41 CFR 102-76.85 - What is a primary function area for purposes of providing an accessible route in leased...

Code of Federal Regulations, 2012 CFR

2012-01-01

... AND CONSTRUCTION Architectural Barriers Act § 102-76.85 What is a primary function area for purposes...), a primary function area is an area that contains a major activity for which the leased facility is intended. Primary function areas include areas where services are provided to customers or the public, and...

41 CFR 102-76.85 - What is a primary function area for purposes of providing an accessible route in leased...

Code of Federal Regulations, 2013 CFR

2013-07-01

... AND CONSTRUCTION Architectural Barriers Act § 102-76.85 What is a primary function area for purposes...), a primary function area is an area that contains a major activity for which the leased facility is intended. Primary function areas include areas where services are provided to customers or the public, and...

41 CFR 102-76.85 - What is a primary function area for purposes of providing an accessible route in leased...

Code of Federal Regulations, 2014 CFR

2014-01-01

... AND CONSTRUCTION Architectural Barriers Act § 102-76.85 What is a primary function area for purposes...), a primary function area is an area that contains a major activity for which the leased facility is intended. Primary function areas include areas where services are provided to customers or the public, and...

41 CFR 102-76.85 - What is a primary function area for purposes of providing an accessible route in leased...

Code of Federal Regulations, 2010 CFR

2010-07-01

... AND CONSTRUCTION Architectural Barriers Act § 102-76.85 What is a primary function area for purposes...), a primary function area is an area that contains a major activity for which the leased facility is intended. Primary function areas include areas where services are provided to customers or the public, and...

Utility of a thematic network in primary health care: a controlled interventional study in a rural area

PubMed Central

Coma del Corral, Maria Jesús; Abaigar Luquín, Pedro; Cordero Guevara, José; Olea Movilla, Angel; Torres Torres, Gerardo; Lozano Garcia, Javier

2005-01-01

Background UniNet is an Internet-based thematic network for a virtual community of users (VCU). It supports a virtual multidisciplinary community for physicians, focused on the improvement of clinical practice. This is a study of the effects of a thematic network such as UniNet on primary care medicine in a rural area, specifically as a platform of communication between specialists at the hospital and doctors in the rural area. Methods In order to study the effects of a thematic network such as UniNet on primary care medicine in a rural area, we designed an interventional study that included a control group. The measurements included the number of patient displacements due to disease, number of patient hospital stays and the number of prescriptions of drugs of low therapeutic utility and generic drug prescriptions by doctors. These data were analysed and compared with those of the control center. Results Our study showed positive changes in medical practice, reflected in the improvement of the evaluated parameters in the rural health area where the interventional study was carried out, compared with the control area. We discuss the strengths and weaknesses of UniNet as a potential medium to improve the quality of medical care in rural areas. Conclusion The rural doctors had an effective, useful, user-friendly and cheap source of medical information that may have contributed to the improvement observed in the medical quality indices. PMID:16042778

Architectonic subdivisions of neocortex in the tree shrew (Tupaia belangeri)

PubMed Central

Wong, Peiyan; Kaas, Jon H.

2010-01-01

Tree shrews are small mammals that bear some semblance to squirrels, but are actually close relatives of primates. Thus, they have been extensively studied as a model for the early stages of primate evolution. In the present study, subdivisions of cortex were reconstructed from brain sections cut in the coronal, sagittal or horizontal planes, and processed for parvalbumin (PV), SMI-32 immunopositive neurofilament protein epitopes, vesicle glutamate transporter 2 (VGluT2), free ionic zinc, myelin, cytochrome oxidase (CO) and Nissl substance. These different procedures revealed similar boundaries between areas, suggesting the detection of functionally relevant borders and allowed a more precise demarcation of cortical areal boundaries. Primary cortical areas were most clearly revealed by the zinc stain, due to the poor staining of layer 4, as thalamocortical terminations lack free ionic zinc. Area 17 (V1) was especially prominent, as the broad layer 4 was nearly free of zinc stain. However, this feature was less pronounced in primary auditory and somatosensory, cortex. In primary sensory areas, thalamocortical terminations in layer 4 densely express VGluT2. Auditory cortex consists of two architectonically distinct subdivisions, a primary core region (Ac), surrounded by a belt region (Ab) that had a slightly less developed koniocellular appearance. Primary motor cortex (M1) was identified by the absence of VGluT2 staining in the poorly developed granular layer 4 and the presence of SMI-32 labeled pyramidal cells in layers 3 and 5. The presence of well-differentiated cortical areas in tree shrews indicates their usefulness in studies of cortical organization and function. PMID:19462403

Development of a Knowledge Management Model for the Development of a Quality Public Sector Management System for the Office of the Primary Educational Service Area

ERIC Educational Resources Information Center

Khotbancha, Wijitra; Chantarasombat, Chalard; Sriampai, Anan

2015-01-01

The objectives of this research were: 1) to study the current situation and problem of Knowledge Management of the office of the primary education service area, 2) to develop a Knowledge Management model, 3) to study the success of the implementation of the Knowledge Management system. There were 25 persons in the target group. There were 2 kinds…

Internal performance characteristics of vectored axisymmetric ejector nozzles

NASA Technical Reports Server (NTRS)

Lamb, Milton

1993-01-01

A series of vectoring axisymmetric ejector nozzles were designed and experimentally tested for internal performance and pumping characteristics at NASA-Langley Research Center. These ejector nozzles used convergent-divergent nozzles as the primary nozzles. The model geometric variables investigated were primary nozzle throat area, primary nozzle expansion ratio, effective ejector expansion ratio (ratio of shroud exit area to primary nozzle throat area), ratio of minimum ejector area to primary nozzle throat area, ratio of ejector upper slot height to lower slot height (measured on the vertical centerline), and thrust vector angle. The primary nozzle pressure ratio was varied from 2.0 to 10.0 depending upon primary nozzle throat area. The corrected ejector-to-primary nozzle weight-flow ratio was varied from 0 (no secondary flow) to approximately 0.21 (21 percent of primary weight-flow rate) depending on ejector nozzle configuration. In addition to the internal performance and pumping characteristics, static pressures were obtained on the shroud walls.

Mathematics Performance and Principal Effectiveness: A Case Study of Some Coastal Primary Schools in Sri Lanka

ERIC Educational Resources Information Center

Egodawatte, Gunawardena

2012-01-01

This mixed method research study is situated in the school effectiveness research paradigm to examine the correlation between the effectiveness of urban, primary school principals and their students' performance in mathematics. Nine, urban, primary schools from Negombo, a coastal fishing area in Sri Lanka, were selected; their student achievements…

Children's Television Behaviour: Its Antecedents and Relationship to School Performance. A Study of the Television Viewing Behaviour of Children in Grade 6 of State Primary Schools in the Metropolitan Area of Melbourne. Occasional Paper No. 14.

ERIC Educational Resources Information Center

Sharman, Kevin James

A study was conducted to describe the television viewing habits of grade 6 children in primary schools within the metropolitan area of Melbourne, Australia; to examine the nature of the relationships between factors found to be relevant in explaining television behavior; and to examine the relationship between television behavior and school…

Congenital deafness affects deep layers in primary and secondary auditory cortex

PubMed Central

Berger, Christoph; Kühne, Daniela; Scheper, Verena

2017-01-01

Abstract Congenital deafness leads to functional deficits in the auditory cortex for which early cochlear implantation can effectively compensate. Most of these deficits have been demonstrated functionally. Furthermore, the majority of previous studies on deafness have involved the primary auditory cortex; knowledge of higher‐order areas is limited to effects of cross‐modal reorganization. In this study, we compared the cortical cytoarchitecture of four cortical areas in adult hearing and congenitally deaf cats (CDCs): the primary auditory field A1, two secondary auditory fields, namely the dorsal zone and second auditory field (A2); and a reference visual association field (area 7) in the same section stained either using Nissl or SMI‐32 antibodies. The general cytoarchitectonic pattern and the area‐specific characteristics in the auditory cortex remained unchanged in animals with congenital deafness. Whereas area 7 did not differ between the groups investigated, all auditory fields were slightly thinner in CDCs, this being caused by reduced thickness of layers IV–VI. The study documents that, while the cytoarchitectonic patterns are in general independent of sensory experience, reduced layer thickness is observed in both primary and higher‐order auditory fields in layer IV and infragranular layers. The study demonstrates differences in effects of congenital deafness between supragranular and other cortical layers, but similar dystrophic effects in all investigated auditory fields. PMID:28643417

Cervical Screening for Women with Learning Disability: Current Practice and Attitudes within Primary Care in Edinburgh

ERIC Educational Resources Information Center

Wood, Rachael; Douglas, Margaret

2007-01-01

This study aimed to evaluate current practice in, and to explore primary care professionals' views about, providing cervical screening to women with learning disability, in two areas of Edinburgh. A postal questionnaire was sent to all 24 GP practices in the project area: 20 responded. Seven respondents were invited to participate in follow up…

Impact of physician distribution policies on primary care practices in rural Quebec.

PubMed

Da Silva, Roxane Borgès; Pineault, Raynald

2012-01-01

Accessibility and continuity of primary health care in rural Canada are inadequate, mainly because of a relative shortage of family physicians. To alleviate the uneven distribution of physicians in rural and urban regions, Quebec has implemented measures associated with 3 types of physician practices in rural areas. The objectives of our study were to describe the practices of these types of physicians in a rural area and to analyze the impact of physician distribution policies aimed at offsetting the lack of resources. Data were drawn from a medical administrative database and included information related to physicians' practices in the rural area of Beauce, Que., in 2007. The practices of permanently settled physicians in rural areas differ from those of physicians who substitute for short periods. Permanently settled physicians offer mostly primary care services, whereas physicians who temporarily substitute devote much of their time to hospital-based practice. Physician distribution policies implemented in Quebec to compensate for the lack of medical resources in rural areas have reduced the deficit in hospital care but not in primary care.

Who Drops out from Primary Schools in China? Evidence from Minority-Concentrated Rural Areas

ERIC Educational Resources Information Center

Lu, Meichen; Cui, Manlin; Shi, Yaojiang; Chang, Fang; Mo, Di; Rozelle, Scott; Johnson, Natalie

2016-01-01

One of the Millennium Development Goals is to ensure universal access to primary education by 2015. However, primary school dropout remains a challenge in many developing countries. While official statistics in China report aggregated primary school dropout of only 0.2%, almost no independent, survey-based studies have sought to verify these…

Improving Fine Motor Skills in Young Children: An Intervention Study

ERIC Educational Resources Information Center

Brown, Carol G.

2010-01-01

The aim of this study was to evaluate the effect of the Primary Movement programme on the fine motor skills of children in an early years setting in an area of high social disadvantage. Primary Movement is a programme which can be used as an early intervention technique to help children inhibit persistent primary reflexes that have been shown to…

Epidemiology of pediculosis capitis among schoolchildren in the eastern area of Bangkok, Thailand.

PubMed

Rassami, Watcharawit; Soonwera, Mayura

2012-11-01

To determine the prevalence of infestation with head lice in primary schoolchildren in the eastern area of Bangkok, Thailand. The present study was to determine the head lice infestation (Pediculosis) levels in primary schoolchildren, during May, 2011 to July, 2011, A total of 3 747 schoolchildren aged 5-12 years old from 12 selected primary school of Ladkrabang district, the eastern area of Bangkok were examined for head lice. Pediculosis was defined as the presence of at least on living adult, nymph and viable egg. The overall head lice infestation rate was 23.32% and infestation rate was higher in girls (47.12%) than in boys (0%). The infestation rate among schoolchildren varied from 12.62% to 29.76%. The infestation rate among girls varied from 26.07% (12 years old group) to 55.89% (8 years old group). Pediculosis is a common public health problem affecting primary schoolchildren in eastern area of Bangkok and those levels are epidemic importance.

Epidemiology of pediculosis capitis among schoolchildren in the eastern area of Bangkok, Thailand

PubMed Central

Rassami, Watcharawit; Soonwera, Mayura

2012-01-01

Objective To determine the prevalence of infestation with head lice in primary schoolchildren in the eastern area of Bangkok, Thailand. Methods The present study was to determine the head lice infestation (Pediculosis) levels in primary schoolchildren, during May, 2011 to July, 2011, A total of 3 747 schoolchildren aged 5-12 years old from 12 selected primary school of Ladkrabang district, the eastern area of Bangkok were examined for head lice. Pediculosis was defined as the presence of at least on living adult, nymph and viable egg. Results The overall head lice infestation rate was 23.32% and infestation rate was higher in girls (47.12%) than in boys (0%). The infestation rate among schoolchildren varied from 12.62% to 29.76%. The infestation rate among girls varied from 26.07% (12 years old group) to 55.89% (8 years old group). Conclusions Pediculosis is a common public health problem affecting primary schoolchildren in eastern area of Bangkok and those levels are epidemic importance. PMID:23569868

Free establishment of primary health care providers: effects on geographical equity.

PubMed

Isaksson, David; Blomqvist, Paula; Winblad, Ulrika

2016-01-23

A reform in 2010 in Swedish primary care made it possible for private primary care providers to establish themselves freely in the country. In the former, publicly planned system, location was strictly regulated by local authorities. The goal of the new reform was to increase access and quality of health care. Critical arguments were raised that the reform could have detrimental effects on equity if the new primary health care providers chose to establish foremost in socioeconomically prosperous areas. The aim of this study is to examine how the primary care choice reform has affected geographical equity by analysing patterns of establishment on the part of new private providers. The basis of the design was to analyse socio-economic data on individuals who reside in the same electoral areas in which the 1411 primary health care centres in Sweden are established. Since the primary health care centres are located within 21 different county councils with different reimbursement schemes, we controlled for possible cluster effects utilizing generalized estimating equations modelling. The empirical material used in the analysis is a cross-sectional data set containing socio-economic data of the geographical areas in which all primary health care centres are established. When controlling for the effects of the county council regulation, primary health care centres established after the primary care choice reform were found to be located in areas with significantly fewer older adults living alone as well as fewer single parents - groups which generally have lower socio-economic status and high health care needs. However, no significant effects were observed for other socio-economic variables such as mean income, percentage of immigrants, education, unemployment, and children <5 years. The primary care choice reform seems to have had some negative effects on geographical equity, even though these seem relatively minor.

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2015-01-01

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

Surveillance of mother-to-child HIV transmission: socioeconomic and health care coverage indicators.

PubMed

Barcellos, Christovam; Acosta, Lisiane Morelia Weide; Lisboa, Eugenio; Bastos, Francisco Inácio

2009-12-01

To identify clustering areas of infants exposed to HIV during pregnancy and their association with indicators of primary care coverage and socioeconomic condition. Ecological study where the unit of analysis was primary care coverage areas in the city of Porto Alegre, Southern Brazil, in 2003. Geographical Information System and spatial analysis tools were used to describe indicators of primary care coverage areas and socioeconomic condition, and estimate the prevalence of liveborn infants exposed to HIV during pregnancy and delivery. Data was obtained from Brazilian national databases. The association between different indicators was assessed using Spearman's nonparametric test. There was found an association between HIV infection and high birth rates (r=0.22, p<0.01) and lack of prenatal care (r=0.15, p<0.05). The highest HIV infection rates were seen in areas with poor socioeconomic conditions and difficult access to health services (r=0.28, p<0.01). The association found between higher rate of prenatal care among HIV-infected women and adequate immunization coverage (r=0.35, p<0.01) indicates that early detection of HIV infection is effective in those areas with better primary care services. Urban poverty is a strong determinant of mother-to-child HIV transmission but this trend can be fought with health surveillance at the primary care level.

Evaluation of Primary Immunization Coverage of Infants Under Universal Immunization Programme in an Urban Area of Bangalore City Using Cluster Sampling and Lot Quality Assurance Sampling Techniques

PubMed Central

K, Punith; K, Lalitha; G, Suman; BS, Pradeep; Kumar K, Jayanth

2008-01-01

Research Question: Is LQAS technique better than cluster sampling technique in terms of resources to evaluate the immunization coverage in an urban area? Objective: To assess and compare the lot quality assurance sampling against cluster sampling in the evaluation of primary immunization coverage. Study Design: Population-based cross-sectional study. Study Setting: Areas under Mathikere Urban Health Center. Study Subjects: Children aged 12 months to 23 months. Sample Size: 220 in cluster sampling, 76 in lot quality assurance sampling. Statistical Analysis: Percentages and Proportions, Chi square Test. Results: (1) Using cluster sampling, the percentage of completely immunized, partially immunized and unimmunized children were 84.09%, 14.09% and 1.82%, respectively. With lot quality assurance sampling, it was 92.11%, 6.58% and 1.31%, respectively. (2) Immunization coverage levels as evaluated by cluster sampling technique were not statistically different from the coverage value as obtained by lot quality assurance sampling techniques. Considering the time and resources required, it was found that lot quality assurance sampling is a better technique in evaluating the primary immunization coverage in urban area. PMID:19876474

Concerned Citizens: Children and the Future

ERIC Educational Resources Information Center

Holden, Cathie

2006-01-01

Recent initiatives in England have promoted education for citizenship, including teaching about topical global issues, for both primary and secondary pupils. Little is known, however, of primary children's interest in this area or the extent to which they see themselves as active citizens. This article reports on a study into primary children's…

Supplementary motor area and primary auditory cortex activation in an expert break-dancer during the kinesthetic motor imagery of dance to music.

PubMed

Olshansky, Michael P; Bar, Rachel J; Fogarty, Mary; DeSouza, Joseph F X

2015-01-01

The current study used functional magnetic resonance imaging to examine the neural activity of an expert dancer with 35 years of break-dancing experience during the kinesthetic motor imagery (KMI) of dance accompanied by highly familiar and unfamiliar music. The goal of this study was to examine the effect of musical familiarity on neural activity underlying KMI within a highly experienced dancer. In order to investigate this in both primary sensory and motor planning cortical areas, we examined the effects of music familiarity on the primary auditory cortex [Heschl's gyrus (HG)] and the supplementary motor area (SMA). Our findings reveal reduced HG activity and greater SMA activity during imagined dance to familiar music compared to unfamiliar music. We propose that one's internal representations of dance moves are influenced by auditory stimuli and may be specific to a dance style and the music accompanying it.

Time-resolved characterization of primary and secondary particle emissions of a modern gasoline passenger car

NASA Astrophysics Data System (ADS)

Karjalainen, P.; Timonen, H.; Saukko, E.; Kuuluvainen, H.; Saarikoski, S.; Aakko-Saksa, P.; Murtonen, T.; Dal Maso, M.; Ahlberg, E.; Svenningsson, B.; Brune, W. H.; Hillamo, R.; Keskinen, J.; Rönkkö, T.

2015-11-01

Changes in traffic systems and vehicle emission reduction technologies significantly affect traffic-related emissions in urban areas. In many densely populated areas the amount of traffic is increasing, keeping the emission level high or even increasing. To understand the health effects of traffic related emissions, both primary and secondary particles that are formed in the atmosphere from gaseous exhaust emissions need to be characterized. In this study we used a comprehensive set of measurements to characterize both primary and secondary particulate emissions of a modern gasoline passenger car. Our aerosol particle study covers the whole process chain in emission formation, from the engine to the atmosphere, and takes into account also differences in driving patterns. We observed that in mass terms, the amount of secondary particles was 13 times higher than the amount of primary particles. The formation, composition, number, and mass of secondary particles was significantly affected by driving patterns and engine conditions. The highest gaseous and particulate emissions were observed at the beginning of the test cycle when the performance of the engine and the catalyst was below optimal. The key parameter for secondary particle formation was the amount of gaseous hydrocarbons in primary emissions; however, also the primary particle population had an influence. Thus, in order to enhance human health and wellbeing in urban areas, our study strongly indicates that in future legislation, special attention should be directed into the reduction of gaseous hydrocarbons.

Spatial Access to Primary Care Providers in Appalachia

PubMed Central

Donohoe, Joseph; Marshall, Vince; Tan, Xi; Camacho, Fabian T.; Anderson, Roger T.; Balkrishnan, Rajesh

2016-01-01

Purpose: The goal of this research was to examine spatial access to primary care physicians in Appalachia using both traditional access measures and the 2-step floating catchment area (2SFCA) method. Spatial access to care was compared between urban and rural regions of Appalachia. Methods: The study region included Appalachia counties of Pennsylvania, Ohio, Kentucky, and North Carolina. Primary care physicians during 2008 and total census block group populations were geocoded into GIS software. Ratios of county physicians to population, driving time to nearest primary care physician, and various 2SFCA approaches were compared. Results: Urban areas of the study region had shorter travel times to their closest primary care physician. Provider to population ratios produced results that varied widely from one county to another because of strict geographic boundaries. The 2SFCA method produced varied results depending on the distance decay weight and variable catchment size techniques chose. 2SFCA scores showed greater access to care in urban areas of Pennsylvania, Ohio, and North Carolina. Conclusion: The different parameters of the 2SFCA method—distance decay weights and variable catchment sizes—have a large impact on the resulting spatial access to primary care scores. The findings of this study suggest that using a relative 2SFCA approach, the spatial access ratio method, when detailed patient travel data are unavailable. The 2SFCA method shows promise for measuring access to care in Appalachia, but more research on patient travel preferences is needed to inform implementation. PMID:26906524

The Implementation of Schools' Policy in the Development of the Local Content Curriculum in Primary Schools in Pacitan, Indonesia

ERIC Educational Resources Information Center

Maryono

2016-01-01

This study aims to describe the culture and local potential in Pacitan, East Java, as well as the implementation of local content in primary schools in the area, and some factors that support and hinder their implementation. This research is a qualitative case study. There were five primary schools used as samples obtained through purposive…

Observation and simulation of net primary productivity in Qilian Mountain, western China.

PubMed

Zhou, Y; Zhu, Q; Chen, J M; Wang, Y Q; Liu, J; Sun, R; Tang, S

2007-11-01

We modeled net primary productivity (NPP) at high spatial resolution using an advanced spaceborne thermal emission and reflection radiometer (ASTER) image of a Qilian Mountain study area using the boreal ecosystem productivity simulator (BEPS). Two key driving variables of the model, leaf area index (LAI) and land cover type, were derived from ASTER and moderate resolution imaging spectroradiometer (MODIS) data. Other spatially explicit inputs included daily meteorological data (radiation, precipitation, temperature, humidity), available soil water holding capacity (AWC), and forest biomass. NPP was estimated for coniferous forests and other land cover types in the study area. The result showed that NPP of coniferous forests in the study area was about 4.4 tCha(-1)y(-1). The correlation coefficient between the modeled NPP and ground measurements was 0.84, with a mean relative error of about 13.9%.

Carbonic fluid inclusions in amphibolite-facies pelitic schists from Bodonch area, western Mongolian Altai

NASA Astrophysics Data System (ADS)

Zorigtkhuu, Oyun-Erdene; Tsunogae, Toshiaki; Dash, Batulzii

We report first fluid inclusion data on amphibolite-facies pelitic schists from Bodonch area of western Mongolian Altai in the Central Asian Orogenic Belt. Three categories of fluid inclusions have been observed in quartz: dominant primary and secondary inclusions, and least dominant pseudosecondary inclusions. The melting temperatures of all the categories of inclusions lie in the narrow range of -57.5 °C to -56.6 °C, close to the triple point of pure CO2. Homogenization of fluids occurs into liquid phase at temperature between -33.3 °C to +19.4 °C, which convert into densities in the range of 0.78 g/cm3 to 1.09 g/cm3. The estimated CO2 isochores for primary and pseudosecondary high-density inclusions is broadly consistent with the peak metamorphic condition of the studied area (6.3-7.3 kbar at 655 °C). The results of this study, together with the primary and pseudosecondary nature of the inclusions, indicate CO2 was the dominant fluid component during the peak amphibolite-facies metamorphism of the study area. The examined quartz grains are texturally associated with biotite, kyanite and staurolite, which are regarded as high-grade minerals formed during prograde to peak metamorphism. Therefore quartz probably formed by high-grade metamorphism and the primary fluid inclusions trapped in the minerals probably preserve fluids at around peak metamorphism.

Atlas of optimal coil orientation and position for TMS: A computational study.

PubMed

Gomez-Tames, Jose; Hamasaka, Atsushi; Laakso, Ilkka; Hirata, Akimasa; Ugawa, Yoshikazu

2018-04-17

Transcranial magnetic stimulation (TMS) activates target brain structures in a non-invasive manner. The optimal orientation of the TMS coil for the motor cortex is well known and can be estimated using motor evoked potentials. However, there are no easily measurable responses for activation of other cortical areas and the optimal orientation for these areas is currently unknown. This study investigated the electric field strength, optimal coil orientation, and relative locations to optimally stimulate the target cortex based on computed electric field distributions. A total of 518,616 stimulation scenarios were studied using realistic head models (2401 coil locations × 12 coil angles × 18 head models). Inter-subject registration methods were used to generate an atlas of optimized TMS coil orientations on locations on the standard brain. We found that the maximum electric field strength is greater in primary somatosensory cortex and primary motor cortex than in other cortical areas. Additionally, a universal optimal coil orientation applicable to most subjects is more feasible at the primary somatosensory cortex and primary motor cortex. We confirmed that optimal coil angle follows the anatomical shape of the hand motor area to realize personalized optimization of TMS. Finally, on average, the optimal coil positions for TMS on the scalp deviated 5.5 mm from the scalp points with minimum cortex-scalp distance. This deviation was minimal at the premotor cortex and primary motor cortex. Personalized optimal coil orientation is preferable for obtaining the most effective stimulation. Copyright © 2018. Published by Elsevier Inc.

39 CFR 254.2 - Definition of primary function area and criteria used to determine whether an alteration has an...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Definition of primary function area and criteria used to determine whether an alteration has an effect on an area containing a primary function that is... ARCHITECTURAL BARRIERS ACT § 254.2 Definition of primary function area and criteria used to determine whether an...

39 CFR 254.2 - Definition of primary function area and criteria used to determine whether an alteration has an...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Definition of primary function area and criteria used to determine whether an alteration has an effect on an area containing a primary function that is... ARCHITECTURAL BARRIERS ACT § 254.2 Definition of primary function area and criteria used to determine whether an...

39 CFR 254.2 - Definition of primary function area and criteria used to determine whether an alteration has an...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Definition of primary function area and criteria used to determine whether an alteration has an effect on an area containing a primary function that is... ARCHITECTURAL BARRIERS ACT § 254.2 Definition of primary function area and criteria used to determine whether an...

39 CFR 254.2 - Definition of primary function area and criteria used to determine whether an alteration has an...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Definition of primary function area and criteria used to determine whether an alteration has an effect on an area containing a primary function that is... ARCHITECTURAL BARRIERS ACT § 254.2 Definition of primary function area and criteria used to determine whether an...

39 CFR 254.2 - Definition of primary function area and criteria used to determine whether an alteration has an...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Definition of primary function area and criteria used to determine whether an alteration has an effect on an area containing a primary function that is... ARCHITECTURAL BARRIERS ACT § 254.2 Definition of primary function area and criteria used to determine whether an...

The impacts of implementation of National Essential Medicines Policies on primary healthcare institutions: a cross-sectional study in China.

PubMed

Guo, Zhigang; Guan, Xiaodong; Shi, Luwen

2017-11-13

In 2009, China implemented the National Essential Medicines Policies (NEMPs) as part of a new round of medical system reforms. This study aims to evaluate the impacts of the NEMPs on primary healthcare institutions and discuss the roles of the policies in the new healthcare reforms of China. The study selected a total of six representative provinces of China, generating a sample of 261 primary healthcare institutions from August to December in 2010. A questionnaire survey developed by the study team was distributed to all of the primary healthcare institutions. Nine indicators from three dimensions as the outcome variables were used and calculated to evaluate the impacts of implementation of policies. All of the outcome variables were tested using independent-samples T test between the treatment group (with the NEMPs implemented) and the control group (without the NEMPs implemented). The ratio of drug sales and institution revenues at primary healthcare institutions was 42.99% in the treatment group, which was significantly lower than the control group (53.90%, p < 0.01), while the ratio of financial subsidies of the treatment group was shown to be higher (30.78% VS 20.82%, p < 0.01). The rate of healthcare workers income growth was greater in the treatment group (15.35% VS 5.79%, p = 0.006). The treatment group exhibited higher outpatient and emergency visits per month in urban areas (2720 VS 1763 visits per month) and rural areas (3830 VS 3633), and higher prescriptions per month in urban areas (2048 VS 1025, p = 0.005) and rural areas (3806 VS 3251). The treatment group used more essential medicines and received greater income from essential medicines while the drug price markup rate was lower. The NEMPs appear to affect the transformation of the operation mechanisms of primary healthcare institutions, the improvement of the mechanisms for government investment, and the healthcare pricing system. Meanwhile, the gaps between urban and rural areas need to be addressed. In conclusion, the NEMPs of China are instrumental to the aim of providing basic healthcare services to every citizen.

Ground vibration monitoring for construction blasting in urban areas.

DOT National Transportation Integrated Search

2001-04-01

The primary objectives of this study were to determine a recommendation for the preblast : area for surveys, and to obtain actual field vibrations from rock blasting : operations, in populated regions within specific geologic units. The area confined...

Utility of linking primary care electronic medical records with Canadian census data to study the determinants of chronic disease: an example based on socioeconomic status and obesity.

PubMed

Biro, Suzanne; Williamson, Tyler; Leggett, Jannet Ann; Barber, David; Morkem, Rachael; Moore, Kieran; Belanger, Paul; Mosley, Brian; Janssen, Ian

2016-03-11

Electronic medical records (EMRs) used in primary care contain a breadth of data that can be used in public health research. Patient data from EMRs could be linked with other data sources, such as a postal code linkage with Census data, to obtain additional information on environmental determinants of health. While promising, successful linkages between primary care EMRs with geographic measures is limited due to ethics review board concerns. This study tested the feasibility of extracting full postal code from primary care EMRs and linking this with area-level measures of the environment to demonstrate how such a linkage could be used to examine the determinants of disease. The association between obesity and area-level deprivation was used as an example to illustrate inequalities of obesity in adults. The analysis included EMRs of 7153 patients aged 20 years and older who visited a single, primary care site in 2011. Extracted patient information included demographics (date of birth, sex, postal code) and weight status (height, weight). Information extraction and management procedures were designed to mitigate the risk of individual re-identification when extracting full postal code from source EMRs. Based on patients' postal codes, area-based deprivation indexes were created using the smallest area unit used in Canadian censuses. Descriptive statistics and socioeconomic disparity summary measures of linked census and adult patients were calculated. The data extraction of full postal code met technological requirements for rendering health information extracted from local EMRs into anonymized data. The prevalence of obesity was 31.6 %. There was variation of obesity between deprivation quintiles; adults in the most deprived areas were 35 % more likely to be obese compared with adults in the least deprived areas (Chi-Square = 20.24(1), p < 0.0001). Maps depicting spatial representation of regional deprivation and obesity were created to highlight high risk areas. An area based socio-economic measure was linked with EMR-derived objective measures of height and weight to show a positive association between area-level deprivation and obesity. The linked dataset demonstrates a promising model for assessing health disparities and ecological factors associated with the development of chronic diseases with far reaching implications for informing public health and primary health care interventions and services.

Modelling multiple hospital outcomes: the impact of small area and primary care practice variation.

PubMed

Congdon, Peter

2006-11-16

Appropriate management of care--for example, avoiding unnecessary attendances at, or admissions to, hospital emergency units when they could be handled in primary care--is an important part of health strategy. However, some variations in these outcomes could be due to genuine variations in health need. This paper proposes a new method of explaining variations in hospital utilisation across small areas and the general practices (GPs) responsible for patient primary care. By controlling for the influence of true need on such variations, one may identify remaining sources of excess emergency attendances and admissions, both at area and practice level, that may be related to the quality, resourcing or organisation of care. The present paper accordingly develops a methodology that recognises the interplay between population mix factors (health need) and primary care factors (e.g. referral thresholds), that allows for unobserved influences on hospitalisation usage, and that also reflects interdependence between hospital outcomes. A case study considers relativities in attendance and admission rates at a North London hospital involving 149 small areas and 53 GP practices. A fixed effects model shows variations in attendances and admissions are significantly related (positively) to area and practice need, and nursing home patients, and related (negatively) to primary care access and distance of patient homes from the hospital. Modelling the impact of known factors alone is not sufficient to produce a satisfactory fit to the observations, and random effects at area and practice level are needed to improve fit and account for overdispersion. The case study finds variation in attendance and admission rates across areas and practices after controlling for need, and remaining differences between practices may be attributable to referral behaviour unrelated to need, or to staffing, resourcing, and access issues. In managerial terms, the analysis points to the utility of formal statistical analysis of hospitalisation rates as a prelude to non-statistical investigation of primary care resourcing and organisation. For example, there may be implications for the location of staff involved in community management of chronic conditions; health managers may also investigate whether some practices have unusual populations (homeless, asylum seekers, students) that explain different hospital use patterns.

Sources and Manifestations of Stress in Female Kindergarten Teachers

ERIC Educational Resources Information Center

Tsai, Eva; Fung, Lena; Chow, Lina

2006-01-01

The study of teacher stress is not a new area of research. However, most of the published research studies have been strongly oriented towards primary and secondary school teachers. Given that the teaching environment of kindergarten differs greatly from primary and secondary schools, this study sets out to examine the sources and manifestations…

Comprehensive shear wave velocity study in the Popular Bluff Area, Southeast Missouri.

DOT National Transportation Integrated Search

2005-04-30

The University of Missouri-Rolla in collaboration with the Missouri Department of Transportation acquired : multiple geophysical, geotechnical and borehole data sets in the Poplar Bluff study area. The primary objective : was to evaluate the utility ...

High frequency of primary hyperaldosteronism among hypertensive patients from a primary care area in Sweden.

PubMed

Westerdahl, Christina; Bergenfelz, Anders; Isaksson, Anders; Wihl, Anders; Nerbrand, Christina; Valdemarsson, Stig

2006-09-01

To search for primary hyperaldosteronism (PHA) among previously known hypertensive patients in primary care, using the aldosterone/renin ratio (ARR), and to evaluate clinical and biochemical characteristics in patients with high or normal ratio. Patient survey study. The study population was recruited by written invitation among hypertensive patients in two primary care areas in Sweden. A total of 200 patients met the criteria and were included in the study. The ARR was calculated from serum aldosterone and plasma renin concentrations. The cut-off level for ARR was set to 100, as confirmed in 28 healthy subjects. Patients with increased ARR were considered for a confirmatory test, using the fludrocortisone suppression test. Of 200 patients, 50 patients had ARR > 100; 26 patients were further evaluated by fludrocortisone suppression test. Seventeen of these patients had an incomplete aldosterone inhibition. In total 17 of 200 evaluated patients (8.5%) had an incomplete suppression with fludrocortisone. This confirms previous reports on a high frequency of PHA. No significant biochemical or clinical differences were found among hypertensive patients with PHA compared with the whole sample.

An Analytic Study of the Uneconomic Lower Primary Schools in Malappuram District

ERIC Educational Resources Information Center

Vijayakumari, K.; Kayikkara, Vaheeda

2010-01-01

Background: A few studies have been conducted on area of uneconomic schools. And most of these studies are related with fertility decline in the state. Purpose: The study intended to find out physical conditions of uneconomic lower primary schools, to identify the factors causing the schools uneconomic and to provide suggestions for improving the…

Strategies to recruit a diverse low-income population to child weight management programs from primary care practices

USDA-ARS?s Scientific Manuscript database

Primary care practices can be used to engage children and families in weight management programs. The Texas Childhood Obesity Research Demonstration (TX CORD) study targeted patients at 12 primary care practices in diverse and low-income areas of Houston, Texas, and Austin, Texas for recruitment to ...

Ground vibration monitoring for construction blasting in urban areas

DOT National Transportation Integrated Search

2001-04-01

The primary objectives of this study were to determine a recommendation for the pre-blast area for surveys, and to obtain actual field vibrations from rock blasting operations, in populated regions within specific geologic units. The area confined wi...

An analysis of computerization in primary care practices.

PubMed

Condon, James V; Smith, Sherry P

2002-12-01

To remain profitable, primary care practices, the front-line health care providers, must provide excellent patient care and reduce expenses while providing payers with accurate data. Many primary care practices have turned to computer technology to achieve these goals. This study examined the degree of computerization of primary care providers in the Augusta, Georgia, metropolitan area as well as the level of awareness of the Health Insurance Portability and Accountability Act (HIPAA) by primary care providers and its potential effect on their future computerization plans. The study's findings are presented and discussed as well as a number of recommendations for practice managers.

Delayed activation of the primary orbitofrontal cortex in post-traumatic anosmia.

PubMed

Lee, Vincent Kyu; Nardone, Raffaele; Wasco, Fern; Panigrahy, Ashok; Zuccoli, Giulio

2016-01-01

Functional magnetic resonance imaging may help in elucidating the pathophysiology of post-traumatic anosmia. Using an fMRI olfactory stimulus paradigm, this study compared BOLD activation of the brain in a 21-year old male research subject with post-traumatic anosmia and a 19-year old male normal healthy control participant. A delayed activation of the primary orbitofrontal cortex was found in the subject with traumatic anosmia, which may represent a crucial pathophysiological mechanism in the subject with traumatic anosmia due to axonal injury or traumatic transection at the lamina cribrosa level. In healthy subjects the activation of secondary cortical areas may be due to the habituation effect in the primary olfactory cortex. This raises the possibility that, in the absence of secondary activation areas-that may act as a feed-back habituation or desensitization in the patient-one of the primary response areas is activated over the longer period of stimulation. The failed activation of these secondary areas in the patient may cause a feed-back habituation or desensitization in the patient and could also play a role in the disturbed perception of odours.

Regional variation in interhemispheric coordination of intrinsic hemodynamic fluctuations.

PubMed

Stark, David E; Margulies, Daniel S; Shehzad, Zarrar E; Reiss, Philip; Kelly, A M Clare; Uddin, Lucina Q; Gee, Dylan G; Roy, Amy K; Banich, Marie T; Castellanos, F Xavier; Milham, Michael P

2008-12-17

Electrophysiological studies have long demonstrated a high degree of correlated activity between the left and right hemispheres, however little is known about regional variation in this interhemispheric coordination. Whereas cognitive models and neuroanatomical evidence suggest differences in coordination across primary sensory-motor cortices versus higher-order association areas, these have not been characterized. Here, we used resting-state functional magnetic resonance imaging data acquired from 62 healthy volunteers to examine interregional correlation in spontaneous low-frequency hemodynamic fluctuations. Using a probabilistic atlas, we correlated probability-weighted time series from 112 regions comprising the entire cerebrum. We then examined regional variation in correlated activity between homotopic regions, contrasting primary sensory-motor cortices, unimodal association areas, and heteromodal association areas. Consistent with previous studies, robustly correlated spontaneous activity was noted between all homotopic regions, which was significantly higher than that between nonhomotopic (heterotopic and intrahemispheric) regions. We further demonstrated substantial regional variation in homotopic interhemispheric correlations that was highly consistent across subjects. Specifically, there was a gradient of interhemispheric correlation, with highest correlations across primary sensory-motor cortices (0.758, SD=0.152), significantly lower correlations across unimodal association areas (0.597, SD=0.230) and still lower correlations across heteromodal association areas (0.517, SD=0.226). These results demonstrate functional differences in interhemispheric coordination related to the brain's hierarchical subdivisions. Synchrony across primary cortices may reflect networks engaged in bilateral sensory integration and motor coordination, whereas lower coordination across heteromodal association areas is consistent with functional lateralization of these regions. This novel method of examining interhemispheric coordination may yield insights regarding diverse disease processes as well as healthy development.

Addressing the primary care workforce: a study of nurse practitioner students' plans after graduation.

PubMed

Budd, Geraldine M; Wolf, Andrea; Haas, Richard Eric

2015-03-01

Primary care is a growing area, and nurse practitioners (NPs) hold promise for meeting the need for additional providers. This article reports on the future plans of more than 300 primary care NP students in family, adult, and adult gerontology programs. The sample was obtained through NP faculty, and data were collected via an online survey. Results indicated that although these students chose primary care, only 48% anticipated working in primary care; 26% planned to practice in rural areas, and 16% planned to work in an inner city. Reasons cited as important for pursuing a primary care position included the long-term patient relationship, faculty and preceptor mentors from the NP program, and clinical experiences as a student. Implications include providing more intensive faculty mentoring to increase the number of individuals seeking primary care positions after graduation and help with future career planning to meet personal career and nursing profession needs. Copyright 2015, SLACK Incorporated.

An ethnobotanical survey of medicinal plants used by the people in Nhema communal area, Zimbabwe.

PubMed

Maroyi, Alfred

2011-06-22

This study documented the pharmaceutical importance of plant resources in Nhema communal area, particularly the significance of medicinal plants in primary healthcare. This is reflected in the great diversity of plants used for medical purposes as well as in their wide range of medicinal applications. Such rich ethnobotanical knowledge and repository of medicinal plants reinforces the need for an evaluation of their biological activity as a basis for developing future medicines. In order to document information on medicinal plants used for primary health care and to maximize the collection of indigenous knowledge in Nhema communal area, nine traditional healers were identified using the Participatory Rapid Appraisal (PRA) approach. Data was collected through open-ended interviews with traditional healers, between January and May 2008. A total of 61 plant species representing 45 genera and 28 families were found to be commonly used in the treatment of 34 different human health problems. More than a third of the plant species were used for diarrhoea, which is a prevalent disease in the study area. The root was the most commonly used plant part while decoction was the most common method of traditional drug preparation. Nhema communal area in the Midlands province, Zimbabwe is endowed with a strong culture of herbal medicine usage for primary healthcare. This is reflected in the number of medicinal plants used and the human ailments they treat. This preservation of indigenous knowledge is due to continued reliance on wild plant resources for primary healthcare by the local community. Deforestation and unsustainable rates of plant use are a serious threat on continued utilization of plant resources for primary healthcare. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

28 CFR 36.403 - Alterations: Path of travel.

Code of Federal Regulations, 2012 CFR

2012-07-01

... access to an area of a facility that contains a primary function shall be made so as to ensure that, to... function area served by that path of travel. (b) Primary function. A “primary function” is a major activity for which the facility is intended. Areas that contain a primary function include, but are not limited...

28 CFR 36.403 - Alterations: Path of travel.

Code of Federal Regulations, 2011 CFR

2011-07-01

... access to an area of a facility that contains a primary function shall be made so as to ensure that, to... function area served by that path of travel. (b) Primary function. A “primary function” is a major activity for which the facility is intended. Areas that contain a primary function include, but are not limited...

28 CFR 36.403 - Alterations: Path of travel.

Code of Federal Regulations, 2014 CFR

2014-07-01

... access to an area of a facility that contains a primary function shall be made so as to ensure that, to... function area served by that path of travel. (b) Primary function. A “primary function” is a major activity for which the facility is intended. Areas that contain a primary function include, but are not limited...

28 CFR 36.403 - Alterations: Path of travel.

Code of Federal Regulations, 2013 CFR

2013-07-01

... access to an area of a facility that contains a primary function shall be made so as to ensure that, to... function area served by that path of travel. (b) Primary function. A “primary function” is a major activity for which the facility is intended. Areas that contain a primary function include, but are not limited...

40 CFR Table 1 to Subpart Gggggg... - Applicability of General Provisions to Primary Zinc Production Area Sources

Code of Federal Regulations, 2011 CFR

2011-07-01

... Primary Zinc Production Area Sources 1 Table 1 to Subpart GGGGGG of Part 63 Protection of Environment... Pollutants for Primary Nonferrous Metals Area Sources-Zinc, Cadmium, and Beryllium Pt. 63, Subpt. GGGGGG, Table 1 Table 1 to Subpart GGGGGG of Part 63—Applicability of General Provisions to Primary Zinc...

40 CFR Table 1 to Subpart Gggggg... - Applicability of General Provisions to Primary Zinc Production Area Sources

Code of Federal Regulations, 2010 CFR

2010-07-01

... Primary Zinc Production Area Sources 1 Table 1 to Subpart GGGGGG of Part 63 Protection of Environment... Pollutants for Primary Nonferrous Metals Area Sources-Zinc, Cadmium, and Beryllium Pt. 63, Subpt. GGGGGG, Table 1 Table 1 to Subpart GGGGGG of Part 63—Applicability of General Provisions to Primary Zinc...

Unequal socioeconomic distribution of the primary care workforce: whole-population small area longitudinal study

PubMed Central

Cookson, Richard; Fleetcroft, Robert; Ali, Shehzad

2016-01-01

Objective To measure changes in socioeconomic inequality in the distribution of family physicians (general practitioners (GPs)) relative to need in England from 2004/2005 to 2013/2014. Design Whole-population small area longitudinal data linkage study. Setting England from 2004/2005 to 2013/2014. Participants 32 482 lower layer super output areas (neighbourhoods of 1500 people on average). Main outcome measures Slope index of inequality (SII) between the most and least deprived small areas in annual full-time equivalent GPs (FTE GPs) per 100 000 need adjusted population. Results In 2004/2005, inequality in primary care supply as measured by the SII in FTE GPs was 4.2 (95% CI 3.1 to 5.3) GPs per 100 000. By 2013/2014, this SII had fallen to −0.7 (95% CI −2.5 to 1.1) GPs per 100 000. The number of FTE GPs per 100 000 serving the most deprived fifth of small areas increased over this period from 54.0 to 60.5, while increasing from 57.2 to 59.9 in the least deprived fifth, so that by the end of the study period there were more GPs per 100 000 need adjusted population in the most deprived areas than in the least deprived. The increase in GP supply in the most deprived fifth of neighbourhoods was larger in areas that received targeted investment for establishing new practices under the ‘Equitable Access to Primary Medical Care’. Conclusions There was a substantial reduction in socioeconomic inequality in family physician supply associated with national policy. This policy may not have completely eliminated socioeconomic inequality in family physician supply since existing need adjustment formulae do not fully capture the additional burden of multimorbidity in deprived neighbourhoods. The small area approach introduced in this study can be used routinely to monitor socioeconomic inequality of access to primary care and to indicate workforce shortages in particular neighbourhoods. http://creativecommons.org/licenses/by/4.0 PMID:26787245

Unequal socioeconomic distribution of the primary care workforce: whole-population small area longitudinal study.

PubMed

Asaria, Miqdad; Cookson, Richard; Fleetcroft, Robert; Ali, Shehzad

2016-01-19

To measure changes in socioeconomic inequality in the distribution of family physicians (general practitioners (GPs)) relative to need in England from 2004/2005 to 2013/2014. Whole-population small area longitudinal data linkage study. England from 2004/2005 to 2013/2014. 32,482 lower layer super output areas (neighbourhoods of 1500 people on average). Slope index of inequality (SII) between the most and least deprived small areas in annual full-time equivalent GPs (FTE GPs) per 100,000 need adjusted population. In 2004/2005, inequality in primary care supply as measured by the SII in FTE GPs was 4.2 (95% CI 3.1 to 5.3) GPs per 100,000. By 2013/2014, this SII had fallen to -0.7 (95% CI -2.5 to 1.1) GPs per 100,000. The number of FTE GPs per 100,000 serving the most deprived fifth of small areas increased over this period from 54.0 to 60.5, while increasing from 57.2 to 59.9 in the least deprived fifth, so that by the end of the study period there were more GPs per 100,000 need adjusted population in the most deprived areas than in the least deprived. The increase in GP supply in the most deprived fifth of neighbourhoods was larger in areas that received targeted investment for establishing new practices under the 'Equitable Access to Primary Medical Care'. There was a substantial reduction in socioeconomic inequality in family physician supply associated with national policy. This policy may not have completely eliminated socioeconomic inequality in family physician supply since existing need adjustment formulae do not fully capture the additional burden of multimorbidity in deprived neighbourhoods. The small area approach introduced in this study can be used routinely to monitor socioeconomic inequality of access to primary care and to indicate workforce shortages in particular neighbourhoods. http://creativecommons.org/licenses/by/4.0. 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/

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.

Infrastructure Availability in the Public Sector Schools: A Case Study of Sindh Province

ERIC Educational Resources Information Center

Mujahid, Nooreen; Noman, Muhammad

2015-01-01

This focus of this study is confined to primary and secondary education in Sindh province. This paper provides a comprehensive review of the facilities available at the primary and secondary schools especially within the context of rural and urban areas. This study investigates 48,865 Government schools in terms of efficient and well-organized…

An Improved Model of Heat-Induced Hyperalgesia—Repetitive Phasic Heat Pain Causing Primary Hyperalgesia to Heat and Secondary Hyperalgesia to Pinprick and Light Touch

PubMed Central

Henrich, Florian; Magerl, Walter; May, Arne

2014-01-01

This study tested a modified experimental model of heat-induced hyperalgesia, which improves the efficacy to induce primary and secondary hyperalgesia and the efficacy-to-safety ratio reducing the risk of tissue damage seen in other heat pain models. Quantitative sensory testing was done in eighteen healthy volunteers before and after repetitive heat pain stimuli (60 stimuli of 48°C for 6 s) to assess the impact of repetitive heat on somatosensory function in conditioned skin (primary hyperalgesia area) and in adjacent skin (secondary hyperalgesia area) as compared to an unconditioned mirror image control site. Additionally, areas of flare and secondary hyperalgesia were mapped, and time course of hyperalgesia determined. After repetitive heat pain conditioning we found significant primary hyperalgesia to heat, and primary and secondary hyperalgesia to pinprick and to light touch (dynamic mechanical allodynia). Acetaminophen (800 mg) reduced pain to heat or pinpricks only marginally by 11% and 8%, respectively (n.s.), and had no effect on heat hyperalgesia. In contrast, the areas of flare (−31%) and in particular of secondary hyperalgesia (−59%) as well as the magnitude of hyperalgesia (−59%) were significantly reduced (all p<0.001). Thus, repetitive heat pain induces significant peripheral sensitization (primary hyperalgesia to heat) and central sensitization (punctate hyperalgesia and dynamic mechanical allodynia). These findings are relevant to further studies using this model of experimental heat pain as it combines pronounced peripheral and central sensitization, which makes a convenient model for combined pharmacological testing of analgesia and anti-hyperalgesia mechanisms related to thermal and mechanical input. PMID:24911787

Enhancing Children's Success in Science Learning: An Experience of Science Teaching in Teacher Primary School Training

ERIC Educational Resources Information Center

Ferreira, Maria Eduarda; Porteiro, Ana Cláudia; Pitarma, Rui

2015-01-01

The Environmental Studies curricular area, taught at primary school level in Portugal, is a challenging context for curricular interdisciplinarity and the achievement of small-scale research and creative and innovative experiences, inside and outside the classroom. From that assumption, we present, under the master course of primary teacher…

Comparative Study of Pupils' Academic Performance between Private and Public Primary Schools

ERIC Educational Resources Information Center

Adeyemi, Sunday B.

2014-01-01

This paper compares pupils' academic performance between the private and public primary schools. The sample, made up of 240 pupils were randomly selected from the private and public primary schools in Ilesa East and West Local Government Council Areas of Osun State, Nigeria. Two instruments were used. A structured questionnaire and Pupils'…

Language Practices and Attitudes of Australian Children of Indian Descent in a Primary Education Setting

ERIC Educational Resources Information Center

Bissoonauth, Anu

2018-01-01

This paper investigated linguistic practices and choices of Australian children of Indian descent, an under-researched group, who are studying Hindi in primary education. Data was collected using a questionnaire and semi-structured interviews with sixty participants across 3 primary schools in the Sydney area. The findings revealed, as expected,…

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.

Challenges Facing Successful Scaling Up of Effective Screening for Cardiovascular Disease by Community Health Workers in Mexico and South Africa: Policy Implications.

PubMed

S, Abrahams-Gessel; Denman, C A; Ta, Gaziano; Ns, Levitt; T, Puoane

The integration of community health workers (CHWs) into primary and secondary prevention functions in health programs and services delivery in Mexico and South Africa has been demonstrated to be effective. Task-sharing related to adherence and treatment, from nurses to CHWs, has also been effectively demonstrated in these areas. HIV/AIDS and TB programs in South Africa have seen similar successes in task-sharing with CHWs in the areas of screening for risk and adherence to treatment. In the area of non-communicable diseases (NCDs), there is a policy commitment to integrating CHWs into primary health care programs at public health facilities in both Mexico and South Africa in the areas of reproductive health and infant health. Yet current programs utilizing CHWs are not integrated into existing primary health care services in a comprehensive manner for primary and secondary prevention of NCDs. In a recently completed study, CHWs were trained to perform the basic diagnostic function of primary screening to assess the risk of suffering a CVD-related event in the community using a non-laboratory risk assessment tool and referring persons at moderate to high risk to local government clinics, for further assessment and management by a nurse or physician. In this paper we compare the experience with this CVD screening study to successful programs in vaccination, reproductive health, HIV/AIDS, and TB specifically to identify the barriers we identified as limitations to replicating these programs in the area of CVD diagnosis and management. We review barriers impacting the effective translation of policy into practice, including scale up issues; training and certification issues; integrating CHW to existing primary care teams and health system; funding and resource gaps. Finally, we suggest policy recommendations to replicate the demonstrated success of programs utilizing task-sharing with CHWs in infectious diseases and reproductive health, to integrated programs in NCD.

Primary care and youth mental health in Ireland: qualitative study in deprived urban areas

PubMed Central

2013-01-01

Background Mental disorders account for six of the 20 leading causes of disability worldwide with a very high prevalence of psychiatric morbidity in youth aged 15–24 years. However, healthcare professionals are faced with many challenges in the identification and treatment of mental and substance use disorders in young people (e.g. young people’s unwillingness to seek help from healthcare professionals, lack of training, limited resources etc.) The challenge of youth mental health for primary care is especially evident in urban deprived areas, where rates of and risk factors for mental health problems are especially common. There is an emerging consensus that primary care is well placed to address mental and substance use disorders in young people especially in deprived urban areas. This study aims to describe healthcare professionals’ experience and attitudes towards screening and early intervention for mental and substance use disorders among young people (16–25 years) in primary care in deprived urban settings in Ireland. Methods The chosen method for this qualitative study was inductive thematic analysis which involved semi-structured interviews with 37 healthcare professionals from primary care, secondary care and community agencies at two deprived urban centres. Results We identified three themes in respect of interventions to increase screening and treatment: (1) Identification is optimised by a range of strategies, including raising awareness, training, more systematic and formalised assessment, and youth-friendly practices (e.g. communication skills, ensuring confidentiality); (2) Treatment is enhanced by closer inter-agency collaboration and training for all healthcare professionals working in primary care; (3) Ongoing engagement is enhanced by motivational work with young people, setting achievable treatment goals, supporting transition between child and adult mental health services and recognising primary care’s longitudinal nature as a key asset in promoting treatment engagement. Conclusions Especially in deprived areas, primary care is central to early intervention for youth mental health. Identification, treatment and continuing engagement are likely to be enhanced by a range of strategies with young people, healthcare professionals and systems. Further research on youth mental health and primary care, including qualitative accounts of young people’s experience and developing complex interventions that promote early intervention are priorities. (350 words) PMID:24341616

A randomised controlled trial of a lengthened and multi-disciplinary consultation model in a socially deprived community: a study protocol.

PubMed

Whitford, David L; Chan, Wai-Sun

2007-06-28

There has been little development of the general practice consultation over the years, and many aspects of the present consultation do not serve communities with multiple health and social problems well. Many of the problems presenting to general practitioners in socio-economically disadvantaged areas are not amenable to a purely medical solution, and would particularly benefit from a multidisciplinary approach. Socio-economic deprivation is also associated with those very factors (more psychosocial problems, greater need for health promotion, more chronic diseases, more need for patient enablement) that longer consultations have been shown to address. This paper describes our study protocol, which aims to evaluate whether a lengthened multidisciplinary primary care team consultation with families in a socially deprived area can improve the psychological health of mothers in the families. In a randomised controlled trial, families with a history of social problems, substance misuse or depression are randomly allocated to an intervention or control group. The study is based in three general practices in a highly deprived area of North Dublin. Primary health care teams will be trained in conducting a multidisciplinary lengthened consultation. Families in the intervention group will participate in the new style multidisciplinary consultation. Outcomes of families receiving the intervention will be compared to the control group who will receive only usual general practitioner care. The primary outcome is the psychological health of mothers of the families and secondary outcomes include general health status, quality of life measures and health service usage. The main aim of this study is to evaluate the effectiveness of a lengthened multidisciplinary team consultation in primary care. The embedded nature of this study in general practices in a highly deprived area ensures generalisability to other deprived communities, but more particularly it promises relevance to primary care. Current Controlled Trials ISRCTN70578736.

Groundwater quality in the Mojave area, California

USGS Publications Warehouse

Dawson, Barbara J. Milby; Belitz, Kenneth

2012-01-01

Groundwater provides more than 40 percent of California’s drinking water. 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. Four groundwater basins along the Mojave River make up one of the study areas being evaluated. The Mojave study area is approximately 1,500 square miles (3,885 square kilometers) and includes four contiguous groundwater basins: Upper, Middle, and Lower Mojave River Groundwater Basins, and the El Mirage Valley (California Department of Water Resources, 2003). The Mojave study area has an arid climate, and is part of the Mojave Desert. Average annual rainfall is about 6 inches (15 centimeters). Land use in the study area is approximately 82 percent (%) natural (mostly shrubland), 4% agricultural, and 14% urban. The primary crops are pasture and hay. The largest urban areas are the cities of Victorville, Hesperia, and Apple Valley (2010 populations of 116,000, 90,000 and 69,000, respectively). Groundwater in these basins is used for public and domestic water supply and for irrigation. The main water-bearing units are gravel, sand, silt, and clay derived from surrounding mountains. The primary aquifers in the Mojave study area are defined as those parts of the aquifers corresponding to the perforated intervals of wells listed in the California Department of Public Health database. Public-supply wells in the Mojave study area are completed to depths between 200 and 600 feet (18 to 61 meters), consist of solid casing from the land surface to a depth of 130 to 420 feet (40 to 128 meters), and are screened or perforated below the solid casing. Recharge to the groundwater system is primarily runoff from the mountains to the south, mostly through the Mojave River channel. The primary sources of discharge are pumping wells and evapotranspiration.

Extinction reveals that primary sensory cortex predicts reinforcement outcome

PubMed Central

Bieszczad, Kasia M.; Weinberger, Norman M.

2011-01-01

Primary sensory cortices are traditionally regarded as stimulus analyzers. However, studies of associative learning-induced plasticity in the primary auditory cortex (A1) indicate involvement in learning, memory and other cognitive processes. For example, the area of representation of a tone becomes larger for stronger auditory memories and the magnitude of area gain is proportional to the degree that a tone becomes behaviorally important. Here, we used extinction to investigate whether “behavioral importance” specifically reflects a sound’s ability to predict reinforcement (reward or punishment) vs. to predict any significant change in the meaning of a sound. If the former, then extinction should reverse area gains as the signal no longer predicts reinforcement. Rats (n = 11) were trained to bar-press to a signal tone (5.0 kHz) for water-rewards, to induce signal-specific area gains in A1. After subsequent withdrawal of reward, A1 was mapped to determine representational areas. Signal-specific area gains — estimated from a previously established brain–behavior quantitative function — were reversed, supporting the “reinforcement prediction” hypothesis. Area loss was specific to the signal tone vs. test tones, further indicating that withdrawal of reinforcement, rather than unreinforced tone presentation per se, was responsible for area loss. Importantly, the amount of area loss was correlated with the amount of extinction (r = 0.82, p < 0.01). These findings show that primary sensory cortical representation can encode behavioral importance as a signal’s value to predict reinforcement, and that the number of cells tuned to a stimulus can dictate its ability to command behavior. PMID:22304434

Decentralization of Education: Community Financing. Directions in Development.

ERIC Educational Resources Information Center

Bray, Mark

This book focuses on the financing of formal primary and secondary education in developing nations. The study does not consider the areas of pre-primary, post-secondary, or nonformal education. Financing includes not only monetary inputs to education, but also material, labor, expertise, and land. The study examines the volume, nature, and…

Attitudes About and Practices of Health Promotion and Prevention Among Primary Care Providers.

PubMed

Luquis, Raffy R; Paz, Harold L

2015-09-01

The Patient Protection and Affordable Care Act's emphasis on health promotion and prevention activities required an examination of the current practices of primary care providers in these areas. A total of 196 primary care providers completed a survey to assess current health promotion and prevention attitudes, practices, and barriers. Results of this study showed that family physicians in Pennsylvania recognize the importance of and their role in providing health promotion and prevention and offer advice in key behavioral and disease prevention areas. Results from the study suggest that their ability to provide these services is hindered by a lack of time and the heavy workload. Although most family physicians provided advice to patients in several health promotion and prevention areas, few participants reported that they referred patients to other health professionals. Finally, when it comes to preventive services, participants ranked blood pressure screening, tobacco use screening, and tobacco use cessation interventions as the most important services. Effective implementation of the Patient Protection and Affordable Care Act will require necessary resources and support of primary care providers to help patients achieve healthier lives. © 2014 Society for Public Health Education.

[Morbidity observed in a health area: Impact on professionals and funding].

PubMed

de Miguel, Pablo; Caballero, Isabel; Rivas, Francisco Javier; Manera, Jaime; de Vicente, María Auxiliadora; Gómez, Ángel

2015-05-01

To analyze morbidity, in the context of a health area, and broken down by health centre, of patients who made contact with healthcare services, in order to propose an adjustment to finance the payment per capita. A descriptive study of morbidity observed in citizens assigned a health area during year 2010. SITE: Health Area 9. Autonomous Community of Madrid. Formed by the municipalities of Fuenlabrada, Humanes, and Moraleja de Enmedio. All levels of health care included. All citizens with health card assigned to a health center in the area who has maintained contact with the public health service's own area. Coded contact of patients are grouped using the Population Grouping Clinical Risk 3M TM Software (CRG). Each patient is included in a homogeneous and exclusive group with a numerical morbidity and clinical sense. Through the health card is known primary care centre, physician, age and sex. The distribution of morbidity is obtained by primary care centre, primary care physician, age and sex analyzing differences and combinations. It was found that the average values of the population morbidity are different in each primary care centre. In order to maintain the principle of equity in health care, it is suggested that an adjustment is made to the per capita payment based on the morbidity rate of the population. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

[Primary Health Care in Austria - Tu Felix Austria nube - Concept for networking in the primary care of Upper Austria].

PubMed

Kriegel, Johannes; Rebhandl, Erwin; Hockl, Wolfgang; Stöbich, Anna-Maria

2017-10-01

The primary health care in rural areas in Austria is currently determined by challenges such as ageing of the population, the shift towards chronic and age-related illnesses, the specialist medical and hospital-related education and training of physicians' as well growing widespread difficulty of staffing doctor's office. The objective is to realize a general practitioner centered and team-oriented primary health care (PHC) approach by establishing networked primary health care in rural areas of Austria. Using literature research, online survey, expert interviews and expert workshops, we identified different challenges in terms of primary health care in rural areas. Further, current resources and capacities of primary health care in rural areas were identified using the example of the district of Rohrbach. Twelve design dimensions and 51 relevant measurement indicators of a PHC network were delineated and described. Based on this, 12 design approaches of PHC concept for the GP-centered and team-oriented primary health care in rural areas have been developed.

Small-area variation in screening for cancer, glucose and cholesterol in Ontario: a cross-sectional study.

PubMed

Fernandes, Kimberly A; Sutradhar, Rinku; Borkhoff, Cornelia M; Baxter, Nancy; Lofters, Aisha; Rabeneck, Linda; Tinmouth, Jill; Paszat, Lawrence

2015-01-01

Screening for cervical, breast and colon cancers, and elevations of cholesterol and glucose, reduces premature cause-specific mortality from these cancers and circulatory diseases. Despite primary care reforms and incentives, and promotion of cancer-screening programs among individuals, participation is suboptimal. We aimed to examine participation as of Dec. 31, 2011, by factors of deprivation, demographics and primary care at the small-area level. From health care administrative databases, we identified people eligible for each screening test, and their participation, in each dissemination area (referred to as small areas, n = 18 950) in Ontario. We calculated rates for each test among small areas (overall and stratified by demographic, socioeconomic and primary care descriptors) and stratified by sex for all tests combined. We loaded all data into a geographic information system. Funnel plots were generated showing the percentage of eligible people who completed screening for all tests by small area, stratified by sex. Overall and stratified screening prevalence ratios were calculated among small areas. Among small areas, the mean and SD for participation in all tests combined was 31.6% (SD 11.0%) for women and 41.2% (SD 12.0%) for men. Screening prevalence among small areas, for each test and for all tests combined, overall and stratified by sex, declined with decreasing percentage with high school completion, decreasing socioeconomic quintile, and decreasing percentage with an identifiable primary care physician. Our results show that the rate of participation in all eligible screening tests among small areas is much lower than the rate of participation in any one particular test. This finding has implications for the design and implementation of strategies to improve rates of screening.

41 CFR 102-76.70 - When are the costs of alterations to provide an accessible path of travel to an altered area...

Code of Federal Regulations, 2013 CFR

2013-07-01

... alterations to provide an accessible path of travel to an altered area containing a primary function... to an altered area containing a primary function disproportionate to the costs of the overall... area containing a primary function are disproportionate to the costs of the overall alterations when...

41 CFR 102-76.70 - When are the costs of alterations to provide an accessible path of travel to an altered area...

Code of Federal Regulations, 2010 CFR

2010-07-01

... alterations to provide an accessible path of travel to an altered area containing a primary function... to an altered area containing a primary function disproportionate to the costs of the overall... area containing a primary function are disproportionate to the costs of the overall alterations when...

41 CFR 102-76.70 - When are the costs of alterations to provide an accessible path of travel to an altered area...

Code of Federal Regulations, 2014 CFR

2014-01-01

... alterations to provide an accessible path of travel to an altered area containing a primary function... to an altered area containing a primary function disproportionate to the costs of the overall... area containing a primary function are disproportionate to the costs of the overall alterations when...

41 CFR 102-76.70 - When are the costs of alterations to provide an accessible path of travel to an altered area...

Code of Federal Regulations, 2012 CFR

2012-01-01

... alterations to provide an accessible path of travel to an altered area containing a primary function... to an altered area containing a primary function disproportionate to the costs of the overall... area containing a primary function are disproportionate to the costs of the overall alterations when...

41 CFR 102-76.70 - When are the costs of alterations to provide an accessible path of travel to an altered area...

Code of Federal Regulations, 2011 CFR

2011-01-01

... alterations to provide an accessible path of travel to an altered area containing a primary function... to an altered area containing a primary function disproportionate to the costs of the overall... area containing a primary function are disproportionate to the costs of the overall alterations when...

Teaching Primary Science in Rural and Regional Australia: Some Challenges Facing Practicing and Pre-Service Teachers

ERIC Educational Resources Information Center

Laidlaw, Kristy-Rebecca; Taylor, Neil; Fletcher, Peter

2009-01-01

The teaching of science has long been viewed as problematic within primary classrooms across Australia. This study explores the teaching of primary science in an area of rural and regional Australia (the New England Region of New South Wales) where small populations, remote settings and isolation can make the teaching of science and other Key…

A Crisis of Professional Identity: How Primary Teachers Are Coming to Terms with Changing Views of Literacy

ERIC Educational Resources Information Center

McDougall, Jenny

2010-01-01

As definitions of literacy become conceptualized, so too do constructions of the primary teacher's identity. This study analyses the discourses that emerged from interviews with a group of Australian primary teachers who talked about their reactions to teaching media. Teachers who embraced this area of learning had a more futures-oriented view of…

What? Me? Teach Dance? Background and Confidence of Primary Preservice Teachers in Dance Education across Five Countries

ERIC Educational Resources Information Center

Russell-Bowie, Deirdre E.

2013-01-01

In primary schools across many countries, dance is now included within the arts key learning area with its own outcomes and content. But as future teachers of dance and other art forms, how do preservice generalist primary teachers perceive their background and confidence in relation to dance and dance education? This study investigates the…

Measures of Social Deprivation That Predict Health Care Access and Need within a Rational Area of Primary Care Service Delivery

PubMed Central

Butler, Danielle C; Petterson, Stephen; Phillips, Robert L; Bazemore, Andrew W

2013-01-01

Objective To develop a measure of social deprivation that is associated with health care access and health outcomes at a novel geographic level, primary care service area. Data Sources/Study Setting Secondary analysis of data from the Dartmouth Atlas, AMA Masterfile, National Provider Identifier data, Small Area Health Insurance Estimates, American Community Survey, Area Resource File, and Behavioural Risk Factor Surveillance System. Data were aggregated to primary care service areas (PCSAs). Study Design Social deprivation variables were selected from literature review and international examples. Factor analysis was used. Correlation and multivariate analyses were conducted between index, health outcomes, and measures of health care access. The derived index was compared with poverty as a predictor of health outcomes. Data Collection/Extraction Methods Variables not available at the PCSA level were estimated at block level, then aggregated to PCSA level. Principal Findings Our social deprivation index is positively associated with poor access and poor health outcomes. This pattern holds in multivariate analyses controlling for other measures of access. A multidimensional measure of deprivation is more strongly associated with health outcomes than a measure of poverty alone. Conclusions This geographic index has utility for identifying areas in need of assistance and is timely for revision of 35-year-old provider shortage and geographic underservice designation criteria used to allocate federal resources. PMID:22816561

Genetic educational needs and the role of genetics in primary care: a focus group study with multiple perspectives

PubMed Central

2011-01-01

Background Available evidence suggests that improvements in genetics education are needed to prepare primary care providers for the impact of ongoing rapid advances in genomics. Postgraduate (physician training) and master (midwifery training) programmes in primary care and public health are failing to meet these perceived educational needs. The aim of this study was to explore the role of genetics in primary care (i.e. family medicine and midwifery care) and the need for education in this area as perceived by primary care providers, patient advocacy groups and clinical genetics professionals. Methods Forty-four participants took part in three types of focus groups: mono-disciplinary groups of general practitioners and midwives, respectively and multidisciplinary groups composed of a diverse set of experts. The focus group sessions were audio-taped, transcribed verbatim and analysed using content analysis. Recurrent themes were identified. Results Four themes emerged regarding the educational needs and the role of genetics in primary care: (1) genetics knowledge, (2) family history, (3) ethical dilemmas and psychosocial effects in relation to genetics and (4) insight into the organisation and role of clinical genetics services. These themes reflect a shift in the role of genetics in primary care with implications for education. Although all focus group participants acknowledged the importance of genetics education, general practitioners felt this need more urgently than midwives and more strongly emphasized their perceived knowledge deficiencies. Conclusion The responsibilities of primary care providers with regard to genetics require further study. The results of this study will help to develop effective genetics education strategies to improve primary care providers' competencies in this area. More research into the educational priorities in genetics is needed to design courses that are suitable for postgraduate and master programmes for general practitioners and midwives. PMID:21329524

Prevalence of head lice infestation and pediculicidal effect of permethrine shampoo in primary school girls in a low-income area in southeast of Iran.

PubMed

Soleimani-Ahmadi, Moussa; Jaberhashemi, Seyed Aghil; Zare, Mehdi; Sanei-Dehkordi, Alireza

2017-07-24

Head lice infestation is a common public health problem that is most prevalent in primary school children throughout the world, especially in developing countries including different parts of Iran. This study aimed to determine the prevalence and risk factors associated with head lice infestation and pediculicidal effect of 1% permethrin shampoo in primary schools girls of Bashagard County, one of the low socioeconomic areas in southeast of Iran. In this interventional study six villages with similar demographical situations were selected and randomly assigned into intervention and control areas. In each area 150 girl students aged 7-12 years were selected randomly and screened for head lice infestation by visual scalp examination. In intervention area, treatment efficacy of 1% permethrin shampoo was evaluated via re-examination for infestation after one, two, and three weeks. Pre-tested structured questionnaire was used to collect data on socio-demographic and associated factors of head lice infestation. The prevalence of head lice infestation was 67.3%. There was significant association between head lice infestation and school grade, family size, parents' literacy, bathing facilities, frequency of hair washing, and use of shared articles (p < 0.05). The effectiveness of 1% permethrin shampoo for head lice treatment was 29.2, 68.9, and 90.3% after the first, second, and third weeks, respectively. The head lice infestation is a health problem in primary school girls of Bashagard County. Improvement of socioeconomic status and providing appropriate educational programs about head lice risk factors and prevention can be effective for reduction of infestation in this area. This trial has been registered and approved by Hormozgan University of Medical Sciences ethical committee (Trial No.764). Trial registration date: March 17 2014.

Community participation in health service reform: the development of an innovative remote Aboriginal primary health-care service.

PubMed

Reeve, Carole; Humphreys, John; Wakerman, John; Carroll, Vicki; Carter, Maureen; O'Brien, Tim; Erlank, Carol; Mansour, Rafik; Smith, Bec

2015-01-01

The aim of this study was to describe the reorientation of a remote primary health-care service, in the Kimberley region of Australia, its impact on access to services and the factors instrumental in bringing about change. A unique community-initiated health service partnership was developed between a community-controlled Aboriginal health organisation, a government hospital and a population health unit, in order to overcome the challenges of delivering primary health care to a dispersed, highly disadvantaged Aboriginal population in a very remote area. The shared goals and clear delineation of responsibilities achieved through the partnership reoriented an essentially acute hospital-based service to a prevention-focussed comprehensive primary health-care service, with a focus on systematic screening for chronic disease, interdisciplinary follow up, health promotion, community advocacy and primary prevention. This formal partnership enabled the primary health-care service to meet the major challenges of providing a sustainable, prevention-focussed service in a very remote and socially disadvantaged area.

Modelling multiple hospital outcomes: the impact of small area and primary care practice variation

PubMed Central

Congdon, Peter

2006-01-01

Background: Appropriate management of care – for example, avoiding unnecessary attendances at, or admissions to, hospital emergency units when they could be handled in primary care – is an important part of health strategy. However, some variations in these outcomes could be due to genuine variations in health need. This paper proposes a new method of explaining variations in hospital utilisation across small areas and the general practices (GPs) responsible for patient primary care. By controlling for the influence of true need on such variations, one may identify remaining sources of excess emergency attendances and admissions, both at area and practice level, that may be related to the quality, resourcing or organisation of care. The present paper accordingly develops a methodology that recognises the interplay between population mix factors (health need) and primary care factors (e.g. referral thresholds), that allows for unobserved influences on hospitalisation usage, and that also reflects interdependence between hospital outcomes. A case study considers relativities in attendance and admission rates at a North London hospital involving 149 small areas and 53 GP practices. Results: A fixed effects model shows variations in attendances and admissions are significantly related (positively) to area and practice need, and nursing home patients, and related (negatively) to primary care access and distance of patient homes from the hospital. Modelling the impact of known factors alone is not sufficient to produce a satisfactory fit to the observations, and random effects at area and practice level are needed to improve fit and account for overdispersion. Conclusion: The case study finds variation in attendance and admission rates across areas and practices after controlling for need, and remaining differences between practices may be attributable to referral behaviour unrelated to need, or to staffing, resourcing, and access issues. In managerial terms, the analysis points to the utility of formal statistical analysis of hospitalisation rates as a prelude to non-statistical investigation of primary care resourcing and organisation. For example, there may be implications for the location of staff involved in community management of chronic conditions; health managers may also investigate whether some practices have unusual populations (homeless, asylum seekers, students) that explain different hospital use patterns. PMID:17109747

Wind power research at Oregon State University. [for selecting windpowered machinery sites

NASA Technical Reports Server (NTRS)

Hewson, E. W.

1973-01-01

There have been two primary thrusts of the research effort to date, along with several supplementary ones. One primary area has been an investigation of the wind fields along coastal areas of the Pacific Northwest, not only at the shoreline but also for a number of miles inland and offshore as well. Estimates have been made of the influence of the wind turbulence as measured at coastal sites in modifying the predicted dependence of power generated on the cube of the wind speed. Wind flow patterns in the Columbia River valley have also been studied. The second primary thrust has been to substantially modify and improve an existing wind tunnel to permit the build up of a boundary layer in which various model studies will be conducted. One of the secondary studies involved estimating the cost of building an aerogenerator.

Satellite-based primary forest degradation assessment in the Democratic Republic of the Congo, 2000-2010

NASA Astrophysics Data System (ADS)

Zhuravleva, I.; Turubanova, S.; Potapov, P.; Hansen, M.; Tyukavina, A.; Minnemeyer, S.; Laporte, N.; Goetz, S.; Verbelen, F.; Thies, C.

2013-06-01

Primary forest extent, loss and degradation within the Democratic Republic of the Congo (DRC) were quantified from 2000 to 2010 by combining directly mapped forest cover extent and loss data (CARPE) with indirectly mapped forest degradation data (intact forest landscapes, IFL). Landsat data were used to derive both map inputs, and data from the GLAS (Geoscience Laser Altimetry System) sensor were employed to validate the discrimination of primary intact and primary degraded forests. In the year 2000, primary humid tropical forests occupied 104 455 kha of the country, with 61% of these forests classified as intact. From 2000 to 2010, 1.02% of primary forest cover was lost due to clearing, and almost 2% of intact primary forests were degraded due to alteration and fragmentation. While primary forest clearing increased by a factor of two between 2000-2005 and 2005-2010, the degradation of intact forests slightly decreased. Fragmentation and selective logging were the leading causes of intact forest degradation, accounting for 91% of IFL area change. The 10 year forest degradation rate within designated logging permit areas was 3.8 times higher compared to other primary forest areas. Within protected areas the forest degradation rate was 3.7 times lower than in other primary forest areas. Forest degradation rates were high in the vicinity of major urban areas. Given the observed forest degradation rates, we infer that the degradation of intact forests could increase up to two-fold over the next decade.

Primary care physicians in underserved areas. Family physicians dominate.

PubMed Central

Burnett, W H; Mark, D H; Midtling, J E; Zellner, B B

1995-01-01

Using the definitions of "medically underserved areas" developed by the California Health Manpower Policy Commission and data on physician location derived from a survey of California physicians applying for licensure or relicensure between 1984 and 1986, we examined the extent to which different kinds of primary care physicians located in underserved areas. Among physicians completing postgraduate medical education after 1974, board-certified family physicians were 3 times more likely to locate in medically underserved rural communities than were other primary care physicians. Non-board-certified family and general physicians were 1.6 times more likely than other non-board-certified primary care physicians to locate in rural underserved areas. Family and general practice physicians also showed a slightly greater likelihood than other primary care physicians of being located in urban underserved areas. PMID:8553635

Effectiveness of Supervisions Conducted by Primary Education Supervisors According to School Principals' Evaluations

ERIC Educational Resources Information Center

Yavuz, Mustafa

2010-01-01

The author conducted a qualitative case study. The population of the study consisted of 8 randomly selected school principals in the area of primary education supervisors working in Konya, a province of the Turkish Republic. Face-to-face and semistructured interviews were held with the school principals within the population for 90 min. The…

Psychiatrist Availability, Social Disintegration, and Suicide Deaths in U.S. Counties, 1990-1995

ERIC Educational Resources Information Center

Kposowa, Augustine J.

2009-01-01

Previous studies have found that primary care resources are associated with various health outcomes. The primary purpose of the study was to test for associations between psychiatrist availability, social disintegration and suicide rates. Data utilized were from the 2002 Area Resource File on U.S. counties (N=3080). Suicide rates were averaged…

Tradeoffs in overstory and understory aboveground net primary productivity in southwestern ponderosa pine stands

Treesearch

Kyla E. Sabo; Stephen C. Hart; Carolyn Hull Sieg; John Duff Bailey

2008-01-01

Previous studies in ponderosa pine forests have quantified the relationship between overstory stand characteristics and understory production using tree measurements such as basal area. We built on these past studies by evaluating the tradeoff between overstory and understory aboveground net primary productivity (ANPP) in southwestern ponderosa pine forests at the...

Music Activities in Primary School: Students' Preferences in the Spanish Region of Murcia

ERIC Educational Resources Information Center

Vicente-Nicolás, Gregorio; Mac Ruairc, Gerry

2014-01-01

The aim of this study was to determine the preferences of primary school children in relation to the types of activities that typically take place in music classrooms. For the purposes of this study, these classroom-based music activities have been categorised into five areas: singing, playing instruments, listening, reading and writing music and…

Leadership for Primary Schools: An Examination of Innovation within an Austrian Educational Context

ERIC Educational Resources Information Center

Heißenberger, Petra

2016-01-01

This study examined relationships between the work of innovative school principals and innovative primary schools determined by defining eight areas of school leadership: Instructional Development, Classroom Management, School Organization, Social Interaction, Personnel Development, Cooperation, Infrastructure and School Marketing. A questionnaire…

Mobile Technologies in the Service of Students' Learning of Mathematics: The Example of Game Application A.L.E.X. in the Context of a Primary School in Cyprus

ERIC Educational Resources Information Center

Kyriakides, Andreas O.; Meletiou-Mavrotheris, Maria; Prodromou, Theodosia

2016-01-01

This article reports on the main experiences gained from a 2-year study which incorporated A.L.E.X., an educational puzzle game available on iPad or Android tablet devices, within the primary school mathematics curriculum. The study took place in a public primary school, located in a rural area of Cyprus. The majority of its students come from low…

The Determinants of Labor Force Participation Rates, with Special Reference to the Ozark Low-Income Area. Final Report.

ERIC Educational Resources Information Center

Sandmeyer, Robert L.; Warner, Larkin B.

The study's primary purpose was to identify and evaluate the relative importance of factors responsible for the generally low labor force participation rates observable in the Ozark Low-Income Area, and variations in rates within the area itself. The study focused on 108 contiguous, rural-oriented, low-income counties in the states of Arkansas,…

Factors influencing the use of primary care physicians and public health departments for childhood immunization.

PubMed

Mainous, A G; Hueston, W J

1993-09-01

The purpose of the study was to examine factors influencing the use of primary care physicians and public health departments for childhood immunization for patients in rural and urban areas. A telephone survey employing probability sampling (random digit dialing) was conducted to obtain data from a sample of adults (> or = 18 years) living in Kentucky. Data are from 97 households with children under age 5 living in the home. The majority of the respondents (95%) reported that their children had received immunizations. The primary locations for receipt of immunizations were the health department (51%) and a primary care physician's office (37%). Sixty-five percent of those who used the health department for childhood immunizations reported that they did so for financial reasons. Individuals who received immunizations from the health department were more likely than those who received them at a primary care physician's office to have incomes at or below the poverty level and live in a rural area. The results of a logistic regression computed on use of the health department or primary care physician for immunizations indicated rural/urban residence as the only significant predictor, with urban residents 3.7 times more likely than rural residents to receive immunizations from a primary care physician. These results suggest that many families in rural areas have primary care physicians, but use the health department for their routine childhood immunizations. The results support previous data which indicate that delivery of childhood immunizations by primary care physicians is less available to rural than urban individuals.

[Traffic accidents: a health problem in primary care].

PubMed

Blanquer, J J; Rapa, M; Melchor, A; Jiménez, T; Adam, A; Mulet, M J

1993-09-15

To discover the prevalence and most relevant epidemiological characteristics of the victims of traffic accidents which occur in our health area. Hospital Casualty department (HC), Health area 19, Alcoy. This was an observational, crossover study, based on the collection of data from all those patients who had been brought into the HC for attention because of a traffic accident and who were attended between October 1, 1990 and September 31, 1991. During the study period a total of 1,111 traffic accident victims were attended. Their average age was 26.62 (SD +/- 15.95), with 69.6% being men and 30.2% women. 60.7% of the victims were attended on non-working days or the eve of a non-working day. 44.5% of those involved in accidents were in four-wheeled vehicles; 40% on two-wheeled vehicles and 11.1% of the victims were pedestrians. Injuries were light in 73.3% of cases; moderate in 15.9% and in the other 8.8% serious, grave or critical. 43.7% of the total had the accident in an urban area and 40.9% on the open road. The high prevalence of victims of accidents (8.3 per 1000 inhabitants) observed in our health area can be explained by the type of study. It is vital to obtain valid information of the real importance of this health problem. The primary care doctor must take preventive action concerning traffic accidents: a) through full studies of traffic accident levels among primary care centre users; b) primary preventive action, through the spreading of information on norms of safety; and c) secondary and tertiary prevention, by means of effective and efficacious outpatient emergency measures, as well as a thorough rehabilitation of accident victims.

Report of Accomplishments under the Airport Improvement Program.

DTIC Science & Technology

1982-09-30

Acquire snow removal equipment; conduct City of Portland feasibility study. Portland International (PRIMARY) Presque Isle 01 $ 15,840 Airport Master Plan...update to terminal City of Presque Isle area plan). Northern Maine Regional (PRIMARY) Presque Isle 02 $ 118,869 Rehabilitate terminal access road...City of Presque Isle Northern Maine Regional (PRIMARY) Rockland 01 $ 40,252 Airport Master Plan (update). Knox County Knox County Regional (COMMERCIAL

Effects of Language of Instruction on Learning of Literacy Skills among Pre-Primary School Children from Low-Income Urban Communities in Kenya

ERIC Educational Resources Information Center

Hungi, Njora; Njagi, Joan; Wekulo, Patricia; Ngware, Moses

2018-01-01

This study investigates the relationship between the language of instruction and learning of literacy skills among pre-primary school children in a multilingual environment. The sample consists of 1867 learners from low-income urban households, attending 147 low-cost private pre-primary schools located in low-income areas of Nairobi, Kenya. About…

Improving Primary Education in Pakistan: An Examination of the Association between School Autonomy and Children's Learning Outcomes

ERIC Educational Resources Information Center

Rahim, Bushra

2017-01-01

The purpose of this study is to explore the impact of the delegation of financial authority to public primary schools through Parent-Teacher Councils (PTCs) on learning outcomes of primary school children in the Khyber Pakhtunkhwa (KP) province, Pakistan. The learning outcomes were measured in three subject areas (Urdu, English, and Mathematics).…

From Recipient to Contributor: The Story of a Social Justice Leader in a Hong Kong Primary School

ERIC Educational Resources Information Center

Szeto, Elson

2014-01-01

This article presents a principal's story of social justice practice in a Hong Kong primary school. The narration accounts for the notion of social justice through his practice in various ways. Studying in a "rooftop" primary school located in a public housing area in Hong Kong was the principal's salient memory of his first year of…

An enhanced two-step floating catchment area (E2SFCA) method for measuring spatial accessibility to primary care physicians.

PubMed

Luo, Wei; Qi, Yi

2009-12-01

This paper presents an enhancement of the two-step floating catchment area (2SFCA) method for measuring spatial accessibility, addressing the problem of uniform access within the catchment by applying weights to different travel time zones to account for distance decay. The enhancement is proved to be another special case of the gravity model. When applying this enhanced 2SFCA (E2SFCA) to measure the spatial access to primary care physicians in a study area in northern Illinois, we find that it reveals spatial accessibility pattern that is more consistent with intuition and delineates more spatially explicit health professional shortage areas. It is easy to implement in GIS and straightforward to interpret.

Net primary productivity distribution in the BOREAS region from a process model using satellite and surface data

NASA Astrophysics Data System (ADS)

Liu, J.; Chen, J. M.; Cihlar, J.; Chen, W.

1999-11-01

The purpose of this paper is to upscale tower measurements of net primary productivity (NPP) to the Boreal Ecosystem-Atmosphere Study (BOREAS) study region by means of remote sensing and modeling. The Boreal Ecosystem Productivity Simulator (BEPS) with a new daily canopy photosynthesis model was first tested in one coniferous and one deciduous site. The simultaneous CO2 flux measurements above and below the tree canopy made it possible to isolate daily net primary productivity of the tree canopy for model validation. Soil water holding capacity and gridded daily meteorological data for the region were used as inputs to BEPS, in addition to 1 km resolution land cover and leaf area index (LAI) maps derived from the advanced very high resolution radiometer (AVHRR) data. NPP statistics for the various cover types in the BOREAS region and in the southern study area (SSA) and the northern study area (NSA) are presented. Strong dependence of NPP on LAI was found for the three major cover types: coniferous forest, deciduous forest and cropland. Since BEPS can compute total photosynthetically active radiation absorbed by the canopy in each pixel, light use efficiencies for NPP and gross primary productivity could also be analyzed. From the model results, the following area-averaged statistics were obtained for 1994: (1) mean NPP for the BOREAS region of 217 g C m-2 yr-1; (2) mean NPP of forests (excluding burnt areas in the region) equal to 234 g C m-2 yr-1; (3) mean NPP for the SSA and the NSA of 297 and 238 g C m-2 yr-1, respectively; and (4) mean light use efficiency for NPP equal to 0.40, 0.20, and 0.33 g C (MJ APAR)-1 for deciduous forest, coniferous forest, and crops, respectively.

Personal hygiene among primary school children living in a slum of Kolkata, India.

PubMed

Sarkar, M

2013-09-01

For children, maintenance of personal hygiene helps to improve the quality of life and longevity. This is of particular importance in a slum community with compromised living situation. This study was undertaken to find out the knowledge and practice of personal hygiene among the primary school children living in a slum area, to identify any misconception among them regarding the maintenance of personal hygiene, to find out their morbidity pattern, and also to elicit the relationship between practice of personal hygiene among the children and the literacy status of their mother. A cross-sectional observational study was conducted among 104 primary school children of a primary school situated in the slum area of Chetla, Kolkata, India with the help of a predesigned, pre-tested and structured questionnaire. Data were analyzed statistically by simple proportions and tests of significance. It was found that the female students were more knowledgeable than the male students regarding the maintenance of personal hygiene. There was a wide gap between practice and knowledge of personal hygiene among the primary school children living in the slum area. Even, misconceptions do exist on certain indicators of personal hygiene among the students. Statistically significant association was observed between practices of personal hygiene among the primary school children and the literacy status of their mother. Future of a society depends considerably on the health of its children. The parents and the school teachers, as constructive shapers of children's health behaviors, should play a responsible role in early education of children on personal hygiene.

Dental caries status of students from migrant primary schools in Shanghai Pudong New Area.

PubMed

Liu, Cheng-Jun; Zhou, Wei; Feng, Xue-Shan

2016-03-05

In China, there is a large migrant population. A significant proportion of children of the migrant population in China are not able to attend public schools due to the lack of local household registration (HuKou). They turn to privately-operated migrant schools, which are usually under-funded, have bad environmental facilities and are inadequately staffed compared to public schools. This study aims to describe the dental caries status of students from migrant primary schools in Shanghai Pudong New Area and factors that influence their caries status. Children (7-12 years old) from migrant primary schools in Shanghai Pudong New Area were randomly selected through a multi-stage cluster sampling method. Following the recommendation of the World Health Organization, caries experiences were recorded using the dmft index. A questionnaire to survey the children's socio-demographic characteristics and oral health-related behaviours was completed by the children's parents or guardians. A total of 1385 children in migrant primary schools were invited, of which 1323 joined the survey (95.5 %). Among all the surveyed subjects, the prevalence rate of dental caries was 74.7 % (65.7 % for primary teeth and 28.1 % for permanent teeth). The mean (SD) dmft scores were 3.17 (3.12), 2.74 (3.02) for the primary teeth and 0.44 (0.84) for the permanent teeth, and 99.5 % of the carious teeth received no treatment. Students from migrant primary schools in Shanghai Pudong New Area had bad conditions of dental caries and most of the carious teeth were left untreated. The caries experience was associated with tooth brushing habits, snacking habits, dental visit and gender.

Intratumor heterogeneity and clonal evolution in an aggressive papillary thyroid cancer and matched metastases.

PubMed

Le Pennec, Soazig; Konopka, Tomasz; Gacquer, David; Fimereli, Danai; Tarabichi, Maxime; Tomás, Gil; Savagner, Frédérique; Decaussin-Petrucci, Myriam; Trésallet, Christophe; Andry, Guy; Larsimont, Denis; Detours, Vincent; Maenhaut, Carine

2015-04-01

The contribution of intratumor heterogeneity to thyroid metastatic cancers is still unknown. The clonal relationships between the primary thyroid tumors and lymph nodes (LN) or distant metastases are also poorly understood. The objective of this study was to determine the phylogenetic relationships between matched primary thyroid tumors and metastases. We searched for non-synonymous single-nucleotide variants (nsSNVs), gene fusions, alternative transcripts, and loss of heterozygosity (LOH) by paired-end massively parallel sequencing of cDNA (RNA-Seq) in a patient diagnosed with an aggressive papillary thyroid cancer (PTC). Seven tumor samples from a stage IVc PTC patient were analyzed by RNA-Seq: two areas from the primary tumor, four areas from two LN metastases, and one area from a pleural metastasis (PLM). A large panel of other thyroid tumors was used for Sanger sequencing screening. We identified seven new nsSNVs. Some of these were early events clonally present in both the primary PTC and the three matched metastases. Other nsSNVs were private to the primary tumor, the LN metastases and/or the PLM. Three new gene fusions were identified. A novel cancer-specific KAZN alternative transcript was detected in this aggressive PTC and in dozens of additional thyroid tumors. The PLM harbored an exclusive whole-chromosome 19 LOH. We have presented the first, to our knowledge, deep sequencing study comparing the mutational spectra in a PTC and both LN and distant metastases. This study has yielded novel findings concerning intra-tumor heterogeneity, clonal evolution and metastases dissemination in thyroid cancer. © 2015 Society for Endocrinology.

The relative influence of nutrients and habitat on stream metabolism in agricultural streams

USGS Publications Warehouse

Frankforter, J.D.; Weyers, H.S.; Bales, J.D.; Moran, P.W.; Calhoun, D.L.

2010-01-01

Stream metabolism was measured in 33 streams across a gradient of nutrient concentrations in four agricultural areas of the USA to determine the relative influence of nutrient concentrations and habitat on primary production (GPP) and respiration (CR-24). In conjunction with the stream metabolism estimates, water quality and algal biomass samples were collected, as was an assessment of habitat in the sampling reach. When data for all study areas were combined, there were no statistically significant relations between gross primary production or community respiration and any of the independent variables. However, significant regression models were developed for three study areas for GPP (r 2 = 0.79-0.91) and CR-24 (r 2 = 0.76-0.77). Various forms of nutrients (total phosphorus and area-weighted total nitrogen loading) were significant for predicting GPP in two study areas, with habitat variables important in seven significant models. Important physical variables included light availability, precipitation, basin area, and in-stream habitat cover. Both benthic and seston chlorophyll were not found to be important explanatory variables in any of the models; however, benthic ash-free dry weight was important in two models for GPP. ?? 2009 The Author(s).

Race, gender, and language concordance in the primary care setting.

PubMed

Martin, Brian C; Shi, Leiyu; Ward, Ryan D

2009-01-01

The purpose of this paper is to examine race, gender and language concordance in terms of importance to primary care. The 2003 Medical Expenditure Panel Survey Household Component (MEPS) was used. Four distinguishing primary care attributes and selected measures were operationalized primarily from a sample subset that identified a usual source of care (USC): accessibility to USC; interface between primary care and specialist services; treatment decisions; and preventive services received from the USC. Bivariate and multivariate results are reported. Adjusting for covariates, the following items remained statistically significant: race--choosing primary care physician as USC, USC having office hours, and going to USC for new health problems; gender--choosing primary care physician as USC and USC having office hours; and language--lack of difficulty contacting the USC after hours. However, these items appear to be isolated cases rather than indicators that concordance plays a key role in determining primary care quality. Language barriers/communication issues are the only areas where improvement appears warranted. While the study has strong accessibility and interpersonal relationship measures, service coordination and comprehensiveness indicators are limited. The analyses' cross-sectional nature also poses a problem in drawing causal relationships and conclusive findings. Finally, sample size limitations preclude stratified analyses across racial/ethnic groups, an important consideration as the relationships between concordance and quality may vary across groups. This study indicates that more research is needed in this area to determine future resource allocation and policy direction. The unique contribution of the study is to suggest that race and gender concordance may not accurately predict primary health care quality.

Nonurgent use of a pediatric emergency department: a preliminary qualitative study.

PubMed

Chin, Nancy P; Goepp, Julius G; Malia, Timothy; Harris, LeWanza; Poordabbagh, Armin

2006-01-01

To understand patterns of decision making among families presenting to a pediatric emergency department (ED) for nonacute care and to understand pediatric ED staff responses. Cross-sectional qualitative study using in-depth interviews, direct observations, and nonidentifying demographic data. Eleven percent of visits made during the study period were identified as nonacute. All were made by families from low-income areas. Three main themes emerged: (1) most families had been referred by their primary care providers; (2) the complexity of living in low-income areas makes the ED a choice of convenience for these stressed families; and (3) mistrust of primary health services was not identified by our respondents as a motivator for ED utilization, in contrast with other published data. Two themes emerged from ED staff: (1) actual nonurgent visit rates were lower than staff estimates; and (2) these visits produced frustration among staff members, although their degrees of insight and understanding of factors motivating these visits were variable. In this setting, nonacute visits occurred with lower than perceived frequency and caused disproportionate frustration among staff and families. These visits appear to be driven more by consequences of system design and structure than by family members' decision making. Mistrust of primary care services was not a strong family decision-making factor; the study's setting may have limited its ability to capture such data. Recommended system changes to lower barriers to primary care include expanded office hours, subsidized staffing for offices in medically underserved areas, and lowering barriers to sick care.

The Contribution of Teachers' Peer-and Self-Assessment for the Implementation of Active Learning Strategies: Perceptions of Ethiopia Primary School Teachers

ERIC Educational Resources Information Center

Mengistie, Solomon Melesse

2014-01-01

The present study tries to investigate the contribution of primary school teachers' peer- and self- assessment for effective implementation of active learning in their actual classrooms. In this study, areas in which self-reflection and peer assessment include three broad categories, such as methods of teaching and learning, instructional resource…

Status of Biodiversity and Its Conservation in the Kobadak River Basin of Maheshpur Upazila, Jhenaidah, Bangladesh

ERIC Educational Resources Information Center

Uddin, Jashim Md.

2015-01-01

This research project represents the Status of Biodiversity and Its Conservation of Kobadak River basin of Maheshpur Upazila. The study was designed to develop a set of information about the present condition of biodiversity of the study area. Both primary and secondary data have been used to fulfill the survey successfully. Primary data have been…

Teachers' Beliefs on Foreign Language Teaching Practices in Early Phases of Primary Education: A Case Study

ERIC Educational Resources Information Center

Caner, Mustafa; Subasi, Gonca; Kara, Selma

2010-01-01

The purpose of the study was to examine whether teacher beliefs would play a role in their actual practices while teaching target language in early phases of primary education, principally, in kindergarten and first grades in a state school. As it is a very broad research area, the researchers exclusively analyzed teaching practices and teaching…

77 FR 38838 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-29

... Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage Areas AGENCY: Health... facilities designated as primary medical care, mental health, and dental health professional shortage areas... primary care, dental, or mental health services in these HPSAs. NHSC health [[Page 38839

Patients' perspectives on the medical primary-secondary care interface: systematic review and synthesis of qualitative research.

PubMed

Sampson, Rod; Cooper, Jamie; Barbour, Rosaline; Polson, Rob; Wilson, Philip

2015-10-15

To synthesise the published literature on the patient experience of the medical primary-secondary care interface and to determine priorities for future work in this field aimed at improving clinical outcomes. Systematic review and metaethnographic synthesis of primary studies that used qualitative methods to explore patients' perspectives of the medical primary-secondary care interface. International primary-secondary care interface. EMBASE, MEDLINE, CINAHL Plus with Full text, PsycINFO, Psychology and Behavioural Sciences Collection, Health Business Elite, Biomedica Reference Collection: Comprehensive Library, Information Science & Technology Abstracts, eBook Collection, Web of Science Core Collection: Citation Indexes and Social Sciences Citation Index, and grey literature. Studies were eligible for inclusion if they were full research papers employing qualitative methodology to explore patients' perspectives of the medical primary-secondary care interface. The 7-step metaethnographic approach described by Noblit and Hare, which involves cross-interpretation between studies while preserving the context of the primary data. The search identified 690 articles, of which 39 were selected for full-text review. 20 articles were included in the systematic review that encompassed a total of 689 patients from 10 countries. 4 important areas specific to the primary-secondary care interface from the patients' perspective emerged: barriers to care, communication, coordination, and 'relationships and personal value'. Patients should be the focus of any transfer of care between primary and secondary systems. From their perspective, areas for improvement may be classified into four domains that should usefully guide future work aimed at improving quality at this important interface. PROSPERO CRD42014009486. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Primary studies of trace quantities of green vegetation in Mono Lake area using 1990 AVIRIS data

NASA Technical Reports Server (NTRS)

Chen, Zhi-Kang; Elvidge, Chris D.; Groeneveld, David P.

1992-01-01

Our primary results in Jasper Ridge Biological Preserve indicate that high spectral resolution Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) data may provide a substantial advantage in vegetation, based on the chlorophyll red edge feature from 700-780 nm. The chlorophyll red edge was detected for green vegetation cover as low as 4.8 percent. The objective of our studies in Mono Lake area is to continue the experiments performed in Jasper Ridge and to examine the persistence of red edge feature of trace quantities of green vegetation for different plant communities with non-uniform soil backgrounds.

Topical Oxybutynin 10% Gel for the Treatment of Primary Focal Hyperhidrosis: A Randomized Double-blind Placebo-controlled Split Area Study.

PubMed

Artzi, Ofir; Loizides, Christophoros; Zur, Eyal; Sprecher, Eli

2017-10-02

Limited efficacy, costs, side-effects and complications are issues of concern for most current therapeutic modalities for focal hyperhidrosis. This study evaluated the efficacy of topical oxybutynin 10% gel in treating 61 patients with primary focal hyperhidrosis. The gel was applied to the right or left axilla, palms or soles vs. a placebo compound to the contralateral side for 30 days. A blinded visual grading of the change in starch-iodine tests was performed by 2 non-involved physicians. The Hyperhidrosis Disease Severity Scale (HDSS) and Dermatology Life Quality Index (DLQI) questionnaires were administered before and after treatment. The patients rated their satisfaction with treatment. Fifty-three patients completed the 4-week treatment. Sweat reduction in the drug-treated sweating areas was higher than in the control-treated areas. There was a significant mean improvement in pre- and post-treatment HDSS and DQLI (p = 0.001 for both). Thirty-nine subjects (74%) reported moderate-to-high satisfaction. Twice-daily topical application of oxybutynin 10% gel appears to be an effective, safe and well-tolerated treatment for focal primary hyperhidrosis.

Effects of a small seagull colony on trophic status and primary production in a Mediterranean coastal system (Marinello ponds, Italy)

NASA Astrophysics Data System (ADS)

Signa, Geraldina; Mazzola, Antonio; Vizzini, Salvatrice

2012-10-01

Colonies of seabirds have been shown to influence nutrient cycling and primary production of coastal areas, but knowledge is still limited above all for smaller colonies. This study evaluates the influence of a small resident seagull colony (Larus michahellis Naumann, 1840) on a Mediterranean coastal system (Marinello ponds, Sicily, Italy). The presence of ornithogenic organic matter from seagull guano was first assessed at increasing distances from the colony using δ15N to indicate the effects of guano on the trophic status and primary production. The pond directly affected by guano deposition showed an anomalous water and sediment chemistry, especially regarding physico-chemical variables (pH), nitrogen isotopic signature, nutrient balance and phytoplankton biomass. These effects were not observed in the adjacent ponds, highlighting pronounced, small spatial-scale variability. Given the worldwide presence of seabird colonies and the scarcity of research on their effect on coastal marine areas, the study shows that seabird-mediated input may be important in influencing ecosystem dynamics of coastal areas, even where both the system in question and the colony are small.

Prevalence of somatization and minor psychiatric morbidity in primary healthcare in saudi arabia: a preliminary study in asir region.

PubMed

Alqahtani, Mohammed M; Salmon, Peter

2008-01-01

To determine the prevalence of psychological disorders and somatization among primary care patients from a semi-urban area of the Kingdom of Saudi Arabia. Screening of consecutive patients with the 12-item and 28-item versions of the General Health Questionnaires and assessments of physical symptoms associated with somatization, using the HSCL-12. Eight primary care health centres in Assir, Saudi Arabia. About half of the sample had one or more psychological disorders. The prevalence of somatization detected by the GHQ-28 was 16%. The prevalence of somatization indicated by GPs' identification of medically unexplained symptoms was 14%. Women displayed higher levels of somatization than men. This study reported prevalence of psychological disorders that was as high as found in the more modern areas of Saudi Arabia such as Riyadh. The view that individuals in less open areas are protected from psychological disorders associated with stress and lifestyle pressure seems to be unsubstantiated. The results highlight the potential value of screening for psychological disorders using such simple instruments as the GHQ.

Integrating Health Information Systems into a Database Course: A Case Study

ERIC Educational Resources Information Center

Anderson, Nicole; Zhang, Mingrui; McMaster, Kirby

2011-01-01

Computer Science is a rich field with many growing application areas, such as Health Information Systems. What we suggest here is that multi-disciplinary threads can be introduced to supplement, enhance, and strengthen the primary area of study in a course. We call these supplementary materials "threads," because they are executed…

An Empirical Study on the Effect of School Consolidation in Rural Areas on Student Achievement

ERIC Educational Resources Information Center

Mei, Dong; Fang, Chang; Yuanyan, Bai

2013-01-01

With Shaanxi province as an example, this study presents empirical evidence on the effect of primary school consolidation in rural areas on student achievement, using the difference-in-differences method. The results show no significant differences in student achievement between consolidated schools and nonconsolidated schools. If student…

Impact of Implementing a Primary Enforcement Seat Belt Law in Florida : A Case Study

DOT National Transportation Integrated Search

2012-08-01

On June 30, 2009, Florida implemented a primary seat belt law. The State was already engaged in a Rural : Demonstration Program (RDP) to increase belt usage in rural areas in the northern part of the State and participated : regularly in annual Click...

NHEXAS PHASE I ARIZONA STUDY--PESTICIDES IN DUST ANALYTICAL RESULTS

EPA Science Inventory

The Pesticides in Dust data set contains analytical results for measurements of up to 3 pesticides in 437 dust samples over 278 households. Samples were taken by collecting dust from the indoor floor areas in the main room and in the bedroom of the primary resident. The primary...

Time-resolved characterization of primary particle emissions and secondary particle formation from a modern gasoline passenger car

NASA Astrophysics Data System (ADS)

Karjalainen, Panu; Timonen, Hilkka; Saukko, Erkka; Kuuluvainen, Heino; Saarikoski, Sanna; Aakko-Saksa, Päivi; Murtonen, Timo; Bloss, Matthew; Dal Maso, Miikka; Simonen, Pauli; Ahlberg, Erik; Svenningsson, Birgitta; Brune, William Henry; Hillamo, Risto; Keskinen, Jorma; Rönkkö, Topi

2016-07-01

Changes in vehicle emission reduction technologies significantly affect traffic-related emissions in urban areas. In many densely populated areas the amount of traffic is increasing, keeping the emission level high or even increasing. To understand the health effects of traffic-related emissions, both primary (direct) particulate emission and secondary particle formation (from gaseous precursors in the exhaust emissions) need to be characterized. In this study, we used a comprehensive set of measurements to characterize both primary and secondary particulate emissions of a Euro 5 level gasoline passenger car. Our aerosol particle study covers the whole process chain in emission formation, from the tailpipe to the atmosphere, and also takes into account differences in driving patterns. We observed that, in mass terms, the amount of secondary particles was 13 times higher than the amount of primary particles. The formation, composition, number and mass of secondary particles was significantly affected by driving patterns and engine conditions. The highest gaseous and particulate emissions were observed at the beginning of the test cycle when the performance of the engine and the catalyst was below optimal. The key parameter for secondary particle formation was the amount of gaseous hydrocarbons in primary emissions; however, also the primary particle population had an influence.

Immunocytochemical investigation of immune cells within human primary and permanent tooth pulp.

PubMed

Rodd, H D; Boissonade, F M

2006-01-01

The aim of this study was to determine whether there are any differences in the number and distribution of immune cells within human primary and permanent tooth pulp, both in health and disease. The research took the form of a quantitative immunocytochemical study. One hundred and twenty-four mandibular first permanent molars and second primary molars were obtained from children requiring dental extractions under general anaesthesia. Following exodontia, 10-microm-thick frozen pulp sections were processed for indirect immunofluorescence. Triple-labelling regimes were employed using combinations of the following: (1) protein gene product 9.5, a general neuronal marker; (2) leucocyte common antigen (LCA); and (3) Ulex europaeus I lectin, a marker of vascular endothelium. Image analysis was then used to determine the percentage area of immunostaining for LCA. Leucocytes were significantly more abundant in the pulp horn and mid-coronal region of intact and carious primary teeth, as compared to permanent teeth (P < 0.05, anova). Both dentitions demonstrated the presence of well-localized inflammatory cell infiltrates and marked aborization of pulpal nerves in areas of dense leucocyte accumulation. Primary and permanent tooth pulps appear to have a similar potential to mount inflammatory responses to gross caries The management of the compromised primary tooth pulp needs to be reappraised in the light of these findings.

Improving diagnostic recognition of primary hyperparathyroidism with machine learning.

PubMed

Somnay, Yash R; Craven, Mark; McCoy, Kelly L; Carty, Sally E; Wang, Tracy S; Greenberg, Caprice C; Schneider, David F

2017-04-01

Parathyroidectomy offers the only cure for primary hyperparathyroidism, but today only 50% of primary hyperparathyroidism patients are referred for operation, in large part, because the condition is widely under-recognized. The diagnosis of primary hyperparathyroidism can be especially challenging with mild biochemical indices. Machine learning is a collection of methods in which computers build predictive algorithms based on labeled examples. With the aim of facilitating diagnosis, we tested the ability of machine learning to distinguish primary hyperparathyroidism from normal physiology using clinical and laboratory data. This retrospective cohort study used a labeled training set and 10-fold cross-validation to evaluate accuracy of the algorithm. Measures of accuracy included area under the receiver operating characteristic curve, precision (sensitivity), and positive and negative predictive value. Several different algorithms and ensembles of algorithms were tested using the Weka platform. Among 11,830 patients managed operatively at 3 high-volume endocrine surgery programs from March 2001 to August 2013, 6,777 underwent parathyroidectomy for confirmed primary hyperparathyroidism, and 5,053 control patients without primary hyperparathyroidism underwent thyroidectomy. Test-set accuracies for machine learning models were determined using 10-fold cross-validation. Age, sex, and serum levels of preoperative calcium, phosphate, parathyroid hormone, vitamin D, and creatinine were defined as potential predictors of primary hyperparathyroidism. Mild primary hyperparathyroidism was defined as primary hyperparathyroidism with normal preoperative calcium or parathyroid hormone levels. After testing a variety of machine learning algorithms, Bayesian network models proved most accurate, classifying correctly 95.2% of all primary hyperparathyroidism patients (area under receiver operating characteristic = 0.989). Omitting parathyroid hormone from the model did not decrease the accuracy significantly (area under receiver operating characteristic = 0.985). In mild disease cases, however, the Bayesian network model classified correctly 71.1% of patients with normal calcium and 92.1% with normal parathyroid hormone levels preoperatively. Bayesian networking and AdaBoost improved the accuracy of all parathyroid hormone patients to 97.2% cases (area under receiver operating characteristic = 0.994), and 91.9% of primary hyperparathyroidism patients with mild disease. This was significantly improved relative to Bayesian networking alone (P < .0001). Machine learning can diagnose accurately primary hyperparathyroidism without human input even in mild disease. Incorporation of this tool into electronic medical record systems may aid in recognition of this under-diagnosed disorder. Copyright © 2016 Elsevier Inc. All rights reserved.

Using Clinical Questions Asked by Primary Care Providers Through eConsults to Inform Continuing Professional Development.

PubMed

Archibald, Douglas; Liddy, Clare; Lochnan, Heather A; Hendry, Paul J; Keely, Erin J

2018-01-01

Continuing professional development (CPD) offerings should address the educational needs of health care providers. Innovative programs, such as electronic consultations (eConsults), provide unique educational opportunities for practice-based needs assessment. The purpose of this study is to assess whether CPD offerings match the needs of physicians by coding and comparing session content to clinical questions asked through eConsults. This study analyzes questions asked by primary care providers between July 2011 and January 2015 using a service that allows specialists to provide consultation over a secure web-based server. The content of these questions was compared with the CPD courses offered in the area in which these primary care providers are practicing over a similar period (2012-2014). The clinical questions were categorized by the content area. The percentage of questions asked about each content area was calculated for each of the 12 specialties consulted. CPD course offerings were categorized using the same list of content areas. Percentage of minutes dedicated to each content area was calculated for each specialty. The percentage of questions asked and the percentage of CPD course minutes for each content area were compared. There were numerous congruencies and discrepancies between the proportion of questions asked about a given content area and the CPD minutes dedicated to it. Traditional needs assessment may underestimate the need to address topics that are frequently the subject of eConsults. Planners should recognize eConsult questions as a valuable source of practice-associated challenges that can identify professional development needs of physicians.

Standing on the Precipice: Evaluating Final-Year Physiotherapy Students' Perspectives of Their Curriculum as Preparation for Primary Health Care Practice

PubMed Central

O'Donoghue, Grainne; Doody, Catherine; O'Neill, Geraldine; Barrett, Terry; Cusack, Tara

2016-01-01

Purpose: To explore final-year physiotherapy students' perceptions of primary health care practice to determine (1) aspects of their curriculum that support their learning, (2) deficiencies in their curriculum, and (3) areas that they believe should be changed to adequately equip them to make the transition from student to primary health care professional. Methods: Framework analysis methodology was used to analyze group opinion obtained using structured group feedback sessions. Sixty-eight final-year physiotherapy students from the four higher education institutions in Ireland participated. Results: The students identified several key areas that (1) supported their learning (exposure to evidence-based practice, opportunities to practise with problem-based learning, and interdisciplinary learning experiences); (2) were deficient (primary health care placements, additional active learning sessions, and further education and practice opportunities for communication and health promotion), and (3) required change (practice placements in primary health care, better curriculum organization to accommodate primary health care throughout the programme with the suggestion of a specific primary health care module). Conclusion: This study provides important insights into physiotherapy students' perceptions of primary health care. It also provides important indicators of the curriculum changes needed to increase graduates' confidence in their ability to take up employment in primary health care. PMID:27909366

Root canal morphology of primary molars: a micro-computed tomography study.

PubMed

Fumes, A C; Sousa-Neto, M D; Leoni, G B; Versiani, M A; da Silva, L A B; da Silva, R A B; Consolaro, A

2014-10-01

This was to investigate the root canal morphology of primary molar teeth using micro-computed tomography. Primary maxillary (n = 20) and mandibular (n = 20) molars were scanned at a resolution of 16.7 μm and analysed regarding the number, location, volume, area, structured model index (SMI), area, roundness, diameters, and length of canals, as well as the thickness of dentine in the apical third. Data were statistically compared by using paired-sample t test, independent sample t test, and one-way analysis of variance with significance level set as 5%. Overall, no statistical differences were found between the canals with respect to length, SMI, dentine thickness, area, roundness, and diameter (p > 0.05). A double canal system was observed in the mesial and mesio-buccal roots of the mandibular and maxillary molars, respectively. The thickness in the internal aspect of the roots was lower than in the external aspect. Cross-sectional evaluation of the roots in the apical third showed flat-shaped canals in the mandibular molars and ribbon- and oval-shaped canals in the maxillary molars. External and internal anatomy of the primary first molars closely resemble the primary second molars. The reported data may help clinicians to obtain a thorough understanding of the morphological variations of root canals in primary molars to overcome problems related to shaping and cleaning procedures, allowing appropriate management strategies for root canal treatment.

The role of a bus network in access to primary health care in Metropolitan Auckland, New Zealand.

PubMed

Rocha, C M; McGuire, S; Whyman, R; Kruger, E; Tennant, M

2015-09-01

Background: This study examined the spatial accessibility of the population of metropolitan Auckland, New Zealand to the bus network, to connect them to primary health providers, in this case doctors (GP) and dentists. Analysis of accessibility by ethnic identity and socio-economic status were also carried out, because of existing health inequalities along these dimensions. The underlying hypothesis was that most people would live within easy reach of primary health providers, or easy bus transport to such providers. An integrated geographic model of bus transport routes and stops, with population and primary health providers (medical. and dental practices) was developed and analysed. Although the network of buses in metropolitan Auckland is substantial and robust it was evident that many people live more than 150 metres from a stop. Improving the access to bus stops, particularly in areas of high primary health care need (doctors and dentists), would certainly be an opportunity to enhance spatial access in a growing metropolitan area.

Innovation in the Management of Primary School Construction in Afghanistan. A Case Study. Educational Building Report 9.

ERIC Educational Resources Information Center

Ahmad, Fazel

By 1973 there were very great disparities between the opportunities for education in the urban and rural areas of Afghanistan. This case study concerns provincial school construction programs for hundreds of small buildings in the remotest areas of what is one of the most mountainous countries of the world. A study proposed alternative building…

Factors influencing motivation and retention of primary healthcare workers in the rural areas of Oyo State, Nigeria.

PubMed

Jegede, Ayodele S; Adejumo, Prisca; Ushie, Boniface Ayanbekongshie

2013-01-01

Limited data exist on retention of primary healthcare (PHC) staff in rural areas, crippling the already fragile healthcare systems in Nigeria. This study investigated why PHC staff would or would not want to work in rural areas and how they could be retained. Four hundred and twelve (412) health workers and caregivers, and 21 key informants were interviewed in Ona-Ara LGA. Logistic regression statistics was used to analyse quantitative data and narrative for qualitative data. There was no significant factor influencing health workers' unwillingness to work in rural areas and, relationship between their demographic characteristics and perceived reasons to do so. Combined factors influencing PHC workers' willingness to work in rural areas influenced use of PHC. Financial and non-financial incentives are responsible for workers' motivation to work in rural areas. The mal-distribution of health facilities and health workers between urban and rural areas must be addressed. Copyright © 2013 Longwoods Publishing.

Measuring the attractiveness of rural communities in accounting for differences of rural primary care workforce supply.

PubMed

McGrail, Matthew R; Wingrove, Peter M; Petterson, Stephen M; Humphreys, John S; Russell, Deborah J; Bazemore, Andrew W

2017-01-01

Many rural communities continue to experience an undersupply of primary care doctor services. While key professional factors relating to difficulties of recruitment and retention of rural primary care doctors are widely identified, less attention has been given to the role of community and place aspects on supply. Place-related attributes contribute to a community's overall amenity or attractiveness, which arguably influence both rural recruitment and retention relocation decisions of doctors. This bi-national study of Australia and the USA, two developed nations with similar geographic and rural access profiles, investigates the extent to which variations in community amenity indicators are associated with spatial variations in the supply of rural primary care doctors. Measures from two dimensions of community amenity: geographic location, specifically isolation/proximity; and economics and sociodemographics were included in this study, along with a proxy measure (jurisdiction) of a third dimension, environmental amenity. Data were chiefly collated from the American Community Survey and the Australian Census of Population and Housing, with additional calculated proximity measures. Rural primary care supply was measured using provider-to-population ratios in 1949 US rural counties and in 370 Australian rural local government areas. Additionally, the more sophisticated two-step floating catchment area method was used to measure Australian rural primary care supply in 1116 rural towns, with population sizes ranging from 500 to 50 000. Associations between supply and community amenity indicators were examined using Pearson's correlation coefficients and ordinary least squares multiple linear regression models. It was found that increased population size, having a hospital in the county, increased house prices and affluence, and a more educated and older population were all significantly associated with increased workforce supply across rural areas of both countries. While remote areas were strongly linked with poorer supply in Australia, geographical remoteness was not significant after accounting for other indicators of amenity such as the positive association between workforce supply and coastal location. Workforce supply in the USA was negatively associated with fringe rural area locations adjacent to larger metropolitan areas and characterised by long work commutes. The US model captured 49% of the variation of workforce supply between rural counties, while the Australian models captured 35-39% of rural supply variation. These data support the idea that the rural medical workforce is maldistributed with a skew towards locating in more affluent and educated areas, and against locating in smaller, poorer and more isolated rural towns, which struggle to attract an adequate supply of primary care services. This evidence is important in understanding the role of place characteristics and rural population dynamics in the recruitment and retention of rural doctors. Future primary care workforce policies need to place a greater focus on rural communities that, for a variety of reasons, may be less attractive to doctors looking to begin or remain working there.

Features of Inner Structure of Placer Gold of the North-Eastern Part Siberian Platform

NASA Astrophysics Data System (ADS)

Gerasimov, Boris; Zhuravlev, Anatolii; Ivanov, Alexey

2017-12-01

Mineral and raw material base of placer and ore gold is based on prognosis evaluation, which allows to define promising areas regarding gold-bearing deposit prospecting. But there are some difficulties in gold primary source predicting and prospecting at the North-east Siberian platform, because the studied area is overlapped by thick cover of the Cenozoic deposits, where traditional methods of gold deposit prospecting are ineffective. In this connection, detailed study of typomorphic features of placer gold is important, because it contains key genetic information, necessary for development of mineralogical criteria of prognosis evaluation of ore gold content. Authors studied mineralogical-geochemical features of placer gold of the Anabar placer area for 15 years, with a view to identify indicators of gold, typical for different formation types of primary sources. This article presents results of these works. In placer regions, where primary sources of gold are not identified, there is need to study typomorphic features of placer gold, because it contains important genetic information, necessary for the development of mineralogical criteria of prognosis evaluation of ore gold content. Inner structures of gold from the Anabar placer region are studied, as one of the diagnostic typomorphic criteria as described in prominent method, developed by N.V. Petrovskaya [1980]. Etching of gold was carried out using reagent: HCl + HNO3 + FeCl3 × 6H2O + CrO3 +thioureat + water. Identified inner structures wer studied in details by means of scanning electron microscope JEOL JSM-6480LV. Two types of gold are identified according to the features of inner structure of placer gold of the Anabar region. First type - medium-high karat fine, well processed gold with significantly changed inner structure. This gold is allochthonous, which was redeposited many times from ancient intermediate reservoirs to younger deposits. Second type - low-medium karat, poorly rounded gold with unchanged inner structure. Poor roundness of gold particles and preservation of their primary inner structures indicate close proximity of primary source.

HIGH REACTIVITY SORBENTS FOR SO2 CONTROL

EPA Science Inventory

The paper discusses studies, relating to air pollution control from coal-fired utility boilers, that show that the primary variable affecting sorbent reactivity at high temperature or at low temperature with water droplets is surface area. For the development of high surface area...

Content and Student Factors in Mastering Environmental Studies--Nature in Primary Education: Evidence from a National Assessment in Flanders (Belgium)

ERIC Educational Resources Information Center

Janssen, Rianne; Crauwels, Marion

2011-01-01

A large-scale paper-and-pencil assessment of the attainment targets of environmental studies with a focus on the subject area nature was held in primary education in Flanders (Belgium). The tests on different subfields of nature, i.e. the human body, healthcare, organisms, ecosystems, environmental care and non-living nature, were administered to…

An adaptive two-stage sequential design for sampling rare and clustered populations

USGS Publications Warehouse

Brown, J.A.; Salehi, M.M.; Moradi, M.; Bell, G.; Smith, D.R.

2008-01-01

How to design an efficient large-area survey continues to be an interesting question for ecologists. In sampling large areas, as is common in environmental studies, adaptive sampling can be efficient because it ensures survey effort is targeted to subareas of high interest. In two-stage sampling, higher density primary sample units are usually of more interest than lower density primary units when populations are rare and clustered. Two-stage sequential sampling has been suggested as a method for allocating second stage sample effort among primary units. Here, we suggest a modification: adaptive two-stage sequential sampling. In this method, the adaptive part of the allocation process means the design is more flexible in how much extra effort can be directed to higher-abundance primary units. We discuss how best to design an adaptive two-stage sequential sample. ?? 2008 The Society of Population Ecology and Springer.

Evaluation of primary immunization coverage of infants under universal immunization programme in an urban area of bangalore city using cluster sampling and lot quality assurance sampling techniques.

PubMed

K, Punith; K, Lalitha; G, Suman; Bs, Pradeep; Kumar K, Jayanth

2008-07-01

Is LQAS technique better than cluster sampling technique in terms of resources to evaluate the immunization coverage in an urban area? To assess and compare the lot quality assurance sampling against cluster sampling in the evaluation of primary immunization coverage. Population-based cross-sectional study. Areas under Mathikere Urban Health Center. Children aged 12 months to 23 months. 220 in cluster sampling, 76 in lot quality assurance sampling. Percentages and Proportions, Chi square Test. (1) Using cluster sampling, the percentage of completely immunized, partially immunized and unimmunized children were 84.09%, 14.09% and 1.82%, respectively. With lot quality assurance sampling, it was 92.11%, 6.58% and 1.31%, respectively. (2) Immunization coverage levels as evaluated by cluster sampling technique were not statistically different from the coverage value as obtained by lot quality assurance sampling techniques. Considering the time and resources required, it was found that lot quality assurance sampling is a better technique in evaluating the primary immunization coverage in urban area.

Potential access to primary health care: what does the National Program for Access and Quality Improvement data show?

PubMed Central

Uchôa, Severina Alice da Costa; Arcêncio, Ricardo Alexandre; Fronteira, Inês Santos Estevinho; Coêlho, Ardigleusa Alves; Martiniano, Claudia Santos; Brandão, Isabel Cristina Araújo; Yamamura, Mellina; Maroto, Renata Melo

2016-01-01

Objective: to analyze the influence of contextual indicators on the performance of municipalities regarding potential access to primary health care in Brazil and to discuss the contribution from nurses working on this access. Method: a multicenter descriptive study based on secondary data from External Evaluation of the National Program for Access and Quality Improvement in Primary Care, with the participation of 17,202 primary care teams. The chi-square test of proportions was used to verify differences between the municipalities stratified based on size of the coverage area, supply, coordination, and integration; when necessary, the chi-square test with Yates correction or Fisher's exact test were employed. For the population variable, the Kruskal-Wallis test was used. Results: the majority of participants were nurses (n=15.876; 92,3%). Statistically significant differences were observed between the municipalities in terms of territory (p=0.0000), availability (p=0.0000), coordination of care (p=0.0000), integration (p=0.0000) and supply (p=0.0000), verifying that the municipalities that make up area 6 tend to have better performance in these dimensions. Conclusion: areas 4,5 and 6 performed better in every analyzed dimension, and the nurse had a leading role in the potential to access primary health care in Brazil. PMID:26959332

Cheating Tendency in Examinations among Secondary School Students in Nigeria: A Case Study of Schools in the Odukpani Local Government Area, Cross River State

ERIC Educational Resources Information Center

Bisong, Nonso Ngozika; Akpama, Felicia; Edet, Pauline B.

2009-01-01

This study is designed to examine cheating tendency among secondary school students in Nigeria, with evidence from schools in the Odukpani Local Government Area of Cross River State. A total of 331 respondents in Senior Secondary 3 classes were randomly selected from 10 post-primary schools in the area. A survey questionnaire was used to elicit…

The impact of family planning on primary school enrolment in sub-national areas within 25 African countries.

PubMed

Longwe, Abiba; Smits, Jeroen

2013-06-01

We study how the availability and use of family planning services in African countries influences the family planning situation of households and through this the educational participation of young children. A district panel dataset is used for 441 urban and rural areas within 233 districts of 25 countries. Path analysis shows that a decrease in the number of births is associated with an increase in educational participation in the area. The number of births is negatively associated with acceptance, knowledge and actual use of contraceptives in the area. As reversed causality and selection bias seem unlikely, the identified relationship probably is at least partially causal. Hence, investments in family planning services in poor areas are not only important because they allow women to plan their births better, but also because they may lead to higher primary enrolment rates and thus contribute to the region's future economic growth.

28 CFR 35.151 - New construction and alterations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... contains a primary function shall be made so as to ensure that, to the maximum extent feasible, the path of... alteration. (i) Primary function. A “primary function” is a major activity for which the facility is intended. Areas that contain a primary function include, but are not limited to, the dining area of a cafeteria...

28 CFR 35.151 - New construction and alterations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... contains a primary function shall be made so as to ensure that, to the maximum extent feasible, the path of... alteration. (i) Primary function. A “primary function” is a major activity for which the facility is intended. Areas that contain a primary function include, but are not limited to, the dining area of a cafeteria...

28 CFR 35.151 - New construction and alterations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... contains a primary function shall be made so as to ensure that, to the maximum extent feasible, the path of... alteration. (i) Primary function. A “primary function” is a major activity for which the facility is intended. Areas that contain a primary function include, but are not limited to, the dining area of a cafeteria...

28 CFR 36.403 - Alterations: Path of travel.

Code of Federal Regulations, 2010 CFR

2010-07-01

... access to an area of a facility that contains a primary function shall be made so as to ensure that, to... disproportionate to the cost of the overall alteration. (b) Primary function. A “primary function” is a major activity for which the facility is intended. Areas that contain a primary function include, but are not...

Investigation the opinions of the primary science teachers toward practice of teaching and learning activities in science learning area

NASA Astrophysics Data System (ADS)

Chamnanwong, Pornpaka; Thathong, Kongsak

2018-01-01

In preparing a science lesson plan, teachers may deal with numerous difficulties. Having a deep understanding of their problems and their demands is extremely essential for the teachers in preparing themselves for the job. Moreover, it is also crucial for the stakeholders in planning suitable and in-need teachers' professional development programs, in school management, and in teaching aid. This study aimed to investigate the primary school science teachers' opinion toward practice of teaching and learning activities in science learning area. Target group was 292 primary science teachers who teach Grade 4 - 6 students in Khon Kaen Province, Thailand in the academic year of 2014. Data were collected using Questionnaire about Investigation the opinions of the primary science teachers toward practice of teaching and learning activities in science learning area. The questionnaires were consisted of closed questions scored on Likert scale and open-ended questions that invite a sentence response to cover from LS Process Ideas. Research findings were as follow. The primary science teachers' level of opinion toward teaching and learning science subject ranged from 3.19 - 3.93 (mean = 3.43) as "Moderate" level of practice. The primary school science teachers' needs to participate in a training workshop based on LS ranged from 3.66 - 4.22 (mean = 3.90) as "High" level. The result indicated that they were interested in attending a training course under the guidance of the Lesson Study by training on planning of management of science learning to solve teaching problems in science contents with the highest mean score 4.22. Open-ended questions questionnaire showed the needs of the implementation of the lesson plans to be actual classrooms, and supporting for learning Medias, innovations, and equipment for science experimentation.

Challenges to the Israeli healthcare system: attracting medical students to primary care and to the periphery.

PubMed

Weissman, Charles; Zisk-Rony, Rachel Yaffa; Avidan, Alexander; Elchalal, Uriel; Tandeter, Howard

2018-05-29

The greatest challenges facing healthcare systems include ensuring a sufficient supply of primary care physicians and physicians willing to work in rural or peripheral areas. Especially challenging is enticing young physicians to practice primary care in rural/peripheral areas. Identifying medical students interested in primary care and in residencies in Israel's periphery should aid the healthcare leadership. It may be particularly important to do so during the clinical years, as this is the stage at which many future physicians begin to crystallize their specialty and location preferences. Questionnaires, distributed to 6 consecutive 5th-year classes of the Hebrew University - Hadassah School of Medicine, from 2010 to 2016, elicited information on criteria for choosing a career specialty, criteria for choosing a residency program and whether one-time monetary grants authorized in the 2011 physicians' union contract would attract students to residencies in the periphery. Completed questionnaires were returned by 511 of 740 (69%) students. Ninety-eight (19%) were interested in a primary care residency, 184 (36%) were unsure and 229 (45%) were not interested. Students interested in primary care were significantly less interested in specialties that perform procedures/surgeries and in joining a medical school faculty, while being more inclined towards specialties dealing with social problems, controllable lifestyles and working limited hours. The percentage of students interested in primary care was stable during the study period. Forty-eight of the students indicated interest in residencies in the country's periphery, and 42% of them were also interested in primary care residencies. Overall, only 3.7% of students were interested in both a primary care residency and a residency in the periphery. Thirty percent of the students indicated that the monetary incentives tempted them to consider a residency in the periphery. Fifty-three percent of these students reported that they did not yet know the geographic area where they wished to do their residency, as compared to only 22% among those not interested in incentives. This study provides the healthcare leadership with information on the characteristics of the students at a centrally-located medical school who tend to be more interested in primary care and in working in the periphery. Specifically, the study found that students interested in primary care desire a positive life/work balance, something that Israeli non-hospital primary care practice provides. Students considering residencies in the periphery were similarly inclined. Moreover, about a third of students had positive thoughts about monetary incentives for residencies in peripheral hospitals. These students should be identified early during their clinical experience so that attempts to recruit them to the periphery can commence before their specialty and location preferences have fully crystallized. Parallel studies should be performed at additional Israeli medical schools.

41 CFR 102-76.80 - What is required if the costs of alterations to provide an accessible path of travel to an...

Code of Federal Regulations, 2010 CFR

2010-07-01

... to provide an accessible path of travel to an altered area containing a primary function are... accessible path of travel to an altered area containing a primary function are disproportionate to the costs... exceeding 20 percent of the costs of the alterations to the primary function area. Priority should be given...

41 CFR 102-76.80 - What is required if the costs of alterations to provide an accessible path of travel to an...

Code of Federal Regulations, 2012 CFR

2012-01-01

... to provide an accessible path of travel to an altered area containing a primary function are... accessible path of travel to an altered area containing a primary function are disproportionate to the costs... exceeding 20 percent of the costs of the alterations to the primary function area. Priority should be given...

41 CFR 102-76.80 - What is required if the costs of alterations to provide an accessible path of travel to an...

Code of Federal Regulations, 2013 CFR

2013-07-01

... to provide an accessible path of travel to an altered area containing a primary function are... accessible path of travel to an altered area containing a primary function are disproportionate to the costs... exceeding 20 percent of the costs of the alterations to the primary function area. Priority should be given...

41 CFR 102-76.80 - What is required if the costs of alterations to provide an accessible path of travel to an...

Code of Federal Regulations, 2011 CFR

2011-01-01

... to provide an accessible path of travel to an altered area containing a primary function are... accessible path of travel to an altered area containing a primary function are disproportionate to the costs... exceeding 20 percent of the costs of the alterations to the primary function area. Priority should be given...

41 CFR 102-76.80 - What is required if the costs of alterations to provide an accessible path of travel to an...

Code of Federal Regulations, 2014 CFR

2014-01-01

... to provide an accessible path of travel to an altered area containing a primary function are... accessible path of travel to an altered area containing a primary function are disproportionate to the costs... exceeding 20 percent of the costs of the alterations to the primary function area. Priority should be given...

Walkability around primary schools and area deprivation across Scotland.

PubMed

Macdonald, Laura; McCrorie, Paul; Nicholls, Natalie; Ellaway, Anne

2016-04-14

A number of studies based in the US, Canada, and Australia, have found evidence of associations between the built environment (BE) and mode of transport to school, and links between active travel and deprivation. Limited research in the UK compares potential BE supports for walking to school by area deprivation. Within this study, we gathered data on BE attributes previously linked to active travel, i.e., street/path connectivity, and dwelling density, created a composite 'walkability score' (WS) for areas around primary schools across urban Scotland, and explored whether poorer areas exhibit lower scores than more affluent areas, or vice versa. We consider this to be a novel approach as few studies have compared BE features by deprivation across a whole country. Address and road/path maps were obtained and primary schools (N = 937) across mainland Scotland were mapped. Schools were attributed income deprivation scores (scores divided into quintiles (Q1: least deprived, Q5: most deprived)). Catchment area (CA) boundaries, i.e., the geographic area representing eligibility for local school attendance, were drawn around schools, and WS calculated for each CA. We compared mean WS by income quintile (ANOVA), for all local authorities (LAs) combined (N = 29), and separately for the four LAs with the greatest number of schools included in the analysis. For all LAs combined, the least deprived quintile (Q1) showed a significantly lower WS (-0.61), than quintiles 3, 4 and 5 (Q2: -0.04 (non-sig), Q3: 0.38, Q4: 0.09, Q5: 0.18); while for Glasgow the second least deprived quintile (Q2) showed significantly higher WS (Q1: 1.35, Q2: 1.73), than middling (Q3: 0.18) and most deprived quintiles (Q4: 0.06, Q5: -0.10). WS differ by deprivation with patterns varying depending on the spatial scale of the analysis. It is essential that less walkable areas are provided with the resources to improve opportunities to engage in active travel.

Clinical and radiographic evaluation of zinc oxide with aloe vera as an obturating material in pulpectomy: an in vivo study.

PubMed

Khairwa, Abhishek; Bhat, Manohar; Sharma, Rajesh; Satish, V; Maganur, Prabhadevi; Goyal, Anil Kumar

2014-01-01

Pulp therapy for pulpally involved primary teeth continues to be a challenge to clinicians. One of the major areas of continued research is in the area of finding obturating materials to suit the specific properties of these teeth. Zinc oxide eugenol is used frequently in pulpectomy for the obturation of the primary teeth. To evaluate clinically and radiographically a mixture of zinc oxide eugenol and aloe vera as an obturating material. A total of 50 children, aged between 4 and 9 years, who were screened for unilateral or bilateral carious deciduous molars were studied. Out of these, 15 children were randomly selected for endodontic treatment. Obturation was done with a mixture of zinc oxide powder and aloe vera gel. Clinical and radiographic evaluation was done after 7 days, 1 month, 3 months, 6 months, and 9 months. The data were statistically analyzed. Endodontic treatment using a mixture of zinc oxide powder and aloe vera gel in primary teeth has shown good clinical and radiographic success. A detailed observational study with longer follow-up will highlight the benefits of aloe vera in primary teeth as an obturating medium.

A Study on Sixth Grade Students' Misconceptions and Errors in Spatial Measurement: Length, Area, and Volume

ERIC Educational Resources Information Center

Tan Sisman, Gulcin; Aksu, Meral

2016-01-01

The purpose of the present study was to portray students' misconceptions and errors while solving conceptually and procedurally oriented tasks involving length, area, and volume measurement. The data were collected from 445 sixth grade students attending public primary schools in Ankara, Türkiye via a test composed of 16 constructed-response…

Status and trends in demography of northern spotted owls, 1985-2003.

Treesearch

R.G. Anthony; E.D. Forsman; A.B. Franklin; D.R. Anderson; K.P. Burnham; G.C. White; C.J. Schwarz; J.D. Nichols; J.E. Hines; G.S. Olson; S.H. Ackers; L.S. Andrews; B.L. Biswell; P.C. Carlson; L.V. Diller; K.M. Dugger; K.E. Fehring; T.L. Fleming; R.P. Gerhardt; S.A. Gremel; R.J. Gutierrez; P.J. Happe; D.R. Herter; J.M. Higley; R.B. Horn; L.L. Irwin; P.J. Loschl; J.A. Reid; S.G. Sovern

2006-01-01

We analyzed demographic data from northern spotted owls(Strix occidentalis caurina)from 14 study areas in Washington, Oregon, and California for 1985-2003. The 14 study areas made up approximately 12 percent of the range of the subspecies and included federal, tribal, private, and mixed federal and private lands. Our primary objectives were to...

[Introduction of capillary glycosylated haemoglobin determination in a Primary Care Health Area: Multicentre study of the evolution of patients with type 2 diabetes mellitus].

PubMed

Núñez-Sánchez, M Á; Cervantes-Cuesta, M Á; Brocal-Ibañez, P; Salmeron-Arjona, E; León-Martínez, L P; Cerezo-Sanmartin, M

The aim of this study was to evaluate the efficiency of a joint intervention that included educational components, self-assessment, and information to optimise diabetes control through the introduction of instant capillary glycosylated haemoglobin (HbA1c) determination in Primary Care. A multicentre prospective descriptive study was carried out over 3years in 10Primary Care Centres of the Area VII Murcia East. At the end of the study there were 804 patients with type 2 diabetes (DM2). Patients were divided into 4 groups based on initial values of HbA1c, and if changes in their treatment were needed. HbA1c, body mass index, and blood pressure were monitored. A financial assessment was also performed on the impact of the implementation of a protocol to measure instant capillary RESULTS: A significant reduction was observed in HbA1c values. The initial HbA1c mean value was 7.4±1.4%, which decreased to a final value of 6.9±1.0% (P<.001). At the end of the study, 71.4% of patients included reached diabetic control objectives. In addition, the financial assessment demonstrated that the implementation of this diabetes control system led to a decrease of the 24.7% in spending on glucose strips after the first year of study in Area VII Murcia Health Service. The introduction of capillary HbA1c determination in Primary Care has demonstrated to improve diabetes control and the efficiency of the health personnel. Furthermore, a reduction in the health costs of patients with DM2 was also shown. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

The Anthropogenic "Greenhouse Effect": Greek Prospective Primary Teachers' Ideas about Causes, Consequences and Cures

ERIC Educational Resources Information Center

Ikonomidis, Simos; Papanastasiou, Dimitris; Melas, Dimitris; Avgoloupis, Stavros

2012-01-01

This study explores the ideas of Greek prospective primary teachers about the anthropogenic greenhouse effect, particularly about its causes, consequences and cures. For this purpose, a survey was conducted: 265 prospective teachers completed a closed-form questionnaire. The results showed serious misconceptions in all areas (causes, consequences…

Project-Based Learning in Primary Schools: Effects on Pupils' Learning and Attitudes

ERIC Educational Resources Information Center

Kaldi, Stavroula; Filippatou, Diamanto; Govaris, Christos

2011-01-01

This study focuses upon the effectiveness of project-based learning on primary school pupils regarding their content knowledge and attitudes towards self-efficacy, task value, group work, teaching methods applied and peers from diverse ethnic backgrounds. A cross-curricular project was implemented within the curriculum area of environmental…

Primary School Teachers' Understanding of Environmental Issues: An Interview Study.

ERIC Educational Resources Information Center

Summers, Mike; Kruger, Colin; Childs, Ann; Mant, Jenny

2000-01-01

Uses in-depth interviews to explore the understanding of a non-random sample of 12 practicing primary school teachers in four areas: (1) biodiversity; (2) the carbon cycle; (3) ozone; and (4) global warming. Identifies those underpinning science concepts that were well understood, and those which were not so well understood. (Author/SAH)

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--PESTICIDES IN DUST ANALYTICAL RESULTS

EPA Science Inventory

The Pesticides in Dust data set contains analytical results for measurements of up to 8 pesticides in 91 dust samples over 91 households. Samples were taken by collecting dust from the indoor floor areas in the main room and in the bedroom of the primary resident. The primary p...

Assessment of Primary Representational Systems with Neurolinguistic Programming: Examination of Preliminary Literature.

ERIC Educational Resources Information Center

Dorn, Fred J.; And Others

1983-01-01

Reviews the inconsistent findings of studies on neurolinguistic programing and recommends some areas that should be examined to verify various claims. Discusses methods of assessing client's primary representational systems, including predicate usage and eye movements, and suggests that more reliable methods of assessing PRS must be found. (JAC)

Where Western Australian Graduate Diploma of Education Primary Students Source Their Information on Sustainability

ERIC Educational Resources Information Center

Lummis, Geoff W.; Morris, Julia E.; Lock, Graeme; Odgaard, Judith

2015-01-01

Sustainability has recently been made a cross-curriculum priority in Australia, through the development and implementation of the Australian Curriculum. Subsequently, primary and secondary teachers across all subject areas are required to integrate Education for Sustainability (EfS) into formal education. A recent research case study was…

Carbon budget of oligotrophic mires in the Southern Taiga of Western Siberia under anthropogenic impact

NASA Astrophysics Data System (ADS)

Golovatskaya, Eugenia; Dyukarev, Egor

2010-05-01

Role of peatlands in the global greenhouse gases budget is highly relevant. According to present estimates peatlands in undisturbed conditions act as a sink for the atmospheric carbon. Anthropogenic impact on peatlands (melioration, changes in land use, influence of underground water catchments) results in water table lowering, changing in vegetation cover, and degradation of peat deposit. Peatlands could provide a significant positive feedback for climate changes if warming and peatlands drying stimulates bulk soil organic matter decomposition which enhances CO2 release to the atmosphere. Western Siberian peatlands usually represented big bog massifs. Big peatlands have higher stability to external influence. Small peatlands have all signs of big bogs but react on changes in environmental variables more quickly. The present study is devoted to investigation of primary carbon fluxes (CO2 emission and net primary productivity) and carbon balance at oligotrophic bogs in native condition (key area "Bakchar") and under anthropogenic impact (key area "Ob'-Tom'"). The key area "Bakchar" is located between the Iksa and Bakchar rivers (56o58`N 82o36`E) at the Bakcharskoe bog (area 1400 km2). The key area "Ob'-Tom'"is located in the northern part of Ob' and Tom' interfluve (56o21`N 82o31`E). The "Bakchar" key area includes the following ecosystems: pine- shrub-sphagnum community, a similar community with stunted (low) pine trees, and sedge-sphagnum fen. Two small peatlands were studied at Ob' and Tom' interfluve. Kirsanovskoe bog includes pine- shrub-sphagnum community and sedge fen. Timiryazevskoe bog was represented by pine- shrub-sphagnum (TPSS) community and sedge fen. An infrared gas analyzer OPTOGAS 500.4 (OPTEC Corp., St.-Petersburg, Russia) attached to a static opaque plastic been used for carbon dioxide emission measurements. The net primary productivity was measured by clipping method (Golovatskaya and Dyukarev, Plant Soil 2009). Peatlands at "Ob'-Tom'" key area are under impact of water catchments for Tomsk city supply. Changes in deep waters results in changes of hydrological regime and environment transformations. Water level drawdown leads to increase of aerobic layer thickness, intensification of plant remains decomposition, peat layers compacting and rises of CO2 emission from the surface. Carbon dioxide emission from bogs of "Ob'-Tom'" key area is about two times higher than emission from pristine bogs ("Bakchar" key area). Aboveground net primary productivity determined without tree layer at all studied peatlands has similar values. Belowground net primary productivity at "Ob'-Tom'" key area if 4-7 times higher than at "Bakchar" key area depending on the ecosystem type. An essential increase in root density after water level depletion results in increase on total net productivity by 2.4 times. Carbon budget for pristine peatlands ("Bakchar" key area) varies from 27 (open fen) to 46 (low ryam) gC/m2/yr. Peatlands of "Ob'-Tom'" key area accumulates about 210 gC/m2/yr in average. Our observations of the elements of carbon exchange have shown that at present all studied peatlands act as carbon sinks. Long-term water table lowering at least at first stage stipulates carbon removing from the atmosphere and accumulation in a form of peat. Work was partially supported by Russian Fund of Basic Researches (08-05-00426/a, 08-05-92501).

Temporal Consistency Between Gross Primary Production and Solar-Induced Chlorophyll Fluorescence in the Ten Most Populous Megacity Areas over Years

NASA Technical Reports Server (NTRS)

Cui, Yaoping; Xiao, Xiangmin; Zhang, Yao; Dong, Jinwei; Qin, Yuanwei; Doughty, Russell B.; Zhang, Geli; Wang, Jie; Wu, Xiaocui; Qin, Yaochen;

Barriers to primary care responsiveness to poverty as a risk factor for health.

PubMed

Bloch, Gary; Rozmovits, Linda; Giambrone, Broden

2011-06-29

Poverty is widely recognized as a major determinant of poor health, and this link has been extensively studied and verified. Despite the strong evidentiary link, little work has been done to determine what primary care health providers can do to address their patients' income as a risk to their health. This qualitative study explores the barriers to primary care responsiveness to poverty as a health issue in a well-resourced jurisdiction with near-universal health care insurance coverage. One to one interviews were conducted with twelve experts on poverty and health in primary care in Ontario, Canada. Participants included family physicians, specialist physicians, nurse practitioners, community workers, advocates, policy experts and researchers. The interviews were analysed for anticipated and emergent themes. This study reveals provider- and patient-centred structural, attitudinal, and knowledge-based barriers to addressing poverty as a risk to health. While many of its findings reinforce previous work in this area, this study's findings point to a number of areas front line primary care providers could target to address their patients' poverty. These include a lack of provider understanding of the lived reality of poverty, leading to a failure to collect adequate data about patients' social circumstances, and to the development of inappropriate care plans. Participants also pointed to prejudicial attitudes among providers, a failure of primary care disciplines to incorporate approaches to poverty as a standard of care, and a lack of knowledge of concrete steps providers can take to address patients' poverty. While this study reinforces, in a well-resourced jurisdiction such as Ontario, the previously reported existence of significant barriers to addressing income as a health issue within primary care, the findings point to the possibility of front line primary care providers taking direct steps to address the health risks posed by poverty. The consistent direction and replicability of these findings point to a refocusing of the research agenda toward an examination of interventions to decrease the health impacts of poverty.

The brain map of gait variability in aging, cognitive impairment and dementia. A systematic review

PubMed Central

Tian, Qu; Chastan, Nathalie; Bair, Woei-Nan; Resnick, Susan M.; Ferrucci, Luigi; Studenski, Stephanie A.

2017-01-01

While gait variability may reflect subtle changes due to aging or cognitive impairment (CI), associated brain characteristics remain unclear. We summarize structural and functional neuroimaging findings associated with gait variability in older adults with and without CI and dementia. We identified 17 eligible studies; all were cross-sectional; few examined multiple brain areas. In older adults, temporal gait variability was associated with structural differences in medial areas important for lower limb coordination and balance. Both temporal and spatial gait variability were associated with structural and functional differences in hippocampus and primary sensorimotor cortex and structural differences in anterior cingulate cortex, basal ganglia, association tracts, and posterior thalamic radiation. In CI or dementia, some associations were found in primary motor cortex, hippocampus, prefrontal cortex and basal ganglia. In older adults, gait variability may be associated with areas important for sensorimotor integration and coordination. To comprehend the neural basis of gait variability with aging and CI, longitudinal studies of multiple brain areas are needed. PMID:28115194

Experiences with primary healthcare in Fuzhou, urban China, in the context of health sector reform: a mixed methods study.

PubMed

McCollum, Rosalind; Chen, Lieping; ChenXiang, Tang; Liu, Xiaoyun; Starfield, Barbara; Jinhuan, Zheng; Tolhurst, Rachel

2014-01-01

China has recently placed increased emphasis on the provision of primary healthcare services through health sector reform, in response to inequitably distributed health services. With increasing funding for community level facilities, now is an opportune time to assess the quality of primary care delivery and identify areas in need of further improvement. A mixed methodology approach was adopted for this study. Quantitative data were collected using the Primary Care Assessment Tool-Chinese version (C-PCAT), a questionnaire previously adapted for use in China to assess the quality of care at each health facility, based on clients' experiences. In addition, qualitative data were gathered through eight semi-structured interviews exploring perceptions of primary care with health directors and a policy maker to place this issue in the context of health sector reform. The study found that patients attending community health and sub-community health centres are more likely to report better experiences with primary care attributes than patients attending hospital facilities. Generally low scores for community orientation, family centredness and coordination in all types of health facility indicate an urgent need for improvement in these areas. Healthcare directors and policy makers perceived the need for greater coordination between levels of health providers, better financial reimbursement, more formal government contracts and recognition/higher status for staff at the community level and more appropriate undergraduate and postgraduate training. Copyright © 2013 John Wiley & Sons, Ltd.

The First Estimates of Marbled Cat Pardofelis marmorata Population Density from Bornean Primary and Selectively Logged Forest.

PubMed

Hearn, Andrew J; Ross, Joanna; Bernard, Henry; Bakar, Soffian Abu; Hunter, Luke T B; Macdonald, David W

2016-01-01

The marbled cat Pardofelis marmorata is a poorly known wild cat that has a broad distribution across much of the Indomalayan ecorealm. This felid is thought to exist at low population densities throughout its range, yet no estimates of its abundance exist, hampering assessment of its conservation status. To investigate the distribution and abundance of marbled cats we conducted intensive, felid-focused camera trap surveys of eight forest areas and two oil palm plantations in Sabah, Malaysian Borneo. Study sites were broadly representative of the range of habitat types and the gradient of anthropogenic disturbance and fragmentation present in contemporary Sabah. We recorded marbled cats from all forest study areas apart from a small, relatively isolated forest patch, although photographic detection frequency varied greatly between areas. No marbled cats were recorded within the plantations, but a single individual was recorded walking along the forest/plantation boundary. We collected sufficient numbers of marbled cat photographic captures at three study areas to permit density estimation based on spatially explicit capture-recapture analyses. Estimates of population density from the primary, lowland Danum Valley Conservation Area and primary upland, Tawau Hills Park, were 19.57 (SD: 8.36) and 7.10 (SD: 1.90) individuals per 100 km2, respectively, and the selectively logged, lowland Tabin Wildlife Reserve yielded an estimated density of 10.45 (SD: 3.38) individuals per 100 km2. The low detection frequencies recorded in our other survey sites and from published studies elsewhere in its range, and the absence of previous density estimates for this felid suggest that our density estimates may be from the higher end of their abundance spectrum. We provide recommendations for future marbled cat survey approaches.

The First Estimates of Marbled Cat Pardofelis marmorata Population Density from Bornean Primary and Selectively Logged Forest

PubMed Central

Hearn, Andrew J.; Ross, Joanna; Bernard, Henry; Bakar, Soffian Abu; Hunter, Luke T. B.; Macdonald, David W.

2016-01-01

The marbled cat Pardofelis marmorata is a poorly known wild cat that has a broad distribution across much of the Indomalayan ecorealm. This felid is thought to exist at low population densities throughout its range, yet no estimates of its abundance exist, hampering assessment of its conservation status. To investigate the distribution and abundance of marbled cats we conducted intensive, felid-focused camera trap surveys of eight forest areas and two oil palm plantations in Sabah, Malaysian Borneo. Study sites were broadly representative of the range of habitat types and the gradient of anthropogenic disturbance and fragmentation present in contemporary Sabah. We recorded marbled cats from all forest study areas apart from a small, relatively isolated forest patch, although photographic detection frequency varied greatly between areas. No marbled cats were recorded within the plantations, but a single individual was recorded walking along the forest/plantation boundary. We collected sufficient numbers of marbled cat photographic captures at three study areas to permit density estimation based on spatially explicit capture-recapture analyses. Estimates of population density from the primary, lowland Danum Valley Conservation Area and primary upland, Tawau Hills Park, were 19.57 (SD: 8.36) and 7.10 (SD: 1.90) individuals per 100 km2, respectively, and the selectively logged, lowland Tabin Wildlife Reserve yielded an estimated density of 10.45 (SD: 3.38) individuals per 100 km2. The low detection frequencies recorded in our other survey sites and from published studies elsewhere in its range, and the absence of previous density estimates for this felid suggest that our density estimates may be from the higher end of their abundance spectrum. We provide recommendations for future marbled cat survey approaches. PMID:27007219

Correlation between patients' reasons for encounters/health problems and population density in Japan: a systematic review of observational studies coded by the International Classification of Health Problems in Primary Care (ICHPPC) and the International Classification of Primary care (ICPC).

PubMed

Kaneko, Makoto; Ohta, Ryuichi; Nago, Naoki; Fukushi, Motoharu; Matsushima, Masato

2017-09-13

The Japanese health care system has yet to establish structured training for primary care physicians; therefore, physicians who received an internal medicine based training program continue to play a principal role in the primary care setting. To promote the development of a more efficient primary health care system, the assessment of its current status in regard to the spectrum of patients' reasons for encounters (RFEs) and health problems is an important step. Recognizing the proportions of patients' RFEs and health problems, which are not generally covered by an internist, can provide valuable information to promote the development of a primary care physician-centered system. We conducted a systematic review in which we searched six databases (PubMed, the Cochrane Library, Google Scholar, Ichushi-Web, JDreamIII and CiNii) for observational studies in Japan coded by International Classification of Health Problems in Primary Care (ICHPPC) and International Classification of Primary Care (ICPC) up to March 2015. We employed population density as index of accessibility. We calculated Spearman's rank correlation coefficient to examine the correlation between the proportion of "non-internal medicine-related" RFEs and health problems in each study area in consideration of the population density. We found 17 studies with diverse designs and settings. Among these studies, "non-internal medicine-related" RFEs, which was not thought to be covered by internists, ranged from about 4% to 40%. In addition, "non-internal medicine-related" health problems ranged from about 10% to 40%. However, no significant correlation was found between population density and the proportion of "non-internal medicine-related" RFEs and health problems. This is the first systematic review on RFEs and health problems coded by ICHPPC and ICPC undertaken to reveal the diversity of health problems in Japanese primary care. These results suggest that primary care physicians in some rural areas of Japan need to be able to deal with "non-internal-medicine-related" RFEs and health problems, and that curriculum including practical non-internal medicine-related training is likely to be important.

Fact Sheets and Additional Information Regarding the Primary National Ambient Air Quality Standard (NAAQS) for Sulfur Dioxide

EPA Pesticide Factsheets

Find tools for primary standards for Sulfur Dioxide, maps of nonattainment areas, an overview of the proposal, projected nonattainment areas for 2020, and a presentation on the 2011 SO2 primary NAAQS revision.

Assessing the impact of urbanization on regional net primary productivity in Jiangyin County, China.

PubMed

Xu, C; Liu, M; An, S; Chen, J M; Yan, P

2007-11-01

Urbanization is one of the most important aspects of global change. The process of urbanization has a significant impact on the terrestrial ecosystem carbon cycle. The Yangtze Delta region has one of the highest rates of urbanization in China. In this study, carried out in Jiangyin County as a representative region within the Yangtze Delta, land use and land cover changes were estimated using Landsat TM and ETM+ imagery. With these satellite data and the BEPS process model (Boreal Ecosystem Productivity Simulator), the impacts of urbanization on regional net primary productivity (NPP) and annual net primary production were assessed for 1991 and 2002. Landsat-based land cover maps in 1991 and 2002 showed that urban development encroached large areas of cropland and forest. Expansion of residential areas and reduction of vegetated areas were the major forms of land transformation in Jiangyin County during this period. Mean NPP of the total area decreased from 818 to 699 gCm(-2)yr(-1) during the period of 1991 to 2002. NPP of cropland was only reduced by 2.7% while forest NPP was reduced by 9.3%. Regional annual primary production decreased from 808 GgC in 1991 to 691 GgC in 2002, a reduction of 14.5%. Land cover changes reduced regional NPP directly, and the increasing intensity and frequency of human-induced disturbance in the urbanized areas could be the main reason for the decrease in forest NPP.

Assessing the impact of urbanization on net primary productivity using multi-scale remote sensing data: a case study of Xuzhou, China

NASA Astrophysics Data System (ADS)

Tan, Kun; Zhou, Songyang; Li, Erzhu; Du, Peijun

2015-06-01

An improved Carnegie Ames Stanford Approach (CASA) model based on two kinds of remote sensing (RS) data, Landsat Enhanced Thematic Mapper Plus (ETM +) and Moderate Resolution Imaging Spectro-radiometer (MODIS), and climate variables were applied to estimate the Net Primary Productivity (NPP) of Xuzhou in June of each year from 2001 to 2010. The NPP of the study area decreased as the spatial scale increased. The average NPP of terrestrial vegetation in Xuzhou showed a decreasing trend in recent years, likely due to changes in climate and environment. The study area was divided into four sub-regions, designated as highest, moderately high, moderately low, and lowest in NPP. The area designated as the lowest sub-region in NPP increased with expanding scale, indicating that the NPP distribution varied with different spatial scales. The NPP of different vegetation types was also significantly influenced by scale. In particular, the NPP of urban woodland produced lower estimates because of mixed pixels. Similar trends in NPP were observed with different RS data. In addition, expansion of residential areas and reduction of vegetated areas were the major reasons for NPP change. Land cover changes in urban areas reduced NPP, which could chiefly be attributed to human-induced disturbance.

Differentiation of Enhancing Glioma and Primary Central Nervous System Lymphoma by Texture-Based Machine Learning.

PubMed

Alcaide-Leon, P; Dufort, P; Geraldo, A F; Alshafai, L; Maralani, P J; Spears, J; Bharatha, A

2017-06-01

Accurate preoperative differentiation of primary central nervous system lymphoma and enhancing glioma is essential to avoid unnecessary neurosurgical resection in patients with primary central nervous system lymphoma. The purpose of the study was to evaluate the diagnostic performance of a machine-learning algorithm by using texture analysis of contrast-enhanced T1-weighted images for differentiation of primary central nervous system lymphoma and enhancing glioma. Seventy-one adult patients with enhancing gliomas and 35 adult patients with primary central nervous system lymphomas were included. The tumors were manually contoured on contrast-enhanced T1WI, and the resulting volumes of interest were mined for textural features and subjected to a support vector machine-based machine-learning protocol. Three readers classified the tumors independently on contrast-enhanced T1WI. Areas under the receiver operating characteristic curves were estimated for each reader and for the support vector machine classifier. A noninferiority test for diagnostic accuracy based on paired areas under the receiver operating characteristic curve was performed with a noninferiority margin of 0.15. The mean areas under the receiver operating characteristic curve were 0.877 (95% CI, 0.798-0.955) for the support vector machine classifier; 0.878 (95% CI, 0.807-0.949) for reader 1; 0.899 (95% CI, 0.833-0.966) for reader 2; and 0.845 (95% CI, 0.757-0.933) for reader 3. The mean area under the receiver operating characteristic curve of the support vector machine classifier was significantly noninferior to the mean area under the curve of reader 1 ( P = .021), reader 2 ( P = .035), and reader 3 ( P = .007). Support vector machine classification based on textural features of contrast-enhanced T1WI is noninferior to expert human evaluation in the differentiation of primary central nervous system lymphoma and enhancing glioma. © 2017 by American Journal of Neuroradiology.

[Internal Exposure Levels of PAHs of Primary School Students in Guangzhou].

PubMed

Su, Hui; Zhao, Bo; Zhang, Su-kun; Liu, Shan; Ren, Ming-zhong; Li, Jie; Shi, Xiao-xia

2015-12-01

In order to investigate the internal exposure levels of polycyclic aromatic hydrocarbons (PAHs) in primary school students of Guangzhou, the research collected urine of 78 and 86 primary school students from two primary schools in the summer of 2014, one school located in the ordinary residential area and the other in the industrial area. The contents of 10 kinds of OH-PAHs were tested by the rapid liquid chromatography coupled to triple quadruple tandem mass spectrometry. The results showed that the concentrations of total OH-PAHs in primary school students in the residential zone ranged from 0.83 µmol · mol⁻¹ to 80.63 µmol · mol⁻¹, while those in industrial area ranged from 1.06 µmol · mol⁻¹ to 72.47 µmol · mol⁻¹. The geometric average concentrations were 6.18 µmol · mol⁻¹ and 6.47 µmol · mol⁻¹, respectively, and there was no statistical significance between them (P > 0.05). Comparison of the exposure levels of different components of PAHs in the two areas found that all the OH-PAHs had no significant difference except for the levels of 1- OHP (P < 0.05). We should also pay attention to the higher exposure levels of PAHs in both areas when compared with other researches. In addition, the OH-PAHs in primary school students in the ordinary residential area had a good correlation between 0. 511 and 0.928 (P < 0.01), whereas there was no correlation between 1-OHP and 2-OHN, 1-OHN in the primary school students in the industrial area and other OH-PAHs had relatively weak correlation ranging from 0.338 to 0.855 (P < 0.01). This difference might indicate different pollution sources of PAHs in different functional areas, which was relatively single in the residential area, while the industrial area was polluted by multiple sources of industrial enterprises and logistics transportation emissions.

Primary care physician supply and other key determinants of health care utilisation: the case of Switzerland

PubMed Central

Busato, André; Künzi, Beat

2008-01-01

Background The Swiss government decided to freeze new accreditations for physicians in private practice in Switzerland based on the assumption that demand-induced health care spending may be cut by limiting care offers. This legislation initiated an ongoing controversial public debate in Switzerland. The aim of this study is therefore the determination of socio-demographic and health system-related factors of per capita consultation rates with primary care physicians in the multicultural population of Switzerland. Methods The data were derived from the complete claims data of Swiss health insurers for 2004 and included 21.4 million consultations provided by 6564 Swiss primary care physicians on a fee-for-service basis. Socio-demographic data were obtained from the Swiss Federal Statistical Office. Utilisation-based health service areas were created and were used as observational units for statistical procedures. Multivariate and hierarchical models were applied to analyze the data. Results Models within the study allowed the definition of 1018 primary care service areas with a median population of 3754 and an average per capita consultation rate of 2.95 per year. Statistical models yielded significant effects for various geographical, socio-demographic and cultural factors. The regional density of physicians in independent practice was also significantly associated with annual consultation rates and indicated an associated increase 0.10 for each additional primary care physician in a population of 10,000 inhabitants. Considerable differences across Swiss language regions were observed with reference to the supply of ambulatory health resources provided either by primary care physicians, specialists, or hospital-based ambulatory care. Conclusion The study documents a large small-area variation in utilisation and provision of health care resources in Switzerland. Effects of physician density appeared to be strongly related to Swiss language regions and may be rooted in the different cultural backgrounds of the served populations. PMID:18190705

Primary care physician supply and other key determinants of health care utilisation: the case of Switzerland.

PubMed

Busato, André; Künzi, Beat

2008-01-11

The Swiss government decided to freeze new accreditations for physicians in private practice in Switzerland based on the assumption that demand-induced health care spending may be cut by limiting care offers. This legislation initiated an ongoing controversial public debate in Switzerland. The aim of this study is therefore the determination of socio-demographic and health system-related factors of per capita consultation rates with primary care physicians in the multicultural population of Switzerland. The data were derived from the complete claims data of Swiss health insurers for 2004 and included 21.4 million consultations provided by 6564 Swiss primary care physicians on a fee-for-service basis. Socio-demographic data were obtained from the Swiss Federal Statistical Office. Utilisation-based health service areas were created and were used as observational units for statistical procedures. Multivariate and hierarchical models were applied to analyze the data. Models within the study allowed the definition of 1018 primary care service areas with a median population of 3754 and an average per capita consultation rate of 2.95 per year. Statistical models yielded significant effects for various geographical, socio-demographic and cultural factors. The regional density of physicians in independent practice was also significantly associated with annual consultation rates and indicated an associated increase 0.10 for each additional primary care physician in a population of 10,000 inhabitants. Considerable differences across Swiss language regions were observed with reference to the supply of ambulatory health resources provided either by primary care physicians, specialists, or hospital-based ambulatory care. The study documents a large small-area variation in utilisation and provision of health care resources in Switzerland. Effects of physician density appeared to be strongly related to Swiss language regions and may be rooted in the different cultural backgrounds of the served populations.

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.

Transcranial direct current stimulation to primary motor area improves hand dexterity and selective attention in chronic stroke.

PubMed

Au-Yeung, Stephanie S Y; Wang, Juliana; Chen, Ye; Chua, Eldrich

2014-12-01

The aim of this study was to determine whether transcranial direct current stimulation (tDCS) applied to the primary motor hand area modulates hand dexterity and selective attention after stroke. This study was a double-blind, placebo-controlled, randomized crossover trial involving subjects with chronic stroke. Ten stroke survivors with some pinch strength in the paretic hand received three different tDCS interventions assigned in random order in separate sessions-anodal tDCS targeting the primary motor area of the lesioned hemisphere (M1lesioned), cathodal tDCS applied to the contralateral hemisphere (M1nonlesioned), and sham tDCS-each for 20 mins. The primary outcome measures were Purdue pegboard test scores for hand dexterity and response time in the color-word Stroop test for selective attention. Pinch strength of the paretic hand was the secondary outcome. Cathodal tDCS to M1nonlesioned significantly improved affected hand dexterity (by 1.1 points on the Purdue pegboard unimanual test, P = 0.014) and selective attention (0.6 secs faster response time on the level 3 Stroop interference test for response inhibition, P = 0.017), but not pinch strength. The outcomes were not improved with anodal tDCS to M1lesioned or sham tDCS. Twenty minutes of cathodal tDCS to M1nonlesioned can promote both paretic hand dexterity and selective attention in people with chronic stroke.

The English Education in Primary Schools in Minor Ethnic Areas in Western China--Taking Leshan City as an Example

ERIC Educational Resources Information Center

Bing, Wang

2016-01-01

As we all know, China is a country with many ethnic minorities mainly living in the northeastern and southwestern China. The English education in the primary schools in these areas is an important issue. The article analyzes the status quo of English education in primary schools in minor ethnic areas, taking the Leshan city, a western one as an…

Relationship between Instructional Leadership of Headmaster and Work Discipline and Work Motivation and Academic Achievement in Primary School at Special Areas of Central Jakarta

ERIC Educational Resources Information Center

Supriadi, Eddi; Yusof, Hj. Abdul Raheem Bin Mohamad

2015-01-01

The study aimed to investigate the relationship between the instructional leadership of the headmaster and the work discipline of teachers and the work motivation and the academic achievement of primary school students from Special Province of Central Jakarta. The research method will be done with quantitative research methods. The study uses data…

Groundwater quality in the Monterey Bay and Salinas Valley groundwater basins, California

USGS Publications Warehouse

Kulongoski, Justin T.; Belitz, Kenneth

2011-01-01

The Monterey-Salinas study unit is nearly 1,000 square miles and consists of the Santa Cruz Purisima Formation Highlands, Felton Area, Scotts Valley, Soquel Valley, West Santa Cruz Terrace, Salinas Valley, Pajaro Valley, and Carmel Valley groundwater basins (California Department of Water Resources, 2003; Kulongski and Belitz, 2011). These basins were grouped into four study areas based primarily on geography. Groundwater basins in the north were grouped into the Santa Cruz study area, and those to the south were grouped into the Monterey Bay, the Salinas Valley, and the Paso Robles study areas (Kulongoski and others, 2007). The study unit has warm, dry summers and cool, moist winters. Average annual rainfall ranges from 31 inches in Santa Cruz in the north to 13 inches in Paso Robles in the south. The study areas are drained by several rivers and their principal tributaries: the Salinas, Pajaro, and Carmel Rivers, and San Lorenzo Creek. The Salinas Valley is a large intermontane valley that extends southeastward from Monterey Bay to Paso Robles. It has been filled, up to a thickness of 2,000 feet, with Tertiary and Quaternary marine and terrestrial sediments that overlie granitic basement. The Miocene-age Monterey Formation and Pliocene- to Pleistocene-age Paso Robles Formation, and Pleistocene to Holocene-age alluvium contain freshwater used for supply. The primary aquifers in the study unit are defined as those parts of the aquifers corresponding to the perforated intervals of wells listed in the California Department of Public Health database. Public-supply wells are typically drilled to depths of 200 to 650 feet, consist of solid casing from the land surface to depths of about 175 to 500 feet, and are perforated below the solid casing. Water quality in the primary aquifers may differ from that in the shallower and deeper parts of the aquifer system. Groundwater movement is generally from the southern part of the Salinas Valley north towards the Monterey Bay. Land use in the study unit is about 44 percent (%) natural (mostly grassland and forests), 43% agricultural, and 13% urban. The primary agricultural uses are row crops, pasture, hay, and vineyards. The largest urban areas are the cities of Santa Cruz, Watsonville, Monterey, Salinas, King City, and Paso Robles. Recharge to the groundwater system is primarily from stream-channel infiltration from the major rivers and their tributaries, and from infiltration of water from precipitation and irrigation. The primary sources of discharge are water pumped for irrigation and municipal supply, evaporation, and discharge to streams.

Geostatistical and GIS analysis of the spatial variability of alluvial gold content in Ngoura-Colomines area, Eastern Cameroon: Implications for the exploration of primary gold deposit

NASA Astrophysics Data System (ADS)

Takodjou Wambo, Jonas Didero; Ganno, Sylvestre; Djonthu Lahe, Yannick Sthopira; Kouankap Nono, Gus Djibril; Fossi, Donald Hermann; Tchouatcha, Milan Stafford; Nzenti, Jean Paul

2018-06-01

Linear and nonlinear geostatistic is commonly used in ore grade estimation and seldom used in Geographical Information System (GIS) technology. In this study, we suggest an approach based on geostatistic linear ordinary kriging (OK) and Geographical Information System (GIS) techniques to investigate the spatial distribution of alluvial gold content, mineralized and gangue layers thicknesses from 73 pits at the Ngoura-Colomines area with the aim to determine controlling factors for the spatial distribution of mineralization and delineate the most prospective area for primary gold mineralization. Gold content varies between 0.1 and 4.6 g/m3 and has been broadly grouped into three statistical classes. These classes have been spatially subdivided into nine zones using ordinary kriging model based on physical and topographical characteristics. Both mineralized and barren layer thicknesses show randomly spatial distribution, and there is no correlation between these parameters and the gold content. This approach has shown that the Ngoura-Colomines area is located in a large shear zone compatible with the Riedel fault system composed of P and P‧ fractures oriented NE-SW and NNE-SSW respectively; E-W trending R fractures and R‧ fractures with NW-SE trends that could have contributed significantly to the establishment of this gold mineralization. The combined OK model and GIS analysis have led to the delineation of Colomines, Tissongo, Madubal and Boutou villages as the most prospective areas for the exploration of primary gold deposit in the study area.

Eye Injuries Among Primary School Children in Enugu, Nigeria: Rural vs Urban.

PubMed

Okpala, Nonso Ejikeme; Umeh, Rich Enujioke; Onwasigwe, Ernest Nnemeka

2015-01-01

A cross-sectional survey of the prevalence of eye injuries among primary school children in two noncontiguous local government areas of Enugu State of Nigeria was undertaken. One of the local government areas was urban, while the other one was rural. Children who were <15 years in two randomly selected primary schools in the urban area and three randomly selected schools in the rural area were interviewed and examined with Snellen chart, pen torch, head loupe, and direct ophthalmoscope. The findings were recorded using a semi-structured questionnaire and the World Health Organization Programme for Prevention of Blindness (WHO/PBL) eye examination form. Training on visual acuity measurement was done for each of the class teachers. A total of 1,236 children <15 years of age were studied and analyzed. Slightly more females, 652 (52.8%), than males, 584 (47.2%), constituted the sample population giving a female/male ratio of 1.1:1. A total of 98 (7.93%) children had evidence of injury to the eye or its adnexa. Eyelid scar was the commonest (5.34%) followed by eyebrow scar (2.10%). Canthal scar was the next (0.32%). Two girls had monocular blindness from eye trauma (0.16%). One had leucoma, while the other had a dislocated lens. All the monocular blind children of this study were from the urban area. The home was the commonest environment for an eye injury (69.39%) followed by the school (20.41%). The farm was next in frequency (7.14%), especially among boys in the rural area. The church and the road/street constituted the remainder. Regarding persons causing the injury, the child's playmate was the commonest (55.10%) followed by self (27.55%). Parents and guardians were the next (9.18%). These were injuries associated with corporal punishment. Corporal punishment-related eye injury, according to this study, appears to be common in the rural area and affects boys predominantly. Other human intermediary agents that cause an eye injury include passersby (2.04%), RTA (2.04%), siblings (2.04%), and others (1.02%). The primary agents that caused an eye injury were sticks/wood, 29 (29.60%); stone, 21 (21.43%); pieces of metal, 19 (19.39%); fall, 10 (10.20%); fight/fist blow, 9 (9.918%); plastic, 2 (2.04%); fingernails, 2 (2.04%); farm tools/fruits, 2 (2.04%); and RTA, glass, and headbutt, each 1.02%. Farm implements/fruits as well as fingernails appear to be fairly common primary agents that cause an eye injury in the rural Enugu, Nigeria. In terms of prevalence, there was no significant difference between the urban and rural areas. The findings from this study showed a high prevalence of eye injury among primary school children. In terms of treatment, 58.16% of the children with an eye injury had no form of treatment for it. The children from this study with monocular blindness did not receive adequate medical treatment. Treatment of an eye injury, according to this study, was sought from chemists (19.39%), at hospital/health centers (16.33%), at home (3.06%), and from traditional healers (3.06%). The persons who treated an eye injury, as observed from this study, were doctors (14.29%), nurses (4.08%), chemists (17.35%), and traditional healers and fathers (3.06% each). The frequency of noninjury-related diagnosis made in this study was refractive error, 4.85%; allergic conjunctivitis, 1.94%; oculocutaneous albinism, 0.24%; prepapillary vascular loops, 0.40%; and then ptosis, exotropia, stye, corneal opacity, and retinitis pigmentosa, 0.08% each. The annual incidence of an eye injury according to this study was 3.48%. The majority of the causes of an eye injury, as per this study, were preventable. Appropriate promotion of preventive eye care among children may go a long way in reducing the burden of blindness from eye injuries.

Eye Injuries Among Primary School Children in Enugu, Nigeria: Rural vs Urban

PubMed Central

Okpala, Nonso Ejikeme; Umeh, Rich Enujioke; Onwasigwe, Ernest Nnemeka

2015-01-01

A cross-sectional survey of the prevalence of eye injuries among primary school children in two noncontiguous local government areas of Enugu State of Nigeria was undertaken. One of the local government areas was urban, while the other one was rural. Children who were <15 years in two randomly selected primary schools in the urban area and three randomly selected schools in the rural area were interviewed and examined with Snellen chart, pen torch, head loupe, and direct ophthalmoscope. The findings were recorded using a semi-structured questionnaire and the World Health Organization Programme for Prevention of Blindness (WHO/PBL) eye examination form. Training on visual acuity measurement was done for each of the class teachers. A total of 1,236 children <15 years of age were studied and analyzed. Slightly more females, 652 (52.8%), than males, 584 (47.2%), constituted the sample population giving a female/male ratio of 1.1:1. A total of 98 (7.93%) children had evidence of injury to the eye or its adnexa. Eyelid scar was the commonest (5.34%) followed by eyebrow scar (2.10%). Canthal scar was the next (0.32%). Two girls had monocular blindness from eye trauma (0.16%). One had leucoma, while the other had a dislocated lens. All the monocular blind children of this study were from the urban area. The home was the commonest environment for an eye injury (69.39%) followed by the school (20.41%). The farm was next in frequency (7.14%), especially among boys in the rural area. The church and the road/street constituted the remainder. Regarding persons causing the injury, the child’s playmate was the commonest (55.10%) followed by self (27.55%). Parents and guardians were the next (9.18%). These were injuries associated with corporal punishment. Corporal punishment-related eye injury, according to this study, appears to be common in the rural area and affects boys predominantly. Other human intermediary agents that cause an eye injury include passersby (2.04%), RTA (2.04%), siblings (2.04%), and others (1.02%). The primary agents that caused an eye injury were sticks/wood, 29 (29.60%); stone, 21 (21.43%); pieces of metal, 19 (19.39%); fall, 10 (10.20%); fight/fist blow, 9 (9.918%); plastic, 2 (2.04%); fingernails, 2 (2.04%); farm tools/fruits, 2 (2.04%); and RTA, glass, and headbutt, each 1.02%. Farm implements/fruits as well as fingernails appear to be fairly common primary agents that cause an eye injury in the rural Enugu, Nigeria. In terms of prevalence, there was no significant difference between the urban and rural areas. The findings from this study showed a high prevalence of eye injury among primary school children. In terms of treatment, 58.16% of the children with an eye injury had no form of treatment for it. The children from this study with monocular blindness did not receive adequate medical treatment. Treatment of an eye injury, according to this study, was sought from chemists (19.39%), at hospital/health centers (16.33%), at home (3.06%), and from traditional healers (3.06%). The persons who treated an eye injury, as observed from this study, were doctors (14.29%), nurses (4.08%), chemists (17.35%), and traditional healers and fathers (3.06% each). The frequency of noninjury-related diagnosis made in this study was refractive error, 4.85%; allergic conjunctivitis, 1.94%; oculocutaneous albinism, 0.24%; prepapillary vascular loops, 0.40%; and then ptosis, exotropia, stye, corneal opacity, and retinitis pigmentosa, 0.08% each. The annual incidence of an eye injury according to this study was 3.48%. The majority of the causes of an eye injury, as per this study, were preventable. Appropriate promotion of preventive eye care among children may go a long way in reducing the burden of blindness from eye injuries. PMID:26124686

Impact of population density on collision rates in a rapidly developing rural, exurban area of Los Angeles County.

PubMed

Fischer, Kelly; Sternfeld, Isabelle; Melnick, Douglas Sloan

2013-04-01

To determine if the commonly acknowledged relationships between population density and traffic collisions are found at the subcounty level and to describe how collision characteristics may vary substantially at a local level, with a particular emphasis on exurban areas. Los Angeles County collision data were obtained from the California Highway Patrol and the census tract and service planning area (SPA) for each collision were determined. The correlation between population density and collision rates by census tract was calculated within each SPA and for the entire county. Primary collision factors were compared for geographic areas of different population densities within one exurban SPA in Los Angeles County. An inverse relationship was found between collision rates and population density within Los Angeles County. Primary collisions factors were different in areas of the county with different population densities, with driving or biking under the influence particularly common in the most rural area. Subcounty analyses are very important to the study of traffic collisions. Traffic problems in rapidly developing exurban areas may be quite different from those in older, more established areas.

Helwan University Project Developing Primary School Pupils' Abilities and Skills at Some Egyptian Underprivileged Areas (Slums). (Field Study)

ERIC Educational Resources Information Center

El-Tayeb, Mahmoud N.; El Nashar, Mohamed; Zeid, Mai M.; El-Sayed, Magda; Ramadan, Mohamed A.; Hamdi, Safia M.; El-Affy, Nabila; Ebeid, Amina K.; El-Marasi, Sonia S.; Abou-Elmahty, Maher

2010-01-01

Through directing concerted efforts and educational services of seven Faculties of Helwan University towards socially underprivileged pupils in slum areas (EL-Marg area in big Cairo) this research project had two main aims: firstly, modifying a set of arbitrary behaviors of those pupils, in a trial to develop some behavior skills associated with…

Pain distribution in primary care patients with hip osteoarthritis.

PubMed

Poulsen, Erik; Overgaard, Søren; Vestergaard, Jacob T; Christensen, Henrik W; Hartvigsen, Jan

2016-12-01

Hip osteoarthritis (OA) is the most common diagnosis in primary care adult patients presenting with hip pain but pain location and pain distribution in primary care patients with hip OA have been reported inadequately. To describe pain location and pain distribution in primary care patients with clinical and radiographic confirmed hip OA. Primary care patients with unilateral clinical and radiographic hip OA living on the island of Funen, Denmark were recruited from primary care to participate in a randomized clinical trial. At baseline, patients recorded pain intensity using an 11-box numeric rating scale and the distribution of hip pain using a manikin displaying three separate views: front, back and lateral. Pain drawings were analysed using a template to determine the most frequent pain locations and distribution of pain. Pain drawings were completed by 109 patients of which 108 (99%) were valid. The mean age of patients was 65 (SD 9) years and 44% were females. The mean pain intensity was 5.4 (SD 2.0). A total of 77% had marked the greater trochanter area, 53% the groin area, 42% the anterior/lateral thigh area, 38% the buttock area, 17% the knee and 15% the lower leg area. No patients marked pain exclusively in the areas of the knee, posterior thigh or lower leg. The most common pain locations of patients with hip OA presenting to primary care are the greater trochanter, groin, thigh and buttock areas. No patients recorded pain exclusively in the knee or lower leg. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Effectiveness of a Federal Healthy Start program in reducing primary and repeat teen pregnancies: our experience over the decade.

PubMed

Salihu, Hamisu M; August, Euna M; Jeffers, Delores F; Mbah, Alfred K; Alio, Amina P; Berry, Estrellita

2011-06-01

To evaluate the effectiveness of a Federal Healthy Start program in reducing primary and repeat teen pregnancies in a disadvantaged community. An ecological study that compares trends in teen pregnancy in the catchment area in which the community-based intervention was administered with two ecologic controls: the county (Hillsborough) and the state (Florida). Our catchment area is East Tampa, a socio-economically disadvantaged community in Hillsborough County, Florida. Preconception care targeted teenagers between the ages of 10 and 19 years. Interconception care involved young mothers under the age of 20 with a previous birth. The population was comprised primarily of African Americans. Preconception care services for primary teen pregnancy reduction offered sex education, family planning, drug and violence prevention education, and communication and negotiation skills acquisition. Interconception care service offered young women health education through monthly home visitation or monthly peer support group meetings addressing a range of topics using the life course perspective as framework. Reduction in primary teen pregnancy and repeat teen pregnancy among adolescents. The decline in primary teen pregnancy in the catchment area was 60% and 80% greater than the reduction experienced at the county level and at the state level respectively over the period of the study. However, efforts to prevent repeat pregnancy were not successful. The Federal Healthy Start Preconception Care program, in collaboration with community partners, contributed to the prevention of first-time teen pregnancy in a community faced with significant social and economic challenges. Copyright © 2011 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

PubMed Central

2013-01-01

Summary Introduction and objectives. For children, maintenance of personal hygiene helps to improve the quality of life and longevity. This is of particular importance in a slum community with compromised living situation. This study was undertaken to find out the knowledge and practice of personal hygiene among the primary school children living in a slum area, to identify any misconception among them regarding the maintenance of personal hygiene, to find out their morbidity pattern, and also to elicit the relationship between practice of personal hygiene among the children and the literacy status of their mother. Methods. A cross-sectional observational study was conducted among 104 primary school children of a primary school situated in the slum area of Chetla, Kolkata, India with the help of a predesigned, pre-tested and structured questionnaire. Data were analyzed statistically by simple proportions and tests of significance. Results. It was found that the female students were more knowledgeable than the male students regarding the maintenance of personal hygiene. There was a wide gap between practice and knowledge of personal hygiene among the primary school children living in the slum area. Even, misconceptions do exist on certain indicators of personal hygiene among the students. Statistically significant association was observed between practices of personal hygiene among the primary school children and the literacy status of their mother. Discussion and conclusions. Future of a society depends considerably on the health of its children. The parents and the school teachers, as constructive shapers of children's health behaviors, should play a responsible role in early education of children on personal hygiene. PMID:24783893

Optic disc size and other parameters from optical coherence tomography in Vietnamese-Americans.

PubMed

Peng, Pai-Huei; Fu, Sheena; Nguyen, Ngoc; Porco, Travis; Lin, Shan C

2011-08-01

To investigate the optic disc parameters by optical coherence tomography (OCT) in Vietnamese with various types of glaucoma. Medical charts of Vietnamese and White patients within a single practice were reviewed. Disc and rim areas by OCT were compared among nonglaucoma controls, different types of glaucoma, and glaucoma suspect. The association of these parameters with demographic and ocular features was evaluated. Data from 1416 Vietnamese and 57 White patients were included. A larger mean disc area was observed in eyes with primary angle-closure glaucoma than in eyes with primary angle-closure and primary angle-closure suspect (both P<0.001). There was no association between disc size with central corneal thickness (P=0.051) and sex (P=0.155). Vietnamese patients with glaucoma and glaucoma suspicion had larger discs than diagnosis-matched Whites (P=0.043 and 0.021, respectively). Vietnamese patients with glaucoma seem to have larger optic discs than White patients. Central corneal thickness had no association with disc area in this study population.

[Meanings and methods of territorialization in primary health care].

PubMed

Pessoa, Vanira Matos; Rigotto, Raquel Maria; Carneiro, Fernando Ferreira; Teixeira, Ana Cláudia de Araújo

2013-08-01

Territorially-based participative analytical methodologies taking the environmental question and work into consideration are essential for effective primary health care. The study analyzed work and environment-related processes in the primary health care area and their repercussions on the health of workers and the community in a rural city in Ceará, whose economy is based on agriculture for export,. It sought to redeem the area and the proposal of actions focused on health needs by the social subjects through the making of social, environmental and work-related maps in workshops within the framework of action research. Examining the situation from a critical perspective, based on social participation and social determination of the health-disease process with regard to the relations between production, environment and health, was the most important step in the participative map-making process, with the qualitative material interpreted in light of discourse analysis. The process helped identify the health needs, the redemption of the area, strengthened the cooperation between sectors and the tie between the health of the worker and that of the environment, and represented an advance towards the eradication of the causes of poor primary health care services.

Access to primary care for socio-economically disadvantaged older people in rural areas: A qualitative study.

PubMed

Ford, John A; Turley, Rachel; Porter, Tom; Shakespeare, Tom; Wong, Geoff; Jones, Andy P; Steel, Nick

2018-01-01

We aim to explore the barriers to accessing primary care for socio-economically disadvantaged older people in rural areas. Using a community recruitment strategy, fifteen people over 65 years, living in a rural area, and receiving financial support were recruited for semi-structured interviews. Four focus groups were held with rural health professionals. Interviews and focus groups were audio-recorded and transcribed. Thematic analysis was used to identify barriers to primary care access. Older people's experience can be understood within the context of a patient perceived set of unwritten rules or social contract-an individual is careful not to bother the doctor in return for additional goodwill when they become unwell. However, most found it difficult to access primary care due to engaged telephone lines, availability of appointments, interactions with receptionists; breaching their perceived social contract. This left some feeling unwelcome, worthless or marginalised, especially those with high expectations of the social contract or limited resources, skills and/or desire to adapt to service changes. Health professionals' described how rising demands and expectations coupled with service constraints had necessitated service development, such as fewer home visits, more telephone consultations, triaging calls and modifying the appointment system. Multiple barriers to accessing primary care exist for this group. As primary care is re-organised to reduce costs, commissioners and practitioners must not lose sight of the perceived social contract and models of care that form the basis of how many older people interact with the service.

Fact Sheets and Additional Information Regarding the 2010 Revision to the Primary National Ambient Air Quality Standards (NAAQS) for Sulfur Dioxide

EPA Pesticide Factsheets

Find tools for primary standards for Sulfur Dioxide, maps of nonattainment areas, an overview of the proposal, projected nonattainment areas for 2020, and a presentation on the 2011 SO2 primary NAAQS revision.

Gender Integration of a Core Content Area Teacher/Athletic Coach in the Rural Southeastern United States

ERIC Educational Resources Information Center

Brown, Alan

2012-01-01

Research on the occupational socialization of teachers and coaches has largely centered on physical education teachers and rarely on teachers from core content areas (i.e. English, foreign language, mathematics, science and social studies) who also coach athletics. The primary purpose of this single-case study was to explore the socialization of a…

IEA Pre-Primary Study: Phase 1, National Research Report, 1991. Nigeria.

ERIC Educational Resources Information Center

Onibokun, Yemi

This study examined the early childhood care of 4- to 5-year-old children in Nigeria. Data were obtained from 842 Parent Guardian Questionnaires from urban areas and 409 from rural areas. The first part of the report describes the characteristics of the sample population. These items include language used at home; household size and composition;…

BOREAS Level-0 NS001 TMS Imagery: Digital Counts in BIL Format

NASA Technical Reports Server (NTRS)

Hall, Forrest G. (Editor); Newcomer, Jeffrey A.; Dominguez, Roseanne

2000-01-01

For BOREAS, the NS001 TMS imagery, along with the other remotely sensed images, was collected in order to provide spatially extensive information over the primary study areas. This information includes detailed land cover and biophysical parameter maps such as fPAR and LAI. Data collections occurred over the study areas during the 1994 field campaigns.

What happens when you want to talk to the animals: lessons of a career in animal bioacoustics

NASA Astrophysics Data System (ADS)

Bowles, Ann E.

2004-05-01

Animal bioacoustics (AB) is the study of sound in nonhuman animal biology. I entered the field because I was interested in the evolution of language, and I wanted to study the acoustic communication of whales and dolphins. Topics like this within the scope of AB make the discipline accessible to students and laypeople. Although career opportunities are limited (professionals declaring AB as their primary area represent only 3% of ASA membership [http://www.acoustics.org/WIA, statistics for 2000]), an interest in AB can foster entry into more marketable disciplines. It has been a particularly important avenue for bringing women into careers in traditionally male-dominated subject areas. For example, women represent 14% of the ASA membership and 12% or fewer of those declaring Underwater Acoustics, Engineering Acoustics, and Noise as their primary interest. However, 25% of those declaring AB as their primary interest are women, and AB includes all three topic areas within its scope. Unfortunately, AB is still fairly inaccessible to interested lay professionals such as educators, science writers, and environmental planners. By helping them to develop a deeper understanding of topics in AB, ASA can help them foster careers in acoustics.

Lung Parenchymal Assessment in Primary and Secondary Pneumothorax.

PubMed

Bintcliffe, Oliver J; Edey, Anthony J; Armstrong, Lynne; Negus, Ian S; Maskell, Nick A

2016-03-01

The definition of primary spontaneous pneumothorax excludes patients with known lung disease; however, the assumption that the underlying lung is normal in these patients is increasingly contentious. The purpose of this study was to assess lung structure and compare the extent of emphysema in patients with primary versus secondary spontaneous pneumothorax and to patients with no pneumothorax in an otherwise comparable control group. We identified patients treated for pneumothorax by screening inpatient and outpatient medical records at one medical center in the United Kingdom. From this group, 20 patients had no clinically apparent underlying lung disease and were classified as having a primary spontaneous pneumothorax, and 20 patients were classified as having a secondary spontaneous pneumothorax. We assembled a control group composed of 40 subjects matched for age and smoking history who had a unilateral pleural effusion or were suspected to have a thoracic malignancy and had a chest computed tomography scan suitable for quantitative analysis. Demographics and smoking histories were collected. Quantitative evaluation of low-attenuation areas of the lung on computed tomography imaging was performed using semiautomated software, and the extent of emphysema-like destruction was assessed visually. The extent of emphysema and percentage of low-attenuation areas was greater for patients with primary spontaneous pneumothorax than for control subjects matched for age and smoking history (median, 0.25 vs. 0.00%; P = 0.019) and was also higher for patients with secondary pneumothorax than those with primary spontaneous pneumothorax (16.15 vs. 0.25%, P < 0.001). Patients with primary pneumothorax who smoked had significantly greater low-attenuation area than patients with primary pneumothorax who were nonsmokers (0.7 vs. 0.1%, P = 0.034). The majority of patients with primary spontaneous pneumothorax had quantifiable evidence of parenchymal destruction and emphysema. The exclusion of patients with underlying lung disease from the definition of primary spontaneous pneumothorax should be reappraised.

FDG PET detection of unknown primary tumors.

PubMed

Bohuslavizki, K H; Klutmann, S; Kröger, S; Sonnemann, U; Buchert, R; Werner, J A; Mester, J; Clausen, M

2000-05-01

The management of patients presenting with metastases of unknown primary origin remains a clinical challenge despite a large variety of imaging modalities. The aim of this study was to evaluate FDG PET in detecting the sites of primary cancer in these patients. Fifty-three patients with metastatic cervical adenopathy (n = 44) or extracervical metastases (n = 9) of unknown primary origin were included after extensive but inconclusive conventional diagnostic work-up. Patients received 370 MBq FDG (10 mCi) intravenously, and whole-body images were acquired at 60 min after injection. Clinical, surgical, and histopathologic findings and complete correlative imaging were used to assess the results. In 27 of 53 patients FDG PET showed focal tracer accumulations corresponding to potential primary tumor sites located in the lungs (n = 12), the palatine tonsil (n = 5), the salivary glands (n = 2), the nasopharynx (n = 1), the oropharynx (n = 3), the maxillary sinus (n = 1), and the larynx (n = 1). Moreover, in 2 patients FDG PET revealed lesions suspected to be tumors in the breast and the ileocolonic area. In 20 (37.8%) of these 53 patients FDG PET was true-positive, identifying the primary tumor in the lungs (n = 10), the head and neck region (n = 8), the breast (n = 1), and the ileocolonic area (n = 1). In 6 of 27 patients FDG PET was false-positive, predominantly identifying suspicious areas in the palatine tonsil (n = 3). One patient denied further diagnostic work-up after PET; thus, positive PET could not be evaluated. In 26 of 53 patients PET did not reveal lesions suspected to be the primary. However, primary tumors were not found in these patients at clinical follow-up. FDG PET is a valuable diagnostic tool in patients with cancer of unknown primary because it imaged unknown primary tumors in about one third of all patients investigated. In addition, FDG PET assists in both guiding biopsies for histologic evaluation and selecting the appropriate treatment protocols for these patients.

PBC triggers in water reservoirs, coal mining areas and waste disposal sites: from Newcastle to New York.

PubMed

Smyk, Daniel; Mytilinaiou, Maria G; Rigopoulou, Eirini I; Bogdanos, Dimitrios P

2010-01-01

Various environmental factors have been proposed as triggers of primary biliary cirrhosis (PBC), a progressive autoimmune cholestatic liver disease which is characterised by the destruction of the small intrahepatic bile ducts. Support for their pathogenic role in PBC is provided by epidemiological studies reporting familial clustering and clusters of the disease within a given geographical area. The seminal study by Triger reporting that the great majority of PBC cases in the English city of Sheffield drank water from a specific water reservoir, has been followed by studies reporting disease 'hot spots' within a restricted geographic region of the former coal mining area of Newcastle. The New York study reporting an increased risk and significant clustering of PBC cases near toxic federal waste disposal sites has added strength to the notion that environmental factors, possibly in the form of infectious agents or toxic/chemical environmental factors in areas of contaminated land, water or polluted air may play a key role in the development of the disease. This review discusses the findings of reports investigating environmental factors which may contribute to the cause of primary biliary cirrhosis.

Differences in the use of spirometry between rural and urban primary care centers in Spain.

PubMed

Márquez-Martín, Eduardo; Soriano, Joan B; Rubio, Myriam Calle; Lopez-Campos, Jose Luis

2015-01-01

The aim of this study is to evaluate the ability and practice of spirometry, training of technicians, and spirometry features in primary care centers in Spain, evaluating those located in a rural environment against those in urban areas. An observational cross-sectional study was conducted in 2012 by a telephone survey in 970 primary health care centers in Spain. The centers were divided into rural or urban depending on the catchment population. The survey contacted technicians in charge of spirometry and consisted of 36 questions related to the test that included the following topics: center resources, training doctors and technicians, using the spirometer, bronchodilator test, and the availability of spirometry and maintenance. Although the sample size was achieved in both settings, rural centers (RCs) gave a lower response rate than urban centers (UCs). The number of centers without spirometry in rural areas doubled those in the urban areas. Most centers had between one and two spirometers. However, the number of spirometry tests per week was significantly lower in RCs than in UCs (4 [4.1%] vs 6.9 [5.7%], P<0.01). The availability of a specific schedule for conducting spirometries was higher in RCs than in UCs (209 [73.0%] vs 207 [64.2%], P=0.003). RCs were more satisfied with the spirometries (7.8 vs 7.6, P=0.019) and received more training course for interpreting spirometry (41.0% vs 33.2%, P=0.004). The performance of the bronchodilator test showed a homogeneous measure in different ways. The spirometer type and the reference values were unknown to the majority of respondents. This study shows the differences between primary care RCs and UCs in Spain in terms of performing spirometry. The findings in the present study can be used to improve the performance of spirometry in these areas.

Differences in the use of spirometry between rural and urban primary care centers in Spain

PubMed Central

Márquez-Martín, Eduardo; Soriano, Joan B; Rubio, Myriam Calle; Lopez-Campos, Jose Luis

2015-01-01

Objectives The aim of this study is to evaluate the ability and practice of spirometry, training of technicians, and spirometry features in primary care centers in Spain, evaluating those located in a rural environment against those in urban areas. Methods An observational cross-sectional study was conducted in 2012 by a telephone survey in 970 primary health care centers in Spain. The centers were divided into rural or urban depending on the catchment population. The survey contacted technicians in charge of spirometry and consisted of 36 questions related to the test that included the following topics: center resources, training doctors and technicians, using the spirometer, bronchodilator test, and the availability of spirometry and maintenance. Results Although the sample size was achieved in both settings, rural centers (RCs) gave a lower response rate than urban centers (UCs). The number of centers without spirometry in rural areas doubled those in the urban areas. Most centers had between one and two spirometers. However, the number of spirometry tests per week was significantly lower in RCs than in UCs (4 [4.1%] vs 6.9 [5.7%], P<0.01). The availability of a specific schedule for conducting spirometries was higher in RCs than in UCs (209 [73.0%] vs 207 [64.2%], P=0.003). RCs were more satisfied with the spirometries (7.8 vs 7.6, P=0.019) and received more training course for interpreting spirometry (41.0% vs 33.2%, P=0.004). The performance of the bronchodilator test showed a homogeneous measure in different ways. The spirometer type and the reference values were unknown to the majority of respondents. Conclusion This study shows the differences between primary care RCs and UCs in Spain in terms of performing spirometry. The findings in the present study can be used to improve the performance of spirometry in these areas. PMID:26316737

Illness absenteeism rates in primary and secondary schools in 2013-2014 in England: was there any impact of vaccinating children of primary-school age against influenza?

PubMed

Green, H K; Brousseau, N; Andrews, N; Selby, L; Pebody, R

2016-09-09

A phased introduction of routine influenza vaccination of healthy children was recommended in the UK in 2012, with the aim of protecting both vaccinated children and the wider population through reducing transmission. In the first year of the programme in 2013-2014, 4- to 11-year-olds were targeted in pilot areas across England. This study assesses if this was associated with school absenteeism, an important societal burden of influenza. During the spring 2014 term when influenza predominantly circulated, the proportion of absence sessions due to illness was compared between vaccination pilot and non-pilot areas for primary schools (to measure overall impact) and secondary schools (to measure indirect impact). A linear multilevel regression model was applied, adjusting for clustering within schools and potential school-level confounders, including deprivation, past absenteeism, and ethnicity. Low levels of influenza activity were reported in the community in 2013-2014. Primary schools in pilot areas had a significantly adjusted decrease in illness absenteeism of 0·05% relative to non-pilot schools; equivalent to an average of 4 days per school. In secondary schools, there was no significant indirect impact of being located in a pilot area on illness absenteeism. These insights can be used in conjunction with routine healthcare surveillance data to evaluate the full benefits of such a programme.

An overview of current Navy programs to develop thrust augmenting ejectors

NASA Technical Reports Server (NTRS)

Green, K. A.

1979-01-01

The primary objective of Navy sponsored research in thrust augmentation is the development of an improved augmenter for V/STOL application. In support of this goal, a data base is being established to provide an accurate prediction capability for use in ejector design. A general technology development of ejectors and associated effects presently is split into the more specific areas of lift and control, since thrust augmenting ejectors may be suitable for both. Research areas examined include advanced diffuser and end wall design; advanced primary nozzles; analytic studies; augmenting reaction controls; and nozzle design.

A systematic review of strategies to recruit and retain primary care doctors.

PubMed

Verma, Puja; Ford, John A; Stuart, Arabella; Howe, Amanda; Everington, Sam; Steel, Nicholas

2016-04-12

There is a workforce crisis in primary care. Previous research has looked at the reasons underlying recruitment and retention problems, but little research has looked at what works to improve recruitment and retention. The aim of this systematic review is to evaluate interventions and strategies used to recruit and retain primary care doctors internationally. A systematic review was undertaken. MEDLINE, EMBASE, CENTRAL and grey literature were searched from inception to January 2015. Articles assessing interventions aimed at recruiting or retaining doctors in high income countries, applicable to primary care doctors were included. No restrictions on language or year of publication. The first author screened all titles and abstracts and a second author screened 20%. Data extraction was carried out by one author and checked by a second. Meta-analysis was not possible due to heterogeneity. Fifty-one studies assessing 42 interventions were retrieved. Interventions were categorised into thirteen groups: financial incentives (n = 11), recruiting rural students (n = 6), international recruitment (n = 4), rural or primary care focused undergraduate placements (n = 3), rural or underserved postgraduate training (n = 3), well-being or peer support initiatives (n = 3), marketing (n = 2), mixed interventions (n = 5), support for professional development or research (n = 5), retainer schemes (n = 4), re-entry schemes (n = 1), specialised recruiters or case managers (n = 2) and delayed partnerships (n = 2). Studies were of low methodological quality with no RCTs and only 15 studies with a comparison group. Weak evidence supported the use of postgraduate placements in underserved areas, undergraduate rural placements and recruiting students to medical school from rural areas. There was mixed evidence about financial incentives. A marketing campaign was associated with lower recruitment. This is the first systematic review of interventions to improve recruitment and retention of primary care doctors. Although the evidence base for recruiting and care doctors is weak and more high quality research is needed, this review found evidence to support undergraduate and postgraduate placements in underserved areas, and selective recruitment of medical students. Other initiatives covered may have potential to improve recruitment and retention of primary care practitioners, but their effectiveness has not been established.

Using video-based observation research methods in primary care health encounters to evaluate complex interactions.

PubMed

Asan, Onur; Montague, Enid

2014-01-01

The purpose of this paper is to describe the use of video-based observation research methods in primary care environment and highlight important methodological considerations and provide practical guidance for primary care and human factors researchers conducting video studies to understand patient-clinician interaction in primary care settings. We reviewed studies in the literature which used video methods in health care research, and we also used our own experience based on the video studies we conducted in primary care settings. This paper highlighted the benefits of using video techniques, such as multi-channel recording and video coding, and compared "unmanned" video recording with the traditional observation method in primary care research. We proposed a list that can be followed step by step to conduct an effective video study in a primary care setting for a given problem. This paper also described obstacles, researchers should anticipate when using video recording methods in future studies. With the new technological improvements, video-based observation research is becoming a promising method in primary care and HFE research. Video recording has been under-utilised as a data collection tool because of confidentiality and privacy issues. However, it has many benefits as opposed to traditional observations, and recent studies using video recording methods have introduced new research areas and approaches.

Teachers' Involvement in Implementing the Basic Science and Technology Curriculum of the Nine-Year Basic Education

ERIC Educational Resources Information Center

Odili, John Nwanibeze; Ebisine, Sele Sylvester; Ajuar, Helen Nwakaife

2011-01-01

The study investigated teachers' involvement in implementing the basic science and technology curriculum in primary schools in WSLGA (Warri South Local Government Area) of Delta State. It sought to identify the availability of the document in primary schools and teachers' knowledge of the objectives and activities specified in the curriculum.…

Distribution of Primary School Enrollments in Eastern Africa. World Bank Staff Working Papers Number 511.

ERIC Educational Resources Information Center

Maas, Jacob van Lutsenburg; Criel, Geert

Distribution of primary school enrollments within and among 15 countries of the Eastern African region was examined by drawing exclusively on routine annual statistics and by emphasizing simple computer-generated indicators. In its first phase, the study made inter-country comparisons that indicated which countries and which areas in the region…

Words and Objects at the Tip of the Left Temporal Lobe in Primary Progressive Aphasia

ERIC Educational Resources Information Center

Mesulam, M.-Marsel; Wieneke, Christina; Hurley, Robert; Rademaker, Alfred; Thompson, Cynthia K.; Weintraub, Sandra; Rogalski, Emily J.

2013-01-01

Eleven of 69 prospectively enrolled primary progressive aphasics were selected for this study because of peak atrophy sites located predominantly or exclusively within the anterior left temporal lobe. Cortical volumes in these areas were reduced to less than half of control values, whereas average volume elsewhere in the left hemisphere deviated…

Spatial accessibility of primary health care in China: A case study in Sichuan Province.

PubMed

Wang, Xiuli; Yang, Huazhen; Duan, Zhanqi; Pan, Jay

2018-05-10

Access to primary health care is considered a fundamental right and an important facilitator of overall population health. Township health centers (THCs) and Community health centers (CHCs) serve as central hubs of China's primary health care system and have been emphasized during recent health care reforms. Accessibility of these hubs is poorly understood and a better understanding of the current situation is essential for proper decision making. This study assesses spatial access to health care provided by primary health care institutions (THCs/CHCs) in Sichuan Province as a microcosm in China. The Nearest-Neighbor method, Enhanced Two-Step Floating Catchment Area (E2SFCA) method, and Gini Coefficient are utilized to represent travel impedance, spatial accessibility, and disparity of primary health care resources (hospital beds, doctors, and health professionals). Accessibilities and Gini Coefficients are correlated with social development indexes (GDP, ethnicity, etc.) to identify influencing factors. Spatial access to primary health care is better in southeastern Sichuan compared to northwestern Sichuan in terms of shorter travel time, higher spatial accessibility, and lower inequity. Social development indexes all showed significant correlation with county averaged spatial accessibilities/Gini Coefficients, with population density ranking top. The disparity of access to primary health care is also apparent between ethnic minority and non-minority regions. To improve spatial access to primary health care and narrow the inequity, more township health centers staffed by qualified health professionals are recommended for northwestern Sichuan. Improved road networks will also help. Among areas with insufficient primary health care, the specific counties where demographics are dominated by older people and children due to widespread rural-urban migration of the workforce, and by ethnic minorities, should be especially emphasized in future planning. Copyright © 2018 Elsevier Ltd. All rights reserved.

Groundwater quality in Coachella Valley, California

USGS Publications Warehouse

Dawson, Barbara J. Milby; Belitz, Kenneth

2012-01-01

Groundwater provides more than 40 percent of California’s drinking water. 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. Coachella Valley is one of the study areas being evaluated. The Coachella study area is approximately 820 square miles (2,124 square kilometers) and includes the Coachella Valley groundwater basin (California Department of Water Resources, 2003). Coachella Valley has an arid climate, with average annual rainfall of about 6 inches (15 centimeters). The runoff from the surrounding mountains drains to rivers that flow east and south out of the study area to the Salton Sea. Land use in the study area is approximately 67 percent (%) natural, 21% agricultural, and 12% urban. The primary natural land cover is shrubland. The largest urban areas are the cities of Indio and Palm Springs (2010 populations of 76,000 and 44,000, respectively). Groundwater in this basin is used for public and domestic water supply and for irrigation. The main water-bearing units are gravel, sand, silt, and clay derived from surrounding mountains. The primary aquifers in Coachella Valley are defined as those parts of the aquifers corresponding to the perforated intervals of wells listed in the California Department of Public Health database. Public-supply wells in Coachella Valley are completed to depths between 490 and 900 feet (149 to 274 meters), consist of solid casing from the land surface to a depth of 260 to 510 feet (79 to 155 meters), and are screened or perforated below the solid casing. Recharge to the groundwater system is primarily runoff from the surrounding mountains, and by direct infiltration of irrigation. The primary sources of discharge are pumping wells, evapotranspiration, and underflow to the Salton Sea and Imperial Valley areas.

Prevalence of undifferentiated fever in adults of Rawalpindi having primary dengue fever.

PubMed

Zafar, Humaira; Hayyat, Abbas; Akhtar, Naeem; Rizwan, Syeda Fatima

2013-06-01

The objectives of the study were to highlight early subclinical presentation of dengue viral infection (DVI) as an undifferentiated febrile illness. The descriptive cross-sectional study was carried out at Microbiology Department, Rawalpindi Medical College from March to September 2009. Stratified random sampling was used to select subjects from various urban and rural areas of Rawalpindi, and Serum IgG anti-dengue antibodies were detected by using 3rd generation enzyme-linked immunosorbent assay (ELISA). Out of the total 240 subjects, 69 (28.75%) were found to be positive for anti-dengue IgG antibodies. Of the positive cases, 41 (59.4%) - comprising 31 (44.9%) urban residents - and 10 (14.4%) rural residents presented with a previous history of undifferentiated fever (p<0.05). It was concluded that primary DVI can present as subclinical form in healthy population residing in rural and urban areas of Rawalpindi, which is an alarming situation indicating the spread of disease in the study area.

An anatomical and functional topography of human auditory cortical areas

PubMed Central

Moerel, Michelle; De Martino, Federico; Formisano, Elia

2014-01-01

While advances in magnetic resonance imaging (MRI) throughout the last decades have enabled the detailed anatomical and functional inspection of the human brain non-invasively, to date there is no consensus regarding the precise subdivision and topography of the areas forming the human auditory cortex. Here, we propose a topography of the human auditory areas based on insights on the anatomical and functional properties of human auditory areas as revealed by studies of cyto- and myelo-architecture and fMRI investigations at ultra-high magnetic field (7 Tesla). Importantly, we illustrate that—whereas a group-based approach to analyze functional (tonotopic) maps is appropriate to highlight the main tonotopic axis—the examination of tonotopic maps at single subject level is required to detail the topography of primary and non-primary areas that may be more variable across subjects. Furthermore, we show that considering multiple maps indicative of anatomical (i.e., myelination) as well as of functional properties (e.g., broadness of frequency tuning) is helpful in identifying auditory cortical areas in individual human brains. We propose and discuss a topography of areas that is consistent with old and recent anatomical post-mortem characterizations of the human auditory cortex and that may serve as a working model for neuroscience studies of auditory functions. PMID:25120426

Mobility match study in Prince George's County, Maryland

DOT National Transportation Integrated Search

1994-11-01

The primary focus of this study was to develop non-traditional transit : alternatives to better serve the residents of Prince George's County. The study : identified the transportation needs of the area, evaluated the applicabilty of : traditional an...

A comparison of the workload of rural and urban primary care physicians in Germany: analysis of a questionnaire survey

PubMed Central

2011-01-01

Background Many western countries are facing an existing or imminent shortage of primary care physicians especially in rural areas. In Germany, working in rural areas is often thought to be associated with more working hours, a higher number of patients and a lower income than working in urban areas. These perceptions might be key reasons for the shortage. The aim of this analysis was to explore if working time, number of treated patients per week or proportion of privately insured patients vary between rural and urban areas in Germany using two different definitions of rurality within a sample of primary care physicians including general practitioners, general internists and paediatricians. Methods This is a secondary analysis of pre-collected data raised by a questionnaire that was sent to a representative random sample of 1500 primary care physicians chosen by data of the National Association of Statutory Health Insurance Physicians from all federal states in Germany. We employed two different methods of defining rurality; firstly, level of rurality as rated by physicians themselves (urban area, small town, rural area); secondly, rurality defined according to the Organisation for Economic Co-operation and Development. Results This analysis was based upon questionnaire data from 715 physicians. Primary care physicians in single-handed practices in rural areas worked on average four hours more per week than their urban counterparts (p < 0.05). Physicians' gender, the number of patients treated per week and the type of practice (single/group handed) were significantly related to the number of working hours. Neither the proportion of privately insured patients nor the number of patients seen per week differed significantly between rural and urban areas when applying the self-rated classification of rurality. Conclusion Overall this analysis identified few differences between urban and rural primary care physician working conditions. To counter future misdistribution of primary care, students should receive practical experience in rural areas to get more practical knowledge on working conditions. PMID:21988900

[Neuroanatomy of Frontal Association Cortex].

PubMed

Takada, Masahiko

2016-11-01

The frontal association cortex is composed of the prefrontal cortex and the motor-related areas except the primary motor cortex (i.e., the so-called higher motor areas), and is well-developed in primates, including humans. The prefrontal cortex receives and integrates large bits of diverse information from the parietal, temporal, and occipital association cortical areas (termed the posterior association cortex), and paralimbic association cortical areas. This information is then transmitted to the primary motor cortex via multiple motor-related areas. Given these facts, it is likely that the prefrontal cortex exerts executive functions for behavioral control. The functional input pathways from the posterior and paralimbic association cortical areas to the prefrontal cortex are classified primarily into six groups. Cognitive signals derived from the prefrontal cortex are conveyed to the rostral motor-related areas to transform them into motor signals, which finally enter the primary motor cortex via the caudal motor-related areas. Furthermore, it has been shown that, similar to the primary motor cortex, areas of the frontal association cortex form individual networks (known as "loop circuits") with the basal ganglia and cerebellum via the thalamus, and hence are extensively involved in the expression and control of behavioral actions.

Fast food restaurant locations according to socioeconomic disadvantage, urban-regional locality, and schools within Victoria, Australia.

PubMed

Thornton, Lukar E; Lamb, Karen E; Ball, Kylie

2016-12-01

Features of the built environment provide opportunities to engage in both healthy and unhealthy behaviours. Access to a high number of fast food restaurants may encourage greater consumption of fast food products. The distribution of fast food restaurants at a state-level has not previously been reported in Australia. Using the location of 537 fast food restaurants from four major chains (McDonald׳s, KFC, Hungry Jacks, and Red Rooster), this study examined fast food restaurant locations across the state of Victoria relative to area-level disadvantage, urban-regional locality (classified as Major Cities, Inner Regional, or Outer Regional), and around schools. Findings revealed greater locational access to fast food restaurants in more socioeconomically disadvantaged areas (compared to areas with lower levels of disadvantage), nearby to secondary schools (compared to primary schools), and nearby to primary and secondary schools within the most disadvantaged areas of the major city region (compared to primary and secondary schools in areas with lower levels of disadvantage). Adjusted models showed no significant difference in location according to urban-regional locality. Knowledge of the distribution of fast food restaurants in Australia will assist local authorities to target potential policy mechanisms, such as planning regulations, where they are most needed.

[Appraisal of occupational stress and strain in primary and secondary school teachers].

PubMed

Wang, Z; Lan, Y; Li, J; Wang, M

2001-09-01

This study was conducted to assess occupational stress and strain in primary and secondary school teachers. A test of occupational stress and strain was carried out by using Occupational Stress Inventory Revised Edition (OSI-R) in 1460 primary and secondary school teachers (teacher group) and 319 mental workers in non-educational area (non-teacher group as control). The results showed the level of occupational stress in role overload and physical environment in the teacher group was significantly higher than that in the non-teacher group (P < 0.05). In teacher group the level of occupational stress and strain increased with age; the occupational stress and strain in male teachers were significantly higher than those in female teachers (P < 0.01); the occupational stress and strain in secondary school teachers were significantly higher than those in primary school teachers. These results indicate: to protect and promote primary and secondary school teacher's health, particularly male teachers' health, to mitigate their work pressure and to raise the quality of education are important tasks in the area of occupational health.

Clients’ Willingness to Pay for Immunization Services in the Urban and Rural Primary Health Centers of Enugu State, Nigeria

PubMed Central

Ossai, Edmund Ndudi; Fatiregun, Akinola Ayoola

2015-01-01

Our study aims at determining the pattern of willingness of clients to pay for childhood immunization services in urban and rural primary health centers of Enugu state, Nigeria. Using a cross-sectional design, 800 clients who presented with their children/wards to receive childhood immunization services were selected at the primary health center in rural and urban local government areas of the state. The mean age was 28.9±4.5 and 26.7±5.1 years in the urban and rural areas respectively. About 54.5% of clients in the urban and 55.3% in the rural area were willing to pay for immunization services. The clients willingness to pay was influenced by: non satisfaction with immunization services, (OR=0.3, 95%CI: 0.2-0.5), younger age, (OR=1.4, 95%CI: 1.0-2.0) marital status (OR=2.8, 95%CI: 1.2-6.5), proximity to health centers (OR=0.6, 95%CI: 0.4-0.8), and delivering in a private health facility (OR=0.4, 95%CI: 0.1-0.9). The study suggests that the economic value that clients give to immunization services was similar in the rural and urban areas, and this could be increased by improving the level of clients’ satisfaction for the services among others. PMID:28299135

The Effect of Text Materials with Relevant Language, Illustrations and Content Upon the Reading Achievement and Reading Preference (Attitude) of Black Primary and Intermediate Inner-City Students.

ERIC Educational Resources Information Center

Grant, Gloria W.

The purpose of this study was to examine the effect of text materials with relevant language, illustrations, and content upon the reading achievement and reading preference (attitude) of black primary and intermediate grade inner-city students. The subjects for the study were 330 black students enrolled in three schools in a large urban area. A…

Fiberglass distribution poles: A case study

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

Miller, M.F.; Hosford, G.S.; Boozer, J.F. III

1995-01-01

This paper addresses the design considerations and manufacturing techniques along with mechanical test results of fiberglass reinforced composite (FRC) primary distribution poles. With it`s light weight, and virtually no maintenance it offers a viable alternative for use in remote and inaccessible locations. This paper also discusses a case study where seventy five FRC primary distribution poles have been installed on a distribution system in a remote area accessible only by foot and helicopter.

Geology and land use in the western part of the Gulf Coast coal-bearing region

USGS Publications Warehouse

Warwick, Peter D.; Aubourg, C.E.; Hook, R.W.; SanFilipo, John R.

2002-01-01

This map series is a compilation of the outcrop geology in the U.S. Gulf Coast coal region. The maps show the regional geologic setting for primary coal occurrences and detailed geology and historic mining areas.The CD contains ESRI ArcView SHP files of cities, urban areas, historical mines (points and polygons), counties, current mines, 1:100,000 quadrangle outlines of the study area, fossil fuel powerplants, nuclear powerplants, political boundaries, federally managed lands, roads and railroads in the study area, hydrology in the study area (polygons and arcs), geology nomenclature breaks, geological features (faults), and geology. ArcExplorer is included on the CD.

Cognitive processing in the primary visual cortex: from perception to memory.

PubMed

Supèr, Hans

2002-01-01

The primary visual cortex is the first cortical area of the visual system that receives information from the external visual world. Based on the receptive field characteristics of the neurons in this area, it has been assumed that the primary visual cortex is a pure sensory area extracting basic elements of the visual scene. This information is then subsequently further processed upstream in the higher-order visual areas and provides us with perception and storage of the visual environment. However, recent findings show that such neural implementations are observed in the primary visual cortex. These neural correlates are expressed by the modulated activity of the late response of a neuron to a stimulus, and most likely depend on recurrent interactions between several areas of the visual system. This favors the concept of a distributed nature of visual processing in perceptual organization.

Impact of different approaches of primary care mental health on the prevalence of mental disorders.

PubMed

Moscovici, Leonardo; de Azevedo-Marques, Joao Mazzoncini; Bolsoni, Lívia Maria; Rodrigues-Junior, Antonio Luiz; Zuardi, Antonio Waldo

2018-05-01

AimTo compare the impact of three different approaches to primary care mental health on the prevalence of mental disorders. Millions of people suffer from mental disorders. As entry point into the health service, primary healthcare plays an important role in providing mental health prevention and treatment. Random sample of households in three different areas of the city of Ribeirão Preto (state of São Paulo, Brazil) were selected, and 20 trained medical students conducted interviews using a mental health screening instrument, the Mini-Screening of Mental Disorders, and a socio-demographic datasheet. Primary care mental health was provided in each area through a specific approach. The influence of the area of residence and the socio-demographic variables on the prevalence of mental disorder was explored and analyzed by univariate binary logistic regression and then by a multiple logistic regression model.FindingsA total of 1545 subjects were interviewed. Comparison between the three areas showed a significantly higher number of people with mental disorders in the area covered by the primary care team that did not have physicians with specific primary care mental health training, even when this association was adjusted for the influence of age, education, and socio-economic status.Our results suggest that residing in areas with family physicians with mental health training is associated with a lower prevalence of mental disorders.

The Use of Multi-Source Satellite and Geospatial Data to Study the Effect of Urbanization of Primary Productivity in the United States

NASA Technical Reports Server (NTRS)

Imhoff, M. L.; Tucker, C. J.; Lawrence, W. T.; Stutzer, D.; Rusin, Robert

2000-01-01

Data from two different satellites, a digital land cover map, and digital census data were analyzed and combined in a geographic information system to study the effect of urbanization on photosynthetic vegetation productivity in the United States. Results show that urbanization can have a measurable but variable impact on the primary productivity of the land surface. Annual productivity can be reduced by as much as 20 days in some areas, but in resource limited regions, photosynthetic production can be enhanced by human activity. Overall, urban development reduces the productivity of the land surface and those areas with the highest productivity are directly in the path of urban sprawl.

Root mass, net primary production and turnover in aspen, jack pine and black spruce forests in Saskatchewan and Manitoba, Canada.

PubMed

Steele, Sarah J.; Gower, Stith T.; Vogel, Jason G.; Norman, John M.

1997-01-01

Root biomass, net primary production and turnover were studied in aspen, jack pine and black spruce forests in two contrasting climates. The climate of the Southern Study Area (SSA) near Prince Albert, Saskatchewan is warmer and drier in the summer and milder in the winter than the Northern Study Area (NSA) near Thompson, Manitoba, Canada. Ingrowth soil cores and minirhizotrons were used to quantify fine root net primary production (NPPFR). Average daily fine root growth (m m(-2) day(-1)) was positively correlated with soil temperature at 10-cm depth (r(2) = 0.83-0.93) for all three species, with black spruce showing the strongest temperature effect. At both study areas, fine root biomass (measured from soil cores) and fine root length (measured from minirhizotrons) were less for jack pine than for the other two species. Except for the aspen stands, estimates of NPPFR from minirhizotrons were significantly greater than estimates from ingrowth cores. The core method underestimated NPPFR because it does not account for simultaneous fine root growth and mortality. Minirhizotron NPPFR estimates ranged from 59 g m(-2) year(-1) for aspen stands at SSA to 235 g m(-2) year(-1) for black spruce at NSA. The ratio of NPPFR to total detritus production (aboveground litterfall + NPPFR) was greater for evergreen forests than for deciduous forests, suggesting that carbon allocation patterns differ between boreal evergreen and deciduous forests. In all stands, NPPFR consistently exceeded annual fine root turnover and the differences were larger for stands in the NSA than for stands in the SSA, whereas the difference between study areas was only significant for black spruce. The imbalance between NPPFR and fine root turnover is sufficient to explain the net accumulation of carbon in boreal forest soils.

Satisfaction of Patients Attending in Primary Healthcare Centers in Riyadh, Saudi Arabia: A Random Cross-Sectional Study.

PubMed

Almutairi, Khalid M

2017-06-01

This study aims to determine the level of satisfaction of patients who visit primary healthcare centers in Riyadh, Saudi Arabia. The investigation was a cross-sectional study conducted in twenty randomly selected primary healthcare centers in Riyadh, Saudi Arabia from October to December 2014. A descriptive data analysis was performed. Eligible participants had visited at least one of the selected primary healthcare centers within the past 12 months. A total of 1741 participants completed the survey, providing a response rate of 87 % (43 % male, 57 % female). The highest satisfaction rates were in the following areas: comprehensiveness and coordination 76.2 % (95 % CI 74.8 ± 77.5), communication 72.7 % (95 % CI 71.3 ± 74) and attitude of staff 73.4 % (95 % CI 72.1 ± 74.8) The areas of greatest concern expressed by the participants were the length of the wait and the quality of the facility 55.4 % (95 % CI 53.3 ± 57.5), 50.5 % (95 % CI 48.3 ± 52.7), respectively. The majority of the patients attending primary healthcare centers in Riyadh showed high levels of satisfaction; however, there are still some factors that need to be considered and improved upon. These include the accessibility of primary healthcare centers as well as waiting time of patients. The results of the current study showed relative improvement in other factors such as comprehensiveness and coordination, communication and attitude of staff. The level of satisfaction of patients and stakeholders shows the progress of the quality of care in healthcare facilities in Riyadh, Saudi Arabia.

An explorative study of factors contributing to the job satisfaction of primary care midwives.

PubMed

Warmelink, J Catja; Hoijtink, Kirsten; Noppers, Marloes; Wiegers, Therese A; de Cock, T Paul; Klomp, Trudy; Hutton, Eileen K

2015-04-01

the main objectives of our study was to gain an understanding of how primary care midwives in the Netherlands feel about their work and to identify factors associated with primary care midwives׳ job satisfaction and areas for improvement. a qualitative analysis was used, based on the constructivist/interpretative paradigm. Three open-ended questions in written or online questionnaire, analysed to identify factors that are linked with job satisfaction, were as follows: 'What are you very satisfied with, in your work as a midwife?', 'What would you most like to change about your work as a midwife?' and 'What could be improved in your work?'. 20 of the 519 primary care practices in the Netherlands in May 2010 were included. at these participating practices 99 of 108 midwives returned a written or online questionnaire. in general, most of the participating primary care midwives were satisfied with their job. The factors positively associated with their job satisfaction were their direct contact with clients, the supportive co-operation and teamwork with immediate colleagues, the organisation of and innovation within their practice group and the independence, autonomy, freedom, variety and opportunities that they experienced in their work. Regarding improvements, the midwives desired a reduction in non-client-related activities, such as paperwork and meetings. They wanted a lower level of work pressure, and a reduced case-load in order to have more time to devote to individual clients׳ needs. Participants identified that co-operation with other partners in the health care system could also be improved. our knowledge, our study is the first explorative study on factors associated with job satisfaction of primary care midwives. While there are several studies on job satisfaction in health care; little is known about the working conditions of midwives in primary care settings. Although the participating primary care midwives in the Netherlands were satisfied with their job, areas for improvement were identified. The results of our study can be relevant for countries that have a comparable obstetric system as in the Netherlands, or are implementing or scaling up midwifery-led care. Copyright © 2015 Elsevier Ltd. All rights reserved.

Clustering of unhealthy lifestyle behaviours and associations with perceived and actual weight status among primary school children in China: A nationally representative cross-sectional study.

PubMed

Zhang, Juan; Feng, Xiaoqi; Zhai, Yi; Li, Weirong; Lv, Yue-Bin; Astell-Burt, Thomas; Shi, Xiaoming

2018-07-01

Few studies have focused on clustering of unhealthy lifestyle behaviours among primary school children and potential associations with perceived and actual weight status. An index was constructed from adding up 13 unhealthy behaviours measured by survey responses. Multilevel linear regressions were used to analyse associations between child personal characteristics, perceived and actual weight status with the unhealthy lifestyle index among 11,157 children in primary schools across China. Parental and area factors were also taken into account, including education, weight status, physical activity, urban/rural and area socioeconomic circumstances. The unhealthy lifestyle index normally distributed, with 84.5% of children reporting between 2 and 6 unhealthy behaviours. Boys reported more unhealthy behaviours compared with girls (coefficient 0.32, 95%CI 0.26 to 0.37) and children in urban areas had fewer unhealthy behaviours than their rural counterparts (-0.29, 95%CI -0.56 to -0.03). An interaction revealed stronger 'protective' effects of living in cities for girls than boys, which were not explained by differences in child overweight/obesity. More unhealthy behaviours were characteristic of children in more affluent areas, and of those born to mothers and/or fathers with lower educational attainment. Children who perceived themselves as overweight or underweight both scored higher on the unhealthy lifestyle index. Unhealthy behaviours that could increase the risk of childhood obesity are common among Chinese primary school children, particularly among boys in cities, those in more affluent areas and with parents with lower education. There was no effect of actual weight status on number of unhealthy behaviours. Perceived, but not actual weight status, was also a significant correlate of unhealthy behaviours. Clustering of unhealthy lifestyle behaviours that could increase the risk of childhood obesity are common among Chinese primary school children, particularly among boys in cities, those in more affluent areas and with parents with lower education. Perceived, but not actual weight status, was also a significant correlate of unhealthy lifestyle. This has important implications for public health because understanding clustering of unhealthy lifestyle behaviours can be used to assist in the development of targeted obesity prevention initiatives. Copyright © 2018. Published by Elsevier Inc.

Perception of health care providers toward geriatric oral health in Belgaum district: A cross-sectional study.

PubMed

Mehta, Nishant; Rajpurohit, Ladusingh; Ankola, Anil; Hebbal, Mamata; Setia, Priyanka

2015-05-01

To access knowledge and practices related to the oral health of geriatrics among the health care providers practicing in urban and rural areas. Older adults have identified a number of barriers that contribute to lack of dental service use. However, barriers that clinicians encounter in providing dental treatment to older adults are not as clear-cut. 236 health professionals (of allopathy, ayurveda, and homeopathy) from urban and rural areas were assessed by means of structured questionnaire related to oral health practices and beliefs. Doctors practicing in urban areas assessed dental care needs more frequently (P = 0.038) and performed greater practices related to oral health of geriatrics (P = 0.043) than the doctors practicing in primary health care (PHC) centers (rural) (P = 0.038). Owing to the relative lack of knowledge among rural practitioners, there is a need to integrate primary health care with oral care in rural areas.

Gene expression profiles in anatomically and functionally distinct regions of the normal aged human brain

PubMed Central

Liang, Winnie S.; Dunckley, Travis; Beach, Thomas G.; Grover, Andrew; Mastroeni, Diego; Walker, Douglas G.; Caselli, Richard J.; Kukull, Walter A.; McKeel, Daniel; Morris, John C.; Hulette, Christine; Schmechel, Donald; Alexander, Gene E.; Reiman, Eric M.; Rogers, Joseph; Stephan, Dietrich A.

2008-01-01

In this article, we have characterized and compared gene expression profiles from laser capture microdissected neurons in six functionally and anatomically distinct regions from clinically and histopathologically normal aged human brains. These regions, which are also known to be differentially vulnerable to the histopathological and metabolic features of Alzheimer’s disease (AD), include the entorhinal cortex and hippocampus (limbic and paralimbic areas vulnerable to early neurofibrillary tangle pathology in AD), posterior cingulate cortex (a paralimbic area vulnerable to early metabolic abnormalities in AD), temporal and prefrontal cortex (unimodal and heteromodal sensory association areas vulnerable to early neuritic plaque pathology in AD), and primary visual cortex (a primary sensory area relatively spared in early AD). These neuronal profiles will provide valuable reference information for future studies of the brain, in normal aging, AD and other neurological and psychiatric disorders. PMID:17077275

Evaluation of a primary-care setting at a veterinary teaching hospital by a student business group: implementing business training within the curriculum.

PubMed

Louisa Poon, W Y; Covington, Jennifer P; Dempsey, Lauren S; Goetgeluck, Scott L; Marscher, William F; Morelli, Sierra C; Powell, Jana E; Rivers, Elizabeth M; Roth, Ira G

2014-01-01

This article provides an introduction to the use of students' business skills in optimizing teaching opportunities, student learning, and client satisfaction in a primary health care setting at a veterinary teaching hospital. Seven veterinary-student members of the local chapter of the Veterinary Business Management Association (VBMA) evaluated the primary-care service at the University of Georgia (UGA) veterinary teaching hospital and assessed six areas of focus: (1) branding and marketing, (2) client experience, (3) staff and staffing, (4) student experience, (5) time management, and (6) standard operating procedures and protocols. For each area of focus, strengths, weaknesses, opportunities, and threats were identified. Of the six areas, two were identified as areas in need of immediate improvement, the first being the updating of standard operating protocols and the second being time management and the flow of appointments. Recommendations made for these two areas were implemented. Overall, the staff and students provided positive feedback on the recommended changes. Through such a student-centered approach to improving the quality of their education, students are empowered and are held accountable for their learning environment. The fact that the VBMA functions without a parent organization and that the primary-care service at UGA functions primarily as a separate entity from the specialty services at the College of Veterinary Medicine allowed students to have a direct impact on their learning environment. We hope that this model for advancing business education will be studied and promoted to benefit both veterinary education and business practice within academia.

Increasing inequality in childhood obesity in primary schools in a northern English town.

PubMed

Black, M; Joseph, V; Mott, L; Maheswaran, R

2018-05-01

To undertake an analysis of National Child Measurement Programme (NCMP) data to quantify the obesity prevalence gap over time between children in primary schools in the most and least deprived areas of Doncaster. The research design for this study was retrospective quantitative analysis of secondary data. The study undertook secondary analysis of NCMP data on obesity prevalence in children in Reception Year and Year 6 in primary schools in Doncaster for the period 2006-2007 to 2014-2015. Data were combined into three 3-year periods (2006-2007 to 2008-2009; 2009-2010 to 2011-2012; and 2012-2013 to 2014-2015), and schools were grouped by deprivation based on the national Indices of Multiple Deprivation 2015. Analysis was undertaken to assess whether there is a difference in obesity prevalence for Reception Year and Year 6 children in schools in the most deprived areas compared with the least deprived (prevalence gap), over time. The difference in obesity prevalence between children attending schools in the most and least deprived areas has increased over time. For Reception Year children, the prevalence gap has widened from a difference of 1.01% higher in the most deprived schools in 2006-2007 to 2008-2009 to 3.64% higher in 2012-2013 to 2014-2015. In the same time periods, for Year 6 children, the obesity prevalence gap has also increased over time from 2.82% to 5.08%. There is inequality in relation to obesity in primary school children in Doncaster with those in schools in the most deprived areas carrying the greatest burden. Research is needed to understand why the plateau seen nationally is not reaching the most deprived children. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Association between respiratory prescribing, air pollution and deprivation, in primary health care.

PubMed

Sofianopoulou, Eleni; Rushton, Stephen P; Diggle, Peter J; Pless-Mulloli, Tanja

2013-12-01

We investigated the association between respiratory prescribing, air quality and deprivation in primary health care. Most previous studies have used data from secondary and tertiary care to quantify air pollution effects on exacerbations of asthma and chronic obstructive pulmonary disease (COPD). However, these outcomes capture patients who suffer from relatively severe symptoms. This is a population-based ecological study. We analysed respiratory medication (salbutamol) prescribed monthly by 63 primary care practices, UK. Firstly, we captured the area-wide seasonal variation in prescribing. Then, using the area-wide variation in prescribing as an offset, we built a mixed-effects model to assess the remaining variation in relation to air quality and demographic variables. An increase of 10 μg/m(3) in ambient PM10 was associated with an increase of 1% (95% CI: 0.1-2%) in salbutamol prescribing. An increase of 1 SD in income and employment deprivation was associated with an increase of 20.5% (95% CI: 8.8-33.4%) and 14.7% (95% CI: 4.3-26.2%) in salbutamol prescribing rate, respectively. The study provides evidence that monthly respiratory prescribing in primary care is a useful indicator of the extent to which air pollution exacerbates asthma and COPD symptoms. Respiratory prescribing was higher on deprived populations.

42 CFR 414.66 - Incentive payments for physician scarcity areas.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Physician Scarcity Area (PSA) for primary or specialist care are eligible for a 5 percent incentive payment. (c) Primary care physicians furnishing services in primary care PSAs are entitled to an additional 5... section 1861(r)(1) of the Act, furnishing services in specialist care PSAs are entitled to an additional 5...

47 CFR 11.18 - EAS Designations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Designations. (a) National Primary (NP) is a source of EAS Presidential messages. (b) Local Primary (LP) is a... as specified in its EAS Local Area Plan. If it is unable to carry out this function, other LP sources... broadcast stations in the Local Area. (c) State Primary (SP) is a source of EAS State messages. These...

47 CFR 11.18 - EAS Designations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Designations. (a) National Primary (NP) is a source of EAS Presidential messages. (b) Local Primary (LP) is a... as specified in its EAS Local Area Plan. If it is unable to carry out this function, other LP sources... broadcast stations in the Local Area. (c) State Primary (SP) is a source of EAS State messages. These...

Effects of ICT Group Work on Interactions and Social Acceptance of a Primary Pupil with Asperger's Syndrome

ERIC Educational Resources Information Center

Lewis, Lynda; Trushell, John; Woods, Pat

2005-01-01

The aim of this study was to ascertain whether collaborative group work on a computer, facilitated by an adult, could provide a means for a primary schoolboy with Asperger's Syndrome (AS) -- moderately-highly affected in all areas of the "triad of impairments" -- to develop appropriate task-related interactions with his peers. Data were gathered…

Moonlighting among Teachers in Urban Tanzania: A Survey of Public Primary Schools in Ilala District

ERIC Educational Resources Information Center

Timothy, Vedastus L.; Nkwama, Skeeter

2017-01-01

Despite the widespread prevalence, teacher moonlighting is one of the under-researched areas. Using data from 313 public primary school teachers in Ilala District, this study examined the determinants of teacher moonlighting. The findings show that 39.4% of teachers had a secondary income generating activity. Sex and age of the teacher were…

VARIABILITY IN NET PRIMARY PRODUCTION AND CARBON STORAGE IN BIOMASS ACROSS OREGON FORESTS - AN ASSESSMENT INTEGRATING DATA FROM FOREST INVENTORIES, INTENSIVE SITES, AND REMOTE SENSING. (R828309)

EPA Science Inventory

We used a combination of data from USDA Forest Service inventories, intensive
chronosequences, extensive sites, and satellite remote sensing, to estimate biomass
and net primary production (NPP) for the forested region of western Oregon. The
study area was divided int...

Policy Review of the Primary and Junior Secondary Education Sub-Sectors in East Java. Educational Policy and Planning Project. A Government of Indonesia-USAID Project.

ERIC Educational Resources Information Center

Soebagio, Retno L.; And Others

Indonesian representatives and the Educational Research and Development Center studied East Javanese primary and junior secondary schools to develop a database for future planning and to identify deficiencies, constraints, and areas for fruitful reform. Issues of enrollment, personnel, curriculum, facilities and equipment, cost, and financing were…

Pupils' Environmental Awareness and Knowledge: A Springboard for Action in Primary Schools in Kenya's Rift Valley

ERIC Educational Resources Information Center

Mutisya, Sammy M.; Barker, Miles

2011-01-01

This study was carried out with 276 standard eight pupils in eleven primary schools in the rural town of Narok in Kenya's Rift Valley. It evaluated their awareness of key environmental issues in their local area and their knowledge about the causes, effects and solutions pertaining to these environmental issues. A descriptive research design was…

How Do Interprofessional Student Teams Interact in a Primary Care Clinic? A Qualitative Analysis Using Activity Theory

ERIC Educational Resources Information Center

Kent, Fiona; Francis-Cracknell, Alison; McDonald, Rachael; Newton, Jennifer M.; Keating, Jennifer L.; Dodic, Miodrag

2016-01-01

Practice based interprofessional education opportunities are proposed as a mechanism for health professionals to learn teamwork skills and gain an understanding of the roles of others. Primary care is an area of practice that offers a promising option for interprofessional student learning. In this study, we investigated what and how students from…

Pre-Service Teachers' Use of Dynamic Discourse Variables during Classroom Teaching

ERIC Educational Resources Information Center

Kaya, Sibel; Ceviz, Asli Elgun

2017-01-01

The aim of this study is to examine the nature of questioning in primary classrooms taught by teacher candidates. The participants were 39 teacher candidates enrolled in the Department of Primary Education at a large university in Western Turkey as well as 3rd and 4th-grade students in four schools located in the area. Each teacher candidate has…

Using Self-Efficacy to Measure Primary School Teachers' Perception of ICT: Results from Two Studies

ERIC Educational Resources Information Center

Fanni, F.; Rega, I.; Cantoni, L.

2013-01-01

The aim of this article is twofold. First, the final results of two research projects, which investigated the impact of Information and Communication Technology (ICT) on primary schools teachers in disadvantaged areas in Brazil (BET k-12) and South Africa (MELISSA), are presented and discussed. Second, the Self-Efficacy construct is proposed as a…

Understanding the Teaching and Learning of Fractions: A South African Primary School Case Study

ERIC Educational Resources Information Center

Brijlall, Deonarain; Maharaj, Aneshkumar; Molebale, Justin

2011-01-01

The authors explored the teaching and learning of fractions by reflecting on teachers and learners' views on practical work and their classroom practices. The teachers and learners were from two primary schools in a rural area in KwaZulu-Natal (South Africa). Questionnaires, in which teachers and learners expressed their views on practical work…

Emergency Department Coverage by Primary Care Physicians in a Rural Practice-Based Research Network: Incentives, Confidence, and Training

ERIC Educational Resources Information Center

Lew, Edward; Fagnan, Lyle J.; Mattek, Nora; Mahler, Jo; Lowe, Robert A.

2009-01-01

Context: In rural areas of the United States, emergency departments (EDs) are often staffed by primary care physicians, as contrasted to urban and suburban hospitals where ED coverage is usually provided by physicians who are residency-trained in emergency medicine. Purpose: This study examines the reasons and incentives for rural Oregon primary…

Primary biliary cirrhosis: an epidemiological study.

PubMed Central

Triger, D R

1980-01-01

A three-year study (1977-9) of primary biliary cirrhosis in the city of Sheffield disclosed 34 cases, a point prevalence of 54 per million population. Closer inspection showed an apparent clustering of cases, and the prevalence in relation to one water reservoir appeared to be more than ten times that of the other reservoirs. Nevertheless, analyses of the water showed no significant relevant differences between the reservoir serving areas with a high prevalence of cirrhosis and other reservoirs. Despite the inconclusive results of the water analyses, these findings do suggest that an environmental agent may be a cause of primary biliary cirrhosis and that further epidemiological studies may help to elucidate the cause. PMID:7427444

Care management process of breast cancer in primary health-care system, Golestan Province, Iran, 2013-2014.

PubMed

Hajiebrahimi, Zahra; Mahmoodi, Ghahraman; Abedi, Ghasem

2017-01-01

Health-care service processes need to be assessed over time. We aimed to assess the breast cancer care process in primary health system of Golestan Province, North Iran. To perform a descriptive cross-sectional study, information on breast cancer care processes in primary health-care system was collected using a "collecting form" from 234 health houses, 29 health posts, 44 urban health centers, and 80 rural health centers in Golestan Province. Registered data in the centers and patients' journal were used in data collection. Moreover, we collected data on all women who were diagnosed with breast cancer in 2014 to know the characteristics of the patients. Around 50% of health workers at rural or urban area were trained on breast cancer. Moreover, 2% of women from general population in rural area and around 6% of them in urban area have been trained on breast cancer. Mean age of women diagnosed with breast cancer was 48 ± 10 years and 40.2% of them were affected at age between 43 and 52 years. The results showed that 18.9% of women have received their information through self-study before the diagnosis of breast cancer while 53.8% of them received their information from the private clinics after diagnosis of breast cancer. The process of breast cancer care in Golestan Province needs to be improved in the primary health-care level. Both inter- and multi-disciplinary activities are needed.

Productivity in the barents sea--response to recent climate variability.

PubMed

Dalpadado, Padmini; Arrigo, Kevin R; Hjøllo, Solfrid S; Rey, Francisco; Ingvaldsen, Randi B; Sperfeld, Erik; van Dijken, Gert L; Stige, Leif C; Olsen, Are; Ottersen, Geir

2014-01-01

The temporal and spatial dynamics of primary and secondary biomass/production in the Barents Sea since the late 1990s are examined using remote sensing data, observations and a coupled physical-biological model. Field observations of mesozooplankton biomass, and chlorophyll a data from transects (different seasons) and large-scale surveys (autumn) were used for validation of the remote sensing products and modeling results. The validation showed that satellite data are well suited to study temporal and spatial dynamics of chlorophyll a in the Barents Sea and that the model is an essential tool for secondary production estimates. Temperature, open water area, chlorophyll a, and zooplankton biomass show large interannual variations in the Barents Sea. The climatic variability is strongest in the northern and eastern parts. The moderate increase in net primary production evident in this study is likely an ecosystem response to changes in climate during the same period. Increased open water area and duration of open water season, which are related to elevated temperatures, appear to be the key drivers of the changes in annual net primary production that has occurred in the northern and eastern areas of this ecosystem. The temporal and spatial variability in zooplankton biomass appears to be controlled largely by predation pressure. In the southeastern Barents Sea, statistically significant linkages were observed between chlorophyll a and zooplankton biomass, as well as between net primary production and fish biomass, indicating bottom-up trophic interactions in this region.

Productivity in the Barents Sea - Response to Recent Climate Variability

PubMed Central

Dalpadado, Padmini; Arrigo, Kevin R.; Hjøllo, Solfrid S.; Rey, Francisco; Ingvaldsen, Randi B.; Sperfeld, Erik; van Dijken, Gert L.; Stige, Leif C.; Olsen, Are; Ottersen, Geir

2014-01-01

The temporal and spatial dynamics of primary and secondary biomass/production in the Barents Sea since the late 1990s are examined using remote sensing data, observations and a coupled physical-biological model. Field observations of mesozooplankton biomass, and chlorophyll a data from transects (different seasons) and large-scale surveys (autumn) were used for validation of the remote sensing products and modeling results. The validation showed that satellite data are well suited to study temporal and spatial dynamics of chlorophyll a in the Barents Sea and that the model is an essential tool for secondary production estimates. Temperature, open water area, chlorophyll a, and zooplankton biomass show large interannual variations in the Barents Sea. The climatic variability is strongest in the northern and eastern parts. The moderate increase in net primary production evident in this study is likely an ecosystem response to changes in climate during the same period. Increased open water area and duration of open water season, which are related to elevated temperatures, appear to be the key drivers of the changes in annual net primary production that has occurred in the northern and eastern areas of this ecosystem. The temporal and spatial variability in zooplankton biomass appears to be controlled largely by predation pressure. In the southeastern Barents Sea, statistically significant linkages were observed between chlorophyll a and zooplankton biomass, as well as between net primary production and fish biomass, indicating bottom-up trophic interactions in this region. PMID:24788513

Type of primary education is associated with condom use at sexual debut among Chilean adolescents.

PubMed

Huneeus, Andrea; Deardorff, Julianna; Lahiff, Maureen; Guendelman, Sylvia

2014-05-01

Although condom use in adolescence is related to higher lifetime educational attainment, the association between primary education (from kindergarten to eighth grade) and adolescent sexual behavior is not well understood. This study examined the association between type of school in which primary education was completed-public, charter, or private-and condom use at sexual debut among Chilean adolescents. Drawing on the 2009 Chilean National Youth Survey, a population-based sample of general community youth aged 15 to 29 years, we conducted a study of the 4217 participants who reported onset of sexual activity during adolescence. Bivariate and multple logistic regression was used to examine the relationship between type of primary school attended (60.1% public, 30.3% charter, and 9.6% private) and condom use at sexual debut while controlling for sociodemographic characteristics and sexual behavior. Compared with students who completed their primary education in private or charter schools, students who completed their primary education in public schools had 1.85 (95% confidence interval, 1.12-3.04) and 1.67 (95% confidence interval, 1.26-2.23) higher odds, respectively, of not using condoms at sexual debut. Odds were similar for students living in urban settings, whereas there were too few students attending private schools in rural areas to allow meaningful estimates. Independent of household income, primary schooling is associated with sexual health behaviors among Chilean adolescents living in urban areas and can serve as a target for public health interventions designed to prevent sexually transmitted infections in adolescence.

PREVALENCE AND DETERMINANTS OF STUNTING AMONG PRIMARY SCHOOL CHILDREN IN RURAL AND URBAN COMMUNITIES IN OBAFEMI OWODE LOCAL GOVERNMENT AREA, SOUTHWESTERN NIGERIA

PubMed Central

Adenuga, W.U.; Obembe, T.A.; Odebunmi, K.O.; Asuzu, M.C.

2017-01-01

Background: Studies on stunting in children have largely focused on the underfive, establishing it as a strong predictor of mortality in these children. Few studies have documented the prevalence or determinants of stunting among school children in southwestern Nigeria. The aim of the study was to determine the prevalence and predictors of stunting among selected primary school children in rural and urban communities of Obafemi Owode Local Government Area, Ogun State. Method: A cross-sectional study of rural and urban primary school children was conducted. An interviewer-administered questionnaire was used to collect information on respondents' and parents' socio-demographic characteristics. Stunting was defined as height-for-age less than two standard deviations from the median height-for-age of the standard World Health Organization reference population. Using EPI-INFO version 6.03, children were classified as stunted if z-scores of height-for-age were less than 2 standard deviations below the National Centre for Health statistics (NCHS)/WHO median. Height and weight were taken using a stadiometer and weighing scale respectively. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) Version 16.0 while predictors were determined using logistic regression at 95% level of significance. Results: A total of 1,160 primary school children were studied with 52.2% from rural schools. Males constituted 57.1% and 51.8% in the rural and urban school respectively. Prevalence of stunting among rural school children was 46.2%, and was significantly higher (p≤0.001) than among urban children at 33.8%. Younger children <10 years (OR: 0.088; 95CI: 0.052 - 0.150) and children between 11-12 years (OR: 0.534; 95CI: 0.322 - 0.886) were at a significantly lower risk of stunting both in rural schools compared to children >13 years. Conclusion: The prevalence of stunting was high especially among pupils from schools in the rural communities. This underscores the need for urgent feasible and effective nutrition programs for primary school children especially those in rural schools within the study area. PMID:28970765

A Longitudinal Study of the Presence of Dental Anomalies in the Primary and Permanent Dentitions of Cleft Lip and/or Palate Patients.

PubMed

Suzuki, Akira; Nakano, Masayuki; Yoshizaki, Keigo; Yasunaga, Atsushi; Haruyama, Naoto; Takahashi, Ichiro

2017-05-01

  The aim is to survey primary and permanent dental anomalies: hypodontia, microdontia, a supernumerary tooth, and fused teeth in patients with cleft lip and/or palate.   Retrospective longitudinal study Subjects :  The subjects were selected from all 1724 patients with cleft lip and/or palate who were registered at the orthodontic clinic of Kyushu University Hospital, Fukuoka, Japan, from 1970 to 2009. Finally, 994 subjects were evaluated for primary dentition, 1352 for permanent dentition, and 871 for the longitudinal changes from primary to permanent dentition.   The prevalence of dental anomalies was compared for each tooth type, among various cleft types, between males and females, and between the alveolar cleft area and the noncleft area.   The prevalence of hypodontia was 16.2% for primary dentition and 52.7% for permanent dentition in the subjects with cleft lip and/or palate. Hypodontia increased with the severity of the cleft type. Multiple hypodontia was found more frequently in the subjects with bilateral cleft lip and palate and the subjects with unilateral cleft lip and palate. Microformed lateral incisors were found in 22.7% of permanent lateral incisors but not in primary dentition. Supernumerary teeth were found in 17.7% of the subjects with cleft lip and/or palate for primary maxillary dentition and in 5.7% for permanent maxillary dentition.   The prevalence of hypodontia was greater in permanent dentition than in primary dentition; although, it was not much different between males and females or between the right and left sides. The prevalence of dental anomalies was significantly different among four groups by cleft type: cleft lip, cleft lip and alveolus, cleft lip and palate, and cleft palate.

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

PubMed

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

2010-03-01

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

Development of a Distance-to-Roadway Proximity Metric to Compare Near-Road Pollutant Levels to a Central Site Monitor

EPA Science Inventory

The primary objective of the Detroit Exposure and Aerosol Research Study (DEARS) was to compare air pollutant concentrations measured at various neighborhoods, or exposure monitoring areas (EMAs), throughout a major metropolitan area to levels measured at a central site or commun...

Wildlife esthetics and auto campers in the Superior National Forest.

Treesearch

David. W. Lime; Charles T. Cushwa

1969-01-01

Many resource managers feel that a high percentage of excursions to forested areas are planned with the objective of seeing wildlife in mind. However, a study of campers in the Superior National Forest did not show wildlife to be a primary attraction of the area, although it was an important supplementary attraction.

A constructed wet meadow model for forested lands in the Southwest

Treesearch

Dave Pawelek; Roy Jemison; Daniel Neary

1999-01-01

Improving primary roads in the Zuni Mountains of New Mexico must take into consideration the wet meadows and upland areas. This study looks at spring flow rates, erosion, channels and changes in plant cover and composition. The goal is to help planners design environmentally sensitive roadways for wet meadow areas.

Professional Education In-Service Needs of Agriculture Instructors in Iowa Postsecondary Area Vocational Schools.

ERIC Educational Resources Information Center

Byler, Bennie L.; Lindahl, Thomas J.

The primary objective of the study was to identify the professional inservice education needs of agriculture instructors in postsecondary area vocational schools, and determine if differences exist among instructors and adminstrative personnel regarding perceived instructor inservice needs. The population consisted of all of the Iowa community…

Acquisition of Content Area Vocabulary for Students with Learning Disabilities.

ERIC Educational Resources Information Center

Keel, Marie C.; Slaton, Deborah Bott; Blackhurt, A. Edward

2001-01-01

This study compared effects of two variations of the constant-time-delay (CTD) procedure on the observational learning of content area vocabulary by seven primary grade students with learning disabilities in a small group instructional setting. Both conditions (every student writes all words or only target student writes) were equally effective…

Health Careers Education for Rural Primary Schoolchildren

ERIC Educational Resources Information Center

Gorton, Susan M.

2011-01-01

International and national studies have reported that health professionals who grew up in a rural area are more likely to return to work in a rural area than their urban raised counterparts. The chronic severe shortage of health professionals in rural and remote Australia has meant inequitable health care for rural and remote communities and a…

The evolution of neocortex in primates

PubMed Central

Kaas, Jon H.

2013-01-01

We can learn about the evolution of neocortex in primates through comparative studies of cortical organization in primates and those mammals that are the closest living relatives of primates, in conjunction with brain features revealed by the skull endocasts of fossil archaic primates. Such studies suggest that early primates had acquired a number of features of neocortex that now distinguish modern primates. Most notably, early primates had an array of new visual areas, and those visual areas widely shared with other mammals had been modified. Posterior parietal cortex was greatly expanded with sensorimotor modules for reaching, grasping, and personal defense. Motor cortex had become more specialized for hand use, and the functions of primary motor cortex were enhanced by the addition and development of premotor and cingulate motor areas. Cortical architecture became more varied, and cortical neuron populations became denser overall than in nonprimate ancestors. Primary visual cortex had the densest population of neurons, and this became more pronounced in the anthropoid radiation. Within the primate clade, considerable variability in cortical size, numbers of areas, and architecture evolved. PMID:22230624

The evolution of neocortex in primates.

PubMed

Kaas, Jon H

2012-01-01

We can learn about the evolution of neocortex in primates through comparative studies of cortical organization in primates and those mammals that are the closest living relatives of primates, in conjunction with brain features revealed by the skull endocasts of fossil archaic primates. Such studies suggest that early primates had acquired a number of features of neocortex that now distinguish modern primates. Most notably, early primates had an array of new visual areas, and those visual areas widely shared with other mammals had been modified. Posterior parietal cortex was greatly expanded with sensorimotor modules for reaching, grasping, and personal defense. Motor cortex had become more specialized for hand use, and the functions of primary motor cortex were enhanced by the addition and development of premotor and cingulate motor areas. Cortical architecture became more varied, and cortical neuron populations became denser overall than in nonprimate ancestors. Primary visual cortex had the densest population of neurons, and this became more pronounced in the anthropoid radiation. Within the primate clade, considerable variability in cortical size, numbers of areas, and architecture evolved. Copyright © 2012 Elsevier B.V. All rights reserved.

Short-Term Associations between Air Pollution Concentrations and Respiratory Health-Comparing Primary Health Care Visits, Hospital Admissions, and Emergency Department Visits in a Multi-Municipality Study.

PubMed

Taj, Tahir; Malmqvist, Ebba; Stroh, Emilie; Oudin Åström, Daniel; Jakobsson, Kristina; Oudin, Anna

2017-05-31

Acute effects of air pollution on respiratory health have traditionally been investigated with data on inpatient admissions, emergency room visits, and mortality. In this study, we aim to describe the total acute effects of air pollution on health care use for respiratory symptoms (ICD10-J00-J99). This will be done by investigating primary health care (PHC) visits, inpatient admissions, and emergency room visits together in five municipalities in southern Sweden, using a case-crossover design. Between 2005 and 2010, there were 81,019 visits to primary health care, 38,217 emergency room visits, and 25,271 inpatient admissions for respiratory symptoms in the study area. There was a 1.85% increase (95% CI: 0.52 to 3.20) in the number of primary health care visits associated with a 10 µg/m³ increase in nitrogen dioxide (NO₂) levels in Malmö, but not in the other municipalities. Air pollution levels were generally not associated with emergency room visits or inpatient admissions, with one exception (in Helsingborg there was a 2.52% increase in emergency room visits for respiratory symptoms associated with a 10 µg/m³ increase in PM 10 ). In conclusion, the results give weak support for short-term effects of air pollution on health care use associated with respiratory health symptoms in the study area.

A Small Disc Area Is a Risk Factor for Visual Field Loss Progression in Primary Open-Angle Glaucoma: The Glaucoma Stereo Analysis Study.

PubMed

Kitaoka, Yasushi; Tanito, Masaki; Yokoyama, Yu; Nitta, Koji; Katai, Maki; Omodaka, Kazuko; Nakazawa, Toru

2018-01-01

The Glaucoma Stereo Analysis Study, a cross-sectional multicenter collaborative study, used a stereo fundus camera (nonmyd WX) to assess various morphological parameters of the optic nerve head (ONH) in glaucoma patients. We compared the associations of each parameter between the visual field loss progression group and no-progression group. The study included 187 eyes of 187 patients with primary open-angle glaucoma or normal-tension glaucoma. We divided the mean deviation (MD) slope values of all patients into the progression group (<-0.3 dB/year) and no-progression group (≧-0.3 dB/year). ONH morphological parameters were calculated with prototype analysis software. The correlations between glaucomatous visual field progression and patient characteristics or each ONH parameter were analyzed with Spearman's rank correlation coefficient. The MD slope averages in the progression group and no-progression group were -0.58 ± 0.28 dB/year and 0.05 ± 0.26 dB/year, respectively. Among disc parameters, vertical disc width (diameter), disc area, cup area, and cup volume in the progression group were significantly less than those in the no-progression group. Logistic regression analysis revealed a significant association between the visual field progression and disc area (odds ratio 0.49/mm 2 disc area). A smaller disc area may be associated with more rapid glaucomatous visual field progression.

Is Inferior Alveolar Nerve Block Sufficient for Routine Dental Treatment in 4- to 6-year-old Children?

PubMed

Pourkazemi, Maryam; Erfanparast, Leila; Sheykhgermchi, Sanaz; Ghanizadeh, Milad

2017-01-01

Pain control is one of the most important aspects of behavior management in children. The most common way to achieve pain control is by using local anesthetics (LA). Many studies describe that the buccal nerve innervates the buccal gingiva and mucosa of the mandible for a variable extent from the vicinity of the lower third molar to the lower canine. Regarding the importance of appropriate and complete LA in child-behavior control, in this study, we examined the frequency of buccal gingiva anesthesia of primary mandibular molars and canine after inferior alveolar nerve block injection in 4- to 6-year-old children. In this descriptive cross-sectional study, 220 4- to 6-year-old children were randomly selected and entered into the study. Inferior alveolar nerve block was injected with the same method and standards for all children, and after ensuring the success of block injection, anesthesia of buccal mucosa of primary molars and canine was examined by stick test and reaction of child using sound, eye, motor (SEM) scale. The data from the study were analyzed using descriptive statistics and statistical software Statistical Package for the Social Sciences (SPSS) version 21. The area that was the highest nonanesthetized was recorded as in the distobuccal of the second primary molars. The area of the lowest nonanesthesia was also reported in the gingiva of primary canine tooth. According to this study, in 15 to 30% of cases, after inferior alveolar nerve block injection, the primary mandibular molars' buccal mucosa is not anesthetized. How to cite this article: Pourkazemi M, Erfanparast L, Sheykhgermchi S, Ghanizadeh M. Is Inferior Alveolar Nerve Block Sufficient for Routine Dental Treatment in 4- to 6-year-old Children? Int J Clin Pediatr Dent 2017;10(4):369-372.

Access to primary care for socio-economically disadvantaged older people in rural areas: A qualitative study

PubMed Central

Turley, Rachel; Porter, Tom; Shakespeare, Tom; Wong, Geoff; Jones, Andy P.; Steel, Nick

2018-01-01

Objective We aim to explore the barriers to accessing primary care for socio-economically disadvantaged older people in rural areas. Methods Using a community recruitment strategy, fifteen people over 65 years, living in a rural area, and receiving financial support were recruited for semi-structured interviews. Four focus groups were held with rural health professionals. Interviews and focus groups were audio-recorded and transcribed. Thematic analysis was used to identify barriers to primary care access. Findings Older people’s experience can be understood within the context of a patient perceived set of unwritten rules or social contract–an individual is careful not to bother the doctor in return for additional goodwill when they become unwell. However, most found it difficult to access primary care due to engaged telephone lines, availability of appointments, interactions with receptionists; breaching their perceived social contract. This left some feeling unwelcome, worthless or marginalised, especially those with high expectations of the social contract or limited resources, skills and/or desire to adapt to service changes. Health professionals’ described how rising demands and expectations coupled with service constraints had necessitated service development, such as fewer home visits, more telephone consultations, triaging calls and modifying the appointment system. Conclusion Multiple barriers to accessing primary care exist for this group. As primary care is re-organised to reduce costs, commissioners and practitioners must not lose sight of the perceived social contract and models of care that form the basis of how many older people interact with the service. PMID:29509811

[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.

Racial Disparities In Geographic Access To Primary Care In Philadelphia.

PubMed

Brown, Elizabeth J; Polsky, Daniel; Barbu, Corentin M; Seymour, Jane W; Grande, David

2016-08-01

Primary care is often thought of as the gateway to improved health outcomes and can lead to more efficient use of health care resources. Because of primary care's cardinal importance, adequate access is an important health policy priority. In densely populated urban areas, spatial access to primary care providers across neighborhoods is poorly understood. We examined spatial variation in primary care access in Philadelphia, Pennsylvania. We calculated ratios of adults per primary care provider for each census tract and included buffer zones based on prespecified drive times around each tract. We found that the average ratio was 1,073; the supply of primary care providers varied widely across census tracts, ranging from 105 to 10,321. We identified six areas of Philadelphia that have much lower spatial accessibility to primary care relative to the rest of the city. After adjustment for sociodemographic and insurance characteristics, the odds of being in a low-access area were twenty-eight times greater for census tracts with a high proportion of African Americans than in tracts with a low proportion of African Americans. Project HOPE—The People-to-People Health Foundation, Inc.

Developing a Universal Reading Comprehension Intervention for Mainstream Primary Schools within Areas of Social Deprivation for Children with and without Language-Learning Impairment: A Feasibility Study

ERIC Educational Resources Information Center

McCartney, Elspeth; Boyle, James; Ellis, Sue

2015-01-01

Background: Some children in areas of social deprivation in Scotland have lower reading attainment than neighbouring children in less deprived areas, and some of these also have lower spoken language comprehension skills than expected by assessment norms. There is a need to develop effective reading comprehension interventions that fit easily into…

Primary Study of Attitudes of Schoolchildren in Rural and Remote Areas toward Digital Imaging Learning--Taking Film-Making Summer Camp as an Example

ERIC Educational Resources Information Center

Lee, Szu-Hsin

2016-01-01

No matter how fast or wide digital technology develops, because of the gap between urban and rural areas, a digital divide in the education system still exists. The researcher joined the digital film-making summer camp, where the major objective was to decrease the digital divide between urban and rural areas. Thirty schoolchildren from one…

Methodology for Augmenting Existing Paths with Additional Parallel Transects

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

Wilson, John E.

2013-09-30

Visual Sample Plan (VSP) is sample planning software that is used, among other purposes, to plan transect sampling paths to detect areas that were potentially used for munition training. This module was developed for application on a large site where existing roads and trails were to be used as primary sampling paths. Gap areas between these primary paths needed to found and covered with parallel transect paths. These gap areas represent areas on the site that are more than a specified distance from a primary path. These added parallel paths needed to optionally be connected together into a single path—themore » shortest path possible. The paths also needed to optionally be attached to existing primary paths, again with the shortest possible path. Finally, the process must be repeatable and predictable so that the same inputs (primary paths, specified distance, and path options) will result in the same set of new paths every time. This methodology was developed to meet those specifications.« less

Researching primary engineering education: UK perspectives, an exploratory study

NASA Astrophysics Data System (ADS)

Clark, Robin; Andrews, Jane

2010-10-01

This paper draws attention to the findings of an exploratory study that critically identified and analysed relevant perceptions of elementary level engineering education within the UK. Utilising an approach based upon grounded theory methodology, 30 participants including teachers, representatives of government bodies and non-profit providers of primary level engineering initiatives were interviewed. Three main concepts were identified during the analysis of findings, each relevant to primary engineering education. These were pedagogic issues, exposure to engineering within the curriculum and children's interest. The paper concludes that the opportunity to make a real difference to children's education by stimulating their engineering imagination suggests this subject area is of particular value.

A model of regional primary production for use with coarse resolution satellite data

NASA Technical Reports Server (NTRS)

Prince, S. D.

1991-01-01

A model of crop primary production, which was originally developed to relate the amount of absorbed photosynthetically active radiation (APAR) to net production in field studies, is discussed in the context of coarse resolution regional remote sensing of primary production. The model depends on an approximately linear relationship between APAR and the normalized difference vegetation index. A more comprehensive form of the conventional model is shown to be necessary when different physiological types of plants or heterogeneous vegetation types occur within the study area. The predicted variable in the new model is total assimilation (net production plus respiration) rather than net production alone or harvest yield.

Understanding the Science of Environmental Issues: Development of a Subject Knowledge Guide for Primary Teacher Education.

ERIC Educational Resources Information Center

Summers, Mike; Kruger, Colin; Childs, Ann; Mant, Jenny

2001-01-01

Uses a questionnaire to explore understanding in practicing primary school teachers (n=170), primary trainees (n= 120), and secondary science trainees (n=88) in the areas of biodiversity, carbon cycle, ozone, and global warming. Suggests that both basic explanations and difficulties in understanding of teachers in some areas can usefully inform…

Using video-based observation research methods in primary care health encounters to evaluate complex interactions

PubMed Central

Asan, Onur; Montague, Enid

2015-01-01

Objective The purpose of this paper is to describe the use of video-based observation research methods in primary care environment and highlight important methodological considerations and provide practical guidance for primary care and human factors researchers conducting video studies to understand patient-clinician interaction in primary care settings. Methods We reviewed studies in the literature which used video methods in health care research and, we also used our own experience based on the video studies we conducted in primary care settings. Results This paper highlighted the benefits of using video techniques such as multi-channel recording and video coding and compared “unmanned” video recording with the traditional observation method in primary care research. We proposed a list, which can be followed step by step to conduct an effective video study in a primary care setting for a given problem. This paper also described obstacles researchers should anticipate when using video recording methods in future studies. Conclusion With the new technological improvements, video-based observation research is becoming a promising method in primary care and HFE research. Video recording has been under-utilized as a data collection tool because of confidentiality and privacy issues. However, it has many benefits as opposed to traditional observations, and recent studies using video recording methods have introduced new research areas and approaches. PMID:25479346

Using MODIS data for understanding changes in seagrass meadow health: a case study in the Great Barrier Reef (Australia).

PubMed

Petus, Caroline; Collier, Catherine; Devlin, Michelle; Rasheed, Michael; McKenna, Skye

2014-07-01

Stretching more than 2000 km along the Queensland coast, the Great Barrier Reef Marine Park (GBR) shelters over 43,000 square km of seagrass meadows. Despite the status of marine protected area and World Heritage listing of the GBR, local seagrass meadows are under stress from reduced water quality levels; with reduction in the amount of light available for seagrass photosynthesis defined as the primary cause of seagrass loss throughout the GBR. Methods have been developed to map GBR plume water types by using MODIS quasi-true colour (hereafter true colour) images reclassified in function of their dominant colour. These data can be used as an interpretative tool for understanding changes in seagrass meadow health (as defined in this study by the seagrass area and abundance) at different spatial and temporal scales. We tested this method in Cleveland Bay, in the northern GBR, where substantial loss in seagrass area and biomass was detected by annual monitoring from 2007 to 2011. A strong correlation was found between bay-wide seagrass meadow area and biomass and exposure to turbid Primary (sediment-dominated) water type. There was also a strong correlation between the changes of biomass and area of individual meadows and exposure of seagrass ecosystems to Primary water type over the 5-year period. Seagrass meadows were also grouped according to the dominant species within each meadow, irrespective of location within Cleveland Bay. These consolidated community types did not correlate well with the exposure to Primary water type, and this is likely to be due to local environmental conditions with the individual meadows that comprise these groupings. This study proved that remote sensing data provide the synoptic window and repetitivity required to investigate changes in water quality conditions over time. Remote sensing data provide an opportunity to investigate the risk of marine-coastal ecosystems to light limitation due to increased water turbidity when in situ water quality data is not available or is insufficient. Copyright © 2014 Elsevier Ltd. All rights reserved.

A qualitative study of the relationship between clinician attributes, organization, and patient characteristics on implementation of a disease management program.

PubMed

Brazil, Kevin; Cloutier, Michelle M; Tennen, Howard; Bailit, Howard; Higgins, Pamela S

2008-04-01

The purpose of this study was to examine the challenges of integrating an asthma disease management (DM) program into a primary care setting from the perspective of primary care practitioners. A second goal was to examine whether barriers differed between urban-based and nonurban-based practices. Using a qualitative design, data were gathered using focus groups in primary care pediatric practices. A purposeful sample included an equal number of urban and nonurban practices. Participants represented all levels in the practice setting. Important themes that emerged from the data were coded and categorized. A total of 151 individuals, including physicians, advanced practice clinicians, registered nurses, other medical staff, and nonmedical staff participated in 16 focus groups that included 8 urban and 8 nonurban practices. Content analyses identified 4 primary factors influencing the implementation of a DM program in a primary care setting. They were related to providers, the organization, patients, and characteristics of the DM program. This study illustrates the complexity of the primary care environment and the challenge of changing practice in these settings. The results of this study identified areas in a primary care setting that influence the adoption of a DM program. These findings can assist in identifying effective strategies to change clinical behavior in primary care practices.

Use of the internet for health information among primary care patients in rural West Texas.

PubMed

Zhang, Yan; Jones, Betsy; Spalding, Mary; Young, Rodney; Ragain, Mike

2009-06-01

Little is known about how primary care patients in rural, remote or border areas use the internet for their health information. This study examined the factors related to internet use for medical information among primary care clinic patients in such areas of West Texas. A convenience sample was drawn from nine clinics that serve low-income rural area populations. Surveys were distributed to the patients during a 6-week period in the winter of 2006. The analytical sample included 1890 participants. Logistic regressions were conducted. Of 1890 subjects, 699 (37%) reported having used the internet for medical information. Among those who reported using the internet for health information, respondents' primary usage pattern was to request more health information (29.9%), followed by the purchase of health supplies (13.4%). Most internet users (78.8%) agreed that the online medical/health information had improved their understanding of a specific condition, disease, or treatment. Almost 60% of the internet users thought the information was reliable. The correlates of internet use included health insurance, self-rated health, health confidence, and number of worried days as well as age, education level, ethnicity, and language. Our findings showed a much lower rate of internet use for medical/health information compared with a 2006 nationwide survey. This finding suggests that promoting health/medical information through websites or other on-line resources might not be the most effective way to reach a majority of patients in remote, rural or border areas.

Using Geographic Information Systems (GIS) to understand a community's primary care needs.

PubMed

Dulin, Michael F; Ludden, Thomas M; Tapp, Hazel; Blackwell, Joshua; de Hernandez, Brisa Urquieta; Smith, Heather A; Furuseth, Owen J

2010-01-01

A key element for reducing health care costs and improving community health is increased access to primary care and preventative health services. Geographic information systems (GIS) have the potential to assess patterns of health care utilization and community-level attributes to identify geographic regions most in need of primary care access. GIS, analytical hierarchy process, and multiattribute assessment and evaluation techniques were used to examine attributes describing primary care need and identify areas that would benefit from increased access to primary care services. Attributes were identified by a collaborative partnership working within a practice-based research network using tenets of community-based participatory research. Maps were created based on socioeconomic status, population density, insurance status, and emergency department and primary care safety-net utilization. Individual and composite maps identified areas in our community with the greatest need for increased access to primary care services. Applying GIS to commonly available community- and patient-level data can rapidly identify areas most in need of increased access to primary care services. We have termed this a Multiple Attribute Primary Care Targeting Strategy. This model can be used to plan health services delivery as well as to target and evaluate interventions designed to improve health care access.

Groundwater quality in the Indian Wells Valley, California

USGS Publications Warehouse

Dawson, Barbara J. Milby; Belitz, Kenneth

2012-01-01

Groundwater provides more than 40 percent of California’s drinking water. 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. Indian Wells Valley is one of the study areas being evaluated. The Indian Wells study area is approximately 600 square miles (1,554 square kilometers) and includes the Indian Wells Valley groundwater basin (California Department of Water Resources, 2003). Indian Wells Valley has an arid climate and is part of the Mojave Desert. Average annual rainfall is about 6 inches (15 centimeters). The study area has internal drainage, with runoff from the surrounding mountains draining towards dry lake beds in the lower parts of the valley. Land use in the study area is approximately 97.0 percent (%) natural, 0.4% agricultural, and 2.6% urban. The primary natural land cover is shrubland. The largest urban area is the city of Ridgecrest (2010 population of 28,000). Groundwater in this basin is used for public and domestic water supply and for irrigation. The main water-bearing units are gravel, sand, silt, and clay derived from the Sierra Nevada to the west and from the other surrounding mountains. Recharge to the groundwater system is primarily runoff from the Sierra Nevada and to the west and from the other surrounding mountains. Recharge to the groundwater system is primarily runoff from the Sierra Nevada and direct infiltration from irrigation and septic systems. The primary sources of discharge are pumping wells and evapotranspiration near the dry lakebeds. The primary aquifers in the Indian Wells study area are defined as those parts of the aquifers corresponding to the perforated intervals of wells listed in the California Department of Public Health database. Public-supply wells in Indian Wells Valley are completed to depths between 240 and 800 feet (73 to 244 meters), consist of solid casing from the land surface to a depth of 180 to 260 feet (55 to 79 meters), and are screened or perforated below the solid casing.

Vision screening in preschool children: comparison of orthoptists and clinical medical officers as primary screeners.

PubMed Central

Bolger, P G; Stewart-Brown, S L; Newcombe, E; Starbuck, A

1991-01-01

OBJECTIVE--To see if there were differences in referral rates and abnormalities detected from two areas that were operating different preschool vision screening programmes. DESIGN--Cohort study using case notes of referrals. SETTING--Community based secondary referral centres in the county of Avon. PATIENTS--263 referrals from a child population of 7105 in Southmead district, an area that used orthoptists as primary vision screeners; 111 referrals from a child population of 2977 in Weston-super-Mare, an area that used clinical medical officers for screening. MAIN OUTCOME MEASURES--Amblyopia and squint detection rates, together with false positive referral rates. RESULTS--The amblyopia detection rate in Southmead district was significantly higher than in Weston-super-Mare (11/1000 children v 5/1000), as was the detection rate of squint (11/1000 v 3/1000). However, the false positive referral rate from Southmead was significantly lower than that from Weston-super-Mare (9/1000 v 23/1000). CONCLUSION--Preschool vision screening using orthoptists as primary screeners offers a more effective method of detecting visual abnormalities than using clinical medical officers. PMID:1747671

Activity in the primary somatosensory cortex induced by reflexological stimulation is unaffected by pseudo-information: a functional magnetic resonance imaging study

PubMed Central

2013-01-01

Background Reflexology is an alternative medical practice that produces beneficial effects by applying pressure to specific reflex areas. Our previous study suggested that reflexological stimulation induced cortical activation in somatosensory cortex corresponding to the stimulated reflex area; however, we could not rule out the possibility of a placebo effect resulting from instructions given during the experimental task. We used functional magnetic resonance imaging (fMRI) to investigate how reflexological stimulation of the reflex area is processed in the primary somatosensory cortex when correct and pseudo-information about the reflex area is provided. Furthermore, the laterality of activation to the reflexological stimulation was investigated. Methods Thirty-two healthy Japanese volunteers participated. The experiment followed a double-blind design. Half of the subjects received correct information, that the base of the second toe was the eye reflex area, and pseudo-information, that the base of the third toe was the shoulder reflex area. The other half of the subjects received the opposite information. fMRI time series data were acquired during reflexological stimulation to both feet. The experimenter stimulated each reflex area in accordance with an auditory cue. The fMRI data were analyzed using a conventional two-stage approach. The hemodynamic responses produced by the stimulation of each reflex area were assessed using a general linear model on an intra-subject basis, and a two-way repeated-measures analysis of variance was performed on an intersubject basis to determine the effect of reflex area laterality and information accuracy. Results Our results indicated that stimulation of the eye reflex area in either foot induced activity in the left middle postcentral gyrus, the area to which tactile sensation to the face projects, as well as in the postcentral gyrus contralateral foot representation area. This activity was not affected by pseudo information. The results also indicate that the relationship between the reflex area and the projection to the primary somatosensory cortex has a lateral pattern that differs from that of the actual somatotopical representation of the body. Conclusion These findings suggest that a robust relationship exists between neural processing of somatosensory percepts for reflexological stimulation and the tactile sensation of a specific reflex area. PMID:23711332

Topographical effects of climate dataset and their impacts on the estimation of regional net primary productivity

NASA Astrophysics Data System (ADS)

Sun, L. Qing; Feng, Feng X.

2014-11-01

In this study, we first built and compared two different climate datasets for Wuling mountainous area in 2010, one of which considered topographical effects during the ANUSPLIN interpolation was referred as terrain-based climate dataset, while the other one did not was called ordinary climate dataset. Then, we quantified the topographical effects of climatic inputs on NPP estimation by inputting two different climate datasets to the same ecosystem model, the Boreal Ecosystem Productivity Simulator (BEPS), to evaluate the importance of considering relief when estimating NPP. Finally, we found the primary contributing variables to the topographical effects through a series of experiments given an overall accuracy of the model output for NPP. The results showed that: (1) The terrain-based climate dataset presented more reliable topographic information and had closer agreements with the station dataset than the ordinary climate dataset at successive time series of 365 days in terms of the daily mean values. (2) On average, ordinary climate dataset underestimated NPP by 12.5% compared with terrain-based climate dataset over the whole study area. (3) The primary climate variables contributing to the topographical effects of climatic inputs for Wuling mountainous area were temperatures, which suggest that it is necessary to correct temperature differences for estimating NPP accurately in such a complex terrain.

[Accidents with biological material in health care workers in 2 primary health care areas (1990-1999)].

PubMed

Hernández Navarrete, M J; Montes Villameriel, F J; Solano Bernad, V M; Sánchez Matienzo, D; del Val García, J L; Gil Montalbán, E; Arribas Llorente, J L

2001-09-15

To find out the exposures with biological material in health care workers in primary health care, registered in the biological accidents database from Preventive Medicine Service in Miguel Servet Universitary Hospital of Zaragoza. Descriptive study of a retrospective cohort. SITE: Primary health care, Areas II and V of Zaragoza.Participants. Workers in this areas, distributed by: physician, nursing staff, auxiliary, orderly, housekeeping staff, others. Data of: workers, accident, serologic source, worker protection and vaccinal status of hepatitis B. The incidence of accidents was 26 (period 1997-1999). Most proportion of accidents were declared by nursing (78%). The highest occupational incidence was in auxiliary (63 ). In 90,1% of the cases, the accident was needlestick injury. The source was known in 67,7% of cases. The accidents occurred in hands in 96,8% of cases, and only one third of workers carried gloves. Results obtained are similar with previous studies about this event. We must insist on the need to declare these accidents, providing more information and accessibility for the declaration to worker. Moreover, we must insist on the correct application in the health care field of the standard precautions, because almost 50% of accidents are evitable, and to increase hepatitis B vaccination covertures.

Evaluating Area-Based Socioeconomic Status Indicators for Monitoring Disparities within Health Care Systems: Results from a Primary Care Network

PubMed Central

Berkowitz, Seth A; Traore, Carine Y; Singer, Daniel E; Atlas, Steven J

2015-01-01

Objective To determine which area-based socioeconomic status (SES) indicator is best suited to monitor health care disparities from a delivery system perspective. Data Sources/Study Setting 142,659 adults seen in a primary care network from January 1, 2009 to December 31, 2011. Study Design Cross-sectional, comparing associations between area-based SES indicators and patient outcomes. Data Collection Address data were geocoded to construct area-based SES indicators at block group (BG), census tract (CT), and ZIP code (ZIP) levels. Data on health outcomes were abstracted from electronic records. Relative indices of inequality (RIIs) were calculated to quantify disparities detected by area-based SES indicators and compared to RIIs from self-reported educational attainment. Principal Findings ZIP indicators had less missing data than BG or CT indicators (p < .0001). Area-based SES indicators were strongly associated with self-report educational attainment (p < .0001). ZIP, BG, and CT indicators all detected expected SES gradients in health outcomes similarly. Single-item, cut point defined indicators performed as well as multidimensional indices and quantile indicators. Conclusions Area-based SES indicators detected health outcome differences well and may be useful for monitoring disparities within health care systems. Our preferred indicator was ZIP-level median household income or percent poverty, using cut points. PMID:25219917

Preparation of a primary argon beam for the CERN fixed target physics.

PubMed

Küchler, D; O'Neil, M; Scrivens, R; Thomae, R

2014-02-01

The fixed target experiment NA61 in the North Area of the Super Proton Synchrotron is studying phase transitions in strongly interacting matter. Up to now they used the primary beams available from the CERN accelerator complex (protons and lead ions) or fragmented beams created from the primary lead ion beam. To explore a wider range of energies and densities a request was made to provide primary argon and xenon beams. This paper describes the results of the setting up and 10 week test run of the Ar(11+) beam from the 14.5 GHz ECR ion source and the linear accelerator (Linac3) at CERN.

Neural networks for Braille reading by the blind.

PubMed

Sadato, N; Pascual-Leone, A; Grafman, J; Deiber, M P; Ibañez, V; Hallett, M

1998-07-01

To explore the neural networks used for Braille reading, we measured regional cerebral blood flow with PET during tactile tasks performed both by Braille readers blinded early in life and by sighted subjects. Eight proficient Braille readers were studied during Braille reading with both right and left index fingers. Eight-character, non-contracted Braille-letter strings were used, and subjects were asked to discriminate between words and non-words. To compare the behaviour of the brain of the blind and the sighted directly, non-Braille tactile tasks were performed by six different blind subjects and 10 sighted control subjects using the right index finger. The tasks included a non-discrimination task and three discrimination tasks (angle, width and character). Irrespective of reading finger (right or left), Braille reading by the blind activated the inferior parietal lobule, primary visual cortex, superior occipital gyri, fusiform gyri, ventral premotor area, superior parietal lobule, cerebellum and primary sensorimotor area bilaterally, also the right dorsal premotor cortex, right middle occipital gyrus and right prefrontal area. During non-Braille discrimination tasks, in blind subjects, the ventral occipital regions, including the primary visual cortex and fusiform gyri bilaterally were activated while the secondary somatosensory area was deactivated. The reverse pattern was found in sighted subjects where the secondary somatosensory area was activated while the ventral occipital regions were suppressed. These findings suggest that the tactile processing pathways usually linked in the secondary somatosensory area are rerouted in blind subjects to the ventral occipital cortical regions originally reserved for visual shape discrimination.

Recruiting and Retaining Primary Care Physicians in Urban Underserved Communities: The Importance of Having a Mission to Serve

PubMed Central

Ryan, Gery; Ramey, Robin; Nunez, Felix L.; Beltran, Robert; Splawn, Robert G.; Brown, Arleen F.

2010-01-01

Objectives. We examined factors influencing physician practice decisions that may increase primary care supply in underserved areas. Methods. We conducted in-depth interviews with 42 primary care physicians from Los Angeles County, California, stratified by race/ethnicity (African American, Latino, and non-Latino White) and practice location (underserved vs nonunderserved area). We reviewed transcriptions and coded them into themes by using standard qualitative methods. Results. Three major themes emerged in relation to selecting geographic- and population-based practice decisions: (1) personal motivators, (2) career motivators, and (3) clinic support. We found that subthemes describing personal motivators (e.g., personal mission and self-identity) for choosing a practice were more common in responses among physicians who worked in underserved areas than among those who did not. By contrast, physicians in nonunderserved areas were more likely to cite work hours and lifestyle as reasons for selecting their current practice location or for leaving an underserved area. Conclusions. Medical schools and shortage-area clinical practices may enhance strategies for recruiting primary care physicians to underserved areas by identifying key personal motivators and may promote long-term retention through work–life balance. PMID:20935263

Recruiting and retaining primary care physicians in urban underserved communities: the importance of having a mission to serve.

PubMed

Odom Walker, Kara; Ryan, Gery; Ramey, Robin; Nunez, Felix L; Beltran, Robert; Splawn, Robert G; Brown, Arleen F

2010-11-01

We examined factors influencing physician practice decisions that may increase primary care supply in underserved areas. We conducted in-depth interviews with 42 primary care physicians from Los Angeles County, California, stratified by race/ethnicity (African American, Latino, and non-Latino White) and practice location (underserved vs nonunderserved area). We reviewed transcriptions and coded them into themes by using standard qualitative methods. Three major themes emerged in relation to selecting geographic- and population-based practice decisions: (1) personal motivators, (2) career motivators, and (3) clinic support. We found that subthemes describing personal motivators (e.g., personal mission and self-identity) for choosing a practice were more common in responses among physicians who worked in underserved areas than among those who did not. By contrast, physicians in nonunderserved areas were more likely to cite work hours and lifestyle as reasons for selecting their current practice location or for leaving an underserved area. Medical schools and shortage-area clinical practices may enhance strategies for recruiting primary care physicians to underserved areas by identifying key personal motivators and may promote long-term retention through work-life balance.

The Changing Nature of the Role of Principals in Primary and Junior Secondary Schools in South Australia Following the Introduction Local School Management (Partnerships 21)

ERIC Educational Resources Information Center

Sahid, Abdul

2004-01-01

This paper discusses the changing nature of the role of principals following the introduction of local school management (Partnerships 21) in South Australia. The study reports the series of interviews with primary and junior secondary principals with regard to their roles in several areas namely; instructional leadership, teachers' professional…

Changes in habitat use at rainforest edges through succession: A case study of understory birds in the Brazilian Amazon

Treesearch

Luke L. Powell; Gustavo Zurita; Jared D.  Wolfe; Erik I.  Johnson; Philip C  Stouffer

2015-01-01

Primary tropical rain forests are being rapidly perforated with new edges via roads, logging, and pastures, and vast areas of secondary forest accumulate following abandonment of agricultural lands. To determine how insectivorous Amazonian understory birds respond to edges between primary rain forest and three age classes of secondary forest, we radio-tracked two...

Hares, Tortoises and the Social Construction of the Pupil: Differentiated Learning in French and English Primary Schools

ERIC Educational Resources Information Center

Raveaud, Maroussia

2005-01-01

This article examines differentiation by task as it is used and perceived in French and English primary schools. It highlights the influence of national context on teaching and learning. The study rests on classroom observations in 12 Key Stage 1 classes located in socially disadvantaged areas. The first section sets the mission of schooling in a…

Action Verbs and the Primary Motor Cortex: A Comparative TMS Study of Silent Reading, Frequency Judgments, and Motor Imagery

ERIC Educational Resources Information Center

Tomasino, Barbara; Fink, Gereon R.; Sparing, Roland; Dafotakis, Manuel; Weiss, Peter H.

2008-01-01

Single pulse transcranial magnetic stimulation (TMS) was applied to the hand area of the left primary motor cortex or, as a control, to the vertex (STIMULATION: TMS[subscript M1] vs. TMS[subscript vertex]) while right-handed volunteers silently read verbs related to hand actions. We examined three different tasks and time points for stimulation…

Using Blended Learning to Facilitate the Mathematical thought Processes of Primary School Learners in a Computer Laboratory: A Case Study in Calculating Simple Areas

ERIC Educational Resources Information Center

Naidoo, N.; Naidoo, R.

2007-01-01

Primary school learners' first encounters with mathematics in a traditional learning environment often create lifelong "math phobia."(Papert 1980) The situation in a country emerging from an oppressive education system designed to educationally disempower the majority of the population is much worse. The typical scenario in a previously…

Curriculum Guide for Spanish Language Arts, Primary Level C = Guia para la ensenanza de las artes del lenguaje espanol, primaria, nivel C. (Grade 1).

ERIC Educational Resources Information Center

Chicago Board of Education, IL. Dept. of Curriculum.

The curriculum guide for teachers of Spanish language arts for native Spanish-speaking primary students in the Chicago public schools' bilingual education program is introduced by a section defining the areas to be emphasized in the program: word attack, comprehension skills, study skills, literature appreciation, and writing skills. Sections…

The development and optimisation of a primary care-based whole system complex intervention (CARE Plus) for patients with multimorbidity living in areas of high socioeconomic deprivation

PubMed Central

O'Brien, Rosaleen; Fitzpatrick, Bridie; Higgins, Maria; Guthrie, Bruce; Watt, Graham; Wyke, Sally

2016-01-01

Objectives To develop and optimise a primary care-based complex intervention (CARE Plus) to enhance the quality of life of patients with multimorbidity in the deprived areas. Methods Six co-design discussion groups involving 32 participants were held separately with multimorbid patients from the deprived areas, voluntary organisations, general practitioners and practice nurses working in the deprived areas. This was followed by piloting in two practices and further optimisation based on interviews with 11 general practitioners, 2 practice nurses and 6 participating multimorbid patients. Results Participants endorsed the need for longer consultations, relational continuity and a holistic approach. All felt that training and support of the health care staff was important. Most participants welcomed the idea of additional self-management support, though some practitioners were dubious about whether patients would use it. The pilot study led to changes including a revised care plan, the inclusion of mindfulness-based stress reduction techniques in the support of practitioners and patients, and the stream-lining of the written self-management support material for patients. Discussion We have co-designed and optimised an augmented primary care intervention involving a whole-system approach to enhance quality of life in multimorbid patients living in the deprived areas. CARE Plus will next be tested in a phase 2 cluster randomised controlled trial. PMID:27068113

A New Framework for Software Visualization: A Multi-Layer Approach

DTIC Science & Technology

2006-09-01

primary target is an exploration of the current state of the area so that we can discover the challenges and propose solutions for them. The study ...Small define both areas of study to collectively be a part of Software Visualization. 22 Visual Programming as ’Visual Programming’ (VP) refers to...founded taxonomy, with the proper characteristics, can further investigation in any field of study . A common language or terminology and the existence of

Groundwater quality in the Antelope Valley, California

USGS Publications Warehouse

Dawson, Barbara J. Milby; Belitz, Kenneth

2012-01-01

Groundwater provides more than 40 percent of California’s drinking water. 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. Antelope Valley is one of the study areas being evaluated. The Antelope study area is approximately 1,600 square miles (4,144 square kilometers) and includes the Antelope Valley groundwater basin (California Department of Water Resources, 2003). Antelope Valley has an arid climate and is part of the Mojave Desert. Average annual rainfall is about 6 inches (15 centimeters). The study area has internal drainage, with runoff from the surrounding mountains draining towards dry lakebeds in the lower parts of the valley. Land use in the study area is approximately 68 percent (%) natural (mostly shrubland and grassland), 24% agricultural, and 8% urban. The primary crops are pasture and hay. The largest urban areas are the cities of Palmdale and Lancaster (2010 populations of 152,000 and 156,000, respectively). Groundwater in this basin is used for public and domestic water supply and for irrigation. The main water-bearing units are gravel, sand, silt, and clay derived from surrounding mountains. The primary aquifers in Antelope Valley are defined as those parts of the aquifers corresponding to the perforated intervals of wells listed in the California Department of Public Health database. Public-supply wells in Antelope Valley are completed to depths between 360 and 700 feet (110 to 213 meters), consist of solid casing from the land surface to a depth of 180 to 350 feet (55 to 107 meters), and are screened or perforated below the solid casing. Recharge to the groundwater system is primarily runoff from the surrounding mountains, and by direct infiltration of irrigation and sewer and septic systems. The primary sources of discharge are pumping wells and evapotranspiration near the dry lakebeds.

Neural correlates of conversion disorder: overview and meta-analysis of neuroimaging studies on motor conversion disorder.

PubMed

Boeckle, Markus; Liegl, Gregor; Jank, Robert; Pieh, Christoph

2016-06-10

Conversion Disorders (CD) are prevalent functional disorders. Although the pathogenesis is still not completely understood, an interaction of genetic, neurobiological, and psychosocial factors is quite likely. The aim of this study is to provide a systematic overview on imaging studies on CDs and investigate neuronal areas involved in Motor Conversion Disorders (MCD). A systematic literature search was conducted on CD. Subsequently a meta-analysis of functional neuroimaging studies on MCD was implemented using an Activation Likelihood Estimation (ALE). We calculated differences between patients and healthy controls as well as between affected versus unaffected sides in addition to an overall analysis in order to identify neuronal areas related to MCD. Patients with MCD differ from healthy controls in the amygdala, superior temporal lobe, retrosplenial area, primary motor cortex, insula, red nucleus, thalamus, anterior as well as dorsolateral prefrontal and frontal cortex. When comparing affected versus unaffected sides, temporal cortex, dorsal anterior cingulate cortex, supramarginal gyrus, dorsal temporal lobe, anterior insula, primary somatosensory cortex, superior frontal gyrus and anterior prefrontal as well as frontal cortex show significant differences. Neuronal areas seem to be involved in the pathogenesis, maintenance or as a result of MCD. Areas that are important for motor-planning, motor-selection or autonomic response seem to be especially relevant. Our results support the emotional unawareness theory but also underline the need of more support by conduction imaging studies on both CD and MCD.

Computational Study of Primary Electrons in the Cusp Region of an Ion Engine's Discharge Chamber

NASA Technical Reports Server (NTRS)

Stueber, Thomas J. (Technical Monitor); Deshpande, Shirin S.; Mahalingam, Sudhakar; Menart, James A.

2004-01-01

In this work a computer code called PRIMA is used to study the motion of primary electrons in the magnetic cusp region of the discharge chamber of an ion engine. Even though the amount of wall area covered by the cusps is very small, the cusp regions are important because prior computational analyses have indicated that most primary electrons leave the discharge chamber through the cusps. The analysis presented here focuses on the cusp region only. The affects of the shape and size of the cusp region on primary electron travel are studied as well as the angle and location at which the electron enters the cusp region. These affects are quantified using the confinement length and the number density distributions of the primary electrons. In addition to these results comparisons of the results from PRIMA are made to experimental results for a cylindrical discharge chamber with two magnetic rings. These comparisons indicate the validity of the computer code called PRIMA.

Hurricane Sandy - Public Health Situation Updates - PHE

Science.gov Websites

National Veterinary Response Team from HHS will provide primary and acute care for pets at a large pet Team from HHS anticipates providing primary and acute care for pets in the hard hit area New York City from HHS anticipates providing primary and acute care for pets in the hard hit area New York City known

Preliminary assessment of the computer-based Taenia solium educational program 'The Vicious Worm' on knowledge uptake in primary school students in rural areas in eastern Zambia.

PubMed

Hobbs, Emma C; Mwape, Kabemba Evans; Van Damme, Inge; Berkvens, Dirk; Zulu, Gideon; Mambwe, Moses; Chembensofu, Mwelwa; Phiri, Isaac Khozozo; Masuku, Maxwell; Bottieau, Emmanuel; Devleesschauwer, Brecht; Speybroeck, Niko; Colston, Angela; Dorny, Pierre; Willingham, Arve Lee; Gabriël, Sarah

2018-03-01

The zoonotic helminth Taenia solium is endemic in Zambia, causing human (taeniasis and (neuro)cysticercosis) and pig (porcine cysticercosis) diseases with high health, social and economic burdens. We aimed to evaluate the impact of a health educational program intended to lead to powerful and cumulative improvements in knowledge, attitudes and practices that decrease parasite transmission and disease occurrence. Half-day health education workshops were conducted in three primary schools in the highly endemic Eastern Province of Zambia, using the computer-based T. solium educational program 'The Vicious Worm'. Questionnaires were administered before and after the educational component to determine the program's impact on knowledge uptake in primary school students. In total, 99 students participated: 38 males and 61 females, with a median age of 14 years (range 10-18 years). Baseline general knowledge of T. solium, including awareness of the different human and pig disease states, and disease diagnosis, treatment and prevention, was quite high (average score 62%) and consistent across all three study areas. Participants' knowledge had significantly increased after the educational component, particularly regarding parasite transmission and disease prevention. Preliminary assessment of 'The Vicious Worm' indicates it is an effective tool for the short-term T. solium education of primary school students in Zambia. Follow-up studies are planned to assess the longer term impact of the program on knowledge uptake in the study neighbourhoods. Inclusion of tailored 'The Vicious Worm' educational workshops should be considered in integrated cysticercosis control programs in endemic areas of sub-Saharan Africa. © 2018 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Prevalence of Multifocal Primary Hyperhidrosis and Symptom Severity Over Time: Results of a Targeted Survey.

PubMed

Glaser, Dee Anna; Ballard, Angela M; Hunt, Niquette L; Pieretti, Lisa J; Pariser, David M

2016-12-01

There is a paucity of data on the prevalence of multifocal primary hyperhidrosis and changes in hyperhidrosis severity over time. The goal of this study was to better understand multifocal primary hyperhidrosis, prevalence and distribution of hyperhidrosis by focal site, age of onset of symptoms by focal area, and change in hyperhidrosis severity over time and with seasons. The International Hyperhidrosis Society, through an unrestricted research grant from Revance Therapeutics, conducted an online survey of registered visitors to its Web site. Participants identified as having "excessive sweating" and opted to participate in the survey (23 questions) after an e-mail invitation. The survey data illustrate that multifocal primary hyperhidrosis is more common than previously believed and that multifocal hyperhidrosis is more common than singular focal hyperhidrosis (81% of patients reported 3 or more focal hyperhidrotic sites). The data also show that sweating symptom severity does not improve with age but stays the same or gets worse and is "bothersome" throughout the year. Recognition of the chronic and multifocal nature of primary hyperhidrosis is useful for treating hyperhidrosis patients long term and illustrates a need for treatments or treatment combinations that are effective for multiple body areas.

Spatial working memory impairment in primary onset middle-age type 2 diabetes mellitus: An ethology and BOLD-fMRI study.

PubMed

Huang, Ran-Ran; Jia, Bao-Hui; Xie, Lei; Ma, Shu-Hua; Yin, Jing-Jing; Sun, Zong-Bo; Le, Hong-Bo; Xu, Wen-Can; Huang, Jin-Zhuang; Luo, Dong-Xue

2016-01-01

To explore mild cognitive dysfunction and/or spatial working memory impairment in patients with primary onset middle-age type 2 diabetes mellitus (T2DM] using ethology (behavior tests) and blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI). Eighteen primary onset T2DM patients and 18 matched subjects with normal blood glucose levels were all tested using the Montreal cognitive assessment scale test, the Wechsler Memory Scale Chinese-revised test, and scanned using BOLD-fMRI (1.5T, EPI sequence) while performing the n-back task to find the activation intensity of some cognition-related areas. The ethology results showed that T2DM patients had a mild cognitive impairment and memory dysfunction (P < 0.05). The fMRI scan identified a neural network consisting of bilateral dorsolateral prefrontal cortex (DLPFC), bilateral premotor area (PreMA), bilateral parietal lobe (PA), and anterior cingulate cortex (ACC) / supplementary motor area (SMA) that was activated during the n-back task, with right hemisphere dominance. However, only the right PA and ACC/SMA showed a load effect via quantitative analysis in the T2DM group; the activation intensity of most working memory-related brain areas for the T2DM group were lower than for the control group under three memory loads. Furthermore, we found that the activation intensity of some cognition-related areas, including the right insular lobe, left caudate nucleus, and bilateral hippocampus/parahippocampal gyrus were lower than the control group under the memory loads. Diabetes-related brain damage of primary onset middle-age T2DM patients with right DLPFC-posterior parietal lobe and parahippocampal gyrus default network causes impairment of spatial working memory and mild cognitive dysfunction. © 2015 Wiley Periodicals, Inc.

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

PubMed

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

2013-01-01

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

Differences in Physical Activity Levels between Urban and Rural School Children in Cyprus

ERIC Educational Resources Information Center

Loucaides, Constantinos A.; Chedzoy, Sue M.; Bennett, Neville

2004-01-01

This study attempted to examine differences in physical activity levels between urban and rural primary school children. The sample consisted of 256 Greek-Cypriot children and their parents from two schools representing urban areas and three schools representing rural areas. Children's activity levels were assessed for 4 weekdays in the winter and…

Primary School Teachers' Levels of Self-Efficacy According to Various Settlement Areas

ERIC Educational Resources Information Center

Erdemir, Naki

2011-01-01

The purpose of this study was to determine how elementary teachers use computers, the Internet, and educational technology in the educational process. The purpose was also to gain information regarding the teachers' possession of technological devices and their levels of self-efficacy in using them among the different types of settlement areas.…

The Special Education Core Curriculum Manual, Basic Level. Learning Skills, Oral Language, Reading, Mathematics.

ERIC Educational Resources Information Center

Margolis, Leonard

The manual is designed to serve as a guideline for teachers and child study teams who have the primary responsibility for the education of handicapped children in four areas--learning skills, oral language, reading, and mathematics. Sections for each of the above areas are subdivided into the following objectives and activities: gross motor…

Process Analysis of Typhoon Related Ozone Pollution over the Pearl River Delta during the PRIDE-PRD2006

NASA Astrophysics Data System (ADS)

Li, Y.; Wang, X.; Zhang, Y.

2014-12-01

There were two typhoon processes during Campaign PRIDE-PRD2006 in July 2006 and serious ozone pollution episodes occurred before the landing of the typhoons. Chemical transport model CMAQ was employed in this work to simulate the ozone pollution episode related by the typhoon KAEMI. According to the meteorological conditions, the pollution episode could be divided into three phases with the movement of the typhoon, which were (1) far away from the continent; (2) coming close to the continent; (3) before landing. Process analysis was applied to get the contributions of physical and chemical processes for the ozone. It revealed that transport process was dominant during this pollution episode, and the influence of chemical process increased in the second phase. Three typical regions, northern rural area, urban area and Hong Kong area, were selected to study the contribution of each chemical and physical process. In the first phase, the primary process in northern rural area and the urban area was vertical diffusion, accounting for 47% and 46% respectively. In the second phase, the primary process in northern rural area and the urban area was chemical process, accounting for 33% and 31% respectively. In the third phase, the region of high concentration ozone moved southward. For Hong Kong area, the western inflow was prominent as 40%. Sensitivity study showed that urban areas were VOCs-limited regime with decreased ozone concentration when reducing the emission of VOCs. On the contrary, the ozone concentration in downwind rural areas decreased with the reduction of NOx, and the reason may be the decrement of the accumulated precursors.

Comparative study of carbon free and carbon containing Li4Ti5O12 electrodes

NASA Astrophysics Data System (ADS)

Pohjalainen, Elina; Kallioinen, Jani; Kallio, Tanja

2015-04-01

Traditionally electrodes for lithium ion batteries are manufactured using carbon additives to increase the conductivity. However, in case of lithium titanate, Li4Ti5O12 (LTO), carbon free electrodes have gathered some interest lately. Therefore two LTO materials synthesized using the same synthesis but different end milling process resulting in materials with different particle size and surface area are compared here using electrodes manufactured with and without carbon additives. Both LTO samples (LTO-SP with small primary particle size and high surface area, and LTO-LP with larger primary particle size and small surface area) produce similar capacities and voltages with or without carbon additives at low C-rates at the room temperature. However, at high C-rates and/or sub-zero temperatures electrodes with carbon additives produce higher capacities and smaller ohmic losses and this behavior is more pronounced for the LTO electrodes with smaller primary particle size and larger surface area. These results show that the feasibility of carbon free LTO electrodes depends on the properties of LTO affecting the morphology of the electrode and consequently, the transport properties. This is most pronounced under conditions where electron and Li+ ion transfer become limiting (high C-rates and low temperature).

Local emission of primary air pollutants and its contribution to wet deposition and concentrations of aerosols and gases in ambient air in Japan

NASA Astrophysics Data System (ADS)

Aikawa, Masahide; Hiraki, Takatoshi; Tomoyose, Nobutaka; Ohizumi, Tsuyoshi; Noguchi, Izumi; Murano, Kentaro; Mukai, Hitoshi

2013-11-01

We studied wet deposition by precipitation and the concentrations of aerosols and gases in ambient air in relation to the primary air pollutants discharged from domestic areas. The concentrations of aerosols and gases were influenced by nearby emissions except for non-sea-salt SO, which is transported long distances. The area facing the Sea of Japan showed much larger wet deposition than other areas, although the domestic emissions of the primary air pollutants there were small and showed a peak in wet deposition from October to March, as distinct from April to September in other areas. We performed the correlation analyses between wet deposition of each component and the product of the concentrations of corresponding aerosols and gases in ambient air and the two-thirds power of the precipitation. From the results, following scavenging processes were suggested. • Sulfate and ammonium were scavenged in precipitation as particulate matter such as (NH4)2SO4 and NH4HSO4. • Nitrate was scavenged mainly in precipitation through gaseous HNO3. • Ammonium was complementarily scavenged in precipitation through aerosols such as (NH4)2SO4 and NH4HSO4 and through gaseous NH3.

Uptake and impact of vaccinating school age children against influenza during a season with circulation of drifted influenza A and B strains, England, 2014/15.

PubMed

Pebody, Richard G; Green, Helen K; Andrews, Nick; Boddington, Nicola L; Zhao, Hongxin; Yonova, Ivelina; Ellis, Joanna; Steinberger, Sophia; Donati, Matthew; Elliot, Alex J; Hughes, Helen E; Pathirannehelage, Sameera; Mullett, David; Smith, Gillian E; de Lusignan, Simon; Zambon, Maria

2015-01-01

The 2014/15 influenza season was the second season of roll-out of a live attenuated influenza vaccine (LAIV) programme for healthy children in England. During this season, besides offering LAIV to all two to four year olds, several areas piloted vaccination of primary (4-11 years) and secondary (11-13 years) age children. Influenza A(H3N2) circulated, with strains genetically and antigenically distinct from the 2014/15 A(H3N2) vaccine strain, followed by a drifted B strain. We assessed the overall and indirect impact of vaccinating school age children, comparing cumulative disease incidence in targeted and non-targeted age groups in vaccine pilot to non-pilot areas. Uptake levels were 56.8% and 49.8% in primary and secondary school pilot areas respectively. In primary school age pilot areas, cumulative primary care influenza-like consultation, emergency department respiratory attendance, respiratory swab positivity, hospitalisation and excess respiratory mortality were consistently lower in targeted and non-targeted age groups, though less for adults and more severe end-points, compared with non-pilot areas. There was no significant reduction for excess all-cause mortality. Little impact was seen in secondary school age pilot only areas compared with non-pilot areas. Vaccination of healthy primary school age children resulted in population-level impact despite circulation of drifted A and B influenza strains.

A possible association of idiopathic osteosclerosis with excessive occlusal forces.

PubMed

Misirlioglu, Melda; Nalcaci, Rana; Baran, Ilgi; Adisen, Mehmet Zahit; Yilmaz, Selmi

2014-03-01

The aim of the study was to determine the relationship between idiopathic osteosclerotic lesions and occlusal forces using the T-Scan II computerized occlusal analysis device, and to test the sensitivity of the system in occlusal analysis. The study was conducted with 21 volunteers with idiopathic osteosclerosis (IO; 14 women, 7 men) aged between 17 and 62 years (mean 29.95). For every patient, seven or eight recordings were made with the T-Scan II occlusal analysis device in maximum intercuspation, and the last two (excluding any with technical problems) were chosen for evaluation. For each lesion-related area, the distribution of high occlusal forces from two different movies was analyzed. In 18 patients (85.71%), lesions were observed in an area of high occlusal force, and in 13 patients (61.9%), the lesions were located at the first area subjected to high occlusal forces. The percentage distribution of high forces at a lesion related area ranged from 0% to 88%. On average, the high forces at an osteosclerotic lesion area accounted for 20% of the maximum total force. No statistical differences were observed between the measurements of the two selected recordings (P > .05). The findings of this study suggest a possible relationship between IO and occlusal forces and primary contacts. T-Scan II was found to be a successful diagnostic device for detecting primary contacts and excessive occlusal forces.

PERCHLORATE ACCUMULATION FROM FERTILIZER IN LEAFY VEGETATION

EPA Science Inventory

Perchlorate contaminated water and soil has been identified in many areas of the United States. Previous studies indicated that the primary source of contamination was from industry and military operations that use perchlorate as an oxidzing agent. However, recent studies have fo...

Ground-Water Quality Beneath Irrigated Cropland of the Northern and Southern High Plains Aquifer, Nebraska and Texas, 2003-04

USGS Publications Warehouse

Stanton, Jennifer S.; Fahlquist, Lynne

2006-01-01

A study of the quality of ground water beneath irrigated cropland was completed for the northern and southern High Plains aquifer. Ground-water samples were collected from 30 water-table monitoring wells in the northern agricultural land-use (NAL) study area in Nebraska in 2004 and 29 water-table monitoring wells in the southern agricultural land-use (SAL) study area in Texas in 2003. The two study areas represented different agricultural and hydrogeologic settings. The primary crops grown in the NAL study area were corn and soybeans, and the primary crop in the SAL study area was cotton. Overall, pesticide and fertilizer application rates were larger in the NAL study area. Also, precipitation and recharge rates were greater in the NAL study area, and depths to water and evapotranspiration rates were greater in the SAL study area. Ground-water quality beneath irrigated cropland was different in the two study areas. Nitrate concentrations were larger and pesticide detections were more frequent in the NAL study area. Nitrate concentrations in NAL samples ranged from 1.96 to 106 mg/L (milligrams per liter) as nitrogen, with a median concentration of 10.6 mg/L. Water in 73 percent of NAL samples had at least one pesticide or pesticide degradate detected. Most of the pesticide compounds detected (atrazine, alachlor, metolachlor, simazine, and degradates of those pesticides) are applied to corn and soybean fields. Nitrate concentrations in SAL samples ranged from 0.96 to 21.6 mg/L, with a median of 4.12 mg/L. Water in 24 percent of SAL samples had at least one pesticide or pesticide degradate detected. The pesticide compounds detected were deethylatrazine (a degradate of atrazine and propazine), propazine, fluometuron, and tebuthiuron. Most of the pesticides detected are applied to cotton fields. Dissolved-solids concentrations were larger in the SAL area and were positively correlated with both nitrate and chloride concentrations, suggesting a combination of human and natural sources. Dissolved-solids concentrations in NAL samples ranged from 272 to 2,160 mg/L, with a median of 442 mg/L, and dissolved solids in SAL samples ranged from 416 to 3,580 mg/L, with a median of 814 mg/L.

Primary care providers’ experiences with and perceptions of personalized genomic medicine

PubMed Central

Carroll, June C.; Makuwaza, Tutsirai; Manca, Donna P.; Sopcak, Nicolette; Permaul, Joanne A.; O’Brien, Mary Ann; Heisey, Ruth; Eisenhauer, Elizabeth A.; Easley, Julie; Krzyzanowska, Monika K.; Miedema, Baukje; Pruthi, Sandhya; Sawka, Carol; Schneider, Nancy; Sussman, Jonathan; Urquhart, Robin; Versaevel, Catarina; Grunfeld, Eva

2016-01-01

Abstract Objective To assess primary care providers’ (PCPs’) experiences with, perceptions of, and desired role in personalized medicine, with a focus on cancer. Design Qualitative study involving focus groups. Setting Urban and rural interprofessional primary care team practices in Alberta and Ontario. Participants Fifty-one PCPs. Methods Semistructured focus groups were conducted and audiorecorded. Recordings were transcribed and analyzed using techniques informed by grounded theory including coding, interpretations of patterns in the data, and constant comparison. Main findings Five focus groups with the 51 participants were conducted; 2 took place in Alberta and 3 in Ontario. Primary care providers described limited experience with personalized medicine, citing breast cancer and prenatal care as main areas of involvement. They expressed concern over their lack of knowledge, in some circumstances relying on personal experiences to inform their attitudes and practice. Participants anticipated an inevitable role in personalized medicine primarily because patients seek and trust their advice; however, there was underlying concern about the magnitude of information and pace of discovery in this area, particularly in direct-to-consumer personal genomic testing. Increased knowledge, closer ties to genetics specialists, and relevant, reliable personalized medicine resources accessible at the point of care were reported as important for successful implementation of personalized medicine. Conclusion Primary care providers are prepared to discuss personalized medicine, but they require better resources. Models of care that support a more meaningful relationship between PCPs and genetics specialists should be pursued. Continuing education strategies need to address knowledge gaps including direct-to-consumer genetic testing, a relatively new area provoking PCP concern. Primary care providers should be mindful of using personal experiences to guide care. PMID:27737998

Primary care providers' experiences with and perceptions of personalized genomic medicine.

PubMed

Carroll, June C; Makuwaza, Tutsirai; Manca, Donna P; Sopcak, Nicolette; Permaul, Joanne A; O'Brien, Mary Ann; Heisey, Ruth; Eisenhauer, Elizabeth A; Easley, Julie; Krzyzanowska, Monika K; Miedema, Baukje; Pruthi, Sandhya; Sawka, Carol; Schneider, Nancy; Sussman, Jonathan; Urquhart, Robin; Versaevel, Catarina; Grunfeld, Eva

2016-10-01

To assess primary care providers' (PCPs') experiences with, perceptions of, and desired role in personalized medicine, with a focus on cancer. Qualitative study involving focus groups. Urban and rural interprofessional primary care team practices in Alberta and Ontario. Fifty-one PCPs. Semistructured focus groups were conducted and audiorecorded. Recordings were transcribed and analyzed using techniques informed by grounded theory including coding, interpretations of patterns in the data, and constant comparison. Five focus groups with the 51 participants were conducted; 2 took place in Alberta and 3 in Ontario. Primary care providers described limited experience with personalized medicine, citing breast cancer and prenatal care as main areas of involvement. They expressed concern over their lack of knowledge, in some circumstances relying on personal experiences to inform their attitudes and practice. Participants anticipated an inevitable role in personalized medicine primarily because patients seek and trust their advice; however, there was underlying concern about the magnitude of information and pace of discovery in this area, particularly in direct-to-consumer personal genomic testing. Increased knowledge, closer ties to genetics specialists, and relevant, reliable personalized medicine resources accessible at the point of care were reported as important for successful implementation of personalized medicine. Primary care providers are prepared to discuss personalized medicine, but they require better resources. Models of care that support a more meaningful relationship between PCPs and genetics specialists should be pursued. Continuing education strategies need to address knowledge gaps including direct-to-consumer genetic testing, a relatively new area provoking PCP concern. Primary care providers should be mindful of using personal experiences to guide care. Copyright© the College of Family Physicians of Canada.

Environmental factors associated with primary care access among urban older adults.

PubMed

Ryvicker, Miriam; Gallo, William T; Fahs, Marianne C

2012-09-01

Disparities in primary care access and quality impede optimal chronic illness prevention and management for older adults. Although research has shown associations between neighborhood attributes and health, little is known about how these factors - in particular, the primary care infrastructure - inform older adults' primary care use. Using geographic data on primary care physician supply and surveys from 1260 senior center attendees in New York City, we examined factors that facilitate and hinder primary care use for individuals living in service areas with different supply levels. Supply quartiles varied in primary care use (visit within the past 12 months), racial and socio-economic composition, and perceived neighborhood safety and social cohesion. Primary care use did not differ significantly after controlling for compositional factors. Individuals who used a community clinic or hospital outpatient department for most of their care were less likely to have had a primary care visit than those who used a private doctor's office. Stratified multivariate models showed that within the lowest-supply quartile, public transit users had a higher odds of primary care use than non-transit users. Moreover, a higher score on the perceived neighborhood social cohesion scale was associated with a higher odds of primary care use. Within the second-lowest quartile, nonwhites had a lower odds of primary care use compared to whites. Different patterns of disadvantage in primary care access exist that may be associated with - but not fully explained by - local primary care supply. In lower-supply areas, racial disparities and inadequate primary care infrastructure hinder access to care. However, accessibility and elder-friendliness of public transit, as well as efforts to improve social cohesion and support, may facilitate primary care access for individuals living in low-supply areas. Copyright © 2012 Elsevier Ltd. All rights reserved.

Spatial Patterns of Forest Cover Loss in the Democratic Republic of Congo

NASA Astrophysics Data System (ADS)

Molinario, G.; Hansen, M.; Potapov, P.; Justice, C. O.

2013-12-01

Three groups of metrics of spatial patterns of forest cover loss were calculated for the Democratic Republic of Congo (DRC). While other studies had previously assessed landscape patterns in the Congo Basin, they had done so for small areas due to data limitations. The input data for this study, the Forets d;Afrique Central Evaluee par Teledetection(FACET), allowed the analysis to be performed at the national level. FACET is a landsat-scale dataset giving an unprecedented synoptic view of forest cover and forest cover loss for the DRC for three time periods: 2000, 2005 and 2010. The three groups of metrics evaluated the following spatial characteristics of forest cover loss for the same standard 1.5km unit of area: proportions of typologies of forest lost, forest fragmentation and proximity of forest loss patches from other land cover types. Results indicate that there are several different typologies of forest cover loss in the DRC, and offer quantitative explanations of these differences, providing a valuable locally-relevant tool for land use planning, available at the national level. Spatial patterns of forest cover loss highlight differences between areas of high primary forest loss due to agriculture conversion in frontier deforestation, such as in the east of the country, areas of equivalent primary and secondary forest loss emanating from the rural complex and areas of variable proportions of primary and secondary forest loss but important ecological repercussions of forest fragmentation due to isolated, but systematic forest perforations. Typologies of spatial patterns of forest cover loss are presented as well as their correlated drivers, and ecological, conservation and land use planning considerations are discussed.

Primary care physician workforce and Medicare beneficiaries' health outcomes.

PubMed

Chang, Chiang-Hua; Stukel, Therese A; Flood, Ann Barry; Goodman, David C

2011-05-25

Despite a widespread interest in increasing the numbers of primary care physicians to improve care and to moderate costs, the relationship of the primary care physician workforce to patient-level outcomes remains poorly understood. To measure the association between the adult primary care physician workforce and individual patient outcomes. A cross-sectional analysis of the outcomes of a 2007 20% sample of fee-for-service Medicare beneficiaries aged 65 years or older (N = 5,132,936), which used 2 measures of adult primary care physicians (general internists and family physicians) across Primary Care Service Areas (N = 6542): (1) American Medical Association (AMA) Masterfile nonfederal, office-based physicians per total population and (2) office-based primary care clinical full-time equivalents (FTEs) per Medicare beneficiary derived from Medicare claims. Annual individual-level outcomes (mortality, ambulatory care sensitive condition [ACSC] hospitalizations, and Medicare program spending), adjusted for individual patient characteristics and geographic area variables. Marked variation was observed in the primary care physician workforce across areas, but low correlation was observed between the 2 primary care workforce measures (Spearman r = 0.056; P < .001). Compared with areas with the lowest quintile of primary care physician measure using AMA Masterfile counts, beneficiaries in the highest quintile had fewer ACSC hospitalizations (74.90 vs 79.61 per 1000 beneficiaries; relative rate [RR], 0.94; 95% confidence interval [CI], 0.93-0.95), lower mortality (5.38 vs 5.47 per 100 beneficiaries; RR, 0.98; 95% CI, 0.97-0.997), and no significant difference in total Medicare spending ($8722 vs $8765 per beneficiary; RR, 1.00; 95% CI, 0.99-1.00). Beneficiaries residing in areas with the highest quintile of primary care clinician FTEs compared with those in the lowest quintile had lower mortality (5.19 vs 5.49 per 100 beneficiaries; RR, 0.95; 95% CI, 0.93-0.96), fewer ACSC hospitalizations (72.53 vs 79.48 per 1000 beneficiaries; RR, 0.91; 95% CI, 0.90-0.92), and higher overall Medicare spending ($8857 vs $8769 per beneficiary; RR, 1.01; 95% CI, 1.004-1.02). A higher level of primary care physician workforce, particularly with an FTE measure that may more accurately reflect ambulatory primary care, was generally associated with favorable patient outcomes.

Alaska: Glaciers of Kenai Fjords National Park and Katmai National Park and Preserve (Chapter 12)

NASA Technical Reports Server (NTRS)

Giffen, Bruce A.; Hall, Dorothy K.; Chien, Janet Y.L.

2007-01-01

Much recent research points to the shrinkage of the Earth's small glaciers, however, few studies have been performed to quantify the amount of change over time. We measured glacier-extent changes in two national parks in southeastern Alaska. There are hundreds of glaciers in Kenai Fjords National Park (KEFJ) and Katmai National Park and Preserve (KATM) covering over 2373 sq km of parkland. There are two primary areas of glaciation in KEFJ - the Harding Icefield and the Grewingk-Yalik Glacier Complex, and three primary areas of glaciation in KATM - the Mt. Douglas area, the Kukak Volcano to Mt. Katmai area and the Mt. Martin area. We performed glacier mapping using satellite imagery, from the 1970s, 1980s, and from 2000. Results of the analysis show that there has been a reduction in the amount of glacier ice cover in the two parks over the study period, of approximately 22 sq km of ice, approximately - 1.6% from 1986 to 2000 (for KEFJ), and of approximately 76 sq km of glacier ice, or about -7.7% from 1986187 to 2000 (for KATM). In the future, measurements of surface elevation changes of these ice masses should be acquired; together with our extent-change measurements, the volume change of the ice masses can then be determined to estimate their contribution to sea-level rise. The work is a continuation of work done in KEFJ, but in KATM, our measurements represent the first comprehensive study of the glaciers in this remote, little-studied area.

Some Observation on the Strengths and Weaknesses of the British Primary Schools. Project for Workshops--Studying Informal Education in the British Setting--England, Summer 1974.

ERIC Educational Resources Information Center

Sorensen, Roselie

In this paper some comparisons are made between the British Primary School system and the American school system. For example, the role of the British headmaster/mistress is considerably more powerful than the role of the American principal in areas concerning curriculum content, school personnel, use of auxiliary personnel, scheduling of…

Practice Characteristics of Graduates of East Tennessee State University Quillen College of Medicine: Factors Related to Career Choices in Primary Care

ERIC Educational Resources Information Center

Click, Ivy A.

2013-01-01

The nation is facing a physician shortage, specifically in relation to primary care and in rural underserved areas. The most basic function of a medical school is to educate physicians to care for the national population. The purpose of this study was to examine the physician practicing characteristics of the graduates of East Tennessee State…

Providing Effective Support to Teachers in Addressing Social, Emotional and Behavioural Difficulties in Mainstream Classrooms in a Bangalore Pre-Primary School

ERIC Educational Resources Information Center

D'Souza, Mildred; Jament, Johnson

2015-01-01

This article reports a study conducted on children's social, emotional and behavioural difficulties (SEBD) in a single pre-primary school in Bangalore, with the objective of developing a behaviour management policy for use by teachers. Limited evidence is available in the Indian literature in the area of SEBD and it remains important to know how…

BOREAS Level-3s Landsat TM Imagery Scaled At-sensor Radiance in LGSOWG Format

NASA Technical Reports Server (NTRS)

Nickeson, Jaime; Knapp, David; Newcomer, Jeffrey A.; Cihlar, Josef; Hall, Forrest G. (Editor)

2000-01-01

For BOReal Ecosystem-Atmosphere Study (BOREAS),the level-3s Landsat Thematic Mapper (TM) data, along with the other remotely sensed images,were collected in order to provide spatially extensive information over the primary study areas. This information includes radiant energy,detailed land cover, and biophysical parameter maps such as Fraction of Photosynthetically Active Radiation (FPAR) and Leaf area Index (LAI). CCRS collected and supplied the level-3s images to BOREAS for use in the remote sensing research activities. Geographically,the bulk of the level-3s images cover the BOREAS Northern Study Area (NSA) and Southern Study Area (SSA) with a few images covering the area between the NSA and SSA. Temporally,the images cover the period of 22-Jun-1984 to 30-Jul-1996. The images are available in binary,image-format files.

Urban-suburban differences in GP requests for lumbosacral spine radiographs in a primary healthcare centre in Malta.

PubMed

Pullicino, Glorianne; Sciortino, Philip; Francalanza, Sean; Sciortino, Paul; Pullicino, Richard

2018-04-01

Due to demographic changes, growing demands, technological developments and rising healthcare costs, analysis of resources in rural and urban primary care clinics is crucial. However, data on primary care provision in rural and suburban areas are lacking. Moreover, health inequities in small island communities tend to be reduced by social homogeneity and an almost indiscernible urban-rural difference. The aim of the study was to examine the urban-suburban differences in the indications for lumbosacral spine radiographs in a public primary healthcare centre in Malta. A list of all patients who underwent lumbosacral spine radiography in a public primary healthcare centre between January and June 2014 was obtained. The indications for lumbosacral spine radiographs were compared against the evidence-based indications posited by the America College of Radiology, the American Society of Spine Radiology, the Society for Pediatric Radiology and the Society of Skeletal Radiology in 2014. Differences between suburban and urban areas were analysed using the χ² test. Direct logistic regression was used to estimate the influences of different patients' characteristics and imaging indications in urban and suburban areas. The logistic regression model predicting the likelihood of different factors occurring with suburban patients as opposed to those residing in urban areas contained four independent variables (private/public sector, examination findings, osteoporosis, infection). The full model containing all predictors was statistically significant, c2 (4, N=1112) = 26.57, p≤0.001, indicating that the model was able to distinguish between patients residing in rural and urban areas. All four of the independent variables made a unique, statistically significant contribution to the model. The model as a whole explained between 2.4% (Cox and Snell R2) and 3.6% (Nagelkerke R2) of the variance in suburban/urban areas, and correctly classified 78.5% of cases. All four of the independent variables made a unique statistically significant contribution to the model. General practitioner (GP) requests for patients residing in suburban areas were more likely to be submitted from the private sector whereas urban GPs tended to include more examination findings. Requests by GPs for lumbosacral spine radiographs due to osteoporosis and infection tended to be more prevalent for urban patients. Such findings provide information for policymakers to improve equity in health care and resource allocations within the settings of urbanity and rurality.

Survey of the knowledge and management of transient ischemic attacks among primary care physicians and nurses.

PubMed

Purroy, F; Cruz Esteve, I; Galindo Ortego, M G; Marsal Mora, J R; Oró, M; Plana, A

2011-05-01

Transient ischaemic attack (TIA) patients often report that Primary Care physicians (PCPs) and nurses are their main medical contacts after onset of symptoms in our health area. There are few studies on the knowledge and management of TIA among Community and Family Medicine professionals. Our aim was to study the current knowledge and practice in the management of TIA patients among Primary Care physicians and nurses. A cross-sectional survey with seven questions about TIA was conducted among 640 PCPs and nurses from Primary Care centres in our health area. In total, 285 (46.7% PCPs) took participate in the study. Of these, 239 (83.9%) participants knew the duration of a TIA. However only 40 (14%) recognised all clinical symptoms. An urgent neuroimaging was preferred by 67%. Only 42.5% agreed that an urgent cervical duplex would be useful in these patients. Transcranial Doppler was recognised by only 35.4%. A majority (78.2%) of participants agreed that TIA patients must be admitted to hospital. PCPs had the best knowledge of TIA (odds ratio [OR] 2.138; 95% CI 1.124-4.067; P = 0.021) but there were no differences between physicians and nurses on the management of these patients. Nurses from rural Primary Care centers had the worst level of knowledge (OR 0.410; 95% CI 0.189-0.891; P = 0.024). TIA was well recognized as a medical emergency. However, knowledge of clinical symptoms of TIA must be improved. Copyright © 2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

Outness, Stigma, and Primary Health Care Utilization among Rural LGBT Populations.

PubMed

Whitehead, J; Shaver, John; Stephenson, Rob

2016-01-01

Prior studies have noted significant health disadvantages experienced by LGBT (lesbian, gay, bisexual, and transgender) populations in the US. While several studies have identified that fears or experiences of stigma and disclosure of sexual orientation and/or gender identity to health care providers are significant barriers to health care utilization for LGBT people, these studies have concentrated almost exclusively on urban samples. Little is known about the impact of stigma specifically for rural LGBT populations, who may have less access to quality, LGBT-sensitive care than LGBT people in urban centers. LBGT individuals residing in rural areas of the United States were recruited online to participate in a survey examining the relationship between stigma, disclosure and "outness," and utilization of primary care services. Data were collected and analyzed regarding LGBT individuals' demographics, health care access, health risk factors, health status, outness to social contacts and primary care provider, and anticipated, internalized, and enacted stigmas. Higher scores on stigma scales were associated with lower utilization of health services for the transgender & non-binary group, while higher levels of disclosure of sexual orientation were associated with greater utilization of health services for cisgender men. The results demonstrate the role of stigma in shaping access to primary health care among rural LGBT people and point to the need for interventions focused towards decreasing stigma in health care settings or increasing patients' disclosure of orientation or gender identity to providers. Such interventions have the potential to increase utilization of primary and preventive health care services by LGBT people in rural areas.

Outness, Stigma, and Primary Health Care Utilization among Rural LGBT Populations

PubMed Central

Whitehead, J.; Shaver, John; Stephenson, Rob

2016-01-01

Background Prior studies have noted significant health disadvantages experienced by LGBT (lesbian, gay, bisexual, and transgender) populations in the US. While several studies have identified that fears or experiences of stigma and disclosure of sexual orientation and/or gender identity to health care providers are significant barriers to health care utilization for LGBT people, these studies have concentrated almost exclusively on urban samples. Little is known about the impact of stigma specifically for rural LGBT populations, who may have less access to quality, LGBT-sensitive care than LGBT people in urban centers. Methodology LBGT individuals residing in rural areas of the United States were recruited online to participate in a survey examining the relationship between stigma, disclosure and “outness,” and utilization of primary care services. Data were collected and analyzed regarding LGBT individuals’ demographics, health care access, health risk factors, health status, outness to social contacts and primary care provider, and anticipated, internalized, and enacted stigmas. Results Higher scores on stigma scales were associated with lower utilization of health services for the transgender & non-binary group, while higher levels of disclosure of sexual orientation were associated with greater utilization of health services for cisgender men. Conclusions The results demonstrate the role of stigma in shaping access to primary health care among rural LGBT people and point to the need for interventions focused towards decreasing stigma in health care settings or increasing patients’ disclosure of orientation or gender identity to providers. Such interventions have the potential to increase utilization of primary and preventive health care services by LGBT people in rural areas. PMID:26731405

Electronic clinical records in primary care for estimating disease burden and management. An example of COPD.

PubMed

Verde-Remeseiro, Luis; López-Pardo, Estrella; Ruano-Ravina, Alberto; Gude-Sampedro, Francisco; Castro-Calvo, Ramón

2015-01-01

Chronic obstructive pulmonary disease (COPD) is a significant health problem in developed countries. We aimed to estimate the prevalence of COPD in a single Spanish healthcare area. We also aimed to assess if there are any differences in prevalence and spirometry use among primary care services by utilizing already registered information. We designed a cross-sectional study to determine the prevalence of COPD and the performance of spirometries in each primary care service. A total of 8,444 patients were diagnosed with COPD, with a prevalence of 2.6% for individuals older than 39 years. The prevalence increased with age and was much higher in men. Significant heterogeneity was found in the prevalence of COPD and spirometry use among primary care services. COPD was underdiagnosed and there was wide variability in spirometry use in our area. Greater efforts are needed to diagnose COPD in order to improve its clinical outcomes and to refine registries so that they can be used as reliable sources of information. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

The KASCADE-Grande experiment

NASA Astrophysics Data System (ADS)

Apel, W. D.; Arteaga, J. C.; Badea, A. F.; Bekk, K.; Bertaina, M.; Blümer, J.; Bozdog, H.; Brancus, I. M.; Buchholz, P.; Cantoni, E.; Chiavassa, A.; Cossavella, F.; Daumiller, K.; de Souza, V.; Di Pierro, F.; Doll, P.; Engel, R.; Engler, J.; Finger, M.; Fuhrmann, D.; Ghia, P. L.; Gils, H. J.; Glasstetter, R.; Grupen, C.; Haungs, A.; Heck, D.; Hörandel, J. R.; Huege, T.; Isar, P. G.; Kampert, K.-H.; Kang, D.; Kickelbick, D.; Klages, H. O.; Link, K.; łuczak, P.; Ludwig, M.; Mathes, H. J.; Mayer, H. J.; Melissas, M.; Milke, J.; Mitrica, B.; Morello, C.; Navarra, G.; Nehls, S.; Oehlschläger, J.; Ostapchenko, S.; Over, S.; Palmieri, N.; Petcu, M.; Pierog, T.; Rebel, H.; Roth, M.; Schieler, H.; Schröder, F.; Sima, O.; Stümpert, M.; Toma, G.; Trinchero, G. C.; Ulrich, H.; Weindl, A.; Wochele, J.; Wommer, M.; Zabierowski, J.

2010-08-01

KASCADE-Grande is the enlargement of the KASCADE extensive air shower detector, realized to expand the cosmic ray studies from the previous 10 14-10 17 eV primary energy range to 10 18 eV. This is performed by extending the area covered by the KASCADE electromagnetic array from 200×200 to 700×700 m 2 by means of 37 scintillator detector stations of 10 m 2 area each. This new array is named Grande and provides measurements of the all-charged particle component of extensive air showers ( Nch), while the original KASCADE array particularly provides information on the muon content (Nμ). Additional dense compact detector set-ups being sensitive to energetic hadrons and muons are used for data consistency checks and calibration purposes. The performance of the Grande array and its integration into the entire experimental complex is discussed. It is demonstrated that the overall observable resolutions are adequate to meet the physical requirements of the measurements, i.e. primary energy spectrum and elemental composition studies in the primary cosmic ray energy range of 10 16-10 18 eV.

Short-Term Associations between Air Pollution Concentrations and Respiratory Health—Comparing Primary Health Care Visits, Hospital Admissions, and Emergency Department Visits in a Multi-Municipality Study

PubMed Central

Taj, Tahir; Malmqvist, Ebba; Stroh, Emilie; Oudin Åström, Daniel; Jakobsson, Kristina; Oudin, Anna

2017-01-01

Acute effects of air pollution on respiratory health have traditionally been investigated with data on inpatient admissions, emergency room visits, and mortality. In this study, we aim to describe the total acute effects of air pollution on health care use for respiratory symptoms (ICD10-J00-J99). This will be done by investigating primary health care (PHC) visits, inpatient admissions, and emergency room visits together in five municipalities in southern Sweden, using a case-crossover design. Between 2005 and 2010, there were 81,019 visits to primary health care, 38,217 emergency room visits, and 25,271 inpatient admissions for respiratory symptoms in the study area. There was a 1.85% increase (95% CI: 0.52 to 3.20) in the number of primary health care visits associated with a 10 µg/m3 increase in nitrogen dioxide (NO2) levels in Malmö, but not in the other municipalities. Air pollution levels were generally not associated with emergency room visits or inpatient admissions, with one exception (in Helsingborg there was a 2.52% increase in emergency room visits for respiratory symptoms associated with a 10 µg/m3 increase in PM10). In conclusion, the results give weak support for short-term effects of air pollution on health care use associated with respiratory health symptoms in the study area. PMID:28561792

Geographic Accessibility of Pulmonologists for Adults With COPD: United States, 2013.

PubMed

Croft, Janet B; Lu, Hua; Zhang, Xingyou; Holt, James B

2016-09-01

Geographic clusters in prevalence and hospitalizations for COPD have been identified at national, state, and county levels. The study objective is to identify county-level geographic accessibility to pulmonologists for adults with COPD. Service locations of 12,392 practicing pulmonologists and 248,160 primary care physicians were identified from the 2013 National Provider Identifier Registry and weighted by census block-level populations within a series of circular distance buffer zones. Model-based county-level population counts of US adults ≥ 18 years of age with COPD were estimated from the 2013 Behavioral Risk Factor Surveillance System. The percentages of all estimated adults with potential access to at least one provider type and the county-level ratio of adults with COPD per pulmonologist were estimated for selected distances. Most US adults (100% in urbanized areas, 99.5% in urban clusters, and 91.7% in rural areas) had geographic access to a primary care physician within a 10-mile buffer distance; almost all (≥ 99.9%) had access to a primary care physician within 50 miles. At least one pulmonologist within 10 miles was available for 97.5% of US adults living in urbanized areas, but only for 38.3% in urban clusters and 34.5% in rural areas. When distance increased to 50 miles, at least one pulmonologist was available for 100% in urbanized areas, 93.2% in urban clusters, and 95.2% in rural areas. County-level ratios of adults with COPD per pulmonologist varied greatly across the United States, with residents in many counties in the Midwest having no pulmonologist within 50 miles. County-level geographic variations in pulmonologist access for adults with COPD suggest that those adults with limited access will have to depend on care from primary care physicians. Published by Elsevier Inc.

Designing a sampling system for concurrently measuring outdoor recreation visitation and describing visitor characteristics

Treesearch

Donald B.K. English; Stanley J. Zarnoch; Susan M. Kocis

2004-01-01

Two primary information needs for managing recreation areas and the visitors to those areas are: (1) good estimates of visitation volume, and (2) accurate descriptions of visitor characteristics, such as length of stay, frequency of visit, and primary activity. For National Forests in the United States of America with large undeveloped areas, efficient sampling for the...

Prevalence of Intestinal Protozoans among Schoolchildren in Suburban Areas near Yangon, Myanmar.

PubMed

Kim, Min-Jae; Jung, Bong-Kwang; Cho, Jaeeun; Kim, Deok-Gyu; Song, Hyemi; Lee, Keon-Hoon; Cho, Seon; Htoon, Thi Thi; Tin, Htay Htay; Chai, Jong-Yil

2016-06-01

Although intestinal protozoans are common etiologies of diarrhea, few studies have been conducted in Myanmar. This study planned to investigate the prevalence of Giardia lamblia, Entamoeba coli, Entamoeba histolytica, and Endolimax nana among schoolchildren and their guardians in suburban areas near Yangon, Myanmar. We performed a cross-sectional survey among schoolchildren and their guardians from 7 primary schools in South Dagon and Hlaing Thar Yar districts, Yangon, Myanmar. Stool samples were observed with a microscope after concentration technique and iodine staining. Total 821 stool samples, including 556 from schoolchildren and 265 from guardians, were examined. The median age was 6 years old for schoolchildren and 36 years old for guardians. A 53.1% of the school children and 14.6 % of the guardians were males. The overall prevalence of each intestinal protozoan species was as follows: 3.4% (28/821) for G. lamblia; 3.5% (29/821) for E. coli; 1.2% (10/821) for E. histoytica, and 3.0% for E. nana. This study showed that intestinal protozoans are common in primary schoolchildren and their guardians in suburban areas near Yangon, Myanmar. Health interventions, such as hand washing education, improvement of sanitation, and establishment of water purification systems are urgently needed in this area.

Prevalence of Intestinal Protozoans among Schoolchildren in Suburban Areas near Yangon, Myanmar

PubMed Central

Kim, Min-Jae; Jung, Bong-Kwang; Cho, Jaeeun; Kim, Deok-Gyu; Song, Hyemi; Lee, Keon-Hoon; Cho, Seon; Htoon, Thi Thi; Tin, Htay Htay; Chai, Jong-Yil

2016-01-01

Although intestinal protozoans are common etiologies of diarrhea, few studies have been conducted in Myanmar. This study planned to investigate the prevalence of Giardia lamblia, Entamoeba coli, Entamoeba histolytica, and Endolimax nana among schoolchildren and their guardians in suburban areas near Yangon, Myanmar. We performed a cross-sectional survey among schoolchildren and their guardians from 7 primary schools in South Dagon and Hlaing Thar Yar districts, Yangon, Myanmar. Stool samples were observed with a microscope after concentration technique and iodine staining. Total 821 stool samples, including 556 from schoolchildren and 265 from guardians, were examined. The median age was 6 years old for schoolchildren and 36 years old for guardians. A 53.1% of the school children and 14.6 % of the guardians were males. The overall prevalence of each intestinal protozoan species was as follows: 3.4% (28/821) for G. lamblia; 3.5% (29/821) for E. coli; 1.2% (10/821) for E. histoytica, and 3.0% for E. nana. This study showed that intestinal protozoans are common in primary schoolchildren and their guardians in suburban areas near Yangon, Myanmar. Health interventions, such as hand washing education, improvement of sanitation, and establishment of water purification systems are urgently needed in this area. PMID:27417092

Health information technology workforce needs of rural primary care practices.

PubMed

Skillman, Susan M; Andrilla, C Holly A; Patterson, Davis G; Fenton, Susan H; Ostergard, Stefanie J

2015-01-01

This study assessed electronic health record (EHR) and health information technology (HIT) workforce resources needed by rural primary care practices, and their workforce-related barriers to implementing and using EHRs and HIT. Rural primary care practices (1,772) in 13 states (34.2% response) were surveyed in 2012 using mailed and Web-based questionnaires. EHRs or HIT were used by 70% of respondents. Among practices using or intending to use the technology, most did not plan to hire new employees to obtain EHR/HIT skills and even fewer planned to hire consultants or vendors to fill gaps. Many practices had staff with some basic/entry, intermediate and/or advanced-level skills, but nearly two-thirds (61.4%) needed more staff training. Affordable access to vendors/consultants who understand their needs and availability of community college and baccalaureate-level training were the workforce-related barriers cited by the highest percentages of respondents. Accessing the Web/Internet challenged nearly a quarter of practices in isolated rural areas, and nearly a fifth in small rural areas. Finding relevant vendors/consultants and qualified staff were greater barriers in small and isolated rural areas than in large rural areas. Rural primary care practices mainly will rely on existing staff for continued implementation and use of EHR/HIT systems. Infrastructure and workforce-related barriers remain and must be overcome before practices can fully manage patient populations and exchange patient information among care system partners. Efforts to monitor adoption of these skills and ongoing support for continuing education will likely benefit rural populations. © 2014 National Rural Health Association.

Laminar and cytoarchitectonic features of the cerebral cortex in the Risso's dolphin (Grampus griseus), striped dolphin (Stenella coeruleoalba), and bottlenose dolphin (Tursiops truncatus).

PubMed

Furutani, Rui

2008-09-01

The present investigation carried out Nissl, Klüver-Barrera, and Golgi studies of the cerebral cortex in three distinct genera of oceanic dolphins (Risso's dolphin, striped dolphin and bottlenose dolphin) to identify and classify cortical laminar and cytoarchitectonic structures in four distinct functional areas, including primary motor (M1), primary sensory (S1), primary visual (V1), and primary auditory (A1) cortices. The laminar and cytoarchitectonic organization of each of these cortical areas was similar among the three dolphin species. M1 was visualized as five-layer structure that included the molecular layer (layer I), external granular layer (layer II), external pyramidal layer (layer III), internal pyramidal layer (layer V), and fusiform layer (layer VI). The internal granular layer was absent. The cetacean sensory-related cortical areas S1, V1, and A1 were also found to have a five-layer organization comprising layers I, II, III, V and VI. In particular, A1 was characterized by the broadest layer I, layer II and developed band of pyramidal neurons in layers III (sublayers IIIa, IIIb and IIIc) and V. The patch organization consisting of the layer IIIb-pyramidal neurons was detected in the S1 and V1, but not in A1. The laminar patterns of V1 and S1 were similar, but the cytoarchitectonic structures of the two areas were different. V1 was characterized by a broader layer II than that of S1, and also contained the specialized pyramidal and multipolar stellate neurons in layers III and V.

MR-monitored LITT as a palliative concept in patients with high grade gliomas: preliminary clinical experience.

PubMed

Reimer, P; Bremer, C; Horch, C; Morgenroth, C; Allkemper, T; Schuierer, G

1998-01-01

The purpose of this study was to evaluate the clinical utility of laser-induced thermotherapy (LITT) as a palliative treatment for patients with high-grade gliomas. Four consenting patients with recurrent high grade III/IV gliomas near the primary language or motor areas were palliatively treated with LITT (2-5 W, 3-13 minutes; Neodym YAG Laser, Dornier, Friedrichshafen, Germany). Temperature monitoring was performed by T1-weighted turbo-fast low-angle shot (FLASH) imaging at 1.5 T (Siemens Magnetom SP 4000, Siemens, Erlangen, Germany). MRI studies before LITT included contrast-enhanced conventional scans and functional activation studies to localize the primary motor cortex or language areas using an echo-planar imaging (EPI) spin-echo (SE) sequence. Follow-up studies consisted of contrast-enhanced conventional scans as well as diffusion studies (contrast-enhanced Fourier-acquired steady-state technique and EPI-SE) and perfusion studies (EPI-SE with .2 mmol of gadolinium (Gd)/kg body weight) to differentiate post-therapeutic effects from residual or recurrent tumor growth. Local tumor control was achieved in areas with laser energy deposition with clinically stable conditions > or = 6 months. Conventional contrast-enhanced scans demonstrated strong enhancement surrounding ablated tumor components, which showed a reduction in CBV/CBF. Perfusion studies were useful to discriminate granulomatous tissue enhancement from residual or recurrent tumor growth. Careful application of LITT may evolve as an alternative palliative concept for patients with end-stage high-grade cerebral gliomas reducing clinical symptoms from circumscribed areas of pathology.

Preparation of a primary argon beam for the CERN fixed target physics

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

Küchler, D., E-mail: detlef.kuchler@cern.ch; O’Neil, M.; Scrivens, R.

2014-02-15

The fixed target experiment NA61 in the North Area of the Super Proton Synchrotron is studying phase transitions in strongly interacting matter. Up to now they used the primary beams available from the CERN accelerator complex (protons and lead ions) or fragmented beams created from the primary lead ion beam. To explore a wider range of energies and densities a request was made to provide primary argon and xenon beams. This paper describes the results of the setting up and 10 week test run of the Ar{sup 11+} beam from the 14.5 GHz ECR ion source and the linear acceleratormore » (Linac3) at CERN.« less

A GPS coverage model

NASA Technical Reports Server (NTRS)

Skidmore, Trent A.

1994-01-01

The results of several case studies using the Global Positioning System coverage model developed at Ohio University are summarized. Presented are results pertaining to outage area, outage dynamics, and availability. Input parameters to the model include the satellite orbit data, service area of interest, geometry requirements, and horizon and antenna mask angles. It is shown for precision-landing Category 1 requirements that the planned GPS 21 Primary Satellite Constellation produces significant outage area and unavailability. It is also shown that a decrease in the user equivalent range error dramatically decreases outage area and improves the service availability.

Educators' Understanding of Young Children's Typical and Problematic Sexual Behaviour and Their Training in This Area

ERIC Educational Resources Information Center

Ey, Lesley-anne; McInnes, Elspeth; Rigney, Lester Irabinna

2017-01-01

As part of a wider study, this paper reports on Australian educators' understanding of children's typical and problematic sexual behaviour and their source of training in this area. A sample of 107 educators from government, independent and Catholic primary schools, preschools and care organisations across Australia answered an online…

Language Attitudes of Asturian Students in the Area of Navia-Eo (Spain)

ERIC Educational Resources Information Center

González-Riaño, Xosé; Hevia-Artime, Isabel; Fernández-Costales, Alberto

2013-01-01

This paper presents a synthesis of a pioneering study that approaches the sociolinguistic and educational reality of the area of Navia-Eo, a region in the western part of Asturias (Spain). This research aims to provide an insight into the language attitudes and the sociolinguistic awareness of students in the final year of primary education. Using…

MANTLE: An Investigation of the Non-Text Elements Included in Social Studies Textbooks

ERIC Educational Resources Information Center

Murphy, Debra D.

2017-01-01

The textbook is often a primary resource for teachers in elementary content areas, and it is often used to the exclusion of other resources. Research indicates that students may not have sufficient exposure to elements of nonfiction texts in order to be successful when encountering them in the content area. For many years, there has been little…

Impacts of Second Home Development on Housing Prices in the Southern Appalachian Highlands

Treesearch

Seong-Hoon Cho; David H. Newman; David N. Wear

2003-01-01

This study estimates the value of socioeconomic, spatial and environmental attributes on housing prices of both urban and rural communities in the primary and second home areas of the Southern Appalachian Highlands, using the hedonic property price model. Distance and environmental attributes are valued more heavily in the rural communities of the second home area than...

Conduct Problems in Children Attending Pre-Primary Schools in Rural Areas of Pakistan

ERIC Educational Resources Information Center

Bhamani, Shelina; Ayub, Nadia

2014-01-01

The aim of this study was to explore the conduct problems faced by school going children in the rural areas of Pakistan. Two hypotheses were formulated to explore the significant differences between the intervention and non-intervention groups and gender on the variables of conduct and internalization. The data of a total 386 young children were…

Forest and rangeland ecosystem condition indicators: identifying national areas of opportunity using data development analysis

Treesearch

John G. Hof; Curtis H. Flather; Tony J. Baltic; Rudy M. King

2004-01-01

This article reports the methodology and results of a data envelopment analysis (DEA) that attempts to identify areas in the country where there is maximum potential for improving the forest and rangeland condition, based on 12 indicator variables. This analysis differs from previous DEA studies in that the primary variables are measures of human activity and...

The endocranial cast of an early miocene edentate, Hapalops indifferens Ameghino (Mammalia, Edentata, Tardigrada, Megatheriidae). Comparative study with brains of recent sloths.

PubMed

Dozo, M T

1987-01-01

A natural endocranial cast which represents a complete brain of a specimen of Hapalops indifferens is described. Comparing this cast to brains of actual Tardigrada, it shows a telencephalic morphology and a pattern of neocortical sulci that resemble more the brain of Bradypus rather than that of Choloepus. The neocortical sulci homologate the lateral or corono-lateral, suprasylvian and pseudosylvian sulci. Taking into account the studies of cortical maps in Bradypus and the notable similitude of the pattern of neocortical sulci between Bradypus and H. indifferens, the possible representation of the primary sensitive and motor somatic areas, secondary sensitive somatic area, visual and auditory areas are inferred. As in Bradypus, the primary sensitive and motor somatotopic organizations would be overlapped and would not be mirror images; they would show a predominance of the area of the forelimb. The relative brain size of H. indifferens is similar or higher than that of sloths of the genus Bradypus. The close resemblance between Bradypus and Hapalops, with respect to its brain morphology and relative brain size. is congruent with the current hypothesis of the phylogenetic relations between fossil and recent Tardigrada.

The relationship of ethnicity, socio-economic factors and malnutrition in primary school children in north of Iran: a cross-sectional study.

PubMed

Veghari, Gholamreza

2012-05-29

The main objective of this study was to assess the malnutrition and some socio-economic related factors based on three ethnic groups among primary school children in north of Iran in 2010. This cross-sectional study was carried out through multistage cluster random sampling on 5698 subjects (2505 Fars-native, 2154 Turkman, and 1039 Sistani) in 112 schools. Well-trained staffs completed the questionnaire and measured students' weight and height. Malnutrition estimated the Z-score less than -2SD for underweight, stunting and wasting were calculated using the cutoffs from WHO references. Generally, malnutrition was observed in 3.20%, 4.93% and 5.13% based on underweight, stunting and wasting respectively. It was more common in girls than in boys and in Sistani than in other ethnic groups. The correlation between malnutrition based on underweight and stunting and ethnicity was statistically significant (P=0.001). Results of logistic regression analyses showed that the risk of malnutrition was in rural area 1.34 times more than urban area, in girls 1.17 times more than boys, in Sistani ethnic group 1.82 times more than Fars-native ethnic group, in low economic families 2.01 times more than high economic families. Underweight, stunting and wasting are the health problems in primary school children in north of Iran with a higher prevalence in girls, in rural areas, and in Sistani ethnic group.

[Plan for improving pharmacy indicators in a primary health area of Madrid. Description and results].

PubMed

Izquierdo-Palomares, José Manuel; Carretón, María José Almodóvar; Fernández, Luís Carlos Saiz; Gómez, Raquel Siguín; Gómez, Carlos López; Elustondo, Sofía Garrido

2011-03-01

To evaluate the results of a plan for improving pharmacy indicators in a Primary Care (PC) Health Area. Quasi-experimental study with a control group. The differences between the pre-intervention (Jan-Dec 2007) and post-intervention (Jan-Dec 2008) periods were evaluated. Intervention group: Primary Care doctors from PC Area 7 of the Community of Madrid (n=397). the rest of PC doctors of the Community of Madrid (n=4428). A multi-focus plan in which the main activities were: sessions in the health centres with the worst results, involvement of those responsible for the Rational Use of Drugs, interviews with the doctors with the most improvable indicators, recognition of those with good indicators, and preparing short notes on drugs. Prescription and notification indicators associated with the safety of drugs. In relation to Madrid, the absolute improvements of Area 7 in the accumulated indicators, %Generic drugs, %Statins, %ARAII y %Omeprazole were 0.29; 1.17; 0.61 and 0.37 percentage points, respectively. DHD Osteoporosis equalled the improvement of Madrid. In Area 7, the increase in notifications of suspected serious ADRs was 180% and number of ADR notifications of ADRs was 233%, better than the Madrid data (48% and 21%). The notification of medication errors showed similar increases in both groups (PC Area 7 1567% vs. Madrid PC 1633%). Implementing a multi-focus improvement plan with feasible and specific actions can be a useful tool for improving pharmacy indicators. Copyright © 2009 Elsevier España, S.L. All rights reserved.

Evaluation of the effects of sea-level change and coastal canal management on saltwater intrusion in the Biscayne aquifer of south Florida, USA

NASA Astrophysics Data System (ADS)

Hughes, J. D.; Sifuentes, D. F.; White, J.

2015-12-01

Sea-level increases are expected to have an effect on the position of the freshwater-saltwater interface in the Biscayne aquifer in south Florida as a result of the low topographic relief of the area and high rates of groundwater withdrawal from the aquifer. To study the effects that future sea-level increases will have on saltwater intrusion in the Biscayne aquifer in Broward County, Florida, a three-dimensional, variable-density, groundwater-flow and transport model was developed. The model was calibrated to observed groundwater heads and chloride concentrations for a 62-year period that includes historic increases in sea level, development of a surface-water management system to control flooding, and increases in groundwater withdrawals as the area transitioned from agricultural to urban land uses. Sensitivity analyses indicate that downward leakage of saltwater from coastal canals and creeks was the primary source of saltwater to the Biscayne aquifer during the last 62-years in areas where the surface-water system is not actively managed and is tidally influenced. In areas removed from the coastal canals and creeks or under active surface-water management, historic groundwater withdrawals were the primary cause of saltwater intrusion into the aquifer. Simulation of future conditions suggests that possible increases in sea level will result in additional saltwater intrusion. Model scenarios suggest that additional saltwater intrusion will be greatest in areas where coastal canals and creeks were historically the primary source of seawater. Future saltwater intrusion in those areas, however, may be reduced by relocation of salinity-control structures.

In vitro effects of cisplatin-functionalized silica nanoparticles on chondrocytes

NASA Astrophysics Data System (ADS)

Bhowmick, Tridib Kumar; Yoon, Diana; Patel, Minal; Fisher, John; Ehrman, Sheryl

2010-10-01

In this study, we evaluated the combined effect of a known toxic molecule, cisplatin, in combination with relatively nontoxic nanoparticles, amorphous fumed silica, on chondrocyte cells. Cisplatin was attached to silica nanoparticles using aminopropyltriethoxy silane as a linker molecule, and characterized in terms of size, shape, specific surface area, as well as the dissolution of cisplatin from the silica surface. The primary particle diameter of the as-received silica nanoparticles ranged from 7.1 to 61 nm, estimated from measurements of specific surface area, and the primary particles were aggregated. The effects of cisplatin-functionalized silica particles with different specific surface areas (41, 85, 202, 237, and 297 m2/g) were compared in vitro on chondrocytes, the parenchymal cell of hyaline cartilage. The results show that adverse effects on cell function, as evidenced by reduced metabolic activity measured by the MTT assay and increased membrane permeability observed using the Live/Dead stain, can be correlated with specific surface area of the silica. Cisplatin-functionalized silica nanoparticles with the highest specific surface area incited the greatest response, which was almost equivalent to that induced by free cisplatin. This result suggests the importance of particle specific surface area in interactions between cells and surface-functionalized nanomaterials.

Reversible heart rhythm complexity impairment in patients with primary aldosteronism

NASA Astrophysics Data System (ADS)

Lin, Yen-Hung; Wu, Vin-Cent; Lo, Men-Tzung; Wu, Xue-Ming; Hung, Chi-Sheng; Wu, Kwan-Dun; Lin, Chen; Ho, Yi-Lwun; Stowasser, Michael; Peng, Chung-Kang

2015-08-01

Excess aldosterone secretion in patients with primary aldosteronism (PA) impairs their cardiovascular system. Heart rhythm complexity analysis, derived from heart rate variability (HRV), is a powerful tool to quantify the complex regulatory dynamics of human physiology. We prospectively analyzed 20 patients with aldosterone producing adenoma (APA) that underwent adrenalectomy and 25 patients with essential hypertension (EH). The heart rate data were analyzed by conventional HRV and heart rhythm complexity analysis including detrended fluctuation analysis (DFA) and multiscale entropy (MSE). We found APA patients had significantly decreased DFAα2 on DFA analysis and decreased area 1-5, area 6-15, and area 6-20 on MSE analysis (all p < 0.05). Area 1-5, area 6-15, area 6-20 in the MSE study correlated significantly with log-transformed renin activity and log-transformed aldosterone-renin ratio (all p < = 0.01). The conventional HRV parameters were comparable between PA and EH patients. After adrenalectomy, all the altered DFA and MSE parameters improved significantly (all p < 0.05). The conventional HRV parameters did not change. Our result suggested that heart rhythm complexity is impaired in APA patients and this is at least partially reversed by adrenalectomy.

Spatial and temporal changes in desertification in the southern region of the Tengger Desert from 1973 to 2009

NASA Astrophysics Data System (ADS)

Guan, Qingyu; Guan, Wenqian; Yang, Jing; Zhao, Shilei; Pan, Baotian; Wang, Lei; Song, Na; Lu, Min; Li, Fuchun

2017-07-01

The sandy land in the southern region of the Tengger Desert is adjacent to cities and towns, and land desertification poses a threat to the livelihood and production of local residents. To determine dynamic changes in local desertification, five periods (1973, 1987, 1992, 2001, and 2009) of remote sensing data are studied by remote sensing (RS) and geographic information system (GIS). The desert contraction area is primarily centered around three units (Wuwei, Gulang, and Jingtai) and nearby regions of Zhongwei City. The primary desert expansion areas include the west side of Helan Mountain (WSHM), the Central Mountainous Area (CMA), and the eastern and western Zhongwei units far from towns. From 1973 to 2009, the degree of change in the contracting part of the primary desert expansion unit showed an increasing trend; in brief, most of the desert (especially after 2001) has been developing in a direction in which desertification has been gradually controlled. The primary desert expansion areas are less affected by human activity, but they are primarily controlled by natural factors (especially wind and terrain). The desert contraction areas occur around the towns and nearby regions with frequent human activity; desertification is primarily controlled by human factors. With rapid economic development (especially after 2000), the scale of the cultivated area, town, and ecological protection engineering has gradually expanded, and the latter two are primarily built on a previous desert, which is the root cause of the reduction in the desert areas around the towns and the shrinkage toward north of border. Therefore, reasonable and effective human activity in the southern region of the Tengger Desert is playing a crucial role in preventing desertification.

[Health literacy in patients with heart failure treated in primary care].

PubMed

Santesmases-Masana, Rosalia; González-de Paz, Luis; Real, Jordi; Borràs-Santos, Alicia; Sisó-Almirall, Antoni; Navarro-Rubio, Maria Dolors

2017-01-01

The level of health literacy is examined, as well as its conditioning factors in patients with heart failure who are seen routinely in a Primary Health Care Area. A multicentre cross-sectional study. 10 Primary care centres from the metropolitan area of Barcelona. Patients diagnosed with heart failure. to have visited the Primary Health Care centre in the last year, being able to arrive at the primary care setting independently, and voluntarily participation. Health Literacy Survey-European Union - Questionnaire (HLS-EU-Q) and Spanish version of the European Heart Failure Self-care Behaviour Scale. An analysis was made of the relationships between health literacy, self-care practices, sociodemographic, and clinical variables using ANOVA test and a multiple linear regression model. The study included 318 patients (51.2% women) with a mean age of 77.9±8.7 years. The index of health literacy of 79.6% (n=253) of the participants indicated problems in understanding healthcare information. Health literacy level was explained by academic level (P<.001), the extent of heart failure (P=.032), self-care, and age (P<.04).The academic level explained 61.6% of the health of literacy (95% bootstrap: 44.58%; 46.75%). In patients with stable heart failure, it is important to consider all factors that help patients to understand the healthcare information. Health literacy explains patient self-care attitude in heart failure. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Assessment of the impact of increased solar ultraviolet radiation upon marine ecosystems

NASA Technical Reports Server (NTRS)

Vandyke, H.

1977-01-01

Specifically, the study has addressed the following: (1) potential for irreversible damage to the productivity, structure and/or functioning of a model estuarine ecosystem by increased UV-B radiation or ecosystems highly stable or amenable to adaptive change, and (2) the sensitivity of key community components (the primary producers, consumers, and decomposers) to increased UV-B radiation. Three areas of study were examined during the past year: (1) a continuation of the study utilizing the two seminatural ecosystem chambers, (2) a pilot study utilizing three flow-through ecosystem tanks enclosed in a small, outdoor greenhouse, and (3) sensitivity studies of representative primary producers and consumers.

Is Inferior Alveolar Nerve Block Sufficient for Routine Dental Treatment in 4- to 6-year-old Children?

PubMed Central

Erfanparast, Leila; Sheykhgermchi, Sanaz; Ghanizadeh, Milad

2017-01-01

Introduction Pain control is one of the most important aspects of behavior management in children. The most common way to achieve pain control is by using local anesthetics (LA). Many studies describe that the buccal nerve innervates the buccal gingiva and mucosa of the mandible for a variable extent from the vicinity of the lower third molar to the lower canine. Regarding the importance of appropriate and complete LA in child-behavior control, in this study, we examined the frequency of buccal gingiva anesthesia of primary mandibular molars and canine after inferior alveolar nerve block injection in 4- to 6-year-old children. Study design In this descriptive cross-sectional study, 220 4- to 6-year-old children were randomly selected and entered into the study. Inferior alveolar nerve block was injected with the same method and standards for all children, and after ensuring the success of block injection, anesthesia of buccal mucosa of primary molars and canine was examined by stick test and reaction of child using sound, eye, motor (SEM) scale. The data from the study were analyzed using descriptive statistics and statistical software Statistical Package for the Social Sciences (SPSS) version 21. Results The area that was the highest nonanesthetized was recorded as in the distobuccal of the second primary molars. The area of the lowest nonanesthesia was also reported in the gingiva of primary canine tooth. Conclusion According to this study, in 15 to 30% of cases, after inferior alveolar nerve block injection, the primary mandibular molars’ buccal mucosa is not anesthetized. How to cite this article: Pourkazemi M, Erfanparast L, Sheykhgermchi S, Ghanizadeh M. Is Inferior Alveolar Nerve Block Sufficient for Routine Dental Treatment in 4- to 6-year-old Children? Int J Clin Pediatr Dent 2017;10(4):369-372. PMID:29403231

The contribution of dietitians to the primary health care workforce.

PubMed

Howatson, Alexandra; Wall, Clare R; Turner-Benny, Petrina

2015-12-01

Dietetic intervention is effective in the management of nutrition-related conditions and their comorbidities. New Zealand has an increasing need for primary and preventive health care to reduce the burden of non-communicable disease. To review the recent evidence of effectiveness of dietetic intervention in primary health care on health and wider economic outcomes. Health benefits and cost benefits of employing dietitians to perform nutrition intervention in the primary health care setting are evaluated in the areas of obesity in conjunction with diabetes and cardiovascular disease, and malnutrition in older adults. An electronic literature search of four scientific databases, websites of major dietetic associations and high-impact nutrition and dietetic journals was conducted. Randomised controlled trials and non-randomised studies conducted from 2000 to 2014 were included. Dietetic intervention demonstrates statistically and clinically significant impacts on health outcomes in the areas of obesity, cardiovascular disease, diabetes, and malnutrition in older adults, when compared to usual care. Dietitians working in primary health care can also have significant economic benefits, potentially saving the health care system NZ$5.50-$99 for every NZ$1 spent on dietetic intervention. New Zealand must look to new models of health care provision that are not only patient-centred but are also cost-effective. This review demonstrates that dietitians in primary health care can improve patients' health and quality of life. Increasing the number of dietitians working in primary health care has the potential to make quality nutrition care accessible and affordable for more New Zealanders.

BOREAS Level-0 ER-2 Aerial Photography

NASA Technical Reports Server (NTRS)

Newcomer, Jeffrey A.; Dominquez, Roseanne; Hall, Forrest G. (Editor)

2000-01-01

For BOReal Ecosystem-Atmosphere Study (BOREAS), the ER-2 and other aerial photography was collected to provide finely detailed and spatially extensive documentation of the condition of the primary study sites. The ER-2 aerial photography consists of color-IR transparencies collected during flights in 1994 and 1996 over the study areas.

PARTICIPANT RECRUITMENT AND RETENTION FOR THE NERL RTP PM PANEL STUDY

EPA Science Inventory

EPA's National Exposure Research Laboratory (NERL) completed a 12 month Particulate Matter (PM) Panel Study in the Research Triangle Park, NC area in May 2001. A primary goal of the study was to compare PM levels measured at an ambient and residential sites with those from per...

The Study of Foreign Language Teachers-- Teacher Efficacy and Native Speakership

ERIC Educational Resources Information Center

Liaw, En-Chong

2009-01-01

This study aims at examining the differences between native and nonnative foreign language teachers at a major northeast university. The primary areas of investigation are "teacher efficacy" and "teacher perceptions of language teaching." The results of this study suggested that both nativeness and wide repertoire of teaching…

Modeling the spatial-temporal dynamics of net primary production in Yangtze River Basin using IBIS model

USGS Publications Warehouse

Zhang, Z.; Jiang, H.; Liu, J.; Zhu, Q.; Wei, X.; Jiang, Z.; Zhou, G.; Zhang, X.; Han, J.

2011-01-01

The climate change has significantly affected the carbon cycling in Yangtze River Basin. To better understand the alternation pattern for the relationship between carbon cycling and climate change, the net primary production (NPP) were simulated in the study area from 1956 to 2006 by using the Integrated Biosphere Simulator (IBIS). The results showed that the average annual NPP per square meter was about 0.518 kg C in Yangtze River Basin. The high NPP levels were mainly distributed in the southeast area of Sichuan, and the highest value reached 1.05 kg C/m2. The NPP increased based on the simulated temporal trends. The spatiotemporal variability of the NPP in the vegetation types was obvious, and it was depended on the climate and soil condition. We found the drought climate was one of critical factor that impacts the alterations of the NPP in the area by the simulation. ?? 2011 IEEE.

[Identifying potentially inappropriate prescriptions in patients over 65 years-old using original Beers criteria and their Spanish adaptation].

PubMed

Pastor Cano, Josep; Aranda García, Ana; Gascón Cánovas, Juan José; Sánchez Ruiz, José Francisco; Rausell Rausell, Víctor José; Tobaruela Soto, Mariana

2018-02-01

To compare the detection of potentially inappropriate medication (PIM) using the original Beers criteria, a global reference for evaluating prescriptions in the elderly, and their Spanish version. Retrospective observational study LOCATION: A Primary Care area in the province of Murcia, Spain. A total of 7,856 subjects aged 65 and over, with at least one drug prescribed in a Primary Care Area of Spain during study period. Illnesses and treatments registered in the Primary Care computerised medical history of patients were analysed during a 12month study period (2012). The original Beers criteria and their Spanish adaptation were used to evaluate PIM, considering both sets of criteria overall, and individually. The median age of the patients was 76.0years, with the majority females (56.6%). Patients received a median of 13 active substances and 66 medical prescriptions. The percentage of patients prescribed PIM ranged from 44.8% according to the original Beers criteria to 49.4% with the Spanish adaptation. PIMs are frequent in our context. The original Beers criteria, if not adapted to the local drug catalogue, underestimated the frequency of PIM in the elderly population studied. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Does Migration Limit the Effect of Health Insurance on Hypertension Management in China?

PubMed

Fang, Hai; Jin, Yinzi; Zhao, Miaomiao; Zhang, Huyang; A Rizzo, John; Zhang, Donglan; Hou, Zhiyuan

2017-10-20

Background: In China, rapid urbanization has caused migration from rural to urban areas, and raised the prevalence of hypertension. However, public health insurance is not portable from one place to another, and migration may limit the effectiveness of this non-portable health insurance on healthcare. Our study aims to investigate whether migration limits the effectiveness of health insurance on hypertension management in China. Methods: Data were obtained from the national baseline survey of the China Health and Retirement Longitudinal Study in 2011, including 4926 hypertensive respondents with public health insurance. Outcome measures included use of primary care, hypertension awareness, medication use, blood pressure monitoring, physician advice, and blood pressure control. Multivariate logistic regressions were estimated to examine whether the effects of rural health insurance on hypertension management differed between those who migrated to urban areas and those who did not migrate and lived in rural areas. Results: Among hypertensive respondents, 60.7% were aware of their hypertensive status. Compared to rural residents, the non-portable feature of rural health insurance significantly reduced rural-to-urban migrants' probabilities of using primary care by 7.8 percentage points, hypertension awareness by 8.8 percentage points, and receiving physician advice by 18.3 percentage points. Conclusions: In China, migration to urban areas limited the effectiveness of rural health insurance on hypertension management due to its non-portable nature. It is critical to improve the portability of rural health insurance, and to extend urban health insurance and primary care coverage to rural-to-urban migrants to achieve better chronic disease management.

Does Migration Limit the Effect of Health Insurance on Hypertension Management in China?

PubMed Central

Fang, Hai; Jin, Yinzi; Zhang, Huyang; A. Rizzo, John; Zhang, Donglan; Hou, Zhiyuan

2017-01-01

Background: In China, rapid urbanization has caused migration from rural to urban areas, and raised the prevalence of hypertension. However, public health insurance is not portable from one place to another, and migration may limit the effectiveness of this non-portable health insurance on healthcare. Our study aims to investigate whether migration limits the effectiveness of health insurance on hypertension management in China. Methods: Data were obtained from the national baseline survey of the China Health and Retirement Longitudinal Study in 2011, including 4926 hypertensive respondents with public health insurance. Outcome measures included use of primary care, hypertension awareness, medication use, blood pressure monitoring, physician advice, and blood pressure control. Multivariate logistic regressions were estimated to examine whether the effects of rural health insurance on hypertension management differed between those who migrated to urban areas and those who did not migrate and lived in rural areas. Results: Among hypertensive respondents, 60.7% were aware of their hypertensive status. Compared to rural residents, the non-portable feature of rural health insurance significantly reduced rural-to-urban migrants’ probabilities of using primary care by 7.8 percentage points, hypertension awareness by 8.8 percentage points, and receiving physician advice by 18.3 percentage points. Conclusions: In China, migration to urban areas limited the effectiveness of rural health insurance on hypertension management due to its non-portable nature. It is critical to improve the portability of rural health insurance, and to extend urban health insurance and primary care coverage to rural-to-urban migrants to achieve better chronic disease management. PMID:29053607

40 CFR 63.11166 - What General Provisions apply to primary beryllium production facilities?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Primary Nonferrous Metals Area Sources-Zinc, Cadmium, and Beryllium Primary Beryllium Production Facilities § 63.11166 What General Provisions apply to primary beryllium production facilities? (a) You must... primary beryllium production facilities? 63.11166 Section 63.11166 Protection of Environment ENVIRONMENTAL...

BESMEX: Bering Sea marine mammal experiment. [with the primary target species being the walrus and bowhead whale

NASA Technical Reports Server (NTRS)

Ray, G. C.; Wartzok, D.

1974-01-01

Predictive ecological models are being studied for the management and conservation of the walrus, and the bowhead whale in the Bering Sea. The influence of sea ice on the distribution, and carrying capacity of the area for these two mammals is to be investigated with the primary target species being the walrus. Remote sensing and radio tracking is considered a requirement for assessing the walrus ecosystem.

Parents, Quality, and School Choice: Why Parents in Nairobi Choose Low-Cost Private Schools over Public Schools in Kenya's Free Primary Education Era

ERIC Educational Resources Information Center

Zuilkowski, Stephanie Simmons; Piper, Benjamin; Ong'ele, Salome; Kiminza, Onesmus

2018-01-01

Low-cost private schools (LCPS) are widespread in Kenya, particularly in urban areas. This study examines the reasons that parents send children to fee-charging schools in a context of free public primary education. Drawing on parent survey and interview data, as well as interviews with national policy makers, we found that parents who chose LCPS…

Competition and rural primary care programs.

PubMed

Ricketts, T C

1990-04-01

Rural primary care programs were established in areas where there was thought to be no competition for patients. However, evidence from site visits and surveys of a national sample of subsidized programs revealed a pattern of competitive responses by the clinics. In this study of 193 rural primary care programs, mail and telephone surveys produced uniform data on the organization, operation, finances, and utilization of a representative sample of clinics. The programs were found to compete in terms of: (1) price, (2) service mix, (3) staff availability, (4) structural accessibility, (5) outreach, and (6) targeting a segment of the market. The competitive strategies employed by the clinics had consequences that affected their productivity and financial stability. The strategies were related to the perceived missions of the programs, and depended heavily upon the degree of isolation of the program and the targeting of the services. The competitive strategy chosen by a particular program could not be predicted based on service area population and apparent competitors in the service area. The goals and objectives of the programs had more to do with their competitive responses than with market characteristics. Moreover, the chosen strategies may not meet the demands of those markets.

Association between infant formula feeding and dental fluorosis and caries in Australian children.

PubMed

Do, Loc G; Levy, Steven M; Spencer, A John

2012-01-01

The objective of this study was to evaluate associations between patterns of infant formula feeding and dental fluorosis and caries in a representative sample of Australian children. A population-based study gathered information on fluoride exposure in early childhood. Information on infant formula feeding and fluoridation status was used to group children: three groups in nonfluoridated areas (formula nonuser, user for ≤6 months, and user for 6+ months) and four groups in fluoridated areas (nonuser, user with nonfluoridated water, user with fluoridated water for ≤6 months, and user with fluoridated water for 6+ months). Children aged 8-13 years were examined for fluorosis using the Thylstrup and Fejerskov (TF) Index. Primary tooth caries experience recorded at age 8-9 years was extracted from clinical records. Fluorosis cases were defined as having TF 1+ on maxillary incisors. Fluorosis prevalence and primary caries experience were compared across formula user groups in multivariable regression models adjusting for other factors. Total sample was 588 children. Children in fluoridated areas had higher prevalence of very mild to mild fluorosis, but lower caries experience than those in nonfluoridated areas. Among children in nonfluoridated areas, formula users for 6+ months had significantly higher prevalence of fluorosis compared with nonusers. There was no significant difference in fluorosis prevalence among the formula users in fluoridated areas. Among children in fluoridated areas, formula users with nontap water had higher caries experience. Infant formula use was associated with higher prevalence of fluorosis in nonfluoridated areas but not in fluoridated areas. Type of water used for reconstituting infant formula in fluoridated areas was associated with caries experience. © 2011 American Association of Public Health Dentistry.

Cropping Pattern Detection and Change Analysis in Central Luzon, Philippines Using Multi-Temporal MODIS Imagery and Artificial Neural Network Classifier

NASA Astrophysics Data System (ADS)

dela Torre, D. M.; Perez, G. J. P.

2016-12-01

Cropping practices in the Philippines has been intensifying with greater demand for food and agricultural supplies in view of an increasing population and advanced technologies for farming. This has not been monitored regularly using traditional methods but alternative methods using remote sensing has been promising yet underutilized. This study employed multi-temporal data from MODIS and neural network classifier to map annual land use in agricultural areas from 2001-2014 in Central Luzon, the primary rice growing area of the Philippines. Land use statistics derived from these maps were compared with historical El Nino events to examine how land area is affected by drought events. Fourteen maps of agricultural land use was produced, with the primary classes being single-cropping, double-cropping and perennial crops with secondary classes of forests, urban, bare, water and other classes. Primary classes were produced from the neural network classifier while secondary classes were derived from NDVI threshold masks. The overall accuracy for the 2014 map was 62.05% and a kappa statistic of 0.45. 155.56% increase in single-cropping systems from 2001 to 2014 was observed while double cropping systems decreased by 14.83%. Perennials increased by 76.21% while built-up areas decreased by 12.22% within the 14-year interval. There are several sources of error including mixed-pixels, scale-conversion problems and limited ground reference data. An analysis including El Niño events in 2004 and 2010 demonstrated that marginally irrigated areas that usually planted twice in a year resorted to single cropping, indicating that scarcity of water limited the intensification allowable in the area. Findings from this study can be used to predict future use of agricultural land in the country and also examine how farmlands have responded to climatic factors and stressors.

Deterioration of soil fertility by land use changes in South Sumatra, Indonesia: from 1970 to 1990

NASA Astrophysics Data System (ADS)

Lumbanraja, Jamalam; Syam, Tamaluddin; Nishide, Hiroyo; Kabul Mahi, Ali; Utomo, Muhajir; Sarno; Kimura, Makoto

1998-10-01

We monitored the land use changes in a hilly area of West Lampung, South Sumatra, Indonesia, from 1970 to 1990. The main data sources were the land use maps produced in 1970, 1978, 1984 and 1990 covering the area of 27 km×27 km. Transmigration and the resultant effect of increased population were the major driving forces in land use changes. Fifty-seven per cent of the study area was covered with primary forests in 1970, but only 13% in 1990. Areas under plantations, which were absent in 1970, increased to 60% in 1990. In addition, the change from monoculture plantations (mostly coffee plantation) to mixed plantations was noticeable from 1984 to 1990. Total upland areas including upland areas under shifting cultivation and upland fields with crops and vegetables decreased from 21% in 1970 to 0·1% in 1990. Soil chemical properties (total organic C, total N, available P, total P, exchangeable cations, cation exchangeable capacity (CEC), etc.) were analysed for lands under different land use forms after deforestation in the study area. Soil samples (surface layers, 0-20 cm, and subsurface layers, 20-40 cm) were collected from three different locations, each comprised of four different land use systems: i.e. primary forests, secondary forests, coffee plantations and cultivated lands. The contents of total organic C, total N, available P, total P, exchangeable cations and CEC decreased significantly with land use change from primary forests to the other land use forms. Cultivated lands exhibited the lowest values. Although less remarkable than in the surface layers, the amounts of total organic C, total N, total P, exchangeable cations and CEC were also decreased by forest clearing in the subsurface layers.Based on the land use changes from 1978 in the study area and the deterioration of soil chemical properties by forest clearing, total decreases in the amounts of nutrients in the surface and subsurface layers were estimated. The land use changes were estimated to have decreased the total amounts of total organic C, total N, available P, total P, exchangeable cations and CEC by 2-9% in 1984 and by 2-15% in 1990 in the surface layers, and by 1-6%% in 1984 and by 2-9% in 1990 in the subsurface layers from the levels in 1978, respectively.

40 CFR 81.338 - Oregon.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 18 2014-07-01 2014-07-01 false Oregon. 81.338 Section 81.338... AREAS FOR AIR QUALITY PLANNING PURPOSES Section 107 Attainment Status Designations § 81.338 Oregon. Oregon—1971 Sulfur Dioxide NAAQS (Primary and Secondary) Designated area Does not meet primary standards...

40 CFR 81.324 - Minnesota.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 18 2014-07-01 2014-07-01 false Minnesota. 81.324 Section 81.324... AREAS FOR AIR QUALITY PLANNING PURPOSES Section 107 Attainment Status Designations § 81.324 Minnesota. Minnesota—1971 Sulfur Dioxide NAAQS (Primary and Secondary) Designated area Does not meet primary standards...

40 CFR 81.306 - Colorado.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 18 2014-07-01 2014-07-01 false Colorado. 81.306 Section 81.306... AREAS FOR AIR QUALITY PLANNING PURPOSES Section 107 Attainment Status Designations § 81.306 Colorado. Colorado—1971 Sulfur Dioxide NAAQS (Primary and Secondary) Designated Area Does not meet primary standards...

Apparatus and method for mapping an area of interest

DOEpatents

Staab, Torsten A. Cohen, Daniel L.; Feller, Samuel [Fairfax, VA

2009-12-01

An apparatus and method are provided for mapping an area of interest using polar coordinates or Cartesian coordinates. The apparatus includes a range finder, an azimuth angle measuring device to provide a heading and an inclinometer to provide an angle of inclination of the range finder as it relates to primary reference points and points of interest. A computer is provided to receive signals from the range finder, inclinometer and azimuth angle measurer to record location data and calculate relative locations between one or more points of interest and one or more primary reference points. The method includes mapping of an area of interest to locate points of interest relative to one or more primary reference points and to store the information in the desired manner. The device may optionally also include an illuminator which can be utilized to paint the area of interest to indicate both points of interest and primary points of reference during and/or after data acquisition.

41 CFR 102-76.75 - What costs are included in the costs of alterations to provide an accessible path of travel to an...

Code of Federal Regulations, 2012 CFR

2012-01-01

... primary function for facilities subject to the standards in § 102-76.65(a)? 102-76.75 Section 102-76.75... altered area containing a primary function for facilities subject to the standards in § 102-76.65(a)? For... of travel to an altered area containing a primary function include the costs associated with— (a...

41 CFR 102-76.75 - What costs are included in the costs of alterations to provide an accessible path of travel to an...

Code of Federal Regulations, 2013 CFR

2013-07-01

... primary function for facilities subject to the standards in § 102-76.65(a)? 102-76.75 Section 102-76.75... altered area containing a primary function for facilities subject to the standards in § 102-76.65(a)? For... of travel to an altered area containing a primary function include the costs associated with— (a...

41 CFR 102-76.75 - What costs are included in the costs of alterations to provide an accessible path of travel to an...

Code of Federal Regulations, 2011 CFR

2011-01-01

... primary function for facilities subject to the standards in § 102-76.65(a)? 102-76.75 Section 102-76.75... altered area containing a primary function for facilities subject to the standards in § 102-76.65(a)? For... of travel to an altered area containing a primary function include the costs associated with— (a...

41 CFR 102-76.75 - What costs are included in the costs of alterations to provide an accessible path of travel to an...

Code of Federal Regulations, 2010 CFR

2010-07-01

... primary function for facilities subject to the standards in § 102-76.65(a)? 102-76.75 Section 102-76.75... altered area containing a primary function for facilities subject to the standards in § 102-76.65(a)? For... of travel to an altered area containing a primary function include the costs associated with— (a...

41 CFR 102-76.75 - What costs are included in the costs of alterations to provide an accessible path of travel to an...

Code of Federal Regulations, 2014 CFR

2014-01-01

... primary function for facilities subject to the standards in § 102-76.65(a)? 102-76.75 Section 102-76.75... altered area containing a primary function for facilities subject to the standards in § 102-76.65(a)? For... of travel to an altered area containing a primary function include the costs associated with— (a...

Primary Pulmonary Mucinous (Colloid) Adenocarcinoma that Arose in the Cavernomyoplasty Area in a Patient with Tuberculosis: A Rare Case Report.

PubMed

Yener, Neşe A; Sariman, Nesrin; Atasoy, Mehmet M; Midi, Ahmet; Örki, Alpay

2017-01-01

Primary pulmonary mucinous (colloid) adenocarcinoma is a rare type of lung cancer. Its arising in the cavernomyoplasty area has not been reported before. We here describe a sixty-year-old man with a previous history of multidrug-resistant and surgically-treated tuberculosis who was diagnosed as primary mucinous adenocarcinoma in the cavernomyoplasty site. We discuss the relevant literature on this rare entity.

Brain activity related to phonation in young patients with adductor spasmodic dysphonia.

PubMed

Kiyuna, Asanori; Maeda, Hiroyuki; Higa, Asano; Shingaki, Kouta; Uehara, Takayuki; Suzuki, Mikio

2014-06-01

This study investigated the brain activities during phonation of young patients with adductor spasmodic dysphonia (ADSD) of relatively short disease duration (<10 years). Six subjects with ADSD of short duration (mean age: 24. 3 years; mean disease duration: 41 months) and six healthy controls (mean age: 30.8 years) underwent functional magnetic resonance imaging (fMRI) using a sparse sampling method to identify brain activity during vowel phonation (/i:/). Intragroup and intergroup analyses were performed using statistical parametric mapping software. Areas of activation in the ADSD and control groups were similar to those reported previously for vowel phonation. All of the activated areas were observed bilaterally and symmetrically. Intergroup analysis revealed higher brain activities in the SD group in the auditory-related areas (Brodmann's areas [BA] 40, 41), motor speech areas (BA44, 45), bilateral insula (BA13), bilateral cerebellum, and middle frontal gyrus (BA46). Areas with lower activation were in the left primary sensory area (BA1-3) and bilateral subcortical nucleus (putamen and globus pallidus). The auditory cortical responses observed may reflect that young ADSD patients control their voice by use of the motor speech area, insula, inferior parietal cortex, and cerebellum. Neural activity in the primary sensory area and basal ganglia may affect the voice symptoms of young ADSD patients with short disease duration. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Developing a universal reading comprehension intervention for mainstream primary schools within areas of social deprivation for children with and without language-learning impairment: a feasibility study.

PubMed

McCartney, Elspeth; Boyle, James; Ellis, Sue

2015-01-01

Some children in areas of social deprivation in Scotland have lower reading attainment than neighbouring children in less deprived areas, and some of these also have lower spoken language comprehension skills than expected by assessment norms. There is a need to develop effective reading comprehension interventions that fit easily into the school curriculum and can benefit all pupils. A feasibility study of reading comprehension strategies with existing evidence of efficacy was undertaken in three mainstream primary schools within an area of social deprivation in west central Scotland, to decide whether further investigation of this intervention was warranted. Aims were to measure comprehension of spoken language and reading via standardised assessments towards the beginning of the school year (T1) in mainstream primary school classrooms within an area of social deprivation; to have teachers introduce previously-validated text comprehension strategies, and to measure change in reading comprehension outcome measures towards the end of the year (T2). A pre- and post-intervention cohort design was used. Reading comprehension strategies were introduced to staff in participating schools and used throughout the school year as part of on-going reading instruction. Spoken language comprehension was measured by TROG-2 at T1, and reading progress by score changes from T1 to T2 on the WIAT-II(UK) -T reading comprehension scale. Forty-seven pupils in five classes in three primary schools took part: 38% had TROG-2 scores below the 10(th) centile. As a group, children made good reading comprehension progress, with a medium effect size of 0.46. Children with TROG-2 scores below the 10(th) centile had lower mean reading scores than others at T1 and T2, although with considerable overlap. However, TROG-2 did not make a unique contribution to reading progress: children below the 10(th) centile made as much progress as other children. The intervention was welcomed by schools, and the measure of reading comprehension proved responsive to change. The outcomes suggest the reading intervention may be effective for children with and without spoken language comprehension difficulties, and warrants further investigation in larger, controlled, studies. © 2014 Royal College of Speech and Language Therapists.

Vascular status in human primary and permanent teeth in health and disease.

PubMed

Rodd, Helen D; Boissonade, Fiona M

2005-04-01

The present study sought to compare the vascular status of human primary teeth with that of human permanent teeth, and to determine whether caries or painful pulpitis was associated with changes in vascularity. Coronal pulps were removed from 62 primary and 62 permanent mandibular molars with a known pain history. Teeth were categorized as intact, moderately carious or grossly carious. Pulp sections were labelled with Ulex europaeus I lectin (UEIL), which is a marker of human vascular endothelium. Image analysis was then used to quantify the percentage area of UEIL-labelled tissue (vascularity) and the number of blood vessels present within three regions: the pulp horn, the subodontoblastic region, and the mid-coronal pulp. Only the mid-coronal region of the primary tooth pulp was found to be significantly more vascular than the corresponding area of the permanent tooth pulp. Both dentitions showed a significant increase in vascularity within the pulp horn region with caries progression, but this was not accompanied by an increase in vessel number. There was no correlation between vascularity and pain symptoms. These findings suggest that the primary tooth pulp is more vascular than its successor within the mid-coronal region. However, the functional and clinical significance of this finding remains speculative.

Decision making in cancer primary prevention and chemoprevention.

PubMed

Gorin, Sherri Sheinfeld; Wang, Catharine; Raich, Peter; Bowen, Deborah J; Hay, Jennifer

2006-12-01

We know very little about how individuals decide to undertake, maintain, or discontinue cancer primary prevention or chemoprevention. The aims of this article are to (a) examine whether and, if so, how traditional health behavior change models are relevant for decision making in this area; (b) review the application of decision aids to forming specific, personal choices between options; and (c) identify the challenges of evaluating these decision processes to suggest areas for future research. Theoretical models and frameworks derived from the health behavior change and decision-making fields were applied to cancer primary prevention choices. Decision aids for the human papillomavirus (HPV) vaccine, Hormone Replacement Therapy (HRT), and tamoxifen were systematically examined. Traditional concepts such as decisional balance and cues to action are relevant to understanding cancer primary prevention choices; Motivational Interviewing, Self-Determination Theory, and the Preventive Health Model may also explain the facilitators of decision making. There are no well-tested HPV vaccine decision aids, although there have been some studies on aids for HPV testing. There are several effective decision aids for HRT and tamoxifen; evidence-based decision aid components have also been identified. Additional theory-based empirical research on decision making in cancer primary prevention and chemoprevention, particularly at the interface of psychology and behavioral economics, is suggested.

A warning to the Brazilian Speech-Language Pathology and Audiology community about the importance of scientific and clinical activities in primary progressive aphasia.

PubMed

Beber, Bárbara Costa; Brandão, Lenisa; Chaves, Márcia Lorena Fagundes

2015-01-01

This article aims to warn the Brazilian Speech-Language Pathology and Audiology scientific community about the importance and necessity of scientific and clinical activities regarding Primary Progressive Aphasia. This warning is based on a systematic literature review of the scientific production on Primary Progressive Aphasia, from which nine Brazilian articles were selected. It was observed that there is an obvious lack of studies on the subject, as all the retrieved articles were published in medical journals and much of it consisted of small samples; only two articles described the effectiveness of speech-language therapy in patients with Primary Progressive Aphasia. A perspective for the future in the area and characteristics of Speech-Language Therapy for Primary Progressive Aphasia are discussed. As a conclusion, it is evident the need for greater action by Speech-Language Pathology and Audiology on Primary Progressive Aphasia.

Water Pollution Prediction in the Three Gorges Reservoir Area and Countermeasures for Sustainable Development of the Water Environment.

PubMed

Li, Yinghui; Huang, Shuaijin; Qu, Xuexin

2017-10-27

The Three Gorges Project was implemented in 1994 to promote sustainable water resource use and development of the water environment in the Three Gorges Reservoir Area (hereafter "Reservoir Area"). However, massive discharge of wastewater along the river threatens these goals; therefore, this study employs a grey prediction model (GM) to predict the annual emissions of primary pollution sources, including industrial wastewater, domestic wastewater, and oily and domestic wastewater from ships, that influence the Three Gorges Reservoir Area water environment. First, we optimize the initial values of a traditional GM (1,1) model, and build a new GM (1,1) model that minimizes the sum of squares of the relative simulation errors. Second, we use the new GM (1,1) model to simulate historical annual emissions data for the four pollution sources and thereby test the effectiveness of the model. Third, we predict the annual emissions of the four pollution sources in the Three Gorges Reservoir Area for a future period. The prediction results reveal the annual emission trends for the major wastewater types, and indicate the primary sources of water pollution in the Three Gorges Reservoir Area. Based on our predictions, we suggest several countermeasures against water pollution and towards the sustainable development of the water environment in the Three Gorges Reservoir Area.

Access to primary care for socioeconomically disadvantaged older people in rural areas: a realist review.

PubMed

Ford, John A; Wong, Geoff; Jones, Andy P; Steel, Nick

2016-05-17

The aim of this review is to identify and understand the contexts that effect access to high-quality primary care for socioeconomically disadvantaged older people in rural areas. A realist review. MEDLINE and EMBASE electronic databases and grey literature (from inception to December 2014). Broad inclusion criteria were used to allow articles which were not specific, but might be relevant to the population of interest to be considered. Studies meeting the inclusion criteria were assessed for rigour and relevance and coded for concepts relating to context, mechanism or outcome. An overarching patient pathway was generated and used as the basis to explore contexts, causal mechanisms and outcomes. 162 articles were included. Most were from the USA or the UK, cross-sectional in design and presented subgroup data by age, rurality or deprivation. From these studies, a patient pathway was generated which included 7 steps (problem identified, decision to seek help, actively seek help, obtain appointment, get to appointment, primary care interaction and outcome). Important contexts were stoicism, education status, expectations of ageing, financial resources, understanding the healthcare system, access to suitable transport, capacity within practice, the booking system and experience of healthcare. Prominent causal mechanisms were health literacy, perceived convenience, patient empowerment and responsiveness of the practice. Socioeconomically disadvantaged older people in rural areas face personal, community and healthcare barriers that limit their access to primary care. Initiatives should be targeted at local contextual factors to help individuals recognise problems, feel welcome, navigate the healthcare system, book appointments easily, access appropriate transport and have sufficient time with professional staff to improve their experience of healthcare; all of which will require dedicated primary care resources. 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/

40 CFR 63.11164 - What General Provisions apply to primary zinc production facilities?

Code of Federal Regulations, 2011 CFR

2011-07-01

... primary zinc production facilities? 63.11164 Section 63.11164 Protection of Environment ENVIRONMENTAL... Primary Nonferrous Metals Area Sources-Zinc, Cadmium, and Beryllium Primary Zinc Production Facilities § 63.11164 What General Provisions apply to primary zinc production facilities? (a) If you own or...

40 CFR 63.11164 - What General Provisions apply to primary zinc production facilities?

Code of Federal Regulations, 2010 CFR

2010-07-01

... primary zinc production facilities? 63.11164 Section 63.11164 Protection of Environment ENVIRONMENTAL... Primary Nonferrous Metals Area Sources-Zinc, Cadmium, and Beryllium Primary Zinc Production Facilities § 63.11164 What General Provisions apply to primary zinc production facilities? (a) If you own or...

Environmental setting and factors that affect water quality in the Georgia-Florida Coastal Plain study unit

USGS Publications Warehouse

Berndt, M.P.; Oaksford, E.T.; Darst, M.R.; Marella, R.L.

1996-01-01

The Georgia-Florida Coastal Plain study unit covers an area of nearly 62,000 square miles in the southeastern United States, mostly in the Coastal Plain physiographic province. Land resource provinces have been designated based on generalized soil classifications. Land resource provinces in the study area include: the Coastal Flatwoods, the Southern Coastal Plain, the Central Florida Ridge, the Sand Hills, and the Southern Piedmont. The study area includes all or parts of seven hydrologic subregions: the Ogeechee-Savannah, the Altamaha- St.Marys, the Suwannee, the Ochlockonee, the St. Johns, the Peace-Tampa Bay, and the Southern Florida. The primary source of water for public supply in the study area is ground water from the Upper Floridan aquifer. In 1990, more than 90 percent of the 2,888 million gallons per day of ground water used came from this aquifer. The population of the study area was 9.3 million in 1990. The cities of Jacksonville, Orlando, St. Petersburg, Tallahassee, and Tampa, Florida, and parts of Atlanta and Savannah, Georgia, are located in the study area. Forest and agricultural areas are the most common land uses in the study area, accounting for 48 percent and 25 percent of the study area, respectively. Climatic conditions range from temperate in Atlanta, Georgia, where mean annual temperature is about 61.3 degrees Fahrenheit, to subtropical in Tampa, Florida, where mean annual temperature is about 72.4 degrees Fahrenheit. Long-term average precipitation (1961-90) ranges from 43.9 inches per year in Tampa, Florida, and 44.6 in Macon, Georgia, to 65.7 inches per year in Tallahassee, Florida. Floods in the study area result from frontal systems, hurricanes, tropical storms, or severe thunderstorms. Droughts are not common in the study area,especially in the Florida part of the study area due to extensive maritime exposure. The primary physical and cultural characteristics in the study area include physiography, soils and land resource provinces, geologic setting, ground-water systems, surface- water systems, climate, floods, droughts, population, land use, and water use. Factors affecting water quality in the study area are land use (primarily urban and agricultural land uses), water use in coastal areas, hydrogeology, ground-water/surface-water interaction, geology, and climate. Surface-water quality problems in urban areas have occurred in the Ogeechee, Canoochee, Ocmulgee, St. Marys, Alapaha, Withlacoochee (north), Santa Fe, Ochlockonee, St. Johns, and Oklawaha Rivers and include nitrogen and phosphorus loading, low dissolved oxygen, elevated bacteria, sediment, and turbidity, and increased concentrations of metals. In agricultural areas, surface-water quality problems include elevated nitrogen and phosphorus concentrations, erosion, and sedimentation and have occurred in the Ocmulgee, St. Marys, Santa Fe, Ochlockonee, St. Johns, Oklawaha, Withlacoochee (South), Hillsborough, and Alafia Rivers. Ground water-quality problems such as saltwater intrusion have occurred mostly in coastal areas and were caused by excessive withdrawals.

Physico-chemical quality of drinking water in villages of Primary Health Centre, Waghodia, Gujarat (India).

PubMed

Desai, Gaurav; Vasisth, Smriti; Patel, Maharshi; Mehta, Vaibhav; Bhavsar, Bharat

2012-07-01

16 water samples were collected to study the physical and chemical quality of water of main source of drinking water in the villages of Primary Health Centre, Waghodia of Vadodara district of Gujarat. The values recommended by Indian Standard for Drinking Water (IS 10500:1991) were used for comparison of observed values. The study indicates that the contamination problem in these villages is not alarming at present, but Waghodia being industrial town, ground water quality may deteriorate with passage of time, which needs periodical monitoring. The study provides the local area baseline data which may be useful for the comparison of future study.

Nutritional status of urban and rural primary school pupils in Lagos State, Nigeria.

PubMed

Ekekezie, O O; Odeyemi, K A; Ibeabuchi, N M

2012-01-01

This study was carried out in Lagos State in Ikorodu LGA (rural), a largely agrarian area producing raw materials for agro-allied industries and Ikeja LGA (urban), a highly-developed metropolis and commercial centre. Hitherto, studies showed that undernutrition had been the main form of malnutrition among Nigerian children. However with influences from urbanization, westernization and globalization in cosmopolitan Lagos, it is imperative to find out if the global epidemic of overweight and obesity has caught on. To compare the nutritional status of primary school pupils in urban and rural LGAs in Lagos State, Nigeria. This was a cross , sectional comparative study. A multistage sampling method was adopted. Data were collected from 529 pupils with an interviewer administered questionnaire. Their weight and height were recorded in pre-designed proforma and converted to nutritional indices. The prevalence rates of underweight, stunting and wasting in the rural area were 49.6%, 50.8% and 24.2% respectively; while it was 15.1%, 16.6% and 13.6% in the urban area respectively. There was overnutrition in the urban area: 15.1% were overweight and 13.2% were obese. The mean nutritional indices were significantly lower among the rural pupils than urban pupils (p<0.001) in each case. Undernutrition is still a major health problem among school children in Lagos State, Nigeria, more so in the rural area. There is an emergence of overweight and obesity in the urban area. A comprehensive programme to improve nutritional status is recommended as part of a well funded school health programme.

On the Urban-Rural Differences in Classroom Environment in Compulsory Education in the Eastern Coastal Developed Areas of China

ERIC Educational Resources Information Center

Sun, Furong; Xie, Limin

2008-01-01

Totally 789 students from 18 schools (9 primary schools and 9 junior high schools) at a medium managed level from Shanghai, Wenzhou, and Aojiang, which are located in the Eastern coastal developed areas of China were investigated with the questionnaire of Hong Kong Classroom Environment Scale in this study. The result indicates that the actual…

Electromyography (EMG) analysis on impact of classroom chair and table usage among primary school students in Perlis

NASA Astrophysics Data System (ADS)

Jing, Ewe Hui; Shan, Lim Shaiu; Effendi, M. S. M.; Rosli, Muhamad Farizuan

2017-09-01

The existing design of primary school classroom chair and table had brought low back pain, neck pain and shoulder pain problems respectively among students in primary school. The purpose of this study is to relate the electromyography (EMG) analysis with the most critical area of the body during sitting and writing. Six male and six female primary school students from SK Seri Perlis with no back pain, neck pain and shoulder pain problems involved were invited as respondents in this study. EMG experiment was carried out by first determined the critical point at T9 and L3 from thoracic and lumbar segment respectively for ECG electrode placement and performed with a series of sitting trials for analysis. The sitting trials performed were slouch to lumbopelvic sitting and slouch to thoracic sitting follow by instruction. Next, the electrode placement was identified at C2-C3 on cervical spine for neck and at midpoint between C7 to the lateral edge of acromion spanning for shoulder respectively. These points were identified for a series of writing task performing for the EMG analysis. There were two type of writing task which included writing by looking at the whiteboard and paper placed on the table. The subjects were instructed to rest during the experiment when necessary. During lumbopelvic sitting posture, the average muscle activation on lumbar area was at the highest peak. The peak indicated that there was critical effect from the experimental finding. The performance of writing task from whiteboard gave rise a higher impact on neck muscle while writing task from paper had a greater impact on shoulder muscle. The critical affected muscle on these areas was proven on these written tasks. The EMG experiment showed that the existing design of primary school classroom chair and table had brought impact on lumbar, neck and shoulder towards the students who were using. A future recommendation suggests that to redesign primary school classroom chair and table which develop with prototype for improvement of EMG result testing.

Is the health of people living in rural areas different from those in cities? Evidence from routine data linked with the Scottish Health Survey.

PubMed

Teckle, P; Hannaford, P; Sutton, M

2012-02-17

To examine the association between rurality and health in Scotland, after adjusting for differences in individual and practice characteristics. Mortality and hospital record data linked to two cross sectional health surveys. Respondents in the community-based 1995 and 1998 Scottish Health Survey who consented to record-linkage follow-up. Hypertension, all-cause premature mortality, total hospital stays and admissions due to coronary heart disease (CHD). Older age and lower social class were strongly associated with an increased risk of each of the four health outcomes measured. After adjustment for individual and practice characteristics, no consistent pattern of better or poorer health in people living in rural areas was found, compared to primary cities. However, individuals living in remote small towns had a lower risk of a hospital admission for CHD and those in very remote rural had lower mortality, both compared with those living in primary cities. This study has shown how linked data can be used to explore the possible influence of area of residence on health. We were unable to find a consistent pattern that people living in rural areas have materially different health to that of those living in primary cities. Instead, we found stronger relationships between compositional determinants (age, gender and socio-economic status) and health than contextual factors (including rurality).

Prevalence of primary headache disorders in a population aged 60 years and older in a rural area of Northern China.

PubMed

Zhang, Yajing; Shi, Zhihong; Hock, Duncan; Yue, Wei; Liu, Shuling; Zhang, Ying; Liu, Shuai; Zhao, Lei; Lu, Hui; Guan, Yalin; Wang, Xiaodan; Wsiniewski, Thomas; Ji, Yong

2016-12-01

Primary headache disorders are among the most common neurological complaints worldwide, and are significant causes of disability. Data are limited on the prevalence of primary headaches among individuals aged 60 years and older in China. The purpose of our study was to investigate the prevalence and characteristics of primary headaches among people aged 60 years and older in a rural area of northern China. A door-to-door survey was conducted in Ji County of Tianjin Province. A total of 5248 residents aged 60 years and older were visited from 2014 to 2015, unannounced, and basic sociodemographic and headache diagnostic information was collected via a questionnaire. Primary headache was classified tension-type headaches, migraines, chronic headache, and unclassified headache. The 1-year prevalence for primary headaches in Ji county is 10.30 %. The 1-year prevalence of tension-type headaches, migraines, chronic headache, and unclassified headache is 2.02 %, 0.85 %, 3.79 %, and 3.63 %. The 1-year prevalence of primary headache was higher in women than in men. The 1-year prevalence of primary headache was decreased with increasing age. The 1-year prevalence of tension-type headaches and chronic headache were decreased with higher education. Headache in the elderly was mild to moderate and not serious. In a population older than 60 years of age in rural, northern China, we found the 1-year prevalence of primary headache was 10.30 %, of tension-type headaches was 2.02 %, of migraines was 0.85 %, of chronic headache was 3.79 %, and of unclassified headache was 3.63 %. The prevalence of all of these was much lower than those observed in previous studies examining prevalence rates in the general population. The results of our study also indicated that women are more likely to have primary headache than men. We also found that chronic headache was frequent among the elderly. Participants with higher education levels were more predisposed than healthy participants to tension-type headaches. We also found that respondents who did not participate in social activities had a decreased predisposition for primary headache in general, as well as for unclassified headache. Lastly, we found that participants who had heart disease were more likely than healthy participants to experience primary headache, tension-type headache, chronic headache, and unclassified headache.

Inter-generational change in African elephant range use is associated with poaching risk, primary productivity and adult mortality.

PubMed

Goldenberg, Shifra Z; Douglas-Hamilton, Iain; Wittemyer, George

2018-05-30

Repeated use of the same areas may benefit animals as they exploit familiar sites, leading to consistent home ranges over time that can span generations. Changing risk landscapes may reduce benefits associated with home range fidelity, however, and philopatric animals may alter movement in response to new pressures. Despite the importance of range changes to ecological and evolutionary processes, little tracking data have been collected over the long-term nor has range change been recorded in response to human pressures across generations. Here, we investigate the relationships between ecological, demographic and human variables and elephant ranging behaviour across generations using 16 years of tracking data from nine distinct female social groups in a population of elephants in northern Kenya that was heavily affected by ivory poaching during the latter half of the study. Nearly all groups-including those that did not experience loss of mature adults-exhibited a shift north over time, apparently in response to increased poaching in the southern extent of the study area. However, loss of mature adults appeared to be the primary indicator of range shifts and expansions, as generational turnover was a significant predictor of range size increases and range centroid shifts. Range expansions and northward shifts were associated with higher primary productivity and lower poached carcass densities, while westward shifts exhibited a trend to areas with higher values of primary productivity and higher poached carcass densities relative to former ranges. Together these results suggest a trade-off between resource access, mobility and safety. We discuss the relevance of these results to elephant conservation efforts and directions meriting further exploration in this disrupted society of a keystone species. © 2018 The Author(s).

Subtidal benthic megafauna in a productive and highly urbanised semi-enclosed bay (Ría de Vigo, NW Iberian Peninsula)

NASA Astrophysics Data System (ADS)

Aneiros, Fernando; Rubal, Marcos; Troncoso, Jesús S.; Bañón, Rafael

2015-11-01

The Ría de Vigo is a semi-enclosed bay with high primary productivity due to the influence of coastal upwelling-downwelling dynamics. The area is heavily populated and affected by numerous human activities, which lead to sediment modification. Epibenthic megafauna from the non-estuarine zones of this bay has been studied in order to describe its spatial distribution, testing possible differences between inner and outer areas. With that purpose, 75 sites have been sampled by means of a towing dredge. Megafauna was identified to the lowest taxonomic level possible, and each taxon counted and weighted. 113 different taxa were identified and a high spatial heterogeneity was observed in terms of abundance, biomass, taxa richness, diversity and evenness. Suspension-feeding molluscs dominated the innermost part of the studied area, and were substituted by echinoderms towards the external zones; this spatial pattern was also reflected in the results of multivariate analyses. These shifts in taxonomic and trophic guild composition of the assemblages have been tentatively related to differences in pollution levels and primary productivity along the main axis of the bay.

GIS residency footprinting: analyzing the impact of family medicine graduate medical education in Hawai'i.

PubMed

Hixon, Allen L; Buenconsejo-Lum, Lee E; Racsa, C Philip

2012-04-01

Access to care for patients in Hawai'i is compromised by a significant primary care workforce shortage. Not only are there not enough primary care providers, they are often not practicing in locations of high need such as rural areas on the neighbor islands or in the Pacific. This study used geographic information systems (GIS) spatial analysis to look at practice locations for 86 University of Hawai'i Family Medicine and Community Health graduates from 1993 to the 2010. Careful alumni records were verified and entered into the data set using the street address of major employment. Questions to be answered were (1) what percentage of program graduates remain in the state of Hawai'i and (2) what percentage of graduates practice in health professional shortage areas (HPSAs) throughout the United States. This study found that 73 percent of graduates remain and practice in Hawai'i with over 36 percent working in Health Professional Shortage Areas. Spatial analysis using GIS residency footprinting may be an important analytic tool to ensure that graduate medical education programs are meeting Hawai'i's health workforce needs.

Perceived effects of the economic recession on population mental health, well-being and provision of care by primary care users and professionals: a qualitative study protocol in Portugal

PubMed Central

Frasquilho, Diana; Cardoso, Graça; Pereira, Nádia; Silva, Manuela; Caldas-de-Almeida, José Miguel; Ferrão, João

2017-01-01

Introduction Economic recession periods can pose accentuated risks to population’s mental health and well-being as well as additional threats to health systems. Users and health professionals are key stakeholders in care delivery; however, little attention has been given to their experiences of the crisis. This paper presents a qualitative study protocol to assess users’ and health professionals’ perceptions about the effects of the post-2008 economic recession on mental health and care delivery in the Lisbon Metropolitan Area, Portugal. Methods and analysis The methodology to assess perceived effects of the economic recession by primary care users and professionals on population mental health, well-being and provision of care is presented. Focus groups with users and semistructured interviews with health professionals will be carried out in three primary healthcare units in Lisbon areas especially affected by the crisis. Thematic analysis of full-transcribed interviews will be conducted using an iterative and reflexive approach. Ethics and dissemination The study protocol was approved by the Ethics Committee of NOVA Medical School, NOVA University of Lisbon. The findings will be useful for other researchers and policy-makers to develop and implement the assessment of prevailing experiences of users and health professionals on the effects of the economic recession on mental health and quality of care in primary health context, promoting their involvement and contribution to services responsiveness. PMID:28871022

Climatology of the autumn Red Sea trough

NASA Astrophysics Data System (ADS)

Awad, Adel M.; Mashat, Abdul-Wahab S.

2018-03-01

In this study, the Sudan low and the associated Red Sea trough (RST) are objectively identified using the mean sea level pressure (SLP) data from the National Center for Environmental Prediction/National Center for Atmospheric Research (NCEP/NCAR) reanalysis dataset covering the period 1955-2015. The Sudan low was detected in approximately 60.6% of the autumn periods, and approximately 83% of the detected low-pressure systems extended into RSTs, with most generated at night and during cold months. The distribution of the RSTs demonstrated that Sudan, South Sudan and Red Sea are the primary development areas of the RSTs, generating 97% of the RSTs in the study period. In addition, the outermost areas affected by RSTs, which include the southern, central and northern Red Sea areas, received approximately 91% of the RSTs originating from the primary generation areas. The synoptic features indicated that a Sudan low developed into an RST when the Sudan low deepened in the atmosphere, while the low pressures over the southern Arabian Peninsula are shallow and the anticyclonic systems are weakened over the northern Red Sea. Moreover, stabile areas over Africa and Arabian Peninsula form a high stability gradient around the Red Sea and the upper maximum winds weaken. The results of the case studies indicate that RSTs extend northward when the upper cyclonic and anticyclonic systems form a high geopotential gradient over Arabian Peninsula. Furthermore, the RST is oriented from the west to the east when the Azores high extends eastward and the Siberian high shrinks eastward or shifts northward.

Brain correlates to facial motor imagery and its somatotopy in the primary motor cortex.

PubMed

Soliman, Ramy S; Lee, Sanghoon; Eun, Seulgi; Mohamed, Abdalla Z; Lee, Jeungchan; Lee, Eunyoung; Makary, Meena M; Kathy Lee, Seung Min; Lee, Hwa-Jin; Choi, Woo Suk; Park, Kyungmo

2017-03-22

Motor imagery (MI) has attracted increased interest for motor rehabilitation as many studies have shown that MI shares the same neural networks as motor execution (ME). Nevertheless, MI in terms of facial movement has not been studied extensively; thus, in the present study, we investigated shared neural networks between facial motor imagery (FMI) and facial motor execution (FME). In addition, FMI somatotopy within-face was investigated between the forehead and the mouth. Functional MRI was used to examine 34 healthy individuals with ME and MI paradigms for the forehead and the mouth. The general linear model and a paired t-test were performed to define the facial area in the primary motor cortex (M1) and this area has been used to investigate somatotopy between the forehead and mouth FMI. FMI recruited similar brain motor areas as FME, but showed less neural activity in all activated regions. The facial areas in M1 were distinguishable from other body movements such as finger movement. Further investigation of this area showed that forehead and mouth imagery tended to lack a somatotopic representation for position on M1, and yet had distinct characteristics in terms of neural activity level. FMI showed different characteristics from general MI as the former exclusively activated facial processing areas. In addition, FME and FMI showed different characteristics in terms of BOLD signal level, while sharing the same neural areas. The results imply a potential usefulness of MI training for rehabilitation of facial motor disease considering that forehead and mouth somatotopy showed no clear position difference, and yet showed a significant BOLD signal intensity variation.

THE RESEARCH TRIANGLE PARK PARTICULATE MATTER PANEL STUDY: PM MASS CONCENTRATION RELATIONSHIPS

EPA Science Inventory

The U.S. Environmental Protection Agency has recently performed the Research Triangle Park Particulate Matter Panel Study. This was a one-year investigation of PM and related co-pollutants involving participants living within the RTP area of North Carolina. Primary goals were t...

Clusters in Short-term Disease Course in Participants With Primary Dupuytren Disease.

PubMed

Lanting, Rosanne; van den Heuvel, Edwin R; Werker, Paul M N

2016-03-01

The course of Dupuytren disease (DD) is thought to be progressive; however, the course differs for each patient. The purpose of this study was to study the rate and pattern of progression of DD. We prospectively analyzed the course of DD at intervals of 3 to 6 months in 247 Dutch participants with primary DD by measuring the surface area of nodules and cords and the total passive extension deficit. The association between surface area and Tubiana stage was tested with generalized estimating equations. Latent class models were used to study different clusters in changes regarding the course of the disease. The variance in disease course between participants was large. Regarding the change in surface area (in all fingers) and total passive extension deficit (in the ring and little finger), different clusters were observed. Progression of disease was seen but there were also signs of stability and even regression. Patients with a smaller surface area at baseline were more likely to exhibit regression. This study showed that DD is not always progressive and that up to 75% of patients have a different short-term disease course, such as stability or even regression of disease. This should be taken into account when evaluating the effects of treatment for early-phase DD and in the design of future studies. Furthermore, this information may be useful when counseling patients. Prognostic II. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Review of Lead-Zinc Mining Impact on Landscape in the Tri-State Mining District using Small Unmanned Aerial Vehicles.

NASA Astrophysics Data System (ADS)

Bhakta, K. D.; Yeboah-Forson, A.

2015-12-01

The Tri-State lead and zinc mining district in SW Missouri, SE Kansas, and NE Oklahoma encompasses nearly 2,500 sq. miles of land and at its peak accounted for half of the US zinc (23,000,000 tons) production that surpassed one billion dollars in economic value. Once these lead and zinc rich ores were extracted, mining and milling sites were abandoned leaving behind a new landscape with numerous environmental challenges. Since 1970, most of the sites have been targeted for remediation and reclamation by federal and state agencies including the EPA. In order to capture the full extent of the impact of lead and zinc mining in the Tri-State area, numerous geoscientific approaches including data from small unmanned aerial vehicle (UAV) were employed to investigate the influence of mining in the study area. The study presented here is focused on observational assessment of the existing landscape using multiple commercial high-definitions data from UAVs to study different sites across areas of concern in the three states. Primary results (images) gathered and analyzed DEM and GIS data from abandoned mines showed the potential to provide a quick snapshot of successful or unsuccessful remediated areas. Although research and remediation of the Tri-State mining district are a continuous process, evidence from this geomorphic study suggest that UAVs can provide a quick overview of the remediated landscape or serve as a primary background tool for a more detail site-specific environmental study.

BOREAS Level-0 ER-2 Daedalus TMS Imagery Digital Counts in BIL Format

NASA Technical Reports Server (NTRS)

Newcomer, Jeffrey A.; Dominguez, Roseanne; Hall, Forrest G. (Editor)

2000-01-01

The level-0 Daedalus Thematic Mapper Simulator (TMS) imagery, along with the other remotely sensed images, was collected to provide spatially extensive information about radiant energy over the primary BOReal Ecosystem-Atmosphere Study (BOREAS) study areas. This information includes detailed land cover and biophysical parameter maps such as fraction of Photosynthetically Active Radiation (fPAR) and Leaf Area Index (LAI). Two flights of the Daedalus TMS instrument were made onboard the ER-2 aircraft on 16-Sep-1994 and 17-Sep-1994.

Does the Primary Care Behavioral Health Model Reduce Emergency Department Visits?

PubMed

Serrano, Neftali; Prince, Ronald; Fondow, Meghan; Kushner, Kenneth

2018-04-16

To examine the impact of integrating behavioral health services using the primary care behavioral health (PCBH) model on emergency department (ED) utilization. Utilization data from three Dane County, Wisconsin hospitals and four primary care clinics from 2003 to 2011. We used a retrospective, quasi-experimental, controlled, pre-post study design. Starting in 2007, two clinics began integrating behavioral health into their primary care practices with a third starting in 2010. A fourth, nonimplementing, community clinic served as control. Change in emergency department and primary care utilization (number of visits) for patients diagnosed with mood and anxiety disorders was the outcomes of interest. Retrospective data were obtained from electronic patient records from the three main area hospitals along with primary care data from participating clinics. Following the introduction of the PCBH model, one clinic experienced a statistically significant (p < .01, 95 percent CI 6.3-16.3 percent), 11.3 percent decrease in the ratio of ED visits to primary care encounters, relative to a control site, but two other intervention clinics did not. The PCBH model may be associated with a reduction in ED utilization, but better-controlled studies are needed to confirm this result. © Health Research and Educational Trust.

Morphometric study of the two fused primary ossification centers of the clavicle in the human fetus.

PubMed

Baumgart, Mariusz; Wiśniewski, Marcin; Grzonkowska, Magdalena; Badura, Mateusz; Dombek, Małgorzata; Małkowski, Bogdan; Szpinda, Michał

2016-10-01

A satisfactory understanding of the clavicle development may be contributing to both the diagnosis of its congenital defects and prevention of perinatal damage to the shoulder girdle. This study was carried out to examine the transverse and sagittal diameters, cross-sectional area and volume of the two fused primary ossification centers of the clavicle. Using the methods of CT, digital-image analysis and statistics, the size for two fused primary ossification centers of the clavicle in 42 spontaneously aborted human fetuses at ages of 18-30 weeks was studied. Without any male-female and right-left significant differences, the best fit growth models for two fused primary ossification centers of the clavicle were as follows: y = -31.373 + 15.243 × ln(age) ± 1.424 (R (2) = 0.74) for transverse diameter, y = -7.945 + 3.225 × ln(age) ± 0.262 (R (2) = 0.78), y = -4.503 + 2.007 × ln(age) ± 0.218 (R (2) = 0.68), and y = -4.860 + 2.117 × ln(age) ± 0.200 (R (2) = 0.73) for sagittal diameters of the lateral, middle and medial ends respectively, y = -31.390 + 2.432 × age ± 4.599 (R (2) = 0.78) for cross-sectional area, and y = 28.161 + 0.00017 × (age)(4) ± 15.357 (R (2) = 0.83) for volume. With no sex and laterality differences, the fused primary ossification centers of the clavicle grow logarithmically in both transverse and sagittal diameters, linearly in cross-sectional area, and fourth-degree polynomially in volume. Our normative quantitative findings may be conducive in monitoring normal fetal growth and screening for inherited faults and anomalies of the clavicle in European human fetuses.

Medians

DOT National Transportation Integrated Search

1996-02-01

This discussion paper summarizes the literature relating to the use of medians on major roadways. The primary focus is on safety due to the sizable amount of literature in this area and the very limited number of studies relating to such topics as th...

T-wave area as biomarker of clinical response to cardiac resynchronization therapy.

PubMed

Végh, Eszter M; Engels, Elien B; van Deursen, Caroline J M; Merkely, Béla; Vernooy, Kevin; Singh, Jagmeet P; Prinzen, Frits W

2016-07-01

There is increasing evidence that left bundle branch block (LBBB) morphology on the electrocardiogram is a positive predictor for response to cardiac resynchronization therapy (CRT). We previously demonstrated that the vectorcardiography (VCG)-derived T-wave area predicts echocardiographic CRT response in LBBB patients. In the present study, we investigate whether the T-wave area also predicts long-term clinical outcome to CRT. This is a retrospective study consisting of 335 CRT recipients. Primary endpoint were the composite of heart failure (HF) hospitalization, heart transplantation, left ventricular assist device implantation or death during a 3-year follow-up period. HF hospitalization and death alone were secondary endpoints. The patient subgroup with a large T-wave area and LBBB 36% reached the primary endpoint, which was considerably less (P < 0.01) than for patients with LBBB and a small T-wave area or non-LBBB patients with a small or large T-wave area (48, 57, and 51%, respectively). Similar differences were observed for the secondary endpoints, HF hospitalization (31 vs. 51, 51, and 38%, respectively, P < 0.01) and death (19 vs. 42, 34, and 42%, respectively, P < 0.01). In multivariate analysis, a large T-wave area and LBBB were the only independent predictors of the combined endpoint besides high creatinine levels and use of diuretics. T-wave area may be useful as an additional biomarker to stratify CRT candidates and improve selection of those most likely to benefit from CRT. A large T-wave area may derive its predictive value from reflecting good intrinsic myocardial properties and a substrate for CRT. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Different cortical activation patterns during voluntary eccentric and concentric muscle contractions: an fMRI study.

PubMed

Kwon, Yong-Hyun; Park, Ji-Won

2011-01-01

Concentric and eccentric muscle contractions have distinct differences in their neuromuscular and neurophysiologic characteristics. However, although many evidences regarding the features of these types of muscle contraction have emerged, there have been few neuroimaging studies to compare the two types of contractions. Therefore, we investigated whether cortical activity associated with eccentric contraction of the wrist extensors differed from that of concentric contraction, using functional MRI (fMRI). Fifteen right-handed healthy subjects were enrolled in this study. During 4 repeating blocks of eccentric and concentric muscle contraction paradigms, the brain was scanned with fMRI. The differences in the BOLD signal intensities during the performance of eccentric and concentric exercise were compared in the predetermined regions of interest. Our findings revealed that many cortical areas associated with motor performance were activated, including the primary motor area, the inferior parietal lobe, the pre-supplementary area (pre-SMA), the anterior cingulate cortex, the prefrontal area, and the cerebellum. In addition, lower signal intensities were seen in the right primary motor cortex and right cerebellum during eccentric contractions compared with concentric contractions, whereas higher signal intensities were detected in other cortical areas during eccentric contractions. In the study, we demonstrated that eccentric and concentric muscle contractions induced quite different patterns of cortical activity respectively. These findings might be attributed to different strategy of neuro-motor processing and a higher level of cognitive demand for the performance of motor task with a higher degree of difficulty such as that required during eccentric contractions in comparison of concentric contractions.

Primary school accident reporting in one education authority

PubMed Central

Latif, A; Williams, W; Sibert, J

2002-01-01

Background: Studies have shown a correlation between increased accident rates and levels of deprivation in the community. School accident reporting is one area where an association might be expected. Aims: To investigate differences in primary school accident rates in deprived and more affluent wards, in an area managed by one education authority. Methods: Statistical analysis of accident form returns for 100 primary schools in one education authority in Wales over a two year period, in conjunction with visits to over one third of school sites. Results: Accident report rates from schools in deprived wards were three times higher than those from schools in more affluent wards. School visits showed that this discrepancy was attributable primarily to differences in reporting procedures. One third of schools did not report accidents and approximately half did not keep records of minor accidents. Conclusions: The association between school accident report rates and deprivation in the community is complex. School accident data from local education authorities may be unreliable for most purposes of collection. PMID:11827900

Primary school accident reporting in one education authority.

PubMed

Latif, A H A; Williams, W R; Sibert, J

2002-02-01

Studies have shown a correlation between increased accident rates and levels of deprivation in the community. School accident reporting is one area where an association might be expected. To investigate differences in primary school accident rates in deprived and more affluent wards, in an area managed by one education authority. Statistical analysis of accident form returns for 100 primary schools in one education authority in Wales over a two year period, in conjunction with visits to over one third of school sites. Accident report rates from schools in deprived wards were three times higher than those from schools in more affluent wards. School visits showed that this discrepancy was attributable primarily to differences in reporting procedures. One third of schools did not report accidents and approximately half did not keep records of minor accidents. The association between school accident report rates and deprivation in the community is complex. School accident data from local education authorities may be unreliable for most purposes of collection.

Mental Computation: Evidence from Fifth Graders

ERIC Educational Resources Information Center

Erdem, Emrullah

2017-01-01

The current study examines the mental computation performance owned by students at fifth grade. This study was carried out with 118 fifth graders (11-12-year-olds) studying at 3 randomly selected primary schools that served low and middle socio-economic areas in a city of Turkey. "Mental Computation Test (MCT)" has been used to reach how…

40 CFR 81.355 - Puerto Rico.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 18 2014-07-01 2014-07-01 false Puerto Rico. 81.355 Section 81.355... AREAS FOR AIR QUALITY PLANNING PURPOSES Section 107 Attainment Status Designations § 81.355 Puerto Rico. Puerto Rico—1971 Sulfur Dioxide NAAQS (Primary and Secondary) Designated area Does not meet primary...

Evolution of a Family Nurse Practitioner Program to Improve Primary Care Distribution

ERIC Educational Resources Information Center

Andrus, Len Hughes; Fenley, Mary D.

1976-01-01

Describes a Family Nurse Practitioner Program that has effectively improved the distribution of primary health care manpower in rural areas. Program characteristics include selection of personnel from areas of need, decentralization of clinical and didactic training sites, competency-based portable curriculum, and circuit-riding institutionally…

A retrospective study of root canal therapy in non-vital primary molars.

PubMed

Stallaert, K M; Sigal, M J; Titley, K C; Andrews, P B

2016-12-01

This study was performed to assess the clinical and radiographic success rates of a formocresol and zinc oxide eugenol (ZOE) primary molar root canal therapy (RCT) technique. The effects of this treatment on the permanent successors and on exfoliation times were also investigated. Study design: the retrospective study included 161 patients with 211 primary molars treated by RCT by a single operator in a private paediatric dental office in the Toronto area. Data were coded and entered into a Microsoft Excel database and analysis undertaken using SPSS software. Predominantly non-parametric tests were used to evaluate statistical differences (p < 0.05). A clinical success rate of 90% (190/211) and a radiographic success rate of 77.3% (136/176) were obtained. Following RCT in a primary molar, enamel defects were found in 6.8% (7/103) of premolars, all of which occurred in first premolars, and in patients treated at a mean age of 54.1 months (p < 0.005). Treated molars exfoliated on average 7.6 months sooner than contralateral teeth (p < 0.005). This formocresol and ZOE RCT is a viable treatment for necrotic primary molars and yielded very high clinical and acceptable radiographic success rates.

Nitrogen-controlled intra- and interspecific competition between Populus purdomii and Salix rehderiana drive primary succession in the Gongga Mountain glacier retreat area.

PubMed

Song, Mengya; Yu, Lei; Jiang, Yonglei; Lei, Yanbao; Korpelainen, Helena; Niinemets, Ülo; Li, Chunyang

2017-06-01

In this study, intra- and interspecific competition were investigated in early successional Salix rehderiana Schneider and later-appearing Populus purdomii Rehder under non-fertilized (control) and nitrogen (N)-fertilized conditions in the Hailuogou glacier retreat area. Our aim was to discover whether N is a key factor in plant-plant competition and whether N drives the primary succession process in a glacier retreat area. We analyzed differences in responses to intra- and interspecific competition and N fertilization between P. purdomii and S. rehderiana, including parameters such as biomass accumulation, nutrient absorption, non-structural carbohydrates, photosynthetic capacity, hydrolysable amino acids and leaf ultrastructure. In the control treatments, S. rehderiana individuals subjected to interspecific competition benefited from the presence of P. purdomii plants, as indicated by higher levels of biomass accumulation, photosynthetic capacity, N absorption, amino acid contents and photosynthetic N-use efficiency. However, in the N-fertilized treatments, P. purdomii individuals exposed to interspecific competition benefited from the presence of S. rehderiana plants, as shown by a higher growth rate, enhanced carbon gain capacity, greater amino acid contents, and elevated water-use efficiency, whereas the growth of S. rehderiana was significantly reduced. Our results demonstrate that N plays a pivotal role in determining the asymmetric competition pattern among Salicaceae species during primary succession. We argue that the interactive effects of plant-plant competition and N availability are key mechanisms that drive primary succession in the Gongga Mountain glacier retreat area. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Laminar and cytoarchitectonic features of the cerebral cortex in the Risso's dolphin (Grampus griseus), striped dolphin (Stenella coeruleoalba), and bottlenose dolphin (Tursiops truncatus)

PubMed Central

Furutani, Rui

2008-01-01

The present investigation carried out Nissl, Klüver-Barrera, and Golgi studies of the cerebral cortex in three distinct genera of oceanic dolphins (Risso's dolphin, striped dolphin and bottlenose dolphin) to identify and classify cortical laminar and cytoarchitectonic structures in four distinct functional areas, including primary motor (M1), primary sensory (S1), primary visual (V1), and primary auditory (A1) cortices. The laminar and cytoarchitectonic organization of each of these cortical areas was similar among the three dolphin species. M1 was visualized as five-layer structure that included the molecular layer (layer I), external granular layer (layer II), external pyramidal layer (layer III), internal pyramidal layer (layer V), and fusiform layer (layer VI). The internal granular layer was absent. The cetacean sensory-related cortical areas S1, V1, and A1 were also found to have a five-layer organization comprising layers I, II, III, V and VI. In particular, A1 was characterized by the broadest layer I, layer II and developed band of pyramidal neurons in layers III (sublayers IIIa, IIIb and IIIc) and V. The patch organization consisting of the layer IIIb-pyramidal neurons was detected in the S1 and V1, but not in A1. The laminar patterns of V1 and S1 were similar, but the cytoarchitectonic structures of the two areas were different. V1 was characterized by a broader layer II than that of S1, and also contained the specialized pyramidal and multipolar stellate neurons in layers III and V. PMID:18625031

Chasm in primary care provision in a universal health system: Findings from a nationally representative survey of health facilities in Malaysia

PubMed Central

Sivasampu, Sheamini; Khoo, Ee Ming; Mohamad Noh, Kamaliah

2017-01-01

Background Malaysia has achieved universal health coverage since 1980s through the expansion of direct public provision, particularly in rural areas. However, no systematic examination of the rural-urban distribution of primary care services and resources has been conducted to date for policy impact evaluation. Methods We conducted a national cross-sectional survey of 316 public and 597 private primary care clinics, selected through proportionate stratified random sampling, from June 2011 through February 2012. Using a questionnaire developed based on the World Health Organization toolkits on monitoring health systems strengthening, we examined the availability of primary care services/resources and the associations between service/resource availability and clinic ownership, locality, and patient load. Data were weighted for all analyses to account for the complex survey design and produce unbiased national estimates. Results Private primary care clinics and doctors outnumbered their public counterparts by factors of 5.6 and 3.9, respectively, but the private clinics were significantly less well-equipped with basic facilities and provided a more limited range of services. Per capita densities of primary care clinics and workforce were higher in urban areas (2.2 clinics and 15.1 providers per 10,000 population in urban areas versus 1.1 clinics and 11.7 providers per 10,000 population in rural areas). Within the public sector, the distribution of health services and resources was unequal and strongly favored the urban clinics. Regression analysis revealed that rural clinics had lower availability of services and resources after adjusting for ownership and patient load, but the associations were not significant except for workforce availability (adjusted odds ratio [OR]: 0.82; 95% confidence interval [CI]: 0.71–0.96). Conclusions Targeted primary care expansion in rural areas could be an effective first step towards achieving universal health coverage, especially in countries with limited healthcare resources. Nonetheless, geographic expansion alone is inadequate to achieve effective coverage in a dichotomous primary care system, and the role of the private sector in primary care delivery should not be overlooked. PMID:28196113

Chasm in primary care provision in a universal health system: Findings from a nationally representative survey of health facilities in Malaysia.

PubMed

Lim, Huy Ming; Sivasampu, Sheamini; Khoo, Ee Ming; Mohamad Noh, Kamaliah

2017-01-01

Malaysia has achieved universal health coverage since 1980s through the expansion of direct public provision, particularly in rural areas. However, no systematic examination of the rural-urban distribution of primary care services and resources has been conducted to date for policy impact evaluation. We conducted a national cross-sectional survey of 316 public and 597 private primary care clinics, selected through proportionate stratified random sampling, from June 2011 through February 2012. Using a questionnaire developed based on the World Health Organization toolkits on monitoring health systems strengthening, we examined the availability of primary care services/resources and the associations between service/resource availability and clinic ownership, locality, and patient load. Data were weighted for all analyses to account for the complex survey design and produce unbiased national estimates. Private primary care clinics and doctors outnumbered their public counterparts by factors of 5.6 and 3.9, respectively, but the private clinics were significantly less well-equipped with basic facilities and provided a more limited range of services. Per capita densities of primary care clinics and workforce were higher in urban areas (2.2 clinics and 15.1 providers per 10,000 population in urban areas versus 1.1 clinics and 11.7 providers per 10,000 population in rural areas). Within the public sector, the distribution of health services and resources was unequal and strongly favored the urban clinics. Regression analysis revealed that rural clinics had lower availability of services and resources after adjusting for ownership and patient load, but the associations were not significant except for workforce availability (adjusted odds ratio [OR]: 0.82; 95% confidence interval [CI]: 0.71-0.96). Targeted primary care expansion in rural areas could be an effective first step towards achieving universal health coverage, especially in countries with limited healthcare resources. Nonetheless, geographic expansion alone is inadequate to achieve effective coverage in a dichotomous primary care system, and the role of the private sector in primary care delivery should not be overlooked.

MX Siting Investigation. Preliminary Biological and Cultural Resources Inventory and Environmental Evaluation of the Proposed Operational Base Sites in Coyote Spring Valley and the Milford-Beryl Area.

DTIC Science & Technology

1981-03-20

There are no croplands within the study area. Oil and gas leases are widely scattered in the area, and deep tests are currently being drilled. There...sightings from Uinta Basin in 1972 and 1975, from New Green River, Utah, in 1976, and from Rich and Emery counties in 1977 and 1978. The primary prey...located in a transitional area between the Great Basin and the Mojave Desert, and it contains vegeta- tion representative of both regions. Plant and

Seasonal and interannual patterns in primary production ...

EPA Pesticide Factsheets

Measurements of primary production and respiration provide fundamental information about the trophic status of aquatic ecosystems, yet such measurements are logistically difficult and expensive to sustain as part of long-term monitoring programs. However, ecosystem metabolism parameters can be inferred from high frequency water quality data collections using autonomous logging instruments. For this study, we analyzed such time series datasets from three Gulf of Mexico estuaries: Grand Bay, MS, Weeks Bay AL and Apalachicola Bay FL. Data were acquired from NOAA's National Estuarine Research Reserve System Wide Monitoring Program and used to calculate gross primary production (GPP), ecosystem respiration (ER) and net ecosystem metabolism (NEM) using Odum's open water method. The three systems present a diversity of estuaries typical of the Gulf of Mexico region, varying by as much as 2 orders of magnitude in key physical characteristics, such as estuarine area, watershed area, freshwater flow, and nutrient loading. In all three systems, gross primary production (GPP) and ecosystem respiration (ER) displayed strong seasonality, peaking in summer and being lowest during winter. Peak rates of GPP and ER exceeded 200 mmol O2 m-2 d-1 52 in all three estuaries. To our knowledge, this is the only study examining long term trends in rates of GPP, ER and NEM in estuaries. Variability in metabolism tended to be small among sites within each estuary. Nitrogen loading was high

Primary stabbing headache.

PubMed

Pareja, Juan A; Sjaastad, Ottar

2010-01-01

Primary stabbing headache is characterized by transient, cephalic ultrashort stabs of pain. It is a frequent complaint with a prevalence of 35.2%, a female preponderance, and a mean age of onset of 28 years (Vågå study). Attacks are generally characterized by moderate to severe, jabbing or stabbing pain, lasting from a fraction of a second to 3s. Attack frequency is generally low, with one or a few attacks per day. The paroxysms generally occur spontaneously, during daytime. Most patients exhibit a sporadic pattern, with an erratic, unpredictable alternation between symptomatic and non-symptomatic periods. Paroxysms are almost invariably unilateral. Temporal and fronto-ocular areas are most frequently affected. Attacks tend to move from one area to another, in either the same or the opposite hemicranium. Jabs may be accompanied by a shock-like feeling and even by head movement - "jolts" -or vocalization. On rare occasions, conjunctival hemorrhage and monocular vision loss have been described as associated features. Primary stabbing headache may concur, synchronously or independently, with other primary headaches. In contrast to what is the case in adults, in childhood it is not usually associated with other headaches. Treatment is rarely necessary. Indomethacin, 75-150 mg daily, may seem to be of some avail. Celecoxib, nifedipine, melatonin, and gabapentin have been reported to be effective in isolated cases and small series of patients. The drug studies need corroboration. Copyright © 2011 Elsevier B.V. All rights reserved.

Groundwater quality in the Owens Valley, California

USGS Publications Warehouse

Dawson, Barbara J. Milby; Belitz, Kenneth

2012-01-01

Groundwater provides more than 40 percent of California’s drinking water. 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. Owens Valley is one of the study areas being evaluated. The Owens study area is approximately 1,030 square miles (2,668 square kilometers) and includes the Owens Valley groundwater basin (California Department of Water Resources, 2003). Owens Valley has a semiarid to arid climate, with average annual rainfall of about 6 inches (15 centimeters). The study area has internal drainage, with runoff primarily from the Sierra Nevada draining east to the Owens River, which flows south to Owens Lake dry lakebed at the southern end of the valley. Beginning in the early 1900s, the City of Los Angeles began diverting the flow of the Owens River to the Los Angeles Aqueduct, resulting in the evaporation of Owens Lake and the formation of the current Owens Lake dry lakebed. Land use in the study area is approximately 94 percent (%) natural, 5% agricultural, and 1% urban. The primary natural land cover is shrubland. The largest urban area is the city of Bishop (2010 population of 4,000). Groundwater in this basin is used for public and domestic water supply and for irrigation. The main water-bearing units are gravel, sand, silt, and clay derived from surrounding mountains. Recharge to the groundwater system is primarily runoff from the Sierra Nevada, and by direct infiltration of irrigation. The primary sources of discharge are pumping wells, evapotranspiration, and underflow to the Owens Lake dry lakebed. The primary aquifers in Owens Valley are defined as those parts of the aquifers corresponding to the perforated intervals of wells listed in the California Department of Public Health database. Public-supply wells in Owens Valley are completed to depths between 210 and 480 feet (64 to 146 meters), consist of solid casing from the land surface to a depth of 50 to 80 feet (15 to 24 meters), and are screened or perforated below the solid casing.

Social deprivation and prevalence of chronic kidney disease in the UK: workload implications for primary care.

PubMed

Hossain, M P; Palmer, D; Goyder, E; El Nahas, A M

2012-02-01

The 'inverse care law' suggests that populations with the poorest health outcomes also tend to have poorer access to high-quality care. The new general practitioner (GP) contract in the UK aimed to reduce variations in care between areas by collecting information on processes and outcomes of chronic disease management. This study investigated whether, despite reductions in inequalities, primary care in deprived areas is still at a disadvantage due to the higher prevalence of chronic diseases, using chronic kidney disease (CKD) as an example. Initially, data from a hospital-based cohort of CKD patients were analysed to investigate the clustering of CKD patients across area-level deprivation using a geographical information system that employed kernel density estimation. Data from the Quality and Outcomes Framework were then analysed to explore the burden of CKD and associated non-communicable chronic diseases (NCD) and assess the potential impact on GPs' workload by area-level deprivation. There was a significant clustering of CKD patients referred to the hospital in the most deprived areas. Both the prevalence of CKD and associated conditions and caseload per GP were significantly higher in deprived areas. In the most deprived areas, there is an increased burden of major chronic disease and a higher caseload for clinicians. These reflect significant differences in workload for practices in deprived areas, which needs to be addressed.

Dental therapists/hygienists working in remote-rural primary care: a structured review of effectiveness, efficiency, sustainability, acceptability and affordability.

PubMed

Freeman, Ruth; Lush, Cathy; MacGillveray, Steve; Themessl-Huber, Markus; Richards, Derek

2013-04-01

To examine the use of dental therapist/hygienists to provide primary dental treatment in remote-rural areas with regard to their effectiveness, efficiency, sustainability, acceptability and costs (affordability). The structured literature review of studies indexed in Medline, Embase and CinAHL was conducted using search terms relevant to 'dental therapists' and 'remote-rural'. Remote-rural was defined as 'those (individuals) with a greater than 30-minute drive time to the nearest settlement with a population of greater than 10,000'. From 1,175 publications screened, 21 studies from 19 publications were initially included. Only seven studies were included that explicitly focused on remote-rural areas. Four were surveys and three were qualitative studies. All of the included studies were reported within the last 7 years. The methodological quality of the surveys varied, particularly with regard to their response rates. All three of the qualitative studies were assessed as potentially weak methodologies. Regarding the research question, none of the studies included provided data relevant to understanding efficiency, cost issues or the acceptability of dental therapists. The available empirical evidence contained only indirect indicators about the sustainability of dental therapy in rural areas. The available data indicates that dental therapist/hygienists have suitable skills and could constitute a valuable asset to meet the dental demands in remote-rural areas. However, the evidence base is limited and of a poor quality. There is a need to put in place 'well-designed interventions with robust evaluation to examine cost-effectiveness and benefits to patients and the health workforce'. © 2013 FDI World Dental Federation.

Ethnic differences in primary angle-closure glaucoma.

PubMed

Yip, Jennifer L Y; Foster, Paul J

2006-04-01

Observational studies from different countries have shown that populations of East Asian origin have a higher frequency of primary angle-closure glaucoma compared with those of European or African descent. As half of all cases of glaucoma reside in Asia, and with primary angle-closure glaucoma carrying a higher rate of visual morbidity, primary angle-closure glaucoma poses an important public health problem; however, the inconsistent use of techniques and definitions to detect and diagnose primary angle-closure glaucoma has resulted in difficulties in interpreting the accuracy and comparability of such data. Therefore it is important to review these studies in the light of a consistent classification system. There are increasing reports that support previous findings on the incidence and prevalence of primary angle-closure glaucoma in different ethnic groups. There have also been further investigations into the mechanism and natural history of primary angle-closure glaucoma in Asian populations. International investigations into primary angle-closure glaucoma have demonstrated reproducible evidence that ethnic variations do exist. Cross-sectional studies in this area have also suggested that differences in anterior chamber depth, together with its association with peripheral anterior synechiae, may be part of the underlying mechanism behind these differences. The ideas generated need to be further explored with longitudinal data of changes in anterior chamber depth and peripheral anterior synechiae in different populations. The detailed mechanisms behind the development of angle-closure and primary angle-closure glaucoma should also be investigated.

Metaphors of Teacher Candidates' Regarding the Concept of "Non-Governmental Organizations" (NGOs)

ERIC Educational Resources Information Center

Selanik-Ay, Tugba

2016-01-01

In this study, a learning area in social studies curriculum called "Groups, institutions and social organizations" was used. It can be seen that an important role for teachers in a social studies programme is to benefit from non-governmental organizations. The aim of this study is to investigate primary school teacher candidates' social…

Combining tractography and cortical measures to test system-specific hypotheses in multiple sclerosis

PubMed Central

Gorgoraptis, Nikos; Wheeler-Kingshott, Claudia AM; Jenkins, Thomas M; Altmann, Daniel R; Miller, David H; Thompson, Alan J; Ciccarelli, Olga

2010-01-01

The objective was to test three motor system-specific hypotheses in multiple sclerosis patients: (i) corticospinal tract and primary motor cortex imaging measures differ between multiple sclerosis patients and controls; (ii) in patients, these measures correlate with disability; (iii) in patients, corticospinal tract measures correlate with measures of the ipsilateral primary motor cortex. Eleven multiple sclerosis patients with a history of hemiparesis attributable to a lesion within the contralateral corticospinal tract, and 12 controls were studied. We used two advanced imaging techniques: (i) diffusion-based probabilistic tractography, to obtain connectivity and fractional anisotropy of the corticospinal tract; and (ii) FreeSurfer, to measure volume, thickness, surface area, and curvature of precentral and paracentral cortices. Differences in these measures between patients and controls, and relationships between each other and to clinical scores, were investigated. Patients showed lower corticospinal tract fractional anisotropy and smaller volume and surface area of the precentral gyrus than controls. In patients, corticospinal tract connectivity and paracentral cortical volume, surface area, and curvature were lower with increasing disability; lower connectivity of the affected corticospinal tract was associated with greater surface area of the ipsilateral paracentral cortex. Corticospinal tract connectivity and new measures of the primary motor cortex, such as surface area and curvature, reflect the underlying white and grey matter damage that contributes to disability. The correlation between lower connectivity of the affected corticospinal tract and greater surface area of the ipsilateral paracentral cortex suggests the possibility of cortical adaptation. Combining tractography and cortical measures is a useful approach in testing hypotheses which are specific to clinically relevant functional systems in multiple sclerosis, and can be applied to other neurological diseases. PMID:20215478

Corticospinal control of the thumb-index grip depends on precision of force control: a transcranial magnetic stimulation and functional magnetic resonance imagery study in humans.

PubMed

Bonnard, M; Galléa, C; De Graaf, J B; Pailhous, J

2007-02-01

The corticospinal system (CS) is well known to be of major importance for controlling the thumb-index grip, in particular for force grading. However, for a given force level, the way in which the involvement of this system could vary with increasing demands on precise force control is not well-known. Using transcranial magnetic stimulation and functional magnetic resonance imagery, the present experiments investigated whether increasing the precision demands while keeping the averaged force level similar during an isometric dynamic low-force control task, involving the thumb-index grip, does affect the corticospinal excitability to the thumb-index muscles and the activation of the motor cortices, primary and non-primary (supplementary motor area, dorsal and ventral premotor and in the contralateral area), at the origin of the CS. With transcranial magnetic stimulation, we showed that, when precision demands increased, the CS excitability increased to either the first dorsal interosseus or the opponens pollicis, and never to both, for similar ongoing electromyographic activation patterns of these muscles. With functional magnetic resonance imagery, we demonstrated that, for the same averaged force level, the amplitude of blood oxygen level-dependent signal increased in relation to the precision demands in the hand area of the contralateral primary motor cortex in the contralateral supplementary motor area, ventral and dorsal premotor area. Together these results show that, during the course of force generation, the CS integrates online top-down information to precisely fit the motor output to the task's constraints and that its multiple cortical origins are involved in this process, with the ventral premotor area appearing to have a special role.

Temporal characteristics of audiovisual information processing.

PubMed

Fuhrmann Alpert, Galit; Hein, Grit; Tsai, Nancy; Naumer, Marcus J; Knight, Robert T

2008-05-14

In complex natural environments, auditory and visual information often have to be processed simultaneously. Previous functional magnetic resonance imaging (fMRI) studies focused on the spatial localization of brain areas involved in audiovisual (AV) information processing, but the temporal characteristics of AV information flow in these regions remained unclear. In this study, we used fMRI and a novel information-theoretic approach to study the flow of AV sensory information. Subjects passively perceived sounds and images of objects presented either alone or simultaneously. Applying the measure of mutual information, we computed for each voxel the latency in which the blood oxygenation level-dependent signal had the highest information content about the preceding stimulus. The results indicate that, after AV stimulation, the earliest informative activity occurs in right Heschl's gyrus, left primary visual cortex, and the posterior portion of the superior temporal gyrus, which is known as a region involved in object-related AV integration. Informative activity in the anterior portion of superior temporal gyrus, middle temporal gyrus, right occipital cortex, and inferior frontal cortex was found at a later latency. Moreover, AV presentation resulted in shorter latencies in multiple cortical areas compared with isolated auditory or visual presentation. The results provide evidence for bottom-up processing from primary sensory areas into higher association areas during AV integration in humans and suggest that AV presentation shortens processing time in early sensory cortices.

ACCUMULATION OF PBDE-47 IN PRIMARY CULTURES OF RAT NEOCORTICAL CELLS.

EPA Science Inventory

Cell culture models are often used in mechanistic studies of toxicant action. However, one area of uncertainty is the extrapolation of dose from the in vitro model to the in vivo tissue. A common assumption of in vitro studies is that media concentration is a predictive marker of...

Summary Report. Indiana College-Level Manpower Study Report Number 8.

ERIC Educational Resources Information Center

Greenberg, Robert M.

Selected findings of seven previously published reports of the College-Level Manpower Study are summarized. Factors involving both manpower supply and demand were investigated and educational and occupational areas in which major supply/demand imbalances exist were determined. The primary goal was to investigate the manpower supply/demand…

The CALL-SLA Interface: Insights from a Second-Order Synthesis

ERIC Educational Resources Information Center

Plonsky, Luke; Ziegler, Nicole

2016-01-01

The relationship between computer-assisted language learning (CALL) and second language acquisition (SLA) has been studied both extensively, covering numerous subdomains, and intensively, resulting in hundreds of primary studies. It is therefore no surprise that CALL researchers, as in other areas of applied linguistics, have turned in recent…

Predictors of relational continuity in primary care: patient, provider and practice factors

PubMed Central

2013-01-01

Background Continuity is a fundamental tenet of primary care, and highly valued by patients; it may also improve patient outcomes and lower cost of health care. It is thus important to investigate factors that predict higher continuity. However, to date, little is known about the factors that contribute to continuity. The purpose of this study was to analyse practice, provider and patient predictors of continuity of care in a large sample of primary care practices in Ontario, Canada. Another goal was to assess whether there was a difference in the continuity of care provided by different models of primary care. Methods This study is part of the larger a cross-sectional study of 137 primary care practices, their providers and patients. Several performance measures were evaluated; this paper focuses on relational continuity. Four items from the Primary Care Assessment Tool were used to assess relational continuity from the patient’s perspective. Results Multilevel modeling revealed several patient factors that predicted continuity. Older patients and those with chronic disease reported higher continuity, while those who lived in rural areas, had higher education, poorer mental health status, no regular provider, and who were employed reported lower continuity. Providers with more years since graduation had higher patient-reported continuity. Several practice factors predicted lower continuity: number of MDs, nurses, opening on weekends, and having 24 hours a week or less on-call. Analyses that compared continuity across models showed that, in general, Health Service Organizations had better continuity than other models, even when adjusting for patient demographics. Conclusions Some patients with greater health needs experience greater continuity of care. However, the lower continuity reported by those with mental health issues and those who live in rural areas is concerning. Furthermore, our finding that smaller practices have higher continuity suggests that physicians and policy makers need to consider the fact that ‘bigger is not always necessarily better’. PMID:23725212

Predictors of relational continuity in primary care: patient, provider and practice factors.

PubMed

Kristjansson, Elizabeth; Hogg, William; Dahrouge, Simone; Tuna, Meltem; Mayo-Bruinsma, Liesha; Gebremichael, Goshu

2013-05-31

Continuity is a fundamental tenet of primary care, and highly valued by patients; it may also improve patient outcomes and lower cost of health care. It is thus important to investigate factors that predict higher continuity. However, to date, little is known about the factors that contribute to continuity. The purpose of this study was to analyse practice, provider and patient predictors of continuity of care in a large sample of primary care practices in Ontario, Canada. Another goal was to assess whether there was a difference in the continuity of care provided by different models of primary care. This study is part of the larger a cross-sectional study of 137 primary care practices, their providers and patients. Several performance measures were evaluated; this paper focuses on relational continuity. Four items from the Primary Care Assessment Tool were used to assess relational continuity from the patient's perspective. Multilevel modeling revealed several patient factors that predicted continuity. Older patients and those with chronic disease reported higher continuity, while those who lived in rural areas, had higher education, poorer mental health status, no regular provider, and who were employed reported lower continuity. Providers with more years since graduation had higher patient-reported continuity. Several practice factors predicted lower continuity: number of MDs, nurses, opening on weekends, and having 24 hours a week or less on-call. Analyses that compared continuity across models showed that, in general, Health Service Organizations had better continuity than other models, even when adjusting for patient demographics. Some patients with greater health needs experience greater continuity of care. However, the lower continuity reported by those with mental health issues and those who live in rural areas is concerning. Furthermore, our finding that smaller practices have higher continuity suggests that physicians and policy makers need to consider the fact that 'bigger is not always necessarily better'.

Teachers' knowledge concerning dental trauma and its management in primary schools in Riyadh, Saudi Arabia.

PubMed

Alsadhan, Salwa A; Alsayari, Najla F; Abuabat, Mashael F

2018-02-22

The main aim of this cross-sectional study was to assess knowledge concerning traumatic dental injuries and their management among primary schoolteachers in Riyadh, Saudi Arabia. The secondary objective was to evaluate the effect of gender, nationality, marital status, school type, geographical area, age group, level of education and years of experience on teachers' knowledge. Data were collected, through a self-administered questionnaire, from both male and female teachers employed in public and private primary schools in the five geographical areas of Riyadh City. The total sample size was 1,520 teachers. Data were entered into the Statistical Package for the Social Sciences. Frequencies and percentages were calculated. An independent t-test and a one-way analysis of variance (ANOVA) were used to calculate significance. The total score for the questions assessing knowledge was calculated out of 9, and the highest score was 7 with an average score of 2.85. Over half of the sampled participants stated that they did not know how to manage soft-tissue injuries. Regarding the management of fractured teeth, 38.8% believed that the fractured part is useless; and for the management of an avulsed permanent tooth, only 6.2% of the respondents selected the correct answer. For the question regarding suitable storage medium of an avulsed tooth, only 19.7% chose milk and 3.2% chose the injured person's saliva. Teachers between 41 and 50 years of age and those with longer years of experience had the highest level of knowledge. Teachers in the north area of Riyadh had a higher level of knowledge than teachers in other areas. There was a lack of knowledge among primary schoolteachers in Riyadh concerning traumatic dental injuries and their management. Statistically significant differences were found among geographical areas, age groups and years of experience; no statistically significant differences were found regarding gender, nationality, marital status, level of education and school type (public/private). © 2018 FDI World Dental Federation.

GP Practices as a One-Stop Shop: How Do Patients Perceive the Quality of Care? A Cross-Sectional Study in Thirty-Four Countries.

PubMed

Schäfer, Willemijn L A; Boerma, Wienke G W; Schellevis, François G; Groenewegen, Peter P

2017-12-29

To contribute to the current knowledge on how a broad range of services offered by general practitioners (GPs) may contribute to the patient perceived quality and, hence, the potential benefits of primary care. Between 2011 and 2013, primary care data were collected among GPs and their patients in 31 European countries, plus Australia, Canada, and New Zealand. In these countries, GPs are the main providers of primary care, mostly specialized in family medicine and working in the ambulatory setting. In this cross-sectional study, questionnaires were completed by 7,183 GPs and 61,931 visiting patients. Moreover, 7,270 patients answered questions about what they find important (their values). In the analyses of patient experiences, we adjusted for patients' values in each country to measure patient perceived quality. Perceived quality was measured regarding five areas: accessibility and continuity of care, doctor-patient communication, patient involvement in decision making, and comprehensiveness of care. The range of GP services was measured in relation to four areas: (1) to what extent they are the first contact to the health care system for patients in need of care, (2) their involvement in treatment and follow-up of acute and chronic conditions, in other words treatment of diseases, (3) their involvement in minor technical procedures, and (4) their involvement in preventive treatments. Data of the patients were linked to the data of the GPs. Multilevel modeling was used to construct scale scores for the experiences of patients in the five areas of quality and the range of services of GPs. In these four-level models, items were nested within patients, nested in GP practices, nested in countries. The relationship between the range of services and the experiences of patients was analyzed in three-level multilevel models, also taking into account the values of patients. In countries where GPs offer a broader range of services patients perceive better accessibility, continuity, and comprehensiveness of care, and more involvement in decision making. No associations were found between the range of services and the patient perceived communication with their GP. The range of GP services mostly explained the variation between countries in the areas of patient perceived accessibility and continuity of care. This study showed that in countries where GP practices serve as a "one-stop shop," patients perceive better quality of care, especially in the areas of accessibility and continuity of care. Therefore, primary care in a country is expected to benefit from investments in a broader range of services of GPs or other primary care physicians. © Health Research and Educational Trust.

77 FR 9532 - Air Quality Designations for the 2010 Primary Nitrogen Dioxide (NO2

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-17

...This rule establishes air quality designations for all areas in the United States for the 2010 Primary Nitrogen Dioxide (NO2) National Ambient Air Quality Standards (NAAQS). Based on air quality monitoring data, the EPA is issuing this rule to designate all areas of the country as ``unclassifiable/attainment'' for the 2010 NO2 NAAQS. The EPA is designating areas as ``unclassifiable/attainment'' to mean that available information does not indicate that the air quality in these areas exceeds the 2010 NO2 NAAQS.

Comparing private and public transport access to diabetic health services across inner, middle, and outer suburbs of Melbourne, Australia.

PubMed

Madill, Rebecca; Badland, Hannah; Mavoa, Suzanne; Giles-Corti, Billie

2018-04-13

Melbourne, Australia is experiencing rapid population growth, with much of this occurring in metropolitan outer suburban areas, also known as urban growth areas. Currently little is known about differences in travel times when using private and public transport to access primary and secondary services across Melbourne's urban growth areas. Plan Melbourne Refresh, a recent strategic land use document has called for a 20 min city, which is where essential services including primary health care, can be accessed within a 20 min journey. Type 2 diabetes mellitus (T2DM) is a major chronic condition in Australia, with some of Melbourne's growth areas having some of the highest prevalence across Australia. This study explores travel times to diabetic health care services for populations residing in inner, middle and outer suburbs of metropolitan Melbourne. Geographic information systems (GIS) software were used to map the location of selected diabetic primary and secondary health care service providers across metropolitan inner, middle, outer established, outer urban growth and outer fringe areas of Melbourne. An origin-destination matrix was used to estimate travel distances from point of origin (using a total of approximately 50,000 synthetic residential addresses) to the closest type of each diabetic health care service provider (destinations) across Melbourne. ArcGIS was used to estimate travel times for private transport and public transport; comparisons were made by area. Our study indicated increased travel times to diabetic health services for people living in Melbourne's outer growth and outer fringe areas compared with the rest of Melbourne (inner, middle and outer established). Compared with those living in inner city areas, the median time spent travelling to diabetic services was between 2.46 and 23.24 min (private motor vehicle) and 12.01 and 43.15 min (public transport) longer for those living in outer suburban areas. Irrespective of travel mode used, results indicate that those living in inner and middle suburbs of Melbourne have shorter travel times to access diabetic health services, compared with those living in outer areas of Melbourne. Private motor vehicle travel times were approximately 4 to 5 times faster than public transport modes to access diabetic health services in all areas. Those living in new urban growth communities spend considerably more time travelling to access diabetic health services - particularly specialists - than those living in established areas across Melbourne.

Relative professional roles in antenatal care: results of a survey in Scottish rural general practice.

PubMed

Farmer, Jane; Stimpson, Paul; Tucker, Janet

2003-11-01

There is evidence of variation and some ambiguity about self-perceived relative professional roles in antenatal care in the UK. There is little information about models of antenatal care provision in UK rural areas. In rural areas, in particular, women have limited choice in accessing health care professionals or alternative primary care delivery settings. In the light of a recent review of Scottish maternity services, it is important and timely to examine models of care and interprofessional working in antenatal care in rural areas. This study explores midwives' and GPs' perceptions about their relative professional roles in remote and rural general practice in Scotland. A questionnaire survey involving all 174 Scottish remote and rural general practices (using one definition of rurality) was conducted, followed by 20 interviews. At least one professional returned a completed questionnaire from 91% of rural practices. A number of areas of dissonance were noted between GPs' and midwives' perceptions of their roles in maternity care and, given the context of service provision, these may impact upon rural patients. Findings are relevant to wider debates on extending the primary care team and strengthening inter-disciplinary working, particularly in rural areas.

Basic instinct undressed: early spatiotemporal processing for primary sexual characteristics.

PubMed

Legrand, Lore B; Del Zotto, Marzia; Tyrand, Rémi; Pegna, Alan J

2013-01-01

This study investigates the spatiotemporal dynamics associated with conscious and non-conscious processing of naked and dressed human bodies. To this effect, stimuli of naked men and women with visible primary sexual characteristics, as well as dressed bodies, were presented to 20 heterosexual male and female participants while acquiring high resolution EEG data. The stimuli were either consciously detectable (supraliminal presentations) or were rendered non-conscious through backward masking (subliminal presentations). The N1 event-related potential component was significantly enhanced in participants when they viewed naked compared to dressed bodies under supraliminal viewing conditions. More importantly, naked bodies of the opposite sex produced a significantly greater N1 component compared to dressed bodies during subliminal presentations, when participants were not aware of the stimulus presented. A source localization algorithm computed on the N1 showed that the response for naked bodies in the supraliminal viewing condition was stronger in body processing areas, primary visual areas and additional structures related to emotion processing. By contrast, in the subliminal viewing condition, only visual and body processing areas were found to be activated. These results suggest that naked bodies and primary sexual characteristics are processed early in time (i.e., <200 ms) and activate key brain structures even when they are not consciously detected. It appears that, similarly to what has been reported for emotional faces, sexual features benefit from automatic and rapid processing, most likely due to their high relevance for the individual and their importance for the species in terms of reproductive success.

[Frequent attendance: the primary care professional's perceptions on the influence of social factors and health care system organisation].

PubMed

Sandín-Vázquez, M; Conde-Espejo, P

2011-01-01

FREQUENT ATTENDANCE: The primary care professional's perceptions on the influence of social factors and health care system organisation. To find out the primary care (PC) professional's perceptions on the social factors and healthcare system organisation that influence frequent attendance. A qualitative study using semi-structured interviews in Primary Care Centres of six Health Areas in the Community of Madrid. Eighteen interviews were conducted, three per area (two physicians and one nurse). Structural sampling was carried out with regards to the variables that could influence the discourse: health area, occupation, sex and number of years worked. The transcriptions were analysed by two investigators and an agreement of interpretation was reached. Among the social factors, health professionals perceived as determining factors: the influence of the media and the medicalization of society, lack of health education and self-care abilities of the population and contextual factors of the patient (social, work and family). Among the health care organisation factors that could influence frequent attendance were, system saturation, appointment on demand, fear of potential lawsuits by the patient, chronic patients protocols, administrative consultations, professional behaviour, and poor coordination with specialised care. According to PC professionals, there are multiple environmental factors, both social and healthcare system organisational factors that encourage frequent attendance. Within the scope of health care system, organisational actions (such as teamwork and coordination with specialists) would help to manage demand. Copyright © 2010 SECA. Published by Elsevier Espana. All rights reserved.

Is long-term exposure to traffic pollution associated with mortality? A small-area study in London.

PubMed

Halonen, Jaana I; Blangiardo, Marta; Toledano, Mireille B; Fecht, Daniela; Gulliver, John; Ghosh, Rebecca; Anderson, H Ross; Beevers, Sean D; Dajnak, David; Kelly, Frank J; Wilkinson, Paul; Tonne, Cathryn

2016-01-01

Long-term exposure to primary traffic pollutants may be harmful for health but few studies have investigated effects on mortality. We examined associations for six primary traffic pollutants with all-cause and cause-specific mortality in 2003-2010 at small-area level using linear and piecewise linear Poisson regression models. In linear models most pollutants showed negative or null association with all-cause, cardiovascular or respiratory mortality. In the piecewise models we observed positive associations in the lowest exposure range (e.g. relative risk (RR) for all-cause mortality 1.07 (95% credible interval (CI) = 1.00-1.15) per 0.15 μg/m(3) increase in exhaust related primary particulate matter ≤2.5 μm (PM2.5)) whereas associations in the highest exposure range were negative (corresponding RR 0.93, 95% CI: 0.91-0.96). Overall, there was only weak evidence of positive associations with mortality. That we found the strongest positive associations in the lowest exposure group may reflect residual confounding by unmeasured confounders that varies by exposure group. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Modification of existing human motor memories is enabled by primary cortical processing during memory reactivation.

PubMed

Censor, Nitzan; Dimyan, Michael A; Cohen, Leonardo G

2010-09-14

One of the most challenging tasks of the brain is to constantly update the internal neural representations of existing memories. Animal studies have used invasive methods such as direct microfusion of protein inhibitors to designated brain areas, in order to study the neural mechanisms underlying modification of already existing memories after their reactivation during recall [1-4]. Because such interventions are not possible in humans, it is not known how these neural processes operate in the human brain. In a series of experiments we show here that when an existing human motor memory is reactivated during recall, modification of the memory is blocked by virtual lesion [5] of the related primary cortical human brain area. The virtual lesion was induced by noninvasive repetitive transcranial magnetic stimulation guided by a frameless stereotactic brain navigation system and each subject's brain image. The results demonstrate that primary cortical processing in the human brain interacting with pre-existing reactivated memory traces is critical for successful modification of the existing related memory. Modulation of reactivated memories by noninvasive cortical stimulation may have important implications for human memory research and have far-reaching clinical applications. Copyright © 2010 Elsevier Ltd. All rights reserved.

Thalamic connections of the core auditory cortex and rostral supratemporal plane in the macaque monkey.

PubMed

Scott, Brian H; Saleem, Kadharbatcha S; Kikuchi, Yukiko; Fukushima, Makoto; Mishkin, Mortimer; Saunders, Richard C

2017-11-01

In the primate auditory cortex, information flows serially in the mediolateral dimension from core, to belt, to parabelt. In the caudorostral dimension, stepwise serial projections convey information through the primary, rostral, and rostrotemporal (AI, R, and RT) core areas on the supratemporal plane, continuing to the rostrotemporal polar area (RTp) and adjacent auditory-related areas of the rostral superior temporal gyrus (STGr) and temporal pole. In addition to this cascade of corticocortical connections, the auditory cortex receives parallel thalamocortical projections from the medial geniculate nucleus (MGN). Previous studies have examined the projections from MGN to auditory cortex, but most have focused on the caudal core areas AI and R. In this study, we investigated the full extent of connections between MGN and AI, R, RT, RTp, and STGr using retrograde and anterograde anatomical tracers. Both AI and R received nearly 90% of their thalamic inputs from the ventral subdivision of the MGN (MGv; the primary/lemniscal auditory pathway). By contrast, RT received only ∼45% from MGv, and an equal share from the dorsal subdivision (MGd). Area RTp received ∼25% of its inputs from MGv, but received additional inputs from multisensory areas outside the MGN (30% in RTp vs. 1-5% in core areas). The MGN input to RTp distinguished this rostral extension of auditory cortex from the adjacent auditory-related cortex of the STGr, which received 80% of its thalamic input from multisensory nuclei (primarily medial pulvinar). Anterograde tracers identified complementary descending connections by which highly processed auditory information may modulate thalamocortical inputs. © 2017 Wiley Periodicals, Inc.

Collaboration of midwives in primary care midwifery practices with other maternity care providers.

PubMed

Warmelink, J Catja; Wiegers, Therese A; de Cock, T Paul; Klomp, Trudy; Hutton, Eileen K

2017-12-01

Inter-professional collaboration is considered essential in effective maternity care. National projects are being undertaken to enhance inter-professional relationships and improve communication between all maternity care providers in order to improve the quality of maternity care in the Netherlands. However, little is known about primary care midwives' satisfaction with collaboration with other maternity care providers, such as general practitioners, maternity care assistance organisations (MCAO), maternity care assistants (MCA), obstetricians, clinical midwives and paediatricians. More insight is needed into the professional working relations of primary care midwives in the Netherlands before major changes are made OBJECTIVE: To assess how satisfied primary care midwives are with collaboration with other maternity care providers and to assess the relationship between their 'satisfaction with collaboration' and personal and work-related characteristics of the midwives, their attitudes towards their work and collaboration characteristics (accessibility). The aim of this study was to provide insight into the professional working relations of primary care midwives in the Netherlands. Our descriptive cross-sectional study is part of the DELIVER study. Ninety nine midwives completed a written questionnaire in May 2010. A Friedman ANOVA test assessed differences in satisfaction with collaboration with six groups of maternity care providers. Bivariate analyses were carried out to assess the relationship between satisfaction with collaboration and personal and work-related characteristics of the midwives, their attitudes towards their work and collaboration characteristics. Satisfaction experienced by primary care midwives when collaborating with the different maternity care providers varies within and between primary and secondary/tertiary care. Interactions with non-physicians (clinical midwives and MCA(O)) are ranked consistently higher on satisfaction compared with interactions with physicians (GPs, obstetricians and paediatricians). Midwives with more work experience were more satisfied with their collaboration with GPs. Midwives from the southern region of the Netherlands were more satisfied with collaboration with GPs and obstetricians. Compared to the urban areas, in the rural or mixed areas the midwives were more satisfied regarding their collaboration with MCA(O)s and clinical midwives. Midwives from non-Dutch origin were less satisfied with the collaboration with paediatricians. No relations were found between the overall mean satisfaction of collaboration and work-related and personal characteristics and attitude towards work. Inter-professionals relations in maternity care in the Netherlands can be enhanced, especially the primary care midwives' interactions with physicians and with maternity care providers in the northern and central part of the Netherlands, and in urban areas. Future exploratory or deductive research may provide additional insight in the collaborative practice in everyday work setting. Copyright © 2017 Elsevier Ltd. All rights reserved.

Risk management of infrastructure development in border area Indonesia - Malaysia

NASA Astrophysics Data System (ADS)

Fitri, Suryani; Trikariastoto, Reinita, Ita

2017-11-01

Border area is geographically adjacent to neighboring countries with the primary function of maintaining state sovereignty and public welfare. Area in question is part of the provinces, districts or cities that directly intersect with national boundaries (or territory) and / or that have a functional relationship (linkage) and has a strategic value for the state. The border area is considered strategic because it involves the national lives of many people in terms of the interests of political, economic, social and cultural as well as defense and security (poleksosbudhankam) both located on land, sea or air. The border area is geographically adjacent to neighboring countries with the primary function of maintaining state sovereignty and public welfare. Area in question is part of the provinces, districts or cities that directly intersect with national boundaries (or territory) and / or that have a functional relationship (linkage) and has a strategic value for the state. To realize the necessary research on the development of the area, based on good practices from other countries some of the city that can meet all these challenges and at least can be applied with minor changes / adjustments. Furthermore, the application must be supported by the availability of funds. This study to discuss about any problems either obstacles or things that drive to develop function becomes an ideal border area with major support infrastructure for housing, transportation, energy availability, and distribution of clean water which will strengthen in its function which consists of five pillars, namely: central community service; trade and distribution center; financial center; tourism center; related to the field of community development. Articulation between key stakeholders such as government, private, and community is a major concern in this study, including in determining the appropriate financing schemes. The results of this study will be recommended to the government to improve the reliability of the infrastructure development of border area, particularly for housing infrastructure projects, transport, energy and clean water.

Extensive cortical rewiring after brain injury.

PubMed

Dancause, Numa; Barbay, Scott; Frost, Shawn B; Plautz, Erik J; Chen, Daofen; Zoubina, Elena V; Stowe, Ann M; Nudo, Randolph J

2005-11-02

Previously, we showed that the ventral premotor cortex (PMv) underwent neurophysiological remodeling after injury to the primary motor cortex (M1). In the present study, we examined cortical connections of PMv after such lesions. The neuroanatomical tract tracer biotinylated dextran amine was injected into the PMv hand area at least 5 months after ischemic injury to the M1 hand area. Comparison of labeling patterns between experimental and control animals demonstrated extensive proliferation of novel PMv terminal fields and the appearance of retrogradely labeled cell bodies within area 1/2 of the primary somatosensory cortex after M1 injury. Furthermore, evidence was found for alterations in the trajectory of PMv intracortical axons near the site of the lesion. The results suggest that M1 injury results in axonal sprouting near the ischemic injury and the establishment of novel connections within a distant target. These results support the hypothesis that, after a cortical injury, such as occurs after stroke, cortical areas distant from the injury undergo major neuroanatomical reorganization. Our results reveal an extraordinary anatomical rewiring capacity in the adult CNS after injury that may potentially play a role in recovery.

What's New in Software? Videocassettes for Parenting.

ERIC Educational Resources Information Center

Hedley, Carolyn N.

1989-01-01

Videocassettes useful in creating educational environments in the home are described, focusing specifically on the areas of parenting and living skills, literature for the primary and intermediate grades, and social studies. A list of 66 recommended videocassettes is included. (JDD)

Cortico-Cortical Connections of Primary Sensory Areas and Associated Symptoms in Migraine.

PubMed

Hodkinson, Duncan J; Veggeberg, Rosanna; Kucyi, Aaron; van Dijk, Koene R A; Wilcox, Sophie L; Scrivani, Steven J; Burstein, Rami; Becerra, Lino; Borsook, David

2016-01-01

Migraine is a recurring, episodic neurological disorder characterized by headache, nausea, vomiting, and sensory disturbances. These events are thought to arise from the activation and sensitization of neurons along the trigemino-vascular pathway. From animal studies, it is known that thalamocortical projections play an important role in the transmission of nociceptive signals from the meninges to the cortex. However, little is currently known about the potential involvement of cortico-cortical feedback projections from higher-order multisensory areas and/or feedforward projections from principle primary sensory areas or subcortical structures. In a large cohort of human migraine patients ( N = 40) and matched healthy control subjects ( N = 40), we used resting-state intrinsic functional connectivity to examine the cortical networks associated with the three main sensory perceptual modalities of vision, audition, and somatosensation. Specifically, we sought to explore the complexity of the sensory networks as they converge and become functionally coupled in multimodal systems. We also compared self-reported retrospective migraine symptoms in the same patients, examining the prevalence of sensory symptoms across the different phases of the migraine cycle. Our results show widespread and persistent disturbances in the perceptions of multiple sensory modalities. Consistent with this observation, we discovered that primary sensory areas maintain local functional connectivity but express impaired long-range connections to higher-order association areas (including regions of the default mode and salience network). We speculate that cortico-cortical interactions are necessary for the integration of information within and across the sensory modalities and, thus, could play an important role in the initiation of migraine and/or the development of its associated symptoms.

Satisfaction with primary care and mental health care among individuals with severe mental illness in a rural area: a seven-year follow-up study of a clinical cohort.

PubMed

Ruud, Torleif; Aarre, Trond F; Boeskov, Berit; le Husevåg, Per Stå; Klepp, Rigmor; Kristiansen, Synnøve Alet; Sandvik, Jorunn

2016-01-01

Most studies of services for people with severe mental illness have been performed in cities. Our 7-year follow-up study aimed to investigate clinical course and satisfaction with services among individuals with severe mental illness who received community mental health services in a rural area. The services were provided by primary care and a community mental health center (CMHC), which worked in close collaboration and emphasized individually tailored case management, relationship-building and continuity of care. All 57 patients with severe mental illness who were seen by the CMHC in 1992-1993 and were still alive in 1999 were asked to participate. Retrospective ratings were performed for the first month of contact in 1992-1993 based on patient records and detailed notes. A semi-structured interview was conducted in 1999-2000 with the 40 patients (70.2 %) who gave written consent to participate in the study. DSM-IV diagnoses were made using OPCRIT. The retrospective baseline ratings and the follow-up interview included assessments of symptoms and functioning using the following instruments: the Brief Psychiatric Rating Scale Expanded version 4 (BPRS-E), the Health of the Nation Outcome Scales (HoNOS), the Global Assessment of Functioning Scale (split version), and the Practical and Social Functioning Scale (PSF). The ratings revealed improvements in psychiatric problems and functioning. Patients with schizophrenia spectrum disorders improved primarily in psychotic symptoms, while patients with severe affective disorders improved primarily in affective symptoms. Large variations in the use of primary care and mental health services were observed, with more intensive specialized mental health services for individuals with schizophrenia spectrum disorders than severe affective disorders. Overall, the patients were satisfied with the provided services. They were most satisfied with GPs and more satisfied with local outpatient and inpatient services than with hospital inpatient services and medication. Patients with severe mental illness in a rural area value local services that emphasize relationships and close collaborations among the CMHC, GPs and primary health and social care. Even in an area with a fairly well-staffed CMHC, the highest patient satisfaction was reported for GPs, indicating the potential key role of GPs for this patient group.

Human-induced stream channel abandonment/capture and filling of floodplain channels within the Atchafalaya River Basin, Louisiana

USGS Publications Warehouse

Kroes, Daniel E.; Kraemer, Thomas F.

2013-01-01

The Atchafalaya River Basin is a distributary system of the Mississippi River containing the largest riparian area in the lower Mississippi River Valley and the largest remaining forested bottomland in North America. Reductions in the area of open water in the Atchafalaya have been occurring over the last 100 years, and many historical waterways are increasingly filled by sediment. This study examines two cases of swamp channels (3/s) that are filling and becoming unnavigable as a result of high sediment loads and slow water velocities. The water velocities in natural bayous are further reduced because of flow capture by channels constructed for access. Bathymetry, flow, suspended sediment, deposited bottom-material, isotopes, and photointerpretation were used to characterize the channel fill. On average, water flowing through these two channels lost 23% of the suspended sediment load in the studied reaches. Along one of the studied reaches, two constructed access channels diverted significant flow out of the primary channel and into the adjacent swamp. Immediately downstream of each of the two access channels, the cross-sectional area of the studied channel was reduced. Isotopic analyses of bottom-material cores indicate that bed filling has been rapid and occurred after detectable levels of Cesium-137 were no longer being deposited. Interpretation of aerial photography indicates that water is bypassing the primary channels in favor of the more hydraulically efficient access channels, resulting in low or no-velocity flow conditions in the primary channel. These swamp channel conditions are typical in the Atchafalaya River Basin where relict large channel dimensions result in flow velocities that are normally too low to carry fine-grained sediment. Constructed channels increase the rate of natural channel avulsion and abandonment as a result of flow capture.

Examining the practice of generalist expertise: a qualitative study identifying constraints and solutions

PubMed Central

Reeve, Joanne; Dowrick, Christopher F; Freeman, George K; Gunn, Jane; Mair, Frances; May, Carl; Mercer, Stewart; Palmer, Victoria; Howe, Amanda; Irving, Greg; Shiner, Alice; Watson, Jessica

2013-01-01

Objectives Provision of person-centred generalist care is a core component of quality primary care systems. The World Health Organisation believes that a lack of generalist primary care is contributing to inefficiency, ineffectiveness and inequity in healthcare. In UK primary care, General Practitioners (GPs) are the largest group of practising generalists. Yet GPs fulfil multiple roles and the pressures of delivering these roles along with wider contextual changes create real challenges to generalist practice. Our study aimed to explore GP perceptions of enablers and constraints for expert generalist care, in order to identify what is needed to ensure health systems are designed to support the generalist role. Design Qualitative study in General Practice. Setting UK primary care. Main outcome measures A qualitative study – interviews, surveys and focus groups with GPs and GP trainees. Data collection and analysis was informed by Normalisation Process Theory. Design and setting Qualitative study in General Practice. We conducted interviews, surveys and focus groups with GPs and GP trainees based mainly, but not exclusively, in the UK. Data collection and analysis were informed by Normalization Process Theory. Participants UK based GPs (interview and surveys); European GP trainees (focus groups). Results Our findings highlight key gaps in current training and service design which may limit development and implementation of expert generalist practice (EGP). These include the lack of a consistent and universal understanding of the distinct expertise of EGP, competing priorities inhibiting the delivery of EGP, lack of the consistent development of skills in interpretive practice and a lack of resources for monitoring EGP. Conclusions We describe four areas for change: Translating EGP, Priority setting for EGP, Trusting EGP and Identifying the impact of EGP. We outline proposals for work needed in each area to help enhance the expert generalist role. PMID:24475347

Constructing Understanding in Primary Science: An Exploration of Process and Outcomes in the Topic Areas of Light and the Earth in Space

ERIC Educational Resources Information Center

Thurston, Allen; Grant, G.; Topping, K. J.

2006-01-01

This study explored the process and outcomes of constructivist methods of enhancing science understanding in the topic areas of light and the earth in space. The sample was drawn from a group of 41 nine-year-old children, delivered in four two-hour weekly sessions. Each session involved different combinations of interactive discussion and…

Estimating soil turnover rate from tree uprooting during hurricanes in Puerto Rico

Treesearch

Melanie T. Lenart; D.A. Falk; F.N. Scatena; W.R. Osterkamp

2010-01-01

Soil turnover by tree uprooting in primary and secondary forests on the island of Puerto Rico was measured in 42 study plots in the months immediately after the passage of a Category 3 hurricane. Trunk basal area explained 61% of the variability of mound volume and 53% of the variability of mound area. The proportion of uprooted trees, the number of uprooted trees, or...

Earth Observatory Satellite system definition study. Report no. 4: Management approach recommendations

NASA Technical Reports Server (NTRS)

1974-01-01

A management approach for the Earth Observatory Satellite (EOS) which will meet the challenge of a constrained cost environment is presented. Areas of consideration are contracting techniques, test philosophy, reliability and quality assurance requirements, commonality options, and documentation and control requirements. The various functional areas which were examined for cost reduction possibilities are identified. The recommended management approach is developed to show the primary and alternative methods.

Coupled Thermo-Mechanical and Photo-Chemical Degradation Mechanisms that determine the Reliability and Operational Lifetimes for CPV Technologies

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

Dauskardt, Reinhold H.

This project sought to identify and characterize the coupled intrinsic photo-chemo-mechanical degradation mechanisms that determine the reliability and operational lifetimes for CPV technologies. Over a three year period, we have completed a highly successful program which has developed quantitative metrologies and detailed physics-based degradation models, providing new insight into the fundamental reliability physics necessary for improving materials, creating accelerated testing protocols, and producing more accurate lifetime predictions. The tasks for the program were separated into two focus areas shown in the figure below. Focus Area 1, led by Reinhold Dauskardt and Warren Cai with a primary collaboration with David Millermore » of NREL, studied the degradation mechanisms present in encapsulant materials. Focus Area 2, led by Reinhold Dauskardt and Ryan Brock with a primary collaboration with James Ermer and Peter Hebert of Spectrolab, studied stress development and degradation within internal CPV device interfaces. Each focus area was productive, leading to several publications, including findings on the degradation of silicone encapsulant under terrestrial UV, a model for photodegradation of silicone encapsulant adhesion, quantification and process tuning of antireflective layers on CPV, and discovery of a thermal cycling degradation mechanism present in metal gridline structures.« less

A cytoarchitecture-driven myelin model reveals area-specific signatures in human primary and secondary areas using ultra-high resolution in-vivo brain MRI.

PubMed

Dinse, J; Härtwich, N; Waehnert, M D; Tardif, C L; Schäfer, A; Geyer, S; Preim, B; Turner, R; Bazin, P-L

2015-07-01

This work presents a novel approach for modelling laminar myelin patterns in the human cortex in brain MR images on the basis of known cytoarchitecture. For the first time, it is possible to estimate intracortical contrast visible in quantitative ultra-high resolution MR images in specific primary and secondary cytoarchitectonic areas. The presented technique reveals different area-specific signatures which may help to study the spatial distribution of cortical T1 values and the distribution of cortical myelin in general. It may lead to a new discussion on the concordance of cyto- and myeloarchitectonic boundaries, given the absence of such concordance atlases. The modelled myelin patterns are quantitatively compared with data from human ultra-high resolution in-vivo 7T brain MR images (9 subjects). In the validation, the results are compared to one post-mortem brain sample and its ex-vivo MRI and histological data. Details of the analysis pipeline are provided. In the context of the increasing interest in advanced methods in brain segmentation and cortical architectural studies, the presented model helps to bridge the gap between the microanatomy revealed by classical histology and the macroanatomy visible in MRI. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Postnatal Development of Intrinsic Horizontal Axons in Macaque Inferior Temporal and Primary Visual Cortices.

PubMed

Wang, Quanxin; Tanigawa, Hisashi; Fujita, Ichiro

2017-04-01

Two distinct areas along the ventral visual stream of monkeys, the primary visual (V1) and inferior temporal (TE) cortices, exhibit different projection patterns of intrinsic horizontal axons with patchy terminal fields in adult animals. The differences between the patches in these 2 areas may reflect differences in cortical representation and processing of visual information. We studied the postnatal development of patches by injecting an anterograde tracer into TE and V1 in monkeys of various ages. At 1 week of age, labeled patches with distribution patterns reminiscent of those in adults were already present in both areas. The labeling intensity of patches decayed exponentially with projection distance in monkeys of all ages in both areas, but this trend was far less evident in TE. The number and extent of patches gradually decreased with age in V1, but not in TE. In V1, axonal and bouton densities increased postnatally only in patches with short projection distances, whereas in TE this density change occurred in patches with various projection distances. Thus, patches with area-specific distribution patterns are formed early in life, and area-specific postnatal developmental processes shape the connectivity of patches into adulthood. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Relational continuity with primary and secondary care doctors: a qualitative study of perceptions of users of the Catalan national health system.

PubMed

Waibel, Sina; Vargas, Ingrid; Coderch, Jordi; Vázquez, María-Luisa

2018-04-10

In the current context of increasingly fragmented healthcare systems where patients are seen by multiple doctors in different settings, patients' relational continuity with one doctor is regaining relevance; however little is known about relational continuity with specialists. The aim of this study is to explore perceptions of relational continuity with primary care and secondary care doctors, its influencing factors and consequences from the viewpoint of users of the Catalan national health system (Spain). We conducted a descriptive-interpretative qualitative study using a two-stage theoretical sample; (i) contexts: three healthcare areas in the Catalan national health system with differing characteristics; (ii) informants: users 18 years or older attended to at both care levels. Sample size (n = 49) was reached by saturation. Data were collected by individual semi-structured interviews, which were audio recorded and transcribed. A thematic content analysis was carried out segmenting data by study area, and leaving room for new categories to emerge from the data. Patients across the areas studied generally experienced consistency of primary care doctors (PCD), alongside some inconsistency of specialists. Consistency of specialists did not seem to be relevant to some patients when their clinical information was shared and used. Patients who experienced consistency and frequent visits with the same PCD or specialist described and valued having established an ongoing relationship characterised by personal trust and mutual accumulated knowledge. Identified consequences were diverse and included, for example, facilitated diagnosis or improved patient-doctor communication. The ascription to a PCD, a health system-related factor, facilitated relational continuity with the PCD, whereas organizational factors (for instance, the size of the primary care centre) favoured consistency of PCD and specialists. Doctor-related factors (for example, high technical competence or commitment to patient care) particulary fostered the development of an ongoing relationship. Consistency of doctors differs depending on the care level as does the relevance attributed to it. Most influencing factors can be applied to both care levels and might be addressed by healthcare managers to foster relational continuity. More research is needed to fully understand the relevance patients assign to relational continuity with specialists.

Where We Have Been and Where We Are Going: A Content Analysis of Articles Published in the Journal of Women's Health Physical Therapy From 2005 to 2015.

PubMed

Bishop, Mark D; Coronado, Rogelio A; Hill, Alexandra D; Alappattu, Meryl J

2017-05-01

The objective of this study was to examine the type and content of Journal of Women's Health Physical Therapy (JWHPT) publications over the last decade. Content and bibliometric analysis of published literature. Component sections, such as the Section on Women's Health (SoWH) of the American Physical Therapy Association provide content expertise to areas of specialty physical therapist practice, thereby supporting the dissemination of evidence for physical therapists to use. Closely aligned with the mission of the SoWH, JWHPT provides evidence reflecting this practice area. The purpose of our analysis was to examine publications within JWHPT to determine how closely JWHPT is meeting the mission and focus of section members. We used established bibliographic methodology to code and review manuscripts published online between 2005 and 2015 in JWHPT using established domains (article type, participant type, research design, study purpose, and area of focus). Total publications and proportion of publications based on domain were described. Impact by citation and author was examined using bibliometric software. Eighteen percent of the items published in JWHPT were original research papers submitted for the first time. Of those papers, the primary study design was cross-sectional experimental research, most commonly studying interventions. The primary practice area reported was management of incontinence. We suggest that a continued need to increase efforts for the submission and publication of a greater proportion of randomized controlled trials and metric articles.

Lamina cribrosa position and Bruch's membrane opening differences between anterior ischemic optic neuropathy and open-angle glaucoma.

PubMed

Rebolleda, Gema; Pérez-Sarriegui, Ane; Díez-Álvarez, Laura; De Juan, Victoria; Muñoz-Negrete, Francisco J

2018-06-01

To compare the optic nerve head morphology among primary open-angle glaucoma, non-arteritic anterior ischemic optic neuropathy eyes, their fellow healthy eyes and control eyes, using spectral-domain optical coherence tomography with enhanced depth imaging. Observational cross-sectional study including 88 eyes of 68 patients. In this study, 23 non-arteritic anterior ischemic optic neuropathy eyes, 17 fellow unaffected eyes, 25 primary open-angle glaucoma eyes, and 23 age-matched control eyes were included. Peripapillary retinal nerve fiber layer thickness and optic disk area were evaluated. Bruch's membrane opening diameter, optic cup depth, anterior lamina cribrosa depth, and prelaminar tissue thickness were assessed. Non-arteritic anterior ischemic optic neuropathy and primary open-angle glaucoma eyes had similar visual field mean deviation and peripapillary retinal nerve fiber layer thickness (P = 0.6 and P = 0.56, respectively). Bruch's membrane opening diameter was significantly larger in primary open-angle glaucoma eyes than in control eyes (P = 0.02). Lamina cribrosa and disk cup were deeper in eyes with primary open-angle glaucoma than both control and non-arteritic anterior ischemic optic neuropathy eyes (P < 0.001). Prelaminar tissue thickness was significantly thinner in primary open-angle glaucoma eyes than in non-arteritic anterior ischemic optic neuropathy eyes (P < 0.001). Lamina cribrosa was shallower in both non-arteritic anterior ischemic optic neuropathy and unaffected fellow eyes compared to healthy eyes (P < 0.001 and P = 0.04, respectively). No differences were found in the optic disk area. A forward lamina cribrosa placement and not a smaller disk could be involved in the pathogenesis of non-arteritic anterior ischemic optic neuropathy. A significantly larger Bruch's membrane opening diameter was found in primary open-angle glaucoma eyes compared with control eyes. This issue has clinical implications because Bruch's membrane opening has been considered a stable reference for disk-related measures.

Nitrogen and phosphorus in streams of the Great Miami River Basin, Ohio, 1998-2000

USGS Publications Warehouse

Reutter, David C.

2003-01-01

Sources and loads of nitrogen and phosphorus in streams of the Great Miami River Basin were evaluated as part of the National Water-Quality Assessment program. Water samples were collected by the U.S. Geological Survey from October 1998 through September 2000 (water years 1999 and 2000) at five locations in Ohio on a routine schedule and additionally during selected high streamflows. Stillwater River near Union, Great Miami River near Vandalia, and Mad River near Eagle City were selected to represent predominantly agricultural areas upstream from the Dayton metropolitan area. Holes Creek near Kettering is in the Dayton metropolitan area and was selected to represent an urban area in the Great Miami River Basin. Great Miami River at Hamilton is downstream from the Dayton and Hamilton-Middletown metropolitan areas and was selected to represent mixed agricultural and urban land uses of the Great Miami River Basin. Inputs of nitrogen and phosphorus to streams from point and nonpoint sources were estimated for the three agricultural basins and for the Great Miami River Basin as a whole. Nutrient inputs from point sources were computed from the facilities that discharge one-half million gallons or more per day into streams of the Great Miami River Basin. Nonpoint-source inputs estimated in this report are atmospheric deposition and commercial-fertilizer and manure applications. Loads of ammonia, nitrate, total nitrogen, orthophosphate, and total phosphorus from the five sites were computed with the ESTIMATOR program. The computations show nitrate to be the primary component of instream nitrogen loads, and particulate phosphorus to be the primary component of instream phosphorus loads. The Mad River contributed the smallest loads of total nitrogen and total phosphorus to the study area upstream from Dayton, whereas the Upper Great Miami River (upstream from Vandalia) contributed the largest loads of total nitrogen and total phosphorus to the Great Miami River Basin upstream from Dayton. An evaluation of monthly mean loads shows that nutrient loads were highest during winter 1999 and lowest during the drought of summer and autumn 1999. During the 1999 drought, point sources were the primary contributors of nitrogen and phosphorus loads to most of the study area. Nonpoint sources, however, were the primary contributors of nitrogen and phosphorus loads during months of high streamflow. Nonpoint sources were also the primary contributors of nitrogen loads to the Mad River during the 1999 drought, owing to unusually large amounts of ground-water discharge to the stream. The Stillwater River Basin had the highest nutrient yields in the study area during months of high streamflow; however, the Mad River Basin had the highest yields of all nutrients except ammonia during the months of the 1999 drought. The high wet-weather yields in the Stillwater River Basin were caused by agricultural runoff, whereas high yields in the Mad River Basin during drought resulted from the large, sustained contribution of ground water to streamflow throughout the year. In the basins upstream from Dayton, an estimated 19 to 25 percent of the nonpoint source of nitrogen and 4 to 5 percent of the nonpoint source of phosphorus that was deposited or applied to the land was transported into streams.

Postgraduate Educational Program for Primary Care Physicians in Remote Areas in Lebanon

ERIC Educational Resources Information Center

Saab, Bassem Roberto; Kanaan, Nabil; Hamadeh, Ghassan; Usta, Jinan

2003-01-01

Introduction: Continuing medical education (CME) is a requirement in many developed countries. Lebanon lacks such a rule; hence, the dictum "once a doctor always a doctor" holds. This article describes a pioneering postgraduate educational program for primary care physicians in remote areas of Lebanon. Method: The Lebanese Society of…

Biomass distribution and productivity of Pinus edulis-Juniperus monosperma woodlands of north-central Arizona

Treesearch

Charles C. Grier; Katherine J. Elliott; Deborah G. McCullough

1992-01-01

Above-ground biomass distribution, leaf area, above-ground net primary productivity and foliage characteristics were determined for 90- and 350-year-old Pinus edulis-Juniperus monosperma ecosystems on the Colorado Plateau of northern Arizona. These ecosystems have low biomass, leaf area and primary productivity compared with forests in wetter...

Waterworks Book. An Activity Book about Mississippi's Coastal Resources for Primary Grades.

ERIC Educational Resources Information Center

Howe, Kevin M.

Coastal resources are highlighted in this activity book for primary school children. Special focus is given to Mississippi's coastal areas, but applications to other geographic areas can be made. Wetland concepts and conditions are developed through a variety of games, puzzles, matching exercises and pictorial explanations. Activities addressing…

23 CFR 750.704 - Statutory requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

...-traveled way and within 660 feet of the nearest edge of the right-of-way, and those additional signs beyond... nearest edge of the right-of-way within areas adjacent to the Interstate and Federal-aid Primary Systems... the nearest edge of the right-of-way within areas adjacent to the Interstate and Federal-aid Primary...

Kleine-Levin Syndrome in an 8-Year-Old Girl with Autistic Disorder: Does Autism Account a Primary or Secondary Cause?

PubMed

Hakim Shoushtari, Mitra; Ghalebandi, Mirfarhad; Tavasoli, Azita; Pourshams, Maryam

2015-01-01

Objective Kleine-Levin syndrome (KLS) is a rare disorder with an unknown etiology. Autism spectrum disorder is characterized by various degrees of impairment in social communication, repetitive behavior and restricted interests. Only four patients of KLS with autistic spectrum disorder (ASD) have been reported so far. This report presents an 8-year-old girl with history of autistic disorder and epilepsy that superimposed KLS. Because of the rarity of KLS and related studies did not address whether autism accounts for a primary or secondary cause, the area required attention further studies.

Differences in the Composition of Archaeal Communities in Sediments from Contrasting Zones of Lake Taihu

PubMed Central

Fan, Xianfang; Xing, Peng

2016-01-01

In shallow lakes, different primary producers might impact the physiochemical characteristics of the sediment and the associated microbial communities. Until now, little was known about the features of sediment Archaea and their variation across different primary producer-dominated ecosystems. Lake Taihu provides a suitable study area with cyanobacteria- and macrophyte-dominated zones co-occurring in one ecosystem. The composition of the sediment archaeal community was assessed using 16S rRNA gene amplicon sequencing technology, based on which the potential variation with respect to the physiochemical characteristics of the sediment was analyzed. Euryarchaeota (30.19% of total archaeal sequences) and Bathyarchaeota (28.00%) were the two most abundant phyla, followed by Crenarchaeota (11.37%), Aigarchaeota (10.24%) and Thaumarchaeota (5.98%). The differences found in the composition of the archaeal communities between the two zones was significant (p = 0.005). Sediment from macrophyte-dominated zones had high TOC and TN content and an abundance of archaeal lineages potentially involved in the degradation of complex organic compounds, such as the order Thermoplasmatales. In the area dominated by Cyanobacteria, archaeal lineages related to sulfur metabolism, for example, Sulfolobales and Desulfurococcales, were significantly enriched. Among Bathyarchaeota, subgroups MCG-6 and MCG-15 were significantly accumulated in the sediment of areas dominated by macrophytes whereas MCG-4 was consistently dominant in both type of sediments. The present study contributes to the knowledge of sediment archaeal communities with different primary producers and their possible biogeochemical functions in sediment habitats. PMID:27708641

Cortical Gray and Adjacent White Matter Demonstrate Synchronous Maturation in Very Preterm Infants.

PubMed

Smyser, Tara A; Smyser, Christopher D; Rogers, Cynthia E; Gillespie, Sarah K; Inder, Terrie E; Neil, Jeffrey J

2016-08-01

Spatial and functional gradients of development have been described for the maturation of cerebral gray and white matter using histological and radiological approaches. We evaluated these patterns in very preterm (VPT) infants using diffusion tensor imaging. Data were obtained from 3 groups: 1) 22 VPT infants without white matter injury (WMI), of whom all had serial MRI studies during the neonatal period, 2) 19 VPT infants with WMI, of whom 3 had serial MRI studies and 3) 12 healthy, term-born infants. Regions of interest were placed in the cortical gray and adjacent white matter in primary motor, primary visual, visual association, and prefrontal regions. From the MRI data at term-equivalent postmenstrual age, differences in mean diffusivity were found in all areas between VPT infants with WMI and the other 2 groups. In contrast, minimal differences in fractional anisotropy were found between the 3 groups. These findings suggest that cortical maturation is delayed in VPT infants with WMI when compared with term control infants and VPT infants without WMI. From the serial MRI data from VPT infants, synchronous development between gray and white matter was evident in all areas and all groups, with maturation in primary motor and sensory regions preceding that of association areas. This finding highlights the regionally varying but locally synchronous nature of the development of cortical gray matter and its adjacent white matter. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

The Optic Nerve Head in Primary Open-Angle Glaucoma Eyes With High Myopia: Characteristics and Association With Visual Field Defects.

PubMed

Chen, Li-Wei; Lan, Yu-Wen; Hsieh, Jui-Wen

2016-06-01

To evaluate the morphologic characteristics of optic neuropathy and its association with visual field (VF) defects in primary open-angle glaucoma (POAG) eyes with high myopia. In this cross-sectional study, we reviewed data from 375 Taiwanese patients (375 eyes) of POAG, ages 20 to 60 years. Optic disc photographs were used for planimetric measurements of morphologic variables. The myopic refraction was divided into high myopia (<-6.0 D) and nonhigh myopia (moderate myopia to hyperopia). The optic disc area was classified as moderate (1.59 to 2.85 mm), large, and small. Differences in characteristics between groups, correlations with the disc area, and factors associated with VF defects were determined. Of the 142 highly myopic eyes, 33 (23%) had a large disc, 26 (18%) had a small disc, and 55 (39%) had a tilted disc. Large discs had a higher cup-to-disc (C/D) area ratio and a higher tilt ratio; small discs had a smaller rim area and a lower tilt ratio (all P<0.05). Characteristics associated with high myopia included a smaller rim area, a higher C/D area ratio, and a lower tilt ratio (all P<0.001). In logistic regression, the refraction, the C/D area ratio, the rim area, and the tilt ratio (all P<0.05) were associated with VF defects. In Taiwanese individuals with POAG, our study found that tilted, large, or small discs were prevalent in highly myopic eyes. Of these characteristics, only the disc tilt and high myopia by itself were associated with the severity of glaucomatous optic neuropathy.