Effect of Computer Animation Technique on Students' Comprehension of the "Solar System and Beyond" Unit in the Science and Technology Course

ERIC Educational Resources Information Center

Aksoy, Gokhan

2013-01-01

The purpose of this study is to determine the effect of computer animation technique on academic achievement of students in the "Solar System and Beyond" unit lecture as part of the Science and Technology course of the seventh grade in primary education. The sample of the study consists of 60 students attending to the 7th grade of primary school…

Prevalence and factors associated with breast milk donation in banks that receive human milk in primary health care units.

PubMed

Meneses, Tatiana Mota Xavier de; Oliveira, Maria Inês Couto de; Boccolini, Cristiano Siqueira

To estimate the prevalence and to analyze factors associated with breast milk donation at primary health care units in order to increase the human milk bank reserves. Cross-sectional study carried out in 2013 in Rio de Janeiro, Brazil. A representative sample of 695 mothers of children younger than 1 year attended to at the nine primary health care units with human milk donation services were interviewed. A hierarchical approach was used to obtain adjusted prevalence ratios (APR) by Poisson regression with robust variance. The final model included the variables associated with breast milk donation (p≤0.05). 7.3% of the mothers had donated breast milk. Having been encouraged to donate breast milk by healthcare professionals, relatives, or friends (APR=7.06), receiving information on breast milk expression by the primary health care unit (APR=3.65), and receiving help from the unit professionals to breastfeed (APR=2.24) were associated with a higher prevalence of donation. Admission of the newborn to the neonatal unit was associated with a lower prevalence of donation (APR=0.09). Encouragement to breast milk donation, and information and help provided by primary health care unit professionals to breastfeeding were shown to be important for the practice of human milk donation. Copyright © 2017. Published by Elsevier Editora Ltda.

Groundwater-Quality Data in the South Coast Range-Coastal Study Unit, 2008: Results from the California GAMA Program

USGS Publications Warehouse

Mathany, Timothy M.; Burton, Carmen A.; Land, Michael; Belitz, Kenneth

2010-01-01

Groundwater quality in the approximately 766-square-mile South Coast Range-Coastal (SCRC) study unit was investigated from May to December 2008, as part of the Priority Basins Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The GAMA Priority Basins Project was developed in response to legislative mandates (Supplemental Report of the 1999 Budget Act 1999-00 Fiscal Year; and, the Groundwater Quality Monitoring Act of 2001 [Sections 10780-10782.3 of the California Water Code, Assembly Bill 599]) to assess and monitor the quality of groundwater in California, and is being conducted by the U.S. Geological Survey (USGS) in cooperation with the California State Water Resources Control Board (SWRCB). The SCRC study unit was the 25th study unit to be sampled as part of the GAMA Priority Basins Project. The SCRC study unit was designed to provide a spatially unbiased assessment of untreated groundwater quality in the primary aquifer systems and to facilitate statistically consistent comparisons of untreated groundwater quality throughout California. The primary aquifer systems (hereinafter referred to as primary aquifers) were defined as that part of the aquifer corresponding to the perforation interval of wells listed in the California Department of Public Health (CDPH) database for the SCRC study unit. The quality of groundwater in shallow or deep water-bearing zones may differ from the quality of groundwater in the primary aquifers; shallow groundwater may be more vulnerable to surficial contamination. In the SCRC study unit, groundwater samples were collected from 70 wells in two study areas (Basins and Uplands) in Santa Barbara and San Luis Obispo Counties. Fifty-five of the wells were selected using a spatially distributed, randomized grid-based method to provide statistical representation of the study unit (grid wells), and 15 wells were selected to aid in evaluation of specific water-quality issues (understanding wells). In addition to the 70 wells sampled, 3 surface-water samples were collected in streams near 2 of the sampled wells in order to better comprehend the interaction between groundwater and surface water in the area. The groundwater samples were analyzed for organic constituents (volatile organic compounds [VOC], pesticides and pesticide degradates, polar pesticides and metabolites, and pharmaceutical compounds), constituents of special interest (perchlorate, N-nitrosodimethylamine [NDMA], and 1,2,3-TCP), naturally occurring inorganic constituents (trace elements, nutrients, dissolved organic carbon [DOC], major and minor ions, silica, total dissolved solids [TDS], and alkalinity), and radioactive constituents (gross alpha and gross beta radioactivity). Naturally occurring isotopes (stable isotopes of hydrogen and oxygen in water, stable isotopes of nitrogen and oxygen in dissolved nitrate, stable isotopes of sulfur in dissolved sulfate, stable isotopes of carbon in dissolved inorganic carbon, activities of tritium, and carbon-14 abundance), and dissolved gases (including noble gases) also were measured to help identify the sources and ages of the sampled groundwater. In total, 298 constituents and field water-quality indicators were investigated. Three types of quality-control samples (blanks, replicates, and matrix-spikes) were collected at approximately 3 to 12 percent of the wells in the SCRC study unit, and the results for these samples were used to evaluate the quality of the data for the groundwater samples. Field blanks rarely contained detectable concentrations of any constituent, suggesting that contamination from sample collection procedures was not a significant source of bias in the data for the groundwater samples. Differences between replicate samples generally were less than 10 percent relative and/or standard deviation, indicating acceptable analytical reproducibility. Matrix-spike recoveries were within the acceptable range (70 to 130 percent) for approximately 84

Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, January -- June 2013

MedlinePlus

... Park, NC) to account for the complex sample design of NHIS, taking into account stratum and primary sampling unit (PSU) identifiers. The Taylor series linearization method was chosen for variance estimation. Trends ...

Unit 802: Language Varies with Approach.

ERIC Educational Resources Information Center

Minnesota Univ., Minneapolis. Center for Curriculum Development in English.

This eighth-grade language unit stresses developing the student's sensitivity to variations in language, primarily the similarities and differences between spoken and written language. Through sample lectures and discussion questions, the students are helped to form generalizations about language: that speech is the primary form of language; that…

NASA/BLM APT, phase 2. Volume 2: Technology demonstration. [Arizona

NASA Technical Reports Server (NTRS)

1981-01-01

Techniques described include: (1) steps in the preprocessing of LANDSAT data; (2) the training of a classifier; (3) maximum likelihood classification and precision; (4) geometric correction; (5) class description; (6) digitizing; (7) digital terrain data; (8) an overview of sample design; (9) allocation and selection of primary sample units; (10) interpretation of secondary sample units; (11) data collection ground plots; (12) data reductions; (13) analysis for productivity estimation and map verification; (14) cost analysis; and (150) LANDSAT digital products. The evaluation of the pre-inventory planning for P.J. is included.

Geochemical surveys in the United States in relation to health.

USGS Publications Warehouse

Tourtelot, H.A.

1979-01-01

Geochemical surveys in relation to health may be classified as having one, two or three dimensions. One-dimensional surveys examine relations between concentrations of elements such as Pb in soils and other media and burdens of the same elements in humans, at a given time. The spatial distributions of element concentrations are not investigated. The primary objective of two-dimensional surveys is to map the distributions of element concentrations, commonly according to stratified random sampling designs based on either conceptual landscape units or artificial sampling strata, but systematic sampling intervals have also been used. Political units have defined sample areas that coincide with the units used to accumulate epidemiological data. Element concentrations affected by point sources have also been mapped. Background values, location of natural or technological anomalies and the geographic scale of variation for several elements often are determined. Three-dimensional surveys result when two-dimensional surveys are repeated to detect environmental changes. -Author

National traffic speeds survey I: 2007 : traffic tech.

DOT National Transportation Integrated Search

2012-09-01

The speed survey reviewed in this edition of "Traffic Tech" was designed as a geographic cluster : sample of primary sampling units (PSUs), which can be : a city, county, or group of two or three counties. PSUs : were chosen to represent a range of c...

How Do Primary Grade Teachers Teach Handwriting? A National Survey

ERIC Educational Resources Information Center

Graham, Steve; Harris, Karen R.; Mason, Linda; Fink-Chorzempa, Barbara; Moran, Susan; Saddler, Bruce

2008-01-01

A random sample of primary grade teachers from across the United States was surveyed about their instructional practices in handwriting. Nine out of every ten teachers indicated that they taught handwriting, averaging 70 minutes of instruction per week. Only 12% of teachers, however, indicated that the education courses taken in college adequately…

The first aluminum coating of the 3700mm primary mirror of the Devasthal Optical Telescope

NASA Astrophysics Data System (ADS)

Bheemireddy, Krishna Reddy; Gopinathan, Maheswar; Pant, Jayshreekar; Omar, Amitesh; Kumar, Brijesh; Uddin, Wahab; Kumar, Nirmal

2016-07-01

Initially the primary mirror of the 3.6m Devasthal Optical Telescope is uncoated polished zerodur glass supplied by Lytkarino Optical Glass Factory, Russia/Advanced Mechanical and Optical Systems, Belgium. In order to do the aluminium coating on the primary mirror the coating plant including washing unit is installed near the telescope (extension building of telescope) by Hind High Vacuum (HHV) Bangalore, India. Magnetron sputtering technique is used for the coating. Several coating trials are done before the primary mirror coating; samples are tested for reflectivity, uniformity, adhesivity and finally commissioned. The primary mirror is cleaned, coated by ARIES. We present here a brief description of the coating plant installation, Mirror cleaning and coating procedures and the testing results of the samples.

Differentials in colostrum feeding among lactating women of block RS Pura of J and K: A lesson for nursing practice.

PubMed

Raina, Sunil Kumar; Mengi, Vijay; Singh, Gurdeep

2012-07-01

Breast feeding is universally and traditionally practicised in India. Experts advocate breast feeding as the best method of feeding young infants. To assess the role of various factors in determining colostrum feeding in block R. S. Pura of district Jammu. A stratified two-stage design with villages as the primary sampling unit and lactating mothers as secondary sampling unit. Villages were divided into different clusters on the basis of population and sampling units were selected by a simple random technique. Breastfeeding is almost universal in R. S. Pura. Differentials in discarding the first milk were not found to be important among various socioeconomic groups and the phenomenon appeared more general than specific.

Agriculture for Little People. Publication No. 0004.

ERIC Educational Resources Information Center

Gasior, Albert G.

The document is a collection of teacher guides to sample units introducing agriculture at the primary level; part or all of the units can be used along with the regular curriculum during the school year. Intended to acquaint K-3 students with agriculture's important role, the purpose of the course is to impart basic knowledge of materials, tools,…

Industrial Work Experience I. Curriculum Guide. General Related Study Units.

ERIC Educational Resources Information Center

Virginia Polytechnic Inst. and State Univ., Blacksburg. Div. of Vocational-Technical Education.

The primary purpose of this guide is to present basic sample instructional materials for the Industrial Work Experience (IWE) Program. It is designed to aid those charged with local administration and coordination of programs in secondary level trade and industrial education, referred to as the IWE training program. The guide contains 10 units of…

Potential impacts of year-round sampling on monitoring presence- absence of invasive flora in the southern United States

Treesearch

Christopher M. Oswalt; Sonja N. Oswalt; W. Keith Moser

2012-01-01

Studies suggest that the southern United States is an area of primary concern with regards to the spread of nonnative invasive plant species. Recent data show that species such as Japanese honeysuckle (Lonicera japonica) and Nepalese browntop (Microstegium vimineum) are invading forests and displacing native species throughout the...

A sampling design framework for monitoring secretive marshbirds

USGS Publications Warehouse

Johnson, D.H.; Gibbs, J.P.; Herzog, M.; Lor, S.; Niemuth, N.D.; Ribic, C.A.; Seamans, M.; Shaffer, T.L.; Shriver, W.G.; Stehman, S.V.; Thompson, W.L.

2009-01-01

A framework for a sampling plan for monitoring marshbird populations in the contiguous 48 states is proposed here. The sampling universe is the breeding habitat (i.e. wetlands) potentially used by marshbirds. Selection protocols would be implemented within each of large geographical strata, such as Bird Conservation Regions. Site selection will be done using a two-stage cluster sample. Primary sampling units (PSUs) would be land areas, such as legal townships, and would be selected by a procedure such as systematic sampling. Secondary sampling units (SSUs) will be wetlands or portions of wetlands in the PSUs. SSUs will be selected by a randomized spatially balanced procedure. For analysis, the use of a variety of methods as a means of increasing confidence in conclusions that may be reached is encouraged. Additional effort will be required to work out details and implement the plan.

Nonmanufacturing Businesses. U.S. Metric Study Interim Report.

ERIC Educational Resources Information Center

Cornog, June R.; Bunten, Elaine D.

In this fifth interim report on the feasibility of a United States changeover to a metric system stems from the U.S. Metric Study, a primary stratified sample of 2,828 nonmanufacturing firms was randomly selected from 28,184 businesses taken from Social Security files, a secondary sample of 2,258 firms was randomly selected for replacement…

Developing nurse and physician questionnaires to assess primary work areas in intensive care units.

PubMed

Rashid, Mahbub; Boyle, Diane K; Crosser, Michael

2014-01-01

The objective of the study was to develop instruments for describing and assessing some aspects of design of the primary work areas of nurses and physicians in intensive care units (ICUs). Separate questionnaires for ICU physicians and nurses were developed. Items related to individual- and unit-level design features of the primary work areas of nurses and physicians were organized using constructs found in the literature. Items related to staff satisfaction and staff use of time in relation to primary work area design were also included. All items and constructs were reviewed by experts for content validity and were modified as needed before use. The final questionnaires were administered to a convenience sample of 4 ICUs in 2 large urban hospitals. A total of 55 nurses and 29 physicians completed the survey. The Cronbach α was used to measure internal consistency, and factor analysis was used to provide construct-related validity. Convergent and discriminant validity were assessed through examining bivariate correlations between relevant scales/items. Analysis of variance was used to identify whether the between-group member responses were significant among the 4 units. The Cronbach α values for all except 3 preliminary scales indicated acceptable reliability. Factor analysis indicated that some preliminary scales could be partitioned into subscales for finer descriptions of the primary work areas. Correlational analysis provided strong evidence of convergent and discriminant validity of all the scales and subscales. The significance level of F-statistics showed that the units were significantly different from each other, providing evidence of more between-unit variance than within-unit variance. Therefore, the questionnaires developed in the study offer a promising departure point for rigorous description and evaluation of the primary work areas in relation to staff satisfaction and use of time in ICUs at a time when the importance of such studies is growing.

Aircrew Sizing Survey 2011

DTIC Science & Technology

2014-10-01

Resource JSF Joint Strike Fighter JPATS Joint Primary Aircraft Training System USMC United States Marine Corps USAF United States Air Force LIST...Surface Anthropometry Resource (CAESAR) was developed for the Joint Strike Fighter (JSF) program. The ACSS was intended to replace the JSF-CAESAR...an aircrew sample was made in 2003 by Hudson et al. They extracted a subset, named JSF CAESAR (Joint Strike Fighter), from the Civilian American and

Nonprescription Antimicrobial Use in a Primary Care Population in the United States

PubMed Central

Zoorob, Roger; Nash, Susan; Trautner, Barbara W.

2016-01-01

Community antimicrobial resistance rates are high in communities with frequent use of nonprescription antibiotics. Studies addressing nonprescription antibiotic use in the United States have been restricted to Latin American immigrants. We estimated the prevalence of nonprescription antibiotic use in the previous 12 months as well as intended use (intention to use antibiotics without a prescription) and storage of antibiotics and examined patient characteristics associated with nonprescription use in a random sample of adults. We selected private and public primary care clinics that serve ethnically and socioeconomically diverse patients. Within the clinics, we used race/ethnicity-stratified systematic random sampling to choose a random sample of primary care patients. We used a self-administered standardized questionnaire on antibiotic use. Multivariate regression analysis was used to identify independent predictors of nonprescription use. The response rate was 94%. Of 400 respondents, 20 (5%) reported nonprescription use of systemic antibiotics in the last 12 months, 102 (25.4%) reported intended use, and 57 (14.2%) stored antibiotics at home. These rates were similar across race/ethnicity groups. Sources of antibiotics used without prescriptions or stored for future use were stores or pharmacies in the United States, “leftover” antibiotics from previous prescriptions, antibiotics obtained abroad, or antibiotics obtained from a relative or friend. Respiratory symptoms were common reasons for the use of nonprescription antibiotics. In multivariate analyses, public clinic patients, those with less education, and younger patients were more likely to endorse intended use. The problem of nonprescription use is not confined to Latino communities. Community antimicrobial stewardship must include a focus on nonprescription antibiotics. PMID:27401572

Results and analysis of saltstone cores taken from saltstone disposal unit cell 2A

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

Reigel, M. M.; Hill, K. A.

2016-03-01

As part of an ongoing Performance Assessment (PA) Maintenance Plan, Savannah River Remediation (SRR) has developed a sampling and analyses strategy to facilitate the comparison of field-emplaced samples (i.e., saltstone placed and cured in a Saltstone Disposal Unit (SDU)) with samples prepared and cured in the laboratory. The primary objectives of the Sampling and Analyses Plan (SAP) are; (1) to demonstrate a correlation between the measured properties of laboratory-prepared, simulant samples (termed Sample Set 3), and the field-emplaced saltstone samples (termed Sample Set 9), and (2) to validate property values assumed for the Saltstone Disposal Facility (SDF) PA modeling. Themore » analysis and property data for Sample Set 9 (i.e. six core samples extracted from SDU Cell 2A (SDU2A)) are documented in this report, and where applicable, the results are compared to the results for Sample Set 3. Relevant properties to demonstrate the aforementioned objectives include bulk density, porosity, saturated hydraulic conductivity (SHC), and radionuclide leaching behavior.« less

Antidepressant Use in Persons Aged 12 and Over: United States, 2005-2008

MedlinePlus

... received from primary care providers. Data sources and methods NHANES is a continuous survey conducted to assess ... percentages were estimated using Taylor series linearization, a method that incorporates the sample design and weights. Overall ...

Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study.

PubMed

Brocklehurst, Peter; Hardy, Pollyanna; Hollowell, Jennifer; Linsell, Louise; Macfarlane, Alison; McCourt, Christine; Marlow, Neil; Miller, Alison; Newburn, Mary; Petrou, Stavros; Puddicombe, David; Redshaw, Maggie; Rowe, Rachel; Sandall, Jane; Silverton, Louise; Stewart, Mary

2011-11-23

To compare perinatal outcomes, maternal outcomes, and interventions in labour by planned place of birth at the start of care in labour for women with low risk pregnancies. Prospective cohort study. England: all NHS trusts providing intrapartum care at home, all freestanding midwifery units, all alongside midwifery units (midwife led units on a hospital site with an obstetric unit), and a stratified random sample of obstetric units. 64,538 eligible women with a singleton, term (≥37 weeks gestation), and "booked" pregnancy who gave birth between April 2008 and April 2010. Planned caesarean sections and caesarean sections before the onset of labour and unplanned home births were excluded. A composite primary outcome of perinatal mortality and intrapartum related neonatal morbidities (stillbirth after start of care in labour, early neonatal death, neonatal encephalopathy, meconium aspiration syndrome, brachial plexus injury, fractured humerus, or fractured clavicle) was used to compare outcomes by planned place of birth at the start of care in labour (at home, freestanding midwifery units, alongside midwifery units, and obstetric units). There were 250 primary outcome events and an overall weighted incidence of 4.3 per 1000 births (95% CI 3.3 to 5.5). Overall, there were no significant differences in the adjusted odds of the primary outcome for any of the non-obstetric unit settings compared with obstetric units. For nulliparous women, the odds of the primary outcome were higher for planned home births (adjusted odds ratio 1.75, 95% CI 1.07 to 2.86) but not for either midwifery unit setting. For multiparous women, there were no significant differences in the incidence of the primary outcome by planned place of birth. Interventions during labour were substantially lower in all non-obstetric unit settings. Transfers from non-obstetric unit settings were more frequent for nulliparous women (36% to 45%) than for multiparous women (9% to 13%). The results support a policy of offering healthy women with low risk pregnancies a choice of birth setting. Women planning birth in a midwifery unit and multiparous women planning birth at home experience fewer interventions than those planning birth in an obstetric unit with no impact on perinatal outcomes. For nulliparous women, planned home births also have fewer interventions but have poorer perinatal outcomes.

Burnout syndrome and its prevalence in primary care nursing: a systematic review and meta-analysis.

PubMed

Monsalve-Reyes, Carolina S; San Luis-Costas, Concepción; Gómez-Urquiza, Jose L; Albendín-García, Luis; Aguayo, Raimundo; Cañadas-De la Fuente, Guillermo A

2018-05-10

burnout syndrome is a significant problem in nursing professionals. Although, the unit where nurses work may influence burnout development. Nurses that work in primary care units may be at higher risk of burnout. The aim of the study was to estimate the prevalence of emotional exhaustion, depersonalization and low personal accomplishment in primary care nurses. We performed a meta-analysis. We searched Pubmed, CINAHL, Scopus, Scielo, Proquest, CUIDEN and LILACS databases up to September 2017 to identify cross-sectional studies assessing primary care nurses' burnout with the Maslach Burnout Inventory were included. The search was done in September 2017. After the search process, n = 8 studies were included in the meta-analysis, representing a total sample of n = 1110 primary care nurses. High emotional exhaustion prevalence was 28% (95% Confidence Interval = 22-34%), high depersonalization was 15% (95% Confidence Interval = 9-23%) and 31% (95% Confidence Interval = 6-66%) for low personal accomplishment. Problems such as emotional exhaustion and low personal accomplishment are very common among primary care nurses, while depersonalization is less prevalent. Primary care nurses are a burnout risk group.

The design of the second German national forest inventory

Treesearch

Gerald Kandler

2009-01-01

In Germany, a sample-based national forest inventory (NFI) took place for the first time from 1986 to 1990 (in West Germany only); the second one took place from 2001 to 2002. The inventory design is based on a systematic distribution of tracts on regular grids of regionally differing width. The primary sampling unit is a quadrangular tract with sides of 150 m. The...

PRIMARY AND SECONDARY CONTRIBUTIONS TO AMBIENT PM IN THE MIDWESTERN UNITED STATES

EPA Science Inventory

Ambient PM^2.5 samples were collected in five Midwestern US cities throughout 2004: East St. Louis, Illinois; Detroit, Michigan; Cincinnati, Ohio; Bondville, Illinois; and Northbrook, Illinois. Monthly composites were analyzed using chemical derivatization coupled with ...

Microbial analysis in primary and persistent endodontic infections by using pyrosequencing.

PubMed

Hong, Bo-Young; Lee, Tae-Kwon; Lim, Sang-Min; Chang, Seok Woo; Park, Joonhong; Han, Seung Hyun; Zhu, Qiang; Safavi, Kamran E; Fouad, Ashraf F; Kum, Kee Yeon

2013-09-01

The aim of this study was to investigate the bacterial community profile of intracanal microbiota in primary and persistent endodontic infections associated with asymptomatic chronic apical periodontitis by using GS-FLX Titanium pyrosequencing. The null hypothesis was that there is no difference in diversity of overall bacterial community profiles between primary and persistent infections. Pyrosequencing analysis from 10 untreated and 8 root-filled samples was conducted. Analysis from 18 samples yielded total of 124,767 16S rRNA gene sequences (with a mean of 6932 reads per sample) that were taxonomically assigned into 803 operational taxonomic units (3% distinction), 148 genera, and 10 phyla including unclassified. Bacteroidetes was the most abundant phylum in both primary and persistent infections. There were no significant differences in bacterial diversity between the 2 infection groups (P > .05). The bacterial community profile that was based on dendrogram showed that bacterial population in both infections was not significantly different in their structure and composition (P > .05). The present pyrosequencing study demonstrates that persistent infections have as diverse bacterial community as primary infections. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Groundwater-quality data in the Klamath Mountains study unit, 2010: results from the California GAMA Program

USGS Publications Warehouse

Mathany, Timothy M.; Belitz, Kenneth

2014-01-01

Groundwater quality in the 8,806-square-mile Klamath Mountains (KLAM) study unit was investigated by the U.S. Geological Survey (USGS) from October to December 2010, as part of the California State Water Resources Control Board (SWRCB) Groundwater Ambient Monitoring and Assessment (GAMA) Program’s Priority Basin Project (PBP). The GAMA-PBP was developed in response to the California Groundwater Quality Monitoring Act of 2001 and is being conducted in collaboration with the SWRCB and Lawrence Livermore National Laboratory (LLNL). The KLAM study unit was the thirty-third study unit to be sampled as part of the GAMA-PBP. The GAMA Klamath Mountains study was designed to provide a spatially unbiased assessment of untreated-groundwater quality in the primary aquifer system and to facilitate statistically consistent comparisons of untreated-groundwater quality throughout California. The primary aquifer system is defined by the perforation intervals of wells listed in the California Department of Public Health (CDPH) database for the KLAM study unit. Groundwater quality in the primary aquifer system may differ from the quality in the shallower or deeper water-bearing zones; shallower groundwater may be more vulnerable to surficial contamination. In the KLAM study unit, groundwater samples were collected from sites in Del Norte, Siskiyou, Humboldt, Trinity, Tehama, and Shasta Counties, California. Of the 39 sites sampled, 38 were selected by using a spatially distributed, randomized grid-based method to provide statistical representation of the primary aquifer system in the study unit (grid sites), and the remaining site was non-randomized (understanding site). The groundwater samples were analyzed for basic field parameters, organic constituents (volatile organic compounds [VOCs] and pesticides and pesticide degradates), inorganic constituents (trace elements, nutrients, major and minor ions, total dissolved solids [TDS]), radon-222, gross alpha and gross beta radioactivity, and microbial indicators (total coliform and Escherichia coli [E. coli]). Isotopic tracers (stable isotopes of hydrogen and oxygen in water, isotopic ratios of dissolved strontium in water, and stable isotopes of carbon in dissolved inorganic carbon), dissolved noble gases, and age-dating tracers (tritium and carbon-14) were measured to help identify sources and ages of sampled groundwater. Quality-control samples (field blanks, replicate sample pairs, and matrix spikes) were collected at 13 percent of the sites in the KLAM study unit, and the results were used to evaluate the quality of the data from the groundwater samples. Field blank samples rarely contained detectable concentrations of any constituent, indicating that contamination from sample collection or analysis was not a significant source of bias in the data for the groundwater samples. More than 99 percent of the replicate pair samples were within acceptable limits of variability. Matrix-spike sample recoveries were within the acceptable range (70 to 130 percent) for approximately 91 percent of the compounds. This study did not evaluate the quality of water delivered to consumers. After withdrawal, groundwater typically is treated, disinfected, and (or) blended with other waters to maintain water quality. Regulatory benchmarks apply to water that is delivered to the consumer, not to untreated groundwater. However, to provide some context for the results, concentrations of constituents measured in the untreated groundwater were compared with regulatory and non-regulatory health-based benchmarks established by the U.S. Environmental Protection Agency (USEPA) and CDPH, and to non-health-based benchmarks established for aesthetic concerns by the CDPH. Comparisons between data collected for this study and benchmarks for drinking water are for illustrative purposes only and are not indicative of compliance or non-compliance with those benchmarks. All concentrations of organic constituents from grid sites sampled in the KLAM study unit were less than health-based benchmarks. In total, VOCs were detected in 16 of the 38 grid sites sampled (approximately 42 percent), pesticides and pesticide degradates were detected in 8 grid sites (about 21 percent), and microbial indicators were detected in 14 grid sites (approximately 37 percent). Inorganic constituents (trace elements, major and minor ions, nutrients, and uranium and other radioactive constituents) and microbial indicators were sampled for at 38 grid sites, and all concentrations were less than health-based benchmarks, with the exception of one detection of boron greater than the CDPH notification level of 1,000 micrograms per liter (μg/L). Generally, concentrations of inorganic constituents with non-health-based benchmarks (iron, manganese, chloride, and TDS) were less than the CDPH secondary maximum contaminant level (SMCL-CA). Exceptions include three detections of iron greater than the SMCL-CA of 300 μg/L, four detections of manganese greater than the SMCL-CA of 50 μg/L, one detection of chloride greater than the recommended SMCL-CA of 250 μg/L, and one detection of TDS greater than the recommended SMCL-CA of 500 μg/L.

Observed intra-cluster correlation coefficients in a cluster survey sample of patient encounters in general practice in Australia

PubMed Central

Knox, Stephanie A; Chondros, Patty

2004-01-01

Background Cluster sample study designs are cost effective, however cluster samples violate the simple random sample assumption of independence of observations. Failure to account for the intra-cluster correlation of observations when sampling through clusters may lead to an under-powered study. Researchers therefore need estimates of intra-cluster correlation for a range of outcomes to calculate sample size. We report intra-cluster correlation coefficients observed within a large-scale cross-sectional study of general practice in Australia, where the general practitioner (GP) was the primary sampling unit and the patient encounter was the unit of inference. Methods Each year the Bettering the Evaluation and Care of Health (BEACH) study recruits a random sample of approximately 1,000 GPs across Australia. Each GP completes details of 100 consecutive patient encounters. Intra-cluster correlation coefficients were estimated for patient demographics, morbidity managed and treatments received. Intra-cluster correlation coefficients were estimated for descriptive outcomes and for associations between outcomes and predictors and were compared across two independent samples of GPs drawn three years apart. Results Between April 1999 and March 2000, a random sample of 1,047 Australian general practitioners recorded details of 104,700 patient encounters. Intra-cluster correlation coefficients for patient demographics ranged from 0.055 for patient sex to 0.451 for language spoken at home. Intra-cluster correlations for morbidity variables ranged from 0.005 for the management of eye problems to 0.059 for management of psychological problems. Intra-cluster correlation for the association between two variables was smaller than the descriptive intra-cluster correlation of each variable. When compared with the April 2002 to March 2003 sample (1,008 GPs) the estimated intra-cluster correlation coefficients were found to be consistent across samples. Conclusions The demonstrated precision and reliability of the estimated intra-cluster correlations indicate that these coefficients will be useful for calculating sample sizes in future general practice surveys that use the GP as the primary sampling unit. PMID:15613248

Samples in applied psychology: over a decade of research in review.

PubMed

Shen, Winny; Kiger, Thomas B; Davies, Stacy E; Rasch, Rena L; Simon, Kara M; Ones, Deniz S

2011-09-01

This study examines sample characteristics of articles published in Journal of Applied Psychology (JAP) from 1995 to 2008. At the individual level, the overall median sample size over the period examined was approximately 173, which is generally adequate for detecting the average magnitude of effects of primary interest to researchers who publish in JAP. Samples using higher units of analyses (e.g., teams, departments/work units, and organizations) had lower median sample sizes (Mdn ≈ 65), yet were arguably robust given typical multilevel design choices of JAP authors despite the practical constraints of collecting data at higher units of analysis. A substantial proportion of studies used student samples (~40%); surprisingly, median sample sizes for student samples were smaller than working adult samples. Samples were more commonly occupationally homogeneous (~70%) than occupationally heterogeneous. U.S. and English-speaking participants made up the vast majority of samples, whereas Middle Eastern, African, and Latin American samples were largely unrepresented. On the basis of study results, recommendations are provided for authors, editors, and readers, which converge on 3 themes: (a) appropriateness and match between sample characteristics and research questions, (b) careful consideration of statistical power, and (c) the increased popularity of quantitative synthesis. Implications are discussed in terms of theory building, generalizability of research findings, and statistical power to detect effects. PsycINFO Database Record (c) 2011 APA, all rights reserved

Optimization Review: Ogallala Ground Water Contamination Superfund Site, Operable Unit 2 (Tip Top Cleaners), Ogallala, Nebraska

EPA Pesticide Factsheets

The Ogallala Ground Water Contamination Superfund site was identified in 1989 through municipal well sampling. Tetrachloroethene (PCE), a solvent commonly used in dry cleaner operations, was the primary ground water target chemical of concern (COC) that..

Assessing the quality of reproductive health services in Egypt via exit interviews.

PubMed

Zaky, Hassan H M; Khattab, Hind A S; Galal, Dina

2007-05-01

This study assesses the quality of reproductive health services using client satisfaction exit interviews among three groups of primary health care units run by the Ministry of Health and Population of Egypt. Each group applied a different model of intervention. The Ministry will use the results in assessing its reproductive health component in the health sector reform program, and benefits from the strengths of other models of intervention. The sample was selected in two stages. First, a stratified random sampling procedure was used to select the health units. Then the sample of female clients in each health unit was selected using the systematic random approach, whereby one in every two women visiting the unit was approached. All women in the sample coming for reproductive health services were included in the analysis. The results showed that reproductive health beneficiaries at the units implementing the new health sector reform program were more satisfied with the quality of services. Still there were various areas where clients showed significant dissatisfaction, such as waiting time, interior furnishings, cleanliness of the units and consultation time. The study showed that the staff of these units did not provide a conductive social environment as other interventions did. A significant proportion of women expressed their intention to go to private physicians owing to their flexible working hours and variety specializations. Beneficiaries were generally more satisfied with the quality of health services after attending the reformed units than the other types of units, but the generalization did not fully apply. Areas of weakness are identified.

[Decisive factors relating to workload in a primary healthcare unit].

PubMed

da Silva, Nilson Rogério

2011-08-01

Work-related diseases o either physical or emotional origin have been on the increase in contemporary society in the different work sectors. They have had a profound impact on health professionals, such as physicians, dentists, nurses, nursing assistants and administrative assistants in the primary healthcare units. This study aimed to establish the decisive factors relating to workload, seeking to identify possible relations between the working conditions and their potential impact on worker health. Thirty-one individuals comprised the sample, namely 12 physicians, 3 dentists, 1 nurse, 9 nursing assistants, 3 dental assistants and 3 business assistants at a PHU (Primary Healthcare Unit) in a city in the interior of the State of São Paulo. For the data collection, structured interviews were conducted through meetings with the specific groups of workers, such that a detailed description of the activities performed by each group could be drafted, as well as a survey of the problems and desirable features involved. The results indicated the presence of physical, cognitive and psychological demands; inadequate communication processes; obsolete equipment; excessive number of users and an inefficient structure to deal with absenteeism.

Language Sample Analysis and Elicitation Technique Effects in Bilingual Children With and Without Language Impairment.

PubMed

Kapantzoglou, Maria; Fergadiotis, Gerasimos; Restrepo, M Adelaida

2017-10-17

This study examined whether the language sample elicitation technique (i.e., storytelling and story-retelling tasks with pictorial support) affects lexical diversity (D), grammaticality (grammatical errors per communication unit [GE/CU]), sentence length (mean length of utterance in words [MLUw]), and sentence complexity (subordination index [SI]), which are commonly used indices for diagnosing primary language impairment in Spanish-English-speaking children in the United States. Twenty bilingual Spanish-English-speaking children with typical language development and 20 with primary language impairment participated in the study. Four analyses of variance were conducted to evaluate the effect of language elicitation technique and group on D, GE/CU, MLUw, and SI. Also, 2 discriminant analyses were conducted to assess which indices were more effective for story retelling and storytelling and their classification accuracy across elicitation techniques. D, MLUw, and SI were influenced by the type of elicitation technique, but GE/CU was not. The classification accuracy of language sample analysis was greater in story retelling than in storytelling, with GE/CU and D being useful indicators of language abilities in story retelling and GE/CU and SI in storytelling. Two indices in language sample analysis may be sufficient for diagnosis in 4- to 5-year-old bilingual Spanish-English-speaking children.

Viral Pollution of Surface Waters Due to Chlorinated Primary Effluents

PubMed Central

Sattar, Syed A.; Westwood, J. C. N.

1978-01-01

The role of chlorinated primary effluents in viral pollution of the Ottawa River (Ontario) was assessed by examining 282 field samples of wastewaters from two different sewage treatment plants over a 2-year period. The talc-Celite technique was used for sample concentration, and BS-C-1 cells were employed for virus detection. Viruses were detected in 80% (75/94) of raw sewage, 72% (68/94) of primary effluent, and 56% (53/94) of chlorinated effluent samples. Both raw sewage and primary effluent samples contained about 100 viral infective units (VIU) per 100 ml. Chlorination produced a 10- to 50-fold reduction in VIU and gave nearly 2.7 VIU/100 ml of chlorinated primary effluent. With a combined daily chlorinated primary effluent output of approximately 3.7 × 108 liters, these two plants were discharging 1.0 × 1010 VIU per day. Because the river has a mean annual flow of 8.0 × 1010 liters per day, these two sources alone produced a virus loading of 1.0 VIU/8 liters of the river water. This river also receives at least 9.0 × 107 liters of raw sewage per day and undetermined but substantial amounts of storm waters and agricultural wastes. It is used for recreation and acts as a source of potable water for some 6.0 × 105 people. In view of the potential of water for disease transmission, discharge of such wastes into the water environment needs to be minimized. PMID:215085

Turned on to Language Arts: Computer Literacy in the Primary Grades.

ERIC Educational Resources Information Center

Guthrie, Larry F.; Richardson, Susan

1995-01-01

Describes Apple Computer's Early Language Connections (ELC) program. Designed for K-2 grades, ELC integrates Macintosh computers, children's literature, instructional software, and other curriculum materials, including sample lessons constructed around thematic units. The literature-based product uses a whole-language approach (with phonics…

INDIVIDUAL PARTICLE ANALYSIS OF PERSONAL SAMPLES FROM THE 1998 BALTIMORE PARTICULATE MATTER STUDY

EPA Science Inventory

The United States Environmental Protection Agency (U.S. EPA) recently conducted the 1998 Baltimore Particulate Matter (PM) Epidemiology-Exposure Study of the Elderly. The primary goal of that study was to establish the relationship between outdoor PM concentrations and actual h...

[Drug supplies in primary care units at the Ministry of Health in Mexico].

PubMed

Gómez-Dantés, O; Garrido-Latorre, F; Tirado-Gómez, L L; Ramírez, D; Macías, C

2001-01-01

To identify the availability of some essential drugs (ED) at primary health care units of the Mexican Ministry of Health (SSA), using data from a research work conducted in 1996 and 1997. A random sample of the 18 sanitary jurisdictions of states participating in the Extension of Coverage Program (ECP) was drawn. All primary care units from selected jurisdictions were evaluated through an inspection visit, using a checklist that included 36 ED. In phase I of the analysis, the absolute number and proportion of units without a single item of any of the 36 drugs were calculated. In the units with available drugs, the median of the distribution was also calculated. In phase II, the medians according to the type of health unit and state was obtained. The statistic utilized for the comparison of the medians was the Scheffé test with one way variance analysis. In addition, the drugs were classified according to their therapeutic indication and the medians and proportion of available drugs were calculated. The differences in proportion were evaluated with the statistic chi 2. During the visits, on average, 18 of the 36 drugs included in the list of the study were found in the health units. The availability of antibiotics, antituberculosis drugs, and antimalarial drugs was particularly poor. In contrast, oral rehydration salts, family planning methods and vaccines were usually available. In general, the PAC3 states presented the best availability figures. The Ministry of Health of México will have to develop an enormous effort to overcome the obstacles related to the supply of essential drugs in primary health care units. Otherwise, all other efforts directed to meet the needs of the non-insured population will end up being useless, and enormous amounts of the already scarce resources of the health sector will be wasted since drugs are a vital component of the long chain of health care.

Public housing relocations in Atlanta, Georgia, and declines in spatial access to safety net primary care

PubMed Central

Cooper, Hannah LF; Wodarski, Stephanie; Cummings, Janet; Hunter-Jones, Josalin; Karnes, Conny; Ross, Zev; Druss, Ben; Bonney, Loida E

2012-01-01

This analysis investigates changes in spatial access to safety-net primary care in a sample of US public housing residents relocating via the HOPE VI initiative from public housing complexes to voucher-subsidized rental units; substance misusers were oversampled. We used gravity-based models to measure spatial access to care, and used mixed models to assess pre-/post-relocation changes in access. Half the sample experienced declines in spatial access of ≥79.83%; declines did not vary by substance misuse status. Results suggest that future public housing relocation initiatives should partner with relocaters, particularly those in poor health, to help them find housing near safety-net clinics. PMID:23060002

Work plan for determining the occurrence of glyphosate, its transformation product AMPA, other herbicide compounds, and antibiotics in midwestern United States streams, 2002

USGS Publications Warehouse

Battaglin, W.A.; Thurman, E.M.; Kolpin, D.W.; Scribner, E.A.; Sandstrom, M.W.; Kuivila, K.M.

2003-01-01

The objective of this study is to determine the distribution of glyphosate and its primary transformation product aminomethylphosphonic acid (AMPA) in midwestern streams during post-application and harvest-season runoff events. Water samples will be collected in 2002 during two post-herbicide-application runoff events and one harvest-season runoff event from 53 sites on streams in the Midwestern United States. All samples will be analyzed at the U.S. Geological Survey Organic Geochemistry Research Laboratory in Lawrence, Kansas, for glyphosate and 20 other herbicides. Samples will also be analyzed for a glyphosate transformation product (AMPA) and 26 other herbicide transformation products, using GC/MS or HPLC/MS. Selected samples will be analyzed for 36 antibiotics or antibiotic transformational products. Results from this study will represent the first broad-scale investigation of glyphosate and AMPA in U.S. water resources.

Evaluation of Bacteroides fragilis GB-124 bacteriophages as novel human-associated faecal indicators in the United States

EPA Science Inventory

Phages infecting human-associated Bacteroides fragilis (GB-124 phages) have been employed in the European Union (EU) to identify human fecal pollution, but their utility for U.S. was unclear. Primary sewage effluent samples were collected seasonally from seven wastewater treatme...

Groundwater-quality data in the Bear Valley and Selected Hard Rock Areas study unit, 2010: Results from the California GAMA Program

USGS Publications Warehouse

Mathany, Timothy M.; Belitz, Kenneth

2013-01-01

Groundwater quality in the 112-square-mile Bear Valley and Selected Hard Rock Areas (BEAR) study unit was investigated by the U.S. Geological Survey (USGS) from April to August 2010, as part of the California State Water Resources Control Board (SWRCB) Groundwater Ambient Monitoring and Assessment (GAMA) Program’s Priority Basin Project (PBP). The GAMA-PBP was developed in response to the California Groundwater Quality Monitoring Act of 2001 and is being conducted in collaboration with the SWRCB and Lawrence Livermore National Laboratory (LLNL). The BEAR study unit was the thirty-first study unit to be sampled as part of the GAMA-PBP. The GAMA Bear Valley and Selected Hard Rock Areas study was designed to provide a spatially unbiased assessment of untreated-groundwater quality in the primary aquifer system and to facilitate statistically consistent comparisons of untreated groundwater quality throughout California. The primary aquifer system is defined as the zones corresponding to the perforation intervals of wells listed in the California Department of Public Health (CDPH) database for the BEAR study unit. Groundwater quality in the primary aquifer system may differ from the quality in the shallow or deep water-bearing zones; shallow groundwater may be more vulnerable to surficial contamination. In the BEAR study unit, groundwater samples were collected from two study areas (Bear Valley and Selected Hard Rock Areas) in San Bernardino County. Of the 38 sampling sites, 27 were selected by using a spatially distributed, randomized grid-based method to provide statistical representation of the primary aquifer system in the study unit (grid sites), and the remaining 11 sites were selected to aid in the understanding of the potential groundwater-quality issues associated with septic tank use and with ski areas in the study unit (understanding sites). The groundwater samples were analyzed for organic constituents (volatile organic compounds [VOCs], pesticides and pesticide degradates, pharmaceutical compounds, and wastewater indicator compounds [WICs]), constituents of special interest (perchlorate, N-nitrosodimethylamine [NDMA], and 1,2,3-trichloropropane [1,2,3-TCP]), and inorganic constituents (trace elements, nutrients, dissolved organic carbon [DOC], major and minor ions, silica, total dissolved solids [TDS], alkalinity, and arsenic and iron species), and uranium and other radioactive constituents (radon-222 and activities of tritium and carbon-14). Isotopic tracers (of hydrogen and oxygen in water, of nitrogen and oxygen in dissolved nitrate, of dissolved boron, isotopic ratios of strontium in water, and of carbon in dissolved inorganic carbon) and dissolved noble gases (argon, helium-4, krypton, neon, and xenon) were measured to help identify the sources and ages of sampled groundwater. In total, groundwater samples were analyzed for 289 unique constituents and 8 water-quality indicators in the BEAR study unit. Quality-control samples (blanks, replicate pairs, or matrix spikes) were collected at 13 percent of the sites in the BEAR study unit, and the results for these samples were used to evaluate the quality of the data from the groundwater samples. Blank samples rarely contained detectable concentrations of any constituent, indicating that contamination from sample collection or analysis was not a significant source of bias in the data for the groundwater samples. Replicate pair samples all were within acceptable limits of variability. Matrix-spike sample recoveries were within the acceptable range (70 to 130 percent) for approximately 84 percent of the compounds. This study did not evaluate the quality of water delivered to consumers. After withdrawal, groundwater typically is treated, disinfected, and (or) blended with other waters to maintain water quality. Regulatory benchmarks apply to water that is delivered to the consumer, not to untreated groundwater. However, to provide some context for the results, concentrations of constituents measured in the untreated groundwater were compared with regulatory and non-regulatory health-based benchmarks established by the U.S. Environmental Protection Agency (USEPA) and CDPH, and to non-health-based benchmarks established for aesthetic concerns by CDPH. Comparisons between data collected for this study and benchmarks for drinking water are for illustrative purposes only and are not indicative of compliance or non-compliance with those benchmarks. All concentrations of organic and special-interest constituents from grid sites sampled in the BEAR study unit were less than health-based benchmarks. In total, VOCs were detected in 17 of the 27 grid sites sampled (approximately 63 percent), pesticides and pesticide degradates were detected in 4 grid sites (approximately 15 percent), and perchlorate was detected in 21 grid sites (approximately 78 percent). Inorganic constituents (trace elements, major and minor ions, nutrients, and uranium and other radioactive constituents) were sampled for at 27 grid sites; most concentrations were less than health-based benchmarks. Exceptions include one detection of arsenic greater than the USEPA maximum contaminant level (MCL-US) of 10 micrograms per liter (μg/L), three detections of uranium greater than the MCL-US of 30 μg/L, nine detections of radon-222 greater than the proposed MCL-US of 4,000 picocuries per liter (pCi/L), and one detection of fluoride greater than the CDPH maximum contaminant level (MCL-CA) of 2 milligrams per liter. Concentrations of inorganic constituents with non-health-based benchmarks (iron, manganese, chloride, and TDS) were less than the CDPH secondary maximum contaminant level (SMCL-CA) in most grid sites. Exceptions include two detections of iron greater than the SMCL-CA of 300 μg/L and one detection of manganese greater than the SMCL-CA of 50 μg/L.

Geochemical evidence for diversity of dust sources in the southwestern United States

USGS Publications Warehouse

Reheis, M.C.; Budahn, J.R.; Lamothe, P.J.

2002-01-01

Several potential dust sources, including generic sources of sparsely vegetated alluvium, playa deposits, and anthropogenic emissions, as well as the area around Owens Lake, California, affect the composition of modern dust in the southwestern United States. A comparison of geochemical analyses of modern and old (a few thousand years) dust with samples of potential local sources suggests that dusts reflect four primary sources: (1) alluvial sediments (represented by Hf, K, Rb, Zr, and rare-earth elements, (2) playas, most of which produce calcareous dust (Sr, associated with Ca), (3) the area of Owens (dry) Lake, a human-induced playa (As, Ba, Li, Pb, Sb, and Sr), and (4) anthropogenic and/or volcanic emissions (As, Cr, Ni, and Sb). A comparison of dust and source samples with previous analyses shows that Owens (dry) Lake and mining wastes from the adjacent Cerro Gordo mining district are the primary sources of As, Ba, Li, and Pb in dusts from Owens Valley. Decreases in dust contents of As, Ba, and Sb with distance from Owens Valley suggest that dust from southern Owens Valley is being transported at least 400 km to the east. Samples of old dust that accumulated before European settlement are distinctly lower in As, Ba, and Sb abundances relative to modern dust, likely due to modern transport of dust from Owens Valley. Thus, southern Owens Valley appears to be an important, geochemically distinct, point source for regional dust in the southwestern United States. Copyright ?? 2002 Elsevier Science Ltd.

Geochemical sampling in arid environments by the U.S. Geological Survey

USGS Publications Warehouse

Hinkle, Margaret E.

1988-01-01

The U.S. Geological Survey (USGS) is responsible for the geochemical evaluations used for mineral resource assessments of large tracts of public lands in the Western United States. Many of these lands are administered by the Bureau of Land Management (BLM) and are studied to determine their suitability or nonsuitability for wilderness designation. Much of the Western United States is arid or semiarid. This report discusses various geochemical sample media that have been used for evaluating areas in arid environments and describes case histories in BLM wilderness study areas in which stream-sediment and heavy-mineral-concentrate sample media were compared. As a result of these case history studies, the nonmagnetic fraction of panned heavy-mineral concentrates was selected as the most effective medium for reconnaissance geochemical sampling for resources other than gold, in arid areas. Nonmagnetic heavy-mineral-concentrate samples provide the primary analytical information currently used in geochemical interpretations of mineral resource potential assessment of BLM lands.

Geochemical and Sulfur-Isotopic Signatures of Volcanogenic Massive Sulfide Deposits on Prince of Wales Island and Vicinity, Southeastern Alaska

USGS Publications Warehouse

Slack, John F.; Shanks, Wayne C.; Karl, Susan M.; Gemery, Pamela A.; Bittenbender, Peter E.; Ridley, W. Ian

2007-01-01

Stratabound volcanogenic massive sulfide (VMS) deposits on Prince of Wales Island and vicinity, southeastern Alaska, occur in two volcanosedimentary sequences of Late Proterozoic through Cambrian and of Ordovician through Early Silurian age. This study presents geochemical data on sulfide-rich samples, in situ laser-ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) of sulfide minerals, and sulfur-isotopic analyses of sulfides and sulfates (barite) for identifying and distinguishing between primary sea-floor signatures and later regional metamorphic overprints. These datasets are also used here in an attempt to discriminate the VMS deposits in the older Wales Group from those in the younger Moira Sound unit (new informal name). The Wales Group and its contained VMS deposits have been multiply deformed and metamorphosed from greenschist to amphibolite grade, whereas the Moira Sound unit and related VMS deposits are less deformed and generally less metamorphosed (lower to middle greenschist grade). Variations in the sulfide mineral assemblages and textures of the VMS deposits in both sequences reflect a combination of processes, including primary sea-floor mineralization and sub-sea-floor zone refining, followed by metamorphic recrystallization. Very coarse grained (>1 cm diam) sulfide minerals and abundant pyrrhotite are restricted to VMS deposits in a small area of the Wales Group, at Khayyam and Stumble-On, which record high-grade metamorphism of the sulfides. Geochemical and sulfur-isotopic data distinguish the VMS deposits in the Wales Group from those in the Moira Sound unit. Although base- and precious-metal contents vary widely in sulfide-rich samples from both sequences, samples from the Moira Sound generally have proportionately higher Ag contents relative to base metals and Au. In situ LA-ICP-MS analysis of trace elements in the sulfide minerals suggests that primary sea-floor hydrothermal signatures are preserved in some samples (for example, Mn, As, Sb, and Tl in pyrite from the Moira Sound unit), whereas in other samples the signatures are varyingly annealed, owing to metamorphic overprinting. A limited LA-ICP-MS database for sphalerite indicates that low-Fe sphalerite is preferentially associated with the most Au rich deposits, the Niblack and Nutkwa. Sulfur-isotopic values for sulfide minerals in the VMS deposits in the Wales Group range from 5.9 to 17.4 permil (avg 11.5?2.7 permil), about 5 to 6 permil higher than those in the Moira Sound unit, which range from -2.8 to 10.4 permil (avg 6.1?4.0 permil). This difference in 34Ssulfide values reflects a dominantly seawater sulfate source of the sulfides and is linked to the 34S values of contemporaneous seawater sulfate, which were slightly higher during the Late Proterozoic through Cambrian than during the Ordovician through Early Silurian.

Status of groundwater quality in the Southern, Middle, and Northern Sacramento Valley study units, 2005-08: California GAMA Priority Basin Project

USGS Publications Warehouse

Bennett, George L.; Fram, Miranda S.; Belitz, Kenneth

2011-01-01

Groundwater quality in the Southern, Middle, and Northern Sacramento Valley study units was investigated as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study units are located in California's Central Valley and include parts of Butte, Colusa, Glenn, Placer, Sacramento, Shasta, Solano, Sutter, Tehama, Yolo, and Yuba Counties. The GAMA Priority Basin Project is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey and the Lawrence Livermore National Laboratory. The three study units were designated to provide spatially-unbiased assessments of the quality of untreated groundwater in three parts of the Central Valley hydrogeologic province, as well as to provide a statistically consistent basis for comparing water quality regionally and statewide. Samples were collected in 2005 (Southern Sacramento Valley), 2006 (Middle Sacramento Valley), and 2007-08 (Northern Sacramento Valley). The GAMA studies in the Southern, Middle, and Northern Sacramento Valley were designed to provide statistically robust assessments of the quality of untreated groundwater in the primary aquifer systems that are used for drinking-water supply. The assessments are based on water-quality data collected by the USGS from 235 wells in the three study units in 2005-08, and water-quality data from the California Department of Public Health (CDPH) database. The primary aquifer systems (hereinafter, referred to as primary aquifers) assessed in this study are defined by the depth intervals of the wells in the CDPH database for each study unit. The quality of groundwater in shallow or deep water-bearing zones may differ from quality of groundwater in the primary aquifers; shallow groundwater may be more vulnerable to contamination from the surface. The status of the current quality of the groundwater resource was assessed by using data from samples analyzed for volatile organic compounds (VOC), pesticides, and naturally occurring inorganic constituents, such as major ions and trace elements. This status assessment is intended to characterize the quality of groundwater resources within the primary aquifers of the three Sacramento Valley study units, not the treated drinking water delivered to consumers by water purveyors. Relative-concentrations (sample concentrations divided by benchmark concentrations) were used for evaluating groundwater quality for those constituents that have Federal or California regulatory or non-regulatory benchmarks for drinking-water quality. A relative-concentration greater than 1.0 indicates a concentration greater than a benchmark. For organic (volatile organic compounds and pesticides) and special-interest (perchlorate) constituents, relative-concentrations were classified as high (greater than 1.0); moderate (equal to or less than 1.0 and greater than 0.1); or low (equal to or less than 0.1). For inorganic (major ion, trace element, nutrient, and radioactive) constituents, the boundary between low and moderate relative-concentrations was set at 0.5. Aquifer-scale proportions were used in the status assessment for evaluating regional-scale groundwater quality. High aquifer-scale proportion is defined as the percentage of the area of the primary aquifers that have a relative-concentration greater than 1.0 for a particular constituent or class of constituents; percentage is based on an areal rather than a volumetric basis. Moderate and low aquifer-scale proportions were defined as the percentage of the primary aquifers that have moderate and low relative-concentrations, respectively. Two statistical approaches-grid-based, which used one value per grid cell, and spatially-weighted, which used the full dataset-were used to calculate aquifer-scale proportions for individual constituents and classes of constituents. High and moderate aquifer-scale proportions were significantly greater for inorgani

Thematic accuracy of the 1992 National Land-Cover Data for the eastern United States: Statistical methodology and regional results

USGS Publications Warehouse

Stehman, S.V.; Wickham, J.D.; Smith, J.H.; Yang, L.

2003-01-01

The accuracy of the 1992 National Land-Cover Data (NLCD) map is assessed via a probability sampling design incorporating three levels of stratification and two stages of selection. Agreement between the map and reference land-cover labels is defined as a match between the primary or alternate reference label determined for a sample pixel and a mode class of the mapped 3×3 block of pixels centered on the sample pixel. Results are reported for each of the four regions comprising the eastern United States for both Anderson Level I and II classifications. Overall accuracies for Levels I and II are 80% and 46% for New England, 82% and 62% for New York/New Jersey (NY/NJ), 70% and 43% for the Mid-Atlantic, and 83% and 66% for the Southeast.

Status of groundwater quality in the San Fernando--San Gabriel study unit, 2005--California GAMA Priority Basin Project

USGS Publications Warehouse

Land, Michael; Kulongoski, Justin T.; Belitz, Kenneth

2012-01-01

Groundwater quality in the approximately 460-square-mile San Fernando--San Gabriel (FG) study unit was investigated as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study area is in Los Angeles County and includes Tertiary-Quaternary sedimentary basins situated within the Transverse Ranges of southern California. The GAMA Priority Basin Project is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey (USGS) and the Lawrence Livermore National Laboratory. The GAMA FG study was designed to provide a spatially unbiased assessment of the quality of untreated (raw) groundwater in the primary aquifer systems (hereinafter referred to as primary aquifers) throughout California. The assessment is based on water-quality and ancillary data collected in 2005 by the USGS from 35 wells and on water-quality data from the California Department of Public Health (CDPH) database. The primary aquifers were defined by the depth interval of the wells listed in the CDPH database for the FG study unit. The quality of groundwater in primary aquifers may be different from that in the shallower or deeper water-bearing zones; shallow groundwater may be more vulnerable to surficial contamination. This study assesses the status of the current quality of the groundwater resource by using data from samples analyzed for volatile organic compounds (VOCs), pesticides, and naturally occurring inorganic constituents, such as major ions and trace elements. This status assessment is intended to characterize the quality of groundwater resources in the primary aquifers of the FG study unit, not the treated drinking water delivered to consumers by water purveyors.

Groundwater quality of southeastern Wyoming

USGS Publications Warehouse

Eddy-Miller, Cheryl A.; Blain, Liberty

2011-01-01

Groundwater is an important resource for domestic, municipal, stock, and irrigation uses in southeastern Wyoming. Thirty-seven percent of water used in the tri-County area, which includes Laramie, Platte, and Goshen Counties, is from groundwater. Most groundwater use in the tri-County area is withdrawn from three primary aquifer groups: Quaternary-age unconsolidated-deposit aquifers, Tertiary-age units of the High Plains aquifer system, and Upper Cretaceous bedrock aquifers (Lance Formation and Fox Hills Sandstone). Authors include selected physical properties and chemicals found in water samples, describe sources and importance, and report maximum levels established by the U.S. Environmental Protection Agency. They also show concentration ranges for selected physical properties and chemicals in samples collected from the three primary aquifer groups in the tri-County area.

Approaches To Teaching Science in the Jordanian Primary School.

ERIC Educational Resources Information Center

Qualter, Anne; Abu-Hola, I. R. A.

2000-01-01

Reports on a study of the influence of different approaches to teaching units from the Jordanian science curriculum on over 600 students from grades 6, 9, and 10. Trains a small sample of male and female teachers in the use of cooperative learning and lecture-demonstration approaches to teaching. (Contains 17 references.) (Author/YDS)

Public stigma and attitudes toward psychological help-seeking in the United Arab Emirates: The mediational role of self-stigma.

PubMed

Vally, Zahir; Cody, Brettjet L; Albloshi, Maryam A; Alsheraifi, Safeya N M

2018-04-17

Scholars argue that public stigma is predictive of self-stigma, and self-stigma is a primary predictor of attitudes toward seeking psychological help (ATPH). This assertion remains undetermined outside of the United States. This study examines a potential mediational model in which internalized stigma was hypothesized to mediate the relationship between public stigma and ATPH using a sample in the United Arab Emirates. Cross-sectional, correlational design; 114 students completed measures of public stigma, self-stigma, and ATPH. Full mediation occurred. The sample exhibited high levels of both public stigma and self-stigma. Psychology students manifested diminished levels of stigma and more favorable ATPH. Results are discussed in relation to the prevalent cultural and contextual factors. Stigma reduction campaigns in this locale should target internalized stigma and its associated socio-cultural nuances. © 2018 Wiley Periodicals, Inc.

Delays in the delivery room of a primary maternity unit: a retrospective analysis of obstetric outcomes.

PubMed

Giannella, Luca; Mfuta, Kabala; Pedroni, Deborah; Delrio, Elisabetta; Venuta, Agnese; Bergamini, Ezio; Cerami, Lillo B

2013-04-01

To compare obstetric outcomes in women undergoing vaginal delivery with or without delay in the 2nd and 3rd stage of labour (SOL). This is an observational retrospective study including 10,416 full-term vaginal deliveries occurred at a primary obstetric unit. Our sample was divided according to the length of 2nd and 3rd SOL: >2 h vs. ≤2 h; and >1 h vs. ≤1 h, respectively. Obstetric outcomes were compared using univariate and multivariate analysis. A prolonged 2nd SOL was associated with severe perineal tears (odds ratio (OR) = 3.53), episiotomy (OR = 3.25), major post-partum hemorrhage (PPH) (OR = 2.35), operative delivery (OR = 3.54), and Asian ethnicity (OR = 12.12). Likewise, a prolonged 3rd SOL was associated with operative deliveries (OR = 10.49), labor induction (OR = 3.24), non-use of oxytocin after delivery (OR = 12.39), major PPH (OR = 46.95), retained placenta (OR = 3.57) and female fetal gender (OR = 4.07). even at a primary care setting, where there are mostly low-risk pregnancies, a prolonged 2nd and 3rd SOL may occur and lead to poor obstetric outcomes. Our findings raise a very controversial issue about the meaning of "low obstetrics risk", given the unpredictability of any labor, and the management of complications in the delivery room of primary maternity units.

Factor Structure and Psychometric Properties of English and Spanish Versions of the Edinburgh Postnatal Depression Scale Among Hispanic Women in a Primary Care Setting

PubMed Central

Hartley, Chelsey M.; Barroso, Nicole; Rey, Yasmin; Pettit, Jeremy W.; Bagner, Daniel M.

2015-01-01

Background Although a number of studies have examined the factor structure of the Edinburgh Postnatal Depression Scale (EPDS) in predominately White or African American samples, no published research has reported on the factor structure among Hispanic women who reside in the United States. Objective The current study examined the factor structure of the EPDS among Hispanic mothers in the United States. Method Among 220 Hispanic women, drawn from a pediatric primary care setting, with an infant aged 0 to 10 months, 6 structural models guided by the empirical literature were evaluated using confirmatory factor analysis. Results Results supported a 2-factor model of depression and anxiety as the best fitting model. Multigroup models supported the factorial invariance across women who completed the EDPS in English and Spanish. Conclusion These findings provide initial support for the 2-factor structure of the EPDS among Hispanic women in the United States. PMID:24807217

Factor structure and psychometric properties of english and spanish versions of the edinburgh postnatal depression scale among Hispanic women in a primary care setting.

PubMed

Hartley, Chelsey M; Barroso, Nicole; Rey, Yasmin; Pettit, Jeremy W; Bagner, Daniel M

2014-12-01

Although a number of studies have examined the factor structure of the Edinburgh Postnatal Depression Scale (EPDS) in predominately White or African American samples, no published research has reported on the factor structure among Hispanic women who reside in the United States. The current study examined the factor structure of the EPDS among Hispanic mothers in the United States. Among 220 Hispanic women, drawn from a pediatric primary care setting, with an infant aged 0 to 10 months, 6 structural models guided by the empirical literature were evaluated using confirmatory factor analysis. Results supported a 2-factor model of depression and anxiety as the best fitting model. Multigroup models supported the factorial invariance across women who completed the EDPS in English and Spanish. These findings provide initial support for the 2-factor structure of the EPDS among Hispanic women in the United States. © 2014 Wiley Periodicals, Inc.

Temporal Trends in Hospitalization for Acute Decompensated Heart Failure in the United States, 1998–2011

PubMed Central

Agarwal, Sunil K.; Wruck, Lisa; Quibrera, Miguel; Matsushita, Kunihiro; Loehr, Laura R.; Chang, Patricia P.; Rosamond, Wayne D.; Wright, Jacqueline; Heiss, Gerardo; Coresh, Josef

2016-01-01

Estimates of the numbers and rates of acute decompensated heart failure (ADHF) hospitalization are central to understanding health-care utilization and efforts to improve patient care. We comprehensively estimated the frequency, rate, and trends of ADHF hospitalization in the United States. Based on Atherosclerosis Risk in Communities (ARIC) Study surveillance adjudicating 12,450 eligible hospitalizations during 2005–2010, we developed prediction models for ADHF separately for 3 International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 428 discharge diagnosis groups: 428 primary, 428 nonprimary, or 428 absent. We applied the models to data from the National Inpatient Sample (11.5 million hospitalizations of persons aged ≥55 years with eligible ICD-9-CM codes), an all-payer, 20% probability sample of US community hospitals. The average estimated number of ADHF hospitalizations per year was 1.76 million (428 primary, 0.80 million; 428 nonprimary, 0.83 million; 428 absent, 0.13 million). During 1998–2004, the rate of ADHF hospitalization increased by 2.0%/year (95% confidence interval (CI): 1.8, 2.5) versus a 1.4%/year (95% CI: 0.8, 2.1) increase in code 428 primary hospitalizations (P < 0.001). In contrast, during 2005–2011, numbers of ADHF hospitalizations were stable (−0.5%/year; 95% CI: −1.4, 0.3), while the numbers of 428-primary hospitalizations decreased by −1.5%/year (95% CI: −2.2, −0.8) (P for contrast = 0.03). In conclusion, the estimated number of hospitalizations with ADHF is approximately 2 times higher than the number of hospitalizations with ICD-9-CM code 428 in the primary position. The trend increased more steeply prior to 2005 and was relatively flat after 2005. PMID:26895710

The SDSS-IV MaNGA Sample: Design, Optimization, and Usage Considerations

NASA Astrophysics Data System (ADS)

Wake, David A.; Bundy, Kevin; Diamond-Stanic, Aleksandar M.; Yan, Renbin; Blanton, Michael R.; Bershady, Matthew A.; Sánchez-Gallego, José R.; Drory, Niv; Jones, Amy; Kauffmann, Guinevere; Law, David R.; Li, Cheng; MacDonald, Nicholas; Masters, Karen; Thomas, Daniel; Tinker, Jeremy; Weijmans, Anne-Marie; Brownstein, Joel R.

2017-09-01

We describe the sample design for the SDSS-IV MaNGA survey and present the final properties of the main samples along with important considerations for using these samples for science. Our target selection criteria were developed while simultaneously optimizing the size distribution of the MaNGA integral field units (IFUs), the IFU allocation strategy, and the target density to produce a survey defined in terms of maximizing signal-to-noise ratio, spatial resolution, and sample size. Our selection strategy makes use of redshift limits that only depend on I-band absolute magnitude (M I ), or, for a small subset of our sample, M I and color (NUV - I). Such a strategy ensures that all galaxies span the same range in angular size irrespective of luminosity and are therefore covered evenly by the adopted range of IFU sizes. We define three samples: the Primary and Secondary samples are selected to have a flat number density with respect to M I and are targeted to have spectroscopic coverage to 1.5 and 2.5 effective radii (R e ), respectively. The Color-Enhanced supplement increases the number of galaxies in the low-density regions of color-magnitude space by extending the redshift limits of the Primary sample in the appropriate color bins. The samples cover the stellar mass range 5× {10}8≤slant {M}* ≤slant 3× {10}11 {M}⊙ {h}-2 and are sampled at median physical resolutions of 1.37 and 2.5 kpc for the Primary and Secondary samples, respectively. We provide weights that will statistically correct for our luminosity and color-dependent selection function and IFU allocation strategy, thus correcting the observed sample to a volume-limited sample.

Psychopathologic differences between cannabis-induced psychoses and recent-onset primary psychoses with abuse of cannabis.

PubMed

Rubio, Gabriel; Marín-Lozano, Jesús; Ferre, Francisco; Martínez-Gras, Isabel; Rodriguez-Jimenez, Roberto; Sanz, Javier; Jimenez-Arriero, Miguel Angel; Carrasco, José Luis; Lora, David; Jurado, Rosa; López-Trabada, José Ramón; Palomo, Tomás

2012-11-01

The study aims to identify psychopathologic variables in cannabis-induced psychosis and recent-onset primary psychoses using the Symptom Checklist-90-R and the Psychiatric Research Interview for Substance and Mental Disorders. A sample of 181 subjects with psychotic symptoms and cannabis use referred to the psychiatry inpatient units of 3 university general hospitals were assessed. The final sample included 50 subjects with a diagnosis of cannabis-induced psychotic disorder (CIPD) and 104 subjects with primary psychotic disorders. Using receiver operating characteristic curves, the most efficient psychopathologic variables for classifying CIPD were interpersonal sensitivity, "depression," phobic anxiety, and Scale to Assess Unawareness of Mental Disorders subscales. The area under the receiver operating characteristic curve of the model including depression and "misattribution" scores was 96.78% (95% confidence interval, 94.43-99.13). Depressive symptoms could be used to distinguish CIPD from other primary psychotic disorders. Clinical variables related to "neurotic" symptoms could be involved in the susceptibility to cannabis-induced psychosis. Copyright © 2012 Elsevier Inc. All rights reserved.

Inventory of Drug Samples in a Health Care Institution

PubMed Central

Soucy, Geneviève; Bussières, Jean-François; Tardif, Lyne; Bailey, Benoît

2009-01-01

Background: Few data exist on the presence of drug samples in health care facilities. Although the use of drug samples has potential benefits, this practice is also controversial, as it can contribute to non-optimal drug use. The objective of this study was to evaluate the inventory of drug samples in a health care institution and to determine compliance with existing policies and procedures. Methods: This descriptive observational study was conducted in a university hospital centre from October 18 to November 1, 2007. A standardized data collection form was used for a physical inventory, which was intended to identify all drug samples available in the institution. The following information was recorded: number of locations where drug samples were found, primary patient care activity performed at each location, number of storage areas in the location, type of storage, presence of a lock, location of the key (if a lock was present), medical specialty, number of physicians and nurses likely to use the samples, reasons given for handing out samples, presence of a designated person to manage the samples, physical inventory (i.e., various details for each distribution unit), and declaration of samples to the pharmacy department. The inventory was conducted by 2 research assistants during day shifts. Results: A total of 84 locations were included in the inventory, and drug samples were found in 21 locations (with a total of 31 storage areas). All of the locations were intended for ambulatory patients (outpatient clinics and day centres). No drug samples were found in inpatient care units. The drug samples, which came from 62 different pharmaceutical companies, represented a total of 159 generic entities and 266 different brands. Of the distribution units for drug samples that were identified during this inventory, 59% were not on the hospital’s local formulary. Furthermore, only 3.5% of the distribution units had been declared to the pharmacy department, in accordance with established policy. The sample distribution units, including expired units, totalled 78 955 doses, with a total value of Can$48 783 (based on unit prices in effect in October 2007). Conclusion: This study presents an inventory of drug samples in an urban health care institution and reports compliance with the institution’s policies and procedures regarding drug samples. Samples were found only in outpatient clinics and represented 2.4 times the hospital’s floor stock of medications. Most of the samples inventoried were not listed on the hospital’s formulary. It appears that the use of drug samples is underestimated in hospital settings. Further studies are needed to evaluate the importance of drug samples and the risks associated with their use. PMID:22478908

THEMATIC ACCURACY OF THE 1992 NATIONAL LAND-COVER DATA (NLCD) FOR THE EASTERN UNITED STATES: STATISTICAL METHODOLOGY AND REGIONAL RESULTS

EPA Science Inventory

The accuracy of the National Land Cover Data (NLCD) map is assessed via a probability sampling design incorporating three levels of stratification and two stages of selection. Agreement between the map and reference land-cover labels is defined as a match between the primary or a...

United States Armed Forces' Voluntary Education Program: The Effect on Enlisted Servicemember Retention.

ERIC Educational Resources Information Center

Brauchle, Kenneth C.

The relationship between servicemembers' participation in the U.S. Armed Forces' off-duty voluntary higher education programs and retention of enlisted personnel in military service was examined through a review of existing and new data. The primary data source was a 1992 Department of Defense-sponsored survey of a stratified sample of…

Psychiatric Comorbidities among Female Adolescents with Anorexia Nervosa

ERIC Educational Resources Information Center

Salbach-Andrae, Harriet; Lenz, Klaus; Simmendinger, Nicole; Klinkowski, Nora; Lehmkuhl, Ulrike; Pfeiffer, Ernst

2008-01-01

This study investigated current comorbid Axis I diagnoses associated with Anorexia Nervosa (AN) in adolescents. The sample included 101 female adolescents treated at a psychiatric unit for primary DSM-IV diagnoses of AN. 73.3% of the AN patients were diagnosed as having a current comorbidity of at least one comorbid Axis I diagnosis, with no…

Summary of mortality statistics and forest health monitoring results for the Northeastern United States

Treesearch

William H. McWilliams; Stanford L. Arner; Charles J. Barnett

1997-01-01

The USDA Forest Service's Forest Inventory and Analysis (FIA) program and the Forest Health Monitoring (FHM) program maintain networks of sample locations providing coarse-scale information that characterize general indicators of forest health. Tree mortality is the primary FIA variable for analyzing forest health. Recent FIA inventories of New York, Pennsylvania...

The American Curriculum: A Documentary History.

ERIC Educational Resources Information Center

Willis, George, Ed.; Schubert, William H., Ed.; Bullough, Robert V., Jr., Ed.; Kridel, Craig, Ed.; Holton, John T., Ed.

This book brings together in one volume a sampling of primary source materials from the historical development of curriculum in the United States. The materials describe what has been or might have been taught in U.S. schools from the 17th century through the 20th century. The materials are arranged in chronological order focusing specific issues…

Sampling and analytical variability associated with determination of aflatoxin and ochratoxin A in capsular ginger powder sold as a dietary supplement

USDA-ARS?s Scientific Manuscript database

Safety of botanicals is of primary concern to the consumers of medicinal plants and dietary supplements. In the United States, the Food and Drug Administration generally recognize ginger as safe. Ginger roots could be contaminated with mycotoxins, which are toxins produced by molds during productio...

Status and understanding of groundwater quality in the Klamath Mountains study unit, 2010: California GAMA Priority Basin Project

USGS Publications Warehouse

Bennett, George L.; Fram, Miranda S.; Belitz, Kenneth

2014-01-01

Groundwater quality in the Klamath Mountains (KLAM) study unit was investigated as part of the Priority Basin Project of the California Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study unit is located in Del Norte, Humboldt, Shasta, Siskiyou, Tehama, and Trinity Counties. The GAMA Priority Basin Project is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey (USGS) and the Lawrence Livermore National Laboratory. The GAMA Priority Basin Project was designed to provide a spatially unbiased, statistically robust assessment of the quality of untreated (raw) groundwater in the primary aquifer system. The assessment is based on water-quality data and explanatory factors for groundwater samples collected in 2010 by the USGS from 39 sites and on water-quality data from the California Department of Public Health (CDPH) water-quality database. The primary aquifer system was defined by the depth intervals of the wells listed in the CDPH water-quality database for the KLAM study unit. The quality of groundwater in the primary aquifer system may be different from that in the shallower or deeper water-bearing zones; shallow groundwater may be more vulnerable to surficial contamination. This study included two types of assessments: (1) a status assessment, which characterized the status of the current quality of the groundwater resource by using data from samples analyzed for volatile organic compounds, pesticides, and naturally occurring inorganic constituents, such as major ions and trace elements, and (2) an understanding assessment, which evaluated the natural and human factors potentially affecting the groundwater quality. The assessments were intended to characterize the quality of groundwater resources in the primary aquifer system of the KLAM study unit, not the quality of treated drinking water delivered to consumers by water purveyors. Relative-concentrations (sample concentrations divided by the health- or aesthetic-based benchmark concentrations) were used for evaluating groundwater quality for those constituents that have Federal or California regulatory or non-regulatory benchmarks for drinking-water quality. A relative-concentration greater than (>) 1.0 indicates a concentration greater than a benchmark, and a relative-concentration less than or equal to (≤) 1.0 indicates a concentration less than or equal to a benchmark. Relative-concentrations of organic constituents were classified as “high” (relative-concentration > 1.0), “moderate” (0.1 Aquifer-scale proportion was used in the status assessment as the primary metric for evaluating regional-scale groundwater quality. High aquifer-scale proportion is defined as the percentage of the area of the primary aquifer system with a relative-concentration greater than 1.0 for a particular constituent or class of constituents; percentage is based on an areal rather than a volumetric basis. Moderate and low aquifer-scale proportions were defined as the percentages of the primary aquifer system with moderate and low relative-concentrations, respectively. The KLAM study unit includes more than 8,800 square miles (mi2), but only those areas near the sampling sites, about 920 mi2, are included in the areal assessment of the study unit. Two statistical approaches—grid-based and spatially weighted—were used to evaluate aquifer-scale proportions for individual constituents and classes of constituents. To confirm this methodology, 90 percent confidence intervals were calculated for the grid-based high aquifer-scale proportions and were compared to the spatially weighted results, which were found to be within these confidence intervals in all cases. Grid-based results were selected for use in the status assessment unless, as was observed in a few cases, a grid-based result was zero and the spatially weighted result was not zero, in which case, the spatially weighted result was used. The status assessment showed that inorganic constituents with human-health benchmarks were detected at high relative-concentrations in 2.6 percent of the primary aquifer system and at moderate relative-concentrations in 10 percent of the system. The high aquifer-scale proportion for inorganic constituents mainly reflected the high aquifer-scale proportions of boron. Inorganic constituents with secondary maximum contaminant levels were detected at high relative-concentrations in 13 percent of the primary aquifer system and at moderate relative-concentrations in 10 percent of the system. The constituents present at high relative-concentrations included iron and manganese. Organic constituents with human-health benchmarks were not detected at high relative-concentrations, but were detected at moderate relative-concentrations in 1.9 percent of the primary aquifer system. The 1.9 percent reflected a spatially weighted moderate aquifer-scale proportion for the gasoline additive methyl tert-butyl ether. Of the 148 organic constituents analyzed, 14 constituents were detected. Only one organic constituent had a detection frequency of greater than 10 percent—the trihalomethane, chloroform. The second component of this study, the understanding assessment, identified the natural and human factors that may have affected the groundwater quality in the KLAM study unit by evaluating statistical correlations between water-quality constituents and potential explanatory factors. The potential explanatory factors evaluated were aquifer lithology, land use, hydrologic conditions, depth, groundwater age, and geochemical conditions. Results of the statistical evaluations were used to explain the occurrence and distribution of constituents in the KLAM study unit. Groundwater age distribution (modern, mixed, or pre-modern), redox class (oxic, mixed, or anoxic), and dissolved oxygen concentration were the explanatory factors that best explained occurrence patterns of the inorganic constituents. High concentrations of boron were found to be associated with groundwater classified as mixed or pre-modern with respect to groundwater age. Boron was also negatively correlated to dissolved oxygen and positively correlated to specific conductance. Iron and manganese concentrations were strongly associated with low dissolved oxygen concentrations, anoxic and mixed redox classifications, and pre-modern groundwater. Specific conductance concentrations were found to be related to pre-modern groundwater, low dissolved oxygen concentrations, and high pH. Chloroform was selected for additional evaluation in the understanding assessment because it was detected in more than 10 percent of wells sampled in the KLAM study unit. Septic tank density was the only explanatory factor that was found to relate to chloroform concentrations.

Food allergy knowledge, attitudes, and beliefs of primary care physicians.

PubMed

Gupta, Ruchi S; Springston, Elizabeth E; Kim, Jennifer S; Smith, Bridget; Pongracic, Jacqueline A; Wang, Xiaobin; Holl, Jane

2010-01-01

To provide insight into food allergy knowledge and perceptions among pediatricians and family physicians in the United States. A national sample of pediatricians and family physicians was recruited between April and July 2008 to complete the validated, Web-based Chicago Food Allergy Research Survey for Primary Care Physicians. Findings were analyzed to provide composite/itemized knowledge scores, describe attitudes and beliefs, and examine the effects of participant characteristics on response. The sample included 407 primary care physicians; 99% of the respondents reported providing care for food-allergic patients. Participants answered 61% of knowledge-based items correctly. Strengths and weaknesses were identified in each content domain evaluated by the survey. For example, 80% of physicians surveyed knew that the flu vaccine is unsafe for egg-allergic children, 90% recognized that the number of food-allergic children is increasing in the United States, and 80% were aware that there is no cure for food allergy. However, only 24% knew that oral food challenges may be used in the diagnosis of food allergy, 12% correctly rejected that chronic nasal problems are not symptom of food allergy, and 23% recognized that yogurts/cheeses from milk are unsafe for children with immunoglobulin E-mediated milk allergies. Fewer than 30% of the participants felt comfortable interpreting laboratory tests to diagnose food allergy or felt adequately prepared by their medical training to care for food-allergic children. Knowledge of food allergy among primary care physicians was fair. Opportunities for improvement exist, as acknowledged by participants' own perceptions of their clinical abilities in the management of food allergy.

Molecular and isotopic analyses of the hydrocarbon gases within gas hydrate-bearing rock units of the Prudhoe Bay-Kuparuk River area in northern Alaska

USGS Publications Warehouse

Valin, Zenon C.; Collett, Timothy S.

1992-01-01

Gas hydrates, which are crystalline substances of water molecules that encase gas molecules, have the potential for being a significant source of natural gas. World-wide estimates for the amount of gas contained in hydrates range from 1.1 x 105 to 2.7 x 108 trillion cubic feet. Gas hydrates exist in many Arctic regions, including the North Slope of Alaska. The two primary objectives of the U.S. Geological Survey Gas Hydrate Research Project are (1) to map the distribution of in-situ gas hydrates on the North Slope of Alaska, and (2) to evaluate the geologic parameters that control the distribution of these gas hydrates. To aid in this study, British Petroleum Exploration, ARCO Alaska, Exxon Company USA, and the Continental Oil Company allowed the U.S. Geological Survey to collect geochemical samples from drilling North Slope production wells. Molecular analysis of gaseous drill cutting and free-flowing gas samples from 10 production wells drilled in the Prudhoe Bay, Kuparuk River, and Milne Point oil fields indicates that methane is the primary hydrocarbon gas in the gas hydrate-bearing stratigraphic units. Isotopic data for several of these rock units indicate that the methane within the inferred gas hydrate occurences originated from both microbial and thermogenic processes.

Evaluating multi-level models to test occupancy state responses of Plethodontid salamanders

USGS Publications Warehouse

Kroll, Andrew J.; Garcia, Tiffany S.; Jones, Jay E.; Dugger, Catherine; Murden, Blake; Johnson, Josh; Peerman, Summer; Brintz, Ben; Rochelle, Michael

2015-01-01

Plethodontid salamanders are diverse and widely distributed taxa and play critical roles in ecosystem processes. Due to salamander use of structurally complex habitats, and because only a portion of a population is available for sampling, evaluation of sampling designs and estimators is critical to provide strong inference about Plethodontid ecology and responses to conservation and management activities. We conducted a simulation study to evaluate the effectiveness of multi-scale and hierarchical single-scale occupancy models in the context of a Before-After Control-Impact (BACI) experimental design with multiple levels of sampling. Also, we fit the hierarchical single-scale model to empirical data collected for Oregon slender and Ensatina salamanders across two years on 66 forest stands in the Cascade Range, Oregon, USA. All models were fit within a Bayesian framework. Estimator precision in both models improved with increasing numbers of primary and secondary sampling units, underscoring the potential gains accrued when adding secondary sampling units. Both models showed evidence of estimator bias at low detection probabilities and low sample sizes; this problem was particularly acute for the multi-scale model. Our results suggested that sufficient sample sizes at both the primary and secondary sampling levels could ameliorate this issue. Empirical data indicated Oregon slender salamander occupancy was associated strongly with the amount of coarse woody debris (posterior mean = 0.74; SD = 0.24); Ensatina occupancy was not associated with amount of coarse woody debris (posterior mean = -0.01; SD = 0.29). Our simulation results indicate that either model is suitable for use in an experimental study of Plethodontid salamanders provided that sample sizes are sufficiently large. However, hierarchical single-scale and multi-scale models describe different processes and estimate different parameters. As a result, we recommend careful consideration of study questions and objectives prior to sampling data and fitting models.

Cefotaxime-resistant E. coli in dairy and beef cattle farms-Joint analyses of two cross-sectional investigations in Germany.

PubMed

Hille, Katja; Ruddat, Inga; Schmid, Annette; Hering, Johanna; Hartmann, Maria; von Münchhausen, Christiane; Schneider, Bettina; Messelhäusser, Ute; Friese, Anika; Mansfeld, Rolf; Käsbohrer, Annemarie; Hörmansdorfer, Stefan; Roesler, Uwe; Kreienbrock, Lothar

2017-07-01

Resistance to third-generation cephalosporins and other beta-lactam antibiotics is of major concern for animal and human health. Knowledge of the prevalence of resistant bacteria in primary production is an important element to estimate transmission along the stages in the food production chain and the exposure of the human population. The primary objective of this study was to determine the prevalence of cefotaxime-resistant commensal E. coli in dairy and beef cattle production units throughout Germany. Secondarily, the association between management factors and the presence of cefotaxime resistance was investigated. In total, 60 beef cattle and 52 dairy cattle production units all over Germany were included. Cefotaxime-resistant E. coli were isolated from at least one sample in 70% (95% CI: 58-83%) of the farms keeping beef cattle and 85% (95% CI: 75-94%) of the farms keeping dairy cattle. The sample prevalence was 35% (161/455; 95% CI: 31-40%) and 48% (156/323; 95% CI: 43-54%), respectively. Most factors associated with resistance to cefotaxime indicate that less intensive production results in a lower number of positive samples. For beef cattle, antimicrobial treatment of the whole animal group was significantly associated with an increased proportion of samples containing cefotaxime resistant E. coli. In addition, our results indicate that better hygiene management could improve the resistance situation on cattle farms. Copyright © 2017 Elsevier B.V. All rights reserved.

Status and understanding of groundwater quality in the North San Francisco Bay groundwater basins, 2004

USGS Publications Warehouse

Kulongoski, Justin T.; Belitz, Kenneth; Landon, Matthew K.; Farrar, Christopher

2010-01-01

Groundwater quality in the approximately 1,000-square-mile (2,590-square-kilometer) North San Francisco Bay study unit was investigated as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study unit is located in northern California in Marin, Napa, and Sonoma Counties. The GAMA Priority Basin Project is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey (USGS) and the Lawrence Livermore National Laboratory. The GAMA North San Francisco Bay study was designed to provide a spatially unbiased assessment of untreated groundwater quality in the primary aquifer systems. The assessment is based on water-quality and ancillary data collected by the USGS from 89 wells in 2004 and water-quality data from the California Department of Public Health (CDPH) database. The primary aquifer systems (hereinafter referred to as primary aquifers) were defined by the depth interval of the wells listed in the CDPH database for the North San Francisco Bay study unit. The quality of groundwater in shallower or deeper water-bearing zones may differ from that in the primary aquifers; shallower groundwater may be more vulnerable to surficial contamination. The first component of this study, the status of the current quality of the groundwater resource, was assessed by using data from samples analyzed for volatile organic compounds (VOC), pesticides, and naturally occurring inorganic constituents, such as major ions and trace elements. This status assessment is intended to characterize the quality of groundwater resources within the primary aquifers of the North San Francisco Bay study unit, not the treated drinking water delivered to consumers by water purveyors. Relative-concentrations (sample concentration divided by the health- or aesthetic-based benchmark concentration) were used for evaluating groundwater quality for those constituents that have Federal and (or) California benchmarks. A relative-concentration greater than (>) 1.0 indicates a concentration above a benchmark, and less than or equal to (=) 1.0 indicates a concentration equal to or below a benchmark. Relative-concentrations of organic and special interest constituents were classified as ?high? (relative-concentration > 1.0), ?moderate? (0.1 1.0), ?moderate? (0.5 < relative-concentration = 1.0), or ?low? (relative-concentration = 0.5). Aquifer-scale proportion was used as a metric for evaluating regional-scale groundwater quality. High aquifer-scale proportion is defined as the percentage of the primary aquifers that have a relative-concentration greater than 1.0; proportion is calculated on an areal rather than a volumetric basis. Moderate and low aquifer-scale proportions were defined as the percentage of the primary aquifers that have moderate and low relative-concentrations, respectively. Two statistical approaches-grid-based and spatially-weighted-were used to evaluate aquifer-scale proportion for individual constituents and classes of constituents. Grid-based and spatially-weighted estimates were comparable in the North San Francisco Bay study unit (90-percent confidence intervals). For inorganic constituents with human-health benchmarks, relative-concentrations were high in 14.0 percent of the primary aquifers, moderate in 35.8 percent, and low in 50.2 percent. The high aquifer-scale proportion of inorganic constituents primarily reflected high aquifer-scale proportions of arsenic (10.0 percent), boron (4.1 percent), and lead (1.6 percent). In contrast, relative-concentrations of organic constituents (one or more) were high in 1.4 percent, moderate in 4.9 percent, and low in 93.7 percent (not detected in 64.8 percent) of the primary aquifers. The high aquifer-scale proport

Impact of the economic downturn on total joint replacement demand in the United States: updated projections to 2021.

PubMed

Kurtz, Steven M; Ong, Kevin L; Lau, Edmund; Bozic, Kevin J

2014-04-16

Few studies have explored the role of the National Health Expenditure and macroeconomics on the utilization of total joint replacement. The economic downturn has raised questions about the sustainability of growth for total joint replacement in the future. Previous projections of total joint replacement demand in the United States were based on data up to 2003 using a statistical methodology that neglected macroeconomic factors, such as the National Health Expenditure. Data from the Nationwide Inpatient Sample (1993 to 2010) were used with United States Census and National Health Expenditure data to quantify historical trends in total joint replacement rates, including the two economic downturns in the 2000s. Primary and revision hip and knee arthroplasty were identified using codes from the International Classification of Diseases, Ninth Revision, Clinical Modification. Projections in total joint replacement were estimated using a regression model incorporating the growth in population and rate of arthroplasties from 1993 to 2010 as a function of age, sex, race, and census region using the National Health Expenditure as the independent variable. The regression model was used in conjunction with government projections of National Health Expenditure from 2011 to 2021 to estimate future arthroplasty rates in subpopulations of the United States and to derive national estimates. The growth trend for the incidence of joint arthroplasty, for the overall United States population as well as for the United States workforce, was insensitive to economic downturns. From 2009 to 2010, the total number of procedures increased by 6.0% for primary total hip arthroplasty, 6.1% for primary total knee arthroplasty, 10.8% for revision total hip arthroplasty, and 13.5% for revision total knee arthroplasty. The National Health Expenditure model projections for primary hip replacement in 2020 were higher than a previously projected model, whereas the current model estimates for total knee arthroplasty were lower. Economic downturns in the 2000s did not substantially influence the national growth trends for hip and knee arthroplasty in the United States. These latest updated projections provide a basis for surgeons, hospitals, payers, and policy makers to plan for the future demand for total joint replacement surgery.

Status and understanding of groundwater quality in the two southern San Joaquin Valley study units, 2005-2006 - California GAMA Priority Basin Project

USGS Publications Warehouse

Burton, Carmen A.; Shelton, Jennifer L.; Belitz, Kenneth

2012-01-01

Groundwater quality in the southern San Joaquin Valley was investigated from October 2005 through March 2006 as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The GAMA Priority Basin Project is conducted by the U.S. Geological Survey (USGS) in collaboration with the California State Water Resources Control Board and the Lawrence Livermore National Laboratory. There are two study units located in the southern San Joaquin Valley: the Southeast San Joaquin Valley (SESJ) study unit and the Kern County Subbasin (KERN) study unit. The GAMA Priority Basin Project in the SESJ and KERN study units was designed to provide a statistically unbiased, spatially distributed assessment of untreated groundwater quality within the primary aquifers. The status assessment is based on water-quality and ancillary data collected in 2005 and 2006 by the USGS from 130 wells on a spatially distributed grid, and water-quality data from the California Department of Public Health (CDPH) database. Data was collected from an additional 19 wells for the understanding assessment. The aquifer systems (hereinafter referred to as primary aquifers) were defined as that part of the aquifer corresponding to the perforation interval of wells listed in the CDPH database for the SESJ and KERN study units. The status assessment of groundwater quality used data from samples analyzed for anthropogenic constituents such as volatile organic compounds (VOCs) and pesticides, as well as naturally occurring inorganic constituents such as major ions and trace elements. The status assessment is intended to characterize the quality of untreated groundwater resources within the primary aquifers in the SESJ and KERN study units, not the quality of drinking water delivered to consumers. Although the status assessment applies to untreated groundwater, Federal and California regulatory and non-regulatory water-quality benchmarks that apply to drinking water are used to provide context for the results. Relative-concentrations (sample concentration divided by benchmark concentration) were used for evaluating groundwater. A relative-concentration greater than 1.0 indicates a concentration greater than the benchmark and is classified as high. The relative-concentration threshold for classifying inorganic constituents as moderate or low was 0.5; for organic constituents the threshold between moderate and low was 0.1. Aquifer-scale proportion was used as the primary metric for assessing the quality of untreated groundwater for the study units. High aquifer-scale proportion is defined as the areal percentage of the primary aquifers with a high relative-concentration for a particular constituent or class of constituents. Moderate and low aquifer-scale proportions were defined as the areal percentage of the primary aquifers with moderate and low relative-concentrations, respectively. Two statistical approaches—grid-based and spatially weighted—were used to evaluate aquifer-scale proportions for individual constituents and classes of constituents. Grid-based and spatially weighted estimates were comparable for the two study units in the southern San Joaquin Valley (within 90 percent confidence intervals). The status assessment showed that inorganic constituents were more prevalent than organic constituents and that relative-concentrations were higher for inorganic constituents than for organic constituents. For inorganic constituents with human-health benchmarks, the relative-concentration of at least one constituent in the SESJ study unit was high in 30 percent of the primary aquifers. In the KERN study unit, the relative-concentration of at least one constituent was high in 23 percent of the primary aquifers. In the SESJ and KERN study units, the inorganic constituents with human-health benchmarks detected at high relative-concentrations in more than 2 percent of the primary aquifers were arsenic, boron, vanadium, nitrate, uranium, and gross alpha radioactivity. Additional constituents with human-health benchmarks—antimony, radium, and fluoride—were detected at high relative-concentrations in the KERN study unit. For inorganic constituents with aesthetic benchmarks (secondary maximum contaminant levels, SMCLs), the relative-concentration of at least one constituent in the SESJ study unit was high in 6.6 percent of the primary aquifers. In the KERN study unit, the relative-concentration of at least one constituent was high in 22 percent of the primary aquifers. Inorganic constituents with aesthetic benchmarks detected at high relative-concentrations in the primary aquifers in the SESJ and KERN study units were iron and manganese. Additional constituents with aesthetic benchmarks—total dissolved solids (TDS), sulfate, and chloride—were detected at high relative-concentrations in the KERN study unit. In contrast, the status assessment for organic constituents with human-health benchmarks showed that relative-concentrations were high in 4.8 percent and 2.1 percent of the primary aquifers in the SESJ and KERN study units, respectively. The special-interest constituent, perchlorate, was detected at high relative-concentrations in 1.2 percent of the primary aquifers in the SESJ study unit. Twenty-eight of the 78 VOCs (not including fumigants) analyzed were detected. Of these 28 VOCs, benzene had high relative-concentrations in the SESJ study unit, and relative-concentrations for the other 27 VOCs were moderate and low. Five of the 10 fumigants were detected; 1,2-dibromo-3-chloropropane (DBCP) was the only fumigant with high relative-concentrations in the SESJ and KERN study units. Of the 136 pesticides and pesticide degradates analyzed, 33 were detected. Human-health benchmarks were established for eighteen of the detected pesticides. Dieldrin was detected at moderate relative-concentrations in the SESJ and KERN study units. All other pesticides detected with human-health benchmarks were present at low relative-concentrations. The detection frequencies for two of these pesticides—simazine and atrazine—were greater than or equal to 10 percent in the SESJ and KERN study units. The understanding assessment of groundwater quality included an analysis of correlations of selected water-quality constituents or classes of constituents with potential explanatory factors. The understanding assessment indicated that the concentrations of many trace elements and major ions were correlated to well depth, groundwater age, and/or geochemical conditions. Many trace elements were positively correlated with depth. Arsenic, boron, vanadium, fluoride, manganese, and iron concentrations increased with well depth or depth to top-of-perforations. The concentrations for these trace elements also were higher in older (pre-modern) groundwater. In contrast, uranium concentrations decreased with increasing depth and groundwater age. Most trace elements were correlated to geochemical conditions. Arsenic, antimony, boron, fluoride, manganese, and iron concentrations generally were higher wherever the pH of the groundwater was greater than 7.6. Concentrations for these constituents generally were higher at low concentrations of dissolved oxygen (DO). Uranium was the exception; uranium concentrations generally were lower at high pH and at high concentrations of DO. Nitrate concentrations generally were lower in deeper wells. Nitrate concentrations also were higher in groundwater with higher DO. Total dissolved solids, sulfate, and chloride concentrations were higher in the KERN study unit than in the SESJ study unit. Total dissolved solids were negatively correlated with pH in the KERN study unit. Total dissolved solids and sulfate were higher in areas with more agricultural land use. Chloride concentrations increased with depth to top-of-perforations in the KERN study unit. Organic constituents and constituents of special interest, like many inorganic constituents, were correlated with well depth, groundwater age, and DO. Unlike most trace elements, however, solvent and pesticide detections, and total trihalomethanes (THM), DBCP, and perchlorate concentrations decreased with increasing well depth. Volatile organic compound, solvent, and pesticide detections, and THM concentrations also were lower in older (pre-modern) groundwater than in modern-age groundwater. Solvent detections and total THM, DBCP, and perchlorate concentrations increased with increasing DO concentrations.

Forest inventory and analysis data for FVS modelers

Treesearch

Patrick D. Miles

2008-01-01

The USDA Forest Service, Forest Inventory and Analysis (FIA) program has been in continuous operation for over 70 years. FIA’s primary objective is to determine the extent, condition, volume, growth, and depletion of timber on the Nation’s forest land. To accomplish this objective, FIA collects sample plot information on all ownerships across the United States.

Infant Temperament in Russia, United States of America, and Israel: Differences and Similarities between Russian-Speaking Families

ERIC Educational Resources Information Center

Gartstein, Maria A.; Peleg, Yana; Young, Brandi N.; Slobodskaya, Helena R.

2009-01-01

The present study addresses cross-cultural differences between infants born to families of Russian immigrants in USA and Israel, as well as Russian families residing in Russia, with the emphasis on evaluating the impact of immigration and acculturation. Community samples of primary caregivers of infants between 3 and 12 months of age were…

Statistics and quality assurance for the Northern Research Station Forest Inventory and Analysis Program, 2016

Treesearch

Dale D. Gormanson; Scott A. Pugh; Charles J. Barnett; Patrick D. Miles; Randall S. Morin; Paul A. Sowers; Jim Westfall

2017-01-01

The U.S. Forest Service Forest Inventory and Analysis (FIA) program collects sample plot data on all forest ownerships across the United States. FIA's primary objective is to determine the extent, condition, volume, growth, and use of trees on the Nation's forest land through a comprehensive inventory and analysis of the Nation's forest resources. The...

Teaching Literacy and Mathematics in Reception Classes: A Survey by HMI.

ERIC Educational Resources Information Center

Office for Standards in Education, London (England).

Her Majesty's Inspectors (HMI) inspected the teaching of literacy and mathematics in the reception year in a sample of 129 schools between autumn 2000 and summer 2001. Most of the schools were designated as primary, teaching children from the age of four or five to eleven. A few schools had nursery classes or units attached to them. In half the…

Walnut Springs Interest Unit, Fairmount Avenue School. Primary Unit--Team I.

ERIC Educational Resources Information Center

State College Area School District, PA.

This environmental education teaching guide was designed for primary teachers who may want to develop their own environmental education units or who may wish to integrate the units contained in the guide into their own curriculum. The units in the guide were developed by primary teachers and reflect the experiences of the Fairmont Avenue School…

Status and understanding of groundwater quality in the Bear Valley and Lake Arrowhead Watershed Study Unit, 2010: California GAMA Priority Basin Project

USGS Publications Warehouse

Mathany, Timothy; Burton, Carmen

2017-06-20

Groundwater quality in the 112-square-mile Bear Valley and Lake Arrowhead Watershed (BEAR) study unit was investigated as part of the Priority Basin Project (PBP) of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study unit comprises two study areas (Bear Valley and Lake Arrowhead Watershed) in southern California in San Bernardino County. The GAMA-PBP is conducted by the California State Water Resources Control Board (SWRCB) in cooperation with the U.S. Geological Survey (USGS) and the Lawrence Livermore National Laboratory.The GAMA BEAR study was designed to provide a spatially balanced, robust assessment of the quality of untreated (raw) groundwater from the primary aquifer systems in the two study areas of the BEAR study unit. The assessment is based on water-quality collected by the USGS from 38 sites (27 grid and 11 understanding) during 2010 and on water-quality data from the SWRCB-Division of Drinking Water (DDW) database. The primary aquifer system is defined by springs and the perforation intervals of wells listed in the SWRCB-DDW water-quality database for the BEAR study unit.This study included two types of assessments: (1) a status assessment, which characterized the status of the quality of the groundwater resource as of 2010 by using data from samples analyzed for volatile organic compounds, pesticides, and naturally present inorganic constituents, such as major ions and trace elements, and (2) an understanding assessment, which evaluated the natural and human factors potentially affecting the groundwater quality. The assessments were intended to characterize the quality of groundwater resources in the primary aquifer system of the BEAR study unit, not the treated drinking water delivered to consumers. Bear Valley study area and the Lake Arrowhead Watershed study area were also compared statistically on the basis of water-quality results and factors potentially affecting the groundwater quality.Relative concentrations (RCs), which are sample concentration of a particular constituent divided by its associated health- or aesthetic-based benchmark concentrations, were used for evaluating the groundwater quality for those constituents that have Federal or California regulatory or non-regulatory benchmarks for drinking-water quality. An RC greater than 1.0 indicates a concentration greater than a benchmark. Organic (volatile organic compounds and pesticides) and special-interest (perchlorate) constituent RCs were classified as “high” (RC greater than 1.0), “moderate” (RC less than or equal to 1.0 and greater than 0.1), or “low” (RC less than or equal to 0.1). For inorganic (radioactive, trace element, major ion, and nutrient) constituents, the boundary between low and moderate RCs was set at 0.5.Aquifer-scale proportion was used as the primary metric in the status assessment for evaluating groundwater quality at the study-unit scale or for its component areas. High aquifer-scale proportion was defined as the percentage of the area of the primary aquifer system with a RC greater than 1.0 for a particular constituent or class of constituents; the percentage is based on area rather than volume. Moderate and low aquifer-scale proportions were defined as the percentage of the primary aquifer system with moderate and low RCs, respectively. A spatially weighted statistical approach was used to evaluate aquifer-scale proportions for individual constituents and classes of constituents.The status assessment for the Bear Valley study area found that inorganic constituents with health-based benchmarks were detected at high RCs in 9.0 percent of the primary aquifer system and at moderate RCs in 13 percent. The high RCs of inorganic constituents primarily reflected high aquifer-scale proportions of fluoride (in 5.4 percent of the primary aquifer system) and arsenic (3.6 percent). The RCs of organic constituents with health-based benchmarks were high in 1.0 percent of the primary aquifer system, moderate in 8.1 percent, and low in 70 percent. Organic constituents were detected in 79 percent of the primary aquifer system. Two groups of organic constituents and two individual organic constituents were detected at frequencies greater than 10 percent of samples from the USGS grid sites: trihalomethanes (THMs), solvents, methyl tert-butyl ether (MTBE), and simazine. The special-interest constituent perchlorate was detected in 93 percent of the primary aquifer system; it was detected at moderate RCs in 7.1 percent and at low RCs in 86 percent.The status assessment in the Lake Arrowhead Watershed study area showed that inorganic constituents with human-health benchmarks were detected at high RCs in 25 percent of the primary aquifer system and at moderate RCs in 41 percent. The high aquifer-scale proportion of inorganic constituents primarily reflected high aquifer-scale proportions of radon‑222 (in 62 percent of the primary aquifer system) and uranium (26 percent). RCs of organic constituents with health-based benchmarks were moderate in 7.7 percent of the primary aquifer system and low in 46 percent. Organic constituents were detected in 54 percent of the primary aquifer system. The only organic constituents that were detected at frequencies greater than 10 percent of samples from the USGS grid sites were THMs. Perchlorate was detected in 62 percent of the primary aquifer system at uniformly low RCs.The second component of this study, the understanding assessment, identified the natural and human factors that could have affected the groundwater quality in the BEAR study unit by evaluating statistical correlations between water-quality constituents and potential explanatory factors. The potential explanatory factors evaluated were land use (including density of septic tanks and leaking or formerly leaking underground fuel tanks), site type, aquifer lithology, well construction (well depth and depth to the top-of-perforated interval), elevation, aridity index, groundwater-age distribution, and oxidation-reduction condition (including pH and dissolved oxygen concentration). Results of the statistical evaluations were used to explain the distribution of constituents in groundwater of the BEAR study unit.In the Bear Valley study area, high and moderate RCs of fluoride were found in sites known to be influenced by hydrothermic conditions or that had high concentrations of fluoride historically. The high RC of arsenic can likely be attributed to desorption of arsenic from aquifer sediments saturated in old groundwater with high pH under reducing conditions. The THMs were detected more frequently at USGS grid sites that were wells, part of a large urban water system, and surrounded by urban land use. Solvents, MTBE, and simazine were all detected more frequently at USGS grid sites that were wells with a greater urban percentage of surrounding land use and that accessed older groundwater than other USGS grid sites. Comparison between the observed and predicted detection frequencies of perchlorate at USGS grid sites indicated that anthropogenic sources could have contributed to low levels of perchlorate in the groundwater of the Bear Valley study area.In the Lake Arrowhead Watershed study area, high and moderate RCs of radon-222 and uranium can be attributed to older groundwater from the granitic fractured-rock primary aquifer system. Low RCs of THMs were detected at USGS grid sites that were wells and part of small water systems. The similarities between the observed and predicted detection frequencies of perchlorate in samples from USGS grid sites indicated that the source and distribution of perchlorate were most likely attributable to precipitation (rain and snow), with minimal, if any, contribution from anthropogenic sources.

Status and understanding of groundwater quality in the northern San Joaquin Basin, 2005

USGS Publications Warehouse

Bennett, George L.; Fram, Miranda S.; Belitz, Kenneth; Jurgens, Bryant C.

2010-01-01

Groundwater quality in the 2,079 square mile Northern San Joaquin Basin (Northern San Joaquin) study unit was investigated from December 2004 through February 2005 as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The GAMA Priority Basin Project was developed in response to the Groundwater Quality Monitoring Act of 2001 that was passed by the State of California and is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey and the Lawrence Livermore National Laboratory. The Northern San Joaquin study unit was the third study unit to be designed and sampled as part of the Priority Basin Project. Results of the study provide a spatially unbiased assessment of the quality of raw (untreated) groundwater, as well as a statistically consistent basis for comparing water quality throughout California. Samples were collected from 61 wells in parts of Alameda, Amador, Calaveras, Contra Costa, San Joaquin, and Stanislaus Counties; 51 of the wells were selected using a spatially distributed, randomized grid-based approach to provide statistical representation of the study area (grid wells), and 10 of the wells were sampled to increase spatial density and provide additional information for the evaluation of water chemistry in the study unit (understanding/flowpath wells). The primary aquifer systems (hereinafter, primary aquifers) assessed in this study are defined by the depth intervals of the wells in the California Department of Public Health database for each study unit. The quality of groundwater in shallow or deep water-bearing zones may differ from quality of groundwater in the primary aquifers; shallow groundwater may be more vulnerable to contamination from the surface. Two types of assessments were made: (1) status, assessment of the current quality of the groundwater resource; and (2) understanding, identification of the natural and human factors affecting groundwater quality. Relative-concentrations (sample concentrations divided by benchmark concentrations) were used for evaluating groundwater quality for those constituents that have Federal or California regulatory or non-regulatory benchmarks for drinking-water quality. Benchmarks used in this study were either health-based (regulatory and non-regulatory) or aesthetic based (non-regulatory). For inorganic constituents, relative-concentrations were classified as high (equal to or greater than 1.0), indicating relative-concentrations greater than benchmarks; moderate (equal to or greater than 0.5, and less than 1.0); or, low (less than 0.5). For organic and special- interest constituents [1,2,3-trichloropropane (1,2,3-TCP), N-nitrosodimethylamine (NDMA), and perchlorate], relative- concentrations were classified as high (equal to or greater than 1.0); moderate (equal to or greater than 0.1 and less than 1.0); or, low (less than 0.1). Aquifer-scale proportion was used as the primary metric in the status assessment for groundwater quality. High aquifer- scale proportion is defined as the percentage of the primary aquifer with relative-concentrations greater than 1.0; moderate and low aquifer-scale proportions are defined as the percentage of the primary aquifer with moderate and low relative- concentrations, respectively. The methods used to calculate aquifer-scale proportions are based on an equal-area grid; thus, the proportions are areal rather than volumetric. Two statistical approaches - grid-based, which used one value per grid cell, and spatially weighted, which used the full dataset - were used to calculate aquifer-scale proportions for individual constituents and classes of constituents. The spatially weighted estimates of high aquifer-scale proportions were within the 90-percent confidence intervals of the grid-based estimates in all cases. The understanding assessment used statistical correlations between constituent relative-concentrations and

Preparing nursing students for enhanced roles in primary care: The current state of prelicensure and RN-to-BSN education.

PubMed

Wojnar, Danuta M; Whelan, Ellen Marie

With the current emphasis on including registered nurses (RNs) on the primary care teams, it is essential that nursing programs prepare students for employment in these settings. This study explored the current state of prelicensure and RN-to-Bachelor of Science in Nursing (BSN) online education regarding the implementation of primary care content in the curricula. A sample of 1,409 schools and/or colleges from across the United States was invited to participate in an online survey. About 529 surveys were returned for an overall response rate of 37.5%. Summative content analysis was used to analyze survey data. Although most respondents have implemented some primary care content, some found it challenging and others have demurred from incorporating primary care content altogether. Nursing leaders and faculty in academia must collaborate with clinical partners to design and expand didactic and clinical learning experiences that emphasize primary care content in the prelicensure and RN-to-BSN education. Copyright © 2016 Elsevier Inc. All rights reserved.

Status and understanding of groundwater quality in the Santa Clara River Valley, 2007-California GAMA Priority Basin Project

USGS Publications Warehouse

Burton, Carmen A.; Montrella, Joseph; Landon, Matthew K.; Belitz, Kenneth

2011-01-01

Groundwater quality in the approximately 460-square-mile Santa Clara River Valley study unit was investigated from April through June 2007 as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The GAMA Priority Basin Project is conducted by the U.S. Geological Survey (USGS) in collaboration with the California State Water Resources Control Board and the Lawrence Livermore National Laboratory. The Santa Clara River Valley study unit contains eight groundwater basins located in Ventura and Los Angeles Counties and is within the Transverse and Selected Peninsular Ranges hydrogeologic province. The Santa Clara River Valley study unit was designed to provide a spatially unbiased assessment of the quality of untreated (raw) groundwater in the primary aquifer system. The assessment is based on water-quality and ancillary data collected in 2007 by the USGS from 42 wells on a spatially distributed grid, and on water-quality data from the California Department of Public Health (CDPH) database. The primary aquifer system was defined as that part of the aquifer system corresponding to the perforation intervals of wells listed in the CDPH database for the Santa Clara River Valley study unit. The quality of groundwater in the primary aquifer system may differ from that in shallow or deep water-bearing zones; for example, shallow groundwater may be more vulnerable to surficial contamination. Eleven additional wells were sampled by the USGS to improve understanding of factors affecting water quality.The status assessment of the quality of the groundwater used data from samples analyzed for anthropogenic constituents, such as volatile organic compounds (VOCs) and pesticides, as well as naturally occurring inorganic constituents, such as major ions and trace elements. The status assessment is intended to characterize the quality of untreated groundwater resources in the primary aquifers of the Santa Clara River Valley study unit, not the quality of treated drinking water delivered to consumers. Relative-concentrations (sample concentration divided by health- or aesthetic-based benchmark concentration) were used for evaluating groundwater quality for those constituents that have Federal and (or) California benchmarks. A relative-concentration greater than 1.0 indicates a concentration greater than a benchmark. For organic and special interest constituents, relative-concentrations were classified as high (greater than 1.0); moderate (greater than 0.1 and less than or equal to 1.0); and low (less than or equal to 0.1). For inorganic constituents, relative-concentrations were classified as high (greater than 1.0); moderate (greater than 0.5 and less than or equal to 1.0); and low (less than or equal to 0.5). Aquifer-scale proportion was used as the primary metric in the status assessment for evaluating regional-scale groundwater quality. High aquifer-scale proportion is defined as the areal percentage of the primary aquifer system with relative-concentrations greater than 1.0. Moderate and low aquifer-scale proportions are defined as the areal percentage of the primary aquifer system with moderate and low relative-concentrations, respectively. Two statistical approaches, grid-based and spatially weighted, were used to evaluate aquifer-scale proportions for individual constituents and classes of constituents. Grid-based and spatially weighted estimates were comparable in the Santa Clara River Valley study unit (within 90 percent confidence intervals). The status assessment showed that inorganic constituents were more prevalent and relative-concentrations were higher than for organic constituents. For inorganic constituents with human-health benchmarks, relative-concentrations (of one or more constituents) were high in 21 percent of the primary aquifer system areally, moderate in 30 percent, and low or not detected in 49 percent. Inorganic constituents with human-health benchmarks with high aquifer-scale proportions were nitrate (15 percent of the primary aquifer system), gross alpha radioactivity (14 percent), vanadium (3.4 percent), boron (3.2 percent), and arsenic (2.3 percent). For inorganic constituents with aesthetic benchmarks, relative-concentrations (of one or more constituents) were high in 54 percent of the primary aquifer system, moderate in 41 percent, and low or not detected in 4 percent. The inorganic constituents with aesthetic benchmarks with high aquifer-scale proportions were total dissolved solids (35 percent), sulfate (22 percent), manganese (38 percent), and iron (22 percent). In contrast, the results of the status assessment for organic constituents with human-health benchmarks showed that relative-concentrations were high in 0 percent (not detected above benchmarks) of the primary aquifer system, moderate in 2.4 percent, and low or not detected in 97 percent. Relative-concentrations of the special interest constituent, perchlorate, were moderate in 12 percent of the primary aquifer system and low or not detected in 88 percent. Relative-concentrations of two VOCs-carbon tetrachloride and trichloroethene (TCE)-were moderate in 2.4 percent of the primary aquifer system. One VOC-chloroform (water disinfection byproduct)-was detected in more than 10 percent of the primary aquifer system but at low relative-concentrations. Of the 88 VOCs and gasoline oxygenates analyzed, 71 were not detected. Pesticides were low or not detected in 100 percent of the primary aquifer system. Of the 118 pesticides and pesticide degradates analyzed, 13 were detected and 5 of those had human-health benchmarks. Two of these five pesticides-simazine and atrazine-were detected in more than 10 percent of the primary aquifer system. The second component of this study, the understanding assessment, was to identify the natural and human factors that affect groundwater quality on the basis of the evaluation of land use, physical characteristics of the wells, and geochemical conditions of the aquifer. Results from these analyses are used to explain the occurrence and distribution of selected constituents in the primary aquifer system of the Santa Clara River Valley study unit. The understanding assessment indicated that water quality varied spatially primarily in relation to depth, groundwater age, reduction-oxidation conditions, pH, and location in the regional groundwater flow system. High and moderate relative-concentrations of nitrate and low relative-concentrations of pesticides were correlated with shallow depths to top-of-perforation, and with high dissolved oxygen. Groundwater of modern and mixed ages had higher nitrate than pre-modern-age groundwater. Decreases in concentrations of total dissolved solids (TDS) and sulfate were correlated with increases in pH. This relationship probably indicates relations of these constituents with increasing depth across most of the Santa Clara River Valley study unit. Previous studies have indicated multiple sources of high concentrations of TDS and sulfate and multiple geochemical processes affecting these constituents in the Santa Clara River Valley study unit. Manganese and iron concentrations were highest in pre-modern-age groundwater at depth and in the downgradient area of the Santa Clara River Valley study unit (closest to the coastline), indicating the prevalence of reducing groundwater conditions in these aquifer zones.

Isolation and characterisation of the biological repeating unit of cepacian, the exopolysaccharide produced by bacteria of the Burkholderia cepacia complex.

PubMed

Cescutti, Paola; Foschiatti, Michela; Furlanis, Linda; Lagatolla, Cristina; Rizzo, Roberto

2010-07-02

The repeating unit of cepacian, the exopolysaccharide produced by the majority of the microorganisms belonging to the Burkholderia cepacia complex, was isolated from inner bacterial membranes and investigated by mass spectrometry, with and without prior derivatisation. Interpretation of the mass spectra led to the determination of the biological repeating unit primary structure, thus disclosing the nature of the oligosaccharide produced in vivo. Moreover, mass spectra recorded on the native sample revealed that acetyl substitution was very variable, producing a mixture of repeating units containing zero to four acyl groups. At the same time, finding acetylated oligosaccharides showed that binding of these substituents occurred in the cellular periplasmic space, before the polymerisation process took place. In the chromatographic peak containing the repeating unit, oligosaccharides shorter than the repeating unit co-eluted. Mass spectrometric analysis showed that they were biosynthetic intermediates of the repeating unit and further investigation revealed the biosynthetic sequence of cepacian building block. Copyright 2010 Elsevier Ltd. All rights reserved.

Family centered care within an infant-toddler unit.

PubMed

Neal, Annmarie; Frost, Michelle; Kuhn, Janna; Green, Angela; Gance-Cleveland, Bonnie; Kersten, Rebecca

2007-01-01

Family centered care (FCC) is an essential component of pediatric nursing. A unit-based FCC Committee was charged with evaluating care on an inpatient infant-toddler unit. The committee adapted the Institute of Family Centered Care survey tools and used them to evaluate parent and staff perceptions of FCC care provided on the unit. The survey tools covered the following areas: environment, nursing care, education, communication, and respect and equality. A convenience sample of 38 parents and 75 staff completed surveys. Families provided significantly more positive responses than the staff did, indicating overall satisfaction with the care received. However, they did identify concerns about educational issues and pain assessment. In contrast, the staff reported more negative perceptions regarding the delivery of FCC, and their primary concern was the unit environment. The FCC Committee used the findings from the survey to first educate the staff and then implement changes to improve the environment and the care delivered.

The Relational-Behavior Survey as a Predictor of HIV-Related Parental Miscommunication: Implications for HIV, Prevention and Education at Primary Healthcare Service Facilities

ERIC Educational Resources Information Center

Chandler, Michele Denise; Chandler, Donald S.; Chandler, Donald S., Jr.; Race, James

2012-01-01

The study examined the relational-behavior survey (RBS) as a predictor of HIV-related parental miscommunication (HPM) among a voluntary sample 75 African American parents at a private healthcare facility located in the southwest region of the United States. A multiple regression analysis indicated that there was significant marginal prediction of…

Yield and ultrasonic modulus of elasticity of red maple veneer

Treesearch

Robert J. Ross; Steven Verhey; John R. Erickson; John W. Forsman; Brian K. Brashaw; Crystal L. Pilon; Xiping Wang

2004-01-01

The purpose of the study was to assess the potential for using red maple sawlogs to manufacture laminated veneer lumber (LVL). The primary objective was to determine the yield of ultrasonically graded veneer from red maple logs. A sample of 48 logs was obtained from six Eastern and Lake States in the United States. The logs were visually graded and shipped to a plywood...

Status of groundwater quality in the Upper Santa Ana Watershed, November 2006--March 2007--California GAMA Priority Basin Project

USGS Publications Warehouse

Kent, Robert; Belitz, Kenneth

2012-01-01

Groundwater quality in the approximately 1,000-square-mile (2,590-square-kilometer) Upper Santa Ana Watershed (USAW) study unit was investigated as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study unit is located in southern California in Riverside and San Bernardino Counties. The GAMA Priority Basin Project is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey and the Lawrence Livermore National Laboratory. The GAMA USAW study was designed to provide a spatially unbiased assessment of untreated groundwater quality within the primary aquifer systems in the study unit. The primary aquifer systems (hereinafter, primary aquifers) are defined as the perforation interval of wells listed in the California Department of Public Health (CDPH) database for the USAW study unit. The quality of groundwater in shallower or deeper water-bearing zones may differ from that in the primary aquifers; shallower groundwater may be more vulnerable to surficial contamination. The assessment is based on water-quality and ancillary data collected by the U.S. Geological Survey (USGS) from 90 wells during November 2006 through March 2007, and water-quality data from the CDPH database. The status of the current quality of the groundwater resource was assessed based on data from samples analyzed for volatile organic compounds (VOCs), pesticides, and naturally occurring inorganic constituents, such as major ions and trace elements. The status assessment is intended to characterize the quality of groundwater resources within the primary aquifers of the USAW study unit, not the treated drinking water delivered to consumers by water purveyors. Relative-concentrations (sample concentration divided by the health- or aesthetic-based benchmark concentration) were used for evaluating groundwater quality for those constituents that have Federal or California regulatory or non-regulatory benchmarks for drinking-water quality. A relative-concentration greater than (>) 1.0 indicates a concentration above a benchmark, and a relative-concentration less than or equal to (≤) 1.0 indicates a concentration equal to or less than a benchmark. Organic and special-interest constituent relative-concentrations were classified as "high" (> 1.0), "moderate" (0.1 1.0), "moderate" (0.5 < relative-concentration ≤ 1.0), or "low" ( ≤ 0.5). Aquifer-scale proportion was used as the primary metric in the status assessment for evaluating regional-scale groundwater quality. Aquifer-scale proportions are defined as the percentage of the area of the primary aquifer system with concentrations above or below specified thresholds relative to regulatory or aesthetic benchmarks. High aquifer-scale proportion is defined as the percentage of the area of the primary aquifers with a relative-concentration greater than 1.0 for a particular constituent or class of constituents; percentage is based on an areal, rather than a volumetric basis. Moderate and low aquifer-scale proportions were defined as the percentage of the primary aquifers with moderate and low relative-concentrations, respectively. Two statistical approaches—grid-based and spatially weighted—were used to evaluate aquifer-scale proportions for individual constituents and classes of constituents. Grid-based and spatially weighted estimates were comparable in the USAW study unit (within 90-percent confidence intervals). Inorganic constituents with human-health benchmarks had relative-concentrations that were high in 32.9 percent of the primary aquifers, moderate in 29.3 percent, and low in 37.8 percent. The high aquifer-scale proportion of these inorganic constituents primarily reflected high aquifer-scale proportions of nitrate (high relative-concentration in 25.3 percent of the aquifer), although seven other inorganic constituents with human-health benchmarks also were detected at high relative-concentrations in some percentage of the aquifer: arsenic, boron, fluoride, gross alpha activity, molybdenum, uranium, and vanadium. Perchlorate, as a constituent of special interest, was evaluated separately from other inorganic constituents, and had high relative-concentrations in 11.1 percent, moderate in 53.3 percent, and low or not detected in 35.6 percent of the primary aquifers. In contrast to the inorganic constituents, relative-concentrations of organic constituents (one or more) were high in 6.7 percent, moderate in 11.1 percent, and low or not detected in 82.2 percent of the primary aquifers. Of the 237 organic and special-interest constituents analyzed for, 39 constituents were detected (21 VOCs, 13 pesticides, 3 pharmaceuticals, and 2 constituents of special interest). All of the detected VOCs had health-based benchmarks, and five of these—1,1-dichloroethene, 1,2-dibromo-3-chloropropane (DBCP), tetrachloroethene (PCE), carbon tetrachloride, and trichloroethene (TCE)—were detected in at least one sample at a concentration above a benchmark (high relative-concentration). Seven of the 13 pesticides had health-based benchmarks, and none were detected above these benchmarks (no high relative-concentrations). Pharmaceuticals do not have health-based benchmarks. Thirteen organic constituents were frequently detected (detected in at least 10 percent of samples without regard to relative-concentrations): bromodichloromethane, chloroform, cis-1,2-dichloroethene, 1,1-dichloroethene, dichlorodifluoromethane (CFC-12), methyl tert-butyl ether (MTBE), PCE, TCE, trichlorofluoromethane (CFC-11), atrazine, bromacil, diuron, and simazine.

The usefulness of Skylab/EREP S-190 and S-192 imagery in multistage forest surveys

NASA Technical Reports Server (NTRS)

Langley, P. G.; Vanroessel, J. (Principal Investigator)

1976-01-01

The author has identified the following significant results. The RMSE of point location achieved with the annotation system on S190A imagery was 100 m and 90 m in the x and y direction, respectively. Potential gains in sampling precision attributable to space derived imagery ranged from 4.9 to 43.3 percent depending on the image type, interpretation method, time of year, and sampling method applied. Seasonal variation was significant. S190A products obtained in September yielded higher gains than those obtained in June. Using 100 primary sample units as a base under simple random sampling, the revenue made available for incorporating space acquired data into the sample design to estimate timber volume was as high as $39,400.00.

Factors related to performance effectiveness of dental nurse in primary care unit in the northeastern part of Thailand.

PubMed

Wijaranaphiti, Saowaluk; Krugkrunjit, Peera; Intaraprasong, Bhusita

2009-12-01

To investigate the relationships between job characteristics, motivation, role stress and performance effectiveness of dental nurses in primary care units in the northeastern part of Thailand. A explanatory cross-sectional study was conducted in 326 dental nurses who were working in 310 PCUs of 19 provinces, 220 amphurs in the northeastern part of Thailand were taken as the study samples. Data were collected by using questionnaires. Pearson's Product Moment Correlation was applied to test between job characteristic model, motivation, role stress and performance effectiveness. The analysis showed that there was no relationship between job characteristics model and performance effectiveness as performing dental task needed 'dealing with others' and 'task significance'. There was a positive relationship between motivation and performance effectiveness at a low level. Role stress was not related to performance effectiveness; however, when the dental nurse had more stress caused by role conflict internal standard, several roles and their performance effectiveness was reduced. From the research result, it is necessary to help construct networks of dental tasks and other public health tasks in obvious forms, for some feedback from agents. Work allocation should be precisely arranged and professional skill should be determined responsibility. Lastly, recruiting dental nurses with proper characteristics in primary care units in the northeastern part of Thailand is crucial as well.

Geographic and stratigraphic distribution of coastal Quaternary aminozones across the Cape Fear Arch, U. S. Atlantic Geology Coastal Plain

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

Wehmiller, J.F.; York, L.L.; Krantz, D.E.

1992-01-01

The interpretation of the regional aminostratigraphy of Coastal Plain Quaternary units from North and South Carolina is potentially affected by sampling biases, variable preservation of coastal records, reoccupation of coastal environments by multiple transgressions, geochemical alteration of samples, variable thermal histories of specific samples, and intergeneric and interlaboratory differences in analytical results.Two primary models for the correlation of emergent Coastal Plain units diverge significantly in southeastern North Carolina. New data from fresh exposure (1990--1991) at emergent sites between Wilmington, NC and Charleston, SC, from previous onshore collections in this region, and from submergent samples between Cape Lookout, NC and Capemore » Romain, SC provide insight into the nature of these correlation issues. Although sampling of the area is not uniform, these results fill a major gap between regions of previous aminostratigraphy study. Inferred early-to-middle Pleistocene aminozones dominate the emergent coastal region between Cape Lookout and Romain, and late Pleistocene aminozones in this area are represented by subsurface samples beneath barrier islands or in shallow inner shelf cores, but have not been found onshore. A map view of the distribution of aminozones along the coast between northeastern NC and central SC mimics that of pre-Quaternary units that thin or disappear over the axis of the Cape Fear Arch, suggesting that the sampled Quaternary record reflects the combination of processes responsible for the preservation of the pre-Quaternary record. This perspective should provide a model for resolution of various geochronological controversies that have arisen because of limited stratigraphic or geochemical data.« less

Determining contributions of biomass burning and other sources to fine particle contemporary carbon in the western United States

NASA Astrophysics Data System (ADS)

Holden, Amanda S.; Sullivan, Amy P.; Munchak, Leigh A.; Kreidenweis, Sonia M.; Schichtel, Bret A.; Malm, William C.; Collett, Jeffrey L., Jr.

2011-02-01

Six-day integrated fine particle samples were collected at urban and rural sampling sites using Hi-Volume samplers during winter and summer 2004-2005 as part of the IMPROVE (Interagency Monitoring of PROtected Visual Environments) Radiocarbon Study. Filter samples from six sites (Grand Canyon, Mount Rainier, Phoenix, Puget Sound, Rocky Mountain National Park, and Tonto National Monument) were analyzed for levoglucosan, a tracer for biomass combustion, and other species by High-Performance Anion-Exchange Chromatography with Pulsed Amperometric Detection (HPAEC-PAD). Contemporary carbon concentrations were available from previous carbon isotope measurements at Lawrence Livermore National Laboratory. Primary contributions of biomass burning to measured fine particle contemporary carbon were estimated for residential wood burning (winter) and wild/prescribed fires (summer). Calculated contributions ranged from below detection limit to more than 100% and were typically higher at rural sites and during winter. Mannitol, a sugar alcohol emitted by fungal spores, was analyzed and used to determine contributions of fungal spores to fine particle contemporary carbon. Contributions reached up to 13% in summer samples, with higher contributions at rural sites. Concentrations of methyltetrols, oxidation products of isoprene, were also measured by HPAEC-PAD. Secondary organic aerosol (SOA) from isoprene oxidation was estimated to contribute up to 22% of measured contemporary carbon. For each sampling site, a substantial portion of the contemporary carbon was unexplained by primary biomass combustion, fungal spores, or SOA from isoprene oxidation. This unexplained fraction likely contains contributions from other SOA sources, including oxidation products of primary smoke emissions and plant emissions other than isoprene, as well as other primary particle emissions from meat cooking, plant debris, other biological aerosol particles, bio-diesel combustion, and other sources. Loss of levoglucosan during atmospheric aging of biomass burning emissions likely also results in an underestimate of apportioned primary smoke contributions.

The relationship between patient safety climate and occupational safety climate in healthcare - A multi-level investigation.

PubMed

Pousette, Anders; Larsman, Pernilla; Eklöf, Mats; Törner, Marianne

2017-06-01

Patient safety climate/culture is attracting increasing research interest, but there is little research on its relation with organizational climates regarding other target domains. The aim of this study was to investigate the relationship between patient safety climate and occupational safety climate in healthcare. The climates were assessed using two questionnaires: Hospital Survey on Patient Safety Culture and Nordic Occupational Safety Climate Questionnaire. The final sample consisted of 1154 nurses, 886 assistant nurses, and 324 physicians, organized in 150 work units, within hospitals (117units), primary healthcare (5units) and elderly care (28units) in western Sweden, which represented 56% of the original sample contacted. Within each type of safety climate, two global dimensions were confirmed in a higher order factor analysis; one with an external focus relative the own unit, and one with an internal focus. Two methods were used to estimate the covariation between the global climate dimensions, in order to minimize the influence of bias from common method variance. First multilevel analysis was used for partitioning variances and covariances in a within unit part (individual level) and a between unit part (unit level). Second, a split sample technique was used to calculate unit level correlations based on aggregated observations from different respondents. Both methods showed associations similar in strength between the patient safety climate and the occupational safety climate domains. The results indicated that patient safety climate and occupational safety climate are strongly positively related at the unit level, and that the same organizational processes may be important for the development of both types of organizational climate. Safety improvement interventions should not be separated in different organizational processes, but be planned so that both patient safety and staff safety are considered concomitantly. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

The Epidemiology of Primary and Revision Total Hip Arthroplasty in Teaching and Nonteaching Hospitals in the United States.

PubMed

Kowalik, Thomas D; DeHart, Matthew; Gehling, Hanne; Gehling, Paxton; Schabel, Kathryn; Duwelius, Paul; Mirza, Amer

2016-06-01

The purpose of this study was to examine the epidemiology of primary and revision total hip arthroplasty (THA) in teaching and nonteaching hospitals. The Healthcare Cost and Utilization Project Nationwide Inpatient Sample was queried from 2006 to 2010 to identify primary and revision THAs at teaching and nonteaching hospitals. A total of 1,336,396 primary and 223,520 revision procedures were identified. Forty-six percent of all primary and 54% of all revision procedures were performed at teaching hospitals. Teaching hospitals performed 17% of their THAs as revisions; nonteaching hospitals performed 12% as revisions. For primary and revision THAs, teaching hospitals had fewer patients aged >65 years, fewer Medicare patients, similar gender rates, more nonwhite patients, and more patients in the highest income quartile compared with nonteaching hospitals. Costs, length of stay, and Charlson Comorbidity Index scores were similar; however, the mortality rate was lower at teaching hospitals. This study found small but significant differences in key epidemiologic and outcome variables in examining primary and revision THA at teaching and nonteaching hospitals. Level III.

Effectiveness of a virtual intervention for primary healthcare professionals aimed at improving attitudes towards the empowerment of patients with chronic diseases: study protocol for a cluster randomized controlled trial (e-MPODERA project).

PubMed

González-González, Ana Isabel; Orrego, Carola; Perestelo-Perez, Lilisbeth; Bermejo-Caja, Carlos Jesús; Mora, Nuria; Koatz, Débora; Ballester, Marta; Del Pino, Tasmania; Pérez-Ramos, Jeannet; Toledo-Chavarri, Ana; Robles, Noemí; Pérez-Rivas, Francisco Javier; Ramírez-Puerta, Ana Belén; Canellas-Criado, Yolanda; Del Rey-Granado, Yolanda; Muñoz-Balsa, Marcos José; Becerril-Rojas, Beatriz; Rodríguez-Morales, David; Sánchez-Perruca, Luis; Vázquez, José Ramón; Aguirre, Armando

2017-10-30

Communities of practice are based on the idea that learning involves a group of people exchanging experiences and knowledge. The e-MPODERA project aims to assess the effectiveness of a virtual community of practice aimed at improving primary healthcare professional attitudes to the empowerment of patients with chronic diseases. This paper describes the protocol for a cluster randomized controlled trial. We will randomly assign 18 primary-care practices per participating region of Spain (Catalonia, Madrid and Canary Islands) to a virtual community of practice or to usual training. The primary-care practice will be the randomization unit and the primary healthcare professional will be the unit of analysis. We will need a sample of 270 primary healthcare professionals (general practitioners and nurses) and 1382 patients. We will perform randomization after professionals and patients are selected. We will ask the intervention group to participate for 12 months in a virtual community of practice based on a web 2.0 platform. We will measure the primary outcome using the Patient-Provider Orientation Scale questionnaire administered at baseline and after 12 months. Secondary outcomes will be the sociodemographic characteristics of health professionals, sociodemographic and clinical characteristics of patients, the Patient Activation Measure questionnaire for patient activation and outcomes regarding use of the virtual community of practice. We will calculate a linear mixed-effects regression to estimate the effect of participating in the virtual community of practice. This cluster randomized controlled trial will show whether a virtual intervention for primary healthcare professionals improves attitudes to the empowerment of patients with chronic diseases. ClicalTrials.gov, NCT02757781 . Registered on 25 April 2016. Protocol Version. PI15.01 22 January 2016.

Primary prevention of pediatric lead exposure requires new approaches to transfusion screening.

PubMed

Gehrie, Eric; Keiser, Amaris; Dawling, Sheila; Travis, James; Strathmann, Frederick G; Booth, Garrett S

2013-09-01

To facilitate further assessment of transfusion-associated lead exposure by designing a procedure to test packed red blood cells (pRBCs) prepared for transfusion. The relationship between pRBCs and whole blood lead concentration was investigated in 27 samples using a modified clinical assay. Lead concentrations were measured in 100 pRBC units. Our sample preparation method demonstrated a correlation between whole blood lead and pRBC lead concentrations (R(2) = 0.82). In addition, all 100 pRBC units tested had detectable lead levels. The median pRBC lead concentration was 0.8 μg/dL, with an SD of 0.8 μg/dL and a range of 0.2-4.1 μg/dL. In addition, after only a few days of storage, approximately 25% of whole blood lead was found in the supernatant plasma. Transfusion of pRBCs is a source of lead exposure. Here we report the quantification of lead concentration in pRBCs. We found a >20-fold range of lead concentrations in the samples tested. Pretransfusion testing of pRBC units according to our proposed approach or donor screening of whole blood lead and selection of below-average units for transfusion to children would diminish an easily overlooked source of pediatric lead exposure. Copyright © 2013 Mosby, Inc. All rights reserved.

Availability of essential medicines in primary health care of the Brazilian Unified Health System.

PubMed

Nascimento, Renata Cristina Rezende Macedo do; Álvares, Juliana; Guerra, Augusto Afonso; Gomes, Isabel Cristina; Costa, Ediná Alves; Leite, Silvana Nair; Costa, Karen Sarmento; Soeiro, Orlando Mario; Guibu, Ione Aquemi; Karnikowski, Margô Gomes de Oliveira; Acurcio, Francisco de Assis

2017-11-13

To characterize the availability of tracer medicines in pharmaceutical services in primary health care of the Brazilian Unified Health System (SUS). This is a cross-sectional and evaluative study, part of the Pesquisa Nacional Sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos - Serviços, 2015 (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines - Services, 2015). To analyze the availability of medicines, we verified 50 items selected from the Relação Nacional de Medicamentos Essenciais (Rename - National List of Essential Medicines) of 2012. Observation scripts were applied to medicine dispensing services in the primary health care. Interviews were carried out with patients, health care professionals, and public managers, using semi-structured questionnaires. The availability index was presented as the percentage of health units where the medicines were available. For statistical analysis, absolute, relative, and mean frequencies were presented (with 95% confidence intervals). The comparison of groups was carried out by Pearson Chi-square tests or variance analysis, when needed. One thousand, one hundred, and seventy-five observation scripts were filled in a national representative sample composed by 273 cities. Statistically significant differences were observed regarding the type of unit, infrastructure, and presence of a pharmacist between regions of Brazil. The average availability of tracer medicines in primary health care was 52.9%, with differences between regions and sampling strata. This index increased to 62.5% when phytotherapic medicines were excluded. We found limited availability of medicines for treatment of chronic and epidemiological diseases, such as tuberculosis and congenital syphilis. The low availability of essential medicines purchased centrally by the Brazilian Ministry of Health indicates deficiencies in supply chain management. The different views on the availability of tracer medicines in SUS confirm the general availability verified in this study. Among patients, about 60% said they obtain medicines in SUS units, data consistent with the lack of medicines reported by medicine dispensers and in line with physicians' evaluations.

Availability of essential medicines in primary health care of the Brazilian Unified Health System

PubMed Central

do Nascimento, Renata Cristina Rezende Macedo; Álvares, Juliana; Guerra, Augusto Afonso; Gomes, Isabel Cristina; Costa, Ediná Alves; Leite, Silvana Nair; Costa, Karen Sarmento; Soeiro, Orlando Mario; Guibu, Ione Aquemi; Karnikowski, Margô Gomes de Oliveira; Acurcio, Francisco de Assis

2017-01-01

ABSTRACT OBJECTIVE To characterize the availability of tracer medicines in pharmaceutical services in primary health care of the Brazilian Unified Health System (SUS). METHODS This is a cross-sectional and evaluative study, part of the Pesquisa Nacional Sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015). To analyze the availability of medicines, we verified 50 items selected from the Relação Nacional de Medicamentos Essenciais (Rename – National List of Essential Medicines) of 2012. Observation scripts were applied to medicine dispensing services in the primary health care. Interviews were carried out with patients, health care professionals, and public managers, using semi-structured questionnaires. The availability index was presented as the percentage of health units where the medicines were available. For statistical analysis, absolute, relative, and mean frequencies were presented (with 95% confidence intervals). The comparison of groups was carried out by Pearson Chi-square tests or variance analysis, when needed. RESULTS One thousand, one hundred, and seventy-five observation scripts were filled in a national representative sample composed by 273 cities. Statistically significant differences were observed regarding the type of unit, infrastructure, and presence of a pharmacist between regions of Brazil. The average availability of tracer medicines in primary health care was 52.9%, with differences between regions and sampling strata. This index increased to 62.5% when phytotherapic medicines were excluded. We found limited availability of medicines for treatment of chronic and epidemiological diseases, such as tuberculosis and congenital syphilis. CONCLUSIONS The low availability of essential medicines purchased centrally by the Brazilian Ministry of Health indicates deficiencies in supply chain management. The different views on the availability of tracer medicines in SUS confirm the general availability verified in this study. Among patients, about 60% said they obtain medicines in SUS units, data consistent with the lack of medicines reported by medicine dispensers and in line with physicians’ evaluations. PMID:29160448

Journal Article: the National Dioxin Air Monitoring Network ...

EPA Pesticide Factsheets

In June, 1998, the U.S. EPA established the National Dioxin Air Monitoring Network (NDAMN). The primary goal of NDAMN is determine the temporal and geographical variability of atmospheric CDDs, CDFs, and coplanar PCBs at rural and nonimpacted locations throughout the United States. Currently operating at 32 sampling stations, NDAMN has three primary purposes: (1) to determine the atmospheric levels and occurrences of dioxin-like compounds in rural and agricultural areas where livestock, poultry and animal feed crops are grown; (2) to provide measurements of atmospheric levels of dioxin-like compounds in different geographic regions of the U.S.; and (3) to provide information regarding the long-range transport of dioxin-like compounds in air over the U.S. At Dioxin 2000, we reported on the preliminary results of monitoring at 9 rural locations from June 1998 through June 1999. By the end of 1999, NDAMN had expanded to 21 sampling stations. Then, at Dioxin 2001, we reported the results of the first 18 months of operation of NDAMN at 15 rural and 6 National Park stations in the United States. The following is intended to be an update to this national monitoring effort. We are reporting the air monitoring results of 17 rural and 8 National Park NDAMN stations operational over 4 sampling moments during calendar year 2000. Two stations located in suburban Washington DC and San Francisco, CA are more urban in character and serve as an indicator of CDD/F and cop

Groundwater-quality data in the Santa Barbara study unit, 2011: results from the California GAMA Program

USGS Publications Warehouse

Davis, Tracy A.; Kulongoski, Justin T.; Belitz, Kenneth

2013-01-01

Groundwater quality in the 48-square-mile Santa Barbara study unit was investigated by the U.S. Geological Survey (USGS) from January to February 2011, as part of the California State Water Resources Control Board (SWRCB) Groundwater Ambient Monitoring and Assessment (GAMA) Program’s Priority Basin Project (PBP). The GAMA-PBP was developed in response to the California Groundwater Quality Monitoring Act of 2001 and is being conducted in collaboration with the SWRCB and Lawrence Livermore National Laboratory (LLNL). The Santa Barbara study unit was the thirty-fourth study unit to be sampled as part of the GAMA-PBP. The GAMA Santa Barbara study was designed to provide a spatially unbiased assessment of untreated-groundwater quality in the primary aquifer system, and to facilitate statistically consistent comparisons of untreated-groundwater quality throughout California. The primary aquifer system is defined as those parts of the aquifers corresponding to the perforation intervals of wells listed in the California Department of Public Health (CDPH) database for the Santa Barbara study unit. Groundwater quality in the primary aquifer system may differ from the quality in the shallower or deeper water-bearing zones; shallow groundwater may be more vulnerable to surficial contamination. In the Santa Barbara study unit located in Santa Barbara and Ventura Counties, groundwater samples were collected from 24 wells. Eighteen of the wells were selected by using a spatially distributed, randomized grid-based method to provide statistical representation of the study unit (grid wells), and six wells were selected to aid in evaluation of water-quality issues (understanding wells). The groundwater samples were analyzed for organic constituents (volatile organic compounds [VOCs], pesticides and pesticide degradates, and pharmaceutical compounds); constituents of special interest (perchlorate and N-nitrosodimethylamine [NDMA]); naturally occurring inorganic constituents (trace elements, nutrients, major and minor ions, silica, total dissolved solids [TDS], alkalinity, and arsenic, chromium, and iron species); and radioactive constituents (radon-222 and gross alpha and gross beta radioactivity). Naturally occurring isotopes (stable isotopes of hydrogen and oxygen in water, stables isotopes of inorganic carbon and boron dissolved in water, isotope ratios of dissolved strontium, tritium activities, and carbon-14 abundances) and dissolved noble gases also were measured to help identify the sources and ages of the sampled groundwater. In total, 281 constituents and water-quality indicators were measured. Three types of quality-control samples (blanks, replicates, and matrix spikes) were collected at up to 12 percent of the wells in the Santa Barbara study unit, and the results for these samples were used to evaluate the quality of the data for the groundwater samples. Blanks rarely contained detectable concentrations of any constituent, suggesting that contamination from sample collection procedures was not a significant source of bias in the data for the groundwater samples. Replicate samples generally were within the limits of acceptable analytical reproducibility. Matrix-spike recoveries were within the acceptable range (70 to 130 percent) for approximately 82 percent of the compounds. This study did not attempt to evaluate the quality of water delivered to consumers; after withdrawal from the ground, untreated groundwater typically is treated, disinfected, and (or) blended with other waters to maintain water quality. Regulatory benchmarks apply to water that is served to the consumer, not to untreated groundwater. However, to provide some context for the results, concentrations of constituents measured in the untreated groundwater were compared with regulatory and non-regulatory health-based benchmarks established by the U.S. Environmental Protection Agency (USEPA) and CDPH and to non-regulatory benchmarks established for aesthetic concerns by CDPH. Comparisons between data collected for this study and benchmarks for drinking water are for illustrative purposes only and are not indicative of compliance or non-compliance with those benchmarks. All organic constituents and most inorganic constituents that were detected in groundwater samples from the 18 grid wells in the Santa Barbara study unit were detected at concentrations less than drinking-water benchmarks. Of the 220 organic and special-interest constituents sampled for at the 18 grid wells, 13 were detected in groundwater samples; concentrations of all detected constituents were less than regulatory and non-regulatory health-based benchmarks. In total, VOCs were detected in 61 percent of the 18 grid wells sampled, pesticides and pesticide degradates were detected in 11 percent, and perchlorate was detected in 67 percent. Polar pesticides and their degradates, pharmaceutical compounds, and NDMA were not detected in any of the grid wells sampled in the Santa Barbara study unit. Eighteen grid wells were sampled for trace elements, major and minor ions, nutrients, and radioactive constituents; most detected concentrations were less than health-based benchmarks. Exceptions are one detection of boron greater than the CDPH notification level (NL-CA) of 1,000 micrograms per liter (μg/L) and one detection of fluoride greater than the CDPH maximum contaminant level (MCL-CA) of 2 milligrams per liter (mg/L). Results for constituents with non-regulatory benchmarks set for aesthetic concerns from the grid wells showed that iron concentrations greater than the CDPH secondary maximum contaminant level (SMCL-CA) of 300 μg/L were detected in three grid wells. Manganese concentrations greater than the SMCL-CA of 50 μg/L were detected in seven grid wells. Chloride was detected at a concentration greater than the SMCL-CA recommended benchmark of 250 mg/L in four grid wells. Sulfate concentrations greater than the SMCL-CA recommended benchmark of 250 mg/L were measured in eight grid wells, and the concentration in one of these wells was also greater than the SMCL-CA upper benchmark of 500 mg/L. TDS concentrations greater than the SMCL-CA recommended benchmark of 500 mg/L were measured in 17 grid wells, and concentrations in six of these wells were also greater than the SMCL-CA upper benchmark of 1,000 mg/L.

Gypsum-permineralized microfossils and their relevance to the search for life on Mars.

PubMed

Schopf, J William; Farmer, Jack D; Foster, Ian S; Kudryavtsev, Anatoliy B; Gallardo, Victor A; Espinoza, Carola

2012-07-01

Orbital and in situ analyses establish that aerially extensive deposits of evaporitic sulfates, including gypsum, are present on the surface of Mars. Although comparable gypsiferous sediments on Earth have been largely ignored by paleontologists, we here report the finding of diverse fossil microscopic organisms permineralized in bottom-nucleated gypsums of seven deposits: two from the Permian (∼260 Ma) of New Mexico, USA; one from the Miocene (∼6 Ma) of Italy; and four from Recent lacustrine and saltern deposits of Australia, Mexico, and Peru. In addition to presenting the first report of the widespread occurrence of microscopic fossils in bottom-nucleated primary gypsum, we show the striking morphological similarity of the majority of the benthic filamentous fossils of these units to the microorganisms of a modern sulfuretum biocoenose. Based on such similarity, in morphology as well as habitat, these findings suggest that anaerobic sulfur-metabolizing microbial assemblages have changed relatively little over hundreds of millions of years. Their discovery as fossilized components of the seven gypsiferous units reported suggests that primary bottom-nucleated gypsum represents a promising target in the search for evidence of past life on Mars. Key Words: Confocal laser scanning microscopy-Gypsum fossils-Mars sample return missions-Raman spectroscopy-Sample Analysis at Mars (SAM) instrument-Sulfuretum.

Decreasing trends in patient satisfaction, accessibility and continuity of care in Finnish primary health care - a 14-year follow-up questionnaire study.

PubMed

Raivio, Risto; Jääskeläinen, Juhani; Holmberg-Marttila, Doris; Mattila, Kari J

2014-05-15

The aim here was to explore trends in patient satisfaction with primary health care and its accessibility and continuity, and to explore whether through reforms and improvements some of the essential goals had been achieved over a 14-year period of time in Finland. Nine questionnaire surveys were conducted over a period of 14 years among patients attending within one week in the 65 health centres in the Tampere University Hospital catchment area. A total of 147,394 responded out of a sample of 333,648 patients. The response rate varied yearly from 53% to 37%. Patient satisfaction with care in Finnish health centres decreased by nearly 9 percentage units from 1998 to 2011. The fall-off was most marked in the age-group over 64 years. There was a 20 percentage unit's reduction in ease of access as reported by patients. Respondents also reported that the continuity of care had deteriorated. Despite major reforms in Finnish health care policy, patients seem to be less satisfied. Our findings challenge both Finnish authorities and GPs to improve the accessibility and continuity of care in primary health services.

Assessment of child and adult users of the degree of orientation of Primary Healthcare in the city of Rio de Janeiro, Brazil.

PubMed

Harzheim, Erno; Pinto, Luiz Felipe; Hauser, Lisiane; Soranz, Daniel

2016-05-01

In the first half of 2014, 6,675 adults and caregivers of children using Primary Care (PC) services in Rio de Janeiro were interviewed using the Primary Care Assessment Tool - PCATool-Brazil. The aim was to arrive at an accurate overview of the extent to which PC services in all of the Planning Areas (PA) of the Rio de Janeiro City Health Department (CHD) - Municipal Health Secretariat have the essential and derivative attributes. This was a cross-sectional study of random, independent samples of the service users (children and adults). Results were measured using the scores assigned to PC attributes. In the opinion of adults and children using PC services, Type A Units - Municipal Healthcare Centers and Family Clinics staffed only with Family Health Teams, performed better than Type B units. The scores for the attributes "first contact accessibility", "comprehensive service - services provided", "community orientation" and "family orientation" still need to be improved. On the other hand "coordinated care" and "continuity" are on their way to quality scores, being always rated at around 6.0 or even higher.

H-Area Seepage Basins groundwater monitoring report

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

Not Available

1993-03-01

During fourth quarter 1992, the groundwater at the H-Area Seepage Basins (HASB) was monitored in compliance with South Carolina Hazardous Waste Management Regulations, R61-79.265, Subpart F. Samples were collected from 130 wells that monitor the three separate hydrostratigraphic units that make up the uppermost aquifer beneath the HASB. A detailed description of the uppermost aquifer is included in the Resource Conservation and Recovery Act Part B Post-Closure Care Permit Application for the H-Area Hazardous Waste Management Facility submitted to the South Carolina Department of Health and Environmental Control in December 1990. Historically, as well as currently, tritium, nitrate, total alpha-emittingmore » radium, gross alpha, and mercury have been the primary constituents observed above final Primary Drinking Water Standards (PDWS) in groundwater at the HASB. Isoconcentration/isoactivity maps included in this report indicate both the concentration/activity and extent of the primary contaminants in each of the three hydrostratigraphic units during first and fourth quarter 1992. Water-level maps indicate that the groundwater flow rates and directions at the HASB have remained relatively constant since the basins ceased to be active in 1988.« less

H-Area Seepage Basins groundwater monitoring report. Fourth quarter 1992 and 1992 summary

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

Not Available

1993-03-01

During fourth quarter 1992, the groundwater at the H-Area Seepage Basins (HASB) was monitored in compliance with South Carolina Hazardous Waste Management Regulations, R61-79.265, Subpart F. Samples were collected from 130 wells that monitor the three separate hydrostratigraphic units that make up the uppermost aquifer beneath the HASB. A detailed description of the uppermost aquifer is included in the Resource Conservation and Recovery Act Part B Post-Closure Care Permit Application for the H-Area Hazardous Waste Management Facility submitted to the South Carolina Department of Health and Environmental Control in December 1990. Historically, as well as currently, tritium, nitrate, total alpha-emittingmore » radium, gross alpha, and mercury have been the primary constituents observed above final Primary Drinking Water Standards (PDWS) in groundwater at the HASB. Isoconcentration/isoactivity maps included in this report indicate both the concentration/activity and extent of the primary contaminants in each of the three hydrostratigraphic units during first and fourth quarter 1992. Water-level maps indicate that the groundwater flow rates and directions at the HASB have remained relatively constant since the basins ceased to be active in 1988.« less

[Factors associated with cross-nursing].

PubMed

von Seehausen, Mariana Pujól; Oliveira, Maria Inês Couto de; Boccolini, Cristiano Siqueira

2017-05-01

This article aims to estimate the prevalence and analyze the factors associated with cross-nursing. A cross-sectional study was conducted in 2013 with interviews with a representative sample of mothers of infants less than one-year-old (n' = 695) attended in nine primary health units in Rio de Janeiro, Brazil. Sociodemographic characteristics were studied; pregnancy, childbirth and primary care assistance; maternal habits and baby features. Adjusted prevalence ratios (PR) were obtained by Poisson Regression, retaining variables associated with the outcome in the final model (p ≤ 0.05). Cross-nursing was practiced by 29.4% of the mothers. Most practitioner mothers were relatives or friends. The following variables were directly associated with cross-nursing: being an adolescent mother (PR' = 1.595), smoking (PR' = 1.396), alcohol consumption (PR' = 1.613), inappropriate baby feeding habits (PR' = 1.371) and infant's age in months (PR' = 1.066). Maternal formal employment was inversely associated with the practice (PR' = 0.579). Cross-nursing has a relevant prevalence among mothers assisted by primary health care units in Rio de Janeiro City. This issue should be addressed, especially among the most vulnerable groups, due to the association with adolescence and with unhealthy habits.

Primary source of income is associated with differences in HIV risk behaviors in street-recruited samples.

PubMed

Essien, E James; Ross, Michael W; Williams, Mark L; Meshack, Angela F; Fernández-Esquer, Maria E; Peters, Ronald J; Ogungbade, GO

2004-06-17

BACKGROUND: The relationship between primary source of income and HIV risk behaviors and the racial/ethnic differences in risk behavior profiles among disadvantaged populations have not been fully explored. This is unusual given that the phenomenon of higher risk in more disadvantaged populations is well-known but the mechanisms remain unclear. We examined the relationship between primary source of income and differences in HIV risk behaviors among four racial/ethnic groups in the southern United States. METHODS: Self-reported data on primary source of income and HIV risk behaviors were collected from 1494 African American, Hispanic, Asian, and White men and women in places of public congregation in Houston, Texas. Data were analyzed using calculation of percentages and by chi-square tests with Yates correction for discontinuity where appropriate. RESULTS: Data revealed that a higher proportion of whites were involved in sex for money exchanges compared to the other racial groups in this sample. The data suggest that similar street sampling approaches are likely to recruit different proportions of people by primary income source and by ethnicity. It may be that the study locations sampled are likely to preferentially attract those involved in illegal activities, specifically the white population involved in sex for drug or money exchanges. Research evidence has shown that people construct highly evolved sexual marketplaces that are localized and most unlikely to cross racial, ethnic, and socioeconomic or geographical boundaries. Thus, the areas that we sampled may have straddled a white sexual marketplace more than that of the other groups, leading to an over-representation of sex exchange in this group. Drug use was highest among those with illegal primary sources of income (sex exchange and drug dealing and theft), and they were also those most likely to have injected drugs rather than administered them by any other route (p < 0.001). In addition, bisexual or homosexual identification was reported by more respondents in the sex exchange as primary source of income category. The number of sexual partners in the last three months followed a similar pattern, with those whose primary source of income was drug dealing or theft reporting relatively high partner numbers. CONCLUSIONS: These data suggest that social disadvantage is associated with HIV risk in part by its association with drug and sex work for survival, and offers one variable that may be associated with the concentration of disease among those at greatest disadvantage by having an illegal and unstable primary income source.

Groundwater-quality data in the Borrego Valley, Central Desert, and Low-Use Basins of the Mojave and Sonoran Deserts study unit, 2008-2010--Results from the California GAMA Program

USGS Publications Warehouse

Mathany, Timothy M.; Wright, Michael T.; Beuttel, Brandon S.; Belitz, Kenneth

2012-01-01

Groundwater quality in the 12,103-square-mile Borrego Valley, Central Desert, and Low-Use Basins of the Mojave and Sonoran Deserts (CLUB) study unit was investigated by the U.S. Geological Survey (USGS) from December 2008 to March 2010, as part of the California State Water Resources Control Board (SWRCB) Groundwater Ambient Monitoring and Assessment (GAMA) Program's Priority Basin Project (PBP). The GAMA-PBP was developed in response to the California Groundwater Quality Monitoring Act of 2001 and is being conducted in collaboration with the SWRCB and Lawrence Livermore National Laboratory (LLNL). The CLUB study unit was the twenty-eighth study unit to be sampled as part of the GAMA-PBP. The GAMA CLUB study was designed to provide a spatially unbiased assessment of untreated-groundwater quality in the primary aquifer systems, and to facilitate statistically consistent comparisons of untreated-groundwater quality throughout California. The primary aquifer systems (hereinafter referred to as primary aquifers) are defined as parts of aquifers corresponding to the perforation intervals of wells listed in the California Department of Public Health (CDPH) database for the CLUB study unit. The quality of groundwater in shallow or deep water-bearing zones may differ from the quality of groundwater in the primary aquifers; shallow groundwater may be more vulnerable to surficial contamination. In the CLUB study unit, groundwater samples were collected from 52 wells in 3 study areas (Borrego Valley, Central Desert, and Low-Use Basins of the Mojave and Sonoran Deserts) in San Bernardino, Riverside, Kern, San Diego, and Imperial Counties. Forty-nine of the wells were selected by using a spatially distributed, randomized grid-based method to provide statistical representation of the study unit (grid wells), and three wells were selected to aid in evaluation of water-quality issues (understanding wells). The groundwater samples were analyzed for organic constituents (volatile organic compounds [VOCs], pesticides and pesticide degradates, and pharmaceutical compounds), constituents of special interest (perchlorate and N-nitrosodimethylamine [NDMA]), naturally-occurring inorganic constituents (trace elements, nutrients, major and minor ions, silica, total dissolved solids [TDS], alkalinity, and species of inorganic chromium), and radioactive constituents (radon-222, radium isotopes, and gross alpha and gross beta radioactivity). Naturally-occurring isotopes (stable isotopes of hydrogen, oxygen, boron, and strontium in water, stable isotopes of carbon in dissolved inorganic carbon, activities of tritium, and carbon-14 abundance) and dissolved noble gases also were measured to help identify the sources and ages of sampled groundwater. In total, 223 constituents and 12 water-quality indicators were investigated. Three types of quality-control samples (blanks, replicates, and matrix spikes) were collected at up to 10 percent of the wells in the CLUB study unit, and the results for these samples were used to evaluate the quality of the data for the groundwater samples. Field blanks rarely contained detectable concentrations of any constituent, suggesting that contamination from sample collection procedures was not a significant source of bias in the data for the groundwater samples. Replicate samples generally were within the limits of acceptable analytical reproducibility. Median matrix-spike recoveries were within the acceptable range (70 to 130 percent) for approximately 85 percent of the compounds. This study did not attempt to evaluate the quality of water delivered to consumers; after withdrawal from the ground, untreated groundwater typically is treated, disinfected, and (or) blended with other waters to maintain water quality. Regulatory benchmarks apply to water that is delivered to the consumer, not to untreated groundwater. However, to provide some context for the results, concentrations of constituents measured in the untreated groundwater were compared with regulatory and non-regulatory health-based benchmarks established by the U.S. Environmental Protection Agency (USEPA) and CDPH, and to non-regulatory benchmarks established for aesthetic concerns by CDPH. Comparisons between data collected for this study and benchmarks for drinking water are for illustrative purposes only and are not indicative of compliance or non-compliance with those benchmarks. Most inorganic constituents detected in groundwater samples from the 49 grid wells were detected at concentrations less than drinking-water benchmarks. In addition, all detections of organic constituents from the CLUB study-unit grid-well samples were less than health-based benchmarks. In total, VOCs were detected in 17 of the 49 grid wells sampled (approximately 35 percent), pesticides and pesticide degradates were detected in 5 of the 47 grid wells sampled (approximately 11 percent), and perchlorate was detected in 41 of 49 grid wells sampled (approximately 84 percent). Trace elements, major and minor ions, and nutrients were sampled for at 39 grid wells, and radioactive constituents were sampled for at 23 grid wells; most detected concentrations were less than health-based benchmarks. Exceptions in the grid-well samples include seven detections of arsenic greater than the USEPA maximum contaminant level (MCL-US) of 10 micrograms per liter (μg/L); four detections of boron greater than the CDPH notification level (NL-CA) of 1,000 μg/L; six detections of molybdenum greater than the USEPA lifetime health advisory level (HAL-US) of 40 μg/L; two detections of uranium greater than the MCL-US of 30 μg/L; nine detections of fluoride greater than the CDPH maximum contaminant level (MCL-CA) of 2 milligrams per liter (mg/L); one detection of nitrite plus nitrate (NO2-+NO3-), as nitrogen, greater than the MCL-US of 10 mg/L; and four detections of gross alpha radioactivity (72-hour count), and one detection of gross alpha radioactivity (30-day count), greater than the MCL-US of 15 picocuries per liter. Results for constituents with non-regulatory benchmarks set for aesthetic concerns showed that a manganese concentration greater than the CDPH secondary maximum contaminant level (SMCL-CA) of 50 μg/L was detected in one grid well. Chloride concentrations greater than the recommended SMCL-CA benchmark of 250 mg/L were detected in three grid wells, and one of these wells also had a concentration that was greater than the upper SMCL-CA benchmark of 500 mg/L. Sulfate concentrations greater than the recommended SMCL-CA benchmark of 250 mg/L were measured in six grid wells. TDS concentrations greater than the SMCL-CA recommended benchmark of 500 mg/L were measured in 20 grid wells, and concentrations in 2 of these wells also were greater than the SMCL-CA upper benchmark of 1,000 mg/L.

Designing an intervention to prevent suicide: PROSPECT (Prevention of Suicide in Primary Care Elderly: Collaborative Trial)

PubMed Central

Bruce, Martha L.; Pearson, Jane L.

1999-01-01

Suicide is a major public health problem with greatest risk in the very old. This paper describes an approach to reducing the risk of suicide by intervening on depression in elderly primary care patients. Depression is an appropriate target for an intervention as it is highly prevalent in primary care, is a strong risk factor for suicide, and is more often than not inadequately treated. PROSPECT (Prevention of Suicide in Primary Care Elderly: Collaborative Trial) is a National institute of Mental Health (NIMH)-funded collaborative study that is testing this approach to suicide risk prevention in 18 primary care practices in the United States. PROSPECT'S intervention of “guideline management” introduces a health specialist into the primary care setting to help physicians provide “on-time, on-target” treatment and long-term management of late-life depression following structured clinical guidelines. The effectiveness of the intervention in reducing suicidal risk and depression is evaluated by following a representative sample of older patients identified using a 2-stage design. PMID:22033641

Hydraulic actuator mechanism to control aircraft spoiler movements through dual input commands

NASA Technical Reports Server (NTRS)

Irick, S. C. (Inventor)

1981-01-01

An aircraft flight spoiler control mechanism is described. The invention enables the conventional, primary spoiler control system to retain its operational characteristics while accommodating a secondary input controlled by a conventional computer system to supplement the settings made by the primary input. This is achieved by interposing springs between the primary input and the spoiler control unit. The springs are selected to have a stiffness intermediate to the greater force applied by the primary control linkage and the lesser resistance offered by the spoiler control unit. Thus, operation of the primary input causes the control unit to yield before the springs, yet, operation of the secondary input, acting directly on the control unit, causes the springs to yield and absorb adjustments before they are transmitted into the primary control system.

Status and understanding of groundwater quality in the San Francisco Bay groundwater basins, 2007—California GAMA Priority Basin Project

USGS Publications Warehouse

Parsons, Mary C.; Kulongoski, Justin T.; Belitz, Kenneth

2013-01-01

Groundwater quality in the approximately 620-square-mile (1,600-square-kilometer) San Francisco Bay study unit was investigated as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study unit is located in the Southern Coast Ranges of California, in San Francisco, San Mateo, Santa Clara, Alameda, and Contra Costa Counties. The GAMA Priority Basin Project is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey (USGS) and the Lawrence Livermore National Laboratory. The GAMA San Francisco Bay study was designed to provide a spatially unbiased assessment of the quality of untreated groundwater within the primary aquifer system, as well as a statistically consistent basis for comparing water quality throughout the State. The assessment is based on water-quality and ancillary data collected by the USGS from 79 wells in 2007 and is supplemented with water-quality data from the California Department of Public Health (CDPH) database. The primary aquifer system is defined by the depth interval of the wells listed in the CDPH database for the San Francisco Bay study unit. The quality of groundwater in shallower or deeper water-bearing zones may differ from that in the primary aquifer system; shallower groundwater may be more vulnerable to surficial contamination. The first component of this study, the status of the current quality of the groundwater resource, was assessed by using data from samples analyzed for volatile organic compounds (VOCs), pesticides, and naturally occurring inorganic constituents, such as major ions and trace elements. Water- quality data from the CDPH database also were incorporated for this assessment. This status assessment is intended to characterize the quality of groundwater resources within the primary aquifer system of the San Francisco Bay study unit, not the treated drinking water delivered to consumers by water purveyors. Relative-concentrations (sample concentration divided by the benchmark concentration) were used for evaluating groundwater quality for those constituents that have Federal and (or) California benchmarks. A relative-concentration greater than (>) 1.0 indicates a concentration greater than a benchmark, and a relative-concentration less than or equal to (≤) 1.0 indicates a concentration equal to or less than a benchmark. Relative-concentrations of organic and special-interest constituents were classified as low (relative- concentration ≤ 0.1), moderate (0.1 1.0). Inorganic constituent relative- concentrations were classified as low (relative-concentration ≤ 0.5), moderate (0.5 1.0). A lower threshold value of relative-concentration was used to distinguish between low and moderate values of organic constituents because organic constituents are generally less prevalent and have smaller relative-concentrations than naturally occurring inorganic constituents. Aquifer-scale proportion was used as the metric for evaluating regional-scale groundwater quality. High aquifer-scale proportion is defined as the percentage of the primary aquifer system that has relative-concentration greater than 1.0 for a particular constituent or class of constituents; proportion is based on an areal rather than a volumetric basis. Moderate and low aquifer-scale proportions were defined as the percentages of the primary aquifer system that have moderate and low relative-concentrations, respectively. Two statistical approaches—grid-based and spatially weighted—were used to evaluate aquifer-scale proportion for individual constituents and classes of constituents. Grid-based and spatially weighted estimates were comparable in the San Francisco Bay study unit (90-percent confidence intervals). Inorganic constituents with health-based benchmarks were present at high relative-concentrations in 5.1 percent of the primary aquifer system, and at moderate relative-concentrations in 25 percent. The high aquifer-scale proportion of inorganic constituents primarily reflected high aquifer-scale proportions of barium (3.0 percent) and nitrate (2.1 percent). Inorganic constituents with secondary maximum contaminant levels were present at high relative-concentrations in 14 percent of the primary aquifer system and at moderate relative-concentrations in 33 percent. The constituents present at high relative-concentrations included total dissolved solids (7.0 percent), chloride (6.1 percent), manganese (12 percent), and iron (3.0 percent). Organic constituents with health-based benchmarks were present at high relative-concentrations in 0.6 percent and at moderate relative-concentrations in 12 percent of the primary aquifer system. Of the 202 organic constituents analyzed for, 32 were detected. Three organic constituents were frequently detected (in 10 percent or more of samples): the trihalomethane chloroform, the solvent 1,1,1-trichloroethane and the refrigerant 1,1,2-trichlorotrifluoroethane. One special-interest constituent, perchlorate, was detected at moderate relative-concentrations in 42 percent of the primary aquifer system. The second component of this work, the understanding assessment, identified some of the primary natural and human factors that may affect groundwater quality by evaluating land use, physical characteristics of the wells, and geochemical conditions of the aquifer. Results from these evaluations were used to explain the occurrence and distribution of constituents in the study unit.

Fluorescent Cell Barcoding for Multiplex Flow Cytometry

PubMed Central

Krutzik, Peter O.; Clutter, Matthew R.; Trejo, Angelica; Nolan, Garry P.

2011-01-01

Fluorescent Cell Barcoding (FCB) enables high throughput, i.e. high content flow cytometry by multiplexing samples prior to staining and acquisition on the cytometer. Individual cell samples are barcoded, or labeled, with unique signatures of fluorescent dyes so that they can be mixed together, stained, and analyzed as a single sample. By mixing samples prior to staining, antibody consumption is typically reduced 10 to 100-fold. In addition, data robustness is increased through the combination of control and treated samples, which minimizes pipetting error, staining variation, and the need for normalization. Finally, speed of acquisition is enhanced, enabling large profiling experiments to be run with standard cytometer hardware. In this unit, we outline the steps necessary to apply the FCB method to cell lines as well as primary peripheral blood samples. Important technical considerations such as choice of barcoding dyes, concentrations, labeling buffers, compensation, and software analysis are discussed. PMID:21207359

Preanalytical quality in clinical chemistry laboratory.

PubMed

Ahmad, M Imteyaz; Ramesh, K L; Kumar, Ravi

2014-01-01

Haemolysis is usually caused by inadequate specimen collection or preanalytical handling and is suggested to be a suitable indicator of preanalytical quality. We investigated the prevalence of detectable haemolysis in all routine venous blood samples in OPDs and IPDs to identify differences in preanalytical quality. Haemolysis index (HI) values were obtained from a Vitros 5,1 in the routine clinical chemistry laboratory for samples collected in the outpatient department (OPD) collection centres, a hospital, and inpatient departments (IPD). Haemolysis was defined as a HI > or = 15 (detection limit). Samples from the OPD with the highest prevalence of haemolysis were 6.1 times (95% confidence interval (CI) 4.0 - 9.2) more often haemolysed compared to the center with the lowest prevalence. Of the samples collected in primary health care, 10.4% were haemolysed compared to 31.1% in the IPDs (p = 0.001). A notable difference in haemolysed samples was found between the IPDs section staffed by emergency medicine physicians and the section staffed by primary health care physicians (34.8% vs. 11.3%, p = 0.001). The significant variation in haemolysis indices among the investigated units is likely to reflect varying preanalytical conditions. The HI is a valuable tool for estimation and follow-up of preanalytical quality in the health care laboratory.

Evaluating best practices for Campylobacter and Salmonella reduction in poultry processing plants.

PubMed

Wideman, N; Bailey, M; Bilgili, S F; Thippareddi, H; Wang, L; Bratcher, C; Sanchez-Plata, M; Singh, M

2016-02-01

Poultry processing plants in the United States were surveyed on their current Campylobacter and Salmonella control practices. Following surveys, data were collected to develop a baseline for prevalence rates of Salmonella and Campylobacter; then changes in practices were implemented and evaluated for improvements in pathogen control. Surveys were sent to the plant Quality Assurance managers to determine production levels, antimicrobial interventions, and current pathogen testing practices. Initial sampling was performed at 6 plants with similar production volumes, at sites that included carcass samples before any pre-evisceration intervention, after exiting the inside-outside bird washer (IOBW), after exiting the pre-chiller, after exiting the primary chiller, and after exiting any post-chill intervention, as well as a water sample from each scalder, pre-chiller, primary chiller, and post-chill dip tank or finishing chiller. Enumerations and enrichments were performed for Campylobacter and Salmonella. Following the baseline sampling, changes in practices were suggested for each plant and a second sampling was conducted to determine their effectiveness. Results demonstrated that peracetic acid (PAA) was the most effective (P < 0.05) antimicrobial currently in use. The use of a post-chill antimicrobial immersion tank and/or use of a cetylpyridinium chloride (CPC) spray cabinet also displayed a further reduction in microbial levels (P < 0.05) when the primary chiller was not sufficient (P > 0.05). Microbial buildup in the immersion tanks demonstrates the need for effective cleaning, sanitation practices, and chiller maintenance to reduce contamination of poultry with Campylobacter and Salmonella. © 2015 Poultry Science Association Inc.

Statistics and quality assurance for the Northern Research Station Forest Inventory and Analysis Program

Treesearch

Dale D. Gormanson; Scott A. Pugh; Charles J. Barnett; Patrick D. Miles; Randall S. Morin; Paul A. Sowers; James A. Westfall

2018-01-01

The U.S. Forest Service Forest Inventory and Analysis (FIA) program collects sample plot data on all forest ownerships across the United States. FIA’s primary objective is to determine the extent, condition, volume, growth, and use of trees on the Nation’s forest land through a comprehensive inventory and analysis of the Nation’s forest resources. The FIA program...

A global reference database from very high resolution commercial satellite data and methodology for application to Landsat derived 30 m continuous field tree cover data

USGS Publications Warehouse

Pengra, Bruce; Long, Jordan; Dahal, Devendra; Stehman, Stephen V.; Loveland, Thomas R.

2015-01-01

The methodology for selection, creation, and application of a global remote sensing validation dataset using high resolution commercial satellite data is presented. High resolution data are obtained for a stratified random sample of 500 primary sampling units (5 km  ×  5 km sample blocks), where the stratification based on Köppen climate classes is used to distribute the sample globally among biomes. The high resolution data are classified to categorical land cover maps using an analyst mediated classification workflow. Our initial application of these data is to evaluate a global 30 m Landsat-derived, continuous field tree cover product. For this application, the categorical reference classification produced at 2 m resolution is converted to percent tree cover per 30 m pixel (secondary sampling unit)for comparison to Landsat-derived estimates of tree cover. We provide example results (based on a subsample of 25 sample blocks in South America) illustrating basic analyses of agreement that can be produced from these reference data. Commercial high resolution data availability and data quality are shown to provide a viable means of validating continuous field tree cover. When completed, the reference classifications for the full sample of 500 blocks will be released for public use.

Groundwater-quality data in the Cascade Range and Modoc Plateau study unit, 2010-Results from the California GAMA Program

USGS Publications Warehouse

Shelton, Jennifer L.; Fram, Miranda S.; Belitz, Kenneth

2013-01-01

Groundwater quality in the 39,000-square-kilometer Cascade Range and Modoc Plateau (CAMP) study unit was investigated by the U.S. Geological Survey (USGS) from July through October 2010, as part of the California State Water Resources Control Board (SWRCB) Groundwater Ambient Monitoring and Assessment (GAMA) Program’s Priority Basin Project (PBP). The GAMA PBP was developed in response to the California Groundwater Quality Monitoring Act of 2001 and is being conducted in collaboration with the SWRCB and Lawrence Livermore National Laboratory (LLNL). The CAMP study unit is the thirty-second study unit to be sampled as part of the GAMA PBP. The GAMA CAMP study was designed to provide a spatially unbiased assessment of untreated-groundwater quality in the primary aquifer system and to facilitate statistically consistent comparisons of untreated-groundwater quality throughout California. The primary aquifer system is defined as that part of the aquifer corresponding to the open or screened intervals of wells listed in the California Department of Public Health (CDPH) database for the CAMP study unit. The quality of groundwater in shallow or deep water-bearing zones may differ from the quality of groundwater in the primary aquifer system; shallow groundwater may be more vulnerable to surficial contamination. In the CAMP study unit, groundwater samples were collected from 90 wells and springs in 6 study areas (Sacramento Valley Eastside, Honey Lake Valley, Cascade Range and Modoc Plateau Low Use Basins, Shasta Valley and Mount Shasta Volcanic Area, Quaternary Volcanic Areas, and Tertiary Volcanic Areas) in Butte, Lassen, Modoc, Plumas, Shasta, Siskiyou, and Tehama Counties. Wells and springs were selected by using a spatially distributed, randomized grid-based method to provide statistical representation of the study unit (grid wells). Groundwater samples were analyzed for field water-quality indicators, organic constituents, perchlorate, inorganic constituents, radioactive constituents, and microbial indicators. Naturally occurring isotopes and dissolved noble gases also were measured to provide a dataset that will be used to help interpret the sources and ages of the sampled groundwater in subsequent reports. In total, 221 constituents were investigated for this study. Three types of quality-control samples (blanks, replicates, and matrix spikes) were collected at approximately 10 percent of the wells in the CAMP study unit, and the results for these samples were used to evaluate the quality of the data for the groundwater samples. Blanks rarely contained detectable concentrations of any constituent, suggesting that contamination from sample collection procedures was not a significant source of bias in the data for the groundwater samples. Replicate samples generally were within the limits of acceptable analytical reproducibility. Matrix-spike recoveries were within the acceptable range (70 to 130 percent) for approximately 90 percent of the compounds. This study did not attempt to evaluate the quality of water delivered to consumers; after withdrawal from the ground, untreated groundwater typically is treated, disinfected, and (or) blended with other waters to maintain water quality. Regulatory benchmarks apply to water that is served to the consumer, not to untreated groundwater. However, to provide some context for the results, concentrations of constituents measured in the untreated groundwater were compared with regulatory and non-regulatory health-based benchmarks established by the U.S. Environmental Protection Agency (USEPA) and CDPH, and to non-regulatory benchmarks established for aesthetic concerns by CDPH. Comparisons between data collected for this study and benchmarks for drinking water are for illustrative purposes only and are not indicative of compliance or non-compliance with those benchmarks. All organic constituents and most inorganic constituents that were detected in groundwater samples from the 90 grid wells in the CAMP study unit were detected at concentrations less than drinking-water benchmarks. Of the 148 organic constituents analyzed, 27 were detected in groundwater samples; concentrations of all detected constituents were less than regulatory and nonregulatory health-based benchmarks, and all were less than 1/10 of benchmark levels. One or more organic constituents were detected in 52 percent of the grid wells in the CAMP study unit: VOCs were detected in 30 percent, and pesticides and pesticide degradates were detected in 31 percent. Trace elements, major ions, nutrients, and radioactive constituents were sampled for at 90 grid wells in the CAMP study unit, and most detected concentrations were less than health-based benchmarks. Exceptions include three detections of arsenic greater than the USEPA maximum contaminant level (MCL-US) of 10 micrograms per liter (µg/L), two detections of boron greater than the CDPH notification level (NL-CA) of 1,000 µg/L, two detections of molybdenum greater than the USEPA lifetime health advisory level (HAL-US) of 40 µg/L, two detections of vanadium greater than the CDPH notification level (NL-CA) of 50 µg/L, one detection of nitrate, as nitrogen, greater than the MCL-US of 10 milligrams per liter (mg/L), two detections of uranium greater than the MCL-US of 30 µg/L and the MCL-CA of 20 picocuries per liter (pCi/L), one detection of radon-222 greater than the proposed MCL-US of 4,000 pCi/L, and two detections of gross alpha particle activity greater than the MCL-US of 15 pCi/L. Results for inorganic constituents with non-regulatory benchmarks set for aesthetic concerns showed that iron concentrations greater than the CDPH secondary maximum contaminant level (SMCL-CA) of 300 µg/L were detected in four grid wells. Manganese concentrations greater than the SMCL-CA of 50 µg/L were detected in nine grid wells. Chloride and TDS were detected at concentrations greater than the upper SMCL-CA benchmarks of 500 mg/L and 1,000 mg/L, respectively, in one grid well. Microbial indicators (total coliform and Escherichia coli [E. coli]) were detected in 11 percent of the 83 grid wells sampled for these analyses in the CAMP study unit. The presence of total coliform was detected in nine grid wells, and the presence of E. coli was detected in one of these same grid wells.

Prevalence of health promotion programs in primary health care units in Brazil

PubMed Central

Ramos, Luiz Roberto; Malta, Deborah Carvalho; Gomes, Grace Angélica de Oliveira; Bracco, Mário M; Florindo, Alex Antonio; Mielke, Gregore Iven; Parra, Diana C; Lobelo, Felipe; Simoes, Eduardo J; Hallal, Pedro Curi

2014-01-01

OBJECTIVE Assessment of prevalence of health promotion programs in primary health care units within Brazil’s health system. METHODS We conducted a cross-sectional descriptive study based on telephone interviews with managers of primary care units. Of a total 42,486 primary health care units listed in the Brazilian Unified Health System directory, 1,600 were randomly selected. Care units from all five Brazilian macroregions were selected proportionally to the number of units in each region. We examined whether any of the following five different types of health promotion programs was available: physical activity; smoking cessation; cessation of alcohol and illicit drug use; healthy eating; and healthy environment. Information was collected on the kinds of activities offered and the status of implementation of the Family Health Strategy at the units. RESULTS Most units (62.0%) reported having in place three health promotion programs or more and only 3.0% reported having none. Healthy environment (77.0%) and healthy eating (72.0%) programs were the most widely available; smoking and alcohol use cessation were reported in 54.0% and 42.0% of the units. Physical activity programs were offered in less than 40.0% of the units and their availability varied greatly nationwide, from 51.0% in the Southeast to as low as 21.0% in the North. The Family Health Strategy was implemented in most units (61.0%); however, they did not offer more health promotion programs than others did. CONCLUSIONS Our study showed that most primary care units have in place health promotion programs. Public policies are needed to strengthen primary care services and improve training of health providers to meet the goals of the agenda for health promotion in Brazil. PMID:25372175

Engine Tune-Up Service. Unit 3: Primary Circuit. Posttests. Automotive Mechanics Curriculum.

ERIC Educational Resources Information Center

Morse, David T.

This book of posttests is designed to accompany the Engine Tune-Up Service Student Guide for Unit 3, Primary Circuit, available separately as CE 031 211. Focus of the posttests is setting the primary ignition circuit. One multiple choice posttest is provided, covering the eight performance objectives contained in the unit. (No answer key is…

Developing and Implementing a Mobile Conservation Education Unit for Rural Primary School Children in Lao PDR

ERIC Educational Resources Information Center

Hansel, Troy; Phimmavong, Somvang; Phengsopha, Kaisone; Phompila, Chitana; Homduangpachan, Khiaosaphan

2010-01-01

In this article, the authors examine the implementation and success of a mobile conservation education unit targeting primary schools in central Lao PDR (People's Democratic Republic). The mobile unit conducted 3-hour interactive programs for school children focused on the importance of wildlife and biodiversity around the primary schools in rural…

Characteristics of an Outpatient Treatment Sample by Primary Substance of Abuse

PubMed Central

Campbell, Aimee N. C.; Nunes, Edward V.; McClure, Erin A.; Hu, Mei-Chen; Turrigiano, Eva; Goldman, Bruce; Stabile, Patricia Quinn

2013-01-01

Objective The current study examines sociodemographic and clinical characteristics, as a function of primary substance of abuse, among clients approached, screened, and assessed for eligibility in a 10-site effectiveness trial of a web-based psychosocial intervention for substance use disorders. Consistent with the design of effectiveness trials, eligibility criteria were broad and exclusion criteria minimal; thus, the recruited sample may be viewed as relatively representative of patients seeking treatment throughout the United States. Methods Chi-square tests for categorical variables and F-tests for continuous variables were used to analyze demographic, substance use, physical and mental health, and sexual risk data collected at screening and baseline; pairwise comparisons between primary substance subgroups for baseline data were conducted if the test statistic p-value was ≤ .01. Results Few participants expressed disinterest in the study at screening due to the computer-assisted intervention. A diverse sample of substance users completed baseline and were enrolled: 22.9% marijuana; 21.7% opiates; 20.9% alcohol; 20.5% cocaine; and 13.9% stimulants. Marijuana users demonstrated the greatest differences across primary substances: they were younger, less likely to be married or attend 12-step meetings, and more likely to be in treatment as a result of criminal justice involvement. All patients, even marijuana users, reported comparable rates of co-occurring mental health disorders and sexual risk, as well as substantial rates of polysubstance use disorders. Conclusion Primary substance of abuse may be a less important indicator of overall severity compared to co-occurring disorders and other factors common across treatment seekers, further demonstrating the need for integrated treatment services and care, as well as comprehensive pre-treatment assessment. PMID:24089040

Multi-species attributes as the condition for adaptive sampling of rare species using two-stage sequential sampling with an auxiliary variable

USGS Publications Warehouse

Panahbehagh, B.; Smith, D.R.; Salehi, M.M.; Hornbach, D.J.; Brown, D.J.; Chan, F.; Marinova, D.; Anderssen, R.S.

2011-01-01

Assessing populations of rare species is challenging because of the large effort required to locate patches of occupied habitat and achieve precise estimates of density and abundance. The presence of a rare species has been shown to be correlated with presence or abundance of more common species. Thus, ecological community richness or abundance can be used to inform sampling of rare species. Adaptive sampling designs have been developed specifically for rare and clustered populations and have been applied to a wide range of rare species. However, adaptive sampling can be logistically challenging, in part, because variation in final sample size introduces uncertainty in survey planning. Two-stage sequential sampling (TSS), a recently developed design, allows for adaptive sampling, but avoids edge units and has an upper bound on final sample size. In this paper we present an extension of two-stage sequential sampling that incorporates an auxiliary variable (TSSAV), such as community attributes, as the condition for adaptive sampling. We develop a set of simulations to approximate sampling of endangered freshwater mussels to evaluate the performance of the TSSAV design. The performance measures that we are interested in are efficiency and probability of sampling a unit occupied by the rare species. Efficiency measures the precision of population estimate from the TSSAV design relative to a standard design, such as simple random sampling (SRS). The simulations indicate that the density and distribution of the auxiliary population is the most important determinant of the performance of the TSSAV design. Of the design factors, such as sample size, the fraction of the primary units sampled was most important. For the best scenarios, the odds of sampling the rare species was approximately 1.5 times higher for TSSAV compared to SRS and efficiency was as high as 2 (i.e., variance from TSSAV was half that of SRS). We have found that design performance, especially for adaptive designs, is often case-specific. Efficiency of adaptive designs is especially sensitive to spatial distribution. We recommend that simulations tailored to the application of interest are highly useful for evaluating designs in preparation for sampling rare and clustered populations.

A comparative study of behavioral and psychological signs and symptoms of dementia in patients with dementia referred to psychogeriatric services in Korea and the United Kingdom.

PubMed

Shah, Ajit; Ellanchenny, Nalini; Suh, Guk-Hee

2004-06-01

There is a paucity of cross-cultural studies of behavioral and psychological symptoms of dementia (BPSD). BPSD were examined in a consecutive series of referrals to a psychogeriatric service in the United Kingdom (U.K.) and in Korea, using the BEHAVE-AD, the Cornell Scale for Depression in Dementia and the Mini-mental State Examination (MMSE). The U.K. service served a well-defined geographical catchment area with a multidisciplinary team and emphasis on home assessments. The Korean service was a nationwide service with limited community resources. The correlates of individual BPSD in each country and the differences between the two countries were examined. Koreans were younger, were more likely to be married, less likely to be single, had a greater number of people in their household and were more likely to live in their own homes than the U.K. sample. Koreans were more likely to be referred by general psychiatrists or family members, and the U.K. sample was more likely to be referred by general practitioners. Koreans were more likely to have Alzheimer's disease and the U.K. sample to have vascular dementia. The Korean sample had a lower MMSE score than the U.K. sample. In both countries, the total BEHAVE-AD score and most subscale scores were negatively correlated with the MMSE score. The total BEHAVE-AD score and all subscale scores were higher in the Korean sample than in the U.K. sample. The prevalence of all BPSD measured with the BEHAVE-AD were higher in the Korean sample (except aggressivity). These differences may be explained by differing interpretation and administration of the measurement instruments, models of service delivery, availability of primary and secondary care services, health seeking behavior of patients and families, cultural influences, and knowledge, expectations and recognition of BPSD by professionals in primary and secondary care. However, despite this, there was possible evidence of genuine differences worthy of further cross-cultural population-based epidemiological study of BPSD between these two countries.

Risk levels for suffering a traffic injury in primary health care. The LESIONAT project.

PubMed

Martín-Cantera, Carlos; Prieto-Alhambra, Daniel; Roig, Lydia; Valiente, Susana; Perez, Katherine; Garcia-Ortiz, Luis; Bel, Jordi; Marques, Fernando; Mundet, Xavier; Bonafont, Xavier; Birules, Marti; Soldevila, Núria; Briones, Elena

2010-03-16

Literature shows that not only are traffic injuries due to accidents, but that there is also a correlation between different chronic conditions, the consumption of certain types of drugs, the intake of psychoactive substances and the self perception of risk (Health Belief Model) and the impact/incidence of traffic accidents. There are few studies on these aspects in primary health care. THE OBJECTIVES of our study are: Main aim: To outline the distribution of risk factors associated with Road Traffic Injuries (RTI) in a driving population assigned to a group of primary health care centres in Barcelona province. Secondly, we aim to study the distribution of diverse risk factors related to the possibility of suffering an RTI according to age, sex and population groups, to assess the relationship between these same risk factors and self risk perception for suffering an RTI, and to outline the association between the number of risk factors and the history of reported collisions. Cross-sectional, multicentre study. 25 urban health care centres. Randomly selected sample of Spanish/Catalan speakers age 16 or above with a medical register in any of the 25 participating primary health care centres. N = 1540.Unit of study: Basic unit of care, consisting of a general practitioner and a nurse, both of whom caring for the same population (1,500 to 2,000 people per unit). Instruments of measurement: Data collection will be performed using a survey carried out by health professionals, who will use the clinical registers and the information reported by the patient during the visit to collect the baseline data: illnesses, medication intake, alcohol and psychoactive consumption, and self perception of risk. We expect to obtain a risk profile of the subjects in relation to RTI in the primary health care field, and to create a group for a prospective follow-up. Clinical Trials.gov Identifier: NCT00778440.

An open cluster-randomized, 18-month trial to compare the effectiveness of educational outreach visits with usual guideline dissemination to improve family physician prescribing

PubMed Central

2014-01-01

Background The Portuguese National Health Directorate has issued clinical practice guidelines on prescription of anti-inflammatory drugs, acid suppressive therapy, and antiplatelets. However, their effectiveness in changing actual practice is unknown. Methods The study will compare the effectiveness of educational outreach visits regarding the improvement of compliance with clinical guidelines in primary care against usual dissemination strategies. A cost-benefit analysis will also be conducted. We will carry out a parallel, open, superiority, randomized trial directed to primary care physicians. Physicians will be recruited and allocated at a cluster-level (primary care unit) by minimization. Data will be analyzed at the physician level. Primary care units will be eligible if they use electronic prescribing and have at least four physicians willing to participate. Physicians in intervention units will be offered individual educational outreach visits (one for each guideline) at their workplace during a six-month period. Physicians in the control group will be offered a single unrelated group training session. Primary outcomes will be the proportion of cyclooxygenase-2 inhibitors prescribed in the anti-inflammatory class, and the proportion of omeprazole in the proton pump inhibitors class at 18 months post-intervention. Prescription data will be collected from the regional pharmacy claims database. We estimated a sample size of 110 physicians in each group, corresponding to 19 clusters with a mean size of 6 physicians. Outcome collection and data analysis will be blinded to allocation, but due to the nature of the intervention, physicians and detailers cannot be blinded. Discussion This trial will attempt to address unresolved issues in the literature, namely, long term persistence of effect, the importance of sequential visits in an outreach program, and cost issues. If successful, this trial may be the cornerstone for deploying large scale educational outreach programs within the Portuguese National Health Service. Trial registration ClinicalTrials.gov number NCT01984034. PMID:24423370

Risk levels for suffering a traffic injury in primary health care. The LESIONAT* project

PubMed Central

2010-01-01

Background Literature shows that not only are traffic injuries due to accidents, but that there is also a correlation between different chronic conditions, the consumption of certain types of drugs, the intake of psychoactive substances and the self perception of risk (Health Belief Model) and the impact/incidence of traffic accidents. There are few studies on these aspects in primary health care. The objectives of our study are: Main aim: To outline the distribution of risk factors associated with Road Traffic Injuries (RTI) in a driving population assigned to a group of primary health care centres in Barcelona province. Secondly, we aim to study the distribution of diverse risk factors related to the possibility of suffering an RTI according to age, sex and population groups, to assess the relationship between these same risk factors and self risk perception for suffering an RTI, and to outline the association between the number of risk factors and the history of reported collisions. Methods/Design Design: Cross-sectional, multicentre study. Setting: 25 urban health care centres. Study population: Randomly selected sample of Spanish/Catalan speakers age 16 or above with a medical register in any of the 25 participating primary health care centres. N = 1540. Unit of study: Basic unit of care, consisting of a general practitioner and a nurse, both of whom caring for the same population (1,500 to 2,000 people per unit). Instruments of measurement: Data collection will be performed using a survey carried out by health professionals, who will use the clinical registers and the information reported by the patient during the visit to collect the baseline data: illnesses, medication intake, alcohol and psychoactive consumption, and self perception of risk. Discussion We expect to obtain a risk profile of the subjects in relation to RTI in the primary health care field, and to create a group for a prospective follow-up. Trial Registration Clinical Trials.gov Identifier: NCT00778440. PMID:20233403

Settlement Unit. Using Primary Sources in the Classroom.

ERIC Educational Resources Information Center

Alabama Dept. of Archives and History, Montgomery.

This teaching unit, "Settlement Unit,"which focuses on the settlement of Alabama's land, is the second in a series of 10 units about Alabama state history, part of a project designed to help teachers integrate the use of primary source materials into their classrooms. Although the units are designed to augment the study of Alabama, they…

Solid Phase Microextraction and Related Techniques for Drugs in Biological Samples

PubMed Central

Moein, Mohammad Mahdi; Said, Rana; Bassyouni, Fatma

2014-01-01

In drug discovery and development, the quantification of drugs in biological samples is an important task for the determination of the physiological performance of the investigated drugs. After sampling, the next step in the analytical process is sample preparation. Because of the low concentration levels of drug in plasma and the variety of the metabolites, the selected extraction technique should be virtually exhaustive. Recent developments of sample handling techniques are directed, from one side, toward automatization and online coupling of sample preparation units. The primary objective of this review is to present the recent developments in microextraction sample preparation methods for analysis of drugs in biological fluids. Microextraction techniques allow for less consumption of solvent, reagents, and packing materials, and small sample volumes can be used. In this review the use of solid phase microextraction (SPME), microextraction in packed sorbent (MEPS), and stir-bar sorbtive extraction (SBSE) in drug analysis will be discussed. In addition, the use of new sorbents such as monoliths and molecularly imprinted polymers will be presented. PMID:24688797

Relation of Shallow Water Quality in the Central Oklahoma Aquifer to Geology, Soils, and Land Use

USGS Publications Warehouse

Rea, Alan H.; Christenson, Scott C.; Andrews, William J.

2001-01-01

The purpose of this report is to identify, describe, and explain relations between natural and land-use factors and ground-water quality in the Central Oklahoma aquifer NAWQA study unit. Natural factors compared to water quality included the geologic unit in which the sampled wells were completed and the properties of soils in the areas surrounding the wells. Land-use factors included types of land use and population densities surrounding sampled wells. Ground-water quality was characterized by concentrations of inorganic constituents, and by frequencies of detection of volatile organic compounds and pesticides. Water-quality data were from samples collected from wells 91 meters (300 feet) or less in depth as part of Permian and Quaternary geologic unit survey networks and from an urban survey network. Concentrations of many inorganic constituents were significantly related to geology. In addition, concentrations of many inorganic constituents were greater in water from wells from the Oklahoma City urban sampling network than in water from wells from low-density survey networks designed to evaluate ambient water quality in the Central Oklahoma aquifer study unit. However, sampling bias may have been induced by differences in hydrogeologic factors between sampling networks, limiting the ability to determine land-use effects on concentrations of inorganic constituents. Frequencies of detection of pesticide and volatile organic compounds (VOC's) in ground-water samples were related to land use and population density, with these compounds being more frequently detected in densely-populated areas. Geology and soil properties were not significantly correlated to pesticide or VOC occurrence in ground water. Lesser frequencies of detection of pesticides in water from wells in rural areas may be due to low to moderate use of those compounds on agricultural lands in the study unit, with livestock production being the primary agricultural activity. There are many possible sources of pesticides and VOC's in the urban areas of Central Oklahoma. Because only existing water-supply wells were sampled, it is not clear from the data collected whether pesticides and VOC's: (1) occur in low concentrations throughout upper portions of the aquifer in urban areas, or (2) are present in ground water only in the immediate vicinity of the wells due to back-flow of those chemicals into the wells or to inflow around cement seals and through gravel packs surrounding well casings of surface runoff containing those compounds.

Test and Validation of the Mars Science Laboratory Robotic Arm

NASA Technical Reports Server (NTRS)

Robinson, M.; Collins, C.; Leger, P.; Kim, W.; Carsten, J.; Tompkins, V.; Trebi-Ollennu, A.; Florow, B.

2013-01-01

The Mars Science Laboratory Robotic Arm (RA) is a key component for achieving the primary scientific goals of the mission. The RA supports sample acquisition by precisely positioning a scoop above loose regolith or accurately preloading a percussive drill on Martian rocks or rover-mounted organic check materials. It assists sample processing by orienting a sample processing unit called CHIMRA through a series of gravity-relative orientations and sample delivery by positioning the sample portion door above an instrument inlet or the observation tray. In addition the RA facilitates contact science by accurately positioning the dust removal tool, Alpha Particle X-Ray Spectrometer (APXS) and the Mars Hand Lens Imager (MAHLI) relative to surface targets. In order to fulfill these seemingly disparate science objectives the RA must satisfy a variety of accuracy and performance requirements. This paper describes the necessary arm requirement specification and the test campaign to demonstrate these requirements were satisfied.

Effect of an educational intervention on the clinical competence for primary healthcare of rheumatic diseases in Mexican physicians.

PubMed

Cabrera-Pivaral, Carlos E; Ramírez-García, Sergio A; Zavala-González, Marco A

2016-01-01

To measure the effect of an educational intervention on clinical competences for diagnosis and treatment of rheumatic diseases in primary healthcare physicians working in the Guadalajara Metropolitan Area, Jalisco, Mexico. Quasi-experimental study conducted in physicians from two primary health care units. The study was carried out in a 40 physicians sample, 21 in Group "A" (intervention) and 19 in Group "B" (control). The clinical competence for diagnosis and treatment of rheumatic diseases was measured in both groups by means of an instrument previously designed and validated (Kuder-Richardson reliability index =0,94). Clinical competence average score prior to intervention was 47 for Group "A" and 42 for Group "B", while after the intervention it was 72 and 47 respectively, which shows statistically significant differences (Wilcoxon test, p<0,05). Clinical competence for diagnosis and treatment of rheumatic diseases in primary healthcare physicians is low; however, it can be improved by implementing educational interventions based on a constructivist approach.

Transfer from primary maternity unit to tertiary hospital in New Zealand - timing, frequency, reasons, urgency and outcomes: Part of the Evaluating Maternity Units study.

PubMed

Grigg, Celia P; Tracy, Sally K; Tracy, Mark; Schmied, Virginia; Monk, Amy

2015-09-01

to examine the transfers from primary maternity units to a tertiary hospital in New Zealand by describing the frequency, timing, reasons and outcomes of those who had antenatal or pre-admission birthplace plan changes, and transfers in labour or postnatally. mixed methods prospective (concurrent) cohort study, which analysed transfer and clinical outcome data (407 primary unit cohort, 285 tertiary hospital cohort), and data from the six week postpartum survey (571 respondents). well, pregnant women booked to give birth in a tertiary maternity hospital or primary maternity unit in one region in New Zealand (2010-2012). All women received midwifery continuity of care, regardless of their intended or actual birthplace. fewer than half of the women who planned a primary unit birth gave birth there (191 or 46.9%). A change of plan may have been made either antenatally or before admission in labour; and transfers were made after admission to the primary unit in labour or during the postnatal stay (about 48 hours). Of the 117 (28.5%) planning a primary unit birth who changed their planned birthplace type antenatally 73 (62.4%) were due to a clinical indication. Earthquakes accounted for 28.1% of birthplace change (during the research period major earthquakes occurred in the study region). Most (73.8%) labour changes occurred before admission in labour to the primary unit. For the 76 women who changed plan at this stage the most common reasons to do so were a rapid labour (25.0%) or prolonged rupture of membranes (23.7%). Transfers in labour from primary unit to tertiary hospital occurred for 27 women (12.6%) of whom 26 (96.3%) were having their first baby. "Slow progress" of labour accounted for 21 (77.8%) of these and 17 (62.9%) were classified as 'non-emergency'. The average transfer time for 'emergency' transfers was 58 minutes. The average time for all labour transfers from specialist consultation to birth was 4.5 hours. Nine postnatal transfers (maternal or neonatal) from a primary unit occurred (4.7%), making a total post-admission transfer rate of 17.3% for the primary unit cohort. birthplace changes were not uncommon, with many women changing their birthplace plan antenatally or prior to admission in labour and some transferring between facilities during or soon after birth. Most changes were due to the development of complications or 'risk factors'. Most transfers were not urgent and took approximately one hour from the decision to arrival at the tertiary hospital. Despite the transfers the neonatal clinical outcomes were comparable between both primary and tertiary cohorts, and there was higher maternal morbidity in the tertiary cohort. although the study size is relatively small, its comprehensive documentation of transfers has the potential to inform future research and the birthplace decision-making of childbearing women and midwives. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

When is acute persistent cough in school-age children and adults whooping cough? A prospective case series study.

PubMed

Philipson, Kathryn; Goodyear-Smith, Felicity; Grant, Cameron C; Chong, Angela; Turner, Nikki; Stewart, Joanna

2013-08-01

Pertussis is a vaccine modified disease in most age groups and hence subtle in its presentation. Current diagnostic approaches require relatively invasive sampling. To determine the incidence of B. pertussis infection among people aged 5-49 years identified in primary care with acute persistent cough using an oral fluid based diagnostic test. Active surveillance of acute persistent cough of 2 weeks duration or greater was established in Auckland, New Zealand from May to October 2011. The 15 participating primary care practices provided care for a socioeconomically diverse population. Recent B. pertussis infection was determined by measurement of IgG antibodies to pertussis toxin (PT) in an oral fluid sample. An IgG antibody titre to PT of ≥70 arbitrary units defined recent infection. Participants reported symptoms at presentation and kept a cough diary. A total of 226 participants were enrolled: 70 (31%) were children (5-16 years) and 156 (69%) were adults (17-49 years). Oral fluid samples were obtained from 225 participants. Ten per cent (23/225) had recent B. pertussis infection including a larger proportion of children than adults (17% versus 7%, P = 0.003). Neither cough duration nor any individual symptom discriminated between those with and without recent B. pertussis infection. Pertussis is a frequent cause of acute persistent cough presenting to primary care. Clinical differentiation of pertussis from other causes of acute persistent cough is difficult. An oral fluid based diagnostic test, which is less invasive than other diagnostic approaches, has high acceptability in primary care.

When is acute persistent cough in school-age children and adults whooping cough?

PubMed Central

Philipson, Kathryn; Goodyear-Smith, Felicity; Grant, Cameron C; Chong, Angela; Turner, Nikki; Stewart, Joanna

2013-01-01

Background Pertussis is a vaccine modified disease in most age groups and hence subtle in its presentation. Current diagnostic approaches require relatively invasive sampling. Aim To determine the incidence of B. pertussis infection among people aged 5–49 years identified in primary care with acute persistent cough using an oral fluid based diagnostic test. Design and setting Active surveillance of acute persistent cough of 2 weeks duration or greater was established in Auckland, New Zealand from May to October 2011. The 15 participating primary care practices provided care for a socioeconomically diverse population. Method Recent B. pertussis infection was determined by measurement of IgG antibodies to pertussis toxin (PT) in an oral fluid sample. An IgG antibody titre to PT of ≥70 arbitrary units defined recent infection. Participants reported symptoms at presentation and kept a cough diary. Results A total of 226 participants were enrolled: 70 (31%) were children (5–16 years) and 156 (69%) were adults (17–49 years). Oral fluid samples were obtained from 225 participants. Ten per cent (23/225) had recent B. pertussis infection including a larger proportion of children than adults (17% versus 7%, P = 0.003). Neither cough duration nor any individual symptom discriminated between those with and without recent B. pertussis infection. Conclusion Pertussis is a frequent cause of acute persistent cough presenting to primary care. Clinical differentiation of pertussis from other causes of acute persistent cough is difficult. An oral fluid based diagnostic test, which is less invasive than other diagnostic approaches, has high acceptability in primary care. PMID:23972198

Family physicians' attitude and practice of infertility management at primary care--Suez Canal University, Egypt.

PubMed

Eldein, Hebatallah Nour

2013-01-01

The very particular natures of infertility problem and infertility care make them different from other medical problems and services in developing countries. Even after the referral to specialists, the family physicians are expected to provide continuous support for these couples. This place the primary care service at the heart of all issues related to infertility. to improve family physicians' attitude and practice about the approach to infertility management within primary care setting. This study was conducted in the between June and December 2010. The study sample comprised 100 family physician trainees in the family medicine department and working in family practice centers or primary care units. They were asked to fill a questionnaire about their personal characteristics, attitude, and practice towards support, investigations, and treatment of infertile couples. Hundred family physicians were included in the study. They were previously received training in infertility management. Favorable attitude scores were detected among (68%) of physicians and primary care was considered a suitable place for infertility management among (77%) of participants. There was statistically significant difference regarding each of age groups, gender and years of experience with the physicians' attitude. There was statistically significant difference regarding gender, perceiving PHC as an appropriate place to manage infertility and attitude towards processes of infertility management with the physicians' practice. Favorable attitude and practice were determined among the study sample. Supporting the structure of primary care and evidence-based training regarding infertility management are required to improve family physicians' attitude and practice towards infertility management.

Family physicians’ attitude and practice of infertility management at primary care - Suez Canal University, Egypt

PubMed Central

Eldein, Hebatallah Nour

2013-01-01

Introduction The very particular natures of infertility problem and infertility care make them different from other medical problems and services in developing countries. Even after the referral to specialists, the family physicians are expected to provide continuous support for these couples. This place the primary care service at the heart of all issues related to infertility. The aim of the work: to improve family physicians' attitude and practice about the approach to infertility management within primary care setting. Methods This study was conducted in the between June and December 2010. The study sample comprised 100 family physician trainees in the family medicine department and working in family practice centers or primary care units. They were asked to fill a questionnaire about their personal characteristics, attitude, and practice towards support, investigations, and treatment of infertile couples. Results Hundred family physicians were included in the study. They were previously received training in infertility management. Favorable attitude scores were detected among (68%) of physicians and primary care was considered a suitable place for infertility management among (77%) of participants. There was statistically significant difference regarding each of age groups, gender and years of experience with the physicians′ attitude. There was statistically significant difference regarding gender, perceiving PHC as an appropriate place to manage infertility and attitude towards processes of infertility management with the physicians′ practice. Conclusion Favorable attitude and practice were determined among the study sample. Supporting the structure of primary care and evidence-based training regarding infertility management are required to improve family physicians' attitude and practice towards infertility management. PMID:24244792

The Affective Reactivity Index: a concise irritability scale for clinical and research settings

PubMed Central

Stringaris, Argyris; Goodman, Robert; Ferdinando, Sumudu; Razdan, Varun; Muhrer, Eli; Leibenluft, Ellen; Brotman, Melissa A

2012-01-01

Background Irritable mood has recently become a matter of intense scientific interest. Here, we present data from two samples, one from the United States and the other from the United Kingdom, demonstrating the clinical and research utility of the parent- and self-report forms of the Affective Reactivity Index (ARI), a concise dimensional measure of irritability. Methods The US sample (n = 218) consisted of children and adolescents recruited at the National Institute of Mental Health meeting criteria for bipolar disorder (BD, n = 39), severe mood dysregulation (SMD, n = 67), children at family risk for BD (n = 35), or were healthy volunteers (n = 77). The UK sample (n = 88) was comprised of children from a generic mental health setting and healthy volunteers from primary and secondary schools. Results Parent- and self-report scales of the ARI showed excellent internal consistencies and formed a single factor in the two samples. In the US sample, the ARI showed a gradation with irritability significantly increasing from healthy volunteers through to SMD. Irritability was significantly higher in SMD than in BD by parent-report, but this did not reach significance by self-report. In the UK sample, parent-rated irritability was differentially related to emotional problems. Conclusions Irritability can be measured using a concise instrument both in a highly specialized US, as well as a general UK child mental health setting. PMID:22574736

First direct landscape-scale measurement of tropical rain forest Leaf Area Index, a key driver of global primary productivity

Treesearch

David B. Clark; Paulo C. Olivas; Steven F. Oberbauer; Deborah A. Clark; Michael G. Ryan

2008-01-01

Leaf Area Index (leaf area per unit ground area, LAI) is a key driver of forest productivity but has never previously been measured directly at the landscape scale in tropical rain forest (TRF). We used a modular tower and stratified random sampling to harvest all foliage from forest floor to canopy top in 55 vertical transects (4.6 m2) across 500 ha of old growth in...

Effect of Fluoride Varnish on Streptococcus mutans Count in Saliva of Caries Free Children Using Dentocult SM Strip Mutans Test: A Randomized Controlled Triple Blind Study.

PubMed

A, Deepti; Jeevarathan, J; Muthu, Ms; Prabhu V, Rathna; Chamundeswari

2008-09-01

The aim of this study was to estimate the count of Streptococcus mutans in saliva of caries free children using Dentocult SM strip mutans and to evaluate the effect of fluoride varnish on the Streptococcus mutans count in saliva of these caries free children. Thirty caries free children were selected for the study based on the information obtained from a questionnaire prepared. They were randomly assigned into the control group and the study group consisting of ten and twenty children respectively. Samples of saliva were collected using the saliva strips from the Dentocult SM kit and after incubation the presence of the Streptococcus mutans was evaluated using the manufacturers' chart. The study group was subjected to Fluor Protector fluoride varnish application after 24 hours following which the samples were collected again. The average Streptococcus mutans count in primary dentition of caries free children was in the range of 10(4) to 10(5) colony forming units/ml. The average Streptococcus mutans count in primary dentition of caries free children after Fluor Protector fluoride varnish application was below 10(4) colony forming units/ml. Fluor Protector fluoride varnish application showed a statistically significant reduction in the Streptococcus mutans count in saliva of the caries free children in the study group.

World War II Unit. Using Primary Sources in the Classroom.

ERIC Educational Resources Information Center

Alabama Dept. of Archives and History, Montgomery.

This teaching unit, "World War II Unit," is the ninth in a series of 10 units about Alabama state history, part of a project designed to help teachers integrate the use of primary source materials into their classrooms. Although the units are designed to augment the study of Alabama, they are useful in the study of U.S. history, world…

Status and understanding of groundwater quality in the San Diego Drainages Hydrogeologic Province, 2004: California GAMA Priority Basin Project

USGS Publications Warehouse

Wright, Michael T.; Belitz, Kenneth

2011-01-01

Groundwater quality in the approximately 3,900-square-mile (mi2) San Diego Drainages Hydrogeologic Province (hereinafter San Diego) study unit was investigated from May through July 2004 as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study unit is located in southwestern California in the counties of San Diego, Riverside, and Orange. The GAMA Priority Basin Project is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey (USGS) and the Lawrence Livermore National Laboratory. The GAMA San Diego study was designed to provide a statistically robust assessment of untreated-groundwater quality within the primary aquifer systems. The assessment is based on water-quality and ancillary data collected by the USGS from 58 wells in 2004 and water-quality data from the California Department of Public Health (CDPH) database. The primary aquifer systems (hereinafter referred to as the primary aquifers) were defined by the depth interval of the wells listed in the California Department of Public Health (CDPH) database for the San Diego study unit. The San Diego study unit consisted of four study areas: Temecula Valley (140 mi2), Warner Valley (34 mi2), Alluvial Basins (166 mi2), and Hard Rock (850 mi2). The quality of groundwater in shallow or deep water-bearing zones may differ from that in the primary aquifers. For example, shallow groundwater may be more vulnerable to surficial contamination than groundwater in deep water-bearing zones. This study had two components: the status assessment and the understanding assessment. The first component of this study-the status assessment of the current quality of the groundwater resource-was assessed by using data from samples analyzed for volatile organic compounds (VOC), pesticides, and naturally occurring inorganic constituents, such as major ions and trace elements. The status assessment is intended to characterize the quality of groundwater resources within the primary aquifers of the San Diego study unit, not the treated drinking water delivered to consumers by water purveyors. The second component of this study-the understanding assessment-identified the natural and human factors that affect groundwater quality by evaluating land use, well construction, and geochemical conditions of the aquifer. Results from these evaluations were used to help explain the occurrence and distribution of selected constituents in the study unit. Relative-concentrations (sample concentration divided by benchmark concentration) were used as the primary metric for relating concentrations of constituents in groundwater samples to water-quality benchmarks for those constituents that have Federal and (or) California benchmarks. For organic and special-interest constituents, relative-concentrations were classified as high (> 1.0), moderate (> 0.1 and ≤1.0), and low (≤0.1). For inorganic constituents, relative concentrations were classified as high (> 1.0), moderate (> 0.5 and ≤1.0), and low (≤0.5). Grid-based and spatially weighted approaches were then used to evaluate the proportion of the primary aquifers (aquifer-scale proportions) with high, moderate, and low relative-concentrations for individual compounds and classes of constituents. One or more of the inorganic constituents with health-based benchmarks were high (relative to those benchmarks) in 17.6 percent of the primary aquifers in the Temecula Valley, Warner Valley, and Alluvial Basins study areas (hereinafter also collectively referred to as the Alluvial Fill study areas because they are composed of alluvial fill aquifers), and in 25.0 percent of the Hard Rock study area. Inorganic constituents with health-based benchmarks that were frequently detected at high relative-concentrations included vanadium (V), arsenic (As), and boron (B). Vanadium and As concentrations were not significantly correlated to either urban or agricultural land use indicating natural sources as the primary contributors of these constituents to groundwater. The positive correlation of B concentration to urban land-use was significant which indicates that anthropogenic activities are a contributing source of B to groundwater. The correlation of V, As and B concentrations to pH was positive, indicating that in alkaline groundwater these constituents are being desorbed from, or being inhibited from adsorbing to, particle surfaces. Inorganic constituents with aesthetic benchmarks that were detected at high relative-concentrations include manganese (Mn), iron (Fe), and total dissolved solids (TDS). In the Alluvial Fill study areas, Mn and TDS were detected at high relative-concentrations in 13.7 percent of the primary aquifers, and Fe in 6.9 percent. In the Hard Rock study area, Mn was detected at high relative-concentrations in 33.3 percent of the primary aquifers, and TDS in 16.7 percent; Fe was not detected at high relative-concentrations. Total dissolved solids concentrations were significantly correlated to agricultural land use suggesting that agricultural practices are a contributing source of TDS to groundwater. Manganese and Fe concentrations were highest in groundwater with low dissolved oxygen and pH indicating that the reductive dissolution of oxyhydroxides may be an important mechanism for the mobilization of Mn and Fe in groundwater. TDS concentrations were highest in shallow wells and in modern (< 50 yrs) groundwater which indicates anthropogenic activities as a source of TDS concentrations in groundwater. The relative-concentrations of organic constituents with health-based benchmarks were high in 3.0 percent of the primary aquifers in the Alluvial Fill study areas. A single detection in the Alluvial Basins study area of the discontinued gasoline oxygenate methyl tert-butyl ether (MTBE) was the only organic constituent detected at a high relative-concentration; high relative-concentrations of these constituents were not detected in the Hard Rock study area. Twelve of 88 VOCs and 14 of 123 pesticides and pesticide degradates analyzed in grid wells were detected. Chloroform was the only VOC detected in more than 10 percent of the grid wells. The herbicides simazine, atrazine, and prometon were each detected in greater than 10 percent of the grid wells. Perchlorate was detected in 22 percent of the grid wells sampled. The understanding assessment showed a significant correlation of trihalomethanes (THMs) and solvents to urban land-use, indicating that detections of these constituents are more likely to occur in groundwater underlying urbanized areas of the study unit. MTBE concentrations were negatively correlated to the distance from the nearest leaking underground fuel tank, indicating that point sources are the most significant contributing factor for MTBE concentrations to groundwater in the study unit. The positive correlation of THM and herbicide concentrations to modern groundwater was significant, as was the negative correlation of herbicide concentrations to pH and anoxic groundwater. The negative correlation of herbicides to pH and anoxic groundwater was likely due to the fact that these constituents were detected more frequently in shallow wells where groundwater conditions tend to be oxic with relatively low pH.

Engine Tune-Up Service. Unit 3: Primary Circuit. Student Guide. Automotive Mechanics Curriculum.

ERIC Educational Resources Information Center

Bacon, E. Miles

This student guide is for Unit 3, Primary Circuit, in the Engine Tune-Up Service portion of the Automotive Mechanics Curriculum. It deals with how to test the primary ignition circuit. A companion review exercise book and posttests are available separately as CE 031 212-213. An introduction tells how this unit fits into the total tune-up service,…

The McCanse Readiness for Death Instrument (MRDI): a reliable and valid measure for hospice care.

PubMed

McCanse, R P

1995-01-01

The purpose of this study was to establish whether or not readiness for death, as an indicator of healthy dying, is a measurable concept. Review of relevant literature revealed consensus regarding the universality of a human need for healthy dying. A theory of healthy dying was derived from the Rogerian paradigm. The McCanse Readiness for Death Instrument (MRDI) was constructed, which included indicators of physiological, psychological, sociological, and spiritual aspects of "healthy" field pattern as death is developmentally approached. The MRDI was a 26-item structured interview questionnaire which generated interval-ratio data through a visual analog scale. A pretest was conducted with a sample of 9 volunteer patients drawn from a small suburban outpatient hospice. The MRDI was concurrently administered to dying individuals, their primary caregivers, and their primary hospice nurses. Correlations between dying individuals' scores and their primary caregivers' estimates of patient death readiness as well as between patients and their primary hospice nurses were very encouraging. Cronbach's coefficient alpha for internal consistency reliability was .59. Content validity was supported by consensus of an expert panel of practicing hospice nurses. Construct validity was demonstrated through legitimate placement of the concept, healthy death readiness, within the theoretical web which supported it. The MRDI was then administered to a sample of 31 terminally-ill individuals, their primary caregivers, and their primary hospice nurses drawn from larger, urban hospice populations in three geographic areas of the United States. The MRDI was also administered to a contrast group of 39 cardiac-impaired individuals who were not terminally-ill. Overall internal consistency of the MRDI was found to be quite favorable (alpha = .76). Debilitating illness and actual mortality in the study sample precluded and/or confounded estimates of test-retest reliability. Convergent validity of the MRDI was indicated by significant correlations between patients' scores and primary caregivers' estimates (r = .35, p < .05) and between patients' scores and primary hospice nurses' estimates (r = .53, p < .01). Discriminant validity of the MRDI was demonstrated by a significant mean difference between the group of terminally-ill patients and the group of non-terminal, cardiac-impaired patients (t = 1.76, p < .01).

Status of groundwater quality in the Borrego Valley, Central Desert, and Low-Use Basins of the Mojave and Sonoran Deserts study unit, 2008-2010: California GAMA Priority Basin Project

USGS Publications Warehouse

Parsons, Mary C.; Hancock, Tracy Connell; Kulongoski, Justin T.; Belitz, Kenneth

2014-01-01

Groundwater quality in the approximately 963-square-mile Borrego Valley, Central Desert, and Low-Use Basins of the Mojave and Sonoran Deserts study unit was investigated as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study unit is located in southern California in San Bernardino, Riverside, San Diego, and Imperial Counties. The GAMA Priority Basin Project is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey and the Lawrence Livermore National Laboratory. The GAMA Borrego Valley, Central Desert, and Low-Use Basins of the Mojave and Sonoran Deserts study was designed to provide a spatially unbiased assessment of the quality of untreated (raw) groundwater in the primary aquifer system. The assessment is based on water-quality and ancillary data collected by the U.S. Geological Survey from 52 wells (49 grid wells and 3 understanding wells) and on water-quality data from the California Department of Public Health database. The primary aquifer system was defined by the depth intervals of the wells listed in the California Department of Public Health database for the Borrego Valley, Central Desert, and Low-Use Basins of the Mojave and Sonoran Deserts study unit. The quality of groundwater in the primary aquifer system may be different from that in the shallower or deeper water-bearing zones; shallow groundwater may be more vulnerable to surficial contamination. This study assesses the status of the current quality of the groundwater resource by using data from samples analyzed for volatile organic compounds (VOCs), pesticides, and naturally occurring inorganic constituents, such as major ions and trace elements. This status assessment is intended to characterize the quality of groundwater resources in the primary aquifer system of the Borrego Valley, Central Desert, and Low-Use Basins of the Mojave and Sonoran Deserts study unit, not the treated drinking water delivered to consumers by water purveyors. Relative-concentrations (sample concentration divided by the health- or aesthetic-based benchmark concentration) were used for evaluating groundwater quality for those constituents that have Federal or California regulatory or non-regulatory benchmarks for drinking-water quality. A relative-concentration greater than 1.0 indicates a concentration greater than a benchmark, and a relative-concentration less than or equal to 1.0 indicates a concentration equal to or less than a benchmark. Relative-concentrations of organic constituents and special-interest constituents [perchlorate and N-nitrosodimethylamine (NDMA)] were classified as high (relative-concentration greater than 1.0), moderate (relative-concentration greater than 0.1 and less than or equal to 1.0), or low (relative-concentration less than or equal to 0.1). Relative-concentrations of inorganic constituents were classified as high (relative-concentration greater than 1.0), moderate (relative-concentration greater than 0.5 and less than or equal to 1.0), or low (relative-concentration less than or equal to 0.5). Aquifer-scale proportion was used as the primary metric in the status assessment for evaluating regional-scale groundwater quality. High aquifer-scale proportion is defined as the percentage of the area of the primary aquifer system with a high relative-concentration for a particular constituent or class of constituents; this percentage is based on an areal rather than a volumetric basis. Moderate and low aquifer-scale proportions were defined as the percentages of the primary aquifer system with moderate and low relative-concentrations, respectively, of a constituent or class of constituents. Two statistical approaches—grid-based and spatially weighted—were used to evaluate aquifer-scale proportions for individual constituents and classes of constituents. Grid-based and spatially weighted estimates were comparable to each other (within 90-percent confidence intervals) in the study unit. Inorganic constituents (one or more) with health-based benchmarks were detected at high relative-concentrations in 48 percent of the primary aquifer system and at moderate relative-concentrations in 26 percent of the primary aquifer system. The high aquifer-scale proportion of inorganic constituents primarily reflected high aquifer-scale proportions of fluoride (27 percent), arsenic (18 percent), molybdenum (16 percent), boron (10 percent), uranium (5.6 percent), gross alpha radioactivity (9.7 percent), and nitrate (2.7 percent). The inorganic constituents with secondary maximum contaminant levels (SMCLs) were detected at high relative-concentrations in 13 percent of the primary aquifer system and at moderate relative-concentrations in 39 percent. The high aquifer-scale proportion for SMCL constituents reflected high aquifer-scale proportions of total dissolved solids (TDS, 11 percent), manganese (2.8 percent), and chloride (2.8 percent). Organic constituents were not detected at high relative-concentrations in the primary aquifer system, and were present at moderate relative-concentrations in 5.0 percent, and at low relative-concentrations or were not detected in 95 percent of the primary aquifer system. Of the 148 organic constituents analyzed, 12 constituents were detected. Two organic constituents, chloroform and tetrachloroethene (PCE), were detected in more than 10 percent of samples, but were detected mostly at low relative-concentrations.

Prevention of child sexual abuse: evaluation of a community media campaign.

PubMed

Rheingold, Alyssa A; Campbell, Carole; Self-Brown, Shannon; de Arellano, Michael; Resnick, Heidi; Kilpatrick, Dean

2007-11-01

Given that mass media techniques have been an effective tool within the public health field for affecting behavioral change, these strategies may prove successful for the primary prevention of child sexual abuse (CSA). This study was an independent evaluation of a CSA media campaign. Two hundred parents were recruited from eight sites across the United States. Results indicated that the combined mass media campaign affected knowledge about CSA at the time of intervention compared to no intervention. No significant differences were found in regards to CSA attitudes. A significant positive impact on primary prevention response behaviors assessed using hypothetical vignettes was found; however, no significant findings were noted for several other behavioral responses. Knowledge and behavioral gains were not maintained at the one-month follow-up. Small sample size at follow-up may have affected findings. Results of this study imply that media campaigns alone may not significantly affect primary prevention of CSA.

Adverse events analysis as an educational tool to improve patient safety culture in primary care: A randomized trial

PubMed Central

2011-01-01

Background Patient safety is a leading item on the policy agenda of both major international health organizations and advanced countries generally. The quantitative description of the phenomena has given rise to intense concern with the issue in institutions and organizations, leading to a number of initiatives and research projects and the promotion of patient safety culture, with training becoming a priority both in Spain and internationally. To date, most studies have been conducted in a hospital setting, even though primary care is the type most commonly used by the public, in our experience. Our study aims to achieve the following: - Assess the registry of adverse events as an education tool to improve patient safety culture in the Family and Community Teaching Units of Galicia. - Find and analyze educational tools to improve patient safety culture in primary care. - Evaluate the applicability of the Hospital Survey on Patient Safety Culture by the Agency for Healthcare Research and Quality, Spanish version, in the context of primary health care. Design and methods Design Experimental unifactorial study of two groups, control and intervention. Study population Tutors and residents in Family and Community Medicine in last year of studies in Galicia, Spain. Sample From the population universe through voluntary participation. Twenty-seven tutor-resident units in each group required, randomly assigned. Intervention Residents and their respective tutor (tutor-resident pair) in teaching units on Family and Community Medicine from throughout Galicia will be invited to participate. Tutor-resident pair that agrees to participate will be sent the Hospital Survey on Patient Safety Culture. Then, tutor-resident pair will be assigned to each group-either intervention or control-through simple random sampling. The intervention group will receive specific training to record the adverse effects found in patients under their care, with subsequent feedback, after receiving instruction on the process. No action will be taken in the control group. After the intervention has ended, the survey will once again be provided to all participants. Outcome measures Change in safety culture as measured by Hospital Survey on Patient Safety Culture CONSORT Extension for Non-Pharmacologic Treatments 2008 was applied. Discussion The most significant limitations on the project are related to selecting a tool to measure the safety environment, the training calendar of residents in Family and Community Medicine in last year of studies and the no-answer bias inherent to research conducted through self-administered surveys. The development and application of a safety culture in the health sector, specifically in primary care, is as yet limited. Thus, identifying the strengths and weaknesses in the safety environment may assist in designing strategies for improvement in the primary care health centers of our region. Trial registration ISRCTN: ISRCTN41911128 PMID:21672197

Perspective: united we stand, divided we fall: the case for a single primary care specialty in the United States.

PubMed

Halvorsen, John G

2008-05-01

Primary care as an academic discipline and key component of the U.S. health care system faces a threatened future, despite numerous studies in the United States and cross-nationally that substantiate its health-promoting benefits. The United States remains the only Western industrialized nation that delivers primary care through three major disciplines rather than as a single specialty. This fragmented model may contribute to the fact that the United States does not have a primary-care-based health care system and that the U.S. population demonstrates poorer health outcomes than do those countries whose health systems are based on primary care and managed by a single primary care specialty. Fragmentation also creates confusion about primary care's identity, diminishes its influence because it does not speak with a common voice, and creates competition for academic and professional status, resources, curricular priority, research and training program funding, patients, and reimbursement. A large, single-specialty body of primary physicians could eliminate much duplication and competition and demonstrate greater political influence with academia, government agencies, insurers, and corporate America. A single specialty that incorporates the strengths of the three primary care disciplines would expand the clinical scope of primary care and could serve as a potent enabling force to lead health system reform. It would also produce measurable benefits for medical student and graduate medical education, health system design and service delivery, and primary care research. The author outlines a plan of action, involving all stakeholders, to initiate and achieve the single-specialty goal.

[Perceptions of primary health care among users and health professionals: a comparison of units with and without family health care in Central-West Brazil].

PubMed

van Stralen, Cornelis Johannes; Belisário, Soraya Almeida; van Stralen, Terezinha Berenice de Sousa; Lima, Angela Maria Dayrell de; Massote, Alice Werneck; Oliveira, Cláudia di Lorenzo

2008-01-01

This study analyzes perceptions of performance by primary health care facilities with and without the Family Health Program in municipalities with more than 100,000 inhabitants. Questionnaires from the Primary Care Assessment Tool developed by John Hopkins University and adapted to Brazil, contemplating eight dimensions of primary health care, were applied to users and professionals from a sample of 36 family health care facilities and 28 traditional primary care facilities. Thirty health professionals with university education, 207 with secondary education, 490 adult users, and 133 family members answered the questionnaires. The overall result did not show significant differences between perceptions of family health care facilities as compared to traditional primary health care facilities, but perceptions of health professionals were consistently more favorable than those of users. Comparing the scores for each dimension, family health care facilities always scored better (with the exception of level of access), but the difference in scores between facilities with and without the Family Health Strategy was only statistically significant for all three categories of respondents in relation to the items "family focus" and "community orientation".

Health Insurance and Disclosure of Same-Sex Sexual Behaviors Among Gay and Bisexual Men in Same-Sex Relationships

PubMed Central

Mitchell, Jason W.

2015-01-01

Abstract Purpose: Gay and bisexual men (GBM) have poorer health outcomes than the general population. Improved health outcomes will require that GBM have access to healthcare and that healthcare providers are aware of their sexual behaviors. This study sought to examine factors associated with having health insurance and disclosure of same-sex sexual behaviors to primary care providers (PCPs) among GBM in primary same-sex relationships. Methods: We conducted an online survey of a national sample of 722 men in same-sex couples living in the United States. Logistic regression and multinomial regression models were conducted to assess whether characteristic differences existed between men who did and did not have health insurance, and between men who did and did not report that their PCP knew about their same-sex sexual activity. Results: Our national sample of same-sex partnered men identified themselves predominantly as gay and white, and most reported having an income and health insurance. Having health insurance and disclosing sexual behavior to PCPs was associated with increasing age, higher education, and higher income levels. Insurance was less prevalent among nonwhite participants and those living in the south and midwest United States. Disclosure of sexual behavior was more common in urban respondents and in the western United States. In 25% of couples, one partner was insured, while the other was not. Conclusions: Having health insurance and disclosing one's sexual behavior to PCPs was suboptimal overall and occurred in patterns likely to exacerbate health disparities among those GBM already more heavily burdened with poorer health outcomes. These factors need to be considered by PCPs and health policymakers to improve the health of GBM. Patient- and provider-targeted interventions could also improve the health outcomes of GBM. PMID:26790018

Understanding the relationship between domestic abuse and suicide behavior in adults receiving primary care: does forgiveness matter?

PubMed

Chang, Edward C; Kahle, Emma R; Yu, Elizabeth A; Hirsch, Jameson K

2014-10-01

This study examined the interrelation of domestic abuse, forgiveness of self, forgiveness of others, and suicide behavior in a community sample of 101 patients receiving primary care from a clinic in the southeastern United States. As expected, it was found that more frequent experience of domestic abuse was associated with more frequent suicide behavior. Results from conducting mediation analyses and using bootstrapping techniques provided support for a model in which the relationship between domestic abuse and suicide behavior was accounted for by forgiveness of self, but not by forgiveness of others. The article concludes with a discussion of some of the implications of the present findings for practice and the study's limitations.

Breast and cervical cancer screening among South Asian immigrants in the United States.

PubMed

Menon, Usha; Szalacha, Laura A; Prabhughate, Abhijit

2012-01-01

South Asian (SA) immigrants (from Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka) constitute the fastest growing of all Asian American immigrants to the United States, with a growth rate of 106% from 1990 to 2001. Data are lacking on health behaviors of this population subgroup, including cancer-related information. : The purpose of this study was to assess rates and correlates of breast and cervical cancer screening in a community sample of SAs. Participants were recruited from among attendees of 3 community-based agency programs. Data were collected in English, Hindi, and Gujarati from a convenience sample of 198 participants. Two-thirds of the sample (n = 127, 65.5%) had ever had a mammogram, whereas only a third (n = 65, 32.8%) had ever had a Papanicolaou smear or vaginal examination. Several predisposing factors (eg, country of birth, years in the United States, acculturation, age, and acknowledged barriers to screening) were significant predictors of breast and cervical screening, whereas the only enabling factor was past screening behavior. Additional study is warranted on cultural aspects of cancer screening behaviors. These data are formative on facilitators and barriers to mammogram and Papanicolaou test completion among these understudied minority women. Nurses who practice in primary care may begin to target health education based on sociodemographics of SA women and emphasize discussion of barriers to screening.

Thematic accuracy of the 1992 National Land-Cover Data for the western United States

USGS Publications Warehouse

Wickham, J.D.; Stehman, S.V.; Smith, J.H.; Yang, L.

2004-01-01

The MultiResolution Land Characteristics (MRLC) consortium sponsored production of the National Land Cover Data (NLCD) for the conterminous United States, using Landsat imagery collected on a target year of 1992 (1992 NLCD). Here we report the thematic accuracy of the 1992 NLCD for the six western mapping regions. Reference data were collected in each region for a probability sample of pixels stratified by map land-cover class. Results are reported for each of the six mapping regions with agreement defined as a match between the primary or alternate reference land-cover label and a mode class of the mapped 3×3 block of pixels centered on the sample pixel. Overall accuracy at Anderson Level II was low and variable across the regions, ranging from 38% for the Midwest to 70% for the Southwest. Overall accuracy at Anderson Level I was higher and more consistent across the regions, ranging from 82% to 85% for five of the six regions, but only 74% for the South-central region.

What patients think about choice in healthcare? A study on primary care services in Finland.

PubMed

Aalto, Anna-Mari; Elovainio, Marko; Tynkkynen, Liina-Kaisa; Reissell, Eeva; Vehko, Tuulikki; Chydenius, Miisa; Sinervo, Timo

2018-06-01

The ongoing Finnish health and social service reform will expand choice by opening the market for competition between public and private service providers. This study examined the attitudes of primary care patients towards choice and which patient-related factors are associated with these attitudes. A sample of attenders during one week in health centres of 12 big cities and municipal consortiums (including seven outsourced local units) and in primary care units of one private company providing outsourced services for municipalities (aged 18-95, n=8128) was used. The questionnaire included questions on choice-related attitudes, sociodemographic factors, health status, use of health services and patient satisfaction. Of the responders, 77% regarded choice to be important, 49% perceived genuine opportunities to make choices and 35% were satisfied with the choice-relevant information. Higher age, low education, having a chronic illness, frequent use of services, having a personal physician and being satisfied with the physician and with waiting times were related to assigning more importance on choice. Younger patients, those with higher education as well as those with chronic illness regarded their opportunities of choosing the service provider and availability of choice-relevant information poorer. The Finnish primary care patients value choice, but they are critical of the availability of choice-relevant information. Choices of patients with complex health care needs should be supported by developing integrated care alternatives and by increasing the availability of information on existing care alternatives to meet their needs.

Accessibility to primary healthcare in the capital city of a northeastern state of Brazil: an evaluation of the results of a programme.

PubMed

Vieira-da-Silva, Ligia Maria; Chaves, Sonia Cristina Lima; Esperidião, Monique Azevedo; Lopes-Martinho, Rosana Machado

2010-12-01

Organisational barriers to primary healthcare are still relevant in developing countries. Although descriptive reports of some experiences focusing on improving accessibility have been published, few studies have evaluated specific interventions aimed at overcoming the organisational obstacles. To evaluate the results of a project designed to improve accessibility to healthcare services in Salvador, Bahia, Brazil. An evaluative, cross-sectional, ex post facto study that included a control group was carried out in a random sample of 710 users of 25 healthcare units of the primary municipal healthcare network. The association between the project implementation degree and outcome variables was measured by prevalence ratios (PR) and statistical inference was based on Taylor series 95% CIs. Better access to primary healthcare was found in units in which the intervention had been implemented than in those in which it had not been implemented, particularly with respect to reducing avoidable queues, the waiting time for scheduling a consultation (PR=0.23; 95% CI 0.15 to 0.34); the time of arrival in the queue (PR=0.16; 95% CI 0.09 to 0.31) and the introduction of a system for scheduling appointments by telephone (PR=0.76; 95% CI 0.70 to 0.83). Owing to the simplicity of the programme and the impact it achieved, it may be reproduced in other underdeveloped countries to improve access to healthcare services. In addition, some of the instruments may be used in routine programme evaluation.

The effect of environmental factors on technical and scale efficiency of primary health care providers in Greece.

PubMed

Kontodimopoulos, Nick; Moschovakis, Giorgos; Aletras, Vassilis H; Niakas, Dimitris

2007-11-17

The purpose of this study was to compare technical and scale efficiency of primary care centers from the two largest Greek providers, the National Health System (NHS) and the Social Security Foundation (IKA) and to determine if, and how, efficiency is affected by various exogenous factors such as catchment population and location. The sample comprised of 194 units (103 NHS and 91 IKA). Efficiency was measured with Data Envelopment Analysis (DEA) using three inputs, -medical staff, nursing/paramedical staff, administrative/other staff- and two outputs, which were the aggregated numbers of scheduled/emergency patient visits and imaging/laboratory diagnostic tests. Facilities were categorized as small, medium and large (<15,000, 15,000-30,000 and >30,000 respectively) to reflect catchment population and as urban/semi-urban or remote/island to reflect location. In a second stage analysis, technical and scale efficiency scores were regressed against facility type (NHS or IKA), size and location using multivariate Tobit regression. Regarding technical efficiency, IKA performed better than the NHS (84.9% vs. 70.1%, Mann-Whitney P < 0.001), smaller units better than medium-sized and larger ones (84.2% vs. 72.4% vs. 74.3%, Kruskal-Wallis P < 0.01) and remote/island units better than urban centers (81.1% vs. 75.7%, Mann-Whitney P = 0.103). As for scale efficiency, IKA again outperformed the NHS (89.7% vs. 85.9%, Mann-Whitney P = 0.080), but results were reversed in respect to facility size and location. Specifically, larger units performed better (96.3% vs. 90.9% vs. 75.9%, Kruskal-Wallis P < 0.001), and urban units showed higher scale efficiency than remote ones (91.9% vs. 75.3%, Mann-Whitney P < 0.001). Interestingly 75% of facilities appeared to be functioning under increasing returns to scale. Within-group comparisons revealed significant efficiency differences between the two primary care providers. Tobit regression models showed that facility type, size and location were significant explanatory variables of technical and scale efficiency. Variations appeared to exist in the productive performance of the NHS and IKA as the two main primary care providers in Greece. These variations reflect differences in primary care organization, economical incentives, financial constraints, sociodemographic and local peculiarities. In all technical efficiency comparisons, IKA facilities appeared to outperform NHS ones irrespective of facility size or location. In respect to scale efficiency, the results were to some extent inconclusive and observed differences were mostly insignificant, although again IKA appeared to perform better.

Primary care: current problems and proposed solutions.

PubMed

Bodenheimer, Thomas; Pham, Hoangmai H

2010-05-01

In 2005, approximately 400,000 people provided primary medical care in the United States. About 300,000 were physicians, and another 100,000 were nurse practitioners and physician assistants. Yet primary care faces a growing crisis, in part because increasing numbers of U.S. medical graduates are avoiding careers in adult primary care. Sixty-five million Americans live in what are officially deemed primary care shortage areas, and adults throughout the United States face difficulty obtaining prompt access to primary care. A variety of strategies are being tried to improve primary care access, even without a large increase in the primary care workforce.

Mycobacterium tuberculosis and Rifampin Resistance, United Kingdom

PubMed Central

Sam, I-Ching; More, Philip; Kemp, Melanie; Brown, Timothy

2006-01-01

The United Kingdom Health Protection Agency Mycobacterium Reference Unit offers a national "Fastrack" molecular service for detecting Mycobacterium tuberculosis complex (MTBC) and rifampin resistance by using the INNO-LiPA Rif.TB assay. We analyzed the service in a routine, nontrial context of 1,997 primary clinical specimens, including 658 nonrespiratory specimens. The overall adjusted concordance, sensitivity, specificity, positive predictive value, and negative predictive value for detecting MTBC were 91.2%, 85.2%, 96.2%, 95.7%, and 86.7%, respectively (unadjusted, 86.7%, 85.2%, 88.2%, 86.9%, and 86.7%), when false-positive samples from patients (n = 83) with a known microbiologic diagnosis of MTBC or patients receiving current or recent antituberculous treatment were excluded. The parameters for detecting rifampin resistance were 99.1%, 95.0%, 99.6%, 92.7%, and 99.7%, respectively. The assay enabled earlier diagnosis of MTBC and rifampin resistance (15.2 days) compared with culture-based techniques (30.7 days). PMID:16704831

Water-quality parameters and benthic algal communities at selected streams in Minnesota, August 2000 - Study design, methods and data

USGS Publications Warehouse

Lee, K.E.

2002-01-01

This report describes the study design, sampling methods, and summarizes the physical, chemical, and benthic algal data for a component of the multiagency study that was designed to document diurnal water-quality measurements (specific conductance, pH, water temperature, and dissolved oxygen), benthic algal community composition and chlorophyll-a content, and primary productivity at 12 stream sites on 6 streams in Minnesota during August 2000. Specific conductance, pH, water temperature, dissolved oxygen concentrations and percent dissolved oxygen saturation measurements were made with submersible data recorders at 30 minute intervals for a period of 3-6 days during August 2000. Benthic algae collected from wood and rock substrate were identified and enumerated. Biovolume (volume of algal cells per unit area), density (number of cells per unit area), and chlorophyll-a content from benthic algae were determined. These data can be used as part of the multiagency study to develop an understanding of the relations among nutrient concentrations, algal abundance, algal community composition, and primary production and respiration processes in rivers of differing ecoregions in Minnesota.

Computer applications in scientific balloon quality control

NASA Astrophysics Data System (ADS)

Seely, Loren G.; Smith, Michael S.

Seal defects and seal tensile strength are primary determinants of product quality in scientific balloon manufacturing; they therefore require a unit of quality measure. The availability of inexpensive and powerful data-processing tools can serve as the basis of a quality-trends-discerning analysis of products. The results of one such analysis are presently given in graphic form for use on the production floor. Software descriptions and their sample outputs are presented, together with a summary of overall and long-term effects of these methods on product quality.

Assessing RN-to-RN peer review on clinical units.

PubMed

Pfeiffer, Judith A; Wickline, Mary A; Deetz, Jill; Berry, Elise S

2012-04-01

The primary purpose of this study was to measure informal registered nurse (RN)-to-RN peer review (defined as collegial communication about the quality of nursing care) at the work-unit level. Survey design with cluster sampling of 28 hospital or ambulatory care units (n = 541 respondents). Results were compared with existing patient safety and satisfaction data. A chi-squared test was used to compare responses against nurse characteristics. Nurses agreed that RN-to-RN peer review takes place on their units, but no correlation with patient safety and satisfaction data was found. Misunderstandings about the meaning of peer review were evident. Open-ended comments revealed barriers to peer review: fear of retribution, language barriers and lack of professionalism. Nurses need clarification of peer review. Issues with common language in a professional environment need to be addressed and nurses can learn collaboration from each other's cultures. Managers should support RN-to-RN peer review on clinical units. Methods used here may be useful to assess current departmental nurse peer review. © 2011 Blackwell Publishing Ltd.

Recruiting hard-to-reach United States population sub-groups via adaptations of snowball sampling strategy

PubMed Central

Sadler, Georgia Robins; Lee, Hau-Chen; Seung-Hwan Lim, Rod; Fullerton, Judith

2011-01-01

Nurse researchers and educators often engage in outreach to narrowly defined populations. This article offers examples of how variations on the snowball sampling recruitment strategy can be applied in the creation of culturally appropriate, community-based information dissemination efforts related to recruitment to health education programs and research studies. Examples from the primary author’s program of research are provided to demonstrate how adaptations of snowball sampling can be effectively used in the recruitment of members of traditionally underserved or vulnerable populations. The adaptation of snowball sampling techniques, as described in this article, helped the authors to gain access to each of the more vulnerable population groups of interest. The use of culturally sensitive recruitment strategies is both appropriate and effective in enlisting the involvement of members of vulnerable populations. Adaptations of snowball sampling strategies should be considered when recruiting participants for education programs or subjects for research studies when recruitment of a population based sample is not essential. PMID:20727089

The Primary Care Physician Workforce: Ethical and Policy Implications

PubMed Central

Starfield, Barbara; Fryer, George E.

2007-01-01

PURPOSE We undertook a study to examine the characteristics of countries exporting physicians to the United States according to their relative contribution to the primary care supply in the United States. METHODS We used data from the World Health Organization and from the American Medical Association Physician Masterfile to gather sociodemographic, health system, and health characteristics of countries and the number of international medical graduates (IMGs) for the countries, according to the specialty of their practice in the United States. RESULTS Countries whose medical school graduates added a relatively greater percentage of the primary care physicians than the overall percentage of primary care physicians in the United States (31%) were poor countries with relatively extreme physician shortages, high infant mortality rates, lower life expectancies, and lower immunization rates than countries contributing relatively more specialists to the US physician workforce. CONCLUSION The United States disproportionately uses graduates of foreign medical schools from the poorest and most deprived countries to maintain its primary care physician supply. The ethical aspects of depending on foreign medical graduates is an important issue, especially when it deprives disadvantaged countries of their graduates to buttress a declining US primary care physician supply. PMID:18025485

Infrastructure of pharmacies of the primary health care in the Brazilian Unified Health System: Analysis of PNAUM - Services data.

PubMed

Leite, Silvana Nair; Manzini, Fernanda; Álvares, Juliana; Guerra, Augusto Afonso; Costa, Ediná Alves; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mário; Farias, Mareni Rocha

2017-11-13

To characterize the infrastructure of the primary health care pharmacies of the Brazilian Unified Health System, aiming at humanizing the offered services. This is a cross-sectional study, of quantitative approach, from data obtained in the Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de Medicamentos - Serviços, 2015 (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines - Services, 2015). Information on 1,175 pharmacies/dispensing units were gathered from direct observation and assessment of dispensing units installations conducted by trained researchers who used a standardized form. The analyzed variables refer to the physical structure of pharmacies or medicine dispensing units of the health units under research. The pharmacy area was greater than 14 m2 in 40.3% of the sampled units, highlighting those from Midwest (56.9%) and Southeast (56.2%) regions and those of Northeast, with only 23.3%. About 80.2% units had waiting rooms with chairs for patients, 31.8% of them had dispensing areas inferior to 5m2, while in 46.2% these areas were superior to 10m2. Bars were found in service counters in 23.8% of health units, thus separating the patient from the professional; 44.1% had internet access. In most units, the area of medicine storage had no refrigerator or freezer for their exclusive storage and 13.7% had a specific room for pharmaceutical consultation. Aiming at achieving care humanization and improving working conditions for professionals, the structuring of the environment of pharmacy services is necessary. This would contribute to the better qualification of pharmacy services, comprising more than medicine delivery. Data on the Northeast region indicated less favorable conditions to the development of adequate dispensing services. Based on the panorama pointed out, we suggest the expansion of stimulus concerning the physical structure of pharmaceutical services, considering regional specificities.

[Technical efficiency assessment of public primary care providers in the Basque Country (Spain), 2010-2013].

PubMed

Cordero, José Manuel; Nuño-Solinís, Roberto; Orueta, Juan F; Polo, Cristina; Del Río-Cámara, Mario; Alonso-Morán, Edurne

2016-01-01

To evaluate the technical efficiency of primary care units operating in the Basque Health Service during the period 2010-2013, corresponding to the implementation of a care integration strategy by health authorities. This study included 11 of the 12 primary care units in the Basque Health Service during the period 2010-2013. Data envelopment analysis (DEA) was used to assess the technical efficiency of the units. In particular, we applied the extension DEA windows to analyse all units as if they were in a single period (33 observations) as well as a conditional model, which allowed incorporation of the effect of the characteristics of the population covered. The outputs considered were a quality index based on fulfilment of different requirements related to primary care delivery and the rate of avoidable hospitalizations (treated as an undesirable output). The inputs used were the number of physicians, the number of nurses and the costs of prescriptions. The morbidity index was included as an exogenous variable. The results showed that the efficiency of all the units improved during the study period. However, this improvement was not greater in the units incorporated in the integrated healthcare organisation. In a context of global transformation of care delivery in the Basque country in the study period, primary care units increased their efficiency. However, this effect was not larger in vertically integrated primary care providers. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

System for portable nucleic acid testing in low resource settings

NASA Astrophysics Data System (ADS)

Lu, Hsiang-Wei; Roskos, Kristina; Hickerson, Anna I.; Carey, Thomas; Niemz, Angelika

2013-03-01

Our overall goal is to enable timely diagnosis of infectious diseases through nucleic acid testing at the point-of-care and in low resource settings, via a compact system that integrates nucleic acid sample preparation, isothermal DNA amplification, and nucleic acid lateral flow (NALF) detection. We herein present an interim milestone, the design of the amplification and detection subsystem, and the characterization of thermal and fluidic control and assay execution within this system. Using an earlier prototype of the amplification and detection unit, comprised of a disposable cartridge containing flexible pouches, passive valves, and electrolysis-driven pumps, in conjunction with a small heater, we have demonstrated successful execution of an established and clinically validated isothermal loop-mediated amplification (LAMP) reaction targeting Mycobacterium tuberculosis (M.tb) DNA, coupled to NALF detection. The refined design presented herein incorporates miniaturized and integrated electrolytic pumps, novel passive valves, overall design changes to facilitate integration with an upstream sample preparation unit, and a refined instrument design that automates pumping, heating, and timing. Nucleic acid amplification occurs in a two-layer pouch that facilitates fluid handling and appropriate thermal control. The disposable cartridge is manufactured using low-cost and scalable techniques and forms a closed system to prevent workplace contamination by amplicons. In a parallel effort, we are developing a sample preparation unit based on similar design principles, which performs mechanical lysis of mycobacteria and DNA extraction from liquefied and disinfected sputum. Our next step is to combine sample preparation, amplification, and detection in a final integrated cartridge and device, to enable fully automated sample-in to answer-out diagnosis of active tuberculosis in primary care facilities of low-resource and high-burden countries.

Women׳s birthplace decision-making, the role of confidence: Part of the Evaluating Maternity Units study, New Zealand.

PubMed

Grigg, Celia P; Tracy, Sally K; Schmied, Virginia; Daellenbach, Rea; Kensington, Mary

2015-06-01

to explore women׳s birthplace decision-making and identify the factors which enable women to plan to give birth in a freestanding midwifery-led primary level maternity unit rather than in an obstetric-led tertiary level maternity hospital in New Zealand. a mixed methods prospective cohort design. data from eight focus groups (37 women) and a six week postpartum survey (571 women, 82%) were analysed using thematic analysis and descriptive statistics. The qualitative data from the focus groups and survey were the primary data sources and were integrated at the analysis stage; and the secondary qualitative and quantitative data were integrated at the interpretation stage. Christchurch, New Zealand, with one tertiary maternity hospital and four primary level maternity units (2010-2012). well (at 'low risk' of developing complications), pregnant women booked to give birth in one of the primary units or the tertiary hospital. All women received midwifery continuity of care, regardless of their intended or actual birthplace. five core themes were identified: the birth process, women׳s self-belief in their ability to give birth, midwives, the health system and birth place. 'Confidence' was identified as the overarching concept influencing the themes. Women who chose to give birth in a primary maternity unit appeared to differ markedly in their beliefs regarding their optimal birthplace compared to women who chose to give birth in a tertiary maternity hospital. The women who planned a primary maternity unit birth expressed confidence in the birth process, their ability to give birth, their midwife, the maternity system and/or the primary unit itself. The women planning to give birth in a tertiary hospital did not express confidence in the birth process, their ability to give birth, the system for transfers and/or the primary unit as a birthplace, although they did express confidence in their midwife. birthplace is a profoundly important aspect of women׳s experience of childbirth. Birthplace decision-making is complex, in common with many other aspects of childbirth. A multiplicity of factors needs converge in order for all those involved to gain the confidence required to plan what, in this context, might be considered a 'countercultural' decision to give birth at a midwife-led primary maternity unit. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Trace element mobility in dolomitic argillites of the Mesoproterozoic Belt-Purcell Supergroup, Western North America

NASA Astrophysics Data System (ADS)

González-Álvarez, Ignacio; Kerrich, Robert

2011-04-01

The Belt-Purcell Supergroup comprises dolomite-rich stratigraphic units in a dominantly siliciclastic succession, where sedimentation spans 1400-1470 Ma. Dolomitic units are variable mixtures of co-sedimented argillite and primary carbonate post-depositionally converted to secondary dolomite. Based on rare earth element (REE) relationships three distinct REE patterns are identified in the dolomite-rich units: Type 1 (T1d; d = dolomitic sample) with REE patterns parallel to post-Archean Upper Continental Crust (PA-UCC), albeit at lower absolute abundances due to dilution by carbonate content; Type 2 (T2d) with Heavy REE (HREE) enrichment but Light REE (LREE) depletion relative to T1d; and Type 3 (T3d) with enrichment in LREE and HREE relative to T1d, but erratic Middle REE (MREE) patterns. There is a progressive increase of ΣREE from T1d through T2d to T3d, whereas for ΣLREE/ΣHREE T2d < T1d < T3d. T1d-T2d and T3d represent three different "snapshots" of a continuous process. In terms of timing, dolomitization of calcite primary sediment in all samples likely took place broadly during burial diagenesis, as inferred for most Proterozoic dolomites. T1d is easily explained by provenance: however, T2d and T3d cannot be related to provenance, weathering or sedimentary sorting processes to explain higher concentrations of HREE referenced to PA-UCC and consequently developed in the sediment from a T1d precursor. The same three REE signatures have been described in previous studies in counterpart siliciclastic counterparts throughout the Belt-Purcell Supergroup at three different locations. Mobility of normally stable REE is accompanied by mobility of normally isochemical high field strength elements (HFSE) in T2d and T3d to give REE/REE, HFSE/HFSE, REE/HFSE and Y/HREE fractionations. No specific REE-HFSE signatures are apparent in the carbonate-rich units as compared to their non-dolomitic siliciclastic counterparts. This unusual mobility of REE and HFSE reflected in T2d and T3d is attributed to alkaline oxidizing post-depositional brines. Salinity was derived from seawater-sediment reactions, dissolution of evaporite minerals, and the smectite-illite transformation, whereas alkaline oxidizing conditions were promoted by groundwater interaction with mafic units in the basin, CO 2 introduced into the system during episodic rifting with mantle degassing, and interaction of syn-sedimentary mafic intrusions with carbonate units at early stages of BPS deposition. Intermittent brine activity, inducing T2d and T3d patterns, spanned >1 Ga as recorded by secondary monazite grains with age distributions that correspond to large scale tectono-thermal events in Laurentia. Post-depositional processes and redistribution of carbonate can have an impact on transitional stratigraphic contacts between dolomitic and siliciclastic units which may have been incorrectly described as primary due to sedimentary environment changes.

Household Coverage of Fortified Staple Food Commodities in Rajasthan, India.

PubMed

Aaron, Grant J; Sodani, Prahlad R; Sankar, Rajan; Fairhurst, John; Siling, Katja; Guevarra, Ernest; Norris, Alison; Myatt, Mark

2016-01-01

A spatially representative statewide survey was conducted in Rajasthan, India to assess household coverage of atta wheat flour, edible oil, and salt. An even distribution of primary sampling units were selected based on their proximity to centroids on a hexagonal grid laid over the survey area. A sample of n = 18 households from each of m = 252 primary sampling units PSUs was taken. Demographic data on all members of these households were collected, and a broader dataset was collected about a single caregiver and a child in the first 2 years of life. Data were collected on demographic and socioeconomic status; education; housing conditions; recent infant and child mortality; water, sanitation, and hygiene practices; food security; child health; infant and young child feeding practices; maternal dietary diversity; coverage of fortified staples; and maternal and child anthropometry. Data were collected from 4,627 households and the same number of caregiver/child pairs. Atta wheat flour was widely consumed across the state (83%); however, only about 7% of the atta wheat flour was classified as fortifiable, and only about 6% was actually fortified (mostly inadequately). For oil, almost 90% of edible oil consumed by households in the survey was classified as fortifiable, but only about 24% was fortified. For salt, coverage was high, with almost 85% of households using fortified salt and 66% of households using adequately fortified salt. Iodized salt coverage was also high; however, rural and poor population groups were less likely to be reached by the intervention. Voluntary fortification of atta wheat flour and edible oil lacked sufficient industry consolidation to cover significant portions of the population. It is crucial that appropriate delivery channels are utilized to effectively deliver essential micronutrients to at-risk population groups. Government distribution systems are likely the best means to accomplish this goal.

15 CFR 5.3 - Assignment of functions and authorities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... instructions issued by the Director, Office of Administrative Services, the head of each primary organization... Administrative Services for the primary organization units located in the main Commerce building and the head of each other primary organization unit will make determinations with respect to the terms of permits...

15 CFR 5.3 - Assignment of functions and authorities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... instructions issued by the Director, Office of Administrative Services, the head of each primary organization... Administrative Services for the primary organization units located in the main Commerce building and the head of each other primary organization unit will make determinations with respect to the terms of permits...

15 CFR 5.3 - Assignment of functions and authorities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... instructions issued by the Director, Office of Administrative Services, the head of each primary organization... Administrative Services for the primary organization units located in the main Commerce building and the head of each other primary organization unit will make determinations with respect to the terms of permits...

15 CFR 5.3 - Assignment of functions and authorities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... instructions issued by the Director, Office of Administrative Services, the head of each primary organization... Administrative Services for the primary organization units located in the main Commerce building and the head of each other primary organization unit will make determinations with respect to the terms of permits...

15 CFR 5.3 - Assignment of functions and authorities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... instructions issued by the Director, Office of Administrative Services, the head of each primary organization... Administrative Services for the primary organization units located in the main Commerce building and the head of each other primary organization unit will make determinations with respect to the terms of permits...

Impact of Shutting Down En Route Primary Radars within CONUS Interior

DTIC Science & Technology

1993-06-01

Remote Control Interface Unit ( RCIU ) RMS software for the primary radar will be deleted. Any dependency of the secondary radar on the primary radar data...Generators RCIU Remote Control and Interface Unit RMM Remote Monitoring and Maintenance RMMS Remote Maintenance Monitoring System RMS Remote Maintenance

Spatial and Temporal Variations in CHLORINE-36 Deposition in the Northern United States

NASA Astrophysics Data System (ADS)

Hainsworth, Laura J.

Chlorine-36, a cosmogenic radioisotope, has been developed for use as a tracer in hydrological systems. The deposition of atmospheric ^{36} Cl, although of primary importance to hydrological applications, has not been well studied. To begin to address this problem, ^{36}Cl has been measured in monthly, wet-only, precipitation samples collected from February, 1991, to January, 1993, at the Elms Environmental Education Center in St. Mary's County, Maryland. In addition, bulk deposition samples were collected over a 1 y period at seven sites across the Northern United States and analyzed for ^{36} Cl. The mean, wet-only ^{36} Cl/Cl ratio for the 2 y sampling period is 68 +/- 19 (x10^{-15} ) and the mean ^{36}Cl concentration is 1.2 +/- 0.1 (x10 ^6) atoms/L. The ^ {36}Cl wet deposition flux data reveal a distinct seasonal deposition pattern, with peaks occurring in March and April. This pattern is attributed to stratospheric/tropospheric exchange. The mean ^{36}Cl wet deposition flux is 38.2 +/- 5 atoms/m^2s. Comparison between wet-only and bulk deposition samples indicates that the difference accounts for approximately 25% of the total ^{36}Cl deposition flux at the Elms site. A new model, using ^{90} Sr to predict the ^{36} Cl deposition pattern, is developed to predict ^{36}Cl/Cl ratios across the United States. Chlorine-36/Cl ratios in bulk deposition samples collected across the northern United States agree well with the model predictions. A mean global ^{36}Cl production rate of approximately 28 to 38 atoms/m^2s is indicated by these samples. A comparison between ^{36 }Cl concentrations in the Aquia and Magothy aquifers in southern Maryland and bulk deposition samples collected at the Elms, MD, site indicated that modern precipitation can account for the ^{36}Cl content in the youngest water in these aquifers. Surface water samples from the Susquehanna River basin reveal ^{36}Cl and stable chloride concentrations an order of magnitude higher than in bulk deposition samples collected at State College, PA. The source of excess ^{36}Cl in the Susquehanna is not known. Possible explanations include 'bomb-pulse' ^{36}Cl and in-situ ^{36}Cl production in surface rocks.

Primary investigations on the potential of a novel diode pumped Er:YAG laser system for bone surgery

NASA Astrophysics Data System (ADS)

Stock, Karl; Diebolder, Rolf; Hausladen, Florian; Wurm, Holger; Lorenz, Swetlana; Hibst, Raimund

2013-03-01

Flashlamp pumped Er:YAG-lasers are successfully clinically used for both precise soft and hard tissue ablation. As an alternative, actually a novel diode pumped Er:YAG laser system (Pantec Engineering AG) becomes available, with mean laser power up to 15W and pulse repetition rate up to 1kHz. The aim of the presented study is to investigate the effect of this laser system on bone tissue at various irradiation parameters, particular at repetition rates exceeding 100 Hz. For reproducible experiments, firstly an appropriate experimental set-up was realized with a beam delivery and focusing unit, a computer controlled stepper unit with sample holder, and a shutter unit. It allowed to move the sample (1mm- 3mm sawed slices of pig bone) with a defined velocity while irradiation by various laser parameters. A water spray served to moisten the sample surfaces. After irradiation the grooves were analyzed by light microscopy and laser scanning microscopy regarding to the ablation quality, the groove geometry, the ablation efficacy, and the thermal effects. The resulting grooves are slightly cone shaped (groove depth up to 3mm, width about 200μm) with sharp edges at the surface. At 1W, 200Hz, 5mm/s sample movement and with water irrigation the measured ablation speed Δz/Δt is 10.8 mm/s. The ablation depth per pulse is 54μm. In conclusion, these first experiments demonstrate that the diode pumped Er:YAG laser system is an efficient tool for use in bone surgery.

How personal and standardized coordination impact implementation of integrated care.

PubMed

Benzer, Justin K; Cramer, Irene E; Burgess, James F; Mohr, David C; Sullivan, Jennifer L; Charns, Martin P

2015-10-02

Integrating health care across specialized work units has the potential to lower costs and increase quality and access to mental health care. However, a key challenge for healthcare managers is how to develop policies, procedures, and practices that coordinate care across specialized units. The purpose of this study was to identify how organizational factors impacted coordination, and how to facilitate implementation of integrated care. Semi-structured interviews were conducted in August 2009 with 30 clinic leaders and 35 frontline staff who were recruited from a convenience sample of 16 primary care and mental health clinics across eight medical centers. Data were drawn from a management evaluation of primary care-mental health integration in the US Department of Veterans Affairs. To protect informant confidentiality, the institutional review board did not allow quotations. Interviews identified antecedents of organizational coordination processes, and highlighted how these antecedents can impact the implementation of integrated care. Overall, implementing new workflow practices were reported to create conflicts with pre-existing standardized coordination processes. Personal coordination (i.e., interpersonal communication processes) between primary care leaders and staff was reported to be effective in overcoming these barriers both by working around standardized coordination barriers and modifying standardized procedures. This study identifies challenges to integrated care that might be solved with attention to personal and standardized coordination. A key finding was that personal coordination both between primary care and mental health leaders and between frontline staff is important for resolving barriers related to integrated care implementation. Integrated care interventions can involve both new standardized procedures and adjustments to existing procedures. Aligning and integrating procedures between primary care and specialty care requires personal coordination amongst leaders. Interpersonal relationships should be strengthened between staff when personal connections are important for coordinating patient care across clinical settings.

Reliability and sensitivity analysis of a system with multiple unreliable service stations and standby switching failures

NASA Astrophysics Data System (ADS)

Ke, Jyh-Bin; Lee, Wen-Chiung; Wang, Kuo-Hsiung

2007-07-01

This paper presents the reliability and sensitivity analysis of a system with M primary units, W warm standby units, and R unreliable service stations where warm standby units switching to the primary state might fail. Failure times of primary and warm standby units are assumed to have exponential distributions, and service times of the failed units are exponentially distributed. In addition, breakdown times and repair times of the service stations also follow exponential distributions. Expressions for system reliability, RY(t), and mean time to system failure, MTTF are derived. Sensitivity analysis, relative sensitivity analysis of the system reliability and the mean time to failure, with respect to system parameters are also investigated.

'Management is a black art'--professional ideologies with respect to temporomandibular disorders.

PubMed

Durham, J; Exley, C; Wassell, R; Steele, J G

2007-06-09

To gain a deeper understanding of the range of influences on the full range of dental professionals who provide treatment for temporomandibular disorders (TMD). Qualitative semi-structured interviews. Primary and secondary care in the North and South of the United Kingdom. A criterion-based purposive sample was taken of dental practitioners, comprising primary and secondary care practitioners. In-depth interviews were conducted and data collection and analysis occurred concurrently until data saturation was achieved. DATA AND DISCUSSION: There was a reported lack of adequate remuneration for provision of treatment for TMD within primary care. This alongside the primary care practitioners' reported uncertainty in diagnosis of TMD appeared to lead to a propensity for referral to secondary care. Practitioners recognised a poor and scanty evidence base on which to base their care, and this allowed for idiosyncratic practice. Often the outcome measure for treatment was a subjective questioning of the patient focussing mainly on relief of pain. There is a need for better quality evidence on which to base TMD treatment, more continuing professional development and improvement in contracting arrangements to enable primary practitioners to feel confident in managing TMD.

Managing resources in NHS dentistry: the views of decision-makers in primary care organisations.

PubMed

Holmes, R D; Donaldson, C; Exley, C; Steele, J G

2008-09-27

To investigate priority setting and decision-making in primary care organisations and to determine how resources are managed in order to meet the oral health needs of local populations. This is a qualitative study. The purposive sample comprised twelve dental public health consultants and six senior finance representatives from contrasting care systems across the United Kingdom. Participants completed a written information sheet followed by a recorded semi-structured telephone interview. Conversations were professionally transcribed verbatim and analysed independently by two investigators using the constant comparative method. The emergent themes focused upon: the role of participants in decision-making; professional relationships; managing change; information needs; and identifying and managing priorities. There was wide interpretation with respect to participants' roles and perceived information needs for decision-making and commissioning. A unifying factor was the importance placed by participants upon trust and the influence of individuals on the success of relationships forged between primary care organisations and general dental practitioners. To facilitate decision-making in primary care organisations, commissioners and managers could engage further with practitioners and incorporate them into commissioning and resource allocation processes. Greater clarity is required regarding the role of dental public health consultants within primary care organisations and commissioning decisions.

A quantitative study of skeletofusimotor innervation in the cat peroneus tertius muscle.

PubMed Central

Jami, L; Murthy, K S; Petit, J

1982-01-01

1. Physiological tests were used to identify skeletofusimotor or beta axons to the cat peroneus tertius muscle in order to assess the proportion of beta axons in the motor supply to this muscle. 2. Static beta axons (beta S) were identified by: (a) observation of a delay between the complete block of extrafusal contraction and the failure of spindle activation upon prolonged stimulation, (b) increase of spindle excitation with stimulation frequencies above that eliciting maximal extrafusal contraction, (c) observation of 'unfused' frequencygram of spindle primary afferent discharge during stimulation of the axon at frequencies above that eliciting complete fusion of extrafusal contraction and (d) static action exerted on the response of the spindle afferent to ramp stretch. 3. Dynamic beta axons (beta D) were identified by the persistence of spindle activation after selective block of extrafusal neuromuscular junctions and by their dynamic action on spindle primary endings. 4. The actions of 116 motor axons (conduction velocity 56-104 m/sec) on ninety-five spindle afferents (fifty-seven from primary and thirty-eight from secondary endings) were examined in ten experiments. Thirty-six beta axons (31% of the total sample) were identified: twenty-four beta S (conduction velocity 69-104 m/sec) and twelve beta D (conduction velocity 56-91 m/sec). 5. Twenty (35%) primary endings were activated by a beta S and sixteen (28%) by a beta D axon. Nineteen (45%) secondary endings were activated by a beta S and five (13%) by a beta D axon. Convergence of beta D and beta S axons on the same spindle occurred in 10% of instances. beta-innervated spindles were also supplied by gamma axons. 6. Most of the beta S motor units were of the fast-fatigue resistant (FR) type, with a few units of the fast-fatigable (FF) type, and nearly all the beta D motor units were of the slow (S) type. PMID:6213764

[National Health and Nutrition Survey 2012: design and coverage].

PubMed

Romero-Martínez, Martín; Shamah-Levy, Teresa; Franco-Núñez, Aurora; Villalpando, Salvador; Cuevas-Nasu, Lucía; Gutiérrez, Juan Pablo; Rivera-Dommarco, Juan Ángel

2013-01-01

To describe the design and population coverage of the National Health and Nutrition Survey 2012 (NHNS 2012). The design of the NHNS 2012 is reported, as a probabilistic population based survey with a multi-stage and stratified sampling, as well as the sample inferential properties, the logistical procedures, and the obtained coverage. Household response rate for the NHNS 2012 was 87%, completing data from 50,528 households, where 96 031 individual interviews selected by age and 14,104 of ambulatory health services users were also obtained. The probabilistic design of the NHNS 2012 as well as its coverage allowed to generate inferences about health and nutrition conditions, health programs coverage, and access to health services. Because of their complex designs, all estimations from the NHNS 2012 must use the survey design: weights, primary sampling units, and stratus variables.

Degree of compliance with the ten steps of the Breastfeeding Friendly Primary Care Initiative and its association with the prevalence of exclusive breastfeeding.

PubMed

Rito, Rosane Valéria Viana Fonseca; Oliveira, Maria Inês Couto de; Brito, Alexandre dos Santos

2013-01-01

To analyze the association between the degree of compliance with the ten steps of the Breastfeeding-Friendly Primary Care Initiative (BFPCI) and the prevalence of exclusive breastfeeding (EBF) in infants younger than six months in the city of Rio de Janeiro. This was a cross-sectional study conducted in a representative sample of 56 primary health care units of this municipality. The assessment of compliance with the ten steps of the BFPCI was carried out by interviewing health care professionals, pregnant women, and mothers; the generated performance scores were classified into tertiles. To obtain the outcome, i.e., the EBF, a data collection questionnaire was applied to mothers of children younger than six months who were followed up at these units in November of 2007. Prevalence ratios were obtained for the EBF using Poisson regression with robust variance. The prevalence of EBF was 47.6%. In the multivariate analysis, the upper tertile of performance showed a 34% higher prevalence of EBF (PR=1.34, 95% CI: 1.24 to 1.44) and the second tertile was 17% higher (PR=1.17, 95% CI: 1.08 to 1.27) than the first tertile. Mothers who did not work outside home had a 75% higher prevalence of EBF (PR=1.75, 95% CI: 1.53 to 2.01); assistance in a basic health unit, as opposed to a family health unit, implied a 10% higher prevalence (PR=1.10, 95% CI: 1.03 to 1.19). The prevalence of EBF decreased 1% for each day of the infant's life (PR=0.993, 95% CI: 0.992 to 0.993). Given the contribution of BFPCI to the practice of EBF, a greater investment in the expansion and sustainability of this initiative is recommended, as well as its association with other strategies to promote, protect, and support breastfeeding. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Work stress of primary care physicians in the US, UK and German health care systems.

PubMed

Siegrist, Johannes; Shackelton, Rebecca; Link, Carol; Marceau, Lisa; von dem Knesebeck, Olaf; McKinlay, John

2010-07-01

Work-related stress among physicians has been an issue of growing concern in recent years. How and why this may vary between different health care systems remains poorly understood. Using an established theoretical model (effort-reward imbalance), this study analyses levels of work stress among primary care physicians (PCPs) in three different health care systems, the United States, the United Kingdom and Germany. Whether professional autonomy and specific features of the work environment are associated with work stress and account for possible country differences are examined. Data are derived from self-administered questionnaires obtained from 640 randomly sampled physicians recruited for an international comparative study of medical decision making conducted from 2005 to 2007. Results demonstrate country-specific differences in work stress with the highest level in Germany, intermediate level in the US and lowest level among UK physicians. A negative correlation between professional autonomy and work stress is observed in all three countries, but neither this association nor features of the work environment account for the observed country differences. Whether there will be adequate numbers of PCPs, or even a field of primary care in the future, is of increasing concern in several countries. To the extent that work-related stress contributes to this, identification of its organizational correlates in different health care systems may offer opportunities for remedial interventions. Copyright 2010 Elsevier Ltd. All rights reserved.

Work stress of primary care physicians in the US, UK and German health care systems

PubMed Central

Siegrist, Johannes; Link, Carol; Marceau, Lisa; von dem Knesebeck, Olaf; McKinlay, John

2010-01-01

Work-related stress among physicians has been an issue of growing concern in recent years. How and why this may vary between different health care systems remains poorly understood. Using an established theoretical model (effort-reward imbalance), this study analyses levels of work stress among primary care physicians (PCPs) in three different health care systems, the United States, the United Kingdom and Germany. Whether professional autonomy and specific features of the work environment are associated with work stress and account for possible country differences are examined. Data are derived from self-administered questionnaires obtained from 640 randomly sampled physicians recruited for an international comparative study of medical decision making conducted from 2005–2007. Results demonstrate country-specific differences in work stress- with the highest level in Germany, intermediate level in the US and lowest level among UK physicians. A negative correlation between professional autonomy and work stress is observed in all three countries, but neither this association nor features of the work environment account for the observed country differences. Whether there will be adequate numbers of PCPs, or even a field of primary care in the future, is of increasing concern in several countries. To the extent that work-related stress contributes to this, identification of its organizational correlates in different health care systems may offer opportunities for remedial interventions. PMID:20494505

Status of groundwater quality in the Coastal Los Angeles Basin, 2006-California GAMA Priority Basin Project

USGS Publications Warehouse

Goldrath, Dara; Fram, Miranda S.; Land, Michael; Belitz, Kenneth

2012-01-01

Groundwater quality in the approximately 860-square-mile (2,227-square-kilometer) Coastal Los Angeles Basin study unit (CLAB) was investigated as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study area is located in southern California in Los Angeles and Orange Counties. The GAMA Priority Basin Project is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey (USGS) and the Lawrence Livermore National Laboratory. The GAMA CLAB study was designed to provide a spatially unbiased assessment of the quality of untreated (raw) groundwater in the primary aquifer system. The assessment is based on water-quality and ancillary data collected in 2006 by the USGS from 69 wells and on water-quality data from the California Department of Public Health (CDPH) database. The primary aquifer system was defined by the depth interval of the wells listed in the CDPH database for the CLAB study unit. The quality of groundwater in the primary aquifer system may be different from that in the shallower or deeper water-bearing zones; shallow groundwater may be more vulnerable to surficial contamination. This study assesses the status of the current quality of the groundwater resource by using data from samples analyzed for volatile organic compounds (VOCs), pesticides, and naturally occurring inorganic constituents, such as major ions and trace elements. This status assessment is intended to characterize the quality of groundwater resources in the primary aquifer system of the CLAB study unit, not the treated drinking water delivered to consumers by water purveyors. Relative-concentrations (sample concentration divided by the health- or aesthetic-based benchmark concentration) were used for evaluating groundwater quality for those constituents that have Federal and (or) California regulatory or non-regulatory benchmarks for drinking-water quality. A relative-concentration greater than (>) 1.0 indicates a concentration greater than a benchmark, and a relative-concentration less than or equal to (≤) 1.0 indicates a concentration equal to or less than a benchmark. Relative-concentrations of organic and special-interest constituents [perchlorate, N-nitrosodimethylamine (NDMA), 1,2,3-trichloropropane (1,2,3-TCP), and 1,4-dioxane] were classified as "high" (relative-concentration>1.0), "moderate" (0.5status assessment for evaluating regional-scale groundwater quality. High aquifer-scale proportion is defined as the percentage of the area of the primary aquifer system with a relative-concentration greater than 1.0 for a particular constituent or class of constituents; percentage is based on an areal rather than a volumetric basis. Moderate and low aquifer-scale proportions were defined as the percentage of the primary aquifer system with moderate and low relative-concentrations, respectively. Two statistical approaches-grid-based and spatially weighted-were used to evaluate aquifer-scale proportions for individual constituents and classes of constituents. Grid-based and spatially weighted estimates were comparable in the CLAB study unit (within 90-percent confidence intervals). Inorganic constituents with human-health benchmarks were detected at high relative-concentrations in 5.6 percent of the primary aquifer system and moderate in 26 percent. High aquifer-scale proportion of inorganic constituents primarily reflected high aquifer-scale proportions of arsenic (1.9 percent), nitrate (1.9 percent), and uranium (1.2 percent). Inorganic constituents with secondary maximum contaminant levels (SMCL) were detected at high relative-concentrations in 18 percent of the primary aquifer system and moderate in 47 percent. The constituents present at high relative-concentrations included total dissolved solids (1.9 percent), manganese (15 percent), and iron (9.4 percent). Relative-concentrations of organic constituents (one or more) were high in 3.7 percent, and moderate in 13 percent, of the primary aquifer system. The high aquifer-scale proportion of organic constituents primarily reflected high aquifer-scale proportions of solvents, including trichloroethene (TCE; 1.7 percent), perchloroethene (PCE; 1.1 percent), and carbon tetrachloride (1.0 percent). Of the 204 organic constituents analyzed, 44 constituents were detected. Eleven organic constituents had detection frequencies of greater than 10 percent: the trihalomethanes chloroform and bromodichloromethane, the solvents TCE, PCE, cis-1,2-dichloroethene, and 1,1-dichloroethene, the herbicides atrazine, simazine, prometon, and tebuthiuron, and the gasoline additive methyl tert-butyl ether (MTBE). Most detections were at low relative-concentrations. The special-interest constituent perchlorate was detected at high relative-concentrations in 0.5 percent of the primary aquifer system, and at moderate relative-concentrations in 35 percent. The special-interest constituent 1,4-dioxane was detected at high relative-concentrations, but an insufficient number of samples was analyzed to provide a representative estimate of aquifer-scale proportion.

The Fracture of Relational Space in Depression: Predicaments in Primary Care Help Seeking

PubMed Central

Bromley, Elizabeth; Kennedy, David; Miranda, Jeanne; Sherbourne, Cathy Donald; Wells, Kenneth B.

2015-01-01

Primary care clinicians treat the majority of cases of depression in the United States. The primary care clinic is also a site for enactment of a disease-oriented concept of depression that locates disorder within an individual body. Drawing on theories of the self and stigma, this article highlights problematics of primary care depression treatment by examining the lived experience of depression. The data come from individuals who screened positive for depressive symptoms in primary care settings and were followed over ten years. After iterative mixed-methodological exploration of a large dataset, we analyzed interviews from a purposive sample of 46 individuals using grounded and phenomenological approaches. We describe two major results. First, we note that depression is experienced as located within and inextricable from relational space and that the self is experienced as relational, rather than autonomous, in depression. Second, we describe the ways in which the experience of depression contradicts a disease-oriented concept such that help-seeking intensifies rather than alleviates the relational problem of depression. We conclude by highlighting that an understanding of illness experience may be essential to improving primary care depression treatment and by questioning the bracketing of relational concerns in depression within the construct of stigma. PMID:27990025

Minding the Gap: Factors Associated With Primary Care Coordination of Adults in 11 Countries.

PubMed

Penm, Jonathan; MacKinnon, Neil J; Strakowski, Stephen M; Ying, Jun; Doty, Michelle M

2017-03-01

Care coordination has been identified as a key strategy in improving the effectiveness, safety, and efficiency of the US health care system. Our objective was to determine whether population or health care system issues are associated with primary care coordination gaps in the United States and other high-income countries. We analyzed data from the 2013 Commonwealth Fund International Health Policy (IHP) survey with multivariate logistic regression analysis. Respondents were adult primary care patients from 11 countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, United Kingdom, and the United States. Poor primary care coordination was defined as participants reporting at least 3 gaps in the coordination of care out of a maximum of 5. Analyses were based on 13,958 respondents. The rate of poor primary care coordination was 5.2% (724/13,958 respondents) overall and highest in the United States, at 9.8% (137/1,395 respondents). Multivariate regression analysis among all respondents found that they were less likely to experience poor primary care coordination if their primary care physician often or always knew their medical history, spent sufficient time, involved them, and explained things well (odds ratio = 0.6 for each). Poor primary care coordination was more likely to occur among patients with chronic conditions (odds ratios = 1.4-2.1 depending on number) and patients younger than 65 years (odds ratios = 1.6-2.3 depending on age-group). Among US respondents, insurance status, health status, household income, and sex were not associated with poor primary care coordination. The United States had the highest rate of poor primary care coordination among the 11 high-income countries evaluated. An established relationship with a primary care physician was significantly associated with better care coordination, whereas being chronically ill or younger was associated with poorer care coordination. © 2017 Annals of Family Medicine, Inc.

Minding the Gap: Factors Associated With Primary Care Coordination of Adults in 11 Countries

PubMed Central

Penm, Jonathan; MacKinnon, Neil J.; Strakowski, Stephen M.; Ying, Jun; Doty, Michelle M.

2017-01-01

PURPOSE Care coordination has been identified as a key strategy in improving the effectiveness, safety, and efficiency of the US health care system. Our objective was to determine whether population or health care system issues are associated with primary care coordination gaps in the United States and other high-income countries. METHODS We analyzed data from the 2013 Commonwealth Fund International Health Policy (IHP) survey with multivariate logistic regression analysis. Respondents were adult primary care patients from 11 countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, United Kingdom, and the United States. Poor primary care coordination was defined as participants reporting at least 3 gaps in the coordination of care out of a maximum of 5. RESULTS Analyses were based on 13,958 respondents. The rate of poor primary care coordination was 5.2% (724/13,958 respondents) overall and highest in the United States, at 9.8% (137/1,395 respondents). Multivariate regression analysis among all respondents found that they were less likely to experience poor primary care coordination if their primary care physician often or always knew their medical history, spent sufficient time, involved them, and explained things well (odds ratio = 0.6 for each). Poor primary care coordination was more likely to occur among patients with chronic conditions (odds ratios = 1.4–2.1 depending on number) and patients younger than 65 years (odds ratios = 1.6–2.3 depending on age-group). Among US respondents, insurance status, health status, household income, and sex were not associated with poor primary care coordination. CONCLUSIONS The United States had the highest rate of poor primary care coordination among the 11 high-income countries evaluated. An established relationship with a primary care physician was significantly associated with better care coordination, whereas being chronically ill or younger was associated with poorer care coordination. PMID:28289109

Antioxidant activity and polyphenol and procyanidin contents of selected commercially available cocoa-containing and chocolate products in the United States.

PubMed

Miller, Kenneth B; Stuart, David A; Smith, Nancy L; Lee, Chang Y; McHale, Nancy L; Flanagan, Judith A; Ou, Boxin; Hurst, W Jeffrey

2006-05-31

In the United States, commercially available foods, including cocoa and chocolate, are being marketed with statements referring to the level of antioxidant activity and polyphenols. For cocoa-containing foods, there has been no comprehensive survey of the content of these and other chemistries. A survey of cocoa and chocolate-containing products marketed in the United States was conducted to determine antioxidant activity and polyphenol and procyanidin contents. Commercially available samples consisted of the top market share products in each of the following six categories: natural cocoa, unsweetened baking chocolate, dark chocolate, semisweet baking chips, milk chocolate, and chocolate syrup. Composite samples were characterized using four different methods: oxygen radical absorbance capacity (ORAC), vitamin C equivalence antioxidant capacity (VCEAC), total polyphenols, and procyanidins. All composite lots were further characterized for percent nonfat cocoa solids (NFCS) and percent fat. Natural cocoas had the highest levels of antioxidant activities, total polyphenols, and procyanidins followed by baking chocolates, dark chocolates and baking chips, and finally milk chocolate and syrups. The results showed a strong linear correlation between NFCS and ORAC (R (2) = 0.9849), total polyphenols (R (2) = 0.9793), and procyanidins (R (2) = 0.946), respectively. On the basis of principal component analysis, 81.4% of the sample set was associated with NFCS, antioxidant activity, total polyphenols, and procyanidins. The results indicated that, regardless of the product category, NFCS were the primary factor contributing to the level of cocoa antioxidants in the products tested. Results further suggested that differences in cocoa bean blends and processing, with the possible exception of Dutching, are minor factors in determining the level of antioxidants in commercially available cocoa-containing products in the United States.

Halo-shaped Flowing Atmospheric Pressure Afterglow – a Heavenly New Design for Simplified Sample Introduction and Improved Ionization in Ambient Mass Spectrometry

PubMed Central

Pfeuffer, Kevin P.; Schaper, J. Niklas; Shelley, Jacob T.; Ray, Steven J.; Chan, George C.-Y.; Bings, Nicolas H.; Hieftje, Gary M.

2013-01-01

The flowing atmospheric pressure afterglow (FAPA) is a promising new source for atmospheric pressure, ambient desorption/ionization mass spectrometry. However, problems exist with reproducible sample introduction into the FAPA source. To overcome this limitation, a new FAPA geometry has been developed in which concentric tubular electrodes are utilized to form a halo-shaped discharge; this geometry has been termed the halo-FAPA or h-FAPA. With this new geometry, it is still possible to achieve direct desorption and ionization from a surface; however, sample introduction through the inner capillary is also possible and improves interaction between the sample material (solution, vapor, or aerosol) and the plasma to promote desorption and ionization. The h-FAPA operates with a helium gas flow of 0.60 L/min outer, 0.30 L/min inner, applied current of 30 mA at 200 V for 6 watts of power. In addition, separation of the discharge proper and sample material prevents perturbations to the plasma. Optical-emission characterization and gas rotational temperatures reveal that the temperature of the discharge is not significantly affected (< 3% change at 450K) by water vapor during solution-aerosol sample introduction. The primary mass-spectral background species are protonated water clusters, and the primary analyte ions are protonated molecular ions (M+H+). Flexibility of the new ambient sampling source is demonstrated by coupling it with a laser ablation unit, a concentric nebulizer and a droplet-on-demand system for sample introduction. A novel arrangement is also presented in which the central channel of the h-FAPA is used as the inlet to a mass spectrometer. PMID:23808829

Halo-shaped flowing atmospheric pressure afterglow: a heavenly design for simplified sample introduction and improved ionization in ambient mass spectrometry.

PubMed

Pfeuffer, Kevin P; Schaper, J Niklas; Shelley, Jacob T; Ray, Steven J; Chan, George C-Y; Bings, Nicolas H; Hieftje, Gary M

2013-08-06

The flowing atmospheric-pressure afterglow (FAPA) is a promising new source for atmospheric-pressure, ambient desorption/ionization mass spectrometry. However, problems exist with reproducible sample introduction into the FAPA source. To overcome this limitation, a new FAPA geometry has been developed in which concentric tubular electrodes are utilized to form a halo-shaped discharge; this geometry has been termed the halo-FAPA or h-FAPA. With this new geometry, it is still possible to achieve direct desorption and ionization from a surface; however, sample introduction through the inner capillary is also possible and improves interaction between the sample material (solution, vapor, or aerosol) and the plasma to promote desorption and ionization. The h-FAPA operates with a helium gas flow of 0.60 L/min outer, 0.30 L/min inner, and applied current of 30 mA at 200 V for 6 W of power. In addition, separation of the discharge proper and sample material prevents perturbations to the plasma. Optical-emission characterization and gas rotational temperatures reveal that the temperature of the discharge is not significantly affected (<3% change at 450 K) by water vapor during solution-aerosol sample introduction. The primary mass-spectral background species are protonated water clusters, and the primary analyte ions are protonated molecular ions (M + H(+)). Flexibility of the new ambient sampling source is demonstrated by coupling it with a laser ablation unit, a concentric nebulizer, and a droplet-on-demand system for sample introduction. A novel arrangement is also presented in which the central channel of the h-FAPA is used as the inlet to a mass spectrometer.

Studies on the primary structure of short polysaccharides using SEC MALDI mass spectroscopy.

PubMed

Garozzo, D; Spina, E; Cozzolino, R; Cescutti, P; Fett, W F

2000-01-12

The introduction of size-exclusion chromatography (SEC) analysis of polysaccharides prior to MALDI mass spectroscopy accounts for the determination of the molecular mass of the repeating unit when neutral homopolymers are investigated. In the case of natural polysaccharides characterised by more complicated structural features (presence of non-carbohydrate substituents, charged groups, etc.), this mass value usually is in agreement with more than one sugar composition. Therefore, it is not sufficient to give the correct monosaccharidic composition of the polysaccharide investigated. To solve this problem, MALDI spectra were recorded on the permethylated sample and post-source decay experiments were performed on precursor ions. In this way, the composition (in terms of Hex, HexNAc, etc.), size and sequence of the repeating unit were determined.

Outbreak of Pseudomonas aeruginosa folliculitis associated with a swimming pool inflatable.

PubMed Central

Tate, D.; Mawer, S.; Newton, A.

2003-01-01

On 18 February 2002, the Communicable Disease Unit was notified by the local Public Health Service Laboratory of a child with a positive skin swab for Pseudomonas aeruginosa. This child had attended the local swimming pool and played on an inflatable, subsequently presenting to a Primary Care Nurse Practitioner with folliculitis. A total of 35 cases was identified during the outbreak. This paper describes a case-control study and microbiological sampling of the cases, the suspected inflatable and a survey of 10 swimming pool inflatables in the local area. The odds ratio for developing folliculitis following use of the inflatable was 12 (95% CI 1.05-136.80). The strain of P. aeruginosa found on the inflatable was identical to that obtained from skin swabs of cases. Nine of 10 (90%) of the inflatables sampled were colonized by P. aeruginosa. Attention should be given to the problem of routine decontamination of swimming pool inflatables. P. aeruginosa folliculitis needs to be considered in the differential diagnosis of skin rashes in children, especially in Primary Care. PMID:12729186

Status and understanding of groundwater quality in the Monterey Bay and Salinas Valley Basins, 2005-California GAMA Priority Basin Project

USGS Publications Warehouse

Kulongoski, Justin T.; Belitz, Kenneth

2011-01-01

Groundwater quality in the approximately 1,000 square mile (2,590 km2) Monterey Bay and Salinas Valley Basins (MS) study unit was investigated as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study unit is located in central California in Monterey, Santa Cruz, and San Luis Obispo Counties. The GAMA Priority Basin Project is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey (USGS) and the Lawrence Livermore National Laboratory. The GAMA MS study was designed to provide a spatially unbiased assessment of the quality of untreated (raw) groundwater in the primary aquifer systems (hereinafter referred to as primary aquifers). The assessment is based on water-quality and ancillary data collected in 2005 by the USGS from 97 wells and on water-quality data from the California Department of Public Health (CDPH) database. The primary aquifers were defined by the depth intervals of the wells listed in the CDPH database for the MS study unit. The quality of groundwater in the primary aquifers may be different from that in the shallower or deeper water-bearing zones; shallow groundwater may be more vulnerable to surficial contamination. The first component of this study, the status of the current quality of the groundwater resource, was assessed by using data from samples analyzed for volatile organic compounds (VOC), pesticides, and naturally occurring inorganic constituents, such as major ions and trace elements. This status assessment is intended to characterize the quality of groundwater resources in the primary aquifers of the MS study unit, not the treated drinking water delivered to consumers by water purveyors. Relative-concentrations (sample concentration divided by the health- or aesthetic-based benchmark concentration) were used for evaluating groundwater quality for those constituents that have Federal and (or) California regulatory or non-regulatory benchmarks for drinking-water quality. A relative-concentration greater than (>) 1.0 indicates a concentration greater than a benchmark, and less than or equal to (≤) 1.0 indicates a concentration less than or equal to a benchmark. Relative-concentrations of organic and special interest constituents [perchlorate, N-nitrosodimethylamine (NDMA), and 1,2,3-trichloropropane (1,2,3-TCP)], were classified as "high" (relative-concentration > 1.0), "moderate" (0.1 1.0), "moderate" (0.5 < relative-concentration ≤ 1.0), or "low" (relative-concentration ≤ 0.5). Aquifer-scale proportion was used as the primary metric in the status assessment for evaluating regional-scale groundwater quality. High aquifer-scale proportion was defined as the percentage of the area of the primary aquifers with a relative-concentration greater than 1.0 for a particular constituent or class of constituents; percentage is based on an areal rather than a volumetric basis. Moderate and low aquifer-scale proportions were defined as the percentage of the primary aquifers with moderate and low relative-concentrations, respectively. Two statistical approaches-grid-based and spatially weighted-were used to evaluate aquifer-scale proportions for individual constituents and classes of constituents. Grid-based and spatially-weighted estimates were comparable in the MS study unit (within 90-percent confidence intervals). Inorganic constituents with human-health benchmarks were detected at high relative-concentrations in 14.5 percent of the primary aquifers, moderate in 35.5 percent, and low in 50.0 percent. High aquifer-scale proportion of inorganic constituents primarily reflected high aquifer-scale proportions of nitrate (7.9 percent), molybdenum (2.9 percent), arsenic (2.8 percent), boron (1.9 percent), and gross alpha-beta radioactivity (1.5 percent). Relative-concentrations of organic constituents (one or more) were high in 0.2 percent, moderate in 6.6 percent, and low in 93.2 percent (not detected in 48.1 percent) of the primary aquifers. The high aquifer-scale proportion of organic constituents primarily reflected high aquifer-scale proportions of tetrachloroethene (0.1 percent) and methyl tert-butyl ether (0.1 percent). Relative-concentration for inorganic constituents with secondary maximum contaminant levels, manganese, total dissolved solids, iron, sulfate, and chloride were high in 18.6, 8.6, 7.1, 2.9, and 1.4 percent of the primary aquifers, respectively. Of the 205 organic and special-interest constituents analyzed, 32 constituents were detected. One organic constituent, the herbicide simazine, was frequently detected (in 10 percent or more of samples), but was detected at low relative-concentrations. The second component of this study, the understanding assessment, identified the natural and human factors that affect groundwater quality by evaluating land use, physical characteristics of the wells, and geochemical conditions of the aquifer. Results from these evaluations were used to explain the occurrence and distribution of constituents in the study unit. The understanding assessment indicated that most wells that contained nitrate were classified as being in agricultural land-use areas, and depths to the top of perforations in most of the wells were less than 350 ft (76 m). High and moderate relative-concentrations of arsenic may be attributed to reductive dissolution of manganese or iron oxides, or to desorption or inhibition of arsenic sorption under alkaline conditions. Arsenic concentrations increased with increasing groundwater depth and residence time (age). Simazine was detected more often in groundwater from wells with surrounding land use classified as agricultural or urban, and with top of perforation depths less than 200 ft (61 m), than in groundwater from wells with natural land use or with deeper depths. Tritium, helium-isotope, and carbon-14 data were used to classify the predominant age of groundwater samples into three categories: modern (water that has entered the aquifer since 1953), pre-modern (water that entered the aquifer prior to 1953 to tens of thousands of years ago), and mixed (mixtures of modern- and pre-modern-age waters). Arsenic concentrations were significantly greater in groundwater with pre-modern age classification than in groundwater with modern-age classification, suggesting that arsenic accumulates with groundwater residence time.

Poliovirus Excretion in Children with Primary Immunodeficiency Disorders, India.

PubMed

Mohanty, Madhu Chhanda; Madkaikar, Manisha Rajan; Desai, Mukesh; Taur, Prasad; Nalavade, Uma Prajwal; Sharma, Deepa Kailash; Gupta, Maya; Dalvi, Aparna; Shabrish, Snehal; Kulkarni, Manasi; Aluri, Jahnavi; Deshpande, Jagadish Mohanrao

2017-10-01

Prolonged excretion of poliovirus can occur in immunodeficient patients who receive oral polio vaccine, which may lead to propagation of highly divergent vaccine-derived polioviruses (VDPVs), posing a concern for global polio eradication. This study aimed to estimate the proportion of primary immunodeficient children with enterovirus infection and to identify the long-term polio/nonpolio enterovirus excreters in a tertiary care unit in Mumbai, India. During September 2014-April 2017, 151 patients received diagnoses of primary immunodeficiency (PID). We isolated 8 enteroviruses (3 polioviruses and 5 nonpolio enteroviruses) in cell culture of 105 fecal samples collected from 42 patients. Only 1 patient with severe combined immunodeficiency was identified as a long-term VDPV3 excreter (for 2 years after identification of infection). Our results show that the risk of enterovirus excretion among children in India with PID is low; however, systematic screening is necessary to identify long-term poliovirus excreters until the use of oral polio vaccine is stopped.

Poliovirus Excretion in Children with Primary Immunodeficiency Disorders, India

PubMed Central

Madkaikar, Manisha Rajan; Desai, Mukesh; Taur, Prasad; Nalavade, Uma Prajwal; Sharma, Deepa Kailash; Gupta, Maya; Dalvi, Aparna; Shabrish, Snehal; Kulkarni, Manasi; Aluri, Jahnavi; Deshpande, Jagadish Mohanrao

2017-01-01

Prolonged excretion of poliovirus can occur in immunodeficient patients who receive oral polio vaccine, which may lead to propagation of highly divergent vaccine-derived polioviruses (VDPVs), posing a concern for global polio eradication. This study aimed to estimate the proportion of primary immunodeficient children with enterovirus infection and to identify the long-term polio/nonpolio enterovirus excreters in a tertiary care unit in Mumbai, India. During September 2014–April 2017, 151 patients received diagnoses of primary immunodeficiency (PID). We isolated 8 enteroviruses (3 polioviruses and 5 nonpolio enteroviruses) in cell culture of 105 fecal samples collected from 42 patients. Only 1 patient with severe combined immunodeficiency was identified as a long-term VDPV3 excreter (for 2 years after identification of infection). Our results show that the risk of enterovirus excretion among children in India with PID is low; however, systematic screening is necessary to identify long-term poliovirus excreters until the use of oral polio vaccine is stopped. PMID:28930011

Using vignettes to assess contributions to the work of addressing child mental health problems in primary care.

PubMed

Wissow, Lawrence S; Zafar, Waleed; Fothergill, Kate; Ruble, Anne; Slade, Eric

2016-01-22

To further efforts to integrate mental health and primary care, this study develops a novel approach to quantifying the amount and sources of work involved in shifting care for common mental health problems to pediatric primary care providers. Email/web-based survey of a convenience sample (n = 58) of Maryland pediatricians (77% female, 58% at their site 10 or more years; 44% in private practice, 52 % urban, 48 % practicing with a co-located mental health provider). Participants were asked to review 11 vignettes, which described primary care management of child/youth mental health problems, and rate them on an integer-based ordinal scale for the overall amount of work involved compared to a 12th reference vignette describing an uncomplicated case of ADHD. Respondents were also asked to indicate factors (time, effort, stress) accounting for their ratings. Vignettes presented combinations of three diagnoses (ADHD, anxiety, and depression) and three factors (medical co-morbidity, psychiatric co-morbidity, and difficult families) reported to complicate mental health care. The reference case was pre-assigned a work value of 2. Estimates of the relationship of diagnosis and complicating factors with workload were obtained using linear regression, with random effects at the respondent level. The 58 pediatricians gave 593 vignette responses. Depression was associated with a 1.09 unit (about 50%) increase in work (95% CL .94, 1.25), while anxiety did not differ significantly from the reference case of uncomplicated ADHD (p = .28). Although all three complicating factors increased work ratings compared with the reference case, family complexity and psychiatric co-morbidity did so the most (.87 and 1.07 units, respectively, P < .001) while medical co-morbidity increased it the least (.44 units, p < .001). Factors most strongly associated with increased overall work were physician time, physician mental effort, and stress; those least strongly associated were staff time, physician physical effort, and malpractice risk. Pediatricians working with co-located mental health providers gave higher work ratings than did those without co-located staff. Both diagnosis and cross-diagnosis complicating factors contribute to the work involved in providing mental health services in primary care. Vignette studies may facilitate understanding which mental health services can be most readily incorporated into primary care as it is presently structured and help guide the design of training programs and other implementation strategies.

Quality of water and chemistry of bottom sediment in the Rillito Creek basin, Tucson, Arizona, 1986-92

USGS Publications Warehouse

Tadayon, Saeid; Smith, C.F.

1994-01-01

Data were collected on physical properties and chemistry of 4 surface water, l4 ground water, and 4 bottom sediment sites in the Rillito Creek basin where artificial recharge of surface runoff is being considered. Concentrations of suspended sediment in streams generally increased with increases in streamflow and were higher during the summer. The surface water is a calcium and bicarbonate type, and the ground water is calcium sodium and bicarbonate type. Total trace ek=nents in surface water that exceeded the U.S. Environmental Protection Agency primary maximum contaminant levels for drinking-water standards were barium, beryllium, cadmium, chromium, lead, mercury and nickel. Most unfiltered samples for suspended gross alpha as uranium, and unadjusted gross alpha plus gross beta in surface water exceeded the U.S. Environmental Protection Agency and the State of Arizona drinking-water standards. Comparisons of trace- element concentrations in bottom sediment with those in soils of the western conterminous United States generally indicate similar concentrations for most of the trace elements, with the exceptions of scandium and tin. The maximum concentration of total nitrite plus nitrate as nitrogen in three ground- samples and total lead in one ground-water sample exceeded U.S. Environmental Protection Agency primary maximum contaminant levels for drinking- water standards, respectively. Seven organochlorine pesticides were detected in surface-water samples and nine in bottom-sediment samples. Three priority pollutants were detected in surface water, two were detected in ground water, and eleven were detected in bottom sediment. Low concentrations of oil and grease were detected in surface-water and bottom- sediment samples.

Engine Tune-Up Service. Unit 3: Primary Circuit. Review Exercise Book. Automotive Mechanics Curriculum.

ERIC Educational Resources Information Center

Bacon, E. Miles

This book of pretests and review exercises is designed to accompany the Engine Tune-Up Service Student Guide for Unit 3, Primary Circuit, available separately as CE 031 211. Focus of the exercises and pretests is testing the primary ignition circuit. Pretests and performance checklists are provided for each of the eight performance objectives…

Institutional Determinants of Organizational Change in Primary Education in Nineteenth Century America and Britain. Final Report.

ERIC Educational Resources Information Center

Smelser, Neil J.

Using historical documents, this report traces the development of the system of primary education in Great Britain and the United States. During the period between 1810 and 1870, both Britain and the United States attempted to form an organization for primary schooling and achieved great progress in the institutionalization and growth of mass…

Search for poliovirus carriers among people with primary immune deficiency diseases in the United States, Mexico, Brazil, and the United Kingdom.

PubMed Central

Halsey, Neal A.; Pinto, Jorge; Espinosa-Rosales, Francisco; Faure-Fontenla, María A.; da Silva, Edson; Khan, Aamir J.; Webster, A. D.; Minor, Philip; Dunn, Glynis; Asturias, Edwin; Hussain, Hamidah; Pallansch, Mark A.; Kew, Olen M.; Winkelstein, Jerry; Sutter, Roland

2004-01-01

OBJECTIVE: To estimate the rate of long-term poliovirus excretors in people known to have B-cell immune deficiency disorders. METHODS: An active search for chronic excretors was conducted among 306 persons known to have immunoglobulin G (IgG) deficiency in the United States, Mexico, Brazil, and the United Kingdom, and 40 people with IgA deficiency in the United States. Written informed consent or assent was obtained from the participants or their legal guardians, and the studies were formally approved. Stool samples were collected from participants and cultured for polioviruses. Calculation of the confidence interval for the proportion of participants with persistent poliovirus excretion was based on the binomial distribution. FINDINGS: No individuals with long-term excretion of polioviruses were identified. Most participants had received oral poliovirus vaccine (OPV) and almost all had been exposed to household contacts who had received OPV. Polioviruses of recent vaccine origin were transiently found in four individuals in Mexico and Brazil, where OPV is recommended for all children. CONCLUSION: Although chronic poliovirus excretion can occur in immunodeficient persons, it appears to be rare. PMID:15106294

International Space Station Major Constituent Analyzer On-Orbit Performance

NASA Technical Reports Server (NTRS)

Gardner, Ben D.; Erwin, Philip M.; Thoresen, Souzan; Granahan, John; Matty, Chris

2011-01-01

The Major Constituent Analyzer (MCA) is an integral part of the International Space Station (ISS) Environmental Control and Life Support System (ECLSS). The MCA is a mass spectrometer-based instrument designed to provide critical monitoring of six major atmospheric constituents; nitrogen, oxygen, hydrogen, carbon dioxide, methane, and water vapor. These gases are sampled continuously and automatically in all United States On-Orbit Segment (USOS) modules via the Sample Distribution System (SDS). The MCA is the primary tool for management of atmosphere constituents and is therefore critical for ensuring a habitable ISS environment during both nominal ISS operations and campout EVA preparation in the Airlock. The MCA has been in operation in the US Destiny Laboratory Module for over 10 years, and a second MCA has been delivered to the ISS for Node 3 operation. This paper discusses the performance of the MCA over the two past year, with particular attention to lessons learned regarding the operational life of critical components. Recent data have helped drive design upgrades for a new set of orbit-replaceable units (ORUs) currently in production. Several ORU upgrades are expected to increase expected lifetimes and reliability.

United States Air Force 611th Air Support Group/Civil Engineering Squadron, Elmendorf AFB, Alaska. Risk assessment Point Lonely Radar Installation, Alaska. Final report

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

Karmi, S.

1996-04-01

This document contains the baseline human health risk assessment and the ecological risk assessment (ERA) for the Point Lonely Distant Early Warning (DEW) Line radar installation. Twelve sites at the Point Lonely radar installation underwent remedial investigations (RIs) during the summer of 1993. The Vehicle Storage Area (SS14) was combined with the Inactive Landfill because the two sites were essentially co-located and were sampled during the RI as a single unit. Therefore, 11 sites are discussed in this risk assessment. The presence of chemical contamination in the soil, sediments, and surface water at the installation was evaluated and reported inmore » the Point Lonely Remedial Investigation/Feasibility Study (RI/FS). The analytical data reported in the RI/FS form the basis for the human health and ecological risk assessments. The primary chemicals of concern (COCs) at the 11 sites are diesel and gasoline from past spills and/or leaks, chlorinated solvents, and manganese. The 11 sites investigated and the types of samples collected at each site are presented.« less

Disparities in Cervical Cancer Characteristics and Survival Between White Hispanics and White Non-Hispanic Women.

PubMed

Khan, Hafiz M R; Gabbidon, Kemesha; Saxena, Anshul; Abdool-Ghany, Faheema; Dodge, John M; Lenzmeier, Taylor

2016-10-01

Cervical cancer is the second most common cancer among women resulting in nearly 500,000 cases annually. Screening leads to better treatment and survival time. However, human papillomavirus (HPV) exposure, screening, and treatment vary among races and ethnicities in the United States. The purpose of this study is to examine disparities in characteristics of cervical cancer and survival of cases between White Hispanic (WH) and White non-Hispanic (WNH) women in the United States. We used a stratified random sampling method to select cervical cancer patient records from nine states; a simple random sampling method to extract the demographic and disease characteristics data within states from the Surveillance Epidemiology and End Results (SEER) database. We used statistical probability distribution methods for discrete and continuous data. The chi-square test and independent samples t-test were used to evaluate statistically significant differences. Furthermore, the Cox Proportional Regression and the Kaplan-Meier survival estimators were used to compare WH and WNH population survival times in the United States. The samples of WNH and WH women included 4,000 cervical cancer cases from 1973-2009. There were statistically significant differences between ethnicities: marital status (p < 0.001); primary site of cancer (p < 0.001); lymph node involvement (p < 0.001); grading and differentiation (p < 0.0001); and tumor behavior (p < 0.001). The mean age of diagnosis for both groups showed no statistical differences. However, the mean survival time for WNH was 221.7 (standard deviation [SD] = 118.1) months and for WH was 190.3 (SD = 120.3), which differed significantly (p < 0.001). Clear disparities exist in risk factors, cervical cancer characteristics, and survival time between WH and WNH women.

Snowball sampling by mail: application to a survey of smokers in the general population.

PubMed

Etter, J F; Perneger, T V

2000-02-01

In a series of surveys intended for current and former smokers but sent to a random sample of the general population, we asked never smokers and smokers who did not wish to participate to transmit the questionnaire to any ever smoker they knew. We compared participants who received the questionnaire directly from us (original participants) to participants who received it from an addressee (secondary participants). Questionnaires on smoking were mailed to 3300 residents of Geneva (Switzerland) in 1997, and returned by 1167 people (35%). The final sample consisted of similar numbers of original participants (n = 578, primary response rate = 18% of total sample, or about 46% of ever smokers) and secondary participants (n = 566). Original participants were 1.7 years older than secondary participants (P = 0.03) and were more likely to be men (50% versus 43%, P = 0.009). Proportions of current smokers, stages of change, confidence in ability to quit smoking, cigarettes per day and attempts to quit smoking were similar in the two groups. Secondary participants had lower self-efficacy scores (-0.30 standard deviation (SD) units, P < 0.03), and they derived more pleasure from smoking (+0.25 SD units, P = 0.04). Among ex-smokers, direct participants were less active than secondary participants in coping with the temptation to smoke (-0.58 SD units, P = 0.002). Associations between smoking-related variables were similar in original and secondary participants. Allowing non-eligible addressees to transmit the questionnaire to someone else doubled the response rate, produced moderate bias on some variables only and had no detectable impact on associations between smoking-related variables.

Groundwater quality in the San Diego Drainages Hydrogeologic Province, California

USGS Publications Warehouse

Wright, Michael T.; Belitz, Kenneth

2011-01-01

More than 40 percent of California's drinking water is from groundwater. To protect this vital resource, the State of California created the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The Priority Basin Project of the GAMA Program provides a comprehensive assessment of the State's groundwater quality and increases public access to groundwater-quality information. The San Diego Drainages Hydrogeologic Province (hereinafter referred to as San Diego) is one of the study units being evaluated. The San Diego study unit is approximately 3,900 square miles and consists of the Temecula Valley, Warner Valley, and 12 other alluvial basins (California Department of Water Resources, 2003). The study unit also consists of all areas outside defined groundwater basins that are within 3 kilometers of a public-supply well. The study unit was separated, based primarily on hydrogeologic settings, into four study areas: Temecula Valley, Warner Valley, Alluvial Basins, and Hard Rock (Wright and others, 2005). The sampling density for the Hard Rock study area, which consists of areas outside of groundwater basins, was much lower than for the other study areas. Consequently, aquifer proportions for the Hard Rock study area are not used to calculate the aquifer proportions shown by the pie charts. An assessment of groundwater quality for the Hard Rock study area can be found in Wright and Belitz, 2011. The temperatures in the coastal part of the study unit are mild with dry summers, moist winters, and an average annual rainfall of about 10 inches. The temperatures in the mountainous eastern part of the study unit are cooler than in the coastal part, with an annual precipitation of about 45 inches that occurs mostly in the winter. The primary aquifers consist of Quaternary-age alluvium and weathered bedrock in the Temecula Valley, Warner Valley, and Alluvial Basins study areas, whereas in the Hard Rock study area the primary aquifers consist mainly of fractured and decomposed granite of Mesozoic age. The primary aquifers are defined as those parts of the aquifers corresponding to the perforated intervals of wells listed in the California Department of Public Health (CDPH) database. Public-supply wells typically are drilled to depths between 200 and 700 feet, consist of solid casing from the land surface to a depth of about 60 to 170 feet, and are perforated, or consist of an open hole, below the solid casing. Water quality in the shallow and deep parts of the aquifer system may differ from water quality in the primary aquifers. Municipal water use accounts for approximately 70 percent of water used in the study unit; the majority of the remainder is used for agriculture, industry, and commerce. Groundwater accounts for approximately 8 percent of the municipal supply, and surface water, the majority of which is imported, accounts for the rest. Recharge to groundwater occurs through stream-channel infiltration from rivers and their tributaries, infiltration in engineered recharge basins, and infiltration of water from precipitation and irrigation. The primary source of discharge is water pumped from wells.

On Tour... Primary Hardwood Processing, Products and Recycling Unit

Treesearch

Philip A. Araman; Daniel L. Schmoldt

1995-01-01

Housed within the Department of Wood Science and Forest Products at Virginia Polytechnic Institute is a three-person USDA Forest Service research work unit (with one vacancy) devoted to hardwood processing and recycling research. Phil Araman is the project leader of this truly unique and productive unit, titled ãPrimary Hardwood Processing, Products and Recycling.ä The...

Distribution and utilization of curative primary healthcare services in Lahej, Yemen.

PubMed

Bawazir, A A; Bin Hawail, T S; Al-Sakkaf, K A Z; Basaleem, H O; Muhraz, A F; Al-Shehri, A M

2013-09-01

No evidence-based data exist on the availability, accessibility and utilization of healthcare services in Lahej Governorate, Yemen. The aim of this study was to assess the distribution and utilization of curative services in primary healthcare units and centres in Lahej. Cross-sectional study (clustering sample). This study was conducted in three of the 15 districts in Lahej between December 2009 and August 2010. Household members were interviewed using a questionnaire to determine sociodemographic characteristics and types of healthcare services available in the area. The distribution of health centres, health units and hospitals did not match the size of the populations or areas of the districts included in this study. Geographical accessibility was the main obstacle to utilization. Factors associated with the utilization of curative services were significantly related to the time required to reach the nearest facility, seeking curative services during illness and awareness of the availability of health facilities (P < 0.01). There is an urgent need to look critically and scientifically at the distribution of healthcare services in the region in order to ensure accessibility and quality of services. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Substance use among persons with homeless experience in primary care.

PubMed

Stringfellow, Erin J; Kim, Theresa W; Gordon, Adam J; Pollio, David E; Grucza, Richard A; Austin, Erika L; Johnson, N Kay; Kertesz, Stefan G

2016-01-01

Community survey data suggest high prevalence of substance use disorders among currently homeless individuals. There are less data regarding illicit drug and alcohol use problems of homeless-experienced persons engaged in primary care. They may have less severe use and require different care responses from primary care teams. The authors surveyed currently and formerly homeless, i.e., homeless-experienced, persons engaged in primary care at five federally funded programs in the United States, administering the World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The ASSIST definitions of lower, moderate, and high risk were used to assess a spectrum of lifetime and recent substance use, from any use to likely dependence, and to identify sociodemographic and health status characteristics associated with severity of use. Almost one half of the sample (N = 601) had recently (within the past three months) used alcohol, and one third had recently used an illicit drug. The most commonly used illicit drugs in the past three months were cannabis (19%), cocaine (16%), and opioids (7.5%). Over one half (59%) of respondents had ASSIST-defined moderate- or high-risk substance use. A significant proportion (31%) of those identified as at moderate risk had no recent substance use, but did report past problematic use. Ten percent of the lower-risk group had past problematic use of alcohol. Severity of use was associated with worse health status, but not with housing status or type of homelessness experienced. Less severe (moderate-risk) use and past problematic use, potentially indicative of remitted substance use disorders, were more common than high-risk use in this primary care, homeless-experienced sample. These findings highlight the urgency of identifying effective ways to reduce risky substance use and prevent relapse in homeless-experienced persons.

Effects of the mental health parity and addictions equality act on depression treatment choice in primary care facilities.

PubMed

Goldberg, Daniel M; Lin, Hsien-Chang

2017-01-01

Objective The Mental Health Parity and Addictions Equality Act (MHPAEA) of 2010 in the United States sought to expand mental health insurance benefits on par with medical benefits. As primary care facilities are often the first step in identifying mental health concerns, it is essential to examine the association of this policy with primary care physicians' choice on depression treatment. Method A retrospective cross-sectional study was conducted using data from the 2007-2012 National Ambulatory Medical Care Survey, including a weighted total of 162,699,930 depression patients. Using the Heckman two-step selection procedure, a logistic and a multinomial regression were conducted to examine the association of the MHPAEA with physicians' two-step process of deciding whether and which type of treatment was prescribed. Sociological factors were controlled. Results Treatment was significantly more likely to be provided after the MHPAEA. Psychotherapy was used for treatment for 10.0% of the sample while medication was used for 75.0% of the sample. Patient race/ethnicity, practice setting, physician specialty, and primary source of payment were associated with diverging likelihood of being prescribed depression treatment. Non-Hispanic White patients were more likely to be provided treatment than non-Hispanic Black patients. Patients were less likely to be prescribed only medication than only psychotherapy after the MHPAEA enactment. Conclusions The MHPAEA was associated with primary care providers' decision and choice on depression treatment. Educational and policy interventions aimed at improving physician's understanding of their own treatment tendencies and decreasing barriers to depression treatment may impact the disparities in underserved, minority, and older populations.

SDSS-IV MaNGA IFS GALAXY SURVEY—SURVEY DESIGN, EXECUTION, AND INITIAL DATA QUALITY

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

Yan, Renbin; Zhang, Kai; Bundy, Kevin

The MaNGA Survey (Mapping Nearby Galaxies at Apache Point Observatory) is one of three core programs in the Sloan Digital Sky Survey IV. It is obtaining integral field spectroscopy for 10,000 nearby galaxies at a spectral resolution of R  ∼ 2000 from 3622 to 10354 Å. The design of the survey is driven by a set of science requirements on the precision of estimates of the following properties: star formation rate surface density, gas metallicity, stellar population age, metallicity, and abundance ratio, and their gradients; stellar and gas kinematics; and enclosed gravitational mass as a function of radius. We describe how thesemore » science requirements set the depth of the observations and dictate sample selection. The majority of targeted galaxies are selected to ensure uniform spatial coverage in units of effective radius (R{sub e}) while maximizing spatial resolution. About two-thirds of the sample is covered out to 1.5 R{sub e} (Primary sample), and one-third of the sample is covered to 2.5 R{sub e} (Secondary sample). We describe the survey execution with details that would be useful in the design of similar future surveys. We also present statistics on the achieved data quality, specifically the point-spread function, sampling uniformity, spectral resolution, sky subtraction, and flux calibration. For our Primary sample, the median r -band signal-to-noise ratio is ∼70 per 1.4 Å pixel for spectra stacked between 1 R{sub e} and 1.5 R{sub e}. Measurements of various galaxy properties from the first-year data show that we are meeting or exceeding the defined requirements for the majority of our science goals.« less

SDSS-IV MaNGA IFS Galaxy Survey—Survey Design, Execution, and Initial Data Quality

NASA Astrophysics Data System (ADS)

Yan, Renbin; Bundy, Kevin; Law, David R.; Bershady, Matthew A.; Andrews, Brett; Cherinka, Brian; Diamond-Stanic, Aleksandar M.; Drory, Niv; MacDonald, Nicholas; Sánchez-Gallego, José R.; Thomas, Daniel; Wake, David A.; Weijmans, Anne-Marie; Westfall, Kyle B.; Zhang, Kai; Aragón-Salamanca, Alfonso; Belfiore, Francesco; Bizyaev, Dmitry; Blanc, Guillermo A.; Blanton, Michael R.; Brownstein, Joel; Cappellari, Michele; D'Souza, Richard; Emsellem, Eric; Fu, Hai; Gaulme, Patrick; Graham, Mark T.; Goddard, Daniel; Gunn, James E.; Harding, Paul; Jones, Amy; Kinemuchi, Karen; Li, Cheng; Li, Hongyu; Maiolino, Roberto; Mao, Shude; Maraston, Claudia; Masters, Karen; Merrifield, Michael R.; Oravetz, Daniel; Pan, Kaike; Parejko, John K.; Sanchez, Sebastian F.; Schlegel, David; Simmons, Audrey; Thanjavur, Karun; Tinker, Jeremy; Tremonti, Christy; van den Bosch, Remco; Zheng, Zheng

2016-12-01

The MaNGA Survey (Mapping Nearby Galaxies at Apache Point Observatory) is one of three core programs in the Sloan Digital Sky Survey IV. It is obtaining integral field spectroscopy for 10,000 nearby galaxies at a spectral resolution of R ˜ 2000 from 3622 to 10354 Å. The design of the survey is driven by a set of science requirements on the precision of estimates of the following properties: star formation rate surface density, gas metallicity, stellar population age, metallicity, and abundance ratio, and their gradients; stellar and gas kinematics; and enclosed gravitational mass as a function of radius. We describe how these science requirements set the depth of the observations and dictate sample selection. The majority of targeted galaxies are selected to ensure uniform spatial coverage in units of effective radius (R e ) while maximizing spatial resolution. About two-thirds of the sample is covered out to 1.5R e (Primary sample), and one-third of the sample is covered to 2.5R e (Secondary sample). We describe the survey execution with details that would be useful in the design of similar future surveys. We also present statistics on the achieved data quality, specifically the point-spread function, sampling uniformity, spectral resolution, sky subtraction, and flux calibration. For our Primary sample, the median r-band signal-to-noise ratio is ˜70 per 1.4 Å pixel for spectra stacked between 1R e and 1.5R e . Measurements of various galaxy properties from the first-year data show that we are meeting or exceeding the defined requirements for the majority of our science goals.

The healthy migrant effect: new findings from the Mexican Family Life Survey.

PubMed

Rubalcava, Luis N; Teruel, Graciela M; Thomas, Duncan; Goldman, Noreen

2008-01-01

We used nationally representative longitudinal data from the Mexican Family Life Survey to determine whether recent migrants from Mexico to the United States are healthier than other Mexicans. Previous research has provided little scientific evidence that tests the "healthy migrant" hypothesis. Estimates were derived from logistic regressions of whether respondents moved to the United States between surveys in 2002 and 2005, by gender and urban versus rural residence. Covariates included physical health measurements, self-reported health, and education measured in 2002. Our primary sample comprised 6446 respondents aged 15 to 29 years. Health significantly predicted subsequent migration among females and rural males. However, the associations were weak, few health indicators were statistically significant, and there was substantial variation in the estimates between males and females and between urban and rural dwellers. On the basis of recent data for Mexico, the largest source of migrants to the United States, we found generally weak support for the healthy migrant hypothesis.

Water Quality Monitor

NASA Technical Reports Server (NTRS)

1982-01-01

An automated water quality monitoring system was developed by Langley Research Center to meet a need of the Environmental Protection Agency (EPA). Designed for unattended operation in water depths up to 100 feet, the system consists of a subsurface buoy anchored in the water, a surface control unit (SCU) and a hydrophone link for acoustic communication between buoy and SCU. Primary functional unit is the subsurface buoy. It incorporates 16 cells for water sampling, plus sensors for eight water quality measurements. Buoy contains all the electronic equipment needed for collecting and storing sensor data, including a microcomputer and a memory unit. Power for the electronics is supplied by a rechargeable nickel cadmium battery that is designed to operate for about two weeks. Through hydrophone link the subsurface buoy reports its data to the SCU, which relays it to land stations. Link allows two-way communications. If system encounters a problem, it automatically shuts down and sends alert signal. Sequence of commands sent via hydrophone link causes buoy to release from anchor and float to the surface for recovery.

Sacred Spaces: Religious and Secular Coping and Family Relationships in the Neonatal Intensive Care Unit.

PubMed

Brelsford, Gina M; Ramirez, Joshua; Veneman, Kristin; Doheny, Kim K

2016-08-01

Preterm birth is an unanticipated and stressful event for parents. In addition, the unfamiliar setting of the intensive care nursery necessitates strategies for coping. The primary study objective of this descriptive study was to determine whether secular and religious coping strategies were related to family functioning in the neonatal intensive care unit. Fifty-two parents of preterm (25-35 weeks' gestation) infants completed the Brief COPE (secular coping), the Brief RCOPE (religious coping), and the Family Environment Scale within 1 week of their infant's hospital admission. This descriptive study found that parents' religious and secular coping was significant in relation to family relationship functioning. Specifically, negative religious coping (ie, feeling abandoned or angry at God) was related to poorer family cohesion and use of denial. These findings have relevance for interventions focused toward enhancing effective coping for families. Further study of religious and secular coping strategies for neonatal intensive care unit families is warranted in a larger more diverse sample of family members.

Correlation between Volume of Apical Periodontitis Determined by Cone-beam Computed Tomography Analysis and Endotoxin Levels Found in Primary Root Canal Infection.

PubMed

Cardoso, Flávia G R; Ferreira, Nádia S; Martinho, Frederico C; Nascimento, Gustavo G; Manhães, Luiz R C; Rocco, Marco A; Carvalho, Cláudio A T; Valera, Marcia C

2015-07-01

This clinical study was conducted to correlate the levels of endotoxins and bacterial counts found in primary endodontic infection with the volume of periapical bone destruction determined by cone-beam computed tomography (CBCT) analysis. Moreover, the levels of bacteria and endotoxins were correlated with the development of clinical features. Twenty-four root canals with primary endodontic disease and apical periodontitis were selected. Clinical features such as pain on palpation, pain on percussion, and previous episode of pain were recorded. The volume (cubic millimeters) of periapical bone destruction was determined by CBCT analysis. Endotoxins and bacterial samplings were collected by using sterile/apyrogenic paper points. Endotoxins were quantified by using limulus amebocyte lysate assay (KQCL test), and bacterial count (colony-forming units [CFU]/mL) was determined by using anaerobic culture techniques. Data were analyzed by Pearson correlation and multiple logistic regression (P < .05). Endotoxins and bacteria were detected in 100% of the root canal samples (24 of 24), with median values of 10.92 endotoxin units (EU)/mL (1.75-128 EU/mL) and 7.5 × 10(5) CFU/mL (3.20 × 10(5)-8.16 × 10(6) CFU/mL), respectively. The median volume of bone destruction determined by CBCT analysis was 100 mm(3) (10-450 mm(3)). The multiple regression analysis revealed a positive correlation between higher levels of endotoxins present in root canal infection and larger volume of bone destruction (P < .05). Moreover, higher levels of endotoxins were also correlated with the presence of previous pain (P < .05). Our findings revealed that the levels of endotoxins found in root canal infection are related to the volume of periapical bone destruction determined by CBCT analysis. Moreover, the levels of endotoxin are related to the presence of previous pain. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Adolescent females and hormonal contraception: a retrospective study in primary care.

PubMed

Krishnamoorthy, Narayanan; Simpson, Colin D; Townend, John; Helms, Peter J; McLay, James S

2008-01-01

The aim of this study was to assess change in the number of adolescent females prescribed hormonal contraception in primary care following the publication in the United Kingdom of the Social Exclusion Unit report on Teenage Pregnancy. We conducted a retrospective observational study of 320 primary care practices in Scotland. Hormonal contraceptive prescribing to girls aged <16 years and those aged 16-19 years was assessed for April 1 to March 31 for the study years 2000-2001 to 2005-2006 from Scottish primary care practice data. Between 2000-2001 and 2005-2006, the proportion of girls aged <16 years and those 16-19 years who were prescribed hormonal contraception by their primary care physicians increased by 82% (p < .001) and 53% (p < .001) respectively. The increase became significant from age 12 years for the combined oral contraceptive, 14 years for the progestogen-only pill, and 15 years for depot progestogens. By 2005-2006, 2.9% of girls aged <16 years and 40.5% of those aged 16-19 years were prescribed some form of hormonal contraception by their primary care physicians. The small number of girls aged <12 years who were prescribed hormonal contraception remained constant over the study period. Since the publication in the United Kingdom of the Social Exclusion Unit Report on Teenage Pregnancy, there has been a significant increase in the number of female adolescents aged > or =12 years prescribed hormonal contraception by their primary care physicians. However the number of individuals prescribed hormonal contraception still remains relatively low in comparison to the reported levels of sexual activity among adolescents in the United Kingdom.

Patient-derived Models of Human Breast Cancer: Protocols for In vitro and In vivo Applications in Tumor Biology and Translational Medicine

PubMed Central

DeRose, Yoko S.; Gligorich, Keith M.; Wang, Guoying; Georgelas, Ann; Bowman, Paulette; Courdy, Samir J.; Welm, Alana L.; Welm, Bryan E.

2013-01-01

Research models that replicate the diverse genetic and molecular landscape of breast cancer are critical for developing the next generation therapeutic entities that can target specific cancer subtypes. Patient-derived tumorgrafts, generated by transplanting primary human tumor samples into immune-compromised mice, are a valuable method to model the clinical diversity of breast cancer in mice, and are a potential resource in personalized medicine. Primary tumorgrafts also enable in vivo testing of therapeutics and make possible the use of patient cancer tissue for in vitro screens. Described in this unit are a variety of protocols including tissue collection, biospecimen tracking, tissue processing, transplantation, and 3-dimensional culturing of xenografted tissue, that enable use of bona fide uncultured human tissue in designing and validating cancer therapies. PMID:23456611

Associations between Child Disabilities and Caregiver Discipline and Violence in Low- and Middle-Income Countries

PubMed Central

Hendricks, Charlene; Lansford, Jennifer E.; Deater-Deckard, Kirby; Bornstein, Marc H.

2014-01-01

Using nationally representative samples of 45,964 2- to 9-year-old children and their primary caregivers in 17 developing countries, we sought to understand relations between children’s cognitive, language, sensory, and motor disabilities and caregivers’ use of discipline and violence. Primary caregivers reported on their child’s disabilities and whether they or anyone in their household had used nonviolent discipline, psychological aggression, and physical violence toward the target child and whether they believed that using corporal punishment is necessary. Logistic regression analyses supported the hypothesis that children with disabilities are treated more harshly than children without disabilities. The findings suggest that policies and interventions are needed to work toward the United Nations’ goals of ensuring that children with disabilities are protected from abuse and violence. PMID:23895329

An exploration of influences on women’s birthplace decision-making in New Zealand: a mixed methods prospective cohort within the Evaluating Maternity Units study

PubMed Central

2014-01-01

Background There is worldwide debate surrounding the safety and appropriateness of different birthplaces for well women. One of the primary objectives of the Evaluating Maternity Units prospective cohort study was to compare the clinical outcomes for well women, intending to give birth in either an obstetric-led tertiary hospital or a free-standing midwifery-led primary maternity unit. This paper addresses a secondary aim of the study – to describe and explore the influences on women’s birthplace decision-making in New Zealand, which has a publicly funded, midwifery-led continuity of care maternity system. Methods This mixed method study utilised data from the six week postpartum survey and focus groups undertaken in the Christchurch area in New Zealand (2010–2012). Christchurch has a tertiary hospital and four primary maternity units. The survey was completed by 82% of the 702 study participants, who were well, pregnant women booked to give birth in one of these places. All women received midwifery-led continuity of care, regardless of their intended or actual birthplace. Results Almost all the respondents perceived themselves as the main birthplace decision-makers. Accessing a ‘specialist facility’ was the most important factor for the tertiary hospital group. The primary unit group identified several factors, including ‘closeness to home’, ‘ease of access’, the ‘atmosphere’ of the unit and avoidance of ‘unnecessary intervention’ as important. Both groups believed their chosen birthplace was the right and ‘safe’ place for them. The concept of ‘safety’ was integral and based on the participants’ differing perception of safety in childbirth. Conclusions Birthplace is a profoundly important aspect of women’s experience of childbirth. This is the first published study reporting New Zealand women’s perspectives on their birthplace decision-making. The groups’ responses expressed different ideologies about childbirth. The tertiary hospital group identified with the ‘medical model’ of birth, and the primary unit group identified with the ‘midwifery model’ of birth. Research evidence affirming the ‘clinical safety’ of primary units addresses only one aspect of the beliefs influencing women’s birthplace decision-making. In order for more women to give birth at a primary unit other aspects of women’s beliefs need addressing, and much wider socio-political change is required. PMID:24951093

Detection of human papillomavirus in pterygium and conjunctival papilloma by hybrid capture II and PCR assays.

PubMed

Takamura, Y; Kubo, E; Tsuzuki, S; Akagi, Y

2008-11-01

To elucidate the putative role of human papillomavirus (HPV) infection in pterygium and conjunctival papilloma. Hybrid capture II (HC-II) and polymerase chain reaction (PCR) assays were performed to detect HPV in pterygium (42 samples obtained from 40 patients) and conjunctival papilloma (8 samples from 6 patients). The amount of HPV DNA was evaluated by measurement of relative light units (RLUs) on a luminometer. All papilloma samples were positive for HPV DNA by PCR and HC-II. The RLU values for specimens of recurrent and re-recurrent papilloma were markedly higher than those for specimens of primary lesions. HPV was detected by PCR in 2 of 42 (4.8%) beta-globin-positive pterygium specimens, whereas HC-II showed that HPV was negative in all pterygium samples. Our results support the hypothesis that HPV DNA is associated with the pathogenesis of conjunctival papilloma, but not pterygium. RLU measurement by HC-II may serve as a marker for evaluating the activity of HPV in conjunctival tumours.

Infrastructure of pharmacies of the primary health care in the Brazilian Unified Health System: Analysis of PNAUM – Services data

PubMed Central

Leite, Silvana Nair; Manzini, Fernanda; Álvares, Juliana; Guerra, Augusto Afonso; Costa, Ediná Alves; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mário; Farias, Mareni Rocha

2017-01-01

ABSTRACT OBJECTIVE To characterize the infrastructure of the primary health care pharmacies of the Brazilian Unified Health System, aiming at humanizing the offered services. METHODS This is a cross-sectional study, of quantitative approach, from data obtained in the Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015). Information on 1,175 pharmacies/dispensing units were gathered from direct observation and assessment of dispensing units installations conducted by trained researchers who used a standardized form. The analyzed variables refer to the physical structure of pharmacies or medicine dispensing units of the health units under research. RESULTS The pharmacy area was greater than 14 m2 in 40.3% of the sampled units, highlighting those from Midwest (56.9%) and Southeast (56.2%) regions and those of Northeast, with only 23.3%. About 80.2% units had waiting rooms with chairs for patients, 31.8% of them had dispensing areas inferior to 5m2, while in 46.2% these areas were superior to 10m2. Bars were found in service counters in 23.8% of health units, thus separating the patient from the professional; 44.1% had internet access. In most units, the area of medicine storage had no refrigerator or freezer for their exclusive storage and 13.7% had a specific room for pharmaceutical consultation. CONCLUSION Aiming at achieving care humanization and improving working conditions for professionals, the structuring of the environment of pharmacy services is necessary. This would contribute to the better qualification of pharmacy services, comprising more than medicine delivery. Data on the Northeast region indicated less favorable conditions to the development of adequate dispensing services. Based on the panorama pointed out, we suggest the expansion of stimulus concerning the physical structure of pharmaceutical services, considering regional specificities. PMID:29160456

How People Live. Language Arts Theme Units: Cross-Curricular Activities for Primary Grades.

ERIC Educational Resources Information Center

McAllister, Elizabeth A.; Hildebrand, Joan M.; Ericson, Joann H.

This book is part of a series of books presenting ready-to-use instructional units on themes typically taught in the primary grades. The topics focus on science, math, social studies or literature, but use language arts skills consistently in each unit. Each book in the series also uses as many frames of mind or intelligences as possible. Within a…

Assessing Science Reasoning and Conceptual Understanding in the Primary Grades Using Standardized and Performance-Based Assessments

ERIC Educational Resources Information Center

Kim, Kyung Hee; VanTassel-Baska, Joyce; Bracken, Bruce A.; Feng, Annie; Stambaugh, Tamra

2014-01-01

Project Clarion, a Jacob K. Javits-funded project, focused on the scale-up of primary-grade science curricula. Curriculum units, based on an Integrated Curriculum Model (ICM), were developed for high-ability learners, but tried out with all students in Title I settings to study the efficacy of the units with all learners. The units focus on the…

The Animals Around Us. Language Arts Theme Units: Cross-Curricular Activities for Primary Grades.

ERIC Educational Resources Information Center

McAllister, Elizabeth A.; Hildebrand, Joan M.; Ericson, Joann H.

This book is part of a series of books presenting ready-to-use instructional units on themes typically taught in the primary grades. The topics focus on science, math, social studies or literature, but use language arts skills consistently in each unit. Each book in the series also uses as many frames of mind or intelligences as possible. Within a…

Remote rural women's choice of birthplace and transfer experiences in rural Otago and Southland New Zealand.

PubMed

Patterson, Jean; Foureur, Maralyn; Skinner, Joan

2017-09-01

Birth in primary midwife-led maternity units has been demonstrated to be a safe choice for well women anticipating a normal birth. The incidence of serious perinatal outcomes for these women is comparable to similarly low risk women, who choose to birth in hospital. New Zealand women have a choice of Lead Maternity Carer (LMC) and birthplace; home, primary birthing unit, or a base hospital, though not all women may have all these choices available locally. Women in rural and rural remote areas can also choose to birth in their rural primary maternity unit. A percentage of these women (approx. 15-17%) will require transfer during labour, an event which can cause distress and often loss of midwifery continuity of care. To explore retrospectively the choice of birth place decisions and the labour and birth experiences of a sample of women resident in remotely zoned, rural areas of the lower South Island of New Zealand. A purposive sample of women living in remote rural areas, recruited by advertising in local newspapers and flyers. Individual semi-structured interviews were digitally recorded using a pragmatic interpretive approach. The data (transcripts and field notes) were analysed using thematic and content analysis. Ethical approval was obtained from the Health and Disability Ethics Committee (HEDC) MEC/06/05/045. Thirteen women consented to participate. Each was resident in a remote rural area having given birth in the previous 18 months. The women had been well during their pregnancies and at the onset of labour had anticipated a spontaneous vaginal birth. Rural remote zoned areas in Otago and Southland in the South Island of New Zealand FINDINGS: Five women planned to birth in a regional hospital and eight chose their nearest rural primary maternity unit. All of the women were aware of the possibility of transfer and had made their decision about their birthplace based on their perception of their personal safety, and in consideration of their distance from specialist care. Themes included, deciding about the safest place to give birth; making the decision to transfer; experiencing transfer in labour, and reflecting on their birth experience and considering future birthplace choices. The experiences of the women show that for some, distance from a base hospital influences their place of birth decisions in remote rural areas of New Zealand and increases the distress for those needing to transfer over large distances. These experiences can result in women choosing, or needing to make different choices for subsequent births; the consequences of which impact on the future sustainability of midwifery services in remote rural areas, a challenge which resonates with maternity service provision internationally. While choices about birth place cannot be reliably predicted, creative solutions are needed to provide rural midwifery care and birth options for women and more timely and efficient transfer services when required. Copyright © 2017 Elsevier Ltd. All rights reserved.

22 CFR 102.12 - Protective services for survivors.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Section 102.12 Foreign Relations DEPARTMENT OF STATE ECONOMIC AND OTHER FUNCTIONS CIVIL AVIATION United... accident. If a scheduled United States carrier is involved in an accident, the primary responsibility for... accident, primary responsibility for providing accommodation and onward transportation for passengers and...

22 CFR 102.12 - Protective services for survivors.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Section 102.12 Foreign Relations DEPARTMENT OF STATE ECONOMIC AND OTHER FUNCTIONS CIVIL AVIATION United... accident. If a scheduled United States carrier is involved in an accident, the primary responsibility for... accident, primary responsibility for providing accommodation and onward transportation for passengers and...

22 CFR 102.12 - Protective services for survivors.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Section 102.12 Foreign Relations DEPARTMENT OF STATE ECONOMIC AND OTHER FUNCTIONS CIVIL AVIATION United... accident. If a scheduled United States carrier is involved in an accident, the primary responsibility for... accident, primary responsibility for providing accommodation and onward transportation for passengers and...

22 CFR 102.12 - Protective services for survivors.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Section 102.12 Foreign Relations DEPARTMENT OF STATE ECONOMIC AND OTHER FUNCTIONS CIVIL AVIATION United... accident. If a scheduled United States carrier is involved in an accident, the primary responsibility for... accident, primary responsibility for providing accommodation and onward transportation for passengers and...

22 CFR 102.12 - Protective services for survivors.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Section 102.12 Foreign Relations DEPARTMENT OF STATE ECONOMIC AND OTHER FUNCTIONS CIVIL AVIATION United... accident. If a scheduled United States carrier is involved in an accident, the primary responsibility for... accident, primary responsibility for providing accommodation and onward transportation for passengers and...

Impact of an Interprofessional Primary Care Training on Fear of Cancer Recurrence on Clinicians' Knowledge, Self-Efficacy, Anticipated Practice Behaviors, and Attitudes Toward Survivorship Care.

PubMed

Berrett-Abebe, Julie; Cadet, Tamara; Nekhlyudov, Larissa; Vitello, Joan; Maramaldi, Peter

2018-02-10

There are an estimated 15.5 million cancer survivors in the United States, with numbers projected to increase. Many cancer survivors are receiving survivorship care in primary care settings, yet primary care providers report a need for additional training on addressing medical and psychosocial concerns of cancer survivors. This paper presents findings from a pilot study on the effectiveness of a novel training for interprofessional primary care providers on the clinically significant issue of fear of cancer recurrence. The on-site training was provided to a total of 46 participants, including physicians (61%), physician assistants (11%), nurse practitioners (7%), nurses (17%), and social workers (4%) in six different primary care practices. The average number of years of professional experience was 18.8, with standard deviation of 10.9. Results of paired-sample t tests indicated that the training increased knowledge and self-efficacy of providers in identifying and addressing FCR. The training was well-received by participants, who had high confidence in implementing practice behavior changes, although they also identified barriers. Results suggest the feasibility of a brief training for continuing education and have implications for models of care delivery in cancer survivorship.

Muddling through the Health System: Experiences of Three Groups of Black Women in Three Regions

PubMed Central

Gary, F; Still, C; Mickels, P; Hassan, M; Evans, E

2018-01-01

Health care disparities are a well-documented concern among patients and providers who care for minority groups in the United States. In this study, focus groups were created from an original sample of 606 Black women representing three regions in the United States: the South, the Midwest, and the Virgin Islands. Composed of 10 randomly selected members each (n = 30), the focus groups provided insights into the nature of these disparities, with some suggestions for viable solutions. Participants voiced concerns about cultural taboos about discussing menopause, financial concerns, and negative experiences with health care leading to distrust in medical systems. The primary solution proposed was an increase in Black health care professionals who would have increased rapport with, empathy for, and understanding of the concerns of Black women. PMID:26371357

A cross-sectional study of the causes of morbidity and mortality in farmed white-tailed deer

PubMed Central

2005-01-01

Abstract Two questionnaires were designed and administered. The first was to a random sample of 340 farmers of white-tailed deer (Odocoileus virginianus) in Canada and the United States. The second was a 10-year retrospective survey of deer submissions to veterinary diagnostic pathology laboratories in Canada and the United States. One-year rates of mortality and common causes of morbidity and mortality for the deer are reported. The primary diagnosis for each record was used to classify diseases into categories, such as parasitic, infectious, toxicological, and neoplastic. Submissions were further classified according to the anatomical location, the pathological change, and the etiology associated with each lesion. Trauma was the most important reported cause of farmed white-tailed deer mortality; necrobacillosis was a major cause of morbidity and mortality, especially in fawns. PMID:16048010

Concentration data for anthropogenic organic compounds in groundwater, surface water, and finished water of selected community water systems in the United States, 2002-10

USGS Publications Warehouse

Carter, Janet M.; Kingsbury, James A.; Hopple, Jessica A.; Delzer, Gregory C.

2010-01-01

The National Water-Quality Assessment Program of the U.S. Geological Survey began implementing Source Water-Quality Assessments (SWQAs) in 2001 that focus on characterizing the quality of source water and finished water of aquifers and major rivers used by some of the larger community water systems in the United States. As used in SWQA studies, source water is the raw (ambient) water collected at the supply well before water treatment (for groundwater) or the raw (ambient) water collected from the river near the intake (for surface water), and finished water is the water that has been treated and is ready to be delivered to consumers. Finished-water samples are collected before the water enters the distribution system. The primary objective of SWQAs is to determine the occurrence of more than 250 anthropogenic organic compounds in source water used by community water systems, many of which currently are unregulated in drinking water by the U.S. Environmental Protection Agency. A secondary objective is to understand recurrence patterns in source water and determine if these patterns also occur in finished water before distribution. SWQA studies were conducted in two phases for most studies completed by 2005, and in one phase for most studies completed since 2005. Analytical results are reported for a total of 295 different anthropogenic organic compounds monitored in source-water and finished-water samples collected during 2002-10. The 295 compounds were classified according to the following 13 primary use or source groups: (1) disinfection by-products; (2) fumigant-related compounds; (3) fungicides; (4) gasoline hydrocarbons, oxygenates, and oxygenate degradates; (5) herbicides and herbicide degradates; (6) insecticides and insecticide degradates; (7) manufacturing additives; (8) organic synthesis compounds; (9) pavement- and combustion-derived compounds; (10) personal-care and domestic-use products; (11) plant- or animal-derived biochemicals; (12) refrigerants and propellants; and (13) solvents. This report presents the analytical results of source- water samples from 448 community water system wells and 21 surface-water sites. This report also presents the analytical results of finished-water samples from 285 wells and 20 surface-water sites from community water systems. Results of quality-assurance/quality-control samples also are presented including data for equipment blanks, field blanks, source solution blanks, and replicate samples.

Investigation Regarding the Pre-Service Trainings of Primary and Middle School Principals in the United States: The Case of the State of Michigan

ERIC Educational Resources Information Center

Gumus, Emine

2015-01-01

The purpose of this research is to determine the requirements of being a school principal and investigate the pre-service trainings of primary and middle school principals in the United States. In accordance with this aim, semi-structured interviews were conducted with 16 primary and middle school principals from the state of Michigan. In this…

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.

Impregnating unconsolidated pyroclastic sequences: A tool for detailed facies analysis

NASA Astrophysics Data System (ADS)

Klapper, Daniel; Kueppers, Ulrich; Castro, Jon M.; Pacheco, Jose M. R.; Dingwell, Donald B.

2010-05-01

The interpretation of volcanic eruptions is usually derived from direct observation and the thorough analysis of the deposits. Processes in vent-proximal areas are usually not directly accessible or likely to be obscured. Hence, our understanding of proximal deposits is often limited as they were produced by the simultaneous events stemming from primary eruptive, transportative, and meteorological conditions. Here we present a method that permits for a direct and detailed quasi in-situ investigation of loose pyroclastic units that are usually analysed in the laboratory for their 1) grain-size distribution, 2) componentry, and 3) grain morphology. As the clast assembly is altered during sampling, the genesis of a stratigraphic unit and the relative importance of the above mentioned deposit characteristics is hard to achieve. In an attempt to overcome the possible loss of information during conventional sampling techniques, we impregnated the cleaned surfaces of proximal, unconsolidated units of the 1957-58 Capelinhos eruption on Faial, Azores. During this basaltic, emergent eruption, fluxes in magma rise rate led to a repeated build-up and collapse of tuff cones and consequently to a shift between phreatomagmatic and magmatic eruptive style. The deposits are a succession of generally parallel bedded, cm- to dm-thick layers with a predominantly ashy matrix. The lapilli content is varying gradually; the content of bombs is enriched in discrete layers without clear bomb sags. The sample areas have been cleaned and impregnated with two-component glue (EPOTEK 301). For approx. 10 * 10 cm, a volume of mixed glue of 20 ml was required. Using a syringe, this low-viscosity, transparent glue could be easily applied on the target area. We found that the glue permeated the deposit as deep as 5 mm. After > 24 h, the glue was sufficiently dry to enable the sample to be laid open. This impregnation method renders it possible to cut and polish the sample and investigate grain-size distribution, componentry, and grain morphology in situ in a 2D-plane. In a first step, the sample surface has been scanned and analysed by means of image analysis software (Image J). After that, selected areas were investigated through thin section analysis. We were able to define depositional units in the (sub)-mm scale and the show the varying relative importance of 1) eruptive style, 2) transportation mode, and 3) the influence of wind and (air) humidity. The presented method is an easy and efficient tool for a detailed stratigraphic investigation of unconsolidated pyroclastic units.

Relationship between leadership styles of hospital pharmacists and perceptions of work-unit effectiveness.

PubMed

Bennett, C R; Grussing, P G; Hutchinson, R A; Stewart, J E

1988-08-01

Relationships between hospital pharmacists' perceptions of their own and their immediate supervisors' leadership styles and their perceptions of the effectiveness of their work units were examined. Pharmacists practicing in 12 large Chicago-area hospitals were asked to complete a four-part questionnaire that consisted of demographic questions, the LEADSelf instrument, the LEADOther instrument, and a measure of perceived work unit effectiveness. Respondents' primary, secondary, and combination leadership styles and their degree of style adaptability were determined and compared with the primary, secondary, and combination leadership styles and style adaptability of their immediate supervisors and with their perceptions of the effectiveness of their work units. Pharmacists involved in providing clinical or drug information services and pharmacists responsible for purchasing activities perceived their work units to be most and least effective, respectively. Most respondents perceived their primary leadership style to be high task-high relationship, but only 32% perceived their immediate supervisors to exhibit this style. Pharmacists who perceived their immediate supervisors to have high relationship leadership styles (based on primary and combination style classifications) had significantly more favorable perceptions of the effectiveness of their work units than did pharmacists who perceived their supervisors to exhibit low relationship styles. Respondents' perceptions of their supervisors' style adaptability were positively and significantly correlated with their perceptions of work-unit effectiveness. Respondents who thought their supervisors' leadership styles were more adaptable than their own had the most favorable perceptions of work-unit effectiveness.(ABSTRACT TRUNCATED AT 250 WORDS)

Occurrence and persistence of fungicides in bed sediments and suspended solids from three targeted use areas in the United States

USGS Publications Warehouse

Smalling, Kelly L.; Reilly, Timothy J.; Sandstrom, Mark W.; Kuivila, Kathryn

2013-01-01

To document the environmental occurrence and persistence of fungicides, a robust and sensitive analytical method was used to measure 34 fungicides and an additional 57 current-use pesticides in bed sediments and suspended solids collected from areas of intense fungicide use within three geographic areas across the United States. Sampling sites were selected near or within agricultural research farms using prophylactic fungicides at rates and types typical of their geographic location. At least two fungicides were detected in 55% of the bed and 83% of the suspended solid samples and were detected in conjunction with herbicides and insecticides. Six fungicides were detected in all samples including pyraclostrobin (75%), boscalid (53%), chlorothalonil (41%) and zoxamide (22%). Pyraclostrobin, a strobilurin fungicide, used frequently in the United States on a variety of crops, was detected more frequently than p,p′-DDE, the primary degradate of p,p′-DDT, which is typically one of the most frequently occurring pesticides in sediments collected within highly agricultural areas. Maximum fungicide concentrations in bed sediments and suspended solids were 198 and 56.7 μg/kg dry weight, respectively. There is limited information on the occurrence, fate, and persistence of many fungicides in sediment and the environmental impacts are largely unknown. The results of this study indicate the importance of documenting the persistence of fungicides in the environment and the need for a better understanding of off-site transport mechanisms, particularly in areas where crops are grown that require frequent treatments to prevent fungal diseases.

Influence of human papillomavirus on the clinical presentation of oropharyngeal carcinoma in the United States.

PubMed

Stenmark, Matthew H; Shumway, Dean; Guo, Cui; Vainshtein, Jeffrey; Mierzwa, Michelle; Jagsi, Reshma; Griggs, Jennifer J; Banerjee, Mousumi

2017-10-01

Much of what is known about the significance of human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma is derived from single-institution retrospective studies, post hoc analyses of tissue specimens from clinical trials, and tissue bank studies with a small sample size. The objective of this study is to investigate the impact of HPV on the frequency and clinical presentation of oropharyngeal carcinoma in a large, national sample with information from patients who underwent HPV testing. Retrospective, cross-sectional study. We identified a comprehensive national sample of 8,359 patients with oropharyngeal carcinoma and known HPV status diagnosed between 2010 and 2011 within the National Cancer Database. Multivariable logistic regression was used to assess correlates of patient and tumor characteristics on HPV status. Among patients with oropharyngeal carcinoma, the frequency of HPV-related squamous cell carcinoma in the United States was 65.4%. HPV-related oropharyngeal carcinoma was associated with younger age, male sex, and white race (P < 0.001). Advanced primary tumor stage was associated with HPV-negative disease (P < 0.001), whereas increasing nodal burden was associated with HPV-positive disease (P < 0.001). Despite less-advanced nodal disease, HPV-negative tumors were associated with a higher likelihood of metastasis at presentation (P < 0.001). HPV now accounts for the majority of newly diagnosed oropharyngeal carcinoma in the United States and is associated with a distinct clinical profile, supporting efforts to re-evaluate the staging and treatment paradigm for HPV-associated oropharyngeal cancer. 4. Laryngoscope, 127:2270-2278, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

77 FR 65581 - Novartis Pharmaceuticals Corporation, Primary Care Business Unit (Sales) Division, East Operating...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-29

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-80,490] Novartis Pharmaceuticals... Workers of Novartis Pharmaceuticals Corporation, Primary Care Business Unit (Sales) Division, East... for Worker Adjustment Assistance on January 6, 2012, applicable to workers of Novartis Pharmaceuticals...

CHEMICAL PUBLICATIONS, THEIR NATURE AND USE.

ERIC Educational Resources Information Center

MELLON, M.G.

THIS PUBLICATION CONTAINS AN ANALYSIS OF TYPES OF CHEMICAL LITERATURE, WHERE THEY MAY BE OBTAINED, AND HOW THEY SHOULD BE USED. PRIMARY, SECONDARY, AND TERTIARY SOURCES OF INFORMATION ARE ANALYZED. PRIMARY SOURCES INCLUDE PERIODICALS, UNITED STATES AND FOREIGN GOVERNMENT PUBLICATIONS, UNITED NATIONS PUBLICATIONS, REPORTS OF NON-GOVERNMENTAL…

Primary teachers' written unit plans in mathematics and their perceptions of essential elements of these

NASA Astrophysics Data System (ADS)

Roche, Anne; Clarke, Doug M.; Clarke, David J.; Sullivan, Peter

2014-12-01

The content and purpose of written unit plans in mathematics is an under-researched area. In this article, we provide a brief overview of research on teachers' planning processes and the place of mental and written plans. We report on data from a questionnaire completed by 357 teachers from Victorian Catholic primary schools, where we focused on possible elements of written unit plans for primary mathematics, and the relative importance which teachers attributed to these elements. We then discuss 48 written unit plans which were provided to us by primary schools from which the 357 teachers were drawn. There was considerable variation in the length, intended teaching time, and level of specification of key ideas in these plans. We discuss this variation, and some discrepancies between the ratings of teachers of the importance of certain elements and their presence in the plans we examined. We also suggest potentially productive areas of future enquiry.

Groundwater-quality data in the Western San Joaquin Valley study unit, 2010 - Results from the California GAMA Program

USGS Publications Warehouse

Mathany, Timothy M.; Landon, Matthew K.; Shelton, Jennifer L.; Belitz, Kenneth

2013-01-01

Groundwater quality in the approximately 2,170-square-mile Western San Joaquin Valley (WSJV) study unit was investigated by the U.S. Geological Survey (USGS) from March to July 2010, as part of the California State Water Resources Control Board (SWRCB) Groundwater Ambient Monitoring and Assessment (GAMA) Program's Priority Basin Project (PBP). The GAMA-PBP was developed in response to the California Groundwater Quality Monitoring Act of 2001 and is being conducted in collaboration with the SWRCB and Lawrence Livermore National Laboratory (LLNL). The WSJV study unit was the twenty-ninth study unit to be sampled as part of the GAMA-PBP. The GAMA Western San Joaquin Valley study was designed to provide a spatially unbiased assessment of untreated-groundwater quality in the primary aquifer system, and to facilitate statistically consistent comparisons of untreated groundwater quality throughout California. The primary aquifer system is defined as parts of aquifers corresponding to the perforation intervals of wells listed in the California Department of Public Health (CDPH) database for the WSJV study unit. Groundwater quality in the primary aquifer system may differ from the quality in the shallower or deeper water-bearing zones; shallow groundwater may be more vulnerable to surficial contamination. In the WSJV study unit, groundwater samples were collected from 58 wells in 2 study areas (Delta-Mendota subbasin and Westside subbasin) in Stanislaus, Merced, Madera, Fresno, and Kings Counties. Thirty-nine of the wells were selected by using a spatially distributed, randomized grid-based method to provide statistical representation of the study unit (grid wells), and 19 wells were selected to aid in the understanding of aquifer-system flow and related groundwater-quality issues (understanding wells). The groundwater samples were analyzed for organic constituents (volatile organic compounds [VOCs], low-level fumigants, and pesticides and pesticide degradates), constituents of special interest (perchlorate, N-nitrosodimethylamine [NDMA], and 1,2,3-trichloropropane [1,2,3-TCP]), and naturally occurring inorganic constituents (trace elements, nutrients, dissolved organic carbon [DOC], major and minor ions, silica, total dissolved solids [TDS], alkalinity, total arsenic and iron [unfiltered] and arsenic, chromium, and iron species [filtered]). Isotopic tracers (stable isotopes of hydrogen, oxygen, and boron in water, stable isotopes of nitrogen and oxygen in dissolved nitrate, stable isotopes of sulfur in dissolved sulfate, isotopic ratios of strontium in water, stable isotopes of carbon in dissolved inorganic carbon, activities of tritium, and carbon-14 abundance), dissolved standard gases (methane, carbon dioxide, nitrogen, oxygen, and argon), and dissolved noble gases (argon, helium-4, krypton, neon, and xenon) were measured to help identify sources and ages of sampled groundwater. In total, 245 constituents and 8 water-quality indicators were measured. Quality-control samples (blanks, replicates, or matrix spikes) were collected at 16 percent of the wells in the WSJV study unit, and the results for these samples were used to evaluate the quality of the data from the groundwater samples. Blanks rarely contained detectable concentrations of any constituent, suggesting that contamination from sample collection procedures was not a significant source of bias in the data for the groundwater samples. Replicate samples all were within acceptable limits of variability. Matrix-spike recoveries were within the acceptable range (70 to 130 percent) for approximately 87 percent of the compounds. This study did not evaluate the quality of water delivered to consumers. After withdrawal, groundwater typically is treated, disinfected, and (or) blended with other waters to maintain water quality. Regulatory benchmarks apply to water that is delivered to the consumer, not to untreated groundwater. However, to provide some context for the results, concentrations of constituents measured in the untreated groundwater were compared with regulatory and non-regulatory health-based benchmarks established by the U.S. Environmental Protection Agency (USEPA) and CDPH, and to non-regulatory benchmarks established for aesthetic concerns by CDPH. Comparisons between data collected for this study and benchmarks for drinking water are for illustrative purposes only and are not indicative of compliance or non-compliance with those benchmarks. Most inorganic constituents detected in groundwater samples from the 39 grid wells were detected at concentrations less than health-based benchmarks. Detections of organic and special-interest constituents from grid wells sampled in the WSJV study unit also were less than health-based benchmarks. In total, VOCs were detected in 12 of the 39 grid wells sampled (approximately 31 percent), pesticides and pesticide degradates were detected in 9 grid wells (approximately 23 percent), and perchlorate was detected in 15 grid wells (approximately 38 percent). Trace elements, major and minor ions, and nutrients were sampled for at 39 grid wells; most concentrations were less than health-based benchmarks. Exceptions include two detections of arsenic greater than the USEPA maximum contaminant level (MCL-US) of 10 micrograms per liter (μg/L), 20 detections of boron greater than the CDPH notification level (NL-CA) of 1,000 μg/L, 2 detections of molybdenum greater than the USEPA lifetime health advisory level (HAL-US) of 40 μg/L, 1 detection of selenium greater than the MCL-US of 50 μg/L, 2 detections of strontium greater than the HAL-US of 4,000 μg/L, and 3 detections of nitrate greater than the MCL-US of 10 μg/L. Results for inorganic constituents with non-health-based benchmarks (iron, manganese, chloride, sulfate, and TDS) showed that iron concentrations greater than the CDPH secondary maximum contaminant level (SMCL-CA) of 300 μg/L were detected in five grid wells. Manganese concentrations greater than the SMCL-CA of 50 μg/L were detected in 16 grid wells. Chloride concentrations greater than the recommended SMCL-CA benchmark of 250 milligrams per liter (mg/L) were detected in 14 grid wells, and concentrations in 5 of these wells also were greater than the upper SMCL-CA benchmark of 500 mg/L. Sulfate concentrations greater than the recommended SMCL-CA benchmark of 250 mg/L were measured in 21 grid wells, and concentrations in 13 of these wells also were greater than the SMCL-CA upper benchmark of 500 mg/L. TDS concentrations greater than the SMCL-CA recommended benchmark of 500 mg/L were measured in 36 grid wells, and concentrations in 20 of these wells also were greater than the SMCL-CA upper benchmark of 1,000 mg/L.

Direct detection of Mycobacterium avium in environmental water and scale samples by loop-mediated isothermal amplification.

PubMed

Nishiuchi, Yukiko; Tamaru, Aki; Suzuki, Yasuhiko; Kitada, Seigo; Maekura, Ryoji; Tateishi, Yoshitaka; Niki, Mamiko; Ogura, Hisashi; Matsumoto, Sohkichi

2014-06-01

We previously demonstrated the colonization of Mycobacterium avium complex in bathrooms by the conventional culture method. In the present study, we aimed to directly detect M. avium organisms in the environment using loop-mediated isothermal amplification (LAMP), and to demonstrate the efficacy of LAMP by comparing the results with those obtained by culture. Our data showed that LAMP analysis has detection limits of 100 fg DNA/reaction for M. avium. Using an FTA(®) elute card, DNA templates were extracted from environmental samples from bathrooms in the residences of 29 patients with pulmonary M. avium disease. Of the 162 environmental samples examined, 143 (88%) showed identical results by both methods; 20 (12%) and 123 (76%) samples were positive and negative, respectively, for M. avium. Of the remaining 19 samples (12%), seven (5%) and 12 (7%) samples were positive by the LAMP and culture methods, respectively. All samples that contained over 20 colony forming units/primary isolation plate, as measured by the culture method, were also positive by the LAMP method. Our data demonstrate that the combination of the FTA elute card and LAMP can facilitate prompt detection of M. avium in the environment.

A comparison of sample unit designs in the national inventory of the U.S.

Treesearch

B. E. Borders; G. H. Brister; N. Grahl; B. D. Shiver; C. J. Cieszewski

2000-01-01

The Forest Inventory and Analysis (FIA) program of the USDA Forest Service has adopted a new sampling unit for the national forest inventory of the U.S. We compared this new sampling unit with five other sampling units. Data from natural loblolly pine (Pinus taeda L.) stands in the Georgia piedmont show that all sample units produce reasonable...

Evaluation of dairy powder products implicates thermophilic sporeformers as the primary organisms of interest.

PubMed

Watterson, M J; Kent, D J; Boor, K J; Wiedmann, M; Martin, N H

2014-01-01

Dairy powder products (e.g., sweet whey, nonfat dry milk, acid whey, and whey protein concentrate-80) are of economic interest to the dairy industry. According to the US Dairy Export Council, customers have set strict tolerances (<500 to <1,000/g) for thermophilic and mesophilic spores in dairy powders; therefore, understanding proliferation and survival of sporeforming organisms within dairy powder processing plants is necessary to control and reduce sporeformer counts. Raw, work-in-process, and finished product samples were collected from 4 dairy powder processing facilities in the northeastern United States over a 1-yr period. Two separate spore treatments: (1) 80°C for 12min (to detect sporeformers) and (2) 100°C for 30min (to detect highly heat resistant sporeformers) were applied to samples before microbiological analyses. Raw material, work-in-process, and finished product samples were analyzed for thermophilic, mesophilic, and psychrotolerant sporeformers, with 77.5, 71.0, and 4.6% of samples being positive for those organisms, respectively. Work-in-process and finished product samples were also analyzed for highly heat resistant thermophilic and mesophilic sporeformers, with 63.7 and 42.6% of samples being positive, respectively. Sporeformer prevalence and counts varied considerably by product and plant; sweet whey and nonfat dry milk showed a higher prevalence of thermophilic and mesophilic sporeformers compared with acid whey and whey protein concentrate-80. Unlike previous reports, we found limited evidence for increased spore counts toward the end of processing runs. Our data provide important insight into spore contamination patterns associated with production of different types of dairy powders and support that thermophilic sporeformers are the primary organism of concern in dairy powders. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Quasi-elastic light scattering: Signal storage, correlation, and spectrum analysis under control of an 8-bit microprocessor

NASA Astrophysics Data System (ADS)

Glatter, Otto; Fuchs, Heribert; Jorde, Christian; Eigner, Wolf-Dieter

1987-03-01

The microprocessor of an 8-bit PC system is used as a central control unit for the acquisition and evaluation of data from quasi-elastic light scattering experiments. Data are sampled with a width of 8 bits under control of the CPU. This limits the minimum sample time to 20 μs. Shorter sample times would need a direct memory access channel. The 8-bit CPU can address a 64-kbyte RAM without additional paging. Up to 49 000 sample points can be measured without interruption. After storage, a correlation function or a power spectrum can be calculated from such a primary data set. Furthermore access is provided to the primary data for stability control, statistical tests, and for comparison of different evaluation methods for the same experiment. A detailed analysis of the signal (histogram) and of the effect of overflows is possible and shows that the number of pulses but not the number of overflows determines the error in the result. The correlation function can be computed with reasonable accuracy from data with a mean pulse rate greater than one, the power spectrum needs a three times higher pulse rate for convergence. The statistical accuracy of the results from 49 000 sample points is of the order of a few percent. Additional averages are necessary to improve their quality. The hardware extensions for the PC system are inexpensive. The main disadvantage of the present system is the high minimum sampling time of 20 μs and the fact that the correlogram or the power spectrum cannot be computed on-line as it can be done with hardware correlators or spectrum analyzers. These shortcomings and the storage size restrictions can be removed with a faster 16/32-bit CPU.

78 FR 3030 - Novartis Pharmaceuticals Corporation, Primary Care Business Unit (Sales) Division, East Operating...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-15

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-80,490] Novartis Pharmaceuticals... Healthcare, and Pro Unlimited, East Hanover, NJ and Off-Site Workers of Novartis Pharmaceuticals Corporation..., applicable to workers of Novartis Pharmaceuticals Corporation, Primary Care Business Unit (Sales) Division...

50 CFR 14.151 - Primary enclosures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR TAKING... Wild Mammals and Birds to the United States Specifications for Sloths, Bats, and Flying Lemurs... located on the upper one-half of the primary enclosure. (b) No more than one sloth, bat, or flying lemur...

Plaque bacterial microbiome diversity in children younger than 30 months with or without caries prior to eruption of second primary molars.

PubMed

Xu, He; Hao, Wenjing; Zhou, Qiong; Wang, Wenhong; Xia, Zhongkui; Liu, Chuan; Chen, Xiaochi; Qin, Man; Chen, Feng

2014-01-01

Our primary objective is to phylogenetically characterize the supragingival plaque bacterial microbiome of children prior to eruption of second primary molars by pyrosequencing method for studying etiology of early childhood caries. Supragingival plaque samples were collected from 10 caries children and 9 caries-free children. Plaque DNA was extracted, used to generate DNA amplicons of the V1-V3 hypervariable region of the bacterial 16S rRNA gene, and subjected to 454-pyrosequencing. On average, over 22,000 sequences per sample were generated. High bacterial diversity was noted in the plaque of children with caries [170 operational taxonomical units (OTU) at 3% divergence] and caries-free children (201 OTU at 3% divergence) with no significant difference. A total of 8 phyla, 15 classes, 21 orders, 30 families, 41 genera and 99 species were represented. In addition, five predominant phyla (Firmicute, Fusobacteria, Proteobacteria, Bacteroidetes and Actinobacteria) and seven genera (Leptotrichia, Streptococcus, Actinomyces, Prevotella, Porphyromonas, Neisseria, and Veillonella) constituted a majority of contents of the total microbiota, independent of the presence or absence of caries. Principal Component Analysis (PCA) presented that caries-related genera included Streptococcus and Veillonella; while Leptotrichia, Selenomonas, Fusobacterium, Capnocytophaga and Porphyromonas were more related to the caries-free samples. Neisseria and Prevotella presented approximately in between. In both groups, the degree of shared organism lineages (as defined by species-level OTUs) among individual supragingival plaque microbiomes was minimal. Our study represented for the first time using pyrosequencing to elucidate and monitor supragingival plaque bacterial diversity at such young age with second primary molar unerrupted. Distinctions were revealed between caries and caries-free microbiomes in terms of microbial community structure. We observed differences in abundance for several microbial groups between the caries and caries-free host populations, which were consistent with the ecological plaque hypothesis. Our approach and findings could be extended to correlating microbiomic changes after occlusion establishment and caries treatment.

The use of forensic botany and geology in war crimes investigations in NE Bosnia.

PubMed

Brown, A G

2006-11-22

From 1997 to 2002 the United Nations International Criminal Tribune for the former Yugoslavia (ICTY) undertook the exhumation of mass graves in NE Bosnia as part of the war crimes investigations aimed at providing evidence for the prosecution of war criminals in The Hague. This involved the location and exhumation of seven former mass graves (primary sites) dug following the fall of Srebrenica in July 1995. These primary mass graves were secretly and hurriedly exhumed three months later and most of the bodies or body parts transported and reburied in a large number of secondary sites many of which were subsequently exhumed by ICTY. The aim of the pollen and soil/sediment studies was to provide an 'environmental profile' of the original site of the samples and use this to match the relocated bodies to the original mass graves. This was part of completing the chain of evidence, providing evidence of the scale and organization of the original atrocities and the subsequent attempts to conceal the evidence related to them. All the primary sites were located in areas of contrasting geology, soils and vegetation, and this allowed matching of the sediment transported in intimate contact with the bodies to the original burial sites, which in some cases were also the execution sites. In all, over 24 sites were investigated, over 240 samples collected and analyzed under low power microscopy and 65 pollen sub-samples fully analyzed. The pollen and sediment descriptions were used in conjunction with the mineralogy (using XRD) of primary and secondary sites in order to provide matches. These matches were then compared with matching evidence from ballistic studies and clothing. The evidence has been used in court and is now in the public domain. It is believed this is the first time 'environmental profiling' techniques have been used in a systematic manner in a war crimes investigation.

Treatment of primary and secondary syphilis. Serological response.

PubMed

Fiumara, N J

1980-06-27

One hundred thirty-eight patients with primary syphillis and 161 patients with secondary syphilis were treated with penicillin G benzathine, 2.4 million units given intramuscularly weekly for two weeks, for a total of 4.8 million units. All 138 patients with primary syphilis had a rapid resolution of their lesions, and all became seronegative within one year. Similarly, the 161 patients with secondary syphilis were cured clinically, and all achieved seronegativity within 24 months.

An Analysis of Modeling Success in Explosive Ordnance Disposal Training

DTIC Science & Technology

2010-03-01

Iraq due to makeshift roadside bombs (Hagey, 2007). EOD units are the primary assets to respond to IED threats. In 2006 alone, the total number of...increase from 2007. One year later, IED attacks increased a further 146 percent (Brook, 2009). As the primary asset to respond to an IED threat, EOD...threats and help protect his units. EOD technicians support the battlefield commander by addressing the primary threats to the coalition forces

Development and validation of a simple questionnaire for the identification of hereditary breast cancer in primary care

PubMed Central

2009-01-01

Background Breast cancer is a significant public health problem worldwide and the development of tools to identify individuals at-risk for hereditary breast cancer syndromes, where specific interventions can be proposed to reduce risk, has become increasingly relevant. A previous study in Southern Brazil has shown that a family history suggestive of these syndromes may be prevalent at the primary care level. Development of a simple and sensitive instrument, easily applicable in primary care units, would be particularly helpful in underserved communities in which identification and referral of high-risk individuals is difficult. Methods A simple 7-question instrument about family history of breast, ovarian and colorectal cancer, FHS-7, was developed to screen for individuals with an increased risk for hereditary breast cancer syndromes. FHS-7 was applied to 9218 women during routine visits to primary care units in Southern Brazil. Two consecutive samples of 885 women and 910 women who answered positively to at least one question and negatively to all questions were included, respectively. The sensitivity, specificity and positive and negative predictive values were determined. Results Of the 885 women reporting a positive family history, 211 (23.8%; CI95%: 21.5–26.2) had a pedigree suggestive of a hereditary breast and/or breast and colorectal cancer syndrome. Using as cut point one positive answer, the sensitivity and specificity of the instrument were 87.6% and 56.4%, respectively. Concordance between answers in two different applications was given by a intra-class correlation (ICC) of 0.84 for at least one positive answer. Temporal stability of the instrument was adequate (ICC = 0.65). Conclusion A simple instrument for the identification of the most common hereditary breast cancer syndrome phenotypes, showing good specificity and temporal stability was developed and could be used as a screening tool in primary care to refer at-risk individuals for genetic evaluations. PMID:19682358

Metagabbro associated with the shear zone on Prins Karls Forland (Svalbard, Arctic)

NASA Astrophysics Data System (ADS)

Maraszewska, Maria; Manecki, Maciej; Czerny, Jerzy; Schneider, David; Myhre, Per Inge; Faehnrich, Karol; Barnes, Christopher

2016-04-01

Prins Karls Forland (PKF) is a N-S elongated island situated west of Spitsbergen in the Svalbard archipelago, High Arctic. The northern part of the island is dominated by siliciclastic metasediments regionally metamorphosed to greenshist facies assemblages during one distinct stage of tectonism. Amphibolite facies garnet-mica schists, mica schists, quartzites and carbonate-silicate rocks exhibiting evidence of at least two distinct, strong deformation episodes (including mylonitization) locally outcrop on the east coast of PKF, termed the Pinkie Unit. A ~1 km wide shear zone containing ductile to brittle structures and distinct outcrops of greenstones (metagabbros and greenschists), associated with magnetite ore, separates these two contrasting tectonic units. Ten samples of greenstones were collected on the slopes of Lauratzonfjellet and Boureefjellet for petrologic and geochemical analyses. Despite intense localized shearing, the metagabbros are undeformed and preserve coarse crystalline, magmatic texture, which is locally poikilitic. The primary magmatic assemblage consists of brown hornblende, plagioclase, biotite and opaque minerals, with accessory apatite and titanite. No relicts of pyroxenes are preserved. Formation of secondary uralite, sericite and chlorite is observed. Metamorphic assemblage consists of actinolite pseudomorhs after hornblende, epidote, and second generation biotite. Blue amphibole is observed in one sample from Boureefjellet; greenschists from Boureefjellet also contain fibrous blue amphibole, as well as garnets, actinolite, epidote and biotite. Some rocks sampled on Boureefjellet are more strongly deformed and exhibit probably two stages of metamorphism: amphibolite facies metamorphism resulting in blue amphibole-garnet assemblage followed by greenschist facies metamorphism resulting in actinolite-epidote-biotite paragenesis. Parallel and overlapping patterns on chondrite-normalized REE diagrams and spider diagrams indicate that these metagabbros are comagmatic. Enrichment in incompatible lighter elements and position of projections on discrimination diagrams suggest ocean island basalt (OIB) character of primary magmas. The age of these rocks is unknown and is an objective of ongoing investigation. This work is partially funded by AGH research grant no 11.11.140.319.

Accuracy or precision: Implications of sample design and methodology on abundance estimation

USGS Publications Warehouse

Kowalewski, Lucas K.; Chizinski, Christopher J.; Powell, Larkin A.; Pope, Kevin L.; Pegg, Mark A.

2015-01-01

Sampling by spatially replicated counts (point-count) is an increasingly popular method of estimating population size of organisms. Challenges exist when sampling by point-count method, and it is often impractical to sample entire area of interest and impossible to detect every individual present. Ecologists encounter logistical limitations that force them to sample either few large-sample units or many small sample-units, introducing biases to sample counts. We generated a computer environment and simulated sampling scenarios to test the role of number of samples, sample unit area, number of organisms, and distribution of organisms in the estimation of population sizes using N-mixture models. Many sample units of small area provided estimates that were consistently closer to true abundance than sample scenarios with few sample units of large area. However, sample scenarios with few sample units of large area provided more precise abundance estimates than abundance estimates derived from sample scenarios with many sample units of small area. It is important to consider accuracy and precision of abundance estimates during the sample design process with study goals and objectives fully recognized, although and with consequence, consideration of accuracy and precision of abundance estimates is often an afterthought that occurs during the data analysis process.

Compositional variation within thick (>10 m) flow units of Mauna Kea Volcano cored by the Hawaii Scientific Drilling Project

NASA Astrophysics Data System (ADS)

Huang, Shichun; Vollinger, Michael J.; Frey, Frederick A.; Rhodes, J. Michael; Zhang, Qun

2016-07-01

Geochemical analyses of stratigraphic sequences of lava flows are necessary to understand how a volcano works. Typically one sample from each lava flow is collected and studied with the assumption that this sample is representative of the flow composition. This assumption may not be valid. The thickness of flows ranges from <1 to >100 m. Geochemical heterogeneity in thin flows may be created by interaction with the surficial environment whereas magmatic processes occurring during emplacement may create geochemical heterogeneities in thick flows. The Hawaii Scientific Drilling Project (HSDP) cored ∼3.3 km of basalt erupted at Mauna Kea Volcano. In order to determine geochemical heterogeneities in a flow, multiple samples from four thick (9.3-98.4 m) HSDP flow units were analyzed for major and trace elements. We found that major element abundances in three submarine flow units are controlled by the varying proportion of olivine, the primary phenocryst phase in these samples. Post-magmatic alteration of a subaerial flow led to loss of SiO2, CaO, Na2O, K2O and P2O5, and as a consequence, contents of immobile elements, such as Fe2O3 and Al2O3, increase. The mobility of SiO2 is important because Mauma Kea shield lavas divide into two groups that differ in SiO2 content. Post-magmatic mobility of SiO2 adds complexity to determining if these groups reflect differences in source or process. The most mobile elements during post-magmatic subaerial and submarine alteration are K and Rb, and Ba, Sr and U were also mobile, but their abundances are not highly correlated with K and Rb. The Ba/Th ratio has been used to document an important role for a plagioclase-rich source component for basalt from the Galapagos, Iceland and Hawaii. Although Ba/Th is anomalously high in Hawaiian basalt, variation in Ba abundance within a single flow shows that it is not a reliable indicator of a deep source component. In contrast, ratios involving elements that are typically immobile, such as La/Nb, La/Th, Nb/Th, Ce/Pb, Sr/Nd, La/Sm, Sm/Yb, Nb/Zr, Nb/Y and La/Yb, are uniform within the units, and they can be used to constrain petrogenetic processes. Nevertheless all elements are mobile under some conditions. For example, a surprising result is that relative to other samples, the uppermost sample collected from subaerial flow Unit 70, less than 1 m below the flow surface, is depleted in P, HREE and Y relative to all other samples from this flow unit. This result is complementary to the P, REE and Y enrichment found in subaerial lava flows from several Hawaiian shields, e.g., Kahoolawe and Koolau Volcanoes. These enrichments require mobilization of REE and followed by deposition a P-rich mineral.

Effect of turbidity on chlorination efficiency and bacterial persistence in drinking water.

PubMed Central

LeChevallier, M W; Evans, T M; Seidler, R J

1981-01-01

To define interrelationships between elevated turbidities and the efficiency of chlorination in drinking water, experiments were performed to measure bacterial survival, chlorine demand, and interference with microbiological determinations. Experiments were conducted on the surface water supplies for communities which practice chlorination as the only treatment. Therefore, the conclusions of this study apply only to such systems. Results indicated that disinfection efficiency (log10 of the decrease in coliform numbers) was negatively correlated with turbidity and was influenced by season, chlorine demand of the samples, and the initial coliform level. Total organic carbon was found to be associated with turbidity and was shown to interfere with maintenance of a free chlorine residual by creating a chlorine demand. Interference with coliform detection in turbid waters could be demonstrated by the recovery of typical coliforms from apparently negative filters. The incidence of coliform masking in the membrane filter technique was found to increase as the turbidity of the chlorinated samples increased. the magnitude of coliform masking in the membrane filter technique increased from less than 1 coliform per 100 ml in water samples of less than 5 nephelometric turbidity units to greater than 1 coliform per 100 ml in water samples of greater than 5 nephelometric turbidity units. Statistical models were developed to predict the impact of turbidity on drinking water quality. The results justify maximum contaminant levels for turbidity in water entering a distribution system as stated in the National Primary Drinking Water Regulations of the Safe Drinking Water Act. Images PMID:7259162

Wilson and the United States Entry into the Great War.

ERIC Educational Resources Information Center

Stark, Matthew J.

2002-01-01

Presents a lesson plan that enables students to learn how to analyze primary sources, while they also learn why the United States entered into World War I. States that this lesson can be used as an introduction to World War I. Includes handouts that feature primary materials. (CMK)

SAFETY GUIDES FOR YOU--IN THE PRIMARY GRADES.

ERIC Educational Resources Information Center

WALKER, LUVERNE CRABTREE

THIS SAFETY INSTRUCTIONAL GUIDE FOR PRIMARY-GRADE TEACHERS PRESENTS NINE DIFFERENT SAFETY UNITS, INCLUDING TRAFFIC SAFETY, PLAYTIME SAFETY, SAFE EATING AND DRINKING HABITS, SAFE CLOTHING, HOME SAFETY, ANIMAL SAFETY, CIVIL DEFENSE SECURITY, AND TESTING SAFETY PRACTICES. EACH UNIT STRESSES THE REASONS FOR ACCENTING SAFETY, WHAT TO KNOW AND DO, AND…

The Early Growth and Development Study: a prospective adoption study from birth through middle childhood.

PubMed

Leve, Leslie D; Neiderhiser, Jenae M; Shaw, Daniel S; Ganiban, Jody; Natsuaki, Misaki N; Reiss, David

2013-02-01

The Early Growth and Development Study is a prospective adoption study of birth parents, adoptive parents, and adopted children recruited in two cohorts (N = 561 triads). The primary study aims are to examine how family, peer, and contextual processes affect children's adjustment, and to examine their interplay (mediation, moderation) with genetic influences. Participants were recruited through adoption agencies located throughout the United States following the birth of a child. Assessments are ongoing, in 9-month intervals until the child reaches 3 years of age and in 1-year intervals thereafter through age 9. Data collection includes the following primary constructs: child temperament, social behavior, school performance, mental health, and health; birth and adoptive parent personality characteristics, mental health, competence, stress, health, context, substance use, parenting, and marital relations; and pregnancy use of drugs and maternal stress during pregnancy. DNA and salivary cortisol samples have also been collected. Analyses have indicated evidence for genotype-environment interactions during early childhood. Study procedures, sample representativeness (including tests of potential confounds in the adoption design), and an overview of findings to date are summarized, and future plans are described.

The Early Growth and Development Study: A Prospective Adoption Study from Birth Through Middle Childhood

PubMed Central

Leve, Leslie D.; Neiderhiser, Jenae M.; Shaw, Daniel S.; Ganiban, Jody; Natsuaki, Misaki N.; Reiss, David

2013-01-01

The Early Growth and Development Study is a prospective adoption study of birth parents, adoptive parents, and adopted children recruited in two cohorts (N = 561 triads). The primary study aims are to examine how family, peer, and contextual processes affect children’s adjustment, and to examine their interplay (mediation, moderation) with genetic influences. Participants were recruited through adoption agencies located throughout the United States following the birth of a child. Assessments are ongoing, in 9-month intervals until the child reaches 3 years of age and in one-year intervals thereafter through age 9. Data collection includes the following primary constructs: child temperament, social behavior, school performance, mental health, and health; birth and adoptive parent personality characteristics, mental health, competence, stress, health, context, substance use, parenting, and marital relations; and pregnancy use of drugs and maternal stress during pregnancy. DNA and salivary cortisol samples have also been collected. Analyses have indicated evidence for genotype-environment interactions during early childhood. Study procedures, sample representativeness (including tests of potential confounds in the adoption design), and an overview of findings to date are summarized, and future plans are described. PMID:23218244

Contraceptive counseling among pediatric primary care providers in Western Pennsylvania: A survey-based study.

PubMed

Papas, Beth Ann; Shaikh, Nader; Watson, Katherine; Sucato, Gina S

2017-01-01

Data suggest that adolescents in the United States receive inadequate contraceptive counseling. This study sought to determine factors affecting pediatricians' discussion of contraception with adolescent patients, with a specific focus on long-acting reversible contraception-implantable contraception and intrauterine devices. A cross-sectional survey was sent via email to a convenience sample of pediatric residents and pediatric primary care providers in Western Pennsylvania. Self-reported contraceptive counseling and prescribing practices in response to clinical vignettes were assessed. Of potential participants (287), 88 (31%) responded. Younger providers and providers who had received contraceptive training were significantly more likely to discuss long-acting reversible contraception methods. Discussion of contraceptive methods also varied by both the age and the sexual history of the patient. Variation in contraceptive counseling potentially results in missed opportunities to counsel about and provide the most effective contraceptive methods. More uniform, universal provider training might alleviate some of these inconsistencies.

Global dynamics of selective attention and its lapses in primary auditory cortex.

PubMed

Lakatos, Peter; Barczak, Annamaria; Neymotin, Samuel A; McGinnis, Tammy; Ross, Deborah; Javitt, Daniel C; O'Connell, Monica Noelle

2016-12-01

Previous research demonstrated that while selectively attending to relevant aspects of the external world, the brain extracts pertinent information by aligning its neuronal oscillations to key time points of stimuli or their sampling by sensory organs. This alignment mechanism is termed oscillatory entrainment. We investigated the global, long-timescale dynamics of this mechanism in the primary auditory cortex of nonhuman primates, and hypothesized that lapses of entrainment would correspond to lapses of attention. By examining electrophysiological and behavioral measures, we observed that besides the lack of entrainment by external stimuli, attentional lapses were also characterized by high-amplitude alpha oscillations, with alpha frequency structuring of neuronal ensemble and single-unit operations. Entrainment and alpha-oscillation-dominated periods were strongly anticorrelated and fluctuated rhythmically at an ultra-slow rate. Our results indicate that these two distinct brain states represent externally versus internally oriented computational resources engaged by large-scale task-positive and task-negative functional networks.

Associations between child disabilities and caregiver discipline and violence in low- and middle-income countries.

PubMed

Hendricks, Charlene; Lansford, Jennifer E; Deater-Deckard, Kirby; Bornstein, Marc H

2014-01-01

Using nationally representative samples of 45,964 two- to nine-year-old children and their primary caregivers in 17 developing countries, this study examined the relations between children's cognitive, language, sensory, and motor disabilities and caregivers' use of discipline and violence. Primary caregivers reported on their child's disabilities and whether they or anyone in their household had used nonviolent discipline, psychological aggression, and physical violence toward the target child and believed that using corporal punishment is necessary. Logistic regression analyses supported the hypothesis that children with disabilities are treated more harshly than children without disabilities. The findings suggest that policies and interventions are needed to work toward the United Nations' goals of ensuring that children with disabilities are protected from abuse and violence. © 2013 The Authors. Child Development © 2013 Society for Research in Child Development, Inc.

Lessons from the polybrominated diphenyl ethers (PBDEs): precautionary principle, primary prevention, and the value of community-based body-burden monitoring using breast milk.

PubMed

Hooper, Kim; She, Jianwen

2003-01-01

Levels of chemicals in humans (body burdens) are useful indicators of environmental quality and of community health. Chemical body burdens are easily monitored using breast milk samples collected from first-time mothers (primiparae) with infants 2-8 weeks of age. Currently, there is no body-burden monitoring program using breast milk in the United States, although ad hoc systems operate successfully in several European countries. In this article we describe the value of such monitoring and important considerations of how it might be accomplished, drawing from our experiences with pilot monitoring projects. Breast milk has several advantages as a sampling matrix: It is simple and noninvasive, with samples collected by the mother. It monitors body burdens in reproductive-age women and it estimates in utero and nursing-infant exposures, all important to community health. Time-trend data from breast milk monitoring serve as a warning system that identifies chemicals whose body burdens and human exposures are increasing. Time trends also serve as a report card on how well past regulatory actions have reduced environmental chemical exposures. Body-burden monitoring using breast milk should include educational programs that encourage breast-feeding. Finally, and most important, clean breast milk matters to people and leads to primary prevention--the limiting of chemical exposures. We illustrate these advantages with polybrominated diphenyl ethers (PBDEs), a formerly obscure group of brominated flame retardants that rose to prominence and were regulated in Sweden when residue levels were found to be rapidly increasing in breast milk. A community-based body-burden monitoring program using breast milk could be set up in the United States in collaboration with the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). WIC has a large number of lactating first-time mothers: It has 6,000 clinics nationwide and serves almost half (47%) the infants born in the United States. Educational programs (e.g., those run by WIC) are needed that encourage breast-feeding, especially in lower-income communities where breast-feeding rates are low and where breast-feeding may help protect the infant from the effects of environmental chemical exposures. Education is also needed about reducing chemical body burdens. A body-burden monitoring program would provide valuable data on time trends, background levels, and community hot spots in need of mitigation and follow-up health studies; develop analytic methods for new chemicals of concern; and archive breast milk samples for future analyses of other agents.

Status of groundwater quality in the Santa Barbara Study Unit, 2011: California GAMA Priority Basin Project

USGS Publications Warehouse

Davis, Tracy A.; Kulongoski, Justin T.

2016-10-03

Groundwater quality in the 48-square-mile Santa Barbara study unit was investigated in 2011 as part of the California State Water Resources Control Board’s Groundwater Ambient Monitoring and Assessment (GAMA) Program Priority Basin Project. The study unit is mostly in Santa Barbara County and is in the Transverse and Selected Peninsular Ranges hydrogeologic province. The GAMA Priority Basin Project is carried out by the U.S. Geological Survey in collaboration with the California State Water Resources Control Board and Lawrence Livermore National Laboratory.The GAMA Priority Basin Project was designed to provide a statistically unbiased, spatially distributed assessment of the quality of untreated groundwater in the primary aquifer system of California. The primary aquifer system is defined as that part of the aquifer corresponding to the perforation interval of wells listed in the California Department of Public Health database for the Santa Barbara study unit. This status assessment is intended to characterize the quality of groundwater resources in the primary aquifer system of the Santa Barbara study unit, not the treated drinking water delivered to consumers by water purveyors.The status assessment for the Santa Barbara study unit was based on water-quality and ancillary data collected in 2011 by the U.S. Geological Survey from 23 sites and on water-quality data from the California Department of Public Health database for January 24, 2008–January 23, 2011. The data used for the assessment included volatile organic compounds; pesticides; pharmaceutical compounds; two constituents of special interest, perchlorate and N-nitrosodimethylamine (NDMA); and naturally present inorganic constituents, such as major ions and trace elements. Relative-concentrations (sample concentration divided by the health- or aesthetic-based benchmark concentration) were used to evaluate groundwater quality for those constituents that have federal or California regulatory and non-regulatory benchmarks for drinking-water quality. For inorganic, organic, and special-interest constituents, a relative-concentration greater than 1.0 indicates a concentration greater than the benchmark and is classified as high. Inorganic constituents are classified as moderate if relative-concentrations are greater than 0.5 and less than or equal to 1.0 and are classified as low if relative-concentrations are less than or equal to 0.5. For organic and special-interest constituents, the boundary between moderate and low relative-concentrations was set at 0.1.Aquifer-scale proportion was used as the primary metric for evaluating regional-scale groundwater quality. High aquifer-scale proportion is defined as the areal percentage of the primary aquifer system with a relative-concentration greater than 1.0 for a particular constituent or class of constituents. Moderate and low aquifer-scale proportions were defined as the areal percentage of the primary aquifer system that had moderate and low relative-concentrations, respectively. Two statistical approaches—grid based and spatially weighted—were used to calculate aquifer-scale proportions for individual constituents and constituent classes. Grid-based and spatially weighted estimates were comparable in this the study (within 90-percent confidence intervals). Grid-based results were selected for use in the status assessment unless, as was observed in a few cases, a grid-based result was zero and the spatially weighted result was not zero, in which case, the spatially weighted result was used.Inorganic constituents that have human-health benchmarks were present at high relative-concentrations in 5.3 percent of the primary aquifer system and at moderate concentrations in 32 percent. High aquifer-scale proportions of inorganic constituents primarily were a result of high aquifer-scale proportions of boron (5.3 percent) and fluoride (5.3 percent). Inorganic constituents that have aesthetic-based benchmarks, referred to as secondary maximum contaminant levels, were present at high relative-concentrations in 58 percent of the primary aquifer system and at moderate concentrations in 37 percent. Iron, manganese, sulfate, and total dissolved solids were the inorganic constituents with secondary maximum contaminant levels present at high relative-concentrations.In contrast, organic and special-interest constituents that have health-based benchmarks were not detected at high relative-concentrations in the primary aquifer system. Of the 218 organic constituents analyzed, 10 were detected—9 that had human-health benchmarks. Organic constituents were present at moderate relative-concentrations in 11 percent of the primary aquifer system. The moderate aquifer-scale proportions were a result of moderate relative-concentrations of the volatile organic compounds methyl tert-butyl ether (MTBE, 11 percent) and 1,2-dichloroethane (5.6 percent). The volatile organic compounds 1,1,1-trichloroethane, 1,1-dichloroethane, bromodichloromethane, chloroform, MTBE, and perchloroethene (PCE); the pesticide simazine; and the special-interest constituent perchlorate were detected at more than 10 percent of the sites in the Santa Barbara study unit. Perchlorate was present at moderate relative-concentrations in 50 percent of the primary aquifer system. Pharmaceutical compounds and NDMA were not detected in the Santa Barbara study unit.

Whole Module Offgas Test Report: Space-X Dragon Module

NASA Technical Reports Server (NTRS)

James, John T.

2012-01-01

Between 7 April and 11 April 2012 a chemist from the JSC Toxicology Group acquired samples of air in 500 ml evacuated canisters from the sealed Dragon Module at the Space-X facility at KSC. Three samples were taken of facility air (two before the test and one after the test), and a total of 9 samples were taken from the sealed module in triplicate at the following times: 0 hours, 48 hours, and 96 hours. The module contained 470 kg, which was 100% of the mass to be launched. Analytical data contained in the Toxicology Group Report (attached) show that the ambient facility air was clean except for almost 9 milligrams per cubic meter of isopropanol (IPA) in the sample taken at the end of the test. Space-X must ensure that IPA is not introduced into the module before it is sealed for launch. Other minor contaminants in the ambient air included the following: perfluoro(2-methyl)pentane and hexamethylcyclotrisiloxane. The first-acquired samples of each triplicate from the module were not analyzed. Analyses of pairs of samples that were taken during the test show excellent agreement between the pairs and a linear increase in the T-values during the 4 days of the test (figure below). The rate of increase averaged 0.124 T units per day. If the time from last purge of the module on the ground to crew first entry on orbit is 10 days, then the T value at first entry should be less than 1.2 units, which is well below the criterion of 3.0 for consideration of additional protection of the crew from offgas products. The primary contributors were as follows: trimethylsilanol (0.057), fluorotrimethylsilane (0.047), acetaldehyde (0.004), hexamethylcyclopentasiloxane (0.003), and toluene (0.002).

Vitamin D Prescribing Practices in Primary Care Pediatrics: Underpinnings From the Health Belief Model and Use of Web-Based Delphi Technique for Instrument Validity.

PubMed

DelGiudice, Nancy J; Street, Nancy; Torchia, Ronald J; Sawyer, Susan S; Bernard, Sylvia Allison; Holick, Michael F

2018-05-24

Vitamin D deficiency and insufficiency is a pandemic problem in children and adolescents in the United States. The problem may be aggravated by the inconsistent implementation of current clinical practice guidelines for vitamin D management by pediatric primary care providers. This study examines the relationship between primary care providers' prescribing vitamin D to children ages 1 through 18 years and their practice actions and knowledge. A descriptive correlation design was used. Participants were recruited from a purposive sample of pediatricians and pediatric nurse practitioners through an online invitation to participate in a survey. Reliability and validity was established for the survey developed by the principal investigator using a web-based Delphi technique. Results from this study indicate that although most providers are aware that vitamin D insufficiency and deficiency are problems, fewer than half currently recommend 600- to 1,000-IU supplementation to their patients ages 1 through 18 years. Copyright © 2018 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Identification, Prevention, and Management of Childhood Overweight and Obesity in a Pediatric Primary Care Center.

PubMed

Reed, Monique; Cygan, Heide; Lui, Karen; Mullen, Mary

2016-08-01

Background In the United States, overweight/obesity among youth has reached epidemic proportions. The purpose of this project was to (1) examine primary care provider adherence to American Academy of Pediatrics guidelines; (2) compare adherence based on patients' weight classification, age, race, and gender; and (3) identify areas for improvement in health care delivery. Methods A retrospective chart audit and feedback quality improvement project was conducted with a stratified random sample of 175 charts of 6- to 19-year-olds seen for well-child visits. Frequencies of provider adherence were reported. χ(2) Analyses of weight classification, age, race, or gender influence on adherence was calculated. Results After discussion with the primary care providers, 5 areas were identified as priorities for change (diagnosis based on BMI, parental history of obesity, sleep assessment, endocrine assessment, and attendance of patients at the follow-up visit). Conclusion Cost-efficient, feasible strategies to improve provider adherence to recommendations for identification, prevention and management of childhood overweight and obesity were identified. © The Author(s) 2015.

Quadratic function between arterial partial oxygen pressure and mortality risk in sepsis patients: an interaction with simplified acute physiology score.

PubMed

Zhang, Zhongheng; Ji, Xuqing

2016-10-13

Oxygen therapy is widely used in emergency and critical care settings, while there is little evidence on its real therapeutic effect. The study aimed to explore the impact of arterial oxygen partial pressure (PaO 2 ) on clinical outcomes in patients with sepsis. A large clinical database was employed for the study. Subjects meeting the diagnostic criteria of sepsis were eligible for the study. All measurements of PaO 2 were extracted. The primary endpoint was death from any causes during hospital stay. Survey data analysis was performed by using individual ICU admission as the primary sampling unit. Quadratic function was assumed for PaO 2 and its interaction with other covariates were explored. A total of 199,125 PaO 2 samples were identified for 11,002 ICU admissions. Each ICU stay comprised 18 PaO 2 samples in average. The fitted multivariable model supported our hypothesis that the effect of PaO 2 on mortality risk was in quadratic form. There was significant interaction between PaO 2 and SAPS-I (p = 0.007). Furthermore, the main effect of PaO 2 on SOFA score was nonlinear. The study shows that the effect of PaO 2 on mortality risk is in quadratic function form, and there is significant interaction between PaO 2 and severity of illness.

Efficacy of chemomechanical caries removal in reducing cariogenic microbiota: a randomized clinical trial.

PubMed

Ammari, Michelle Mikhael; Moliterno, Luiz Flávio Martins; Hirata Júnior, Raphael; Séllos, Mariana Canano; Soviero, Vera Mendes; Coutinho Filho, Wagner Pereira

2014-01-01

The aim of this study was to compare the efficacy of chemochemical methods (Carisolv™ and Papacárie®) versus the manual method (excavators) in reducing the cariogenic microbiota in dentine caries of primary teeth. Forty-six healthy children (5 to 9 years old) having at least one primary tooth with a cavitated dentine carious lesion were included in the study. The teeth presented no clinical or radiographic signs of pulpal involvement. The sample of 74 teeth was randomly divided into three different groups: Papacárie® (n = 25), Carisolv™ (n = 27) and Manual (n = 22). Samples of carious and sound dentine were collected with sterile excavators before and after caries removal in the three groups. The dentine samples were transferred to glass tubes containing a 1mL thioglycollate medium used as a carrier and enriched for microbiological detection of mutans streptococci and Lactobacillus spp, after incubation for 6h at room temperature. The minimum detection value for colony forming units (CFU) was 3.3 x 102 CFU/ml, and the results were converted into scores from 0 to 4. A significant difference was observed in relation to the microbiological scores before and after caries removal for all methods (Wilcoxon test; p < 0.001). The use of chemomechanical methods for caries removal did not improve the reduction of cariogenic microorganisms in dentine caries lesions, in comparison with manual excavation.

Status and understanding of groundwater quality in the Tahoe-Martis, Central Sierra, and Southern Sierra study units, 2006-2007--California GAMA Priority Basin Project

USGS Publications Warehouse

Fram, Miranda S.; Belitz, Kenneth

2012-01-01

Groundwater quality in the Tahoe-Martis, Central Sierra, and Southern Sierra study units was investigated as part of the Priority Basin Project of the California Groundwater Ambient Monitoring and Assessment (GAMA) Program. The three study units are located in the Sierra Nevada region of California in parts of Nevada, Placer, El Dorado, Madera, Tulare, and Kern Counties. The GAMA Priority Basin Project is being conducted by the California State Water Resources Control Board, in collaboration with the U.S. Geological Survey (USGS) and the Lawrence Livermore National Laboratory. The project was designed to provide statistically robust assessments of untreated groundwater quality within the primary aquifer systems used for drinking water. The primary aquifer systems (hereinafter, primary aquifers) for each study unit are defined by the depth of the screened or open intervals of the wells listed in the California Department of Public Health (CDPH) database of wells used for municipal and community drinking-water supply. The quality of groundwater in shallower or deeper water-bearing zones may differ from that in the primary aquifers; shallower groundwater may be more vulnerable to contamination from the surface. The assessments for the Tahoe-Martis, Central Sierra, and Southern Sierra study units were based on water-quality and ancillary data collected by the USGS from 132 wells in the three study units during 2006 and 2007 and water-quality data reported in the CDPH database. Two types of assessments were made: (1) status, assessment of the current quality of the groundwater resource, and (2) understanding, identification of the natural and human factors affecting groundwater quality. The assessments characterize untreated groundwater quality, not the quality of treated drinking water delivered to consumers by water purveyors. Relative-concentrations (sample concentrations divided by benchmark concentrations) were used for evaluating groundwater quality for those constituents that have Federal or California regulatory or non-regulatory benchmarks for drinking-water quality. A relative-concentration (RC) greater than (>) 1.0 indicates a concentration above a benchmark. RCs for organic constituents (volatile organic compounds and pesticides) and special-interest constituents were classified as "high" (RC > 1.0), "moderate" (1.0 ≥ RC > 0.1), or "low" (RC ≤ 0.1). For inorganic constituents (major ions, trace elements, nutrients, and radioactive constituents), the boundary between low and moderate RCs was set at 0.5. A new metric, aquifer-scale proportion, was used in the status assessment as the primary metric for evaluating regional-scale groundwater quality. High aquifer-scale proportion is defined as the percentage of the area of the primary aquifers with RC > 1.0 for a particular constituent or class of constituents; moderate and low aquifer-scale proportions are defined as the percentages of the area of the primary aquifer with moderate and low RCs, respectively. Percentages are based on an areal rather than a volumetric basis. Two statistical approaches—grid-based, which used one value per grid cell, and spatially weighted, which used multiple values per grid cell—were used to calculate aquifer-scale proportions for individual constituents and classes of constituents. The spatially weighted estimates of high aquifer-scale proportions were within the 90-percent (%) confidence intervals of the grid-based estimates in all cases. The status assessment showed that inorganic constituents had greater high and moderate aquifer-scale proportions than did organic constituents in all three study units. In the Tahoe-Martis study unit, RCs for inorganic constituents with health-based benchmarks (primarily arsenic) were high in 20% of the primary aquifer, moderate in 13%, and low in 67%. In the Central Sierra study unit, aquifer-scale proportions for inorganic constituents with health-based benchmarks (primarily arsenic, uranium, fluoride, and molybdenum) were 41% high, 36% moderate, and 23% low. In the Southern Sierra study unit, 32, 34, and 34% of the primary aquifer had high, moderate, and low RCs of inorganic constituents with health-based benchmarks (primarily arsenic, uranium, fluoride, boron, and nitrate). The high aquifer-scale proportions for inorganic constituents with non-health-based benchmarks were 14, 34, and 24% for the Tahoe-Martis, Central Sierra, and Southern Sierra study units, respectively, and the primary constituent was manganese for all three study units. Organic constituents with health-based benchmarks were not present at high RCs in the primary aquifers of the Central Sierra and Southern Sierra study units, and were present at high RCs in only 1% of the Tahoe-Martis study unit. Moderate aquifer-scale proportions for organic constituents were 10%: the trihalomethane chloroform in the Tahoe-Martis study unit; chloroform and the herbicide simazine in the Central Sierra study unit; and chloroform, simazine, the herbicide atrazine, and the solvent perchloroethene in the Southern Sierra study unit. The second component of this study, the understanding assessment, identified the natural and human factors that may have affected groundwater quality in the three study units by evaluating statistical correlations between water-quality constituents and potential explanatory factors. The potential explanatory factors evaluated were land use, septic tank density, climate, relative position in the regional flow system, aquifer lithology, geographic location, well depth and depth to the top of the screened or open interval in the well, groundwater age distribution, pH, and dissolved oxygen concentration. Results of the statistical evaluations were used to explain the occurrence and distribution of constituents in the study units. Aquifer lithology (granitic, metamorphic, sedimentary, or volcanic rocks), groundwater age distribution [modern (recharged since 1952), pre-modern (recharged before 1952), or mixed (containing both modern and pre-modern recharge)], geographic location, pH, and dissolved oxygen were the most significant factors explaining the occurrence patterns of most inorganic constituents. High and moderate RCs of arsenic were associated with pre-modern and mixed-age groundwater and two distinct sets of geochemical conditions: (1) oxic, high-pH conditions, particularly in volcanic rocks, and (2) low-oxygen to anoxic conditions and low- to neutral-pH conditions, particularly in granitic rocks. In granitic and metamorphic rocks, high and moderate RCs of uranium were associated with pre-modern and mixed-age groundwater, low-oxygen to anoxic conditions, and location within parts of the Central Sierra and Southern Sierra study units known to have rocks with anomalously high uranium content compared to other parts of the Sierra Nevada. High and moderate RCs of uranium in sedimentary rocks were associated with pre-modern-age groundwater, oxic and high-pH conditions, and location in the Tahoe Valley South subbasin within the Tahoe-Martis study unit. Land use within 500 meters of the well and groundwater age were the most significant factors explaining occurrence patterns of organic constituents. Herbicide detections were most strongly associated with modern- and mixed-age groundwater from wells with agricultural land use. Trihalomethane detections were most strongly associated with modern- and mixed-age groundwater from wells with > 10% urban land use and (or) septic tank density > 7 tanks per square kilometer. Solvent detections were not significantly related to groundwater age. Eighty-three percent of the wells with modern- or mixed-age groundwater, and 86% of wells with detections of herbicides and (or) THMs had depths to the top of the screened or open interval of 5% agricultural land use and detection of a herbicide or solvent had the highest nitrate concentrations. Comparison between observed and predicted detection frequencies of perchlorate suggests that the perchlorate detected at concentrations < 1 microgram per liter likely reflects the distribution of perchlorate under natural conditions, and that the perchlorate detected at higher concentrations may reflect redistribution of originally natural perchlorate salts by irrigation in the agricultural areas of the Southern Sierra study unit.

Primary care and addiction treatment: lessons learned from building bridges across traditions.

PubMed

Stanley, A H

1999-01-01

A primary care unit combined with residential addiction treatment allows patients with addictive disease and chronic medical or psychiatric problems to successfully complete the treatment. These are patients who would otherwise fail treatment or fail to be considered candidates for treatment. Health care providers should have a background in primary care and have the potential to respond professionally to clinical problems in behavioral medicine. Ongoing professional training and statistical quality management principles can maintain morale and productivity. Health education is an integral part of primary care. The costs of such concurrent care when viewed in the context of the high societal and economic costs of untreated addictive disease and untreated chronic medical problems are low. The principles used to develop this primary care unit can be used to develop health care units for other underserved populations. These principles include identification of specific health care priorities and continuity of rapport with the target population and with addiction treatment staff.

Evidence of biological activity in Hawaiian subsurface basalts

NASA Astrophysics Data System (ADS)

Fisk, M. R.; Storrie-Lombardi, M. C.; Douglas, S.; Popa, R.; McDonald, G.; di Meo-Savoie, C.

2003-12-01

The Hawaii Scientific Drilling Program (HSDP) cored and recovered igneous rock from the surface to a depth of 3109 m near Hilo, Hawaii. Much of the deeper parts of the hole is composed of hyaloclastite (fractured basalt glass that has been cemented in situ with secondary minerals). Some hyaloclastite units have been altered in a manner attributed to microorganisms in volcanic rocks. Samples from one such unit (1336 m to 1404 m below sea level) were examined to test the hypothesis that the alteration was associated with microorganisms. Deep ultraviolet native fluorescence and resonance Raman spectroscopy indicate that nucleic acids and aromatic amino acids are present in clay inside spherical cavities (vesicles) within basalt glass. Chemical mapping shows that phosphorus and carbon were enriched at the boundary between the clay and volcanic glass of the vesicles. Environmental scanning electron microscopy (ESEM) reveals two to three micrometer coccoid structures in these same boundaries. ESEM-linked energy dispersive spectroscopy demonstrated carbon, phosphorous, chloride, and magnesium in these bodies significantly differing from unoccupied neighboring regions of basalt. These observations taken together indicate the presence of microorganisms at the boundary between primary volcanic glass and secondary clays. Amino acids and nucleic acids were extracted from bulk samples of the hyaloclastite unit. Amino acid abundance was low, and if the amino acids are derived from microorganisms in the rock, then there are less than 100,000 cells per gram of rock. Most nucleic acid sequences extracted from the unit were closely related to sequences of Crenarchaeota collected from the subsurface of the ocean floor.

How Online Quality Ratings Influence Patients’ Choice of Medical Providers: Controlled Experimental Survey Study

PubMed Central

Wang, Weiguang; Gao, Guodong (Gordon); Agarwal, Ritu

2018-01-01

Background In recent years, the information environment for patients to learn about physician quality is being rapidly changed by Web-based ratings from both commercial and government efforts. However, little is known about how various types of Web-based ratings affect individuals’ choice of physicians. Objective The objective of this research was to measure the relative importance of Web-based quality ratings from governmental and commercial agencies on individuals’ choice of primary care physicians. Methods In a choice-based conjoint experiment conducted on a sample of 1000 Amazon Mechanical Turk users in October 2016, individuals were asked to choose their preferred primary care physician from pairs of physicians with different ratings in clinical and nonclinical aspects of care provided by governmental and commercial agencies. Results The relative log odds of choosing a physician increases by 1.31 (95% CI 1.26-1.37; P<.001) and 1.32 (95% CI 1.27-1.39; P<.001) units when the government clinical ratings and commercial nonclinical ratings move from 2 to 4 stars, respectively. The relative log odds of choosing a physician increases by 1.12 (95% CI 1.07-1.18; P<.001) units when the commercial clinical ratings move from 2 to 4 stars. The relative log odds of selecting a physician with 4 stars in nonclinical ratings provided by the government is 1.03 (95% CI 0.98-1.09; P<.001) units higher than a physician with 2 stars in this rating. The log odds of selecting a physician with 4 stars in nonclinical government ratings relative to a physician with 2 stars is 0.23 (95% CI 0.13-0.33; P<.001) units higher for females compared with males. Similar star increase in nonclinical commercial ratings increases the relative log odds of selecting the physician by female respondents by 0.15 (95% CI 0.04-0.26; P=.006) units. Conclusions Individuals perceive nonclinical ratings provided by commercial websites as important as clinical ratings provided by government websites when choosing a primary care physician. There are significant gender differences in how the ratings are used. More research is needed on whether patients are making the best use of different types of ratings, as well as the optimal allocation of resources in improving physician ratings from the government’s perspective. PMID:29581091

An Improved Maintenance Model for the Simulation of Strategic Airlift Capability.

DTIC Science & Technology

1982-03-01

developed using SLAM as the primary simulation language. Maintenance manning is modeled at the Air Force Specialty Code level, to allow the possibility of...Atlantic Treaty Organization (NATO) allies is one of our primary national objectives, but recent increases in Soviet ground and air forces (Ref 5:100) have...arrive from the United States. Consequently, the primary objective of the United States Air Force mobility program is to be able, by 1982, to double the

Using discrete event simulation to compare the performance of family health unit and primary health care centre organizational models in Portugal.

PubMed

Fialho, André S; Oliveira, Mónica D; Sá, Armando B

2011-10-15

Recent reforms in Portugal aimed at strengthening the role of the primary care system, in order to improve the quality of the health care system. Since 2006 new policies aiming to change the organization, incentive structures and funding of the primary health care sector were designed, promoting the evolution of traditional primary health care centres (PHCCs) into a new type of organizational unit--family health units (FHUs). This study aimed to compare performances of PHCC and FHU organizational models and to assess the potential gains from converting PHCCs into FHUs. Stochastic discrete event simulation models for the two types of organizational models were designed and implemented using Simul8 software. These models were applied to data from nineteen primary care units in three municipalities of the Greater Lisbon area. The conversion of PHCCs into FHUs seems to have the potential to generate substantial improvements in productivity and accessibility, while not having a significant impact on costs. This conversion might entail a 45% reduction in the average number of days required to obtain a medical appointment and a 7% and 9% increase in the average number of medical and nursing consultations, respectively. Reorganization of PHCC into FHUs might increase accessibility of patients to services and efficiency in the provision of primary care services.

30 CFR 70.207 - Bimonthly sampling; mechanized mining units.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Bimonthly sampling; mechanized mining units. 70... Bimonthly sampling; mechanized mining units. (a) Each operator shall take five valid respirable dust samples from the designated occupation in each mechanized mining unit during each bimonthly period beginning...

Distinctive toxicity of TiO2 rutile/anatase mixed phase nanoparticles on Caco-2 cells.

PubMed

Gerloff, Kirsten; Fenoglio, Ivana; Carella, Emanuele; Kolling, Julia; Albrecht, Catrin; Boots, Agnes W; Förster, Irmgard; Schins, Roel P F

2012-03-19

Titanium dioxide has a long-standing use as a food additive. Micrometric powders are, e.g., applied as whiteners in confectionary or dairy products. Possible hazards of ingested nanometric TiO(2) particles for humans and the potential influence of varying specific surface area (SSA) are currently under discussion. Five TiO(2)-samples were analyzed for purity, crystallinity, primary particle size, SSA, ζ potential, and aggregation/agglomeration. Their potential to induce cytotoxicity, oxidative stress, and DNA damage was evaluated in human intestinal Caco-2 cells. Only anatase-rutile containing samples, in contrast to the pure anatase samples, induced significant LDH leakage or mild DNA damage (Fpg-comet assay). Evaluation of the metabolic competence of the cells (WST-1 assay) revealed a highly significant correlation between the SSA of the anatase samples and cytotoxicity. The anatase/rutile samples showed higher toxicity per unit surface area than the pure anatase powders. However, none of the samples affected cellular markers of oxidative stress. Our findings suggest that both SSA and crystallinity are critical determinants of TiO(2)-toxicity toward intestinal cells. © 2012 American Chemical Society

Guia de Educacion Ambiental para Maestros del Nivel Primario. Los Recursos Naturales en la Ensenanza Primaria. Segunda Edicion. (Environmental Education Guide for Teachers of Primary Level. Natural Resources in Primary Instruction. Second Edition.)

ERIC Educational Resources Information Center

Morillo, Alfredo; Del Valle, Ramona

This guide contains six elementary grade units which focus on environmental concepts considered of major importance by the agricultural personnel of the Dominican Republic. Each of the units shows a cumulative and sequential building of these concepts. Unit 1 (grade 1) focuses on the basics of plant and animal differentiation and on the properties…

[The influence of the advertising in the medication use in a group of elderly attended in a primary health care unit in Aracaju (Sergipe, Brasil)].

PubMed

de Lyra, Divaldo Pereira; Neves, Aline Souza; Cerqueira, Karine Santos; Marcellini, Paulo Sergio; Marques, Tatiane Cristina; de Barros, José Augusto Cabral

2010-11-01

The growth of the Brazilian elderly people has led to a trend to an increase in the medication use. The inadequate use of drugs can be induced by some factors, like advertisement, with the risk of damaging the user's health. The objective of the study was to evaluate the advertisement influence in medication use in a group of elderly patients in a primary health care unit in Aracaju, Sergipe, Brazil. 230 elderly aging over 60 years with both genders had been interviewed from April to June of 2007. The majority of the interviewees (73%) has at least a chronic health condition and 73.9% consumed regularly at least one medication. 17.8% of the sample informed to use medication motivated by publicity influence; 2.2% had considered that the medication never cause damages and 6.5% believed that always it makes well. In this study, correlations have been made and demonstrated that those who presented a higher level of consumption influenced by advertising also think that drugs used are always beneficial and vice versa (p= 0.04). The data showed that part of elderly suffered influence of advertisement to medication use, and are not conscious of risks involved.

The introduction of the meningococcal B (MenB) vaccine (Bexsero®) into the national infant immunisation programme--New challenges for public health.

PubMed

Ladhani, Shamez N; Campbell, Helen; Parikh, Sydel R; Saliba, Vanessa; Borrow, Ray; Ramsay, Mary

2015-12-01

The United Kingdom is the first country to introduce Bexsero(®) (GSK Biologicals), a multicomponent, protein-based vaccine against meningococcal group B (MenB), into the national infant immunisation programme. This vaccine is like no other licensed vaccine and poses a number of implementation and surveillance challenges in England. From 01 September 2015, UK infants were offered a reduced two dose primary immunisation schedule at 2 and 4 months followed by a booster at 12 months. Because of high rates of fever post-vaccination, parents were advised to give their infants three doses of prophylactic paracetamol, with the first dose given as soon as possible after the primary MenB vaccination dose. Since the vaccine only protects against 73-88% of MenB strains causing invasive disease in England, clinical isolates and PCR-positive samples will require extensive characterisation by the Meningococcal Reference Unit (MRU) at Public Health England (PHE) in order to monitor vaccine effectiveness and identify potential vaccine failures. PHE is also conducting detailed clinical and epidemiological surveillance to assess the impact of the MenB immunisation programme on the morbidity and mortality associated with invasive meningococcal disease in infants and young children. Copyright © 2015 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Patient or treatment centre? Where are efforts invested to improve cancer patients' psychosocial outcomes?

PubMed Central

Carey, ML; Clinton-McHarg, T; Sanson-Fisher, RW; Campbell, S; Douglas, HE

2011-01-01

The psychosocial outcomes of cancer patients may be influenced by individual-level, social and treatment centre predictors. This paper aimed to examine the extent to which individual, social and treatment centre variables have been examined as predictors or targets of intervention for psychosocial outcomes of cancer patients. Medline was searched to find studies in which the psychological outcomes of cancer patient were primary variables. Papers published in English between 1999 and 2009 that reported primary data relevant to psychosocial outcomes for cancer patients were included, with 20% randomly selected for further coding. Descriptive studies were coded for inclusion of individual, social or treatment centre variables. Intervention studies were coded to determine if the unit of intervention was the individual patient, social unit or treatment centre. After random sampling, 412 publications meeting the inclusion criteria were identified, 169 were descriptive and 243 interventions. Of the descriptive papers 95.0% included individual predictors, and 5.0% social predictors. None of the descriptive papers examined treatment centre variables as predictors of psychosocial outcomes. Similarly, none of the interventions evaluated the effectiveness of treatment centre interventions for improving psychosocial outcomes. Potential reasons for the overwhelming dominance of individual predictors and individual-focused interventions in psychosocial literature are discussed. PMID:20646035

Crystallization control for remediation of an FetO-rich CaO-SiO2-Al2O3-MgO EAF waste slag.

PubMed

Jung, Sung Suk; Sohn, Il

2014-01-01

In this work, the crystallization behavior of synthesized FetO-rich electric arc furnace (EAF) waste slags with a basicity range of 0.7 to 1.08 was investigated. Crystal growth in the melts was observed in situ using a confocal laser scanning microscope, and a delayed crystallization for higher-basicity samples was observed in the continuous cooling transformation and time temperature transformation diagrams. This result is likely due to the polymerization of the melt structure as a result of the increased number of network-forming FeO4 and AlO4 units, as suggested by Raman analysis. The complex incorporation of Al and Fe ions in the form of AlO4 and FeO4 tetrahedral units dominant in the melt structure at a higher basicity constrained the precipitation of a magnetic, nonstoichiometric, and Fe-rich MgAlFeO4 primary phase. The growth of this spinel phase caused a clear compositional separation from amorphous phase during isothermal cooling at 1473 K leading to a clear separation between the primary and amorphous phases, allowing an efficient magnetic separation of Fe compounds from the slag for effective remediation and recycling of synthesized EAF waste slags for use in higher value-added ordinary Portland cement.

[Prevalence and factors associated with metabolic syndrome in users of primary healthcare units in São Paulo--SP, Brazil].

PubMed

Leitão, Maria Paula Carvalho; Martins, Ignez Salas

2012-01-01

To determine the relationship between metabolic syndrome (MS) and socioeconomic level, life style, health status, family history of morbidity, and residence areas. This is a cross-sectional cohort study. The random sample consisted of users of two primary health care units (Unidades Básicas de Saúde--UBSs) in the city of São Paulo--Jardim Comercial (UBS1), and Jardim Germânia (UBS2), a total of 452 subjects. The NCEP ATP IIIcriterion was used to diagnose MS. Weight, height, abdominal and hip circumferences were measured for the anthropometric evaluation. A general questionnaire was used to obtain sociodemographic and socioeconomic data; family history; medical history; behavioral habits such as smoking, drinking, and physical activity. Multivariate logistic regression was used to establish the association between explanatory variables of interest and MS. At UBS1, MS percentage was 56.1%; at UBS2, 34.0%. There was a direct and significant association between MS and age, female gender, race, smoking, drinking, physical activity level, stress, and family history of heart disease and diabetes mellitus. Education level showed an inverse association. Subjects living in a lower socioeconomic level neighborhood had a higher MS risk. The results suggest that the morbidities that compose MS are a serious publichealth problem in that population.

Family Health Teams workers in Rio de Janeiro: leadership aspects in a study on organizational climate.

PubMed

Santos, Leda Jung Dos; Paranhos, Maurício Sangama

2017-03-01

Organizational climate is understood as the formal or informal perception of policies, practices, actions and organizational procedures, and is a factor of influence in the efficiency of the results, as well as in the conduct of people that are part of an organization. This paper describes one of organizational climate realms, namely, leadership, comparing the strata of professional categories of the Family Health Teams in the city of Rio de Janeiro. Thus, an administrative-based survey was carried out with a sample of n = 9,590 people in 187 primary healthcare units (71 Family Clinics and 116 Municipal Health Centers). The results show that all items that measure the realm of "leadership" were positively evaluated with differences between strata (p-value <0.001). We recommend conducting regular studies and holding leadership workshops in the very health units, as well as using distance-learning tools to exchange information and train staff.

Predicting long-term citation impact of articles in social and personality psychology.

PubMed

Haslam, Nick; Koval, Peter

2010-06-01

The citation impact of a comprehensive sample of articles published in social and personality psychology journals in 1998 was evaluated. Potential predictors of the 10-yr. citation impact of 1580 articles from 37 journals were investigated, including number of authors, number of references, journal impact factor, author nationality, and article length, using linear regression. The impact factor of the journal in which articles appeared was the primary predictor of the citations that they accrued, accounting for 30% of the total variance. Articles with greater length, more references, and more authors were cited relatively often, although the citation advantage of longer articles was not proportionate to their length. A citation advantage was also enjoyed by authors from the United States of America, Canada, and the United Kingdom. 37% of the variance in the total number of citations was accounted for by the study variables.

Mental health status of women in Jordan: a comparative study between attendees of governmental and UN relief and works agency's health care centers.

PubMed

Al-Modallal, Hanan; Hamaideh, Shaher; Mudallal, Rula

2014-05-01

This study aimed at investigating differences in mental health problems between attendees of governmental and United Nations Relief and Works Agency for Palestine Refugees health care centers in Jordan. Further, predictors of mental health problems based on women's demographic profile were investigated. A convenience sample of 620 women attending governmental and United Nations Relief and Works Agency for Palestine Refugees health care centers in Jordan was recruited for this purpose. Independent samples t-tests were used to identify differences in mental health, and multiple linear regression was implemented to identify significant predictors of women's mental health problems. Results indicated an absence of significant differences in mental health problems between attendees of the two types of health care centers. Further, among the demographic indicators that were tested, income, spousal violence, and general health were the predictors of at least three different mental health problems in women. This study highlights opportunities for health professionals to decrease women's propensity for mental health problems by addressing these factors when treating women attending primary care centers in different Jordanian towns, villages, and refugee camps.

Absolute Paleointensity Study of Miocene Tiva Canyon Tuff, Yucca Mountain, Nevada

NASA Astrophysics Data System (ADS)

Patiman, A.; Bowles, J.

2014-12-01

Unoriented samples from the ~12.7 Ma Tiva Canyon (TC) tuff from Yucca Mountain, Nevada are studied in terms of magnetic properties and geomagnetic paleointensity. The magnetic mineralogy and magnetic properties of the TC tuff have previously been well documented, and the remanence-carrier in ~15-m thick zones at the top and bottom of the unit is dominantly is single domain (SD) to superparamagnetic (SP) magnetite, which may be considered ideal for absolute paleointensity studies. Among one of the several episodic volcanic eruptions of the Southwestern Nevada Volcanic Field (SWNVF), the welded TC tuff belongs to the Paintbrush Group. Here we present magnetic properties from two previously unreported sections of the TC tuff, as well as Thellier-type absolute paleointensity estimates. Samples were collected from the lower ~7 m at the base of the flow. Magnetic properties studied include hysteresis, bulk magnetic susceptibility, frequency-dependent susceptibility, and anhysteretic remanent magnetization acquisition. Magnetic property results are consistent with earlier work, showing that the main magnetic mineral is magnetite. SP samples are dominant from the lower ~1 m to ~3.6 m basal unit while the middle unit of ~3.7 m to 7.0 m mainly consists of SD samples. The paleointensity results are closely tied to the stratigraphic height and magnetic properties linked to domain state. The SD samples have consistent absolute paleointensity values 32.40±0.22 uT, VADM 5.74*1022 A.m2 and behaved ideally during paleointensity experiments. The SP samples have consistently higher paleointensity and less ideal behavior, but would likely pass many traditional quality-control tests. Since the magnetite has been interpreted to form by precipitation out of the glass post-emplacement, but at temperatures higher than the Curie temperature, we tentatively interpret the SD remanence to be a primary thermal remanent magnetization and the paleointensity result to be a valid estimate of geomagnetic paleointensity for the Miocene. Post-emplacement vapor-phase alteration might be expected to alter magnetic mineralogy and magnetization, and has been reported in the upper portions of the TC tuff, but not in the lower sections discussed here.

Teaching Students with Disabilities: A Web-Based Examination of Preparation of Preservice Primary School Teachers

ERIC Educational Resources Information Center

Stephenson, Jennifer; O'Neill, Sue; Carter, Mark

2012-01-01

With increasing expectations that preservice teachers will be prepared to teach students with special needs in regular classrooms, it is timely to review relevant units in teacher education courses. Units relevant to special education/inclusion in primary undergraduate teacher preparation courses in Australian tertiary institutions, delivered in…

10 CFR 504.6 - Prohibitions by order (case-by-case).

Code of Federal Regulations, 2013 CFR

2013-01-01

... had, the technical capability to use an alternate fuel as a primary energy source; (2) The unit has... (3) It is financially feasible for the unit to use an alternate fuel as its primary energy source. (b... Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS EXISTING POWERPLANTS § 504.6 Prohibitions by...

10 CFR 504.6 - Prohibitions by order (case-by-case).

Code of Federal Regulations, 2014 CFR

2014-01-01

... had, the technical capability to use an alternate fuel as a primary energy source; (2) The unit has... (3) It is financially feasible for the unit to use an alternate fuel as its primary energy source. (b... Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS EXISTING POWERPLANTS § 504.6 Prohibitions by...

10 CFR 504.6 - Prohibitions by order (case-by-case).

Code of Federal Regulations, 2012 CFR

2012-01-01

... had, the technical capability to use an alternate fuel as a primary energy source; (2) The unit has... (3) It is financially feasible for the unit to use an alternate fuel as its primary energy source. (b... Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS EXISTING POWERPLANTS § 504.6 Prohibitions by...

10 CFR 504.6 - Prohibitions by order (case-by-case).

Code of Federal Regulations, 2011 CFR

2011-01-01

... had, the technical capability to use an alternate fuel as a primary energy source; (2) The unit has... (3) It is financially feasible for the unit to use an alternate fuel as its primary energy source. (b... Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS EXISTING POWERPLANTS § 504.6 Prohibitions by...

78 FR 52897 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-27

... Secretary of Agriculture. The primary objective of the NSIIC is to assist U.S. sheep and goat industries by strengthening and enhancing the production and marketing of sheep, goats, and their products in the United... or goat producers in the United States and (2) have the primary interest of sheep or goat production...

Hydrogeologic framework and simulation of ground-water flow and travel time in the shallow aquifer system in the area of Naval Support Activity Memphis, Millington, Tennessee

USGS Publications Warehouse

Robinson, James L.; Carmichael, John K.; Halford, Keith J.; Ladd, David E.

1997-01-01

Naval Support Activity (NSA) Memphis is a Department of the Navy facility located at the City of Millington, Tennessee, about 5 miles north of Memphis. Contaminants have been detected in surface-water, sediment, and ground-water samples collected at the facility. As part of the Installation Restoration Program, the Navy is considering remedial-action options to prevent or lessen the effect of ground-water contamination at the facility and to control the movement and discharge of contaminants. A numerical model of the ground-water-flow system in the area of NSA Memphis was constructed and calibrated so that quantifiable estimates could be made of ground-water-flow rates, direction, and time-of-travel. The sediments beneath NSA Memphis, to a depth of about 200 feet, form a shallow aquifer system. From youngest to oldest, the stratigraphic units that form the shallow aquifer system are alluvium, loess, fluvial deposits, and the Cockfield and Cook Mountain Formations. The shallow aquifer system is organized into five hydrogeologic units: (1) a confining unit composed of the relatively low permeability sediments of the upper alluvium and the loess; (2) the A1 aquifer comprising sand and gravel of the lower alluvium and the fluvial deposits, and sand lenses in the upper part of the preserved section of the Cockfield Formation; (3) a confining unit composed of clay and silt within the upper part of the Cockfield Formation; (4) the Cockfield aquifer comprising sand lenses within the lower part of the preserved section of the Cockfield Formation; and (5) a confining unit formed by low permeability sediments of the Cook Mountain Formation that composes the upper confining unit for the Memphis aquifer. Thicknesses of individual units vary considerably across the facility. Structural and depositional features that affect the occurrence of ground water in the shallow aquifer system include faulting, an erosional scarp, and 'windows' in the confining units. Underlying the shallow aquifer system is the Memphis aquifer, the primary source of water for NSA Memphis and the City of Memphis, Tennessee. Analyses of sediment cores, aquifer and well specific-capacity tests, and numerical modeling were used to estimate the hydraulic characteristics of units of the shallow aquifer system. The vertical hydraulic conductivity of core samples of the alluvium-loess confining unit ranged from about 8.5 x 10-5 to 1.6 x 10-2 feet per day, and the total porosity of the samples ranged from about 35 to 48 percent. The results of the aquifer test were used to estimate a horizontal hydraulic conductivity of about 5 feet per day for the alluvial-fluvial deposits aquifer. The total porosity of core samples of the alluvial-fluvial deposits aquifer ranged from about 22 to 39 percent. The vertical hydraulic conductivity of core samples of the Cockfield confining unit ranged from about 4.5 x 10-5 to 2.5 x 10-3 feet per day, and the total porosity ranged from about 41 to 55 percent. Well specific-capacity tests indicate that the horizontal hydraulic conductivity of sand units that compose the Cockfield aquifer range from about 0.5 to 3 feet per day. The vertical hydraulic conductivity of core samples of the Cook Mountain confining unit ranged from about 5.0 x 10-6 to 9.9 x 10-4 feet per day. Total porosity of core samples of the Cook Mountain confining unit ranged from about 30 to 42 percent. Ground-water flow and time-of-travel in the shallow aquifer system were simulated using the MODFLOW finite-difference model and the -particle-tracking program MODPATH. A three-layer, steady-state model of the shallow aquifer system was constructed and calibrated to the potentiometric surface of the A1 aquifer. Results of numerical modeling support the proposed conceptual hydrogeologic model of the shallow aquifer system. Ground-water time-of-travel in the A1 aquifer was simulated using an assumed effective porosity of 25 percent. Typical ground-water-flow velocities were on the or

[Gender violence prevalence in female users of health services in Mexico].

PubMed

Olaiz, Gustavo; Rojas, Rosalba; Valdez, Rosario; Franco, Aurora; Palma, Oswaldo

2006-01-01

To identify the prevalence of violence against females among those who are health service beneficiaries in Mexico. The National Survey on Violence against Women (ENVIM, per its Spanish abbreviation) was applied in 2003 to female users of public primary and secondary health care services. The sampling framework was based on a stratified, probabilistic sample in two stages. First the health care units were selected with probability proportional to the number of physicians' offices in the unit, from a list of possible care units. Second, women 15 years and older who sought care at the health care unit were selected for participation in the study through systematic sampling. Univariate analysis and then bivariate analysis were carried out on the data collected with a questionnaire. The sample included 26 042 women between 15 and 92 years of age, with a mean age of 35.8 years. Physical violence during childhood was reported by 42% of the women. Only 7.8% answered yes to a general question about whether they experienced domestic partner violence, but 21.5% reported experiencing violence of any type during the last 12 months as measured by a scale including specific acts of psychological, economic, physical and sexual violence. The most frequently reported type of violence was psychological (19.6%). Of the women who had been pregnant, 14.1% reported having experienced violence during pregnancy, and 4.4% reported being hit in the abdomen. The prevalence of sexual violence was 17.3% and close to half reported being victims of this type of violence before age 15. Higher prevalence of violence was found among women with lower levels of formal education, living in a rented home, in areas with higher overcrowding indices, and users of Ministry of Health care services. Identifying and measuring violence is complex, given the diverse types of violence and how they are perceived and therefore reported by women themselves. This is an important public health problem, in view of the high frequency observed in this study and the immediate implications. These findings indicate the urgent need for interventions to prevent and treat violence.

Land-cover trends in the Mojave basin and range ecoregion

USGS Publications Warehouse

Sleeter, Benjamin M.; Raumann, Christian G.

2006-01-01

The U.S. Geological Survey's Land-Cover Trends Project aims to estimate the rates of contemporary land-cover change within the conterminous United States between 1972 and 2000. A random sampling approach was used to select a representative sample of 10-km by 10-km sample blocks and to estimate change within +/- 1 percent at an 85-percent confidence interval. Landsat Multispectral Scanner, Thematic Mapper, and Enhanced Thematic Mapper Plus data were used, and each 60-m pixel was assigned to one of 11 distinct land-cover classes based upon a modified Anderson classification system. Upon completion of land-cover change mapping for five dates, land-cover change statistics were generated and analyzed. This paper presents estimates for the Mojave Basin and Range ecoregion located in the southwestern United States. Our research suggests land-cover change within the Mojave to be relatively rare and highly localized. The primary shift in land cover is unidirectional, with natural desert grass/shrubland being converted to development. We estimate that more than 1,300 km2 have been converted since 1973 and that the conversion is being largely driven by economic and recreational opportunities provided by the Mojave ecoregion. The time interval with the highest rate of change was 1986 to 1992, in which the rate was 0.21 percent (321.9 km2) per year total change.

Peri-equatorial paleolatitudes for Jurassic radiolarian cherts of Greece

USGS Publications Warehouse

Aiello, I.W.; Hagstrum, J.T.; Principi, G.

2008-01-01

Radiolarian-rich sediments dominated pelagic deposition over large portions of the Tethys Ocean during middle to late Jurassic time as shown by extensive bedded chert sequences found in both continental margin and ophiolite units of the Mediterranean region. Which paleoceanographic mechanisms and paleotectonic setting favored radiolarian deposition during the Jurassic, and the nature of a Tethys-wide change from biosiliceous to biocalcareous (mainly nannofossil) deposition at the beginning of Cretaceous time, have remained open questions. Previous paleomagnetic analyses of Jurassic red radiolarian cherts in the Italian Apennines indicate that radiolarian deposition occurred at low peri-equatorial latitudes, similar to modern day deposition of radiolarian-rich sediments within equatorial zones of high biologic productivity. To test this result for other sectors of the Mediterranean region, we undertook paleomagnetic study of Mesozoic (mostly middle to upper Jurassic) red radiolarian cherts within the Aegean region on the Peloponnesus and in continental Greece. Sampled units are from the Sub-Pelagonian Zone on the Argolis Peninsula, the Pindos-Olonos Zone on the Koroni Peninsula, near Karpenissi in central Greece, and the Ionian Zone in the Varathi area of northwestern Greece. Thermal demagnetization of samples from all sections removed low-temperature viscous and moderate-temperature overprint magnetizations that fail the available fold tests. At Argolis and Koroni, however, the cherts carry a third high-temperature magnetization that generally exhibits a polarity stratigraphy and passes the available fold tests. We interpret the high-temperature component to be the primary magnetization acquired during chert deposition and early diagenesis. At Kandhia and Koliaky (Argolis), the primary declinations and previous results indicate clockwise vertical-axis rotations of ??? 40?? relative to "stable" Europe. Due to ambiguities in hemispheric origin (N or S) and thus paleomagnetic polarity, the observed declinations could indicate either clockwise (CW) or counterclockwise (CCW) vertical-axis rotations. Thus at Adriani (Koroni), the primary declinations indicate either CW or CCW rotations of ??? 95?? or ??? 84??, depending on paleomagnetic polarity and age. The primary inclinations for all Peloponnesus sites indicate peri-equatorial paleolatitudes similar to those found for coeval radiolarian cherts exposed in other Mediterranean orogenic belts. Our new paleomagnetic data support the interpretation that Mesozoic radiolarites within the Tethys Ocean were originally deposited along peri-equatorial belts of divergence and high biologic productivity. ?? 2007 Elsevier B.V. All rights reserved.

Harmonization in laboratory medicine: Requests, samples, measurements and reports.

PubMed

Plebani, Mario

2016-01-01

In laboratory medicine, the terms "standardization" and "harmonization" are frequently used interchangeably as the final goal is the same: the equivalence of measurement results among different routine measurement procedures over time and space according to defined analytical and clinical quality specifications. However, the terms define two distinct, albeit closely linked, concepts based on traceability principles. The word "standardization" is used when results for a measurement are equivalent and traceable to the International System of Units (SI) through a high-order primary reference material and/or a reference measurement procedure (RMP). "Harmonization" is generally used when results are equivalent, but neither a high-order primary reference material nor a reference measurement procedure is available. Harmonization is a fundamental aspect of quality in laboratory medicine as its ultimate goal is to improve patient outcomes through the provision of accurate and actionable laboratory information. Patients, clinicians and other healthcare professionals assume that clinical laboratory tests performed by different laboratories at different times on the same sample and specimen can be compared, and that results can be reliably and consistently interpreted. Unfortunately, this is not necessarily the case, because many laboratory test results are still highly variable and poorly standardized and harmonized. Although the initial focus was mainly on harmonizing and standardizing analytical processes and methods, the scope of harmonization now also includes all other aspects of the total testing process (TTP), such as terminology and units, report formats, reference intervals and decision limits as well as tests and test profiles, requests and criteria for interpretation. Several projects and initiatives aiming to improve standardization and harmonization in the testing process are now underway. Laboratory professionals should therefore step up their efforts to provide interchangeable and comparable laboratory information in order to ultimately assure better diagnosis and treatment in patient care.

The Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS): Unifying Efforts to Inform Practice and Improve Global Outcomes in Peritoneal Dialysis

PubMed Central

Perl, Jeffrey; Davies, Simon J.; Lambie, Mark; Pisoni, Ronald L.; McCullough, Keith; Johnson, David W.; Sloand, James A.; Prichard, Sarah; Kawanishi, Hideki; Tentori, Francesca; Robinson, Bruce M.

2016-01-01

♦ Background: Extending technique survival on peritoneal dialysis (PD) remains a major challenge in optimizing outcomes for PD patients while increasing PD utilization. The primary objective of the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) is to identify modifiable practices associated with improvements in PD technique and patient survival. In collaboration with the International Society for Peritoneal Dialysis (ISPD), PDOPPS seeks to standardize PD-related data definitions and provide a forum for effective international collaborative clinical research in PD. ♦ Methods: The PDOPPS is an international prospective cohort study in Australia, Canada, Japan, the United Kingdom (UK), and the United States (US). Each country is enrolling a random sample of incident and prevalent patients from national samples of 20 to 80 sites with at least 20 patients on PD. Enrolled patients will be followed over an initial 3-year study period. Demographic, comorbidity, and treatment-related variables, and patient-reported data, will be collected over the study course. The primary outcome will be all-cause PD technique failure or death; other outcomes will include cause-specific technique failure, hospitalizations, and patient-reported outcomes. ♦ Results: A high proportion of the targeted number of study sites has been recruited to date in each country. Several ancillary studies have been funded with high momentum toward expansion to new countries and additional participation. ♦ Conclusion: The PDOPPS is the first large, international study to follow PD patients longitudinally to capture clinical practice. With data collected, the study will serve as an invaluable resource and research platform for the international PD community, and provide a means to understand variation in PD practices and outcomes, to identify optimal practices, and to ultimately improve outcomes for PD patients. PMID:26526049

The Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS): Unifying Efforts to Inform Practice and Improve Global Outcomes in Peritoneal Dialysis.

PubMed

Perl, Jeffrey; Davies, Simon J; Lambie, Mark; Pisoni, Ronald L; McCullough, Keith; Johnson, David W; Sloand, James A; Prichard, Sarah; Kawanishi, Hideki; Tentori, Francesca; Robinson, Bruce M

2016-01-01

♦ Extending technique survival on peritoneal dialysis (PD) remains a major challenge in optimizing outcomes for PD patients while increasing PD utilization. The primary objective of the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) is to identify modifiable practices associated with improvements in PD technique and patient survival. In collaboration with the International Society for Peritoneal Dialysis (ISPD), PDOPPS seeks to standardize PD-related data definitions and provide a forum for effective international collaborative clinical research in PD. ♦ The PDOPPS is an international prospective cohort study in Australia, Canada, Japan, the United Kingdom (UK), and the United States (US). Each country is enrolling a random sample of incident and prevalent patients from national samples of 20 to 80 sites with at least 20 patients on PD. Enrolled patients will be followed over an initial 3-year study period. Demographic, comorbidity, and treatment-related variables, and patient-reported data, will be collected over the study course. The primary outcome will be all-cause PD technique failure or death; other outcomes will include cause-specific technique failure, hospitalizations, and patient-reported outcomes. ♦ A high proportion of the targeted number of study sites has been recruited to date in each country. Several ancillary studies have been funded with high momentum toward expansion to new countries and additional participation. ♦ The PDOPPS is the first large, international study to follow PD patients longitudinally to capture clinical practice. With data collected, the study will serve as an invaluable resource and research platform for the international PD community, and provide a means to understand variation in PD practices and outcomes, to identify optimal practices, and to ultimately improve outcomes for PD patients. Copyright © 2016 International Society for Peritoneal Dialysis.

Delivery of Brief Interventions for Heavy Drinking in Primary Care: Outcomes of the ODHIN 5-Country Cluster Randomized Trial

PubMed Central

Anderson, Peter; Coulton, Simon; Kaner, Eileen; Bendtsen, Preben; Kłoda, Karolina; Reynolds, Jillian; Segura, Lidia; Wojnar, Marcin; Mierzecki, Artur; Deluca, Paolo; Newbury-Birch, Dorothy; Parkinson, Kathryn; Okulicz-Kozaryn, Katarzyna; Drummond, Colin; Gual, Antoni

2017-01-01

PURPOSE We aimed to test whether 3 strategies—training and support, financial reimbursement, and an option to direct screen-positive patients to an Internet-based method of giving brief advice—have a longer-term effect on primary care clinicians’ delivery of screening and advice to heavy drinkers operationalized with the Alcohol Use Disorders Identification Test–Consumption (AUDIT-C) tool. METHODS We undertook a cluster randomized factorial trial with a 12-week implementation period in 120 primary health care units throughout Catalonia, England, Netherlands, Poland, and Sweden. Units were randomized to 8 groups: care as usual (control); training and support alone; financial reimbursement alone; electronic brief advice alone; paired combinations of these conditions; and all 3 combined. The primary outcome was the proportion of consulting adult patients (aged 18 years and older) receiving intervention—screening and, if screen-positive, advice—at 9 months. RESULTS Based on the factorial design, the ratio of the log of the proportion of patients given intervention at the 9-month follow-up was 1.39 (95% CI, 1.03–1.88) in units that received training and support as compared with units that did not. Neither financial reimbursement nor directing screen-positive patients to electronic brief advice led to a higher proportion of patients receiving intervention. CONCLUSIONS Training and support of primary health care units has a lasting, albeit small, impact on the proportion of adult patients given an alcohol intervention at 9 months. PMID:28694269

Determining quality in a unit where nursing is the primary intervention.

PubMed

Pearson, A; Durant, I; Punton, S

1989-04-01

Determining quality in a unit where nursing is the primary intervention This paper discusses the use of a variety of quantitative and qualitative methods of measuring quality in a nursing unit. It reports the result of comparing the quality of nursing care between patients admitted to the nursing unit concerned (in Oxford, England) following admission to an acute ward, with patients who spent the whole of their hospitalization in an acute ward. The findings suggest that quality can be best assessed by using a number of methods, and the quality of nursing care delivered in a unit which focuses on therapeutic nursing is significantly and consistently higher than that delivered in acute hospital wards.

Status and understanding of groundwater quality in the central-eastside San Joaquin Basin, 2006: California GAMA Priority Basin Project

USGS Publications Warehouse

Landon, Matthew K.; Belitz, Kenneth; Jurgens, Bryant C.; Kulongoski, Justin T.; Johnson, Tyler D.

2010-01-01

Groundwater quality in the approximately 1,695-square-mile Central Eastside San Joaquin Basin (Central Eastside) study unit was investigated as part of the Priority Basin Project (PBP) of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The GAMA PBP was developed in response to the California Groundwater Quality Monitoring Act of 2001, and is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey and the Lawrence Livermore National Laboratory. The GAMA Central Eastside study unit was designed to provide a spatially unbiased assessment of untreated-groundwater quality, as well as a statistically consistent basis for comparing water quality throughout California. During March through June 2006, samples were collected from 78 wells in Stanislaus and Merced Counties, 58 of which were selected using a spatially distributed, randomized grid-based method to provide statistical representation of the study unit (grid wells), and 20 of which were sampled to evaluate changes in water chemistry along groundwater-flow paths (understanding wells). Water-quality data from the California Department of Public Health (CDPH) database also were used for the assessment.An assessment of the current status of the groundwater quality included collecting samples from wells for analysis of anthropogenic constituents such as volatile organic compounds (VOCs) and pesticides, as well as naturally occurring constituents such as major ions and trace elements. The assessment of status is intended to characterize the quality of untreated-groundwater resources within the primary aquifer system, not the treated drinking water delivered to consumers by water purveyors. The primary aquifer system (hereinafter, primary aquifer) is defined as that part of the aquifer corresponding to the perforation interval of wells listed in the CDPH database for the Central Eastside study unit. The quality of groundwater in shallower or deeper water-bearing zones may differ from that in the primary aquifer; shallower groundwater may be more vulnerable to surficial contamination. The primary aquifer is represented by the grid wells, of which 90 percent had depths to the tops of their perforations of about 80 to 330 feet and depths to bottom of about 100 to 670 feet. Relative-concentrations (sample concentration divided by benchmark concentration) were used as the primary metric for assessing the status of water quality for those constituents that have Federal and (or) California human health or aesthetic benchmarks. A relative-concentration greater than (>) 1.0 indicates a concentration above a benchmark, and less than or equal to (≤) 1.0 indicates a concentration equal to or below a benchmark. For organic and special interest constituents, relative-concentrations were classified as high (>1.0), moderate (≤1.0 and >0.1), or low (≤0.1). For inorganic constituents, relative-concentrations were classified as high (>1.0), moderate (≤1.0 and >0.5), or low (≤0.5). The threshold between low and moderate classifications was lower for organic and special interest constituents than for inorganic constituents because organic constituents generally are less prevalent and have smaller relative-concentrations than inorganic constituents.Grid-based and spatially-weighted approaches, the latter incorporating data from all CDPH wells, were used to evaluate the proportion of the primary aquifer (aquifer-scale proportions) with high, moderate, or low relative-concentrations. For individual constituents or classes of constituents, the aquifer-scale high proportion is the percentage of the area of the study unit having high relative-concentrations within the depth-zones of the primary aquifer. Aquifer-scale moderate and low proportions are defined similarly. Spatially-weighted aquifer-scale high proportions nearly always fell within the 90-percent confidence interval of grid-based aquifer-scale high proportions, indicating that the grid-based approach yielded statistically equivalent results to the spatially-weighted approach incorporating CDPH data.The status assessment for inorganic constituents showed that inorganic constituents (one or more) were high, relative to human-health benchmarks, in 18.0 percent of the primary aquifer, moderate in 44.0 percent, and low in 38.0 percent. Of inorganic constituents with human-health benchmarks, arsenic, vanadium, and nitrate were detected at high relative-concentrations in 15.6 percent, 3.6 percent, and 2.1 percent, respectively, of the primary aquifer. Of inorganic constituents with secondary maximum contaminant levels (SMCL), manganese, iron, and TDS were detected at high relative-concentrations in 4.5 percent, 2.2 percent, and 1.7 percent, respectively, of the primary aquifer.The status assessment for organic constituents showed that organic constituents (one or more) were high, relative to human-health benchmarks, in a smaller proportion of the primary aquifer (1.2 percent) than inorganic constituents (18.0 percent). Organic constituents had moderate relative-concentrations in 14.3 percent, and had low relative-concentrations or were not detected in 84.5 percent, of the primary aquifer. The proportion of the primary aquifer with high relative-concentrations of organic constituents reflected high proportions of the discontinued soil fumigant 1,2-dibromo-3-chlororopane (DBCP; 1.0 percent) and the solvent tetrachloroethene (PCE; 0.2 percent). Most of the organic and special interest constituents detected in groundwater in the Central Eastside study unit have human-health benchmarks. Of the 205 organic and special interest constituents analyzed for, 36 constituents were detected. Of these constituents, 32 were detected only at low relative-concentrations. Four constituents, chloroform, carbon tetrachloride, DBCP, and perchlorate, were detected at moderate relative-concentrations in grid wells. Nine organic and special-interest constituents were detected frequently (detected in greater than 10 percent of samples): the trihalomethanes chloroform, bromoform, bromodichloromethane, and dibromochloromethane; the solvent PCE; the herbicides atrazine, simazine, and metolachlor, and special-interest constituent perchlorate.An assessment of understanding of the groundwater quality included sampling of understanding wells, some of which were perforated in shallower or deeper portions of the aquifer system than the primary aquifer, and analysis of correlations of groundwater quality with land use, depth, age classification, and other potential explanatory factors.The understanding assessment indicated that the concentrations of many constituents were related to depth and groundwater age. However, concentrations of individual constituents or constituent classes also were sometimes related to geochemical conditions, lateral position in the flow system, or land use.High and moderate relative-concentrations of uranium, nitrate, and total dissolved solids (TDS) were detected in some wells where the tops of perforations are within the upper 200 feet of the aquifer system. In wells with the depth to the top of perforations below this depth, concentrations were low. A similar pattern occurred for the sum of herbicide concentrations. These vertical water-chemistry patterns are consistent with the hydrogeologic setting, in which return flows from agricultural and urban land use are the major source of recharge, and withdrawals for irrigation and urban supply are the major source of discharge, resulting in substantial vertical components of groundwater flow.The decrease in concentrations of many constituents with depth reflects in part that groundwater gets older with depth. Tritium, helium-isotopes, and carbon-14 data were used to classify the predominant age of groundwater samples into three categories: modern (water that has entered the aquifer in the last 50 years), pre-modern (water that entered the aquifer more than 50 years, up to tens of thousands of years, ago), and mixed (mixtures of waters with modern and pre-modern ages). Uranium, nitrate, and herbicide concentrations were significantly higher in groundwater having modern- and mixed-ages than pre-modern ages, indicating that these constituents may be affected by anthropogenic activities in the last 50 years.Other patterns in the distribution of nitrate, uranium, and TDS are evident. Isotopic and geochemical data are consistent with partial denitrification of nitrate in some reducing groundwaters in the western and deeper parts of the flow system. Uranium and TDS concentrations increase from east to west across the valley, along the direction of regional lateral groundwater flow.High and moderate relative-concentrations of arsenic can be attributed to reductive dissolution of manganese or iron oxides, or to desorption by high pH waters. Arsenic concentrations also increased with increasing depth and groundwater age. High to moderate relative-concentrations of vanadium primarily are related to high pH under oxic conditions.The frequency of detections of DBCP was greater in areas with orchard-vineyard land use >40 percent and at depths <200 feet. THMs and solvents were correlated positively with percent urban land use. Herbicide concentrations were correlated negatively with percent natural land use. Perchlorate concentrations were significantly greater in waters having modern and mixed ages than waters having pre-modern ages and were significantly and positively correlated with two land uses—percent orchard/vineyard land use and percent urban land use.

A cost-effectiveness analysis of three components of a syndromic surveillance system for the early warning of epidemics in rural China.

PubMed

Ding, Yan; Sauerborn, Rainer; Xu, Biao; Shaofa, Nie; Yan, Weirong; Diwan, Vinod K; Dong, Hengjin

2015-11-14

Syndromic surveillance systems (SSSs) collect non-specific syndromes in early stages of disease outbreaks. This makes an SSS a promising tool for the early detection of epidemics. An Integrated Surveillance System in rural China (ISSC project), which added an SSS to the existing Chinese surveillance system for the early warning of epidemics, was implemented from April 2012 to March 2014 in Jiangxi and Hubei Provinces. This study aims to measure the costs and effectiveness of the three components of the SSS in the ISSC project. The central measures of the cost-effectiveness analysis of the three components of the syndromic surveillance system were: 1) the costs per reported event, respectively, at the health facilities, the primary schools and the pharmacies; and 2) the operating costs per surveillance unit per year, respectively, at the health facilities, the primary schools and the pharmacies. Effectiveness was expressed by reporting outputs which were numbers of reported events, numbers of raw signals, and numbers of verified signals. The reported events were tracked through an internal data base. Signal verification forms and epidemiological investigation reports were collected from local country centers for disease control and prevention. We adopted project managers' perspective for the cost analysis. Total costs included set-up costs (system development and training) and operating costs (data collection, quality control and signal verification). We used self-designed questionnaires to collect cost data and received, respectively, 369 and 477 facility and staff questionnaires through a cross-sectional survey with a purposive sampling following the ISSC project. All data were entered into Epidata 3.02 and exported to Stata for descriptive analysis. The number of daily reported events per unit was the highest at pharmacies, followed by health facilities and finally primary schools. Variances existed within the three groups and also between Jiangxi and Hubei. During a 15-month surveillance period, the number of raw signals for early warning in Jiangxi province (n = 36) was nine times of that in Hubei. Health facilities and primary schools had equal numbers of raw signals (n = 19), which was 9.5 times of that from pharmacies. Five signals were confirmed as outbreaks, of which two were influenza, two were chicken pox and one was mumps. The cost per reported event was the highest at primary schools, followed by health facilities and then pharmacies. The annual operating cost per surveillance unit was the highest at pharmacies, followed by health facilities and finally primary schools. Both the cost per reported event and the annual operating cost per surveillance unit in Jiangxi in each of the three groups were higher than their counterparts in Hubei. Health facilities and primary schools are better sources of syndromic surveillance data in the early warning of outbreaks. The annual operating costs of all the three components of the syndromic surveillance system in the ISSC Project were low compared to general government expenditures on health and average individual income in rural China.

Molecular identification and antibiotic resistant bacteria isolated from primary dentition infections.

PubMed

Loyola-Rodriguez, J P; Garcia-Cortes, J O; Martinez-Martinez, R E; Patiño-Marin, N; Martinez-Castañon, G A; Zavala-Alonso, N V; Amano, A

2014-12-01

Bacterial resistance to antibiotics is a health problem in many parts of the world. The aim of this study was to identify bacteria from dental infections and determine bacterial resistance to antibiotics used in dental care in the primary dentition. This cross-sectional study comprised 60 children who presented for dental treatment for active dental infections in the primary dentition. Samples from dental infections were collected and bacteria were identified by polymerase chain reaction (PCR) assay. Bacterial resistance to antibiotics was determined by colony forming units on agar plates containing amoxicillin, clindamycin and amoxillicin-clavulanic acid (A-CA) tested at 8 μg/ml or 16 μg/ml. Clindamycin in both concentrations tested (8 μg/ml and 16 μg/ml) showed the highest bacterial resistance (85.9%), followed by amoxicillin (43.7%) and A-CA (12.0%). All comparisons among the three antibiotics used in the study exhibited statistical significance (p = <0.05) in both concentrations tested (8 μg/ml and 16 μg/ml), and under aerobic and anaerobic conditions. The most prevalent resistant species identified by PCR in primary dentition infections were: Streptococcus oralis and Prevotella intermedia (75.0%); Treponema denticola and Porphyromonas gingivalis (48.3%); Streptococcus mutans (45.0%); Campylobacter rectus; and Streptococcus salivarius (40%). This study demonstrated that A-CA exhibited the lowest bacterial resistance for clinical isolates in primary dentition infections. © 2014 Australian Dental Association.

Structure and work process in primary care and hospitalizations for sensitive conditions

PubMed Central

Araujo, Waleska Regina Machado; Queiroz, Rejane Christine de Sousa; Rocha, Thiago Augusto Hernandes; da Silva, Núbia Cristina; Thumé, Elaine; Tomasi, Elaine; Facchini, Luiz Augusto; Thomaz, Erika Barbara Abreu Fonseca

2017-01-01

ABSTRACT OBJECTIVE The objective of this study is to investigate whether the characteristics of the structure of primary health units and the work process of primary care teams are associated with the number of hospitalizations for primary care sensitive conditions. METHODS In this ecological study, we have analyzed data of Brazilian municipalities related to sociodemographic characteristics, coverage of care programs, structure of primary health units, and work process of primary care teams. We have obtained the data from the first cycle of the Brazilian Program for Improving Access and Quality of the Primary Care, of the Department of Information Technology of the Brazilian Unified Health System, the Brazilian Institute of Geography and Statistics, and the United Nations Development Programme. The associations have been estimated using negative binomial regression coefficients (β) and respective 95% confidence intervals, with a hierarchical approach in three levels (alpha = 5%). RESULTS In the adjusted analysis for the outcome in 2013, in the distal level, the coverage of the Bolsa Família Program (β = -0.001) and private insurance (β = -0.01) had a negative association, and the human development index (β = 1.13), the proportion of older adults (β = 0.05) and children under the age of five (β = 0.05), and the coverage of the Community Health Agent Strategy (β = 0.002) showed positive association with hospitalizations for primary care sensitive conditions. In the intermediate level, minimum hours (β = -0.14) and availability of vaccines (β = -0.16) showed a negative association, and availability of medications showed a positive association (β = 0.16). In the proximal level, only the variable of matrix support (β = 0.10) showed a positive association. The variables in the adjusted analysis of the number of hospitalizations for primary care sensitive conditions in 2014 presented the same association as in 2013. CONCLUSIONS The characteristics of the structure of primary health units and the work process of the primary care teams impact the number of hospitalizations for primary care sensitive conditions in Brazilian municipalities. PMID:28832757

[Increasing participation of primary care in the management of people with human immunodeficiency virus: hospital care professionals express their views].

PubMed

Ortega López, Angela; Morales Asencio, José Miguel; Rengel Díaz, Cristóbal; Peñas Cárdenas, Eloísa María; González Rodríguez, María José; Prado de la Sierra, Rut

2014-04-01

To determine the opinions of infectious diseases professionals on the possibilities of monitoring patients with HIV in Primary Care. Qualitative study using in-depth interviews. Infectious Diseases Unit in the University Hospital "Virgen de la Victoria" in Málaga. Health professionals with more than one year experience working in infectious diseases. A total of 25 respondents: 5 doctors, 15 nurses and 5 nursing assistants. Convenience sample. Semi-structured interviews were used that were later transcribed verbatim. Content analysis was performed according to the Taylor and Bogdan approach with computer support. Validation of information was made through additional analysis, expert participation, and feedback of part of the results to the participants. Hospital care professionals considered the disease-related complexity of HIV, treatment and social aspects that may have an effect on the organizational level of care. Professionals highlighted the benefits of specialized care, although opinions differed between doctors and nurses as regards follow up in Primary Care. Some concerns emerged about the level of training, confidentiality and workload in Primary Care, although they mentioned potential advantages related to accessibility of patients. Physicians perceive difficulties in following up HIV patients in Primary Care, even for those patients with a good control of their disease. Nurses and nursing assistants are more open to this possibility due to the proximity to home and health promotion in Primary Care. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Next-Generation Sequencing of Matched Primary and Metastatic Rectal Adenocarcinomas Demonstrates Minimal Mutation Gain and Concordance to Colonic Adenocarcinomas.

PubMed

Crumley, Suzanne M; Pepper, Kristi L; Phan, Alexandria T; Olsen, Randall J; Schwartz, Mary R; Portier, Bryce P

2016-06-01

-Colorectal carcinoma is the third most common cause of cancer death in males and females in the United States. Rectal adenocarcinoma can have distinct therapeutic and surgical management from colonic adenocarcinoma owing to its location and anatomic considerations. -To determine the oncologic driver mutations and better understand the molecular pathogenesis of rectal adenocarcinoma in relation to colon adenocarcinoma. -Next-generation sequencing was performed on 20 cases of primary rectal adenocarcinoma with a paired lymph node or solid organ metastasis by using an amplicon-based assay of more than 2800 Catalogue of Somatic Mutations in Cancer (COSMIC)-identified somatic mutations. -Next-generation sequencing data were obtained on both the primary tumor and metastasis from 16 patients. Most rectal adenocarcinoma cases demonstrated identical mutations in the primary tumor and metastasis (13 of 16, 81%). The mutations identified, listed in order of frequency, included TP53, KRAS, APC, FBXW7, GNAS, FGFR3, BRAF, NRAS, PIK3CA, and SMAD4. -The somatic mutations identified in our rectal adenocarcinoma cohort showed a strong correlation to those previously characterized in colonic adenocarcinoma. In addition, most rectal adenocarcinomas harbored identical somatic mutations in both the primary tumor and metastasis. These findings demonstrate evidence that rectal adenocarcinoma follows a similar molecular pathogenesis as colonic adenocarcinoma and that sampling either the primary or metastatic lesion is valid for initial evaluation of somatic mutations and selection of possible targeted therapy.

Comparison of patient evaluations of health care quality in relation to WHO measures of achievement in 12 European countries.

PubMed

Kerssens, Jan J; Groenewegen, Peter P; Sixma, Herman J; Boerma, Wienke G W; van der Eijk, Ingrid

2004-02-01

To gain insight into similarities and differences in patient evaluations of quality of primary care across 12 European countries and to correlate patient evaluations with WHO health system performance measures (for example, responsiveness) of these countries. Patient evaluations were derived from a series of Quote (QUality of care Through patients' Eyes) instruments designed to measure the quality of primary care. Various research groups provided a total sample of 5133 patients from 12 countries: Belarus, Denmark, Finland, Greece, Ireland, Israel, Italy, the Netherlands, Norway, Portugal, United Kingdom, and Ukraine. Intraclass correlations of 10 Quote items were calculated to measure differences between countries. The world health report 2000 - Health systems: improving performance performance measures in the same countries were correlated with mean Quote scores. Intra-class correlation coefficients ranged from low to very high, which indicated little variation between countries in some respects (for example, primary care providers have a good understanding of patients' problems in all countries) and large variation in other respects (for example, with respect to prescription of medication and communication between primary care providers). Most correlations between mean Quote scores per country and WHO performance measures were positive. The highest correlation (0.86) was between the primary care provider's understanding of patients' problems and responsiveness according to WHO. Patient evaluations of the quality of primary care showed large differences across countries and related positively to WHO's performance measures of health care systems.

Where are we on the diffusion curve? Trends and drivers of primary care physicians' use of health information technology.

PubMed

Audet, Anne-Marie; Squires, David; Doty, Michelle M

2014-02-01

To describe trends in primary care physicians' use of health information technology (HIT) between 2009 and 2012, examine practice characteristics associated with greater HIT capacity in 2012, and explore factors such as delivery system and payment reforms that may affect adoption and functionality. We used data from the 2012 and 2009 Commonwealth Fund International Health Policy Surveys of Primary Care Physicians. The data were collected in both years by postal mail between March and July among a nationally representative sample of primary care physicians in the United States. We compared primary care physicians' HIT capacity in 2009 and 2012. We employed multivariable logistic regression to analyze whether participating in an integrated delivery system, sharing resources and support with other practices, and being eligible for financial incentives were associated with greater HIT capacity in 2012. Primary care physicians' HIT capacity has significantly expanded since 2009, although solo practices continue to lag. Practices that are part of an integrated delivery system or share resources with other practices have higher rates of electronic medical record (EMR) adoption, multifunctional HIT, electronic information exchange, and electronic access for patients. Receiving or being eligible for financial incentives is associated with greater adoption of EMRs and information exchange. Federal efforts to increase adoption have coincided with a rapid increase in HIT capacity. Delivery system and payment reforms and federally funded extension programs could offer promising pathways for further diffusion. © Health Research and Educational Trust.

Religious and Secular Coping and Family Relationships in the Neonatal Intensive Care Unit

PubMed Central

Brelsford, Gina M.; Ramirez, Joshua; Veneman, Kristin; Doheny, Kim K.

2017-01-01

Background Preterm birth is an unanticipated and stressful event for parents. In addition, the unfamiliar setting of the intensive care nursery necessitates strategies for coping. Purpose The primary study objective of this descriptive study was to determine whether secular and religious coping strategies were related to family functioning in the neonatal intensive care unit. Methods Fifty-two parents of preterm (25–35 weeks’ gestation) infants completed the Brief COPE (secular coping), the Brief RCOPE (religious coping), and the Family Environment Scale within 1 week of their infant’s hospital admission. Findings This descriptive study found that parents’ religious and secular coping was significant in relation to family relationship functioning. Specifically, negative religious coping (ie, feeling abandoned or angry at God) was related to poorer family cohesion and use of denial. Implications for Practice These findings have relevance for interventions focused toward enhancing effective coping for families. Implications for Research Further study of religious and secular coping strategies for neonatal intensive care unit families is warranted in a larger more diverse sample of family members. PMID:27391569

Hydrogeology of a low-level radioactive-waste disposal site near Sheffield, Illinois

USGS Publications Warehouse

Foster, J.B.; Erickson, J.R.; Healy, R.W.

1984-01-01

The Sheffield low-level radioactive-waste facility is located on 20 acres of rolling terrain 3 miles southwest of Sheffield, Illinois. The shallow hydrogeologic system is composed of glacial sediments. Pennsylvania shale and mudstone bedrock isolate the regional aquifers below from the hydrogeologic system in the overlying glacial deposits. Pebbly sand underlies 67 percent of the site. Two ground-water flow paths were identified. The primary path conveys ground water from the site to the east through the pebbly-sand unit; a secondary path conveys ground water to the south and east through less permeable material. The pebbly-sand unit provides an underdrain that eliminates the risk of water rising into the trenches. Digital computer model results indicate that the pebbly-sand unit controls ground-water movement. Tritium found migrating in ground water in the southeast corner of the site travels approximately 25 feet per year. A group of water samples from wells which contained the highest tritium concentrations had specific conductivities, alkalinities, hardness, and chloride, sulfate, calcium, and magnesium contents higher than normal for local shallow ground water. (USGS)

Clean Energy in City Codes: A Baseline Analysis of Municipal Codification across the United States

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

Cook, Jeffrey J.; Aznar, Alexandra; Dane, Alexander

Municipal governments in the United States are well positioned to influence clean energy (energy efficiency and alternative energy) and transportation technology and strategy implementation within their jurisdictions through planning, programs, and codification. Municipal governments are leveraging planning processes and programs to shape their energy futures. There is limited understanding in the literature related to codification, the primary way that municipal governments enact enforceable policies. The authors fill the gap in the literature by documenting the status of municipal codification of clean energy and transportation across the United States. More directly, we leverage online databases of municipal codes to develop nationalmore » and state-specific representative samples of municipal governments by population size. Our analysis finds that municipal governments with the authority to set residential building energy codes within their jurisdictions frequently do so. In some cases, communities set codes higher than their respective state governments. Examination of codes across the nation indicates that municipal governments are employing their code as a policy mechanism to address clean energy and transportation.« less

Crossing the border for health care: access and primary care characteristics for young children of Latino farm workers along the US-Mexico border.

PubMed

Seid, Michael; Castañeda, Donna; Mize, Ronald; Zivkovic, Mirjana; Varni, James W

2003-01-01

To examine prevalence and correlates of cross-border health care for children of Latino farm workers in counties near the US-Mexico border and to compare access and primary care in the United States and Mexico. Two hundred ninety-seven parents at Head Start centers in San Diego and Imperial counties were surveyed regarding percentage of health care received in Mexico and the United States, access, and primary care characteristics. More than half of all health care was reported as received in Mexico. Reasons for Mexican use revolved around cost, accessibility, and perceptions of effectiveness. Parents of insured children reported slightly more US care, yet even this group reported approximately half of health care in Mexico. Insurance status was related to having a regular source of care, while uninsured children reporting most care in Mexico were less likely than uninsured children in the United States to have had a routine health care visit. Primary care characteristics were related to insurance status and source of care. Uninsured children reporting most care in Mexico fared better in some aspects of primary care than uninsured children reporting most care in the United States and as well as children with insurance receiving care in the United States or Mexico. Children of farm workers living along the US-Mexico border, almost irrespective of insurance status, receive a large proportion of care in Mexico. Especially for uninsured children, parent reports of Mexican care characteristics compare favorably with that received in the United States. Mexican health care might be a buffer against vulnerability to poor health outcomes for these children.

Status and understanding of groundwater quality in the South Coast Interior groundwater basins, 2008: California GAMA Priority Basin Project

USGS Publications Warehouse

Parsons, Mary C.; Kulongoski, Justin T.; Belitz, Kenneth

2014-01-01

Groundwater quality in the approximately 653-square-mile (1,691-square-kilometer) South Coast Interior Basins (SCI) study unit was investigated as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The South Coast Interior Basins study unit contains eight priority groundwater basins grouped into three study areas, Livermore, Gilroy, and Cuyama, in the Southern Coast Ranges hydrogeologic province. The GAMA Priority Basin Project is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey (USGS) and the Lawrence Livermore National Laboratory. The GAMA South Coast Interior Basins study was designed to provide a spatially unbiased assessment of untreated (raw) groundwater quality within the primary aquifer system, as well as a statistically consistent basis for comparing water quality between basins. The assessment was based on water-quality and ancillary data collected by the USGS from 50 wells in 2008 and on water-quality data from the California Department of Public Health (CDPH) database. The primary aquifer system was defined by the depth intervals of the wells listed in the CDPH database for the SCI study unit. The quality of groundwater in the primary aquifer system may be different from that in the shallower or deeper water-bearing zones; shallow groundwater may be more vulnerable to surficial contamination. The first component of this study, the status of the current quality of the groundwater resource, was assessed by using data from samples analyzed for volatile organic compounds (VOCs), pesticides, and naturally occurring inorganic constituents, such as trace elements and minor ions. This status assessment is intended to characterize the quality of groundwater resources within the primary aquifer system of the SCI study unit, not the treated drinking water delivered to consumers by water purveyors. Relative-concentrations (sample concentration divided by the health- or aesthetic-based benchmark concentration) were used for evaluating groundwater quality for those constituents that have Federal or California regulatory or non-regulatory benchmarks for drinking-water quality. A relative-concentration greater than 1.0 indicates a concentration greater than a benchmark, and a relative-concentration less than or equal to 1.0 indicates a concentration equal to or less than a benchmark. Relative-concentrations of organic constituents and special-interest constituents were classified as “high” (relative-concentration greater than 1.0), “moderate” (relative-concentration greater than 0.1 and less than or equal to 1.0), or “low” (relative-concentration less than or equal to 0.1). Relative-concentrations of inorganic constituents were classified as “high” (relative-concentration greater than 1.0), “moderate” (relative-concentration greater than 0.5 and less than or equal to 1.0), or “low” (relative-concentration less than or equal to 0.5). Aquifer-scale proportion was used as the primary metric in the status assessment for evaluating regional-scale groundwater quality. High aquifer-scale proportion is defined as the percentage of the area of the primary aquifer system with a relative-concentration greater than 1.0 for a particular constituent or class of constituents; percentage is based on an areal rather than a volumetric basis. Moderate and low aquifer-scale proportions were defined as the areal percentage of the primary aquifer system with moderate and low relative-concentrations, respectively. Two statistical approaches—grid-based and spatially weighted—were used to evaluate aquifer-scale proportions for individual constituents and classes of constituents. Grid-based and spatially weighted estimates were comparable in the SCI study unit (within 90-percent confidence intervals). Inorganic constituents (one or more) with health-based benchmarks were detected at high relative-concentrations in 29 percent of the primary aquifer system, at moderate relative-concentrations in 37 percent, and at low relative-concentrations in 34 percent. High aquifer-scale proportions of inorganic constituents primarily reflected high aquifer-scale proportions of nitrate (14 percent), boron (8.6 percent), molybdenum (8.6 percent), and arsenic (5.7 percent). In contrast, the relative-concentrations of organic constituents (one or more) were high in 1.6 percent, moderate in 2.0 percent, and low or not detected in 96 percent of the primary aquifer system. Of the 207 organic and special-interest constituents analyzed for, 15 constituents were detected. Perchlorate was found at moderate relative-concentrations in 34 percent of the aquifer. Two organic constituents were frequently detected (in greater than 10 percent of samples): the trihalomethane chloroform and the herbicide simazine. The second component of this study, the understanding assessment, identified natural and human factors that may have affected groundwater quality by evaluating land use, physical characteristics of the wells, and geochemical conditions of the aquifer. This evaluation was done by using statistical tests of correlations between these potential explanatory factors and water-quality data. Concentrations of arsenic, molybdenum, and manganese were generally greater in anoxic and pre-modern groundwater than other groundwater. In contrast, concentrations of nitrate and perchlorate were significantly higher in oxic and modern groundwater. Concentrations of simazine were greater in modern than pre-modern groundwater. Chloroform detections were positively correlated with greater urban land use. Boron concentrations and chloroform detections were higher in the Livermore study area than in the other study areas of the SCI; total dissolved solids and sulfate concentrations were greater in the Cuyama study area.

Detection of triclocarban and two co-contaminating chlorocarbanilides in US aquatic environments using isotope dilution liquid chromatography tandem mass spectrometry.

PubMed

Sapkota, Amir; Heidler, Jochen; Halden, Rolf U

2007-01-01

The antimicrobial compound triclocarban (TCC; 3,4,4'-trichlorocarbanilide; CAS# 101-20-2) is a high-production-volume chemical, recently suggested to cause widespread contamination of US water resources. To test this hypothesis, we developed an isotope dilution liquid chromatography electrospray ionization tandem mass spectrometry method for ultratrace analysis of TCC (0.9 ng/L detection limit) and analyzed low-volume water samples (200 mL) along with primary sludge samples from across the United States. All river water samples (100%) collected downstream of wastewater treatment plants had detectable levels of TCC, as compared to 56% of those taken upstream. Concentrations of TCC (mean+/-standard deviation) downstream of sewage treatment plants (84+/-110 ng/L) were significantly higher (P<0.05; Wilcoxon rank sum test) than those of samples taken upstream (12+/-15 ng/L). Compared to surface water, mean TCC concentrations found in dried, primary sludge obtained from municipal sewage treatment plants in five states were six orders of magnitude greater (19,300+/-7100 microg/kg). Several river samples contained a co-contaminant, identified based on its chromatographic retention time, molecular base ion, and MS/MS fragmentation behavior as 4,4'-dichlorocarbanilide (DCC; CAS# 1219-99-4). In addition to TCC and DCC, municipal sludge contained a second co-contaminant, 3,3',4,4'-tetrachlorocarbanilide (TetraCC; CAS# 4300-43-0). Both newly detected compounds were present as impurities (0.2%(w/w) each) in technical grade TCC (99%). Application of the new method for chlorocarbanilide analysis yielded TCC occurrence data for 13 US states, confirmed the role of sewage treatment plants as environmental inputs of TCC, and identified DCC and TetraCC as previously unrecognized pollutants released into the environment alongside TCC.

Effectiveness of a strategy that uses educational games to implement clinical practice guidelines among Spanish residents of family and community medicine (e-EDUCAGUIA project): a clinical trial by clusters.

PubMed

Del Cura-González, Isabel; López-Rodríguez, Juan A; Sanz-Cuesta, Teresa; Rodríguez-Barrientos, Ricardo; Martín-Fernández, Jesús; Ariza-Cardiel, Gloria; Polentinos-Castro, Elena; Román-Crespo, Begoña; Escortell-Mayor, Esperanza; Rico-Blázquez, Milagros; Hernández-Santiago, Virginia; Azcoaga-Lorenzo, Amaya; Ojeda-Ruiz, Elena; González-González, Ana I; Ávila-Tomas, José F; Barrio-Cortés, Jaime; Molero-García, José M; Ferrer-Peña, Raul; Tello-Bernabé, María Eugenia; Trujillo-Martín, Mar

2016-05-17

Clinical practice guidelines (CPGs) have been developed with the aim of helping health professionals, patients, and caregivers make decisions about their health care, using the best available evidence. In many cases, incorporation of these recommendations into clinical practice also implies a need for changes in routine clinical practice. Using educational games as a strategy for implementing recommendations among health professionals has been demonstrated to be effective in some studies; however, evidence is still scarce. The primary objective of this study is to assess the effectiveness of a teaching strategy for the implementation of CPGs using educational games (e-learning EDUCAGUIA) to improve knowledge and skills related to clinical decision-making by residents in family medicine. The primary objective will be evaluated at 1 and 6 months after the intervention. The secondary objectives are to identify barriers and facilitators for the use of guidelines by residents of family medicine and to describe the educational strategies used by Spanish teaching units of family and community medicine to encourage implementation of CPGs. We propose a multicenter clinical trial with randomized allocation by clusters of family and community medicine teaching units in Spain. The sample size will be 394 residents (197 in each group), with the teaching units as the randomization unit and the residents comprising the analysis unit. For the intervention, both groups will receive an initial 1-h session on clinical practice guideline use and the usual dissemination strategy by e-mail. The intervention group (e-learning EDUCAGUIA) strategy will consist of educational games with hypothetical clinical scenarios in a virtual environment. The primary outcome will be the score obtained by the residents on evaluation questionnaires for each clinical practice guideline. Other included variables will be the sociodemographic and training variables of the residents and the teaching unit characteristics. The statistical analysis will consist of a descriptive analysis of variables and a baseline comparison of both groups. For the primary outcome analysis, an average score comparison of hypothetical scenario questionnaires between the EDUCAGUIA intervention group and the control group will be performed at 1 and 6 months post-intervention, using 95 % confidence intervals. A linear multilevel regression will be used to adjust the model. The identification of effective teaching strategies will facilitate the incorporation of available knowledge into clinical practice that could eventually improve patient outcomes. The inclusion of information technologies as teaching tools permits greater learning autonomy and allows deeper instructor participation in the monitoring and supervision of residents. The long-term impact of this strategy is unknown; however, because it is aimed at professionals undergoing training and it addresses prevalent health problems, a small effect can be of great relevance. ClinicalTrials.gov: NCT02210442 .

Missed connections: Unintended consequences of updated cervical cancer screening guidelines on screening rates for sexually transmitted infections.

PubMed

Bogler, Tali; Farber, Allison; Stall, Nathan; Wijayasinghe, Sheila; Slater, Morgan; Guiang, Charlie; Glazier, Richard H

2015-10-01

To examine the effects of the updated 2012 cervical cancer screening guidelines on the rates of sexually transmitted infection (STI) screening in primary care. Retrospective chart review. Five academic family practice units at St Michael's Hospital in Toronto, Ont. Female patients, aged 19 to 25, who had at least 1 visit with a physician at 1 of the 5 academic family practice units during a 12-month period before (May 1, 2011, to April 30, 2012) or after (November 1, 2012, to October 31, 2013) the release of the updated guidelines. Number of women who received Papanicolaou tests or underwent STI screening; rates of STI screening performed during a Pap test or a periodic health examination; screening rates for HIV, syphilis, and hepatitis C; and the methods used for STI screening before and after the release of the updated guidelines. Results Before the release of the 2012 guidelines, 42 of 100 women had Pap tests and 40 of 100 women underwent STI screening. After the release of the guidelines, 17 of 100 women had Pap tests and 20 of 100 women received STI screening. Female patients were less likely to undergo STI screening under the 2012 guidelines compared with the 2005 guidelines (odds ratio 0.38, 95% CI 0.19 to 0.74; P = .003). Implementation of the 2012 cervical cancer screening guidelines was associated with lower rates of STI screening in the primary care setting. Primary care physicians should screen at-risk women for STIs at any clinically appropriate encounter and consider using noninvasive self-sampling methods.

Breast cancer screening practices among first-generation immigrant muslim women.

PubMed

Hasnain, Memoona; Menon, Usha; Ferrans, Carol Estwing; Szalacha, Laura

2014-07-01

The purpose of this study was to identify beliefs about breast cancer, screening practices, and factors associated with mammography use among first-generation immigrant Muslim women in Chicago, IL. A convenience sample of 207 first-generation immigrant Muslim women (Middle Eastern 51%; South Asian 49%) completed a culturally adapted questionnaire developed from established instruments. The questionnaire was administered in Urdu, Hindi, Arabic, or English, based on participant preference. Internal-consistency reliability was demonstrated for all scales (alpha coefficients ranged from 0.64 to 0.91). Associations between enabling, predisposing, and need variables and the primary outcome of mammography use were explored by fitting logistic regression models. Although 70% of the women reported having had a mammogram at least once, only 52% had had one within the past 2 years. Four factors were significant predictors of ever having had a mammogram: years in the United States, self-efficacy, perceived importance of mammography, and intent to be screened. Five factors were significant predictors of adherence (having had a mammogram in the past 2 years): years in the United States, having a primary care provider, perceived importance of mammography, barriers, and intent to be screened. This article sheds light on current screening practices and identifies theory-based constructs that facilitate and hinder Muslim women's participation in mammography screening. Our findings provide insights for reaching out particularly to new immigrants, developing patient education programs grounded in culturally appropriate approaches to address perceived barriers and building women's self-efficacy, as well as systems-level considerations for ensuring access to primary care providers.

Disseminating the unit of mass from multiple primary realisations

NASA Astrophysics Data System (ADS)

Nielsen, Lars

2016-12-01

When a new definition of the kilogram has been adopted in 2018 as expected, the unit of mass will be realised by the watt balance method, the x-ray crystal density method or perhaps other primary methods still to be developed. So far, the standard uncertainties associated with the available primary methods are at least one order of magnitude larger than the standard uncertainty associated with mass comparisons using mass comparators, so differences in primary realisations of the kilogram are easily detected, whereas many National Metrology Institutes would have to increase their calibration and measurement capabilities (CMCs) if they were traceable to a single primary realisation. This paper presents a scheme for obtaining traceability to multiple primary realisations of the kilogram using a small group of stainless steel 1 kg weights, which are allowed to change their masses over time in a way known to be realistic, and which are calibrated and stored in air. An analysis of the scheme shows that if the relative standard uncertainties of future primary realisations are equal to the relative standard uncertainties of the present methods used to measure the Planck constant, the unit of mass can be disseminated with a standard uncertainty less than 0.015 mg, which matches the smallest CMCs currently claimed for the calibration of 1 kg weights.

Biomass energy inventory and mapping system

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

Kasile, J.D.

1993-12-31

A four-stage biomass energy inventory and mapping system was conducted for the entire State of Ohio. The product is a set of maps and an inventory of the State of Ohio. The set of amps and an inventory of the State`s energy biomass resource are to a one kilometer grid square basis on the Universal Transverse Mercator (UTM) system. Each square kilometer is identified and mapped showing total British Thermal Unit (BTU) energy availability. Land cover percentages and BTU values are provided for each of nine biomass strata types for each one kilometer grid square. LANDSAT satellite data was usedmore » as the primary stratifier. The second stage sampling was the photointerpretation of randomly selected one kilometer grid squares that exactly corresponded to the LANDSAT one kilometer grid square classification orientation. Field sampling comprised the third stage of the energy biomass inventory system and was combined with the fourth stage sample of laboratory biomass energy analysis using a Bomb calorimeter and was then used to assign BTU values to the photointerpretation and to adjust the LANDSAT classification. The sampling error for the whole system was 3.91%.« less

[Strengthening primary health care: a strategy to maximize coordination of care].

PubMed

de Almeida, Patty Fidelis; Fausto, Márcia Cristina Rodrigues; Giovanella, Lígia

2011-02-01

To describe and analyze the actions developed in four large cities to strengthen the family health strategy (FHS) in Brazil. Case studies were carried out in Aracaju, Belo Horizonte, Florianópolis, and Vitória based on semi-structured interviews with health care managers. In addition, a cross-sectional study was conducted with questionnaires administered to a sample of FHS workers and services users. Actions needed to strengthen primary health care services were identified in all four cities. These include increasing the number of services offered at the primary health care level, removing barriers to access, restructuring primary services as the entry point to the health care system, enhancing problem-solving capacity (diagnostic and therapeutic support and networking between health units to organize the work process, training, and supervision), as well as improving articulation between surveillance and care actions. The cities studied have gained solid experience in the reorganization of the health care model based on a strengthening of health primary care and of the capacity to undertake the role of health care coordinator. However, to make the primary care level the customary entry point and first choice for users, additional actions are required to balance supplier-induced and consumer-driven demands. Consumer driven demand is the biggest challenge for the organization of teamwork processes. Support for and recognition of FHS as a basis for primary health care is still an issue. Initiatives to make FHS better known to the population, health care professionals at all levels, and civil society organizations are still needed.

An evolved axial melt lens in the Northern Ibra Valley, Southern Oman Ophiolite

NASA Astrophysics Data System (ADS)

Loocke, M. P.; Lissenberg, C. J.; MacLeod, C. J.

2014-12-01

The axial melt lens (AML) is a common feature lying at the base of the upper crust at fast-spreading mid-ocean ridges. It is thought to play a major role in the evolution of MORB and, potentially, accretion of the plutonic lower crust. In order to better understand the petrological processes that operate in AMLs we have examined the nature and variability of the horizon equivalent to the AML preserved in the Oman ophiolite. We present the results of a detailed investigation of a section east of Fahrah in the Ibra Valley. Here, a suite of 'varitextured' gabbros separates the sheeted dykes above from foliated gabbros below. It comprises 3 distinct units: an ophitic gabbro with pegmatitic patches (patchy gabbro; 70 m thick), overlain by a spotty gabbro (50 m), capped by a quartz-diorite (120 m). The sheeted dykes are observed to root in the quartz-diorite. Contacts between the plutonic units are gradational and subhorizontal. All of the units are isotropic. A total of 110 samples were collected for detailed petrographic and chemical analysis. With the exception of a small number of the diorites, all of the samples have a 'cumulate' component. Primary igneous amphibole is ubiquitous, present even as a minor phase in the foliated gabbros beneath, and indicating extensive differentiation and/or the presence of water in the primary liquid. France et al. (2014, Lithos) report patches of granoblastic material from this horizon in the Fahrah area, and suggest they represent the restites of partially melted pieces of the sheeted dykes. We did not, however, find any such granoblastic material, nor can the quartz-diorites represent partial melt; instead, preliminary geochemical modeling suggests that all of the units can be related by simple progressive fractional crystallization of an Oman axial ('V1' or 'Geotimes') melt. Along with the field relationships, as well as the basaltic andesite to dacite composition of the overlying sheeted dykes, this suggests that the AML was the locus of formation of the highly evolved melts. This contrasts with the more primitive AML and sheeted dyke complex documented in Wadi Abyad. From this we conclude that there is significant lateral variability in AML compositions along the Oman ridge axis.

Effects of interaction between ultramafic tectonite and mafic magma on Nd-Pb-Sr isotopic systems in the Neoproterozoic Chaya Massif, Baikal-Muya ophiolite belt

NASA Astrophysics Data System (ADS)

Amelin, Yuri V.; Ritsk, Eugeni Yu.; Neymark, Leonid A.

1997-04-01

Sm-Nd, Rb-Sr and U-Pb isotopic systems have been studied in minerals and whole rocks of harzburgites and mafic cumulates from the Chaya Massif, Baikal-Muya ophiolite belt, eastern Siberia, in order to determine the relationship between mantle ultramafic and crustal mafic sections. Geological relations in the Chaya Massif indicate that the mafic magmas were emplaced into, and interacted with older solid peridotite. Hand picked, acid-leached, primary rock-forming and accessory minerals (olivine, orthopyroxene, clinopyroxene and plagioclase) from the two harzburgite samples show coherent behavior and yield 147Sm/ 144Nd- 143Nd/ 144Nd and 238U/ 204Pb- 206Pb/ 204Pb mineral isochrons, corresponding to ages of 640 ± 58 Ma (95% confidence level) and 620 ± 71 Ma, respectively. These values are indistinguishable from the crystallization age of the Chaya mafic units of 627 ± 25 Ma (a weighted average of internal isochron Sm-Nd ages of four mafic cumulates). The Rb-Sr and Sm-Nd isotopic systems in the harzburgite whole-rock samples were disturbed by hydrothermal alteration. These alteration-related isotopic shifts mimic the trend of variations in primary isotopic compositions in the mafic sequence, thus emphasizing that isotopic data for ultramafic rocks should be interpreted with great caution. On the basis of initial Sr and Nd values, ultramafic and mafic rocks of the Chaya Massif can be divided into two groups: (1) harzburgites and the lower mafic unit gabbronorites withɛ Nd = +6.6 to +7.1 andɛ Sr = -11 to -16; and (2) websterite of the lower unit and gabbronorites of the upper mafic unit:ɛ Nd = +4.6 to +6.1 andɛ Sr = -8 to -9. Initial Pb isotopic ratios are identical in all rocks studied, with mean values of 206Pb/ 204Pb= 16.994 ± 0.023 and 207Pb/ 204Pb= 15.363 ± 0.015. The similarity of ages and initial isotopic ratios within the first group indicates that the isotopic systems in the pre-existing depleted peridotite were reset by extensive interaction with basaltic magma during formation of the mafic crustal sequence. The isotopic data agree with a hypothesized formation of the Chaya Massif in a suprasubduction-zone environment.

Effects of interaction between ultramafic tectonite and mafic magma on Nd-Pb-Sr isotopic systems in the Neoproterozoic Chaya Massif, Baikal-Muya ophiolite belt

USGS Publications Warehouse

Amelin, Y.V.; Ritsk, E. Yu; Neymark, L.A.

1997-01-01

Sm-Nd, Rb-Sr and U-Pb isotopic systems have been studied in minerals and whole rocks of harzburgites and mafic cumulates from the Chaya Massif, Baikal-Muya ophiolite belt, eastern Siberia, in order to determine the relationship between mantle ultramafic and crustal mafic sections. Geological relations in the Chaya Massif indicate that the mafic magmas were emplaced into, and interacted with older solid peridotite. Hand picked, acid-leached, primary rock-forming and accessory minerals (olivine, orthopyroxene, clinopyroxene and plagioclase) from the two harzburgite samples show coherent behavior and yield 147Sm/144Nd- 143Nd/144Nd and 238U/204Pb-206Pb/204Pb mineral isochrons, corresponding to ages of 640 ?? 58 Ma (95% confidence level) and 620 ?? 71 Ma, respectively. These values are indistinguishable from the crystallization age of the Chaya mafic units of 627 ?? 25 Ma (a weighted average of internal isochron Sm-Nd ages of four mafic cumulates). The Rb-Sr and Sm-Nd isotopic systems in the harzburgite whole-rock samples were disturbed by hydrothermal alteration. These alteration-related isotopic shifts mimic the trend of variations in primary isotopic compositions in the mafic sequence, thus emphasizing that isotopic data for ultramafic rocks should be interpreted with great caution. On the basis of initial Sr and Nd values, ultramafic and mafic rocks of the Chaya Massif can be divided into two groups: (1) harzburgites and the lower mafic unit gabbronorites with ??Nd = +6.6 to +7.1 and ??Sr = -11 to -16; and (2) websterite of the lower unit and gabbronorites of the upper mafic unit: ??Nd = + 4.6 to + 6.1 and ??Sr = - 8 to -9. Initial Pb isotopic ratios are identical in all rocks studied, with mean values of 206Pb/204Pb = 16.994 ?? 0.023 and 207Pb/204Pb = 15.363 ?? 0.015. The similarity of ages and initial isotopic ratios within the first group indicates that the isotopic systems in the pre-existing depleted peridotite were reset by extensive interaction with basaltic magma during formation of the mafic crustal sequence. The isotopic data agree with a hypothesized formation of the Chaya Massif in a suprasubduction-zone environment.

People Around Us. Language Arts Theme Units, Volume V. Cross Curricular Activities for Primary Grades.

ERIC Educational Resources Information Center

McAllister, Elizabeth A.; Hildebrand, Joan M.; Ericson, Joann H.

Suggesting that students in the primary grades can explore the world around them and practice valuable skills in spelling, reading, writing, communication, and language, this book presents cross-curricular units on "people around us" that reach diverse needs by working through emotional memory, deductive reasoning, and multiple intelligences.…

The Pedagogical Potential of Drawing and Writing in a Primary Science Multimodal Unit

ERIC Educational Resources Information Center

Wilson, Rachel E.; Bradbury, Leslie U.

2016-01-01

In consideration of the potential of drawing and writing as assessment and learning tools, we explored how early primary students used these modes to communicate their science understandings. The context for this study was a curricular unit that incorporated multiple modes of representation in both the presentation of information and production of…

29 CFR 14.22 - Availability of classified information to persons not employed by the Department of Labor.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Officer. (b) Access to Top Secret material. Access to Top Secret Information within the primary organizational units of the DOL by employees of other Federal agencies must be approved in advance by the Top Secret Control Officer of the primary organizational unit. (c) Access to Secret and Confidential...

Approaches of Inquiry Learning With Multimedia Resources in Primary Classrooms

ERIC Educational Resources Information Center

So, Wing-Mui Winnie; Kong, Siu-Cheung

2007-01-01

This study aims to examine the design of approaches for inquiry learning with multimedia resources in primary classrooms. The study describes the development of a multimedia learning unit that helps learners understand the natural phenomenon of the movement of the Earth. An analysis of the use of the multimedia learning unit by a teacher in two…

Constitutional Debates on Freedom of Religion: A Documentary History. Primary Documents in American History and Contemporary Issues.

ERIC Educational Resources Information Center

Patrick, John J., Ed.; Long, Gerald P., Ed.

Debates over the separation or accommodation of religion and government have divided the United States since its founding. This collection of over 70 primary documents represents the ideas and issues on the interpretation of the United States Constitution's First Amendment clauses pertaining to establishment and free exercise of religion. The…

Waste management in primary healthcare centres of Iran.

PubMed

Mesdaghinia, Alireza; Naddafi, Kazem; Mahvi, Amir Hossein; Saeedi, Reza

2009-06-01

The waste management practices in primary healthcare centres of Iran were investigated in the present study. A total of 120 primary healthcare centres located across the country were selected using the cluster sampling method and the current situation of healthcare waste management was determined through field investigation. The quantities of solid waste and wastewater generation per outpatient were found to be 60 g outpatient(-1) day(-1) and 26 L outpatient(-1) day(-1), respectively. In all of the facilities, sharp objects were separated almost completely, but separation of other types of hazardous healthcare solid waste was only done in 25% of the centres. The separated hazardous solid waste materials were treated by incineration, temporary incineration and open burning methods in 32.5, 8.3 and 42.5% of the healthcare centres, respectively. In 16.7% of the centres the hazardous solid wastes were disposed of without any treatment. These results indicate that the management of waste materials in primary healthcare centres in Iran faced some problems. Staff training and awareness, separation of healthcare solid waste, establishment of the autoclave method for healthcare solid waste treatment and construction of septic tanks and disinfection units in the centres that were without access to a sewer system are the major measures that are suggested for improvement of the waste management practices.

Users guide to the Most Similar Neighbor Imputation Program Version 2

Treesearch

Nicholas L. Crookston; Melinda Moeur; David Renner

2002-01-01

The Most Similar Neighbor (MSN, Moeur and Stage 1995) program is used to impute attributes measured on some sample units to sample units where they are not measured. In forestry applications, forest stands or vegetation polygons are examples of sample units. Attributes from detailed vegetation inventories are imputed to sample units where that information is not...

Groundwater quality in the Santa Clara River Valley, California

USGS Publications Warehouse

Burton, Carmen A.; Landon, Matthew K.; Belitz, Kenneth

2011-01-01

The Santa Clara River Valley (SCRV) study unit is located in Los Angeles and Ventura Counties, California, and is bounded by the Santa Monica, San Gabriel, Topatopa, and Santa Ynez Mountains, and the Pacific Ocean. The 460-square-mile study unit includes eight groundwater basins: Ojai Valley, Upper Ojai Valley, Ventura River Valley, Santa Clara River Valley, Pleasant Valley, Arroyo Santa Rosa Valley, Las Posas Valley, and Simi Valley (California Department of Water Resources, 2003; Montrella and Belitz, 2009). The SCRV study unit has hot, dry summers and cool, moist winters. Average annual rainfall ranges from 12 to 28 inches. The study unit is drained by the Ventura and Santa Clara Rivers, and Calleguas Creek. The primary aquifer system in the Ventura River Valley, Ojai Valley, Upper Ojai Valley, and Simi Valley basins is largely unconfined alluvium. The primary aquifer system in the remaining groundwater basins mainly consists of unconfined sands and gravels in the upper portion and partially confined marine and nonmarine deposits in the lower portion. The primary aquifer system in the SCRV study unit is defined as those parts of the aquifers corresponding to the perforated intervals of wells listed in the California Department of Public Health (CDPH) database. Public-supply wells typically are completed in the primary aquifer system to depths of 200 to 1,100 feet below land surface (bls). The wells contain solid casing reaching from the land surface to a depth of about 60-700 feet, and are perforated below the solid casing to allow water into the well. Water quality in the primary aquifer system may differ from the water in the shallower and deeper parts of the aquifer. Land use in the study unit is approximately 40 percent (%) natural (primarily shrubs, grassland, and wetlands), 37% agricultural, and 23% urban. The primary crops are citrus, avocados, alfalfa, pasture, strawberries, and dry beans. The largest urban areas in the study unit are the cities of Ventura, Oxnard, Camarillo, Simi Valley, Newhall, and Santa Clarita. Currently, groundwater pumping for agricultural use accounts for the greatest amount of discharge from the aquifer system in the SCRV study unit, followed by municipal use. Recharge to the groundwater system is through stream-channel infiltration from the three main river systems and by direct infiltration of precipitation and irrigation. Recharge facilities in the Oxnard forebay play an important role in recharging the local aquifer systems.

Cognition, emotion, and arithmetic in primary school: A cross-cultural investigation.

PubMed

Rodic, Maja; Cui, Jiaxin; Malykh, Sergey; Zhou, Xinlin; Gynku, Elena I; Bogdanova, Elena L; Zueva, Dina Y; Y Bogdanova, Olga; Kovas, Yulia

2018-06-01

The study investigated cross-cultural differences in variability and average performance in arithmetic, mathematical reasoning, symbolic and non-symbolic magnitude processing, intelligence, spatial ability, and mathematical anxiety in 890 6- to 9-year-old children from the United Kingdom, Russia, and China. Cross-cultural differences explained 28% of the variance in arithmetic and 17.3% of the variance in mathematical reasoning, with Chinese children outperforming the other two groups. No cross-cultural differences were observed for spatial ability and mathematical anxiety. In all samples, symbolic magnitude processing and mathematical reasoning were independently related to early arithmetic. Other factors, such as non-symbolic magnitude processing, mental rotation, intelligence, and mathematical anxiety, produced differential patterns across the populations. The results are discussed in relation to potential influences of parental practice, school readiness, and linguistic factors on individual differences in early mathematics. Statement of contribution What is already known on this subject? Cross-cultural differences in mathematical ability are present in preschool children. Similar mechanisms of mathematical development operate in preschool children from the United Kingdom, Russia, and China. Tasks that require understanding of numbers are best predictors of arithmetic in preschool children. What does this study add? Cross-cultural differences in mathematical ability become greater with age/years of formal education. Similar mechanisms of mathematical development operate in early primary school children from the United Kingdom, Russia, and China. Symbolic number magnitude and mathematical reasoning are the main predictors of arithmetic in all three populations. © 2018 The Authors British Journal of Developmental Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.

Distribution of rubidium, strontium, and zirconium in tuff from two deep coreholes at Yucca Mountain, Nevada

USGS Publications Warehouse

Spengler, Richard W.; Peterman, Zell E.; ,

1991-01-01

Variations in concentrations of trace elements Rb, Sr, and Zr within the sequence of high-silica tuff and dacitic lava beneath Yucca Mountain reflect both primary composition and secondary alteration. Rb and K concentrations have parallel trends. Rb concentrations are significantly lower within intervals containing zeolitic nonwelded to partially welded and bedded tuffs and are higher in thick moderately to densely welded zones. Sr concentrations increase with depth from about 30 ppm in the Topopah Spring Member of the Paintbrush Tuff to almost 300 ppm in the older tuffs. Zr concentrations are about 100 ppm in the Topopah Spring Member and also increase with depth to about 150 ppm in the Lithic Ridge Tuff and upper part of the older tuffs. Conspicuous local high concentrations of Sr in the lower part of the Tram Member, in the dacite lava, and in unit c of the older tuffs in USW G-1, and in the densely welded zone of the Bullfrog Member in USW GU-3/G-3 closely correlate with high concentrations of less-mobile Zr and may reflect either primary composition or elemental redistribution resulting largely from smectitic alteration. Initial 87Sr/86Sr values from composite samples increase upward in units above the Bullfrog Member of the Crater Flat Tuff. The progressive tenfold increase in Sr with depth coupled with the similarity of initial 87Sr/86Sr values within the Bullfrog Member and older units to those of Paleozoic marine carbonates are consistent with a massive influx of Sr from water derived from a Paleozoic carbonate aquifer.

Remote water monitoring system

NASA Technical Reports Server (NTRS)

Grana, D. C.; Haynes, D. P. (Inventor)

1978-01-01

A remote water monitoring system is described that integrates the functions of sampling, sample preservation, sample analysis, data transmission and remote operation. The system employs a floating buoy carrying an antenna connected by lines to one or more sampling units containing several sample chambers. Receipt of a command signal actuates a solenoid to open an intake valve outward from the sampling unit and communicates the water sample to an identifiable sample chamber. Such response to each signal receipt is repeated until all sample chambers are filled in a sample unit. Each sample taken is analyzed by an electrochemical sensor for a specific property and the data obtained is transmitted to a remote sending and receiving station. Thereafter, the samples remain isolated in the sample chambers until the sampling unit is recovered and the samples removed for further laboratory analysis.

Intermittent auscultation versus continuous fetal monitoring: exploring factors that influence birthing unit nurses' fetal surveillance practice using theoretical domains framework.

PubMed

Patey, Andrea M; Curran, Janet A; Sprague, Ann E; Francis, Jill J; Driedger, S Michelle; Légaré, France; Lemyre, Louise; Pomey, Marie-Pascale A; Grimshaw, Jeremy M

2017-09-25

Intermittent Auscultation (IA) is the recommended method of fetal surveillance for healthy women in labour. However, the majority of women receive continuous electronic monitoring. We used the Theoretical Domains Framework (TDF) to explore the views of Birthing Unit nurses about using IA as their primary method of fetal surveillance for healthy women in labour. Using a semi-structured interview guide, we interviewed a convenience sample of birthing unit nurses throughout Ontario, Canada to elicit their views about fetal surveillance. Interviews were recorded and transcribed verbatim. Transcripts were content analysed using the TDF and themes were framed as belief statements. Domains potentially key to changing fetal surveillance behaviour and informing intervention design were identified by noting the frequencies of beliefs, content, and their reported influence on the use of IA. We interviewed 12 birthing unit nurses. Seven of the 12 TDF domains were perceived to be key to changing birthing unit nurses' behaviour The nurses reported that competing tasks, time constraints and the necessity to multitask often limit their ability to perform IA (domains Beliefs about capabilities; Environmental context and resources). Some nurses noted the decision to use IA was something that they consciously thought about with every patient while others stated it their default decision as long as there were no risk factors (Memory, attention and decision processes, Nature of behaviour). They identified positive consequences (e.g. avoid unnecessary interventions, mother-centered care) and negative consequences of using IA (e.g. legal concerns) and reported that the negative consequences can often outweigh positive consequences (Beliefs about consequences). Some reported that hospital policies and varying support from care teams inhibited their use of IA (Social influences), and that support from the entire team and hospital management would likely increase their use (Social influences; Behavioural regulation). We identified potential influences on birthing unit nurses' use of IA as their primary method of fetal surveillance. These beliefs suggest potential targets for behaviour change interventions to promote IA use.

A GPU-accelerated 3D Coupled Sub-sample Estimation Algorithm for Volumetric Breast Strain Elastography

PubMed Central

Peng, Bo; Wang, Yuqi; Hall, Timothy J; Jiang, Jingfeng

2017-01-01

Our primary objective of this work was to extend a previously published 2D coupled sub-sample tracking algorithm for 3D speckle tracking in the framework of ultrasound breast strain elastography. In order to overcome heavy computational cost, we investigated the use of a graphic processing unit (GPU) to accelerate the 3D coupled sub-sample speckle tracking method. The performance of the proposed GPU implementation was tested using a tissue-mimicking (TM) phantom and in vivo breast ultrasound data. The performance of this 3D sub-sample tracking algorithm was compared with the conventional 3D quadratic sub-sample estimation algorithm. On the basis of these evaluations, we concluded that the GPU implementation of this 3D sub-sample estimation algorithm can provide high-quality strain data (i.e. high correlation between the pre- and the motion-compensated post-deformation RF echo data and high contrast-to-noise ratio strain images), as compared to the conventional 3D quadratic sub-sample algorithm. Using the GPU implementation of the 3D speckle tracking algorithm, volumetric strain data can be achieved relatively fast (approximately 20 seconds per volume [2.5 cm × 2.5 cm × 2.5 cm]). PMID:28166493

Modular assembly for supporting, straining, and directing flow to a core in a nuclear reactor

DOEpatents

Pennell, William E.

1977-01-01

A reactor core support arrangement for supporting, straining, and providing fluid flow to the core and periphery of a nuclear reactor during normal operation. A plurality of removable inlet modular units are contained within permanent liners in the lower supporting plate of the reactor vessel lower internals. During normal operation (1) each inlet modular unit directs main coolant flow to a plurality of core assemblies, the latter being removably supported in receptacles in the upper portion of the modular unit and (2) each inlet modular unit may direct bypass flow to a low pressure annular region of the reactor vessel. Each inlet modular unit may include special fluid seals interposed between mating surfaces of the inlet modular units and the core assemblies and between the inlet modular units and the liners, to minimize leakage and achieve an hydraulic balance. Utilizing the hydraulic balance, the modular units are held in the liners and the assemblies are held in the modular unit receptacles by their own respective weight. Included as part of the permanent liners below the horizontal support plate are generally hexagonal axial debris barriers. The axial debris barriers collectively form a bottom boundary of a secondary high pressure plenum, the upper boundary of which is the bottom surface of the horizontal support plate. Peripheral liners include radial debris barriers which collectively form a barrier against debris entry radially. During normal operation primary coolant inlet openings in the liner, below the axial debris barriers, pass a large amount of coolant into the inlet modular units, and secondary coolant inlet openings in the portion of the liners within the secondary plenum pass a small amount of coolant into the inlet modular units. The secondary coolant inlet openings also provide alternative coolant inlet flow paths in the unlikely event of blockage of the primary inlet openings. The primary inlet openings have characteristics which limit the entry of debris and minimize the potential for debris entering the primary inlets blocking the secondary inlets from inside the modular unit.

Thermo Scientific Ozone Analyzer Instrument Handbook

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

Springston, S. R.

The primary measurement output from the Thermo Scientific Ozone Analyzer is the concentration of the analyte (O3) reported at 1-s resolution in units of ppbv in ambient air. Note that because of internal pneumatic switching limitations the instrument only makes an independent measurement every 4 seconds. Thus, the same concentration number is repeated roughly 4 times at the uniform, monotonic 1-s time base used in the AOS systems. Accompanying instrument outputs include sample temperatures, flows, chamber pressure, lamp intensities and a multiplicity of housekeeping information. There is also a field for operator comments made at any time while data ismore » being collected.« less

Status and understanding of groundwater quality in the South Coast Range-Coastal study unit, 2008: California GAMA Priority Basin Project

USGS Publications Warehouse

Burton, Carmen A.; Land, Michael; Belitz, Kenneth

2013-01-01

Groundwater quality in the South Coast Range–Coastal (SCRC) study unit was investigated from May through November 2008 as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study unit is located in the Southern Coast Range hydrologic province and includes parts of Santa Barbara and San Luis Obispo Counties. The GAMA Priority Basin Project is conducted by the U.S. Geological Survey (USGS) in collaboration with the California State Water Resources Control Board and the Lawrence Livermore National Laboratory. The GAMA Priority Basin Project was designed to provide a statistically unbiased, spatially distributed assessment of untreated groundwater quality within the primary aquifer system. The primary aquifer system is defined as that part of the aquifer corresponding to the perforation interval of wells listed in the California Department of Public Health (CDPH) database for the SCRC study unit. The assessments for the SCRC study unit were based on water-quality and ancillary data collected in 2008 by the USGS from 55 wells on a spatially distributed grid, and water-quality data from the CDPH database. Two types of assessments were made: (1) status, assessment of the current quality of the groundwater resource, and (2) understanding, identification of the natural and human factors affecting groundwater quality. Water-quality and ancillary data were collected from an additional 15 wells for the understanding assessment. The assessments characterize untreated groundwater quality, not the quality of treated drinking water delivered to consumers by water purveyors. The first component of this study, the status assessment of groundwater quality, used data from samples analyzed for anthropogenic constituents such as volatile organic compounds (VOCs) and pesticides, as well as naturally occurring inorganic constituents such as major ions and trace elements. Although the status assessment applies to untreated groundwater, Federal and California regulatory and non-regulatory water-quality benchmarks that apply to drinking water are used to provide context for the results. Relative-concentrations (sample concentration divided by benchmark concentration) were used for evaluating groundwater. A relative-concentration greater than (>) 1.0 indicates a concentration greater than the benchmark and is classified as high. Inorganic constituents are classified as moderate if relative-concentrations are >0.5 and less than or equal to (≤) 1.0, or low if relative-concentrations are ≤0.5. For organic constituents, the boundary between moderate and low relative-concentrations was set at 0.1. Aquifer-scale proportion was used in the status assessment as the primary metric for evaluating regional-scale groundwater quality. High aquifer-scale proportion is defined as the areal percentage of the primary aquifer system with a high relative-concentration for a particular constituent or class of constituents. Moderate and low aquifer-scale proportions were defined as the areal percentage of the primary aquifer system with moderate and low relative-concentrations, respectively. Two statistical approaches—grid-based and spatially weighted—were used to evaluate aquifer-scale proportions for individual constituents and classes of constituents. Grid-based and spatially weighted estimates were comparable for the study (within 90 percent confidence intervals). For inorganic constituents with human-health benchmarks, relative-concentrations were high for at least one constituent for 33 percent of the primary aquifer system in the SCRC study unit. Arsenic, molybdenum, and nitrate were the primary inorganic constituents with human-health benchmarks that were detected at high relative-concentrations. Inorganic constituents with aesthetic benchmarks, referred to as secondary maximum contaminant levels (SMCLs), had high relative-concentrations for 35 percent of the primary aquifer system. Iron, manganese, total dissolved solids (TDS), and sulfate were the inorganic constituents with SMCLs detected at high relative-concentrations. In contrast to inorganic constituents, organic constituents with human-health benchmarks were not detected at high relative-concentrations in the primary aquifer system in the SCRC study unit. Of the 205 organic constituents analyzed, 21 were detected—13 with human-health benchmarks. Perchloroethene (PCE) was the only VOC detected at moderate relative-concentrations. PCE, dichlorodifluoromethane (CFC-12), and chloroform were detected in more than 10 percent of the primary aquifer system. Of the two special-interest constituents, one was detected; perchlorate, which has a human-health benchmark, was detected at moderate relative-concentrations in 29 percent of the primary aquifer system and had a detection frequency of 60 percent in the SCRC study unit. The second component of this study, the understanding assessment, identified the natural and human factors that may have affected groundwater quality in the SCRC study unit by evaluating statistical correlations between water-quality constituents and potential explanatory factors. The potential explanatory factors evaluated were land use, septic tank density, well depth and depth to top-of-perforations, groundwater age, density and distance to the nearest formerly leaking underground fuel tank (LUFT), pH, and dissolved oxygen (DO) concentration. Results of the statistical evaluations were used to explain the occurrence and distribution of constituents in the study unit. DO was the primary explanatory factor influencing the concentrations of many inorganic constituents. Arsenic, iron, and manganese concentrations increased as DO concentrations decreased, consistent with patterns expected as a result of reductive dissolution of iron and (or) manganese oxides in aquifer sediments. Molybdenum concentrations increased in anoxic conditions and in oxic conditions with high pH, reflecting two mechanisms for the mobilization of molybdenum—reductive dissolution and pH-dependent desorption under oxic conditions from aquifer sediments. Nitrate concentrations decreased as DO concentrations decreased which would be consistent with degradation of nitrate under anoxic conditions (denitrification). It also is possible that nitrate concentrations decreased in relation to increasing depth and groundwater age and not as a result of denitrification. Groundwater age was another explanatory factor frequently correlated to several inorganic constituents. Iron and manganese concentrations were higher in pre-modern (water recharged before 1952) or mixed-age groundwater. This correlation is one indication that iron and manganese are from natural sources. Nitrate, TDS, and sulfate concentrations were higher in modern groundwater (water recharged since 1952) and may indicate that human activities increase concentrations of nitrate, TDS, and sulfate. Land use was a third explanatory factor frequently correlated with inorganic constituents. Nitrate, TDS, and sulfate concentrations were higher in agricultural land-use areas than in natural land-use areas, indicating that increased concentrations may be a result of agricultural practices. Organic constituents usually were detected at low relative-concentrations; therefore, statistical analyses of relations to explanatory factors usually were done for classes of constituents (for example, pesticides or solvents) as well as for selected constituents. The number of VOCs detected in a well was not correlated to any of the explanatory factors evaluated. The number of pesticide and solvent detections and PCE and CFC-12 concentrations were higher in modern groundwater than in pre-modern groundwater. PCE and CFC-12 also were positively correlated to the density of LUFTs. PCE was negatively correlated to natural land use. Chloroform concentrations were positively correlated to the density of septic systems. Perchlorate concentrations were greater in agricultural areas than in urban or natural areas. Correlation of perchlorate with DO may indicate that perchlorate biodegradation under anoxic conditions may occur. Anthropogenic sources have contributed perchlorate to groundwater in the SCRC study unit, although low levels of perchlorate may occur naturally.

The Self-perception of Text-message Dependency Scale (STDS): Psychometric update based on a United States sample.

PubMed

Liese, Bruce S; Benau, Erik M; Atchley, Paul; Reed, Derek; Becirevic, Amel; Kaplan, Brent

2018-05-14

Some have suggested that text messaging is an addictive behavior. However, this characterization is uncertain, partly due to lack of well-validated measures of text messaging attitudes and behaviors. One standard instrument for measuring text messaging attitudes and behaviors is the Self-perception of Text-message Dependency Scale (STDS), though the psychometric properties of this scale have only been examined with a sample of Japanese youth. The primary objective of this study was to evaluate the STDS in the United States to determine its utility as a measure of text messaging dependence. We were interested in examining the factor structure and determining the extent to which this scale would correlate with two important outcome measures: motor vehicle accidents (MVAs) and moving violations. We analyzed data from 468 adults (age 18-74; 274 women) recruited via Amazon's Mechanical Turk (mTurk) service. Participants completed the STDS and provided information about their driving-related incidents in the past year. First we performed a confirmatory factor analysis, which supported the instrument's original factor structure. Then we tested the relationship between scores on the STDS and two important variables, MVAs and moving violations. We found that the STDS significantly correlated with both MVAs and moving violations. The present study confirms that the STDS is a potentially useful instrument for studying texting dependence in the United States and with adults of all ages. The instrument may be particularly useful in predicting motor vehicle outcomes.

Seroprevalences of anti-Sarcocystis neurona and anti-Neospora hughesi antibodies among healthy equids in the United States.

PubMed

James, Kaitlyn E; Smith, Woutrina A; Conrad, Patricia A; Packham, Andrea E; Guerrero, Leopoldo; Ng, Mitchell; Pusterla, Nicola

2017-06-01

OBJECTIVE To describe the general seroprevalence of anti-Sarcocystis neurona and anti-Neospora hughesi antibodies among healthy equids by use of indirect fluorescent antibody tests and determine potential risk factors for seropositivity. DESIGN Cross-sectional study. SAMPLE Whole blood samples collected from 5,250 equids (1 sample/animal) across 18 states in the United States during October 2013. PROCEDURES Information regarding potential risk factors (geographic region, breed, primary use, sex, and age) was collected along with the blood samples. For each equid, an indirect fluorescent antibody test was used to determine serum titers of antibody against each of the 2 protozoal parasites. Mixed-effects logistic regression models were created to determine ORs for seropositivity. RESULTS The overall seroprevalence of anti-S neurona and anti-N hughesi antibodies in the tested equids was 78% and 34%, respectively. Of the equids, 31% were seropositive and 18% were seronegative for antibodies against both parasites. Factors associated with equids being seropositive for anti-S neurona antibodies were residence in the South, warmblood breed, and age > 5 years. Seroprevalence of anti-N hughesi antibodies did not differ among equids in different states across the country, but warmblood breed and age > 5 years were associated with seropositivity. CONCLUSIONS AND CLINICAL RELEVANCE With regard to risk factors for S neurona and N hughesi exposure and antibody response among tested equids, older age was not unexpected; however, the influences of warmblood breed and geographic location on seropositivity for anti-S neurona antibody but not for anti-N hughesi antibody deserve further investigation.

Effects of historical climate change, habitat connectivity, and vicariance on genetic structure and diversity across the range of the Red Tree Vole (Phenacomys longicaudus) in the Pacific Northwest United States

USGS Publications Warehouse

Miller, Mark P.; Bellinger, R.M.; Forsman, E.D.; Haig, Susan M.

2006-01-01

Phylogeographical analyses conducted in the Pacific Northwestern United States have often revealed concordant patterns of genetic diversity among taxa. These studies demonstrate distinct North/South genetic discontinuities that have been attributed to Pleistocene glaciation. We examined phylogeographical patterns of red tree voles (Phenacomys longicaudus) in western Oregon by analysing mitochondrial control region sequences for 169 individuals from 18 areas across the species' range. Cytochrome b sequences were also analysed from a subset of our samples to confirm the presence of major haplotype groups. Phylogenetic network analyses suggested the presence of two haplotype groups corresponding to northern and southern regions of P. longicaudus' range. Spatial genetic analyses (samova and Genetic Landscape Shapes) of control region sequences demonstrated a primary genetic discontinuity separating northern and southern sampling areas, while a secondary discontinuity separated northern sampling areas into eastern and western groups divided by the Willamette Valley. The North/South discontinuity likely corresponds to a region of secondary contact between lineages rather than an overt barrier. Although the Cordilleran ice sheet (maximum a??12 000 years ago) did not move southward to directly affect the region occupied by P. longicaudus, climate change during glaciation fragmented the forest landscape that it inhabits. Signatures of historical fragmentation were reflected by positive associations between latitude and variables such as Tajima's D and patterns associated with location-specific alleles. Genetic distances between southern sampling areas were smaller, suggesting that forest fragmentation was reduced in southern vs. northern regions.

Demonstration Training Program for Improving the Capacity of Primary Care Units to Function Within an HMO Setting. Final Report.

ERIC Educational Resources Information Center

Detroit Medical Foundation, MI.

The Demonstration Training Program (DTP) undertaken by the Detroit Medical Foundation (DMF) was designed for Primary Care Unit staffs (PCUs) or Physician Corporations (PCs), area health center providers under contract to the Michigan Health Maintenance Organization Plans, Inc. (MHMOP). The major goals of the program were to design an appropriate…

A Bridge Too Far: The Decline in Shared Science Activities during Primary-Secondary Transition

ERIC Educational Resources Information Center

Galton, Maurice

2016-01-01

This article reviews the use of "bridging units" in science to improve curriculum continuity during transition from primary to secondary school. Based on research evidence collected over several decades, it suggests that the use of these units rose to a peak around the time of the millennium, but that in recent years few schools have…

The Making of a Citizen.

ERIC Educational Resources Information Center

Pickle, Catherine; And Others

1987-01-01

Two study units are offered: (1) a primary and intermediate unit entitled "What Are the Boundaries of Freedom of Speech"; and (2) an intermediate unit entitled "What Are the Challenges of Freedom of Religion?" (MT)

The Antebellum Women's Movement, 1820 to 1860. A Unit of Study for Grades 8-11.

ERIC Educational Resources Information Center

Leighow, Susan; Sterner-Hine, Rita

Using primary source documents, this teaching unit focuses on changing women's roles, growing awareness of gender inequities, and activist responses to these conditions in the United States between 1820 and 1860. Teacher background materials include a unit overview, correlation to National Standards for United States History, unit objectives, a…

50 CFR 14.121 - Primary enclosures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Wild Mammals and Birds to the United States Specifications for Nonhuman Primates § 14.121 Primary enclosures. (a) No more than one primate shall be transported in a primary enclosure. However, a mother and... animals that have been habitually housed together may be shipped in the same primary enclosure. Primates...

50 CFR 14.121 - Primary enclosures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Wild Mammals and Birds to the United States Specifications for Nonhuman Primates § 14.121 Primary enclosures. (a) No more than one primate shall be transported in a primary enclosure. However, a mother and... animals that have been habitually housed together may be shipped in the same primary enclosure. Primates...

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/.

Rock magnetic stratigraphy of a mafic layered sill: A key to the Karoo volcanics plumbing system

NASA Astrophysics Data System (ADS)

Maes, S. M.; Ferré, E. C.; Tikoff, B.; Brown, P. E.; Marsh, J. S.

2008-05-01

The Insizwa sill is an ~ 1 km-thick subhorizontal layered mafic intrusion and part of the Karoo Large Igneous Province in South Africa. This well-exposed intrusion consists of several superimposed petrologically and geochemically distinct units. Magnetic methods were used to study the intrusion in order to constrain the physical processes active in these types of bodies during crystallization. Rock magnetism studies indicate that within different petrologic units bulk susceptibility is controlled by primary magnetite (with minor pyrrhotite) and/or paramagnetic minerals (olivine, pyroxene). New magnetic data based on 659 specimens obtained from 3 vertical borehole cores, each spaced 5 km apart, confirm the prominent vertical zonation in low field magnetic susceptibility ( Klf), degree of anisotropy ( Pj) and orientation of the anisotropy of magnetic susceptibility (AMS) axes. The magnetic susceptibility correlates very well with petrographic units and the lateral continuity of magnetic units between boreholes is very consistent. Petrologic units with high, but variable, Klf, also show moderate anisotropy and dominantly vertical foliations. We interpret these patterns to result from inverse fabrics from single domain magnetite. The degree of anisotropy is low in petrologic units with low Klf, which also show shallowly dipping magnetic foliations. We interpret that the magnetic properties of these units are dominated by the paramagnetic minerals. These low Klf petrologic units also show no systematic increase in Klf, suggesting that only minor differentiation is occurring in these units. The dataset derived from 2 surface sampling traverses are consistent with borehole core AMS data, showing a pattern of dominantly steep magnetic foliation and variably plunging magnetic lineation with a NW-SE trend.

Isolation of Primary Fibroblast Culture from Wildlife: the Panthera onca Case to Preserve a South American Endangered Species.

PubMed

Mestre-Citrinovitz, Ana Cecilia; Sestelo, Adrián Jorge; Ceballos, María Belén; Barañao, José Lino; Saragüeta, Patricia

2016-10-10

Cell line establishment of somatic cells is a valuable resource to preserve genetic material of rare, difficult-to-find, endangered and giant species like Jaguar (Panthera onca), the largest South American felid. This unit focuses on the isolation and culture of fibroblasts from Jaguar skin and muscle biopsies, and ear cartilage dissection immediately after death to preserve one of the several endangered species in this biome. These culture techniques enabled us to contribute 570 samples from 45 autochthonous and endangered species, including Jaguar. The fibroblasts obtained are a part of the Genetic Bank of Buenos Aires Zoo with the 6700 samples, including tissues such as muscle, ovarian, testicular, blood, fibroblast cultures, sperm, hair, and fluids and cells from 450 individuals of 87 different species. © 2016 by John Wiley & Sons, Inc. Copyright © 2016 John Wiley & Sons, Inc.

Quality of Water from Shallow Wells in Urban Residential and Light Commercial Areas in Lafayette Parish, Louisiana, 2001 through 2002

USGS Publications Warehouse

Fendick, Robert B.; Tollett, Roland W.

2004-01-01

In 2001-02, the U.S. Geological Survey installed and sampled 28 shallow wells in urban residential and light commercial areas in Lafayette Parish, Louisiana, for a land-use study in the Acadian-Pontchartrain Study Unit of the National Water-Quality Assessment (NAWQA) Program. The wells were installed in the Chicot aquifer system, the primary source of water for irrigation and public-water supplies in southwestern Louisiana. The purpose of this report is to describe the quality of water from the 28 shallow wells and to relate that water quality to natural factors and to human activities. Ground-water samples were analyzed for general ground-water properties and about 240 water-quality contituents, including dissolved solids, major inorganic ions, trace elements, nutrients, dissolved organic carbon (DOC), radon, chlorofluorocarbons, selected stable isotopes, pesticides, pesticide degradation products, and volatile organic compounds (VOC's).

Microaggressions and marijuana use among college students.

PubMed

Pro, George; Sahker, Ethan; Marzell, Miesha

2017-03-09

This study examines the association between exposure to microaggressions and marijuana use, using original survey data from a sample of racial/ethnic minority college students (n = 332) from a large Division I university in the United States. Nearly all of our sample (96%) reported at least one experience with microaggressions in the past 6 months, while 33% reported using marijuana regularly. We modeled regular use of marijuana using multiple logistic regression, with consideration of sex, age, race/ethnicity, and microaggression scale scores as covariates. Age, sex, the microinvalidations subscale score, and the full microaggression scale score were significantly associated with marijuana use in our full models (p < .01; p = .01; p = .02; p = .03, respectively). With each additional experience of microaggression, the odds of regular marijuana use increase. Academic communities may consider the primary prevention of discriminatory behavior when addressing student substance use.

19 CFR 123.51 - Commercial samples transported by automobile through Canada between ports in the United States.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 1 2012-04-01 2012-04-01 false Commercial samples transported by automobile... Commercial samples transported by automobile through Canada between ports in the United States. (a) General... samples by automobile through Canada to another place in the United States without displaying the samples...

19 CFR 123.51 - Commercial samples transported by automobile through Canada between ports in the United States.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 1 2013-04-01 2013-04-01 false Commercial samples transported by automobile... Commercial samples transported by automobile through Canada between ports in the United States. (a) General... samples by automobile through Canada to another place in the United States without displaying the samples...

19 CFR 123.51 - Commercial samples transported by automobile through Canada between ports in the United States.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 1 2011-04-01 2011-04-01 false Commercial samples transported by automobile... Commercial samples transported by automobile through Canada between ports in the United States. (a) General... samples by automobile through Canada to another place in the United States without displaying the samples...

19 CFR 123.51 - Commercial samples transported by automobile through Canada between ports in the United States.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 1 2014-04-01 2014-04-01 false Commercial samples transported by automobile... Commercial samples transported by automobile through Canada between ports in the United States. (a) General... samples by automobile through Canada to another place in the United States without displaying the samples...

19 CFR 123.51 - Commercial samples transported by automobile through Canada between ports in the United States.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Commercial samples transported by automobile... Commercial samples transported by automobile through Canada between ports in the United States. (a) General... samples by automobile through Canada to another place in the United States without displaying the samples...

Illumina MiSeq Sequencing for Preliminary Analysis of Microbiome Causing Primary Endodontic Infections in Egypt

PubMed Central

Azab, Marwa Mohamed; Fayyad, Dalia Mukhtar

2018-01-01

The use of high throughput next generation technologies has allowed more comprehensive analysis than traditional Sanger sequencing. The specific aim of this study was to investigate the microbial diversity of primary endodontic infections using Illumina MiSeq sequencing platform in Egyptian patients. Samples were collected from 19 patients in Suez Canal University Hospital (Endodontic Department) using sterile # 15K file and paper points. DNA was extracted using Mo Bio power soil DNA isolation extraction kit followed by PCR amplification and agarose gel electrophoresis. The microbiome was characterized on the basis of the V3 and V4 hypervariable region of the 16S rRNA gene by using paired-end sequencing on Illumina MiSeq device. MOTHUR software was used in sequence filtration and analysis of sequenced data. A total of 1858 operational taxonomic units at 97% similarity were assigned to 26 phyla, 245 families, and 705 genera. Four main phyla Firmicutes, Bacteroidetes, Proteobacteria, and Synergistetes were predominant in all samples. At genus level, Prevotella, Bacillus, Porphyromonas, Streptococcus, and Bacteroides were the most abundant. Illumina MiSeq platform sequencing can be used to investigate oral microbiome composition of endodontic infections. Elucidating the ecology of endodontic infections is a necessary step in developing effective intracanal antimicrobials. PMID:29849646

Role of Raman spectroscopy and surface enhanced Raman spectroscopy in colorectal cancer

PubMed Central

Jenkins, Cerys A; Lewis, Paul D; Dunstan, Peter R; Harris, Dean A

2016-01-01

Colorectal cancer (CRC) is the fourth most common cancer in the United Kingdom and is the second largest cause of cancer related death in the United Kingdom after lung cancer. Currently in the United Kingdom there is not a diagnostic test that has sufficient differentiation between patients with cancer and those without cancer so the current referral system relies on symptomatic presentation in a primary care setting. Raman spectroscopy and surface enhanced Raman spectroscopy (SERS) are forms of vibrational spectroscopy that offer a non-destructive method to gain molecular information about biological samples. The techniques offer a wide range of applications from in vivo or in vitro diagnostics using endoscopic probes, to the use of micro-spectrometers for analysis of biofluids. The techniques have the potential to detect molecular changes prior to any morphological changes occurring in the tissue and therefore could offer many possibilities to aid the detection of CRC. The purpose of this review is to look at the current state of diagnostic technology in the United Kingdom. The development of Raman spectroscopy and SERS in clinical applications relation for CRC will then be discussed. Finally, future areas of research of Raman/SERS as a clinical tool for the diagnosis of CRC are also discussed. PMID:27190582

Material identification based upon energy-dependent attenuation of neutrons

DOEpatents

Marleau, Peter

2015-10-06

Various technologies pertaining to identifying a material in a sample and imaging the sample are described herein. The material is identified by computing energy-dependent attenuation of neutrons that is caused by presence of the sample in travel paths of the neutrons. A mono-energetic neutron generator emits the neutron, which is downscattered in energy by a first detector unit. The neutron exits the first detector unit and is detected by a second detector unit subsequent to passing through the sample. Energy-dependent attenuation of neutrons passing through the sample is computed based upon a computed energy of the neutron, wherein such energy can be computed based upon 1) known positions of the neutron generator, the first detector unit, and the second detector unit; or 2) computed time of flight of neutrons between the first detector unit and the second detector unit.

Variability of pesticide residues in eggplant units collected from a field trial and marketplaces in Greece.

PubMed

Prodhan, Mohammad Dalower Hossain; Papadakis, Emmanouil-Nikolaos; Papadopoulou-Mourkidou, Euphemia

2018-04-01

Variability of pesticide residues among food items is very important when assessing the risks and food safety for the consumers. Therefore, the present study was undertaken to estimate the unit-to-unit residue variability factors for eggplant. In total, 120 samples from a trial field and 142 samples from different marketplaces in Thessaloniki, Greece, were collected to estimate the variability of pesticide residues in eggplant units. They were extracted by the QuEChERS method and the residues were determined by LC-MS/MS. For the field samples, the unit-to-unit variability factors (VFs) obtained for cypermethrin and deltamethrin residues were 2.54 and 2.51, respectively. The mean residue levels of both pesticides were higher in the composite samples than in the individual samples. The average VFs for the marketplace samples was 3.89. The eggplant units exposed to pesticides were higher in residues than the non-exposed units. The variability factors obtained in the marketplace samples were higher than those in the samples collected from the field trial. A default VF value of 3 for field trials is appropriate for use when assessing the acute dietary intake but a VF for the marketplace samples should be reconsidered with a larger data. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

Coverage and quality of antenatal care provided at primary health care facilities in the 'Punjab' province of 'Pakistan'.

PubMed

Majrooh, Muhammad Ashraf; Hasnain, Seema; Akram, Javaid; Siddiqui, Arif; Memon, Zahid Ali

2014-01-01

Antenatal care is a very important component of maternal health services. It provides the opportunity to learn about risks associated with pregnancy and guides to plan the place of deliveries thereby preventing maternal and infant morbidity and mortality. In 'Pakistan' antenatal services to rural population are being provided through a network of primary health care facilities designated as 'Basic Health Units and Rural Health Centers. Pakistan is a developing country, consisting of four provinces and federally administered areas. Each province is administratively subdivided in to 'Divisions' and 'Districts'. By population 'Punjab' is the largest province of Pakistan having 36 districts. This study was conducted to assess the coverage and quality antenatal care in the primary health care facilities in 'Punjab' province of 'Pakistan'. Quantitative and Qualitative methods were used to collect data. Using multistage sampling technique nine out of thirty six districts were selected and 19 primary health care facilities of public sector (seventeen Basic Health Units and two Rural Health Centers were randomly selected from each district. Focus group discussions and in-depth interviews were conducted with clients, providers and health managers. The overall enrollment for antenatal checkup was 55.9% and drop out was 32.9% in subsequent visits. The quality of services regarding assessment, treatment and counseling was extremely poor. The reasons for low coverage and quality were the distant location of facilities, deficiency of facility resources, indifferent attitude and non availability of the staff. Moreover, lack of client awareness about importance of antenatal care and self empowerment for decision making to seek care were also responsible for low coverage. The coverage and quality of the antenatal care services in 'Punjab' are extremely compromised. Only half of the expected pregnancies are enrolled and out of those 1/3 drop out in follow-up visits.

Adverse events analysis as an educational tool to improve patient safety culture in primary care: a randomized trial.

PubMed

González-Formoso, Clara; Martín-Miguel, María Victoria; Fernández-Domínguez, Ma José; Rial, Antonio; Lago-Deibe, Fernando Isidro; Ramil-Hermida, Luis; Pérez-García, Margarita; Clavería, Ana

2011-06-14

Patient safety is a leading item on the policy agenda of both major international health organizations and advanced countries generally. The quantitative description of the phenomena has given rise to intense concern with the issue in institutions and organizations, leading to a number of initiatives and research projects and the promotion of patient safety culture, with training becoming a priority both in Spain and internationally. To date, most studies have been conducted in a hospital setting, even though primary care is the type most commonly used by the public, in our experience. Our study aims to achieve the following:--Assess the registry of adverse events as an education tool to improve patient safety culture in the Family and Community Teaching Units of Galicia.--Find and analyze educational tools to improve patient safety culture in primary care.--Evaluate the applicability of the Hospital Survey on Patient Safety Culture by the Agency for Healthcare Research and Quality, Spanish version, in the context of primary health care. Experimental unifactorial study of two groups, control and intervention. Tutors and residents in Family and Community Medicine in last year of studies in Galicia, Spain. From the population universe through voluntary participation. Twenty-seven tutor-resident units in each group required, randomly assigned. Residents and their respective tutor (tutor-resident pair) in teaching units on Family and Community Medicine from throughout Galicia will be invited to participate. Tutor-resident pair that agrees to participate will be sent the Hospital Survey on Patient Safety Culture. Then, tutor-resident pair will be assigned to each group--either intervention or control--through simple random sampling. The intervention group will receive specific training to record the adverse effects found in patients under their care, with subsequent feedback, after receiving instruction on the process. No action will be taken in the control group. After the intervention has ended, the survey will once again be provided to all participants. Change in safety culture as measured by Hospital Survey on Patient Safety CultureCONSORT Extension for Non-Pharmacologic Treatments 2008 was applied. The most significant limitations on the project are related to selecting a tool to measure the safety environment, the training calendar of residents in Family and Community Medicine in last year of studies and the no-answer bias inherent to research conducted through self-administered surveys.The development and application of a safety culture in the health sector, specifically in primary care, is as yet limited. Thus, identifying the strengths and weaknesses in the safety environment may assist in designing strategies for improvement in the primary care health centers of our region. ISRCTN: ISRCTN41911128.

Return to the Primary Acute Care Service Among Patients With Multiple Myeloma on an Acute Inpatient Rehabilitation Unit.

PubMed

Fu, Jack B; Lee, Jay; Shin, Ben C; Silver, Julie K; Smith, Dennis W; Shah, Jatin J; Bruera, Eduardo

2017-06-01

Pancytopenia, immunosuppression, and other factors may place patients with multiple myeloma at risk for medical complications. These patients often require inpatient rehabilitation. No previous studies have looked at risk factors for return to the primary acute care service of this patient population. To determine the percentage of and factors associated with return to the primary acute care service of multiple myeloma rehabilitation inpatients. Retrospective review. Acute inpatient rehabilitation unit within a National Cancer Institute Comprehensive Cancer Center. All patients with multiple myeloma admitted to the inpatient rehabilitation unit between March 1, 2004, and February 28, 2015. Return to the primary acute care service was analyzed with demographic information, multiple myeloma characteristics, medications, laboratory values, and hospital admission characteristics. One hundred forty-three inpatient rehabilitation admissions were found during the study period. After we removed multiple admissions of the same patients and planned transfers to the primary acute care service, 122 admissions were analyzed. Thirty-two (26%) patients transferred back to the primary acute care service for unplanned reasons. Multivariate analysis revealed male gender and thrombocytopenia as significantly associated with return to the primary acute care service. The median survival of patients who transferred back to the inpatient primary acute care service was 180 days versus 550 days for those who did not (P < .001). Because of their medical fragility, clinicians caring for rehabilitation inpatients with multiple myeloma should maintain close contact with the primary oncology service. Factors associated with an increased risk of transfer back to the primary acute care service include male gender and thrombocytopenia. IV. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Dedos de Luna. Children's Literature in Spanish: Bilingual Edition. Guia para maestros en espanol e ingles. Elementary Literature Series, Part II.

ERIC Educational Resources Information Center

Walker, Dana; Huerta, Mario

This curriculum unit is designed to give primary school students foreign language experiences and also to support the cultural literacy strand of the California State History-Social Science Framework. The unit is part of an elementary literature series which utilizes quality primary source literature from various world regions and countries and…

Primary Teachers' Written Unit Plans in Mathematics and Their Perceptions of Essential Elements of These

ERIC Educational Resources Information Center

Roche, Anne; Clarke, Doug M.; Clarke, David J.; Sullivan, Peter

2014-01-01

The content and purpose of written unit plans in mathematics is an under-researched area. In this article, we provide a brief overview of research on teachers' planning processes and the place of mental and written plans. We report on data from a questionnaire completed by 357 teachers from Victorian Catholic primary schools, where we focused on…

Women's experiences of transfer from primary maternity unit to tertiary hospital in New Zealand: part of the prospective cohort Evaluating Maternity Units study.

PubMed

Grigg, Celia P; Tracy, Sally K; Schmied, Virginia; Monk, Amy; Tracy, Mark B

2015-12-18

There is worldwide debate regarding the appropriateness and safety of different birthplaces for well women. The Evaluating Maternity Units (EMU) study's primary objective was to compare clinical outcomes for well women intending to give birth in either a tertiary level maternity hospital or a freestanding primary level maternity unit. Little is known about how women experience having to change their birthplace plans during the antenatal period or before admission to a primary unit, or transfer following admission. This paper describes and explores women's experience of these changes-a secondary aim of the EMU study. This paper utilised the six week postpartum survey data, from the 174 women from the primary unit cohort affected by birthplace plan change or transfer (response rate 73%). Data were analysed using descriptive statistics and thematic analysis. The study was undertaken in Christchurch, New Zealand, which has an obstetric-led tertiary maternity hospital and four freestanding midwife-led primary maternity units (2010-2012). The 702 study participants were well, pregnant women booked to give birth in one of these facilities, all of whom received continuity of midwifery care, regardless of their intended or actual birthplace. Of the women who had to change their planned place of birth or transfer the greatest proportion of women rated themselves on a Likert scale as unbothered by the move (38.6%); 8.8% were 'very unhappy' and 7.6% 'very happy' (quantitative analysis). Four themes were identified, using thematic analysis, from the open ended survey responses of those who experienced transfer: 'not to plan', control, communication and 'my midwife'. An interplay between the themes created a cumulatively positive or negative effect on their experience. Women's experience of transfer in labour was generally positive, and none expressed stress or trauma with transfer. The women knew of the potential for change or transfer, although it was not wanted or planned. When they maintained a sense control, experienced effective communication with caregivers, and support and information from their midwife, the transfer did not appear to be experienced negatively. The model of continuity of midwifery care in New Zealand appeared to mitigate the negative aspects of women's experience of transfer and facilitate positive birth experiences.

Explaining direct care resource use of nursing home residents: findings from time studies in four states.

PubMed

Arling, Greg; Kane, Robert L; Mueller, Christine; Lewis, Teresa

2007-04-01

To explain variation in direct care resource use (RU) of nursing home residents based on the Resource Utilization Groups III (RUG-III) classification system and other resident- and unit-level explanatory variables. Primary data were collected on 5,314 nursing home residents in 156 nursing units in 105 facilities from four states (CO, IN, MN, MS) from 1998 to 2004. Study Design. Nurses and other direct care staff recorded resident-specific and other time caring for all residents on sampled nursing units. Care time was linked to resident data from the Minimum Data Set assessment instrument. Major variables were: RUG-III group (34-group), other health and functional conditions, licensed and other professional minutes per day, unlicensed minutes per day, and direct care RU (wage-weighted minutes). Resident- and unit-level relationships were examined through hierarchical linear modeling. Time study data were recorded with hand-held computers, verified for accuracy by project staff at the data collection sites and then merged into resident and unit-level data sets. Resident care time and RU varied between and within nursing units. RUG-III group was related to RU; variables such as length of stay and unit percentage of high acuity residents also were significantly related. Case-mix indices (CMIs) constructed from study data displayed much less variation across RUG-III groups than CMIs from earlier time studies. Results from earlier time studies may not be representative of care patterns of Medicaid and private pay residents. New RUG-III CMIs should be developed to better reflect the relative costs of caring for these residents.

Assessment of water-quality data from Long Lake National Wildlife Refuge, North Dakota--2008 through 2012

USGS Publications Warehouse

Tangen, Brian A.; Finocchiaro, Raymond G.; Gleason, Robert A.; Rabenberg, Michael J.; Dahl, Charles F.; Ell, Mike J.

2013-01-01

ong Lake National Wildlife Refuge, located in south-central North Dakota, is an important habitat for numerous migratory birds and waterfowl, including several threatened or endangered species. The refuge is distinguished by Long Lake, which is approximately 65 square kilometers and consists of four primary water management units. Water levels in the Long Lake units are maintained by low-level dikes and water-control structures, which after construction during the 1930s increased the water-storage capacity of Long Lake and reduced the frequency and volume of flushing flows downstream. The altered water regime, along with the negative precipitation:evaporation ratio of the region, may be contributing to the accumulation of water-borne chemical constituents such as salts, trace metals, and other constituents, which at certain threshold concentrations may impair aquatic plant, invertebrate, and bird communities of the refuge. The refuge’s comprehensive conservation planning process identified the need for water-quality monitoring to assess current (2013) conditions, establish comparative baselines, evaluate changes over time (trends), and support adaptive management of the wetland units. In 2008, the U.S. Geological Survey, U.S. Fish and Wildlife Service, and North Dakota Department of Health began a water-quality monitoring program at Long Lake National Wildlife Refuge to address these needs. Biweekly water-quality samples were collected for ions, trace metals, and nutrients; and in situ sensors and data loggers were installed for the continuous measurement of specific conductance and water depth. Long Lake was characterized primarily by sodium, bicarbonate, and sulfate ions. Overall results for total alkalinity and hardness were 580 and 329 milligrams per liter, respectively; thus, Long Lake is considered alkaline and classified as very hard. The mean pH and sodium adsorption ratio for Long Lake were 8.8 and 10, respectively. Total dissolved solids concentrations averaged approximately 1,750 milligrams per liter, and ranged from 117 to 39,700 milligrams per liter. Twelve of the 14 trace metals detected in the water samples had established North Dakota water-quality standards for aquatic life, and only aluminum and copper consistently exceeded these criteria. Aluminum is considered harmful to aquatic biota in acidic (pH less than 5.5) systems and most of the copper standard exceedances were collected from highly concentrated waters because of evaporation and seasonally low water levels. Concentrations for various forms of nitrogen and phosphorus generally were similar to reported regional values. Specific conductance of Long Lake varied seasonally and annually both within and among management units, with values ranging from less than 500 to nearly 40,000 microsiemens per centimeter at 25 degrees Celsius. Long Lake was characterized by consistent seasonal patterns of increasing specific conductance from spring (March and April) to fall (September and October), with levels stabilizing through the end of the sampling season (November). These seasonal patterns in specific conductance were associated with decreasing water levels throughout the summer due primarily to evaporation and continuous water releases through the Unit 1 outlet structure, which resulted in the concentration of salts. Specific conductance of each unit, along with water levels, also varied among years. Overall, specific conductance levels were greatest during the drier year of 2008 when water levels were low. Specific conductance levels were lowest during the spring of 2009 following above-average volumes of fresh water from snowmelt runoff. Comparisons of specific conductance among sample sites that were spatially distributed within each management unit suggested that spatial variability within units was low except for areas associated with local inflows. Data collected during this study revealed consistent seasonal patterns and low within-unit spatial variability of specific conductance. Based on these data results, future sample collection efforts may be reduced, as well as the number of sample locations, to limit sampling costs. Water-quality samples collected monthly or seasonally during the growing season (spring, summer, and fall) from a single representative location within each water-management unit should provide sufficient data to assess seasonal changes in water-quality over time and provide information for Long Lake management decisions.

Learning from contract change in primary care dentistry: A qualitative study of stakeholders in the north of England.

PubMed

Holmes, Richard D; Steele, Jimmy G; Donaldson, Cam; Exley, Catherine

2015-09-01

The aim of this research was to explore and synthesise learning from stakeholders (NHS dentists, commissioners and patients) approximately five years on from the introduction of a new NHS dental contract in England. The case study involved a purposive sample of stakeholders associated with a former NHS Primary Care Trust (PCT) in the north of England. Semi-structured interviews were conducted with 8 commissioners of NHS dental services and 5 NHS general dental practitioners. Three focus group meetings were held with 14 NHS dental patients. All focus groups and interviews were audio recorded and transcribed verbatim. The data were analysed using a framework approach. Four themes were identified: 'commissioners' views of managing local NHS dental services'; 'the risks of commissioning for patient access'; 'costs, contract currency and commissioning constraints'; and 'local decision-making and future priorities'. Commissioners reported that much of their time was spent managing existing contracts rather than commissioning services. Patients were unclear about the NHS dental charge bands and dentists strongly criticised the contract's target-driven approach which was centred upon them generating 'units of dental activity'. NHS commissioners remained relatively constrained in their abilities to reallocate dental resources amongst contracts. The national focus upon practitioners achieving their units of dental activity appeared to outweigh interest in the quality of dental care provided. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Learning from contract change in primary care dentistry: A qualitative study of stakeholders in the north of England

PubMed Central

Holmes, Richard D.; Steele, Jimmy G.; Donaldson, Cam; Exley, Catherine

2015-01-01

The aim of this research was to explore and synthesise learning from stakeholders (NHS dentists, commissioners and patients) approximately five years on from the introduction of a new NHS dental contract in England. The case study involved a purposive sample of stakeholders associated with a former NHS Primary Care Trust (PCT) in the north of England. Semi-structured interviews were conducted with 8 commissioners of NHS dental services and 5 NHS general dental practitioners. Three focus group meetings were held with 14 NHS dental patients. All focus groups and interviews were audio recorded and transcribed verbatim. The data were analysed using a framework approach. Four themes were identified: ‘commissioners’ views of managing local NHS dental services’; ‘the risks of commissioning for patient access’; ‘costs, contract currency and commissioning constraints’; and ‘local decision-making and future priorities’. Commissioners reported that much of their time was spent managing existing contracts rather than commissioning services. Patients were unclear about the NHS dental charge bands and dentists strongly criticised the contract's target-driven approach which was centred upon them generating ‘units of dental activity’. NHS commissioners remained relatively constrained in their abilities to reallocate dental resources amongst contracts. The national focus upon practitioners achieving their units of dental activity appeared to outweigh interest in the quality of dental care provided. PMID:25765782

Trends in physical activity, sedentary behavior, diet, and BMI among US adolescents, 2001-2009.

PubMed

Iannotti, Ronald J; Wang, Jing

2013-10-01

The high prevalence of adolescent obesity in the United States has been attributed to population changes in physical activity (PA), sedentary behaviors, and dietary behaviors. This study examines 8-year trends in these behaviors in US adolescents ages 11 to 16. Nationally representative samples of US students in grades 6 to 10 were recruited during the 2001-2002 (N = 14607), 2005-2006 (N = 9150), and 2009-2010 (N = 10848) school years by using multistage stratified designs, with census regions and grades as strata, and school districts as the primary sampling units. African-American and Hispanic students were oversampled to obtain better estimates for those groups. Using the Health Behavior in School-aged Children quadrennial surveys, identical questions assessed BMI, PA, and sedentary and dietary behaviors at each school year. Logistic and linear regression analyses were conducted taking into account the sampling design and controlling for age, gender, race/ethnicity, and family affluence. Across the quadrennial surveys, significant increases were identified in number of days with at least 60 minutes of PA, daily consumption of fruits and vegetables, eating breakfast on weekdays and weekends, and BMI. Television viewing and consumption of sweets and sweetened beverages decreased across this same period. These same patterns were seen in all racial/ethnic groups. These patterns suggest that public health efforts to improve the obesity-related behaviors of US adolescents may be having some success. However, alternative explanations for the increase in BMI over the same period need to be considered.

The occurrence of volatile organic compounds in aquifers of the United States

USGS Publications Warehouse

Lapham, Wayne W.; Carter, Janet M.; Zogorski, John S.; Valder, Joshua F.

2006-01-01

The U.S. Geological Survey's National Water-Quality Assessment (NAWQA) Program recently completed a national assessment of volatile organic compounds (VOCs) in ground water (Zogorski and others, 2006). As part of this assessment, samples of ambient ground water collected from 3,498 wells during 1985-2002 were selected for characterizing the occurrence of 55 VOCs in 98 aquifer studies. The 55 VOCs were assigned to the following groups on the basis of their primary usage (or origin): (1) fumigants, (2) gasoline hydrocarbons, (3) gasoline oxygenates, (4) organic synthesis compounds, (5) refrigerants, (6) solvents, and (7) trihalo-methanes (chlorination by-products). The samples were collected throughout the conterminous United States as well as Alaska and Hawaii. The sampled wells had a variety of uses including domestic supply (61 percent), public supply (15 percent), monitoring (10 percent), other (13 percent), and unknown (1 percent). NAWQA aquifer studies are large-scale resource assessments of ground water that provide a general characterization of water-quality conditions in locally and regionally important aquifers or portions thereof. In general, the aquifers (or portions thereof) selected for study were some of the most intensively used aquifers for drinking water in greaterHawaiiOahuAlaskathe Nation. The 98 aquifer studies collectively provide an important national perspective on the current (1985-2002) extent of VOC contamination and regional patterns of VOC occurrence in ground water. More information about this national assessment of VOCs is available at a supporting Web site (http://water.usgs.gov/nawqa/vocs/national_assessment).

Characterization of the microbial community composition and the distribution of Fe-metabolizing bacteria in a creek contaminated by acid mine drainage.

PubMed

Sun, Weimin; Xiao, Enzong; Krumins, Valdis; Dong, Yiran; Xiao, Tangfu; Ning, Zengping; Chen, Haiyan; Xiao, Qingxiang

2016-10-01

A small watershed heavily contaminated by long-term acid mine drainage (AMD) from an upstream abandoned coal mine was selected to study the microbial community developed in such extreme system. The watershed consists of AMD-contaminated creek, adjacent contaminated soils, and a small cascade aeration unit constructed downstream, which provide an excellent contaminated site to study the microbial response in diverse extreme AMD-polluted environments. The results showed that the innate microbial communities were dominated by acidophilic bacteria, especially acidophilic Fe-metabolizing bacteria, suggesting that Fe and pH are the primary environmental factors in governing the indigenous microbial communities. The distribution of Fe-metabolizing bacteria showed distinct site-specific patterns. A pronounced shift from diverse communities in the upstream to Proteobacteria-dominated communities in the downstream was observed in the ecosystem. This location-specific trend was more apparent at genus level. In the upstream samples (sampling sites just below the coal mining adit), a number of Fe(II)-oxidizing bacteria such as Alicyclobacillus spp., Metallibacterium spp., and Acidithrix spp. were dominant, while Halomonas spp. were the major Fe(II)-oxidizing bacteria observed in downstream samples. Additionally, Acidiphilium, an Fe(III)-reducing bacterium, was enriched in the upstream samples, while Shewanella spp. were the dominant Fe(III)-reducing bacteria in downstream samples. Further investigation using linear discriminant analysis (LDA) effect size (LEfSe), principal coordinate analysis (PCoA), and unweighted pair group method with arithmetic mean (UPGMA) clustering confirmed the difference of microbial communities between upstream and downstream samples. Canonical correspondence analysis (CCA) and Spearman's rank correlation indicate that total organic carbon (TOC) content is the primary environmental parameter in structuring the indigenous microbial communities, suggesting that the microbial communities are shaped by three major environmental parameters (i.e., Fe, pH, and TOC). These findings were beneficial to a better understanding of natural attenuation of AMD.

[Usefulness of the budget and the balanced scorecard in managing Primary Care Centres. Impact on staff motivation].

PubMed

Ramón-Jerónimo, Juan Manuel; Flórez-López, Raquel; Domínguez-Lario, Natalia

2018-03-01

To analyse the utility perceived by managers of centers of primary care about management tools (budget and balanced scorecard), together their impact on human resources motivation. Qualitative study (case study) based on grounded theory performed between January and June 2014. Units of Clinical Management of Primary Health (UGCAP) in Metropolitan Health Area of Seville, Spain. UGCAP managers and Health Area (CEO) managers. Data were collected through 8 semi-structured interviews using non-probabilistic intentional sampling with representation and sufficiency criteria of discourse. Interviews were recorded, literally transcripted and analysis through in-vivo codes. Both tools are fully implemented but differently used in primary care centers. Budget is perceived as a coercive management tool, which has been imposed for cost saving; however, it is scarcely adequate for day-by-day management. While balanced scorecard is a more flexible tool that allows identifying financial and welfare problems, budgeting limits heavily reduce the possibility of implementing adequate solutions. The policy of incentives is not adequate either, leading on de-motivation. This study shows that budgeting restrictions have led to a significant reduction in autonomy of Spanish Primary Care centers. Management decision making is much centralised, also focused on cost saving over quality of healthcare. As a result, two needs emerge for the future: increasing centers' autonomy and improving staff commitment through training and professional development programs. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

How Online Quality Ratings Influence Patients' Choice of Medical Providers: Controlled Experimental Survey Study.

PubMed

Yaraghi, Niam; Wang, Weiguang; Gao, Guodong Gordon; Agarwal, Ritu

2018-03-26

In recent years, the information environment for patients to learn about physician quality is being rapidly changed by Web-based ratings from both commercial and government efforts. However, little is known about how various types of Web-based ratings affect individuals' choice of physicians. The objective of this research was to measure the relative importance of Web-based quality ratings from governmental and commercial agencies on individuals' choice of primary care physicians. In a choice-based conjoint experiment conducted on a sample of 1000 Amazon Mechanical Turk users in October 2016, individuals were asked to choose their preferred primary care physician from pairs of physicians with different ratings in clinical and nonclinical aspects of care provided by governmental and commercial agencies. The relative log odds of choosing a physician increases by 1.31 (95% CI 1.26-1.37; P<.001) and 1.32 (95% CI 1.27-1.39; P<.001) units when the government clinical ratings and commercial nonclinical ratings move from 2 to 4 stars, respectively. The relative log odds of choosing a physician increases by 1.12 (95% CI 1.07-1.18; P<.001) units when the commercial clinical ratings move from 2 to 4 stars. The relative log odds of selecting a physician with 4 stars in nonclinical ratings provided by the government is 1.03 (95% CI 0.98-1.09; P<.001) units higher than a physician with 2 stars in this rating. The log odds of selecting a physician with 4 stars in nonclinical government ratings relative to a physician with 2 stars is 0.23 (95% CI 0.13-0.33; P<.001) units higher for females compared with males. Similar star increase in nonclinical commercial ratings increases the relative log odds of selecting the physician by female respondents by 0.15 (95% CI 0.04-0.26; P=.006) units. Individuals perceive nonclinical ratings provided by commercial websites as important as clinical ratings provided by government websites when choosing a primary care physician. There are significant gender differences in how the ratings are used. More research is needed on whether patients are making the best use of different types of ratings, as well as the optimal allocation of resources in improving physician ratings from the government's perspective. ©Niam Yaraghi, Weiguang Wang, Guodong (Gordon) Gao, Ritu Agarwal. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.03.2018.

Contraceptive counseling among pediatric primary care providers in Western Pennsylvania: A survey-based study

PubMed Central

Papas, Beth Ann; Shaikh, Nader; Watson, Katherine; Sucato, Gina S

2017-01-01

Objectives: Data suggest that adolescents in the United States receive inadequate contraceptive counseling. This study sought to determine factors affecting pediatricians’ discussion of contraception with adolescent patients, with a specific focus on long-acting reversible contraception—implantable contraception and intrauterine devices. Methods: A cross-sectional survey was sent via email to a convenience sample of pediatric residents and pediatric primary care providers in Western Pennsylvania. Self-reported contraceptive counseling and prescribing practices in response to clinical vignettes were assessed. Results: Of potential participants (287), 88 (31%) responded. Younger providers and providers who had received contraceptive training were significantly more likely to discuss long-acting reversible contraception methods. Discussion of contraceptive methods also varied by both the age and the sexual history of the patient. Conclusion: Variation in contraceptive counseling potentially results in missed opportunities to counsel about and provide the most effective contraceptive methods. More uniform, universal provider training might alleviate some of these inconsistencies. PMID:28959447

The early growth and development study: a prospective adoption design.

PubMed

Leve, Leslie D; Neiderhiser, Jenae M; Ge, Xiaojia; Scaramella, Laura V; Conger, Rand D; Reid, John B; Shaw, Daniel S; Reiss, David

2007-02-01

The Early Growth and Development Study is a prospective adoption study of birth parents, adoptive parents, and adopted children (N=359 triads) that was initiated in 2003. The primary study aims are to examine how family processes mediate or moderate the expression of genetic influences in order to aid in the identification of specific family processes that could serve as malleable targets for intervention. Participants in the study are recruited through adoption agencies located throughout the United States, following the birth of a child. Assessments occur at 6-month intervals until the child reaches 3 years of age. Data collection includes the following primary constructs: infant and toddler temperament, social behavior, and health; birth and adoptive parent personality characteristics, psychopathology, competence, stress, and substance use; adoptive parenting and marital relations; and prenatal exposure to drugs and maternal stress. Preliminary analyses suggest the representativeness of the sample and minimal confounding effects of current trends in adoption practices, including openness and selective placement. Future plans are described.

Prevalence of hypogonadism in males aged at least 45 years: the HIM study

PubMed Central

MULLIGAN, T; FRICK, MF; ZURAW, QC; STEMHAGEN, A; MCWHIRTER, C

2006-01-01

The Hypogonadism in Males study estimated the prevalence of hypogonadism [total testosterone (TT) <300 ng/dl] in men aged ≥45 years visiting primary care practices in the United States. A blood sample was obtained between 8 am and noon and assayed for TT, free testosterone (FT) and bioavailable testosterone (BAT). Common symptoms of hypogonadism, comorbid conditions, demographics and reason for visit were recorded. Of 2162 patients, 836 were hypogonadal, with 80 receiving testosterone. Crude prevalence rate of hypogonadism was 38.7%. Similar trends were observed for FT and BAT. Among men not receiving testosterone, 756 (36.3%) were hypogonadal; odds ratios for having hypogonadism were significantly higher in men with hypertension (1.84), hyperlipidaemia (1.47), diabetes (2.09), obesity (2.38), prostate disease (1.29) and asthma or chronic obstructive pulmonary disease (1.40) than in men without these conditions. The prevalence of hypogonadism was 38.7% in men aged ≥45 years presenting to primary care offices. PMID:16846397

The Early Growth and Development Study: A Prospective Adoption Design

PubMed Central

Leve, Leslie D.; Neiderhiser, Jenae M.; Ge, Xiaojia; Scaramella, Laura V.; Conger, Rand D.; Reid, John B.; Shaw, Daniel S.; Reiss, David

2014-01-01

The Early Growth and Development Study is a prospective adoption study of birth parents, adoptive parents, and adopted children (N = 350 triads) that was initiated in 2003. The primary study aims are to examine how family processes mediate or moderate the expression of genetic influences in order to aid in the identification of specific family processes that could serve as malleable targets for intervention. Participants in the study were recruited following the birth of the child through adoption agencies located throughout the United States. Assessments occur at 6-month intervals until child age 3 years. Data collection includes the following primary constructs: infant/toddler temperament, social behavior, and health; birth and adoptive parent personality characteristics, psychopathology, competence, stress, and substance use; adoptive parenting and marital relations; and prenatal exposure to drugs and maternal stress. Preliminary analyses suggest the representativeness of the sample and minimal confounding effects of current trends in adoption practices, including openness and selective placement. Future plans are described. PMID:17539368

Knowledge of Abortion Laws and Services Among Low-Income Women in Three United States Cities.

PubMed

Lara, Diana; Holt, Kelsey; Peña, Melanie; Grossman, Daniel

2015-12-01

Low-income women and women of color are disproportionately affected by unintended pregnancy. Lack of knowledge of abortion laws and services is one of several factors likely to hinder access to services, though little research has documented knowledge in this population. Survey with convenience sample of 1,262 women attending primary care or full-scope Ob/Gyn clinics serving low-income populations in three large cities and multivariable analyses with four knowledge outcomes. Among all participants, 53% were first-generation immigrants, 25% identified the correct gestational age limit, 41% identified state parental consent laws, 67% knew partner consent is not required, and 55% knew where to obtain abortion services. In multivariable analysis, first-generation immigrants and primarily Spanish speakers were significantly less likely than higher-generation or primarily English speakers to display correct knowledge. Design and evaluation of strategies to improve knowledge about abortion, particularly among migrant women and non-primary English speakers, is needed.

Groundwater Quality in the Central Eastside San Joaquin Valley, California

USGS Publications Warehouse

Belitz, Kenneth; Landon, Matthew K.

2010-01-01

The Central Eastside study unit is located in California's San Joaquin Valley. The 1,695 square mile study unit includes three groundwater subbasins: Modesto, Turlock, and Merced (California Department of Water Resources, 2003). The primary water-bearing units consist of discontinuous lenses of gravel, sand, silt, and clay, which are derived largely from the Sierra Nevada Mountains to the east. Public-supply wells provide most of the drinking water supply in the Central Eastside. Consequently, the primary aquifer in the Central Eastside study unit is defined as that part of the aquifer corresponding to the perforated interval of wells listed in the California Department of Public Health database. Public-supply wells are typically drilled to depths of 200 to 350 feet, consist of solid casing from the land surface to a depth of about 100 to 200 feet, and they are perforated below the solid casing. Water quality in the shallower and deeper parts of the aquifer system may differ from that in the primary aquifer. The Central Eastside study unit has hot and dry summers and cool, moist, winters. Average annual rainfall ranges from 11 to 15 inches. The Stanislaus, Tuolumne, and Merced Rivers, with headwaters in the Sierra Nevada Mountains, are the primary streams traversing the study unit. Land use in the study unit is approximately 59 percent (%) agricultural, 34% natural (primarily grassland), and 7% urban. The primary crops are almonds, walnuts, peaches, grapes, grain, corn, and alfalfa. The largest urban areas (2003 population in parentheses) are the cities of Modesto (206,872), Turlock (63,467), and Merced (69,512). Municipal water use accounts for about 5% of the total water use in the Central Eastside study unit, with the remainder used for irrigated agriculture. Groundwater accounts for about 75% of the municipal supply, and surface water accounts for about 25%. Recharge to the groundwater flow system is primarily from percolation of irrigation return, precipitation, seepage from reservoirs and rivers, and urban return (Burow and others, 2004; Phillips and others, 2007). The primary sources of discharge are pumping for irrigation and municipal supply, evaporation from areas with a shallow depth to water, and discharge to streams. Recharge at shallow depths and pumping from wells at greater depths causes downward movement of groundwater in the aquifer in the Central Eastside. This vertical movement of water has the potential to carry chemical constituents from shallow depths to the greater depths where supply wells commonly are perforated.

Communication patterns of primary care physicians in the United States and the Netherlands.

PubMed

Bensing, Jozien M; Roter, Debra L; Hulsman, Robert L

2003-05-01

While international comparisons of medical practice have noted differences in length of visit, few studies have addressed the dynamics of visit exchange. To compare the communication of Dutch and U.S. hypertensive patients and their physicians in routine medical visits. Secondary analysis of visit audio/video tapes contrasting a Dutch sample of 102 visits with 27 general practitioners and a U.S. sample of 98 visits with 52 primary care physicians. The Roter Interaction Analysis System applied to visit audiotapes. Total visit length and duration of the physical exam were measured directly. U.S. visits were 6 minutes longer than comparable Dutch visits (15.4 vs 9.5 min, respectively), but the proportion of visits devoted to the physical examination was the same (24%). American doctors asked more questions and provided more information of both a biomedical and psychosocial nature, but were less patient-centered in their visit communication than were Dutch physicians. Cluster analysis revealed similar proportions of exam-centered (with especially long physical exam segments) and biopsychosocial visits in the 2 countries; however, 48% of the U.S. visits were biomedically intensive, while only 18% of the Dutch visits were of this type. Fifty percent of the Dutch visits were socioemotional, while this was true for only 10% of the U.S. visits. U.S. and Dutch primary care visits showed substantial differences in communication patterns and visit length. These differences may reflect country distinctions in medical training and philosophy, health care system characteristics, and cultural values and expectations relevant to the delivery and receipt of medical services.

Integration of public health and primary care: A systematic review of the current literature in primary care physician mediated childhood obesity interventions.

PubMed

Bhuyan, Soumitra S; Chandak, Aastha; Smith, Patti; Carlton, Erik L; Duncan, Kenric; Gentry, Daniel

2015-01-01

Childhood obesity, with its growing prevalence, detrimental effects on population health and economic burden, is an important public health issue in the United States and worldwide. There is need for expansion of the role of primary care physicians in obesity interventions. The primary aim of this review is to explore primary care physician (PCP) mediated interventions targeting childhood obesity and assess the roles played by physicians in the interventions. A systematic review of the literature published between January 2007 and October 2014 was conducted using a combination of keywords like "childhood obesity", "paediatric obesity", "childhood overweight", "paediatric overweight", "primary care physician", "primary care settings", "healthcare teams", and "community resources" from MEDLINE and CINAHL during November 2014. Author name(s), publication year, sample size, patient's age, study and follow-up duration, intervention components, role of PCP, members of the healthcare team, and outcomes were extracted for this review. Nine studies were included in the review. PCP-mediated interventions were composed of behavioural, education and technological interventions or a combination of these. Most interventions led to positive changes in Body Mass Index (BMI), healthier lifestyles and increased satisfaction among parents. PCPs participated in screening and diagnosing, making referrals for intervention, providing nutrition counselling, and promoting physical activity. PCPs, Dietitians and nurses were often part of the healthcare team. PCP-mediated interventions have the potential to effectively curb childhood obesity. However, there is a further need for training of PCPs, and explain new types of interventions such as the use of technology. Copyright © 2015 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Eliminating Health Disparities through Action on the Social Determinants of Health: A Systematic Review of Home Visiting in the United States, 2005-2015.

PubMed

Abbott, Laurie S; Elliott, Lynn T

2017-01-01

The purpose of this systematic literature review was to synthesize the results of transdisciplinary interventions designed with a home visit component in experimental and quasi-experimental studies having representative samples of racial and ethnic minorities. The design of this systematic review was adapted to include both experimental and quasi-experimental quantitative studies. The predetermined inclusion criteria were studies (a) having an experimental or quasi-experimental quantitative design, (b) having a home visit as a research component, (c) including a prevention research intervention strategy targeting health and/or safety issues, (d) conducted in the United States, (e) having representation (at least 30% in the total sample size) of one or more racial/ethnic minority, (f) available in full text, and (g) published in a peer-reviewed journal between January, 2005 and December, 2015. Thirty-nine articles were included in the review. There were 20 primary prevention, 5 secondary prevention, and 14 tertiary prevention intervention studies. Community and home visitation interventions by nurses can provide an effective means for mitigating social determinants of health by empowering people at risk for health disparities to avoid injury, maintain health, and prevent and manage existing disease. © 2016 Wiley Periodicals, Inc.

Drivers for change in primary care of diabetes following a protected learning time educational event: interview study of practitioners.

PubMed

Siriwardena, Aloysius Niroshan; Middlemass, Jo B; Ward, Kate; Wilkinson, Carol

2008-01-19

A number of protected learning time schemes have been set up in primary care across the United Kingdom but there has been little published evidence of their impact on processes of care. We undertook a qualitative study to investigate the perceptions of practitioners involved in a specific educational intervention in diabetes as part of a protected learning time scheme for primary health care teams, relating to changing processes of diabetes care in general practice. We undertook semistructured interviews of key informants from a sample of practices stratified according to the extent they had changed behaviour in prescribing of ramipril and diabetes care more generally, following a specific educational intervention in Lincolnshire, United Kingdom. Interviews sought information on facilitators and barriers to change in organisational behaviour for the care of diabetes. An interprofessional protected learning time scheme event was perceived by some but not all participants as bringing about changes in processes for diabetes care. Participants cited examples of change introduced partly as a result of the educational session. This included using ACE inhibitors as first line for patients with diabetes who developed hypertension, increased use of aspirin, switching patients to glitazones, and conversion to insulin either directly or by referral to secondary care. Other reported factors for change, unrelated to the educational intervention, included financially driven performance targets, research evidence and national guidance. Facilitators for change linked to the educational session were peer support and teamworking supported by audit and comparative feedback. This study has shown how a protected learning time scheme, using interprofessional learning, local opinion leaders and early implementers as change agents may have influenced changes in systems of diabetes care in selected practices but also how other confounding factors played an important part in changes that occurred in practice.

National trends in incidence rates of hospitalization for stroke in children with sickle cell disease.

PubMed

McCavit, Timothy L; Xuan, Lei; Zhang, Song; Flores, Glenn; Quinn, Charles T

2013-05-01

The success of primary stroke prevention for children with sickle cell disease (SCD) throughout the United States is unknown. Therefore, we aimed to generate national incidence rates of hospitalization for stroke in children with sickle cell disease (SCD) before and after publication of the Stroke Prevention Trial in Sickle Cell Anemia (STOP trial) in 1998. We performed a retrospective trend analysis of the 1993-2009 Nationwide Inpatient Sample and Kids' Inpatient Databases. Hospitalizations for SCD patients 0-18 years old with stroke were identified by ICD-9CM code. The primary outcome, the trend in annual incidence rate of hospitalization for stroke in children with SCD, was analyzed by linear regression. Incidence rates of hospitalization for stroke before and after 1998 were compared by the Wilcoxon rank-sum test. From 1993 to 2009, 2,024 hospitalizations were identified for stroke. Using the mean annual incidence rate of hospitalization for stroke from 1993 to 1998 as the baseline, the rate decreased from 1993 to 2009 (point estimate = -0.022/100 patient years [95% CI, -0.039, -0.005], P = 0.027). The mean annual incidence rate of hospitalization stroke decreased by 45% from 0.51 per 100 patient years in 1993-1998 to 0.28 per 100 patient years in 1999-2009 (P = 0.008). Total hospital days and charges attributed to stroke also decreased by 45% and 24%, respectively. After publication of the STOP trial and hydroxyurea licensure in 1998, the incidence of hospitalization for stroke in children with SCD decreased across the United States, suggesting that primary stroke prevention has been effective nationwide, but opportunity for improvement remains. Copyright © 2012 Wiley Periodicals, Inc.

National Trends in Incidence Rates of Hospitalization for Stroke in Children With Sickle Cell Disease

PubMed Central

McCavit, Timothy L.; Xuan, Lei; Zhang, Song; Flores, Glenn; Quinn, Charles T.

2014-01-01

Background The success of primary stroke prevention for children with sickle cell disease (SCD) throughout the United States is unknown. Therefore, we aimed to generate national incidence rates of hospitalization for stroke in children with sickle cell disease (SCD) before and after publication of the Stroke Prevention Trial in Sickle Cell Anemia (STOP trial) in 1998. Procedure We performed a retrospective trend analysis of the 1993–2009 Nationwide Inpatient Sample and Kids’ Inpatient Databases. Hospitalizations for SCD patients 0–18 years old with stroke were identified by ICD-9CM code. The primary outcome, the trend in annual incidence rate of hospitalization for stroke in children with SCD, was analyzed by linear regression. Incidence rates of hospitalization for stroke before and after 1998 were compared by the Wilcoxon rank-sum test. Results From 1993 to 2009, 2,024 hospitalizations were identified for stroke. Using the mean annual incidence rate of hospitalization for stroke from 1993 to 1998 as the baseline, the rate decreased from 1993 to 2009 (point estimate = −0.022/100 patient years [95% CI, −0.039, −0.005], P = 0.027). The mean annual incidence rate of hospitalization stroke decreased by 45% from 0.51 per 100 patient years in 1993–1998 to 0.28 per 100 patient years in 1999–2009 (P = 0.008). Total hospital days and charges attributed to stroke also decreased by 45% and 24%, respectively. Conclusions After publication of the STOP trial and hydroxyurea licensure in 1998, the incidence of hospitalization for stroke in children with SCD decreased across the United States, suggesting that primary stroke prevention has been effective nationwide, but opportunity for improvement remains. PMID:23151905

Revised Healthy Lifestyle-Diet Index and associations with obesity and iron deficiency in schoolchildren: The Healthy Growth Study.

PubMed

Manios, Y; Moschonis, G; Papandreou, C; Politidou, E; Naoumi, A; Peppas, D; Mavrogianni, C; Lionis, C; Chrousos, G P

2015-02-01

The Healthy Lifestyle-Diet Index (HLD-index), previously developed to assess the degree of adherence to dietary and lifestyle guidelines for primary schoolchildren, was revised according to updated recommendations. Τhe association of the revised HLD-index (R-HLD-index) with obesity and iron deficiency (ID) was also examined. A representative sample of 2660 primary schoolchildren from Greece (9-13 years old) participating in the 'Healthy Growth Study' was examined. Twelve components related to dietary and lifestyle patterns were used to develop the R-HLD-index. Scores from 0 up to 4 were assigned to each one of these components, giving a total score ranging from 0 to 48. The associations between the R-HLD-index, obesity and ID were examined via logistic regression analysis. The total score of the R-HLD-index calculated for each one of the study participants was found to range between 2 and 32 units, with higher scores being indicative of a healthier lifestyle and better diet quality. After adjusting for potential confounders, logistic regression analysis showed that an increase in the R-HLD-index score by one unit was associated with 6% lower odds for obesity. However, no significant association was observed between the R-HLD-index score and ID. The R-HLD-index may be a useful tool for public health policy makers and healthcare professionals when assessing diet quality and lifestyle patterns of primary schoolchildren. Identification of children with lower scores in the R-HLD-index and its individual components could guide tailored made interventions targeting specific children and behaviors. © 2013 The British Dietetic Association Ltd.

Visual Information Present in Infragranular Layers of Mouse Auditory Cortex.

PubMed

Morrill, Ryan J; Hasenstaub, Andrea R

2018-03-14

The cerebral cortex is a major hub for the convergence and integration of signals from across the sensory modalities; sensory cortices, including primary regions, are no exception. Here we show that visual stimuli influence neural firing in the auditory cortex of awake male and female mice, using multisite probes to sample single units across multiple cortical layers. We demonstrate that visual stimuli influence firing in both primary and secondary auditory cortex. We then determine the laminar location of recording sites through electrode track tracing with fluorescent dye and optogenetic identification using layer-specific markers. Spiking responses to visual stimulation occur deep in auditory cortex and are particularly prominent in layer 6. Visual modulation of firing rate occurs more frequently at areas with secondary-like auditory responses than those with primary-like responses. Auditory cortical responses to drifting visual gratings are not orientation-tuned, unlike visual cortex responses. The deepest cortical layers thus appear to be an important locus for cross-modal integration in auditory cortex. SIGNIFICANCE STATEMENT The deepest layers of the auditory cortex are often considered its most enigmatic, possessing a wide range of cell morphologies and atypical sensory responses. Here we show that, in mouse auditory cortex, these layers represent a locus of cross-modal convergence, containing many units responsive to visual stimuli. Our results suggest that this visual signal conveys the presence and timing of a stimulus rather than specifics about that stimulus, such as its orientation. These results shed light on both how and what types of cross-modal information is integrated at the earliest stages of sensory cortical processing. Copyright © 2018 the authors 0270-6474/18/382854-09$15.00/0.

Cost-effectiveness of risk stratified followup after urethral reconstruction: a decision analysis.

PubMed

Belsante, Michael J; Zhao, Lee C; Hudak, Steven J; Lotan, Yair; Morey, Allen F

2013-10-01

We propose a novel risk stratified followup protocol for use after urethroplasty and explore potential cost savings. Decision analysis was performed comparing a symptom based, risk stratified protocol for patients undergoing excision and primary anastomosis urethroplasty vs a standard regimen of close followup for urethroplasty. Model assumptions included that excision and primary anastomosis has a 94% success rate, 11% of patients with successful urethroplasty had persistent lower urinary tract symptoms requiring cystoscopic evaluation, patients in whom treatment failed undergo urethrotomy and patients with recurrence on symptom based surveillance have a delayed diagnosis requiring suprapubic tube drainage. The Nationwide Inpatient Sample from 2010 was queried to identify the number of urethroplasties performed per year in the United States. Costs were obtained based on Medicare reimbursement rates. The 5-year cost of a symptom based, risk stratified followup protocol is $430 per patient vs $2,827 per patient using standard close followup practice. An estimated 7,761 urethroplasties were performed in the United States in 2010. Assuming that 60% were excision and primary anastomosis, and with more than 5 years of followup, the risk stratified protocol was projected to yield an estimated savings of $11,165,130. Sensitivity analysis showed that the symptom based, risk stratified followup protocol was far more cost-effective than standard close followup in all settings. Less than 1% of patients would be expected to have an asymptomatic recurrence using the risk stratified followup protocol. A risk stratified, symptom based approach to urethroplasty followup would produce a significant reduction in health care costs while decreasing unnecessary followup visits, invasive testing and radiation exposure. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

27 CFR 19.18 - Samples for the United States.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Provisions § 19.18 Samples for the United States. TTB officers are authorized to take samples of spirits... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Samples for the United States. 19.18 Section 19.18 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE...

27 CFR 24.37 - Samples for the United States.

Code of Federal Regulations, 2011 CFR

2011-04-01

... § 24.37 Samples for the United States. Appropriate TTB officers are authorized to take samples of wine... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Samples for the United States. 24.37 Section 24.37 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE...

78 FR 57033 - United States Standards for Condition of Food Containers

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-17

... containers during production. Stationary lot sampling is the process of randomly selecting sample units from.... * * * * * Stationary lot sampling. The process of randomly selecting sample units from a lot whose production has been... less than \\1/16\\-inch Stringy seal (excessive plastic threads showing at edge of seal 222 area...

Fishes of Missouri River, chute, and flood plain habitats: Chapter 4 in Initial biotic survey of Lisbon Bottom, Big Muddy National Fish and Wildlife Refuge

USGS Publications Warehouse

Grady, Joanne; Milligan, Jim; Chapman, Duane C.; Ehrhardt, Ellen A.; Dieterman, Douglas J.; Galat, David L.; Hooker, John; Kubisiak, John; DeLonay, Aaron; Little, Edward E.; Robinson, Jack; Tibbs, John

1999-01-01

The Lisbon Bottom Unit of the Big Muddy National Fish and Wildlife Refuge (Refuge) is approximately 2,200 acres and is the first complete unit of the Refuge. Primary objectives of the Refuge are to create and restore diverse riverine aquatic habitats and reconnect the Missouri River to its flood plain where feasible. Management seeks to accomplish these objectives by encouraging natural processes of erosion, deposition, and succession to the greatest extent possible.One of the most salient aquatic features of the Lisbon Bottom Unit is a newly created 2-mile-long free-flowing chute, or side channel (Fig. 1). This chute began forming as a levee breech scour hole during the Great Flood of 1993. The chute continued to develop during the 1995 flood and finally cut through to a flowing side channel during the 1996 flood. Extensive erosion and bank sluffing continued during 1997 due to sustained high flows that occurred throughout most of the year. The chute has progressively become wider and deeper with a developing meander pattern and channel bars have begun to form. Lisbon Bottom also contains several seasonal and permanent wetlands and is subject to periodic flooding at high Missouri River stages.Eight studies have been completed or are ongoing to evaluate Missouri River fishes associated with various habitat components of Lisbon Bottom and adjacent Missouri River reaches (Table 1). Several are part of much larger investigations to evaluate fish use of flood-created habitat features, basinwide fish assessment, and endangered or candidate species concerns.At the Lisbon Bottom Unit or in the Missouri River adjacent to the unit 54 fish species were collected (Table 2). Eight of these species have either a protected status under State or Federal laws or biologists consider them to potentially qualify for protected status. The status of the following fish is listed in Table 2: pallid sturgeon x shovelnose sturgeon hybrid, paddlefish, northern pike, sturgeon chub, sicklefin chub, ghost shiner, western silvery minnow, plains minnow, and blue sucker. Equally important to note are fish species that were not collected. The flathead chub, currently listed as State endangered and proposed for Federal listing, were not collected in any of the studies.Common fish species, collected in all seven sampling studies, included gizzard shad, common carp, river carpsucker, and freshwater drum. Paddlefish, skipjack herring, silver carp, white sucker, redfin shiner, western silvery minnow, bullhead minnow, and black bullhead were each collected in only one of the seven studies.Pflieger (1971) developed a guild system for the fishes of Missouri based on distribution patterns and centers of abundance. Fish were assigned to one of four primary faunal groups: Ozark, Big River, Lowland, and Prairie. Two secondary groups (Ozark-prairie and Ozark-lowland) were defined for species equally abundant and distributed in two of the primary areas. Two Ozark-prairie species, shorthead redhorse and white sucker, were collected on or near the Lisbon Bottom Unit.Big River species are found primarily in the Missouri and Mississippi Rivers. The environmental factors controlling fish distribution in these rivers appear to be substrate, current velocity, and turbidity. On or near the Lisbon Bottom Unit 18 Big River species were collected (Table 2).Lowland species are intolerant of siltation and high turbidity. They inhabit standing or slow-moving water with sand, fine gravel, and organic debris substrates. Two Lowland species, bullhead minnow and mosquitofish, were collected in connected scours on the Lisbon Bottom Unit.Prairie species have broader ecological tolerances than the Ozark and Lowland species. They are largely absent in high gradient streams and cool, clear waters. Prairie species make up a significant proportion of Missouri and Mississippi River fishes. Seven Prairie species were collected on or near the Lisbon Bottom Unit (Table 2).The last group, Wide-ranging, was defined as the species more widespread than the other faunal groups with broader environmental tolerances. Most Wide-ranging species occur at least occasionally in all sections of the state. Nineteen Wide-ranging species were collected on or near the Lisbon Bottom Unit (Table 2).Kubisiak (1997) found that isolated scours in the Lower Missouri River were dominated by Wide-ranging species. Connected scours also held Wideranging species but they contained Prairie species and were dominated by Big River species. Faunal group diversity and species richness were compared between isolated (Study l) and connected (Studies 4, 5, 7, and 8) scours of the Lisbon Bottom Unit. Species richness was similar with 22 species collected in isolated scours and an average of 24.8 species collected in connected scours. Isolated scour fish catches were dominated by Wide-ranging fish (59%) with 14% Big River fishes and 14% Prairie fishes. Connected scours had a larger percentage of Big River fish (32%) and fewer Wide-ranging (36%) and Prairie (13%) species than the isolated scours. In the combined studies, Wide-ranging fish dominated the connected scours.A similar comparison was made of fish from chute habitats and the Missouri River. Chute habitats include the Lisbon Bottom Chute, the chute between the right bank and island located at river mile 219, and a shallow channel running between a large sandbar complex and the channel border adjacent to Lisbon Bottom. Species richness in the chutes (35 species) was greater than that of the adjacent river (23 species). Big River species (40%) dominated the chute samples, followed by Wide-ranging at 31% Cand Prairie Cut 14%.The river samples contained equal numbers of Wide-ranging species (35%) and Big River species (35%) with 17% Prairie species. Differences in fish guild diversity and species richness may be due to numerous factors including sampling effort and sampling season. River samples were collected only in Study 3 in October; chute samples were collected in July, August, and October. Fish may have been using the chute in July and August to spawn, feed, or escape high river levels.The Lisbon Bottom Chute is a truly unique feature of the Lower Missouri River. It is the first naturally created side channel to develop since the U.S. Army Corps of Engineers tamed the river. The Corps eliminated 89% of the islands in the Missouri River between 1879 and 1954 (Funk and Robinson 1974). The chutes between the islands and the shore were shallower with less current than the main channel. These areas provided diversity to the Missouri River fish habitat, serving as nursery and feeding areas. The Lisbon Bottom Unit of the Big Muddy National Fish and Wildlife Refuge will continue to be studied in an effort to understand the complex role these areas play in river systems.

Quality of reproductive healthcare for adolescents: A nationally representative survey of providers in Mexico

PubMed Central

De Castro, Filipa; Barrientos-Gutiérrez, Tonatiuh; Leyva-López, Ahideé

2017-01-01

Objective Adolescents need sexual and reproductive health services but little is known about quality-of-care in lower- and middle-income countries where most of the world’s adolescents reside. Quality-of-care has important implications as lower quality may be linked to higher unplanned pregnancy and sexually transmitted infection rates. This study sought to generate evidence about quality-of-care in public sexual and reproductive health services for adolescents. Methods This cross-sectional study had a complex, probabilistic, stratified sampling design, representative at the national, regional and rural/urban level in Mexico, collecting provider questionnaires at 505 primary care units in 2012. A sexual and reproductive quality-of-healthcare index was defined and multinomial logistic regression was utilized in 2015. Results At the national level 13.9% (95%CI: 6.9–26.0) of healthcare units provide low quality, 68.6% (95%CI: 58.4–77.3) medium quality and 17.5% (95%CI: 11.9–25.0) high quality reproductive healthcare services to adolescents. Urban or metropolitan primary care units were at least 10 times more likely to provide high quality care than those in rural areas. Units with a space specifically for counseling adolescents were at least 8 times more likely to provide high quality care. Ministry of Health clinics provided the lowest quality of service, while those from Social Security for the Underserved provided the best. Conclusions The study indicates higher quality sexual and reproductive healthcare services are needed. In Mexico and other middle- to low-income countries where quality-of-care has been shown to be a problem, incorporating adolescent-friendly, gender-equity and rights-based perspectives could contribute to improvement. Setting and disseminating standards for care in guidelines and providing tools such as algorithms could help healthcare personnel provide higher quality care. PMID:28273129

Highly diverse microbiota in dental root canals in cases of apical periodontitis (data of illumina sequencing).

PubMed

Vengerfeldt, Veiko; Špilka, Katerina; Saag, Mare; Preem, Jens-Konrad; Oopkaup, Kristjan; Truu, Jaak; Mändar, Reet

2014-11-01

Chronic apical periodontitis (CAP) is a frequent condition that has a considerable effect on a patient's quality of life. We aimed to reveal root canal microbial communities in antibiotic-naive patients by applying Illumina sequencing (Illumina Inc, San Diego, CA). Samples were collected under strict aseptic conditions from 12 teeth (5 with primary CAP, 3 with secondary CAP, and 4 with a periapical abscess [PA]) and characterized by profiling the microbial community on the basis of the V6 hypervariable region of the 16S ribosomal RNA gene by using Illumina HiSeq2000 sequencing combinatorial sequence-tagged polymerase chain reaction products. Root canal specimens displayed highly polymicrobial communities in all 3 patient groups. One sample contained 5-8 (mean = 6.5) phyla of bacteria. The most numerous were Firmicutes and Bacteroidetes, but Actinobacteria, Fusobacteria, Proteobacteria, Spirochaetes, Tenericutes, and Synergistetes were also present in most of the patients. One sample contained 30-70 different operational taxonomic units; the mean (± standard deviation) was lower in the primary CAP group (36 ± 4) than in the PA (45 ± 4) and secondary CAP (43 ± 13) groups (P < .05). The communities were individually different, but anaerobic bacteria predominated as the rule. Enterococcus faecalis was found only in patients with secondary CAP. One PA sample displayed a significantly high proportion (47%) of Proteobacteria, mainly at the expense of Janthinobacterium lividum. This study provided an in-depth characterization of the microbiota of periapical tissues, revealing highly polymicrobial communities and minor differences between the study groups. A full understanding of the etiology of periodontal disease will only be possible through further in-depth systems-level analyses of the host-microbiome interaction. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Plant resting site preferences and parity rates among the vectors of Rift Valley Fever in northeastern Kenya.

PubMed

Arum, Samwel O; Weldon, Christopher W; Orindi, Benedict; Tigoi, Caroline; Musili, Francis; Landmann, Tobias; Tchouassi, David P; Affognon, Hippolyte D; Sang, Rosemary

2016-05-31

Mosquito lifespan can influence the circulation of disease causing pathogens because it affects the time available for infection and transmission. The life-cycle of mosquitoes is determined by intrinsic and environmental factors, which can include the availability of hosts and suitable resting environments that shelter mosquitoes from extreme temperature and desiccating conditions. This study determined the parity rates (an indirect measure of survival) and plant resting preference of vectors of Rift Valley fever (RVF) in northeastern Kenya. Resting mosquitoes were trapped during the rainy and the dry season using a Prokopack aspirator from vegetation, whereas general adult populations were trapped using CDC light traps. At each site, sampling was conducted within a 1 km(2) area, subdivided into 500 × 500 m quadrants and four 250 × 250 m sub-quadrants from which two were randomly selected as sampling units. In each sampling unit, plants were randomly selected for aspiration of mosquitoes. Only Aedes mcintoshi and Ae. ochraceus were dissected to determine parity rates while all mosquito species were used to assess plant resting preference. Overall, 1124 (79 %, 95 % CI = 76.8-81.1 %) mosquitoes were parous. There was no significant difference in the number of parous Ae. mcintoshi and Ae. ochraceus. Parity was higher in the rainy season than in the dry season. Daily survival rate was estimated to be 0.93 and 0.92 among Ae. ochraceus and Ae. mcintoshi, respectively. Duosperma kilimandscharicum was the most preferred plant species with the highest average capture of primary (3.64) and secondary (5.83) vectors per plant, while Gisekia africana was least preferred. Survival rate of each of the two primary vectors of RVF reported in this study may provide an indication that these mosquitoes can potentially play important roles in the circulation of diseases in northern Kenya. Resting preference of the mosquitoes in vegetation may influence their physiology and enhance longevity. Thus, areas with such vegetation may be associated with an increased risk of transmission of arboviruses to livestock and humans.

Technology and Thematic Units: A Primary Example (Technology Links to Literacy).

ERIC Educational Resources Information Center

Wepner, Shelley B.

1992-01-01

Uses a teacher's thematic unit on endangered species to share how technology can help to make meaningful connections across the curriculum. Shows how the unit includes science, social studies, mathematics, art, language arts, and music. (SR)

Impact of hospital care on incidence of bloodstream infection: the evaluation of processes and indicators in infection control study.

PubMed Central

Kritchevsky, S. B.; Braun, B. I.; Wong, E. S.; Solomon, S. L.; Steele, L.; Richards, C.; Simmons, B. P.

2001-01-01

The Evaluation of Processes and Indicators in Infection Control (EPIC) study assesses the relationship between hospital care and rates of central venous catheter-associated primary bacteremia in 54 intensive-care units (ICUs) in the United States and 14 other countries. Using ICU rather than the patient as the primary unit of statistical analysis permits evaluation of factors that vary at the ICU level. The design of EPIC can serve as a template for studies investigating the relationship between process and event rates across health-care institutions. PMID:11294704

Wear resistance of machine tools' bionic linear rolling guides by laser cladding

NASA Astrophysics Data System (ADS)

Wang, Yiqiang; Liu, Botao; Guo, Zhengcai

2017-06-01

In order to improve the rolling wear resistance (RWR) of linear rolling guides (LRG) as well as prolong the life of machine tools, various shape samples with different units spaces ranged from 1 to 5 mm are designed through the observation of animals in the desert and manufactured by laser cladding. Wear resistance tests reproducing closely the real operational condition are conducted by using a homemade linear reciprocating wear test machine, and wear resistance is evaluated by means of weight loss measurement. Results indicate that the samples with bionic units have better RWR than the untreated one, of which the reticulate treated sample with unit space 3 mm present the best RWR. More specifically, among the punctuate treated samples, the mass loss increases with the increase of unit space; among the striate treated samples, the mass loss changes slightly with the increase of unit space, attaining a minimum at the unit space of 4 mm; among the reticulate treated samples, with the increase of unit space, the mass loss initially decreases, but turns to increase after reaching a minimum at the unit space of 3 mm. Additionally, the samples with striate shape perform better wear resistance than the other shape groups on the whole. From the ratio value of laser treated area to contacted area perspective, that the samples with ratio value between 0.15 and 0.3 possess better wear resistance is concluded.

A Study on Primary and Secondary School Students' Misconceptions about Greenhouse Effect (Erzurum Sampling)

ERIC Educational Resources Information Center

Gul, Seyda; Yesilyurt, Selami

2011-01-01

The aim of this study is to determine what level of primary and secondary school students' misconceptions related to greenhouse effect is. Study group consists of totally 280 students attended to totally 8 primary and secondary schools (4 primary school, 4 secondary school) which were determined with convenient sampling method from center of…

Intertextuality in Read-Alouds of Integrated Science-Literacy Units in Urban Primary Classrooms: Opportunities for the Development of Thought and Language

ERIC Educational Resources Information Center

Varelas, Maria; Pappas, Christine C.

2006-01-01

The nature and evolution of intertextuality was studied in 2 urban primary-grade classrooms, focusing on read-alouds of an integrated science-literacy unit. The study provides evidence that both debunks deficit theories for urban children by highlighting funds of knowledge that these children bring to the classroom and the sense they make of them…

Alaska's Living Tundra. Alaska Wildlife Week, 25-29 April 1988. Unit 6: Primary Teacher's Guide; Upper Elementary Teacher's Guide; Junior/Senior High School Teacher's Guide; Supplement.

ERIC Educational Resources Information Center

Quinlan, Susan E.

Despite its cold and barren appearance, Alaska's tundra supports a surprising variety of insects, birds, and mammals. In this document, three teacher's guides (for primary, upper elementary, and junior and senior high schools) and a supplementary resource packet present a comprehensive unit of study on Alaska's living tundra. The five lessons in…

Wide field of view swept-source optical coherence tomography for peripheral retinal disease

PubMed Central

McNabb, Ryan P.; Grewal, Dilraj S.; Mehta, Rajvi; Schuman, Stefanie G.; Izatt, Joseph A.; Mahmoud, Tamer H.; Jaffe, Glenn J.; Mruthyunjaya, Prithvi; Kuo, Anthony N.

2016-01-01

Background/Aims To assess peripheral retinal lesions and the posterior pole in single, widefield optical coherence tomography (OCT) volumes. Methods A wide field of view swept source OCT (WFOV SSOCT) system was developed using a commercial swept source laser and a custom sample arm consisting of two indirect ophthalmic lenses. Twenty-seven subjects with peripheral lesions (choroidal melanomas, choroidal nevii, sclerochoroidal calcification, retinitis pigmentosa, diabetic retinopathy, retinoschisis, and uveitis) were imaged with the WFOV SSOCT. Volumes were taken in primary gaze. Using the optic nerve to fovea distance as a reference measurement, comparisons were made between the lateral field of view (FOV) of the WFOV SSOCT, current generation spectral domain OCT (SDOCT), and widefield scanning laser ophthalmoscopy (SLO) of the same eyes. Results Peripheral pathologies were captured with WFOV SSOCT in 26 of the 27 subjects. The one not captured was in the far nasal periphery and was not seen in the primary gaze volume. Posterior pole associated pathologies were captured in all subjects. Current generation SDOCT had a mean lateral FOV of 2.08 ± 0.21 optic nerve-to-fovea distance units, WFOV SSOCT had a FOV of 4.62 ± 0.62 units, and SLO had a FOV of 9.35 ± 1.02 units. Conclusion WFOV OCT can be used to examine both peripheral retinal pathology and the posterior pole within a single volume acquisition. SLO had the greatest FOV, but does not provide depth information. Future studies using widefield OCT systems will help further delineate the role of WFOV OCT to quantitatively assess and monitor peripheral retinal disease in three dimensions. PMID:26755643

Patient volume, staffing, and workload in relation to risk-adjusted outcomes in a random stratified sample of UK neonatal intensive care units: a prospective evaluation.

PubMed

Tucker, Janet

2002-01-12

UK recommendations suggest that large neonatal intensive-care units (NICUs) have better outcomes than small units, although this suggestion remains unproven. We assessed whether patient volume, staffing levels, and workload are associated with risk-adjusted outcomes, and with costs or staff wellbeing. 186 UK NICUs were stratified according to volume of patients, nursing provision, and neonatal consultant provision. Primary outcomes were hospital mortality, mortality or cerebral damage, and nosocomial bacteraemia. We studied 13515 infants of all birthweights consecutively admitted to 54 randomly selected NICUs. Multiple logistic regression analyses were done with every primary outcome as the dependent variable. Staff wellbeing and stress were assessed by anonymous mental health index (MHI)-5 questionnaires. Data were available for 13334 (99%) infants. High-volume NICUs treated the sickest infants and had highest crude mortality. Risk-adjusted mortality and mortality or cerebral damage were unrelated to patient volume or staffing provision; however, nosocomial bacteraemia was less frequent in NICUs with low neonatal consultant provision (odds ratio 0.65, 95% CI 0.43-0.98). Mortality was raised with increasing workload in all types of NICUs. Infants admitted at full capacity versus half capacity were about 50% more likely to die, but there was wide uncertainty around this estimate. Most staff had MHI-5 scores that suggested good mental health. The implications of this report for staffing policy, medicolegal risk management, and ethical practice remain to be tested. Centralisation of only the sickest infants could improve efficiency, provided that this does not create excessive workload for staff. Assessment of increased staffing levels that are closer to those in adult intensive care might be appropriate.

Duration of storage influences the hemoglobin rising effect of red blood cells in patients undergoing major abdominal surgery.

PubMed

Hunsicker, Oliver; Hessler, Katarina; Krannich, Alexander; Boemke, Willehad; Braicu, Ioana; Sehouli, Jalid; Meyer, Oliver; Pruß, Axel; Spies, Claudia; Feldheiser, Aarne

2018-04-17

After transfusion of senescent red blood cells (RBCs) a considerable fraction is rapidly cleared from the recipients' circulation. Thus, transfusion of senescent RBCs may be less effective in terms of increasing hemoglobin concentration (cHb) after transfusion. Data were retrospectively obtained in patients who underwent major abdominal surgery between 2006 and 2012. Patients were eligible if they received RBCs during surgery and had at least two arterial blood gas analyses performed. The primary endpoint was the increase of recipients' cHb related to the transfusion of 1 unit of RBCs with respect to different storage periods. Four storage periods were defined according to the distribution of RBC storage of the study population. General estimating equation was used for calculation of the primary endpoint and to adjust for confounding variables. A total of 598 arterial blood gas samples from 120 patients, receiving 429 RBC units, were analyzed. Mean (±SD) RBC storage was 21 (±9) days. RBC storage duration and the increase in recipients' cHb were inversely and gradually related; that is, the older the RBCs, the lower the increase in the recipients' cHb after transfusion (storage < 12 days, ΔcHb per unit RBCs +0.82 [95% confidence interval, 0.42-1.21] g/dL, p < 0.01; storage 12-20 days, +0.66 [0.46-0.86] g/dL, p < 0.01; storage 21-29 days, +0.56 [0.33-0.79] g/dL, p < 0.01; storage ≥30 days, +0.39 [0.07 to 0.71] g/dL, p = 0.02). Transfusion of senescent RBCs increased cHb less effectively than transfusion of fresher RBCs. © 2018 AABB.

Inpatient burden of constipation in the United States: an analysis of national trends in the United States from 1997 to 2010.

PubMed

Sethi, Saurabh; Mikami, Sage; Leclair, John; Park, Richard; Jones, Mike; Wadhwa, Vaibhav; Sethi, Nidhi; Cheng, Vivian; Friedlander, Elizabeth; Bollom, Andrea; Lembo, Anthony

2014-02-01

Constipation is one of the most common outpatient diagnoses in primary care and gastroenterology clinics; however, there is limited data on the inpatient burden of constipation in the United States. The aim of this study was to evaluate inpatient admission rates, length of stay, and associated costs related to constipation from 1997 to 2010. We analyzed the National Inpatient Sample Database for all patients in which constipation (ICD-9 codes: 564.0-564.09) was the principal discharge diagnosis from 1997 to 2010. The statistical significance of the difference in the number of hospital discharges, length of stay, and hospital costs over the study period was determined by utilizing the Spearman's coefficient to describe various trends. Between 1997 and 2010, the number of hospitalizations for patients with a primary discharge diagnosis of constipation increased from 21,190 patients to 48,450 (P<0.001, GoF test), whereas the mean length of hospital stay increased only slightly from 3.0 days to 3.1 days (b=0.008 (0.003-0.014); P=0.004). The mean charges per hospital discharge for constipation increased from $8869 in 1997 (adjusted for long-term inflation) to $17,518 in 2010 (b=745.4 (685.3-805.6); P<0.001)), whereas the total costs increased from $188,109,249 (adjusted for inflation) in 1997 to $851,713,263 in 2010. Although the elderly (65-84 years) accounted for the largest percentage of constipation discharges, patients in the 1-17 years age group had the highest frequency of constipation per 10,000 discharges. The number of inpatient discharges for constipation and associated costs has significantly increased between 1997 and 2010.

Power in health care organizations: contemplations from the first-line management perspective.

PubMed

Isosaari, Ulla

2011-01-01

The aim of this paper is to examine health care organizations' power structures from the first-line management perspective. What liable power structures derive from the theoretical bases of bureaucratic, professional and result based organizations, and what power type do health care organizations represent, according to the empirical data? The paper seeks to perform an analysis using Mintzberg's power configurations of instrument, closed system, meritocracy and political arena. The empirical study was executed at the end of 2005 through a survey in ten Finnish hospital districts in both specialized and primary care. Respondents were all first-line managers in the area and a sample of staff members from internal disease, surgical and psychiatric units, as well as out-patient and primary care units. The number of respondents was 1,197 and the response percentage was 38. The data were analyzed statistically. As a result, it can be seen that a certain kind of organization structure supports the generation of a certain power type. A bureaucratic organization generates an instrument or closed system organization, a professional organization generates meritocracy and also political arena, and a result-based organization has a connection to political arena and meritocracy. First line managers regarded health care organizations as instruments when staff regarded them mainly as meritocracies having features of political arena. Managers felt their position to be limited by rules, whereas staff members regarded their position as having lots of space and influence potential. If the organizations seek innovative and active managers at the unit level, they should change the organizational structure and redistribute the work so that there could be more space for meaningful management. This research adds to the literature and gives helpful suggestions that will be of interest to those in the position of first-line management in health care.

Land use and land cover digital data from 1:250,000- and 1:100,000- scale maps

USGS Publications Warehouse

,

1990-01-01

The Earth Science Information Centers (ESIC) distribute digital cartographic/geographic data files produced by the U.S. Geological Survey (USGS) as part of the National Mapping Program. The data files are grouped into four basic types. The first type, called a Digital Line Graph (DLG), is line map information in digital form. These data files include information on planimetric base categories, such as transportation, hydrography, and boundaries. The second type, called a Digital Elevation Model (DEM), consists of a sampled array of elevations for ground positions that are usually at regularly spaced intervals. The third type, Land Use and Land Cover digital data, provide information on nine major classes of land use such as urban, agricultural, or forest as well as associated map data such as political units and Federal land ownership. The fourth type, the Geographic Names Information System, provides primary information for known places, features, and areas in the United States identified by a proper name.

Digital Elevation Models

USGS Publications Warehouse

,

1993-01-01

The Earth Science Information Center (ESIC) distributes digital cartographic/geographic data files produced by the U.S. Geological Survey (USGS) as part of the National Mapping Program. Digital cartographic data files may be grouped into four basic types. The first of these, called a Digital Line Graph (DLG), is the line map information in digital form. These data files include information on base data categories, such as transportation, hypsography, hydrography, and boundaries. The second type, called a Digital Elevation Model (DEM), consists of a sampled array of elevations for a number of ground positions at regularly spaced intervals. The third type is Land Use and Land Cover digital data which provides information on nine major classes of land use such as urban, agricultural, or forest as well as associated map data such as political units and Federal land ownership. The fourth type, the Geographic Names Information System, provides primary information for all known places, features, and areas in the United States identified by a proper name.

Digital line graphs from 1:24,000-scale maps

USGS Publications Warehouse

,

1990-01-01

The Earth Science Information Centers (ESIC) distribute digital cartographic/geographic data files produced by the U.S. Geological Survey (USGS) as part of the National Mapping Program. Digital cartographic data flles are grouped into four basic types. The first of these, called a Digital Line . Graph (DLG), is line map information in digital form. These data files include information on planimetric base categories, such as transportation, hydrography, and boundaries. The second type, called a Digital Elevation Model (DEM), consists of a sampled array of elevations for a number of ground positions that are usually at regularly spaced intervals. The third type is Land Use and Land Cover digital data, which provides information on nine major classes of land use such as urban, agricultural, or forest as wen as associated map data such as political units and Federal land ownership. The fourth type, the Geographic Names Information System, provides primary information for all known places, features, and areas in the United States identified by a proper name.

Digital line graphs from 1:100,000-scale maps

USGS Publications Warehouse

,

1989-01-01

The National Cartographic Information Center (NCIC) distributes digital cartographic/geographic data files produced by the U.S. Geological Survey (USGS) as part of the National Mapping Program. Digital cartographic data files may be grouped into four basic types. The first of these, called a Digital Line Graph (DLG), is line map information in digital form. These data files include information on planimetric base categories, such as transportation, hydrography, and boundaries. The second form, called a Digital Elevation Model (OEM), consists of a sampled array of elevations for ground positions that are usually, but not always, at regularly spaced intervals. The third type is Land Use and Land Cover digital data, which provides information on nine major classes of land use such as urban, agricultural, or forest as well as associated map data such as political units and Federal land ownership. The fourth type, the Geographic Names Information System, provides primary information for known places, features, and areas in the United States identified by a proper name.

Monitoring and evaluation of antibiotic resistance genes in four municipal wastewater treatment plants in Harbin, Northeast China.

PubMed

Wen, Qinxue; Yang, Lian; Duan, Ruan; Chen, Zhiqiang

2016-05-01

The development and proliferation of antibiotic resistance in pathogenic and environmental microorganisms is of great concern for public health. In this study, the distribution and removal efficiency of intI1 and eight subtypes of antibiotic resistance genes (ARGs) for tetracycline, sulfonamides, beta-lactams resistance in four municipal wastewater treatment plants (WWTPs) in Harbin, which locates in Songhua River basin in cold areas of China, were monitored by real-time fluorescent quantitative PCR. The results showed that intI1 and 6 ARGs except for blaTEM and blaSHV were detected in wastewater and sludge samples and 0.3-2.7 orders of magnitude of ARGs removal efficiency in the four WWTPs were observed. The investigation on the removal of ARGs of different treatment units in one WWTP showed that the biological treatment unit played the most important role in ARGs removal (1.2-1.8 orders of magnitude), followed by UV disinfection, while primary physical treatment units can hardly remove any ARGs. Although all the WWTPs can remove ARGs effectively, ARGs concentrations are still relatively high in the effluent, their further attenuation should be investigated. Copyright © 2016 Elsevier Ltd. All rights reserved.

Patient outcomes for the chronically critically ill: special care unit versus intensive care unit.

PubMed

Rudy, E B; Daly, B J; Douglas, S; Montenegro, H D; Song, R; Dyer, M A

1995-01-01

The purpose of this study was to compare the effects of a low-technology environment of care and a nurse case management case delivery system (special care unit, SCU) with the traditional high-technology environment (ICU) and primary nursing care delivery system on the patient outcomes of length of stay, mortality, readmission, complications, satisfaction, and cost. A sample of 220 chronically critically ill patients were randomly assigned to either the SCU (n = 145) or the ICU (n = 75). Few significant differences were found between the two groups in length of stay, mortality, or complications. However, the findings showed significant cost savings in the SCU group in the charges accrued during the study period and in the charges and costs to produce a survivor. The average total cost of delivering care was $5,000 less per patient in the SCU than in the traditional ICU. In addition, the cost to produce a survivor was $19,000 less in the SCU. Results from this 4-year clinical trial demonstrate that nurse case managers in a SCU setting can produce patient outcomes equal to or better than those in the traditional ICU care environment for long-term critically ill patients.

19 CFR 123.52 - Commercial samples transported by automobile through the United States between ports in Canada.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Commercial samples transported by automobile... Commercial samples transported by automobile through the United States between ports in Canada. (a) General... sealed samples in his automobile without further sealing in the United States, upon compliance with this...

19 CFR 123.52 - Commercial samples transported by automobile through the United States between ports in Canada.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 1 2012-04-01 2012-04-01 false Commercial samples transported by automobile... Commercial samples transported by automobile through the United States between ports in Canada. (a) General... sealed samples in his automobile without further sealing in the United States, upon compliance with this...

19 CFR 123.52 - Commercial samples transported by automobile through the United States between ports in Canada.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 1 2013-04-01 2013-04-01 false Commercial samples transported by automobile... Commercial samples transported by automobile through the United States between ports in Canada. (a) General... sealed samples in his automobile without further sealing in the United States, upon compliance with this...

19 CFR 123.52 - Commercial samples transported by automobile through the United States between ports in Canada.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 1 2011-04-01 2011-04-01 false Commercial samples transported by automobile... Commercial samples transported by automobile through the United States between ports in Canada. (a) General... sealed samples in his automobile without further sealing in the United States, upon compliance with this...

19 CFR 123.52 - Commercial samples transported by automobile through the United States between ports in Canada.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 1 2014-04-01 2014-04-01 false Commercial samples transported by automobile... Commercial samples transported by automobile through the United States between ports in Canada. (a) General... sealed samples in his automobile without further sealing in the United States, upon compliance with this...

Interactive boundary delineation of agricultural lands using graphics workstations

NASA Technical Reports Server (NTRS)

Cheng, Thomas D.; Angelici, Gary L.; Slye, Robert E.; Ma, Matt

1992-01-01

A review is presented of the computer-assisted stratification and sampling (CASS) system developed to delineate the boundaries of sample units for survey procedures. CASS stratifies the sampling units by land-cover and land-use type, employing image-processing software and hardware. This procedure generates coverage areas and the boundaries of stratified sampling units that are utilized for subsequent sampling procedures from which agricultural statistics are developed.

Chemical analyses of coal, coal-associated rocks and coal combustion products collected for the National Coal Quality Inventory

USGS Publications Warehouse

Hatch, Joseph R.; Bullock, John H.; Finkelman, Robert B.

2006-01-01

In 1999, the USGS initiated the National Coal Quality Inventory (NaCQI) project to address a need for quality information on coals that will be mined during the next 20-30 years. At the time this project was initiated, the publicly available USGS coal quality data was based on samples primarily collected and analyzed between 1973 and 1985. The primary objective of NaCQI was to create a database containing comprehensive, accurate and accessible chemical information on the quality of mined and prepared United States coals and their combustion byproducts. This objective was to be accomplished through maintaining the existing publicly available coal quality database, expanding the database through the acquisition of new samples from priority areas, and analysis of the samples using updated coal analytical chemistry procedures. Priorities for sampling include those areas where future sources of compliance coal are federally owned. This project was a cooperative effort between the U.S. Geological Survey (USGS), State geological surveys, universities, coal burning utilities, and the coal mining industry. Funding support came from the Electric Power Research Institute (EPRI) and the U.S. Department of Energy (DOE).

Consumer access to clozapine in Australia: how does this compare to New Zealand and the United Kingdom?

PubMed

Knowles, Sally-Anne; Mcmillan, Sara S; Wheeler, Amanda J

2016-01-01

Clozapine is an antipsychotic medication used in treatment resistant schizophrenia. However, clozapine is associated with a significant adverse effect profile and extensive monitoring is required to optimise consumer safety. Traditionally, clozapine can only be prescribed by a psychiatrist and dispensed at a hospital or hospital affiliated pharmacy in Australia. These restrictions could result in significant treatment burden for consumers taking clozapine. To identify (1) the different models of supply that exist for people living in the community taking clozapine in Australia and compare to those in New Zealand and the United Kingdom, and (2) explore how these supply models may impact on consumer burden from the perspective of professionals involved in the supply of clozapine. Key informants were interviewed (n=8) from Australia, New Zealand and the United Kingdom regarding how consumers, who lived in the community, accessed clozapine. Data were analysed and led to the development of four clozapine supply models. These four models were further validated by an online survey of a wider sample (n=30). Data were analysed thematically and via simple descriptive statistics. Clozapine supply varied depending on location. A secondary care model was utilised in the United Kingdom compared to a community based (primary care) model in New Zealand; Australia utilised a mixture of both secondary and primary care. A key theme from all study participants was that community pharmacy should be utilised to dispense clozapine to consumers living in the community, provided adequate training and safeguards are in place. It was noted that the utilisation of community pharmacies could improve access and flexibility, thereby reducing treatment burden for these consumers. There are predominately two models for supply of clozapine to consumers living in the community in Australia, New Zealand and the United Kingdom. One model utilises secondary care facilities and the other community services. Community pharmacy is ideally placed to increase access to clozapine for consumers living in the community, provided appropriate training and support is given to pharmacists providing this professional service.

Advertising emergency department wait times.

PubMed

Weiner, Scott G

2013-03-01

Advertising emergency department (ED) wait times has become a common practice in the United States. Proponents of this practice state that it is a powerful marketing strategy that can help steer patients to the ED. Opponents worry about the risk to the public health that arises from a patient with an emergent condition self-triaging to a further hospital, problems with inaccuracy and lack of standard definition of the reported time, and directing lower acuity patients to the higher cost ED setting instead to primary care. Three sample cases demonstrating the pitfalls of advertising ED wait times are discussed. Given the lack of rigorous evidence supporting the practice and potential adverse effects to the public health, caution about its use is advised.

Sociodemographic factors associated with pregnant women's level of knowledge about oral health

PubMed Central

Barbieri, Wander; Peres, Stela Verzinhasse; Pereira, Carla de Britto; Peres, João; de Sousa, Maria da Luz Rosário; Cortellazzi, Karine Laura

2018-01-01

ABSTRACT Objective To evaluate knowledge on oral health and associated sociodemographic factors in pregnant women. Methods A cross-sectional study with a sample of 195 pregnant women seen at the Primary Care Unit Paraisópolis I, in São Paulo (SP), Brazil. For statistical analysis, χ2 or Fisher's exact test and multiple logistic regression were used. A significance level of 5% was used in all analyses. Results Schooling level equal to or greater than 8 years and having one or two children were associated with an adequate knowledge about oral health. Conclusion Oral health promotion strategies during prenatal care should take into account sociodemographic aspects. PMID:29694612

An Exploratory Case Study of a Sexual Assault Telephone Hotline: Training and Practice Implications.

PubMed

Colvin, Marianna L; Pruett, Jana A; Young, Stephen M; Holosko, Michael J

2016-06-29

Using archival data, this case study systematically examines telephone calls received by a regional sexual assault hotline in the Southeastern United States over a 5-year period. A stratified random sample (n = 383) reveals that hotline staff require diversity and depth in knowledge and skills, demonstrated by the hotline's primary use as a crisis service, combined with notable use by long-term survivors. Findings include the utility of the hotline by survivors and community stakeholders, categories of assault, the time gap between incidents occurring and contacting the hotline, call severity and urgency, and services and referrals provided. Implications for training, practice, and future research are discussed. © The Author(s) 2016.

Text Complexity: Primary Teachers' Views

ERIC Educational Resources Information Center

Fitzgerald, Jill; Hiebert, Elfrieda H.; Bowen, Kimberly; Relyea-Kim, E. Jackie; Kung, Melody; Elmore, Jeff

2015-01-01

The research question was, "What text characteristics do primary teachers think are most important for early grades text complexity?" Teachers from across the United States accomplished a two-part task. First, to stimulate teachers' thinking about important text characteristics, primary teachers completed an online paired-text…

49 CFR 173.172 - Aircraft hydraulic power unit fuel tank.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 2 2012-10-01 2012-10-01 false Aircraft hydraulic power unit fuel tank. 173.172... Class 1 and Class 7 § 173.172 Aircraft hydraulic power unit fuel tank. Aircraft hydraulic power unit... consist of an aluminum pressure vessel made from tubing and having welded heads. Primary containment of...

49 CFR 173.172 - Aircraft hydraulic power unit fuel tank.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 2 2014-10-01 2014-10-01 false Aircraft hydraulic power unit fuel tank. 173.172... Class 1 and Class 7 § 173.172 Aircraft hydraulic power unit fuel tank. Aircraft hydraulic power unit... consist of an aluminum pressure vessel made from tubing and having welded heads. Primary containment of...

49 CFR 173.172 - Aircraft hydraulic power unit fuel tank.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 2 2011-10-01 2011-10-01 false Aircraft hydraulic power unit fuel tank. 173.172... Class 1 and Class 7 § 173.172 Aircraft hydraulic power unit fuel tank. Aircraft hydraulic power unit... consist of an aluminum pressure vessel made from tubing and having welded heads. Primary containment of...

49 CFR 173.172 - Aircraft hydraulic power unit fuel tank.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 2 2013-10-01 2013-10-01 false Aircraft hydraulic power unit fuel tank. 173.172... Class 1 and Class 7 § 173.172 Aircraft hydraulic power unit fuel tank. Aircraft hydraulic power unit... consist of an aluminum pressure vessel made from tubing and having welded heads. Primary containment of...

49 CFR 173.172 - Aircraft hydraulic power unit fuel tank.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Aircraft hydraulic power unit fuel tank. 173.172... Class 1 and Class 7 § 173.172 Aircraft hydraulic power unit fuel tank. Aircraft hydraulic power unit... consist of an aluminum pressure vessel made from tubing and having welded heads. Primary containment of...

Media Unit. ArtsEdge Curricula, Lessons and Activities.

ERIC Educational Resources Information Center

Robertson, Helen

This "mini" curriculum unit introduces primary children (grades K-3) to the concept of images presented through the media, primarily advertising through print and on television. The unit is divided into three approximately 45-minute lessons. In the unit's first lesson, students will discuss why they like the particular toy they have…

Origin and heterogeneity of pore sizes in the Mount Simon Sandstone and Eau Claire Formation: Implications for multiphase fluid flow

DOE PAGES

Mozley, Peter S.; Heath, Jason E.; Dewers, Thomas A.; ...

2016-01-01

The Mount Simon Sandstone and Eau Claire Formation represent a principal reservoir - caprock system for wastewater disposal, geologic CO 2 storage, and compressed air energy storage (CAES) in the Midwestern United States. Of primary concern to site performance is heterogeneity in flow properties that could lead to non-ideal injectivity and distribution of injected fluids (e.g., poor sweep efficiency). Using core samples from the Dallas Center Structure, Iowa, we investigate pore structure that governs flow properties of major lithofacies of these formations. Methods include gas porosimetry and permeametry, mercury intrusion porosimetry, thin section petrography, and X-ray diffraction. The lithofacies exhibitmore » highly variable intra- and inter-informational distributions of pore throat and body sizes. Based on pore-throat size, samples fall into four distinct groups. Micropore-throat dominated samples are from the Eau Claire Formation, whereas the macropore-, mesopore-, and uniform-dominated samples are from the Mount Simon Sandstone. Complex paragenesis governs the high degree of pore and pore-throat size heterogeneity, due to an interplay of precipitation, non-uniform compaction, and later dissolution of cements. Furthermore, the cement dissolution event probably accounts for much of the current porosity in the unit. The unusually heterogeneous nature of the pore networks in the Mount Simon Sandstone indicates that there is a greater-than-normal opportunity for reservoir capillary trapping of non-wetting fluids — as quantified by CO 2 and air column heights — which should be taken into account when assessing the potential of the reservoir-caprock system for CO 2 storage and CAES.« less

Use of COD, TOC, and Fluorescence Spectroscopy to Estimate BOD in Wastewater.

PubMed

Christian, Evelyn; Batista, Jacimaria R; Gerrity, Daniel

2017-02-01

  Common to all National Pollutant Discharge Elimination System (NPDES) permits in the United States is a limit on biochemical oxygen demand (BOD). Chemical oxygen demand (COD), total organic carbon (TOC), and fluorescence spectroscopy are also capable of quantifying organic content, although the mechanisms of quantification and the organic fractions targeted differ for each test. This study explores correlations between BOD5 and these alternate test procedures using facility influent, primary effluent, and facility effluent samples from a full-scale water resource recovery facility. Relative reductions of the water quality parameters proved to be strong indicators of their suitability as surrogates for BOD5. Suitable correlations were generally limited to the combined datasets for the three sampling locations or the facility effluent alone. COD exhibited relatively strong linear correlations with BOD5 when considering the three sample points (r = 0.985) and the facility effluent alone (r = 0.914), while TOC exhibited a suitable linear correlation with BOD5 in the facility effluent (r = 0.902). Exponential regressions proved to be useful for estimating BOD5 based on TOC or fluorescence (r > 0.95).

[The ecological accident on the Siret River. A possible cyanide intoxication of children].

PubMed

Iordache, C; Azoicăi, Doina; Cristea, Anca; Sărmăşan, Veronica; Iordache, A; Pintilie, Wanda; Olaru, Carmen; Cernahoschi, L; Roşu, Tamara; Vaida, Carmen; Fărmeşanu, Mihaela

2002-01-01

Of our study is to assess the gravity of cyanide intoxication of children, in the ecological accident in January 2001. We included in our study 127 children aged between 2 months and 17 years. They were hospitalized in January and February 2001, in the "Sf. Maria" Children's Hospital. Case analysis was based on data of the emergency unit and units where the children were sent after primary care. We evaluated the patients from clinical and paraclinical point of view and we took samples of biological products in order to confirm the diagnosis. Age distribution was 0-1 year (4%), 1-3 years (7.8%), 3-6 years (9.4%), 6-12 years (33.8%), and 12-18 years (42.5%). The lapse of time between the ingestion of contaminated fish and symptomatology was variable. Measures were taken: removal from toxic contact, hospitalization, antidote administration, and treatment of complications. Although literature data shows that this intoxication appears after the age of three, we found that mother ingestion of contaminated fish, determined intoxication in nursings. Symptoms appeared at 3-12 hours after fish ingestion from the contaminated river and it was suggestive for the diagnosis. First aid measurements were necessary in specialized emergency unit and antidote administration sometimes only in clinical suspicion of intoxication. Correlation between clinical findings and toxic concentrations in urine samples confirm the diagnosis. Our study tries to highlight those ecological accidents with cyanides present important consequences on people and animal's health. The therapeutic intervention must be fast in order to stop blood distribution of the toxic.

Diabetes mellitus and infection: an evaluation of hospital utilization and management costs in the United States.

PubMed

Korbel, Lindsey; Spencer, John David

2015-03-01

The objective of this study is to evaluate the number of diabetics that seek medical treatment in emergency departments or require hospitalization for infection management in the United States. This study also assesses the socioeconomic impact of inpatient infection management among diabetics. We accessed the Healthcare Cost and Utilization Project's Nationwide Emergency Department Sample database and the Nationwide Inpatient Sample database to perform a retrospective analysis on diabetics presenting to the emergency department or hospitalized for infection management from 2006 to 2011. Emergency Department: Since 2006, nearly 10 million diabetics were annually evaluated in the emergency department. Infection was the primary reason for presentation in 10% of these visits. Among those visits, urinary tract infection was the most common infection, accounting for over 30% of emergency department encounters for infections. Other common infections included sepsis, skin and soft tissue infections, and pneumonia. Diabetics were more than twice as likely to be hospitalized for infection management than patients without diabetes. Hospitalization: Since 2006, nearly 6 million diabetics were annually hospitalized. 8-12% of these patients were hospitalized for infection management. In 2011, the inpatient care provided to patients with DM, and infection was responsible for over $48 billion dollars in aggregate hospital charges. Diabetics commonly present to the emergency department and require hospitalization for infection management. The care provided to diabetics for infection management has a large economic impact on the United States healthcare system. More efforts are needed to develop cost-effective strategies for the prevention of infection in patients with diabetes. Copyright © 2015 Elsevier Inc. All rights reserved.

7 CFR 42.143 - Operating Characteristic (OC) curves for on-line sampling and inspection.

Code of Federal Regulations, 2010 CFR

2010-01-01

...=Number of sample units in a subgroup. T=Subgroup tolerance.L=Acceptance limit.S=Starting value. EC02SE91... ng=Number of sample units in a subgroup. T=Subgroup tolerance. L=Acceptance limit. S=Starting value... of sample units in a subgroup. T=Subgroup tolerance. L=Acceptance limit. S=Starting value. EC02SE91...

A re-evaluation of a case-control model with contaminated controls for resource selection studies

Treesearch

Christopher T. Rota; Joshua J. Millspaugh; Dylan C. Kesler; Chad P. Lehman; Mark A. Rumble; Catherine M. B. Jachowski

2013-01-01

A common sampling design in resource selection studies involves measuring resource attributes at sample units used by an animal and at sample units considered available for use. Few models can estimate the absolute probability of using a sample unit from such data, but such approaches are generally preferred over statistical methods that estimate a relative probability...

Model estimates of net primary productivity, evaportranspiration, and water use efficiency in the terrestrial ecosystems of the southern United States

Treesearch

Hanqin Tian; Guangsheng Chen; Mingliang Liu; Chi Zhang; Ge Sun; Chaoqun Lu; Xiaofeng Xu; Wei Ren; Shufen Pan; Arthur Chappelka

2010-01-01

The effects of global change on ecosystem productivity and water resources in the southern United States (SUS), a traditionally ‘water-rich’ region and the ‘timber basket’ of the country, are not well quantified. We carried out several simulation experiments to quantify ecosystem net primary productivity (NPP), evapotranspiration (ET)...

Refractory Sampling Links Efficiency and Costs of Sensory Encoding to Stimulus Statistics

PubMed Central

Song, Zhuoyi

2014-01-01

Sensory neurons integrate information about the world, adapting their sampling to its changes. However, little is understood mechanistically how this primary encoding process, which ultimately limits perception, depends upon stimulus statistics. Here, we analyze this open question systematically by using intracellular recordings from fly (Drosophila melanogaster and Coenosia attenuata) photoreceptors and corresponding stochastic simulations from biophysically realistic photoreceptor models. Recordings show that photoreceptors can sample more information from naturalistic light intensity time series (NS) than from Gaussian white-noise (GWN), shuffled-NS or Gaussian-1/f stimuli; integrating larger responses with higher signal-to-noise ratio and encoding efficiency to large bursty contrast changes. Simulations reveal how a photoreceptor's information capture depends critically upon the stochastic refractoriness of its 30,000 sampling units (microvilli). In daylight, refractoriness sacrifices sensitivity to enhance intensity changes in neural image representations, with more and faster microvilli improving encoding. But for GWN and other stimuli, which lack longer dark contrasts of real-world intensity changes that reduce microvilli refractoriness, these performance gains are submaximal and energetically costly. These results provide mechanistic reasons why information sampling is more efficient for natural/naturalistic stimulation and novel insight into the operation, design, and evolution of signaling and code in sensory neurons. PMID:24849356

The first X-ray diffraction measurements on Mars.

PubMed

Bish, David; Blake, David; Vaniman, David; Sarrazin, Philippe; Bristow, Thomas; Achilles, Cherie; Dera, Przemyslaw; Chipera, Steve; Crisp, Joy; Downs, R T; Farmer, Jack; Gailhanou, Marc; Ming, Doug; Morookian, John Michael; Morris, Richard; Morrison, Shaunna; Rampe, Elizabeth; Treiman, Allan; Yen, Albert

2014-11-01

The Mars Science Laboratory landed in Gale crater on Mars in August 2012, and the Curiosity rover then began field studies on its drive toward Mount Sharp, a central peak made of ancient sediments. CheMin is one of ten instruments on or inside the rover, all designed to provide detailed information on the rocks, soils and atmosphere in this region. CheMin is a miniaturized X-ray diffraction/X-ray fluorescence (XRD/XRF) instrument that uses transmission geometry with an energy-discriminating CCD detector. CheMin uses onboard standards for XRD and XRF calibration, and beryl:quartz mixtures constitute the primary XRD standards. Four samples have been analysed by CheMin, namely a soil sample, two samples drilled from mudstones and a sample drilled from a sandstone. Rietveld and full-pattern analysis of the XRD data reveal a complex mineralogy, with contributions from parent igneous rocks, amorphous components and several minerals relating to aqueous alteration. In particular, the mudstone samples all contain one or more phyllosilicates consistent with alteration in liquid water. In addition to quantitative mineralogy, Rietveld refinements also provide unit-cell parameters for the major phases, which can be used to infer the chemical compositions of individual minerals and, by difference, the composition of the amorphous component.

Activity of lingual, laryngeal and oesophageal receptors in conscious sheep.

PubMed Central

Falempin, M; Rousseau, J P

1984-01-01

Vagal afferent impulse traffic has been studied in conscious sheep by electromyographic recording from the motor units of the sterno-cleido-mastoid (s.c.m.) muscle reinnervated by sensory vagal axons. Units which responded during movements of the tongue and during the pharyngolaryngeal and oesophageal stages of swallowing were chosen for this study. Lingual units showed a phasic discharge bearing a temporal relation to movements of the tongue during licking of the lips or chewing of a bolus before swallowing. Laryngeal units had no spontaneous activity. A discharge occurred with the ascending movement of the larynx during swallowing. Oesophageal units did not exhibit any tonic activity. They fired only at the time of primary or secondary oesophageal peristalsis. The oesophageal units showed a bimodal distribution. The oesophageal receptors are more concentrated at the beginning and the end of the thoracic oesophagus. During primary peristalsis, the afferent discharge was reinforced in only 57% of the cases when sheep swallowed a bolus (pellets or inflated balloons). When the discharge was reinforced, its increase ceased as volumes of the bolus were increased from 20 to 40 ml. During local oesophageal contractions, the afferent discharge was only present when the inflated balloon was located at the site of the receptor. It was enhanced at the time the primary peristaltic wave passed over the balloon. Inflation of a second balloon cranially in the oesophagus led to abolition of the activity of the unit at the caudal site though the distension there was maintained. PMID:6707965

The temporal representation of the delay of dynamic iterated rippled noise with positive and negative gain by single units in the ventral cochlear nucleus.

PubMed

Sayles, Mark; Winter, Ian Michael

2007-09-26

Spike trains were recorded from single units in the ventral cochlear nucleus of the anaesthetised guinea-pig in response to dynamic iterated rippled noise with positive and negative gain. The short-term running waveform autocorrelation functions of these stimuli show peaks at integer multiples of the time-varying delay when the gain is +1, and troughs at odd-integer multiples and peaks at even-integer multiples of the time-varying delay when the gain is -1. In contrast, the short-term autocorrelation of the Hilbert envelope shows peaks at integer multiples of the time-varying delay for both positive and negative gain stimuli. A running short-term all-order interspike interval analysis demonstrates the ability of single units to represent the modulated pitch contour in their short-term interval statistics. For units with low best frequency (approximate < or = 1.1 kHz) the temporal discharge pattern reflected the waveform fine structure regardless of unit classification (Primary-like, Chopper). For higher best frequency units the pattern of response varied according to unit type. Chopper units with best frequency approximate > or = 1.1 kHz responded to envelope modulation; showing no difference between their response to stimuli with positive and negative gain. Primary-like units with best frequencies in the range 1-3 kHz were still able to represent the difference in the temporal fine structure between dynamic rippled noise with positive and negative gain. No unit with a best frequency above 3 kHz showed a response to the temporal fine structure. Chopper units in this high frequency group showed significantly greater representation of envelope modulation relative to primary-like units with the same range of best frequencies. These results show that at the level of the cochlear nucleus there exists sufficient information in the time domain to represent the time-varying pitch associated with dynamic iterated rippled noise.

Health problems related to early discharge of Turkish women.

PubMed

Gözüm, Sebahat; Kiliç, Dilek

2005-12-01

to determine women's problems when discharged early from hospital after normal vaginal birth among a simple convenience sample of mothers in one part of Turkey. a descriptive interview study. primary health-care unit in Erzurum, Turkey. 112 mothers who came to the primary health-care unit for vaccination of their 2-month old babies between May and June 2000. Data were collected by structured face-to-face interviews. A symptom checklist was used to determine health problems. length of hospital stay after delivery was a mean of 7.1+/-7.0 hrs, and 66.1% (n=74) of mothers did not receive appropriate education about potential postpartum health problems. The findings indicated that the morbidity rate of mothers in the postpartum period was high. Among the most prevalent problems experienced by mothers were fatigue (86.6%; n=97), insomnia (80.4%; n=90), breast problems [engorged breast, tenderness and pain] 71.4%; n=80) and constipation 61.7%; n=69). Vaginal infection was reported by 16 mothers (14.3%; n=16). The prevalence of the use of medical services resulting from postnatal health problems in the postpartum period was 42.0% (n=47). About half of the mothers (51.8%; n=58) were not visited by midwives during the first postpartum week after discharge from hospital because both the maternity hospital and mother had not reported any health problems to the midwife. RECOMMENDATIONS FOR PRACTICE: mothers can experience many problems in the postpartum period. It is not possible to predict which mother will experience risks, such as an infection or mastitis. Therefore, women discharged from hospital in the first 24 hrs after birth should be educated about the problems that may arise during the postpartum period. They should also be given professional care and help in their own home by midwives working in the primary-care unit. Mothers should be told to notify their midwives about delivery and discharge in order to receive early follow-up in their homes. We suggest promoting maternal health education that encourages women to seek appropriate and timely care.

Nosocomial infections in a neonatal intensive care unit in South Brazil

PubMed Central

Dal-Bó, Karla; da Silva, Rosemeri Maurici; Sakae, Thiago Mamôru

2012-01-01

Objective The aim of this study was to describe the incidence and epidemiology of nosocomial infection in newborns who were admitted to a neonatal intensive care unit in a hospital in south Santa Catarina, Brazil. Methods A prospective cohort study was conducted for 1 year among 239 neonates who remained as in-patients 48 hours after admission. The criteria that were used to diagnose infection were in accordance with the Centers for Disease Control and Prevention and the National Health Surveillance Agency. Results The incidence of nosocomial infection was 45.8%. The primary reasons for admission were primary bloodstream infection (80.7%) and pneumonia (6.7%). Coagulase-negative Staphylococcus was the most commonly identified agent in the blood cultures and in the hospital unit. Prematurity was the most prevalent reason for admission. The general mortality rate was 12.1%, and mortality from nosocomial infection was 33.8%. Conclusions The incidence of nosocomial infection in the hospital unit was higher than rates that have been reported in other national studies. The major types of nosocomial infection were primary bloodstream infection and pneumonia. PMID:23917937

Evaluation of a technology unit in a girls' primary school

NASA Astrophysics Data System (ADS)

Eke, Marion; Gardner, Paul L.

1991-12-01

Rapid advances in technology are changing the structure of the workforce. There are elite highly-paid hi-tech occupations and low status poorly-paid jobs. Women are unfortunately more likely to be found in the latter category. To allow them to qualify and compete for the higher-status positions, girls need to participate in the physical sciences and in technology studies. However, they are rarely attracted to them in secondary school, possibly because they are already alienated from them by the time they leave primary school. This paper reports some of the outcomes of a curriculum unit taught in two primary school classes in an independent school for girls. The unit was cross-curricular, involving technology, science and other fields of knowledge; it made extensive use of LEGO Technic materials. The evaluation of the unit, based on observations, a teacher journal and pupil questionnaires, focussed upon the issue of whether it assisted the girls to feel happier about working with unfamiliar technology and feel more capable of doing so. Implications for teaching technology are also discussed.

50 CFR 14.131 - Primary enclosures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... same primary enclosure with an adult marine mammal other than its mother. Socially dependent animals (e... 50 Wildlife and Fisheries 1 2013-10-01 2013-10-01 false Primary enclosures. 14.131 Section 14.131 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR TAKING...

50 CFR 14.131 - Primary enclosures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... same primary enclosure with an adult marine mammal other than its mother. Socially dependent animals (e... 50 Wildlife and Fisheries 1 2012-10-01 2012-10-01 false Primary enclosures. 14.131 Section 14.131 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR TAKING...

Integrated terrain mapping with digital Landsat images in Queensland, Australia

USGS Publications Warehouse

Robinove, Charles Joseph

1979-01-01

Mapping with Landsat images usually is done by selecting single types of features, such as soils, vegetation, or rocks, and creating visually interpreted or digitally classified maps of each feature. Individual maps can then be overlaid on or combined with other maps to characterize the terrain. Integrated terrain mapping combines several terrain features into each map unit which, in many cases, is more directly related to uses of the land and to methods of land management than the single features alone. Terrain brightness, as measured by the multispectral scanners in Landsat 1 and 2, represents an integration of reflectance from the terrain features within the scanner's instantaneous field of view and is therefore more correlatable with integrated terrain units than with differentiated ones, such as rocks, soils, and vegetation. A test of the feasibilty of the technique of mapping integrated terrain units was conducted in a part of southwestern Queensland, Australia, in cooperation with scientists of the Queensland Department of Primary Industries. The primary purpose was to test the use of digital classification techniques to create a 'land systems map' usable for grazing land management. A recently published map of 'land systems' in the area (made by aerial photograph interpretation and ground surveys), which are integrated terrain units composed of vegetation, soil, topography, and geomorphic features, was used as a basis for comparison with digitally classified Landsat multispectral images. The land systems, in turn, each have a specific grazing capacity for cattle (expressed in beasts per km 2 ) which is estimated following analysis of both research results and property carrying capacities. Landsat images, in computer-compatible tape form, were first contrast-stretched to increase their visual interpretability, and digitally classified by the parallelepiped method into distinct spectral classes to determine their correspondence to the land systems classes and to areally smaller, but readily recognizable, 'land units.' Many land systems appeared as distinct spectral classes or as acceptably homogeneous combinations of several spectral classes. The digitally classified map corresponded to the general geographic patterns of many of the land systems. Statistical correlation of the digitally classified map and the published map was not possible because the published map showed only land systems whereas the digitally classified map showed some land units as well as systems. The general correspondence of spectral classes to the integrated terrain units means that the digital mapping of the units may precede fieldwork and act as a guide to field sampling and detailed terrain unit description as well as measuring of the location, area, and extent of each unit. Extension of the Landsat mapping and classification technique to other arid and semi-arid regions of the world may be feasible.

African Primary Care Research: qualitative interviewing in primary care.

PubMed

Reid, Steve; Mash, Bob

2014-06-05

This article is part of a series on African Primary Care Research and focuses on the topic of qualitative interviewing in primary care. In particular it looks at issues of study design, sample size, sampling and interviewing in relation to individual and focus group interviews.There is a particular focus on helping postgraduate students at a Masters level to write their research proposals.

A Microfluidic Interface for the Culture and Sampling of Adiponectin from Primary Adipocytes

PubMed Central

Godwin, Leah A.; Brooks, Jessica C.; Hoepfner, Lauren D.; Wanders, Desiree; Judd, Robert L.; Easley, Christopher J.

2014-01-01

Secreted from adipose tissue, adiponectin is a vital endocrine hormone that acts in glucose metabolism, thereby establishing its crucial role in diabetes, obesity, and other metabolic disease states. Insulin exposure to primary adipocytes cultured in static conditions has been shown to stimulate adiponectin secretion. However, conventional, static methodology for culturing and stimulating adipocytes falls short of truly mimicking physiological environments. Along with decreases in experimental costs and sample volume, and increased temporal resolution, microfluidic platforms permit small-volume flowing cell culture systems, which more accurately represent the constant flow conditions through vasculature in vivo. Here, we have integrated a customized primary tissue culture reservoir into a passively operated microfluidic device made of polydimethylsiloxane (PDMS). Fabrication of the reservoir was accomplished through unique PDMS “landscaping” above sampling channels, with a design strategy targeted to primary adipocytes to overcome issues of positive cell buoyancy. This reservoir allowed three-dimensional culture of primary murine adipocytes, accurate control over stimulants via constant perfusion, and sampling of adipokine secretion during various treatments. As the first report of primary adipocyte culture and sampling within microfluidic systems, this work sets the stage for future studies in adipokine secretion dynamics. PMID:25423362

Microscopic Analysis of Corn Fiber Using Corn Starch- and Cellulose-Specific Molecular Probes

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

Porter, S. E.; Donohoe, B. S.; Beery, K. E.

Ethanol is the primary liquid transportation fuel produced from renewable feedstocks in the United States today. The majority of corn grain, the primary feedstock for ethanol production, has been historically processed in wet mills yielding products such as gluten feed, gluten meal, starch, and germ. Starch extracted from the grain is used to produce ethanol in saccharification and fermentation steps; however the extraction of starch is not 100% efficient. To better understand starch extraction during the wet milling process, we have developed fluorescent probes that can be used to visually localize starch and cellulose in samples using confocal microscopy. Thesemore » probes are based on the binding specificities of two types of carbohydrate binding modules (CBMs), which are small substrate-specific protein domains derived from carbohydrate degrading enzymes. CBMs were fused, using molecular cloning techniques, to a green fluorescent protein (GFP) or to the red fluorescent protein DsRed (RFP). Using these engineered probes, we found that the binding of the starch-specific probe correlates with starch content in corn fiber samples. We also demonstrate that there is starch internally localized in the endosperm that may contribute to the high starch content in corn fiber. We also surprisingly found that the cellulose-specific probe did not bind to most corn fiber samples, but only to corn fiber that had been hydrolyzed using a thermochemical process that removes the residual starch and much of the hemicellulose. Our findings should be of interest to those working to increase the efficiency of the corn grain to ethanol process.« less

In the Aftermath of War: Cultural Clashes of the Twenties. A Unit of Study for Grades 9-12.

ERIC Educational Resources Information Center

Gifford, Nina

This unit is a collection of lessons for teaching about cultural clashes. Based on primary sources, the unit contains teacher background materials and three lesson plans with student resources. These lessons deal with the United States between World War I and World War II. The United States emerged from World War I with seismic faults in its…

Development of rotation sample designs for the estimation of crop acreages

NASA Technical Reports Server (NTRS)

Lycthuan-Lee, T. G. (Principal Investigator)

1981-01-01

The idea behind the use of rotation sample designs is that the variation of the crop acreage of a particular sample unit from year to year is usually less than the variation of crop acreage between units within a particular year. The estimation theory is based on an additive mixed analysis of variance model with years as fixed effects, (a sub t), and sample units as a variable factor. The rotation patterns are decided upon according to: (1) the number of sample units in the design each year; (2) the number of units retained in the following years; and (3) the number of years to complete the rotation pattern. Different analytic formulae for the variance of (a sub t) and the variance comparisons in using a complete survey of the rotation patterns.

A new FIA-Type strategic inventory (NFI)

Treesearch

Richard A. Grotefendt; Hans T. Schreuder

2006-01-01

New remote sensing technologies are now available to lower the cost of doing strategic surveys. A new sampling approach for the Forest Inventory and Analysis program (FIA) of the U.S.D.A. Forest Service is discussed involving a bi-sampling unit (BSU) that is composed of a field sample unit (FSU) centered within a large scale (1:1,000 to 1:3,000) photo sample unit (PSU...

STUDY OF HOME DEMONSTRATION UNITS IN A SAMPLE OF 27 COUNTIES IN NEW YORK STATE, NUMBER 3.

ERIC Educational Resources Information Center

ALEXANDER, FRANK D.; HARSHAW, JEAN

AN EXPLORATORY STUDY EXAMINED CHARACTERISTICS OF 1,128 HOME DEMONSTRATION UNITS TO SUGGEST HYPOTHESES AND SCOPE FOR A MORE INTENSIVE STUDY OF A SMALL SAMPLE OF UNITS, AND TO PROVIDE GUIDANCE IN SAMPLING. DATA WERE OBTAINED FROM A SPECIALLY DESIGNED MEMBERSHIP CARD USED IN 1962. UNIT SIZE AVERAGED 23.6 MEMBERS BUT THE RANGE WAS FAIRLY GREAT. A NEED…

Ultra-processed food consumption among infants in primary health care in a city of the metropolitan region of São Paulo, Brazil.

PubMed

Relvas, Gláubia Rocha Barbosa; Buccini, Gabriela Dos Santos; Venancio, Sonia Isoyama

2018-06-08

To analyze the prevalence of ultra-processed food intake among children under one year of age and to identify associated factors. A cross-sectional design was employed. We interviewed 198 mothers of children aged between 6 and 12 months in primary healthcare units located in a city of the metropolitan region of São Paulo, Brazil. Specific foods consumed in the previous 24h of the interview were considered to evaluate the consumption of ultra-processed foods. Variables related to mothers' and children's characteristics as well as primary healthcare units were grouped into three blocks of increasingly proximal influence on the outcome. A Poisson regression analysis was performed following a statistical hierarchical modeling to determine factors associated with ultra-processed food intake. The prevalence of ultra-processed food intake was 43.1%. Infants that were not being breastfed had a higher prevalence of ultra-processed food intake but no statistical significance was found. Lower maternal education (prevalence ratio 1.55 [1.08-2.24]) and the child's first appointment at the primary healthcare unit having happened after the first week of life (prevalence ratio 1.51 [1.01-2.27]) were factors associated with the consumption of ultra-processed foods. High consumption of ultra-processed foods among children under 1 year of age was found. Both maternal socioeconomic status and time until the child's first appointment at the primary healthcare unit were associated with the prevalence of ultra-processed food intake. Copyright © 2018 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Technical issues and conservation conditions of medicines in the primary health care of the Brazilian Unified Health System

PubMed Central

Costa, Ediná Alves; Araújo, Patrícia Sodré; Pereira, Marcelo Tavares; Souto, Ana Cristina; Souza, Gisélia Santana; Guerra, Augusto Afonso; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Alvares, Juliana; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mario; Leite, Silvana Nair

2017-01-01

ABSTRACT OBJECTIVE To characterize the technical issues and conditions of medicines conservation in Primary Health Care of Brazilian regions, responsible for pharmacy/dispensing unit profile; environmental, storage, and dose fractioning conditions; inventory control and waste management; fire and electrical failure safety items; transportation problems; advertising regulation; and pharmacovigilance. METHODS This article is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços (National Survey on Access, Use and Promotion of Rational Use of Medicines – Services)–, a cross-sectional and exploratory study, of evaluative nature, consisting of an information survey within a representative sample of municipalities, stratified by Brazilian regions, which constitute the study domains, and a sample of Primary Health Care services. Pharmaceutical services (PS) were directly observed with photographic record and face-to-face interviews with those responsible for the dispensing of medicines and over the telephone with those responsible for pharmaceutical services. Data were processed with the SPSS® software version 21. RESULTS The investigated dimensions showed relevant deficiencies and inequalities between the regions, generally more favorable in the Southeast and Midwest regions and weaker in the Northeast and North regions. We verified non-compliance with technical requirements and conditions essential to the conservation of medicines, which may interfere with the maintenance of stability and, thus, on their quality, efficacy, and safety. The regulation of advertising/promotion of medicines is still incipient and there is some progress in the structuring of mechanisms regarding pharmacovigilance. CONCLUSIONS The sanitary situation of medicines in Brazilian Primary Health Care is alarming due to the violation of the specific sanitary legislation for dispensing establishments and due to a wide range of requirements essential to the conservation of medicines. We observed a disconnection between the efforts made in the Brazilian Unified Health System to promote access to medicines for all population and the organization and qualification of pharmaceutical services. PMID:29160452

SOURCE APPORTIONMENT OF PRIMARY CARBONACEOUS AEROSOL USING THE COMMUNITY MULTISCALE AIR QUALITY MODEL

EPA Science Inventory

A substantial fraction of fine particulate matter (PM) across the United States is composed of carbon, which may be either emitted in particulate form (i.e., primary) or formed in the atmosphere through gas-to-particle conversion processes (i.e., secondary). Primary carbonaceous...

50 CFR 14.172 - Primary enclosures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Wild Mammals and Birds to the United States Specifications for Birds § 14.172 Primary enclosures. (a) A primary enclosure for birds shall have ventilation openings on two vertical sides that comprise at least... creating a draft. (b) Perches shall be provided for birds that rest by perching. The diameter of the perch...

78 FR 24599 - Order Imposing Recordkeeping and Reporting Obligations on Certain U.S. Financial Institutions...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-25

... Rmeiti & Co. for Exchange as a Financial Institution of Primary Money Laundering Concern AGENCY... institution operating outside the United States that is of primary money laundering concern. The Director of... Institution of Primary Money Laundering Concern (the ``Finding''). Notice of the Finding is published...

Explaining Direct Care Resource Use of Nursing Home Residents: Findings from Time Studies in Four States

PubMed Central

Arling, Greg; Kane, Robert L; Mueller, Christine; Lewis, Teresa

2007-01-01

Objective To explain variation in direct care resource use (RU) of nursing home residents based on the Resource Utilization Groups III (RUG-III) classification system and other resident- and unit-level explanatory variables. Data Sources/Study Setting Primary data were collected on 5,314 nursing home residents in 156 nursing units in 105 facilities from four states (CO, IN, MN, MS) from 1998 to 2004. Study Design Nurses and other direct care staff recorded resident-specific and other time caring for all residents on sampled nursing units. Care time was linked to resident data from the Minimum Data Set assessment instrument. Major variables were: RUG-III group (34-group), other health and functional conditions, licensed and other professional minutes per day, unlicensed minutes per day, and direct care RU (wage-weighted minutes). Resident- and unit-level relationships were examined through hierarchical linear modeling. Data Collection/Extraction Methods Time study data were recorded with hand-held computers, verified for accuracy by project staff at the data collection sites and then merged into resident and unit-level data sets. Principal Findings Resident care time and RU varied between and within nursing units. RUG-III group was related to RU; variables such as length of stay and unit percentage of high acuity residents also were significantly related. Case-mix indices (CMIs) constructed from study data displayed much less variation across RUG-III groups than CMIs from earlier time studies. Conclusions Results from earlier time studies may not be representative of care patterns of Medicaid and private pay residents. New RUG-III CMIs should be developed to better reflect the relative costs of caring for these residents. PMID:17362220

Natural Systems: MINNEMAST Coordinated Mathematics - Science Series, Unit 29.

ERIC Educational Resources Information Center

Bakke, Jeannette; And Others

This volume is the last in a series of 29 coordinated MINNEMAST units in mathematics and science for kindergarten and the primary grades. Intended for use by third-grade teachers, this unit guide provides a summary and overview of the unit, a list of materials needed, and descriptions of three groups of lessons. The purposes and procedures for…

Primary-Graders Study Nutrition

ERIC Educational Resources Information Center

Niedermeyer, Fred C.; Moncrief, Michael H.

1975-01-01

Describes the content of an instructional unit on nutrition prepared by the Dairy Council of California for primary-level school children and the results of its large-scale tryout in 30 California schools. (SDH)

Management Philosophies of Primary School Principals

ERIC Educational Resources Information Center

Tas, Said

2011-01-01

The study aimed to determine the management philosophies of primary school principals. Stratification method of sampling was used in the study. The study sample consisted of 33 school principals and 132 teachers serving at primary education schools in Isparta in the academic year 2008-2009. The "Manager Philosophy Scale" developed by Tanriogen and…

Construction of a remotely sensed area sampling frame for Southern Brazil

NASA Technical Reports Server (NTRS)

Fecso, R.; Gardner, W.; Hale, B.; Johnson, V.; Pavlasek, S. (Principal Investigator)

1982-01-01

A remotely sensed area sampling frame was constructed for selected areas in Southern Brazil. The sampling unit information was stored in digital form in a latitudinal/longitudinal characterized population. Computerized sampling procedures were developed which allow for flexibility in sample unit specifications and sampling designs.

Systematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series.

PubMed

Abraha, Iosief; Rimland, Joseph M; Trotta, Fabiana Mirella; Dell'Aquila, Giuseppina; Cruz-Jentoft, Alfonso; Petrovic, Mirko; Gudmundsson, Adalsteinn; Soiza, Roy; O'Mahony, Denis; Guaita, Antonio; Cherubini, Antonio

2017-03-16

To provide an overview of non-pharmacological interventions for behavioural and psychological symptoms in dementia (BPSD). Systematic overview of reviews. PubMed, EMBASE, Cochrane Database of Systematic Reviews, CINAHL and PsycINFO (2009-March 2015). Systematic reviews (SRs) that included at least one comparative study evaluating any non-pharmacological intervention, to treat BPSD. Eligible studies were selected and data extracted independently by 2 reviewers.The AMSTAR checklist was used to assess the quality of the SRs. Extracted data were synthesised using a narrative approach. 38 SRs and 129 primary studies were identified, comprising the following categories of non-pharmacological interventions: (1) sensory stimulation interventions (25 SRs, 66 primary studies) that encompassed: shiatsu and acupressure, aromatherapy, massage/touch therapy, light therapy, sensory garden and horticultural activities, music/dance therapy, dance therapy, snoezelen multisensory stimulation therapy, transcutaneous electrical nerve stimulation; (2) cognitive/emotion-oriented interventions (13 SRs; 26 primary studies) that included cognitive stimulation, reminiscence therapy, validation therapy, simulated presence therapy; (3) behaviour management techniques (6 SRs; 22 primary studies); (4) Multicomponent interventions (3 SR; four primary studies); (5) other therapies (5 SRs, 15 primary studies) comprising exercise therapy, animal-assisted therapy, special care unit and dining room environment-based interventions. A large number of non-pharmacological interventions for BPSD were identified. The majority of the studies had great variation in how the same type of intervention was defined and applied, the follow-up duration, the type of outcome measured, usually with modest sample size. Overall, music therapy and behavioural management techniques were effective for reducing BPSD. 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/.

Choledochorraphy (primary repair) versus t-tube drainage after open choledochotomy.

PubMed

Saeed, Nadia; Nasir, Muhammad Tauqeer; Khan, Muhammad Iqbal; Channa, Ghulam Asghar

2012-01-01

T-tube drainage used to be standard practice after surgical choledochotomy, but there is now a tendency in some canters to close the common bile duct primarily. This study was designed to compare the clinical results of primary closure with T-tube drainage after open choledocotomy and assess the safety of primary closure for future application. This study was conducted at surgical Unit-3, ward 26 Jinnah Postgraduate Medical Centre Karachi, from January 2007 to January 2008. Forty patients were included in this study out of which 20 underwent primary closure and 20 T-tube placements. It was Quasi-experimental, non-probability, purposive sampling. Main outcome measures were operating time, duration of hospital stay, and postoperative complications. SPSS-10 was used for data analysis. The age of patients in the study ranged from 29-83 years. There were 3 male while 37 female patients. Group-1 consisted of 20 patients underwent primary closure after choledocotomy, while Group-2 also consisted of 20 patients underwent T-tube drainage after duct exploration. Mean hospital stay in Group-1 patients was 7.63 days while in group 2 it was 13.6 days. Overall complication rate in group 1 was 15%, biliary leakage in 1 (5%), jaundice in 1 (5%), wound infection in 1 (5%). No re-exploration was required in Group-1. In Group-2 overall complication rate was 30%, biliary leakage in 2 (2%), jaundice in 1 (5%), dislodgement of T-tube in 1 (5%), wound infection in 1 (5%), and sepsis in 1 (5%) patients. Re-exploration was done in one patient. Primary closure of Common Bile Duct (CBD) is a safe and cost-effective alternative procedure to routine T-tube drainage after open choledocotomy.

A case study of outsourced primary healthcare services in Sindh, Pakistan: is this a real reform?

PubMed

Tanzil, Sana; Zahidie, Aysha; Ahsan, Adeel; Kazi, Ambreen; Shaikh, Babar Tasneem

2014-06-25

Since a decade, low and middle income countries have a rising trend of contracting their primary healthcare services to NGOs. In Pakistan, public sector often lacks capacity to effectively & equitably manage the healthcare services. It led the government to outsource the administration of primary health care services to a semi-autonomous government entity i.e. Peoples' Primary Healthcare Initiative (PPHI). This small scale study has assessed the quality of healthcare services at the contracted Basic Health Units (BHUs) with the PPHI and compared it with those managed by the local district government in the province of Sindh. A cross-sectional mix methods survey was conducted in November 2011. Two BHUs of each type were selected from the districts Karachi and Thatta in Sindh province. BHUs were selected randomly and a purposive sampling technique was used to recruit the study participants at the two study sites. Focus group discussions were conducted with patients visiting the facility while in-depth interviews were conducted with service providers. An observation based resource availability checklist was also administered. There was a significant difference between the PPHI and the district government administered BHUs with regard to infrastructure, availability of essential medicines, basic medical appliances, mini-lab facilities and vehicles for referrals. These BHUs were found to have sufficient number of trained clinical staff and no punctuality and retention issues whatsoever. The district government administered BHUs presented a dismal picture in all the aspects. Out-sourcing of primary healthcare facilities has resulted in significantly improved certain aspects quality and responsiveness of primary healthcare services. This strategy is likely to achieve an efficient and perhaps an equitable healthcare delivery in low and middle income countries where governments have limited capacity to manage healthcare services.

A case study of outsourced primary healthcare services in Sindh, Pakistan: is this a real reform?

PubMed Central

2014-01-01

Background Since a decade, low and middle income countries have a rising trend of contracting their primary healthcare services to NGOs. In Pakistan, public sector often lacks capacity to effectively & equitably manage the healthcare services. It led the government to outsource the administration of primary health care services to a semi-autonomous government entity i.e. Peoples’ Primary Healthcare Initiative (PPHI). This small scale study has assessed the quality of healthcare services at the contracted Basic Health Units (BHUs) with the PPHI and compared it with those managed by the local district government in the province of Sindh. Methods A cross-sectional mix methods survey was conducted in November 2011. Two BHUs of each type were selected from the districts Karachi and Thatta in Sindh province. BHUs were selected randomly and a purposive sampling technique was used to recruit the study participants at the two study sites. Focus group discussions were conducted with patients visiting the facility while in-depth interviews were conducted with service providers. An observation based resource availability checklist was also administered. Results There was a significant difference between the PPHI and the district government administered BHUs with regard to infrastructure, availability of essential medicines, basic medical appliances, mini-lab facilities and vehicles for referrals. These BHUs were found to have sufficient number of trained clinical staff and no punctuality and retention issues whatsoever. The district government administered BHUs presented a dismal picture in all the aspects. Conclusion Out-sourcing of primary healthcare facilities has resulted in significantly improved certain aspects quality and responsiveness of primary healthcare services. This strategy is likely to achieve an efficient and perhaps an equitable healthcare delivery in low and middle income countries where governments have limited capacity to manage healthcare services. PMID:24965769

Recruitment and retention of participants in randomised controlled trials: a review of trials funded and published by the United Kingdom Health Technology Assessment Programme.

PubMed

Walters, Stephen J; Bonacho Dos Anjos Henriques-Cadby, Inês; Bortolami, Oscar; Flight, Laura; Hind, Daniel; Jacques, Richard M; Knox, Christopher; Nadin, Ben; Rothwell, Joanne; Surtees, Michael; Julious, Steven A

2017-03-20

Substantial amounts of public funds are invested in health research worldwide. Publicly funded randomised controlled trials (RCTs) often recruit participants at a slower than anticipated rate. Many trials fail to reach their planned sample size within the envisaged trial timescale and trial funding envelope. To review the consent, recruitment and retention rates for single and multicentre randomised control trials funded and published by the UK's National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme. HTA reports of individually randomised single or multicentre RCTs published from the start of 2004 to the end of April 2016 were reviewed. Information was extracted, relating to the trial characteristics, sample size, recruitment and retention by two independent reviewers. Target sample size and whether it was achieved; recruitment rates (number of participants recruited per centre per month) and retention rates (randomised participants retained and assessed with valid primary outcome data). This review identified 151 individually RCTs from 787 NIHR HTA reports. The final recruitment target sample size was achieved in 56% (85/151) of the RCTs and more than 80% of the final target sample size was achieved for 79% of the RCTs (119/151). The median recruitment rate (participants per centre per month) was found to be 0.92 (IQR 0.43-2.79) and the median retention rate (proportion of participants with valid primary outcome data at follow-up) was estimated at 89% (IQR 79-97%). There is considerable variation in the consent, recruitment and retention rates in publicly funded RCTs. Investigators should bear this in mind at the planning stage of their study and not be overly optimistic about their recruitment projections. 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/.

Recruitment and retention of participants in randomised controlled trials: a review of trials funded and published by the United Kingdom Health Technology Assessment Programme

PubMed Central

Bonacho dos Anjos Henriques-Cadby, Inês; Bortolami, Oscar; Flight, Laura; Hind, Daniel; Knox, Christopher; Nadin, Ben; Rothwell, Joanne; Surtees, Michael; Julious, Steven A

2017-01-01

Background Substantial amounts of public funds are invested in health research worldwide. Publicly funded randomised controlled trials (RCTs) often recruit participants at a slower than anticipated rate. Many trials fail to reach their planned sample size within the envisaged trial timescale and trial funding envelope. Objectives To review the consent, recruitment and retention rates for single and multicentre randomised control trials funded and published by the UK's National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme. Data sources and study selection HTA reports of individually randomised single or multicentre RCTs published from the start of 2004 to the end of April 2016 were reviewed. Data extraction Information was extracted, relating to the trial characteristics, sample size, recruitment and retention by two independent reviewers. Main outcome measures Target sample size and whether it was achieved; recruitment rates (number of participants recruited per centre per month) and retention rates (randomised participants retained and assessed with valid primary outcome data). Results This review identified 151 individually RCTs from 787 NIHR HTA reports. The final recruitment target sample size was achieved in 56% (85/151) of the RCTs and more than 80% of the final target sample size was achieved for 79% of the RCTs (119/151). The median recruitment rate (participants per centre per month) was found to be 0.92 (IQR 0.43–2.79) and the median retention rate (proportion of participants with valid primary outcome data at follow-up) was estimated at 89% (IQR 79–97%). Conclusions There is considerable variation in the consent, recruitment and retention rates in publicly funded RCTs. Investigators should bear this in mind at the planning stage of their study and not be overly optimistic about their recruitment projections. PMID:28320800