assignment like individual suitability and satisfaction do not significantly influence early attrition; the early attrition rate of nonhigh- school ...a recruit with a single previous employer. I I V IS BLANK vi * Various indicators of military job match had no significant impact on early attrition

Understanding Factors Affecting Primary School Teachers' Use of ICT for Student-Centered Education in Mongolia

ERIC Educational Resources Information Center

Li, Shengru; Yamaguchi, Shinobu; Takada, Jun-ichi

2018-01-01

The past two decades witnessed continuous uptake of ICT in education, and the importance of teachers' beliefs for adopting ICT in education was revealed in the context of educational change. In recent years, the Mongolian educational system has placed more emphasis on student-centered education and the use of ICT in teaching and learning. Teacher…

Leaf litter decomposition and elemental change in three Appalachian mountain streams of different pH

Treesearch

Steven W. Solada; Sue A. Perry; William B. Perry

1996-01-01

The decomposition of leaf litter provides the primary nutrient source for many of the headwater mountain streams in forested catchments. An investigation of factors affected by global change that influence organic matter decomposition, such as temperature and pH, is important in understanding the dynamics of these systems. We conducted a study of leaf litter elemental...

Designing Inductive Instructional Activities in a Teacher Training Program to Enhance Conceptual Understandings in Science for Thai Science and Non-Science Teachers

ERIC Educational Resources Information Center

Narjaikaew, Pattawan; Jeeravipoonvarn, Varanya; Pongpisanou, Kanjana; Lamb, Dennis

2016-01-01

Teachers are viewed as the most significant factor affecting student learning. However, research in science education showed that teachers often demonstrate misunderstandings of science very similar to students. The purpose of this research was to correct conceptual difficulties in science of Thai primary school science and non-science teachers…

Nutrient Content of Foods, Nutritional Supplements, and Food Fallacies. Nutrition in Primary Care Series, Number 1.

ERIC Educational Resources Information Center

Gallagher-Allred, Charlette R.; Stein, Joan Z.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

Fab! or Drab?: Increasing the Effectiveness of Teaching and Learning in Summer Classes

ERIC Educational Resources Information Center

Omelicheva, Mariya Y.

2012-01-01

This article reviews the pitfalls and benefits of teaching and learning in summer school and identifies the lack of student interest as the key factor affecting the effectiveness of learning in the summer. The primary goal of this research is to investigate the impact of active learning strategies on generating student interest and improving their…

Resin flow responses to fertilization, wounding and fungal inoculation in loblolly pine (Pinus taeda) in North Carolina

Treesearch

Larissa Knebel; Daniel J. Robinson; Thomas R. Wentworth; Kier D. Klepzig

2009-01-01

Resin flow is the primary means of natural defense against southern pine beetle (Dendroctonus frontalis Zimm.), the most important insect pest of Pinus spp. in the southern United States. As a result, factors affecting resin flowa are of interest to researchers and forest managers. We examined the influence of fertilization, artificial...

Student-Teachers' Verbal Communication Patterns during Their Teaching Practice in "Studies for the Environment" Subject in Early Greek Primary Classes

ERIC Educational Resources Information Center

Malandrakis, George; Karagianni, Aggeliki; Pani, Dimitra

2016-01-01

This study explores the quality of student-teachers' (STs') verbal communication during their teaching practice on the "Studies for the Environment" subject, and identifies potential factors affecting it. Forty-one teaching sessions were analysed revealing that STs dominate classroom talking by having almost an equal number of utterances…

Leaf litter breakdown of native and exotic tree species in two Hawaiian streams that differ in flow

Treesearch

Megan Roberts; Ayron M. Strauch; Tracy Wiegner; Richard A. Mackenzie

2016-01-01

Riparian leaf litter is a major source of allochthonous organic material to temperate and tropical streams, promoting primary and secondary productivity in lotic and nearshore habitats. In tropical island streams, where native leaf-shredding macroinvertebrates are absent, physical fragmentation from stream flow is an important factor affecting leaf litter breakdown and...

On Counting Sheep: The Self-Medication and Coping Strategies of University Students Suffering from Primary Insomnia

ERIC Educational Resources Information Center

Cockcroft, K.; Grasko, D.; Fridjhon, P.

2006-01-01

A factor that affects university students' academic performance is the quantity and quality of their sleep. There is a high rate of insomnia in the general population, but the prevalence of sleep difficulties among university students has not been extensively studied. The current study found that 23 per cent of the researched student population…

Factor Analysis of Therapist-Identified Treatment Targets in Community-Based Children's Mental Health.

PubMed

Love, Allison R; Okado, Izumi; Orimoto, Trina E; Mueller, Charles W

2018-01-01

The present study used exploratory and confirmatory factor analyses to identify underlying latent factors affecting variation in community therapists' endorsement of treatment targets. As part of a statewide practice management program, therapist completed monthly reports of treatment targets (up to 10 per month) for a sample of youth (n = 790) receiving intensive in-home therapy. Nearly 75 % of youth were diagnosed with multiple co-occurring disorders. Five factors emerged: Disinhibition, Societal Rules Evasion, Social Engagement Deficits, Emotional Distress, and Management of Biodevelopmental Outcomes. Using logistic regression, primary diagnosis predicted therapist selection of Disinhibition and Emotional Distress targets. Client age predicted endorsement of Societal Rules Evasion targets. Practice-to-research implications are discussed.

Logistic Regression and Path Analysis Method to Analyze Factors influencing Students’ Achievement

NASA Astrophysics Data System (ADS)

Noeryanti, N.; Suryowati, K.; Setyawan, Y.; Aulia, R. R.

2018-04-01

Students' academic achievement cannot be separated from the influence of two factors namely internal and external factors. The first factors of the student (internal factors) consist of intelligence (X1), health (X2), interest (X3), and motivation of students (X4). The external factors consist of family environment (X5), school environment (X6), and society environment (X7). The objects of this research are eighth grade students of the school year 2016/2017 at SMPN 1 Jiwan Madiun sampled by using simple random sampling. Primary data are obtained by distributing questionnaires. The method used in this study is binary logistic regression analysis that aims to identify internal and external factors that affect student’s achievement and how the trends of them. Path Analysis was used to determine the factors that influence directly, indirectly or totally on student’s achievement. Based on the results of binary logistic regression, variables that affect student’s achievement are interest and motivation. And based on the results obtained by path analysis, factors that have a direct impact on student’s achievement are students’ interest (59%) and students’ motivation (27%). While the factors that have indirect influences on students’ achievement, are family environment (97%) and school environment (37).

Factors Involved in Access and Utilization of Adult Hearing Healthcare: A Systematic Review

PubMed Central

Barnett, Margaret; Hixon, Brian; Okwiri, Neville; Irungu, Catherine; Ayugi, John; Thompson, Robin; Shinn, Jennifer B.; Bush, Matthew L.

2016-01-01

Objective/Hypothesis Hearing loss is a public health concern yet hearing healthcare disparities exist and influence utilization of rehabilitation services. The objective of this review was to systematically analyze the published literature on motivators, barriers, and compliance factors affecting adult patient access and utilization of hearing rehabilitation healthcare. Data Sources and Study Eligibility Criteria Pubmed, PsychINFO, CINAHL, Web of Science were searched for relevant articles. Eligible studies were those containing original, peer-reviewed research in English pertaining to factors affecting adult hearing healthcare access and utilization of hearing aids and cochlear implantation. The search encompassed 1990-2015. Study Appraisal and Synthesis Methods Two investigators independently reviewed all articles and extracted data. Specific variables regarding access to care and compliance to recommended care were extracted from each study. Results Thirty articles were reviewed. The factors affecting access and utilization of hearing rehabilitation could be classified into motivators, barriers, and compliance in treatment or device use. The key motivators to seek care include degree of hearing loss, self-efficacy, family support, and self-recognition of hearing loss. The primary barriers to care were financial limitations, stigma of hearing devices, inconvenience, competing chronic health problems, and unrealistic expectations. Compliance is most affected by self-efficacy, education level, and engagement in the rehabilition process. Conclusion Accessing hearing healthcare is complicated by multiple factors. Considering the current climate in healthcare policy and legislation towards improved access of care, a deeper understanding of motivators, barriers and compliance factors can aid in delivery of effective and efficient hearing healthcare. PMID:27545324

Factors involved in access and utilization of adult hearing healthcare: A systematic review.

PubMed

Barnett, Margaret; Hixon, Brian; Okwiri, Neville; Irungu, Catherine; Ayugi, John; Thompson, Robin; Shinn, Jennifer B; Bush, Matthew L

2017-05-01

Hearing loss is a public health concern, yet hearing healthcare disparities exist and influence utilization of rehabilitation services. The objective of this review was to systematically analyze the published literature on motivators, barriers, and compliance factors affecting adult patient access and utilization of hearing rehabilitation healthcare. Pubmed, PsychINFO, CINAHL, and Web of Science were searched for relevant articles. Eligible studies were those containing original, peer-reviewed research in English pertaining to factors affecting adult hearing healthcare access and utilization of hearing aids and cochlear implantation. The search encompassed 1990 to 2015. Two investigators independently reviewed all articles and extracted data. Specific variables regarding access to care and compliance to recommended care were extracted from each study. Thirty articles were reviewed. The factors affecting access and utilization of hearing rehabilitation could be classified into motivators, barriers, and compliance in treatment or device use. The key motivators to seek care include degree of hearing loss, self-efficacy, family support, and self-recognition of hearing loss. The primary barriers to care were financial limitations, stigma of hearing devices, inconvenience, competing chronic health problems, and unrealistic expectations. Compliance is most affected by self-efficacy, education level, and engagement in the rehabilitation process. Accessing hearing healthcare is complicated by multiple factors. Considering the current climate in healthcare policy and legislation toward improved access of care, a deeper understanding of motivators, barriers, and compliance factors can aid in delivery of effective and efficient hearing healthcare. Laryngoscope, 127:1187-1194, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Factors associated with student learning processes in primary health care units: a questionnaire study.

PubMed

Bos, Elisabeth; Alinaghizadeh, Hassan; Saarikoski, Mikko; Kaila, Päivi

2015-01-01

Clinical placement plays a key role in education intended to develop nursing and caregiving skills. Studies of nursing students' clinical learning experiences show that these dimensions affect learning processes: (i) supervisory relationship, (ii) pedagogical atmosphere, (iii) management leadership style, (iv) premises of nursing care on the ward, and (v) nursing teachers' roles. Few empirical studies address the probability of an association between these dimensions and factors such as student (a) motivation, (b) satisfaction with clinical placement, and (c) experiences with professional role models. The study aimed to investigate factors associated with the five dimensions in clinical learning environments within primary health care units. The Swedish version of Clinical Learning Environment, Supervision and Teacher, a validated evaluation scale, was administered to 356 graduating nursing students after four or five weeks clinical placement in primary health care units. Response rate was 84%. Multivariate analysis of variance is determined if the five dimensions are associated with factors a, b, and c above. The analysis revealed a statistically significant association with the five dimensions and two factors: students' motivation and experiences with professional role models. The satisfaction factor had a statistically significant association (effect size was high) with all dimensions; this clearly indicates that students experienced satisfaction. These questionnaire results show that a good clinical learning experience constitutes a complex whole (totality) that involves several interacting factors. Supervisory relationship and pedagogical atmosphere particularly influenced students' satisfaction and motivation. These results provide valuable decision-support material for clinical education planning, implementation, and management. Copyright © 2014 Elsevier Ltd. All rights reserved.

Soil-transmitted helminth infection and urbanization in 880 primary school children in Nicaragua, 2005.

PubMed

Rosewell, Alexander; Robleto, Guillermo; Rodríguez, Guillermo; Barragne-Bigot, Philippe; Amador, Juan José; Aldighieri, Sylvain

2010-07-01

The prevalence of soil-transmitted helminthiasis is close to half the population in Central America, with the marginalized peri-urban poor disproportionately affected. Previous single province helminth surveys conducted in Nicaragua have shown Ascaris lumbricoides to be the predominant species. In 2005, we conducted a cross-sectional study of 880 children in 10 Nicaraguan primary schools located in four provinces. We aimed to establish the prevalence and intensity of soil-transmitted helminth infections and to investigate the factors associated with helminthiasis. Almost half (46%) of the children were infected with soil-transmitted helminths. Tichuris trichiura was the most common infective species (34.7%). The prevalence and intensity of helminthiasis was heterogeneous in the provinces, with children educated in peri-urban schools most affected. Healthy policies are required that favour the peri-urban poor who have inadequate and declining access to water and sanitation.

Central hypothyroidism and its role for cardiovascular risk factors in hypopituitary patients.

PubMed

Feldt-Rasmussen, Ulla; Klose, Marianne

2016-10-01

Hypothyroidism is characterized by hypometabolism, and may be seen as a part of secondary failure due to pituitary insufficiency or tertiary due to hypothalamic disease. Secondary and tertiary failures are also referred to as central hypothyroidism. Whereas overt primary hypothyroidism has a well-known affection on the heart and cardiovascular system, and may result in cardiac failure, cardiovascular affection is less well recognized in central hypothyroidism. Studies on central hypothyroidism and cardiovascular outcome are few and given the rarity of the diseases often small. Further, there are several limitations given vast difficulties in diagnosing the condition correctly biochemically, and difficulties monitoring the treatment because normal thyroid-pituitary feedback interrelationships are disrupted. The present review summarizes available studies of central adult hypothyroidism and its possible influence on the cardiovascular system, describe differences from primary thyroid failure and seek evidence for performing guidelines for clinical management of this particular thyroid and hypothalamo-pituitary disorder.

Motivated prediction of future feelings: effects of negative mood and mood orientation on affective forecasts.

PubMed

Buehler, Roger; McFarland, Cathy; Spyropoulos, Vassili; Lam, Kent C H

2007-09-01

This article examines the role of motivational factors in affective forecasting. The primary hypothesis was that people predict positive emotional reactions to future events when they are motivated to enhance their current feelings. Three experiments manipulated participants' moods (negative vs. neutral) and orientation toward their moods (reflective vs. ruminative) and then assessed the positivity of their affective predictions for future events. As hypothesized, when participants adopted a reflective orientation, and thus should have been motivated to engage in mood-regulation processes, they predicted more positive feelings in the negative than in the neutral mood condition. This pattern of mood-incongruent affective prediction was not exhibited when participants adopted a ruminative orientation. Additionally, within the negative mood condition, generating affective forecasts had a more positive emotional impact on reflectors than on ruminators. The findings suggest that affective predictions are sometimes driven by mood-regulatory motives.

Posttraumatic stress disorder symptom severity and control beliefs as the predictors of academic burnout amongst adolescents following the Wenchuan Earthquake

PubMed Central

Zhou, Xiao; Zhen, Rui; Wu, Xinchun

2017-01-01

ABSTRACT Background: Previous studies indicate that posttraumatic stress disorder (PTSD) and control beliefs can affect burnout and their unique role in this situation has been examined, but fewer studies have examined their combined role in adolescent’s academic burnout following traumatic events. Objective: This study examined the combined effect of PTSD symptom severity and control beliefs on academic burnout among adolescents, and assessed the moderating role of primary and secondary control beliefs in the relation between PTSD symptom severity and academic burnout. Methods: Seven hundred and forty-five adolescents were investigated using self-report questionnaires, and a series of regression equations examined the impact of PTSD severity and control beliefs on academic burnout. Results: PTSD symptom severity is associated positively with academic burnout, while primary and secondary control beliefs have a negative relation with academic burnout. In addition, primary control beliefs buffer the positive effects of PTSD symptom severity on academic burnout. We found that the positive relation between PTSD symptom severity and academic burnout in the low primary control beliefs group is more intense than that found in the high primary control beliefs group. Conclusions: PTSD symptom severity is a risk factor, whereas primary and secondary control beliefs are protective factors in academic burnout. In addition, PTSD symptom severity and primary control beliefs have a combined effect on academic burnout in adolescents following natural disasters. PMID:29296242

Primary and Secondary HIV Prevention Among Persons with Severe Mental Illness: Recent Findings.

PubMed

Hobkirk, Andréa L; Towe, Sheri L; Lion, Ryan; Meade, Christina S

2015-12-01

Persons with severe mental illness (SMI) have been disproportionately affected by the HIV epidemic, with higher rates of HIV prevalence and morbidity than the general population. Recent research has advanced our understanding of the complex factors that influence primary and secondary HIV prevention for those with SMI. Sex risk in this population is associated with socioeconomic factors (e.g., low income, history of verbal violence) and other health risk behaviors (e.g., substance use, no prior HIV testing). Several interventions are effective at reducing risk behavior, and reviews highlight the need for more well-controlled studies that assess long-term outcomes. Recent research has elucidated barriers that interfere with HIV treatment for SMI populations, including individual (e.g., apathy, substance use), social (e.g., stigma), and system factors (e.g., transportation, clinic wait times). Interventions that coordinate HIV care for individuals with SMI show promise as cost-effective methods for improving medication adherence and quality of life.

Understanding the implementation of interventions to improve the management of chronic kidney disease in primary care: a rapid realist review.

PubMed

Tsang, Jung Yin; Blakeman, Tom; Hegarty, Janet; Humphreys, John; Harvey, Gill

2016-04-04

Chronic kidney disease (CKD) is common and a significant marker of morbidity and mortality. Its management in primary care is essential for maintenance of cardiovascular health, avoidance of acute kidney injury (AKI) and delay in progression to end-stage renal disease. Although many guidelines and interventions have been established, there is global evidence of an implementation gap, including variable identification rates and low patient communication and awareness. The objective of this study is to understand the factors enabling and constraining the implementation of CKD interventions in primary care. A rapid realist review was conducted that involved a primary literature search of three databases to identify existing CKD interventions in primary care between the years 2000 and 2014. A secondary search was performed as an iterative process and included bibliographic and grey literature searches of reference lists, authors and research groups. A systematic approach to data extraction using Normalisation Process Theory (NPT) illuminated key mechanisms and contextual factors that affected implementation. Our primary search returned 710 articles that were narrowed down to 18 relevant CKD interventions in primary care. Our findings suggested that effective management of resources (encompassing many types) was a significant contextual factor enabling or constraining the functioning of mechanisms. Three key intervention features were identified from the many that contributed to successful implementation. Firstly, it was important to frame CKD interventions appropriately, such as within the context of cardiovascular health and diabetes. This enabled buy-in and facilitated an understanding of the significance of CKD and the need for intervention. Secondly, interventions that were compatible with existing practices or patients' everyday lives were readily accepted. In contrast, new systems that could not be integrated were abandoned as they were viewed as inconvenient, generating more work. Thirdly, ownership of the feedback process allowed users to make individualised improvements to the intervention to suit their needs. Our rapid realist review identified mechanisms that need to be considered in order to optimise the implementation of interventions to improve the management of CKD in primary care. Further research into the factors that enable prolonged sustainability and cost-effectiveness is required for efficient resource utilisation.

Sensitivity of the diagnostic radiological index of protection to procedural factors in fluoroscopy.

PubMed

Jones, A Kyle; Pasciak, Alexander S; Wagner, Louis K

2016-07-01

To evaluate the sensitivity of the diagnostic radiological index of protection (DRIP), used to quantify the protective value of radioprotective garments, to procedural factors in fluoroscopy in an effort to determine an appropriate set of scatter-mimicking primary beams to be used in measuring the DRIP. Monte Carlo simulations were performed to determine the shape of the scattered x-ray spectra incident on the operator in different clinical fluoroscopy scenarios, including interventional radiology and interventional cardiology (IC). Two clinical simulations studied the sensitivity of the scattered spectrum to gantry angle and patient size, while technical factors were varied according to measured automatic dose rate control (ADRC) data. Factorial simulations studied the sensitivity of the scattered spectrum to gantry angle, field of view, patient size, and beam quality for constant technical factors. Average energy (Eavg) was the figure of merit used to condense fluence in each energy bin to a single numerical index. Beam quality had the strongest influence on the scattered spectrum in fluoroscopy. Many procedural factors affect the scattered spectrum indirectly through their effect on primary beam quality through ADRC, e.g., gantry angle and patient size. Lateral C-arm rotation, common in IC, increased the energy of the scattered spectrum, regardless of the direction of rotation. The effect of patient size on scattered radiation depended on ADRC characteristics, patient size, and procedure type. The scattered spectrum striking the operator in fluoroscopy is most strongly influenced by primary beam quality, particularly kV. Use cases for protective garments should be classified by typical procedural primary beam qualities, which are governed by the ADRC according to the impacts of patient size, anatomical location, and gantry angle.

Long-term primary culture of neurons taken from chick embryo brain: A model to study neural cell biology, synaptogenesis and its dynamic properties.

PubMed

Kumar, Awanish; Mallick, Birendra Nath

2016-04-01

Studying neuronal growth, development and synaptogenesis are among the hot research topics. However, it is faced with various challenges and technical limitations that include but not limited to donor's species and health, threat to life, age of embryo, glial contamination, real-time tracking, and follow-up. We have successfully standardized a method for long-term primary culture of neurons collected from post-fertilized 9 day incubated chicken embryo brain overcoming the limitations mentioned above. Fertilized eggs were incubated in the laboratory and neurons from the embryonic brain were collected and low-density culture, apparently without glial contamination, was studied at least for 35 days in vitro (DIV). Neurons were characterized by double immunostaining using stringent neuronal and glial markers. Neuronal differentiation, cytomorphology, neurite and axon formation, development and maturation, spine formation and synaptogenesis were tracked in real-time in a stage and time dependent manner. The neurons were transfected with Synaptophysin-RFP to label synaptic vesicles, which were followed in real-time under live-cell imaging. Every step was carried out under controlled laboratory conditions. Eggs are easily available, easy to handle, neurons from desired day of incubation could be conveniently studied for long period in apparently glia-free condition. In addition to common factors affecting primary culture, selection of culture media and cover glass coating are other key factors affecting neuronal cultures. We describe an inexpensive, simpler pure primary neuronal culture method for studying neuronal cell-biology, synaptogenesis, vesicular dynamics and it has potential to grow 3D-multilayered brain in vitro. Copyright © 2016 Elsevier B.V. All rights reserved.

Iraqi primary care system in Kurdistan region: providers' perspectives on problems and opportunities for improvement.

PubMed

Shabila, Nazar P; Al-Tawil, Namir G; Al-Hadithi, Tariq S; Sondorp, Egbert; Vaughan, Kelsey

2012-09-27

As part of a comprehensive study on the primary health care system in Iraq, we sought to explore primary care providers' perspectives about the main problems influencing the provision of primary care services and opportunities to improve the system. A qualitative study based on four focus groups involving 40 primary care providers from 12 primary health care centres was conducted in Erbil governorate in the Iraqi Kurdistan region between July and October 2010. A topic guide was used to lead discussions and covered questions on positive aspects of and current problems with the primary care system in addition to the priority needs for its improvement. The discussions were fully transcribed and the qualitative data was analyzed by content analysis, followed by a thematic analysis. Problems facing the primary care system included inappropriate health service delivery (irrational use of health services, irrational treatment, poor referral system, poor infrastructure and poor hygiene), health workforce challenges (high number of specialists, uneven distribution of the health workforce, rapid turnover, lack of training and educational opportunities and discrepancies in the salary system), shortage in resources (shortage and low quality of medical supplies and shortage in financing), poor information technology and poor leadership/governance. The greatest emphasis was placed on poor organization of health services delivery, particularly the irrational use of health services and the related overcrowding and overload on primary care providers and health facilities. Suggestions for improving the system included application of a family medicine approach and ensuring effective planning and monitoring. This study has provided a comprehensive understanding of the factors that negatively affect the primary care system in Iraq's Kurdistan region from the perspective of primary care providers. From their experience, primary care providers have a role in informing the community and policy makers about the main problems affecting this system, though improvements to the health care system must be taken up at the national level and involve other key stakeholders.

Perceived exertion. Antecedents and applications.

PubMed

Watt, B; Grove, R

1993-04-01

The field of perceived exertion has largely concerned itself with the problem of identifying the primary antecedents to this psychophysiological phenomenon. A vast literature has evolved addressing this problem, but it is fraught with contradictions. At this stage a comprehensive theory of perceived exertion does not exist. It is generally accepted that perception of exertion is dominated by physiological determinants. Physiological sensory cues have been separated into 2 categories: local factors (sensations from the working muscles and joints), and central factors (sensations from the cardiopulmonary system). Major reviews in this area generally agree that local factors dominate perception of exertion. Recent work in perceived exertion has placed an emphasis on examining the contributing psychological factors. Research into the psychological factors affecting perceived exertion has been highly fragmented with no apparent theoretical framework as a base. At the same time it is clear that an integration of psychological and physiological variables is required to obtain theoretically meaningful knowledge of this multidimensional construct. The assumed dominance of physiological factors has been challenged by the contention that in field situations, in which a variety of social psychological influences operate, psychological determinants of perceived exertion may be vastly more influential than previously estimated. Identification of the primary determinants of perceived exertion and knowledge of how these factors are integrated is vital for a concrete theory of perceived exertion to evolve.

Predictors of PTSD symptoms in Brazilian police officers: the synergy of negative affect and peritraumatic dissociation

PubMed Central

Maia, Deborah B.; Marmar, Charles R.; Henn-Haase, Clare; Nóbrega, Augusta; Fiszman, Adriana; Marques-Portella, Carla; Mendlowicz, Mauro V.; Coutinho, Evandro S.F.; Figueira, Ivan

2013-01-01

Background Exposure to traumatic events is a necessary but not a sufficient condition for the development of posttraumatic stress disorder (PTSD). Pretrauma, peritrauma and posttrauma factors interact to impact on symptom severity. The aim of the present study is to determine risk factors for PTSD symptoms in Brazilian police officers. Method In a cross-sectional sample of active duty officers (n = 212), participants were asked to complete a socio-demographic questionnaire and self-report scales on affective traits, cumulative critical incident exposure, peritraumatic distress and dissociation, PTSD symptoms, and social support. Hierarchical linear regression analysis was conducted to examine predictors of PTSD symptoms. Results Variables related to negative affect, job duration, frequency of critical incident exposure, peritraumatic dissociation, and lack of social support remained significant in the final model and explained 55% of the variance in PTSD symptoms. When interaction terms were evaluated, a synergistic effect between negative affect and peritraumatic dissociation was found. Conclusions The risk factors found in this study provide clues on how to elaborate primary prevention strategies regarding PTSD symptoms in police officers. Such initiatives may lessen the impact of repeated exposure to traumatic events on police officers over the course of their careers. PMID:22189925

Cultivar and Year Rather than Agricultural Practices Affect Primary and Secondary Metabolites in Apple Fruit

PubMed Central

Renard, Catherine M. G. C.; Plenet, Daniel; Gautier, Hélène; Touloumet, Line; Girard, Thierry; Simon, Sylvaine

2015-01-01

Many biotic and abiotic parameters affect the metabolites involved in the organoleptic and health value of fruits. It is therefore important to understand how the growers' decisions for cultivar and orchard management can affect the fruit composition. Practices, cultivars and/or year all might participate to determine fruit composition. To hierarchize these factors, fruit weight, dry matter, soluble solids contents, titratable acidity, individual sugars and organics acids, and phenolics were measured in three apple cultivars (‘Ariane’, ‘Melrose’ and ‘Smoothee’) managed under organic, low-input and conventional management. Apples were harvested at commercial maturity in the orchards of the cropping system experiment BioREco at INRA Gotheron (Drôme, 26) over the course of three years (2011, 2012 and 2013). The main factors affecting primary and secondary metabolites, in both apple skin and flesh, were by far the cultivar and the yearly conditions, while the management system had a very limited effect. When considering the three cultivars and the year 2011 to investigate the effect of the management system per se, only few compounds differed significantly between the three systems and in particular the total phenolic content did not differ significantly between systems. Finally, when considering orchards grown in the same pedoclimatic conditions and of the same age, instead of the usual organic vs. conventional comparison, the effect of the management system on the apple fruit quality (Fruit weight, dry matter, soluble solids content, titratable acidity, individual sugars, organic acids, and phenolics) was very limited to non-significant. The main factors of variation were the cultivar and the year of cropping rather than the cropping system. More generally, as each management system (e.g. conventional, organic…) encompasses a great variability of practices, this highlights the importance of accurately documenting orchard practices and design beside the generic type of management in such studies. PMID:26618711

Macrosegregation Caused by Convection Associated with Directional Solidification through Cross-Section Change

NASA Technical Reports Server (NTRS)

Ghods, M.; Lauer, M.; Tewari, S. N.; Poirier, D. R..; Grugel, R. N.

2015-01-01

Al-7 wt% Si and Pb-6 wt% Sb alloy samples were directionally solidified (DS), with liquid above and solid below and gravity pointing down, in cylindrical graphite crucibles through an abrupt cross-section change. Fraction eutectic distribution in the microstructure, primary dendrite spacing and primary dendrite trunk diameters have been measured in the DS samples in the vicinity of section change in order to examine the effect of convection associated with the combined influence of thermosolutal factors and solidification shrinkage. It is observed that convection not only produces extensive radial and axial macrosegregation near cross-section change, it also affects the dendritic array morphology. Primary dendrite spacing and primary dendrite trunk diameter, both, are influenced by this convection. In addition to the experimental results, preliminary results from a numerical model which includes solidification shrinkage and thermosolutal convection in the mushy zone in its analysis will also be presented

Cross talk between primary human renal tubular cells and endothelial cells in cocultures.

PubMed

Tasnim, Farah; Zink, Daniele

2012-04-15

Interactions between renal tubular epithelial cells and adjacent endothelial cells are essential for normal renal functions but also play important roles in renal disease and repair. Here, we investigated cocultures of human primary renal proximal tubular cells (HPTC) and human primary endothelial cells to address the cross talk between these cell types. HPTC showed improved proliferation, marker gene expression, and enzyme activity in cocultures. Also, the long-term maintenance of epithelia formed by HPTC was improved, which was due to the secretion of transforming growth factor-β1 and its antagonist α2-macroglobulin. HPTC induced endothelial cells to secrete increased amounts of these factors, which balanced each other functionally and only displayed in combination the observed positive effects. In addition, in the presence of HPTC endothelial cells expressed increased amounts of hepatocyte growth factor and vascular endothelial growth factor, which have well-characterized effects on renal tubular epithelial cells as well as on endothelial cells. Together, the results showed that HPTC stimulated endothelial cells to express a functionally balanced combination of various factors, which in turn improved the performance of HPTC. The results give new insights into the cross talk between renal epithelial and endothelial cells and suggest that cocultures could be also useful models for the analysis of cellular communication in renal disease and repair. Furthermore, the characterization of defined microenvironments, which positively affect HPTC, will be helpful for improving the performance of this cell type in in vitro applications including in vitro toxicology and kidney tissue engineering.

Assessment of injection practice in primary health care facilities of Shiraz, Iran.

PubMed

Mclaws, Mary-Louise; Ghahramani, Sulmaz; Palenik, Charles John; Keshtkar, Vahid; Askarian, Mehrdad

2014-03-01

Occupational risk for several bloodborne viruses is attributable to unsafe injection practices. To understand injection frequency and safety, we surveyed injection rates and factors influencing injection prescription in primary health care facilities and associated health clinics in Shiraz, Iran. We used both quantitative and qualitative approaches to study the frequency and safety of injections delivered in 27 primary health care facilities. We used observations and 3 data collecting tools. Patterns of 600 general practice physicians' (GPs) prescriptions were also reviewed. In-depth interviews to elicit the factors contributing to injection prescriptions were conducted. The annual per capita injection rate was 3.12. Corticosteroids were prescribed more frequently than antibiotics (P < .001). Knowledge of participants concerning transmission risks for 3 of the most common bloodborne infections (BBIs) was less than 75%. Factors affecting use of injections by GPs included strong patient preference for injections over oral medications and financial benefit for GPs, especially those in private practice settings. Frequency of therapeutic injections in the participating facilities in Shiraz was high. Sociocultural factors in the patient community and their beliefs in the effectiveness of injections exerted influence on GP prescribing practices. Programs for appropriate and safe injection practices should target GP and injection providers, as well as patients, informing them about alternative treatments and possible complications of unnecessary and unsafe injections. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

Ipsilesional motor-evoked potential absence in pediatric hemiparesis impacts tracking accuracy of the less affected hand.

PubMed

Cassidy, Jessica M; Carey, James R; Lu, Chiahao; Krach, Linda E; Feyma, Tim; Durfee, William K; Gillick, Bernadette T

2015-12-01

This study analyzed the relationship between electrophysiological responses to transcranial magnetic stimulation (TMS), finger tracking accuracy, and volume of neural substrate in children with congenital hemiparesis. Nineteen participants demonstrating an ipsilesional motor-evoked potential (MEP) were compared with eleven participants showing an absent ipsilesional MEP response. Comparisons of finger tracking accuracy from the affected and less affected hands and ipsilesional/contralesional (I/C) volume ratio for the primary motor cortex (M1) and posterior limb of internal capsule (PLIC) were done using two-sample t-tests. Participants showing an ipsilesional MEP response demonstrated superior tracking performance from the less affected hand (p=0.016) and significantly higher I/C volume ratios for M1 (p=0.028) and PLIC (p=0.005) compared to participants without an ipsilesional MEP response. Group differences in finger tracking accuracy from the affected hand were not significant. These results highlight differentiating factors amongst children with congenital hemiparesis showing contrasting MEP responses: less affected hand performance and preserved M1 and PLIC volume. Along with MEP status, these factors pose important clinical implications in pediatric stroke rehabilitation. These findings may also reflect competitive developmental processes associated with the preservation of affected hand function at the expense of some function in the less affected hand. Copyright © 2015 Elsevier Ltd. All rights reserved.

Primary stability of a cementless acetabular cup in a cohort of patient-specific finite element models.

PubMed

O'Rourke, Dermot; Al-Dirini, Rami Ma; Taylor, Mark

2018-03-01

The primary stability achieved during total hip arthroplasty determines the long-term success of cementless acetabular cups. Pre-clinical finite element testing of cups typically use a model of a single patient and assume the results can be extrapolated to the general population. This study explored the variability in predicted primary stability of a Pinnacle ® cementless acetabular cup in 103 patient-specific finite element models of the hemipelvis and examined the association between patient-related factors and the observed variability. Cups were inserted by displacement-control into the FE models and then a loading configuration simulating a complete level gait cycle was applied. The cohort showed a range of polar gap of 284-1112 μm and 95th percentile composite peak micromotion (CPM) of 18-624 μm. Regression analysis was not conclusive on the relationship between patient-related factors and primary stability. No relationship was found between polar gap and micromotion. However, when the patient-related factors were categorised into quartile groups, trends suggested higher polar gaps occurred in subjects with small and shallow acetabular geometries and cup motion during gait was affected most by low elastic modulus and high bodyweight. The variation in primary stability in the cohort for an acetabular cup with a proven clinical track record may provide benchmark data when evaluating new cup designs. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1012-1023, 2018. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Turkish Primary Students' Perceptions about Scientist and What Factors Affecting the Image of the Scientists

ERIC Educational Resources Information Center

Turkmen, Hakan

2008-01-01

Students' views of science and scientists have been widely studied. The purpose of this study is to analyze image of scientist from drawn picture of scientists using The Draw-a-Scientist Test (DAST) by 5th grade students and to analyze where this image comes from students minds in changing Turkish educational perspective. Two hundred eighty seven…

Factors Affecting Salamander Density and Distribution within Four Forest Types in Southern Appalachian Mountains

Treesearch

Craig A. Harper; David C. Guynn

1999-01-01

We used a terrestrial vacuum to sample known area plots in order to obtain density estimates of salamanders and their primary prey, invertebrates of the forest floor. We sampled leaf litter and measured various vegetative and topographic parameters within four forest types (oak-pine, oak-hickory, mixed mesophytic and northern hardwoods) and three age classes (0-12,13-...

Interaction between Cognitive and Non-Cognitive Factors: The Influences of Academic Goal Orientation and Working Memory on Mathematical Performance

ERIC Educational Resources Information Center

Lee, Kerry; Ning, Flora; Goh, Hui Chin

2014-01-01

Although the effects of achievement goals and working memory on academic performance are well established, it is not clear whether they jointly affect academic performance. Children from Primary 4 and 6 (N = 608) were administered (a) measures of working memory and updating from the automated working memory battery and a running span task, (b)…

Source/sink patterns of disturbance and cross-scale mismatches in a panarchy of social-ecological landscapes

Treesearch

Nicola1 Zaccarelli; Petrosillo; Irene; Giovanni Zurlini; KurtHans Riitters

2008-01-01

Land-use change is one of the major factors affecting global environmental change and represents a primary human effect on natural systems. Taking into account the scales and patterns of human land uses as source/sink disturbance systems, we describe a framework to characterize and interpret the spatial patterns of disturbances along a continuum of scales in a panarchy...

Disaster Preparedness Knowledge, Beliefs, Risk-Perceptions, and Mitigating Factors of Disaster Preparedness Behaviors of Undergraduate Students at a Large Midwest University

ERIC Educational Resources Information Center

Goddard, Stacy

2017-01-01

Disaster preparedness is a national public health concern. The risk of individuals and communities affected by a natural disaster has increased, and unfortunately this trend is expected to continue. College students could play a primary role in responding to and recovering from a major disaster if they have sufficiently prepared for a disaster. A…

United States Navy Health Care Providers' Attitudes and Satisfaction toward the Usability of the Navy's Primary Learning Portal and Learning Management System

ERIC Educational Resources Information Center

Catanese, Anthony Peter

2013-01-01

The purpose of this study was to investigate if the architectural design factors affected usability of Navy Knowledge Online (NKO) technology along with the user dissatisfaction associated through restricted achievements of online education and training. In this study, attitudes, satisfaction, obstacles, and providers' demographics were also…

Financing Terror: Analysis and Simulation to Affect Terrorist Organizations’ Financial Infrastructures

DTIC Science & Technology

2004-09-15

research on terrorism existed; David Rapoport, professor emeritus of political science at University of California-Los Angeles, lamented on that relative...contains all books published since 1979. 10 research interests-historical, cultural, religious, political , economic, psychological and organizational factors...perspective, tracing the development of non-state political violence in general and how terrorism has become a primary component of modem political

Emotion processing in the criminal psychopath: the role of attention in emotion-facilitated memory.

PubMed

Glass, Samantha J; Newman, Joseph P

2009-02-01

The response modulation hypothesis specifies that low-anxious psychopathic individuals have difficulty processing information outside their primary attentional focus. To evaluate the applicability of this model to affective processing, the authors had 239 offenders, classified with the Psychopathy Checklist--Revised (R. D. Hare, 2003) and the Welsh Anxiety Scale (G. Welsh, 1956), perform 1 of 3 emotion memory tasks that examined the effects of emotion on memory for primary and contextual information. Regardless of anxiety level, psychopathic and control offenders demonstrated a significant and comparable memory bias for emotional over neutral words in the primary conditions. However, psychopathic individuals showed significantly less memory bias than did controls in the contextual conditions. Results indicate that the impact of emotion on memory is moderated by attentional factors.

Diagnostic inertia in obesity and the impact on cardiovascular risk in primary care: a cross-sectional study

PubMed Central

Martínez-St John, Damian RJ; Palazón-Bru, Antonio; Gil-Guillén, Vicente F; Sepehri, Armina; Navarro-Cremades, Felipe; Ramírez-Prado, Dolores; Orozco-Beltrán, Domingo; Carratalá-Munuera, Concepción; Cortés, Ernesto; Rizo-Baeza, María M

2015-01-01

Background Prevalence of diagnostic inertia (DI), defined as a failure to diagnose disease, has not been analysed in patients with obesity. Aim To quantify DI for cardiovascular risk factors (CVRF) in patients with obesity, and determine its association with the cardiovascular risk score. Design and setting Cross-sectional study of people ≥40 years attending a preventive programme in primary healthcare centres in Spain in 2003–2004. Method All patients with obesity attending during the first 6 months of the preventive programme were analysed. Participants had to be free of CVD (myocardial ischaemia or stroke) and aged 40–65 years; the criteria used to measure SCORE (Systematic COronary Risk Evaluation). Three subgroups of patients with obesity with no personal history of CVRF but with poor control of risk factors were established. Outcome variable was DI, defined as poor control of risk factors and no action taken by the physician. Secondary variables were diabetes, fasting blood glucose (FBG), body mass index (BMI), and SCORE. Adjusted odds ratios (OR) was determined using multivariate logistic regression models. Results Of 8687 patients with obesity in the programme, 6230 fulfilled SCORE criteria. Prevalence of DI in the three subgroups was: hypertension, 1275/1816 (70.2%) patients affected (95% CI = 68.1 to 72.3%); diabetes, 335/359 (93.3%) patients affected (95% CI = 90.7 to 95.9%); dyslipidaemia subgroup, 1796/3341 (53.8%) patients affected (95% CI = 52.1 to 55.4%. Factors associated with DI for each subgroup were: for hypertension, absence of diabetes, higher BMI, and greater cardiovascular risk; for dyslipidaemia, diabetes, higher BMI, and greater cardiovascular risk (SCORE); and for diabetes, lower FBG levels, lower BMI, and greater cardiovascular risk. Conclusion This study quantified DI in patients with obesity and determined that it was associated with a greater cardiovascular risk. PMID:26120135

Factors predicting survival following complete surgical remission of pulmonary metastasis in osteosarcoma

PubMed Central

SALAH, SAMER; TOUBASI, SAMAR

2015-01-01

Pulmonary metastasectomy (PM) is associated with improved survival of patients with metastatic osteosarcoma; however, the factors affecting survival following achievement of complete surgical remission remain controversial. The main objective of this study was to report the outcomes and prognostic factors of osteosarcoma patients who achieved complete remission (CR) following PM. We analyzed the effect of demographic and disease-related characteristics on the overall survival (OS) of consecutive patients with metastatic osteosarcoma who were treated at a single institution and achieved CR following PM, through univariate and multivariate analyses. Between January, 2000 and August, 2013, 62 patients with metastatic osteosarcoma were treated and followed up at our institution. A total of 25 patients achieved CR following PM and were included in this analysis. The 5-year OS and disease-free survival following PM were 30 and 21%, respectively. The factors correlated with inferior OS in the univariate analysis included chondroblastic subtype, post-chemotherapy necrosis <90% in the primary tumor, metastasis detected during neoadjuvant or adjuvant chemotherapy and pathological identification of tumor cells reaching the visceral pleural surface of any of the resected nodules. In the multivariate analysis, the chondroblastic subtype was the sole independent adverse prognostic factor (HR=4.6, 95% CI: 1.0–21.3, P=0.044). Therefore, factors associated with tumor biology, including poor tumor necrosis in the primary tumor and detection of metastasis during primary chemotherapy, are associated with poor post-metastasectomy survival. In addition, chondroblastic subtype and visceral pleural involvement predicted poor prognosis in our series. PMID:25469287

Burning mouth syndrome: a review and update.

PubMed

Sun, Andy; Wu, Kai-Ming; Wang, Yi-Ping; Lin, Hung-Pin; Chen, Hsin-Ming; Chiang, Chun-Pin

2013-10-01

Burning mouth syndrome (BMS) is characterized by the presence of burning sensation of the oral mucosa in the absence of clinically apparent mucosal alterations. It occurs more commonly in middle-aged and elderly women and often affects the tongue tip and lateral borders, lips, and hard and soft palate. In addition to a burning sensation, the patients with BMS may also complain unremitting oral mucosal pain, dysgeusia, and xerostomia. BMS can be classified into two clinical forms: primary and secondary BMS. The primary BMS is essential or idiopathic, in which the organic local/systemic causes cannot be identified and a neuropathological cause is likely. The diagnosis of primary BMS depends mainly on exclusion of etiological factors. The secondary BMS is caused by local, systemic, and/or psychological factors; thus, its diagnosis depends on identification of the exact causative factor. When local, systemic or psychological factors are present, treatment or elimination of these factors usually results in a significant clinical improvement of BMS symptoms. Vitamin, zinc, or hormone replacement therapy has been found to be effective for reducing the oral burning or pain symptom in some BMS patients with deficiency of the corresponding factor. If patients still have the symptoms after the removal of potential causes, drug therapy should be instituted. Previous randomized controlled clinical trials found that drug therapy with capsaicin, alpha-lipoic acid, clonazepam, and antidepressants may provide relief of oral burning or pain symptom. In addition, psychotherapy and behavioral feedback may also help eliminate the BMS symptoms. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Study design features affecting outcome in antidepressant trials.

PubMed

Henkel, Verena; Casaulta, Flurina; Seemüller, Florian; Krähenbühl, Stephan; Obermeier, Michael; Hüsler, Jürg; Möller, Hans-Jürgen

2012-12-10

A key issue in the approval process of antidepressants is the inconsistency of results between antidepressant clinical phase III trials. Identifying factors influencing efficacy data is needed to facilitate interpretation of the results. We reviewed data packages submitted as new drug applications to Swissmedic focusing on pivotal, short-term antidepressant trials. Included studies used HAMD-17 or HAMD-21 as primary measures and enrolled patients aged 18-65 years with a diagnosis of major depression. Due to the hierarchical structure of the data a mixed-effect regression model has been applied with responder rates as primary outcome criterion. Random intercepts were estimated for the different trials, while study design factors were assigned as explanatory fixed effects. The final dataset was based upon 35 study reports with a total of N=10,835 patients. Significant results were found for study arm (placebo vs. active compound, p<0.001), sample size (p=0.002), duration of treatment (p=0.024), two or more active treatment arms (p=0.022) and the individual drug (p=0.029). Furthermore, a tendency to an association with the outcome was observed for baseline disease severity (p=0.077) and possibility of dosing adaptation (p=0.076). Due to strict confidentiality agreements, individual drugs are not reported here. Further research should consider additional variables that might have an impact on the results of antidepressant trials. Efficacy data in antidepressant trials is significantly affected by various factors. These factors and their potentially confounding role have to be considered in the interpretation of the results. Copyright © 2012 Elsevier B.V. All rights reserved.

Factors predicting the duration of adrenal insufficiency in patients successfully treated for Cushing disease and nonmalignant primary adrenal Cushing syndrome.

PubMed

Prete, Alessandro; Paragliola, Rosa Maria; Bottiglieri, Filomena; Rota, Carlo Antonio; Pontecorvi, Alfredo; Salvatori, Roberto; Corsello, Salvatore Maria

2017-03-01

Successful treatment of Cushing syndrome causes transient or permanent adrenal insufficiency deriving from endogenous hypercortisolism-induced hypothalamus-pituitary-adrenal-axis suppression. We analyzed pre-treatment factors potentially affecting the duration of adrenal insufficiency. We conducted a retrospective analysis on patients successfully treated for Cushing disease (15 patients) who underwent transsphenoidal surgery, and nonmalignant primary adrenal Cushing syndrome (31 patients) who underwent unilateral adrenalectomy, divided into patients with overt primary adrenal Cushing syndrome (14 patients) and subclinical primary adrenal Cushing syndrome (17 patients). Epidemiological data, medical history, and hormonal parameters depending on the etiology of hypercortisolism were collected and compared to the duration of adrenal insufficiency. The median duration of follow-up after surgery for Cushing disease and primary adrenal Cushing syndrome was 70 and 48 months, respectively. In the Cushing disease group, the median duration of adrenal insufficiency after transsphenoidal surgery was 15 months: younger age at diagnosis and longer duration of signs and symptoms of hypercortisolism before diagnosis and surgery were associated with longer duration of adrenal insufficiency. The median duration of adrenal insufficiency was 6 months for subclinical primary adrenal Cushing syndrome and 18.5 months for overt primary adrenal Cushing syndrome. The biochemical severity of hypercortisolism, the grade of hypothalamus-pituitary-adrenal-axis suppression, and treatment with ketoconazole before surgery accounted for longer duration of adrenal insufficiency. In patients with Cushing disease, younger age and delayed diagnosis and treatment predict longer need for glucocorticoid replacement therapy after successful transsphenoidal surgery. In patients with primary adrenal Cushing syndrome, the severity of hypercortisolism plays a primary role in influencing the duration of adrenal insufficiency after unilateral adrenalectomy.

Political, cultural and economic foundations of primary care in Europe.

PubMed

Kringos, Dionne S; Boerma, Wienke G W; van der Zee, Jouke; Groenewegen, Peter P

2013-12-01

This article explores various contributing factors to explain differences in the strength of the primary care (PC) structure and services delivery across Europe. Data on the strength of primary care in 31 European countries in 2009/10 were used. The results showed that the national political agenda, economy, prevailing values, and type of healthcare system are all important factors that influence the development of strong PC. Wealthier countries are associated with a weaker PC structure and lower PC accessibility, while Eastern European countries seemed to have used their growth in national income to strengthen the accessibility and continuity of PC. Countries governed by left-wing governments are associated with a stronger PC structure, accessibility and coordination of PC. Countries with a social-security based system are associated with a lower accessibility and continuity of PC; the opposite is true for transitional systems. Cultural values seemed to affect all aspects of PC. It can be concluded that strengthening PC means mobilising multiple leverage points, policy options, and political will in line with prevailing values in a country. Copyright © 2013 Elsevier Ltd. All rights reserved.

Clinical vs. structured interview on anxiety and affective disorders by primary care physicians. understanding diagnostic discordance.

PubMed

Balestrieri, Matteo; Baldacci, Sandra; Bellomo, Antonello; Bellantuono, Cesario; Conti, Luciano; Perugi, Giulio; Nardini, Marcello; Borbotti, Marco; Viegi, Giovanni

2007-01-01

To assess in a national sample the ability of GPs to detect psychiatric disorders using a clinical vs. a standardized interview and to characterize the patients that were falsely diagnosed with an anxiety or affective disorder. This is a national, cross-sectional, epidemiological survey, carried out by GPs on a random sample of their patients. The GPs were randomly divided into two groups. Apart from the routine clinical interview, the experimental group (group A) had to administer the Mini-International Neuropsychiatric Interview (MINI). Data was collected by 143 GPs. 17.2% of all patients had a clinical diagnosis of an affective disorder, and 25.4% a clinical diagnosis of an anxiety disorder. In group A, the number of clinical diagnoses was about twice that of MINI diagnoses for affective disorders and one and a half times that for anxiety disorders. The majority of clinical diagnoses were represented by MINI subsyndromal cases (52.3%). Females showed a higher OR of being over-detected by GPs with anxiety disorders or of not being diagnosed with an affective disorder. Being divorced/separated/widowed increased the OR of over-detection of affective and anxiety disorders. The OR of over-detection of an affective or an anxiety disorder was higher for individuals with a moderate to poor quality of life. In the primary care a gap exists between clinical and standardized interviews in the detection of affective and anxiety disorders. Some experiential and social factors can increase this tendency. The use of a psycho.

Perceptions and Attitudes towards Medication Error Reporting in Primary Care Clinics: A Qualitative Study in Malaysia.

PubMed

Samsiah, A; Othman, Noordin; Jamshed, Shazia; Hassali, Mohamed Azmi

2016-01-01

To explore and understand participants' perceptions and attitudes towards the reporting of medication errors (MEs). A qualitative study using in-depth interviews of 31 healthcare practitioners from nine publicly funded, primary care clinics in three states in peninsular Malaysia was conducted for this study. The participants included family medicine specialists, doctors, pharmacists, pharmacist assistants, nurses and assistant medical officers. The interviews were audiotaped and transcribed verbatim. Analysis of the data was guided by the framework approach. Six themes and 28 codes were identified. Despite the availability of a reporting system, most of the participants agreed that MEs were underreported. The nature of the error plays an important role in determining the reporting. The reporting system, organisational factors, provider factors, reporter's burden and benefit of reporting also were identified. Healthcare practitioners in primary care clinics understood the importance of reporting MEs to improve patient safety. Their perceptions and attitudes towards reporting of MEs were influenced by many factors which affect the decision-making process of whether or not to report. Although the process is complex, it primarily is determined by the severity of the outcome of the errors. The participants voluntarily report the errors if they are familiar with the reporting system, what error to report, when to report and what form to use.

An evaluation of factors which can affect the implementation of a health promotion programme under the Schools for Health in Europe framework.

PubMed

Bennett, Annemarie E; Cunningham, Cara; Johnston Molloy, Charlotte

2016-08-01

The Health Promoting Schools concept helps schools to promote health in a sustainable and long-term fashion. However, developing the capacity to promote health in this way can be challenging when a busy teaching curriculum must be fulfilled. This study aimed to identify factors which affect the acceptability of health promotion programmes to the everyday school environment. Semi-structured qualitative interviews were audio-taped with primary school teachers in one Irish county and transcribed verbatim. The resulting transcripts were analysed using content analysis. Thirty-one teachers were interviewed. The factors which may adversely affect the acceptability of health promotion programmes include the: attitude of teachers towards an additional extra-curricular workload; lack of confidence amongst teachers to lead health promotion; and different organisational cultures between schools. When health promotion programmes under the Health Promoting Schools concept are being implemented, it's important to consider: the readiness for change amongst teachers; the resources available to increase staff capacity to promote health; and the ability of a programme to adapt to the different organisational cultures between schools. Copyright © 2016 Elsevier Ltd. All rights reserved.

Determinants of partial or no primary immunisations.

PubMed

Jessop, L J; Kelleher, C C; Murrin, C; Lotya, J; Clarke, A T; O'Mahony, D; Fallon, U B; Johnson, H; Bury, G; Murphy, A W

2010-08-01

To determine if different factors affect children having full, partial or no primary immunisations. This was a crossgenerational cohort study with linkage to primary care and hospital records conducted in urban and rural settings in Ireland, recruiting in 2001-2003 with 5-year follow-up. A total of 749 children with immunisation information took part. The uptake of reported primary immunisations was 92.8% full, 4.9% partial and 2.3% no primary immunisations. Adjusted relative risk ratios for children receiving no primary immunisations were significant for: having a mother who had ever visited an alternative practitioner 3.69 (1.05 to 12.9), a mother with means tested full general medical services eligibility 8.11 (1.58 to 41.65), a mother who scored <50 for the World Health Organization Quality of Life (WHO-QOL) scale psychological domain 8.82 (1.79 to 43.6) or living in the west of Ireland (rural) 3.64 (1.0 to 13.2). Being born prematurely was associated with partial primary immunisation, adjusted OR 4.63 (1.24 to 17.3). Knowledge of these differences will help target campaigns to increase full uptake of primary immunisations.

Tracking Organs Composed of One or Multiple Regions Using Geodesic Active Region Models

NASA Astrophysics Data System (ADS)

Martínez, A.; Jiménez, J. J.

In radiotherapy treatment it is very important to find out the target organs on the medical image sequence in order to determine and apply the proper dose. The techniques to achieve this goal can be classified into extrinsic and intrinsic. Intrinsic techniques only use image processing with medical images associated to the radiotherapy Radiotherapy treatment, as we deal in this chapter. To accurately perform this organ tracking it is necessary to find out segmentation and tracking models that were able to be applied to several image modalities involved on a radiotherapy session (CT CT See Modality , MRI Magnetic resoance imaging , etc.). The movements of the organs are mainly affected by two factors: breathing and involuntary movements associated with the internal organs or patient positioning. Among the several alternatives to track the organs of interest, a model based on geodesic active regions is proposed. This model has been tested over CT Computed tomography images from the pelvic, cardiac, and thoracic area. A new model for the segmentation of organs composed by more than one region is proposed.

Results of liver transplantation in patients with acute liver failure due to Amanita phalloides and paracetamol (acetaminophen) intoxication

PubMed Central

Grąt, Michał; Hołówko, Wacław; Masior, Łukasz; Wronka, Karolina M.; Grąt, Karolina; Stypułkowski, Jan; Patkowski, Waldemar; Krawczyk, Marek

2015-01-01

Introduction Amanita phalloides and paracetamol intoxications are responsible for the majority of acute liver failures. Aim To assess survival outcomes and to analyse risk factors affecting survival in the studied group. Material and methods Of 1369 liver transplantations performed in the Department of General, Transplant, and Liver Surgery, Medical University of Warsaw before December 2013, 20 (1.46%) patients with Amanita phalloides (n = 13, 0.95%) and paracetamol (n = 7, 0.51%) intoxication were selected for this retrospective study. Overall and graft survival at 5 years were set as primary outcome measures. Results Five-year overall survival after liver transplantation in the studied group was 53.57% and 53.85% in patients with paracetamol and Amanita phalloides poisoning, respectively (p = 0.816). Five-year graft survival was 26.79% for patients with paracetamol and 38.46% with Amanita phalloides intoxication (p = 0.737). Risk factors affecting patient survival were: pre-transplant bilirubin concentration (p = 0.023) and higher number of red blood cells (p = 0.013) and fresh frozen plasma (p = 0.004) transfused intraoperatively. Likewise, higher number of red blood cells (p = 0.012) and fresh frozen plasma (p = 0.007) transfused were risk factors affecting 5-year graft survival. Surprisingly, donor and recipient blood type incompatibility was neither the risk factor for 5-year overall survival (p = 0.939) nor the risk factor for 5-year graft survival (p = 0.189). Conclusions In selected intoxicated patients urgent liver transplantation is the only successful modality of treatment. Risk factors affecting survival are in correspondence with the patient's pre-transplant status (bilirubin level in serum) and intraoperative status (number of red blood cells and fresh frozen plasma transfused). PMID:27350835

Serum NGF, BDNF and IL-6 Levels in Postpartum Mothers As Predictors of Infant Development: The Influence of Affective Disorders

PubMed Central

Pinheiro, Karen Amaral Tavares; Pinheiro, Ricardo Tavares; Coelho, Fábio Monteiro da Cunha; da Silva, Ricardo Azevedo; Quevedo, Luciana Ávila; Schwanz, Cristina Carvalhal; Wiener, Carolina David; Manfro, Gisele Gus; Giovenardi, Márcia; Lucion, Aldo Bolten; de Souza, Diogo Onofre; Portela, Luis Valmor; Oses, Jean Pierre

2014-01-01

Background Early adverse experiences are associated with increased risk of developing psychiatric disorders, although little is known about the neurobiological mediators involved. The mechanisms by which early environmental influences may mediate vulnerability in the development of offspring await further investigation. The present study correlated the NGF, BDNF, IL-6 and cortisol levels of mothers with postpartum affective disorders (PPAD) with infant development. Methods A longitudinal study was performed with 152 pregnant women and their infants. Between 60 and 120 days after delivery, women were interviewed and provided biological samples for biochemical analysis, and the infants were examined for neurobiological-motor development. Results Overall, the mothers' history of affective disorders, PPAD and anxiety disorder were associated with infant motor development. Using an adjusted linear regression analysis, PPAD (p = 0.049), maternal anxiety disorder (p = 0.043), NGF level (p = 0.034) and infant cortisol level (p = 0.013) were associated with infant motor development. Using a factorial analysis of primary components, two components were retained. The psychological factor was characterized by a positive loading of a history of affective disorder, PPAD and anxiety disorder. For the biological factor, infant cortisol adhered negatively with infant motor development, but NGF was positively associated. The psychological factor had a negative association, but the biological factor had a positive association with infant motor development. Conclusions There are few studies that have focused on the relationship of biomarkers and infant neurodevelopment. Our study points that psychological and biological factors are associated with infant motor development, however the causal relationship between these factors is still to be defined. PMID:24733087

Serum NGF, BDNF and IL-6 levels in postpartum mothers as predictors of infant development: the influence of affective disorders.

PubMed

Pinheiro, Karen Amaral Tavares; Pinheiro, Ricardo Tavares; Coelho, Fábio Monteiro da Cunha; da Silva, Ricardo Azevedo; Quevedo, Luciana Ávila; Schwanz, Cristina Carvalhal; Wiener, Carolina David; Manfro, Gisele Gus; Giovenardi, Márcia; Lucion, Aldo Bolten; de Souza, Diogo Onofre; Portela, Luis Valmor; Oses, Jean Pierre

2014-01-01

Early adverse experiences are associated with increased risk of developing psychiatric disorders, although little is known about the neurobiological mediators involved. The mechanisms by which early environmental influences may mediate vulnerability in the development of offspring await further investigation. The present study correlated the NGF, BDNF, IL-6 and cortisol levels of mothers with postpartum affective disorders (PPAD) with infant development. A longitudinal study was performed with 152 pregnant women and their infants. Between 60 and 120 days after delivery, women were interviewed and provided biological samples for biochemical analysis, and the infants were examined for neurobiological-motor development. Overall, the mothers' history of affective disorders, PPAD and anxiety disorder were associated with infant motor development. Using an adjusted linear regression analysis, PPAD (p = 0.049), maternal anxiety disorder (p = 0.043), NGF level (p = 0.034) and infant cortisol level (p = 0.013) were associated with infant motor development. Using a factorial analysis of primary components, two components were retained. The psychological factor was characterized by a positive loading of a history of affective disorder, PPAD and anxiety disorder. For the biological factor, infant cortisol adhered negatively with infant motor development, but NGF was positively associated. The psychological factor had a negative association, but the biological factor had a positive association with infant motor development. There are few studies that have focused on the relationship of biomarkers and infant neurodevelopment. Our study points that psychological and biological factors are associated with infant motor development, however the causal relationship between these factors is still to be defined.

A Qualitative Study of Motivating Factors for Pharmacy Student Leadership.

PubMed

Moore, R Joel; Ginsburg, Diane B

2017-08-01

Objective. To understand what motivates student pharmacists to seek a leadership position while in the professional pharmacy program and why these students choose to lead in a particular organization. Methods. A qualitative study was used to answer the research questions. Current student leaders were recruited to participate, and each completed a pre-interview questionnaire and a one-hour interview. All interviews were transcribed, and an interpretive phenomenological approach was used to describe, code, and analyze the experiences. Results. Student leaders were motivated to serve in a leadership position for four reasons: networking opportunities, belief in an organization's mission, ability to affect change, and legacy. Additionally, prior leadership experience and influence played major roles in these student leaders' pursuit of a position. Conclusion. Networking, belief in an organization's mission, ability to affect change, and legacy are the four primary motivating factors for student leadership while in the professional pharmacy program. Knowing these factors should help direct resources in organizational and college efforts to produce qualified and impactful pharmacist leaders.

A Qualitative Study of Motivating Factors for Pharmacy Student Leadership

PubMed Central

Ginsburg, Diane B.

2017-01-01

Objective. To understand what motivates student pharmacists to seek a leadership position while in the professional pharmacy program and why these students choose to lead in a particular organization. Methods. A qualitative study was used to answer the research questions. Current student leaders were recruited to participate, and each completed a pre-interview questionnaire and a one-hour interview. All interviews were transcribed, and an interpretive phenomenological approach was used to describe, code, and analyze the experiences. Results. Student leaders were motivated to serve in a leadership position for four reasons: networking opportunities, belief in an organization’s mission, ability to affect change, and legacy. Additionally, prior leadership experience and influence played major roles in these student leaders’ pursuit of a position. Conclusion. Networking, belief in an organization’s mission, ability to affect change, and legacy are the four primary motivating factors for student leadership while in the professional pharmacy program. Knowing these factors should help direct resources in organizational and college efforts to produce qualified and impactful pharmacist leaders. PMID:28970615

Using representations in geometry: a model of students' cognitive and affective performance

NASA Astrophysics Data System (ADS)

Panaoura, Areti

2014-05-01

Self-efficacy beliefs in mathematics, as a dimension of the affective domain, are related with students' performance on solving tasks and mainly on overcoming cognitive obstacles. The present study investigated the interrelations of cognitive performance on geometry and young students' self-efficacy beliefs about using representations for solving geometrical tasks. The emphasis was on confirming a theoretical model for the primary-school and secondary-school students and identifying the differences and similarities for the two ages. A quantitative study was developed and data were collected from 1086 students in Grades 5-8. Confirmatory factor analysis affirmed the existence of a coherent model of affective dimensions about the use of representations for understanding the geometrical concepts, which becomes more stable across the educational levels.

Factors affecting knowledge transfer from continuing professional education to clinical practice: Development and psychometric properties of a new instrument.

PubMed

Vasli, Parvaneh; Dehghan-Nayeri, Nahid; Khosravi, Laleh

2018-01-01

Despite the emphasis placed on the implementation of continuing professional education programs in Iran, researchers or practitioners have not developed an instrument for assessing the factors that affect the knowledge transfer from such programs to clinical practice. The aim of this study was to design and validate such instrument for the Iranian context. The research used a three-stage mix method. In the first stage, in-depth interviews with nurses and content analysis were conducted, after which themes were extracted from the data. In the second stage, the findings of the content analysis and literature review were examined, and preliminary instrument options were developed. In the third stage, qualitative content validity, face validity, content validity ratio, content validity index, and construct validity using exploratory factor analysis was conducted. The reliability of the instrument was measured before and after the determination of construct validity. Primary tool instrument initially comprised 53 items, and its content validity index was 0.86. In the multi-stage factor analysis, eight questions were excluded, thereby reducing 11 factors to five and finally, to four. The final instrument with 43 items consists of the following dimensions: structure and organizational climate, personal characteristics, nature and status of professionals, and nature of educational programs. Managers can use the Iranian instrument to identify factors affecting knowledge transfer of continuing professional education to clinical practice. Copyright © 2017. Published by Elsevier Ltd.

Risk Factors for Primary Open Angle Glaucoma (POAG) Progression: A Study Ruled in Torino

PubMed Central

Actis, A.G.; Versino, E.; Brogliatti, B.; Rolle, T.

2016-01-01

Purpose: Aim of this retrospective, observational study is to describe features of a population sample, affected by primary open angle glaucoma (POAG) in order to evaluate damage progression on the basis of the emerged individual risk factors. Methods: We included 190 caucasian patients (377 eyes), evaluating relationship between individual risk factors (explicative variables) and MD (Mean Deviation) of standard automated perimetry. We also considered the dependent variable NFI (Neural Fiber Index) of GDx scanning laser polarimetry. Progression has been evaluated through a statistic General Linear Model on four follow up steps (mean follow up 79 months). Results: Factors reaching statistical significance, determining a worsening of the MD variable, are: age (P<0.0001), intraocular pressure (IOP) at follow up (P < 0.0001), female gender (P<0.0001), hypertension (P< 0.0001) and familiarity (P = 0.0006). Factors reaching statistical significance, determining a worsening of the NFI variable, are only IOP at follow up (P = 0.0159) and depression (P = 0.0104). Conclusion: Results of this study confirm and enforce data coming from most recent studies: IOP remains the main risk factor for glaucoma assess and progression; age and familiarity are great risk factors as underlined in the last decades; female sex can be an important risk factors as emerged only in the last years; arterial hypertension should always be evaluated in timing of our clinic follow up. PMID:27347249

Time-lag effects of global vegetation responses to climate change.

PubMed

Wu, Donghai; Zhao, Xiang; Liang, Shunlin; Zhou, Tao; Huang, Kaicheng; Tang, Bijian; Zhao, Wenqian

2015-09-01

Climate conditions significantly affect vegetation growth in terrestrial ecosystems. Due to the spatial heterogeneity of ecosystems, the vegetation responses to climate vary considerably with the diverse spatial patterns and the time-lag effects, which are the most important mechanism of climate-vegetation interactive effects. Extensive studies focused on large-scale vegetation-climate interactions use the simultaneous meteorological and vegetation indicators to develop models; however, the time-lag effects are less considered, which tends to increase uncertainty. In this study, we aim to quantitatively determine the time-lag effects of global vegetation responses to different climatic factors using the GIMMS3g NDVI time series and the CRU temperature, precipitation, and solar radiation datasets. First, this study analyzed the time-lag effects of global vegetation responses to different climatic factors. Then, a multiple linear regression model and partial correlation model were established to statistically analyze the roles of different climatic factors on vegetation responses, from which the primary climate-driving factors for different vegetation types were determined. The results showed that (i) both the time-lag effects of the vegetation responses and the major climate-driving factors that significantly affect vegetation growth varied significantly at the global scale, which was related to the diverse vegetation and climate characteristics; (ii) regarding the time-lag effects, the climatic factors explained 64% variation of the global vegetation growth, which was 11% relatively higher than the model ignoring the time-lag effects; (iii) for the area with a significant change trend (for the period 1982-2008) in the global GIMMS3g NDVI (P < 0.05), the primary driving factor was temperature; and (iv) at the regional scale, the variation in vegetation growth was also related to human activities and natural disturbances. Considering the time-lag effects is quite important for better predicting and evaluating the vegetation dynamics under the background of global climate change. © 2015 John Wiley & Sons Ltd.

Factors controlling the geochemical evolution of fumarolic encrustations, Valley of Ten Thousand Smokes, Alaska

USGS Publications Warehouse

Kodosky, L.G.; Keith, T.E.C.

1993-01-01

Factor and canonical correlation analysis of geochemical data from eight fossil fumaroles suggest that six major factors controlled the formation and evolution of fumarolic encrustations on the 1912 ash-flow sheet in the Valley of Ten Thousand Smokes (VTTS). The six-factor solution model explains a large proportion (low of 74% for Ni to high of 99% for Si) of the individual element data variance. Although the primary fumarolic deposits have been degraded by secondary alteration reactions and up to 75 years of weathering, the relict encrustations still preserve a signature of vapor-phase element transport. This vapor-phase transport probably occurred as halide or oxyhalide species and was significant for As, Sb and Br. At least three, and possibly four, varied temperature leaching events affected the fumarolic deposits. High-temperature gases/liquids heavily altered the ejecta glass and mineral phases adjacent to the fumarolic conduit. As the fumaroles cooled. Fe-rich acidic condensate leached the ejecta and primary fumarolic deposits and resulted in the subsequent precipitation of Fe-hydroxides and/or Fe-oxides. Low- to ambient-temperature leaching and hydration reactions generated abundant hydrated amorphous phases. Up to 87% of the individual element data variance is apparently controlled by the chemistry of the ejecta on which the relict encrustations are found. This matrix chemistry factor illustrates that the primary fumarolic minerals surrounding the active VTTS vents observed by earlier workers have been effectively removed by the dissolution reactions. Element enrichment factors calculated for the VTTS relict encrustations support the statistical factor interpretations. On the average, the relict encrustations are enriched, relative to visibly unaltered matrix protolith, in As, Br, Cr, Sb, Cu, Ni, Pb, Fe, and LOI (an indirect measure of sample H2O content). ?? 1993.

Domestic and Environmental Factors of Chikungunya-affected Families in Thiruvananthapuram (Rural) District of Kerala, India

PubMed Central

Anish, TS; Vijayakumar, K; Leela, Itty Amma KR

2011-01-01

Background: The world is experiencing a pandemic of chikungunya which has swept across Indian Ocean and the Indian subcontinent. Kerala the southernmost state of India was affected by the chikungunya epidemic twice, first in 2006 and then in 2007. Kerala has got geography and climate which are highly favorable for the breeding of Aedes albopictus, the suspected vector. Aim: The aim of the study was to highlight the various domestic and environmental factors of the families affected by chikungunya in 2007 in Thiruvananthapuram district (rural) of Kerala. Settings and design:This is a cross-sectional survey conducted in Thiruvananthapuram (rural) district during November 2007. Settings and design: This is a cross-sectional survey conducted in Thiruvananthapuram (rural) district during November 2007 Materials and Methods: Samples were selected from field area under three Primary Health Centers.These areas represent the three terrains of the district namely the highland, midland, and lowland. The sample size was estimated to be 134 houses from each study area.The field area of health workers was selected as clusters and six subcenters from each primary health center were randomly selected (lot method). Results and Conclusions: The proportion of population affected by chikungunya fever is 39.9% (38.9-40.9%). The investigators observed water holding containers in the peri-domestic area of 95.6% of the houses. According to regression (binary logistic) analysis, the area of residence [adjusted odds ratio (OR) = 8.01 (6.06-14.60)], residing in a non-remote area [adjusted OR=0.25 (0.16-0.38)], perceived mosquito menace [adjusted OR=3.07 (2.31-4.64)], and containers/tires outside the house [adjusted OR=5.61 (2.74-27.58)] were the independent predictors of the occurrence of chikungunya in households. PMID:21572606

Primary Prevention of Colorectal Cancer

PubMed Central

Chan, Andrew T.; Giovannucci, Edward L.

2010-01-01

Colorectal cancer has been strongly associated with a Western lifestyle. In the past several decades, much has been learned about the dietary, lifestyle, and medication risk factors for this malignancy. Although there is controversy about the role of specific nutritional factors, consideration of the dietary pattern as a whole appears useful for formulating recommendations. For example, several studies have shown that high intake of red and processed meats, highly refined grains and starches, and sugars is related to increased risk of colorectal cancer. Replacing these factors with poultry, fish, and plant sources as the primary source of protein; unsaturated fats as the primary source of fat; and unrefined grains, legumes and fruits as the primary source of carbohydrates is likely to lower risk of colorectal cancer. Although a role for supplements, including vitamin D, folate, and vitamin B6, remains uncertain, calcium supplementation is likely to be at least modestly beneficial. With respect to lifestyle, compelling evidence indicates that avoidance of smoking and heavy alcohol use, prevention of weight gain, and the maintenance of a reasonable level of physical activity are associated with markedly lower risks of colorectal cancer. Medications such as aspirin and non-steroidal anti-inflammatory drugs and post-menopausal hormones for women are associated with significant reductions in colorectal cancer risk, though their utility is affected by associated risks. Taken together, modifications in diet and lifestyle should substantially reduce the risk of colorectal cancer and could complement screening in reducing colorectal cancer incidence. PMID:20420944

Happiness as a motivator: positive affect predicts primary control striving for career and educational goals.

PubMed

Haase, Claudia M; Poulin, Michael J; Heckhausen, Jutta

2012-08-01

What motivates individuals to invest time and effort and overcome obstacles (i.e., strive for primary control) when pursuing important goals? We propose that positive affect predicts primary control striving for career and educational goals, and we explore the mediating role of control beliefs. In Study 1, positive affect predicted primary control striving for career goals in a two-wave longitudinal study of a U.S. sample. In Study 2, positive affect predicted primary control striving for career and educational goals and objective career outcomes in a six-wave longitudinal study of a German sample. Control beliefs partially mediated the longitudinal associations with primary control striving. Thus, when individuals experience positive affect, they become more motivated to invest time and effort, and overcome obstacles when pursuing their goals, in part because they believe they have more control over attaining their goals.

Clinical, behavioural and pharmacogenomic factors influencing the response to levothyroxine therapy in patients with primary hypothyroidism-protocol for a systematic review.

PubMed

Dew, Rosie; Okosieme, Onyebuchi; Dayan, Colin; Eligar, Vinay; Khan, Ishrat; Razvi, Salman; Pearce, Simon; Wilkes, Scott

2017-03-21

Suboptimal thyroid hormone therapy including under-replacement and over-replacement is common amongst patients with hypothyroidism. This is a significant health concern as affected patients are at risk of adverse cardiovascular or metabolic consequences. Despite a growing body of evidence on the effects of various factors on thyroid hormone replacement, a systematic appraisal of the evidence is lacking. This review aims to appraise and quantify the extent to which clinical, behavioural and pharmacogenomic factors affect levothyroxine therapy in patients with primary hypothyroidism. The databases Web of Science, Cochrane Library, EMBASE and PubMed will be searched. Patients must be adults over the age of 18 years, suffering from primary hypothyroidism including overt and subclinical hypothyroidism and receiving levothyroxine treatment. Studies in children, pregnant women and patients with secondary or tertiary hypothyroidism will not be included. We will also exclude studies focused on forms of thyroid hormone replacement therapy other than levothyroxine. The primary outcome is to quantify the effect of clinical, behavioural and pharmacogenomic factors on thyroid stimulating hormone (TSH) levels. Secondary outcomes are the effect these factors have on thyroxine (T4) and triiodothyronine (T3) levels, mortality, morbidity, quality of life, treatment complications, adverse effects, physical and social functioning. Studies will be screened through reading the title, abstract and then full text. Two reviewers will independently extract the data and select articles, and a third reviewer will be consulted if there is any disagreement. We will undertake a meta-analysis of studies in which there is a defined intervention or exposure, patients are receiving levothyroxine for hypothyroidism, there is an appropriate control group of levothyroxine treated patients that are not exposed to the intervention, and the primary outcome is determined by serum TSH levels. Studies will comprise of randomised controlled trials as well as observational data. Eligible studies will be assessed for bias using the risk of bias tool available in the Cochrane handbook 2011, and the quality of evidence will be judged according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. A flow diagram describing the data search will be created according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis: The PRISMA statement. A narrative synthesis will be undertaken in the description of the data, and summary tables will be created of the results. This review will be the first systematic review of this nature. The evidence synthesised will be useful to general practitioners in their management of hypothyroidism. Findings will be disseminated at conferences and in professional and peer-reviewed journals. PROSPERO CRD42015027211.

Private primary care physicians' perspectives on factors affecting the adoption of electronic medical records: a qualitative pre-implementation study.

PubMed

Or, Calvin; Wong, Katie; Tong, Ellen; Sek, Antonio

2014-01-01

Use of electronic medical records (EMR) has the potential to offer quality and safety benefits, but without the adoption of the technology, the benefits will not be realized. This study aimed to identify the factors perceived as relevant by private physicians when considering EMR adoption. A qualitative pre-implementation study was conducted using semi-structured, face to face interviews to explore the perspectives of physicians (n=16) operating in private clinics on the factors affecting their adoption of EMR. A multilevel, work system approach and the immersion/crystallization data analysis technique guided the researchers in examining the data, identifying patterns and key themes, and extracting representative quotes to illustrate these themes. The major factors associated with EMR adoption, which relate to the five categories of a work system, were system usefulness; user interface design; technical support; cost; system reliability; the privacy, confidentiality, and security of patient information; physical space in the clinic; data migration process; adverse work-related factors; and the computer and systems skills of physicians. Pre-implementation identification of factors important to adoption can allow system developers to focus proactively on these factors when developing the system and its implementation strategies, to maximize the likelihood of successful introduction.

Factors affecting quality of care in family planning clinics: a study from Iran.

PubMed

Shahidzadeh-Mahani, Ali; Omidvari, Sepideh; Baradaran, Hamid-Reza; Azin, Seyyed-Ali

2008-08-01

Despite good contraceptive coverage rates, recent studies in Iran have shown an alarmingly high incidence of unplanned pregnancy. To determine factors affecting quality of family planning services, a cross-sectional study was performed from June to August 2006 on women visiting urban Primary Health Care clinics in a provincial capital in western Iran. The primary focus of the study was on provider-client interaction. We used a slightly edited version of a UNICEF checklist and a convenient sampling method to assess quality of care in 396 visits to the family planning sections at 25 delivery points. Poor performance was observed notably in Counselling and Choice of method sections. In logistic regression analysis, the following factors were found to be associated with higher quality of care: provider experience [OR (odds ratio)=1.9, CI(0.95) (confidence interval)=1.2-3.0], low provider education (OR=6.7, CI(0.95)=4.0-10.8), smaller workload at the clinic (OR=3.7, CI(0.95)=2.0-6.7), and 'new client' status (OR=4.2, CI(0.95)=2.6-6.7). This study identified the issues of counselling and information exchange as the quality domains in serious need of improvement; these areas are expected to be the focus of future training programmes for care providers. Also, priority should be given to devising effective supervision mechanisms and on-the-job training of senior nursing and midwifery graduates to make them more competent in delivering basic family planning services.

Biological underpinnings of breastfeeding challenges: the role of genetics, diet, and environment on lactation physiology

PubMed Central

Lee, Sooyeon

2016-01-01

Lactation is a dynamic process that has evolved to produce a complex biological fluid that provides nutritive and nonnutritive factors to the nursing offspring. It has long been assumed that once lactation is successfully initiated, the primary factor regulating milk production is infant demand. Thus, most interventions have focused on improving breastfeeding education and early lactation support. However, in addition to infant demand, increasing evidence from studies conducted in experimental animal models, production animals, and breastfeeding women suggests that a diverse array of maternal factors may also affect milk production and composition. In this review, we provide an overview of our current understanding of the role of maternal genetics and modifiable factors, such as diet and environmental exposures, on reproductive endocrinology, lactation physiology, and the ability to successfully produce milk. To identify factors that may affect lactation in women, we highlight some information gleaned from studies in experimental animal models and production animals. Finally, we highlight the gaps in current knowledge and provide commentary on future research opportunities aimed at improving lactation outcomes in breastfeeding women to improve the health of mothers and their infants. PMID:27354238

Factors influencing pharmacist performance: a review of the peer-reviewed literature.

PubMed

Schafheutle, Ellen Ingrid; Seston, Elizabeth Mary; Hassell, Karen

2011-10-01

To undertake a review of peer-reviewed literature to explore factors affecting pharmacists' performance. The following databases were searched: Medline, Embase, Scopus, ISI Web of Knowledge and PsychInfo. Inclusion criteria were: English language only, published between 1990 and 2010 and published in the United Kingdom (UK), United States of America (USA), Canada, Australia, New Zealand or Europe. The search strategy identified 37 items. The review found that there was some evidence to suggest that pharmacists with certain characteristics (e.g. being male, being of ethnic minority origin, working in community pharmacy and having trained overseas) were more likely to experience performance problems. Factors relating to workload and work environment were associated with performance problems, particularly in relation to errors. There was some limited evidence to suggest that experiencing problems with alcohol or drugs could negatively impact on pharmacists' performance. The findings suggest that pharmacist performance may be affected by multiple factors, including personal characteristics such as age, gender, ethnicity, place of primary qualification, factors associated with the workplace and mental and physical health problems. The evidence is not unequivocal and gaps in the literature exist, suggesting that pharmacist performance is an under-researched area. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Effects of long-term nutrient additions on Arctic tundra, stream, and lake ecosystems: beyond NPP.

PubMed

Gough, Laura; Bettez, Neil D; Slavik, Karie A; Bowden, William B; Giblin, Anne E; Kling, George W; Laundre, James A; Shaver, Gaius R

2016-11-01

Primary producers form the base of food webs but also affect other ecosystem characteristics, such as habitat structure, light availability, and microclimate. Here, we examine changes caused by 5-30+ years of nutrient addition and resulting increases in net primary productivity (NPP) in tundra, streams, and lakes in northern Alaska. The Arctic provides an important opportunity to examine how ecosystems characterized by low diversity and low productivity respond to release from nutrient limitation. We review how responses of algae and plants affect light availability, perennial biotic structures available for consumers, oxygen levels, and temperature. Sometimes, responses were similar across all three ecosystems; e.g., increased NPP significantly reduced light to the substrate following fertilization. Perennial biotic structures increased in tundra and streams but not in lakes, and provided important new habitat niches for consumers as well as other producers. Oxygen and temperature responses also differed. Life history traits (e.g., longevity) of the primary producers along with the fate of detritus drove the responses and recovery. As global change persists and nutrients become more available in the Arctic and elsewhere, incorporating these factors as response variables will enable better prediction of ecosystem changes and feedbacks in this biome and others.

Factors affecting physicians' responses to patients' requests for antidepressants: focus group study.

PubMed

Tentler, Aleksey; Silberman, Jordan; Paterniti, Debora A; Kravitz, Richard L; Epstein, Ronald M

2008-01-01

The ways in which patients' requests for antidepressants affect physicians' prescribing behavior are poorly understood. To describe physicians' affective and cognitive responses to standardized patients' (SPs) requests for antidepressants, as well as the attitudinal and contextual factors influencing prescribing behavior. Focus group interviews and brief demographic questionnaires. Twenty-two primary care physicians in 6 focus groups; all had participated in a prior RCT of the influence of patients' requests on physicians' prescribing. Iterative review of interview transcripts, involving qualitative coding and thematic analysis. Physicians participating in the focus groups were frequently unaware of and denied the degree to which their thinking was biased by patient requests, but were able to recognize such biases after facilitated reflection. Common affective responses included annoyance and empathy. Common cognitive reactions resulted in further diagnostic inquiry or in acquiescing to the patient's demands to save time or build the patient-clinician relationship. Patients' requests for medication prompted the participants to err on the side of overtreating versus careful review of clinical indications. Lack of time and participants' attitudes--toward the role of the patient and the pharmaceutical ads--also influenced their responses, prompting them to interpret patient requests as diagnostic clues or opportunities for efficiency. This study provides a taxonomy of affective and cognitive responses to patients' requests for medications and the underlying attitudes and contextual factors influencing them. Improved capacity for moment-to-moment self-awareness during clinical reasoning processes may increase the appropriateness of prescribing.

Decision for Retransplantation of the Liver

PubMed Central

Azoulay, Daniel; Linhares, Marcello M.; Huguet, Emmanuel; Delvart, Valérie; Castaing, Denis; Adam, René; Ichai, Philippe; Saliba, Faouzi; Lemoine, Antoinette; Samuel, Didier; Bismuth, Henri

2002-01-01

Objective To determine the patient factors affecting patient outcome of first liver retransplantation at a single center to help in the decision process for retransplantation. Summary Background Data Given the critical organ shortage, one of the most controversial questions is whether hepatic retransplantation, the only chance of survival for patients with a failing first organ, should be offered liberally despite its greater cost, worse survival, and the inevitable denial of access to primary transplantation to other patients due to the depletion of an already-limited organ supply. The authors’ experience of 139 consecutive retransplantations was reviewed to evaluate the results of retransplantation and to identify the factors that could improve the results. Methods From 1986 to 2000, 1,038 patients underwent only one liver transplant and 139 patients underwent a first retransplant at the authors’ center (first retransplantation rate = 12%). Multivariate analysis was performed to identify variables, excluding intraoperative and donor variables, associated with graft and patient long-term survival following first retransplantation. Lengths of hospital and intensive care unit stay and hospital charges incurred during the transplantation admissions were compared for retransplanted patients and primary-transplant patients. Results One-year, 5-year, and 10-year graft and patient survival rates following retransplantation were 54.0%, 42.5%, 36.8% and 61.2%, 53.7%, and 50.1%, respectively. These percentages were significantly less than those following a single hepatic transplantation at the authors’ center during the same period (82.3%, 72.1%, and 66.9%, respectively). On multivariate analysis, three patient variables were significantly associated with a poorer patient outcome: urgency of retransplantation (excluding primary nonfunction), age, and creatinine. Primary nonfunction as an indication for retransplantation, total bilirubin, and factor II level were associated with a better prognosis. The final model was highly predictive of survival: according to the combination of the factors affecting outcome, 5-year patient survival rates varied from 15% to 83%. Retransplant patients had significantly longer hospital and intensive care unit stays and accumulated significantly higher total hospital charges than those receiving only one transplant. Conclusions These data confirm the utility of retransplantation in the elective situation. In the emergency setting, retransplantation should be used with discretion, and it should be avoided in subgroups of patients with little chance of success. PMID:12454509

BALKANS SECURITY. Current and Projected Factors Affecting Regional Stability

DTIC Science & Technology

2000-04-01

Security Briefing Section II Current Situation in Kosovo and Bosnia primary responsibility for public security in Kosovo. 6 According to a senior KFOR...Integrity * Reliability GAO/NSIAD-00-125BR „.c-miBUTION STATEMENT A ApSwed for Public Release Contents Letter Briefing Section Appendixes Tables...Figures Briefing Section I: Background Briefing Section II: Current Situation in Kosovo and Bosnia Briefing Section III: Projected Security Situation

Study of solid rocket motors for a space shuttle booster. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

Vonderesch, A. H.

1972-01-01

The factors affecting the choice of the 156 inch diameter, parallel burn, solid propellant rocket engine for use with the space shuttle booster are presented. Primary considerations leading to the selection are: (1) low booster vehicle cost, (2) the largest proven transportable system, (3) a demonstrated design, (4) recovery/reuse is feasible, (5) abort can be easily accomplished, and (6) ecological effects are minor.

Factors Influence the Digital Media Teaching of Primary School Teachers in a Flipped Class: A Taiwan Case Study

ERIC Educational Resources Information Center

Cheng, Yung-Hsun; Weng, Chia-Wen

2017-01-01

The current study focuses on the key roles that affect the success of a flipped classroom. The research was conducted with a questionnaire survey created from a study of literature review. Out of a total of 441 samples, 424 valid samples (96.14%) from teachers have been received. The study key conclusions are as follows: (1) a principal leadership…

New Orleans to Venice, Louisiana Hurricane Protection Project, Draft Supplemental Environmental Impact Statement. Appendixes.

DTIC Science & Technology

1984-02-01

General Characteristics of Material. The primary " construction materials are clays and sands. Soil borings disclose that the clay to be removed from the...Chabreck, Robert. 1972. Vegetation, water and soil characteristics of the Louisiana coastal region. Louisiana State University Agricultural ,. Experiment...levels, especially of dieldrin, have resulted in thin eggshells . Other factors affecting the population are shooting, elec- trocution, severe weather

An Evaluation of Factors Affecting Decision Making among 4th Grade Elementary School Students with Low Socio-Economic Status

ERIC Educational Resources Information Center

Kaskaya, Alper; Calp, Sükran; Kuru, Oguzhan

2017-01-01

Decision making is one of the most important life skills. While making correct, timely, accurate and appropriate decisions lead to positive changes in one's life, making incorrect decisions may have a negative impact. It is an important issue to examine what the 4th grade students in primary school have about the decision-making ability to be…

A conceptual investigation of variables affecting the success and acceptance of SMS Marketing in Iran.

PubMed

Adhami, A; Rabiee, A; Adhami, M

2015-01-01

This paper's aim was to develop a conceptual overview of SMS marketing and delineate factors of new communications technologies on business practice. This study, which was a descriptive survey, was built on primary and secondary data source including a literature review of SMS marketing and a Questionnaire were used as the primary means of collecting secondary data. The sample size of 300 patients was determined according to the Cochran formula. Moreover, data analysis was done in SPSS by using linear regression, chi-square, t-test and Binomial test. According to the research, sex, age, education, relevance, timeliness, reliability to sender, sense of control were variables affecting the SMS marketing acceptance. This paper was qualitative and provided a solid conceptual foundation for the future empirical research on e- marketing. The potential limitation was related to the broad user of computer and mobile. In this research, we considered SMS marketing, Mobile marketing, SMS advertising as the same subject. This research will be a useful resource with important insight into the factors that may encourage or determine consumer acceptance of this new form of direct marketing. This paper addressed an important timely issue, and added to the body of literature and knowledge focusing on e-marketing.

Travel distance influences readmissions in colorectal cancer patients-what the primary operative team needs to know.

PubMed

Kelley, Katherine A; Young, J Isaac; Bassale, Solange; Herzig, Daniel O; Martindale, Robert G; Sheppard, Brett C; Lu, Kim C; Tsikitis, V Liana

2018-07-01

Many colorectal cancer patients receive complex surgical care remotely. We hypothesized that their readmission rates would be adversely affected after accounting for differences in travel distance from primary/index hospital and correlate with mortality. We identified 48,481 colorectal cancer patients in the Surveillance, Epidemiology and End Results (SEER)-Medicare database. Travel distance was calculated, using Google Maps, and SAS. Multivariate negative binomial regression was used to identify factors associated with readmission rates. Overall survival was analyzed, using Kaplan-Meier and Cox proportional hazard. Thirty-day readmissions occurred in 14.9% of the cohort, 27.5% of which were to a nonindex hospital. In the colon and rectal cancer cohorts, readmissions were 14.5% and 16.5%, respectively. Rectal cancer patients had an increase in readmission by 13% (incidence rate ratios [IRR] 1.13; 95% confidence interval [CI] 1.05-1.21). Factors associated with readmission were male gender, advanced disease, length of stay (LOS), discharge disposition, hospital volume, Charlson score, and poverty level (P < 0.05). Greater distance traveled increased the likelihood of readmission but did not affect mortality. Travel distance influences readmission rates but not mortality. Discharge readiness to decrease readmissions is essential for colorectal cancer patients discharged from index hospitals. Copyright © 2018 Elsevier Inc. All rights reserved.

Correlates of habitual physical activity and organized sports in German primary school children.

PubMed

Kobel, S; Kettner, S; Kesztyüs, D; Erkelenz, N; Drenowatz, C; Steinacker, J M

2015-03-01

The increased prevalence of childhood obesity has also been attributed to low physical activity (PA) levels. Understanding factors affecting child PA levels is especially important considering the benefits PA offers to youth. This study therefore examined different correlates affecting habitual PA and sports participation in primary school children. Height and weight were measured during a school visit in 1714 children (7.1 ± .6 years). PA and behavioural correlates were assessed by parental questionnaire. The effect of various correlates on PA as well as participation in organized sports was assessed using logistic regression analysis. Significant correlates of PA and sports participation were engagement in sporting activities outside of clubs and children's weight status. Playing outdoors for more than 60 min/day was significant for PA, having well educated parents and being male. Participation in sports was influenced by children's media consumption, active travel to school and having active parents. No influence was found for migration, income, parental weight status and health consciousness. In this study, a multiplicity of independent correlates of PA and sports participation, which require a broad approach to promote an active lifestyle, have been considered. Understanding these factors might support the development of effective health-promoting interventions. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

A conceptual investigation of variables affecting the success and acceptance of SMS Marketing in Iran

PubMed Central

Adhami, A; Rabiee, A; Adhami, M

2015-01-01

This paper’s aim was to develop a conceptual overview of SMS marketing and delineate factors of new communications technologies on business practice. This study, which was a descriptive survey, was built on primary and secondary data source including a literature review of SMS marketing and a Questionnaire were used as the primary means of collecting secondary data. The sample size of 300 patients was determined according to the Cochran formula. Moreover, data analysis was done in SPSS by using linear regression, chi-square, t-test and Binomial test. According to the research, sex, age, education, relevance, timeliness, reliability to sender, sense of control were variables affecting the SMS marketing acceptance. This paper was qualitative and provided a solid conceptual foundation for the future empirical research on e- marketing. The potential limitation was related to the broad user of computer and mobile. In this research, we considered SMS marketing, Mobile marketing, SMS advertising as the same subject. This research will be a useful resource with important insight into the factors that may encourage or determine consumer acceptance of this new form of direct marketing. This paper addressed an important timely issue, and added to the body of literature and knowledge focusing on e-marketing. PMID:28255405

Pain and Depressive Symptoms in Primary Care: Moderating Role of Positive and Negative Affect.

PubMed

Hirsch, Jameson K; Sirois, Fuschia M; Molnar, Danielle; Chang, Edward C

2016-07-01

Pain and its disruptive impact on daily life are common reasons that patients seek primary medical care. Pain contributes strongly to psychopathology, and pain and depressive symptoms are often comorbid in primary care patients. Not all those who experience pain develop depression, suggesting that the presence of individual-level characteristics, such as positive and negative affect, that may ameliorate or exacerbate this association. We assessed the potential moderating role of positive and negative affect on the pain-depression linkage. In a sample of 101 rural, primary care patients, we administered the Brief Pain Inventory, NEO Personality Inventory-Revised positive and negative affect subclusters, and the Center for Epidemiology Scale for Depression. In moderation models, covarying age, sex, and ethnicity, we found that positive affect, but not negative affect, was a significant moderator of the relation between pain intensity and severity and depressive symptoms. The association between pain and depressive symptoms is attenuated when greater levels of positive affects are present. Therapeutic bolstering of positive affect in primary care patients experiencing pain may reduce the risk for depressive symptoms.

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

Jones, A. Kyle, E-mail: kyle.jones@mdanderson.org

Purpose: To evaluate the sensitivity of the diagnostic radiological index of protection (DRIP), used to quantify the protective value of radioprotective garments, to procedural factors in fluoroscopy in an effort to determine an appropriate set of scatter-mimicking primary beams to be used in measuring the DRIP. Methods: Monte Carlo simulations were performed to determine the shape of the scattered x-ray spectra incident on the operator in different clinical fluoroscopy scenarios, including interventional radiology and interventional cardiology (IC). Two clinical simulations studied the sensitivity of the scattered spectrum to gantry angle and patient size, while technical factors were varied according tomore » measured automatic dose rate control (ADRC) data. Factorial simulations studied the sensitivity of the scattered spectrum to gantry angle, field of view, patient size, and beam quality for constant technical factors. Average energy (E{sub avg}) was the figure of merit used to condense fluence in each energy bin to a single numerical index. Results: Beam quality had the strongest influence on the scattered spectrum in fluoroscopy. Many procedural factors affect the scattered spectrum indirectly through their effect on primary beam quality through ADRC, e.g., gantry angle and patient size. Lateral C-arm rotation, common in IC, increased the energy of the scattered spectrum, regardless of the direction of rotation. The effect of patient size on scattered radiation depended on ADRC characteristics, patient size, and procedure type. Conclusions: The scattered spectrum striking the operator in fluoroscopy is most strongly influenced by primary beam quality, particularly kV. Use cases for protective garments should be classified by typical procedural primary beam qualities, which are governed by the ADRC according to the impacts of patient size, anatomical location, and gantry angle.« less

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

Jones, A; Pasciak, A; Wagner, L

Purpose: To evaluate the sensitivity of the Diagnostic Radiological Index of Protection (DRIP) to procedural factors in fluoroscopy in an effort to determine an appropriate set of scatter-mimicking primary beams (SMPB) to be used in measuring the DRIP. Methods: A series of clinical and factorial Monte Carlo simulations were conducted to determine the shape of the scattered X-ray spectra incident on the operator in different clinical fluoroscopy scenarios. Two clinical evaluations studied the sensitivity of the scattered spectrum to gantry angle and patient size while technical factors were varied according to measured automatic dose rate control (ADRC) data. Factorial evaluationsmore » studied the sensitivity of the scattered spectrum to gantry angle, field of view, patient size and beam quality for constant technical factors. Average energy was the figure of merit used to condense fluence in each energy bin to a single numerical index. Results: Beam quality had the strongest influence on the scattered spectrum in fluoroscopy. Many procedural factors affected the scattered spectrum indirectly through their effects on primary beam quality through ADRC, e.g., gantry angle and patient size. Lateral C-arm rotation, common in interventional cardiology, increased the energy of the scattered spectrum, regardless of the direction of rotation. The effect of patient size on scattered radiation depended on ADRC characteristics, patient size, and procedure type. Conclusion: The scattered spectrum striking the operator in fluoroscopy, and therefore the DRIP, is most strongly influenced by primary beam quality, particularly kV. Use cases for protective garments should be classified by typical procedural primary beam qualities, which are governed by the ADRC according to the impacts of patient size, anatomical location, and gantry angle. These results will help determine an appropriate set of SMPB to be used for measuring the DRIP.« less

Incidence of and risk factors for traumatic anterior shoulder dislocation: an epidemiologic study in high-school rugby players.

PubMed

Kawasaki, Takayuki; Ota, Chihiro; Urayama, Shingo; Maki, Nobukazu; Nagayama, Masataka; Kaketa, Takefumi; Takazawa, Yuji; Kaneko, Kazuo

2014-11-01

The incidence of reinjuries due to glenohumeral instability and the major risk factors for primary anterior shoulder dislocation in youth rugby players have been unclear. The purpose of this study was to investigate the incidence, mechanisms, and intrinsic risk factors of shoulder dislocation in elite high-school rugby union teams during the 2012 season. A total of 378 male rugby players from 7 high-school teams were investigated by use of self-administered preseason and postseason questionnaires. The prevalence of a history of shoulder dislocation was 14.8%, and there were 21 events of primary shoulder dislocation of the 74 overall shoulder injuries that were sustained during the season (3.2 events per 1000 player-hours of match exposure). During the season, 54.3% of the shoulders with at least one episode of shoulder dislocation had reinjury. This study also indicated that the persistence of glenohumeral instability might affect the player's self-assessed condition, regardless of the incidence during the current season. By a multivariate logistic regression method, a history of shoulder dislocation on the opposite side before the season was found to be a risk factor for contralateral primary shoulder dislocation (odds ratio, 3.56; 95% confidence interval, 1.27-9.97; P = .02). High-school rugby players with a history of shoulder dislocation are not playing at full capacity and also have a significant rate of reinjury as well as a high risk of dislocating the other shoulder. These findings may be helpful in deciding on the proper treatment of primary anterior shoulder dislocation in young rugby players. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Crosstalk between Two bZIP Signaling Pathways Orchestrates Salt-Induced Metabolic Reprogramming in Arabidopsis Roots

PubMed Central

Hartmann, Laura; Pedrotti, Lorenzo; Weiste, Christoph; Fekete, Agnes; Schierstaedt, Jasper; Göttler, Jasmin; Kempa, Stefan; Krischke, Markus; Dietrich, Katrin; Mueller, Martin J.; Vicente-Carbajosa, Jesus; Hanson, Johannes; Dröge-Laser, Wolfgang

2015-01-01

Soil salinity increasingly causes crop losses worldwide. Although roots are the primary targets of salt stress, the signaling networks that facilitate metabolic reprogramming to induce stress tolerance are less understood than those in leaves. Here, a combination of transcriptomic and metabolic approaches was performed in salt-treated Arabidopsis thaliana roots, which revealed that the group S1 basic leucine zipper transcription factors bZIP1 and bZIP53 reprogram primary C- and N-metabolism. In particular, gluconeogenesis and amino acid catabolism are affected by these transcription factors. Importantly, bZIP1 expression reflects cellular stress and energy status in roots. In addition to the well-described abiotic stress response pathway initiated by the hormone abscisic acid (ABA) and executed by SnRK2 (Snf1-RELATED-PROTEIN-KINASE2) and AREB-like bZIP factors, we identify a structurally related ABA-independent signaling module consisting of SnRK1s and S1 bZIPs. Crosstalk between these signaling pathways recruits particular bZIP factor combinations to establish at least four distinct gene expression patterns. Understanding this signaling network provides a framework for securing future crop productivity. PMID:26276836

Exploring factors that might influence primary-care provider discussion of and recommendation for prostate and colon cancer screening.

PubMed

Kistler, Christine E; Vu, Maihan; Sutkowi-Hemstreet, Anne; Gizlice, Ziya; Harris, Russell P; Brewer, Noel T; Lewis, Carmen L; Dolor, Rowena J; Barclay, Colleen; Sheridan, Stacey L

2018-01-01

Primary-care providers may contribute to the use of low-value cancer screening. We sought to examine circumstances under which primary-care providers would discuss and recommend two types of cancer screening services across a spectrum of net benefit and other factors known to influence screening. This was a cross sectional survey of 126 primary-care providers in 24 primary-care clinics in the US. Participants completed surveys with two hypothetical screening scenarios for prostate or colorectal cancer (CRC). Patients in the scenarios varied by age and screening-request status. For each scenario, providers indicated whether they would discuss and recommend screening. Providers also reported on their screening attitudes and the influence of other factors known to affect screening (short patient visits, worry about lawsuits, clinical reminders/performance measures, and screening guidelines). We examined associations between providers' attitudes and their screening recommendations for hypothetical 90-year-olds (the lowest-value screening). Providers reported they would discuss cancer screening more often than they would recommend it ( P <0.001). More providers would discuss and recommend screening for CRC than prostate cancer ( P <0.001), for younger than older patients ( P <0.001), and when the patient requested it than when not ( P <0.001). For a 90-year-old patient, every point increase in cancer-specific screening attitude increased the likelihood of a screening recommendation (30% for prostate cancer and 30% for CRC). While most providers' reported practice patterns aligned with net benefit, some providers would discuss and recommend low-value cancer screening, particularly when faced with a patient request. More work appears to be needed to help providers to discuss and recommend screening that aligns with value.

Exploring factors that might influence primary-care provider discussion of and recommendation for prostate and colon cancer screening

PubMed Central

Kistler, Christine E; Vu, Maihan; Sutkowi-Hemstreet, Anne; Gizlice, Ziya; Harris, Russell P; Brewer, Noel T; Lewis, Carmen L; Dolor, Rowena J; Barclay, Colleen; Sheridan, Stacey L

2018-01-01

Background Primary-care providers may contribute to the use of low-value cancer screening. Objective We sought to examine circumstances under which primary-care providers would discuss and recommend two types of cancer screening services across a spectrum of net benefit and other factors known to influence screening. Patients and methods This was a cross sectional survey of 126 primary-care providers in 24 primary-care clinics in the US. Participants completed surveys with two hypothetical screening scenarios for prostate or colorectal cancer (CRC). Patients in the scenarios varied by age and screening-request status. For each scenario, providers indicated whether they would discuss and recommend screening. Providers also reported on their screening attitudes and the influence of other factors known to affect screening (short patient visits, worry about lawsuits, clinical reminders/performance measures, and screening guidelines). We examined associations between providers’ attitudes and their screening recommendations for hypothetical 90-year-olds (the lowest-value screening). Results Providers reported they would discuss cancer screening more often than they would recommend it (P<0.001). More providers would discuss and recommend screening for CRC than prostate cancer (P<0.001), for younger than older patients (P<0.001), and when the patient requested it than when not (P<0.001). For a 90-year-old patient, every point increase in cancer-specific screening attitude increased the likelihood of a screening recommendation (30% for prostate cancer and 30% for CRC). Discussion While most providers’ reported practice patterns aligned with net benefit, some providers would discuss and recommend low-value cancer screening, particularly when faced with a patient request. Conclusion More work appears to be needed to help providers to discuss and recommend screening that aligns with value. PMID:29844698

[Mechanism of effects of soil microbes on cuttings rooting of Huperzia serrata].

PubMed

Li, Na; Chen, Jun; Zhu, Da-Yuan

2007-12-01

To study the effects of soil microbes of habitats on the cuttings rooting of Huperzia serrata and its mechanism. The cuttings of H. serrata were planted on the primary habitat soil and on the soil autoclaved, rooting rates were examined respectively. Changes of contents of phenolic compounds (catechin, quercetin, chlorogenic acid, ferulic acid) and indoleacetic acid (IAA) , and changes of activities of polyphenoloxidase (PPO) and peroxydase (POD) during the cuttings rooting were determined. Soil microbes of primary habitat could increase the rooting rate and the number of roots, could increase contents of catechin, chlorogenic acid, ferulic acid and IAA during rooting, and could affect activities of PPO and POD. During the rooting higher contents of catechin, chlorogenic, ferulic acid and IAA caused by soil microbes of primary habitat are important factor for rooting rate.

The effects of self-interstitial clusters on cascade defect evolution beyond the primary damage state

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

Heinisch, H.L.

1997-04-01

The intracascade evolution of the defect distributions of cascades in copper is investigated using stochastic annealing simulations applied to cascades generated with molecular dynamics (MD). The temperature and energy dependencies of annihilation, clustering and free defect production are determined for individual cascades. The annealing simulation results illustrate the strong influence on intracascade evolution of the defect configuration existing in the primary damage state. Another factor significantly affecting the evolution of the defect distribution is the rapid one-dimensional diffusion of small, glissile interstitial loops produced directly in cascades. This phenomenon introduces a cascade energy dependence of defect evolution that is apparentmore » only beyond the primary damage state, amplifying the need for further study of the annealing phase of cascade evolution and for performing many more MD cascade simulations at higher energies.« less

Steroidogenic factor-1 (SF-1, NR5A1) and human disease

PubMed Central

Ferraz-de-Souza, Bruno; Lin, Lin; Achermann, John C.

2011-01-01

Steroidogenic factor-1 (SF-1, Ad4BP, encoded by NR5A1) is a key regulator of adrenal and reproductive development and function. Based upon the features found in Nr5a1 null mice, initial attempts to identify SF-1 changes in humans focused on those rare individuals with primary adrenal failure, a 46,XY karyotype, complete gonadal dysgenesis and Müllerian structures. Although alterations affecting DNA-binding of SF-1 were found in two such cases, disruption of SF-1 is not commonly found in patients with adrenal failure. In contrast, it is emerging that variations in SF-1 can be found in association with a range of human reproductive phenotypes such as 46,XY disorders of sex development (DSD), hypospadias, anorchia, male factor infertility, or primary ovarian insufficiency in women. Overexpression or overactivity of SF-1 is also reported in some adrenal tumors or endometriosis. Therefore, the clinical spectrum of phenotypes associated with variations in SF-1 is expanding and the importance of this nuclear receptor in human endocrine disease is now firmly established. PMID:21078366

Variations in Reading Achievement Across 14 Southern African School Systems: Which Factors Matter?

NASA Astrophysics Data System (ADS)

Hungi, Njora; Thuku, Florence W.

2010-02-01

In this study the authors employed a multilevel analysis procedure in order to examine the pupil and school levels factors that contributed to variation in reading achievement among Grade 6 primary school pupils in 14 southern African school systems (Botswana, Kenya, Lesotho, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Swaziland, Tanzania, Uganda, Zambia, and Zanzibar). The data for this study were collected in 2002 as part of a major project known as the Southern and Eastern Africa Consortium for Monitoring Educational Quality (SACMEQ) that sought to examine the quality of education offered in primary schools in these countries. The most important factors affecting variation in pupil achievement across most of these school systems were grade repetition, pupil socioeconomic background, speaking the language of instruction at home, and Pupil age. South Africa, Uganda and Namibia were among the school systems with the largest between-school variation while Seychelles and Mauritius had the largest within-school variation. Low social equity in reading achievement was evident in Mauritius, Seychelles and Tanzania. Policy implications of the findings are discussed.

Exploring the relationship between math anxiety and gender through implicit measurement

PubMed Central

Rubinsten, Orly; Bialik, Noam; Solar, Yael

2012-01-01

Math anxiety, defined as a negative affective response to mathematics, is suggested as a strong antecedent for the low visibility of women in the science and engineering workforce. However, the assumption of gender differences in math anxiety is still being studied and results are inconclusive, probably due to the use of explicit measures such as direct questionnaires. Thus, our primary objective was to investigate the effects of math anxiety on numerical processing in males and females by using a novel affective priming task as an indirect measure. Specifically, university students (23 males and 30 females) completed a priming task in which an arithmetic equation was preceded by one of four types of priming words (positive, neutral, negative, or related to mathematics). Participants were required to indicate whether the equation (simple math facts based on addition, subtraction, multiplication, or division) was true or false. People are typically found to respond to target stimuli more rapidly after presentation of an affectively related prime than after an affectively unrelated one. In the current study, shorter response latencies for positive as compared to negative affective primes were found in the male group. An affective priming effect was found in the female group as well, but with a reversed pattern. That is, significantly shorter response latencies were observed in the female group for negative as compared to positive targets. That is, for females, negative affective primes act as affectively related to simple arithmetic problems. In contrast, males associated positive affect with simple arithmetic. In addition, only females with lower or insignificant negative affect toward arithmetic study at faculties of mathematics and science. We discuss the advantages of examining pure anxiety factors with implicit measures which are free of response factors. In addition it is suggested that environmental factors may enhance the association between math achievements and math anxiety in females. PMID:23087633

Exploring the relationship between math anxiety and gender through implicit measurement.

PubMed

Rubinsten, Orly; Bialik, Noam; Solar, Yael

2012-01-01

Math anxiety, defined as a negative affective response to mathematics, is suggested as a strong antecedent for the low visibility of women in the science and engineering workforce. However, the assumption of gender differences in math anxiety is still being studied and results are inconclusive, probably due to the use of explicit measures such as direct questionnaires. Thus, our primary objective was to investigate the effects of math anxiety on numerical processing in males and females by using a novel affective priming task as an indirect measure. Specifically, university students (23 males and 30 females) completed a priming task in which an arithmetic equation was preceded by one of four types of priming words (positive, neutral, negative, or related to mathematics). Participants were required to indicate whether the equation (simple math facts based on addition, subtraction, multiplication, or division) was true or false. People are typically found to respond to target stimuli more rapidly after presentation of an affectively related prime than after an affectively unrelated one. In the current study, shorter response latencies for positive as compared to negative affective primes were found in the male group. An affective priming effect was found in the female group as well, but with a reversed pattern. That is, significantly shorter response latencies were observed in the female group for negative as compared to positive targets. That is, for females, negative affective primes act as affectively related to simple arithmetic problems. In contrast, males associated positive affect with simple arithmetic. In addition, only females with lower or insignificant negative affect toward arithmetic study at faculties of mathematics and science. We discuss the advantages of examining pure anxiety factors with implicit measures which are free of response factors. In addition it is suggested that environmental factors may enhance the association between math achievements and math anxiety in females.

[Clinical and prognostic significance of preoperative serum CA153, CEA and TPS levels in patients with primary breast cancer].

PubMed

Chen, Yan; Zheng, Yu-hong; Lin, Ying-ying; Hu, Min-hua; Chen, Yan-song

2011-11-01

To investigate the clinical and prognostic values of preoperative serum CA153, CEA and TPS levels in patients with primary breast cancer. A total of 386 hospitalized patients with stage I ∼ IV breast cancer from Nov 1998 to Feb 2009 were followed up, and their clinicopathological data were analyzed retrospectively to determine the factors affecting their prognosis. First, preoperative serum CA153 expression level was significantly associated with the age of onset and tumor size (P < 0.05), the expression of serum CEA was correlated with tumor size (P < 0.05), and the expression of serum tissue polypeptide specific antigen (TPS) was correlated with tumor size and lymph node metastases (P < 0.05). Second, the overall survival was significantly shorter among patients with elevated serum CA153, CEA or TPS, respectively (P < 0.05 for overall). Finally, multivariate Cox regression analysis indicated that estrogen receptor status (ER) and elevated preoperative values of CA 153 are independent prognostic factors for overall survival (P < 0.05), and CA 153 is a risk factor but estrogen receptor status is a protective factor for overall survival. Higher preoperative expression of serum CA153, CEA or TPS is closely correlated with clinicopathological characteristics and overall survival. The prognosis is poorer in primary breast cancer patients with higher CA15-3 expression level, and pre-treatment CA153 expression level can be used as an independent prognostic parameter in patients with primarily breast cancer.

Job satisfaction: rural versus urban primary health care workers' perception in Ogun State of Nigeria.

PubMed

Campbell, P C; Ebuehi, O M

2011-01-01

Job satisfaction implies doing a job one enjoys, doing it well, and being suitably rewarded for one' efforts. Several factors affect job satisfaction. To compare factors influencing job satisfaction amongst rural and urban primary health care workers in southwestern Nigeria. A cross sectional comparative study recruited qualified health workers selected by multi stage sampling technique from rural and urban health facilities in four local government areas (LGAs) of Ogun State in Southwestern Nigeria. Data were collected and analysed using Epi info V 3.5.1 RESULTS: The response rates were 88(88%) and 91(91%) respectively in the rural and urban areas. While urban workers derived satisfaction from availability of career development opportunities, materials and equipment, in their current job, rural workers derived satisfaction from community recognition of their work and improved staff relationship. Major de-motivating factors common to both groups were lack of supportive supervision, client-provider relationship and lack of in-service training. However more rural 74(84.1%) than urban 62(68.1%) health workers would prefer to continue working in their present health facilities (p=0.04). There was a statistically significant difference between the two groups in job satisfaction with respect to tools availability and career development opportunities (p<0.05). There is dissimilarity in factors influencing job satisfaction between rural and urban healthcare workers. There is need for human resource policy to be responsive to the diverse needs of health workers particularly at the primary level.

Single cells from human primary colorectal tumors exhibit polyfunctional heterogeneity in secretions of ELR+ CXC chemokines.

PubMed

Adalsteinsson, Viktor A; Tahirova, Narmin; Tallapragada, Naren; Yao, Xiaosai; Campion, Liam; Angelini, Alessandro; Douce, Thomas B; Huang, Cindy; Bowman, Brittany; Williamson, Christina A; Kwon, Douglas S; Wittrup, K Dane; Love, J Christopher

2013-10-01

Cancer is an inflammatory disease of tissue that is largely influenced by the interactions between multiple cell types, secreted factors, and signal transduction pathways. While single-cell sequencing continues to refine our understanding of the clonotypic heterogeneity within tumors, the complex interplay between genetic variations and non-genetic factors ultimately affects therapeutic outcome. Much has been learned through bulk studies of secreted factors in the tumor microenvironment, but the secretory behavior of single cells has been largely uncharacterized. Here we directly profiled the secretions of ELR+ CXC chemokines from thousands of single colorectal tumor and stromal cells, using an array of subnanoliter wells and a technique called microengraving to characterize both the rates of secretion of several factors at once and the numbers of cells secreting each chemokine. The ELR+ CXC chemokines are highly redundant, pro-angiogenic cytokines that signal via the CXCR1 and CXCR2 receptors, influencing tumor growth and progression. We find that human primary colorectal tumor and stromal cells exhibit polyfunctional heterogeneity in the combinations and magnitudes of secretions for these chemokines. In cell lines, we observe similar variance: phenotypes observed in bulk can be largely absent among the majority of single cells, and discordances exist between secretory states measured and gene expression for these chemokines among single cells. Together, these measures suggest secretory states among tumor cells are complex and can evolve dynamically. Most importantly, this study reveals new insight into the intratumoral phenotypic heterogeneity of human primary tumors.

Bullying in Pattani primary schools in southern Thailand.

PubMed

Laeheem, K; Kuning, M; McNeil, N; Besag, V E

2009-03-01

The purpose of this research was to examine risk factors that affect the likelihood of students in Pattani primary schools bullying other children. Risk factors investigated include school rural/urban location, age, gender, religion, family physical abuse and preference of cartoon type. Identifying students who are at high risk of bullying could assist educational authorities to introduce better strategies for reducing the problem. A total of 1440 students at public and private primary schools in Pattani province were interviewed to collect relevant data. Pearson's chi-square test was used to assess the associations between the likelihood of bullying and possible risk factors. Logistic regression was used to investigate independent associations between the predictor variables and the outcome. We found that 32.9% reported that they had (ever) bullied other children. Bullying was significant associated with age (odds ratio 1.56 for 11+ years, 95% confidence intervals 1.23, 2.18) and family physical abuse (odds ratio 4.50, 95% confidence intervals 3.40, 5.89). In addition, Those students who preferred action cartoons tended to bully others 1.87 times more than those who preferred watching comedy cartoons. There are significant differences in our population in rates of bullying others that vary according to age, preferred cartoon type and whether or not family (parental) physical abuse has been witnessed. The factor 'preference for cartoon type', not examined in previous research, remained significant after multivariable adjustment. Although there is an association, the cause of this is not clear but merits further examination.

Organizational commitment among general practitioners: a cross-sectional study of the role of psychosocial factors.

PubMed

Kuusio, Hannamaria; Heponiemi, Tarja; Sinervo, Timo; Elovainio, Marko

2010-06-01

To examine whether general practitioners (GP) working in primary health care have lower organizational commitment compared with physicians working in other health sectors. The authors also tested whether psychosocial factors (job demands, job control, and colleague consultation) explain these differences in commitment between GPs and other physicians. Cross-sectional postal questionnaire. Setting and participants. A postal questionnaire was sent to a random sample of physicians (n = 5000) drawn from the Finnish Association database in 2006. A total of 2841 physicians (response rate 57%) returned the questionnaire, of which 2657 (545 GPs and 2090 other physicians) fulfilled all the participant criteria. Organizational commitment was measured with two different indicators: intention to change jobs and low affective commitment. GPs were less committed to their organizations than other physicians. Work-related psychosocial factors (high job demands, low job control, and poor colleague consultation) were all significant risk factors for low organizational commitment. The evidence collected suggests that policies that reduce psychological demands, such as job demands and low control, may contribute to better organizational commitment and, thus, alleviate the shortages of physicians in primary care. Furthermore, giving GPs a stronger say in decisions concerning their work and providing them with more variety in work tasks may even improve the quality of primary care. The strategies for workplace development should focus on redesigning jobs and identifying GPs at higher risk, such as those with especially high job strain.

Factors associated with lip and oral cavity cancer.

PubMed

Ribeiro, Isabella Lima Arrais; de Medeiros, Júlia Julliêta; Rodrigues, Larycia Vicente; Valença, Ana Maria Gondim; Lima Neto, Eufrásio de Andrade

2015-01-01

This study aimed to identify factors associated with the occurrence of primary cancer of the lip and oral cavity regions compared to other types of head and neck cancers according to demographic, socioeconomic data and lifestyle, in Brazil, from 2000 to 2011. A study was conducted using Hospital Cancer Records (Instituto Nacional do Câncer), from 2000 to 2011, totaling 23,153 cases. Data were analyzed by binary logistic regression (response category: primary cancers located in the lip and oral cavity; comparison category; other types of primary cancer in the head and neck, which does not affect the lip and oral cavity) at a significance level α = 5%. The study showed factors associated with higher incidence of cancer in the lip and oral cavity: being of advanced age (OR = 1.16), not having a family history of cancer (OR = 2.38), alcohol consumption (OR = 1.17); former tobacco use (OR = 1.51) or current tobacco use (OR = 1.65); having a previous diagnosis of cancer without treatment (OR =1.66). Being female (OR = 0.92), having completed basic (OR = 0.71) and higher (OR = 0.46) education and having previous diagnosis of cancer with treatment (OR = 0.74) constituted factors associated with lower prevalence of cancer of the lip and oral cavity. Age, absence of family history of cancer, smoking habits and alcohol consumption, and previous diagnosis of cancer without treatment were associated with a higher incidence of cancer of the lip and oral cavity.

A multi-sites analysis on the ozone effects on Gross Primary Production of European forests.

PubMed

Proietti, C; Anav, A; De Marco, A; Sicard, P; Vitale, M

2016-06-15

Ozone (O3) is both a greenhouse gas and a secondary air pollutant causing adverse impacts on forests ecosystems at different scales, from cellular to ecosystem level. Specifically, the phytotoxic nature of O3 can impair CO2 assimilation that, in turn affects forest productivity. This study aims to evaluate the effects of tropospheric O3 on Gross Primary Production (GPP) at 37 European forest sites during the time period 2000-2010. Due to the lack of carbon assimilation data at O3 monitoring stations (and vice-versa) this study makes a first attempt to combine high resolution MODIS Gross Primary Production (GPP) estimates and O3 measurement data. Partial Correlations, Anomalies Analysis and the Random Forests Analysis (RFA) were used to quantify the effects of tropospheric O3 concentration and its uptake on GPP and to evaluate the most important factors affecting inter-annual GPP changes. Our results showed, along a North-West/South-East European transect, a negative impact of O3 on GPP ranging from 0.4% to 30%, although a key role of meteorological parameters respect to pollutant variables in affecting GPP was found. In particular, meteorological parameters, namely air temperature (T), soil water content (SWC) and relative humidity (RH) are the most important predictors at 81% of test sites. Moreover, it is interesting to highlight a key role of SWC in the Mediterranean areas (Spanish, Italian and French test sites) confirming that, soil moisture and soil water availability affect vegetation growth and photosynthesis especially in arid or semi-arid ecosystems such as the Mediterranean climate regions. Considering the pivotal role of GPP in the global carbon balance and the O3 ability to reduce primary productivity of the forests, this study can help in assessing the O3 impacts on ecosystem services, including wood production and carbon sequestration. Copyright © 2016 Elsevier B.V. All rights reserved.

Effects of growth hormone and insulin-like growth factor 1 deficiency on ageing and longevity.

PubMed

Laron, Zvi

2002-01-01

Present knowledge on the effects of growth hormone (GH)/insulin-like growth hormone (IGF)1 deficiency on ageing and lifespan are reviewed. Evidence is presented that isolated GH deficiency (IGHD), multiple pituitary hormone deficiencies (MPHD) including GH, as well as primary IGE1 deficiency (GH resistance, Laron syndrome) present signs of early ageing such as thin and wrinkled skin, obesity, hyperglycemia and osteoporosis. These changes do not seem to affect the lifespan, as patients reach old age. Animal models of genetic MPHD (Ames and Snell mice) and GH receptor knockout mice (primary IGF1 deficiency) also have a statistically significant higher longevity compared to normal controls. On the contrary, mice transgenic for GH and acromegalic patients secreting large amounts of GH have premature death. In conclusion longstanding GH/IGF1 deficiency affects several parameters of the ageing process without impairing lifespan, and as shown in animal models prolongs longevity. In contrast high GH/IGF1 levels accelerate death.

Analysis of 230 cases of emergent surgery for obstructing colon cancer--lessons learned.

PubMed

Aslar, Ahmet Kessaf; Ozdemir, Süleyman; Mahmoudi, Hatim; Kuzu, Mehmet Ayhan

2011-01-01

We aimed to identify prognostic factors affecting clinical outcomes in emergent primary resection. A retrospective analysis of prospectively acquired data of 230 consecutive emergent patients between August 1994 and January 2005 were evaluated in this study. Sixty-nine patients applied with right colon obstruction and 161 patients with left. Resection and primary anastomosis was carried out in 128 patients and resection and stoma in 102 patients. The patients were divided into two cohorts: patients who developed poor outcome within 30 days after surgery and those who did not. Major morbidity or mortality were reported in 60 (26.1%) patients. Analysis revealed that the most important prognostic factors for poor outcome were American Anesthesiology Association (ASA) grade ≥3, Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥11, age >60 years, presence of peritonitis, and surgery during on-call hours. Age >60 years and on-call surgery were determinant factors in right-sided obstructions, whereas ASA grade ≥3, APACHE II score ≥11, and presence of peritonitis were determinant factors in left-sided obstructions. All these factors but the timing of the operation emphasize the pivotal role of the patient's physiological condition on admission. Accurate preoperative evaluation might predict the clinical outcome and help in establishing the most appropriate treatment.

Early Childhood Caries: Prevalence, Risk Factors, and Prevention

PubMed Central

Anil, Sukumaran; Anand, Pradeep S.

2017-01-01

Early childhood caries (ECC) is major oral health problem, mainly in socially disadvantaged populations. ECC affects infants and preschool children worldwide. The prevalence of ECC differs according to the group examined, and a prevalence of up to 85% has been reported for disadvantaged groups. ECC is the presence of one or more decayed, missing, or filled primary teeth in children aged 71 months (5 years) or younger. It begins with white-spot lesions in the upper primary incisors along the margin of the gingiva. If the disease continues, caries can progress, leading to complete destruction of the crown. The main risk factors in the development of ECC can be categorized as microbiological, dietary, and environmental risk factors. Even though it is largely a preventable condition, ECC remains one of the most common childhood diseases. The major contributing factors for the for the high prevalence of ECC are improper feeding practices, familial socioeconomic background, lack of parental education, and lack of access to dental care. Oral health plays an important role in children to maintain the oral functions and is required for eating, speech development, and a positive self-image. The review will focus on the prevalence, risk factors, and preventive strategies and the management of ECC. PMID:28770188

Exploring the Association Between Emotional Abuse and Childhood Borderline Personality Features: The Moderating Role of Personality Traits

PubMed Central

Gratz, Kim L.; Latzman, Robert D.; Tull, Matthew T.; Reynolds, Elizabeth K.; Lejuez, C. W.

2012-01-01

Most of the extant literature on borderline personality disorder has focused on the course, consequences, and correlates of this disorder among adults. However, little is known about childhood borderline personality (BP) features, or the factors associated with the emergence of BP pathology in childhood. A greater understanding of childhood BP features and associated risk factors has important implications for the development of primary and secondary prevention programs. The goal of the present study was to examine the interrelationships among two BP-relevant traits (affective dysfunction and impulsivity), a BP-relevant environmental stressor (emotional abuse), and BP features in a sample of 225 children aged 11 to 14 years. Results provide support for the role of both trait vulnerabilities and environmental stressors in childhood BP features. Further, findings highlight the moderating role of affective dysfunction in the relationship between emotional abuse and childhood BP features. PMID:21658531

Primary Care Physicians' Experience with Electronic Medical Records: Barriers to Implementation in a Fee-for-Service Environment

PubMed Central

Ludwick, D. A.; Doucette, John

2009-01-01

Our aging population has exacerbated strong and divergent trends between health human resource supply and demand. One way to mitigate future inequities is through the adoption of health information technology (HIT). Our previous research showed a number of risks and mitigating factors which affected HIT implementation success. We confirmed these findings through semistructured interviews with nine Alberta clinics. Sociotechnical factors significantly affected physicians' implementation success. Physicians reported that the time constraints limited their willingness to investigate, procure, and implement an EMR. The combination of antiquated exam room design, complex HIT user interfaces, insufficient physician computer skills, and the urgency in patient encounters precipitated by a fee-for-service remuneration model and long waitlists compromised the quantity, if not the quality, of the information exchange. Alternative remuneration and access to services plans might be considered to drive prudent behavior during physician office system implementation. PMID:19081787

[Genetic aspects in congenital hypothyrodism].

PubMed

Perone, Denise; Teixeira, Silvânia S; Clara, Sueli A; Santos, Daniela C dos; Nogueira, Célia R

2004-02-01

Congenital hypothyroidism (CH) affects between 1:3,000 and 1:4,000 newborns. Many genes are essential for normal development of the hypothalamus-pituitary-thyroid axis and hormone production, and are associated with CH. About 85% of primary hypothyroidism is called thyroid digenesis and evidence suggests that mutations in transcription factors (TTF2, TTF1, and PAX-8) and TSH receptor gene could be responsible for the disease. Genetic defects of hormone synthesis could be caused by mutations in the following genes: NIS (natrium-iodide symporter), pendrine, thyreoglobulin (TG), peroxidase (TPO). Recently, mutations in the THOX-2 gene have also been related to organification defects. Central hypothyroidism affects about 1:20,000 newborns and has been associated with mutations in pituitary transcriptional factors (POUIF1, PROP1, LHX3, and HESX1). The syndrome of resistance to thyroid hormone is rare, implies a hypothyroidism state for some tissues and is frequently associated with dominant autosomal mutations in the beta-receptor (TRss).

Exploring Physician Perspectives of Residency Holdover Handoffs: A Qualitative Study to Understand an Increasingly Important Type of Handoff.

PubMed

Duong, Jonathan A; Jensen, Trevor P; Morduchowicz, Sasha; Mourad, Michelle; Harrison, James D; Ranji, Sumant R

2017-06-01

The term "holdover admissions" refers to patients admitted by an overnight physician and whose care is then transferred to a new primary team the next morning. Descriptions of the holdover process in internal medicine are sparse. To identify important factors affecting the quality of holdover handoffs at an internal medicine (IM) residency program and to compare them to previously identified factors for other handoffs. We undertook a qualitative study using structured focus groups and interviews. We analyzed data using qualitative content analysis. IM residents, IM program directors, and hospitalists at a large academic medical center. A nine-question open-ended interview guide. We identified 13 factors describing holdover handoffs. Five factors-physical space, standardization, task accountability, closed-loop verification, and resilience-were similar to those described in prior handoff literature in other specialties. Eight factors were new concepts that may uniquely affect the quality of the holdover handoff in IM. These included electronic health record access, redundancy, unwritten thoughts, different clinician needs, diagnostic uncertainty, anchoring, teaching, and feedback. These factors were organized into five overarching themes: physical environment, information transfer, responsibility, clinical reasoning, and education. The holdover handoff in IM is complex and has unique considerations for achieving high quality. Further exploration of safe, efficient, and educational holdover handoff practices is necessary.

The stainless steel crown debate: friend or foe?

PubMed

Uston, Karen A; Estrella, Maria Regina P

2011-01-01

In this article, we will explore the use of the stainless steel crown (SSC) in dentistry today. For the pediatric population, many factors can affect the choice of restoration, such as the variations between primary and permanent tooth morphology, oral environment, and patient selection. The current literature and dentistry guidelines encourage dentists to make an informed decision when determining the restoration recommended for a carious primary molar. To further help educate dental providers on the topic of SSCs the following items will be reviewed: the indications; techniques for placement; advantages; and drawbacks when compared to alternative restorative materials. Regardless of personal opinion, the SSC should continue to be recognized for its efficiency, cost-effectiveness, and successful treatment modality.

Towards rational therapy with monoamine oxidase inhibitors.

PubMed

Tyrer, P

1976-04-01

A rational approach to the use of monoamine oxidase inhibitors (MAOIs) is outlined. Patients suitable for treatment cannot be classified adequately using conventional diagnostic labels. They include those with primary symptoms of hypochondriasis, agoraphobia and social phobias, irritability, somatic anxiety and anergia; those with primary depressed mood, guilt, ideas of reference and personality disorders seldom respond. There is great variation in the interval between the first administration of these drugs and clinical response, and this may account for the inconsistencies in published trials. The type of drug and its dose may affect rate of response, as may biochemical factors, including acetylator and monoamine oxidase status. To obtain maximum benefit, a course of therapy with MAOIs should last for several months.

Interactive effects of multiple climate change factors on ammonia oxidizers and denitrifiers in a temperate steppe.

PubMed

Zhang, Cui-Jing; Shen, Ju-Pei; Sun, Yi-Fei; Wang, Jun-Tao; Zhang, Li-Mei; Yang, Zhong-Ling; Han, Hong-Yan; Wan, Shi-Qiang; He, Ji-Zheng

2017-04-01

Global climate change could have profound effects on belowground microbial communities and subsequently affect soil biogeochemical processes. The interactive effects of multiple co-occurring climate change factors on microbially mediated processes are not well understood. A four-factorial field experiment with elevated CO2, watering, nitrogen (N) addition and night warming was conducted in a temperate steppe of northern China. Real-time polymerase chain reaction and terminal-restriction fragment length polymorphism, combined with clone library techniques, were applied to examine the effects of those climate change factors on N-related microbial abundance and community composition. Only the abundance of ammonia-oxidizing bacteria significantly increased by nitrogen addition and decreased by watering. The interactions of watering × warming on the bacterial amoA community and warming × nitrogen addition on the nosZ community were found. Redundancy analysis indicated that the ammonia-oxidizing archaeal community was affected by total N and total carbon, while the community of bacterial amoA and nosZ were significantly affected by soil pH. According to a structural equation modeling analysis, climate change influenced net primary production indirectly by altering microbial abundance and activities. These results indicated that microbial responses to the combination of chronic global change tend to be smaller than expected from single-factor global change manipulations. © FEMS 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Factors affecting delays in first trimester pregnancy termination services in New Zealand.

PubMed

Silva, Martha; McNeill, Rob; Ashton, Toni

2011-04-01

To identify the factors affecting the timeliness of services in first trimester abortion service in New Zealand. Primary data were collected from all patients attending nine abortion clinics between February and May 2009. The outcome measured was delay between the first visit with a referring doctor and the date of the abortion procedure. Patient records (n=2,950) were audited to determine the timeline between the first point of entry to the health system and the date of abortion. Women were also invited to fill out a questionnaire identifying personal factors affecting access to services (n=1,086, response rate = 36.8%). Women who went to private clinic had a significantly shorter delay compared to public clinics. Controlling for clinic type, women who went to clinics that offered medical abortions or clinics that offered single day services experienced less delay. Also, women who had more than one visit with their referring doctor experienced a greater delay than those who had a single visit. The earlier in pregnancy women sought services the longer the delay. Women's decision-making did not have a significant effect on delay. Several clinic level and systemic factors are significantly associated with delay in first trimester abortion services. In order to ensure the best physical and emotional outcomes, timeliness of services must improve. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.

Plant community, primary productivity, and environmental conditions following wetland re-establishment in the Sacramento-San Joaquin Delta, California

USGS Publications Warehouse

Miller, R.L.; Fujii, R.

2010-01-01

Wetland restoration can mitigate aerobic decomposition of subsided organic soils, as well as re-establish conditions favorable for carbon storage. Rates of carbon storage result from the balance of inputs and losses, both of which are affected by wetland hydrology. We followed the effect of water depth (25 and 55 cm) on the plant community, primary production, and changes in two re-established wetlands in the Sacramento San-Joaquin River Delta, California for 9 years after flooding to determine how relatively small differences in water depth affect carbon storage rates over time. To estimate annual carbon inputs, plant species cover, standing above- and below-ground plant biomass, and annual biomass turnover rates were measured, and allometric biomass models for Schoenoplectus (Scirpus) acutus and Typha spp., the emergent marsh dominants, were developed. As the wetlands developed, environmental factors, including water temperature, depth, and pH were measured. Emergent marsh vegetation colonized the shallow wetland more rapidly than the deeper wetland. This is important to potential carbon storage because emergent marsh vegetation is more productive, and less labile, than submerged and floating vegetation. Primary production of emergent marsh vegetation ranged from 1.3 to 3.2 kg of carbon per square meter annually; and, mid-season standing live biomass represented about half of the annual primary production. Changes in species composition occurred in both submerged and emergent plant communities as the wetlands matured. Water depth, temperature, and pH were lower in areas with emergent marsh vegetation compared to submerged vegetation, all of which, in turn, can affect carbon cycling and storage rates. ?? Springer Science+Business Media B.V. 2009.

Factors and misperceptions of routine childhood immunization service uptake in Ethiopia: findings from a nationwide qualitative study

PubMed Central

Tadesse, Tefera; Getachew, Kinde; Assefa, Tersit; Ababu, Yohannes; Simireta, Tesfaye; Birhanu, Zewdie; Hailemichael, Yohannes

2017-01-01

Introduction While the routine childhood immunization program might be affected by several factors, its identification using qualitative evidence of caretakers is generally minimal. This article explores the various factors and misperceptions of routine childhood immunization service uptake in Ethiopia and provides possible recommendations to mitigate them. Methods In this study, we used a qualitative multiple case study design collecting primary data from 63 focus group discussions (FGDs) conducted with a purposefully selected sample of children's caretakers (n = 630). Results According to the results of this study, the use of routine childhood immunization is dependent on four major factors: caretakers' behavior, family characteristics, information and communication and immunization service system. In addition, the participants had some misperceptions about routine childhood immunization. For example, immunization should be taken when the child gets sick and a single dose vaccine is enough for a child. These factors and misperceptions are complex and sometimes context-specific and vary between categories of caretakers. Conclusion Our interpretations suggest that no single factor affects immunization service uptake alone in a unique way. Rather, it is the synergy among the factors that has a collective influence on the childhood immunization system. Therefore, intervention efforts should target these multiple factors simultaneously. Importantly, this study recommends improving the quality of existing childhood immunization services and building awareness among caretakers as crucial components. PMID:29675124

Factors affecting 30-month survival in lung cancer patients.

PubMed

Mahesh, P A; Archana, S; Jayaraj, B S; Patil, Shekar; Chaya, S K; Shashidhar, H P; Sunitha, B S; Prabhakar, A K

2012-10-01

Age adjusted incidence rate of lung cancer in India ranges from 7.4 to 13.1 per 100,000 among males and 3.9 to 5.8 per 100,000 among females. The factors affecting survival in lung cancer patients in India are not fully understood. The current study was undertaken to evaluate the factors affecting survival in patients diagnosed with lung cancer attending a tertiary care cancer institute in Bangalore, Karnataka, India. Consecutive patients with primary lung cancer attending Bangalore Institute of Oncology, a tertiary care centre at Bangalore, between 2006 and 2009 were included. Demographic, clinical, radiological data were collected retrospectively from the medical records. A total of 170 consecutive subjects (128 males, 42 females) diagnosed to have lung cancer; 151 non-small cell lung cancer (NSCLC) and 19 small cell lung cancer (SCLC) were included. A higher proportion of never-smokers (54.1%) were observed, mostly presenting below the age of 60 yr. Most subjects were in stage IV and III at the time of diagnosis. More than 50 per cent of patients presented with late stage lung cancer even though the duration of symptoms is less than 2 months. The 30-month overall survival rates for smokers and never-smokers were 32 and 49 per cent, respectively. No significant differences were observed in 30 month survival based on age at presentation, gender and type of lung cancer. Cox proportional hazards model identified never-smokers and duration of symptoms less than 1 month as factors adversely affecting survival. Our results showed that lung cancer in Indians involved younger subjects and associated with poorer survival as compared to other ethnic population. Studies on large sample need to be done to evaluate risk factors in lung cancer patients.

Factors affecting 30-month survival in lung cancer patients

PubMed Central

Mahesh, P.A.; Archana, S.; Jayaraj, B.S.; Patil, Shekar; Chaya, S.K.; Shashidhar, H.P.; Sunitha, B.S.; Prabhakar, A.K.

2012-01-01

Background & objectives: Age adjusted incidence rate of lung cancer in India ranges from 7.4 to 13.1 per 100,000 among males and 3.9 to 5.8 per 100,000 among females. The factors affecting survival in lung cancer patients in India are not fully understood. The current study was undertaken to evaluate the factors affecting survival in patients diagnosed with lung cancer attending a tertiary care cancer institute in Bangalore, Karnataka, India. Methods: Consecutive patients with primary lung cancer attending Bangalore Institute of Oncology, a tertiary care centre at Bangalore, between 2006 and 2009 were included. Demographic, clinical, radiological data were collected retrospectively from the medical records. Results: A total of 170 consecutive subjects (128 males, 42 females) diagnosed to have lung cancer; 151 non-small cell lung cancer (NSCLC) and 19 small cell lung cancer (SCLC) were included. A higher proportion of never-smokers (54.1%) were observed, mostly presenting below the age of 60 yr. Most subjects were in stage IV and III at the time of diagnosis. More than 50 per cent of patients presented with late stage lung cancer even though the duration of symptoms is less than 2 months. The 30-month overall survival rates for smokers and never-smokers were 32 and 49 per cent, respectively. No significant differences were observed in 30 month survival based on age at presentation, gender and type of lung cancer. Cox proportional hazards model identified never-smokers and duration of symptoms less than 1 month as factors adversely affecting survival. Interpretation & conclusions: Our results showed that lung cancer in Indians involved younger subjects and associated with poorer survival as compared to other ethnic population. Studies on large sample need to be done to evaluate risk factors in lung cancer patients. PMID:23168702

Ecosystem Carbon Storage in Alpine Grassland on the Qinghai Plateau

PubMed Central

Liu, Shuli; Zhang, Fawei; Du, Yangong; Guo, Xiaowei; Lin, Li; Li, Yikang; Li, Qian; Cao, Guangmin

2016-01-01

The alpine grassland ecosystem can sequester a large quantity of carbon, yet its significance remains controversial owing to large uncertainties in the relative contributions of climate factors and grazing intensity. In this study we surveyed 115 sites to measure ecosystem carbon storage (both biomass and soil) in alpine grassland over the Qinghai Plateau during the peak growing season in 2011 and 2012. Our results revealed three key findings. (1) Total biomass carbon density ranged from 0.04 for alpine steppe to 2.80 kg C m-2 for alpine meadow. Median soil organic carbon (SOC) density was estimated to be 16.43 kg C m-2 in alpine grassland. Total ecosystem carbon density varied across sites and grassland types, from 1.95 to 28.56 kg C m-2. (2) Based on the median estimate, the total carbon storage of alpine grassland on the Qinghai Plateau was 5.14 Pg, of which 94% (4.85 Pg) was soil organic carbon. (3) Overall, we found that ecosystem carbon density was affected by both climate and grazing, but to different extents. Temperature and precipitation interaction significantly affected AGB carbon density in winter pasture, BGB carbon density in alpine meadow, and SOC density in alpine steppe. On the other hand, grazing intensity affected AGB carbon density in summer pasture, SOC density in alpine meadow and ecosystem carbon density in alpine grassland. Our results indicate that grazing intensity was the primary contributing factor controlling carbon storage at the sites tested and should be the primary consideration when accurately estimating the carbon storage in alpine grassland. PMID:27494253

Ecosystem Carbon Storage in Alpine Grassland on the Qinghai Plateau.

PubMed

Liu, Shuli; Zhang, Fawei; Du, Yangong; Guo, Xiaowei; Lin, Li; Li, Yikang; Li, Qian; Cao, Guangmin

2016-01-01

The alpine grassland ecosystem can sequester a large quantity of carbon, yet its significance remains controversial owing to large uncertainties in the relative contributions of climate factors and grazing intensity. In this study we surveyed 115 sites to measure ecosystem carbon storage (both biomass and soil) in alpine grassland over the Qinghai Plateau during the peak growing season in 2011 and 2012. Our results revealed three key findings. (1) Total biomass carbon density ranged from 0.04 for alpine steppe to 2.80 kg C m-2 for alpine meadow. Median soil organic carbon (SOC) density was estimated to be 16.43 kg C m-2 in alpine grassland. Total ecosystem carbon density varied across sites and grassland types, from 1.95 to 28.56 kg C m-2. (2) Based on the median estimate, the total carbon storage of alpine grassland on the Qinghai Plateau was 5.14 Pg, of which 94% (4.85 Pg) was soil organic carbon. (3) Overall, we found that ecosystem carbon density was affected by both climate and grazing, but to different extents. Temperature and precipitation interaction significantly affected AGB carbon density in winter pasture, BGB carbon density in alpine meadow, and SOC density in alpine steppe. On the other hand, grazing intensity affected AGB carbon density in summer pasture, SOC density in alpine meadow and ecosystem carbon density in alpine grassland. Our results indicate that grazing intensity was the primary contributing factor controlling carbon storage at the sites tested and should be the primary consideration when accurately estimating the carbon storage in alpine grassland.

The Relationship Between Neutrophil–Lymphocyte Ratio and Primary Patency of Percutaneous Transluminal Angioplasty in Hemodialysis Arteriovenous Fistula Stenosis When Using Conventional and Drug-Eluting Balloons

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

Çildağ, Mehmet Burak, E-mail: mbcildag@yahoo.com; Çildağ, Songül, E-mail: songulcildag@yahoo.com; Köseoğlu, Ömer Faruk Kutsi, E-mail: kutsikoseoglu@yahoo.com

ObjectiveThe aim of this study is to investigate the potential association of neutrophil–lymphocyte ratio (NLR) between primary patency of percutaneous transluminal angioplasty (PTA) in hemodialysis arteriovenous fistula stenosis and type (Conventional and Drug-Eluting) of balloons used in PTA.Material-MethodThis retrospective study consists of 78 patients with significant arteriovenous fistulas stenosis who were treated with PTA by using Drug-Eluting Balloon (DEB) (n = 29) or Conventional Balloon (CB) (n = 49). NLR was calculated from preinterventional blood samples. All patients were classified into two groups. Group A; primary patency <12 months (43/78), Group B; primary patency ≥12 months (35/78). Cox regression analysis and Kaplan–Meier method were used to determine respectivelymore » independent factors affecting the primary patency and to compare the primary patency for the two balloon types.ResultsNLR ratio and balloon type of the two groups were significantly different (p = 0.002, p = 0.010). The cut-off value of NLR was 3.18 for determination of primary patency, with sensitivity of 81.4 % and specificity of 51.4 %. Primary patency rates between PTA with DEB and CB displayed statistically significant differences (p < 0.05). The cut-off value was 3.28 for determination of 12-month primary patency with the conventional balloon group; sensitivity was 81.8 % and specificity was 81.3 %. There was no statistical relation between NLR levels and the drug-eluting balloon group in 12-month primary patency (p = 0.927).ConclusionIncreased level of NLR may be a risk factor in the development of early AVF restenosis after successful PTA. Preferring Drug-Eluting Balloon at an increased level of NLR can be beneficial to prolong patency.« less

Advanced Video Activity Analytics (AVAA): Human Factors Evaluation

DTIC Science & Technology

2015-05-01

video, and 3) creating and saving annotations (Fig. 11). (The logging program was updated after the pilot to also capture search clicks.) Playing and... visual search task and the auditory task together and thus automatically focused on the visual task. Alternatively, the operator may have intentionally...affect performance on the primary task; however, in the current test there was no apparent effect on the operator’s performance in the visual search task

Cashmere growth control in Liaoning cashmere goat by ovarian carcinoma immunoreactive antigen-like protein 2 and decorin genes

PubMed Central

2018-01-01

Objective The study investigated the biological functions and mechanisms for controlling cashmere growth of Liaoning cashmere goat by ovarian carcinoma immunoreactive antigen-like protein 2 (OCIAD2) and decorin (DCN) genes. Methods cDNA library of Liaoning cashmere goat was constructed in early stages. OCIAD2 and DCN genes related to cashmere growth were identified by homology analysis comparison. The expression location of OCIAD2 and DCN genes in primary and secondary hair follicles (SF) was performed using in situ hybridization. The expression of OCIAD2 and DCN genes in primary and SF was performed using real-time polymerase chain reaction (PCR). Results In situ hybridization revealed that OCIAD2 and DCN were expressed in the inner root sheath of Liaoning cashmere goat hair follicles. Real-time quantitative PCR showed that these genes were highly expressed in SF during anagen, while these genes were highly expressed in primary hair follicle in catagen phase. Melatonin (MT) inhibited the expression of OCIAD2 and promoted the expression of DCN. Insulin-like growth factors-1 (IGF-1) inhibited the expression of OCIAD2 and DCN, while fibroblast growth factors 5 (FGF5) promoted the expression of these genes. MT and IGF-1 promoted OCIAD2 synergistically, while MT and FGF5 inhibited the genes simultaneously. MT+IGF-1/MT+FGF5 inhibited DCN gene. RNAi technology showed that OCIAD2 expression was promoted, while that of DCN was inhibited. Conclusion Activation of bone morphogenetic protein (BMP) signaling pathway up-regulated OCIAD2 expression and stimulated SF to control cell proliferation. DCN gene affected hair follicle morphogenesis and periodic changes by promoting transforming growth factor-β (TGF-β) and BMP signaling pathways. OCIAD2 and DCN genes have opposite effects on TGF-β signaling pathway and inhibit each other to affect the hair growth. PMID:29514440

Experimental pre-clinical assessment of the primary stability of two cementless femoral knee components.

PubMed

Berahmani, Sanaz; Hendriks, Maartje; Wolfson, David; Wright, Abraham; Janssen, Dennis; Verdonschot, Nico

2017-11-01

To achieve long-lasting fixation of cementless implants, an adequate primary stability is required. We aimed to compare primary stability of a new cementless femoral knee component (Attune®) against a conventional implant (LCS®) under different loading conditions. Six pairs of femora were prepared following the normal surgical procedure. Calibrated CT-scans and 3D-optical scans of the bones were obtained to measure bone mineral density (BMD) and cut accuracy, respectively. Micromotions were measured in nine regions of interest at the bone-implant interface using digital image correlation. The reconstructions were subjected to the implant-specific's peak tibiofemoral load of gait and a deep knee bend loading profiles. Afterwards, the implants were pushed-off at a flexion angle of 150°. Micromotions of Attune were significantly lower than LCS under both loading conditions (P ≤ 0.001). Cut accuracy did not affect micromotions, and BMD was only a significant factor affecting the micromotions under simplified gait loading. No significant difference was found in high-flex push-off force, but Attune required a significantly higher load to generate excessive micromotions during push-off. Parallel anterior and posterior bone cuts in the LCS versus the tapered bone cuts of the Attune may explain the difference between the two designs. Additionally, the rims at the borders of the LCS likely reduced the area of contact with the bone for the LCS, which may have affected the initial fixation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Alignment between Chronic Disease Policy and Practice: Case Study at a Primary Care Facility

PubMed Central

Draper, Claire A.; Draper, Catherine E.; Bresick, Graham F.

2014-01-01

Background Chronic disease is by far the leading cause of death worldwide and of increasing concern in low- and middle-income countries, including South Africa, where chronic diseases disproportionately affect the poor living in urban settings. The Provincial Government of the Western Cape (PGWC) has prioritized the management of chronic diseases and has developed a policy and framework (Adult Chronic Disease Management Policy 2009) to guide and improve the prevention and management of chronic diseases at a primary care level. The aim of this study is to assess the alignment of current primary care practices with the PGWC Adult Chronic Disease Management policy. Methods One comprehensive primary care facility in a Cape Town health district was used as a case study. Data was collected via semi-structured interviews (n = 10), focus groups (n = 8) and document review. Participants in this study included clinical staff involved in chronic disease management at the facility and at a provincial level. Data previously collected using the Integrated Audit Tool for Chronic Disease Management (part of the PGWC Adult Chronic Disease Management policy) formed the basis of the guide questions used in focus groups and interviews. Results The results of this research indicate a significant gap between policy and its implementation to improve and support chronic disease management at this primary care facility. A major factor seems to be poor policy knowledge by clinicians, which contributes to an individual rather than a team approach in the management of chronic disease patients. Poor interaction between facility- and community-based services also emerged. A number of factors were identified that seemed to contribute to poor policy implementation, the majority of which were staff related and ultimately resulted in a decrease in the quality of patient care. Conclusions Chronic disease policy implementation needs to be improved in order to support chronic disease management at this facility. It is possible that similar findings and factors are present at other primary care facilities in Cape Town. At a philosophical level, this research highlights the tension between primary health care principles and a diseased-based approach in a primary care setting. PMID:25141191

Alignment between chronic disease policy and practice: case study at a primary care facility.

PubMed

Draper, Claire A; Draper, Catherine E; Bresick, Graham F

2014-01-01

Chronic disease is by far the leading cause of death worldwide and of increasing concern in low- and middle-income countries, including South Africa, where chronic diseases disproportionately affect the poor living in urban settings. The Provincial Government of the Western Cape (PGWC) has prioritized the management of chronic diseases and has developed a policy and framework (Adult Chronic Disease Management Policy 2009) to guide and improve the prevention and management of chronic diseases at a primary care level. The aim of this study is to assess the alignment of current primary care practices with the PGWC Adult Chronic Disease Management policy. One comprehensive primary care facility in a Cape Town health district was used as a case study. Data was collected via semi-structured interviews (n = 10), focus groups (n = 8) and document review. Participants in this study included clinical staff involved in chronic disease management at the facility and at a provincial level. Data previously collected using the Integrated Audit Tool for Chronic Disease Management (part of the PGWC Adult Chronic Disease Management policy) formed the basis of the guide questions used in focus groups and interviews. The results of this research indicate a significant gap between policy and its implementation to improve and support chronic disease management at this primary care facility. A major factor seems to be poor policy knowledge by clinicians, which contributes to an individual rather than a team approach in the management of chronic disease patients. Poor interaction between facility- and community-based services also emerged. A number of factors were identified that seemed to contribute to poor policy implementation, the majority of which were staff related and ultimately resulted in a decrease in the quality of patient care. Chronic disease policy implementation needs to be improved in order to support chronic disease management at this facility. It is possible that similar findings and factors are present at other primary care facilities in Cape Town. At a philosophical level, this research highlights the tension between primary health care principles and a diseased-based approach in a primary care setting.

Factors affecting early and long-term outcomes after completion pneumonectomy.

PubMed

Chataigner, Olivier; Fadel, Elie; Yildizeli, Bedrettin; Achir, Abdallah; Mussot, Sacha; Fabre, Dominique; Mercier, Olaf; Dartevelle, Philippe G

2008-05-01

To identify factors that affect operative mortality and morbidity and long-term survival after completion pneumonectomy. We retrospectively reviewed the charts of consecutive patients who underwent completion pneumonectomy at our cardiothoracic surgery department from January 1996 to December 2005. We identified 69 patients, who accounted for 17.8% of all pneumonectomies during the study period; 22 had benign disease and 47 malignant disease (second primary lung cancer, n=19; local recurrence, n=17; or metastasis, n=11). There were 50 males and 19 females with a mean age of 60 years (range, 29-80 years). Postoperative mortality was 12% and postoperative morbidity 41%. Factors associated with postoperative mortality included obesity (p=0.005), coronary artery disease (p=0.03), removal of the right lung (p=0.02), advanced age (p=0.02), and renal failure (p<0.0001). Preoperative renal failure was the only significant risk factor for mortality by multivariate analysis (p=0.036). Bronchopleural fistula developed in seven patients (10%), with risk factors being removal of the right lung (p=0.04) and mechanical stump closure (p=0.03). Overall survival was 65% after 3 years and 46% after 5 years. Long-term survival was not affected by the reason for completion pneumonectomy. Although long-term survival was acceptable, postoperative mortality and morbidity rates remained high, confirming the reputation of completion pneumonectomy as a challenging procedure. Significant comorbidities and removal of the right lung were the main risk factors for postoperative mortality. Improved patient selection and better management of preoperative renal failure may improve the postoperative outcomes of this procedure, which offers a chance for prolonged survival.

Depression and use of health care services in patients with advanced cancer

PubMed Central

Lo, Christopher; Calzavara, Andrew; Kurdyak, Paul; Barbera, Lisa; Shepherd, Frances; Zimmermann, Camilla; Moore, Malcolm J.; Rodin, Gary

2013-01-01

Abstract Objective To examine whether depression in patients with advanced cancer is associated with increased rates of physician visits, especially to primary care. Design Retrospective, observational study linking depression survey data to provincial health administration data. Setting Toronto, Ont. Participants A total of 737 patients with advanced cancer attending Princess Margaret Hospital, who participated in the Will to Live Study from 2002 to 2008. Main outcome measures Frequency of visits to primary care, oncology, surgery, and psychiatry services, before and after the depression assessment. Results Before the assessment, depression was associated with an almost 25% increase in the rate of primary care visits for reasons not related to mental health (rate ratio [RR] = 1.23, 95% CI 1.00 to 1.50), adjusting for medical morbidity and other factors. After assessment, depression was associated with a 2-fold increase in the rate of primary care visits for mental health–related reasons (RR = 2.35, 95% CI 1.18 to 4.66). However, depression was also associated during this time with an almost 25% reduction in the rate of oncology visits (RR = 0.78, 95% CI 0.65 to 0.94). Conclusion Depression affects health care service use in patients with advanced cancer. Individuals with depression were more likely to see primary care physicians but less likely to see oncologists, compared with individuals without depression. However, the frequent association of disease-related factors with depression in patients with advanced cancer highlights the need for communication between oncologists and primary care physicians about the medical and psychosocial care of these patients. PMID:23486819

Interprofessional education: preparing psychologists for success in integrated primary care.

PubMed

Cubic, Barbara; Mance, Janette; Turgesen, Jeri N; Lamanna, Jennifer D

2012-03-01

Rapidly occurring changes in the healthcare arena mean time is of the essence for psychology to formalize a strategic plan for training in primary care settings. The current article articulates factors affecting models of integrated care in Academic Health Centers (AHCs) and describes ways to identify and utilize resources at AHCs to develop interprofessional educational and clinical integrated care opportunities. The paper asserts that interprofessional educational experiences between psychology and other healthcare providers are vital to insure professionals value one another's disciplines in health care reform endeavors, most notably the patient-centered initiatives. The paper highlights ways to create shared values and common goals between primary care providers and psychologists, which are needed for trainee internalization of integrated care precepts. A developmental perspective to training from pre-doctoral, internship and postdoctoral levels for psychologists in integrated care is described. Lastly, a call to action is given for the field to develop more opportunities for psychology trainees to receive education and training within practica, internships and postdoctoral fellowships in primary care settings to address the reality that most patients seek their mental health treatment in primary care settings.

Remineralization of primary tooth enamel from individuals with Down syndrome.

PubMed

Okamoto, Takuma; Shibata, Munenori; Tsuboi, Shinji; Nakagaki, Haruo; Fukuta, Osamu; Kusabe, Yoshitaka; Inukai, Junko

2011-01-01

The purpose of this study was to clarify the characteristics of primary tooth enamel of Down syndrome patients (DSPs). We examined 9 primary teeth of Down syndrome children and 11 primary teeth of normally developed children to investigate the remineralization processes of enamel by transverse microradiography and X ray micro analyzer (XMA). Mineral loss, lesion depth, maximum mineral value, minimum mineral value, depth of maximum mineral value, and depth of minimum mineral value were used to analyze transverse microradiography (TMR). In addition, we calculated the percentage of enamel remineralization. All the parameters in the 2 groups showed marked recovery. The results indicated that the Down syndrome group was significantly remineralized the same way as the control group. According to the comparison of mineral content distribution by XMA, the content distribution of magnesium was different between the 2 groups. While recovery through remineralization of primary teeth was similar between Down syndrome children and normally developed children, the mechanism of remineralization process may be different between the 2 groups; consequently, magnesium may be considered as one of the factors affecting recovery.

Some old drugs improve late primary patency rate of native arteriovenous fistulas in hemodialysis patients.

PubMed

Righetti, Marco; Ferrario, GianMichele; Serbelloni, Paola; Milani, Silvana; Tommasi, Adalberto

2009-01-01

Vascular access failure causes 20% of all hospitalizations of dialysis patients. Native arteriovenous fistulas, the best type of dialysis vascular access, have a 1-year primary patency rate that is extremely variable, ranging 40-80%. Neointimal hyperplasia is the most important cause of arteriovenous fistula late primary dysfunction. In recent years the arteriovenous fistula late primary patency rate has not improved because of the increase of old uremic patients with a high number of comorbidities and the lack of new therapeutic interventions. Therefore, we performed a long-term case-control study to analyze which factors or drugs may affect native arteriovenous fistula late primary patency rate in 60 incident hemodialysis patients. The arteriovenous fistula late primary patency rate was 75.1% after 12 months, 58.5% after 24 months, and 50% after 987 days. Homocysteine levels during follow-up had a significant direct association with vascular access failure (event vs. event-free 28.5+/-1.9 vs. 22.3+/-1.2 micromol/L, p<0.01). Folate values had a trend toward an inverse relationship with arteriovenous fistula failure (event vs. event-free 11.5+/-1.2 vs. 14.6 vs. 1.1 ng/mL, p=0.06). Patients treated with folic acid and/or statin had an arteriovenous fistula late primary patency rate significantly higher than patients without folic acid and statin therapy, respectively, 81.7% vs. 66% after 1 year and 71.5% vs. 39.1% after 2 years (p=0.02). Many other factors were not associated with vascular access failure. Statin and homocysteine-lowering folic acid therapy is associated with prolonged arteriovenous fistula survival. It is important to perform randomized trials to verify our observation.

40 CFR 60.170 - Applicability and designation of affected facility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Performance for Primary Zinc Smelters § 60.170 Applicability and designation of affected facility. (a) The provisions of this subpart are applicable to the following affected facilities in primary zinc smelters...

Prevalence of depression among women attending a primary urban care clinic in Malaysia.

PubMed

Sidik, Sherina Mohd; Arroll, Bruce; Goodyear-Smith, Felicity; Ahmad, Rozali

2012-07-01

Depression affects more women than men in Malaysia. The objective of this paper was to determine the prevalence of depression and its associated factors among women attending a government primary care clinic. A cross-sectional study was conducted in a government-funded primary care clinic in Malaysia. Consecutive adult female patients attending the clinic during the data collection period were invited to participate. The participants completed self-administered questionnaires (including the validated Patient Health Questionnaire [PHQ-9], which was translated into the Malay language). A total of 895 female patients participated in the study (response rate 87.5%). The prevalence of depression (PHQ-9 scores ≥ 10) was 12.1%. Based on multiple logistic regression analysis, certain stressful life events were found to be associated with depression (p < 0.05). These factors, arranged from highest to lowest risk, were financial problems (odds ratio [OR] 3.7, 95% confidence interval [CI] 2.2-6.2), unhappiness in the parent-child relationship (OR 3.0, 95% CI 1.2-7.5), history of serious illness (OR 2.4, 95% CI 1.1-5.2), unhappiness in family relationships (OR 2.3, 95% CI 1.1-4.7) and unhappiness at work (OR 2.2, 95% CI 1.1-4.3) (p < 0.05). The prevalence of depression among participants in this study was clinically significant and corresponded with the findings of other international studies. Factors associated with depression need to be highlighted and addressed accordingly. Clinicians in Malaysia should be aware of this prevalence when making diagnoses in primary care.

Differences between physicians in the likelihood of referral and acceptance of elderly patients for dialysis-influence of age and comorbidity.

PubMed

Visser, Annemieke; Dijkstra, Geke J; Huisman, Roel M; Gansevoort, Ron T; de Jong, Paul E; Reijneveld, Sijmen A

2007-11-01

Incidence of dialysis in elderly patients in the Netherlands is low compared to other countries. This study aims to assess the impact of patients' age and comorbidity on the likelihood of referral and acceptance of patients for dialysis and whether this is affected by physician characteristics. A vignette study was performed among 209 primary care physicians, 162 non-nephrology specialists and 20 nephrologists working in the north of the Netherlands. Physicians were offered six vignettes concerning case-reports of patients with end-stage renal disease (ESRD) and varying comorbidities or circumstances and asked about the likelihood of referral/acceptance of the patient in the given circumstances. The likelihood of referral within groups of physicians varied widely, especially within the group of primary care physicians and non-nephrology specialists, but was not affected by characteristics of physicians. The likelihood of referral or acceptance of patients for dialysis depended on the patient's age, and type and severity of comorbidity. In general, primary care physicians and non-nephrology specialists were less likely to refer than nephrologists were to accept. Differences within and between groups of physicians were larger for 80- than for 65-year-old patients, and for patients with less severe shortness of breath and cognitive impairments and more severe diabetes and social impairments. Hardly any differences were found for patients with cancer. Patients' age and comorbidities affect the likelihood of referral. Differences between groups of physicians suggest that there is insufficient agreement on the extent to which these factors should affect the referral/acceptance of patients for dialysis. These findings underline the need for more research into circumstances under which patients might benefit from dialysis. Guidelines should be developed to improve the referral of elderly and less healthy patients.

Medical comorbidities and perioperative allogeneic red blood cell transfusion are risk factors for surgical site infection after shoulder arthroplasty.

PubMed

Everhart, Joshua S; Bishop, Julie Y; Barlow, Jonathan D

2017-11-01

Multiple perioperative factors have been implicated in infection risk after shoulder arthroplasty. The purpose of this study was to determine surgical site infection (SSI) risk due to medical comorbidities or blood transfusion after primary or revision shoulder arthroplasty. Comprehensive data on medical comorbidities, surgical indication, perioperative transfusion, and SSI were obtained for 707 patients who underwent primary or revision hemiarthroplasty or total shoulder arthroplasty in a single hospital system. Multivariate Poisson regression was used to determine the independent association between allogeneic red blood cell transfusion, medical comorbidities, and SSI after controlling for procedure. The SSI rate was 1.9% for primary hemiarthroplasties and 1.3% for primary total shoulder arthroplasties. Among patients without prior shoulder infection, revision arthroplasty or prior open reduction and internal fixation had higher SSI risk than primary arthroplasties (incidence risk ratio [IRR], 11.4; 95% confidence interval [CI], 3.84-34.0; P < .001); among primary arthroplasties, SSI risk factors included male gender (IRR, 60.0; CI, 4.39-819; P = .002), rheumatoid arthritis (IRR, 8.63; CI, 1.84-40.4; P = .006), and long-term corticosteroid use (IRR, 37.4; CI, 5.79-242; P < .001). Perioperative allogeneic red blood cell transfusion significantly increased SSI risk and was dose dependent (IRR, 1.68 per unit packed red blood cell; CI, 1.21-2.35; P = .002). Gender, rheumatoid arthritis, and long-term (>1 year) corticosteroid use affect SSI risk after shoulder arthroplasty. Revision surgery, particularly in the setting of prior infection, increased risk of future infection. Finally, allogeneic red blood cell transfusion increases SSI risk after shoulder arthroplasty in a dose-dependent manner. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

From patient care to research: a validation study examining the factors contributing to data quality in a primary care electronic medical record database.

PubMed

Coleman, Nathan; Halas, Gayle; Peeler, William; Casaclang, Natalie; Williamson, Tyler; Katz, Alan

2015-02-05

Electronic Medical Records (EMRs) are increasingly used in the provision of primary care and have been compiled into databases which can be utilized for surveillance, research and informing practice. The primary purpose of these records is for the provision of individual patient care; validation and examination of underlying limitations is crucial for use for research and data quality improvement. This study examines and describes the validity of chronic disease case definition algorithms and factors affecting data quality in a primary care EMR database. A retrospective chart audit of an age stratified random sample was used to validate and examine diagnostic algorithms applied to EMR data from the Manitoba Primary Care Research Network (MaPCReN), part of the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). The presence of diabetes, hypertension, depression, osteoarthritis and chronic obstructive pulmonary disease (COPD) was determined by review of the medical record and compared to algorithm identified cases to identify discrepancies and describe the underlying contributing factors. The algorithm for diabetes had high sensitivity, specificity and positive predictive value (PPV) with all scores being over 90%. Specificities of the algorithms were greater than 90% for all conditions except for hypertension at 79.2%. The largest deficits in algorithm performance included poor PPV for COPD at 36.7% and limited sensitivity for COPD, depression and osteoarthritis at 72.0%, 73.3% and 63.2% respectively. Main sources of discrepancy included missing coding, alternative coding, inappropriate diagnosis detection based on medications used for alternate indications, inappropriate exclusion due to comorbidity and loss of data. Comparison to medical chart review shows that at MaPCReN the CPCSSN case finding algorithms are valid with a few limitations. This study provides the basis for the validated data to be utilized for research and informs users of its limitations. Analysis of underlying discrepancies provides the ability to improve algorithm performance and facilitate improved data quality.

Tetanus vaccination status and its associated factors among women attending a primary healthcare center in Cairo governorate, Egypt.

PubMed

Hassan, Azza M; Shoman, Ahmed E; Abo-Elezz, Nahla F; Amer, Marwa M

2016-09-01

Maintaining maternal and neonatal tetanus (MNT) elimination status in Egypt requires continued strengthening of routine tetanus toxoid (TT) immunization services for pregnant women. To measure the frequency rate of TT vaccination among women attending the well-baby clinic at the El-Darb El-Ahmar primary healthcare center in Cairo governorate and to identify different associated factors. This was a cross sectional study that targeted 277 mothers who attended the well-baby clinic at the El-Darb El-Ahmar primary healthcare center. Mothers were interviewed by a questionnaire inquiring about their sociodemographic characteristics, obstetric history, details of the last pregnancy, TT vaccination status and knowledge of the TT vaccine, and MNT disease. The results showed that 60.6% had taken all required doses of TT vaccine and 42.6% of the mothers studied were fully protected against MNT in their last birth. The rate of vaccination was found to be affected by mothers' socioeconomic level, education level, place of receiving antenatal care, health education about importance of TT vaccine, knowledge of mothers about NT disease and TT vaccine and the source of this knowledge.

Perceptions and Attitudes towards Medication Error Reporting in Primary Care Clinics: A Qualitative Study in Malaysia

PubMed Central

Samsiah, A.; Othman, Noordin; Jamshed, Shazia; Hassali, Mohamed Azmi

2016-01-01

Objective To explore and understand participants’ perceptions and attitudes towards the reporting of medication errors (MEs). Methods A qualitative study using in-depth interviews of 31 healthcare practitioners from nine publicly funded, primary care clinics in three states in peninsular Malaysia was conducted for this study. The participants included family medicine specialists, doctors, pharmacists, pharmacist assistants, nurses and assistant medical officers. The interviews were audiotaped and transcribed verbatim. Analysis of the data was guided by the framework approach. Results Six themes and 28 codes were identified. Despite the availability of a reporting system, most of the participants agreed that MEs were underreported. The nature of the error plays an important role in determining the reporting. The reporting system, organisational factors, provider factors, reporter’s burden and benefit of reporting also were identified. Conclusions Healthcare practitioners in primary care clinics understood the importance of reporting MEs to improve patient safety. Their perceptions and attitudes towards reporting of MEs were influenced by many factors which affect the decision-making process of whether or not to report. Although the process is complex, it primarily is determined by the severity of the outcome of the errors. The participants voluntarily report the errors if they are familiar with the reporting system, what error to report, when to report and what form to use. PMID:27906960

Team-based primary care: The medical assistant perspective.

PubMed

Sheridan, Bethany; Chien, Alyna T; Peters, Antoinette S; Rosenthal, Meredith B; Brooks, Joanna Veazey; Singer, Sara J

Team-based care has the potential to improve primary care quality and efficiency. In this model, medical assistants (MAs) take a more central role in patient care and population health management. MAs' traditionally low status may give them a unique view on changing organizational dynamics and teamwork. However, little empirical work exists on how team-based organizational designs affect the experiences of low-status health care workers like MAs. The aim of this study was to describe how team-based primary care affects the experiences of MAs. A secondary aim was to explore variation in these experiences. In late 2014, the authors interviewed 30 MAs from nine primary care practices transitioning to team-based care. Interviews addressed job responsibilities, teamwork, implementation, job satisfaction, and learning. Data were analyzed using a thematic networks approach. Interviews also included closed-ended questions about workload and job satisfaction. Most MAs reported both a higher workload (73%) and a greater job satisfaction (86%) under team-based primary care. Interview data surfaced four mechanisms for these results, which suggested more fulfilling work and greater respect for the MA role: (a) relationships with colleagues, (b) involvement with patients, (c) sense of control, and (d) sense of efficacy. Facilitators and barriers to these positive changes also emerged. Team-based care can provide low-status health care workers with more fulfilling work and strengthen relationships across status lines. The extent of this positive impact may depend on supporting factors at the organization, team, and individual worker levels. To maximize the benefits of team-based care, primary care leaders should recognize the larger role that MAs play under this model and support them as increasingly valuable team members. Contingent on organizational conditions, practices may find MAs who are willing to manage the increased workload that often accompanies team-based care.

Animal species endangerment: The role of environmental pollution

USGS Publications Warehouse

Pattee, Oliver H.; Fellows, Valerie L.; Bounds, Dixie L.; Hoffman, David J.; Rattner, Barnett A.; Burton, G. Allen; Cairns, John

2003-01-01

Multiple factors contribute to the decline of species. Habitat destruction is the primary factor that threatens species. affecting 73 % of endangered species. The second major factor causing species decline is the introduction of nonnative species. affecting 68% of endangered species. Pollution and overharvesting were identified as impacting, respectively, 38 and 15% of endangered species. Other factors affecting species decline include hybridization, competition, disease, and other interspecific interactions. Once a species is reduced to a remnant of its former population size and distribution, its vulnerability to catastrophic pollution events increases, frequently exceeding or replacing the factors responsible for the initial decline. Small, isolated populations are particularly vulnerable to catastrophic loss by an acute event. such as a chemical spill or pesticide application. However, when it comes to surviving a single disaster, widespread subpopulations of a species are far more resilient and ensure genetic survival. Hypothesizing theoretical concerns of potential factors that could affect an endangered species could predispose the scientific and political communities to jeopardizing threats. The user of recovery plans as a data source must be aware of the bias within the data set. These data should be used with the caveat that the source of information in recovery plans is not always based on scientific research and rigorous data collection. Over 58% of the information identifying species threats is based on estimates or personal communication. while only 42% is based on peer reviewed literature, academic research. or government reports. Many recovery plans were written when a species was initially listed in the 1970s or 1980s. Politics, human disturbance, and habitat demand issues evolve over a 20- to 30-year period. leaving much of the threats facing endangered species outdated and inadequate. These data are most valuable when used to facilitate reviews of Section 7 consultations and environmental impact statements, review permit applications, conduct environmental risk assessments, prioritize research needs. and identify limiting factors affecting species health. These data are also useful in identifying potential threats to species' health. Without properly identifying threats to endangered species based on sound. scientific research. there is little hope to successfully recover an endangered species.

Affective functioning among early adolescents at high and low familial risk for depression and their mothers: A focus on individual and transactional processes across contexts

PubMed Central

McMakin, Dana L.; Burkhouse, Katie L.; Olino, Thomas M.; Siegle, Greg J.; Dahl, Ronald E.; Silk, Jennifer S.

2013-01-01

This study aimed to characterize affective functioning in families of youth at high familial risk for depression, with particular attention to features of affective functioning that appear to be critical to adaptive functioning but have been underrepresented in prior research including: positive and negative affect across multiple contexts, individual and transactional processes, and affective flexibility. Interactions among early adolescents (ages 9-14) and their mothers were coded for affective behaviors across both positive and negative contexts. Primary analyses compared never-depressed youth at high (n=44) and low (n=57) familial risk for depression. The high risk group showed a relatively consistent pattern for low positive affect across negative and positive contexts at both the individual and transactional level. In contrast to prior studies focusing on negative affect that did not support disruptions in negative affect, the data from this study suggest variability by context: (i.e. increased negativity in a positive, but not negative, context) and individual vs. transactional processes (e.g., negative escalation). Findings are discussed in concert with attention to affect flexibility, contextual and transactional factors. PMID:21744058

Regulatory effects of cotranscriptional RNA structure formation and transitions.

PubMed

Liu, Sheng-Rui; Hu, Chun-Gen; Zhang, Jin-Zhi

2016-09-01

RNAs, which play significant roles in many fundamental biological processes of life, fold into sophisticated and precise structures. RNA folding is a dynamic and intricate process, which conformation transition of coding and noncoding RNAs form the primary elements of genetic regulation. The cellular environment contains various intrinsic and extrinsic factors that potentially affect RNA folding in vivo, and experimental and theoretical evidence increasingly indicates that the highly flexible features of the RNA structure are affected by these factors, which include the flanking sequence context, physiochemical conditions, cis RNA-RNA interactions, and RNA interactions with other molecules. Furthermore, distinct RNA structures have been identified that govern almost all steps of biological processes in cells, including transcriptional activation and termination, transcriptional mutagenesis, 5'-capping, splicing, 3'-polyadenylation, mRNA export and localization, and translation. Here, we briefly summarize the dynamic and complex features of RNA folding along with a wide variety of intrinsic and extrinsic factors that affect RNA folding. We then provide several examples to elaborate RNA structure-mediated regulation at the transcriptional and posttranscriptional levels. Finally, we illustrate the regulatory roles of RNA structure and discuss advances pertaining to RNA structure in plants. WIREs RNA 2016, 7:562-574. doi: 10.1002/wrna.1350 For further resources related to this article, please visit the WIREs website. © 2016 Wiley Periodicals, Inc.

Cultural aspects of primary healthcare in india: A case- based analysis.

PubMed

Worthington, Roger P; Gogne, Anupriya

2011-06-16

Delivering quality primary care to large populations is always challenging, and that is certainly the case in India. While the sheer magnitude of patients can create difficulties, not all challenges are about logistics. Sometimes patient health-seeking behaviour leads to delays in obtaining medical help for reasons that have more to do with culture, social practice and religious belief. When primary care is accessed via busy state-run outpatient departments there is often little time for the physician to investigate causes behind a patient's condition, and these factors can adversely affect patient outcomes. We consider the case of a woman with somatic symptoms seemingly triggered by psychological stresses associated with social norms and familial cultural expectations. These expectations conflict with her personal and professional aspirations, and although she eventually receives psychiatric help and her problems are addressed, initially, psycho-social factors underlying her condition posed a hurdle in terms of accessing appropriate medical care. While for many people culture, belief and social norms exert a stabilising, positive influence, in situations where someone's personal expectations differ significantly from accepted social norms, individual autonomy can be directly challenged, and in which case, something has to give. The result of such challenges can negatively impact on health and well-being, and for patients with immature defence mechanisms for dealing with inner conflict, such an experience can be damaging and ensuing somatic disturbances are often difficult to treat. Patients with culture-bound symptoms are not uncommon within primary care in India or in other Asian countries and communities. We argue that such cases need to be properly understood if satisfactory patient outcomes are to be achieved. While some causes are structural, having to do with how healthcare is accessed and delivered, others are about cultural values, social practices and beliefs. We note how some young adult women are adversely affected and discuss some of the ethical issues that arise.

Cultural aspects of primary healthcare in india: A case- based analysis

PubMed Central

2011-01-01

Delivering quality primary care to large populations is always challenging, and that is certainly the case in India. While the sheer magnitude of patients can create difficulties, not all challenges are about logistics. Sometimes patient health-seeking behaviour leads to delays in obtaining medical help for reasons that have more to do with culture, social practice and religious belief. When primary care is accessed via busy state-run outpatient departments there is often little time for the physician to investigate causes behind a patient's condition, and these factors can adversely affect patient outcomes. We consider the case of a woman with somatic symptoms seemingly triggered by psychological stresses associated with social norms and familial cultural expectations. These expectations conflict with her personal and professional aspirations, and although she eventually receives psychiatric help and her problems are addressed, initially, psycho-social factors underlying her condition posed a hurdle in terms of accessing appropriate medical care. While for many people culture, belief and social norms exert a stabilising, positive influence, in situations where someone's personal expectations differ significantly from accepted social norms, individual autonomy can be directly challenged, and in which case, something has to give. The result of such challenges can negatively impact on health and well-being, and for patients with immature defence mechanisms for dealing with inner conflict, such an experience can be damaging and ensuing somatic disturbances are often difficult to treat. Patients with culture-bound symptoms are not uncommon within primary care in India or in other Asian countries and communities. We argue that such cases need to be properly understood if satisfactory patient outcomes are to be achieved. While some causes are structural, having to do with how healthcare is accessed and delivered, others are about cultural values, social practices and beliefs. We note how some young adult women are adversely affected and discuss some of the ethical issues that arise. PMID:21679415

Hospital organizational factors affect the use of immediate breast reconstruction after mastectomy for breast cancer in the Netherlands.

PubMed

Schreuder, K; van Bommel, A C M; de Ligt, K M; Maduro, J H; Vrancken Peeters, M T F D; Mureau, M A M; Siesling, S

2017-08-01

Significant hospital variation in the use of immediate breast reconstruction (IBR) after mastectomy exists in the Netherlands. Aims of this study were to identify hospital organizational factors affecting the use of IBR after mastectomy for ductal carcinoma in situ (DCIS) or invasive breast cancer (BC) and to analyze whether these factors explain the variation. Patients with DCIS or primary invasive BC treated with mastectomy between 2011 and 2013 were selected from the national NABON Breast Cancer Audit. Hospital and organizational factors were collected with an online web-based survey. Regression analyses were performed to determine whether these factors accounted for the hospital variation. In total, 78% (n = 72) of all Dutch hospitals participated in the survey. In these hospitals 16,471 female patients underwent a mastectomy for DCIS (n = 1,980) or invasive BC (n = 14,491) between 2011 and 2014. IBR was performed in 41% of patients with DCIS (hospital range 0-80%) and in 17% of patients with invasive BC (hospital range 0-62%). Hospital type, number of plastic surgeons available and attendance of a plastic surgeon at the MDT meeting increased IBR rates. For invasive BC, higher percentage of mastectomies and more weekly MDT meetings also significantly increased IBR rates. Adjusted data demonstrated decreased IBR rates for DCIS (average 35%, hospital range 0-49%) and invasive BC (average 15%, hospital range 0-18%). Hospital organizational factors affect the use of IBR in the Netherlands. Although only partly explaining hospital variation, optimization of these factors could lead to less variation in IBR rates. Copyright © 2017 Elsevier Ltd. All rights reserved.

Hierarchical modeling of indoor radon concentration: how much do geology and building factors matter?

PubMed

Borgoni, Riccardo; De Francesco, Davide; De Bartolo, Daniela; Tzavidis, Nikos

2014-12-01

Radon is a natural gas known to be the main contributor to natural background radiation exposure and only second to smoking as major leading cause of lung cancer. The main concern is in indoor environments where the gas tends to accumulate and can reach high concentrations. The primary contributor of this gas into the building is from the soil although architectonic characteristics, such as building materials, can largely affect concentration values. Understanding the factors affecting the concentration in dwellings and workplaces is important both in prevention, when the construction of a new building is being planned, and in mitigation when the amount of Radon detected inside a building is too high. In this paper we investigate how several factors, such as geologic typologies of the soil and a range of building characteristics, impact on indoor concentration focusing, in particular, on how concentration changes as a function of the floor level. Adopting a mixed effects model to account for the hierarchical nature of the data, we also quantify the extent to which such measurable factors manage to explain the variability of indoor radon concentration. Copyright © 2014 Elsevier Ltd. All rights reserved.

Adult Antisocial Behavior and Affect Regulation among Primary Crack/Cocaine-Using Women

ERIC Educational Resources Information Center

Litt, Lisa Caren; Hien, Denise A.; Levin, Deborah

2003-01-01

The relationship between deficits in affect regulation and Adult Antisocial Behavior (ASB) in primary crack/cocaine-using women was explored in a sample of 80 inner-city women. Narrative early memories were coded for two components of affect regulation, Affect Tolerance and Affect Expression, using the Epigenetic Assessment Rating Scale (EARS;…

Factors Affecting Physicians’ Responses to Patients’ Requests for Antidepressants: Focus Group Study

PubMed Central

Silberman, Jordan; Paterniti, Debora A.; Kravitz, Richard L.; Epstein, Ronald M.

2007-01-01

Background The ways in which patients’ requests for antidepressants affect physicians’ prescribing behavior are poorly understood. Objective To describe physicians’ affective and cognitive responses to standardized patients’ (SPs) requests for antidepressants, as well as the attitudinal and contextual factors influencing prescribing behavior. Design Focus group interviews and brief demographic questionnaires. Participants Twenty-two primary care physicians in 6 focus groups; all had participated in a prior RCT of the influence of patients’ requests on physicians’ prescribing. Measurements Iterative review of interview transcripts, involving qualitative coding and thematic analysis. Results Physicians participating in the focus groups were frequently unaware of and denied the degree to which their thinking was biased by patient requests, but were able to recognize such biases after facilitated reflection. Common affective responses included annoyance and empathy. Common cognitive reactions resulted in further diagnostic inquiry or in acquiescing to the patient’s demands to save time or build the patient–clinician relationship. Patients’ requests for medication prompted the participants to err on the side of overtreating versus careful review of clinical indications. Lack of time and participants’ attitudes—toward the role of the patient and the pharmaceutical ads—also influenced their responses, prompting them to interpret patient requests as diagnostic clues or opportunities for efficiency. Conclusions This study provides a taxonomy of affective and cognitive responses to patients’ requests for medications and the underlying attitudes and contextual factors influencing them. Improved capacity for moment-to-moment self-awareness during clinical reasoning processes may increase the appropriateness of prescribing. PMID:17987348

Comparison of oral streptococci biofilm in caries-free and caries-affected preschool Mexican children.

PubMed

Martinez-Martinez, Rita E; Fujiwara, Taku; Patiño-Marin, Nuria; Hoshino, Tomonori; Wilson, Michael; Loyola-Rodríguez, Juan P

2012-01-01

Interaction of oral streptococci biofilm is the main etiological factor for dental caries. The aim of the study was to compare oral streptococci (OS) distribution in the biofilm of primary dentition from caries-free and caries-affected preschool Mexican children. This cross-sectional study involved 40 caries-free and 40 caries-affected children with primary dentition. Each child was examined using the dmfs index, DNA was extracted from saliva and presence of OS was determined by PCR. Data obtained showed no statistical difference regarding age and gender (P > 0.05). Streptococcus mutans (Smut), Streptococcus sobrinus (Ssob) and their combination showed significant statistical differences between groups (P < 0.05). Smut, Streptococcus sanguinis and Streptococcus gordonii had an inverse relation with dmfs index and Ssob had a direct relation similar to combined with Smut. Smut-Ssob combined with other OS showed statistical differences (P < 0.05). In free-caries group Streptococcus gordonii was more frequently identified than Smut. The ratio Smut/Streptococcus sanguinis could represent a high risk of dental caries development; this ratio was higher in the caries-affected (1.18) than in the caries-free group (0.32). In conclusion, OS play an important role in dental caries predisposition and severity, not only the presence of Smut and Srob, but also the complexity and distribution of OS in the biofilm.

Statin adherence and risk of acute cardiovascular events among women: a cohort study accounting for time-dependent confounding affected by previous adherence.

PubMed

Lavikainen, Piia; Helin-Salmivaara, Arja; Eerola, Mervi; Fang, Gang; Hartikainen, Juha; Huupponen, Risto; Korhonen, Maarit Jaana

2016-06-03

Previous studies on the effect of statin adherence on cardiovascular events in the primary prevention of cardiovascular disease have adjusted for time-dependent confounding, but potentially introduced bias into their estimates as adherence and confounders were measured simultaneously. We aimed to evaluate the effect when accounting for time-dependent confounding affected by previous adherence as well as time sequence between factors. Retrospective cohort study. Finnish healthcare registers. Women aged 45-64 years initiating statin use for primary prevention of cardiovascular disease in 2001-2004 (n=42 807). Acute cardiovascular event defined as a composite of acute coronary syndrome and acute ischaemic stroke was our primary outcome. Low-energy fractures were used as a negative control outcome to evaluate the healthy-adherer effect. During the 3-year follow-up, 474 women experienced the primary outcome event and 557 suffered a low-energy fracture. The causal HR estimated with marginal structural model for acute cardiovascular events for all the women who remained adherent (proportion of days covered ≥80%) to statin therapy during the previous adherence assessment year was 0.78 (95% CI: 0.65 to 0.94) when compared with everybody remaining non-adherent (proportion of days covered <80%). The result was robust against alternative model specifications. Statin adherers had a potentially reduced risk of experiencing low-energy fractures compared with non-adherers (HR 0.90, 95% CI 0.76 to 1.07). Our study, which took into account the time dependence of adherence and confounders, as well as temporal order between these factors, is support for the concept that adherence to statins in women in primary prevention decreases the risk of acute cardiovascular events by about one-fifth in comparison to non-adherence. However, part of the observed effect of statin adherence on acute cardiovascular events may be due to the healthy-adherer effect. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Environmental influences on development of type 2 diabetes and obesity: challenges in personalizing prevention and management.

PubMed

Ershow, Abby G

2009-07-01

Recent epidemic increases in the U.S. prevalence of obesity and diabetes are a consequence of widespread environmental changes affecting energy balance and its regulation. These environmental changes range from exposure to endocrine disrupting pollutants to shortened sleep duration to physical inactivity to excess caloric intake. Overall, we need a better understanding of the factors affecting individual susceptibility and resistance to adverse exposures and behaviors and of determinants of individual response to treatment. Obesity and diabetes prevention will require responding to two primary behavioral risk factors: excess energy intake and insufficient energy expenditure. Adverse food environments (external, nonphysiological influences on eating behaviors) contribute to excess caloric intake but can be countered through behavioral and economic approaches. Adverse built environments, which can be modified to foster more physical activity, are promising venues for community-level intervention. Techniques to help people to modulate energy intake and increase energy expenditure must address their personal situations: health literacy, psychological factors, and social relationships. Behaviorally oriented translational research can help in developing useful interventions and environmental modifications that are tailored to individual needs. Copyright 2009 Diabetes Technology Society.

Analysis on factors affecting household customers decision in using electricity at peak time and its correlation towards saving electricity

NASA Astrophysics Data System (ADS)

Pasasa, Linus; Marbun, Parlin; Mariza, Ita

2015-09-01

The purpose of this paper is to study and analyse the factors affecting customer decisions in using electricity at peak-load hours (between 17.00 to 22.00 WIB) and their behaviors towards electricity conservation in Indonesian household. The underlying rationale is to influence a reduction in energy consumption by stimulating energy saving behaviors, thereby reducing the impact of energy use on the environment. How is the correlation between the decisions in using electricity during peak load hours with the household customer's behavior towards saving electricity? The primary data is obtained by distributing questionnaires to customers of PT. PLN Jakarta Raya and Tangerang Distribution from Household segment. The data is analysed using the Structural Equation Model (SEM) and AMOS Software. The research is finding that all factors (Personal, Social, PLN Services, Psychological, and Cultural) are positively influence customer decision in using electricity at peak load hours. There is a correlation between the decisions in using electricity during peak load hours with the household customer's behavior towards saving electricity.

Hierarchy in factors affecting fish biodiversity in floodplain lakes of the Mississippi Alluvial Valley

USGS Publications Warehouse

Dembkowski, D.J.; Miranda, L.E.

2012-01-01

River-floodplain ecosystems offer some of the most diverse and dynamic environments in the world. Accordingly, floodplain habitats harbor diverse fish assemblages. Fish biodiversity in floodplain lakes may be influenced by multiple variables operating on disparate scales, and these variables may exhibit a hierarchical organization depending on whether one variable governs another. In this study, we examined the interaction between primary variables descriptive of floodplain lake large-scale features, suites of secondary variables descriptive of water quality and primary productivity, and a set of tertiary variables descriptive of fish biodiversity across a range of floodplain lakes in the Mississippi Alluvial Valley of Mississippi and Arkansas (USA). Lakes varied considerably in their representation of primary, secondary, and tertiary variables. Multivariate direct gradient analyses indicated that lake maximum depth and the percentage of agricultural land surrounding a lake were the most important factors controlling variation in suites of secondary and tertiary variables, followed to a lesser extent by lake surface area. Fish biodiversity was generally greatest in large, deep lakes with lower proportions of watershed agricultural land. Our results may help foster a holistic approach to floodplain lake management and suggest the framework for a feedback model wherein primary variables can be manipulated for conservation and restoration purposes and secondary and tertiary variables can be used to monitor the success of such efforts. ?? 2011 Springer Science+Business Media B.V.

Factors affecting fish biodiversity in floodplain lakes of the Mississippi Alluvial Valley

USGS Publications Warehouse

Miranda, Leandro E.; Dembkowski, Daniel J.

2012-01-01

River-floodplain ecosystems offer some of the most diverse and dynamic environments in the world. Accordingly, floodplain habitats harbor diverse fish assemblages. Fish biodiversity in floodplain lakes may be influenced by multiple variables operating on disparate scales, and these variables may exhibit a hierarchical organization depending on whether one variable governs another. In this study, we examined the interaction between primary variables descriptive of floodplain lake large-scale features, suites of secondary variables descriptive of water quality and primary productivity, and a set of tertiary variables descriptive of fish biodiversity across a range of floodplain lakes in the Mississippi Alluvial Valley of Mississippi and Arkansas (USA). Lakes varied considerably in their representation of primary, secondary, and tertiary variables. Multivariate direct gradient analyses indicated that lake maximum depth and the percentage of agricultural land surrounding a lake were the most important factors controlling variation in suites of secondary and tertiary variables, followed to a lesser extent by lake surface area. Fish biodiversity was generally greatest in large, deep lakes with lower proportions of watershed agricultural land. Our results may help foster a holistic approach to floodplain lake management and suggest the framework for a feedback model wherein primary variables can be manipulated for conservation and restoration purposes and secondary and tertiary variables can be used to monitor the success of such efforts.

Co-sleeping and childhood enuresis in China.

PubMed

Ma, Jun; Li, Shenghui; Jiang, Fan; Jin, Xingming; Shen, Xiaoming; Li, Fei

2014-01-01

Co-sleeping is associated with disturbance of the natural sleep pattern, including sleep fragmentation and daytime sleepiness. Nocturnal enuresis (NE) or bed-wetting, although benign, is a significant cause of distress to affected children and their caregiver(s). This study investigated the relationship between co-sleeping and NE in primary school children from China. Data from a previous sleep study of primary school children from 8 cities across China were analyzed. Multivariable regression analysis was performed to assess the relationship between co-sleeping and NE while controlling for a number of confounding factors. The prevalence of NE in co-sleeping and non-co-sleeping children in different age groups was evaluated. The prevalence of co-sleeping and NE in children aged 5 to 12 years was 22.8% and 4.6%, respectively. Co-sleeping was associated with a higher prevalence of NE in primary school age children (odds ratio [OR], 1.50; 95% confidence interval [CI], 1.27-1.77; p < .001) after adjusting for confounding factors. The differences in the prevalence of NE between co-sleepers and non-co-sleepers were significant in the 9-year age group (OR, 1.49; 95% CI, 1.06-2.11; p = .025) and 11- to 12-year age group (OR, 3.16; 95% CI, 2.19-4.57; p < .001). Co-sleeping may increase the risk of NE in primary school children, particularly in those aged 11 to 12 years.

Sorting nexin 9 differentiates ligand-activated Smad3 from Smad2 for nuclear import and transforming growth factor β signaling

PubMed Central

Wilkes, Mark C.; Repellin, Claire E.; Kang, Jeong-Han; Andrianifahanana, Mahefatiana; Yin, Xueqian; Leof, Edward B.

2015-01-01

Transforming growth factor β (TGFβ) is a pleiotropic protein secreted from essentially all cell types and primary tissues. While TGFβ’s actions reflect the activity of a number of signaling networks, the primary mediator of TGFβ responses are the Smad proteins. Following receptor activation, these cytoplasmic proteins form hetero-oligomeric complexes that translocate to the nucleus and affect gene transcription. Here, through biological, biochemical, and immunofluorescence approaches, sorting nexin 9 (SNX9) is identified as being required for Smad3-dependent responses. SNX9 interacts with phosphorylated (p) Smad3 independent of Smad2 or Smad4 and promotes more rapid nuclear delivery than that observed independent of ligand. Although SNX9 does not bind nucleoporins Nup153 or Nup214 or some β importins (Imp7 or Impβ), it mediates the association of pSmad3 with Imp8 and the nuclear membrane. This facilitates nuclear translocation of pSmad3 but not SNX9. PMID:26337383

State dependence of noise correlations in macaque primary visual cortex

PubMed Central

Ecker, Alexander S.; Berens, Philipp; Cotton, R. James; Subramaniyan, Manivannan; Denfield, George H.; Cadwell, Cathryn R.; Smirnakis, Stelios M.; Bethge, Matthias; Tolias, Andreas S.

2014-01-01

Shared, trial-to-trial variability in neuronal populations has a strong impact on the accuracy of information processing in the brain. Estimates of the level of such noise correlations are diverse, ranging from 0.01 to 0.4, with little consensus on which factors account for these differences. Here we addressed one important factor that varied across studies, asking how anesthesia affects the population activity structure in macaque primary visual cortex. We found that under opioid anesthesia, activity was dominated by strong coordinated fluctuations on a timescale of 1–2 Hz, which were mostly absent in awake, fixating monkeys. Accounting for these global fluctuations markedly reduced correlations under anesthesia, matching those observed during wakefulness and reconciling earlier studies conducted under anesthesia and in awake animals. Our results show that internal signals, such as brain state transitions under anesthesia, can induce noise correlations, but can also be estimated and accounted for based on neuronal population activity. PMID:24698278

State dependence of noise correlations in macaque primary visual cortex.

PubMed

Ecker, Alexander S; Berens, Philipp; Cotton, R James; Subramaniyan, Manivannan; Denfield, George H; Cadwell, Cathryn R; Smirnakis, Stelios M; Bethge, Matthias; Tolias, Andreas S

2014-04-02

Shared, trial-to-trial variability in neuronal populations has a strong impact on the accuracy of information processing in the brain. Estimates of the level of such noise correlations are diverse, ranging from 0.01 to 0.4, with little consensus on which factors account for these differences. Here we addressed one important factor that varied across studies, asking how anesthesia affects the population activity structure in macaque primary visual cortex. We found that under opioid anesthesia, activity was dominated by strong coordinated fluctuations on a timescale of 1-2 Hz, which were mostly absent in awake, fixating monkeys. Accounting for these global fluctuations markedly reduced correlations under anesthesia, matching those observed during wakefulness and reconciling earlier studies conducted under anesthesia and in awake animals. Our results show that internal signals, such as brain state transitions under anesthesia, can induce noise correlations but can also be estimated and accounted for based on neuronal population activity. Copyright © 2014 Elsevier Inc. All rights reserved.

Factors affecting surf zone phytoplankton production in Southeastern North Carolina, USA

NASA Astrophysics Data System (ADS)

Cahoon, Lawrence B.; Bugica, Kalman; Wooster, Michael K.; Dickens, Amanda Kahn

2017-09-01

The biomass and productivity of primary producers in the surf zone of the ocean beach at Wrightsville Beach, North Carolina, USA, were measured during all seasons, along with environmental parameters and nutrient levels. Variation in biomass (chlorophyll a) was associated with temperature. Primary production (PP), measured by in situ 14-C incubations, was a function of chlorophyll a, tide height at the start of incubations, and rainfall in the preceding 24-hr period. Biomass-normalized production (PB) was also a function of tide height and rainfall in the preceding 24-hr period. We interpreted these results as evidence of surf production 1) as combined contributions of phytoplankton and suspended benthic microalgae, which may confound application of simple P-E models to surf zone production, and 2) being regulated by nutrient source/supply fluctuations independently from other factors. Surf zone biomass and production levels are intermediate between relatively high estuarine values and much lower coastal ocean values. Surf zone production may represent an important trophic connection between these two important ecosystems.

Addressing the determinants of child mental health: intersectionality as a guide to primary health care renewal.

PubMed

McPherson, Charmaine M; McGibbon, Elizabeth A

2010-09-01

Primary health care (PHC) renewal was designed explicitly to attend to the multidimensional factors impacting on health, including the social determinants of health. These determinants are central considerations in the development of integrated, cross-sectoral, and multi-jurisdictional policies such as those that inform models of shared mental health care for children. However, there are complex theoretical challenges in translating these multidimensional issues into policy. One of these is the rarely discussed interrelationships among the social determinants of health and identities such as race, gender, age, sexuality, and social class within the added confluence of geographic contexts. An intersectionality lens is used to examine the complex interrelationships among the factors affecting child mental health and the associated policy challenges surrounding PHC renewal. The authors argue that an understanding of the intersections of social determinants of health, identity, and geography is pivotal in guiding policy-makers as they address child mental health inequities using a PHC renewal agenda.

Reconstruction in oral malignancy: Factors affecting morbidity of various procedures

PubMed Central

Chakrabarti, Suvadip; Chakrabarti, Preeti Rihal; Desai, Sanjay M.; Agrawal, Deepak; Mehta, Dharmendra Y.; Pancholi, Mayank

2015-01-01

Aims and Objective: (1) To study the age and sex distribution of patient with oral malignancies. (2) To analyze various types of surgery performed. (3) Evaluation of reconstruction and factors affecting complications and its relation to the type of reconstruction. Materials and Methods: Cases of oral malignancies, undergoing surgery for the same in Sri Aurobindo Medical College and PG Institute, Indore from the period from October 1, 2012, to March 31, 2015. Results: Out of analysis of 111 cases of oral malignancy, 31 (27.9%) cases were in the fifth decade of life with male to female ratio 1.9:1. The commonest site of cancer was buccal mucosa. Forty-seven cases (43.2%) were in stage IVa. Diabetes was the most common co-morbidity reported, accounting for 53.9% of cases with reported morbidity. Tobacco chewing was the common entity in personal habits. All the cases underwent neck dissection along with resection of the primary. Hemimandibulectomy was the most preferred form of primary resection accounting for 53.15% (59 cases), followed by wide resection of primary 27% (30 cases). Pectoralis major myocutaneous (PMMC) flap only was the most common reconstruction across the study population. PMMC alone accounted for 38.7% (43 cases). The infection rate was 16.21%. PMMC alone accounted for 5 out of 18 (27.8%) of total infection rate, and 4.5% of the total study population. PMMC + deltopectoral accounted for 5 out of 18 (27.8%) of total infection rate, and 4.5% of the total study population. Conclusion: PMMC is a major workhorse for reconstruction with better functional outcome and acceptance among operated patients. PMID:26981469

Mutations in CypA Binding Region of HIV-1 Capsid Affect Capsid Stability and Viral Replication in Primary Macrophages.

PubMed

Setiawan, Laurentia C; van Dort, Karel A; Rits, Maarten A N; Kootstra, Neeltje A

2016-04-01

Mutations in the cyclophilin A (CypA) binding region in the HIV-1 capsid affect their dependency on the known HIV-1 cofactor CypA and allow escape from the HIV-1 restriction factor Trim5α in human and simian cells. Here we study the effect of these mutations in the CypA binding region of capsid on cofactor binding, capsid destabilization, and viral replication in primary cells. We showed that the viral capsid with mutations in the CypA binding region (CypA-BR) interacted efficiently with CypA, but had an increased stability upon infection as compared to the wild-type capsid. Interestingly, the wild-type virus was able to infect monocyte-derived macrophages (MDM) more efficiently as compared to the CypA-BR mutant variant. The lower infectivity of the CypA-BR mutant virus in MDM was associated with lower levels of reverse transcription products. Similar to the wild-type virus, the CypA-BR mutant variant was unable to induce a strong innate response in primary macrophages. These data demonstrate that mutations in the CypA binding site of the capsid resulted in higher capsid stability and hampered infectivity in macrophages.

Perceived benefits and barriers and self-efficacy affecting the attendance of health education programs among uninsured primary care patients.

PubMed

Kamimura, Akiko; Nourian, Maziar M; Jess, Allison; Chernenko, Alla; Assasnik, Nushean; Ashby, Jeanie

2016-12-01

Lifestyle interventions have shown to be effective in improving health status, health behaviors, and self-efficacy. However, recruiting participants to health education programs and ensuring the continuity of health education for underserved populations is often challenging. The goals of this study are: to describe the attendance of health education programs; to identify stages of change to a healthy lifestyle; to determine cues to action; and to specify factors affecting perceived benefits and barriers to healthy food choices and physical activity among uninsured primary care patients. Uninsured primary care patients utilizing a free clinic (N=621) completed a self-administered survey from September to December of 2015. US born English speakers, non-US born English speakers, and Spanish speakers reported different kinds of cues to action in attending health education programs. While self-efficacy increases perceived benefits and decreases perceived barriers for physical activity, it increases both perceived benefits and perceived barriers for healthy food choices. The participants who had attended health education programs did not believe that there were benefits for healthy food choices and physical activity. This study adds to the body of literature on health education for underserved populations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Hepatitis C virus utilizes VLDLR as a novel entry pathway.

PubMed

Ujino, Saneyuki; Nishitsuji, Hironori; Hishiki, Takayuki; Sugiyama, Kazuo; Takaku, Hiroshi; Shimotohno, Kunitada

2016-01-05

Various host factors are involved in the cellular entry of hepatitis C virus (HCV). In addition to the factors previously reported, we discovered that the very-low-density lipoprotein receptor (VLDLR) mediates HCV entry independent of CD81. Culturing Huh7.5 cells under hypoxic conditions significantly increased HCV entry as a result of the expression of VLDLR, which was not expressed under normoxic conditions in this cell line. Ectopic VLDLR expression conferred susceptibility to HCV entry of CD81-deficient Huh7.5 cells. Additionally, VLDLR-mediated HCV entry was not affected by the knockdown of cellular factors known to act as HCV receptors or HCV entry factors. Because VLDLR is expressed in primary human hepatocytes, our results suggest that VLDLR functions in vivo as an HCV receptor independent of canonical CD81-mediated HCV entry.

An analysis of factors affecting attitudes toward same-sex marriage: do the media matter?

PubMed

Lee, Tien-Tsung; Hicks, Gary R

2011-01-01

Using a survey of more than 5,000 American consumers, this study examines connections between attitudes toward same-sex marriage and media consumption. A positive attitude is predicted by being liberal and less religious, supporting gender and racial equality, willing to try anything once, considering television the primary form of entertainment, watching political talk shows, and reading blogs. The theoretical and methodological contributions and real-world implications of these findings are discussed.

Crystallization over the liquid layer

NASA Astrophysics Data System (ADS)

Bogonosov, K. A.; Maksimovskii, S. N.

2013-04-01

In this article, a new phenomenon of high-speed crystallization of metals in a low-temperature plasma formed as a result of the effect of a short laser pulse is considered. The mechanism of the way the reaction occurs on the surface of the melt formed under the effect of the laser pulse on an amorphous substrate is described. The main factors affecting the crystallization process are described. Primary attention is paid to laminar convection and the latent heat of crystallization.

Prognostic factors for primary central nervous system lymphomas treated with high-dose methotrexate-based chemo-radiotherapy.

PubMed

Lee, Jeunghun; Shishido-Hara, Yukiko; Suzuki, Kaori; Shimizu, Saki; Kobayashi, Keiichi; Kamma, Hiroshi; Shiokawa, Yoshiaki; Nagane, Motoo

2017-10-01

Primary central nervous system lymphoma (PCNSL) remains an aggressive and refractory tumor despite high-dose methotrexate-based chemo-radiotherapy. Age and performance status have been shown to be important clinical prognostic factors, however others, especially molecular factors, affecting the prognosis are still uncertain. We investigate clinical, neuroimaging and immunohistochemical data in tissue from 41 PCNSL patients treated primarily with methotrexate-based chemo-radiotherapy and evaluate the influence of potential prognostic factors on clinical outcome as well as correlation among these factors. Median progression-free survival (PFS) and overall survival (OS) were 29 and 73 months, respectively. Expression of the mismatch repair (MMR) proteins, MLH1, MSH2, MSH6 and PMS2, correlated tightly with each other and high expression of MSH2 was significantly associated with better OS and PFS (P = 0.005 and P = 0.007), while methotrexate metabolism-related proteins did not affect survival. In addition, low expression of PMS2 was an independent predictor of methotrexate resistance (P = 0.039). Among neuroimaging findings, involvement of the fornix and tegmentum/velum were significantly associated with poorer OS (P < 0.001 and P = 0.013) and PFS (P = 0.014 and P = 0.043, respectively). Germinal center B cell (GCB)-PCNSL subtype as opposed to non-GCB subtype, tended toward better survival. Regarding oncogenes, cMYC-positive cases showed unfavorable OS (P = 0.046). By multivariate analysis, MSH2 and involvement of the fornix were independent predictors for both OS and PFS, whereas tegmentum/velum location and cMYC expression were significantly associated with OS. Although further studies are needed, these results suggest that MMR protein expression, as well as specific deep locations and cMYC expression, may be a novel prognostic and predictive markers for PCNSL. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Sexual HIV Risk Among Male Parolees and Their Female Partners: The Relate Project

PubMed Central

Comfort, Megan; Reznick, Olga Grinstead; Dilworth, Samantha E.; Binson, Diane; Darbes, Lynae A.; Neilands, Torsten B.

2014-01-01

Background The massively disproportionate impact of America’s prison boom on communities of color has raised questions about how incarceration may affect health disparities, including disparities in HIV. Primary partners are an important source of influence on sexual health. In this paper, we investigate sexual HIV risk among male-female couples following a man’s release from prison. Methods We draw upon data from the Relate Project, a novel cross-sectional survey of recently released men and their female partners in Oakland and San Francisco, California (N=344). Inferential analyses use the actor-partner model to explore actor and partner effects on sexual HIV risk outcomes. Results Dyadic analyses of sexual HIV risk among male parolees and their female partners paint a complex portrait of couples affected by incarceration and of partners’ influences on each other. Findings indicate that demographic factors such as education level and employment status, individual psycho-social factors such as perception of risk, and relationship factors such as commitment and power affect sexual HIV risk outcomes. Conclusion The Relate Project provides a novel dataset for the dyadic analysis of sexual risk among male parolees and their female partners, and results highlight the importance of focusing on the couple as a unit when assessing HIV risk and protective behaviors. Results also indicate potentially fruitful avenues for population-specific interventions that may help to reduce sexual health disparities among couples affected by incarceration. PMID:25642396

Perspective: A Dynamics-Based Classification of Ventricular Arrhythmias

PubMed Central

Weiss, James N.; Garfinkel, Alan; Karagueuzian, Hrayr S.; Nguyen, Thao P.; Olcese, Riccardo; Chen, Peng-Sheng; Qu, Zhilin

2015-01-01

Despite key advances in the clinical management of life-threatening ventricular arrhythmias, culminating with the development of implantable cardioverter-defibrillators and catheter ablation techniques, pharmacologic/biologic therapeutics have lagged behind. The fundamental issue is that biological targets are molecular factors. Diseases, however, represent emergent properties at the scale of the organism that result from dynamic interactions between multiple constantly changing molecular factors. For a pharmacologic/biologic therapy to be effective, it must target the dynamic processes that underlie the disease. Here we propose a classification of ventricular arrhythmias that is based on our current understanding of the dynamics occurring at the subcellular, cellular, tissue and organism scales, which cause arrhythmias by simultaneously generating arrhythmia triggers and exacerbating tissue vulnerability. The goal is to create a framework that systematically links these key dynamic factors together with fixed factors (structural and electrophysiological heterogeneity) synergistically promoting electrical dispersion and increased arrhythmia risk to molecular factors that can serve as biological targets. We classify ventricular arrhythmias into three primary dynamic categories related generally to unstable Ca cycling, reduced repolarization, and excess repolarization, respectively. The clinical syndromes, arrhythmia mechanisms, dynamic factors and what is known about their molecular counterparts are discussed. Based on this framework, we propose a computational-experimental strategy for exploring the links between molecular factors, fixed factors and dynamic factors that underlie life-threatening ventricular arrhythmias. The ultimate objective is to facilitate drug development by creating an in silico platform to evaluate and predict comprehensively how molecular interventions affect not only a single targeted arrhythmia, but all primary arrhythmia dynamics categories as well as normal cardiac excitation-contraction coupling. PMID:25769672

Lactoferrin – A Novel Bone Growth Factor

PubMed Central

Naot, Dorit; Grey, Andrew; Reid, Ian R; Cornish, Jillian

2005-01-01

Lactoferrin is an iron-binding glycoprotein that belongs to the transferrin family. It is present in breast milk, in epithelial secretions, and in the secondary granules of neutrophils. In healthy subjects lactoferrin circulates at concentrations of 2–7 x 10−6 g/ml. Lactoferrin is a pleiotropic factor with potent antimicrobial and immunomodulatory activities. Recently, we have shown that lactoferrin can also promote bone growth. At physiological concentrations, lactoferrin potently stimulates the proliferation and differentiation of primary osteoblasts and also acts as a survival factor inhibiting apoptosis induced by serum withdrawal. Lactoferrin also affects osteoclast formation and, in murine bone marrow culture, lactoferrin potently inhibits osteoclastogenesis. In vivo, local injection of lactoferrin above the hemicalvaria of adult mice results in substantial increases in the dynamic histomorphometric indices of bone formation and bone area. The mitogenic effect of lactoferrin in osteoblast-like cells is mediated mainly through LRP1, a member of the family of low-density lipoprotein receptor-related proteins that are primarily known as endocytic receptors. Using confocal laser scanning microscopy, we demonstrated that fluorescently labeled lactoferrin is endocytosed and can be visualized in the cytoplasm of primary osteoblastic cells. Lactoferrin also induces activation of p42/44 MAPK signaling in primary osteoblasts, but the two pathways seem to operate independently as activation of MAPK signaling, but not endocytosis, is necessary for the mitogenic effect of lactoferrin. We conclude that lactoferrin may have a physiological role in bone growth and healing, and a potential therapeutic role as an anabolic factor in osteoporosis. PMID:16012127

Nutritional Ingredients Modulate Adipokine Secretion and Inflammation in Human Primary Adipocytes

PubMed Central

Romacho, Tania; Glosse, Philipp; Richter, Isabel; Elsen, Manuela; Schoemaker, Marieke H.; van Tol, Eric A.; Eckel, Jürgen

2015-01-01

Nutritional factors such as casein hydrolysates and long chain polyunsaturated fatty acids have been proposed to exert beneficial metabolic effects. We aimed to investigate how a casein hydrolysate (eCH) and long chain polyunsaturated fatty acids could affect human primary adipocyte function in vitro. Incubation conditions with the different nutritional factors were validated by assessing cell vitality with lactate dehydrogenase (LDH) release and neutral red incorporation. Intracellular triglyceride content was assessed with Oil Red O staining. The effect of eCH, a non-peptidic amino acid mixture (AA), and long-chain polyunsaturated fatty acids (LC-PUFAs) on adiponectin and leptin secretion was determined by enzyme-linked immunosorbent assay (ELISA). Intracellular adiponectin expression and nuclear factor-κB (NF-κB) activation were analyzed by Western blot, while monocyte chemoattractant protein-1 (MCP-1) release was explored by ELISA. The eCH concentration dependently increased adiponectin secretion in human primary adipocytes through its intrinsic peptide bioactivity, since the non-peptidic mixture, AA, could not mimic eCH’s effects on adiponectin secretion. Eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and DHA combined with arachidonic acid (ARA) upregulated adiponectin secretion. However, only DHA and DHA/ARA exerted a potentanti-inflammatory effect reflected by prevention of tumor necrosis factor-α (TNF-α) induced NF-κB activation and MCP-1 secretion in human adipocytes. eCH and DHA alone or in combination with ARA, may hold the key for nutritional programming through their anti-inflammatory action to prevent diseases with low-grade chronic inflammation such as obesity or diabetes. PMID:25629558

Classroom Animals Provide More Than Just Science Education

NASA Astrophysics Data System (ADS)

Herbert, Sandra; Lynch, Julianne

2017-03-01

Keeping classroom animals is a common practice in many classrooms. Their value for learning is often seen narrowly as the potential to involve children in learning biological science. They also provide opportunities for increased empathy, as well as socio-emotional development. Realization of their potential for enhancing primary children's learning can be affected by many factors. This paper focuses on teachers' perceptions of classroom animals, drawing on accounts and reflections provided by 19 participants located in an Australian primary school where each classroom kept an animal. This study aims to progress the conversation about classroom animals, the learning opportunities that they afford, and the issues they present. Phenomenographic analysis of data resulted in five categories of teachers' perceptions of the affordances and constraints of keeping classroom animals.

The primary prevention of cardiovascular disease: nurse practitioners using behaviour modification strategies.

PubMed

Farrell, Todd Charles; Keeping-Burke, Lisa

2014-01-01

Cardiovascular disease (CVD) places great financial strain on the health care system and dramatically affects individual quality of life. As primary health care providers, nurse practitioners (NPs) are ideally positioned to advise clients on risk factor and lifestyle modifications that ameliorate the impact of CVD. While the lifestyle targets for CVD prevention are established, the most effective means of achieving these goals remain uncertain. Behaviour modification strategies, including motivational interviewing (MI) and the transtheoretical model (TTM), have been suggested, but neither approach is established as being more efficacious than the other. In this paper, evidence on the effectiveness of the two approaches for modifying smoking, diet, and exercise behaviour are presented, and a recommendation for NP practice is made.

Optical force and torque on a dielectric Rayleigh particle by a circular Airy vortex beam

NASA Astrophysics Data System (ADS)

Chen, Musheng; Huang, Sujuan; Shao, Wei; Liu, Xianpeng

2018-03-01

Optical force and torque exerted on the Rayleigh particles by tightly focused circularly polarized circular Airy vortex beams (CAVB) in the far field are studied in this paper. The relation between parameters of circularly polarized CAVB and the trapping properties is numerically analyzed based on Rayleigh models and the Debye diffraction theory. The results show that both the high refractive index and low refractive index particles can be fully stably trapped in three dimensions by circularly polarized CAVB. The parameters of circularly polarized CAVB greatly affect the optical force. The longitudinal and transverse gradient force increase with the increase of decay factor and scaling factor, and decrease with the increase of the radius of the first primary ring and topological charges. The positions of the longitudinal stable equilibrium move toward the high numerical aperture lens when the scaling factor and the radius of the primary ring increase. The trapping range is broadened with the decrease of scaling factor. The optical orbital torque (OOT) of circularly polarized CAVB has circular symmetry and remains positive or negative. With the increase of topological charges, the peak value of OOT first increases and then decreases after reaches a maximum. These results are useful for optical trapping, optical levitation and particle acceleration.

Incidence and risk factors for post-traumatic stress disorder in a population affected by a severe flood.

PubMed

Fontalba-Navas, A; Lucas-Borja, M E; Gil-Aguilar, V; Arrebola, J P; Pena-Andreu, J M; Perez, J

2017-03-01

We aimed to study the risk of developing post-traumatic stress disorder (PTSD) symptoms in people who resided in an affected area by an extremely severe flood, and sociodemographic risk factors associated with this condition. A geographic information system (GIS) was used to distribute the rainfall data. A case-control study was developed to study the relationship between PTSD and sociodemographic risk factors. To delineate the areas affected by the flood and the intensity of this rainfall in comparison with historical hydrological data, we employed geographical information systems (GIS). Then, we recruited a representative sample of the affected population and another population sample that lived at the time of this disaster in adjacent geographical areas that were not affected. Both groups were randomly selected in primary care practices, from December 1st 2012 to January 31st 2013. All participants, 70 from the affected areas and 91 from the non-affected, filled a sociodemographic questionnaire and the trauma questionnaire (TQ) to identify and rate PTSD symptoms. Our GIS analysis confirmed that the amount of precipitation in 2012 in the areas affected by the flood was exceptionally high compared with historical average rainfall data (461l per square metre vs 265). Individuals who resided in the affected areas at the time of the flood were at much higher risk of developing PTSD symptoms (OR: 8.18; 95% CI: 3.99-17.59) than those living in adjacent, non-affected localities. Among the sociodemographic variables included in this study, only material and financial losses were strongly associated with the onset of PTSD (P < 0.001). Physical risk during this life-threatening catastrophe also indicated a positive correlation with later development of PTSD symptoms; however, it did not reach statistical significance (P = 0.06). Populations affected by severe floods may suffer an increase of PTSD symptoms in the following months. This finding, along with the importance of material losses as a predictor for such disorder, may help develop effective plans to minimize the negative impact of these natural disasters on public health. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

What affects response rates in primary healthcare-based programmes? An analysis of individual and unit-related factors associated with increased odds of non-response based on HCV screening in the general population in Poland

PubMed Central

Parda, Natalia; Stępień, Małgorzata; Zakrzewska, Karolina; Madaliński, Kazimierz; Kołakowska, Agnieszka; Godzik, Paulina; Rosińska, Magdalena

2016-01-01

Objectives Response rate in public health programmes may be a limiting factor. It is important to first consider their delivery and acceptability for the target. This study aimed at determining individual and unit-related factors associated with increased odds of non-response based on hepatitis C virus screening in primary healthcare. Design Primary healthcare units (PHCUs) were extracted from the Register of Health Care Centres. Each of the PHCUs was to enrol adult patients selected on a random basis. Data on the recruitment of PHCUs and patients were analysed. Multilevel modelling was applied to investigate individual and unit-related factors associated with non-response. Multilevel logistic model was developed with fixed effects and only a random intercept for the unit. Preliminary analysis included a random effect for unit and each of the individual or PHCU covariates separately. For each of the PHCU covariates, we applied a two-level model with individual covariates, unit random effect and a single fixed effect of this unit covariate. Setting This study was conducted in primary care units in selected provinces in Poland. Participants A total of 242 PHCUs and 24 480 adults were invited. Of them, 44 PHCUs and 20 939 patients agreed to participate. Both PHCUs and patients were randomly selected. Results Data on 44 PHCUs and 24 480 patients were analysed. PHCU-level factors and recruitment strategies were important predictors of non-response. Unit random effect was significant in all models. Larger and private units reported higher non-response rates, while for those with a history of running public health programmes the odds of non-response was lower. Proactive recruitment, more working hours devoted to the project and patient resulted in higher acceptance of the project. Higher number of personnel had no such effect. Conclusions Prior to the implementation of public health programme, several factors that could hinder its execution should be addressed. PMID:27927665

What affects response rates in primary healthcare-based programmes? An analysis of individual and unit-related factors associated with increased odds of non-response based on HCV screening in the general population in Poland.

PubMed

Parda, Natalia; Stępień, Małgorzata; Zakrzewska, Karolina; Madaliński, Kazimierz; Kołakowska, Agnieszka; Godzik, Paulina; Rosińska, Magdalena

2016-12-07

Response rate in public health programmes may be a limiting factor. It is important to first consider their delivery and acceptability for the target. This study aimed at determining individual and unit-related factors associated with increased odds of non-response based on hepatitis C virus screening in primary healthcare. Primary healthcare units (PHCUs) were extracted from the Register of Health Care Centres. Each of the PHCUs was to enrol adult patients selected on a random basis. Data on the recruitment of PHCUs and patients were analysed. Multilevel modelling was applied to investigate individual and unit-related factors associated with non-response. Multilevel logistic model was developed with fixed effects and only a random intercept for the unit. Preliminary analysis included a random effect for unit and each of the individual or PHCU covariates separately. For each of the PHCU covariates, we applied a two-level model with individual covariates, unit random effect and a single fixed effect of this unit covariate. This study was conducted in primary care units in selected provinces in Poland. A total of 242 PHCUs and 24 480 adults were invited. Of them, 44 PHCUs and 20 939 patients agreed to participate. Both PHCUs and patients were randomly selected. Data on 44 PHCUs and 24 480 patients were analysed. PHCU-level factors and recruitment strategies were important predictors of non-response. Unit random effect was significant in all models. Larger and private units reported higher non-response rates, while for those with a history of running public health programmes the odds of non-response was lower. Proactive recruitment, more working hours devoted to the project and patient resulted in higher acceptance of the project. Higher number of personnel had no such effect. Prior to the implementation of public health programme, several factors that could hinder its execution should be addressed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Clinical Features of 294 Turkish Patients with Chronic Myeloproliferative Neoplasms

PubMed Central

Andıç, Neslihan; Ünübol, Mustafa; Yağcı, Eren; Akay, Olga Meltem; Yavaşoğlu, İrfan; Kadıköylü, Vefki Gürhan; Bolaman, Ali Zahit

2016-01-01

Objective: Myeloproliferative neoplasms (MPNs) share common clonal stem cells but show significant differences in their clinical courses. The aim of this retrospective study was to evaluate thrombotic and hemorrhagic complications, JAK2 status, gastrointestinal and cardiac changes, treatment modalities, and survival in MPNs in Turkish patients. Materials and Methods: Medical files of 294 patients [112 essential thrombocythemia (ET), 117 polycythemia vera (PV), 46 primary myelofibrosis, and 19 unclassified MPN cases] from 2 different universities in Turkey were examined. Results: Older age, higher leukocyte count at diagnosis, and JAK2 mutation positivity were risk factors for thrombosis. Platelet count over 1000x109/L was a risk factor for hemorrhagic episodes. Hydroxyurea treatment was not related to leukemic transformation. Median follow-up time was 50 months (quartiles: 22.2-81.75) in these patients. Patients with primary myelofibrosis had the shortest survival of 137 months when compared with 179 months for ET and 231 months for PV. Leukemic transformation, thromboembolic events, age over 60 years, and anemia were found to be the factors affecting survival. Conclusion: Thromboembolic complications are the most important preventable risk factors for morbidity and mortality in MPNs. Drug management in MPNs is done according to hemoglobin and platelet counts. Based on the current study population our results support the idea that leukocytosis and JAK2 positivity are more important risk factors for thrombosis than hemoglobin and platelet values. PMID:27094255

Environmental Risk Factors in Psoriasis: The Point of View of the Nutritionist

PubMed Central

Barrea, Luigi; Nappi, Francesca; Di Somma, Carolina; Savanelli, Maria Cristina; Falco, Andrea; Balato, Anna; Balato, Nicola; Savastano, Silvia

2016-01-01

Psoriasis is a common, chronic, immune-mediated skin disease with systemic pro-inflammatory activation, where both environmental and genetic factors contribute to its pathogenesis. Among the risk factors for psoriasis, evidence is accumulating that nutrition plays a major role, per se, in psoriasis pathogenesis. In particular, body weight, nutrition, and diet may exacerbate the clinical manifestations, or even trigger the disease. Understanding the epidemiological relationship between obesity and psoriasis is also important for delineating the risk profile for the obesity-related comorbidities commonly found among psoriatic patients. Moreover, obesity can affect both drug’s pharmacokinetics and pharmacodynamics. Additionally, the overall beneficial effects on the obesity-associated comorbidities, clinical recommendations to reduce weight and to adopt a healthy lifestyle could improve the psoriasis severity, particularly in those patients with moderate to severe disease, thus exerting additional therapeutic effects in the conventional treatment in obese patients with psoriasis. Education regarding modifiable environmental factors is essential in the treatment of this disease and represents one of the primary interventions that can affect the prognosis of patients with psoriasis. The goal is to make psoriatic patients and health care providers aware of beneficial dietary interventions. The aim of this review is to assess the relevance of the environmental factors as modifiable risk factors in psoriasis pathogenesis, with particular regard to the involvement of obesity and nutrition in the management of psoriasis, providing also specific nutrition recommendations. PMID:27455297

Critical factors for the return-to-work process among people with affective disorders: Voices from two vocational approaches.

PubMed

Porter, Susann; Lexén, Annika; Johansson, Suzanne; Bejerholm, Ulrika

2018-05-22

Depression is among the major causes of disability with a negative impact on both daily life and work performance. Whilst depression is the primary cause of sick-leave and unemployment in today's workplace there is a lack of knowledge of the needs of individuals with depression regarding their return-to-work (RTW) process. To explore which factors are of critical importance for people suffering from depression and who also are unemployed in their RTW-process and to explore the impact of two vocational approaches on the service users' experiences. The study included participants in two vocational rehabilitation approaches; Individual Enabling and Support (IES) and Traditional Vocational Rehabilitation (TVR). Qualitative methods were applied to explore critical factors in the RTW-process. Individuals with affective disorders including depression and bipolar disorder were included.RESULTSThree themes emerged as critical factors; Experiencing hope and power, Professionals' positive attitudes, beliefs and behaviours, and Employing a holistic perspective and integrating health and vocational service.CONCLUSIONThis study has demonstrated critical factors for the return-to-work process as experienced by persons with depression. To experience hope and power, to meet professionals that believe "you can work", who use a person-centred and holistic service approach, are such factors necessary for gaining a real job. In particular, professionals in TVR need to embrace this understanding since their services were not experienced as including these elements.

Host and Viral Factors in HIV-Mediated Bystander Apoptosis

PubMed Central

Garg, Himanshu; Joshi, Anjali

2017-01-01

Human immunodeficiency virus (HIV) infections lead to a progressive loss of CD4 T cells primarily via the process of apoptosis. With a limited number of infected cells and vastly disproportionate apoptosis in HIV infected patients, it is believed that apoptosis of uninfected bystander cells plays a significant role in this process. Disease progression in HIV infected individuals is highly variable suggesting that both host and viral factors may influence HIV mediated apoptosis. Amongst the viral factors, the role of Envelope (Env) glycoprotein in bystander apoptosis is well documented. Recent evidence on the variability in apoptosis induction by primary patient derived Envs underscores the role of Env glycoprotein in HIV disease. Amongst the host factors, the role of C-C Chemokine Receptor type 5 (CCR5), a coreceptor for HIV Env, is also becoming increasingly evident. Polymorphisms in the CCR5 gene and promoter affect CCR5 cell surface expression and correlate with both apoptosis and CD4 loss. Finally, chronic immune activation in HIV infections induces multiple defects in the immune system and has recently been shown to accelerate HIV Env mediated CD4 apoptosis. Consequently, those factors that affect CCR5 expression and/or immune activation in turn indirectly regulate HIV mediated apoptosis making this phenomenon both complex and multifactorial. This review explores the complex role of various host and viral factors in determining HIV mediated bystander apoptosis. PMID:28829402

Assessment of microbial risk factors and impact of meteorological conditions during production of baby spinach in the Southeast of Spain.

PubMed

Castro-Ibáñez, I; Gil, M I; Tudela, J A; Ivanek, R; Allende, A

2015-08-01

There is a timely need to evaluate the effect agricultural factors and meteorological conditions on fresh produce contamination. This study evaluated those risk factors and described, for the first time, the distribution of indicator microorganisms (Escherichia coli, Enterococcus, coliforms, and Enterobacteriaceae) and the prevalence of foodborne pathogens (Enterohaemorrhagic E. coli, Listeria monocytogenes and Salmonella spp.) in baby spinach grown in the Southeast of Spain. A longitudinal study was conducted on three farms (2011-2013). Results obtained for E. coli highlighted soil and irrigation water as important factors affecting the microbial safety of baby spinach. Significant differences in the proportion of E. coli positive samples were found between treated (46.1%) and untreated (100%) irrigation water. However, the microbial quality of irrigation water didn't affect E. coli prevalence in produce. All E. coli positive spinach samples were detected at the highest observed temperature range suggesting that ambient temperature affects the probability and extent of spinach contamination. Salmonella spp. was detected by RT-PCR in manure, soil, irrigation water and baby spinach but only two of them (manure and irrigation water) were confirmed by isolation in culture media. Salmonella RT-PCR positive samples showed higher levels of E. coli than Salmonella negative samples. This preliminary finding supports recent identification of E. coli as a suitable parameter for the hygiene criterion at the primary production of leafy greens. Copyright © 2015 Elsevier Ltd. All rights reserved.

Subjective cognitive concerns and neuropsychiatric predictors of progression to the early clinical stages of Alzheimer disease.

PubMed

Donovan, Nancy J; Amariglio, Rebecca E; Zoller, Amy S; Rudel, Rebecca K; Gomez-Isla, Teresa; Blacker, Deborah; Hyman, Bradley T; Locascio, Joseph J; Johnson, Keith A; Sperling, Reisa A; Marshall, Gad A; Rentz, Dorene M

2014-12-01

To examine neuropsychiatric and neuropsychological predictors of progression from normal to early clinical stages of Alzheimer disease (AD). From a total sample of 559 older adults from the Massachusetts Alzheimer's Disease Research Center longitudinal cohort, 454 were included in the primary analysis: 283 with clinically normal cognition (CN), 115 with mild cognitive impairment (MCI), and 56 with subjective cognitive concerns (SCC) but no objective impairment, a proposed transitional group between CN and MCI. Two latent cognitive factors (memory-semantic, attention-executive) and two neuropsychiatric factors (affective, psychotic) were derived from the Alzheimer's Disease Centers' Uniform Data Set neuropsychological battery and Neuropsychiatric Inventory brief questionnaire. Factors were analyzed as predictors of time to progression to a worse diagnosis using a Cox proportional hazards regression model with backward elimination. Covariates included baseline diagnosis, gender, age, education, prior depression, antidepressant medication, symptom duration, and interaction terms. Higher/better memory-semantic factor score predicted lower hazard of progression (hazard ratio [HR] = 0.4 for 1 standard deviation [SD] increase, p <0.0001), and higher/worse affective factor score predicted higher hazard (HR = 1.3 for one SD increase, p = 0.01). No other predictors were significant in adjusted analyses. Using diagnosis as a sole predictor of transition to MCI, the SCC diagnosis carried a fourfold risk of progression compared with CN (HR = 4.1, p <0.0001). These results identify affective and memory-semantic factors as significant predictors of more rapid progression from normal to early stages of cognitive decline and highlight the subgroup of cognitively normal elderly with SCC as those with elevated risk of progression to MCI. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Nutrition and educational achievement of urban primary schoolchildren in Malaysia.

PubMed

Shariff, Z M; Bond, J T; Johnson, N E

2000-12-01

The relationship between nutrition, health and educational achievement of school-age population in less developed countries has been of interest to many researchers due to the frequent observation that many children did not complete primary school and those who completed, did not do as well as children in the developed countries. Nevertheless, nutritional and health status by itself is not the only variable affecting educational achievement, since biological, psychological, socioeconomic and cultural factors could directly or indirectly affect both nutrition, health status and educational achievement. The mechanism by which health and nutrition influence educational achievement is not well established, but poor health and malnutrition in early childhood may affect cognitive abilities, necessary for learning process and consequently educational achievement. A study was conducted in Kuala Lumpur, Malaysia, to investigate the relationship between nutritional status and educational achievement among primary schoolchildren from low income households (n = 399). A high percentage of them were mild-significantly underweight (52%), stunted (47%) and wasted (36%) and increasingly overweight (6%). In general, more boys than girls were found to experience some form of malnutrition. While weight-for-height did not differ significantly according to family, child and school factors, weight-for-age and height-for-age differed significantly by gender. Also, height-for-age was significantly related to household income. This indicates that stunting may be a consequence of prolonged socioeconomic deprivation. Educational achievement was measured based on test scores for Malay language (ML), English language (EL) and mathematics (MT). While a majority of the schoolchildren obtained optimum scores (>75) for ML and MT, the majority of them had insufficient scores (<50) for EL. Children's total score (TS) for the three subjects was significantly associated with household socioeconomic status, gender, birth order and heightfor- age. Even after controlling for household socioeconomic status, significant association between TS and height-for-age persisted. In this sample of schoolchildren, household income, gender, birth order and height-forage were significant predictors of TS. The finding that height-for-age is related to educational achievement agrees with other studies, which have reported that height-for-age, compared to weight-for-height or weight-forage is linked to educational achievement. Height-for-age reflects the accumulation of nutritional deprivation throughout the years, which may consequently affect the cognitive development of the children.

Primary prevention of colorectal cancer: myth or reality?

PubMed

Crosara Teixeira, Marcela; Braghiroli, Maria Ignez; Sabbaga, Jorge; Hoff, Paulo M

2014-11-07

Colorectal cancer incidence has been rising strongly in parallel with economic development. In the past few decades, much has been learned about the lifestyle, dietary and medication risk factors for this malignancy. With respect to lifestyle, compelling evidence indicates that prevention of weight gain and maintenance of a reasonable level of physical activity can positively influence in lowering the risk. Although there is controversy about the role of specific nutritional factors, consideration of dietary pattern as a whole appears useful for formulating recommendations. Though quite often recommended, the role for many supplements, including omega-3, vitamin D, folate, and vitamin B6, remains unsettled. Only calcium and vitamin D supplementation appear to add a modest benefit, particularly in those with a low daily intake. With regard to chemoprevention, medications such as aspirin and nonsteroidal anti-inflammatory drugs, and postmenopausal hormonal replacement for women might be associated with substantial reductions in colorectal cancer risk, though their utility is affected by their side effect profile. However, the role of agents such as statins, bisphosphonates and antioxidants have yet to be determined. Ultimately, primary prevention strategies focusing on modifying environmental, lifestyle risk factors, and chemopreventive drugs are options that have already been tested, and may impact on colon cancer incidence.

Postoperative vesicoureteral reflux after high-pressure balloon dilation of the ureterovesical junction in primary obstructive megaureter. Incidence, management and predisposing factors.

PubMed

García-Aparicio, Luis; Blázquez-Gómez, Eva; de Haro, Irene; Garcia-Smith, Natalie; Bejarano, Miguel; Martin, Oriol; Rodo, Joan

2015-12-01

To describe the incidence, predisposing factors and management of postoperative vesicoureteral reflux (VUR) after high-pressure balloon dilation to treat primary obstructive megaureter (POM). We have reviewed patients that underwent endoscopic treatment for POM from May 2008 to November 2013. All patients were evaluated with renal ultrasound, voiding cystourethrography and diuretic renogram. Endoscopic treatment was done with high-pressure balloon dilation of the ureterovesical junction under general anesthesia; a double-J stenting was done in all patients. Follow-up was performed with ultrasonography, voiding cystourethrography and a diuretic renogram in all patients. Fifteen boys and five girls with a mean age of 14.18 months (3-103) were reviewed. A total of 22 ureters underwent HPBD to treat POM. Ureterohydronephrosis improves in 19 ureters. After endoscopic treatment, six ureters developed VUR. Four ureters were managed surgically, and in the other two, VUR disappeared in a second cystogram. The presence of parameatal diverticulum in the preoperative cystography and those patients with bilateral POM are factors related to postoperative VUR (p < 0.05). Urinary tract infection after HPBD was observed in four patients, but only one of them was affected with VUR.

Cultural expressions of depression and the development of the Indonesian Depression Checklist.

PubMed

Widiana, Herlina Siwi; Simpson, Katrina; Manderson, Lenore

2018-06-01

Depression may manifest differently across cultural settings, suggesting the value of an assessment tool that is sensitive enough to capture these variations. The study reported in this article aimed to develop a depression screening tool for Indonesians derived from ethnographic interviews with 20 people who had been diagnosed as having depression by clinical psychologists at primary health centers. The tool, which we have termed the Indonesian Depression Checklist (IDC), consists of 40 items. The tool was administered to 125 people assessed to have depression by 40 clinical psychologists in primary health centers. The data were analyzed with Confirmatory Factor Analysis (CFA) (IBM SPSS AMOS Software). CFA identified a five-factor hierarchical model ( χ 2  = 168.157, p = .091; CFI = .963; TLI = .957; RMSEA = .036). A 19-item inventory of the IDC, with five factors - Physical Symptoms, Affect, Cognition, Social Engagement and Religiosity - was identified. There was a strong correlation between the total score of the IDC and total score of the Center for Epidemiological Studies-Depression scale (revised version CES-D), a standard tool for assessing symptoms of depression. The IDC accommodates culturally distinctive aspects of depression among Indonesians that are not included in the CES-D.

The role of androgen receptor CAG repeat polymorphism and other factors which affect the clinical response to testosterone replacement in metabolic syndrome and type 2 diabetes: TIMES2 sub-study.

PubMed

Stanworth, R D; Akhtar, S; Channer, K S; Jones, T H

2014-02-01

The TIMES2 (testosterone replacement in hypogonadal men with either metabolic syndrome or type 2 diabetes) study reported beneficial effects of testosterone replacement therapy (TRT) on insulin resistance and other variables in men with diabetes or metabolic syndrome. The androgen receptor CAG repeat polymorphism (AR CAG) is known to affect stimulated AR activity and has been linked to various clinically relevant variables. To assess the role of AR CAG in the alteration of clinical response to TRT in the TIMES2 study. Subgroup analysis from a multicentre, randomised, double-blind, placebo-controlled and parallel group study. Outpatient study recruiting from secondary and primary care. A total of 139 men with hypogonadism and type 2 diabetes or metabolic syndrome, of which 73 received testosterone during the TIMES2 study. Testosterone 2% transdermal gel vs placebo. Regression coefficient of AR CAG from linear regression models for each variable. AR CAG was independently positively associated with change in fasting insulin, triglycerides and diastolic blood pressure during TRT with a trend to association with HOMA-IR - the primary outcome variable. There was a trend to negative association between AR CAG and change in PSA. There was no association of AR CAG with change in other glycaemic variables, other lipid variables or obesity. AR CAG affected the response of some variables to TRT in the TIMES2 study, although the association with HOMA-IR did not reach significance. Various factors may have limited the power of our study to detect the significant associations between AR CAG, testosterone levels and change in variables with testosterone treatment. Analysis of similar data sets from other clinical trials is warranted.

Job satisfaction of nurse practitioners: an analysis using Herzberg's theory.

PubMed

Koelbel, P W; Fuller, S G; Misener, T R

1991-04-01

The current sociopolitical and economic forces affecting health care may lead to job dissatisfaction among nurse practitioners, according to results of a South Carolina study. A mailed survey that consisted of the Index of Job Satisfaction and the Minnesota Satisfaction Questionnaire--Short Form was used to test Herzberg's dual-factor theory of job satisfaction. A response rate of 90 percent was attained, with a final sample of 132 nurse practitioners and midwives. Consistent with the predictions of Herzberg's model, intrinsic factors served as sources of job satisfaction, while extrinsic factors were the primary sources of job dissatisfaction. Nurse practitioners in the sample reported a moderate amount of satisfaction with their "overall jobs." Suggestions are provided for ways both nurse practitioners and health administrators can enhance job satisfaction.

[Maintaining mechanism of species diversity of land plant communities].

PubMed

Shang, Wenyan; Wu, Gang; Fu, Xiao; Liu, Yang

2005-03-01

The maintaining mechanism of species diversity of land plant communities is a key and advancing edge in biodiversity study. Botanists and ecologists have presented many hypotheses and theories with controversies, and no general theory system was available. In this paper, the problem was reviewed mainly on two scales. The first was big spatial scale, aiming at the physical and natural factors that affect the species diversity, including histories and ages of plant communities, gradient changes such as latitude gradient, water gradient, altitude gradient and soil nutrients gradient, area effect, and isolation; and the second was concentrated on a special plant community, and mainly discussed the relationships of biodiversity with biotic factors (primary productivity, relationship between species, and gap dynamics) and abiotic factors (succession, disturbance and spatial heterogeneity, and human activity).

Predicting length of stay from an electronic patient record system: a primary total knee replacement example.

PubMed

Carter, Evelene M; Potts, Henry W W

2014-04-04

To investigate whether factors can be identified that significantly affect hospital length of stay from those available in an electronic patient record system, using primary total knee replacements as an example. To investigate whether a model can be produced to predict the length of stay based on these factors to help resource planning and patient expectations on their length of stay. Data were extracted from the electronic patient record system for discharges from primary total knee operations from January 2007 to December 2011 (n=2,130) at one UK hospital and analysed for their effect on length of stay using Mann-Whitney and Kruskal-Wallis tests for discrete data and Spearman's correlation coefficient for continuous data. Models for predicting length of stay for primary total knee replacements were tested using the Poisson regression and the negative binomial modelling techniques. Factors found to have a significant effect on length of stay were age, gender, consultant, discharge destination, deprivation and ethnicity. Applying a negative binomial model to these variables was successful. The model predicted the length of stay of those patients who stayed 4-6 days (~50% of admissions) with 75% accuracy within 2 days (model data). Overall, the model predicted the total days stayed over 5 years to be only 88 days more than actual, a 6.9% uplift (test data). Valuable information can be found about length of stay from the analysis of variables easily extracted from an electronic patient record system. Models can be successfully created to help improve resource planning and from which a simple decision support system can be produced to help patient expectation on their length of stay.

Economies through Application of Nonmedical Primary-Preventative Health: Lessons from the Healthy Country Healthy People Experience of Australia’s Aboriginal People

PubMed Central

Campbell, David

2016-01-01

The World Health Organization reports noncommunicable disease as a global pandemic. While national and international health research/policy bodies, such as the World Health Organization and the Australian Institute of Health and Welfare, emphasize the importance of preventative health, there is a continuing distortion in the allocation of resources to curative health as a result of government failure. Government failure is, in part, the result of a political response to individual preference for certainty in receiving treatment for specific health conditions, rather than the uncertainty of population-based preventative intervention. This has led to a failure to engage with those primary causative factors affecting chronic disease, namely the psychosocial stressors, in which the socioeconomic determinants are an important component. Such causal factors are open to manipulation through government policies and joint government-government, government-private cooperation through application of nonmedical primary-preventative health policies. The health benefits of Aboriginal people in traditional land management, or caring-for-country, in remote to very remote Australia, is used to exemplify the social benefits of nonmedical primary-preventative health intervention. Such practices form part of the “healthy country, health people” concept that is traditionally relied upon by Indigenous peoples. Possible health and wider private good and public good social benefits are shown to occur across multiple disciplines and jurisdictions with the possibility of substantial economies. General principles in the application of nonmedical primary-preventative health activities are developed through consideration of the experience of Afboriginal people participation in traditional caring-for-country. PMID:27482574

Modeling secondary accidents identified by traffic shock waves.

PubMed

Junhua, Wang; Boya, Liu; Lanfang, Zhang; Ragland, David R

2016-02-01

The high potential for occurrence and the negative consequences of secondary accidents make them an issue of great concern affecting freeway safety. Using accident records from a three-year period together with California interstate freeway loop data, a dynamic method for more accurate classification based on the traffic shock wave detecting method was used to identify secondary accidents. Spatio-temporal gaps between the primary and secondary accident were proven be fit via a mixture of Weibull and normal distribution. A logistic regression model was developed to investigate major factors contributing to secondary accident occurrence. Traffic shock wave speed and volume at the occurrence of a primary accident were explicitly considered in the model, as a secondary accident is defined as an accident that occurs within the spatio-temporal impact scope of the primary accident. Results show that the shock waves originating in the wake of a primary accident have a more significant impact on the likelihood of a secondary accident occurrence than the effects of traffic volume. Primary accidents with long durations can significantly increase the possibility of secondary accidents. Unsafe speed and weather are other factors contributing to secondary crash occurrence. It is strongly suggested that when police or rescue personnel arrive at the scene of an accident, they should not suddenly block, decrease, or unblock the traffic flow, but instead endeavor to control traffic in a smooth and controlled manner. Also it is important to reduce accident processing time to reduce the risk of secondary accident. Copyright © 2015 Elsevier Ltd. All rights reserved.

Factors associated with the number of lesions excised for each skin cancer: a study of primary care physicians in Queensland, Australia.

PubMed

Baade, Peter D; Youl, Philippa H; Janda, Monika; Whiteman, David C; Del Mar, Christopher B; Aitken, Joanne F

2008-11-01

To assess physician, patient, and skin lesion characteristics that affect the number of benign skin lesions excised by primary care physicians for each skin cancer. Prospective study collecting clinical, patient, and histopathologic details of excisions or biopsies of skin lesions by random samples of primary care physicians. Southeast Queensland involving traditional family medicine physicians (n = 104; response rate, 53.9%) and family medicine physicians working in 27 primary care skin cancer clinics (n = 50; response rate, 75.0%). Of 28 755 skin examinations recorded during the study, 11 403 skin lesions were excised or biopsied; 97.5% of the excised lesions had clinical and histologic diagnoses recorded. Number of lesions needed to excise or biopsy (NNE) for 1 melanoma (pigmented lesions only) and NNE for 1 nonmelanoma skin cancer (nonpigmented lesions only). The NNE for nonpigmented lesions (n = 8139) was 1.5 (95% confidence interval, 1.4-1.6) and for pigmented lesions (n = 2977) was 19.6 (16.2-22.9). The NNE estimates were up to 8 times lower if the physician thought the lesion was likely to be malignant and up to 2.5 times higher if there was strong patient pressure to excise. The NNE estimates varied by other physician-, patient-, and lesion-related variables. Clinical impressions of excised skin lesions were strongly associated with NNE estimates. By focusing on pigmented skin lesions and by addressing the physician- and patient-specific factors identified, the effectiveness of future training for primary care physicians in the clinical management of skin cancer could be improved.

How do stakeholder groups vary in a Delphi technique about primary mental health care and what factors influence their ratings?

PubMed

Campbell, S M; Shield, T; Rogers, A; Gask, L

2004-12-01

While mental health is a core part of primary care, there are few validated quality measures and little relevant internationally published research. Consensus panel methods are a useful means of developing quality measures where evidence is sparse and/or opinions are diverse. However, little is known about the dynamics of consensus techniques and the factors that influence the judgements and ratings of panels and individual panelists. (1) To describe differences in panel ratings on the quality of primary mental health care services by patient, carer, professional and managerial panels within a Delphi procedure; and (2) to explore why different panels and panelists rate quality indicators of primary mental health care differently. Two round postal Delphi technique and exploratory semi-structured interviews. 115 panelists across 11 panels. Eleven panelists were subsequently interviewed. 87 of 334 indicators (26%) were rated face valid by all 11 panels. There was little disagreement within panel ratings but significant differences between panels. The GP panel rated the least number of indicators valid (n = 138, 41%) and carers the most (n = 304, 91%). The way in which panelists interpreted and conceptualised the indicators and their definition of quality of mental health care affected the way in which participants made their ratings. Stakeholders in primary mental health care have diverse views of quality of care and these differences translate into how they rate quality indicators. Exploratory interviews suggest that ratings are influenced by past experience, expectations, definitions of quality of care, and perceived power relationships between stakeholders.

40 CFR 60.190 - Applicability and designation of affected facility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Primary Aluminum Reduction Plants § 60.190 Applicability and designation of affected facility. (a) The affected facilities in primary aluminum reduction plants to which this subpart applies are...

Complex numerical responses to top-down and bottom-up processes in vertebrate populations.

PubMed Central

Sinclair, A R E; Krebs, Charles J

2002-01-01

Population growth rate is determined in all vertebrate populations by food supplies, and we postulate bottom-up control as the universal primary standard. But this primary control system can be overridden by three secondary controls: top-down processes from predators, social interactions within the species and disturbances. Different combinations of these processes affect population growth rates in different ways. Thus, some relationships between growth rate and density can be hyperbolic or even have multiple nodes. We illustrate some of these in marsupial, ungulate and rabbit populations. Complex interactions between food, predators, environmental disturbance and social behaviour produce the myriad observations of population growth in nature, and we need to develop generalizations to classify populations. Different animal groups differ in the combination of these four processes that affect them, in their growth rates and in their vulnerability to extinction. Because conservation and management of populations depend critically on what factors drive population growth, we need to develop universal generalizations that will relieve us from the need to study every single population before we can make recommendations for management. PMID:12396514

Drivers of U.S. Household Energy Consumption, 1980-2009

EIA Publications

2015-01-01

In 2012, the residential sector accounted for 21% of total primary energy consumption and about 20% of carbon dioxide emissions in the United States (computed from EIA 2013). Because of the impacts of residential sector energy use on the environment and the economy, this study was undertaken to help provide a better understanding of the factors affecting energy consumption in this sector. The analysis is based on the U.S. Energy Information Administration's (EIA) residential energy consumption surveys (RECS) 1980-2009.

Cancer and Lesbian, Gay, Bisexual, Transgender/Transsexual, and Queer/Questioning Populations (LGBTQ)

PubMed Central

Quinn, Gwendolyn P.; Sanchez, Julian A.; Sutton, Steven K.; Vadaparampil, Susan T.; Nguyen, Giang T.; Green, B. Lee; Kanetsky, Peter A.; Schabath, Matthew B.

2015-01-01

This article provides an overview of the current literature on seven cancer sites that may disproportionately affect lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) populations. For each cancer site we present and discuss the descriptive statistics, primary prevention, secondary prevention and preclinical disease, tertiary prevention and late stage disease, and clinical implications. Finally, an overview of psychosocial factors related to cancer survivorship is offered as well as strategies for improving access to care. PMID:26186412

Superimposed Preeclampsia.

PubMed

Guedes-Martins, Luís

2017-01-01

Superimposed preeclampsia refers to women with chronic arterial hypertension (primary or secondary) who develop preeclampsia (PE). Because hypertension affects 5-15 % of pregnancies, it is itself a matter of concern. However, this concern should be permanent, given the increased risk of the hypertension worsening and, particularly, the appearance of superimposed PE. The search for factors that underlie or promote the development of this disorder has been the subject of intense research. However, despite the wealth of knowledge, the cause or causes remain to be determined.

Prospective Turkish Primary Teachers' Views about the Use of Computers in Mathematics Education

ERIC Educational Resources Information Center

Dogan, Mustafa

2012-01-01

The use of computers and technology in mathematics education affects students' learning, achievements, and affective dimensions. This study explores prospective Turkish primary mathematics teachers' views about the use of computers in mathematics education. The sample comprised of 129 fourth-year prospective primary mathematics teachers from two…

Prognostic factors in canine appendicular osteosarcoma – a meta-analysis

PubMed Central

2012-01-01

Background Appendicular osteosarcoma is the most common malignant primary canine bone tumor. When treated by amputation or tumor removal alone, median survival times (MST) do not exceed 5 months, with the majority of dogs suffering from metastatic disease. This period can be extended with adequate local intervention and adjuvant chemotherapy, which has become common practice. Several prognostic factors have been reported in many different studies, e.g. age, breed, weight, sex, neuter status, location of tumor, serum alkaline phosphatase (SALP), bone alkaline phosphatase (BALP), infection, percentage of bone length affected, histological grade or histological subtype of tumor. Most of these factors are, however, only reported as confounding factors in larger studies. Insight in truly significant prognostic factors at time of diagnosis may contribute to tailoring adjuvant therapy for individual dogs suffering from osteosarcoma. The objective of this study was to systematically review the prognostic factors that are described for canine appendicular osteosarcoma and validate their scientific importance. Results A literature review was performed on selected studies and eligible data were extracted. Meta-analyses were done for two of the three selected possible prognostic factors (SALP and location), looking at both survival time (ST) and disease free interval (DFI). The third factor (age) was studied in a qualitative manner. Both elevated SALP level and the (proximal) humerus as location of the primary tumor are significant negative prognostic factors for both ST and DFI in dogs with appendicular osteosarcoma. Increasing age was associated with shorter ST and DFI, however, was not statistically significant because information of this factor was available in only a limited number of papers. Conclusions Elevated SALP and proximal humeral location are significant negative prognosticators for canine osteosarcoma. PMID:22587466

Prognostic factors in canine appendicular osteosarcoma - a meta-analysis.

PubMed

Boerman, Ilse; Selvarajah, Gayathri T; Nielen, Mirjam; Kirpensteijn, Jolle

2012-05-15

Appendicular osteosarcoma is the most common malignant primary canine bone tumor. When treated by amputation or tumor removal alone, median survival times (MST) do not exceed 5 months, with the majority of dogs suffering from metastatic disease. This period can be extended with adequate local intervention and adjuvant chemotherapy, which has become common practice. Several prognostic factors have been reported in many different studies, e.g. age, breed, weight, sex, neuter status, location of tumor, serum alkaline phosphatase (SALP), bone alkaline phosphatase (BALP), infection, percentage of bone length affected, histological grade or histological subtype of tumor. Most of these factors are, however, only reported as confounding factors in larger studies. Insight in truly significant prognostic factors at time of diagnosis may contribute to tailoring adjuvant therapy for individual dogs suffering from osteosarcoma. The objective of this study was to systematically review the prognostic factors that are described for canine appendicular osteosarcoma and validate their scientific importance. A literature review was performed on selected studies and eligible data were extracted. Meta-analyses were done for two of the three selected possible prognostic factors (SALP and location), looking at both survival time (ST) and disease free interval (DFI). The third factor (age) was studied in a qualitative manner. Both elevated SALP level and the (proximal) humerus as location of the primary tumor are significant negative prognostic factors for both ST and DFI in dogs with appendicular osteosarcoma. Increasing age was associated with shorter ST and DFI, however, was not statistically significant because information of this factor was available in only a limited number of papers. Elevated SALP and proximal humeral location are significant negative prognosticators for canine osteosarcoma.

Biometric Factors Associated With Acute Primary Angle Closure: Comparison of the Affected and Fellow Eye.

PubMed

Atalay, Eray; Nongpiur, Monisha E; Baskaran, Mani; Sharma, Sourabh; Perera, Shamira A; Aung, Tin

2016-10-01

To compare ocular biometric and anterior segment parameters between the affected and fellow eye in subjects with acute primary angle closure (APAC). We evaluated 76 subjects with unilateral APAC who had undergone bilateral laser peripheral iridotomy before enrollment. Imaging was done using anterior segment optical coherence tomography and a customized software was used to measure the following: angle opening distance (AOD750); trabecular-iris space area (TISA750); iris thickness (IT750); iris curvature (ICURV); iris area (IAREA); anterior chamber depth; area and volume (ACD; ACA and ACV); anterior chamber width (ACW); anterior vault (ACD+LV); lens vault (LV); and pupil diameter (PD). We used A-scan ultrasonography to measure axial length (AL) and lens thickness (LT). Mean differences in ocular biometric and anterior segment parameters were assessed using linear mixed model adjusting for PD. A total of 53 subjects (36 females, 67.9%) with a mean age of 62.7 ± 8.1 years were analyzed after excluding 17 unanalyzable images in at least one eye. Affected eyes had shallower ACD, smaller ACA, ACV, anterior vault, TISA750, AOD750, and ICURV (all P < 0.05). Axial length, ACW, LV, LT, IAREA, and IT750 did not differ between the eyes. In the affected eyes, IT750 was significantly associated AOD750 (P < 0.05); whereas in the fellow eyes, IT750 and AL was predictive of AOD750 (all P < 0.05). Eyes with previous APAC had smaller anterior segment dimensions when compared with their fellow eyes. Iris thickness was the strongest predictor of angle width in both affected and fellow eyes.

Primary assembly of soil communities: disentangling the effect of dispersal and local environment.

PubMed

Ingimarsdóttir, María; Caruso, Tancredi; Ripa, Jörgen; Magnúsdóttir, Olöf Birna; Migliorini, Massimo; Hedlund, Katarina

2012-11-01

It has long been recognised that dispersal abilities and environmental factors are important in shaping invertebrate communities, but their relative importance for primary soil community assembly has not yet been disentangled. By studying soil communities along chronosequences on four recently emerged nunataks (ice-free land in glacial areas) in Iceland, we replicated environmental conditions spatially at various geographical distances. This allowed us to determine the underlying factors of primary community assembly with the help of metacommunity theories that predict different levels of dispersal constraints and effects of the local environment. Comparing community assembly of the nunataks with that of non-isolated deglaciated areas indicated that isolation of a few kilometres did not affect the colonisation of the soil invertebrates. When accounting for effects of geographical distances, soil age and plant richness explained a significant part of the variance observed in the distribution of the oribatid mites and collembola communities, respectively. Furthermore, null model analyses revealed less co-occurrence than expected by chance and also convergence in the body size ratio of co-occurring oribatids, which is consistent with species sorting. Geographical distances influenced species composition, indicating that the community is also assembled by dispersal, e.g. mass effect. When all the results are linked together, they demonstrate that local environmental factors are important in structuring the soil community assembly, but are accompanied with effects of dispersal that may "override" the visible effect of the local environment.

Environmental factors influencing the spatio-temporal distribution of Carybdea marsupialis (Lineo, 1978, Cubozoa) in South-Western Mediterranean coasts.

PubMed

Canepa, Antonio; Fuentes, Verónica; Bosch-Belmar, Mar; Acevedo, Melissa; Toledo-Guedes, Kilian; Ortiz, Antonio; Durá, Elia; Bordehore, César; Gili, Josep-Maria

2017-01-01

Jellyfish blooms cause important ecological and socio-economic problems. Among jellyfish, cubozoans are infamous for their painful, sometimes deadly, stings and are a major public concern in tropical to subtropical areas; however, there is little information about the possible causes of their outbreaks. After a bloom of the cubomedusa Carybdea marsupialis (Carybdeidae) along the coast of Denia (SW Mediterranean, Spain) in 2008 with negative consequences for local tourism, the necessity to understand the ecological restrictions on medusae abundance was evident. Here we use different models (GAM and zero-inflated models) to understand the environmental and human related factors influencing the abundance and distribution of C. marsupialis along the coast of Denia. Selected variables differed among medusae size classes, showing different environmental restriction associated to the developmental stages of the species. Variables implicated with dispersion (e.g. wind and current) affected mostly small and medium size classes. Sea surface temperature, salinity and proxies of primary production (chl a, phosphates, nitrates) were related to the abundances of small and large size classes, highlighting the roles of springtime salinity changes and increased primary production that may promote and maintain high densities of this species. The increased primary (and secondary) production due to anthropogenic impact is implicated as the factor enabling high numbers of C. marsupialis to thrive. Recommendations for monitoring blooms of this species along the study area and applicable to Mediterranean Sea include focus effort in coastal waters where productivity have been enriched by anthropogenic activities.

Burnout Subtypes and Absence of Self-Compassion in Primary Healthcare Professionals: A Cross-Sectional Study

PubMed Central

Montero-Marin, Jesus; Zubiaga, Fernando; Cereceda, Maria; Piva Demarzo, Marcelo Marcos; Trenc, Patricia; Garcia-Campayo, Javier

2016-01-01

Background Primary healthcare professionals report high levels of distress and burnout. A new model of burnout has been developed to differentiate three clinical subtypes: ‘frenetic’, ‘underchallenged’ and ‘worn-out’. The aim of this study was to confirm the validity and reliability of the burnout subtype model in Spanish primary healthcare professionals, and to assess the explanatory power of the self-compassion construct as a possible protective factor. Method The study employed a cross-sectional design. A sample of n = 440 Spanish primary healthcare professionals (214 general practitioners, 184 nurses, 42 medical residents) completed the Burnout Clinical Subtype Questionnaire (BCSQ-36), the Maslach Burnout Inventory General Survey (MBI-GS), the Self-Compassion Scale (SCS), the Utrecht Work Engagement Scale (UWES) and the Positive and Negative Affect Schedule (PANAS). The factor structure of the BCSQ-36 was estimated using confirmatory factor analysis (CFA) by the unweighted least squares method from polychoric correlations. Internal consistency (R) was assessed by squaring the correlation between the latent true variable and the observed variables. The relationships between the BCSQ-36 and the other constructs were analysed using Spearman’s r and multiple linear regression models. Results The structure of the BCSQ-36 fit the data well, with adequate CFA indices for all the burnout subtypes. Reliability was adequate for all the scales and sub-scales (R≥0.75). Self-judgement was the self-compassion factor that explained the frenetic subtype (Beta = 0.36; p<0.001); isolation explained the underchallenged (Beta = 0.16; p = 0.010); and over-identification the worn-out (Beta = 0.25; p = 0.001). Other significant associations were observed between the different burnout subtypes and the dimensions of the MBI-GS, UWES and PANAS. Conclusions The typological definition of burnout through the BCSQ-36 showed good structure and appropriate internal consistence in Spanish primary healthcare professionals. The negative self-compassion dimensions seem to play a relevant role in explaining the burnout profiles in this population, and they should be considered when designing specific treatments and interventions tailored to the specific vulnerability of each subtype. PMID:27310426

Primary teachers conducting inquiry projects: effects on attitudes towards teaching science and conducting inquiry

NASA Astrophysics Data System (ADS)

van Aalderen-Smeets, Sandra I.; Walma van der Molen, Juliette H.; van Hest, Erna G. W. C. M.; Poortman, Cindy

2017-01-01

This study used an experimental, pretest-posttest control group design to investigate whether participation in a large-scale inquiry project would improve primary teachers' attitudes towards teaching science and towards conducting inquiry. The inquiry project positively affected several elements of teachers' attitudes. Teachers felt less anxious about teaching science and felt less dependent on contextual factors compared to the control group. With regard to attitude towards conducting inquiry, teachers felt less anxious and more able to conduct an inquiry project. There were no effects on other attitude components, such as self-efficacy beliefs or relevance beliefs, or on self-reported science teaching behaviour. These results indicate that practitioner research may have a partially positive effect on teachers' attitudes, but that it may not be sufficient to fully change primary teachers' attitudes and their actual science teaching behaviour. In comparison, a previous study showed that attitude-focused professional development in science education has a more profound impact on primary teachers' attitudes and science teaching behaviour. In our view, future interventions aiming to stimulate science teaching should combine both approaches, an explicit focus on attitude change together with familiarisation with inquiry, in order to improve primary teachers' attitudes and classroom practices.

Comparison of the number of supervisors on medical student satisfaction during a child and adolescent psychiatry rotation.

PubMed

Mascioli, Kelly J; Robertson, Catharine J; Douglass, Alan B

2016-01-01

Traditionally, third-year medical students are assigned to one supervisor during their 1-week rotation in child and adolescent psychiatry. However, the majority of supervisory staff in the Division of Child and Adolescent Psychiatry opted to switch the supervision schedule to one in which some medical students are assigned to two primary supervisors. The aim of the study was to determine if students assigned to two primary supervisors had greater rotation satisfaction compared with students assigned to one primary supervisor during a 1-week clerkship rotation in child and adolescent psychiatry. A satisfaction questionnaire was sent to 110 third-year medical students who completed their child and adolescent clerkship rotation. Based on the responses, students were divided into groups depending on their number of supervisors. Questionnaire responses were compared between the groups using independent t-tests. When students who had one primary supervisor were compared to students who had two primary supervisors, the lone item showing a statistically significant difference was regarding improvement of assessment reports/progress notes. The number of supervisors does not significantly affect the satisfaction of students during a 1-week clerkship rotation in child and adolescent psychiatry. Other factors are important in rotation satisfaction.

Dynamic Testing of a Pre-stretched Flexible Tube for Identifying the Factors Affecting Modal Parameter Estimation

NASA Astrophysics Data System (ADS)

Unnikrishnan, Madhusudanan; Rajan, Akash; Basanthvihar Raghunathan, Binulal; Kochupillai, Jayaraj

2017-08-01

Experimental modal analysis is the primary tool for obtaining the fundamental dynamic characteristics like natural frequency, mode shape and modal damping ratio that determine the behaviour of any structure under dynamic loading conditions. This paper discusses about a carefully designed experimental method for calculating the dynamic characteristics of a pre-stretched horizontal flexible tube made of polyurethane material. The factors that affect the modal parameter estimation like the application time of shaker excitation, pause time between successive excitation cycles, averaging and windowing of measured signal, as well as the precautions to be taken during the experiment are explained in detail. The modal parameter estimation is done using MEscopeVESTM software. A finite element based pre-stressed modal analysis of the flexible tube is also done using ANSYS ver.14.0 software. The experimental and analytical results agreed well. The proposed experimental methodology may be extended for carrying out the modal analysis of many flexible structures like inflatables, tires and membranes.

Ambulatory rehabilitation in multiple sclerosis.

PubMed

Kelleher, Kevin John; Spence, William; Solomonidis, Stephan; Apatsidis, Dimitrios

2009-01-01

Multiple sclerosis (MS) is an autoimmunogenic disease involving demyelination within the central nervous system. Many of the typical impairments associated with MS can affect gait patterns. With walking ability being one of the most decisive factors when assessing quality of life and independent living, this review focuses on matters, which are considered of significance for maintaining and supporting ambulation. This article is an attempt to describe current research and available interventions that the caring healthcare professional can avail of and to review the present trends in research to further these available options. Evidence-based rehabilitation techniques are of interest in the care of patients with MS, given the various existing modalities of treatment. In this review, we summarise the primary factors affecting ambulation and highlight available treatment methods. We review studies that have attempted to characterise gait deficits within this patient population. Finally, as ambulatory rehabilitation requires multidisciplinary interventions, we examine approaches, which may serve to support and maintain ambulation within this patient group for as long as possible.

Effect of reducing acid etching time on bond strength to noncarious and caries-affected primary and permanent dentin.

PubMed

Scheffel, Débora Lopes Salles; Ricci, Hérica Adad; de Souza Costa, Carlos Alberto; Pashley, David Henry; Hebling, Josimeri

2013-01-01

The purpose was to evaluate the effect of acid etching time on the bond strength of a simplified etch-and-rinse adhesive system to noncarious and caries-affected dentin of primary and permanent teeth. Twenty-four extracted primary and permanent teeth were divided into three groups, according to the acid etching time. Four teeth from each group were exposed to a microbiological caries-inducing protocol. After caries removal, noncarious and caries-affected dentin surfaces were etched with 37 percent phosphoric acid for five, 10, or 15 seconds prior to the application of Prime & Bond NT adhesive. Crowns were restored with resin composite and prepared for microtensile testing. Data were submitted to Kruskal-Wallis and Mann-Whitney tests (α=0.05). Higher bond strengths were obtained for noncarious dentin vs. caries-affected dentin for both primary and permanent teeth. Reducing the acid etching time from 15 to five seconds did not affect the bond strength to caries-affected or noncarious dentin in primary teeth. For permanent teeth, lower bond strength values were observed when the noncarious dentin was etched for five seconds, while no difference was seen between 10 and 15 seconds. For Prime & Bond NT, the etching of dentin for five seconds could be recommended for primary teeth, while 10 seconds would be the minimum time for permanent teeth.

Orbit/launch vehicle tradeoff studies. Earth Observatory Satellite system definition study (EOS)

NASA Technical Reports Server (NTRS)

1974-01-01

An evaluation of the Earth Observatory Satellite (EOS) design, performance, and cost factors which affect the choices of an orbit and a launch vehicle is presented. Primary emphasis is given to low altitude (300 to 900 nautical miles) land resources management applications for which payload design factors are defined. The subjects considered are: (1) a mission model, (2) orbit analysis and characterization, (3) characteristics and capabilities of candidate conventional launch vehicles, and space shuttle support. Recommendations are submitted for the EOS-A mission, the Single Multispectral Scanner payload, the Single Multispectral Scanner plus Thematic Mapper payload, the Dual Multispectral Scanner payload, and the Dual Multispectral Scanner plus Thematic Mapper payload.

Mapping the Factors Affecting Household Food Security of Tuberculosis Patients in Coastal Region of Surabaya

NASA Astrophysics Data System (ADS)

Susilaningrum, D.; Ulama, B. S. S.; Lathifah, R.

2018-04-01

Food security is a condition of a person who has access to adequate, safe, and nutritious food to meet the needs of a healthy life. Affordability of food is determined by the aggregate purchasing power. It is also can be measured by the amount of poverty in Indonesia which reached 28,07 million in 2014. According to data from the health department, the largest TB cases in Indonesia were in East Java Province and Surabaya accounted for the largest number, there are 48379 cases in 2015. This study mapping the factors that affect household food security of TB patients in the coastal areas of Surabaya. This study used secondary data sources from 11 clinics i.e. TB patient's addres and primary data source to survey patients about food security. Variables used in this study are variables related to socioeconomic factors and sanitary factors. Those variables will be analyzed descriptively and mapping using biplot analysis. Biplot generated based on socio-economic factors, sanitary factors, and status of households in 11 districts Surabaya that near the beach geographically. The result shows that 64% of TB patient households are food insecure than the left are food secure. More than 50% of TB patient households have a good house physically. From the result of mapping between sub-districts and factors, formed five groups consisting of: 1) Benowo and Mulyorejo; 2) Asemrowo, Gunung Anyar, Sukolilo and Pabean Cantikan; 3) Semampir, Krembangan and Bulak; 4) Kenjeran; and 5) Rungkut.

Co-digestion of manure with grass silage and pulp and paper mill sludge using nutrient additions.

PubMed

Hagelqvist, Alina; Granström, Karin

2016-08-01

There is an increasing worldwide demand for biogas. Anaerobic co-digestion involves the treatment of different substrates with the aim of improving the production of biogas and the stability of the process. This study evaluates how methane production is affected by the co-digestion of pig and dairy manure with grass silage and pulp and paper mill sludge and assesses whether methane production is affected by factors other than nutrient deficiency, low buffering capacity, inadequate dilution, and an insufficient activity and amount of microorganism culture. Anaerobic digestion was performed in batch reactors under mesophilic conditions for 20 days. The season of grass silage and manure collection proved to be an important factor affecting methane production. Spring grass silage produced a maximum of 250 mL/VSadded and spring manure 150 mL/VSadded, whereas autumn grass silage produced at most 140 ml/VSadded and autumn manure 45 mL/VSadded. The pulp mill sludge used is comprised of both primary and secondary sludge and produced at most 50 mL/VSadded regardless of season; this substrate benefitted most from co-digestion.

Tumor microenvironment: Modulation by decorin and related molecules harboring leucine-rich tandem motifs.

PubMed

Goldoni, Silvia; Iozzo, Renato V

2008-12-01

Decorin, the prototype member of the small leucine-rich proteoglycans, resides in the tumor microenvironment and affects the biology of various types of cancer by downregulating the activity of several receptors involved in cell growth and survival. Decorin binds to and modulates the signaling of the epidermal growth factor receptor and other members of the ErbB family of receptor tyrosine kinases. It exerts its antitumor activity by a dual mechanism: via inhibition of these key receptors through their physical downregulation coupled with attenuation of their signaling, and by binding to and sequestering TGFbeta. Decorin also modulates the insulin-like growth factor receptor and the low-density lipoprotein receptor-related protein 1, which indirectly affects the TGFbeta receptor pathway. When expressed in tumor xenograft-bearing mice or injected systemically, decorin inhibits both primary tumor growth and metastatic spreading. In this review, we summarize the latest reports on decorin and related molecules that are relevant to cancer and bring forward the idea of decorin as an anticancer therapeutic and possible prognostic marker for patients affected by various types of tumors. We also discuss the role of lumican and LRIG1, a novel cell growth inhibitor homologous to decorin. (c) 2008 Wiley-Liss, Inc.

Observed oil and gas field size distributions: A consequence of the discovery process and prices of oil and gas

USGS Publications Warehouse

Drew, L.J.; Attanasi, E.D.; Schuenemeyer, J.H.

1988-01-01

If observed oil and gas field size distributions are obtained by random samplings, the fitted distributions should approximate that of the parent population of oil and gas fields. However, empirical evidence strongly suggests that larger fields tend to be discovered earlier in the discovery process than they would be by random sampling. Economic factors also can limit the number of small fields that are developed and reported. This paper examines observed size distributions in state and federal waters of offshore Texas. Results of the analysis demonstrate how the shape of the observable size distributions change with significant hydrocarbon price changes. Comparison of state and federal observed size distributions in the offshore area shows how production cost differences also affect the shape of the observed size distribution. Methods for modifying the discovery rate estimation procedures when economic factors significantly affect the discovery sequence are presented. A primary conclusion of the analysis is that, because hydrocarbon price changes can significantly affect the observed discovery size distribution, one should not be confident about inferring the form and specific parameters of the parent field size distribution from the observed distributions. ?? 1988 International Association for Mathematical Geology.

Factors affecting registered nurses' use of medication administration technology in acute care settings: A systematic review.

PubMed

San, Tay Hui; Lin, Serena Koh Siew; Fai, Chan Moon

Information technology to aid reduction in medication errors has been encouraged over the years and one of them is the medication administration technology. It consists of the electronic Medication Administration Record, Bar-Code Medication Administration system and Automated Medication Dispensing system. Studies had examined the effectiveness and impact of this technology to reduce medication error. However, user's acceptance towards this technology has often been neglected. To date, no systematic review has been undertaken to examine the possible factors that affect nurses' use of this technology in the acute care settings. The objective of this systematic review was to explore and determine the factors that affect nurses' use of medication administration technology in the acute care settings. All quantitative studies published in English which examined factors affecting nurses' use of the medication administration technology were considered.Primary focus was on registered nurses with experience of operating medication administration technology in the acute care settings. Other healthcare personnel were excluded.This review considered studies that evaluated factors affecting nurses' use of the medication administration technology.The outcome measures of interest were the factors that affect nurses' use of the medication administration technology in the acute care settings. The search was conducted across published and unpublished databases. A search was conducted in JBI Library of Systematic Reviews, The Cochrane Library, CINAHL, MEDLINE, Scopus, ScienceDirect, Wiley InterScience, SpringerLink, PsycINFO (ovid), Web of science, ProQuest Dissertations and Theses, and MedNar. Papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review, using the standardised critical appraisal instruments developed by the Joanna Briggs Institute. Quantitative data were extracted from papers included in the review using a standardised data extraction tool developed by the JBI. Findings were presented in narrative summary due to heterogeneity of the study designs. Six descriptive studies were included in this review. Nurses' use of the technology can be influenced by a combination of complex and inter-related factors, such as organisational factors, and user and system characteristics. In order to successfully implement medication administration technology, system, user and organisational factors have to be collaborated concurrently.Users' needs should be accommodated when designing the system features. Prior to system implementation, institutions should consider the users' demographical characteristics and provide adequate preparations and training. A supportive culture from the institution and colleagues is also important.There is a significant need for further research in this field. Further research to discover potential factors in different settings, locations and countries are suggested. Studies to evaluate nurses' use of the technology at regular intervals are also required.

Microglia: An Interface between the Loss of Neuroplasticity and Depression

PubMed Central

Singhal, Gaurav; Baune, Bernhard T.

2017-01-01

Depression has been widely accepted as a major psychiatric disease affecting nearly 350 million people worldwide. Research focus is now shifting from studying the extrinsic and social factors of depression to the underlying molecular causes. Microglial activity is shown to be associated with pathological conditions, such as psychological stress, pathological aging, and chronic infections. These are primary immune effector cells in the CNS and regulate the extensive dialogue between the nervous and the immune systems in response to different immunological, physiological, and psychological stressors. Studies have suggested that during stress and pathologies, microglia play a significant role in the disruption of neuroplasticity and have detrimental effects on neuroprotection causing neuroinflammation and exacerbation of depression. After a systematic search of literature databases, relevant articles on the microglial regulation of bidirectional neuroimmune pathways affecting neuroplasticity and leading to depression were reviewed. Although, several hypotheses have been proposed for the microglial role in the onset of depression, it is clear that all molecular pathways to depression are linked through microglia-associated neuroinflammation and hippocampal degeneration. Molecular factors such as an excess of glucocorticoids and changes in gene expression of neurotrophic factors, as well as neuro active substances secreted by gut microbiota have also been shown to affect microglial morphology and phenotype resulting in depression. This review aims to critically analyze the various molecular pathways associated with the microglial role in depression. PMID:28943841

Informing aetiologic research priorities for squamous cell oesophageal cancer in Africa: A review of setting-specific exposures to known and putative risk factors

PubMed Central

McCormack, V; Menya, D; Munishi, MO; Dzamalala, C; Gasmelseed, N; Roux, M Leon; Assefa, M; Odipo, O; Watts, M; Mwasamwaja, AO; Mmbaga, BT; Murphy, G; Abnet, CC; Dawsey, SM; Schüz, J

2018-01-01

Oesophageal squamous cell carcinoma (ESCC) is one of the most common cancers in most Eastern and Southern African countries, but its aetiology has been understudied to date. To inform its research agenda, we undertook a review to identify, of the ESCC risk factors that have been established or strongly suggested worldwide, those with a high prevalence or high exposure levels in any ESCC-affected African setting and the sources thereof. We found that for almost all ESCC risk factors known to date, including tobacco, alcohol, hot beverage consumption, nitrosamines and both inhaled and ingested PAHs, there is evidence of population groups with raised exposures, the sources of which vary greatly between cultures across the ESCC corridor. Research encompassing these risk factors is warranted and is likely to identify primary prevention strategies. PMID:27466161

Primary repair vs. colostomy in colon injuries.

PubMed

Robles-Castillo, Javier; Murillo-Zolezzi, Adrián; Murakami, Pablo Daniel; Silva-Velasco, Jorge

2009-01-01

Colon trauma is frequent and its prevalence is difficult to establish because of the different factors that intervene in its origin. In Mexico, traumatic colon injuries, albeit stab wounds or gunshot wounds, are on the rise. Our objective was to evaluate the most appropriate management for traumatic colon injuries. We conducted a retrospective study of 178 case files of patients with abdominal trauma and colon lesions during a 5-year period from January 2003 to June 2008 from the General Hospital of Balbuena, Mexico City. The study compared the use of primary closure vs. colostomy, analyzing variables such as sex, age, type of wound, severity of lesion and mortality. There were a total of 178 patients; 156 were male (87.6%) and 22 were female (12.4%). The most affected age group was between 21 and 30 years; 74 patients (41.6%) had stab wounds and 104 patients (58.4%) had gunshot wounds. Management consisted mainly of primary closure in 92 cases (51.7%) vs. colostomy in 86 patients (48.3%). However, 64% of gunshot wounds were treated with colostomy. Reported mortality was 9.55% and this was due to different factors such as multiple organ injury. Treatment of traumatic colon injury should be case specific, taking into account the mechanism of the lesion, its severity and associated injuries.

Men's Preconception Health: A Primary Health-Care Viewpoint.

PubMed

O'Brien, Anthony Paul; Hurley, John; Linsley, Paul; McNeil, Karen Anne; Fletcher, Richard; Aitken, John Robert

2018-05-01

The purpose of this article is to theoretically explore men's preconception health as a mechanism to enhance fertility, as well as the health and well-being of the subject and his descendants. Premorbid risk factors and behaviors associated with stress, environmental toxins, excessive alcohol consumption, smoking, lack of exercise/obesity, and the use of illicit drugs are all known to affect fecundity. While there are many health clinics available to women, where advice in areas such as postnatal care of the newborn, family planning, and couples fertility is provided, there are few, if any, equivalent health clinics available to men. Additionally, getting men to attend primary health-care services has also been continuously problematic, even in the context of there being a clearly discernible need for treatment. It is argued in this article that an impetus is required to encourage men to focus on and improve their preconception health and to utilize primary health-care services to take action. An assertive men's preconception health outlook can positively influence the conjugal relationship, fathering, male self-esteem, and continued good health. Using the sometimes complex concept of preconception health as a motivating factor for healthy lifestyle adaptation has the potential to improve male fertility outcomes and general health and well-being, as well as the health of future generations.

Modifiable factors in the management of glaucoma: a systematic review of current evidence.

PubMed

Hecht, Idan; Achiron, Asaf; Man, Vitaly; Burgansky-Eliash, Zvia

2017-04-01

Primary open angle glaucoma is a chronic optic neuropathy affecting millions of people worldwide and represents a major public health issue. Environmental factors, behaviors, and diet are intimately related to patient health and may play a role in the pathogenesis and progression of glaucoma. This study aims to review the literature, focusing on the last three years, regarding modifiable lifestyle interventions in the management of primary open angle glaucoma. Electronic databases were searched for studies published between January 2013 and July 2016 on the topic of lifestyle interventions in primary open angle glaucoma. Sleeping with the head elevated and avoiding the worst eye-dependent side during sleep may slightly lower intraocular pressure and reduce visual field loss. Some food supplements and moderate aerobic exercise may also reduce intraocular pressure up to 2.0 and 3.0 mmHg, respectively. Frequency of coffee intake may be associated with disease progression. Potential negative effects are associated with weight-lifting and yoga exercises. Certain lifestyle habits could influence glaucoma progression, yet no specific interventions are currently supported by robust evidence. Awareness of the possible influences of certain habits should help guide clinical advice and is important to help patients avoid adverse outcomes and take an active role in the management of their disease.

Statistical Modelling for Dropped Out School Children (DOSC) in East Nusa Tenggara Province Indonesia

NASA Astrophysics Data System (ADS)

Guntur, R. D.; Lobo, M.

2017-02-01

A research has been carried out to investigate the characteristics of reasons for DOSC and to determine the statistical model explaining factors which influence on the DOSC in the age group 7 - 18 years in East Nusa Tenggara (ENT) Province. Primary data of out of school children had been collected throughout interviews using prepared questionnaires in three selected districts. Data was then analysed using descriptive and logistic regression method. The analysis shows that from the 341 samples, there were 194DOSC. The majority of them were males, lived in the countryside, had farmer parents, had family size of 5, and had mothers with only primary education level. The main reasons of children to drop out from the primary and junior education levels were the inabilities of paying the school fees and the willingness to work in the farms to help their parents. For senior education level, it was because of the unaffordable school tuitions and no desire of children in having good education. Both partial and simultaneous parameter tests in the logistic regression model show that children who lived in countryside, from poor families, males were the three factors that significantly affected the number of DOSC in the group age with odds ratio values 2.48; 2.37; 1.97 respectively.

The Populus class III HD ZIP, popREVOLUTA, influences cambium initiation and patterning of woody stems.

PubMed

Robischon, Marcel; Du, Juan; Miura, Eriko; Groover, Andrew

2011-03-01

The secondary growth of a woody stem requires the formation of a vascular cambium at an appropriate position and proper patterning of the vascular tissues derived from the cambium. Class III homeodomain-leucine zipper (HD ZIP) transcription factors have been implicated in polarity determination and patterning in lateral organs and primary vascular tissues and in the initiation and function of shoot apical meristems. We report here the functional characterization of a Populus class III HD ZIP gene, popREVOLUTA (PRE), that demonstrates another role for class III HD ZIPs in regulating the development of cambia and secondary vascular tissues. PRE is orthologous to Arabidopsis (Arabidopsis thaliana) REVOLUTA and is expressed in both the shoot apical meristem and in the cambial zone and secondary vascular tissues. Transgenic Populus expressing a microRNA-resistant form of PRE presents unstable phenotypic abnormalities affecting both primary and secondary growth. Surprisingly, phenotypic changes include abnormal formation of cambia within cortical parenchyma that can produce secondary vascular tissues in reverse polarity. Genes misexpressed in PRE mutants include transcription factors and auxin-related genes previously implicated in class III HD ZIP functions during primary growth. Together, these results suggest that PRE plays a fundamental role in the initiation of the cambium and in regulating the patterning of secondary vascular tissues.

Factors affecting motivation and retention of primary health care workers in three disparate regions in Kenya.

PubMed

Ojakaa, David; Olango, Susan; Jarvis, Jordan

2014-06-06

The World Health Organization (WHO) and the Government of Kenya alike identify a well-performing health workforce as key to attaining better health. Nevertheless, the motivation and retention of health care workers (HCWs) persist as challenges. This study investigated factors influencing motivation and retention of HCWs at primary health care facilities in three different settings in Kenya - the remote area of Turkana, the relatively accessible region of Machakos, and the disadvantaged informal urban settlement of Kibera in Nairobi. A cross-sectional cluster sample design was used to select 59 health facilities that yielded interviews with 404 health care workers, grouped into 10 different types of service providers. Data were collected in November 2011 using structured questionnaires and a Focus Group Discussion guide. Findings were analyzed using bivariate and multivariate methods of the associations and determinants of health worker motivation and retention. The levels of education and gender factors were lowest in Turkana with female HCWs representing only 30% of the workers against a national average of 53%. A smaller proportion of HCWs in Turkana feel that they have adequate training for their jobs. Overall, 13% of the HCWs indicated that they had changed their job in the last 12 months and 20% indicated that they could leave their current job within the next two years. In terms of work environment, inadequate access to electricity, equipment, transport, housing, and the physical state of the health facility were cited as most critical, particularly in Turkana. The working environment is rated as better in private facilities. Adequate training, job security, salary, supervisor support, and manageable workload were identified as critical satisfaction factors. Family health care, salary, and terminal benefits were rated as important compensatory factors. There are distinct motivational and retention factors that affect HCWs in the three regions. Findings and policy implications from this study point to a set of recommendations to be implemented at national and county levels. These include gender mainstreaming, development of appropriate retention schemes, competitive compensation packages, strategies for career growth, establishment of a model HRH community, and the conduct of a discrete choice experiment.

Factors affecting motivation and retention of primary health care workers in three disparate regions in Kenya

PubMed Central

2014-01-01

Background The World Health Organization (WHO) and the Government of Kenya alike identify a well-performing health workforce as key to attaining better health. Nevertheless, the motivation and retention of health care workers (HCWs) persist as challenges. This study investigated factors influencing motivation and retention of HCWs at primary health care facilities in three different settings in Kenya - the remote area of Turkana, the relatively accessible region of Machakos, and the disadvantaged informal urban settlement of Kibera in Nairobi. Methods A cross-sectional cluster sample design was used to select 59 health facilities that yielded interviews with 404 health care workers, grouped into 10 different types of service providers. Data were collected in November 2011 using structured questionnaires and a Focus Group Discussion guide. Findings were analyzed using bivariate and multivariate methods of the associations and determinants of health worker motivation and retention. Results The levels of education and gender factors were lowest in Turkana with female HCWs representing only 30% of the workers against a national average of 53%. A smaller proportion of HCWs in Turkana feel that they have adequate training for their jobs. Overall, 13% of the HCWs indicated that they had changed their job in the last 12 months and 20% indicated that they could leave their current job within the next two years. In terms of work environment, inadequate access to electricity, equipment, transport, housing, and the physical state of the health facility were cited as most critical, particularly in Turkana. The working environment is rated as better in private facilities. Adequate training, job security, salary, supervisor support, and manageable workload were identified as critical satisfaction factors. Family health care, salary, and terminal benefits were rated as important compensatory factors. Conclusions There are distinct motivational and retention factors that affect HCWs in the three regions. Findings and policy implications from this study point to a set of recommendations to be implemented at national and county levels. These include gender mainstreaming, development of appropriate retention schemes, competitive compensation packages, strategies for career growth, establishment of a model HRH community, and the conduct of a discrete choice experiment. PMID:24906964

Factors Affecting Choice of Specialty Among First-year Medical Students of Four Universities in Different Regions of Turkey

PubMed Central

Dikici, Mustafa Fevzi; Yaris, Fusun; Topsever, Pinar; Filiz, Tuncay Muge; Gurel, Fazil Serdar; Cubukcu, Mahcube; Gorpelioglu, Suleyman

2008-01-01

Aim To determine the factors affecting medical students’ choice of the specialty of family medicine. Methods The study was conducted in the period from 2004-2006 and comprised 770 first-year medical students from Ondokuz Mayis, Karadeniz Technical, Kocaeli, and Adnan Menderes Universities, Turkey. The questionnaire included questions on demographic data and 6 “yes/no” or open-ended questions on students’ career aspirations and the specialty of family medicine. Results The response rate was 93.1% (n = 717, 54.7% male). Nearly all students (n = 714, 99.6%) showed an intention to specialize after receiving the medical doctor degree. A total of 187 students (26.2%) showed an intention to work in primary care without specialization “for a temporary period” to “gain some experience.” Family medicine was the least preferred specialty (n = 7, 0.9%). The most important reasons for the choice of specialty were “better financial opportunities” and “prestige” (n = 219, 30.5%), followed by “personal development” (n = 149, 20.8%), “more benefits for the patient” (n = 128, 17.9%), and “wish to work in an urban area” (n = 32, 4.5%). The most preferred specialties were cardiology (n = 179, 25.0%), pediatrics (n = 121, 16.9%), ophthalmology (n = 47, 6.6%), physical therapy and rehabilitation (n = 34, 4.7%), and obstetrics and gynecology (n = 32, 4.5%). Conclusion Prestige, money, and personal development are important factors in career decision-making among medical students in Turkey. This should be taken into consideration when conducting reforms at the primary level. PMID:18581621

Stromal derived factor-1 regulates bone morphogenetic protein 2-induced osteogenic differentiation of primary mesenchymal stem cells

PubMed Central

Hosogane, Naobumi; Huang, Zhiping; Rawlins, Bernard A.; Liu, Xia; Boachie-Adjei, Oheneba; Boskey, Adele L.; Zhu, Wei

2010-01-01

Stromal derived factor-1 (SDF-1) is a chemokine signaling molecule that binds to its transmembrane receptor CXC chemokine receptor-4 (CXCR4). While we previously detected that SDF-1 was co-required with bone morphogenetic protein 2 (BMP2) for differentiating mesenchymal C2C12 cells into osteoblastic cells, it is unknown whether SDF-1 is similarly involved in the osteogenic differentiation of mesenchymal stem cells (MSCs). Therefore, here we examined the role of SDF-1 signaling during BMP2-induced osteogenic differentiation of primary MSCs that were derived from human and mouse bone marrow. Our data showed that blocking of the SDF-1/CXCR4 signal axis or adding SDF-1 protein to MSCs significantly affected BMP2-induced alkaline phosphatase (ALP) activity and osteocalcin (OCN) synthesis, markers of preosteoblasts and mature osteoblasts, respectively. Moreover, disrupting the SDF-1 signaling impaired bone nodule mineralization during terminal differentiation of MSCs. Furthermore, we detected that blocking of the SDF-1 signaling inhibited the BMP2-induced early expression of Runt-related factor-2 (Runx2) and osterix (Osx), two “master” regulators of osteogenesis, and the SDF-1 effect was mediated via intracellular Smad and Erk activation. In conclusion, our results demonstrated a regulatory role of SDF-1 in BMP2-induced osteogenic differentiation of MSCs, as perturbing the SDF-1 signaling affected the differentiation of MSCs towards osteoblastic cells in response to BMP2 stimulation. These data provide novel insights into molecular mechanisms underlying MSC osteogenesis, and will contribute to the development of MSC therapies for enhancing bone formation and regeneration in broad orthopaedic situations. PMID:20362069

Citizen's Charter in a primary health-care setting of Nepal: An accountability tool or a "mere wall poster"?

PubMed

Gurung, Gagan; Gauld, Robin; Hill, Philip C; Derrett, Sarah

2018-02-01

Despite some empirical findings on the usefulness of citizen's charters on awareness of rights and services, there is a dearth of literature about charter implementation and impact on health service delivery in low-income settings. To gauge the level of awareness of the Charter within Nepal's primary health-care (PHC) system, perceived impact and factors affecting Charter implementation. Using a case study design, a quantitative survey was administered to 400 participants from 22 of 39 PHC facilities in the Dang District to gauge awareness of the Charter. Additionally, qualitative interviews with 39 key informants were conducted to explore the perceived impact of the Charter and factors affecting its implementation. Few service users (15%) were aware of the existence of the Charter. Among these, a greater proportion were literate, and there were also differences according to ethnicity and occupational group. The Charter was usually not properly displayed and had been implemented with no prior public consultation. It contained information that provided awareness of health facility services, particularly the more educated public, but had limited potential for increasing transparency and holding service providers accountable to citizens. Proper display, consultation with stakeholders, orientation or training and educational factors, follow-up and monitoring, and provision of sanctions were all lacking, negatively influencing the implementation of the Charter. Poor implementation and low public awareness of the Charter limit its usefulness. Provision of sanctions and consultation with citizens in Charter development are needed to expand the scope of Charters from information brochures to tools for accountability. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Reducing the physician workforce crisis: Career choice and graduate medical education reform in an emerging Arab country.

PubMed

Ibrahim, Halah; Nair, Satish Chandrasekhar; Shaban, Sami; El-Zubeir, Margaret

2016-01-01

In today's interdependent world, issues of physician shortages, skill imbalances and maldistribution affect all countries. In the United Arab Emirates (UAE), a nation that has historically imported its physician manpower, there is sustained investment in educational infrastructure to meet the population's healthcare needs. However, policy development and workforce planning are often hampered by limited data regarding the career choice of physicians-in-training. The purpose of this study was to determine the specialty career choice of applicants to postgraduate training programs in the UAE and factors that influence their decisions, in an effort to inform educational and health policy reform. To our knowledge, this is the first study of career preferences for UAE residency applicants. All applicants to residency programs in the UAE in 2013 were given an electronic questionnaire, which collected demographic data, specialty preference, and factors that affected their choice. Differences were calculated using the t-test statistic. Of 512 applicants, 378 participated (74%). The most preferred residency programs included internal medicine, pediatrics, emergency medicine and family medicine. A variety of clinical experience, academic reputation of the hospital, and international accreditation were leading determinants of career choice. Potential future income was not a significant contributing factor. Applicants to UAE residency programs predominantly selected primary care careers, with the exception of obstetrics. The results of this study can serve as a springboard for curricular and policy changes throughout the continuum of medical education, with the ultimate goal of training future generations of primary care clinicians who can meet the country's healthcare needs. As 65% of respondents trained in medical schools outside of the UAE, our results may be indicative of medical student career choice in countries throughout the Arab world.

Differentiated and Medullary Thyroid Cancer: Surgical Management of Cervical Lymph Nodes

PubMed Central

Asimakopoulos, P.; Nixon, I.J.; Shaha, A.R.

2017-01-01

Thyroid cancer metastasises to the central and lateral compartments of the neck frequently and early. The impact of nodal metastases on outcome is affected by the histological subtype of the primary tumour and the patient’s age, as well as the size, number and location of those metastases. The impact of extranodal extension has recently been highlighted as an important prognosticating factor. Although clinically evident nodal disease in the lateral neck compartments has a significant impact on both survival and recurrence, microscopic metastases to the central or the lateral neck in well-differentiated thyroid cancer do not significantly affect outcome. Here we discuss the surgical management of neck metastases in well-differentiated and medullary thyroid carcinoma. PMID:28094086

Interactive effect of negative affectivity and anxiety sensitivity in terms of mental health among Latinos in primary care.

PubMed

Zvolensky, Michael J; Paulus, Daniel J; Bakhshaie, Jafar; Garza, Monica; Ochoa-Perez, Melissa; Medvedeva, Angela; Bogiaizian, Daniel; Robles, Zuzuky; Manning, Kara; Schmidt, Norman B

2016-09-30

From a public health perspective, primary care medical settings represent a strategic location to address mental health disapirty among Latinos. Yet, there is little empirical work that addresses affective vulnerability processes for mental health problems in such settings. To help address this gap in knowledge, the present investigation examined an interactive model of negative affectivity (tendency to experience negative mood states) and anxiety sensitivity (fear of the negative consequences of aversive sensations) among a Latino sample in primary care in terms of a relatively wide range of anxiety/depression indices. Participants included 390 Latino adults (Mage=38.7, SD=11.3; 86.9% female; 95.6% reported Spanish as first language) from a primary care health clinic. Primary dependent measures included depressive, suicidal, social anxiety, and anxious arousal symptoms, number of mood and anxiety disorders, and disability. Consistent with prediction, the interaction between negative affectivity and anxiety sensitivity was significantly related to suicidal, social anxiety, and anxious arousal symptoms, as well as number of mood/anxiety diagnoses and disability among the primary care Latino sample. The form of the interactions indicated a synergistic effect, such that the greatest levels of each outcome were found among those with high negative affectivity and high anxiety sensitivity. There was a trending interaction for depressive symptoms. Overall, these data provide novel empirical evidence suggesting that there is a clinically-relevant interplay between anxiety sensitivity and negative affectivity in regard to the expression of anxiety and depressive symptoms among a Latino primary care sample. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Let us fight and support one another: adolescent girls and young women on contributors and solutions to HIV risk in Zambia

PubMed Central

Butts, Stefani A; Parmley, Lauren E; Alcaide, Maria L; Rodriguez, Violeta J; Kayukwa, Annette; Chitalu, Ndashi; Weiss, Stephen M; Jones, Deborah L

2017-01-01

In Zambia, adolescent girls and young women (AGYW) are disproportionately affected by human immunodeficiency virus (HIV), social, cultural and economic factors making them particularly vulnerable. This study was designed to understand the context in which AGYW are at risk and to identify perceived drivers of the epidemic and potential strategies to reduce HIV risk. Focus group discussions were conducted with AGYW in Zambian districts with the highest HIV prevalence from February through August 2016. The focus group guide addressed HIV risk factors and strategies for HIV prevention in AGYW. Focus group discussions were recorded, translated and transcribed, themes identified and responses coded. Results suggest that gender inequality undermined potentially protective factors against HIV among AGYW. Poverty and stigmatization were major barriers to accessing available HIV prevention services as well as primary risk factors for HIV infection. Sponsorship to support AGYW school attendance, programs for boys and girls to foster gender equality and financial assistance from the government of Zambia to support AGYW most in need were proposed as strategies to reduce HIV risk. Results highlight the utility of using community-based research to guide potential interventions for the affected population. Future research should explore the use of multilevel interventions to combat HIV among AGYW. PMID:29033613

Feasibility, efficacy, and predictive factors for the technical success of endoscopic nasogallbladder drainage: a prospective study.

PubMed

Yane, Kei; Maguchi, Hiroyuki; Katanuma, Akio; Takahashi, Kuniyuki; Osanai, Manabu; Kin, Toshifumi; Takaki, Ryo; Matsumoto, Kazuyuki; Gon, Katsushige; Matsumori, Tomoaki; Tomonari, Akiko; Nojima, Masanori

2015-03-01

Several studies have shown the useful-ness of endoscopic nasogallbladder drainage (ENGBD) in patients with acute cholecystitis. However, the procedure is difficult, and factors that affect technical success have not yet been clarified. We conducted a prospective study to eval-uate the technical feasibility, efficacy, and predictive factors for the technical success of ENGBD in patients with acute cholecystitis. All patients with moderate or severe acute cholecystitis who were enrolled underwent ENGBD between April 2009 and April 2011. Patients with surgically altered anatomy or pancreatobiliary malignancies were ex-cluded. The primary outcomes included technical success, clinical success, and complications. Factors that could affect the technical success were also examined. Of the 27 patients who underwent ENGBD during the study period, technical success was achieved in 21 (78%) and clinical improvement was achieved in 20 (95%). Early complications were encountered in four patients (15%). Gallbladder wall thickness (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.08 to 2.47) and age (OR, 1.16; 95% CI, 1.00 to 1.35) were effective predictors of technical failure. ENGBD was effective in resolving acute cholecystitis; however, this modality was technically challenging and had a limited suc-cess rate. Because of technical difficulties, ENGBD should be reserved for limited indications. (Gut Liver, 2015;9239-246).

Let us fight and support one another: adolescent girls and young women on contributors and solutions to HIV risk in Zambia.

PubMed

Butts, Stefani A; Parmley, Lauren E; Alcaide, Maria L; Rodriguez, Violeta J; Kayukwa, Annette; Chitalu, Ndashi; Weiss, Stephen M; Jones, Deborah L

2017-01-01

In Zambia, adolescent girls and young women (AGYW) are disproportionately affected by human immunodeficiency virus (HIV), social, cultural and economic factors making them particularly vulnerable. This study was designed to understand the context in which AGYW are at risk and to identify perceived drivers of the epidemic and potential strategies to reduce HIV risk. Focus group discussions were conducted with AGYW in Zambian districts with the highest HIV prevalence from February through August 2016. The focus group guide addressed HIV risk factors and strategies for HIV prevention in AGYW. Focus group discussions were recorded, translated and transcribed, themes identified and responses coded. Results suggest that gender inequality undermined potentially protective factors against HIV among AGYW. Poverty and stigmatization were major barriers to accessing available HIV prevention services as well as primary risk factors for HIV infection. Sponsorship to support AGYW school attendance, programs for boys and girls to foster gender equality and financial assistance from the government of Zambia to support AGYW most in need were proposed as strategies to reduce HIV risk. Results highlight the utility of using community-based research to guide potential interventions for the affected population. Future research should explore the use of multilevel interventions to combat HIV among AGYW.

Race/Ethnic Differences in the Associations of the Framingham Risk Factors with Carotid IMT and Cardiovascular Events

PubMed Central

Hoefer, Imo E.; Eijkemans, Marinus J. C.; Asselbergs, Folkert W.; Anderson, Todd J.; Britton, Annie R.; Dekker, Jacqueline M.; Engström, Gunnar; Evans, Greg W.; de Graaf, Jacqueline; Grobbee, Diederick E.; Hedblad, Bo; Holewijn, Suzanne; Ikeda, Ai; Kitagawa, Kazuo; Kitamura, Akihiko; de Kleijn, Dominique P. V.; Lonn, Eva M.; Lorenz, Matthias W.; Mathiesen, Ellisiv B.; Nijpels, Giel; Okazaki, Shuhei; O’Leary, Daniel H.; Pasterkamp, Gerard; Peters, Sanne A. E.; Polak, Joseph F.; Price, Jacqueline F.; Robertson, Christine; Rembold, Christopher M.; Rosvall, Maria; Rundek, Tatjana; Salonen, Jukka T.; Sitzer, Matthias; Stehouwer, Coen D. A.; Bots, Michiel L.; den Ruijter, Hester M.

2015-01-01

Background Clinical manifestations and outcomes of atherosclerotic disease differ between ethnic groups. In addition, the prevalence of risk factors is substantially different. Primary prevention programs are based on data derived from almost exclusively White people. We investigated how race/ethnic differences modify the associations of established risk factors with atherosclerosis and cardiovascular events. Methods We used data from an ongoing individual participant meta-analysis involving 17 population-based cohorts worldwide. We selected 60,211 participants without cardiovascular disease at baseline with available data on ethnicity (White, Black, Asian or Hispanic). We generated a multivariable linear regression model containing risk factors and ethnicity predicting mean common carotid intima-media thickness (CIMT) and a multivariable Cox regression model predicting myocardial infarction or stroke. For each risk factor we assessed how the association with the preclinical and clinical measures of cardiovascular atherosclerotic disease was affected by ethnicity. Results Ethnicity appeared to significantly modify the associations between risk factors and CIMT and cardiovascular events. The association between age and CIMT was weaker in Blacks and Hispanics. Systolic blood pressure associated more strongly with CIMT in Asians. HDL cholesterol and smoking associated less with CIMT in Blacks. Furthermore, the association of age and total cholesterol levels with the occurrence of cardiovascular events differed between Blacks and Whites. Conclusion The magnitude of associations between risk factors and the presence of atherosclerotic disease differs between race/ethnic groups. These subtle, yet significant differences provide insight in the etiology of cardiovascular disease among race/ethnic groups. These insights aid the race/ethnic-specific implementation of primary prevention. PMID:26134404

Race/Ethnic Differences in the Associations of the Framingham Risk Factors with Carotid IMT and Cardiovascular Events.

PubMed

Gijsberts, Crystel M; Groenewegen, Karlijn A; Hoefer, Imo E; Eijkemans, Marinus J C; Asselbergs, Folkert W; Anderson, Todd J; Britton, Annie R; Dekker, Jacqueline M; Engström, Gunnar; Evans, Greg W; de Graaf, Jacqueline; Grobbee, Diederick E; Hedblad, Bo; Holewijn, Suzanne; Ikeda, Ai; Kitagawa, Kazuo; Kitamura, Akihiko; de Kleijn, Dominique P V; Lonn, Eva M; Lorenz, Matthias W; Mathiesen, Ellisiv B; Nijpels, Giel; Okazaki, Shuhei; O'Leary, Daniel H; Pasterkamp, Gerard; Peters, Sanne A E; Polak, Joseph F; Price, Jacqueline F; Robertson, Christine; Rembold, Christopher M; Rosvall, Maria; Rundek, Tatjana; Salonen, Jukka T; Sitzer, Matthias; Stehouwer, Coen D A; Bots, Michiel L; den Ruijter, Hester M

2015-01-01

Clinical manifestations and outcomes of atherosclerotic disease differ between ethnic groups. In addition, the prevalence of risk factors is substantially different. Primary prevention programs are based on data derived from almost exclusively White people. We investigated how race/ethnic differences modify the associations of established risk factors with atherosclerosis and cardiovascular events. We used data from an ongoing individual participant meta-analysis involving 17 population-based cohorts worldwide. We selected 60,211 participants without cardiovascular disease at baseline with available data on ethnicity (White, Black, Asian or Hispanic). We generated a multivariable linear regression model containing risk factors and ethnicity predicting mean common carotid intima-media thickness (CIMT) and a multivariable Cox regression model predicting myocardial infarction or stroke. For each risk factor we assessed how the association with the preclinical and clinical measures of cardiovascular atherosclerotic disease was affected by ethnicity. Ethnicity appeared to significantly modify the associations between risk factors and CIMT and cardiovascular events. The association between age and CIMT was weaker in Blacks and Hispanics. Systolic blood pressure associated more strongly with CIMT in Asians. HDL cholesterol and smoking associated less with CIMT in Blacks. Furthermore, the association of age and total cholesterol levels with the occurrence of cardiovascular events differed between Blacks and Whites. The magnitude of associations between risk factors and the presence of atherosclerotic disease differs between race/ethnic groups. These subtle, yet significant differences provide insight in the etiology of cardiovascular disease among race/ethnic groups. These insights aid the race/ethnic-specific implementation of primary prevention.

Survival in cats with primary and secondary cardiomyopathies.

PubMed

Spalla, Ilaria; Locatelli, Chiara; Riscazzi, Giulia; Santagostino, Sara; Cremaschi, Elena; Brambilla, Paola

2016-06-01

Feline cardiomyopathies (CMs) represent a heterogeneous group of myocardial diseases. The most common CM is hypertrophic cardiomyopathy (HCM), followed by restrictive cardiomyopathy (RCM). Studies comparing survival and outcome for different types of CM are scant. Furthermore, little is known about the cardiovascular consequences of systemic diseases on survival. The aim of this retrospective study was to compare survival and prognostic factors in cats affected by HCM, RCM or secondary CM referred to our institution over a 10 year period. The study included 94 cats with complete case records and echocardiographic examination. Fifty cats presented HCM, 14 RCM and 30 secondary CM. A statistically significant difference in survival time was identified for cats with HCM (median survival time of 865 days), RCM (273 days) and secondary CM (<50% cardiac death rate). In the overall population and in the primary CM group (HCM + RCM), risk factors in the multivariate analysis, regardless of the CM considered, were the presence of clinical signs, an increased left atrial to aortic root (LA/Ao) ratio and a hypercoagulable state. Primary CMs in cats share some common features (ie, LA dimension and hypercoagulable state) linked to feline cardiovascular physiology, which influence survival greatly in end-stage CM. The presence of clinical signs has to be regarded as a marker of disease severity, regardless of the underlying CM. Secondary CMs are more benign conditions, but if the primary disease is not properly managed, the prognosis might also be poor in this group of patients. © ISFM and AAFP 2015.

Factors Affecting Loss of Tympanic Membrane Mobility in Acute Otitis Media Model of Chinchilla

PubMed Central

Guan, Xiying; Chen, Yongzheng; Gan, Rong Z.

2014-01-01

Recently we reported that middle ear pressure (MEP), middle ear effusion (MEE), and ossicular changes each contribute to the loss of tympanic membrane (TM) mobility in a guinea pig model of acute otitis media (AOM) induced by S. pneumoniae (Guan and Gan, 2013). However, it is not clear how those factors vary along the course of the disease and whether those effects are reproducible in different species. In this study, a chinchilla AOM model was produced by transbullar injection of Haemophilus influenzae. Mobility of the TM at the umbo was measured by laser vibrometry in two treatment groups: 4 days (4D) and 8 days (8D) post inoculation. These time points represent relatively early and later phases of AOM. In each group, the vibration of the umbo was measured at three experimental stages: unopened, pressure-released, and effusion-removed ears. The effects of MEP and MEE and middle ear structural changes were quantified in each group by comparing the TM mobility at one stage with that of the previous stage. Our findings show that the factors affecting TM mobility do change with the disease time course. The MEP was the dominant contributor to reduction of TM mobility in 4D AOM ears, but showed little effect in 8D ears when MEE filled the tympanic cavity. MEE was the primary factor affecting TM mobility loss in 8D ears, but affected the 4D ears only at high frequencies. After the release of MEP and removal of MEE, residual loss of TM mobility was seen mainly at low frequencies in both 4D and 8D ears, and was associated with middle ear structural changes. Our findings establish that the factors contributing to TM mobility loss in the chinchilla ear were similar to those we reported previously for the guinea pig ears with AOM. Outcomes did not appear to differ between the two major bacterial species causing AOM in these animal models. PMID:24406734

Electron beam induced etching of carbon nanotubes enhanced by secondary electrons in oxygen.

PubMed

Yoshida, Hideto; Tomita, Yuto; Soma, Kentaro; Takeda, Seiji

2017-05-12

Multi-walled carbon nanotubes (CNTs) are subjected to electron-beam-induced etching (EBIE) in oxygen. The EBIE process is observed in situ by environmental transmission electron microscopy. The partial pressure of oxygen (10 and 100 Pa), energy of the primary electrons (80 and 200 keV), and environment of the CNTs (suspended or supported on a silicon nitride membrane) are investigated as factors affecting the etching rate. The EBIE rate of CNTs was markedly promoted by the effects of secondary electrons that were emitted from a silicon nitride membrane under irradiation by primary electrons. Membrane supported CNTs can be cut by EBIE with a spatial accuracy better than 3 nm, and a nanogap of 2 nm can be successfully achieved between the ends of two suspended CNTs.